WQ0043006_Application (FTSE)_20211111

DocuSign Envelope ID: 696EE1A5-2F33-4493-9ABC-006D28$E7C33
DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 06-21 & SUPPORTING DOCUMVN r A'rrnN
Application Number: (iobecompletecQtioDapt of Environmentai Q%=.i':jr
i
All items must be completed or the application will be returnr8- NOV 11 2021
1. APPLICANT INFORMATION:
I. Applicant's name: Town ofHolly Springs pg1C iSiL Tieginnal 0ffICA_
2. Applicant type: ❑ individual ❑ Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State,:County ® Municipal ❑ Other
3. Signature authority's name: Kendra D. Parrish, PE _ per 15A NCAC 02T ,0106ib1
Title: Executive Director of Utilities & Infrastructure Service
4. Applicant's mailing address: 128_South _Main_Street,-PO Box 8.-..._.... -
City: Holly Springs State: NC'Zip: 27540
5. Applicant's contact information:
Phone number: [phone] Email Address: Kendra.narrish(ahollysurinpsnc.-gov —
IL PROJECT INFORMATION:
I. Project name: Oakview Phase I
2.
Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
If modification, provide the existing permit number: WQ00 and issued date:
For modifications, also attach a detailed narrative description as described in Item G of the checklist.
If new construction, but part of a master plan, provide the existing permit number: WQ00
3. County where project is located: Wake
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.6569 Longitude: 78.8719
5. Parcel ID (if applicable) : 0639943500. 0639941045. 0639842054, 0639837664 (or Parcel ID to closest downstream sewer)
0639721436
Ill. CONSULTANT INFORMATION:
I. Professional Engineer: Blake Hall License Number: 38616
Firm: Timmons Group
Mailing address: 5410 Trinity Rd, Suite 102
City: Raleigh State: NC Zip: 27607
Phone number. [phone] Email Address:: blake.hall a,timmons.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Utley Creek Water Reclamation Facility Permit Number: NCO063096
Owner Name: Town of HollySprings
V. RECEIVING DOWNSTREAM SEWER INFORMATION: * Downstream sewer is being permitted in a
1. Permit Number(s): WQ00 separate application (Oakview Innovation Park)
2. Downstream (Receiving) Sewer Information: 20 inch ® Gravity ❑ Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS00192
Owner Name(s): Town of Holly Springs
FORM: FTA 06-21 Pagel of 5

NC Dept of Environmental Quality
DocuSign Envelope ID- 696EE1A5-2F33-4493-9ABC-OD6D2B8E7C33 ]' 4
V1. GENERAL REQUIREMENTS NOV V 1 021
1. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
❑ Yes ❑ No ® N.A Raleigh Regional Office
2. If the Applicant is a Developer of lots to be sold, has a Developer's Operational Agreement .IFORM: DEVi been attached?
[:]Yes [:]No ® N/A
3. If the Applicant is a Home/Property Owners' Association, has an HOX'POA QperationqL&LreemeptjFORM: H A and
supplementary documentation as required by 15A NCAC 02T.0115(c) been attached?
[:]Yes ❑ No ® NIA
4. Origin of wastewater: (check all that apply):
❑ Residential (Individually Owned) ❑ Retail (stores, centers, malls) ❑ Car Wash
❑ Residential (Leased) ❑ Retail with food preparationiservice ❑ Hotel and/or Motels
❑ School 1 preschool I day care ❑ Medical / dental ;' veterinary facilities ❑ Swimming Pool/Clubhouse
❑ Food and drink facilities ❑ Church ❑ Swimming Pool/Filter Backwash
® Businesses! offices! factories ❑ Nursing Home ❑ Other (Explain in Attachment)
5. Nature of wastewater: %Domestic _._"o Commercial 100 % Industrial (Sc(, IS NCAC 02T .0103t201)
If Industrial, is there a Pretreatment Program in effect? ® Yes❑ No
6. Hasa flow reduction been approved under I SA NCAC 02T .01 141' f)? ❑ Yes ❑ No
➢ If yes, provide a copes of flow reduction approval letter with this application
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(f))
Daily Design Flow a,b
No. of Units
Flow
gall
GPD
gall
GPD
gall
GPD
gal/
GPD
gall
GPD
gall
GPD
Total
0 GPD
a See 15A NCAC 02T,Q1 lab), (d), (e)(1) and tcl12i 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 ofthe Atlantic Intracoastal Waterway to be used as vacation rentals as defined
in G.S. 42A-4).
b Per 15A NCAC 02T .01 14(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: 0 GPD (per 15 A NCAC 02T A 1 14
➢ Do not include future Flows or previously permitted allocations
If permitted flow is zero, please indicate why:
❑ Pump Station;'Force Main or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line.
Please provide supplementary information indicating the approximate timeframe for permitting upstream sewers with flow.
® Flow has already been allocated in Permit Number: Issuance Date: 'Downstream sewer is
being permitted In a
❑ Rehabilitation or replacement of existing sewers with no new flow expected separate application
(Oakview Innovation Park)
❑ Other (Explain):
FORM: FTA 06-21 Page 2 of 5

