WQ0039078_Regional Office Historical File Pre 2018

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ti FR 0 tOu AJY
March 8, 2017
Michael Wagner, Manager
Wagner Property Group, LLC
2502 North Rocky Point Drive, Suite 865
Tampa, FL 33607
ROY COOPER
Governor
MICHAEL S. RRGAN
Secretary
S. JAY ZIMMERMAN
Thrector
Subject: Permit No. WQ0039078
Wagner Property Group, LLC
The Village Shoppes
Wastewater Collection System Extension Perrin it
Catawba County
Dear Mr. Wagner:
In accordance with your application received March 8, 2017,.we are forwarding herewith Permit No.
WQ0039078 dated March 8,, 2017 to the Wagner Property Group, LLC (Permit -tee) forthe construction and.
operation upon certification ofthe subject wastewater collection system extension. This permit shall be
effective from the date of issuance until rescinded and shall he subject to the conditions and limitations as
specified therein. This cover letter shall be considered a part of this permit and is therefore incorporated
therein by reference.
Please pay particular attention to the following conditions contained within this permit:
Condition It I: This permit shall not be automatic -ally transferable; a request must be made and approved.
Condition 11.4: Requires that the wastewater collection facilities be properly operated and maintained in
accordance with I5.A NCAC 2T .0403 or any individual system -wide collection system
permit issued to the Permittee.
It shall be the responsibility of the Permittee to ensure that the as -constructed project meets the appropriate
design criteria and rules. Failure to comply may result in penalties in accordance with North Carolina
General Statute §143-215.6A through §I43-215.6C, construction of additional or replacement wastewater
collection facilities, and/or referral of the North Carolina -licensed Professional Engineer to the licensing
board.
State or North CarolinaEnvironmental Quality! Water Resources I Water Quality Regional Operations
Mooresville Regional Office 610 East Center Avenue, Suite 301 Mooresville, North Camlin.a 2'81i 5
704 663 1699

If any parts, requirements, or limitations contained in this permit are unacceptable, you have the tight t
request an adjudicatory hearing upon written request within 30 days following receipt of this permit. This
request must be in the form of a written petition, conforming to Chapter 150B of North Carolina General
Statutes, and filed with the Office of Administrative Hearings, 6714 Mail Service Center, Raleigh, NC
27699-6714. Unless such demands are made, this permit shall be final and binding.
If you need additional information concerning this matter, please contact Ori Tutia at [phone] or
via e-mail at ori.tuviagricdem.gov.
Sincerely,
by W. Corey Basinger, Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources, NCDEQ
cc: Eric Hampton (P.E.) (E-copy)
Mooresville Regional Office Files
Water Resources Central Files
PERES (E-copy)
Page 2 of 8

Environmental
Quality
STATE OF NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENTAL QUALITY
WASTEWATER COLLECTION SYSTEM EXTENSION PERMIT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North
Carolina as amended, and other applicable Laws, Rules, and Regulations, permission is hereby
granted to the
Wagner Property Group, LLC
Catawba County
for the construction and operation of approximately 732 linear feet of 8-inch private gravity
sewer, to serve The Village Shoppes, and the discharge of 0 additional gallons per day of
collected wastewater into the Wagner Property Group, LLC existing sewerage system, pursuant
to the application received March 8, 2017, and in conformity with I 5A NCAC 2T; the Division's
Gravity Sewer Minimum Design Criteria adopted February 12, 1996, as applicable; the
Division's Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force
Mains adopted June 1, 2000, as applicable; and other supporting data subsequently filed and
approved by the Department of Environment and Natural Resources and considered a part of this
permit.
7,500 GPD generated by this project have been previously allocated under permit WQ0037628.
This permit shall be effective from the date of issuance until rescinded and shall be subject to
the specified conditions and limitations contained therein.
by W. Corey Basinger, Regional Supervisor
Water Quality Regional Operations Section
Division of Water Resources, NCDEQ
By authority of the Environmental Management Commission
Permit Number: WQ0039078
Permit Issued: March 8, 2017
Page 3 of 8

