WQ0042290_Application (FTSE)_20210305

State of North Carolina
DWk
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Watcr Resources FTA 0.3-16 S SUPPORTING DOCUMENTATION
Application Number: _ ZZ ._ (to be completed b) MR)
All items must be completed or the application will be returned
I. APPLICANT INFORIIATIO,N:
1. Applicant's name: Cite ol'Sanii)rd (compan%, municipalit}, I IOA, utiiit,,, etc.)
2. Applicant t%pe: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privatcly-Ottned Public Utility
❑ Federal ❑ State/Count% ® Municipal ❑ Other
3. Signatureaulhority*s name: Paul Weeks Jr. per ISA ti'_CnC' 021' .0106(h)
Title: Cit% Engineer
4. Applicant's mailing address: 225 F. Wcatherspong Street
Cit}: Sanfiord State: NC Zip: 27330-
5. Applicant's contact information:
Phone number: (919) 777-1 122 1=mail Address: paukyeeks cr saniordne.net
II. PROJECT INFORMATION:
I. Project name: Blue I louse Apartments
2. Application Project status: ® Proposed (Ne%% Permit) ❑ Lxisting Permit/Project
If modification, pro%ide the existing permit number: 11'Q00 and issued date: ---
I f new construction but part of a master plan. provide the existing, permit number: WQOO
3. County «'Isere project is located: Lee
4. Approximate Coordinates (Decimal Degrees)_ Latitude: 35.457836 Longitude-79.147688'
S. Parcel ID (if applicable): 9652-61-0830-00
(or Parcel ID toeIosest downstream sewer)
III. CONSULTANT INFORMATION:
I. Professional Engineer: Jared Nlatthens License Number: 048494
Firm: The Cum Engineering Group. PLI,C
Mailing address: 205 S. I-uquaN A%c.
City: ruquav-Farina State: NC Zip: 27526-2212
Phone number: (919) 52-0849 Email Address: fared cr_t urrvenc.com
IV. WASTEWATER TREATMENT FACILITY (W%VTF) INFORMATION:
1. Facility Name: Bit' Ruffaio WW rP Permit Number_ NCO024147
Owner Name: Cit\ of San lord
V. RECEIVING DOWNSTREAM SEWER INFORtMATION (if different than NNA%:TF):
1. Permit Number(s): WQ Downstream (Receiving) Scwer Size: 8 inch
Scstem 11'ide_Collection SNstem Permit \umher(s)(il'annlic, ): WQCS00047
Owner Name(s): Cith of Sanlbrd
rORNI: I -TA 04-16 Pace I of5

V1. GENERAL REQUIREMENTS
I. Ifthc Applicant is a Privatch-Owned Public Utility, has a Certiiicatc ofi'ublic Comenienec and Necessity been attached'?
❑ Ycs [:)No ZMA
2. If the Applicant is a Developer of lots to be sold. has a Developer's Operational Agreement FORNL DI`A' been attached?
❑ Yes ❑No ®N.-'A
3. Ifthe Applicant is a I IomcrPro verty Qxlners' ASSUCiati0n. has an O perational Agreem4ix I-ORNI: 110A been attached'?
❑ Yes [—]No ®N.-A
4. Origin of wastewater: (check all that apply):
❑ Residential Owned ❑ Retail (stores, centers, malls) ❑ Car %Vash
® Residential Leased ❑ Retail with trod preparalion'sm ice ❑ I lotel and/or Motels
❑ School / preschool / day care ❑ Medical / dental / vetcrinar� facilities ❑ Swimmine. Pool /Clubhouse
❑ food and drink facilities ❑ Church ❑ S%%imming Pool/Filter Backwash
❑ Businesses / offices / factories ❑ Nursing home ❑ Other (Explain in Attachment)
5. Nature of wastewater. 100 Residential % Domestic/Commercial Pa Commercial
% Industrial (See 15A NCAC 02 T_0103120))
I- Is there a Pretreatment Program in of feet? ❑ Yes ❑ No
6. Has a flow reduction been approved under 15A NCAC 02T .n 114 f)? ❑ Yes ❑ No
If ves. twoviden co v of flow reduction approval letter
7. Summarize wastewater generated by projlect:
Establishment Type (see 02TA1141f)}
Daily Design Flow " b
No. of Units
Flow
Multi-Fandly Residential
240 gaVunit
204
54.360 GPD
Amenity Site
10 gallperson
40
400 GPD
gall
GPD
gull
GPD
eaV
GPD
gal;
GPD
Tnlul
54.760 GPD
a See I5A NCAC 021_.01 141h). (dt,_(elf 11 and feff2l for ca%cats to wastewater design flow rates (i.e.. minimum flow per
dwelling: proposed unknown non-residential dc%elopment 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. 42.A-4).
b Per 15A NCAC 02T .0114(c). design flow rates I'or establishments not identified [in table 15A NCAC 021'.01141 shall
be determined using, a%ailable Ilow data. water using fixtures, occupant% or operation patterns, and other measured data.
8. Wastewater generated by project: 54.760 GPD (per 15A N('AC 02'I .M 14)
i Do not include future floes or pre%ioush permitted allocations
li'permitted flow is zero, indicate whv:
❑ Pump Station or Gravity Sewer where tlow will be permitted in subsequent permits that connect to this line
❑ Ho" has already been allocated in Permit Number:
❑ Rehabilitation or replacement of existing sewer witli no nett Ilo%% expected
❑ Other(Explain):
I:ORNI: FTA 04-16 Page 2 of

