WQ0037355_Regional Office Historical File Pre 2018

NCDENR
North Carolina Department of Environmen
Pat McCrory
Governor
Mr. Fred Matrt lli, VP Land Operation
Standard Pacific of the Carolinas, [.LC
6701 Carmel Road, Suite 425
Charlotte, NC 28226
Dear
con strtic t
effective
specified therein, This cover letter and supplement shall be considered
therefore incorporated therein by' reference.
Nlatru
September 24,
d Na
ur cotttl lets• application received September 16,
WQ0037355, dated September 24, 2014, to Standard. Pact
nd operation of the subject wastewater collection system
the date of issuance until rescinded, and shall be subject to
Resources
John E Skvarl
Secre
e are forwarding hei
the Carolinas, _LC for the
ision. This pennit shall be
aoriditions and limitations as
part of this permit and are
Please pay particular attention to the following conditions contained within this perrnit:
Condition 11.4: Requires that the wastew
accordance with 1 SA NC /
permit issued to the Perrnitt.ee,
be responsibility of the Standard Pacitic r f tl • Carolinas, l..
meets the appropriate design criteria and rules. Failure tr:
accordance with North Carolina. General Statute § 143-215.6A tin
additional or replacement wastewater collection facilities, andlor re:
Professional Engineer to the licensing board,
,( to ensure that the as -constructed
comply may result in penalties in
u h § 143-215.6C, construction of
urral of the North Carolina -licensed
If any parts, requirements, or limitations contained in this permit titre ttttaeceptab
request an adjudieatory hearing upon 'written request within 30 days following receipt of
request t mst be in the form of a written petition, conformiing to C:. hapter 1 Shc'13 of North t
Statutes, artd filed with the Office of Administrative Hearings, 6714 Mail Service Cen
27699-6714, Unless such demands are made, this permit shall be final and binding,
right to
it. This
neral
Raleit h, NC
A pry OportunilyaAk rmahve IIcn Eu pov r

MT. Fred Matrulli
September 24, 2014
Page Two
If you need additional information concerning this matter, please contact Michael Parker at (704) 235-
2194 or via e-mail at [e-mail].
Sincerely,
for Thomas A. Reeder
Division of Water Resources
by Michael L. Parker
Surface Water Protection Supervisor
Mooresville Regional Office
Electronic copy: Marc Houle, P.E.
cc: Mooresville Regional Office, Surface Water Protection Section
Water Resources Central Files
PERCS (e- copy)
Barbara Gross (e-copy)
Willis Horton (e-copy)

I
ArA
NCDENR
STATE OF NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
WASTEWATER COLLECTION SYSTEM EXTENSION PERMIT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended, and other applicable Laws, Rules, and Regulations, permission is hereby granted to the
Standard Pacific of the Carolinas, LLC
for the construction and operation of approximately 1419 Iinear feet of 8-inch gravity sewer to serve the
Palisades, Tract III, Phase I development, and the discharge of 14,250 gallons per day of collected
domestic wastewater into the McAlpine Creek WWTP existing sewerage system, pursuant to the
complete application received September 16, 2014, and in conformity with 15A NCAC 2T; the Division's
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 data subsequently filed and approved by the Department of
Environment and Natural Resources and considered a part of this permit.
This permit shall be effective from the date of issuance until rescinded and shall be subject to the
specified conditions and limitations contained therein.
rmit issued this the 24th day of September, 2014.
for Thomas A. Reeder
Division of Water Resources
By Authority of The Environmental Management Commission
Permit Number: WQ0037355

PP EMENT TO FERN IT (COWER SHEE1
Standard Pacific of the Carolinas, LIX is he by authorized to:
Construct, and then operate upon certification the afi rententioned wastewater collection extension, The
sewage and wastewater collected by this system shall be treated in the McAlpine Creek 'Was ater
Treatment Facility prior to being discharged into the receiving stream.
Permitting of this project does not constitute: an accepta.nce of any part of the project that does not meet
15A NCAC 2T; the Division of Water Resources (Division) Gravity Sewer Minimum Design Criteria
adopted February 12, 1996 as applicable; and the Division's,Minimum Design, Criteria for the Fast -Track
Permitting of Pump Stations and Force Mains adopted June 1, 2000 as applicable, unless specitic:aally
mentioned herein. Division approval is based on acceptance of the certification provided by a North
Carolina -licensed Professional Engineer in the application. It shall be the Pernuttee's responstbili:t:v to
ensure that the as -constructed project meets the appropriate design criteria and rules.
Construction and operation is contingent upon compliance with the Standard Conditions and any Special
Conditions identified below.
IAL CONDITIONS
If, at tiny time, the additional wastewater flow volume made tributary to this sewer
exceed the value permitted herein, a modification shall be requested for this permit fro
Resources to properly allocate the subject wastewater Clow,
nsion. is belie'
to Division of
a
No flow in excess of the quantity permitted herein, ltit,25t) CiPI , shall he made trinary to 4,he subject sewer
y°ste.ttr tantil an application for permit modification for an increase in flr w has been subntt`tterf to and approved
bv' the Division of Water Resources,
I,. STD N1, RD CONDITIONS
This permit is not transferable:. In the event there is a destre fair floe wastewater collection tacilitie. to change
ownership, or there is a name change of the Perminee, a formal permit request shall he submitted to the
Division accompanied by documentation from the parties involved, and other supporting materials as may he
appropriate. The approval of this request shall be considered on its merits and may or may not be approved.
This permit hall become voidable unless the wastewater collection facilities are constructed in accordance with
the conditions of this permit; 1.5A ?CAC 2T; the Division. of Water Resources (Division) Gravity Sewer
Minimum Design Criteria adopted February 12, .1996 as applicable; the Division's Minirnunr Design Criteria
for the Fast -Track Permitting of Pump Stations and Force Mains adopted June 1. 2000 as applicable; and other
supporting materials unless specifically mentioned herein.
This permit alto'' be efffect`ive only with respect to the nature and volume of wastes descril ed in the application
and other supporting data.
'The wastewater collect:acrn facilitiest shall be properly maintained and operated at all times. The Pertnitiee shall
aitt compliance with an individual .system -wide collection system permit for the operation and
,nance of these facilities as required by ISA NCAC 2T .0403. 1f an individual permit is not required, the
ing performance criteria shall be niet as provided in 15A. NCAC'2' .0403:

I
a. .The sewer system shall be effectively maintained and operated at all times to prevent discharge to land or
surface waters, and to prevent any contravention of groundwater standards or surface water standards.
b. A map of the sewer system shall be developed and shall be actively maintained.
c. An operation and maintenance plan including pump station inspection frequency, preventative maintenance
schedule, spare parts inventory and overflow response has been developed and implemented.
d. Pump stations that are not connected to a telemetry system shall be inspected every day (i.e. 365 days per
year). Pump stations that are connected to a telemetry system shall be inspected at least once per week.
e. High -priority sewer lines shall be inspected at Ieast once per every six -months and inspections are
documented.
f. A general observation of the entire sewer system shall be conducted at least once per year.
g. Overflows and bypasses shall .be reported to the appropriate Division regional office in accordance with
I5A NCAC 2B .0506(a), and public notice shall be provided as required by North Carolina General Statute
§ 143-215.1 C.
h. A Grease Control Program is in place as follows:
1. For public owned collection systems, the Grease Control Program shall include at least biannual
distribution of educational materials for both commercial and residential users and the legal means to
require grease interceptors at existing establishments. The plan shall also include legal means for
inspections of the grease interceptors, enforcement for violators and the legal means to control grease
entering the system from other public and private satellite sewer systems.
2. For privately owned collection systems, the Grease Control Program shall include at least bi-annual
distribution of grease education materials to users of the collection system by the permittee or its
representative.
3. Grease education materials shall be distributed more often than required in Parts (1) and (2) of this
Subparagraph if necessary to prevent grease -related sanitary sewer overflows.
Right-of-ways and easements shall be maintained in the full easement width for personnel and equipment
accessibility.
j. Documentation shall be kept for Subparagraphs (a) through (i) of this Rule for a minimum of three years
with exception of the map, which shall be maintained for the life of the system.
5. Noncompliance Notification:
The Permittee shall report by telephone to a Water Resources staff member at the Mooresville Regional Office,
telephone number [phone], as soon as possible, but in no case more than 24 hours or on the next
working day, following the occurrence or first knowledge of the occurrence of either of the following:
a. Any process unit failure, due to known or unknown reasons, that renders the facility incapable of
adequate wastewater transport, such as mechanical or electrical failures of pumps, line blockage or
breakage, etc.; or
b. Any SSO and/or spill over 1,000 gallons; or
c. Any SSO and/or spill, regardless of volume, that reaches surface water

Voice mail messages or faxed information is permissible., but this shall not he considered as the initial verbal
report. Overflows and spills occurring outside normal business hours may also be reported to the Division of
Emergency Management at telephone number [phone] or (919) '733-3300, ,Persons reporting any of the
above occurrences shall file a spill report by completing and submitting Part I. of Form. CS-SSO (or the most
current ,Division approved form) within five days following first knoWledge of the occurrence, This report must
outline the actions taken or proposed, to be taken to ensure that the problern does not recur., Part II of Form CS-
,SSO (or the most current Division approved form) can also be completed to show that the SS() was beyond
control,.
Constniction of the gravity sewers, pump stations, and force mains shall he scheduled so as not to interrupt
service by the existing utilities nor result in an overflow or bypass discharge of wastewater to the surface waters
of the State,
'7, Per 15A 'NCAC 217,0116, upon completion of construction and prior to operation of these permitted facilities,
the completed Engineering Certification form attached to this permit, shall be ,submitted with the required
supporting documents to the address provided on the form. A complete, certification is one where the form) is
fully executed and the supporting documents are provided as applicable. Any wastewater flow made tributary
to the wastewater collection system extension prior to completion of this ;Engineer's Certificationshall he
considered a violation of the permit and shall subject the Perunittee to appropriate enforcement action.,
If the permit is issued to a private entity with an Operational Agreement, then a copy of the Articles of
Incorporation, Declarations/Covenants/Restrictions, and Bylaws that have been appropriately filed with
the applicable County's Register of Deeds office shall he submitted with the certification.
A complete certification is one where the form is fully executed and the supporting documents are provided as
.applicable. Supporting documentation. shall include the following:
a, One copy of the project construction record, ,drawings (plan & profile views of sewer lines & force mains)
of the wastewater collection systern extension. Final record drawings should be clear on the plans or on
digital media (CD or DVD disk) and are defined as the design drawings that are marked up or annotated
with after construction information and show required buffers, separation distances,. material changes, etc,
h. One copy of the supporting pump station design calculations (selected pumps, systern curve, operating
point, buoyancy ,calculations, available storage if portable generator(s) or storage greater than longest past
three year outage reliability option selected) for any pump stations permitted as part of this 'project,
Changes to the project: that do not result in .non-compliance with this permit, regulations, or the Minimum
Design Criteria should he clearly identified, on the record drawings, on the certification in the space
provided, or in written summary form„
Prior to Certification (Final or Partial): Permit modifications are required for any changes resulting in non-
compliance with this permit, (inducting. pipe length increases of 10% or greater, increased flow, pump station
design capacity design increases of 5% or greater, and increases in the number/type of connections),
regulations, or the Minimum Design Criteria. Requested modifications or variances to the Minimum Design
Criteria will be reviewed on a case-b:‘,/-case basis and each on its own merit,. Please note that variances to the
Minimum Design Criteria should he requested and approved during the permitting process prior to construction,
After -construction requests are discouraged by the Division and .may not he approved, thus requiring
replacement or repair prior to certification & activation
8, A copy of the construction record drawings shall be maintained on file hy the Perrnittee fr the life .of the
wastewater collection facilities,

Failure to abide by the conditions and limitations contained in this permit; 15A NCAC 2T; the Division's
Gravity Sewer Design Criteria adopted February 12, 1996 as applicable; the Division's Minimum Design
Criteria for the Fast -Track Permitting of Pump Station and Force Mains adopted June 1, 2000 as applicable; and
other supporting materials may subject the Permittee to an enforcement action by the Division, in accordance
with North Carolina General Statutes § 143-215.6A through §143-215.6C, construction of additional or
replacement wastewater collection facilities, and/or referral of the North Carolina -licensed Professional
Engineer to the licensing board.
10. In the event that the wastewater collection facilities fail to perform satisfactorily, including the creation of
nuisance conditions, the Permittee shall take immediate corrective action, including those as may be required by
this Division, such as the construction of additional or replacement facilities.
11. The issuance of this permit shall not exempt the Permittee from complying with any and all statutes, rules,
regulations, or ordinances that may be imposed by other government agencies (local, state and federal) which
have jurisdiction, including but not limited to applicable river buffer rules in 15A NCAC 2B .0200, erosion and
sedimentation control requirements in 15A NCAC Ch. 4 and under the Division's General Permit NCG010000,
and any requirements pertaining to wetlands under 15A NCAC 2B .0200 and 15A NCAC 2H .0500.

