WQ0044475_Application (FTSE)_20230711

DocuSign Envelope 10: F101578B-063B-45E&8149-AB5B9iO82F8AjC Dept Of
p Ell, r:[)rrnlerltal Quailty
State of .Nol'III C'arolilm
DWRDeparttirteni of 1?In-irollu)clit:►I OIlalijN
* UN - M3 Divisiole of W.11er Ftetiourre.e
Division of Water Resources F.%ST •1'R.1CK 5F:11'J�;R Sl'S I l ,\! F:\TF: \,tilnV ,►I'1'1.1('.11'If1V
Raleigh Regior)aJ (j&A 406-21 .\ SU['POR-I-INC I)O('Ii.'%l _,jNj- l'l()N
,II,I,hy:rtinn Vnn,by[': Lc�Qc�o�F�1F"TS rr„1,�,,.,,F, •t
Ir.rzlF; It4t'kF
All items uttlst Ile cant )lc'Ic(l ur Ille a 1 tGcalitln tit ill t)r rclurnetl
I. APPLICANT INFORMATION.
1. II,I,hr.uu's rl.tirir: 'It of f folk. S,rin�S
'. App1lcant 1}fty; ❑ ln(li+itlnal Ell'nrltnraltnn —[� (;yncral 1'nrtnyr:�hr, — -- --
i ❑ I'rr,:rtcly [t,t,;l lhrltillr C)lililti
❑ Fytlyr:ll ❑ smic1('uumv Q 11'lunrci rrl
- 1 ❑ OI hrr
t S1; nahnr unlit<,r11}'s name: Kendrr.1). Parrish 11l=
'!'illy: I;sccuu(}' I )if l)tingics �\ Inl,i ra uclinr tic! t wv
4.1�c
— — —
II,I,11r tal'� nt,tilinL:uC,irya: i?s Snuth Afain Sh'yyt. N) line X
Ow: Ilull�.Shiilt ti -- ---- _—..- -
_ State: NC Zip. 27$4(1
S- 11,I,liy:,rtr'4 ynn[;1ct nllimn:,tiun: —
1'h,uty m11114.r I')Ir)I 577-.:I �n I.1„ail :1(rtlrys: Kyn(Ira.irurl,harr hnll};y,riusnc.#ut
I1, !'ItO.lf?("I' I�\F�OR�Ir1'TF(lV;
I. Proiccl Hume Regency Subdivision - Phase 3
II 1 'I talus: ® l'r(Il,nsedINca, 11cr'nnl)
❑ I:xl�lin4, I'rrn,ihf'rnlrcl
Il a nt„tfifieatinn• I,t'nvitic the cXiSlilll,cnttil uuntl,cr. 11'(IfNI
P`nr IIIoI1ilic;l1i0nX, also :111:Ic11 :I detailed n:u r:Ilive (lescripfinn ;ts dexcrihell in Item G nl lire chrrklisl.
ll'Ik 1 runslrucli„n. but burl ufu 111a,1y, plan. I,r(nuly the c.xrshn); Ityrnut nunlhcr: 11OfH}
3- ['tmru}• where Itr,icel "> Inc:1ly(l:
4. r1I,In„xrl11:11e (•tittl'tlnulles (,)ycinlal I)yFrecsl: kllilutle: 35.646+J f.nn� rtlhlc,
- 78 889 i
.5- I':uryl f l) [ r f a1tl,lirahlw 1 . 0639311837
— - �_ _ IrwI"ur+�'cl ll) lu (-fu.csl ,Imrntilrt.;,tn.cnyrl
rn. cO�tilll.'rrl�;'r-l:�FOR,�I,1rl(�N:
I. I'rnlcaainnal I'nuntcer: .Icryln} 1 ,_fulylr _ — I,iccr,sc Nund,rr: 11*
--
l'n}':
Apl 27713
I'hunc nunlhyr: N)It}►.3(,f_Sfltl[! ._. I.n,:,il rl(Itlrt.�s.: .jlineh,rrnu'utl.,nlu•n.rnm -
IY. ll,lti'I [?11':11'1:It'['RE?.► F 111?.\"I' 1.►(.'!!.I'I'1` (11'11'fFi INFORMATION: - -
I I�acilit�• r,ian,c- l.11lcv (.1•(;�1; 14'cucr f•�clanlnitun Facriitt,�
I'ernul \vnlbcr Sf(Irn[a3[It)I,
t )w•rtcr ;urn:: T(nvn nl' I Ec,lfy Sl,rin�S .
