WQ0038055_Application (FTSE)_20150929

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FAYETTEVILLL riLLOU JI l ul rig• FAST -TRACK APPLICATION (FTA 10-14)
Division of Water Resources for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS
State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
General — When submitting this 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.
For more information, visit the Water Quality Permitting Section's website or;
contact the Regional Office serving your county
Unless otherwise noted, the Applicant shall submit one original and one copy of the application and supporting
documentation to the appropriate Regional Office (see page 3).
A. Cover Letter:
® Include a brief project narrative describing the final design (i.e system and/or pump station to ultimately
serve 500 homes, but flow for only 100 homes being requested now). For modifications, clearly explain
the reason for the modification (i.e. adding another phase, changing line size, length, etc).
B. Application Form (FTA 10-14):
® Submit the completed and appropriately executed Fast -Track (FTA 10-14) Application. Any unauthorized
content changes to this form shall result in the application being returned. If necessary for clarity or due
to space restrictions, attachment to the application may be made, as long as the attachments are
numbered to correspond to the section and item to which they refer. You do not need to submit detailed
plans and specifications unless you respond NO to item B(13).
® The Professional Engineer's Certification of the application shall be signed, sealed and dated by a North
Carolina licensed Professional Engineer.
O The Applicant's Certification 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).
C. Application Fee:
® Submit a check in the amount of $480 to: North Carolina Department of Environment and Natural
Resources (NCDENR).
Checks shall be dated within 90 days of application submittal.
D. Certificate of Public Convenience and Necessity (For Privately -Owned Public Utilities Only):
D Per 15A NCAC 02T .0115(a)(1), provide two copies of 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 two copies of a letter from the North Carolina Utilities Commission's Water and Sewer 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.
❑ The project name in the CPCN or letter must match that provided in Item A(2)a of this application.
E. Operational Agreements (For Home/Property Owners' Associations and Developers of lots to be sold):
Home/Property Owners' Associations
❑ Per 15A NCAC 02T .0115(c), submit the properly executed Operational Agreement (HOA 08-13).
❑ Per 15A NCAC 02T .0115(c), submit a copy of the Articles of Incorporation, Declarations and By-laws.
e Developers of lots to be sold
❑ Per 15A NCAC 02T .0115(b), submit the properly executed Operational Agreement (DEV 08-13).
Even if the project may be turned over to a municipality upon completion, Form DEV 08-13 is required.
INSTRUCTIONS FOR APPLICATION F"1'A 10-14 & St'PPORTING DOCUMENTATION Page I of 6

F. Downstream Sewer, WWTF Capacity and Flow Tracking/Acceptance Form (FTSE 08-13)
Submit the completed and appropriately executed Flow Tracking/Acceptance for Sewer Extension Permit
(FTSE 08-13) Form for all applications.
The applicant (and owners of downstream sewers, pump stations and/or treatment facilities submitting
form FTSE 08-13 certifies that the addition of the volume of wastewater to be permitted in this project
has been evaluated along the route to the receiving treatment plant, and that the flow from this project
will not cause capacity related sanitary sewer overflows or overburden any downstream pump station en
route to the receiving wastewater treatment plant.
e Where the applicant is not the owner of the downstream sewer, submit two copies of form FTSE 08-13
from the owner of the downstream sewer and owner of the WWTF, if different.
The flow acceptance indicated in form FTSE 08-13 must not expire prior to permit issuance and must be
dated Tess than one year prior to the application date.
:- Submittal of this application and form FTSE 08-13 indicates that owner has adequate capacity
and will not violate G.S. 143-215.67(a).
Intergovernmental agreements or other contracts will not be accepted in lieu of a project -specific
FTSE 08-13.
G. Site Map (All Application Packages):
® Submit an 8.5-inch x 11-inch color copy of a USGS Topographic Map of sufficient scale to identify the
entire project area and closest surface waters. Each map must include at a minimum:
The location of the sewer line and pump stations and be of reproducible quality.
Downstream connection points and the permit number for the receiving sewer (if known)
Pump Station Locations and the longitude and latitude for each pump station (if applicable)
El Include a street level map showing all relevant project areas.
H. Stream Classification (WSCAS 01-15)
O Submit the completed and appropriately executed Watershed Classification Attachment form
(WSCAS 01-15) if any portion of the sewer system project is within 100 feet of any surface water or
wetlands.
A variance must be requested for encroachment within required setbacks or buffers pursuant to 15A
NCAC 02T .0305(f)
I. Environmental Assessments (Projects subject to an Environmental Assessment (EA)):
Projects involving an Environmental Assessment per 15A NCAC 01 C .0408, must be submitted for a full
technical review and must be submitted to the PERCS Unit on application forms provided by the Division.
J. Alternative Sewer Systems
✓ Projects involving low pressure sewer systems, vacuum sewer systems and other alternative sewer
systems must be submitted for a full technical review and must be submitted to the PERCS Unit on
application forms provided by the Division.
K. Flow Direction
• Many wastewater treatment systems are entering into agreements for regionalization efforts and
emergency treatment capacity. Parts of the system are installed so that the wastewater flow can be
directed to more than one treatment facility. If this is the case with the project, please indicate in B(12)
and give the permit number of the second facility.
L. Certifications — Section C
The application must be certified by both the applicant and the design engineer who is a North Carolina
Registered Professional Engineer (PE). The applicant signature must match the signing official listed in
Item A(1b). The PE should NOT certify the application if he/she is unfamiliar with 15A NCAC Chapter
2T, The Gravity Sewer Minimum Design Criteria (most recent version) and the Minimum Design Criteria
for the Permitting of Pump Stations and Force Mains (most recent version), as applicable to the project.
INSTRUCTIONS FOR APPLICATION FTA 10-14 & SUPPORTING DOCUMENTATION Page 2 of 6

