WQ0044378_Application (FTSE)_20230508

State of North Carolina
1 W`
Department of Environmental Quality
DWR Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 06-21 & SUPPORTING DOCUMENTATION
Application Number: (to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: Gateway Communities, NC LLC (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State/County ❑ Municipal ® Other
3. Signature authority's name: David Ransenberg per 15A NCAC 02T .0106(b)
Title: President
4. Applicant's mailing address: 13860 Ballantyne Corporate Place, Suite 175
City: Charlotte State: NC Zip: 28277-
5. Applicant's contact information:
Phone number: [phone] Email Address: dave(i�gatecomllc.com
II. PROJECT INFORMATION:
1. Project name: The Willows at Burlington
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: Alamance
4. Approximate Coordinates (Decimal Degrees): Latitude: 36.0712' Longitude:-79.5162'
5. Parcel ID (if applicable): 8844757040 (or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
l . Professional Engineer: Clay Oliver License Number: 27400
Firm: Timmons Group
Mailing address: 5410 Trinity Road, Suite 102
City: Raleigh State: NC Zip: 27607-
Phone number: [phone] Email Address: [e-mail]
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Permit Number:
Owner Name:
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. Permit Number(s): WQ
2. Downstream (Receiving) Sewer Information: inch ❑ Gravity ❑ Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS
Owner Name(s):
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?
❑ Ycs ❑ 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: 100 % Domestic % 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(t))
Daily Design Flow d•b
No. of Units
Flow
Residential Multi -family — One- and Two-
Bedroom Apartments
0 gal/day
205
0 GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
TotaI7
0 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: 0 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): Flow is being permitted under a separate application as part of the public portion of the sewer system
within The Willows at Burlington.
FORM: FTA 06-21 Page 2 of 5

Vll. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
8 640 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) T 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 2.01 C.l .b. ❑ 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(f) & W? ® Yes ❑ No
15A NCAC 02T.0305(f) 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 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)
j 36 inches
➢ If noncompliance with 02T.0305( or (gl see Section X.1 of this application
*15A NCAC 02T.0305(g) contains alternatives where separations in 02T.0305(D 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 webnage
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 213.0202
5. Does the project require coverage/authorization under a 404 Nationwide/individual permits ❑ Yes® No
or 401 Water Quality Certifications?
➢ Please provide the permit 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:
I. Does the submitted system comply with ISA NCAC 02T, the Minimum Design Criteria for the Pennitting 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 anoroval of the nermit, and projects requiring a variance anproval may be subicet to loneer
review times. For projects requiring two or more variances or where the variance is determined by the Division to be a
sianificant portion of the oroiect, the full technical review is required.
2. Professional Engineer's Certification:
I.
1. __-_-,__ Cl____._____.______ _, attest that this application for' �¢�%.
(Professional Engm er's name from Application Item III 1 ) (Project Name from Application Item It�
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 Sewersslatest version), and the Minimum Design Criteria for the Fast -Track Pennitting
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 56.0701)
`\\ J t t t-I31 t i.t.r1��
(H North Carolina Professional Engineer's seal, signature, and date: ��� �CA r?o
�
O ESsip'��2
o27aoo410
qua
00\so
Applicant's CertificatiVi per 15A NCAC 02T .0106(b):
t, attest that this application for
(Signs a Authority ame from ppli iun Item 13 ) (Project Name rrom Application Item 11 t)
attest that this application has been reviewed by me and is accurate and complete to the best of my knowledge.
1 understand that if all required parts of this application are not completed and that if all required supporting documentation
and attachments are not included, this application package is subject to being returned as incomplete. I understand that any
discharge of wastewater from this non -discharge system to surface waters or the land will result in an immediate enforcement
action that may include civil penalties, injunctive relief, and/or criminal prosecution. I will make no claim against the Division
of Water Resources should a condition of this pertnit 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:. ��y_ __ -- . - _. // ---_- _ Date: 5 J uJ
FORM: FTA 06-21 Page 5 of 5