1'. RECEIVING DOWNSTREAM SEWER INFORMATION; -- — -- �'
I. I'crmil Numberl.): 11(jlul -I[ 60S
Dow•nslrcam (Itcccl, nlgi Sywct' 1111in.nlatinn: ntrh XI [ �r.n rh
.._ Force NhIll
1, SySlynl 11ritic (uilyrlinn Svtilenl Permi[ Numbcr(L,)!rl al,l,lryuhlyi; }IrO['tinllfO'
( )vrlcr
I'1zc I r�i �

DocuSign Envelope ID: F1 D15788-063B45E8-8149-AB5B91082F8A
1 I, GENERAL [UQUIRi?M[;i1"I'S
1. Ville AjIpilcaitt i,;l I'risaltrll'-O%%Ixd Public illilill'. h;I.a C'enifiealc of Puhlte ['un%'enirnrr;lrtll NCee„11\ hrrn :utanc�tl'
❑ Yes ❑ No Q N A
I f IIle AI,I,Ik li I )c%'L+«lIcr of Inls Iu he sold. Ims :i
Ih3Y1n!'tir'S��.�L��1I,11 `t:lii��lll t.F(}�, • [) �V� been ,ul.lelteti'
❑Yes ❑Nu QNA
II"lI1C r\1'I,1rrSlll( i:;1 11t,r1li rPr„l, i'lY ()%1'nt:i' \"SIi -lalloll. has all l {) } (]�y�ry�l��1. fr,,.,,.,��.1M11LLQkj : 1 Lf3i�, ai,41
aq,l,Irnteniney d,1cuntrnlalr„n a.. rctlurrell b1' r SA N(•AU (12'1'.OI he lllanc�tl;` *� �1+J ..�,
4. On+�ln of 1r,Iaelt;ller. (check all 11mi nl,pfy)
® ke�nlenlial (Indi%•itivaily (►%rrlvd) ❑ Retail 1.lolrs. ccn[ers
❑, ntalle)
Relail %1•itll laud I,rrp:u:rlion Rcr1 Ice ❑ I late{ .nttLtip. \loick
❑❑ School preschool tfa\ care ❑ 1\9cdird ; dental. ccicrilt:n•Y I:Iciblies ❑ tiululntulr Put+! [ hrhhuu,e
l-ood anti drink laciiii,es ❑ churell
❑ litthlnes"C% office., 1aooricN ❑ 51%II111111nL !'ut,l'I-tllt'I- Ihlckl%a 11
❑ Nursing I lortic ❑ Other ( I x1 lanl ill A(lachillrrlll
�. Nalure ul %t;lshu'.uu �_lfll)++ • Ih,mc.li+ '..('untnlcicial '.. Induslriaf ! ' I S * ;
``� L t} II N.UPl1
!f hnlli.uial• rs Iherc.a I'rrllratlncot I'rn> r:ull in cilcct' ❑ 1'c•❑:.
(,_ f la, a Ilan re,hretiun hrrn ahl,rovctr under ISA N('��; qm 11 l ''
II' ►'cv Iro►�ide :1 cal n. of [lo►r reduction a ► rrusrtl ! Itrr t1 il�l�i�this®t Ilicati❑r No
7, timmolariie %,;I.Ic%%'atrr 4cner:itctl f,) projecl:
I Ii s(al)lisl)niclit TVI)c (.see 112'1*,0 1 14(f)) Daily Design hlo►► 1 _
\u• of Itni(s [ lolr
Single Family Home - -- �- -�-
- 255 ) ah w)lt 109 27,795 (i111)
gall
7.795
:i %cc I SA N('A(' U?'I' •Il I '
stud t al t , for caveats to %%aslewiller design 114m ralc+ (I c., nununullt Iln%1 per
Ilurflnt : proposcd unknown non resideitlia! delrAry,inrrlt usc.: ptthlic arcc�. lileililie. hx:urd uc,n' 111.01 l,uhlu II<c arr;ty
Intl re.Idell"'11 l,rol,cl'1y o"letI sonlh ul' c:l.l (Wipe Allarttrc lrllt'acoll"Ell 11';lter%%•aa• II, he tiwtl ,i,, v� lc:tllon rcnlok i. deiilled
ill (i.5yl1AA¢). -
h Pet I �;1 N( r1(.' O�'I' .OI 141c), dcxign llntt r:ue, lilt rslahlitilnoclrl, nnl Itfelltilied fill faille 1 SA NUAC WT-01 141 shall he
delcnwuleti u.iu� :nailahlr Ik,1l data, ualer usnt listrnuti, ucrulr,nlc�' or ol,eration l,allrrn..:uul nllirr tttc-si�llrcd ,lata.