SUPPLEMENT TO PERMIT COVER SHEET
Wagner Property Group, LI,C is hereby authorized to:
Construct, and then operate upon certification the aforementioned wastewater collection extension, The
sewage and wastewater collected by this system shall be treated in the City of Hickory -Catawba Plant
Wastewater Treatment Facility in accordance with Permit Number NC0025542.
Permitting of this project does not constitute an acceptance of any part of the project that does not meet
15A NCAC 2T; the Division's Gravity Sewer Minimum Design Criteria adopted February 12, 1996, as
applicable; and the Division's Minimum Design Criteria for the Fast -Track Permitting of Pump Stations
and Force Mains adopted June 1, 2000, as applicable, unless specifically mentioned herein. Division
approval is based on acceptance of the certification provided by a North Carolina -licensed Professional
Engineer in the application. It shall be the Permittee's responsibility to ensure that the as -constructed
project meets the appropriate design criteria and rules.
Construction and operation is contingent upon compliance with the Standard Conditions and any Special.
Conditions identified below.
. SPECIAL CONDITIONS
1) No flow in excess of the quantity permitted herein, 0 additional GPD, shall be made tributary to
the subject sewer system until an application for permit modification for an increase in flow has
been submitted to and approved by the Division. [15A NCAC 02T.0304 (b)].
II. STANDARD CONDITIONS
This permit is not transferable. In the event there is a desire for the wastewater collection facilities
to change ownership, or there is a name change of the Permittee, a formal permit request shall be
submitted to the Division accompanied by documentation from the parties involved, and other
supporting materials as may be appropriate. The approval of this request shall be considered on its
merits and may or may not be approved. [15A NCAC 02T.0104; G.S 143-215.1(0)]
2. This permit shall become voidable unless the wastewater collection facilities are constructed in
accordance with the conditions of this permit; 15A NCAC 2T; the Division's Gravity Sewer
Minimum Design Criteria adopted February 12, 1996, as applicable; the Division's Minimum Design
Criteria for the Fast -Track Permitting of Pump Stations and Force Mains adopted June 1, 2000, as
applicable; and other supporting materials unless specifically mentioned herein. [15A NCAC
02T.0110]
This permit shall be effective only with respect to the nature and volume of wastes described in the
application and other supporting data. [15A NCAC 02T .0110]
4. The wastewater collection facilities shall be properly maintained and operated at all times. The
Pennittee shall maintain compliance with an individual systemwide collection system permit for the
operation and maintenance of these facilities as required by 15A NCAC 2T .0403. If an individual
permit is not required, the following performance criteria shall be met: [15A NCAC 02T .0108(b)]:
Page 4 of 8

a. The sewer system shall be effectively maintained and operated at all times to prevent discharge
to land or surface waters, and to prevent any contravention of groundwater standards or surface
water standards.
b. A map of the sewer system shall be developed and shall be acti
aintained,
c. An operation and maintenance plan including pump station inspection 'frequency,preventative
maintenance schedule, spare parts inventory and overflow response has been developed and
implemented.
d. Pump stations that are not connectedto a telemetry system shall he inspected every day .e. 365
days per year). Pump stations that are connected to a telemetry system shall be inspected at least
once per week.
e. High -priority sewer lines shall. be inspected at least once per every six months and inspections
documented.
g.
A general observation of the entire seer system shall be conducted at least once per year.
Overflows and bypasses shall be reported to the appropriate Division regional office in
accordance with 1,5A NCAC 2B .0506(a), and public notice shall be provided as required by
North Carolina General Statute §143 -215.1C.
h. A Grease Control Program is in place as follows:
1. For public owned collection systems, the Grease Control Program shall include at least
biannual distribution of educational materials for both commercial and residential users and
the legal means to require grease interceptors at existing establishments. The plan shall also
include legal means for inspections of the grease interceptors, enforcement for violators and
the legal means to control grease entering the system from other public and private satellite
sewer systems.
2. For privately owned collection systems, the Grease Control Program shall include at least bi-
annual distribution of grease education materials to users of the collection system by the
permittee or its representative.
3 Grease education materials shall be distributed more often than required in Parts (1) and (2)
of this Subparagraph if necessary to prevent grease -related sanitary sewer overflow.s.
i. Right-of-ways and easements shall be maintained in the full easement width for personnel and
equipment accessibility.
j. .Documentation shall be kept for Subparagraphs (a) through (i) of this Rule for a minimum of
three years with exception of the map, which shall be maintained for the life of the system.
5. 'fhe Permittee shall report by telephone to a water resources staff -member at the Mooresville Regional
Office, telephone number [phone], as soon as possible, but in no case more than 24 hours
-following the occurrence or first knowledge of the occurrence of either of the following
. a. Any process unit failure, due to known or unknown reasons, that renders the facility
incapable of adequate wastewater transport, such as mechanical or electrical failures of
pumps, line blockage or breakage, etc.; or
b. Any SSO and/or spill over 1,000 gal.lons, or
c. Any SSO and/or spill, regardless of volume, that reaches surface water
Page 5 of 8

