WQ0043971_Application (FTSE)_20221110

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 DOCUMENTATION
Application Number: w 0011.36171(to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: 15-501 East LLC (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ® Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ StatelCounty ❑ Municipal ❑ Other
3. Signature authority's name: Tim Smith per I5A NCAC 02T _0106tb1
Title: Owner/Manager
4. Applicant's mailing address: 105 Weston Estates Way
City: Cary State: NC Zip: 27513-
5. Applicant's contact information-
Phone number: [phone] Email Address: [e-mail]
II. PROJECT INFORMATION:
1. Project name: Mellott Pump Station and Utilities
2. Application/Project status: ® Proposed (New Permit) ❑ 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: Chatham
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.6435 • Longitude: -79.1779
5. Parcel ID (if applicable): 07101, 75037, 75038, 78535, and 95381 (or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Wesley Hutchins License Number: 049224
Firm: McKim & Creed, Inc.
Mailing address: 170 Varsity Dr., Suite 500
City: Raleigh State: NC Zip: 27606-2689
Phone number: [phone] Email Address: [e-mail]
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
l . Facility Name: Chatham Park Water Recovery Center Permit Number: W00039375
Owner Name: Clearwater64 LLC
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
l . Pcrmit Number(s): WQ0040741
2. Downstream (Receiving) Sewer Information: 16 inch ® Gravity 0 Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS00I46
Owner Name(s): Town of Pittsboro
FORM: FTA 06-21
Page 1 of 5
--.›....,, ,..i,v„ni,M„a 101dan 7141

VI. GENERAL REQUIREMENTS
I . 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 l2 Y ucr's Operaii na! Agtrm.ent (FORM: DEVI• been attached?
❑ Yes No ZN/A
3. if the Applicant is a Home/Property Owners' Association, has an RQ.A.'POA Operational A rccment (FORM: HOA) and
supplementary documentation as required by 15A NCAC 02T.01 15(c) been attached?
❑ Yes ❑ No ® NIA
4. Origin of wastewater: (check all that apply):
❑ Residential (Individually Owned) ❑ Retail (stores, centers, malls)
❑ Residential (Leased) ❑ Retail with food preparation/service
❑ School / preschool / day care ❑ Medical / dental / veterinary facilities
❑ Food and drink facilities ❑ Church
❑ Businesses / offices / factories ❑ Nursing Home
❑ Car Wash
❑ Hotel and/or Motels
❑ Swimming Pool/Clubhouse
❑ Swimming Pool/Filter Backwash
❑ Other (Explain in Attachment)
5. Nature of wastewater : % Domestic % Commercial % Industrial (See 15A NCAC 02T .0103(20))
If Industrial, is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Has a flow reduction been approved under 15A N('A(' 02T .011440 ® 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''b
No. of Units
Flow
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
GPD
a See I5A WA(. [}2T .01 14(b1,, apes) 1q 21 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 C.S. 42A 4).
b Per I5A NCAC 02T .0114(c), design flow rates for establishments not identified [in table I, A N A Q2T 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 I5A NCAC 02T .01 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:
❑ Rehabilitation or replacement of existing sewers with no new flow expected
® Other (Explain): Project does not generate wastewater. Future projects will provide permits for new flow.
FORM: FTA 06-21
Page 2 of 5

