WQ0041975_Application (FTSE)_20200914

NC Department of
Environmental Quality
Received
SEP 14 2020
Winston-Salem
Regional Office
Mr. Corey Basinger
NCDENR — Division of Water Resources
450 West Hanes Mill Road, Suite 300
Winston-Salem, NC 27105
Dear Corey:
DAMS • MARTIN • POWELL dm ENGINEERS & SURVEYORS
September 8, 2020
Re: City of High Point
Ledford South Subdivision Phase 4
Sewer Extensions
DMP Project 190181
On behalf of the City of High Point and the Owners in regards to the referenced project, we are
enclosing the following information for your review and approval:
• Two (2) copies of Fast -Track Sewer System Extension Application (FTA 04-16)
• Two (2) copies of Flow Reduction Letter from NCDWQ to City of High Point
• Two (2) copies of Owner Operational Agreement of referenced project
• Two (2) copies of Flow Tracking/Acceptance for Sewer Extension Applications (FTSE 04-
16)
Two (2) copies of 8.5x11 color USGS quad map
• Two (2) copies of 8.5x11 color Aerial site map
• $480 review fee
Ledford Downs, LLC, proposes to install 880 LF of 8-inch sewer line and appurtenances for
Ledford South Subdivision — Phase 4. The LLC is paying for the permit, but the permit is in the
City's name since they will take over ownership of the sewer extensions after the work is
completed, tested, and accepted.
We trust the enclosed information is complete and will allow for approval to be issued at an early
date. However, should you have any questions or require additional information, please contact
our office.
Sincerely,
DAVIS-MARTIN-POWELL & ASSOCIATES, INC.
(G-,//JZOCQ m
Lisa Meadows
C: Chuck Jones
File
T: 336-886-4821 • F: 336-886-4458 • License: F-0245
6415 Old Plank Road, High Point, NC 27265 • www.dmp-inc.com

State of North Carolina
Department of Environmental Quality
Division of Water Resources
Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number:
(to be completed by DWR)
All items must be completed or the aonlication will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: Ledford Downs. LLC (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ® General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State/County ❑Municipal ❑ Other
3. Signature authority's name: Cranford A. Jones per 15A NCAC 02T .0106(b)
Title: Partner
4. Applicant's mailing address: 3705 A West Market St N C Department of
PP g Environmental Quality
City: Greensboro State: NC Zip: 27403-_ Received
5. Applicant's contact information: SEP 14 2020
Phone number: 336) 669-4760 Email Address: ciones(cdcjcoco.com Winston-Salem
II. PROJECT INFORMATION: Regional Office
1, Project name: Ledford South Phase 4
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
If a modification, provide the existing permit number: W000_ and issued date:
If new construction but part of a master plan, provide the existing permit number: W00028617
3. County where project is located: Davidson
4. Approximate Coordinates (Decimal Degrees): Latitude: 35,945050' Longitude:-80.112784'
5. Parcel ID (if applicable):
(or Parcel ID to closest downstream sewer)
III w0leMs) _ff AW90QWe] 4Ur:vCira
1. Professional Engineer: Lesley R. England License Number: 027568
Firm: Davis -Martin -Powell & Associates
Mailing address: 6415 Old Plank Road
City: High Point State: NC Zip: 27265
Phone number: 336 886-4821 Email Address: lee le and(n dmp-inc.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORtMATION:
1. Facility Name: Westside WWTF Permit Number: NC 0024228
Owner Name: City of High Point
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): W OOQ 28617 Downstream (Receiving) Sewer Size: 8 inch
System Wide Collection System Permit Number(s) (if applicable): WQCS_
Owner Name(s): Ledford South Subdivision
FORM: FTA 04-16 Pagel of 5