Voice mail messages or faxed information is permissible, but this shall not be considered as the initial
verbal report. Overflows and spills occurring outside normal business hours may also be reported to
the Division of Emergency Management at telephone number [phone], or [phone].
Persons reporting any of the above occurrences shall file a spill report by completing and submitting
Part I. of Form CS-SSO (or the most current Division approved form) within five days following first
knowledge of the occurrence. This report must outline the actions taken or proposed to be taken to
ensure that the problem does not recur, Part 11 of Form CS-SSO (or the most current Division
approved form) can also be completed to show that the SSO Was beyond control. [G.S. 143-
215.1.C(a1)]
6. Construction of the gravity sewers, pump stations, and force mains shall be scheduled so as not to
interrupt service by the existing utilities nor result in an overflow or bypass. discharge of wastewater
to the surface waters ofthe State. [15,A NC.AC 021.01.08(b)]
7. Upon completion of construction and prior to operation of these permitted facilities, the completed
Engineering Certification form attached to this permit shall be submitted with the required supporting
documents to the address provided on the form, A complete certification is one where the form is
.fully executed and the supporting documents are provided as applicable. Any wastewater flow made
tributary. to the wastewater collection system extension prior to completion of this Engineer's
Certification shall be considered a violation of the permit. and shall subject the Permittee to
appropriate enforcement actions.
If the permit is issued to a private entity with an Operational Agreement, then a copy of the
Articles of Incorporation, Declarations/Covenants/Restrictions, and Bylaws that have been
appropriately filed with the applicable County's Register of Deeds office shall be submitted
with the certification.
A complete certification is one where the form is fully executed and the supporting documents are
provided as applicable. Supporting documentation shall include the following:
a. One copy of the project construction record drawings (plan & profile views of sewer lines &
force mains) of the wastewater collection system extension. Final record drawings should he
clear on the plans or on digital media (CD or MID disk) and are defined as the design drawings
that are marked up or annotated with after construction information and show required buffers,
separation distances, material changes, etc,
b. One copy of the supporting applicable design calculations including pipe and pump sizing„
velocity, pump cycle times, and level control settings, .pump station buoyancy, wet well storage,
surge protection, detention time in the wet well, and force ma.in, ability to flush low points in
force mains with a pump cycle, and downstream sewer capacity analysis. If a portable power
source or pump is dedicated to multiple stations, an evaluation of all the pump stations' storage
capacities and the rotation schedule of the portable power source or pump, include travel
timefrarnes, shall be provided.
c. Changes to the project that do not result in non-compliance with this permit, regulations, or the
:Minimum Design Criteria should be clearly identified on the record drawings, on the certification
in the space provided, or in written summary form.
Prior to Certification (Final or Partial): Permit modifications are required for any changes resulting
in non-compliance with this permit (including pipe length increases of 10% or greater, increased
flow, pump station design capacity design increases. of 5(.1/0 or greater, and increases in the
number/type of c.onnections), regulations, or the Minimum Design. Criteria. Requested modifications
Page 6 of 8

or variances to the Minimum Design Criteria will be reviewed on a case -by -case basis and each on
its own merit. Please note that variances to the Minimum Design Criteria should be requested and
approved during the permitting process prior to construction, After -construction requests are
discouraged by the Division and may not be approved, thus requiring replacement or repair prior to
certification & activation. [15A NCAC 02T .0116]
Gravity sewers installed greater than ten percent below the minimum required slope per the Division's
Gravity Sewer Minimum Design Criteria shall not be acceptable and shall not be certified until
corrected. If there is an unforeseen obstacle in the field where all viable solutions have been
examined, a slope variance can be requested from the Division with firm supporting documentation.
This shall be done through a permit modification with fee. Such variance requests will be evaluated
on a case -by -case basis. Resolution of such request shall be evident prior to completing and
submitting the construction certification, [ 15A NCAC 02T,0105(n)]
9, A copy of the construction record drawings shall be maintained on file by the Permittee forforthe life
of the wastewater collection facilities, [15A NCAC 02T .0116]
10. Failure to abide by the conditions and limitations contained in this permit; 15A NCAC 2T; the
Division's Gravity Sewer Design Criteria adopted February 12, 1996, as applicable; the Division's
Minimum Design Criteria for the Fast -Track Permitting of Pump Station and Force Mains adopted
June 1, 2000, as applicable; and other supporting materials may subject the Permittee to an
enforcement action by the Division, in accordance with North Carolina General Statutes §143-215.6A
through §143-215.6C, construction of additional or replacement wastewater collection facilities,
and/or referral of the North Carolina -licensed Professional Engineer to the licensing board. [15A
NCAC 02T .0104; 15A NCAC 02T .0108(b-c)]
11. In the event that the wastewater collection facilities fail to perform satisfactorily', including the
creation of nuisance conditions, the Permittee shall take immediate corrective action, including those
as may be required by this Division, such as the construction of additional or replacement facilities.
[15A NCAC 02T .0110; 15A NCAC 02T .0108(b)]
12, The issuance of this permit shall not exempt the Permittee from complying with any and all statutes,
rules, regulations, or ordinances that may be imposed by the Division any other Federal, State, or
Local government agencies which have jurisdiction or obtaining other permits which maybe required
by the Division or any other Federal, State, of Local government agencies. [G.S. 143-215.1(b)]
Page 7 of 8