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
Water Quality Section
2090 US Highway 70
Swannanoa, North Carolina 28778
[phone]
[phone] Fax
Avery, Buncombe, Burke, Caldwell, Cherokee,
Clay, Graham, Haywood, Henderson, Jackson,
Macon, Madison, McDowell, Mitchell, Polk,
Rutherford, Swain, Transylvania, Yancey
Fayetteville Regional Office
Water Quality Section
225 Green Street Suite 714
Fayetteville, North Carolina 28301-5094
[phone]
[phone] Fax
Anson, Bladen, Cumberland, Harnett, Hoke,
Montgomery, Moore, Robeson, Richmond,
Sampson, Scotland
Mooresville Regional Office
Water Quality Section
610 E. Center Avenue
Mooresville, North Carolina 28115
[phone]
[phone] Fax
Alexander, Cabarrus, Catawba, Cleveland,
Gaston, Iredell, Lincoln, Mecklenburg, Rowan,
Stanly, Union
Raleigh Regional Office
Water Quality Section
1628 Mail Service Center
Raleigh, North Carolina 27699-1628
[phone]
[phone] Fax
Chatham, Durham, Edgecombe, Franklin,
Granville, Halifax, Johnston, Lee, Nash,
Northampton, Orange, Person, Vance, Wake,
Warren, Wilson
Washington Regional Office
Water Quality Section
943 Washington Square Mall
Washington, North Carolina 27889
[phone]
[phone] Fax
Beaufort, Bertie, Camden, Chowan, Craven,
Currituck, Dare, Gates, Greene, Hertford, Hyde,
Jones, Lenoir, Martin, Pamlico, Pasquotank,
Perquimans, Pitt, Tyrrell, Washington, Wayne
Wilmington Regional Office
Water Quality Section
127 Cardinal Drive Extension
Wilmington, North Carolina 28405
[phone]
[phone] Fax
Brunswick, Carteret, Columbus, Duplin, New
Hanover, Onslow, Pender
Winston-Salem Regional Office
Water Quality Section
450 W. Hanes Mill Road
Suite 300
Winston-Salem, North Carolina 27105
[phone]
Alamance, Allegheny, Ashe, Caswell, Davidson,
Davie, Forsyth, Guilford, Rockingham, Randolph,
Stokes, Surry, Watauga, Wilkes, Yadkin
INSTRUCTIONS FOR APPLICATION FTA 10-14 & SUPPORTING DOCUMENTATION Page 3 of 6