VI1. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 021' .0305 & -N1DC Gravity Se►rers :
1. Summarize gra► ity sewer to be permitted;
Size (incites) Length (feet) Material
8 1008 Dill
8 1597 PVC (C900)
Section II & M of the MDC for Permitting ol-Gra%it} Sewers contains information related to design criteria
Section III contains information related to minimum slopes fir era► it% sewer(s)
Oversizing lines to meet minimum slope requirement is not allowed and a violation of the NI DC
Vill. PUMP STATION DESIGN CRITERIA (if Applicable) —02T.030-5&NI DC (PyinStations.-Force Mains:
COMPLETE FOR EACII PUMP STATION INCLUDED IV THIS PROJECT
I. Pump station number or name:
2. Approximate Coordinates (Decimal Decrees); Latitude: T° Longitude: -
3. Design flow of the pump station: millions gallons per day (firm capacit% )
4. Operational point(s) ofthe pump(s): gallons per minute at _ _. reef total d) namic head JD[ I)
5. Summarize the force main to be permitted ( for this Pump Station):
Size (inches) Length {feet) Material
6. Power rcliab4t) in accordance with I SA NCAC' 02T .0 305(h)(1 !:
❑ Slandb) power source or pump with automatic activation and telcmetn - I5A NCAC 02T .0305(h)(I)(I3)_
Required fbr all pump stations with an ateruec daih flow greater than or equal to 15.000 gallons per day
:- Must be permanent to facility
Or if the pump station has an average Bail) flo►► less than 15.000 gallons per da);
❑ Portable power source with manual acth ation. quick -connection receptacle and telemetry - 15A NCAC 02'1'
.0305(h)(1)(C)
or
❑ Portable puntpinc unit witli plugged emergency pump eonncction and telemetry - 15A NCAC 02T .0305(lt)(1)(C):
It shall be demonstrated to the Division that the portable source is o►►ned or contracted b) the applicant (draft agreement)
and is compatible with the station.
[('the portable power sourer or pump is dedicated to multiple pump stations. an e►aluation of all the pump stations'
storage capacities and the rotation schedule of the portable power source or pump. including Iravel timeframes. shall be
provided in the case of a multiple station power outage.
FORM: F-1"A 04-16 Page 3 of 5