VI. GENERAL REQUIREMENTS
1. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
❑ Yes ❑No NN/A
2. If the Applicant is a Developer of lots to be sold, has a Developer's Operational Agreement (FORM: DEV) been attached?
N Yes [-]No [-]N/A
3. If the Applicant is a Home/Prooerty Owners' Association. has an Operational Agreement (FORM: HOA) been attached?
❑ Yes NNo ❑N/A
4. Origin of wastewater: (check all that apply):
N Residential Owned ❑ Retail (stores, centers, malls) ❑ Car Wash
❑ Residential Leased ❑ Retail with food preparation/service ❑ Hotel and/or Motels
❑ School /preschool / day care ❑ Medical / dental / veterinary facilities ❑ Swimming Pool /Clubhouse
❑ Food and drink facilities ❑ Church ❑ Swimming Pool/Filter Backwash
❑ Businesses / offices / factories ❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater: 100 % Domestic/Commercial % Commercial
_ % Industrial (See 15A NCAC 02T .0103(20))
"Is there a Pretreatment Program in effect? ❑ Yes N No
6. Hasa flow reduction been approved under 15A NCAC 02T .0114(f)? N Yes ❑ No
➢ If yes, provide a cony of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(n
Daily Design Flow •,b
No. of Units
Flow
Residential Homes
270 gal/day
19
5130 GPD
gaV
GPD
gal/
GPD
gall
GPD
gal/
GPD
gal/
GPD
Total
5130 GPD
a See 15A NCAC 02T .0114(b). (d). (e)(1) and (e)(2) for caveats to wastewater design flow rates (i.e., minimum flow per
dwelling; proposed unknown non-residential development uses; public access facilities located near high public use areas;
and residential property located south or east of the Atlantic Intracoastal Waterway to be used as vacation rentals as defined
in G.S. 42A-4).
b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified [in table 15A NCAC 02T.01 I ] shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 5 130 GPD (per 15A NCAC 02T .0114)
➢ Do not include future flows or previously permitted allocations
If permitted flow is zero, indicate why:
❑ Pump Station or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line
❑ Flow has already been allocated in Permit Number:
❑ Rehabilitation or replacement of existing sewer with no new flow expected
❑ Other (Explain):
FORM: FTA 04-16 Page 2 of 5

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
8 880 PVC SDR 26
➢ Section II & III of the MDC for Permitting of Gravity Sewers contains information related to design criteria
➢ Section III contains information related to minimum slopes for gravity sewer(s)
➢ Oversizing lines to meet minimum slope requirement is not allowed and a violation of the MDC
VHI. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC (Pum) Stations/Force Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name: N/A
2. Approximate Coordinates (Decimal Degrees): Latitude: Longitude:
3. Design flow of the pump station: _ millions gallons per day (firm capacity)
4. Operational point(s) of the pump(s): _ gallons per minute at _ feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches) Length (feet) Material
6. Power reliability in accordance with 15A NCAC 02T .0305(h)(l):
❑ Standby power source or pump with automatic activation and telemetry - 15A NCAC 02T .0305(h)(1)(B).
➢ Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
➢ Must be permanent to facility
Or if the pump station has an average daily flow less than 15,000 gallons per day:
❑ Portable power source with manual activation, quick -connection receptacle and telemetry - 15A NCAC 02T
.0305(h)(1)(C)
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry - 15A NCAC 02T .0305(h)(1)(C):
➢ It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant (draft agreement)
and is compatible with the station.
➢ If the portable power source or pump is dedicated to multiple pump stations, an evaluation of all the pump stations' storage
capacities and the rotation schedule of the portable power source or pump, including travel timeframes, shall be provided
in the case of a multiple station power outage.
FORM: FTA 04-16 Page 3 of 5

IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(f)):
1. Does the project comply with all separations found in 15A NCAC 02T.0305(f) & (g) 0 Yes ❑ No
➢ 15A NCAC 02T.0305(f9 contains minimum separations that shall be provided for sewer systems:
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below vertical
24 inches
Water mains vertical -water over sewer including in benched trenches
18 inches
Water mains(horizontal)
10 feet
Reclaimed water lines vertical - reclaimed over sewer
18 inches
Reclaimed water lines horizontal - reclaimed over sewer
2 feet
**Any private or public water supply source, including any wells, WS-I waters of Class I or
Class II impounded reservoirs used as a source of drinking water
100 feet
**Waters classified WS (except WS-I or WS-V), B, SA, ORW, HOW, or SB from normal
high water or tide elevation and wetlands see item IX.2
50 feet
**Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches
10 feet
Any building foundation
5 feet
Any basement
10 feet
Top slope of embankment or cuts of 2 feet or more vertical height
10 feet
Drainage systems and interceptor drains
5 feet
Any swimming pools
10 feet
Final earth grade vertical
36 inches
➢ 15A NCAC 02T.0305(g) contains alternatives where separations in 02T.0305(f) cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water Classifications webpage
➢ If noncompliance with 02T.0305(f) or (0. see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ®Yes ❑ No ❑ N/A
➢ See the Division's draft separation requirements for situations where separation cannot be meet
➢ No variance is required if the alternative design criteria specified is utilized in design and construction
D As built documents should reference the location of areas effected
3. Does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .0200? ❑ Yes ❑ No R N/A
D This would include Trout Buffered Streams per 15A NCAC 2B.0202
4. Does the project require coverage/authorization under a 404 Nationwide or ❑ Yes ® No
individual permits or 401 Water Quality Certifications?
Information can be obtained from the 401 & Buffer Permitting Branch
5. Does project comply with 15A NCAC 02T.0105(c)(6) (additional permits/certifications)? ® Yes ❑ No
Per 15A NCAC 02T.0105(c)(6), directly related environmental permits or certification applications are being prepared, have
been applied for, or have been obtained. Issuance of this permit is contingent on issuance of dependent permits (erosion and
sedimentation control plans, stormwater management plans, etc.).
6. Does this project include any sewer collection lines that are deemed "high -priority?"
Per 15A NCAC 02T.0402, "high -priority sewer" means "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to streambanks that is subject to erosion that undermines or deteriorates the sewer.
❑ Yes ® No ❑ N/A
D If yes, include an attachment with details for each line, including type (aerial line, size, material, and location).
High priority lines shall be inspected by the permittee or its representative at least once every six -months and inspections
documented per 15A NCAC 02T.0403(a)(5) or the permitee's individual System -Wide Collection permit.
FORM: FTA 04-16 Page 4 of 5

X. CERTIFICATIONS:
1. Does the submitted system comply with 15A NCAC 02T, the Minimum Design. Criteria for the Per.
and Force Mains (latest version), and the Gravitv Sewer Minimum Design Criteria (latest version) as
►Fe�Mo
IFNo, complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents for
review. Anproval of the request is required prior to submittal of the Fast Track Application and supporting documents.
2. Professional Engineer's Certification:
I, Lesley R. England attest that this application for
(Professional Engineer's name from Application Item 111.1.)
has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans, specifications,
engineering calculations, and all other supporting documentation to the best of my knowledge. I further attest that to the best
of my knowledge the proposed design has been prepared in accordance with the applicable regulations, Gravity Sewer
Minimum Design Criteria for Gravity Sewers (latest version), and the Minimum Design Criteria for the Fast -Track Permitting
of Pump Stations and Force Mains (latest version). Although other professionals may have developed certain portions of this
submittal package, inclusion of these materials under my signature and seal signifies that I have reviewed this material and
have judged it to be consistent with the proposed design.
NOTE — In accordance with General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed $10,000, as well as civil penalties up to $25,000 per violation.
North Carolina Professional Engineer's seal, signature, and date:
3. Applicant's Certification per 175A NCAC 02T .0I06(b):
(Signature Authority's name & title from Application Item 1.3.)
this application for
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required parts of
this application are not completed and that if all required supporting documentation and attachments are not included, this
application package is subject to being returned as incomplete. I understand that any discharge of wastewater from this non -
discharge system to surface waters or the land will result in an immediate enforcement action that may include civil penalties,
injunctive relief, and/or criminal prosecution. I will make no claim against the Division of Water Resources should a condition
of this permit be violated. I also understand that if all required parts of this application package are not completed and that if
all required supporting information and attachments are not included, this application package will be returned to me as
incomplete.
NOTE — In accordance with General Statutes 143-215.6A and I43-215.613 any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed $10,000 as well as civil penalties up to $25,000 per violation.
t
// vU
Signature: C�---✓� -r __ Date:
-6-2-0
FORM: FTA 04-16 Page 5 of 5

