WQ0042070_Application (FTSE)_20201022

Is
State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300— FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: V6 a�a (to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION: t L C
1. Applicant's name: DLH Development (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ IndividuaI fz Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State;'County ❑ Municipal ❑ Other
3. Signature authority's name: David Haskins per .15A NCAC 02T .0106(b)
Title: Registered Agent hli�"�i�"�A401Ks2+'
4. Applicant's mailing address: 3605 Hwv 96
City: Oxford State: NC Zip: 27565-
5. Applicant's contact information:
Phone number: 9( 19) 691-3714 Email Address: trabarhomesllc(@, mg ail.com
IL PROJECT INFORMATION:
I . Project name: Owen's Ridge Subdivision
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Pennit/Project
If a modification, provide the existing permit number: WQ00� and issued date: n
d
If new construction but part of a master plan, provide the existing permit number: WQ00 ;;J
3. County where project is located: Granville
4. Approximate Coordinates (Decimal Degrees): Latitude: 36.205096' Longitude:-78.724880' Q-4 <
70
5. Parcel ID (if applicable): 9864665555
(or Parcel ID to closest downstream sewer) o' N
v
III. CONSULTANT INFORMATION: 0 �.
I . Professional Engineer: Chad E Abbott License Number: 036242
Firm: C3 Design & Engineering, PLLC'
Mailing address: PO Box 0361
City: Creedmoor State: NC Zip: 27522-
Phone number: (9j 9) 625-7368 Email Address: chad c3desi nen .com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: SGWASA W WTP Permit Number: NCO026824
Owner Name: SGWASA
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ_ Downstream (Receiving) Sewer Size: inch
S%stem Wide Collection 5%.stem Permit Numbers iif. applicable: WQCS_
OwnerName(s): SGWASA
FORM: FTA 04-16 Page 1 of

VI. GENERAL REQUIREMENTS
I. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
❑ Yes ❑No ®N/A
2. If the Applicant is a Developer of lots to be sold, has a Developer's Operational .Ailreement [FORM. DEV1 been attached?
®Yes [:]No ❑NIA
3. If the Applicant is a Home Prppertv,Owners' Association, has an Operational A grVment FORM: H A been attached?
❑ Yes ❑No ®NIA
4. Origin of wastewater: (check all that apply)-
® Residential Owned ❑ Retail (stores, centers, malls) ❑ Car Wash
❑ Residential Leased ❑ Retail with food preparation/service ❑ Hotel and/or Motels
❑ School I preschool / day care ❑ Medical I dental I veterinary facilities ❑ Swimming Pool /Clubhouse
❑ Food and drink facilities ❑ Church ❑ Swimming Pool/Filter Backwash
❑ Businesses I offices / factories ❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater: 100 % Domestic/Commercial _% Commercial
_I % Industrial (.See 15A N CAC 02TAI03129D
f Is there a Pretreatment Program in effect? ❑ Yes [:]No
6. Hasa flow reduction been approved under 15A NCAC 02T .01 14(-Q? ❑ Yes ®No
➢ If provide a cony of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(f}l
Daily Design Flow'-b
No. of Units
Flow
Single Family Residential (9 Lots with 3
BR/Lot)+
88 gal/BR
27
2 376 GPD
gall
GPD
gall
GPD
gal/
GPD
gal/
GPD
gall
GPD
Total
2,376 GPD
a See 15A NCAC 02T .01 I4(b)- (d),_(e)(1) and (0(21 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. 42A4).
b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified (in table 15A NCAC 02T.01141 shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 2,376 GPD (per 15A NCAC 02T .01 l4)
➢ 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 Iine
❑ Flow has already been allocated in Permit Number:
❑ Rehabilitation or replacement of existing sewer with no new flow expected
❑ Other (Explain):
FORM: FTA 04- l 6 Page 2 of 5

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
I. Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
6 57 Ductile Iron
➢ Section 11 &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
VII1. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC(Pump Stations/Force Mains),:
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name:
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 N AC 02T .0 OS h 1
❑ Standby power source or pump with automatic activation and telemetry - 15A NCAC 02T .0305(h)(l)(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 timefiames, 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 .0 05
➢ 15A NCAC 02T.0305(f) contains minimum separations that shall hp nrnw;rtPri fnr [a,uar eyeto—
® Yes ❑ No
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-1 waters of Class I or
Class 11 impounded reservoirs used as a source of drinking water
100 feet
**Waters classified WS (except WS-1 or WS-V), B, SA, ORW, HQW, 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 NtvAC 02T.0305(s;} contains alternatives where separations in 02T.0305(fl cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water Classifications web aue
➢ If noncompliance with 02T.0305(f)2g= 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
➢ 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 ® NIA
➢ 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 PermittinZ Branch
5. Does project comply with 15A NCAC 02T.0105(c)(61(additional permits/certifications)? ®Yes [:]No
Per 1 c A NCAC 02T,0105(!* , 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.
El Yes ®No ❑N`A
➢ 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 I5A NCAC 02T.0403(a)(5) or the permitee's individual System -Wide Collection permit.
FORM: FTA 04-16 Page 4 of 5

