WQ0043964_Application_20221213

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 DOCUMENTATION
Application Number:14Q Obi-0 (to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
RECEIVED/NCDEQ/DWR
NOV 3 0 2022
WOROS
MOORESVILLE REGIONAL OFFICE
1. Applicant's name: Leonard Greene Limited Partnership (company, municipality, HOA, utility, etc.)
2. Applicant type: 0 Individual 0 Corporation
® General Partnership ❑ Privately -Owned Public Utility
❑ Federal 0 State/County 0 Municipal
3. Signature authority's name: David Cooper, Jr. per 15A NCAC 02T .0106(b)
Title: Authorized Representative
4. Applicant's mailing address: 500 S Front Street, 10th Floor
City: Columbus State: OH Zip: 43215-
5. Applicant's contact information:
Phone number: [phone] Email Address: [e-mail]
0 Other
II. PROJECT INFORMATION:
1. Project name: Leonard Greene -Private
2. Application/Project status: ® Proposed (New Permit) 0 Existing Permit/Project
If a 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: Gaston
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.3228° Longitude: -81.1642°
5. Parcel ID (if applicable): 169874 (or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Jeffrey D. McCluskey
Firm: Mc2 Engineering, Inc.
Mailing address: 2110 Ben Craig Drive, Suite 400
City: Charlotte State: NC Zip: 28262-_
Phone number: [phone] Email Address: Jeffs mc2eng.com
License Number: 29606
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Town of Dallas Wastewater Treatment Plant Permit Number: NC0068888
Owner Name: Town of Dallas
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. Permit Number(s): WQ
2. Downstream (Receiving) Sewer Information: 8 inch El Gravity ❑ Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS00165
Owner Name(s): Town of Dallas
FORM: FTA 06-21
Page 1 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 ® N/A
2. If the Applicant is a Developer of lots to be sold, has a Developer'sOperational ._.Agreeme.t(FOft t1; DEV) been attached?
❑Yes ❑No N/A
3. If the Applicant is a Home/Property Owners' Association, has an HOA/POA Operational Agreement (FORM: HOA) and
supplementary documentation as required by 15A NCAC 02T.0115(c) been attached?
❑ Yes ❑ No ® N/A
4. Origin of wastewater: (check all that apply):
❑ Residential (Individually Owned)
® Residential (Leased)
❑ School / preschool / day care
❑ Food and drink facilities
❑ Businesses / offices / factories
❑ Retail (stores, centers, malls)
❑ Retail with food preparation/service
❑ Medical / dental / veterinary facilities
❑ Church
❑ Nursing Home
❑ Car Wash
❑ Hotel and/or Motels
❑ Swimming Pool/Clubhouse
❑ Swimming Pool/Filter Backwash
❑ Other (Explain in Attachment)
5. Nature of wastewater : 100 % Domestic % Commercial % Industrial (See 15A -N AC 02"l' .0103(20))
If Industrial, is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Has a flow reduction been approved under 15A NCAC 02'l' .0114(f)? ❑ Yes ® No
➢ If yes, provide a copy 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
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
GPD
a See 15A NCAC 02"1' .0114(b), (d), (e)(1) and (e)(2) 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 i.S. 421-4).
b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified [in table 15A NC`AC 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 1 S A NCAC 02T .0114)
➢ 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:
❑ Rehabilitation or replacement of existing sewers with no new flow expected
® Other (Explain): Proposed flow is included with Leonard Greene -Public (permitted separately)
FORM: FTA 06-21
Page 2 of 5

V11. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
6
626.46
DIP/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 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
1. 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.1.b. ❑ Grinder Pump ❑ Mechanical Bar Screen D Other (please specify)
6. Power reliability in accordance with 15A NCAC 02T .0305(h)(1):
❑ 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.
➢ 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
as part of this permit application in the case of a multiple station power outage.
FORM: FTA 06-21 Page 3 of 5

IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(1)):
1. Does the project comply with all separations/alternatives found in 15A NCAC 02T .0305(f) & (g)?
15A NCAC 02T.0305(f) 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)
18 inches
2Water mains (vertical - water over sewer preferred, including in benched trenches)
18 inches
2Water 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, 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
D. If noncompliance with 02T.0305(f) or (g), see Section X.1 of this application
*15A NCAC 02T.0305(g1 contains alternatives where separations in 02T.0305(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 webpage
2. Does this project comply with the minimum separation requirements for water mains? ® Yes ❑ No ❑ N/A
➢ If no, please refer 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
D. Please provide supplementary information identifying the areas of non-conformance.
D. See the Division's draft separation requirements 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: ® No
If yes, does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .0200? ❑ Yes ❑ No
D. This includes Trout Buffered Streams per 15A NCAC 2B.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 number/permitting status in the cover letter if coverage/authorization is required.
6. Does project comply with 15A NCAC 02T.0105(c)(6) (additional permits/certifications)? ® Yes ❑ No
Per 15A NCAC 02T.0105(c)(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 15A NCAC 02T.0403(a)(5) or the permittee's individual System -Wide Collection permit.
FORM: FTA 06-21 Page 4 of 5