W ATE
ap 9Q Michael F. Easley, Governor
�O G William G.Rossdr:,Secretary.
h r North Carolina Department of Environment and Natural Resources .
Coleen H. Sullins, Director
Wslon of Water Quality
June 27, 2007
rteealvFo
Terry L. Houk, Asst. Director of Public Services Hs. Gooc�r cvn
City of High Point JUN Z.9 20. .
P.O. Box 230
High Point, North Carolina 27261 R'�"io�ais;�
Subject; EastsideWWTP(NC0024210)
& Westside W WTP (NC0024228)
Residential Flow Reduction Approval
Guilford County
Dear Mr, Houk:
On June 25, 2007, the Division of Water Quality received a flow reduction request for residences in
the city of High Point served by the Eastside W WTP (NC0024210) & the Westside W WTP
(NC0024228). The letter requests an.allowable flow rate of 240 GPD per 3 bedroom residential
connection based on the evaluated data from the W WT P and the active number of residential
connections.
The DMR data provided between January 2005 and December 2006 with daily readings taken during
November 2006 was analyzed by central office and regional office staff. Based upon this data the
Division hereby approves the use of 90 GPD per residential bedroom with a minimum of 180 gpd
for one and two bedroom units in all applicable non -discharge permit applications. Flow shall be
incremented by 90lgpd for each bedroom above two. Regardless of the adjusted desien daily
wastewater flow rate at no time shall the wastewater flows exceed the effluent limits defined in the
NPDES permit for the treatment facility or exceed the capacity of the sewers downstream of an new
sewer extension or service connection(sl.
The residential water usage data include 13 residences with "0" flow. These residences were excluded
from the calculations. This resulted in an average daily flow of 150 GPD.
If you have any questions or comments regarding this matter, please contact Deborah Gore at
[phone] ext. 593 [email: [e-mail]).
., . incerely,
c, tColeen H. Sullins
cc: Steve Tedder, Winston-Salem Regional Office 1�
Steve Mauney, Winston-Salem Regional Office
NPDES Permit File No. NCO024228
PERCS Flow Reduction File
One Pretreatment, Emergency Response and Collection Systems Unit Internet httpA2o.ennnastate.us/PERCS
NOrthCarolina 1617 Mail Service Center, Raleigh, NC 27699-1617 An Equal Opportunity Action Employer
NiyFtiral/ Telephone [phone] Fax [phone]%recyded/10%post-consumer paper