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1. Owner/Permittee:
la. Campbell University
Application Number.
(to be completed by DWR) a o03S 0 CS -
Full Legal Name (company, municipality, HOA, utility, etc.)
1b. Jim Roberts, Vice President for Business & Treasurer
Signing Official Name and Title (Please review 15A NCAC 2T .0106 (b) for authorized signing officials)
1 c. The legal entity who will own this system is:
❑ Individual 0 Federal 0 Municipality 0 State/County ® Private Partnership ❑ Corporation 0 Other (specify):
ld. PO Box 97 le. Buies Creek
Mailing Address City
1 f. NC lg. 27506
State Zip Code
lh. 919-893-1240 1 i. N/A 1j. [e-mail]
Telephone
Facsimile E-mail
2. Proiect (Facilitvl Information:
2a. Campbell University — South Residence Hall
Brief Project Name (permit will refer to this name)
3. Contact Person:
3a. Roy P. Lorenzen , Senior Project Manager, Stewart Engineering
2b. Harnett
County Where Project is Located
Name and Affiliation of Someone Who Can Answer Questions About this Application
3b. 919-866-4813
Phone Number
1. Project is ® New
3c. [e-mail]
E-mail
0 Modification (of an existing permit) If Modification, Permit No.:
2. Owner is ❑ Public (skip to Item 8(3)) ® Private (go to Item 2(a))
2a. If private, applicant will be:
® Retaining Ownership (i.e. store, church, single office, etc.) or
0 Leasing units (lots, townhomes, etc. - skip to Item 13(3))
0 Selling units (lots, townhomes, etc. - go it, Item B(2b))
3. Hamett County Public Utilities
2b. If sold, facilities owned by a (must choose one)
❑ Public Utility (Instruction D)
❑ Homeowner Assoc./Developer (Instruction E)
Owner of Wastewater Treatment Facility (VVWTF) Treating Wastewater From This Project
4a. North Hamett Regional Treatment Facility
Name of VVWTF
5a. HCDPU
Owner of Downstream Sewer
4b. NC0021636
WVTF Permit No.
b. 12 I® Gravity 5c. Unknown
leceiving Sewer Size p Force Main Permit # of Downstream Sewer (Instruction F)
6. The origin of this wastewater is (check all that apply):
❑ Residential Subdivision
❑ Apartments/Condominiums
❑ Mobile Home Park
® School
❑ Restaurant
❑ Office
0 Retail (Stores, shopping centers)
0 Institution
❑ Hospital
0 Church
❑ Nursing Home
0 Other (specify):
7. Volume of wastewater to be allocated or permitted for this particular project: 23.880
*Do not Include future flows or previously permitted allocations
% Domestic/Commercial
% Industrial
(Attach Description)
Other
(Attach Description)
gallons per day
8. If the permitted flow is zero, indicate why:
❑ Pump Station, Outfall or Interceptor Line where flow will be permitted in subsequent permits that connect to this line
❑ Flow has already been allocated in Permit No.
❑ Rehabilitation or replacement of existing sewer with no new flow expected
(see 15A NCAC 02T .0303 to determine if a permit is required)
FTA 10-14 APPLICATION Page 4 of 6

9. Provide the wastewater flow calculations used in determining the permitted flow in accordance with 15A NCAC 2T .0114 for
the value in Item B(7) AND/OR the design flow for line or pump station sizing if a reduced or zero flow is being requested in
Item B(7). Values other than that in 15A NCAC 2T .0114 (b) and (c) must be supported with actual water or wastewater use j
data in accordance with 15A NCAC 2T .0114 (f).
120 gal/bed/day x 199 beds = 23,880 gal/day
10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary)
New Gravity or Additional 1
Size (inches) Length (feet) Force Main
8 104 Gravity
6 103 Gravity
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11. Summary of Pump Stations w/ associated Force Mains to be Permitted (attach additional sheets as necessary)
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•—+ Longitude: Latitude:
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F.. Design Flow Operational Point Power Reliability Option
(MGD) GPM �TDH 1 - permanent generator w/ATS; Force Main Size Force Main Length
2 - portable generator w/MTS
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Z Pump Station Location ID: (self chosen - as shown on plans/map for reference)
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2 Longitude: Latitude:
L
W Design Flow Power Reliability Option
O. (MGD) Operational Point 1 - permanent generator w/ATS; Force Main Size Force Main Length
Oi GPM @TDH 2 - portable generator w/MTS
12. Will the wastewater flow in the proposed sewer lines or pump stations be able to be directed to another treatment facility?
❑ Yes ® No If Yes, permit number of 2nd treatment facility :
(RO — if "yes" to B,12 please contact the Central Office PERCS Unit)
13. Does the sewer system comply with the Minimum Design Criteria for the Permittina of Puma Stations and Force Mains
(latest version), the Gravity Sewer Minimum Design Criteria (latest version) and 15A NCAC Chapter 2T as applicable?
❑ Yes ❑ No
If No, complete and submit the Variance/Altemative Design Request (VADC 10-141 application and supporting
documents for review. Approval of the request is required prior to submittal of the Fast Track Application and
supporting documents.
FTA 10-14 APPLICATION Page 5 of 6

