WQ0041124_Regional Office Historical File Pre 2018

Division of Water Resourc
State of North Carolina
Department of Environmental Quality
Division of Water Resources
I5A NCAC 02T .0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: o 00 Li tmcurnQletzd ley rsw ti
All items must be completed or the application will be return, d
APPLICANT INFORMATION:
1. Applicants name: City of}Iickory (company, municipality, IIOA, utility, etc.)
Applicant type: ❑ Individual
❑ Federal
ty t;;t t L3 ERRIOW I
® Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ State/County ! Municipal 0 Other
3. Sigtranrre authority's name: Warren Wood per 15A NCAC 021' .0106(h.)
Title: City Manager
4. Applicant's mailing address: PO BOX 398
City: llick.ory State: NC Zip: 28603-
5. Applicants contact information:
Phone number: (828) 323-742.7 Email Address: sp+ nne1l r)hickorync.gov
PROJECT INFORMATION:
1. Project name: Townes at Shrills Ford
2. Application, Project status: I Proposed (New Permit,) © Existing; Permit/P.o
Ifa modific,ation provide the existing permit number WQ00 and issued date:
Ifnew construction but part of a roaster plan, provide the existing permit number: WOOD
3. County where project is located: Catawba
4. Approximate Coordinates (Decimal De,grees). Latitude: 35.588715°` 1.on.gitude: -80_ 2:3 1_
5m Parcel ID (if applicable): 461709058372, 461713048911. 461.71.3141976
(or Parcel ID to closest downstream sewer)
M. CONSULTANT INFORMATION:
Professional Engineer: Barry M. Fay License Number: 33046
Firm: American Engineering Associates - Southeast PA
Mailing address: 8008 Corporate Center Dr Suite 1 10
City: Charlotte State: NC Zip. 28226-_
Phone number: (704) 3.5-2438 Email Address: hfayn aiueri an a„corn
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
Facility Name: Hickory -Catawba Permit Number; NC0025542
Owner Name: City ofHickory
RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
I Permit Number(s): WQ Downstream (Receiving) Sewer Size: 15 inch
System Wide Collection System Permit Numher(s) (if applicible): WQCS00256
Owner Names) City of }Hickory
I' RN FTA 04-16
Page I of5

VI. GENERAL .REQUIREME,NTS
r the Applicant is a Privately-Owmed
2, if the Applicant is a
11 the ,A.pplicant is a
I- Utility, has a Certificate of Public Convenience and Necessity been hccn taheL1.
El Yes [IN° HisEA
evel. per of lots to he sold, has a Developer's Operational !_ygreementifORM: DEVI been attached?
El Yes LiNo N/A
te/Pr(»ertv C 'tiers° .Association„ has an Operational Agreement 1-10,N) been attached?
LI Yes EINo LIN/A
4, Origin of wastewater: (check all that apply):
Residential Owned
El Residential Leased
El School / prescho„11 day care
fl Food tand drink facilities
tsinesses 1 ortices / Factories
El Retail (stores, centers, malls)
LJ Retail with food preparation/service
El Medical / dental / veterinary facilities
Eli Church
Nursing llome
5. Nature o'was - % Domestic/Commercial % Commercial
Industrial (See .15A NCAC 02T ..0103:(20))
>Is there a Pretreatment Program in effect? Yc
6, Ilas a 11ow reduction been approved under 15A NCAC 021 ,011,4(1)? [2] Yes fl No
Ves, provide a copy of flow reduction approval letter
.7, Summarize mtstcwater generated by project:
Establish men t 'IType (see 02T.0 I I 4( D)
csidential Tomihome 1 Ini (3 bedrooms)
Lil Car Wash
El Hotel andfor 'Motels
Swimming Pool /Clubhouse
El Swimming Pool/Filter Backwash
El Other (Explain in Attachment)
-77
Daily Design Flow ab Nu, of Units
360 g a Eday
Flow
153 55,08.0 GPD
Clubhouse I() eallpeitson
gal!
50 500 GPI)
GPD
gall GPO
gall GPD
55;580 CiPD
L mu,/
a See 1.5A NCAC 02/1 .011402), (d),“)(1nd (0),(2) liar caveats to wastewater design flow rates minimum flow per
dwelling:, proposed unknown non-residential development uses: puhlic access f act' ities 1ocated near high public use areas;
niJ resiclential property located south or cast of the Atlantic Intracoastal Waterway to he used .4ts vacation rentals as defined
in (i.S, 42.A-4),
Per 15A 'NCAC 02T .0114(c), deign llow rates tor establishments not identi lied lin table 15A. NCAC 02T.01141shall be
dCte Tr:11W fled using available flow data.. water using fixtures, °CCU parley or operation patterns, and Other Measured data.
WaSte\Va tor generated by project: .36720 ( P1.) (per 1.5.A, NC,AC 02T .0114)
Do not include future flows or previously permitted allocations
1 permitted flow is z.er o, indicate ‘vhvi
El Pump Station or Gravity Sewer where flow will he permitted in suhsequent permits that connect to this 10e
El Flow has already been allocated in Permit Number: _
Rehabilitation or replacement cir existing sewer \,),,ith. no newt e'pecicd
(Explain);
FORM: EIA 04-16 Page 2 of .5