STATE OF NORTH CAROLINA
COUNTY OF Davidson Permit
DEVELOPER'S OPERATIONAL AGREEMENT
This AGREEMENT made pursuant to G.S. 143-215.1 (dl) and entered into this day of
, by and between the North Carolina Environmental Management
Commission, an agency of the State of North Carolina; hereinafter known as the COMMISSION; and
Ledford Downs, LLG , a corporation/general partnership registered/licensed to do
business in the State of North Carolina, hereinafter known as the DEVELOPER.
WITNESSETH:
1. The DEVELOPER is the owner of the certain lands lying in Davidson County, upon
which it is erecting and will erect dwelling units and other improvements, said development to beknown
as Ledford South, Phase 4 (hereinafter the Development).
2, The DEVELOPER desires, to construct a wastewater collection system with pumps, wastewater treatment
works, and/or disposal facilities (hereinafter Disposal System) to provide sanitary sewage disposal to serve
the Development on said lands.
3. The DEVELOPER has applied to the COMMISSION for the issuance of a permit pursuant to G.S. 143-
215.1 to construct, maintain, and operate the Disposal System.
4. The DEVELOPER has created or shall create unit ownership in said dwellings units, other improvements
and lands through filing of a Declaration of Unit Ownership (hereinafter Declaration), pursuant to Chapter
47C or 47F of the North Carolina General Statutes.
5. The DEVELOPER has caused to be formed or will cause to be formed at the time of filing of the
Declaration, Ledford South HOA, Inc. (hereinafter
Association), a non-profit corporation organized and existing under and by the virtue of the laws of the State
of North Carolina, for the purpose, among others, of handling the property, affairs and business of the
Development; of operating, maintaining, re -constructing and repairing the common elements of the lands
and improvements subject to unit ownership, including the Disposal System; and of collecting dues and
assessments to provide funds for such operation, maintenance, re -construction andrepair.
6. The COMMISSION desires to assure that the Disposal System of the Development is properly constructed,
maintained and operated in accordance with law and permit provisions in order to protect the quality of the
waters of the State and the public interest therein.
NOW, THEREFORE, in consideration of the promises and the benefits to be derived by each of the parties
hereto, the COMMISSION and DEVELOPER do hereby mutually agree as follows:
1. The DEVELOPER shall construct the Disposal System in accordance with the permit and plans and
specifications hereafter issued and approved by the COMMISSION, and shall thereafter properly operate
and maintain such systems and facilities in accordance with applicable permit provisions andlaw.
2, The DEVELOPER shall not transfer ownership and/or control of the Disposal System to the Association
until construction has been completed in accordance with the permit and approved plans, and the staff of
the Division of Water Resources has inspected and approved of the facilities. In order to change the name
of the permit holder, the DEVELOPER must request that the permit be reissued to the Association. The
request must include a copy of the Association Bylaws andDeclaration.
3. The DEVELOPER shall not transfer, convey, assign or otherwise relinquish or release its responsibility for
the operation and maintenance of its Disposal System until apermit has been reissued to the DEVELOPER's
successor.
FORM:. DEV 03-19 Page I of 2

4. 'The DEVELOPER shall provide in the Declaration and Association Bylaws that the Disposal System and
appurtenances thereto are part of the common elements and shall thereafter be properly maintained and
operated in conformity with law and the provisions of the permit for construction, operation, repair, and
maintenance of the system and facilities. The Declaration and Bylaws shall identify the entire wastewater
treatment, collection and disposal system as a common element which will receive the highest priority for
expenditures by the Association except for Federal, State, and local taxes and insurance.
5. The DEVELOPER shall provide in the Declaration and Association Bylaws that the Disposal System will
be maintained out of the common expenses. In order to assure that there shall be funds readily available to
repair; maintain or construct the Disposal System, beyond the routine operation and maintenance expenses,
the Declaration and Association Bylaws shall provide that a fund be created out of the common expenses.
Such fund shall be separate from the routine maintenance funds allocated for the facility and shall be part
of the yearly budget.
6. In the event the common expense allocation and separate fund are not adequate for the construction, repair,
and maintenance of the Disposal System, the Declaration and Association Bylaws shall provide for special
assessments to cover such necessary costs. There shall be no limit on the amount of such assessments, and
the Declaration and Bylaws shall provide that such special assessments can be made as necessary at any
time.
7. If a wastewater collection system and wastewater treatment and/or disposal facility provided by any city;
town, village, county, water and sewer authorities, or other unit of government shall hereinafter become
available to serve the Development, the DEVELOPER shall take such action as is necessary to cause the
existing and future wastewater of the Development to be accepted and discharged into said governmental
system, and shall convey or transfer as much of the Disposal System and such necessary easements as the
governmental unit mayrequire as condition of accepting the Development's wastewater.
8. Recognizing that it would be contrary to the public interest and to the public health, safety and welfare for
the Association to enter into voluntary dissolution without having made adequate provision forthe continued
proper maintenance, repair and operation of its Disposal System, the DEVELOPER shall provide in the
Association Bylaws that the Association shall not enter into voluntary dissolution without first having
transferred its said system and facilities to some person, corporation or other entity acceptable to and
approved by the COMMISSION by the issuance of apermit.
9. The agreements set forth in numbered paragraphs 1, 2, 3, 4, 5, 6, 7, and 8 above shall be conditions of any
permit issued by the COMMISSION to the DEVELOPER for the construction, maintenance, repair and
operation of the Disposal System.
10. A copy of this agreement shall be filed at the Register of Deeds in the County(ies) where the Declaration is
filed and in the offices of the Secretary of State of North Carolina with the Articles of Incorporation of the
Association.
IN WITNESS WHEREOF, this agreement was executed in duplicate originals by the duly authorized
representative of the parties hereto on the day and year written as indicated by each of the parties named below:
FOR THE ENVIRONMENTAL
MANAGEMENT COMMISSION
S. Daniel Smith
Director, Division of Water Resources
Cranford A. Jones - Member/Manager
Print Name and Title
(Date) (Date)
FORM: DEV 03-19 Page 2 of 2

