WQ0044035_Application_20230110

DW
' 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 Nu1111),,T: c C J to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: Break Bread Ventures (company, municipality, IIOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership
❑ Federal ❑ Statc/County ❑ Municipal
3. Signature authority's name: Rob Bryan per 15A NCAC 02T .0106(b)
Title: CDO
4. Applicant's mailing address: 3517 Broadfield Read
City: Charlotte State: NC Zip: 18 226-.
5. Applicant's contact information:
Phone number: [phone] Email Address: rbryaiiCnbrcakbrcadventures.com
II. PROJECT INFORMATION:
RECEIVED/NCDEQ/DWR
JAN 10 2023
WQROS
MOORESVILLE REGIONAL_ OFFICE
❑ Privately -Owned Public Utility
❑ Other
1. Project name: Slim Chickens Restaurant
2. Application/Project status: ® Proposccl (New Permit) ❑ Existing Permit/Project
If a modification, provide the existing permil 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: Cab -an -Lis
4. Approximate Coordinates (Decimal Dq),,rccs): L,`Itituda 35.4275° Longitude:-80.6121°
5. Parcel ID (if applicable): 5611-94-5395 & 561 1 (or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Alex Bockman, l'II.iccnse Number: 051253
Firm: Stimmel Associates, PA
Mailing address: 601 Trade Street NW, Suit' "700
City: Winston Salem Statc::XC Zip: 27101-__
Phone number: (336 723-1067 (',mail ;Address: abocl<manC(�stimmelpa.com
IV. WASTEWATER TREATMENT FACILITY (WAYFF) INFORMATION:
1. Facility Name: Rocky River Re ig onal W,is_tc\Natcr'1'r_catment plant Permit Number: NC0036269
Owner Name: Water and Sewer Authority 01'C';1l1arrus County
V. RECEIVING DOWNSTREAM SEWERIN1,OHVIATION:
1. Permit Number(s): WQ
2. Downstream (Receiving) Sewer Information: S inch CXI Gravity ❑ Force Main
3. System Wide Collection System Permit NumlMr(s) (if applicable): WQCS00326
Owner Name(s): City of Concord
FORM: FTA 06-21 Page I of 5

Division of Water Resources
Application Number:
State of North Carolina
Department of Environmental Quality
Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 06-21 & SUPPORTING DOCUMENTATION
by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: Break Bread Ventures (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ® Corporation ❑ General Partnership
❑ Federal ❑ State/County ❑ Municipal
3. Signature authority's name: Rob Bryan per 15A NCAC 02T .0106(b)
Title: CDO
4. Applicant's mailing address: 3517 Broadfield Road
City: Charlotte State: NC Zip: 28226-
5. Applicant's contact information:
Phone number: (704 488-8680 Email Address: rbryangbreakbreadventures.com
H. PROJECT INFORMATION:
1. Project name: Slim Chickens Restaurant
JAN 1 (;� ,-'(.
WORDS
MOORESVILLE REGIONAL OFFICE
❑ Privately -Owned Public Utility
❑ Other
2. Application/Project status: ❑ Proposed (New Permit) ® Existing Permit/Project
vide the existing permit number:ow-mand issued date: 09/10/1999,
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: Cabarrus
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.4275 ° Longitude:-80.6121 °
5. Parcel ID (if applicable): 5611-94-5395 & 5611 (or Parcel ID to closest downstream sewer)
M. CONSULTANT INFORMATION:
1. Professional Engineer: Alex Beckman, PELicense Number: 051253
Firm: Stimmel Associates, PA
Mailing address: 601 Trade Street NW, Suite 200
City: Winston Salem State: NC Zip: 27101-
Phone number: [phone] Email Address: abockmangstimnielpa.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Rocky River Regional Wastewater Treatment Plant Permit Number: NCO036269
Owner Name: Water and Sewer Authority of Cabarrus County
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. Permit Number(s): WQ
2. Downstream (Receiving) Sewer Information: 8 inch Z Gravity ❑ Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS00326
Owner Name(s): City of Concord
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's Operational Agreement (FORM: 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) ❑ Retail (stores, centers, malls) ❑ Car Wash
❑ Residential (Leased) ❑ Retail with food preparation/service ❑ Hotel and/or Motels
❑ School / preschool / 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 100 % Commercial % Industrial (See 15A NCAC 02T .0103(20))
If Industrial, is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Hasa flow reduction been approved under 15A NCAC 02T .0114(fl? ❑ 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',
No. of Units
Flow
Restaurant, Single Service
20 gal/per seat
1
1960 GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
1960 GPD
a See 15A NCAC 02T .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 G.S. 42A-4).