FAST TRACK ENGINEERING CERTIFICATION
Permittee: Standard Pacific of the Carolinas, LLC Permit No, WQ0037355
Project: Palisades, Tract HI, Phase I — Mecklenburg County Issue Date: 09/24/2014
Complete and submit this 'form to the permit issuing regional office with the following;
• One copy of the project record drawings (plan & profile views and detail drawings of sewer lines) of the wastewater
collection system extension, Final record drawings should be clear on the plans or on digital media (CD or DVD
disk) in pdf format, Record drawings should indicate the design and the markedup changes during construction„
• Supporting design calculations (selected pumps, system curve, operating point, available storage if portable
generator(s) or storage greater than longest past three year outage reliability option selected) for any pump stations
permitted as part of this project
• Changes to the project should be clearly identified on the record drawings or in wntten summary form, Permit
modifications are re uJdforanchanesresuItinlnnoncomIjancewfththiserrnjt requlations or
ns shoujbesubmIfteortocejjf3caton.
This project shall not be considered complete nor allowed to operate until the Division has received this Engineer's
Certification and all required supporting documentation, Therefore, it is highly recommended that this certification
be nt in a mannerman atrovidesroofofrecept by the Division.
PERMITTEE'S CERTIFICATION
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
Printed Name, Title
Signature Date
ENGINEER'S CERTIFICATION
El Partial El Final
, as a duly registered Professional Engineer in the State of North Carolina,
having been authorized to observe (0 periodically, Li] weekly, Ej full time) the construction of the subject project
for the Permittee hereby state that, to the best of my abilities, due care and diligence was used in the obseniation
of the construction such that the construction was observed to be built within substantial compliance of thus
permit, 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, signature, and date:
SEND THIS FORM & SUPPORTING DOCUMENTATION
WITH REQUIRED ATTACHMENTS TO THE FOLLOWING ADDRESS
SURFACE WATER PROTECTION SUPERVISOR
MOORESVILLE REGIONAL OFFICE
610 EAST CENTER AVENUE, SUITE 301
MOORESVILLE, NC 28115
The Permittee is responsible for tracking all partial certifications up until a final certification is received, Any
wastewater flow made tributary to the wastewater collection system extension prior to completion of this
Engineer's Certification shall be considered a violation of the permit and shall subject the Permittee to appropriate
enforcement actions,
1.)WQ Use ardy:
FloNN from ads, proicci. triirmiL11*^..

STATE OF NORTH CAROLINA _
COUNTY OF ed,4) Permit No. ��\C �7 '7
DEVELOPER'S OPERATIONAL AGREEMENT
This AGREEMENT made pursuant to G.S. 143-215.1 (di) and entered into this 2 514 day of
20� , by and between the North Carolina Environmental Management
_Co ission, an agency of the State of North Carolina, hereinafter known as the COMMISSION; and
4/rieA derae / .L ap.'�, of Lie, a corporation/general partnership registered/licensed to do
business in the State of N&th Carolina, hereinafter known as the DEVELOPER.
WITNESSETH:
I. The DEVELOPER is the owner of the certain lands lying in Mecklenburg County, upon
which it is erecting and will erect dwelling units and other improvements, said development to be known
as Palisades Tract 3 Ph. 1 (hereinafter the Development).
2. The DEVELOPER desires, to construct a wastewater collection system with pumps, wastewater treatment
works, and/or disposal facilities (hereinafter Disposal System) to provide sanitary sewage disposal to serve
the Development on said lands.
3. The DEVELOPER has applied to the COMMISSION for the issuance of a permit pursuant to G.S. 143-
215.1 to construct, maintain, and operate the Disposal System.
4. The DEVELOPER has created or shall create unit ownership in said dwellings units, other improvements
and lands through filing of a Declaration of Unit Ownership (hereinafter Declaration), pursuant to Chapter
47C or 47F of the North Carolina General Statutes.
5. The DEVELOPER has caused to be formed or will cause to be formed at the time of filing of the
Declaration, the (Unit Owners' Association) (hereinafter
Association), a non-profit corporation organized and existing under and by the virtue of the laws of the
State of North Carolina, for the purpose, among others, of handling the property, affairs and business of
the Development; of operating, maintaining, re -constructing and repairing the common elements of the
lands and improvements subject to unit ownership, including the Disposal System; and of collecting dues
and assessments to provide funds for such operation, maintenance, re -construction and repair.
6. The COMMISSION desires to assure that the Disposal System of the Development is properly
constructed, maintained and operated in accordance with law and permit provisions in order to protect the
quality of the waters of the State and the public interest therein.
NOW, THEREFORE, in consideration of the promises and the benefits to be derived by each of the parties
hereto, the COMMISSION and DEVELOPER do hereby mutually agree as follows:
1. The DEVELOPER shall construct the Disposal System in accordance with the permit and plans and
specifications hereafter issued and approved by the COMMISSION, and shall thereafter properly operate
and maintain such systems and facilities in accordance with applicable permit provisions and law.
2. The DEVELOPER shall not transfer ownership and/or control of the Disposal System to the Association
until construction has been completed in accordance with the permit and approved plans, and the staff of
the Division of Water Resources has inspected and approved of the facilities. In order to change the name
of the permit holder, the DEVELOPER must request that the permit be reissued to the Association. The
request must include a copy of the Association Bylaws and Declaration.
3. The DEVELOPER shall not transfer, convey, assign or otherwise relinquish or release its responsibility
for the operation and maintenance of its Disposal System until a permit has been reissued to the
DEVELOPER's successor.
FORM: DEV 08-13 Page 1 of 2

