WQ0042797_Application (FTSE)_20210819

State of North Carolina
Department of Environmental Quality
DWR Division of Water Resources
15A NCAC 02T .0300 - FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: W. V D g7q(to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: Town of Stantonsbure (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State."County ® Municipal ❑ Other
3. Signature authority's name: David Beaman per 15A NCAC 02T .0106tbj
Title: Town Manaeer�3n
4. Applicant's mailing address: 108 Commercial Avenue
City: Stantonsbutg State: NC Zip: 27883- _ �{,t% • l # "J�1�
5. Applicant's contact information: _
na Ipluaiuuuj►nu330;4a(1oN►
Phone number: [phone] Email Address: david townofstantonsbur .com
11. PROJECT INFORMATION:
1. Project name: Briar Farm
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
If a modification, provide the existing permit number: WQ0000213 and issued date:
If new construction but part of a master plan, provide the existing permit number: WQ00...
3. County where project is located: Wilson
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.603 - Longitude:-77.808
5. Parcel ID (if applicable): 3657-77-0648
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Robert S. Bartlett License Number: 20106
Firm: Bartlett EnOneerine & Surveying, PC
Mailing address: 1906 Nash Street N.
City: Wilson State: NC Zip: 27893-
Phone number: [phone] Email Address: robertAbartletteng.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Stantonsbure WWTP Permit Number: NCO057606
Owner Name: Town of StantonsburQ
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ Downstream (Receiving) Sewer Size: 8 inch
System Wide Collection System Permit Number(s) (if applicable): WOCS00213
Owner Name(s): Town of Stantonsbure
FORM: FTA 04- l6 Page l 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?
❑ Yes ❑No ®NIA
2. If the Applicant is a Developer of lots to be sold, has a Devel9per's O erational Agreement (FORM: DEV) been attached?
❑ Yes ❑No ®NIA
3. If the Applicant is a HomeiProuerty Owners'. Amociation, has an Operational AereementtFQRM: HOA) been attached?
❑ Yes ❑No ®NIA
4. Origin of wastewater: (check all that apply):
® Residential Owned ❑ Retail (stores, centers, malls) ❑ Car Wash
❑ Residential Leased ❑ Retail with food preparation/service ❑ Hotel and/or Motels
❑ School l preschool I day care ❑ Medical 1 dental.-` veterinary facilities ❑ Swimming Pool /Clubhouse
❑ Food and drink facilities ❑ Church ❑ Swimming Pool/Filter Backwash
❑ Businesses i offices / factories ❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater: 100 % DomesticlCommercial __. % Commercial
% Industrial (See 15A NCAC 02T .0103(20))
1Is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Hasa flow reduction been approved under I5,A NCAC 02T .0l 14(1}? ❑ Yes ®No
➢ If yes, provide a cony of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 01T.0114M)
Daily Design Flow 10
No. of Units
Flow
Residential
480 gal/Day
41
19,680 GPD
gals
GPD
gall
GPD
gall
GPD
gall
GPD
gall
GPD
Total
19,680 GPD
a See I SA NCAC 02T .01 14(b), (d), (e)f 1) and Lej for caveats to wastewater design flow rates (i.e., minimum flow per
dwelling; proposed unknown non-residential 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 15A NCAC 02T.01 14] shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 19,680 GPD (per 15A NCAC 02T _01.1 _4)
➢ Do not include future flows or previously permitted allocations
If permitted flow is zero, indicate why:
❑ Pump Station or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line
❑ Flow has already been allocated in Permit Number:
❑ Rehabilitation or replacement of existing sewer with no new flow expected
❑ Other (Explain):
FORM: FTA 04-16 Page 2 of 5

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers);
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
8
3,805
PVC
➢ 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 (Pumil Stations/Force 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 (firm capacity)
4. Operational point(s) of the pump(s): gallons per minute at feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches) Length (feet) Material
6. Power reliability in accordance with 15A NCAC 02T .0305i h L l 1:
❑ 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(h)(1)(C)
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry - 15A NCAC 02T .0305(h)(t)(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 timeframes, 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 .0305 f{i&}
➢ 15A NCAC 02T.0305f1? contains minimum separations that shall be provided for sewer systems-,
❑ Yes ❑ No
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below vertical
24 inches
Water mains vertical -water over sewer including in benched trenches
18 inches
Water mains horizontal
10 feet
Reclaimed water lines vertical - reclaimed over sewer
18 inches
Reclaimed water lines horizontal - reclaimed over sewer
2 feet
"Any private or public water supply source, including any wells, WS-I waters of Class I or
Class II impounded reservoirs used as a source of drinking water
100 feet
"Waters classified WS (except WS-I or WS-V), B, SA, ORW, HQW, or SB from normal
high water or tide elevation and wetlands see item IX.2
50 feet
**Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches
10 feet
Any building foundation
5 feet
Any basement
10 feet
Top slope of embankment or cuts of 2 feet or more vertical height
10 feet
Draina e systems and interceptor drains
5 feet
Any swimmin pools
10 feet
Final earth grade vertical
36 inches
➢ 15A NCAC 02T.0305(y,} contains alternatives where separations in 02T.0305(f) cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water_ Classifications weblpn
➢ if noncompliance with 02T.0305(f) orb see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) ❑ Yes ❑ No ®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
➢ 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 02B -0200? ❑ Yes ❑ No ® N A
➢ This would include Trout Buffered Streams per 15A NCAC 213.0202
4. Does the project require coveragelauthorization under a 404 Nationwide or ❑ Yes ® No
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�6) (additional permitsrcertifications)? ® Yes [:]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 15A NCAC 02T.0402, "high -priority sewer" means "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to streambanks that is subject to erosion that undermines or deteriorates the sewer.
❑ Yes ❑ No ® 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

X. ' CERTIFICATIONS:
1. Does the submitted system comply with j5A NCAC 02T, the Minimum Design Criteria for the Pei-mi ting of Pump Stations
and Force Mains (latest version), and the GravitySewer Minimum Design Criteria .(latest version) as applicable?
® Yes ❑ No
If No, complete and submit the VarianceiAltemative Design Request application (VADC 10-14) and supporting documents for
review. Approval of the request is required prior to submittal of the Fast Track Application and supporting documents.
2. Professional Engineer's Certification:
I, I O LII S. 16 M_ru�z� attest that this application for
(Professional Engineer's name from Application Item 111.1.)
has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans, specifications,
engineering calculations, and all other supporting documentation to the best of my knowledge. 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 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 143-215.613, 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 violatiork
North Carolina Professional Engineer's seal, signature, and date:
3. Applicant's Certification per 15A NCAC 02T .0106(b):
I, R. �?OqM4AI ) Taattest that this application for
(Signature Authority's name & title from Application Item I.3.)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required parts of
this application are not completed and that if all required supporting documentation and attachments are not included, this
application package is subject to being returned as incomplete. I understand that any discharge of wastewater from this non -
discharge system to surface waters or the land will result in an immediate enforcement action that may include civil penalties,
injunctive relief, and/or criminal prosecution. I will make no claim against the Division of Water Resources should a condition
of this permit be violated. I also understand that if all required parts of this application package are not completed and that if
all required supporting information and attachments are not included, this application package will be returned to me as
incomplete.
NOTE - In accordance with General Statutes 143-215.6A and 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.
Date: 17/p/
FORM: FTA 04-16 Page 5 of 5

State of North Carolina
Department of Environmental Quality
Division of Water Resources
DIv14,1ali of wale l Re'.otli ce Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: Town of Stantonsburg
Project Name for which flow is being requested: Briar Farm
More than one FTSE May be required for a single project If lite owner of Ilse WWTP is not responsible for all punrp
stetsons along the route of the proposers wastewater flow.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Stantonsburg WWTP
b. WWTP Facility Permit #: NC 0057606
c. WWTP facility's permitted flow
d. Estimated obligated flow not yet tributary to the WWTP
e. WWTP facility's actual avg. flow
f. Total flow for this specific request
g. Total actual and obligated flows to the facility
h. Percent of permitted flow used
AlI flows are in MGD
0.375
(-0.060)Less Saratoga
0.3136
0.0144
0.268
72%
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 the WWTP:
(A)
(B)
(C) (D)=(B+C) (E)=(A-D)
Design
Obligated,
Pump
Pump
Average
Approx.
Not Yet Total Current
Station
Station
Firm Daily Flow**
Current
Tributary Flow Plus
(Name or
Permit
Capacity, * (Firm 1 pl),
Avg. Daily
Daily Flow, Obligated Available
Number)
No.
MGD MGD
Flow, MGD
MGD Flow Capacity***
* The Firm Capacity (design flow) 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
(po not less than 2.5, per Section 2.02(A)(4)(c) of the Minimum Design Criteria.
*** 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 < 0.
Downstream Facility Name (Sewer): Stantonsburg Sanitary Sewer System
Downstream Permit Number: WQCS00213
Page 1 of 6
FTSE 10-18

III. Certification Statement:
I David R. Beaman _ _ 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 certifies that the receiving collection system or treatment
works has adequate capacity to transport and treat the proposed new wastewater.
Signing Official Signature
Title of Signing Official
.-/ L d /
Date
Page 2 of 6
FTSE 10-18

1906 Nash Street North Wilson, NC 27893-1726
Phone: [phone] Fax: [phone]
www.barticitus.com
August 17, 2021
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
Raleigh Regional Office
1628 Mail Service Center
Raleigh, North Carolina 27699-1628
Reference: Fast Track Application for Gravity Sewers
Public Sewer Extension
Briar Farm
Sand Pit Road
Stantonsburg, North Carolina
To Whom It May Concern:
a av
Fn`f�a�fi
4110P f
mac@
The attached application is for a 41-lot residential development within the Town of Stantonsburg,
Wilson County, North Carolina. The lots are split along the frontage of Sand Pit Road on the north
and south and will require the extension of the existing 8" sewer main and manholes within the
Sand Pit Road (SR 1539) Right -of -Way with laterals serving the lots.
Enclosed for your review and approval are two (2) copies of the following items related to the
above referenced project:
■ Fast Track Application for Gravity Sewers
■ Engineering Report
■ Flow Tracking / Acceptance Form
■ USGS Topographic Map
■ Feature Report
■ Google Image Location Map
■ $480.00 Sewer Permit Application Fee
P--. PROJECT FILES -Brier Fnn' Pmnits\Sanitary Seu+er ExlensioM20 103 NCDENR Cora Leler.doc

Should you have any questions or require further information during your review, please let us
know.
RespectfulfiL
Steve Oliverio
Project Manager
Enclosures
P;'._PROJECT FILES'.Hnar FannTermiWSanttarySewer Eatermon520 103 NCDENR Cover Letler.dnc

ENGINEERING REPORT
SEWER SYSTEM EXTENSION
BRIAR FARM
STANTONSBURG, NORTH CAROLINA
AUGUST 17, 2021
Wastewater Treatment Facility
Stantonsburg WWTP
NPDES Permit No. NCO057606
Applicant/Owner Name & Address
Town of Stantonsburg
108 Commercial Drive
Stantonsburg, North Carolina 27883
Proiect Name & Location
Briar Farm
Sand Pit Road (SR 1539)
Stantonsburg, North Carolina
Project Summary
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The project is for a new forty-one (41) lot residential subdivision located on the north & south
side of Sand Pit Road (SR 1539), east of NC 58. This project will include the installation of
approximately 3,805 linear feet of 8" diameter PVC gravity sewer line, eight (8) standard
manholes, four (4) 5' diameter manhole, 4" sewer services and other necessary appurtenances.
P-% PROJECT F1LE&Bnar Fwm\PermiWSanimry Sewer Exlen110nQ1 130 Sewer Engineering Report.dce

STATE OF NORTH CAROLINA
DEPARTMENT OF NATURAL RESOURCES
AND COMMUNITY DEVELOPMENT
RALEIGH, NORTH CAROLINA
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118/2021 Wilson County, GIS - Property Report
Wilson Countv Parcel Report
PIN:
3857-77-0648.000
Parcel Number
3657770648 000
Current Owner ID:
8S948B40
Physical Address:
704 SAND PIT RD
Owner & Address:
H & S LAND LLC
3204 MASH ST N STE C
Date Sold:
1578009600000
Deed Reference:
2816 - 608
Deed Year.
2020
Plat Reference:
Deed Acres:
729.86
Actual Year Built:
1842
Effective Year Built:
1850
Main Improvement
Finished Area:
Tax Year:
Assessed Current
Land Value.
Assessed Current
Improvement Value:
Total Assessed
Current Value:
Current Land Use
Yes or No:
Current Land Use Value:
Current Land
Fair Market Value:
Current Improvement
Fair Market Value:
Current Total
Fair Market Value:
Total Tax Owed:
Grantor.
Previous ParcelNumber.
Previous Deed Reference:
Plat Book/Page:
Legal Description:
Sales Amount:
Sales Instrument:
Sales Instrument Description:
Sales Disqualifaction Code:
Sales Dlsquallfaction Code Description:
Date Sold:
Vacant Improved Code:
Land Current Usage Code:
Land Rate:
Fair Market Value
Land Rate Code:
Parcel Description Code 1:
Parcel Description Code 2:
Multiple Land Segments:
3814
2020
$286,129
$121.693
$407.822
Y
$286.129
$601,119
$121.693
$722,812
$0
JOHN & CAROLYN LANE REV TRUST.
FOLEY DOROTHY HBHOWARD C H III
42-183
7604 SAND PIT RD
THOMPSON LN FARM 729.86AC
$658,OOD
WD
WARRANTY DEED
20200103
AC -ACRES
5010
50 - RURAL HOMESiTE
01 - RESIDENTIAL
MLT
hops:llgis.wilson-co.com/mapslassets/wilsontPropertyReport.html?3657770648.000 f f3

116,12821
Wlbton Cou*. GIs - Property Report
GIS Calculated Acres
of Seleded Polygon
Road Frontage:
Current Use Code Main Improvement
Main Improvement Dersiptton Code:
Main Improvement Description:
C mbuction Ouaxty Grade Decription Code:
Depredation Table:
Number of Bedrooms:
Number of Half Bathrooms:
H1/AC:
Firoplaca Yes or No:
Basement Yes or No:
Alfadwd Garage Yee or No:
PeroeM of Construction Complete:
Number of Improvements:
Neighborhood Coda:
Tax District
Township:
Urea:
Vacinity Map
Ortho hoto rah Ma
11.35
1
R2.0- 113
RESIDENTIAL - SFR 2.o STY
C+05 - C+05 GRADE
RC
7
FORCED AR HEAT W1 AC - 3814 SF
N-
N-
N-
100%
001
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17 - CJSWIMOYTON FD
10 - STANTONSBURG
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