t)Ivlslon of Miter Re�iourcea
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer )extension Applications
(FTSE 10-18)
Application Number: 2020�j5,� , _Tit
Entity Requesting Allocation: Ledford DOwns.LLC
Project Name for which flow is being requested; Ledford South Phase 4
More thetil one FEW dlt(P be reyrrlred for a shrgle profecl {lYhe olvner ofthe IP)VTP is uor responsible foroll pnlop
stations aloug the ramie ofUia proposed rvastewrilerJloly.
II. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility name: Westside WWTP
b. WWTP Facility Permit k: NC-0024228
All flolps are lit MGD
C. WWTP facility permitted flow: 8.2000
d. Estimated obligated flow not yet tributary to the WWTP: 0.0401
e. WWTP facility's actual average flow: 3.1638
f. Total flow for this specific request:
g. Total actual and obligated flows to the facility:
It. Percent of permitted flow used:
0,0040
3.2080
39.12%
Complete this section for each pump station you are responsible for along the route of this proposed
wastewater flow.
List pump stations located between the project connection point and the WWTP.
(A) (n) (C)
(D)-(aiC)
(EN(A-D)
Pump Pump Firm Design Approx. Obligated,
Station Station Capacity' Average Current Not
Total Current
Available
Yet
or lkmait Daily Flows Avg. Daily Tributary
Flow Plus
Obligated
Capacdy s
Number)(Nanno
Number) Number (Finn/pt), Flow, Daily Flow,
Flow
NIGD
MGD
\IGD
MGD
MGD
MCD
waufao ll9t'fe
XC000417e
9.PM1
'aim
3.1639
0.0401
)SOJo
4.994
a
AN/A
2N1,1
MA
AWA
lN1h
RN/A
4NU
4NIA
avlA
MA
4NN
4S/A
AWA
MA
4N/A
AN/A
ANtA
4NG
4N/A
AN/A
MA
4.Y/A
4N/A
h22q 4N/A VIA AN/A MA 4NIA
The Fh•m Cnpaciq• (design flmv) orany print sinilon is dcflned as the nmxlmunt pumped flow that
can be achieved with the largest transit taken out of sea••ice.
44 Design Average Flow is the firm capacity orthe pump station divided by the perking hector (pn not
less than 2.5, per Section 2.02(A)(4)(c)of the Slininnm Design Criteria.
44t A Planning Assessment Addendum shelf be attached for each pump sin Iion located batureen the
project connection point and the WWTP where the Available Capacity is 5 a.
unstrcnns pacitityNnnre (Sewer):
unstreant Permit Number.
41411% "A
Page 1 of 6
FTSE 10-18

Certification Statement
I, Terry Houk certify to the best of my knowledge that the addition of the volume of
wastewater to be permitted in this project has been evaluated along the route to the receiving wastewater
treatment facility and that the flow from this project is not anticipated to cause any capacity related
sanitary sewer overflows or overburden any downstream pump station en route to the receiving treatment
plant under normal circumstances, given the implementation of the planned improvements identified in the
planning assessment where applicable. This analysis has been performed in accordance with local
established policies and procedures using the best available data. This certification applies to those items
listed above in Sections 1 and Il plus all attached planning assessment addendums for which I ant the
responsible party. Signature of this form certifies that the receiving collection system or treatment works
has adequate capacity to transport and treat the proposed new wastewater.
Signing
P-M&IC SZxYicES biP�Le?a2
Title of SigningOfficial
8/13/2020
Date
PAae 2 of 8
FTSE 10-18

The National Map Advanced Viewer
4
ii rfn I
J
.r-
it i "air t
j ty k .L31'
G9
it
h
-
it
r
61
8/3/2020, 3:45:32 PM
„ 1 ,
= t
1 lilir i i
I tits •� i�
SITE
a
vil
� "
1
tom'
i
,I ,It
ii
M4 [
u
'Vi ,l
ill rt di -
U
,
I
d ( r
I �
i
y
1:18,056
0 0.13 0.25 0.5 rni
0 0.2 OA 0.8 kin
USGS The National Map: National Boundaries Dataset, 3DEP Elevation
Program, Geographic Names Information System, National Hydrography
Dataset, National Land Cover Database, National Structures Dataset, and
National Transportation Dataset; USES Global Ecosystems; U.S. Census
USES
USGS The National Map: National Boundaries Dataset, 3DEP Elevation Program, Geographic Names Information System, National Hydrography Dataset, National Land Cover Database, National

E
r
E �
® o
N ,
e
�D
��
�d
opt.
a Y-
nvrry:GreCv
_
2I
a
i �.

STATE OF NORTH CAROLINA
COUNTY OF Davidson
Permit No.
DEVELOPER'S OPERATIONAL AGREEMENT
This AGREEMENT made pursuant to G.S. 143-215.1 (it 1) and entered into this _ day of
l) , by and between the North Carolina Environmental Management
Commi gency of the State of North Carolina, hereinafter known as the COMMISSION; and
Ledford Downs, LLC , a corporation/general partnership registered/licensed to do
business in the State of North Carolina, hereinafter known as theDEVELOPER.
WITNESSETH:
1. The DEVELOPER is the owner of the certain lands lying in Davidson County, upon
whichitis erecting and will erect dwelling units and other improvements, said development to heknown
as Ledford South, Phase 4 (hereinafter the Development).
2. The DEVELOPER desires, to construct a wastewater collection system with pumps, wastewater treatment
works, and/or disposal facilities (hereinafter Disposal System) to provide sanitary sewage disposal to serve
the Development on said lands.
3. The DEVELOPER has applied to the COMMISSION for the issuance of a permit pursuant to G.S. 143-
215.1 to construct, maintain, and operate the Disposal System.
4. The DEVELOPER has created or shall create unit ownership in said dwellings units, other improvements
and lands through filing of a Declaration of Unit Ownership (hereinafter Declaration), pursuant to Chapter
47C or 47F of the North Carolina General Statutes.
5, The DEVELOPER has caused to be formed or will cause to be formed at the time of filing of the
Declaration; Ledford South HOA, Inc. (hereinafter
Association), a non-profit corporation organized and existing under and by the virtue of the laws of the State
of North Carolina, for the purpose, among others, of handling the property, affairs and business of the
Development; of operating, maintaining, re -constructing and repairing the common elements of the lands
and improvements subject to unit ownership, including the Disposal System; and of collecting dues and
assessments to provide funds for such operation, maintenance, re -construction andrepair.
6. The COMMISSION desires to assure that the Disposal System of the Development is properly constructed,
maintained and operated in accordance with law and permit provisions in order to protect the quality of the
waters of the State and the public interest therein.
NOW, THEREFORE, in consideration ofthe promises and the benefits to be derived by each of the parties
hereto, the COMMISSION and DEVELOPER do hereby mutually agree as follows:
1. The DEVELOPER shall construct the Disposal System in accordance with the permit and plans and
specifications hereafter issued and approved by the COMMISS[ON, and shall thereafter properly operate
and maintain such systems and facilities in accordance with applicable permit provisions andlaw.
2 The DEVELOPER shall not transfer ownership and/or control of the Disposal System to the Association
until construction has been completed in accordance with the permit and approved plans, and the staff of
the Division of Water Resources has inspected and approved of the facilities. in order to change the name
of the permit holder, the DEVELOPER must request that the permit be reissued to the Association. The
request must include a copy of the Association Bylaws andDectaration:
3. The DEVELOPER shall not transfer, convey, assign or otherwise relinquish or release its responsibility for
the operation and maintenance of its Disposal System until a permit has been reissued to the DEVELOPER's
successor.
FORM:. DEV 03-19 Page I of 2