\1`a.(ct%'alcrgcocraledI)v1lloicel: 27,795 (il'i){l,c•r VM'T (I 1
Do nol Ilu•lu(fe linure III) %rti or previtIllsly ltrrn»ue,l .ilA,calu, ti ((
II'perntittcil Ito%% is ecru. l)Icase irulic:lte tsh�:
❑ !'unll, titalltul`l orec \lain or { ira%l!y tie%cer where Ilo1% %%ill hr I,clnlllled ill suhsctlllertt l,ernuls that connctl In Ihi� lilte
I'Ira.r I,ru%'illc .ul,l,lcntrnl:u-y ulli,rnrllnw iodil•;,IioL the ;rpl,rotinrltc limeliarnC for Ilcrntif inn ul,arcaul .e%rer, wilh Ilu%,
❑ I 101%7 h.t.:rh•eatI% here allocated in l'crmit Nnnlhu:
—u
Is.u:ur Date-
❑ ltehal+ihl.uion ur rcl,hlecnlenl tII e\iS1illt; wwas 1%'llll no ate,%• llotr C.Npectcd —" —
❑ ( )(her I I.-Np tin ..
1 1=T_1 lit, 21

DocuS!gn Envelope ID. F101578B-063B-45E8-8149-AB5B91082F'8A
VFF. CRAVI'I'l, SEWER DESIGN CRITERIA (If,11l1llicahle)-L)M(13115 & muC•(Gr>lrinr slryrm):
I, titI111I1iJl'I/c _'I:rrlIN' sewer to he permil tell:
Size (lrlcheq I Length (feet) I Material
-Inch 2,614 p�f(
inch 1,29$
1)n'
4rcllun 11 .� Ili ofthc �11)(' li,r I'ernnuin oI'(ir n il� .tieuer, ton1:1lIL. infi,nu:ui,�it related h, dcsien rriwria
�eclion I I! enntaina ullorn,:Ihon rcl:Ilcd to nm,i+nuur ,lol,rs !or cr•ivrtv sct,�rls) .
(hcrsiiirll; Ihns to Irlect mirlilmlrtl slope rcquircrrlents is nr►t :lllnned and a vinlafiull of file 1I1)(
l IIJ, I'11,1fi'S(1'I'IO\ I)FSIG\ ('RI.1'FR41 (1f,%pplicahlc)--112T,f1305�l
I'itc►1,11)l. A'A PAR I COPY Oh TIIIS.VAOF..FOR VACH PUMP MA I ION ITV( Li'!)I I) l�\ 1,] lfti)'It( ),11
I. I`ulul, ,I;Itrun nulnhrr nr n:unc _ - -
' 1l,pru>:rmate 1 ,+nrtlinale+lf)erin►al I)rf;rcctil: ...— i,alitutle:
I <1tl�ltti,le
x. f„Ial nunlher „I' I11u11ps of the pomp Malian;—
fh,i�n "I lilt: I,ur1111 ,taboo: million, V.111olls per d,ly I firm callacityl
1 Ill, should I-01ccl Ilte tolal ( il'AI loi' the Imnll, .!anion „lilt the largesl 111111111 oul o!
I- [►perali,+oat puinittil I,er Ilulnl,l+); _ gallon, her nnrtute I(Wh]l •ir.