4. The DEVELOPER shall provide i.n the Declaration and Association Bylaws that the Disposal System and
appurtenances thereto are part of the common elements and shall thereafter be properly maintained and
operated in conformity with law and the provisions of the permit for construction, operation, repair, and
maintenance of the system and facilities. The Declaration and Bylaws shall identify the entire wastewater
treatment, collection and disposal system as a common element which will receive the highest priority for
expenditures by the Association except for Federal, State, and local taxes and insurance.
5. The DEV.ELO.PER shall provide in the Declaration and Association Bylaws that the Disposal System will
be maintained out of the common expenses. In order to assure that there shall be funds readily available to
repair, maintain or construct the Disposal System, beyond the routine operation and maintenance
expenses, the Declaration and Association Bylaws shall provide that a fund be created out of the common
expenses. Such fund shall be separate from the routine maintenance funds allocated for the facility and
shall be part of the yearly budget.
6.. In the event the common expense allocation and separate fund are not adequate for the construction,
repair, and maintenance of the Disposal System, the Declaration and Association Bylaws shall provide for
special assessments to cover such necessary costs. There shall be no limit on the amount of such
assessments, and the Declaration and Bylaws shall provide that such special assessments can be made as
necessary at any time.
7, If a wastewater ,collection system and wastewater treatment and/or disposal facility provided by any city,
town, village, county, water and sewer authorities, or other unit of government shall hereinafter become
available to serve the Development, the DEVELOPER shall take such action as is necessary to cause the
existing and future wastewater of the Development to be accepted and discharged into said governmental
system, and shall convey or transfer as much of the Disposal System and such necessary easements as the
governmental unit may require as condition of accepting the Development's wastewater.
8RecogniLing that it would be contrary to the public interest and to the public health, safety and Welfare for
the Association to enter into voluntary dissolution without having made adequate provision for the
continued proper maintenance, repair and operation of its Disposal System, the DEVELOPER shall
provide in the Association Bylaws that the Association shall not enter into voluntary dissolution without
first having transferred its said system and facilities to some person, corporation or other entity acceptable
to and approved by the COMMISSION by the issuance of a permit,
9. The agreements set forth in numbered paragraphs I, 2, 3, 4, 5, 6, 7, and 8 above shall be conditions °laity
permit issued by the COMMISSION to the DEVELOPER for the construction, maintenance, repair and
operation of the Disposal System,
10. A copy of this agreement shall be filed at the Register of Deeds in the County(les) where the Declaration is
filed and in the offices of the Secretary of State of North Carolina with the Articles of Incorporation of the
Association.
IN WITNESS WHEREOF, this agreement was executed in duplicate originals by the duly authorized
representative of the parties hereto on the day and year )vritten as indicated by each of the parties named below:
FOR IRE ENVIRONMENTAL
AGEMET COMMISSION
r,Thomas A. Reeder, Director
Division of Water Resources
5"-14_,NOK) PACA op .114e
Name ofD)iVELQPE1
B
(S ignature
FORM: DEV 08-13
Page 2 of 2

USE
Name and
lb Cocain..
one Numl
Project is
2 Owner is ...-; Publi
4a' Mc!..
Na'?t.r. Di
2#.
Applicatia ra Number:
cited by DWR)
zed signing 0
28226
Zip Code
his iAppI cet!is
Permit No,:
appicantwflf be:
., tItem P (g
Private ���c} � - 20
Ownership e. store, church, 5iptgle office, etc.) or
its (lefts, townharnetc. - skip to Item (3))
go to Item 8(2b,)))
VV`d l.l,:u Permit No,
0e origin of this weslew
tdential Subdivision
talents/Condominiums
ter !Q t k3 ? resC air C „ti t. �' Cwt.ttr?�<t or ,"`t p e rs,lt;:.IiCu
uture flows or prev0us]y permitted &lacati ns
Other (spe,:.d
ion 0)
uction E)
e tson F;)
,.,omeA tic/ omme ` iail
gift, industrials`
(Attach Dk,'rr':. rf,

9. Provide the wastewater flow calculations used in determining the permitted flow in accordance with 15ANCAC2TCl111, 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
data in accordance with 15A NCAC 2T 0114 (f),
75 single family lots x 190 gpditot = 14,250 gpd
10 Summary of Sewer Lines to be Permitted (attach additional sheets if necessary)
Size (inches) Length (feet)
8
New Gravity or Additional
Force Main
1419 New Gravity
z
11 Summary of Pump Stations w/ associated Force Mains to be Per tted (attach additional sheets as necessaryz
0 Pump Station Location ID: (se!f chosen - as shown on plans/map for reference)
C-)
Longitude: Latitude:
z
0
Design Flow
(MGD)
Power Reliability Option
Operational Point
1 permanent generator w/ATS; Force Main Size Force Main Length
GPM TOR
2 - portable generator wlMTS
re
0
LL
Pump Station Location ID: (self chosen - as shown on plans/map for reference)
2 Longitude: Latitude:
Ce
LLI
CL Design Flow
Operational Point Power Reliability Option
(MGD) GPM @TDH 1 - permanent generator wlATS; Force Main Size Force Main Length
ai
2 - portable generator wfMTS
12. Will the wastewater flow in the proposed sewer lines or pump stations be able to be directed to another treatment facility?
EJ Yes No If Yes, perrnit number of 2r'd treatment facility
(RO - if 'yes" to B,12 please contact the Central Office, PE.RCS Unit)
13, Does the sewer system comply with the N1i0:0.1YDID41gritereIPLtteEerthitlit10P1E),grDP51attetiShrldEPrEP_MAL05
(latest version), the GravibtSewer Minimum De -sign Criteriq (latest version) and 15A NCAC", ChivIer 21 as applicable?
Yes Ej No If No, please reference the pertinent minimum design criteria or regulation and indicate why a
variance is requested. SUBMIT TWO COPIES OF PLANS, SPECIFICATIONS OR CALCULATIONS
PERTINENT TO THE VARIANCE WITH YOUR APPLICATION
FTA 08-13 APPLICATION Page 5 016

