WQ0023336_Application (FTSE)_20031126

,.ACKAPPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 1
USE THE TAB KEY TO MOVE FROM FIELD TO FIELD! Application Number:
(to be completed by DWQ) tO Q 61!)a 33 3 j
1. Owner:
1 a. Public Works Commission of the City of Fayetteville
Full Legal Name (company, municipality, HOA, utility, etc.)
Ib. Joseph E. Glass, P.E. - Water Resources Engineering Manager
Signing Official Name and Title (Please review 15A NCAC 2H .0206(b) for authorized signing officials!)
1 c. The legal entity who will own this system is:
El Individual ❑ Federal ® Municipality ❑ State/County ❑ Private Partnership ❑ Corporation ❑ Other (specify):
ld. 955 Old Wilmington Road le. Fa etteville
Street Address
If. North Carolina
z
Q 1 h. [phone] 1 i. [phone]
QTelephone Facsimile
O 2. Project (Facility) Information:
a2a. King's Grant Subdivision -Multifamily Tract (Section C) 2b. Cumberland
State
G. Brief Project Name (permit will refer to this name)
< 13. Contact Person: Pimna Chomchai, P.E.
Q 3a. The Rose Group, Inc.
City
lg. 28301
Zip Code
1j. 'oe.•lass • fa •wc.com
E-mail
County Where Project is Located
Almm. nn'i Affilinfinn of Cnmiv.nn \AIk- l'nn Aneu.n.• ll.,enfi...... AM..t at.... A....G....a...,
THE
ROSE
GROUP.
ENGINEERS • PLANNERS • SURVEYORS
P.O. Box 103
Fayetteville, NC
28302
THE SUM OF FOUR HUNDRED U.S. Dollars 00/100 ONLY
PAY
TO THE
ORDER
OF
NC DENR
225 Green Street
Fayetteville, NC 28301-5043
tp[Poo 3�3k
BB&T
Branch Banking and Trust Company
66-1121531
45755
DATE AMOUNT
10/20/2003 $400.00
THE ROSE GROUP. INC.
Caart

& BOTTOM BORDERS - COLORED PATTERN ARTIFICIAL `;4ATERMARK. ON REVERSE SIDE. - MI SING FEATURE IND CATES .A COP','
Ce LAI rcesiuenuai auoaivision
ll.l ElApartments/Condominiums
0- 0 Mobile Home Park
0 School
m 0 Restaurant
O Office
u uar vvasn
❑ Institution
❑ Hospital
❑ Church
❑ Nursing Home
❑ Other (specify):
100 % Domestic/Commercial
% Industrial
% Other (specify):
. Volume of wastewater to be permitted in this project: 13.740 gallons per day
. If the permitted flow is zero, indicate why:
❑ Interceptor Line - Flow will be permitted is 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
VVA A' /M

NOV ?.
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
FAST -TRACK APPLICATION
for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS
(Pressure sewers systems are not to be included as part of this application package)
INSTRUCTIONS: Indicate that you have included the following list of required application package items by checking the
space provided next to each item. Failure to submit all required items will lead to your application being returned as
incomplete or additional processing and review time. This form may be photocopied for use as an original.
® I. Application Form - Submit one original and one copy of the completed and appropriately executed application
form. Any changes to this form will result in the application being returned. The Division of Water Quality
(Division) will only accept application packages that have been fully completed with all applicable items
addressed. You do not need to submit detailed plans and specifications unless you respond NO to Item B(12).
® II. Application Fee - Submit a check in the amount of $400 made payable to: North Carolina Department of
Environment and Natural Resources (NCDENR).
❑ III. Certificates of Public Convenience and Necessity — If the application is being submitted in the name of a
privately -owned public utility, submit two copies of the Certificate of Public Convenience and Necessity (CPCN)
which demonstrates that the public utility is authorized to hold the utility franchise for the area to be served by the
sewer extension. If a CPCN has not been issued, provide two copies of a letter from the North Carolina Utilities
Commission's Public Staff that states that an application for a franchise has been received, that the service area
is contiguous to an existing franchised area, and/or that franchise approval is expected. The project name in the
CPCN or letter must match that provided in Item A(2a) of this application.
❑ IV. Operational Agreements — Submit one original and two copies of a properly executed operational agreement if
the sewer extension will be serving residential or commercial lots (e.g., houses, condominiums, townhomes,
outparcels, etc.) that will be owned by a homeowners' association or developer (Item B(2b)). If the applicant is a
homeowners' association, use Form HOA 02/03. If the applicant is a developer, use Form DEV 02/03. EVEN IF
THE PROJECT WILL BE TURNED OVER TO A MUNICIPALITY, FORM DEV 02/03 IS REQUIRED.
❑ V. Flow Acceptance Letters — If the owner of the downstream sewers and/or WWTF is different from the applicant,
submit two copies of a flow acceptance letter from the owner of the downstream sewers and WVVTF, if different.
Flow acceptance letters must contain the following minimum information: applicant and project name, amount of
flow accepted, and name and permit number of the receiving sewers/WVVTF. The flow acceptance must not
expire prior to permit issuance and must be dated less than a year prior to the application date.
Intergovernmental agreements or other contracts will not be accepted in lieu of a project -specific flow acceptance
letter.
® VI. Map — Submit an 8.5-inch by 11-inch copy of the portion of a 7.5-minute USGS Topographic Map along with this
form. The map should identify the entire project area location as well as the closest downslope surface waters as
clearly as possible. Each map portion must be labeled with the map name and number, the identified location,
and be of clear and reproducible quality. For instance, if the project involves 4 miles of interceptor sewer that
traverses over or near several different waterbodies (or counties, basins, etc.), the map should have location ID's
for each different waterbody (where the sewer line is within 100 feet of such waterbody - see Instruction VII).
❑ VII. Watershed Classifications — Section C
• If any portion of the project is within 100 feet of any down slope surface water, Section C must be completed
for the pertinent sections.
• If the entire project area is a minimum of 100 feet away from any down slope surface waters BUT there is a
pump station involved where a history of power outage is to be used to provide adequate design storage
instead of dual feed or permanent or portable generator, Section C must be completed to demonstrate that
the closest down slope surface water is Class C (see 15A NCAC 2H .0219(h)(3)(D)).
• Use the guidance document entitled, "Determining Watershed Classifications for Form FTA 02/03 (Fast -Track
Sewer Systems)" available from http://h2o.enr.state.nc.us/ndpu or by contacting the appropriate regional
office.
INSTRUCTIONS FOR FORM FTA 02/03

•
❑ VIII. Environmental Assessments — If this project is subject to an Environmental Assessment (EA) ]15A NCAC
01C .0500], this application can not be used. Send the project application on Form PSFMGSA 10/99 to the
Non -Discharge Permitting Unit, 1617 Mail Service Center, Raleigh, NC 27699-1617. Applications can not be
processed until a Finding of No Significant Impact (FONSI) or Environmental Impact Statement (EIS) has been
issued. A copy is to be submitted with that permit application.
® IX. Certifications — Section D
The application must be certified by both the applicant and a North Carolina Registered Professional Engineer
(PE). The applicant signature must match the signing official listed in Item A(1 b). The PE should NOT certify the
application if he/she is unfamiliar with 15A NCAC 2H .0200, the Gravity Sewer Minimum Design Criteria (most
recent version) and the Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains
(most recent version), as applicable to the project. Certification by a PE who is unfamiliar with these documents
is subject to NC Board referral.
THE COMPLETED FTA 02/03 APPLICATION PACKAGE, INCLUDING ALL SUPPORTING DOCUMENTS AND $400
FEE, SHOULD BE SENT TO THE APPROPRIATE
REGIONAL OFFICE
ADDRESS
COUNTIES SERVED
Asheville Regional Office
59 Woodfin Place
Asheville, North Carolina 28801
[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
225 Green Street Suite 714
Fayetteville, North Carolina 28301
[phone]
[phone] Fax
Anson, Bladen, Cumberland, Harnett, Hoke,
Montgomery, Moore, Robeson, Richmond,
Sampson, Scotland
Mooresville Regional Office
919 N Main Street
Mooresville, North Carolina 28115
[phone]
[phone] Fax
Alexander, Cabarrus, Catawba, Cleveland,
Gaston, Iredell, Lincoln, Mecklenburg, Rowan,
Stanly, Union
Raleigh Regional Office
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
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
127 Cardinal Drive Extension
Wilmington, North Carolina 28405
[phone]
[phone] Fax
Brunswick, Carteret, Columbus, Duplin, New
Hanover, Onslow, Pender
Winston-Salem Regional
Office
585 Waughtown Street
Winston-Salem, North Carolina
27107
[phone]
[phone] Fax
Alamance, Alleghany, Ashe, Caswell,
Davidson, David, Forsyth, Guilford,
Rockingham, Randolph, Stokes, Surry,
Watauga, Wilkes, Yadkin
For more information, visit our web site at: http://h2o.enr.state.nc.us✓ndpu/
INSTRUCTIONS FOR FORM FTA 02/03

FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS
PAGE 1
USE THE TAB KEY TO MOVE FROM FIELD TO FIELD! Application Number: -7
(to be completed by DWQ) mitypQ v 33
1. Owner:
1 a. Public Works Commission of the City of Fayetteville
Full Legal Name (company, municipality, HOA, utility, etc.)
...___......_. _.__...
Z 1 b. Joseph E. Glass, P.E. — Water Resources Engineering Manager
0 Signing Official Name and Title (Please review 15A NCAC 2H .0206(b) for authorized signing officials!)
F"" lc. The legal entity who will own this system is:
• Individual ■ Federal Municipality ■ State/County ■ Private Partnership ■ Corporation • Other (specify):
Fa
Ce 1 d. 955 Old Wilmington Road le. Fayetteville
0 Street Address City
LL
Z If. North Carolina 1g. 28301
z State Zip Code
0 El h. [phone] li. [phone] 1 j. joe.glass©faypwc.com
Q Telephone Facsimile E-mail
o 2. Project (Facility) Information:
1
a 2a. King's Grant Subdivision -Multifamily Tract (Section C) 2b. Cumberland
G. Brief Project Name (permit will refer to this name) County Where Project is Located
< 3. Contact Person: Pimna Chomchai, P.E.
Q 3a. The Rose Group, Inc.
Name and Affiliation of Someone Who Can Answer Questions About this Application
3b. 910-323-3400 Ext. 223 3c. [e-mail]
Phone Number E-mail
1. Project is 0 New • Modification
(of an existing permit) If Modification, Permit No.:
2. Owner is 0 Public (skip to Item B(3)) • Private (go to Item 2(a))
2a. If private, applicant will be:
2b. If sold, facilities owned by a (must choose one)
• Retaining Ownership (i.e. store, church, single office, etc.) • Public Utility (Instruction III)
• Leasing units (lots, townhomes, etc. - skip to Item B(3)) • Homeowner Assoc./Developer (Instruction IV)
• Selling units (lots, townhomes, etc.
- go to Item B(2b))
Z 3. Public Works Commission
0
Owner of Wastewater Treatment Facility (WWTF) Treating Wastewater From This Project
iH
5 4a. Cross Creek 4b. NC0023957
0 ! Name of WWWTF WTF Permit No.
0 ,5a. Public Works Commission
5b. 15" 6c.
Z Owner of Downstream Sewer
Receiving Sewer Size Permit Number of Downstream Sewer
H 6. The origin of this wastewater is (check all that apply):
22
0 Residential Subdivision ■ Car Wash
W■ Apartments/Condominiums
IN Institution 100 % Domestic/Commercial
12 ■ Mobile Home Park
• Hospital
■ School
• Church % Industrial
Im • Restaurant
• Nursing Home
■ Office
% Other (specify):
■ Other (specify):
7. Volume of wastewater to be permitted
in this project: 13.740 gallons per day
8. If the permitted flow is zero, indicate
why:
is subsequent permits that connect to this line
in Permit No.
• Interceptor Line - Flow will be permitted
• Flow has already been allocated
■ Rehabilitation or replacement of
existing sewer with no new flow expected
CT A A'l /AZ

,.FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 2
I. Provide the wastewater flow calculations used in determining the permitted flow in accordance with 15A NCAC 2H
.0219(1) for Item B(7) or the design flow for line or pump station sizing if zero flow in the space below. Values other than
that in 15A NCAC 2H .0219(1)(1-2) must be approved prior to submittal of this application. Submit a separate request to
the Division of Water Quality, Non -Discharge Permitting Unit, 1617 Mail Service Center, Raleigh, NC 27699-1617 in
accordance with 15A NCAC 2H .0219(1)(3).
There will be 112 units of condominiums with 3 bedrooms per unit; 120 gal/unit/day X 112 units =13,440 gal per day.
There will be a swimming pool in this Section C. Assume that there will be 30 people using the pool in 1 day;
10 gaUperson/day X 30 people = 300 gal per day.
Total wastewater flow =13,440 gallon per day + 300 gallon per day =13,740 gallon per day
10. Summary of Sewer Lines to be Permitted (attach additional sheets if necessary)
ENTER TOTAL LINE LENGTH IN MILES
0.64
11. Summary of Pump Stations to be Permitted (attach additional sheets as necessary)
2
0
LL
Z
cc
W
a
E12. Does the sewer system comply with the Minimum Design Criteria for the Fast Track Permitting of Pump Stations and Force
COMains (latest version), the Gravity Sewer Minimum Design Criteria (latest version) and 15A NCAC 2H .0200 as applicable?
® Yes ❑ No If no, please reference the pertinent minimum design criteria or regulation and indicate why a
variance is requested:
Location ID
(as shown on plans
Design Flow
(MGD)
Operational Point
GPM @ TDH
Gravity or Force Main
(pull down menu)
Gravity
Power Reliability Option
(dual line feed, permanent generator,
portable generator, wet well storage)
;SUBMIT TWO COPIES OF PLANS, SPECIFICATIONS OR CALCULATIONS PERTINENT TO THE VARIANCE WITH YOUR APPLICATION
13. Have the following permits/certifications been submitted for approval?
Wetland/Stream Crossings - General Permit or 401 Certification? ® Yes ❑ No ❑ N/A
Sedimentation and Erosion Control Plan? ❑ Yes ® No ❑ N/A
Stormwater? ❑ Yes ❑ No ® N/A
ICI" A An /AZ

,FAST -TRACK APPLICATION for GRAVITY SEWERS, PUMP STATIONS, AND FORCE MAINS PAGE 3
1 attest that this application for King Grant -Multifamily Tract - Section C 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 retumed 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.
Signing Official . atu
Professional En • sneer's Certification:
H
Q ❑ A Watershed Classification is not needed because all parts of the project are at least 100 feet away from any down
(.) slope waterbody; AND,
LL' 0 A Watershed Classification is not needed because the design does not depend on wet well storage as a power
reliability option for any pump station near a Class C down slope waterbody.
aLocation ID Waterbody Stream Waterbody
.J on Map River Basin Index Classification
35078-B8-TF-024 Cape Fear 18-24-3 (1) 0 WS-IV
W
1. Use the Division's guidance document entitled, "DETERMINING STREAM CLASSIFICATIONS FOR FORM FTA 02/03
z (FAST -TRACK SEWER SYSTEMS)" to collect and record the stream classification data below (attach additional sheets as
O necessary). This document is available from our web site or by contacting the appropriate Division of Water Quality
regional office (see instructions for addresses) OR indicate the following:
Name of
Waterbody County
McPherson Creek Cumberland
C .2/4,
u)
I attest that this a
pp ion ng u � ami y
complete and consistent with the information in the engineering plans, calculations, and all other supporting documentation
I —to the best of my knowledge. I further attest that to the best of my knowledge the proposed design has been prepared in
Q accordance with the applicable regulations, Gravity Sewer Minimum Design Criteria for Gravity Sewers adopted February
V 12, 1996, and the Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains adopted June
LL I 1, 2000 and the watershed classification in accordance with Division guidance. Although certain portions of this submittal
package may have been developed by other professionals, inclusion of these materials under my signature and seal
re signifies that I have reviewed this material and have judged it to be consistent with the proposed design. Note: In
W accordance with NC General Statutes 143-215.6A and 143-215.68, any person who knowingly makes any false statement,
t 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.
2a. Pimna Chomchai, P.E.
complete
ti for Ki Grant-M ltif 7 Tract - Section C has been reviewed by me and is accurate
Professional Engineer Name
2b. The Rose Group, Inc.
Engineering Firm
2c. 104 Gillespie Street
Address
2d. Fayetteville
City
2g. 910-323-3400 2h. 910-323-1028 2i. [e-mail]
2e. NC 2f. 28301
State Zip
Telephone Facsimile
E-mail
• Submit the 8.5" x 11" topographic map as required in Instruction VI regardless of whether a classification is provided!
'1. Applicant's Certification:
Date
"'-',,�♦4,,7� ■GNS G -4
Seal, Signature & Date
LTA Al/A

edICUrodInisyR2Orsolividag 10120203SMISMA,12001/

REQUIREMENTS & SPECIFICATIONS
FOR Nov 2620
SEWER MAIN EXTENSIONS
FOR
THE PUBLIC WORKS COMMISSION
FAYETTEVILLE, NORTH CAROLINA
CUMBERLAND COUNTY
PROJECT:
Kings Grant Phase I
Multi Family Tract
DATE SUBMITTED November 24, 2003