FAST TRACK SEWER ENGINEERING CERTIFICATION
PERMITTEE: WAGNER PROPERTY GROUP, I.LC
PERMIT #: WQ0039078
PROJECT: THE VILLAGE SHOPPES
ISSUE DATE: MARCH 8, 2017
This project shall not be considered complete nor allowed to operate in accordance with standard
Condition 7 of this permit until the Division has received this Certification and all required supporting
documentation, It should be submitted in a manner that documents the Division's receipt. Send the
required documentation to the Regional Supervisor, Water Quality Regional Operations Section at the
address noted in the page footer,
Any wastewater flow made tributary to the wastewater collection system extension prior to completion
of this Certification shall be considered a violation of the permit and shall subject the Permittee to
appropriate enforcement actions. The Permittee is responsible for tracking all partial certifications up
until a final certification is received by the Division. A Final Certification shall be a complete set of
record drawings and design calculations regardless of whether partials have been submitted.
PERMITTEE'S CERTIFICATION
I, the undersigned agent for the Pennittee, hereby state that this project has been constructed pursuant to
the applicable standards & requirements, the Professional IEngineer below has provided applicable
design/construction information to the Permittee, and the Permittee is prepared to operate & maintain the
wastewater collection- system permitted herein or portions thereof.
Printed Name, Title
Signature Date
ENGINEER'S CERTIFICATION
1, , as a duly registered Professional Eilgineer in the State of North Carolina,
having been authorized to observe (E periodically, Ej weekly, Li j full time) the construction of the
project name and location as referenced above for the above Permittee hereby state that, to the best of my
abilities, due care and diligence was used in the observation of the construction such that the construction
was observed to be built within substantial compliance of this permit; 15A NCAC 02T; the Division of
Water Resources' (Division) Gravity Sewer Minimum Design Criteria adopted February 12, 1996, as
applicable; the Division's Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and
Force Mains adopted June 1, 2000, as applicable; and other supporting materials.
North Carolina Professional Engineer's Seal w/signature & date:
C Final E Partial (include description)
Certification Comments/Qualifiers (attach if necessary):
NC DWR — Water Quality Regional Operations Section 610 East Center Avenue, Suite 301, Mooresville, NC 28115
Mooresville Regional Office Phone: [phone] FAX: [phone]

K' I ey >»
February 13, 2017
0
n
NCDENR - DEQ
Attn: Mr, Corey Basinger
Mooresville Regional Office
610 E. Center Avenue
Mooresville, NC 28115
RE: The Village Shoppes
7883 Village Center North, Sher Ford, NC
On -site Gravity Sewer
FTA 08-13 Narrative
Mr Basinger:
The gravity sewer system being proposed will serve a 49,098 square -foot grocery store a 1,200
square -feet of retail space. The proposed structure will gravity feed via 1F of
8" PVC and six (6) proposed manholes to an existing manhole and 15°' PVC gravity line along the NC
Hwy 1501 right-of-way which terminates at the Hickory Catawba WWTF permit #NC0025542,
• FTA 04-16 — VSF Shoppes
• FTSE 04-16 — VSF Shoppes
• USGS Map including site boundary and sewer alignment
• Street Level Map
• Site Utility Plan
• Sewer Profile
We trust this meets your needs for approval of this project; please feel free to call me at (704) 319-
5686 if you have any questions or concerns. We look forward continuing our relationship on this
project.
Sincerely yours,
KIMLEY-HORN AND ASSOCIATES, INC.
Nathan A. Tidd, PLA
Project Manager
(K:\CHL_PRJ4017328000 - Sherrilis Ford Publix104 - Permits and Approvals\Sewer12O17-0213 - Private SS Permit
Submitta11L2017-0213 NCDENR FTA Cover Letter,docx)

Corporations %ivision
Page 1 of 1
Elaine F. Marsh
Secretary
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View Document Filings File an Annual Report Amend a Previous Annual Report
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Corporate Names
Legal: WPG - Catawba LLC
Limited Liability Company Information
Sosld: 1510781
Status: Current -Active
Annual Report Status: Current
Citizenship: Foreign
Date Formed: 4/14/2016
Fiscal Month:
State of Incorporation: FL
Registered Agent: Capitol Corporate
Corporate Addresses
ee
Inc.
Reg Mailing: 120 Penmarc Drive Suite 118
Raleigh„ NC 27603
Reg Office: 120 Penmarc Drive Suite 118
Raleigh, NC 27603
Mailing: 2502 N Rocky Point Drive Suite 865
Tampa, FL 33607
Principal Office: 2502 N Rocky Point Drive Suite 865
Tampa, FL 33607
Company Officials
Alf LLCs are managed by their managers pursuant to N.C.G.S, 57D-3-20,
North Carolina
DEPARTMENT OF„ THE
SECRETARY OF STATE
PO tax 29622 Raleigh, NC 27026-0622 019j807-2000 Account
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https;/Jwww.sosne.g©v/Searehlprofcorp/12144792 3/7/2017