b Per 15A NCAC 02T .0114(c), design flow rates for establishments not identified [in table 15A NCAC 02T.0114] shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 1960 GPD (per 15A 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):
FORM: FTA 06-21 Page 2 of 5

VH. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
➢ 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
VIH. 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: 0Longitude: -
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.Lb. ❑ Grinder Pump ❑ Mechanical Bar Screen ❑ 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(f)):
1. Does the project comply with all separations/alternatives found in 15A NCAC 02T .0305(_) & (g)? ® Yes ❑ No
15A 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
ZWater mains (vertical - water over sewer preferred, including in benched trenches)
18 inches
ZWater 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 R 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(fl or (g), see Section X.1 of this application
* 15A NCAC 02T.0305(g) 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
➢ 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: ® No
If yes, does the project comply with setbacks found in the river basin rules per 15A NCAC 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 15A NCAC 02T.0105(c)(6) (additional permits/certifications)? ® Yes El 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?
[91 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 longer
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, _Alex Bockman , attest that this application for Slim Chickens Restaurant
(Professional Engineer's name from Application Item III.1.) (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 143-215.613, 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. 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: Oki I I I/////
N A RG
SEAL T•;
051253
01 /05/2
4R1 HI
3. Applicant's Certification per 15A NCAC 02T .0106(b):
I, Rob Bryan , attest that this application for Slim Chickens Restaurant
(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: ✓pm
Date: 01/05/2023
FORM: FTA 06-21 Page 5 of 5

Lat Purser
&Associates, Inc.
BBV-Concord Parkway North (Concord), LLC ("BBV-Concord")
c/o Break Bread Ventures, LLC
Rob Bryan
3517 Broadfield Road
Charlotte, NC 28226
MY PTS
N the
As a follow-up to our prior conversations and our telephone call with Ori Tuvia at NC DEQ, this letter serves as
permission from Lat Purser & Associates, Inc. (LPA), as the holder of Permit No. WQ0016774, to add the new
additional flow approved by the City of Concord (pursuant to the approval letter from the City for 1960 GPD of
flow) to the existing permitted sewer collection system.
We understand that this approval will result in a new permit being issued to you for just the additional flow
into the existing system and that BBV-Concord will be responsible for this new permit and all requirements
relative to the new flow provided thereby.
I also understand that it is agreeable to all parties to pursue a transfer of the system to the City of Concord
and the parties will work together towards that goal.
Sincerely,
Lat Purser & Associates, Inc.
y C o d tti BBV- cord:
By:
Its:
Commercial Real Estate Services 1 4530 Park Road • Suite 410 • Charlotte, NC 28209 1 t 704.519.4200 • f 704.525.8700
Charlotte • Raleigh • Jacksonville

WI U-,040
Stimmel CHAR OTTE,N 282027101
CHARLOTTE, NC 28202
www.stimmelpa.com 336.723.1067
LANDSCAPE ARCHITECTURE CIVIL ENGINEERING LAND PLANNING
January 06, 2023
Ori Tuvia, Environmental Engineer
NCDEQ
610 East Center Avenue, Suite 301
Mooresville, NC 28115
Tel.#: [phone]
ori.tuvia .ncdenr.gov
RE: Proposed Slim Chickens Restaurant — 948 Concord Parkway North
Fast Track Sewer System Extension Application for Update to Permit for new service tap
Wastewater Flow Application Project Narrative & Supporting Calculations
This letter serves as both the Project Narrative associated with FTA 06-21 Application, as well as provide
supporting calculations associated with flow allocation request.
