SWA000081_NCDEQ Storm Fast Track Application - Signed_20201116

DEMO USE ONLY
Date Received Fee Paid Permit Number
SW Program(s): 11 Coastal SA-HQW EJ Coastal SA-ORW 1-1 Coastal FW-ORVV 0 Coastal Other
11 Non-coastal HQVV El Non-coastal ORW F1 Urbanizing Areas El USMP
NC DECK Division of Energy, Mineral and Land Resources
STATE S"TORMWATER FAST" TRACK PROCESS'
"AUTHORIZATION TO CONSTRUCT" (ATC) PERMIT APPLICATION FORM
Link to AoDlication Instructions
A. ELIGIBILITY FOR FAST-TRACK PERMITTING
To be considered for a Fast Track ATC Permit,Ll of the items below must be checked. If any item cannot
be checked, then the project must apply under the Standard Permitting Process.
Z The project and all SCMs (including existing SCMs,associated with the project)will meet all applicable
requirements of 15A NCAC 02H ,1000- ,1062, including the Minimum Design Criteria (MDC), upon project
completion.
N The project is not proposing an alternative design.
Z The project is not claiming an exemption from the MDC based on vested rights, a waiver or a Director's
Certification.
Z The project is not out of compliance with,an existing stormwater permit or any other environmental permit.
Z The project is not applying for an offsite permit, an exemption, or a minor modification (as defined in 15A
NCAC 02H .1002(25))to an existing state stormwater permit.
Z The project application bears the signature and seal of a professional licensed pursuant to either Chapter 89A
or 89C of the NC General Statutes.
Z I understand that at project completion, an application with the as-built stormwater plans (as described in 15A
NCAC 02H .1'044 must be submitted, and DEC will review the as-built stormwater plans to confirm
compliance with the MDC. Approval of the as-built stormwater plans will be required before the Erosion and
Sedimentation Control Plan for the project may be closed out.
Z I understand that the Fast Track ATC Permit will expire five years after the date of issuance.
B. GENERAL INFORMATION
1 Project Name: Horsepasture River Wastewater Treatment Plant& Collection System Improvements
2. Previous Project Name(if applicable):
3. Location of Project(street address): US HVVY 64
City:Cashiers Couinty:Jackson Zip:28717
4. Directions to project(from nearest major intersection):
ApQroximately 2.25,miles east on US-64 from intersection of US-64 and NC-107 in dowtown Cashiers, NC.
5. Latitude:35' 07' 45" N Longitude:830 04' 06"W of the main entrance to the project.
C, PERMIT INFORMATION
1. Specify whether project is (check one):
Z New, no previous application
F1 New, replacing a previous Fast Track ATC Permit-- provide previous permit number: SWA
By choosing this option, you are also requesting that DEQ rescind the previous Fast Track ATC Permit
upon issuance of the new Fast Track ATC Permit.
$1(, nivvat(�; IFast 'T fa.���k�Al C Ap�:�iicaflon Foi ni Plage "I of 9
Feb 10 2018

F-1 Major Modification, replacing an existing stormwater permit-provide existing permit number SW
Status of construction? E] Not Started R Partially Completed El Completed
Mawr modifications must be submitted by the original permittee and are allowed only if the SWpemiit is
not expired. Minor modifications must use Standard Pennitting Process. By choosing this option, you
are also reqUesting that DEQ rescind the previous SW Permit upon issuance of the new Fast
Track ATC Pen-nit.
E] Transfer of existing Fast Track ATC Permit-provide existing ATC permit number: SWA
2. Applicable state stormwater program(s) (check a//that apply):
E] Coastal SA-HQW El Urbanizing Areas (Phase 2)
❑ Coastal SA-ORW 0 Non-Coastal HQW
Is any portion of the project within 575 feet
of SA-ORW waters? El Yes El No Z Noin-Coastal ORW
F-1 Coastal Freshwater ORW El USMP
R Coastal-Other
3, Other Permits (as applicable; write "NA"for those permit types that are not applicable):
Project Name Permit/Appi Issue Date Other Information
No.
LAMA Major NA
Erosion& Horsepasture River Wastewater JACKS- Application Disturbed Area 6.70
Sedimentation Control Treatment Plant &Collection 2021 submitted_ acre
System Improvements 8/26/2020
NPDES Industrial
NA NA
Stormwater
404/401 Permit Horsepasture River WWTP & QWR# Submitted Proposed Impacts
Collection System 2020FI-25 3.75 If/ac
Improvements SAW-2013-
.......... 10712
4. Local jurisdiction for building permits: Jackson County.
Point of Contact:Tiffany Qualls Phone#: [phone]
D. CONTACT INFORMATION
1. Applicant/Financially Responsible Party (may be an Organization):Tuckaseigee Water and Sewer Authority
Signing Official Name &Title:Daniel Manring, Excecutive Director
Street Address:1246 VV Main Street
City:Sylva State.-NC Zip:28779
Mailing Address(if different):
City: State:— Zip:_
Phone: (828) 586-5189 Fax:
Email: d a,[e-mail]
2. If the Applicant is a Corporation or LLC (Address must match address on file with NC Dept of the Secretary of
State):
Name of Registered Agent:
Mailing Address:
City: State:- Zip:
Phone, Fax:
Email:
1-:asl AIT,Al,)Acad.on Foi,rn Page 2 of 9 Feti, I0, 20,18