R
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number:
All Items must be completed or the applicati+an will be return ed
APPLICANT INFORMATION:
1, Applicant's name: Wagner Property. Group, LLC (company, municipality, HOA, utility, etc.)
2, Applicant type: [11 individual © Corporation [] General Partnership (] Privately -Owned Public Utility
© Federal [] State/County ® Municipal Q' Other
3. Signature authority's name: Michael Wagner per 15ANCAC 02I...1..1ta
Title: Manager
4, Applicant's nailing address: 2502 N. Rocky Point Drive, Suite 865
City: Tampa State: FL Zip: 33607-
5. Applicant's contact information:
Phone number: (813).284-7974 Email Address: kgreer(ithickorync,gov
be compl
ed by DWR)
U. PROJECT INFORMATION:
I. Project name: The Village Shoppes
2. Application/Project status: Proposed (New Permit) U Existing Permit/Project
if a modification, provide the existing permit number: WQ00LL and issued date:
If new construction but part of a master plan, provide the existing permit number: WQ00
3. County where project is located: Catawba
4. Approximate Coordinates ('Decimal Degrees): Latitude: 80.989505`' Longitude:-35,58397
5. Parcel ID (ifapplicabie):
(or Parcel ID to closest downstream sewer)
I11. CONSULTANT INFORMATION:
I, Professional Engineer: Eric Hampton License Number: NC034426
Firm: Kimley-Horn and. Associates, Inc.
Mailing address: 200 South Trying Street, Suite 200
City: Charlotte State: NC Zip: 28202-
Phone number: [phone] Email Address: Eric,Hampton@Kitnley-Hornzcoan
1V. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: 'Hickory -Catawba Plant Permit Number: 0025542
Owner Name: City of Hickory
V. RECEIVING DOWNSTREAM. SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ0Q3762S Downstream (Receiving) Sewer Size: 1.5 inch
System Wide Collection System Permit Number(s) (if applicable): WQCS
Owner Name(s):
FORM: FTA 04-16
Page 1 of 5

' VI. GENERAL REQUIREMENTS
1, If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessitybeen attached?
Yes ON° NIA
2. If the Applicant is a Developer oflots to be sold, has a Developer's Operational .Agreernent (FORM; DEY) been attached?
E] Yes ONo N/A
3. If the Applicant is a 11onielPropertv9witers' Association, has an (Verational Agreement (FORM: 110A) been attached?
El Yes ENo N/A
4. Origin of wastewater: (check all that apply):
LI Residential Owned
D Residential Leased
School / preschool / day care
Ej Food and drink facilities
Ili Businesses offices / factories
Retail (stores, centers, malls)
Retail with food preparation/service
El Medical / dental I veterinary facilities
[1] Church
E] Nursing Home
EJ Car Wash
EI Hotel and/or Motels
LI Swimming Pool /Clubhouse
El Swimming Pool Filter Backwash
l:11 Other (Explain in Attachment)
5, Nature ofwastewater % Domestic/Commercial. 100 % Commercial
94) Industrial (See I 5A NCAC 02T ,Ol03(201)
to.Is there a Pretreatment Program in effect? LI Yes El No
6. Has a flow reduction been approved under 15A NCAC 02T ,0114( 0? El Yes No
If yes., provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Ty
O2TO1l4
Grocery with food preparation
Stores and shopping centers without food.
Daily Design Flow a,b
130 gal/1000
100 galll000 sf
gal/
gal/
gal/
gall
No. of Units
49,098
11,200 sf
Total
Flow
6,383 GPD
1,120 GPD
GPD
GPD
GPD
GPD
0 GPD
a See 15A NCA.0 02-1 ,01.1.4'b d e)(2) for caveats to wastewater design flow rates(Le,„ minimum flow per
dvvelling; proposed unknown nort-residentialdevelopment 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 (i,S, 42A-4).
b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified fin table 15A NCAC 02T.0 I 14] shall be
determined using available flow data, water using fixtures; occupancy or operation pattems, arid other measured data.
8. Wastewater generated by project: 7,5Q1GPD (per 15A NC,AC 02T ,011.4)
Do not include future flows or previously permitted allocations
permitted flow is zero, indicate why:
E] Pump Station or Gravity Sewer vhere flow will be permitted in subsequent permits that connect to this line
Flow has already been allocated in Permit Number: WQ0037628
El Rehabilitation or replacement of existing sewer with no new flow expected
E] Other (Explain):
FORM: FTA 04-16
Page 2 of 5

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (GravitySewers):
1, Summarize gravity sewer to be perrnitted:
Size (inches)
Length (feet)
Material
8"
732
PVC
> 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
VIII. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC (Pump Stations/Fore 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 (flrm capacity)
4. Operational point(s) of the pump(s): _ gallons per minute at feet total dynamic head (TRH)
5. Summarize the force main to be perrnitted (for this Pump Station):
Length (feet)
6. Power reliability' in accordance with 15A NCAC02T .0305 h
D 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(hX1)(C)
Or
O Portable pumping unit with plugged emergency purnp 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 allthe 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