1\. SETBACKS & SEPARATIONS—(02B.0200 & 1>A NCACO2T.0305(i)):
1. Does the project compl) %%ith all separations tound in 15_A.NCAC' 0?�f .0,0103(1) & ILI ® Yes ❑ No
I5A NCAC 02T.0305M contains minimum scriarations that shall he nrm ided for sever ,%,tame•
Setback Parameter*
5c aration R, uired
Storm se%%crs. and other utilities not listed helms (%crtical)
24 inches
Water mains (vertical -water over sewer including in benched trenches)
18 inches
Water mains Ihorizontal)
10 lect
Reclaimed %%atcr lines f%ertical - reclaimed over se%%cr)
18 inches
Reclaimed N%ater lines (horizontal - reclaimed over sewer)
2 feet
**Any private or public water suppl% source, including any %%ells, WS-I a aters of Class I or
Class 11 impounded reservoirs used as a source ofdrinkin� «ater
100 feet
**Waters classified WS (except WS-I or WS-V). B. SA. ORW. I IQ\V. or SB from normal
high water (or tide elevation) and wetlands (sec item IX.2)
50 feet
**Any other stream, lake, impoundment, or ground %%-atcr lowering and surface drainage
ditches
10 feet
Any building foundation
5 feet
Anv basement
10 feet
Top slope of embankment or cuts of 2 feet or more %ertical height
10 feet
Drainage s� stems and interceptor drains
5 feet
Any s%Nirnming pools
10 lect
Final earth �radc (vertical)
36 inch,,
15A NC'AC 0'_ 1'.0305(,1 contains alternatives where separations in 021".03051 f) cannot be achic%ed.
> **Stream classifications can be identified using the Division's NC Surtace \eater Classifications- %%chnaLe
> If noncompliance with 021.0305(f) or (�� sec Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 tect ofseparation) ❑ Yes ❑ No ® N'A
See the Division's draft separation requirements liar situations %%here separation cannot be meet
Y No variance is required itthe alternative design criteria specified is utilized in design and construction
i As built documents should rclercncc the location of areas effected
3. Does the project comply with setbacks found in the river basin rules per 15A NCAC' (1213 *NXI,° ❑ Yes ❑ No ® N A
This would include -Trout Buffered Streams per 15A N- A(7 2R.It?02
4. Does the project require coverage/authorization under a 404 Natiom%ide or ®1"es ❑ No
individual permits or401 Water Quality Certifications?
Inlbrmation can be obtained from the 401 & Buf'fer Permitting Branch
5. Dues project comply with 15A NCAC 02T.0105c (6) (additional perm its'ccrtiIications);" ® 1'cs ❑ No
Per 15A NCAC' 02.1'.0105(c)(6), directly related environmental permits or certification applications are being prepared. have
been applied tor, 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 %katers, siphon. or sewer
positioned parallel to streambanks that is subject to erosion that undermines or deteriorates the sc►ver.
❑ Yes ® No ❑ NIA
Ifycs. 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 file permitee's indisidunl System -Wide Collection permit.
FORM: FTA 04-16 Page 4 ol'5

UUtAt'alvil 61l vwl-C IV. JJJ/1UL4 V-p �Yf"Ml4M-Q(�{�L-�lyyJJ��"IJQCOy
X. CERTIFICATIONS:
Does the submitted system comply with 15.1 ti( 1( oll, the t`Iminiiun he,iLli t'nt.ri.t for the 11cnngttng if rump Staunn;
aii,l l"„rce \ Lt t . I l.,tc;t %vt a m. and the [,ray rt, Setti L:rMinim un [ irsi,n t l iteri.t i lait:tit � er.ion l as applicable? -
® Yes ❑ No
If No, complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents
for review. .1 irusal ul' the rer nest is r•ec aired print, ru sobrnittal of the fast 11-36 A r rlicaliou and su r wrtin{*
documents.
2. Professional Engineer's Certification:
/111f7-f�'Gt1 _ _ ,itt:,i that this application for
(Professional Engineer's name from Application Item II1.1.)
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. l 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 525,000 per violation.
North Carolina Professional Engineer's seal, signature, and dale: �s%� 1I'' 111f
ESSIp <�� �
Q.. O -�, T
.�. AL
• Q SE� fn
3. Applicant's Certification per 15A NCAC 02T .0106(b):
I Paul M. weeks Jr. P.E. City Engineer
nature Authority's attest that this application for
(Signature ty's name & title from Application Itcm 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 ld 3_,1 5_4,13, 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 525,000 per violation.
oaaastgned by -
Signature: Signature: �S `�' P' 3/4/2021
Date
FORM: FTA 04-16 Page 5 of