3, The Applicant is the (check all that apply):
0 Property Owner
F-1 Lessee (Attach a copy of the lease agreement&complete Item 4.)
R Purchaser(Attach a copy of the pending sales agreement&complete Item 4.)
R Developer(Attach a copy of the development agreement&complete Item 4.)
4. If the Applicant is NOT the Property Owner(skip to Item 5 if the Applicant IS the Property Owner):
Property Owner Name/Organization:
Signing Official & Title:
Street Address:
City: State: zip,
Mailing Address(if applicable):
City: State-.— zip':
Phone: Fax:
Email:
5. The licensed Design Professional that will be retained for the duration of the project, who may provide
information on the Applicant's behalf, and who will prepare and certify the as-built package:
Consulting Engineer/Landscape Architect:Scott Burwell
Consulting Firm: McGill Associates, PA
Mailing Address-.55 Broad St
City-.Asheville State:NC Zp.-28801
Phone: (828 ) 252-0575 Fax: (858) 252-2518
Email:scottburwell mcgillassociates.com
6. [OPTIONAL] If you would like to designate another person to answer questions about the project,
Name &Title'.
Organization-.
Mailing Address:
City.. State: zip:
Phone: Fax:
Email:
E. PROJ ECT' IN FORMATION
1. Specify the type of project(check one), R Low Density Z High Density
2. Briefly summarize how the stormwater runoff will be,treated/conveyed:
Based on pos,t-construction conditions, alll runoff within the improved drainage areas will be captured with
ditches and/or pipes, and detained in the proposed wet pond, All offsite stormwater runoff will be bypassed
around the promect area and will not be treated.
3. Stormwater runoff from this project drains to the Savannah River basin(s).
4. Receiving water information if more than 3 receiving waters,provide additional information on an attached sheet):
Receiving Receiving Receiving
Water 1 Water 2 Water 3
Receiving Stream Name Horsepasture River
Stream Classification QTR;+
Stream Index Number 4-13-(0.5)
Stal rnwale Fast 1I rack ATG Appficah.)d i Fori,ln Page 3 cnf 9 ('e[) K), 2(H8

5. IDraject area and density information-',--.
Total! Property Area 67,600 sf
Total Surface Water Area 43�000 sf
Considered to include:
• the normal pool of impounded structures;
® the area between the banks of streams and rivers;and
• the area below the Normal High Water(NHW)line or Mean High Water(MHM line.
Total Coastal Wetlands Area 0 sf
Considered to include: coastal wetlands landward from the NHW(or MHW)line.
Total Project Area 225,300 sf
Excludes the surface water area and coastal wetland area,identified above,.
May or may not be the same as Property Area.
Built-Upon Area (BUA)associated with Existing Development 0 sf
"Existing development"means those projects that are built or those projects that have established a
vested right under North Carolina law as of the effective date of the state stormwater program or
applicable local government ordinance to which the project is subject.
Proposed New BUA 72,,500 sf
Includes proposed new BUA that is not associated with existing development.
"13 UA"is defined in N.C.G.S. 143-214.7(b2). It includes, but is not limited to.:buildings, roads,parking
areas, sidewalks, and some gravel areas. The design volume of SCMs must take into account the runoff
from build out from all Surfaces draining to the SCM in accordance with 15A NCAC 02H.1050(1).
Project Density
wlExisting Development: Project Density=[New BLIA]I[Total Project Area—Existing BUAJ x 100 or 32.1 %
w1b Existing Development: Project Density=[Now BUAJITotal Project Area]x 100
6. Anticipated construction start date January 2021
7, Is the project located within 5 rnfles of a public airport? Z No n Yes
If'Yes,'see S.L. 2012-200, Part VI: httg://www.ncleg!,net/Sessions/20,1 1/13ills/Senate/PQF/aZZ0�vQdf and
DECK Stormwater Design Manual Chapter E-4 Airports.
8. For projects in Union County: Contact DEMLR Central Office Stormwater staff at 919-707-9200 to determine
if the project is located within a Threatened& Endangered Species watershed that may be subject to more
stringent stormwater requirements per 15A NCAC 026 .0600.
Stonriwater Farr!Trar,' ATC Appp cation Form Page 4 of 9 Feb, 10, 2018