X. CERTIFICATIONS:
Does the submitted system comply with ISA NCAC 02T, the Minim m,_Dcsign_f.ri is o_r.the Fcrmi1Eing of PNEn tilt ! 5
imd Furcc_Mains.flatest version), and the Gravity Sewer Minimum Design Criteria LIatcst version as applicable?
® Yes ❑ No
If No, complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents for
review. Approval of the request is required Prior to submittal of the Fast Tracts Application and supporting documents.
2. Professii Engineer's Certification:
h - r * attest that this application for
(Professional Engin er's name from Application Item I11.1.)
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. 1 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: 11 R
'SAL r.
i 036242
3. Applicant's Certification per 15A NCAC 02T .0106(b):
I, David B Haskins Member/Manager attest that this application for
(Signature Authority's name & title from Application Item 1.3.)
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 143-215.613, 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.
Signature: (23 Date:
9/22/2020
FORM: FTA 04-16
Page 5 of 5

NC Dept ofEnvironmcntal Qus►lit
OCT 2 7 2020
State of North Carolina
1� Re(ionLll�. Department of Environmental Quality
Dw RRalciDivision of Water Resources
Division of Water Resources Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: SGWASA
Project Name for which flow is being requested: Owen's Ride Subdivision
More than one ME may be "ubvd for a sfngk project if the owner of the WWTP is not rmponsfble for au pump
stations along the route of thepmposed wastewater floras
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: SGWASA WWTP
b. WWTP Facility Permit #: NCO026824
c. WWTP facility's permitted flow
d. Estimated obligated flow not yet tributary to the WWTP
e. WWTP facility's actual avg. flow
f. Total flow for this specific request
g. Total actual and obligated flows to the facility
AUfI'ows are in MGD
5.5
1.117
1.93
0.002376
3.049
h. Percent of permitted flow used 55.4%
H. 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)
(13)
(C)
(1)r(B+C)
(E)-(A-D)
Design
Obligated,
Pump Pump
Average
Approx.
Not Yet
Total Current
Station Station
Firm
Daily Flow"
Current
Tributary
Flow Plus
(Name or Permit
Capacity, •
(Firm / pf),
Avg. Daily
Daily Flow,
Obligated
Available
Number) No.
MGD
MGD
Flow, MGD
MGD
Flow
Capacity***
Ruitan PS
0.046
0.018
0.002
0.002
0.004
0.016
Stem Main PS
OA67
0.187
0.043
0.002
0.045
0.144
Mangum Farms 1 PS
1.094
0.313
0.047
0.062
0.109
0.204
* The Firm Capacity (design flow) of any pump station Is defined as the masimunt pumped flow
that can be achieved with the largest pump taken out of service.
** Design Average Daily Flow is the firm capacity of the pump station divided by a peaking factor
(pf) not less than 2.5, per Section 2.02(Ax4)(c) of the Minimum Design Criteria.
*** A Planning Assessment Addendum shall be attached for each pump station located
between the project connection point and the WWTP where the Available Capacity Is a 0.
Downstream Facility Name (Sewer): SGWASA WWTP
Downstream Permit Number: NCO026824
Page 1 of 6
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�. LIMITED LIABILITY COMPANY ANNUAL REPORT ■
10l20r7
NAME OF LIMITED LIABILITY COMPANY: DLH Development, LLC
SECRETARY OF STATE ID NUMBER: 1736104 STATE OF FORMATION: NC
REPORT FOR THE CALENDAR YEAR: 2019 �■ ■0
SECTION A: REGISTERED AGENTS INFORMATION
1. NAME OF REGISTERED AGENT: David B Haskins
2. SIGNATURE OF THE NEW REGISTERED AGENT:
SIGNATURE CONSTITUTES CONSENT TO THE APPOINTMENT
3. REGISTERED AGENT OFFICE STREET ADDRESS & COUNTY 4. REGISTERED AGENT OFFICE MAILING ADDRESS
3605 Hwy 96 _ 3605 Hwy 96
Oxford, NC 27565 Granville Oxford, NC 27565 Granville
SECTION H: PRINCIPAL OFFICE INFORMATION
1. DESCRIPTION OF NATURE OF BUSINESS: Real Estate Investment
2. PRINCIPAL OFFICE PHONE NUMBER: [phone] 3. PRINCIPAL OFFICE EMAIL:
4. PRINCIPAL OFFICE STREET ADDRESS S. PRINCIPAL OFFICE MAILING ADDRESS @'
3605 Hwy 96 - 3605 Hwy 96 9N.
Oxford, NC 27565 Granville Oxford, NC 27565 Granville
6. Select one of the following if applicable. (Optional see Instructions)
❑ The company is a veteran -owned small business
❑ The company is a service -disabled veteran -owned small business
SECTION C: COMPANY OFFICIALS (Enter additional company officials in Section E.)
NAME: David B Haskins
TITLE: Member
ADDRESS:
NAME: Trabar Homes, LLC
TITLE: Managing Member
ADDRESS:
3605 Hwy 96 3605 Hwy 96
Oxford, NC 27565 Granville Oxford, NC 27565 Granville ^
NC Dept of F.nvironmel'U'll QUaltit
OCT 7 7 2020
NAME: Ralcigh Regional OITICIL
TITLE:
ADDRESS:
SECTION D: CERTIFICATION OF ANNUAL REPORT. Section D must be completed in its entirely by a person/business entity.
SIGNATURE DATE
Form must be signed by a Company Official listed under Section C of This form.
Print at Type Name of Company Official Print or Type Title of Company Official
SUBMIT THIS ANNUAL REPORT WITH THE REQUIRED FILING FEE OF $200
MAIL TO: Secretary of State, Business Registration Divlslan, Post Office Box 29525. Raleigh, NC 2762"525