2
0
14, Have the following permitslcertrfications been submitted for approval for the system or project to be served?
Wetland/Stream Crossings - General Permit or 401 Certification? I, , Yes II No ' N/A
Sedimentation and Erosion Control Plan? El Yes El No 0 N/A
Trout Buffer Waiver? 0 Yes © No ] NIA
Stormwater? Z Yes © No ® NAA
15. Does this project include any high priority fines (15, NCA 0211r_C/402_1(2_1) involve aerial lines„ siphons, or interference
manholes)? These lines will be considered high cariorfty and must be checked once every six months
Check if Yes: 0 and provide details:
la.
Owner/Permittee's
r, FEP $14-r L
of Signing Official and Project Name
est that this application for r,�t�i has been
reviewed by me and is accurate and complete to the best of my knowledge. 1 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. Note: In accordance with North Carolina General
Statutes 14 215.6A and 143-2 5,66, any person who knowingly makes any false statement, representation, or
certification in any application sh 41 be guilty of a Class 2 misdemeanor which may include a fine not to exceed $10,400
as well as cj?`penalta up to '© per relation.
Signing Official Signature
ENGINEERING DESIGN DOCUMENTS MUST'; COMPLETED PRIOR TO SUBMITTAL OF THIS
APPLICATION, THESE DOCUMENTS MUST INCLUDE PLAN AND PROFILE OF SEWERS, THEIR PROXIMITY;
TO OTHER UTILITIES, DESIGN CALCULATIONS, ETC, REFER TO 15A NCAC 02T .0305
2. Professional Engineer's Certification: (Signature of Design Engineer and Project Name)
1, M rc A Houle ,attest that this application for_ Palisades Tract 3rPh. 1
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. 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 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 °t43�215.64 andw143-215.6B, 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
2a. Marc A. Houle, PE
Professional Engineer Name
2b. Yarbrough Willian
Engineering Firm
& Houle Inc
2c. P.O. Box 7007 - ...._, .�-_.... _.. ............._.._.wd.
Mailing Address
2d, Charlotte 2e. NC 2f. 28241
City State -_�- Z'rp_..-
2g. 704-55-619
Telephone
t1
04-556-0505 21. march [e-mail]
Facsimile
E-mail
NC PE •Sea, Signature
PTA 08- l 3 A_PPLICN
6 of 6

•
LEGEND
INDEX OF _,SHEETS
SHEET NO. 1 COVER SHEET
SHEET NO. 2 TRUNK TO FEALE COURT, FEALE COURT
SHEET NO. 3 HAWKWATCH LANE c / i -
SHEET NO. 4 DETAIL SHEET 1 /� //
G \\
� ems: \
/ 9
sae sy SAL. sR41
.1;5D 11DFi f ti '•�_�_
1` \+4'� 4. , ' /' t , 7 1 a, --VA } lT E'T7 NOW 0R FOOMERLY �
��� Q�iGO\ I r PALISADES EPISCOPAL SCHOOL y
. `` Q'. i iy I {�? I.:_T _ 1 P[F0: 2568s-- n lit
w f_TA% R 217-till-78 y`
a f� I °If ss N S ,:
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--- •�-{l�Exlsr��lMa�Y
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�21
75
CALL HE O PE--IY4£
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Tp
A} SMITMY 4YR IAT:RVS ME 10 5£ WS161IC AT A D7PR16'0 SRA.',T
a°
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pap AN ozostANEL
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,An1Wx M SYPNML Dl1C1E9}
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A1A) UWUORWRO WALL
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10.) OCF480 MG
512 11 6T10STAG 0051 PS GtV(A3ME TA DOI NWOR A � lNal
OE Rama AM CfATF. AT GM LOW.,
DESIGN COMPANY: YARBROUGH-WIWAMS & HOULE, INC.
PLANS PREPARED BY: MAH
ADDRESS P.O. BOX 7007, CHARLOTTE, N.C. 28241
PHONE [phone] FAX: [phone]
DATE DESIGN COMPLETED: MARCH 20, 2008
SURVEY COMPANY: YARBROOG*4-1HLIJAJAS & HOULE, INC.
SURVEYED BY: SR
A➢ORMSS: P.O. BOX 7007, CHARLOTTE, N.C. 28241
PHONE [phone] FAX [phone]
DATE SURVEY COMPLETED
DEVELOPER: STANDARD PACLF1C OF THE CAROUNAS, LLC
ADDRESS: 6701 CARMEL ROAD, 5961E 425, CHARLOTTE, NC, 28226
PHONE [phone] FAX [phone]
CONTACT: FRED MAIIWW
CONTRACTOR:
INSPECTOR:
DATE TO SYSTEMS a RECORDS:
BY:
INSIDE CHARLOTTE () YES (() NO: MECKLENBURG COUNTY
TOPO N0: 551 BASIN: SIUDMAN BRANCH
PRIVATE GRAVITY SANITAR SEWER COLLECTION TO SERVE
PALISADES TRACT 3 PHASE 1
NOW OR FORMERLY
PALISADES EPISCOPAL SCHOOL
DEER 25659-10
TAX /: 212-191-75
XMH 2
TA. 0,0602
(6F60.00)
F71 PRIVATE
8' TEIFMAIN'
Now 0R F0RMPRLY
WM818181 E GOLF CLUB LLB
DEED: 22328-703
TAX R 217-181-02
EX M 5
STA. 0t00.00
(10+51.00)
Ili-00 LP
W TWAIN
FUTURE PRIVATE
4" LOW PRESSURE
FUTURE PRIVATE
8' WATERMAN
FUTURE PRIVATE
3' LOW PRESSURE
FVIURE PRAY
5' WATERMM
FUTURE PRIVATE
4' LOW PRESSURE
/ 16 /
NCY! OR FORMERLY
TIM0EREAi(E SOLE 12.L10 11C
DEED: 22328-793
TAIL R 217-161-C2
FUTURE PRIVATE
2' LOW PRESSURE
FUTURE PRIVATE
2' WATERMAN
24 21
FUTURE PRIVATE
2' WATERMAIN
41
NOW E FORMERLY
DEED: 223 11-793
TAX M: 217-161-02
cos
FUTURE PRIVATE
2' LOW PRESSURE
40
18
COSTING 6 SAN. SY,R.. a3-. SS -1-
PROPOSED € SAM.550.
COSTING SAN. M. MANHOLE Cs
PRIPOSF0 SAN. SRR. MANHOLE •
USING WATER MAJN W
PREMED WATER MARL
E161106 WOW VALVE 46'
PROPOSED WATER VALVE
EIRSDNG EVE HYDRANT 2?
PROPOSED FRE HYDRANT
WATER METER O
L)NDERGRCUN0 TELEPHONE UT —
UNDERGROUND CABLE - UC
OVEWIAD ELECTRIC OE
OIA)ERGROUND EIECTTLC Ur.
DIMITY POLE/GUY ME 0-
T6AER LINE • •
Eb5RN6 CAS MAIN C
CAS VALVE
E)a5RN6 WATER R/W
PROPOSED WATER R/W ----
ROAD/STREI:i RAY — RAY
--
PROPERTY LINE
EDGE 6F PAV7IENT .
GROUND PROFILE
EOSTW2IRON PIN
r MARSH 4 6
CREEK OR BRANCH:
RIP RAP
TREE
BUONO
RAILROAD
GUARD 9AL
PIERS
DWOE£
FENCE ( LABEL TYPE )
STREET S(CN ( LABEL TYPE )
STORM DRAIN /CATCH BASIN
SEDIMENT Fula (SILT FENCE) STD. 6.62 '-
TEMPORARY SEDIMENT TRAP STD. 6.60 —
CHIECK DAM STD. 6.62
TEMPORARY DIVEIS0N STD 620
TEMPORARY STREAM Qi059NG STD. 6.70 -
THIS PLAN Is A FINAL DESIGN —NOT
RELEASED FOR CONSTRUCTION
UNLESS INITTALLF,rATED APPROVED:
APPROVED: f
fi ;
N0.
Wio
DOS. R5: j C-E475
YAILHROQGB-W11 TTAMC & HOULE!, INC.
Venturing o Sarveli•g ° 8Mglnrrring
704.671JW0 93.14.NEM611A1:)
CATE
BY
EIEYRSON
APPROVALS (SEALS)
NCPLS(sA mD AN:17)
NCPE (PCCORa DRAY7l611)
SUMMARY OF SEWER MAINS & MANHOLES
SIZE
LENGTH
SIZE
LENGTH .
B°
1,419E LF.
NUMBER OF MANHOLES: 9
TOTAL NO. LOTS SERVED: 75
PROJECT NAME: PALISADES TRACT 3 PH 1 10.40 AC.
DAZE FEB; 3, 2014 SCALE 1°= 100'
JOB NO:
DATE OF ACTIVATION:
DATE AS BUILT BY:
237-54