legit It,lal dvn;Inae he-u1 t ft)I11
5. 5illlllll;li'I/e Ihr li,rce imlilt 141 he pernulted Oor- [Ills !+(!!till S1.11111n), -
Size (inches)—Lcilalll (fcetl 1 Material
It ail} ptlrtioll t11 the li,ltrc Iliad!! !, less Than a•incltc, in tlinnlcici. please idcntil', Ilx nit hod of"ti„lids rr,lnclitYl Ik'l
\11)('I'.til��\I tierlinn �.UI('.l.h ❑ (�nntlrr i'n1u11 ❑ \'1rch:utirat Ii:Ir tierce!, ❑ r)Ihcrll,lca,r,perit�r)
{, 1'ot+cr !gill Ihihty nl aecni-tl:Ink-V wl(h 15A NC'AC 02T,Ui[I
❑ til.uulhv 1,u,ver suuier „r ❑ 5tailmly primp
\lust 11O1": uttsrnlalic arin-311M) old telemetry • 13A iVl',\(' Ili"I'.fll(IS(hll f ltli};
{ Ilryuircd I'or all I,ttn,p stullon, ,!lilt an avcr.tgc daily 114 s,v greater dials or ctµral to 1 5•011M c;illon. l,er day
{lull he perulallcnt lu facilih :nitl mad nos hr porlahlc
I FI if'the I)un,I, slaholl Ilds ail aYerliv daily Ilrnv Ics, than 1 5.(I(,tlpall„ns per d.iv I SA N( At n' I .Wm5(h)( Ill( I.
❑ 1'ol'I;Ihlc I1t111e1 ,curer ,rill, Illarimil nelil': lmll. tItIIC'1+dttnlleCllt,ll rea_el,ladc and leleniru-v -
❑ t'orl:,hle pn111l,1n!: mlil „Id) phigged enicl-peneV I)unit, eollnectioil :Ind icienictrv:
lnriude docunlrnlatron Ihal the I,onahtc<,uret is nl�netl nr cnnlr,Iclrti hy the applicant alul is con,p.11lble „ill, file stauun
x I1`the I,nrintlte Ix+,vcr source (Ir pt111111 is dcdicuted to nu111tilIc Imillp Alliom. all evaluation of all lltt: Iltnnll sttni,Ills, SlIonlee
cal,acitieN and the rolalioll WI)Vkltlle„ f lllc portable pourer source or pun,I1. Inclutlnie Irnvel timehanle," -01.111 h,: 111114 pled
•Is Karl of Ihn perinil „1,plicallorl in (Ile e:Isc of a Inul[iple ,I 1114311 power [linage.
t wm_ 1 T;1 11n-11

DocuSign Envelope ID- F1D1578B-063B-45E8-8149-AB5B91082F8A
r v St"MACKS & SPP %RA 1 IONS — (112I1 .0200 R 15A NCAC 02'r .113115(1)):
i. 1k+ws the ' pru11 el cunll,is s+ill) :Ill scf,:nautlll ahrrnalls"es Bound in IS
till V(.'M (12'I m
c(,nnrlils milumum
Sefhack Paranlrlcl-
Sturm uu'crw ;,n(l ulhcr ulililics not lisle([ bclr,a' i rerllcnl l
® YC% [] VI,
helms 111:11 , Ilal I be f,rovit ed 1111',e,tcr systeill,
---�ticp:u'alin[1 Rrquirrd
,r:11" 111T, MI111 (VOI.11caI scaler over. Scsc'cr' I,refi:rred. n1c•ludln in hrncin(f rrcnchc,I
11':IICI' lii:lills 111u1'I/lull.III — —
IlecLlimcd ss':ur:r lines Isrrfirl! -
rrcialnled carer scu'rrl
llrclainlyd n'alcr line Ihnrv(,ni:l! - reclainlcd us'cr srucrl--�
� 11 ailll:Ill' 111 ,tlnllc 11':Ilel \lr „ . _. ��
! I y suurcc. Includjl>e any u'clls. 11'S-1 u'alcil,1'('ias i car CIas. I I imiuurrnlc+f reser•rt,irs used as a ,uiarr nftfrinking aaicr. and nsx,,rialcd ,sciFnuh
**lV,uers elassilied 11'S (rxccpl 11'S-1 nr IYS-L'!. 11, iO11r, for till !i'urn n1rm:11
111gh ts':uta' inr title clr,alit'll) :tn(I lcellands assucl:ncd tells the<e staler:* (-
It i[cin I\?I
F* 1m' ulhcr slrcaIn. laic. inlhuundnlen(, ()r grnttn(f wafer lus,'cringsurface dranl.1ge -- ditches. ;u ,c, 11 :Is Ivellailds :ltisuciatc(I with ihesc u'alcrs car ela.%mfied as 11'1..