4i Nhu-001
Nil,
State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
DItitsIon of watt-` R`s"`lrcc" Flow Tracking/Acceptance for Sewer Extension Permit Applications
(FTSE 10-18)
Entity Requesting Allocation City of Burlington
Project Name for which flow is being requested: The Willows at Burlington
Afore than one FTSE may be required for as it igle prgjecI if the owner ofthe WIPlP is not responsible for all putnp stations along
the route of the proposed wastewaterJlow.
1. Complete this section only i f you are the owner of the wastewater treatment plant.
a. WWTP Facility Name:
b. WWTP Facility Permit 4:
South Burlington WWTP
NC0023876
All flows are in MGD
c. WWTP facility's permitted flow
12.00
d. Estimated obligated flow not yet tributary to the WWTP
1.156333
e. WWTP facility's actual avg. flow
6.330000
f, Total flow for this specific request
0.049200
g. Total actual and obligated flows to the facility
7.535533
h. Percent of permitted flow used
62.80%
11. Complete this section for each pump station you are responsible for along the route of this
proposed wastewater flow.
List pump stations located between the project connection point and the WWTP
Pump Station
(Name or
Number)
None
(A)
(B)
(C)
(D)=(B+C) (E)=(A-D)
Design
Obligated,
Average Daily
Approx.
Not Yet
Total Current
Firm Flow**
Current Avg.
Tributary
Flow Plus
Capacity, * (Firm/pf),
Daily Flow,
Daily Flow,
Obligated Available
GPD GPD
GPD
GPD
Flow Capacity***
* 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 pumpstation divided by a
peaking factor (pf) 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 the Available Capacity <_ 0.
Downstream Facility Name (Sewer)
Downstream Permit Number:
N/A
N/A
1 of 6 FTSE 10-18

III. Certification Statement:
1, W. Todd Lambert, P.E. 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 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 asssessment 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 Sections I and II plus all attached planning
assessment addendums for which 1 am the responsible party. Signature of this form certifies that the
receiving collection system or treatment works has adequate capacity to transport and treat the proposed new
wastewater.
Signing Official Signature
City Engineer
Title of Signing Official
q
b
Date
2 of 6 FTSE 10-16

PROJECT NARRATIVE
Project Name: The Willows at Burlington
Location: 1408 St. Marks Church Road, Burlington, NC
PIN: 8844-75-7040
Owners: Willows Burlington LP
13860 Ballantyne Corporate Place, Suite 175
Charlotte, NC 28277
Developer: Willows Burlington LP
13860 Ballantyne Corporate Place, Suite 175
Charlotte, NC 28277
Contact: David Ransenberg
Consultant: Timmons Group
Clay Oliver, PE
5410 Trinity Road, Suite 102
Raleigh, NC 27607
Phone: [phone]
PROJECT DESCRIPTION AND NARRATIVE:
The proposed project is in the City of Burlington, NC and is located at 1408 St. Marks Church Road,
approximately 800 feet north of Boone Station Drive. The scope of this project will include the construction
of three buildings containing a total of 205 multi -family, one- and two -bedroom apartments on 6.84 acres.
The proposed private gravity sanitary sewer system will consist of approximately 640 LF of 8" PVC. The
remaining gravity sanitary sewer system on the site will be public. The public portion and associated flow
are being permitted under a separate application.
The private portion of the new gravity sanitary sewer system will be owned, operated, and maintained by
the property owner.

The Willows at Burlington
RURAL RETREAT ROAD
VICINITY MAP

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Topographic Map Year: 2016 Order Number: 21102500111
Address: 1408 St Marks Church Rd, NC E R S
Quadrangle(s): Gibsonville, NC; Burlington, NC © ERIS Information Inc.
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TIMMONS GROUP
YOUR VISION ACHIEVED THROUGH OURS.
TRANSMITTAL
TO: NCDEQ DWR — Winston-Salem Regional Office
450 W. Hanes Mill Road, Suite 300
Winston-Salem, NC 27105
ATTN: SS Fast Track Permitting personnel
® ENCLOSED PLEASE FIND:
❑ WE ARE SENDING UNDER SEPARATE COVER:
NC Department ai
Environmental Quality
Fey. Received
MAY 0 8 2023
Winston-Salem
Regional Office
Date: 05/05/2023 Job #: 49709
Project: The Willows at Burlington
Reference:
Copies Sent To:
COPIES
DATE
NUMBER
DESCRIPTION
1
1
Fast Track Sewer Application (Incl. Flow Acceptance Form/
Certification Statement
1
2
Check for $480
1
3
Project Narrative
1
4
USGS ma
1
5
Vicinity Ma
THESE ITEMS ARE TRANSMITTED:
If enclosures are not as noted, please notify us at once.
COMMENTS:
Feel free to contact me with any questions at 984-222-1613 or @ [e-mail]
Thank you,
Clay Oliver, PE
Project Manager
SIGNED:
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