Project Narrative
The site is located within a commercial area (C-2 Heavy Commercial zoning district), at 948 Concord Parkway
North, on an outparcel lot of an existing Lowe's Home Improvement store. Lot is currently a vacant commercial
lot, formerly a Wells Fargo bank. The scope of the project is to repurpose the existing building / lot to a proposed
Slim Chickens restaurant. To the east and west of Concord Parkway North, there are several existing similar
quick -serve restaurants that provide comparable purpose.
The restaurant will include restrooms for customers, and a grease interceptor will treat all sanitary waste exiting
the kitchen prior to discharging into a private sanitary sewer main that is currently tied into the existing lot.
Supporting Calculations
Below are the calculations associated with the 1960 gallons per day flow allocation request.
• DEQ 2T calculations for a Restaurant (the proposed use) is based on 20 GPD per seat. Slim Chickens
proposing 66 interior seats and 32 exterior seats for a total of 98 seats. 98 seats x 20 GPD = 1960 GPD.
Please review this information and let us know if you have any questions.
Sincerely,
Jessie Lester, Partner - Project Manager
SAPA (Stimmel Associates, PA)

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Limited Liability Company
Legal Name
Break Bread Ventures, LLC
Information
Sosld: 2068377
Status: Current -Active
Date Formed: 10/19/2020
Citizenship: Domestic
Annual Report Due Date: April 15th
CurrentAnnual Report Status:
Registered Agent: Bryan, Robert P., III
Addresses
Mailing
Principal Office
Reg Office
Reg Mailing
1334 Bellemeade Lane
1334 Bellemeade Lane
3517 Broadfield Road
3517 Broadfield Road
Charlotte, NC 28270
Charlotte, NC 28270
Charlotte, NC 28226
Charlotte, NC 28226
Company Officials
All LLCs are managed by their managers pursuant to N.C.G.S. 57D-3-20.
Manager
Robert P. Bryan III
3517 Broadfield Road
Charlotte NC 28226
https://www.sosnc.gov/online_services/search/13usiness Registration —Results 1/10/2023

V
!ORTH CAROLINA
High Performance Living
December 19, 2022
Break Bread Ventures, LLC
Rob Bryan, Manager
3517 Broadfield Road
Charlotte, NC 28226
P: [phone]
Email: [e-mail]
635 Alfred Brown Jr Court SW., P.O. Box 308, Concord, NC 28026-www.concordnc.gov
SUBJECT: City of Concord Willingness to Serve
Private Wastewater Collection System Extension/Modification
City of Concord Project Title: Slim Chickens
City of Concord Project # 2022-047 (Accela Case: PRS2022-02227)
Receipt Date: December 16, 2022 WSACC Flow Acceptance
December 2, 2022 (Complete Package)
Engineering Plan Seal Date: November 17, 2022
WSACC Rocky River WWTP — NCO036269
City of Concord, Cabarrus County, North Carolina
Dear Rob Bryan:
This letter is to confirm that on December 2, 2022, our office received the Slim Chickens engineering
plans and specifications, a digital copy of the engineering plans, and private wastewater collection system
application, as prepared and sealed by Alexander H. Bockman, NCPE, with Stimmel Associates, PA for
the private wastewater collection system extension consisting of approximately 20 linear feet of 4-inch
sewer main with cleanouts and other appurtenances to serve a commercial fast-food restaurant with 98
seats and drive -through service located Concord Parkway, with an estimated commercial wastewater
discharge addition of 1,960 GPD.
The City of Concord's public wastewater collection system has the capacity to accommodate the
estimated total average wastewater discharge of 1,960 GPD based on the information indicated on the
NCDENR Fast Track application for the project. The City of Concord, however, will not guarantee the
acceptance of any additional requests, revisions, deficiencies, or expansions that were not included in the
consulting engineer's submitted engineering plans, specifications, reports, and/or calculations associated
with this private system.