FORM WSCAS 08-13
WATERSHED CLASSIFICATION ATTACHMENT
FOR SEWER SYSTEMS
cant Name
holarc A, Houle, PE.
onal Engineer Name
Meit A. :Hattie, :PE
ocation
ID
1
Pro"ect Name
Palisades *Dad 3 Fti, I
Engineering Firm Name
Yarbrough-liVilliarns &
,
Name of Wa erbody1 County
Catawba River Meck
River Waterbody Stream
Basin Index No.
Catawba 11-(123.5)
Waterbody
Classification
WS-V,B
4-
If unnamed, indicate "unnamed tributary to X", where X is the named waterbody to which the unnamed tributary joins.
I certify that as a Registered Professional Engineer in the State of
North Carolina that I have diligently followed the Division's instructions
for classifying waterbodies and that the above classifications are
inclusive of the stated project, complete and correct to the best of my
knowledge and belief
PE Seal, Signature and Date
*** END OF FORM WSCAS 08-13 ***
FORM: WSCAS 08-13 Page 1 of 1

•
TM
CHARLOTTE.
CHARLOTTE-M ECKLE N BU RG
UTILITY DEPARTMENT
April 22, 2014
Mr. Fred Matrulli
Standard Pacific of the Carolinas, LLC
6701 Carmel Road
Suite 425
Charlotte, NC 28226
SUBJECT: WATER AND SEWER FLOW ACCEPTANCE
PALISADES TRACT 3
TAX PARCEL# 217-161-06
C-MU TRACKING# 600-14-541
A flow acceptance study of the subject site has been completed and the following has been determined:
Charlotte -Mecklenburg Utility Department agrees to accept the gravity sewage flow of 30,590 gallons per
day (161 single-family Tots x 190 gpd/lot) from this project for transmission to the McAlpine Creek
Wastewater Treatment Plant; NPDES permit number NC0024970, for treatment. This acceptance of flow
is based on the existing capacity of the designated publicly owned treatments works. Please see attached
FTSE form.
Charlotte -Mecklenburg Utility Department agrees to fumish water to the subject project. The water quality
to the subject project is regulated by the State Drinking Water Act Amendments of 1986, and The Water
Supply Management Plan, PWS ID # 0160010, on file with the Public Water Supply Section of NCDENR.
However, Charlotte -Mecklenburg Utility Department cannot guarantee a constant pressure or quality of
flow.
Due to the involvement of other agencies and continuing growth of the water and sewer system, the
ability to provide service for future projects cannot be guaranteed nor reserved. Connection to the
Charlotte -Mecklenburg Utility Department system is accepted on a first come, first served basis.
The applicant should understand that this letter is not authorization to construct private water or sewer
systems, as the appropriate local or State permits are required prior to construction. if the appropriate
authorization to construct permits are not obtained and construction has not started within one (1) year of
issuance of this flow acceptance letter, and payment for any service connection(s) has not been received
within (1) year of the issuance of this flow acceptance letter. this flow acceptance approval shall be
rescinded and a new flow acceptance study must be made. If you have any questions, you may contact
me at [phone].
Sincerely, ` ��
AOo_.t `xt..ccx7�r
Barbara Gross
Engineering Assistant
CHARLOTTE-MECKLENBURG UTILITY DEPARTMENT
Engineering Division • Installation & Development Services
www.cmutilities.com
700 North Tryon Street
Charlotte, NC 28202
Ph: 704/432-5801
Fax: [phone]