Vll, GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & NIDC (Gravity Sewersi:
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
8
3,500
PVC
8
200
DIP
12
30
DIP
D 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)
D 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: Mellott Pump Station
2. Approximate Coordinates (Decimal Degrees): Latitude: 35.7516. Longitude:-79.1517 .
3. Total number of pumps at the pump station: 2
3. Design flow of the pump station: 0.24 millions gallons per day (firm capacity)
D This should reflect the total GPM for the pump station with the largest pump out of service.
4. Operational point(s) per pump(s): 165 gallons per minute (GPM) at 180 feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches)
Length (feet)
Material
6
3,800
PVC
6
200
DIP
If any portion of the force main is Icss than 4-inches in diameter, please identify the me hod of solids reduction per
MDCPSFM Section 2.0I C.1,b. ❑ Grinder Pump ❑ Mechanical Bar Screen ❑ Other (please specify)
6. Power reliability in accordance with ISA NCAC 02T .0305011(11:
® Standby power source or ❑ Standby pump
D Must have automatic activation and telemetry - 15A NCAC 02T.0305(h)(1)(B)_
D Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
D 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 I5A 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(f)):
1. Does the project comply with all separations/alternatives found in 15A NS:Aj` 02T .0305L {g)? ® Yes ❑ No
I5A NCAC 02T.0305(fl contains minimum separations that shall 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)
I0 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 I1 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.0305(f) or (g), see Section X.I of this application
* I SA NCAC 02T.0305( ) contains alternatives where separations in 02T.03051 I) 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 wcbo u
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 ® NJA
> Please provide supplementary information identifying the areas of non-conformance.
> 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: Haw River ❑ No
If yes, does the project comply with setbacks found in the river basin rules per ISA NCACI 02B .0200? ® Yes ❑ No
> 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 I SA NCAC 02T.06) (additional permits?certifications)? ® Yes ❑ No
Per 15A_NC'A "_02T Q 11_ 160), 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 b.A. NCAC U2T.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 ycs, 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 ISA NCAC 02T. the Minimum Crilifor the Permitting of Plump, Sialions
and Force lwlzirt* Hates' vcr;innl, and the Gravity sewer Minimum I] i q Criteria /Nest 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. Annroval of the request will be issued
concurrently with the annroval of the permit. and nrolects revirine a variance approval may be subiect to longer
review times. For protects teautr1ne two or more variances or where the variance is determined by the Division to be a
sfenilieant portion or the oroiect. the full technical review is required,
2. Professional Engineer's Certification: �y p
I, Weittij �..�r.R..tns , attest that this application for / /� ILL f'1 f ✓tv jl s�s.��^ L V i
(Professional Engineer's name from Application item III I.) (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,
Minimum Dcsig Criteria for Gravi iy Sewepi icst version), and the Minimum Design Criteria for the Fa>t-Track Permitting
gr Pimp Stations and Force tMoins,imam version). Although other professionals may have developed certain portions of This
submittal package, inclusion of these materials under my signature and scal signifies that I have reviewed This material and
have judged it to be consistent with the proposed design.
NOTE In accordance with General Statutes I43-215.6A and I43-215.6B, 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 $25,000 per violation. Misrepresentation of the application
information, including failure to disclose any design non-compliance with the applicable Rules and design criteria, may subject
the North Carolina -licensed Professional Engineer to referral to the licensing board. (21 NCAC 56.0701)
North Carolina Professional Engineer's seal, signature, and date: ��s``-(H CAgO''�,,
s�OQ`• F.$Si, r410 .,
:$
1't► units,+ L
IAdcs
3. Applicant's Certification per 15A NCAC 02T .0106(b):
I, , attest that this application for 1 104-4 & a
(Signature Autho ty Namc frwn Application !tern 1.3.1 (project Name from Applicat n Item 11.1)
u't1 tl'}1
es
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 riot completed and that if all required supporting documentation
and attachments are not included, this application package is subject to being returned as incomplete. 1 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. l 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 10 me as incomplete.
NOTE — [n 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_ l 34 Zz »
Page 5 of 5

DESIGN NARRATIVE
FOR
FAST TRACK SANITARY SEWER PERMIT
CHATHAM PARK
Iiw Many Choices. One Pace.
CHATHAM PARK INVESTORS LLC
MELLOTT PUMP STATION AND UTILITIES
105 Weston Estates Way
Cary, North Carolina 27513
M&C Project # 01561-0020
November 2022
Prepared by:
McKIM&CREED
ENCtNI:FRS SURVEYORS PIANNFRS
Wesley Hutchins, PE
McKim & Creed, Inc.
1730 Varsity Drive, Suite 500
Raleigh, NC 27606
P: 919 233 8091