VII. GRAY TY SR DESIGN CRITERIA (If Applicable) - 02T _0305 & MDC (Gravity Sewers):
Sramnaarize gray
o be permitted:
Size (inches)
Length (feet)
rial
goy
3,358
1,670
PVC
DIP
Section II & III f dte MDC for Permitting of Gravity Sewers contains inlhrrmation re.Ittted'to design criteria
Section 113 contains information related to minimum slopes for gravity sewer(s)
Oversizi.ng lines to meet minimum slope requirement is not allowed and a vi©latrrrn of the MDC
Vlli. 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: ®a� Longitude: -
3. Design flow of the turnip station: taaillioras gallons per day (firma eapac ity)
4, Operational point(s) of the purnp(s): gallons per minute at feet to't dynamic head ("I'DII)
5. Summarize the force stain to be permitted (for this Pump Station):
Size (inches)
Length (feet)
6. Power reliabdity in accordance wi
kwiC. C' t)2'i- .0305(h`l()):
LJ Standby power source or pump with automatic activation and telemetry - ]. SA NCAC 02'h .0305(h)(1)(Il
Required for all pump stations with an average daily flow greater than or equal to 15,O00 gallons per day.
w Must be permanent to facility
Or if the pump station has an average daily flow less than l 5,000 gallons per day:
0 Portable power source with manual activation, quick -connection. receptacle and Idle
,0305(b)(i)(C)
or
© Portable puurtaping, tuttit with plugged et'target
15A .NCAC 02T
p connection atad telemetry - 15A NCAC 0.2T .0.305(h)(I)(2):
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,
lithe portable power source or pump is dedicated to multiple pump stations„ an evaluation of all the pump stations' storage
capacities and the rotation schedule of the portable power source or pump, including travel timeframes, shall be provided
in the case of a multiple station power outage.
FORM: :VITA 04-16
Page 3 of 5

IX. SETBACKS & SEPARATIONS — (0213 .0200 & 15A NCAC 02T .0305(I)):
I. Does the project comply with all separations found in 15,A NCA.0 02T .0305(f) & (g)
15A NCAC 02T,0305(1) contains minimum separations that shall be provided for sewer s" stems:
Setback Parameter*
Storin sewers and other utilities not listed below (vertical)
Water mains v I -water over sewer including in benched trenches)
Water mains 'h
Yes DNo
Se aration Recuired
24 inches
18 inches
10 fee
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-I waters of Class I or
Class 11 impounded reservoirs used as a source of drinking water
**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 1X,2)
**Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches
An foundation
Any basement
Top slope .of embankment or cuts of 2 feet or more v
Drainage systems and interceptor drains
Any .swimming pools
Final earth grade (vertical)
10 feet
10 ,feet.
5 feet
10 feet
36 inches
15.A NCAC 02T.0305(0 contains alternatives where separations in 021,0305(0 cannot be achieved,.
**Stream classifications can be identified using the Division's NCSurface Water Classifications webpage
If noncompliance with 02T,0305 see Section X of this application,
Does the project eornply with separation requirements for wetlands? (50 feet of separation) Yes D No El N/A
See the Division's draft separation requirements for situations where separation cannot be meet
fr 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 NiCe
This would include Trout Buffered Streams per 15A NCAC 214,0202
4. Does the project, require coverage/authorization under a 404 Nationwide or
individual permits or 401 Water Quality Certifications?
Information can be obtained from the 401 & Buffer Permitting Branch
.5, Does project comply with 15A NCAC 02T.0105(c)(6) (additional permitslcertifications)?
Yes LINo JNA
Yes Nc
Yes 1 INo
Per 1,5A NCAC 021 0105(c)(61, 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 (eroswn and
sedimentation control plans, stormvvater management plans, etc.),
6. Does this project include any sewer collection lines that are deemed "high -priority?"
Per 15A NCAC 0.2T,0402, "high -priority sewer" means "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to sneambanks that is subject to erosion that undeimines or deteriorates, the sewer,
t] Yes PNo DNA
3,, 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 ISA NCAC 02T.0403(a)(5) or the permitees individual System -Wide Collection permit,
FoRm: FrA 04-16 Page 4 of 5

X. CERTIFICATIONS:
1. Does the submitted system complywith 15A NCAC 02T, the Nlinimum ;Design Criteria tbr the Permit' g of Pump Stations
'orce Maw s (latest version), and the Gravity Sewer Minimum Design Criteria (latest yersionj as applicable?
Yes DNo
11No, complete and submit the VarianeelAlternative Design Request application (VADC 10-14) and supporting documents for
review, Ap,pnwal of the reguest is regured nrior to submittal of the Fast Track Applkation and tin d um n s.
2. Professional Engineer's Certification:
his application for
has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans, sTecifications,
engineering ealculation.s, and all other supporting .doctunentation to the best of my knowledge, I further attest that to the best
of my knowledge the proposed design has been prepared in accordance with the applicable regulations, Gravity Sewer
Minimum Design Criteria :for Gravity Sewers (latest version), and the Minimum Design Criteria for the Fast -Track Permitting
of Pump Stations and Force Mains (latest version). Although other professionals may have developed certain portions of this
submittal package, inclusion of these materials under my signature and seal signifies that 1 have reviewed this material and
have judged it to be consistent with the proposed design.
NOTE In accordance with General Statutes 1.43-215,6A and 143-215.6B, any person who knowingly makes any false.
statement, mpresenta.tion, or certification in any application package shall he guilty f a Cla - 2 misdemeanor, which may
include a fine not to exceed $10,000, as well as civil penalties up to $25,000 per
North Carolina Professional Engineer's seal, signature, and date:
3. Applicant's ('ertificar -in per 1.5A NCAC 021 .0106(b):
Signature Authority's name & title from Application Item I.3.)
•
. %
7AL .
046
. -17---/
• . •
Y M.
attest thatthis application for
has been reviewed by me and is accurate and complete to the best of my knowledge,. I understand that if all required ,parts of
this application are not completed and that if all required supporting documentation and attachments are not included, this
application package is subject to being returned as incomplete. I understand that any discharge of wastewater from this non. -
discharge system to surface waters or the land will result in an immediate enforcement action that may include civil penalties,
injunctive relief, and/or criminal prosecution. I will make no claim against the Division of Water Resources should a condition
of this permit he 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 143-215,611, any person who knowingly snakes any fidse
statement., representation or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed $1.0,000 as well as civil penalties up to $25,000 per violation.
Signature:
Date:
FORM: FrA 04-16
Page 5 of 5

Div t sti,:in of Water r e 5
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: C.Ity of Hickory
Project Name for which flow is being requested: Townes at Sherrills Ford
,fore than one. FTSE may be required Or a single project if the owner of the ;f1177P is not responsible for all pump stations along the
route of the proposed wastewater flols%
Conmlete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Flickoi-y-Catawba Wastewater Treatment Plant
b, WWTP Facility Permit NC0025542
c. WWTP facility's permitted flow
d. Estimated obligated flow not yet tributary to the WWTP
e. WWTP facility's actual avg. flow
-1. Total flow for this specific request
g. Total actual and obligated flows to the facility
It Percent of permitted flow used
AR flows are in MGD
1.5
0,24852
0.1089
0.05558
0.413
27.5%
IL Complete this section for each pump station you are responsible for along the route &this proposed wastewater flow.
List pump stations located between the project connection point and the WWTP:
Punip Purnp
Station Station
(Name or Permit
Number) No.
Village
Center
Sherrills
Ford
Mollys
Backbone
Brown
Chapel
* The
Firm
Capacity, *
MGD
(A)
Design
Average
Daily How"
(Firm
.MGD
(B) (C) (D)=(B+C) (E)=(A-D)
Obligated,
Approx. Not Yet Total Current
Current -Tributary Flow:Plus
Avg. Daily Daily Flow, Obligated Available.
Flow, MGD MGD Flow Capacity***
1.375 0.55 0.0537 0,2555
1.73
0.692
0.0537 0.2555
0.3092 0.2408
0,3092 0.3828
1.825 0.73 0.0537 0,2555
1.825
0,3092 0.4208
0.73 0.0537 0.2555 0.3092 0.4208
Firm Capacity (design flow) o any pump station is defined as the masimum pumped flow that can be achieved
with the largest pump taken out of service.
** Design Average Daily How is the firm capacity of the pump station divided hy a peaking factor fp° not less than 2.5,
per Section 2.02(A)(4)(c) of the Nlinimum Design Criteria.
*** A Planning Assessment Addendum shall be attached for each pump station located
connection point and the WINVTP where the Available Capacity is ,‹ O.
Downstream Facility Name (Sewer): Hickor) -Catawba Collection System
between the project
Downstream Permit Number: WQCS00256
Page 1. of 6
FT -SE 10-18

III. Certification Statement:
I Warren Wood. City Manager certify to the best of my knowledge that the addition of
the volume of ss astewater to be permitted in this project has been evaluated along the route to the receiving
XN, aster at e r treatment facility and that the flow from this project is not anticipated to cause any capacity
related sanitary, sewer overflows or oyerhurden any downstream pump station en route to the receising
treatment plant under normal circumstances, given the implementation of the planned improvements
identified in the planning assessment where applicable. 'Fins analysis has been performed in accordance
ith local established policies and procedures using the hest available data. 'this certification applies to
those items listed abos e in Sections I and II plus all attached planning assessment addenawns tor which 1
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.
Signing Official Signature
(it) Manager
Title of Signing Official
Date
-Page.r2:of

35'
USGS Topographic Map
Portion o LAKE NORMAN NORTH QUADRANGLE - 7.5 Minute Series