DocuSign Envelope ID: 696EE1A5-2F33-4493-9ABC-OD6D2B8E7C33
V11. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & ML&LGravitj Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
$
183
DIP
8
1,344
PVC
➢ Section II & Ili 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 requirements is not allowed and a violation of the MDC
VIII. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC (Pump Stations;Force Mains):
PROVIDE A SEPARATE COPY OF THIS PAGE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
Pump station number or name:
2. Approximate Coordinates (Decimal Degrees): Latitude: Longitude:
3. Total number of pumps at the pump station:
3. Design flow of the pump station: millions gallons per day (firm capacity)
➢ This should reflect the total GPM for the pump station with the largest pump out of service.
4. Operational point(s) per pump(s): gallons per minute (GPM) at: feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches) Length (feet) Material
If any portion of the force main is less than 4-inches in diameter, please identify the method of solids reduction per
MDCPSFM Section 2.01C.I.b. ❑ Grinder Pump ❑ Mechanical Bar Screen ❑ Other (please specify)
6. Power reliability in accordance with .15A NCAC 02T .0305 h)(] ):
❑ Standby power source or ❑ Standby pump
➢ Must have 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 and may not be portable
Or if the pump station has an average daily flow less than 15,000 gallons per day 15A NCACO2T.0305(h)(1)(C):
❑ Portable power source with manual activation, quick -connection receptacle and telemetry -
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry:
➢ Include documentation that the portable source is owned or contracted by the applicant and is compatible with the station.
➢ Ifthe 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
as part of this permit application in the case of a multiple station power outage.
FORM: FTA 06-21 Page 3 of 5

DocuSign Envelope ID: 696EE1A5-2F33-4493 9A8C-0D6D2B8E7(.33
IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(t)):
1. Does the project comply with all separations/alternatives found in 15A. NCAC 02T _0305(D &t P ® Yes ❑ No
15A NCAC 02T.0305(fl contains minimum separations that shal l be provided for sewer systems -
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below (vertical)
18 inches
'Water mains (vertical - water over sewer preferred, 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 1 or
Class 11 impounded reservoirs used as a source of drinking water, and associated wetlands.
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 associated with these waters (see item IX.2)
50 feet
**Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches, as well as wetlands associated with these waters or classified as WL.
10 feet
Any building foundation (horizontal)
5 feet
Any basement (horizontal)
10 feet
Top slope of embankment or cuts of 2 feet or more vertical height
10 feet
Drainage systems and interceptor drains
5 feet
Any swimming pools
10 feet
Final earth grade (vertical)
36 inches
➢ If noncompliance with 02T (forUj see Section X.I of this application
* 15A NCAC 02T.0301contains alternatives where separations in 02T.D305(f} cannot be achieved. Please check "yes"
above if these alternatives are used and provide narrative information to explain.
**Stream classifications can be identified using the Division's NC Surface Water Classifications webpa�,e
2. Does this project comply with the minimum separation requirements for water mains? ® Yes ❑ No ❑ N;'A
➢ If no, please rcfer to 15A NCAC 18C.0906(f) for documentation requirements and submit a separate document,
signed;'sealed by an NC licensed PE, verifying the criteria outlined in that Rule.
3. Does the project comply with separation requirements for wetlands? ® Yes [-]No ❑ N.:A
➢ Please provide supplementary information identifying the areas of non-conformance.
➢ See the Division's draft 5eVaration recluiremqnls for situations where separation cannot be met.
➢ No variance is required if the alternative design criteria specified is utilized in design and construction.
4. Is the project located in a river basin subject to any State buffer rules? ❑ Yes Basin name: _Cape Fear ® No
If yes, does the project comply with setbacks found in the river basin rules per II SA NCAC 02B .02(2107 ® Yes ❑ No
➢ This includes Trout Buffered Streams per 15A'+ UAC 213,0202
5. Does the project require coverage/authorization under a 404 Nationwide! individual permits ® Yes ❑ No
or 401 Water Quality Certifications?
➢ Please provide the permit numberfpermitting status in the cover letter if coverage'authorization is required.
6. Does project comply with 15A NCAC 02T.01051cJL6) (additional permits/certifications)? ® Yes ❑ No
Per 15A NCAC 02T,0105tc)(6), directly related environmental permits or certification applications must be 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.).
7. Does this project include any sewer collection lines that are deemed "high -priority?" ❑ Yes ® No
Per 15A NCAC 02T_0402, "high -priority sewer" means any aerial sewer, sewer contacting surface waters,
siphon, or sewers positioned parallel to streambanks that are subject to erosion that undermines or deteriorates the sewer.
Siphons and sewers suspended through interference/conflict boxes require a variance approval.
➢ 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 ISA NCAC 02T.0403(a)(5) or the permittee's individual System -Wide Collection permit.
FORM: FTA 06-21 Page 4 of 5

DocuSign Envelope ID 696EEIA5-2F33-4493-9ABC-OD6D2B8E7C33
NC Dept of Environmental Quality
X. CERTIFICATIONS: NU h 1 20Z1
I. Does the submitted system comply with 15A NC;AC.42T, the MinimUm Desi n Cri or the Permtutng c)f Pump Stations
anti Force Mains latest version), and the Gravity Sewer Minimum Design Criteria ( latest version) as applicable?
® Yes ❑ No Raleigh Regional Office
If no, for projects requiring a single variance, complete and submit the VariancelAlternative Design Request application
(VADC 10-14) and supporting documents for review to the Central Office. Approval of the request will be issued
concurrently with the approval of the hermit, and protects requiring a variance approval, may be subject to longer
review times. For ro'ects reauiring two or more variances or where the variance is determined by the Division to be a
significant portion of the proaect, the full technical review is required.
2. Professional Engineer's Certification:
1, Blake Hall , attest that this application for Oakview Phase l
(Professional Engineer's name from Application Item II[ t) {Project Name from Application Item 11 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. 1 further
attest that to the best of my knowledge the proposed design has been prepared in accordance with the applicable regulations,
h1 inimum Design Criteria for 'r vi y. Sewers I latest versionl, and the '0 inimum Design Criteria for the Fa51-Track Permitting
of Purr1R Stations and Force Mains (latt�5t 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 143-215.6B, 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. Misrepresentation of the application
information, including failure to disclose any design non-compliance with the applicable Rules and design criteria, may subject
the North Carolina -licensed Professional Engineer to referral to the licensing board. (21 NCAC 56.0701)
`k %t%II•Iirrr��i
North Carolina Professional Engineer's seal, signature, and date:
d dF�53/0
'
.74
— 957062C04 -
F�,,U 038616 10 20/2021
Dae;Signid.� Blake Ha I
.^'GINS .•�� �:
3. Applicant's Certification per 15A NCAC 02T .0106(b):
1, Kendra D. Parrish, PE , attest that this application for Oakview Phase I
(Signature Authority Name from Application Item [3 )
(Project Name from Application Item II I )
attest that this application 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. 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. 1 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-? r1.613., 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 violation.
"Igo" by,
Signature: Ll!t __ Date:
10/21/2021
FORM: FTA 06-21 Page 5 of 5

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€7ocuSign Envelope ID: 696EE1A5-2F33-4493-9ABC-4D6D2B8E7C33
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4. `T THE TOWN OF
October 20, 2021
Director, Division of Water Resources
Raleigh Regional Office
Water Quality Operation Section
3800 Barrett Drive
Raleigh, NC 27609
Wo_1 ly S
prings
Re: Application for Sewer Extension Permit
Project: Oakview Phase 1
Dear Sir or Madam:
Please find enclosed the following items in application for a sewer extension permit to the Town
of Holly Springs existing sewer distribution system:
0 One original and one copy cover letter including a project narrative
o A check in the amount of $480.00
0 One original and one copy of the State of North Carolina Fast Track Sewer System
Extension Application (FTA 04- l 6)
0 Two copies of FTSE 04-16 Flow Tracking/Acceptance Form
0 Two color copies of a 8.5-inch by I I -inch portion of a 7.5 minute USGS Topographic
Map showing project area
0 Two copies of a street level map showing all relevant project areas
0 One copy of the locally -required Design and Application Certification
Feel free to contact me at 919-577-3150 should you have any questions or need additional
information in order to process this application.
Sincerely,
UDoeu by
4_*_
tP9F3"rrish, P.E., CFM
Executive Director of Utilities and Infrastructure
KP• tr
cc: Project Consultant Engineer, Blake Hall, PE
Rachel Ingham, Utility Engineer
Drew Johnson, Development Construction Manager
Theresa Randall. Utility Permitting Specialist
Project file'Correspondence # 10041
DDSS
10/20/2021
Rachel Ingham
Utility Engineer
30U2
04 1'12o18
Utilities and Infrastructure Services
P.O. Box 8 • 128 S. Main Street • HolIy Springs, NC 27540 • www.hoIlyspringsnc,us