DESIGN NARRATIVE
1.0 PROJECT DESCRIPTION
The Mellott Pump Station and Utilities project installs approximately 3,800 linear feet of 6 inch
PVC sanitary sewer force main; approximately 200 linear feet of 6-inch DIP sanitary sewer force
main; approximately 3,500 linear feet of 8-inch PVC gravity sanitary sewer; approximately 200
linear feet of 8-inch DIP gravity sanitary sewer; and approximately 30 linear feet of 12-inch DIP
gravity sanitary sewer. The proposed sanitary sewer force main begins at the proposed pump
station and extends to an existing 12-inch PVC force main along Suttle Road (SR 1809). The
prosed gravity sanitary sewer is a new gravity outfall installed for future development and
extends from a proposed manhole near Suttles Rd (SR 1809) and extends to the proposed pump
station, paralleling the proposed force main. The project also includes construction of a duplex
sanitary sewer pump station and water service line. The total project has approximately 2.72
acres of disturbed area.
2.0 EXISTING SYSTEM
The proposed sanitary sewer force main will tie-in to an existing force main along Suttles Road
(SR 1809), owned by the Town of Pittsboro. The proposed gravity sanitary sewer will tie-in to
the proposed wet well at Mellott Pump Station. The downstream receiving sewer is permitted
under WQ0040741.
3.0 PROPOSED ADDITIONS
The proposed construction will add approximately 3,800 linear feet of 6-inch PVC sanitary
sewer force main; approximately 200 linear feet of 6-inch DIP sanitary sewer force main;
approximately 3,500 linear feet of 8-inch PVC gravity sanitary sewer; approximately 200 linear
feet of 8-inch DIP gravity sanitary sewer; and approximately 30 linear feet of 12-inch DIP
gravity sanitary sewer. The proposed sanitary sewer force main begins at the proposed pump
station and extends to an existing 12-inch PVC force main along Suttle Road (SR 1809). The
prosed gravity sanitary sewer is a new gravity outfall installed for future development and
extends from a proposed manhole near Suttles Rd (SR 1809) and extends to the proposed pump
station, paralleling the proposed force main. The project does not include the permitting of new
sanitary sewer flows. Other consultants will provide permits for the new flows in future projects
for the development.
The proposed sanitary sewer pump station, identified as Mellott Pump Station, is designed for a
firm capacity of 0.24 MGD. The pump station construction will consist of one 10' by 11.5' wet

well with two submersible pumps, one meter vault with bypass piping, odor control with bulk
chemical storage, electrical and control panel rack, and a generator. The pump station is
designed for permanent onsite backup generator; therefore, a power reliability plan has not
been included with this submittal. The construction will also include a water service line with
yard hydrant. An access drive is proposed by others, as shown on the plans.

j McICEM&CREElaDeptofa ante Quality
NOV 10 2022
Venture IV Building
1730 Varsily Drive
Raleigh, NC 27606
919.233.8091
Fax [phone]
www.mckirncreecl.com
ENGINEERS
SURVEYORS
PLANNERS
Raleigh Regional Office
November 10, 2022 M&C 01561-0020
NCDEQ Water Quality Section
3800 Barrett Drive
Raleigh, NC 27609
RE: 15-501 East LLC
Mellott Pump Station and Utilities
Fast Track Sewer System Extension Application
To Whom It May Concern:
We respectfully submit this application for a Fast Track Sewer System
Extension Application on behalf of the 15-501 East LLC for the subject project.
The Mellott Pump Station and Utilities project installs approximately 3,800
linear feet of 6-inch PVC sanitary sewer force main; approximately 200 linear
feet of 6-inch DIP sanitary sewer force main; approximately 3,500 linear feet of
8-inch PVC gravity sanitary sewer; approximately 200 linear feet of 8-inch DIP
gravity sanitary sewer; and approximately 30 linear feet of 12-inch DIP gravity
sanitary sewer.
The project also includes construction of a duplex sanitary sewer pump station.
The project is under review for the following permits: Town of Pittsboro
Riparian Buffer Authorization, Town of Pittsboro Construction Drawing
Approval, and Chatham County Soil Erosion and Sedimentation Control.
Environmental permitting (including 401/404) is pending and will be obtained
prior to construction. A flow reduction is pending and will be provided upon
approval.
1 '..OI561 t0O20', ENO. 4O-Permit'.4S-DEM, DEI-1, DOT. Etc', WW Permits, NCDEQ Fart Track Sewer Cover Letter For Submittal Doc