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
WC/06 <.>
Application Number: - if {to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: Ci f (company, municipality, HOA, utility, etc.)
2. Applicant type. El Individual E] Corporation El General Partnership Ili Privately -Owned Public Utility
El Federal [J State/County Municipal El Other
3, Signature authority's name: Warren Wood per I5A NCAC 02T .0106(b)
Title: City Manager
4. Applicant's mailing address: PO BOX 398
City: Hickory State: NC Zip: 28603
5. Applicant's contact information:
Phone number: [phone] Email Address: spennell(cD,hickorYnc,gov
Et:;E: tvE iNt R
II. PROJECT INFORMATION:
1.
Project name: Townes at Sherrills Ford
Application/Project status: Proposed (New Pemiit) El Existing Permit/Project
If a modification, provide the existing permit number WQOO 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: 35,588715Longitude: -80.982321'
5, Parcel ID (if applicable): 461709058372, 461713048911, 461713141976
(or Parcel ID to closest downstream sewer)
III, CONSULTANT INFORMATION:
1, Professional Engineer: Barry M. Fay License Number: 33046
Finn: American Engineeri, &Associates - Southeast PA
Mailing address: 8008 Corporate Center Dr, Suite 110
City: Charlotte State: NC Zip: 28226-
Phone number, [phone] Email Address: bfayaamerican--ea,com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Hickory -Catawba Pemiit Number: NC0025542
Owner Name: City of Hickory
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1, Permit Number(s): WQ Downstream (Receiving) Sewer Size: 15 inch
ystem Wide Collection System Permit Number(s) (if applicable): WQCS00256
Owner Name(s): City of Hickory
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 Necessity been attached?
Li1Yes E1No N/A
If the Applicant is a Developer of lots to be sold, has a Developer's Operational Agreement (FORM: DEV) been attached?
[1] Yes No N/A
3. If the Applicant is a Home/Property OwnersAssociation, has an Operational Agreement (FORM: FIQ, ) been attached?
El Yes EN N/A
4, Origin of wastewater: (check all that apply):
Residential Owned
Ej Residential Leased
El School preschool / day care
El Food and drink facilities
Ei Businesses / offices factories
El Retail (stores, centers, malls)
Retail with food preparation/service
rj Medical / dental / veterinary facilities
El Church
I] Nursing Horne
5. Nature of wastewater : 100 % Domestic/Commercial % Commercial
% Industrial (See 15.A NCAC 02T ,0103(20))
Is there a Pretreatment Program in effect?
6. Has a flow reduction been approved under ,i,A,C2Ll14
If yes, provide a copy of tlow reduction approval
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114M)
Residential Townhome Unit
Clubhouse
Dal
El Yes
Flow
240 gal/day
10 gal/person
gall
gal/
LI Car Wash
El Hotel and/or -Motels
Swimming Pool /Clubhouse
{1} Swimming PooVFilter Backwash
Ej Other (Explain in Attachment)
El Yes LINo
EiNo
No. of Units
153
50
Flow
36,720 GPD
500 GPD
gal/
gal/
Total
GPD
GPD
GPD
GPD
37,220 GPD
a See 15A NCAC 02T ,0114(b), (d), (e)(1) and (e)(2) for caveats to wastewater design flow rates (Le., minimum flow per
dwelling; proposed unknown nonresidential development uses; public access facilities located near high public use areas;
and residential property located south or east of the Atlantic Intracoastal Waterway to be used as vacation rentals as defined
in G.S. 42A-4),
b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified [in table I5A NCAC 02T,0114] shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 36,720 GPD (per 15A NCAC 02T .0114)
> Do not include future flows or previously permitted allocations
If permitted flow is zero, indicate why:
11 Pump Station or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line
El Flow has already been allocated in Permit Number:
El Rehabilitation or replacement of existing sewer with no new flow expected
rj Other (Explain):
FORM: FTA 04-16 Page 2 of 5

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & M Gravity Sewer*
I. Summarize gravity sewer to be permitted:
> Section II & III of the MDC for Permitting of Gravity Sewers contains information related to design criteria
> Section III contains information related to minimum slopes for gravity sewer(s)
> Oversizing lines to meet minimum slope requirement is not allowed and a violation of the MDC
VIII PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC (Pump Stations/Force
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
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches)
Length (feet)
feet total dynamic head (TDH)
Material
6. Power reliability in accordance with J5A NCAC 02T ,0305(h)( I):
0 Standby power source or pump with automatic activation and telemetry - 15A NCAC 02T .0305(h)(1)(B)i
> 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:
El Portable power source with manual activation, quick -connection receptacle and telemetry - I5A NCAC 02T
.0305(h)(I)(C)
or
0 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 timefrairies, 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 .0305th & (g)
15A NCAC 02T,0305(f) containscontams mrnimumseparations that shall be provided for s
StormStorrn sewers and other utilities rio
averse
mains horizonta
Setback Parameter*
fisted below (vertical)
in benched
0 Yes 0 No
paration Required
24 inches
18 inches
0 f
Reclaimed water lines (vertical - reclaimed over sewer)
iaimed water line
eclaimed over sewer
**Any private or public water supply source, including any wells, WS-I waters of Class 1 or
Claas 11 irnpounded reservoirs used as a source ofdrnkigwater
aters classified WS (except WS-1 or WS-V), B, SA, ORW, 1-1QW, or SB from normal
high water (or tide elevation) and wetlands (see item IX,2)
**Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches
Any building foundation
Any basement
inches
fi
e
50 feet
Any swimming pools
Final earth grade (vertical)
5 feet
feei
36 inches
A 15 A NCAC 02 T,0305(g) contains alternatives where separations in 02T.0305(f) cannot be achieved.
> **Stream classifications can be identified using the Division's NC Surface Water Classifications webpage
> If noncompliance with 02T.0305(f) or (g), see Section X of this application
. Does the project comply with separation requirements for wetlands? (50 feet of separation) Yes 0 No 0 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
A 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 243 .0200? [E] Yes 0 No 0 N/A
> This would include Trout Buffered Streams per 15A NCAC 2110202
4. Does the project require coverage/authorization under a 404 Nationwide or
individual permits or 401 Water Quality Certifications?
> information can be obtained from the 401 84, Buffer Permitting Branch
LI Yes
5, Does project comply with l5A NCAC 02T,0105(c)(6) (additional permitslcertifications)? Yes Ej No
Per 15A NCAC 02T.0105(c)(6), directly related environmental permits or certification applications are being prepared, have
been applied for, or have been obtained, Issuance of this permit is contingent on issuance of dependent permits (erosion and
sedimentation control plans, stormwater management plans, etc.).
6. Does this project include any sewer collection lines that are deemed "high -priority'?"
Per I5A NCAC 02T.0402, "high -priority sewer" means "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to strcanibanks that is subject to erosion that undermines or deteriorates the sewer
El Yes No Ej 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 15A NCAC 02T.0403(a)(5) or the permitee's individual System -Wide Collection permit.
FORM: FTA 04-16 Page 4 of 5

4
X. CERTIFICATIONS:
Does the submitted system comply with 15A NCAC 02T, the Minimum Design Criteria for the Permitting of Pump Stations
and Force Mains and the Gravity Se er Minimum Design Criteria (latest version) as applicable?
E Yes LINo
If No, complete and submit the Variance/Alternative Design Request application (VADC 10-14) arid supporting documents for
review, Approval of the request is required prior to submittal of the Fast Track Application and supporting documents.
Professional Engineer's Certification:
I 0
:Profesona1 Engineer'sfrom Application Item
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. 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 Class 2 misderneanor, which may
include a fine not to exceed $10,000, as well as civil penalties up to $25,000 per viola
North Carolina Professional Engineer's seal, signature, and date:
3, Applicant's Certification per 15A NCAC 02T 06(b):
1, Warren Wood, City Manager
(Signature Authority's name & title from Application Item 1.1)
attest that this application for
has been reviewed by me and is accurate and complete to the best of my knowledge, I understand that &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, anikor criminal prosecution. I 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 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 143-215.68, 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,
FORM: FTA 04-16 Page 5 of 5

FAST TRACK SEWER ENGINEERINGCERTIFICATION
PERMITTEE: CITY OF HICKORY
.PERMIT 'WQ0041124
PROJECT: 'TOWNIES AT SHERRILLS FORD
ISSUE DATE: SEPTEMBER 26, 2019
REC8VECADDEr rwq
FEB 2 6
WORM
MOORESVILLE REGIONAL
This project shall not he 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 looter,
Any wastewater flow made tribunary to the, wa.stewater 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.
PERAILI:TEE'S CERTIFICATION
1, the undersigned agent for the Pei -mince, hereby state that this project. has been constructed pursuant to
the applicable standards & requirements, the Professional Engineer below has provided applicable
design/construction information to the Permittee, and the Permitter is prepared to operate & maintain the
Wastewater collection system permitted herein or portions thereof,
Printed Name, Title
ENGINEER'S CEICTIFICATION
Date
as a dt. .E-n egistered Professional n.neer in the State of North Carolina,
iavitig een authorized to observe periodically, I weekly, f.ull time) the construction of the
project name and location :is 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 he built. within substantial compliance of this permit; 5,028 linear feet of 8-inch public
gravity sewer; ISA NCAC 02-1'; the Division of Water Resources' (Division) Gravity Sewer Minimum
Design Criteria adopted February 12, 1.996, as applicable; the Division's Minimum. Design Criteria for
the .Fastzf rack Permitting of Pump Stations and Force Mains adopted June 1, 2000, as applicable; and
other supporting m.a.terials.
North Carolina "r. Aessional EnOneer's Seal wisignature & date:
Uf<rnal [11 Partial (include description)
44 hi aWt
Certification Comments/Qualifiers (attach if necessary):
NC DWR - Water Quality Regiona Operations Section 610 East Center Avenue, Suite 301, Mooresville„ NC 28115
Mooresvifle .fieWonal Office Phone: [phone] FAX: [phone]