State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 08-13)
Project Applicant Name: Yarbrough -Williams & Houle, Inc.
Project Name for which flow is being requested: palisades, Tract 3
More than one FTSE may be required for a single project if the owner of the WWTP is not responsible for all 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: McAlpine Creek, Irwin Creek, Sugar Creek WWTP
b. WWTP Facility Permit #: MC0024970, NC0024945, NC0024937
c. WWTP facility's permitted flow
d. Estimated obligated flow not yet tributary to the WWTP
e. WWTP facility's actual avg. flow
f. TotaI flow for this specific request
g. Total actual and obligated flows to the facility
h. Percent of permitted flow used
All flows are in MGD
99.0
10.280
66.785
0.03059
77.064
77.8%-
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:
Pump
Station
(Name or
Number)
Palisades #2
Firm
Capacity,*
MGD
0.776
Studman Branch 1.310
Steele Creek
8.600
(A)
Design
Average Daily
Flow**
(Firm / pt),
MGD
0.310
0.524
(B)
Approx.
Current Avg.
Daily Flow,
MGD
(C)
Obligated,
Not Yet
Tributary
Daily Flow,
MGD
0.018 .031
0.045 0.072
3.44 5.822 0.163
Total Current
Flow Plus
Obligated
Flow
(D)=(B+C) (E)=(A-D)
Available
Capacity***
0.049 0.261
0.117
5.985
0.407
-2.545
* 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 < 0.
Page 1 of 6
FTSE 08-13

III.Ce rtification Statement:
I ,Uprr .5-.r- 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 indicates acceptance of this wastewater flow.
Page 2 of 6
FTSE 08-13

Pry
F"1rSE PLANNING ASSESSMENT ADDENDUM (PAA)
Submit a planning assessment addendum for each pump station Listed in Section II where Available
Capacity is < O.
Pump Station (Name or Number):
Given that:
a. The proportion and amount of Obligated, Not Yet Tributary Daily Flow (C) accounts for
2.72 % and o.163 MGD of the Available Capacity (E) in Pump Station
Steele creek ; and that
b. The rate of activation of this obligated, not yet tributary capacity is currently approximately
0.163 MGD per year; and that
c. A funded Capital Project that will provide the required planned capacity, namely
Steele Creek Pump Station Replacement and Relief Sewer is in design or under construction with
planned completion in December 2016 ; and/or
d. The following applies:
The Steele Creek Pump Station replacement proiect will provide a new regional facility capable of
handling build -out flows in the basin_ The project has funding appropriated and will be bid in Spring of
2014 with an expected completion in December 2016.
Therefore:
Given reasonably expected conditions and planning information, there is sufficient justification
to allow this flow to be permitted, without a significant likelihood of over -allocating capacity in
the system infrastructure.
I understand that this does not relieve the collection system owner from complying with G.S.
143-215.67(a) which prohibits the introduction of any waste in excess of the capacity of the
waste disposal system.
Signing Official Signature
Page3 of6
y/zr/(5(
Date
FTSE 08-13

North Carolina Secretary of State Page 1 of 1
North Carolina
F. marshal/ D EPA[R M _ENT OF THE
- �.-
Account Login Register
, Secretary ECRETARY OF T ATE
P3 Box. 20Raedi. NC 27626-9322: (9i91O7-200
Date: 9/16/2014
Click here to:
View Document Filings I File an Annual Report j
J Print a Pre -populated Annual Report Fillable PDF Form I Amend A Previous Annual Report I
Corporation Names
Name Name Type
NC' STANDARD PACIFIC OF THE
CAROLINAS, LLC
NC WESTFIELD HOMES OF THE PREY LEGAL
CAROLINAS, LLC
Limited Liability Company Information
LEGAL
SOSID:
Status:
Effective Date:
Citizenship:
State of Inc.:
Duration:
Annual Report Status:
Registered Agent
0665971
Current -Active
3/4/2003
FOREIGN
DE
PERPETUAL
CURRENT
Agent Name:
Office Address:
Mailing Address:
Principal Office
NATIONAL REGISTERED AGENTS, INC.
150 FAYETTEVILLE STREET,
BOX 1011
RALEIGH NC 27602-1011
150 FAYETTEVILLE STREET,
BOX 1011
RALEIGH NC 27602-1011
Office Address:
Mailing Address:
Officers/Company Officials
6701 CARMEL RD., SUITE 425
CHARLOTTE NC 28226-0203
15360 BARRANCA PARKWAY
IRVINE CA 92618-2215
Title:
Name:
Business Address:
AUTHORIZED REPRESENTATIVE
ELLIOT MANN
6701 CARMEL ROAD, SUITE 425
CHARLOTTE NC 28226
This website is provided to the public as a part of the Secretary of State Knowledge Base (SOSKB) system. Version:
4040
http:I/www.secretary.state.nc.us/corporations/Corp. aspx?PitetnId-5621692
9/16/2014

YARBROUGH-WIL:
AMS & HOULE, INC.
Planning • Surveying • Engineering
NCBELS C-0475
SC COA332
PROJECT NARRATIVE
Project: Palisades Tract 3 Ph. 1
Location: Palisades, Charlotte, NC ETJ,.
Mecklenburg County
North Carolina
Background:
The Project is part of a master planned community located within the ETJ of Charlotte NC.
Previous Permitting:.
The Project's Erosion and Sedimentation Control Plan was approved by City of Charlotte on Sept. 11, 2014 - Project.
ID: SDRSFR=2014-00025
Sanitary Sewer System and Water Supply System:
The private water supply system and sanitary sewer system will serve 75 single family lots. An existing
8"waterline on Fiawkwatch Lane will serve the project. The proposed sanitary sewer system is completely gravity
fed with 1,419 feet of 8" sewer line proposed.
730 Windsor Oat Ct. (28273) • P.O. Box 7007 (28241)• Charlotte, NC • 704. 56 990 ax 704.556.0505

1

f111771'17;-H4
YARBROUGR-WILLIAMS & HOULE, INC.
P.O. Box 7007 Chartotte, NC 26241 I OA
(70.4) 556-1990 1;‘,.ThaY.aioN
Fax [phone]
TO t/ 12, /t7
720 -1
0198
loa No.
WE ARE SENDING YOU 'Atthed LI Under separate cover via „ .the following iterns
Shop drawings 0 Prints Eti Plans El Samples Specifications
0 Copy of letter C„.1 Change order
NO
THESE ARE "TRA TIED as checked below;
For approval
D For your use
I1.1 As requested
0 For review and comment
REMARKS
COPY TO
SCJE TION
0 Approved as submitted
0 Approved as noted
L,3 Returned for corrections
CI Resubmit _ copies for approval
El Submit „ . copies for distribution
El Return „corrected prints
FOR BIDS DUE El PRINTS RETURNED AFTER LOAN TO US
SIGNED: L41
11 enclosures are not as noted, kindly notify us at on

•
VPerCentral Files: APS , SWP _
9/24/2014
Permit Number WQ0037355 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
michaei.parker
Coastal SWRuIe
Permitted Flow
14,250
Facility
Version Permit Classification
1.00 individual
Permit Contact Affiliation
Facility Name
Palisades Tract 3 Phase 1
Location Address
Owner
Major/Minor Region
Minor Mooresville
County
Mecklenburg
Facility Contact Affiliation
Owner Name
Standard Pacific of the Carolinas LLC
Dates/Events
Owner Type
Non -Government
Owner Affiliation
Fred Matrulli
6701 Carmel Rd
Charlotte
NC 28226
Orig issue
9/24/2014
Scheduled
App Received Draft Initiated Issuance Public Notice Issue Effective Expiration
9/16/2014 9/24/2014 9/24/2014
Regulated Activities Requested !Received Events
Subdivision
Wastewater collection
Outfall
Additional information requested
Additional information received
Waterbody Name Streamindex Number Current Class Suhbasin

Water Resources
ENVIR©NME'N "FAL QUALITY
February 15, 2016
Mr. Fred Matrulli, VP Land Operations,
Standard Pacific of the Carolinas, LLC
6701 Carmel Road, Suite 425
Charlotte, NC 28226
SUBJECT: Final Engineering Certification Acknowledgement
Project: Palisades, Tract III, Phase
Permit No. WQ0037355
Permittee: Standard Pacific of the Carolinas. LLC
County: Mecklenburg
Dear Mr. Matrulli:
PAT MCCRORY
R. VAN DER VAART
SOCrelory
S. JAY ZIMMERMAN
The Division of Water Resource's Mooresville Regional. Office received the final engineering
certification with record drawings for the subject sewer extension project on 02/12/20 1.6. Enclosed
is a certification page for your records. A full review of the certification materials may or may not
be conducted. It is assumed that receipt of this certification indicates compliance with all
regulations, design criteria and the permit. However, if a full technical review is conducted, you
will be notified of any items of non-compliance.
Please be reminded that the Permittee is responsible for keeping a copy of the final record drawings
for the life of the project, If you have not received such copy from your consultant, please contact
them immediately to obtain a copy.
Lastly, you are receiving this letter because the Division has you fisted as the responsible party. If
this permitted system is no longer owned by you or your company, please complete Form PNOCF
since the permit is not automatically transferable. Form PNOCF can be downloaded from
htt :/1 ortal.ncdenr.or web/w /s / s/cs/ noc from the Collection Systems Applications page.
Should you have any questions, please do not hesitate to contact me at [phone].
Sincerely,
Barry Love
Environmental Specialist
cc: Mr. Marc A. Houle (Yarbrough-Williams&Houle,Inc.,730Windsor Oak Ct.,Char.NC 28273)
Central Files
MRO
State of North Carolina I Environmental Quality I Water Resources
610 E. Center Avenue, Suite 301, Mooresville, NC 28115
Phone: [phone] \ Internet: wvw.ncdenr.gov

plir ST TRACk ENGINEERING CERTIFICATION
Permittee: Standard Pacific of the Carolinas, LLC Permit No. WQ0037355
Project: Palisades, Tract III, Phase I — Mecklenburg County Issue Date: 09/24/2014
Complete and submit this form to the permit issuing regionef-Ofifee,with the foltoWirtgE
O One copy of the project record drawings (plan & profile views and detail drawings of sewer lines) of the wastewater
collection system extension, Final record drawings should be clear on the plans or on digital media (CD or DVD
disk) in pdf format, Record drawings should indicate the design and the marked up changes during construction,
• Supporting design calculations (selected pumps, system curve, operating point, available storage if portable
generator(s) or storage greater than longest past three year outage reliability option selected) for any pump stations
permitted as part of this project
O Changes to the project should be clearly identified on the record drawings or in written summary form, Permit
modifications are required for any changes resulting in non-compliance with this permit, regulations or
minimum design criteria. Modifications should be submitted prior to certification.
This project shall not be considered complete nor allowed to operate until the Division has received this Engineer's
Certification and all required supporting documentation, Therefore, it is highly recommended that this certification
be sent in a manner that provides proof of receipt by the Division.
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,
-1,11-14
1)(
Printed Name, Title
ure
ENGINEER'S CERTIFICATION
Ej Partial Final
C, , as a duly registered Professional Engineer in the State of North Carolina,
ha n een authorized to observe 4 periodically, El weekly, EI full time) the construction of the subject project
for the 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 be built within substantial compliance of this
permit, 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,
Date
North Carolina Professional Engineer's
Seal, signatu , and e:
SEND THIS FORM & SUPPORTING DOCUMENTATION
WITH REQUIRED ATTACHMENTS TO THE FOLLOWING ADDRESS
SURFACE WATER PROTECTION SUPERVISOR
MOORESVILLE REGIONAL OFFICE
610 EAST CENTER AVENUE, SUITE 301
MOORESVILLE, NC 28115
The Permittee is responbk for tracking all partial certifications up until a final certification is received Any
wastewater flow made tributary to the wastewater collection system extension prior to completion of this
Engineer's Certification shall be considered a violation of the permit and shall subject the Permittee to appropriate
enforcement actions.