NCDE�IR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Charles Wakild, P. E. Dee Freeman
Governor Drector Secretary
January 4`h, 2012
Lindsay L. Mize, P.E., Executive Director
South Granville Water and Sewer Authority NC Be
Pt Central Avenue pt OfEnvironmentaI Qtp,ll�ti
Suite B
Butner, NC 27509 OCT 2 7 2020
Subject: South Granville Water and Sewer Authority Ralcibh Rc t
Residential FIow Reduction Request ontt! Ottice
Granville County
Dear Mr. Mize:
On October 7th, 2011, the Pretreatment, Emergency Response and Collection Systems (PERCS)
Unit received a flow reduction request for future residential connections to the South Granville
Water and Sewer Authority (SGWASA) sewage collection system. This adjustment would apply
to all of SGWASA's permitted bul not yet tributary residential connections and all future
residential connections tributary to the SGWASA collection system.
Based upon the analysis submitted and a previous study conducted for the City of Creedmoor's
collection system, the Division of Water Quality (Division) hereby approves an adjusted daily
sewage design flow rate of 88 gallons per day per bedroom effective immediately, to be applied
as follows:
A) For existing permits with flow not yet tributary to the SGWASA collection system:
1) The Division will not reissue permits for previously permitted projects. If reissued
permits are desired, a permit modification application with the appropriate fee must
be submitted for each permit to be modified. ,
B) For new sewer extension applications with proposed flows tributary to the SGWASA
collection system:
1) The flow reduction is applicable to residential single family dwellings only
2) The minimum flow for 1 and 2 bedroom dwellings shall be 176 gallons per day
3) This flow reduction shall not apply for sewer extension applications and/or permits
for any other public or private organizations whose wastewater flows are or might
become tributary to the SGWASA collection system.
107 Mill Service Center, Re -'soh, North Caroline 27699.1617
Loatlon 512 N Se6sbury SI Ralooh, North Carolina 27604
Phone [phone]FAX-91940744921Customer Se(vW-1.877-623.6748
Internet: w".nc*alemua6.oro
An Eqwl opportunity t Aran&*@ At'tipn Empiarer �ac Karoii na
)UMM1111

F' a. DESIGN &
ENGINEERING, PLLC
CLIENT -FOCUSED - COMPREHENSIVE - COST-EFFECTIVE
October 20, 2020
NCDEQ— Raleigh Regional Office
Attn: Water Quality Section
1628 Mail Service Center
Raleigh, NC 27699
919-791-4200
2597 E. LYON STATION RD, STE 102
PO BOX ief
CREEDNOOR, NC 27522
9f"j"99B
lVC11%of
En ent�
Orr f uairi.
RE: 1$-070 Owen's Ridge Subdivision — 207 Old NC 75, Stem, NC 275$1 ,r
Fast Track Sewer Extension Submittal #1 rhe
Enclosed are the following documents:
QTY
DESCRIPTION
REC'D BY
1 ACTION RE 'D
or (21 FYI ONLY
2
1- A - Application
(1)
1
2 - 3 — Cover Letter
(2)
1
3 - C— Application Fee
(2)
1
4 - D — Proof of Registered Business
(2)
1
5 - E - FTSE & Flow Reduction Letter
(2)
1
6 - F — Site Maps (USGS Topo Map, Aerial Map)
(2)
1
7 - J — Operational Agreement
(2)
1
8 - Utility and Plan & Profile Plans
(1)
ACTION RE 'D:
(1) Review and approve
Please do not hesitate to contact us should you have any questions or comments regarding the
contents.
Regards,
zb-�dq
Allison AvereTe
C3 Design & Engineering, PLLC
[e-mail]
J.\cabbott\DD-PROJECTS\2018118-070\CIVIL-18-070\Submittais12020-xx-xx DWR - Fast Track Sewer Extension\Doc\2020-09-22
Transmittai.docx