CERTIFICATION CHECKLIST
To be completed by the certifying engineer prior to operation of the permitted sewers, per 15.A NCAC 02T.0116,
eord
EQ/DWR
I- L. Li 21-221
WOROS
MOORESVILLE REGIONAL OFFICE
1) Has permittee information changed since the permit was issued (or last m dined): change of mailing address,
change of ownership, transfer from developer to HOA/10A, etc, El Yes
If yes, please provide either a change of ownership Conn or new contact information. Note that transfer of
permits from the developer to the HOA/POA must occur with, the first certification.
2) Have the as -built drawings have been signed, sealed, and dated by an N.C. PE? No
3) Final Engineering certification', Yes I— No
• If Partial Engineering certification, provide detailed narrative including what is being certified in the current
phase, what was previously certified (if applicable)„ and what is left to be certified.
4) Adequate information related to sewer lines: 12S Yes [1] No LI N/A
• Three feet minimum cover has been provided for all sewers unless 'ferrous pipe was installed,
• Minimum diameters for gravity,' sewers are 8-inches for public lines and 6-inches for private lines,
• Manholes have been installed: At the end of each inc.lat all changes in grade, size, or alignment, at all
intersections, and at distances not greater than 425 feet; minimum diameter shall be 4 feet (48-inches).
.Adequate information related to pump stations: 1— Yes rj No N/A
• Ensure power reliability option was selected per I5A NCAC 02T.0305(h),
5)
Certifying Engineer:
Certification Review Date:
Project Name: 105
WQ00 9 a 2'i Project County:
6) Was project construction completed in accordance with all of the following: EJ Yes LI No 1 1 N/A
• 1.5A NCAC 02T, minimum. Design Criteria (MDC) for the permitting of Gravity Sewers (latest version), and
MDC for the Permitting of Pump Stations and Force Mains (latest version)?
if not, a variance approval is required in accordance with 15A NCAC 02T.0105(b), prior to certification, and
operation.
• Contact: the Central Office to discuss the variance to determine a course of action.
• Applicant must submit- two copies of the variance request form., plans, specifications, calculations, and any other
pertinent information to the Central Office (one hard copy, one digital copy).
• The central office wili review the variance request, and if approvable, specific language regarding the variance
will be incorporated into the permit, either via a special condition or a supplementary letter. A copy of the
reissued permit with variance language or the variance letter "mist be maintained with the original documents.
7) Does the project contains high priority lines (15A NCAC 02T .0402 2
• If yes, ensure that the permit already contains the necessary condition related to high priority lines 15A NCAC
02T.0403 (a)(5). if the permit does not include this language, the Fast Track reviewer will reissue the pemnt with
the appropriate language,
8) Are Permit modifications are required for any changes resulting in non-compliance with this permit chiding but not
limited to pipe length changes of 1094) or greater, change in flow, pump sf- tion design capacity design change of 5% or
greater, and/or change in the number/type of connections)? Yes No
• If yes, a permit modification request must he submitted to the appropriate Regional Office, and a modified
penult with revised certification must be issued prior to certification and operation.
NC DWR — Water Quality Regional Operations Section 610 East Center Avenue, Suite 301, Mooresville, NC 28115
Mooresville Regional Office Phone: [phone] FAX: [phone]