00cuSign Envelope 10: E8243FSO•F788.41C4-6FAB-7CIAF3AO6E75
State of North Carolina
Department of Environmental Quality
Division of Water Resources
)glow Tracking for Sewer Extension Applications
(FTSE 10-18)
Application Number: I FT-318
Entity Requesting Allocation: Cityol*Sanlbrd
Project Name for which flow is being requested: Southeastern Development (Blue House Apts.)
More Ihiut one FTSE nurj' be required for a single project if the owner of the II'IVTP is not responsible jar rill puntp
stations along the route of the proposed wastewater flaw.
Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility name: Big Buffalo Wastewater Treatment Plant
b WWTP Facility Permit #: N00024147
Ali flows are in MGD
c.
WWTP facility permitted flow:
12.0000
d.
Estimated obligated flow not yet tributary to the WWTP:
1.0350
e.
WWTP facility's actual average now:
5,7330
f.
Total flow for this specific request:
0.0548
g.
Total actual and obligated flows to the facility:
6.8228
h.
Percent of permitted flow used:
57%
Complete this section for each pump station you are responsible for along the route of this proposed
List pump stations located between the project connection point and the WWTP.
(A) (11) (C) (D)=(b+C)
(E)=(A-D)
Pump
Pump Firm Design Appros Obligated. Total Current
A%atlable
Station
Station Capacity, A%crage Current Not Vet Flax Plus
Capacih''
(Nameor
Permit Dads Flog" Mg. Dad% Tributan Obligated
Number)
Number iF,rm'nll Flo", Daih I'lou. Flo«
\ICI) \IG!) MG0 NIGD MGD
INIGO
Ga ster Creek
4002 40291 1 6114 1 0195 02197 1.2392
03722
zbag buffalo
NN A AN A "N A -:N A ON -A
NN A
X
AN -A uN A iiN A IN A NNA
XN A
ti
NN A =N A NN A uN A #N-A
NN A
s
NNA #NA NNA xNA #NA
GNA
X
ON A NN A #N A pN-A NN'A
-N-A
t.'1'hc Firm Capacity (design now) or tiny pump station is derined as the ntaximnin pumped flmti Ihnt
can be achieved with the largest pump laken out or -service.
2. Design Average Plow is the arm capacity or the pump station divided by the peaking factor (pf) not
less than 2.5, per Scetion 2.02(A)(4)(c) of the.NIinimnm I)csign Criteria.
3. A Planning Assessment Addendum shall he attached for each pump station located beween the
project connection point and the NIA I't' %%here the Available Capacity is 511.
Downstream Facility Name (Sewer): City of Sanford Collection System
Downstream Permit Number: WQCS00047
Page 1 of 6 FTSE 10-10

DocuSign Envelope ID. E8243F60-F7B8-41C4-BFAB-7C1AF3A86E75
I11. Certification Statement
I, Paul Weeks, Jr. PE, certify to the best ofmy 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 I and 11 plus all attached planning
assessment addendums for which I am 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.
�DocuSigned by:
LPaa h. i>ut,tks ,tfV'. P.f,
BBC39EM 6--B9
�tiigrri!tg Official Signature
City Engineer
Title gf fining Official
0103M
Dare
Page 2 of 6 FTSE 10-18

State of North Carolina
rywk Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
liiOO= of Wafer Resources INSTRUCTIONS FOR FORM: FTA 04-I6 S SUPPORTING DOCUMENTATION
'['his application is for sewer extensions involving graN ity sewers. pump stations and force mains, or any combination that has been
certified by a professional engineer and the applicant that the project nicets the requirements of 15A NCAC 021 and the Division's
Minimum Design Criteria and that plans, specifications and supporting documents have been prepared in accordance with, 15A
NCAC 02T, 15A NCAC 02T .03001 Division policies and aoo_d cnginecring uractices.
While no upfront engineering design documents are required for submittal, in accordance with 15A NCAC 02'r .0305(b), design
documents must be prepared prior to submittal of a fast track permit application to the Division. This would include plans. design
calculations, and project specifications referenced in 15.A NCAC 021 ,0+a!i and the applicable minimum design criteria. These
documents shall he available upon request by the Division.
Projects that are deemed permitted (do not require a permit from the Dk ision) are explained in 15A NCAC 021.0303
Projects not eligible for review via the fast track process (must be submitted for full technical review):
Projects that require an environmental assessment in accordance %% th I5A NCAC IC .0100:
Projects that do not meet any part ot'the minimum design criteria (NIDC) document;
Projects that invoke a variance from the requirements of 15A NCAC 2T:
Pressure sever sy stems utilizing septic tank -effluent pumps JSJ'17l's) or simplex grinder pumps;
S I'EP or simplex grinder pumps connecting to pressurized s%stems (c.g, force mains):
Vacuum sewer s%stems.
General — When submitting, an application, please use the following instructions as a checklist in order to ensure all required
items are submitted. Adherence to these instructions and checking the provided boxes will help produce a quicker review time
and reduce the amount of requested additional information. Failure to submit all required items will necessitate additional
processing and review time, and may result in return of the application. Unless otherwise noted, the Applicant shall submit
one ori-inal and one copy of the application and supporting documentation.
A. One Original and One Copy of Application and Supporting Documents
® Required unless otherwise noted
B. Cover Leiter (Required for All Application Packages):
0 List all items included in the application package, as well as a brief description of the requested permitting action.
Be specific as to the system type, number of homes served, flow allocation required, etc.
If necessary for clarity, include attachments to the application forni.
C. Application Fee (All New and Major Modification Application Packages):
® Submit a check or money order in due amount of $480.00 dated within 90 days of application submittal.
Payable to North Carolina Department of En%iron mentaI Quality (NC DEQ)
D. Fast Track (Form: FTA 04-16) Application (Required for All Application Packages):
® Submit the completed and appropriately executed application.
If necessary for clarity or due to space restrictions, attachments to the application may be made,
❑ If the Applicant Type in Item 1.2 is a corporation or company, provide documentation it is registered for business %ti ith
the North Carolina Secretary of State.
❑ If the Applicant Type in Item 1.2 is a partnership or dfb;'a, enclose a copy of the certificate filed with the Register of
Deeds in the county of business.
® The Project Name in Item I1.1 shall be consistent with the project name on the flow acceptance letters, a�treements, etc.
® The Professional Engineer's Certification on Page 5 of the application shall be signed, sealed and dated by a North
Carolina licensed Professional Engineer.
ED The Applicant's Certification on Page 5 of the application shall be signed in accordance with 15A NCAC 02T .0106(b).
Per 15A NCAC 02T .0106(c), an alternate person may be designated as the signing official if a delegation letter is
provided from a person who meets the criteria in 15A NCAC 02T .0106(b).
INSTRUCTIONS I- OR FORM: IJA 04-16 & SUPPORTING DOCUNIENTA"I ION Page I of 3