November 10, 2022
Page 2
Included in this submittal are the following documentation:
• Fast Track Application (Form: FTA 04-16), with attached documentation
of business registry
• Project Narrative
• USGS Quad Map and Aerial Map (showing project area and approximate
locations of proposed gravity sewer)
• One (1) CD with PDFs of the submittal package
• Check No. 14091 in the amount of $480.00
Please do not hesitate to contact me at whutchinsTlmckimcreed.com should you
have any questions or concerns. We appreciate your time and consideration
regarding this matter.
Sincerely,
McKIM & CREED, INC.
Wesley Hutchins, P.E.
Project Manager
cc: Robin Rose, Chatham Park Investors LLC (electronic)

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LIMITED LIABILITY COMPANY ANNUAL REPORT 1
t,r202,
NAME OF LIMITED LIABILITY COMPANY: 15-501 East LLC
SECRETARY OF STATE ID NUMBER. 1634504
REPORT FOR THE CALENDAR YEAR: 2022
SECTION A: REGISTERED AGENTS INFORMATION
STATE OF FORMATION
1. NAME OF REGISTERED AGEN-: Corporation Service Company
NC
Fling Office Use Only
E - Filed Annual Report
1634504
CA202210413890
4/14/2022 04:16
Changes
2. SIGNATURE OF THE NEW REGISTERED AGENT:
SIGNATURE CONSTITUTES CONSENT TO THE APPO NTMENT
3. REGISTERED AGENT OFFICE STREET ADDRESS & COUNTY 4. REGISTERED AGENT OFFICE MAILING ADDRESS
2626 Glenwood Ave, Ste 550 2626 Glenwood Ave, Ste 550
Raleigh, NC 27608 Wake County Raleigh, NC 27608
SECTION B: PRINCIPAL OFFICE INFORMATION
1. DESCRIPTION OF NATURE OF BUSINESS: Real Estate
2. PRINCIPAL OFFICE PHONE NUMBER: [phone]
4. PRINCIPAL OFFICE STREET ADDRESS
100 Matrix Drive, 8000
Cary, NC 27513
3. PRINCIPAL OFFICE EMAIL: Privacy Redaction
5. PRINCIPAL OFFICE MAILING ADDRESS
100 Matrix Drive, 8000
Cary, NC 27513
6. Select one of the following if applicable. (Optional see Instructions)
❑ The company is a veteran -owned small business
❑ The company is a service -disabled veteran -owned small business
SECTION C: COMPANY OFFICIALS (Enter additional company officials in Section E.)
NAME: Timothy R. Smith NAME: Julian W. Rawl
NAME: Donald R Parker
TITLE: Vice President TITLE: Vice President TITLE: Manager
ADDRESS:
100 Matrix Drive 8000
Cary, NC 27513
ADDRESS: ADDRESS:
100 Matrix Drive 8000
Cary, NC 27513
100 Matrix Drive 8000
Cary, NC 27513
SECTION D: CERTIFICATION OF ANNUAL REPORT. Section D must be completed in its entirety by a person/business entity.
David B. Kelm 4/14/2022
SIGNATURE DATE
Form must be signed by a Company Official listed under Section C of This form.
David B. Kelm Secretary
Print or Type Name of Company Official Print or Type Title of Company Official
SUBMIT THIS ANNUAL REPORT WITH THE REQUIRED FILING FEE OF $200.00
MAIL. TO: Secretary of State, Business Registration Division, Post Office Box 29525, Raleigh, NC 27626-0525

SECTION E: ADDITIONAL COMPANY OFFICIALS
NAME: Donald R Parker
TITLE: President
NAME: Donald R Parker
TITLE: Treasurer
NAME: David B. Keim
TITLE: Secretary
ADDRESS: ADDRESS: ADDRESS:
100 Matrix Drive 8000 100 Matrix Drive 8000 100 Matrix Drive 8000
Car+, NC 27513 _ Cary, NC 27513 Cary, NC 27513
NAME: NAME: NAME:
TITLE: TITLE: TITLE:
ADDRESS: ADDRESS: ADDRESS:
NAME: NAME: NAME:
TITLE: TITLE: TITLE:
ADDRESS: ADDRESS: ADDRESS:
NAME: NAME: NAME:
TITLE: TITLE: TITLE:
ADDRESS:
ADDRESS: ADDRESS:
NAME: NAME:
TITLE: TITLE:
ADDRESS: ADDRESS:
Name:
TITLE:
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NAME: NAME: NAME:
TITLE: TITLE: TITLE:
ADDRESS: ADDRESS: ADDRESS: