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Home My WebLink AboutWQ0022725_Application_20230417l of NW& COV&S DWR Dsparbuo of Quft Iiiv "$fWabrRwmm 176t►ldole e! idA NCAC 42U —FMCLAD= WATT! SYffr=—SAL a !! irwtam &LIS UCTMwI—A_Pn CA14TII AT w ' 2. Pwmit No.: WQ00 �4....,� ' Ph= mmsber: ( — 4+ Curb CCmtaat per: s, .l. �a J 1 4'� i LLA �f��,J, .}t' • � R �� srlt lil %' ��'UL 1. PWoal addroee:iO4i{a' CatnW Paeael No.: SUft NC vg l y y5 2. Thm m l hW�Hf�yp�oodo to do Shh dgdM&l daetp/ea =6TFmWffi-1LE wB- uow 7= 1. Pwxoitmd flaw: GPD (2h MUMM dd0^m*k jbw bated on wkat Am bmp� _ M 0 0 0 $. Ae�tldlt flo�P. t3PD (� A ��y l Oli tidrga �Amr 6wn ► Tr ow D 3. Avaeage flaw: PD (71�e erll npaftdifmw on d wpabw a km&rywtrit Ali m) �P $*• % (Mikk 9W aviemP flow bt Bm 9 by AvAv-&�flm in jUm 2) `3. wmmwmw Domes&:Ijv%. aim: �. up: 2. Vest► the ApplkAoT dace oot Lave my ovm dae a mow ha. Poee M to U&W.AC 42T U12q,c, . P=& IN s Sdidee dwU wt be SmOd Eft AppHout or mW aloe► hu as attpatd e121W fie. FUt1►d: RW R 02-21 Pale 3 of 6 INCrMWV-CPXRATORIN I IffAKZCffAR=(ONQIIIM MUTM OWAPPLWARSPORMOUNMVErATEM 1. CIRC: r/ Linde: —Ij7 Cwd&m&n No.: 2- 4 )Adftadd=L wost Oeea." A -es dOr;v- Chr. Jec"d 1I7I3 soft we_ zip: g-?gq rmw n .1 - - 39,7/salect Ar,4;IC- — Mnan- 2. Bak -Up&& M--Ikh ;Q;. oc, 8 /6-r bffahSvddr=L- 6-33 W4S-* Qua,.-44r--- C%r 911// iveiv.,I! )N/S State: eel. gyp: a7qpvtr m 6,004 x 4 z o I. List di WOMMM and Map WoMM UMWMd wft Somvwftpermit. AftWhWMWOddWM%ff womy.. /aV� Tj p P4%d Nm vaims LiT7P Freeboard Ledtwb Laskoemb Sdft Sdad Sdeft OdM Select Soled Select saw vil-RUATMPMNM (LiL, WWW. WHadw "dam, NPDRS, Nd&ab) O%dhm m*wd= We to is mwIng PWMIL Anwh addhianal shaft ffnamomy. Penh Type PaugNiL 7"s, Select —.-.--Rdguomft Balm Sabot Baud SOW Sdwt .I. List all pmcdwMmmbmft Walk umdMdvi& the renewing ponaL Agesh ad&dmd dwa Mmoseary. Well Kum P,trval Na lbtu— Gradimt Lenduam L&dtwb LM&" sabot Soled sallot SdM Seim Sol" S" Saba Seded Seim soloot Solid Sdbn • Saba Select 5decL Beim doot select Salsas SAW Select sdm Saba Sol" POEM; RW3-R 02-21 Pep 2 oaf ultonumbMumadds =ode Well mwwfmg pentL Alto&uWlhonv sbmb ff nomm 1. �' 61 _ • 8f o a YI a O i 4� a� 4 dd RVI&a 02.21 pop 3 of6 Waa tiro firailIity peramied or had a n4or madwoodoan boo d deer Sq*u w 1, 20M ❑ Yes—ftmwat to . submit a gibe mWpwoot to Se mqWmmou in J14KW T.4?AWi. These - --mbam 1 ❑ A soaladmop ofdo gibe wbh tWopgWo aoamar bWvala not eacc "ft 10its or 2S pwwW ofbDW sioesalief and dowhW au liw Wrolated strno oul aad tP Ms t do SM A* of 6a tre�mt, amaps, and udUzodon wm ❑ sea mappia� ... ebawa as aI! udUsedm aloes. ❑ Deliaa dw of tl� oc®plianoe and review ba®dodoo per 15A NCAC 02iJ .OSQIWM. ❑ mks as m4.*M by 154 NCAC 82U .Qnl, sibs property badxiee wither 500 fast of all Oft m=4 ghup, lad udliamiart sio. a —SW Atbeahm oA. AITAI' I "IIIWIN - AVfBUWMD>�ATJDo@r . _W...- _ ...._ - - - _..� - - - :rw_SlipAftchmwtEk WP+e at i4► is Soatinn I, Item 3 greet $ro -pmwaattollA ❑ No -Submit a . _ _ �.-...._.. pwuwd ba 3SA = W ,QI tiro y to WSL Does ft Woft iwt tnalude an ap w.W flow tuduatkw? 