TX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(1)):
1. Does the project comply with all separations found in 15A NCAC 021 .0305(t) kig)
15A NCAC 02T,0305(f) contains minirnum searations that shall be irovided for
Setback
e *
orrn sewersand other ot listed below (verttcal
ater main
cal -water over sewer includin
horizon
in benched trencbes
Reclaimed water lines (vertical - reclaimed over sewer)
Reclaimed water lines (horizontal - reclaimed over sewer)
**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
s classified WS (except WS-I or WS-V), B, SA, ORW, HQW, or S13 from normal
a (or tide elevation) and wetlands (see item IX.2)
y other stream, lake, impoundment, or ground water lowering and surface drainage
ditches
Any building foundation
Any basement
To 1 ofernbankrnent or cuts of 2
DrainagsanJnterceptOr drai
Ati swimrning oo1s
Final grade (vertical)
or more vertical
Yes El No
t s::
Separarion Required
24 inches
18 inches
10 feet
18 inches
2 feet
100 feet
0 feet
10 feet
5 feet
0 feet
0 feet
5 feet
10 feet
36 inches
I 5A NCAC 02T0305(g) contains alternatives where separations in 021.0.305(1) cannot be achieved,
• **Stream classifications can be identified using the Division's NC SurfaceWater Cla.ssi fications lvebnage
• If noncompliance with 02T,0305ifi oiliA see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation)
• 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
Yes No
3. Does the project comply with all setbacks found in the river basin rules per 1.5A NCAC 02B .0200? Yes LI No
• This would include Trout Buffered Streams per I5A NCAC 213.0202
4. Does the project comply with an individual 404 Permit or any 401 Certifications? El Yes [I] No
• Wetland -related permits shall be requested, obtained, and adhered to for projects that impact wetlands or surface waters
• Information can be obtained from the 401 & Buffer Permitting Branch
5. Does project comply with I.5A NCAC 021.0105(4() (additional 'permits/certifications)? D Yes LI No
Per 15A NCAC 021.01.05(g)(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 0.2'1.0402, "high -priority sewer" inea.ns "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel. to streanibank.s that is subject to erosion that undermines or deteriorates the sewer.
[IYes No
If yes, include an attachment with details for each tine, including type (aerial line, size, material, and location),
High priority lines shaU 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 I 5A NCAC 02T, the Minimum Design Criteria for the Permitting of Pump Stations
and Force Mains (latest version), and the Gravity Sewer Minimum Design Criteria (latest version) as applicable?
Yes El 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 repaired prior to submittal of the Fast Track Application and supporting documents.
2, Professional Engine- rtification:
1,
ional Engineer's name from Application Item IRA.)
attest that this application for
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 Desi. 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 rnay
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:
i
0
11.Z
it
3. Applicant's Certification per 15A NCAC 02T .0106(b):
1 Li 1 G-
ignature Authority's nathe & title from Application ltern 1.3.)
attest that 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. 1 will make no claim against the Division of Water Resources should a condition
of this permit be violated. 1 also understand that if all required parts of this application package are not completed and that if
all required supporting infonnation 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 143-215,6B, 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.
Signature:
Date:
FORM: FTA 04-16
Page 5 of 5

.„.
— _
aivicl(rin Fte-:Ncoire.ot.4
State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 08-13)
Project Applicant Name: City of Hickory
Project Name for which_ flow is being requested The Village Shoppes
More than one FTSE may be required jbr a single project if the owner of the WWTP is not responsible for all pump
stations along the route of the proposed wastewater flow.
1, Complete this section only if you are the owner of the wastewater treatment pianL
a. WWTP Facility Name: Hickory -Catawba Wastewater Treatment Plant
b. WWTP Facility Permit #: NC0025542
c. WWII' facility's permitted flow
d. Estimated obligated flow not yet tributary to the W
e. WWTP facility's actual avg. flow
f Total flow for this specific request
Allfiows are in MGD
1,5
P 0.3684
0.0800
0.00762-This amount was
included in the previously
allocated 0.300 MGD
g. Total actual and obligated flows to the facility 0.4484
h. Percent of permitted flow used 30%
II. 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 theWWTP:
(A) (B) (C) (D)=(B+C) (E)=(A-D)
Design Obligated,
Pump Average Daily Approx. Not Yet Total Current
Station Firm Flow** Current Avg. Tributary Flow Plus
(Name or Capacity,* (Firni / pt), Daily Flow, Daily Flow, Obligated Available
Number) MGD MGD MGD MGD Flow Capacity***
Browns
Chapel 0,73 0.73 3000 0 3000 0.73
Terripan
Creek 0.73 0.73 3000 0 3000 0.73
Merlins Ford 0,692
0,692 3000
Village
Center 0.55 0,55
Terrell
1000
0
0
3000 0.692
1000 0.55
0.23 0.23 500 0 500 0.23
* The Firm Capacity of any pump station is defined as the maximwn 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 (pi) not less than 2.5,
Page 1 of 7
FTSE 08-13