DocuSigrt Envelope ID: 696EE1A5-2F33-4493-9ASC-OD6D268E7C33
DO NOT SUBMIT SEWER EXTENSION APPLICATIONS UNTIL
CONSTRUCTION DRAWINGS HAVE BEEN APPROVED BY STAFF!
Sewer Design and Application Certification
Note: This form must be submitted with the Fast Tract Application for extension to the Town of
Holly Springs Sewer System
Project: Oakview Phase I
Design Engineer: Timmons Group; Blake Hall
Address: 5410 Trinity Rd, Suite 102, Raleigh, NC 27607
Phone Number: 919-866-4933 Email: [e-mail]
Date Complete Application Package Received by Town:
Date Approved.l0/20/2021 (by q 10/21/2021 (by KD C)L_,,,,���byDJ)
As design engineer for this project, I certify the following (please check (x) each applicable box)_
® That the design of the project is in complete conformance with the Town of Holly
Springs Engineering Design and Construction Standards and NC DEQ Sanitary Sewer
Design Regulations;
® That each of the following items are completed and enclosed for submittal to the State fors
a sewer extension permit: O'
0 One cover letter that includes a project narrative
o A check in the amount of $480.00 to NC DEQ E
o A check in the amount of $200.00 to the Town of Holly Springs L
0 One State of North Carolina form FTA 04-16 Fast Tract Sewer System 3
Extension Application
0 One FTSE 10-18 Flow Tracking for Sewer Extension Applications
0 One color copy of an 8.5-inch by 11-inch portion of a 7.5-minute USGS
Topographic Map showing project area
0 One copy of a street level map showing all relevant project areas
0 One copy of the locally -required Design and Application Certification (this
form)
Design Engineer's Signature Date 9l8/21
Please contact Theresa Randall at [phone] or theresax-dndalWholl rjngs
jnc,g2v if you
have any questions.
2003 sewer Design Application Certification
01.14.21
Utilities and Infrastructure Services
P.O. Box 8 • 128 S. Main Street • Holly Springs, NC 27540 • www.hollyspringsnc.gov

DocuSigfn Envelope ID- 696EE1A5-2F33-4493-9ABC-OD6D2B8E7C33
5410 Tnnity Road
TIMMONS GROUP Suite
Raleigh,
NC 27607
Cover Letter-Oakview Phase
ENCLOSED PLEASE FIND:
P 919.866.4951
F 919.859 5663
www.timmons.com
COPIES
DATE
NUMBER
DESCRIPTION
1
Full Size Civil Plan Set
1
Fast Track Sewer System Extension Application
1
Sewer Design and Application Certification
1
USGS To o Map and Site Ma
The proposed project is in Town of Holly Springs, located in Oakview Innovation park near the
intersection of New Hill Holly Springs Road and Green Oaks Parkway. The scope of the project will
include the construction of two 104,000 SF buildings, associated parking, water main, reclaimed
water services and sanitary sewer main. Associated 401/404 permits have been approved_ Refer to
permit numbers DWR# 20201873 and SAW-2015-02137. The sanitary sewer main, approximately
1,532 LF, is anticipated to provide capacity for the following wastewater flows which were included
in the Oakview Innovation Park Sewer Main permit to the State:
Site Method Acres Flow Factor
(GPD/ac)
Crescent (Life 1500 GPD/AC 25.5 1500
Science Buildings)
Gallons per Peaking Peak Flow
Day Factor Rate
(GPM)
38,250 1 3.0 1 82.0
Flows for the Oakview Phase 1 development were determined using 1500 GPD per acre. Based on
previous projects done, 1500 GPD rather than the state recommended flows follows more closely to what
these developments need. The proposed sanitary sewer system will serve the 2 new buildings and
connect to the new gravity sanitary sewer system leading to the existing pump station. This main
will be owned, operated, and maintained by the Town of Holly Springs.
ENGINEERING - DESIGN I TECHNOLOGY