113 Ya — Subrnf# a oopyli�e flaw radnattatt approval ktiar, m well es fbe miaasurad mpr avaegSe amount of waataa�atet fiow cou bused por mak fior the 12 monde prior m p w* raoewal. If my of&me mem ft wmism am wilfm 2O% of the iqporovad fiow M&WdM vabe; the Promitbae astern prvvide a raevah oum of the n&wed fkry valve pm mml to the► req h m MA =T.,QU4! J).' ❑ No -- M* AWwhmamt C. wrrA�IT D - caarIcATs OW PUMAC caarvi M AZW NXICEIRM f Lbe AppUnw. a Pr-.. f!Y-Owned Public. Uwir, ❑ Yoe — Purwsm to 15A NICE 0 ' �4115.iptl] s. au6mit the Oartiticate of Pubho Quyaaiesaoe and Neamny fkaaa the MQ& demmaaranrating the AppOcent is auffimi cd to mold the utility ftwAlm a — Skip A#aabm of D. ATTAi IT E— OPN"TMMIAL ALIT Is ,AXG=at a Hamelfroparty Owners` Aeeoaiatiaa ar De kqw of Loh to be SO1d? ea �HomealPnapeKty►�' Aeeaahtian) — Pucauant to 4�i',01! ig�►. eubnrit an eaueaattad MOMHOU Punt to 1SA MAC if the applicant is a *pay f wd Hammowww or Propertp own wo Assodadc a, submit a oapy of the Artfles of %outposts % ems, and By -I [� Yee Mavfter of Lots to be W — Paraaant to 15A w=D2T_ 01151e1Q. submit u ao wiled am, RM Permian! b4 if ft oppliew 3a • 4aveloper of late to be saki, embmit a oopy of the Arataiaa ofl=xgx aatiom, Dams, and By-lawa. ❑ No - Skip Aftchamm! B, FORX RWS-R 02-2i Pqp4cf6 i Tm og FDi WAMMATER72M71UMCAMOTM L ibe � s fib'. ►. �Y � p�� .�._...._.._... ...,� . ��. ❑ fee= Pigoead�a i!►e�aa�tgaertia�. �No 81� Attac�a�t F. Does the bq►deadic isl iiao�m �; � 4 ete�oeed 709LY ❑ Ya (tie bykaalie is stt 6m 7O bat Ise thm 80* — P-ruad io prior 1b mocaedigs 80 pseamt adf twq 1.1111 MR11hydraft oom ty (based on d o vamp thaw dw ft &oLee calendar year), tho pumit w abaci aubaai M NoWbuhs vwdR dam of d Wr Mate wastewater l:ealmeN udltaadam, and dbpcad needs. Tole wdogdm eba1l cad bw pi m 8x meeldgp lataso waasewater treatmaaetl , ac di�oeal meda bar edtber ea aedam alike e�ridnp ayd m% elinalm oesedaot a ofmcta M= ftWI, Or WAN ocoaarvat m and daii kolde &o now aft3mdi hrAw vm smea. If empaaaiom it not peopoeed ar is peopoaed �r a ltar data a a:ef8eadca abali be nude that waatswater teeaiment needs vM be met based om pant peach =eooeda and Ad= prow& pee&aticn% and as opp mprlab j d II i wb& oamesvadon plms or odder maasae I to gow: and om. ❑ Yes (de carprwW dm 80'Xej—Pnooeedto to m=atgaeellam. ❑ No — 8ddp AttaoLmeot F. Itowwasad Yee obo•a doe. d o M dremlle nap dW im 8eoden M Item 4 acaoeed sorb? Cl Yea (the o eapadb is p udw GM Saxe -- Pmmd to paior !a go peceant �e ayatean'e pm&ftd bdmb aapey (baaod art the avm p flaw during So lsat aaWWw yead}, &a p®ittae dM abtWn sit paemia needed for own" of the Wm ewdw gamma, tebliiartioa. oe diepmd Nam rA if om ewd= is awkA eabmitdnalpLas W9dftdic=fwm1vMl04 aaonwoodmsdmddLlfageodmiaaatpeopoaedarispscpoaed tl r a beer lose, s as ftU be made tbm wwwwoatar uummt needs wlli be moot based on past gmwd<:eoomL and lIx 1 Vowlh pow, sly ae qpqe^ shall imb & ocm mvatiogn pbm or odsar WeadSo meaeac m to adum waste &W ndocamL ❑ No-8bip Atbolmeae�P. .k:L.!'.Ai i r :PA. F4,,, ';? •F'�f ..M:f,.l:a .�� : r-:�1:'ri�:M.:�.-"I�:M'•'..,, Dees" Pia 21fte own aft oftw land aaa ddod wlds the amb.dw oadiecdcm, tsaaimw% omveymwo, sad ub1indw ayd m? n— Skip ANdbood 0. ❑ No — Pmeoaert to 11,! MbC D;T .