** A Planning A s ss a Addendum shall be attached ur each pump station located
between the project cowl tton point and th P where the Available Capacity is
.tio. State etlt
dreg Surratt eertlfytd the best of my knowledge that the addition of
the vofume of wastewater to be permitted tted 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 notmal circumstances, given the implementation of
the planned improverrients identified in the pi: *rig assessment where applicable. This al sis
has been performed in accordance with local established policies and procedures using the best
available data, This certification applies to those ites listed above in ecti b land II plus all
attached pl lug assessment addend for which 1 r the responsible p . i attire of this
fora indicates acceptance of this wastewater flow.
t i a c a `matt r
Page 2 o
FTSE 0843

Property Boundary
NC Roads

- Proposed Sewer
.wo-- Property Boundary
NC Roads

Transmittal
Suite 200
200 South Tryon St
Charlotte, North Cardina
28202
TEL [phone]
FAX 919.677,2050
Date: 2/13/2017 Job Number: 017328000
Project Name: The Village Shoppes
To: Department of Water Resources
Mr, Corey Basinger
:ifocChfitti1L181
610 E. Center Avenue
Mooresville, NC 28115
We are sending these by
u.s. Mail
El Other:
[J As requested
We are sending you
4
FedEx
et10Wbitatssnptdiospintidt5hrtitettt,ibnct
El Hand Deliver
Attached [1 Under separate cover via
the following items:
Shop Draysktgs LJPrints/Plans Samples I I Specifications []Change Orders
EI Other:
Copies Date No, Description
2
2/13/2011
1
DWR Sewer Application Package
tt51
These are transmitted as checked below:
For your use Approved as submitted [] Resubmit Copes for approval
IA Approved as noted Submit Copies for distribution
ri For review and comment LI Returned for corrections D Return Li Corrected prints
Remarks:
For signature.
Copy to: File
Signed Nathan Tidd, FLA
Page 1
--------

Central Files APS SWP
3/8/2011
Permit Number W00039078 Permit Tracking Slip
Mogi ern Category
Non -discharge
Permit Type
Gravity Sewer Extension, Puny Stations, & Pressure Sewer Extensions
PrimeryeillayMwer
• gettuvia
Paratated Raw
'0 ....
Status Pr otec 1 Type
In review New Project
Mormon
Parma Crandall: abon
indvidual
Parcae Contact Afferation
Farrell Name
The Village Shopes
Location Address.
Owner
Maioriblinor Realm)
Minot Mooresville
County
Feeney Coreact Ainbabon
(Leta
Owner Name
Larmadatawbe 14,C
Oates ..Eurents
Owner lane
NrCeovernment
Owned Ardeenon
beetled Wagner
2502 N Rocky Pond Dr
Tampa FL, 334507
Ong [belle
Ann Received Draft initiated
3/6,42011
Reguat ea Actt
Food preparabom mem
Retail
Wastewater colleclion
°Wait
Scheduled
issuance
Panda Nonce ssue
Requested rRacerred Eve/Its
, 4
Affilibonal maul elation rendered
Eiter...twe Expeabon
allaternally Name
Stroambudell Nurnbor Current Mass Subbase)

PAY
TO THE
ORDER OF
ME
6
0
wml14 Fargo .FBank, N,A.
owe CORD
MST FADE f N 3aA RY IttittlE8
KIMLEY-HORN AND ASSOCIATES, INC,
200 SOUTH TRYON STREET
SUITE 200
CHARLOTTE, NC 28202

Water R esources
ENVIRONMENTAL QUALPTV
January 10, 2018
Michael Wagner, Manager
Wagner Property Group, LLC
2502 North Rocky Point Drive, Suite 865
Tampa, FL 33607
SUBJECT: Final Engineering Certification Acknowledgement
The Village Shoppes
Permit No, WQ0039078
Permitee: Wagner Property Group, LLC
County: Catawba
Dear Mr. Wagner:
ROY COOPER.
Governor
MICHAEL S. REGAN
Secretary
LINDA CULPEPPER
Interim Director
The Division of Water Resource's Mooresville Regional Office received the final engineering
certification with record drawings for the subject sewer extension project on 1/9/2018. Enclosed
is a certification page for your records. A full review of the certification materials may or may not
be conducted. It is assumed that receipt of this certification indicates compliance with all
regulations, design criteria and the permit. However, if a full technical review is conducted, you
will be notified of any items of non-compliance.
Please be reminded that the Permittee is responsible for keeping a copy of the final record drawings
for the life of the project. If you have not received such copy from your consultant, please contact
them immediately to obtain a copy.
Lastly, you are receiving this letter because the Division has you listed as the responsible party. If
this permitted system is no longer owned by you or your company, please complete Forrn PNOCF
since the permit is not automatically transferable. Form PNOCF can be downloaded from
http://portal.ncdenr.org/web/wq/swp/ps/cs/pnoc from the Collection Systems Applications page.
Should you have any questions, please do not hesitate to contact Ori Tuvia at [phone], or at
[e-mail].
cc: Tidd Nathan P.E. (E-copy)
Central Files
MRO
Sincerely,
Ori Tuvia, Environmental Engineer
Mooresville Regional Office
Division of Water Resources, DEQ
State of North Carolina En
Quality'8vates Resources
Canter Avenue, Suite 301, Mooresville, FIG 28115
7`V 4-663-16%11n1ernet; cvww,scdenr.gov

