WQ0022469_Application (FTSE)_20030407

State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality -=
FAST -TRACK APPLICATION I n
for GRAVITY SEWERS, PUMP STATIONS, AND FORCE M
N
(Pressure sewers systems are not to be included as part of this application package)
THIS FORM MAYBE PHOTOCOPIED FOR USE AS AN ORIGINAL.
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INSTRUCTIONS: Indicate that you have included the following list of required application package items by signing your
initials in the space provided next to each item. Failure to submit all required items will lead to additional processing and review
time/for the permit application.
✓ A. 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 IV 6 and/or item IV 10.
B. Attachment - Submit the completed and properly executed Form WSCA 10/99 for each watershed within the project
location.
C. Application Fee - Submit a check in the amount of $400 made payable to: North Carolina Department of Environment
and Natural Resources (NCDENR).
D. 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, 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
Certificate of Public Convenience and Necessity has not been issued, provide two copies of a letter from the NC
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.
AIIA E. 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. If the applicant is a homeowners' association, use
Form HOA 10/99. If the applicant is a developer, use Form DEV 10/99.
F. 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 W WTF. 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/WWTF. 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.
THE COMPLETED APPLICATION PACKAGE, INCLUDING ALL SUPPORTING INFORMATION AND
MATERIALS, SHOULD BE SENT TO THE FOLLOWING ADDRESS:
NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
NON -DISCHARGE PERMITTING UNIT
By U.S. Postal Service: By Courier/Special Delivery:
1617 MAIL SERVICE CENTER 512 NORTH SALISBURY STREET, SUITE 1219
RALEIGH, NORTH CAROLINA 27699-1617 RALEIGH, NORTH CAROLINA 27604
TELEPHONE NUMBER: [phone]
FACSIMILE NUMBER: [phone]
For more information, visit our web site at: h2o.ennstatenc.us/irdpu/
FORM: FTA 06/00 Page 1 of 5

Application Number:
I. GENERAL INFORMATION:
1. Applicant's name (name of the municipality, corporation, individual, etc.):
2. Owner's or signing official's name and title (15A NCAC 2H .0206(b)):
3. Name and complete address of applicant:
(to be completed by DWQ)
City: Raleigh State: NC Zip: 27604 1 " 1
Telephone number: (919) 8724924 Facsimile number: ( 919) 876-420 L
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4. Project name (name of the subdivision, facility or establishment, etc.): Research Commmir—
Sanitary Sewer Outfall- Phase I
5. County where project is located: Durham
6. Fee submitted: $ 400.00 (See Instruction C.)
7. Name and complete address of engineering firm: Piedmont Land Design, LLP
8366-104 Six Forks Road
City: Raleigh State: NC Zip: 27615
Telephone number: ( 919) 845-7600 Facsimile number: ( 919) 845-7703
8. Name and affiliation of contact person who can answer questions about application:
Ron Hendricks PE / Partner w/ Piedmont Land Design. LLP
IL PERMIT INFORMATION
1. Project is: _x new; modification
2. If this application is being submitted as a result of a modification to an existing permit, provide:
existing permit number N/A and the issuance date N/A
3. Applicant is: public _x_ private
If private, units (lots, townhomes, etc.) are: _x_ leased (Skip to item Ill.); sold
If sold, facilities owned by a: public utility (See Instruction D.);
homeowners' association/developer (See Instruction E.)
III. INFORMATION ON WASTEWATER:
1. Please provide a one- or two -word description specifying the origin of the wastewater (school,
subdivision, hospital, commercial facility, industry, apartments, condominiums, etc.):
Office - This main will serve 3 new office buildings in the future.
2. Volume of wastewater generated by this project: 125 gallons per day
3. Explanation of how wastewater flow was determined (15A NCAC 2H .0219(1)):
5 Employees 0 25 gallons/emplovee
FORM: FTA 06/00 Page 2 of 5

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4. Nature of wastewater: 100 % Domestic/Commercial; % Industrial;
% Other waste - specify:
5. If wastewater is industrial in nature: NIA
a. Level of pretreatment that has been provided to ensure protection of the receiving collection system
and wastewater treatment facility:
b. If a pretreatment permit is required, has one been issued? Yes; No. If yes, please
attach a copy of the pretreatment permit. If no, provide date application was submitted:
IV. DESIGN INFORMATION:
1. Brief project description: Install approx. 4131f of 8" DI Sanitary Sewer Phase I) main to serve
the existinia office building and the future redevelopment of this area..
2. Owner and name of wastewater treatment facility (WWTF) receiving wastewater (See Instruction F.): _
Durham County - Triangle WWTP
3. WWTF permit number (NC00***** or WQ00*****): NC 0026051
4. List the owner(s) of any intermediate sewers if different from applicant or owner of WWTF (See
Instruction F.): NIA
5. Summary of GRAVITY SEWER to be permitted:
Diameter (inches) Length (linear feet)
8" DI 413
6. Does the subject gravity sewer collection system comply with the most recent version of the Gravity
Sewer Minimum Design Criteria and 15A NCAC 2H .0200? x Yes; No. If no, please
identify criteria and explain:
7. Summary of PUMP STATIONS to be permitted: N/A
No. or
Name
Design Flow
(MGD)
Pump Operational Points
GPM feet TDH
Reliability Option
Selected
FORM: FTA 06/00 Page 3 of 5

8. Summary of FORCE MAIN to be permitted:
Diameter Length
(inches) (linear feet)
9. List any equipment being utilized that is not specifically mentioned elsewhere in the application or as
part of the Minimum Design Criteria (e.g., telemetry, hoist, odor control equipment, mechanical bar
screens, etc.):
N/A
10. Do the subject pump stations and force mains comply with the Minimum Design Criteria for the Fast -
Track Permitting of Pump Stations and Force Mains document adopted June 1, 2000 and 15A NCAC 2H
.0200? Yes; No. If no, please identify criteria and explain:
N/A
NOTE: If you responded NO to item IVA and/or item IV.10. above, two (2) copies
of detailed plans, specifications, supporting information, and any other materials
pertaining to the identified criteria should be submitted with the
completed and appropriately executed application form.
FORM: FTA 06/00 Page 4 of 5

V.
Professional Engineer's Certification:
I, Ronald P. Hendricks. Jr. , attest that this application for Gravity Sewer Extension -
Research Commons 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 design has been prepared in accordance with the applicable regulations, Gravity Sewer Minimum
Design Criteria for Gravity 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. Although certain portions of
this submittal package may have been developed by other professionals, 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 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.
North Carolina Professional Engineer's seal, signature, and date:
Applicant's Certification:
I, Carmen Liuzzo Vice President of Highwoods Pronerties Inc the general partner of Highwoods Realty
Limited Partnership Inc. attest that this application for Gravity Sewer Extension -Research Commons
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 information and
attachments are not included, this application package will be returned to me as incomplete. Note: In
accordance with NC General Statutes 143-215.6A and 143-215.613, 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 not to exceed $10,000 as well as civil penalties up to $25,000 per violation.
Signature: Date: 3 0 3
Carman J. Witte
Vice President and Chief Financial Otficx
FORM: FTA 06/00 Page 5 of 5

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P{\02PROJ\4000\4000-LDDT\dwg\4000E-CONSTBASE.dwg 06/04/2003 12133116 PM EDT
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Plan
Date
April 2003
Scale :
1" = 50'
Sheet No. SD 11 of 18