-Ol wcJ, i? ow oof an Basemen% lease spree =% sad amavaebown apeaem w a kmft the PeeaMW to cpaeaoes and makdoin tba waatewdw odleod n, #nat=K oomveymoa, sad udlsaaf m ep►A m an pe�apaodyaat awned by the Permbsae` " An the Pocm t o!s efflfadom of imp n, I oanwo ENo Yea — sip Aft maeat IL —Pt ov& the aamnposed efilkdom and 6* eomeaet hemms&& A1TATI-- 21&ZIRMBCVGMMM Dow the mcb ft peemtt iwb* my GompHaw 8obedaloaY (0aa & tiaa I of tbs aawt reo * Dewed peen * wo — 8nbmie doasmaotaslam tbot tine ecaaplla� ecbedalaa have hem mat —s; AtteobmeotL ATi'A iTd—tLZ►MlJALTMAim+ Door do Pumdow bay qy a @ft odd pcuMw a aat+t mft viWdamdP ' ❑ Ya (owl P=dtiw) — Submtt pegmeo! for the dull paf r, arpsoalaf ro edon sequeee. ❑ Yee (vlol dwo — 8,1 " a oopy ofyaer rmpomse to the Notice of Ydoladm Q—Skip AU maWL PE]Os11d: RWSR 02-21 Pape 5 alb g1Tl'aC�IT K-MMiTRULWAMWATIM Dana dre wmbwdw oc btlaaa ia< sadloE� 1II, lteoz 3 h�obtde ate► 41 wmstswabe d ❑ jts- Pioaced to Ine seat queoft . WFIRO ft Ansc maptI . Ass � astuee � the iad�lsl wastesvatec aheaped sines �s Lai permit ieswnaa (i.e., changes L. ind�sstdeb process, tiara of new models or d micils, ❑ Ya - Provide a CbEl OW wslyflil of the wmWw tw paramt to the mgnl=emts in II& =Q OW MJW PwvWc ran overview of *o m iftchu g pmoom% = rove ty atf all ehamicel end bWogfod there~ used in the MOW and art a�view of �e olaaaiag a� tbastmaat ma8radoSogy. ❑ Na - Pmvi6 an 049v of tha nmaWW aft process; an hma lmy of all cbmalW and bio&SW massmials used in dw mm mhwkming pmceas; mad an oymMow of this aln*g sad ianetm m medadolaiq►. ATrACi MOML-►SRTIA=WA1V= Does the aacdng pem"m hualade setbmot waivers? ❑ Yes - Passwat to liA NCAC W-MV. pr M& w bwb waivere Set bave beam m be notmlm4ApWbysUpmrdm mvolvak amd recmW vd1h the county aq&w of Deeds. Wabvem mvahft the cmWbamca Wmadary " be is mwrdamm with ISA NCAC 02If .0107. ❑ No - skip Aftu mss#t L APMWAM C=TW Wqm Sam th d this application (i aatuty a*irmd name asnated in 8mdm x Item 3) leas bean mviewed by aaa sad hataw &W to dw beet of my knowledge. I undaadaad toad U sll required parts of Ibis won packW era sot eomplaled, end ihmt sli required sepporift h* matioa and attachmacts in mat io tided, thn applicedc a pwlmp wlii be ratarned as iocomgl t I 1 11 pe pursuant is 13A NCAC 02T .0120E b►, that the qqd we i% or mW pammt, av'bsidiary, or adm aiTiliai a offie gVIkuthas: not boon convicted ofenvitmunm l crimes under; not pmvkmdy abmxkmmd a wastewater b*Mmamt amity without properly damn the $ailitlr "paid a evil parish , aat bom oompifaat with any aampbmm sdmdo a in a p owk sa lemcmt agmanont, or arden, not pair! an stmad iba. Nutt The Applicant's Cart on Ad be signed p mose# to 13 A 1W'.AG Q27 ,p1 OB+ tj. An abunnte peace may be ddgpbd me the aipft afcial if a lamer is pmvided purraant to 15A NCAC 02 _QlO fc?. ftmrat to f 143t2—!Lc,A and 1143-213j6H. ear pmson who knawitxgly makes aw Bake gatemtamt, aprounudan, or mom in my mppUndon paclop shill be guilty of s Mass 2 misdameow. WbM sm ioabeda a fine not to aaaaed $10,000 as well as civil peaunm op io a3po pp violation. THE COMPLETED APPLICATWO11, . AZTACH1EM = LL M S1QRMnTED All A SWGLE PDF FHX VM i �• > �2, iF PORK: RWS-R 02-21 Pye 6 ef6 b