The City of Concord's willingness to serve is effective only with respect to the project scope, nature and
volume of wastewater described in the City of Concord Preliminary Wastewater Flow (PWWA)
application and NCDEQ Fasttrack application for Slim Chickens and subject to the terms in the WSACC
flow acceptance letter, dated December 13, 2022 for Slim Chickens; and the terms of the City of Concord
sewer allocation policy, City of Concord Council's sewer allocation approval conditions, and the most
current WSACC Sewer Allocation and Commitment Policy terms, as follows: The sewer capacity
allocation is a preliminary process and does not guarantee commitment of sewer capacity by WSACC
until the building permit is obtained and the system development fee is paid as is discussed in the Sewer
Capacity Commitment section of this Policy.
Engineering
Phone [phone] Fax [phone]

The sewer capacity allocation is automatically cancelled upon the passing of the Expiration Date if the
project has not commenced. Commencement of the project is defined as being under construction with
grading initiated and significant water and sewer infrastructure in progress. The sewer capacity allocation
may also be cancelled if-
(i) the project's water and sewer infrastructure is not completed within three (3) years from the date of
the flow acceptance letter,
(ii) building permits are not obtained and system development fees are not paid within four (4) years
from the date of the flow acceptance letter,
(iii)the jurisdiction and developer make a request to WSACC in writing that the allocation be
rescinded, or
(iv) a mutual agreement is reached between WSACC, the jurisdiction and the developer that the
allocation be rescinded.
THE CITY OF CONCORD AND ITS STAFF ARE NOT RESPONSIBLE FOR ERRORS IN
DESIGNS, CALCULATIONS, DRAWINGS OR STATEMENTS SUBMITTED BY
APPLICANTS, THEIR TECHNICAL CONSULTANTS, SURVEYORS OR ENGINEERS. THE
CITY OF CONCORD AND ITS STAFF ARE NOT RESPONSIBLE FOR FINDING OR
CORRECTING ANY ERRORS OR DEFICIENCIES IN PLANS SUBMITTED TO THE CITY OF
CONCORD FOR REVIEW AND APPROVAL. THE CITY OF CONCORD DISCLAIMS ANY
LIABILITY FOR ERRORS CONTAINED IN PLANS SUBMITTED TO THE CITY OF
CONCORD. THE SIGNATURE OF THE CITY OF CONCORD ENGINEER MAY NOT BE
RELIED UPON TO ESTABLISH ANY DUTY OR RELATIONSHIP (SUCH AS A THIRD -
PARTY BENEFICIARY) WITH ANY PARTY USING THIS PLAN OR DRAWING. PARTIES
USING THIS DOCUMENT SHOULD CONDUCT THEIR OWN REVIEW AND ANALYSIS FOR
MAKING A DECISION IN RELIANCE ON THIS DOCUMENT.
This letter shall not be construed as an Authorization to Construct by the City of Concord. All applicable
permits associated with this project must be obtained and copies must be presented on site prior to
commencement of the work.
IMPORTANT: The Break Bread Ventures, LLC must submit a copy of the NCDEQ-Division of Water
Resources, Non -Discharge approval letter and authorization to construct permit and a copy of the
engineer's final certification to the City of Concord prior to interconnection with the City of Concord's
public wastewater collection system. The City of Concord must be present to observe the connection of
this private system, in order to meet the Standard Specifications for Wastewater Collection and Water
Distribution for Cabarrus County. Contact Gary Stansbury, Construction Administrator, at (704) 920-
5404 at least 48 hours prior to the initiating system connection.
Construction of the private wastewater collection system project shall be in accordance with 15A NCAC
02T.0300; The Division of Water Quality's Gravity Sewer Minimum Design Criteria adopted February
12, 1996, as applicable. This does not constitute an acceptance of any part of the project that does not
meet North Carolina Administrative Code Title 15A 02T.0300, as applicable. Failure to comply may
result in penalties in accordance with North Carolina General Statute § 143-215.6A through § 143-215.6C,
construction of additional or replacement facilities, and/or referral of the North Carolina -licensed
Professional Engineer to the licensing board.