X. CERTIFICATIONS:
1. Does the submitted system comply with 15A NCAC 02T, the Minimum Design Criteria for the Permitting of Pump Stations
and Force Mains (latest version). and the Gravity Sewer Minimum Design Criteria (latest version) as applicable?
® Yes ❑ No
If no, for projects requiring a single variance, complete and submit the Variance/Alternative 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 permit. and projects requiring a variance approval may be subject to loner
review times. For projects requiring two or more variances or where the variance is determined by the Division to be a
significant portion of the project, the full technical review is required.
2. Professional Engineer's Certification:
I, _Jeffrey D. McCluskey , attest that this application for Leonard Greene — c t v c k' <'
(Professional Engineer's name from Application item iii.l.) (Project Name from Application Item II.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,
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 143-215.6B, 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 �� g701)
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North Carolina Professional Engineer's seal, signature, and date:
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3. Applicant's Certification per 15A NCAC 02T .0106(b):
I, David Cooper, Jr. , attest that this application for Leonard Greene 13C4.
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(Signature Authority Name from Application Item I.3.) (Project Name from Application Item II.1)
attest that this application 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.
Signature:
FORM: FTA 06-21
Date:
Page 5 of 5

me2
ENGINEERING
SITE/CIVIL ENGINEERING
LAND PLANNING
STORM WATER MANAGEMENT
UTILITY ENGINEERING
CONSTRUCTION ADMIN
November 28, 2022
Mooresville Regional Office
610 E. Center Avenue
Mooresville, NC 28115
Re: Leonard Greene -Private
Sanitary Sewer Collection for Leonard Greene Apartments
The proposed project includes connecting to the proposed 8" Public PVC/DIP
gravity sanitary sewer (permitted separately). This new private 626.46 if of 6"
gravity sewer will serve the proposed 120 unit apartment buildings and a
clubhouse.
The property is located off of Evans Lake Road, Dallas NC. The site is more
specifically defined as Parcel ID #169874.
The proposed on -site sanitary sewer on the subject property will consist of a private
6" sanitary sewer laterals to serve 3 - 40-unit apartment buildings along with a
clubhouse. This permit only includes the private 6" sanitary sewer system.
Jeffr
President

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State of North Carolina
Department of the Secretary of State
SOSID: 2266433
Date Filed: 9/10/2021 12:37:00 PM
Elaine F. Marshall
North Carolina Secretary of State
C2021 244 00478
CERTIFICATE OF DOMESTIC LIMITED PARTNERSHIP
INCLUDING OPTIONAL APPLICATION AS A REGISTERED LIMITED
LIABILITY LIMITED PARTNERSHIP
Pursuant to §59-201 of the General Statutes of North Carolina, the undersigned hereby submits this Certificate of
Domestic Limited Partnership.
1. The name of the limited partnership is: Leonard Greene Limited Partnership
(The name must contain the words "Limited Partnership," or the abbreviation "L.P." or "LP," or the combination "Ltd.
Partnership". if the limited partnership is a limited liability limited partnership, as indicated in Item 11, below, the name
must contain the words "Registered Limited Liability Limited Partnership," "Limited Liability Limited Partnership," or the
abbreviation "L.L.L.P.," "R.L.L.L.P.," "LLLP," or "RLLLP".)
2. If formed prior to October 1, 1986, complete this section:
County of Filing: County File Number:
Date of Filing:
3. Name of Registered Agent: Paige H. Pease
4. Address of Registered Agent's Office:
Number and Street: 16151 Lancaster Highway, Suite B
City: Charlotte State: NC Zip Code: 28277 County: Mecklenburg
5. Address and telephone number of office where records are kept, if not kept at registered office:
Office Telephone Number:
Number and Street:
City: State: Zip Code: County:
6. Latest date upon which the limited partnership is to dissolve. (If no date is specified, there shall be no limit on the
limited partnership's duration.)
7. State the name, and address, including county and city or town, and street and number, if any, of each general
partner. (Attach additional sheets if necessary.)
Leonard Greene GP, LLC - 500 S. Front St., 10th Floor Columbus OH, 43215-7628 United States
Franklin County
8. This registration will be effective upon filing, unless a future date and/or time is specified:
BUSINESS REGISTRATION DIVISION
(Revised August, 2017)
P.O. BOX 29622
Page 1
RALEIGH, NC 27626-0622
Form LP-01

9. The following and attached signatures of EACH general partner constitute an affirmation under the penalty of
perjury that the facts herein arc true. (Attach additional sheets if necessary.)
(a)
If the general partner is an individual, complete this section:
Signature: Date: 9/1/2021
Typed or Printed Name:
General Partner
Signature: Date:
Typed or Printed Name:
Signature: Date:
Typed or Printed Name:
(b) If the general partner is a corporation or other entity, complete this section.
Name of corporation or other entityLeonard Greene GP, LLC
Signature ofofficerJennifer Ricci, Vice President
Name and Title ofofficerJennifer Ricci, Vice President
Date9/1 /2021
Name of corporation or other entity
Signature of officer
Name and Title of officer
Date
10. (Optional): Please provide a business a -mail address: Privacy Redaction
The Secretary of State's Office will e-mail the business automatically at the address provided at no charge when a
document is filed. The e-mail provided will not be viewable on the website. For more information on why this
service is being offered, please see the instructions for this document.
11. (Optional): Complete this section ONLY if the limited partnership is to be a limited liability limited partnership at
the time of its formation.
❑ (Check here and complete the following information. The limited partnership is a limited liability limited
partnership. (Complete the following information.)
The street address of the principal office of the limited liability limited partnership is:
• Principal Office Street Address
Number and Street:
City: State:OH Zip Code: County:
• The principal office telephone number:
• Principal Office mailing address (if different from the street address of the principal office above) is:
Number and Street:
City: State: OH Zip Code: County:
• The fiscal year end of the limited liability limited partnership is: 12/31
NOTES: Filing fee is $50.00 if #11 Option is not selected. If #11 Option is selected the fee is $125.00.
This document must be filed with the Secretary of State.
BUSINESS REGISTRATION DIVISION P.O. BOX 29622
(Revised August, 2017) Page 2
RALEIGH, NC 27626-0622
Form LP-01