E. Flow Tracking/Acceptance Form (Form: F'fSE 04-16) (If Applicable):
® Submit the completed and executed FTSE form from the owners of the downstream sewers and treatment facility.
Multiple forms maybe required where the downstream sewer owner and wastewater treatment facility are different.
The flow acceptance indicated in forni FTSE must not expire prior to permit issuance and must be dated less than one
year prior to the application date.
.- Submittal of this application and form FTSE indicates that owner has adequate capacity- and will not violate G.S,_143,
21567a.
Intergovernmental agreements or other contracts i%ill not be accepted in lieu of a project -specific FTSE.
F. Site Maps (All Application Packages):
® Submit an 8.5-inch x I I -inch color copy of a USGS Topographic Map of sufficient scale to identify the entire project
area and closest surface waters.
Location of the project (gravity sewer, pump stations R force main)
Downstream connection points and permit number (if known) for the receiving sewer
® Include a street level map (aerial) showing general project area so that Division staff can easily locate it in the field.
C. Existing Permit (All Modification Packages):
❑ Submit the most recently issued existing pennit.
❑ Provide a list of any items within the permit the Applicant would like the Division to address during the permit
modification (i.e., permit description, flaw allocation, treatment facility, etc.).
Fi. Power Reliability Plan (Required if portable reliability option utilized for Pump Station):
❑ Per 15A NCAC 02T .0305(Ii)( 1), submit documentation of power reliability for pumping stations.
This alternative is only available for average daily flows less than 15,000 gallons per da)
It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant and is
compatible with the station. The Division will accept a letter signed by the applicant (see 15A NCAC 02T .0106(b)) or
proposed contractor, stating that "the portable power generation unit or portable, independently -powered pumping
units, associated appurtenances and personnel are available for distribution and operation of this pump 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 he provided in the case of a multiple station power outage. (Required at time of certification)
1. Certificate of Public Convenience and Necessity (All Application Packages for Privately -Owned Public Utilities):
❑ Per 15A NCAC 02'r .0i 15 a I provide the Certificate of Public Convenience and Necessity from the North Carolina
Utilities Commission demonstrating the Applicant is authorized to hold the utility franchise for the area to be served by
the sewer extension, or
❑ Provide a letter from the North Carolina Ltilities ('0511rn!'Sion's Water and Seer Division Public Staff stating an
application for a franchise has been received and that the service area is contiguous to an existing franchised area or
that franchise approval is expected.
J. Operational Agreements (Applications from HOA/POA and Developers for lots to be sold):
❑ HomeMropertv Owners' Associations
Cl Per 15A NCAC02T .0115(c), submit the properly executed Operational Aureement (FORM: FIOA).
❑ Per 15A NCAC 02T Al 15(c), submit a copy of the Articles of Incorporation, Declarations and By-laws.
❑ Developers of lots to be sold
❑ Per 15A NCAC 02T .01 15(b), submit the properly executed Operational Agreement (FORM: DEV).
Foi• mote Mfornratiat, visit the Division .v coll c oti sy.4 emT trebvile
INSTRUC"LIONS FOR I'ORM: F'I'A 04-16 K SUPPORTING DOCUNIE:N'I'A3ION Page 2 of3