Engineering
Phone [phone] • Fax (704) 786,4521

Please be aware that the City will not assume any responsibility for the operation and maintenance of the
subject private wastewater collection system that is located on the property beyond the public utility
easement/rights-of-way.
The Break Bread Ventures, LLC will be responsible for complying with the regulatory requirements in
accordance with North Carolina Administrative Code Title 15A 02T.0300, the maintenance and operation
of the private wastewater collection system, and obtaining the required permit approvals associated with
the private wastewater collection system. Please review this section of the Administrative Code prior to
submitting your application to the State. If the permit applicant is unable to perform all of the operation
and maintenance duties required by the State's Administrative Code, a private wastewater collection
system extension should not be requested.
The City reserves the right to disconnect the subject wastewater collection system and potable water
service from the City of Concord's public system if improper operation and maintenance of the private
system violations of any Federal, State or local regulations, ordinances, or policies.
After the private wastewater collection system has been constructed and prior to water service activation,
the Break Bread Ventures, LLC must complete the NCDEQ DWR regulatory requirements in accordance
with North Carolina Administrative Code 15A NCAC 2T for final approval and the Break Bread
Ventures, LLC's engineer must certify that the private wastewater collection system has been installed in
accordance with North Carolina Administrative Code 15A NCAC 2T. A copy of the engineer's
certifications, private system final approval/acceptance letter, and correspondences, as applicable must be
submitted to the City of Concord.
Sincerely, Sincerely,
City of Concord City of Concord
Digitally signed by Sue
lye
S U e 1u ' yd a Date: 2022.12.19
13:56:24-05'00'
M. Sue Hyde, PE (Date)
Director of Engineering
Attachments: WSACC Approval Letter
FTSE-01/14 signed by Sue M. Hyde on Dec. 7, 2022
FTSE-01/14 signed by J. Thomas Hahn, on Dec 15, 2022
Electronic cc: Project #2022-047
Stimmel Associates, PA
Alexander H. Bockman, NCPE,
601 Trade Street NW, Suite 200
Winston-Salem, NC 27101
P: [phone] 1 Email: [e-mail]
Gary Stansbury, Construction Administrator, [e-mail]
M. Sue Hyde, Director of Engineering, [e-mail]
12/19/2022
Kevin Plemmons, PE (Date)
Water Resources Engineering Manager
Engineering
Phone [phone] • Fax [phone]

WASTEWATER FLOW ACCEPTANCE FORM
FOR THE
WATER AND SEWER AUTHORITY OF CABARRUS COUNTY
Jurisdiction Requesting Flow Acceptance: Private -Flow Date: 12/5/2022
®City of Concord ❑City of Kannapolis ❑Town of Harrisburg ❑Town of Mt. Pleasant
❑Charlotte Mecklenburg Utilities
Project Title, Description, and Number of Lots/Unit:
Project Title: Slim Chickens —(Project #2022-047 & PRS2022-02227)
Description: The Slim Chickens engineering plans and specifications, as prepared and sealed by Alex Bockman, NCPE,
with Stimmel Associates, PA, for the private wastewater collection system extension consisting of approximately 20
linear feet of 4-inch sanitary sewer and other appurtenances to serve a 3,523 sq. ft. restaurant located off/on of US-29/US-
601 Concord Parkway N, with a domestic wastewater discharge of 1,960 GPD.
*Number of Lots: 1 OR *Number of Units: *Must be included in request.