FAST TRACK SEWER ENGINEERti CERTIFICATION
PERMITTEE: WAGNER PROPERTY GROUP, LLC
PERMIT #: WQ0039078
PROJECT: THE VILLAGE SHOPPES
ISSUE DATE; MARCH 8, 2017
WOROS
This project shall not be considered cotnplete nor allowed to operate in accordance with standard
Condition 7 of this permit until the Division has received this Certification and all required supporting
documentation. It should be submitted in a manner that documents the Division's receipt, Send the
required documentation to the Regional Supervisor, Water Quality Regional Operations Section at the
address noted in the page footer,
Any wastewater flow made tributary to the wastewater collection system extension prior to completion
of this Certification shall be considered a violation of the petrnit and shall subject the .Permittee to
appropriate enforcement actions. The Permitter: is responsible fot tracking all partial certifications up
until a final certification is received by the Division. A Final Certification shalt be a complete set of
record drawings and design calculations regardless of whether partials have been submitted.
PERMITTEE'S CERTIFICATION
1, the undersigned agent for the
the applicable standards & requir
design/construction information to t
wastewater collection system perm
W
Printed Name, Ti
tees hereby state that this project has been constructed pursuant to
nts, the Professional Engineer below has provided applicable
ttee, and the Permittee is prepared to operate & maintain the
in
f,
ENGINEER'S CERTIFICATIO
y registered Prs
g Veen authori:r d to obset +e � perlodicall
project name and location as refercnced above for the above P`e
abilities, due care and diligence was used in the observation of the co
was observed to be built within substantial compliance of this permit; l5A NCAC 02T; the Division of
Water Resources' (Division) Gravity Sewer Minimum. Design Criteria adopted February 12, 1996, as
applicable; the Division's Minimum Design Criteria for the Fast -Track Permitting of Pum ' Cations and
Force Mains adopted June 1, 2000, as applicable; and other supporting
North Carolina Professional Engineer's Seal w/signature & date:
to Final © Partial (include description)
4-Certitication Comments/Qualifiers (attach if necessary):
Observations were performed by those under my responsible charge.
As -built survey provided by contractor's surveyors
near in the State of North Carolina,
construction of the
eby state that, to the best of my
ion such that the construction
NC DWR —Water Quality Regional Operations Section t<t East Center Avenue, Suite 301, Mooresville, NC 28115
Mooresville Regional Office
Phone: [phone] FAX: [phone]

4
Water Resources
ENV;PONMENTAL CAM,o're
As built check list (reference 2T .0300)
Reviewed By: Ori Tuvia
Review Date: 1/10/2018
Project Name: The Village Shoppes
WQ#: WQ0039078
1) As -built has been signed, sealed, and dated by an N.C. PE Yes
No
ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
S. JAY ZIMMERMAN
Director
Adequate information related to sewer lines :
Note that per the 2T and MDC, there is a minimum 8" for public gravity or minimum 6" for
private gravity, Three (3) feet minimum cover shall be provided for all sewers unless ferrous
material pipe is specified. Manholes shall be installed: at the end of each line, at all changes in
grade, size, or alignment, at all intersections, and at distances not greater than 425 feet, minimum
diameter of manholes shall be 4 feet (48 inches), Yes LJ No L. N/A
3) Adequate information related to pump stations:
Ensure power reliability option is selected (15A NCAC 02T.0305(h)).
—1 Yes E No N/A
4) Is Project design is in accordance with (see section B.13 of FTA 12-12)
15A NCAC 02T Gravity Sewer Minimum Design Criteria (latest version) Minimum Design
Criteria for Permitting of Pump Stations and Force Mains (latest version). I— Yes —I No N/A
If no, a variance approval is required per the requirements of 15A NCAC 02T.0105(b)
_1 Applicant must submit TWO copies of the plans, specifications, and calculations
Contact the Central Office to discuss the variance request to determine a course of action.
The central office will review the variance request, and if approvable, specific language
regarding the variance will be forwarded to the Regional Office reviewer to incorporate into the
pemiit. A copy of the variance letter (or email correspondence) should be kept with the
application file.
5 ) Project contains high priority lines (15A NCAC 02T .0402(2)) Yes No
If Yes, insure that the permit contains the necessary condition related to high priority lines 15A
NCAC 02T.0403 (a)(5)
6) Is the Sewer As -built length within 10°/0 of the fast track applied Length?
( I Original length of pipe — As built length l/ Original length) < 10%. Yes 11 No
If no application need to be modified
State of North Carolina( Environmental Quality 1 Water ResourceWater Quality kegicrnal Operations
Mooresville, Regional Office 1610 East Center Avenue, Suite 30 Mooresville, North Carolina 28115
704 663 1699