THE COMPLETED APPLICATION PACKAGE INCLDING ALL SUPPORTING INFORMATION AND
MATERIALS, SHOULD BE SENT TO THE APPROPRIATE REGIONAL OFFICE:
REGIONAL OFFICE
ADDRESS
COUNTIES SERVED
Asheville_Regional Office
2090 US Highway 70
Avery, Buncombe, Burke, Caldwell, Cherokee,
Water Quality Section
Swannanoa, North Carolina 28778
Clay, Graham, Haywood, Henderson, Jackson,
(828) 2964500
Macon, Madison, McDowell, Mitchell, Polk,
[phone] Fax
Rutherford, Swain, Transylvania, Yancey
Fayetteville Regional Office
225 Green Street Suite 714
Anson, Bladen, Cumberland, Harnett, Hoke,
Water Quality Section
Fayetteville, North Carolina 28301-5094
Montgomery. Moore, Robeson, Richmond,
[phone]
Sampson, Scotland
[phone] Fax
Mooresville Regional Office
610 E. Center Avenue
Alexander, Cabarrus, Catawba, Cleveland,
Water Quality Section
Mooresville, North Carolina 28115
Gaston, Iredell, Lincoln, Mecklenburg, Rowan,
[phone]
Stanly, Union
[phone] Fax
_Raleigh Regional Office
1628 Mail Service Center
Chatham, Durham, Edgecombe, Franklin,
Water Quality Section
Raleigh, North Carolina 27699-1628
Granville, Halifax, Johnston, Lee, Nash,
[phone]
Northampton, Orange, Person, Vance, Wake,
[phone] Fax
Warren, Wilson
Washington Regional Office
943 Washington Square Mall
Beaufort, Bertie, Camden, Chowan, Craven,
Water Quality Section
Washington, North Carolina 27889
Currituck, Dare, Gates, Greene, Hertford, Hyde,
[phone]
Jones, Lenoir, Martin, Pamlico, Pasquotank,
[phone] Fax
Perquimans, Pitt, Tyrrell, Washington, Wayne
_Wilmington Regional Office
127 Cardinal Drive Extension
Brunswick, Carteret, Columbus, Duplin, New
Water Quality Section
Wilmington, North Carolina 28405
Hanover, Onslow, Pander
[phone]
[phone] Fax
Winston-Salem Regional Office
450 W. Hanes Mi.I Road
Alamance, Alleghany, Ashe, Caswell, Davidson,
Water Quality Section
Suite 300
Davie, Forsyth, Guilford, Rockingham, Randolph,
Winston-Salem North Carolina 27105
Stokes, Surry, Watauga, Wilkes, Yadkin
[phone]
INSTRUCTIONS FOR I'OR�\1: F'I'A 04-16 & SUPPORTING DOCUNIL-NTATION 1'age3 nf3

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ENGINEERINGL
January 25, 2021
Jason Robinson, PE
NC Department of Environment Quality
Division of Water Resources
Raleigh Regional Office
Water Quality Section
1628 Mail Service Center
Raleigh, NC 27699-1628
I9191791-4200
RE: Blue House Apartments, Sanford
Sewer Fast Track Sanitary Sewer Application Cover Letter
Jason,
Enclosed please find documentation, design data, application fee and other resources necessary to
review the Fast Track Application for the public sanitary sewer system of Blue House Apartments in
Sanford, NC. This application is for the 13 apartment buildings plus the amen ty center for which
Sanford have approved the water allocation. The wastewater generated by the development lota,s
49,360 GPD. Construction of the sanitary sewer lines wilt connect to two existing pubic sewer lines at
the east and west side of the property, which feed to the Big Buffalo Waste Water Treatment Pant
The Crossings development is located at 2505 Dalrymple Street in Sanford. The property involved is
located within the City of Sanford, NC planning jurisdiction.
The sanitary sewer system consists of 1008 feet of 8' DIP and 1597 of 8" PVC grav ty service
connecting to existing public gravity main lines. There are 10 new manholes to be installed in the
development.
At the completion of construction. the system will be certified by a Licensed professional eng-neer in
accordance with NCDEQ and State and local regulations.
Sincerely,
Jared Matthews, PE
Project Engineer II
T 19191552-0849 205 5.FuquayAvenue
F 19191 552-2043 Fuquay-Varina, NC 27526
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Blue House Apartments Street Maps (Supplemental)
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