14. Have the following permits/certifications been submitted for approval for the system or project to be served?
Wetland/Stream Crossings - General Permit or 401 Certification?
Sedimentation and Erosion Control Plan?
Trout Buffer Waiver?
Stormwater?
❑ Yes ❑ No ® N/A
® Yes ❑ No ❑ N/A
❑ Yes ❑ No ® N/A
❑ Yes ❑ No ®N/A
15. Does this project include any high priority lines (15A NCAC 02T .0402 (2)) involve aerial lines, siphons, or interference
manholes)? These lines will be considered hiseh Priority and must be checked once every six months
Check if Yes: ❑ and provide details:
1. Owner/Permittee's Certification: (Signature of Signing Official and Project Name)
1, Jim Roberts attest that this application for Campbell University — South Residence Hall has been reviewed by me
and is accurate and complete to the best of my knowledge. I understand that if all ►equired parts of this application are not
completed and that if all requited supporting documentat/on and attachments am not included, this application package is
subject to being returned as incomplete. Note: In accordance with North Carolina General Statutes 143-215.6A and 143-
215.68, any person who knowingly makes any false statement, representation, or certification in any application shall be
guilty of a Class 2 misdemeanor, which may include a fine not to exceed $10,000 as well as civil penalties up to $25,000
per violation.
1 a.
a AAA
Signir Official Signature
q �+jzol5
Date
ENGINEERING DESIGN DOCUMENTS MUST BE COMPLETED PRIOR TO SUBMITTAL OF THIS
APPLICATION. THESE DOCUMENTS MUST INCLUDE PLAN AND PROFILE OF SEWERS, THEIR PROXIMITY
U) TO OTHER UTILITIES, DESIGN CALCULATIONS, ETC. REFER TO 15A NCAC 02T .0305
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Q2. Professional Engineer's Certification: (Signature of Design Engineer and Project Name)
▪ 1, Roy P. Lorenzen ,attest that this application for Campbell University — South Residence Hall has been reviewed
by me and is accurate, complete and consistent with the information in the engineering plans, calculations, and all other
- supporting documentation to the best of my knowledge. I further attest that to the best of my knowledge the proposed
WIJdesign has been prepared in accordance with the applicable regulations, Gravity Sewer Minimum Design Criteria for Gravity
L Sewers adopted February 12, 1996, and the Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and
Force Mains adopted June 1, 2000 and the watershed classification in accordance with Division guidance. 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 NC General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false
statement, representation, or ce►tification in any application shell 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.
V
2a. Roy P. Lorenzen
Professional Engineer Name
2b. Stewart
Engineering Firm
2c. 421 Fayetteville Street, Suite 400
Mailing Address
2d. Raleigh
City
2g. 919-886-4813
2h. 919-380-8750
Telephone Facsimile
2e. NC 2f. 27601
State Zip
2i. riorenzengstewartinc.com
E-mail
FTA 10-14 APPLICATION Page 6 of 6
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NC PE Seal, Signature & Date

State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
Flow Tracking/Acceptance for Sewer Extension Permit Applications
(FTSE 06-13)
Project Applicant Name: Campbell University
Project Name for which flow is being requested: South Residence Hall — 23,880gpd
More than one FTSE may he required for a single project if the owner of the WWTP is not responsible for ull pump
stations along the route of the proposed wastewater flow
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: North Harnett Regional WWTP
b. WWTP Facility Permit #: NC0021636
c. WWTP facility's permitted flow
Fuquay Varina Allocated Flow
Lillington Allocated Flow
Angier Allocated Flow
d. Estimated obligated flow not yet tributary to the WWTP
FV Obligated Flow NYT
Lillington Obligated Flow NYT
HC Obligated Flow NYT
Angier Obligated Flow NYT
e. WWTP facility's actual avg. Clow
FV Actual Flow
Lillington Actual Flow
HC Actual Flow
Angier Actual Flow
f. Total flow for this specific request
g. Total actual and obligated flows to the facility
FV Actual Avg. + Obligated Flow
Lillington Actual Avg. + Obligated Flow
HC Actual Avg. + Obligated Flow+ Request
Angier Actual + Obligated Flow
h. Percent of permitted flow used
*North Harnett WWTP is being evaluated by NCDENR-
DWR for planned future expansion.
All flows are in MGD
5.600 MGD
2.60 MGD
1.20 MGD
1.008 MGD
1.199 MGD
0.836 MGD
0.101 MGD
0.221 MGD
0.041 MGD
4.302 MGD
1.269 MGD
0.637MGD
1.918 MGD
0.478 MGD
0.024 MGD
5.538 MGD
2.118 MGD
0.738 MGD
2.163 MGD
0.519 MGD
98.89% (Overall)
Page 1 of 6
FTSF 06-1 3

I1. Complete this section for each pump station you are responsible for along the route of this
proposed wastewater flow.
List pump stations located between the project connection point and the WWTP:
(A) (B) (C) (D)=(B+C) (E)=(A-D)
Design Obligated.
Average Daily Approx. Not Yet Total Current
Firm Flow** Current Avg. Tributary Flow Plus
Pump Station Capacity,* (Firni / pf), Daily Flow. Daily Flow. Obligated Available
(Name or Number) MGD MGD MGD MGD Flow Capacity***
SLS #10B 2.304 0.921 0.563 0.091 0.654 0.267
HCDPU Regional 14.4
SLS # 120 (10 000eom) 5.76 2.22 1.014 3.250 2.511
* The Firm Capacity of any pump station is defined as the maximum pumped flow that
can be achieved with the largest pump taken out of service.
** Design Average Daily Flow is the firm capacity of the pump station divided by a peaking
factor (pf) not less than 2.5.
*** A Planning Assessment Addendum shall be attached for each pump station located
between the project connection point and the WWTP where the Available Capacity is < O.
III.
Certification Statement:
I Steve Ward — Director of Public Utilities certify to the best of my 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 II
plus all attached planning assessment addendums for which I am the responsible party.
Signature of this form inc ates acceptance of this wastewater flow.
? it
Signing Ofircial Signature Date
Page 2 of 6
FTS E 06-13

STEWART
LETTER OF TRANSMITTAL
TO
rnipcsim
ip
sEP2sze-
�wR
FROM. i tVILLE REGION,
NCDENR-DWQ
Colie Crosby
225 Green Street Suite 714
STEWART
Fayetteville, NC 28301
[phone]
DATE
SENT VIA
09/24/2015
Mail Delivery
PROJECT NUMBER
PROJECT NAME
C15001
Campbell University - South Residence Hall
COPIES
DATE
DESCRIPTION
2
-
Cover Letter
2
-
Signed Application Form
2
-
Site Maps (USGS Topographic / Street Level map)
1
-
Check in the amount of $480
2
-
Flow Tracking Acceptance Form
For approval
For review & comment
C
Returned for corrections
EFor
your use
Approved as submitted
E
Returned after review
E
As requested
Approved as noted
C
Resubmit copies for approval
COMMENTS
Please find the enclosed submittal package for the above referenced sewer service
line addition for the Campbell University- South Residence Hall project. Please let me
know if you need any additional information or have any questions.
Thank you,
SIG
Colie Crosby
Received By:
421 FAYETTEVILLE STREET MALL
SUITE 400
RALEIGH, NC T 919.380.8750
27601 F 919.380.8752

STEWART
September 24, 2015
Division of Water Resources
Fayetteville Regional Office
225 Green Street, Suite 714
Fayetteville, NC 28301
NCDENR Division of Water Resources - Sewer Fast Track Application
Campbell University - South Residence Hall
The Campbell University South Residence Hall site is located approximately 1,200
linear feet east of the intersection of US 421 / NC 27 and Leslie Campbell Avenue
along Leslie Campbell Avenue. The project is proposing an approximate 150 linear
feet of 6" P.V.C. gravity sewer service from the proposed South Residence Hall
building. There is an estimated 23,880 gal/day increase in flow to the existing system
provided by the proposed residence hall. These values are based on 120 gal/bed/day,
(from NCDENR 2T rules) for the proposed 199 beds.
These services will tie into the Sanitary Sewer piping completed as part of the Early
Utility Relocation Package under the Permit #WQ0037030, Campbell University
Water and Sewer Utility Relocation Wastewater Collection System Extension Permit,
August 6, 2015.
The existing system flow will be carried downstream by a 12" Harnett County
Department of Public Utilities permitted sewer and treated at the North Harnett
Regional Sewer Plant.
If you have any questions, feel free to contact me at your convenience.
Sincerely,
Colie Crosby
421 Fayetteville Street, Suite 400
Raleigh, NC 27601
P: 919-866-4796
Email: [e-mail]
STRONGER BY DESIGN
421 FAYETTEVILLE ST.
SUITE 400
RALEIGH, NC T 919.380.8750
27601 F 919.380.8752

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USE THE TAB KEY TO MOVE FROM FIELD TO FIELD
1. Owner/Permittee:
la. Campbell University
Full Legal Name (company, municipality, HOA, utility, etc.)
Application Number:
(to be completed by DWR)
CEIVEtt))
SEP 2 12015
FAYETTEVI!_I_E RFGf(1NI
(:3; 3oi
1 b. Jim Roberts, Vice President for Business & Treasurer
Signing Official Name and Title (Please review 15A NCAC 27 .0106 (b) for authorized signing officials)
1 c. The legal entity who will own this system is:
❑ Individual ❑ Federal ❑ Municipality ❑ State/County ® Private Partnership ❑ Corporation ['Other (specify):
ld. PO Box 97
Mailing Address City
1 f. NC lg. 27506
le. Buies Creek
State
919-893-1240
Zip Code
1 i. N/A 1j. [e-mail]
Telephone Facsimile
2. Project (Facility) Information:
2a. Campbell University — South Residence Hall
Brief Project Name (permit will refer to this name)
3. Contact Person:
3a. Roy P. Lorenzen , Senior Project Manager, Stewart Engineering
E-mail
2b. Hamett
County Where Project is Located
Name and Affiliation of Someone Who Can Answer Questions About this Application
3b. 919-866-4813 3c. [e-mail]
Phone Number E-mail
1. Project is ® New ❑ Modification (of an existing permit) If Modification, Permit No.:
2. Owner is ❑ Public (skip to Item B(3)) ® Private (go to Item 2(a))
2a. If private, applicant will be:
® Retaining Ownership (i.e. store, church, single office, etc.) or
❑ Leasing units (lots, townhomes, etc. - skip to Item B(3))
❑ Selling units (lots, townhomes, etc. - go to Item B(2b))
3. Hamett County Public Utilities
2b. If sold facilities owned by a (must choose one)
❑ Public Utility (Instruction D)
❑ Homeowner Assoc./Developer (Instruction E)
I_ OFFICE
STEWART ENGINEERING, INC.
OPERATING ACCOUNT
421 FAYETTEVILLE ST. SUITE 400
RALEIGH, NC 27601
[phone]
PAY
Four Hundred Eighty and 00/100 Dollars
TO
NCDENR
c/o ENR Building
217 West Jones Street
Raleigh, NC 27603
PNC BANK, N.A.--
15-3-540
Account #: Stewart
CHECK DATE
14050
September 9, 2015
AMOUNT
480.00
5/ttifelfrt
Details on back.
8
FTA 10-14 APPLICATION Page 4 of

Central Files: APS _ SWP
10/2/2015
Permit Number WQ0038055 ° Permit Tracking Slip
Program Category Status Project Type
Non -discharge Active New Project
Permit Type
Gravity Sewer Extension, Pump Stations, & Pressure Sewer Extensions
Primary Reviewer
trent.allen
Coastal SWRuIe
Permitted Flow
23,880
Facility
Version Permit Classification
1.00 Individual
Permit Contact Affiliation
Facility Name
Campbell Unibersity - South Residence Hall
Location Address
Owner
Major/Minor Region
Minor Fayetteville
County
Harnett
Facility Contact Affiliation
Owner Name
Campbell University Inc
Dates/Events
Owner Type
Non -Government
Owner Affiliation
Jim Roberts
PO Box 97
Buies Creek
NC 27506
Orig Issue
10/2/2015
Scheduled
App Received Draft Initiated Issuance Public Notice Issue Effective Expiration
9/29/2015 10/2/2015 10/2/2015
Regulated Activities Requested /Received Events
Wastewater collection Additional information requested
Additional information received
Outfall
Waterbody Name Streamlndex Number
Current Class Subbasin

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B
� 22
• wf —
ta
6,3
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•
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