Where will the new line be connected:
❑ Directly into a WSACC Interceptor
❑ Into the Jurisdiction's existing collection system
® Into a private line
Describe the location of the tie-in line to which the new sewer line will connect: The proposed 4-inch private sanitary
sewer extension will tie in to the existing private line, which extends to the 24, 30, and 36-inch public sanitaryy sewer
system, and extends to the 48-inch Irish Buffalo Creek RCP WSACC Irish Buffalo Creek Sewer Outfall Interceptor
Which WSACC Interceptor will the flow ultimately be discharged into: 48-inch material WSACC Name Interceptor
What is the WSACC manhole number that the flow will be discharged into? +/- Node 011067
What is the quantity of flow that will be discharged? 1,960 GPD
Flow type:
® Domestic 100 ❑ Commercial % ❑ Industrial %
Name of wastewater treatment facility (WWTF) receiving wastewater:
® Rocky River Wastewater Treatment Facility — Permit #NC0036269
❑ Muddy Creek Wastewater Treatment Facility — Permit #NC0081621
Design drawings of new lines will be submitted to WSACC with the request for acceptance. Drawings can be submitted
as a digital file (DWG) or distance and bearing starting with the tap on existing infrastructure.
If the new line is to connect directly into a WSACC interceptor, detailed drawings including specification of the tap, will
be required before flow acceptance will be provided.
Mark Lomax at 704-786-1783, ext. 231, must be notified 48 hours in advance of a connection into a WSACC interceptor.
WSACC will inspect connection before, during, and after completion.
If construction is not started within two (2) year from the date of approval of the flow acceptance for this project, the
approval is rescinded and a second request and approval will be required for the project.
WSACC USE ONLY:
:0
DATE:
Current sewer model shows an Interceptor as being surcharged south of the manhole in question.
Approved ❑ Not Approved
Current Sewer Model shows:

D-WR
State of North Carolina
Department of Environmental Quality
Di isl.an of 'kaV Ater.Resources Division of Water Resources
Flow Tracking/Acceptance for Sewer Extension Permit Applications
(FTSE—01/14)
(JURISDICTION USE ONLY)
Slim Chickens —(Project #2022-047 & PRS2022-02227)
Jurisdiction Requesting Flow Acceptance for Collection System:
®City of Concord ❑City of Kannapolis ❑Town of Harrisburg ❑Town of Mt. Pleasant
❑Charlotte Mecklenburg Utilities
Project Title, Description, and Number of LotstUnit:
Project Title: Slim Chickens —(Project #2022-047 & PRS2022-02227) Lots: 1
Description: The Slim Chickens engineering plans and specifications, as prepared and sealed by Alex Bockman, NCPE, with
Stimmel Associates, PA, for the private wastewater collection system extension consisting of approximately 20 linear feet of fl-
inch sanitary sewer and other appurtenances to serve a 3,523 sq. ft. restaurant located off/on of US-29/US-601 Concord
Parkway N, with a domestic wastewater discharge of 1,960 GPD.
What is the quantity of flow that will be discharged? 1,960 GPD
Flow type:
® Domestic 100 % ❑ Commercial % ❑ Industrial %
Section I - List the Jurisdiction's pump stations located between the project connection point and the WSACC
Interceptor connection point.
Pump Station
(Name or Number)
Firm Capacity *
MGD
(A)
Design Average Daily Flow **
(Firm/pf)
MGD
(B)
Approx. Current
Average Daily Flow
MGD
(C)
Obligated, Not Yet
Tributary Daily Flow
MGD
(D) _ (B+C)
Total Current Flow
Plus Obligated Flow
MGD
(E)=(A-D)
Available
Capacity***
MGD
*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 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 Available Capacity is < 0.
Section II. Jurisdiction's Certification Statement:
I, M. Sue Hyde, certify that, to the best of my knowledge, the addition of the volume of wastewater to be permitted in this
project has been evaluated along the route to the receiving WSACC interceptor; and the flow from this project is not anticipated
to cause any capacity related sanitary sewer overflows or overburden on any downstream pump station in route to the receiving
WSACC interceptor 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 Section I plus all attached planning
assessment addendums for which, to the best of my knowledge, will not adversely affect the downstream sewer capacity.
Signature of this form indicates accept xn�bi any astsigmat ( Ao Sue Hyde
Sue Hyde Date: 2022.12.07 10:16:14
-0s�00'
Jurisdiction's Signing Official Signature Date
Revision Date: 08/09/13

WSACC
NO 110011015 a HC Ster ft sedor • ISO 15001:1018
December 13, 2022
Mr. Lloyd Payne
City Manager
City of Concord
P.O. Box 308
Concord, NC 28026-0308
Subject: Flow Acceptance Request — City of Concord
Slim Chickens Restaurant
Dear Mr, Payne:
WATER & SEWER AUTHORITY
OF CABARRUS COUNTY
232 Davidson Hwy.
Concord, NC 28027
704.786.1783 0 701.795.1564 Fax
www.wsacc.org
This is a notice of capacity for the flow acceptance request received by the Water and Sewer Authority of
Cabarrus County (WSACC) from the City of Concord on December 7, 2022. WSACC has or will have
capacity at the Rocky River Regional Wastewater Treatment Plant and appropriate sewer interceptors to
transport and treat the commercial wastewater from the proposed project entitled Slim Chickens
Restaurant, located off/on US-29/US-601 Concord Parkway N. The referenced project will serve a
restaurant with 98 seats, with a projected wastewater flow of 1,960 gallons per day (gpd). The
wastewater generated by this project will be conveyed through a proposed and existing sewer system and
then enter WSACC's system at the existing 48-inch Irish Buffalo Creek Interceptor. WSACC
acknowledges it has or will have capacity for wastewater from the proposed development based on
information provided by Stimmel Associates, PA (Civil Engineer for the project) using North Carolina
Department of Environmental Quality (NCDEQ) wastewater flow guidelines.
If construction of this project does not commence within two (2) years of the date of this notice, the notice
is rescinded and a second request and notice will be required before flow capacity is accepted. Please
notify WSACC, in writing, when construction of this project is initiated. This sewer capacity allocation
may also be cancelled pursuant to the conditions set forth in the WSACC Sewer Allocation and
Commitment Policy.
Please note that the final commitment to service to provide rvasteivater treatment services shall occur
upon application for a building permit for the project and when system development fees are paid
pursuant to N.C.G.S. §162A, Article 8. ,� /1
If you have any questions, please call me at (704) 7
X
N
Executive Director
cc; Sherri Moore/Concord
Alex Bookman, PE/Stimmel Associates, PA
Chad VonCannon, PE/WSACC
Thomas Hahn, PE/WSACC
Mark Lomax/WSACC
Trent Gobble/WSACC

1
Divis-loFi of Water Resonrctes
(WSACC USE ONLY) Slim Chickens
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracldng for Sewer Extension Applications
(FTSE--10/18)
Section 1. Name of wastewater treatment facility (WWTF) receiving wastewater:
® Rocky River Wastewater Treatment Facility— Permit #NC0036269
❑ Muddy Creels Wastewater Treatment Facility — Permit #NC0081621
WWTP facility's permitted flow, MGD 26.500
Estimated obligated flow not yet tributary to the WWTP, MGD 3.467
WWTP facility's actual avg. daily flow, MGD 20.971 (79.14% of permit)
Total flow for this specific request, MGD 0.002
Total actual and obligated flows to the facility, MGD 24.440
Percent of permitted flow used 92.23%
Section Il. Pump stations along the route from the Jurisdiction's connection point to the WWTP,
Pump Station
Pump Station
Firnt
A
Designs Average
B
Approx. CURCIU
(C)
Obligated, Not Yet
(D)=(B+C)
Total Current Flow
(B)=(A-D)
(Name or
Number)
Permit No.
Capacity *
MGD
Daily Flow **
im/
(1'• PO
Average Daily
Flow
Tributary Daily Flow
Plus Obligated flow
Available
Capacitykkk
MGD
MGD
NIGD
MGDlvIGD
RRRWWTP
NCO036269
55.440
22,176
12.812
0.786
13.598
8.578
MPS
* The Firm Capacity (design now) or 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 (pri not less than 2.5, per Section 2.02(A)(4)(c) of the Minimum
Design Crilerin.
***A Planning Assessment Addendum shall be attached for each pump station located between (lie project connection point and the WWTP where Available
Capacity is < 0.
Section Ill. WSACC Certification Statement:
I, Michael Wilson, 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 from the connection to the WSACC interceptor 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 aslessment where applic le. This analysis has been performed in accordance with local
established policies and procedures usi t {e t available data// his certification applies to those items listed above in Section I and
Section 11 plus all attached planning a n4 addendums For hich I am the responsible party. Signature of this form indicates
WSACC's guarantee of capacity fo h' water flow. No ithslanding the guarantee of capacity, WSACC does not make a
commitment to service this wastes a r until a • ildii g rot is requested through the Cabarrus Coun Building Inspections
Department and WSA ceiv ay nt of tl ste elopment Fee. /
WSACC's Signing Officfdl Signature

WASTEWATER FLOW ACCEPTANCE FORM
FOR THE
WATER AND SEWER AUTHORITY OF CABARRUS COUNTY
Jurisdiction Requesting Flow Acceptance: Private -Flow Date: 12/5/2022
®Cityof Concord []City of Kannapolis OTown of Harrisburg ❑Town of Mt. Pleasant
❑Charlotte Mecklenburg Utilities
Project Title, Description, and Number of Lots/Unit:
Project Title: Slim Chickens —(Protect #2022-047 & PRS2022-02227)
Description: The Slim Chickens engineering Rlans and suecifications as prepared and sealed by Alex Bockman NCPE
with Stintmel Associates PA for the private wastewater collection system extension consisting of approximately 20
linear feet of 44nch sanitary sewer and other appurtenances to serve a 3,523 soft restaurant located off/on of US-29/US-
601 Concord Parkway N, with a domestic wastewater discharge of 1,960 GPD.
*Number of Lots: 1 OR *Number of Units: *Must be included in request.
Where will the new line be connected:
❑ Directly into a WSACC Interceptor
❑ Into the Jurisdiction's existing collection system
® Into a private line
Describe the location of the tle4n line to which the new sewer line will connect: The proposed 4-inch private sanitary
sewer extension will tie in to the existingprivate line, which extends to the 24, 30, and 36-inch public sanitary sewer
system and extends to the 48-inch Irish Buffalo Creek RCP WSACC Irish Buffalo Creek Sewer Outfall Interceptor
Which WSACC Interceptor will the flow ultimately be discharged into: 48-inch material WSACC Name Interceptor
What is the WSACC manhole number that the flow will be discharged into? +/- Node 011067
What is the quantity of flow that will be discharged? 1,960 GPD
Flow type:
® Domestic 100 % ❑ Commercial % ❑ Industrial %
Name of wastewater treatment facility (WWTF) receiving wastewater:
® Rocky River Wastewater Treatment Facility — Permit #NC0036269
❑ Muddy Creek Wastewater Treatment Facility — Permit #NC0081621
Design drawings of new lines will be submitted to WSACC with the request for acceptance. Drawings can be submitted
as a digital file (DWG) or distance and bearing starting with the tap on existing infrastructure.
If the new line is to connect directly into a WSACC interceptor, detailed drawings including specification of the tap, will
be required before flow acceptance will be provided.
Mark Lomax at 704-786-1783, ext. 231, must be notified 48 hours in advance of a connection into a WSACC interceptor.
WSACC will inspect connection before, during, and after completion.
If construction is not started within two (2) year froin lire date of approval of the flow acceptance for this project, tyre
approval is rescinded and a second request and approval will be required for the project.
WSACC USE ONLY:
DATE: Ii.
Current sewer model shows an Interceptor as being surcharged south of the manhole in question.
yApproved ❑ Not Approved
❑ Current Sewer Model shows: Su Ct at N C .x4tr is CAME- m ern, t 5f 0 RI) AT
NNMII.A.GA vJ CIUMS