F. SUBMIT,rAL REQUREMEN,rs
Submit the |ioetio package to the nastai8A Waters) mrDE&8LR
Central Office (Urbanizing Areas Ph 2, US&4P, Non-Coastal HQV0ORW). Only application packages that include
�Lll requ�mad items listed below will be accepted and reviewed.
Initial each item below%oindicate that the meqLfiredinformation is provided in the application package:
Initials
SB 1 Two original signed hard oop�eaamd one electronic copy ofthis State Sbormwa1er Fast Track
Process"Authorization bo Construct" (AJC) Pemnrt Application Form.
S�_____ 2. Permit application processing fee of$505payable hnNCDEQ.
fQi 3. Two bard copies and one deotnanio copy of a USGS map identifying the project location
and GPS coordinates for the project, If the receMng water is Class SA or the receiving water
drains to Class SA waters within 1/2mi|ecf the project boundary, include the 1/2nnfleradius
on the map. If the project is within 575 feet of CIass SA-ORW waters, include the 575-foot
radius on the map,
S�B 4 Two original signed hard copies and one electronic copy of a site pIan depicting the boundary
of the project or project phase currently being permitted, including the Iocations of SCMs,
streams, wetlands, and buffers.
SB 5 Two hard copies and one electronic copy of a construction sequence that discusses how any
future development on the project may bephased.
.SBL G. A copy of the most current property deed. Deed book:2{65PaQeNo: 337
7. [IF APPLICABLE] When the applicant is amorpu:stion ore limited liability corporation (LLC): Provide
two hard copies and one electronic copy of documentation from the NC Secretary of State, urother
official documentation, which supports the titles and positions held by the persons listed
in Section C.2 per 15A NCAC2N, 1O43(3)(b). The corporation orLLC must be listed aaanactive
corporation in good standing with the NC Department of the Secretary of State; otherwise, the
application will be returned.
8. [IF APPLICABLE]When the applicant is aPmrtnemship or other person engaging im business under
an assumed name, attach a copy ofthe Certificate of Assumed Name.
0. [IF APPLICABLE] When the appRcantio not the property owner: Provide two hard copies and one
electronic copy of lease agreements, affidavitm, pending sales agreement, development agreement,
or other documents showing that the appficant has obtained legal rights to submit a stormwater
permrt application within the proposed project area.
18. [IF APPLICABLE] If modifying an existing permit for completed or partially completed pnojeca, a copy
of the designer's certification.
Siormma1erFaal�Trook All CApp|ico\ionForm Page5of9 Fm� 10 2018

G. CERTIFICATION OF APPLICANT] FINANC&ALLYRESPONS81 E PARTY
The Appficant, who is also the Financially Responsib&e Party, identified in Section D of this form must sign and have
mmterzed the following guaranty:
8. (print or type name ofA 8r tlF/nmncioXyRanponsib/ePa .
certify that the information included on this permit applicafion form is, to the best of my knowledge, correct and
that-.
1 the design has been or willbe completed i rdwith the WNOC as setforth i Rules 15ANCAC
02H .1050 through .1062, to the best of my knowledge;
u� the lete is the basis for the
design shall not be exceeded, to the best of my knowledge; and
1 As the applicant, I shall maintain a licensed professional'of record for the duration of the project
who will prepare and certify
professional before the project is complete, then I shall provide an updated
guaranty with the current licensed professional's seal. A licensed professional shall inform
the Division ifhe ianm longer associated with this project.
The above information ia true and correct to the best ofmy knowledge and belief and was provided byme under oath |
agree to provide corrected information should there be any change in the information provided herein,
Type or pri, me Tifie or Authority
Signature Date
--------'-----------'---------'--'-----'------'--'--'--------------------'---
a Notary PLIJ:)Iic for the State of
County of do hereby certify that 1729'1�
persVnumymppeaneooenoremexnm day of fv . �dC)AC). anU acknowledge the
xu ion H 7a ' n or a tbrmwater permit. Witness my hand and official seal,
SEAL
My commission expires
Gkoi: Fma�TrechATCApp|ioahonForm Page, 8uf9 Feb 18 2O18

H. DEMN PROFESSIONAL'S CER"rIFICKnON
To be completed by the Design Professional identified in Section D,5,
1, Scott Burwell , attest to the following:
1. This application has been reviewed by me and is accurate and complete, to the best of my knowledge;
2. The design has been completed in accordance with the MIDC as set forth in Rules 15A NICAC 02H
.1050 through .1062, as applicable;
1 The percentage built-upon area that is the basis for the design will not be exceeded; and
4. 11 have the expertise, education, and experience required to design the SCIVIs proposed in this
application in accordance with the MDC as set forth in Rules 15A NCAC 02H .1050 through .1062,
5, l will provide all documents and certified as-built plans in hard copy and electronic format related to
this permit to a new Applicant/Property Owner and to DEMLR upon transfer of this permit to a new
Applicant/Property(Owner.
Note: In accordance with N.C.G.S, 143-215.6A and 143-215.613, any person who knowingly makes any false
statement, representation, or certification in any application 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. In addition, any person
who knowingly makes any false statement, representation, or certification in any application may be reported to
the appropriate NC professional licensing board.
Signature: Date:
CARO
S S
0 .......
SEAL
S AL
039177
'NY
SkinTom'-itei ATC Aqr�)plic,@tion Rvnl P,`�gE 7 M 9 Fe[') 14.), 20,18

L PROPERTY OWNERS ALITHORIZATlON 11F APPI ICAN r is Iq01- THE RRUPERTYOWNER)
1, (print or type name of the Property Owner) certify that I
own the property identified in this permiit application, and thus give permission to (print or type nanne of Applicant)
-with (print or type name of Applicant's
organization) to develop the project as
currently proposed, A copy of the lease agreement or pending property sales contract has been provided with the
submittal, which indicates the party responsible for the operation and maintenance of the stormwater system.
As the legal property owner I acknowledge, understand, and agree by my signature below, that if my designated
agent (entity listed in Contact Information, item 1) dissolves their company and/or cancels or defaults on their
lease agreement, or pending sale, responsibility for compliance with the DEMLR Stormwater permit reverts back
to me, the property owner. As the property owner, it is my responsibifity to notify DEMLR immediately and submit
a completed Name/Ownership Change Form within 30 clays; otherwise I will be operating a stormwater treatment
facility without a valid permit. I understand that the operation of a stormwater treatment facility without a valid
permit is a violation of NC C~eneral Statue 143-215.1 and may result in appropriate enforcement action including
the assessment of civil penalties of up to$25,000 per day, pursuant to NCGS 143-215.6.
Signature: Date:
I, a Notary Public for the State of
County of do hereby certify that
personally appeared before me this day of and acknowledge the
due execution of the application for a stormwater permit. Witness my hand and official sea],
SEAL
My commission expires
Stoi mwater Fast Track ATC Apphcation Form Page,8 of 9 Feb. 101, 20�8

,T. CEIRTIFICA"HON OF Ct)RRENT PIER M"TEE (CU'VIPL.E rE ONLY IF RERIWIT '1"'RXNSFER IIS
REQUESTED)
1, (print or type name of the Cnrrent Pern?ittee) am submitting
this request for a transfer of Fast Track ATC permit#SWA With the
submission of this transfer request I am providing a copy of the most recent permit, all related' documentsand as-
built plans certified by my design professional in hard copy and electronic format to the Proposed
Perm ittee/Applican t identified in Section G of this application and to DEMLR . I further attest that this request for
a permit transfer is accurate and complete to the best of my knowledge, I assign all rights and obligations as
permittee to the proposed permittee named in Section G of this form,
Signature: Date:
a Notary Pubhc for the State of
County of do hereby certify that
personally appeared before me this - day of and acknowledge the
due execution of the application for a stormwater permit. Witness my hand and official seal,
SEAL
My commission expires
Storm\mMer Fast Track ATC Appkation Form Page 9 of 9 Feb. 10, 2018