FAST TRACK SEWER ENGINEERING CERTIFICATION
REcElvED/NcoEoirmR
PERMITTEE: CITY OF HICKORY
PERMIT #: WO0041114
PROJECT: TOWNES AT SHERRILLS FORD
ISSUE DATE: SEPTEMBER 26, 2019
'3 I 0 r3S2,1
A/OROS
MOORESVILLE REGIONAL OFFICE
This project shall not he 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
docutnentation. It should be submitted in a manner that documents the Division's receipt. Send the
requireddocumentation 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 he 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 Permittee, hereby state that this project has been constructed. pursuant to
the applicable standards & requirements, the Professional Engineer 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.
I I
WOW' Apcyc litCe iffeyyr
Printed Name, Ti . e / Sigma'
ENGINEER'S CERTIFICATION
as a duly registered Professional Engineer in the State of North Carolina,
mg be authoriz to observe (K periodically, Ej Nveekly, En full time) the construction of the
project name and location as referenced above for the above Permittee hereby state t„hat, 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; 5,028 linear feet of 8-inch public
gravity sewer; 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:
El Final
Pa la
01— 131
de description)
rAtiekif
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]

CERTIF1CATION CT IE+'I I I T
To be completed by, the cert
fyin.g Engineer
ftcation Review Date:
ngineer prior to operation of the permitted sewers, per 1 5A NCA.0 02T.01 16.
Project Name: e5
WQ00 Lj 1 1 2 '' Project County:
alas pca'mittee information el
change of ownership, transfer
•
per
a
d since the permit ,vas isstied (or
n developer to IIOA/Pt:)A, etc,
led):
Yes No
please provide either a change of ownership '.Darr or new contact infornaticm
is frcarn the developer to the bIOA/POA must occur with the first certitictrtion,
2) Have the as -built drawings have been signed, sealed, and dated hye an N.C. PC?',
Final Engineering certitication`? Yes No Lc,+ 5a" 59 8
• If Partial Engineering certification, provide detailed narrative including what is being certified in the current
phase, what was previously certified (if applicable), and what is left to be certified.
4) Adequate information related to sewer lines: 'Yes [] No El N/A
• T'hree feet minimum cover has been provided for all sewers unless ferrous pipe was installed.
• Minimum diameters for gravity sewers are 8-inches for public lines and 6-inches for private lines.
• Manholes have been installed: At the end ()leach line, at all changes in grade, size, or alignment, at all
intersections. and rat el.istarices not greater than 425 feet: minimum diameter shall be 4 feet (48-inches).
dress,
IONAL OFFICE
Note that transt
Adequate inforananon related to pump stations:
Yes LI No E1 N/A
• Ertsure poorer reliability option was selected per 15A NCAC 02T,0305(h).
`as project c:orrstruetion completed in accordance with all of the following: Yes No Nr°A
• 15A NCAC 02T, Mini Design Criteria (MDC) far the permitting of Gravit Sewers (latest F°e.r irar7
MDC for the Permitting of Pump Stations and Force Mains (latest version)?
got, a variance approval is required in accordance with I SA NCAC 022T.0105(b), prior to certification ;and
operation.
• Contact the Central Office to diseus,s the var
• Applicant must submit two copies of the variance re
pertinent information to the Central Office (ogre
The central office will review the variance request
�r°ill be incorporated into the permit, either via a spec
•
deternt
a course or rtet.ron.
plans, specifications. calculations, and any other
one digital copy).
approvable, specific language regar
condition or a supplementary letter. A copy
and
reissued permit with variance language or the variance letter must be maintained with the original doe
e project co
02T.0403 (a`
the appropriate Ia
gh prio
>ad4 cog
it sloes not i
(1.5A NCAC 02T .0402(2))`? [ Yes No
Are Permit modifications are requited fret rtny than
limited to pipe length changes ot .
greater, ancttor change in the nunihtype ofconnections)`
• If yes, a permit wodifcatic:rn recltrest rntrst i.
permit with revised cer•tifiet►tion must be
the necessary. condition related to h
P
ines 15A, NCAC
ds language, the Fast Track rev'icsser evi.11 reissue
cornpl iance
pump stratic :a desigr
Yes F7 No
but not
ubmitt:ed to th.e appropriate .Regional Office, and a ►nodified
►red prior to certification and operation.
NC DWR — Water Quality Regional Operations Section 610 East Center Avenue, Suite 301, Mooresville, NC 28115
Mooresville Regional 0
Phone: (704) 6
699 FAX:[phone]