4. The DEVELOPER shall provide in the Declaration and Association Bylaws that the Disposal System and
appurtenances thereto are part of the common elements and shall thereafter be properly maintained and
operated in conformity with law and the provisions of the permit for construction, operation; repair, and
maintenance of the system and facilities. The Declaration and Bylaws shall identify the entire wastewater
treatment, collection and disposal system as a common element which will receive the highest priority for
expenditures by the Association except for Federal, State, and local taxes and insurance.
5. The DEVELOPER shall provide in the Declaration and Association Bylaws that the Disposal System will
be maintained out of the common expenses. In order to assure that there shall be funds readily available to
repair, maintain or construct the Disposal System, beyond the routine operation and maintenance expenses,
the Declaration and Association Bylaws shall provide that a fund be created out of the common expenses.
Such fund shall be separate from the routine maintenance funds allocated for the facility and shall be part
of the yearly budget.
6. In the event the common expense allocation and separate fund are not adequate for the construction, repair,
and maintenance of the Disposal System, the Declaration and Association Bylaws shall provide for special
assessments to cover such necessary costs. There shall be no limit on the amount of such assessments, and
the Declaration and Bylaws shall provide that such special assessments can be made as necessary at any
time.
7. If a wastewater collection system and wastewater treatment and/or disposal facility provided by any city;
town, village, county, water and sewer authorities, or other unit of government shall hereinafter become
available to serve the Development, the DEVELOPER shall take such action as is necessary to cause the
existing and future wastewater of the Development to be accepted and discharged into said governmental
system, and shall convey or transfer as much of the Disposal System and such necessary easements as the
governmental unit mayrequire as condition of accepting the Development's wastewater.
8. Recognizing that it would be contrary to the public interest and to the public health, safety and welfare for
the Association to enter into voluntary dissolution without having made adequate provision forthe continued
proper maintenance, repair and operation of its Disposal System, the DEVELOPER shall provide in the
Association Bylaws that the Association shall not enter into voluntary dissolution without first having
transferred its said system and facilities to some person, corporation or other entity acceptable to and
approved by the COMMISSION by the issuance of apermit.
9. The agreements set forth in numbered paragraphs 1, 2, 3, 4, 5, 6, 7, and 8 above shall be conditions of any
permit issued by the COMMISSION to the DEVELOPER for the construction, maintenance, repair and
operation of the Disposal System.
M A copy of this agreement shall be filed at the Register of Deeds in the County(ies) where the Declaration is
filed and in the offices of the Secretary of State of North Carolina with the Articles of Incorporation of the
Association.
IN WITNESS WHEREOF, this agreement was executed in duplicate originals by the duly authorized
representative of the parties hereto on the day and year written as indicated by each of the parties named below:
FOR THE ENVIRONMENTAL
MANAGEMENT COMMISSION
S. Daniel Smith
Director, Division of Water Resources
Cranford A. Jones - Member/Manager
Print Name and Title
(Date) (Date)
FORM: DEV 03-19 Page 2 of 2