ii-t 1'Ilnllns Jnnllln111011 (lltll'1lUIIl:rll
nns' h:hcrtu•nt (hllrizun(al I
TI, •i lcrn entr,allKlllerll 11, cills t,1 feel cal' 1111H'c 1'Crlival 116011
i}rain;
ss•ac•Inx ❑It(I nllcrccl,l„r drlins
_Ally ,seirlilningflouts
Floal car111 grade I s'crlic;oll — Ill I'ccl
`— `-- -- _ I--- th knell(;
fl'n,anunllsh;lilrc,rit)fl2f.03USCl,nr.ceSectiunX•It,f[hisllhpliratilm —
*J5 NC'AC' q,)-r.0WW
cun[ains alit rrl.11rs c, ss here scl,arahuus in 112T.(I�(ISf ( l.
cam[,+t hr achlcs'ed. I'Icast: nc�ci "ac,'
.bore il'Ihe<c allcrnallrc, :n'c used ant! i,i'us idc narlalis a ulli,rmIIS 11t In exl,hl:2
**titrc,ull.l;hsrfirllum, c:m he Idcnlilic(f trying the 1)irision',s NCSurlace W; Icr C1;htiific tl)ul s evch u
proj'cct cuI1111 )• will) Illy millimunl Separaliun requirelticnts li,r Water Imlil]"'
11"10. lllr:lsc 1-06' to i 5A NC'AC I ti(:.il!luhfll fill. duclimemalioll requn'euhm, and ,iibmit© I�11un( . 1
srgned'sc.ded bV an NC licensctl IT, s'crii'y'ing the crileria nullined ill tbal Rille-
}lie, the project p colliply wi[h sclsaralioll a- fuircnlems liu' n'etlands.'
I'Icasc 11-m-ldc ,li11 ®1'r, El V1,
I I ! uucnt:IrV Inf(,riu:llilul idcnlil"ViIII; Ihr arcasllfn(,1t•culNilrnlantx'.
r tide Ilic I)111siun•s dial( sCY'Iral II IN, ( rtl is Itp'.tialilailinl.r' S1'llel.e ,c11;[I;111[lll Callp<,i be 11,C1,
r Nit 1:r1•I:Ilke 1,�'� rC(lllll'e(I r! the allernali,'e de,-Igll cullcri.1 ;llecified h tillli/cd ill de,l!,•It and om-prtlt"IIu1l
1 I, ihr I,rujrcl 1r,caled in a riser basin sulljeel I(I a11V SIaIe htll'Icr' ILIP l
II"ve,, tlucn the project c(mg11V still) se(ba4k,s liunld in tllc ris'cr basin rulnl'r i SgINC'AC11(I�fi .112(NI_' � �'1,
'I'llls inrludc, f runt liulii•red Slrcanis ilcl' I5A_NC'A('?13.IIz(}? - �..� c;• 0 Nn
Dues the l,r,ljccl rc(luirc eus'cr;lgc/aulhnrir.a[ilolt uixicra 404 2�:11i1ms+'rdc'indis'i(ha;A I)rrnllls rir 401 Walx•r ( �11:1111\' Ccrlificalinns' Ye" ❑ Not
I'lahc i,rnvldc the Ilerrllil number+l,cl nliit1119 sl:uu, In 111c CIPV l- Idler if rl,ccrigc.:nrthurl/aluln i; reelulred,
(1" I}ues fluff(.- Wllll,lt Willi �
• Cl T.i}If}i C (1}{add1111,11ai lteilnll�+CCrllfll'; 111(11151;'
i'cr f 5J1 NC AC` 112"I".(I Itltclffst. tlirccll�' rcfalyd em irunincnl:d Iscrnlil. or ccrlilic;rlil,ir ;y,l,llcalinnz nm,t l)c hi i » hr Itl.
have Ilcen :Illphccl fill.. cal- have been obtained. Issuanc'c ol'Ihis permit is enniingeilt on Iau,lncc of drprndcn( l,crinit, Icrr,slun
Mitt s2<linlcitl;1114111 crlrilrol Liana. slurltlwalcr imIvagcInew I1F:In,. Cie.).
', I)(,e, Ihl, lsrnircl ul1:f(Idc Ztl]V Sewer c•ulleeli1111 fines lllal arc deCnaU(! 'hllh llrt�
I'rr 4A N('A[' (I?1'.r}lib. "high-ilritn ilk• st`WkTr Means ant' aerial scsscr. sewer clml;lclin stnlac walcr,. 1 c• ®Vu
siphon. or Ne WO,% i,mltlolwd parallel ill streallihank, illat :u'c tiuhjecl ill cl'(,slt,ll ili;il node rm incti 111' 4leteri nl al e; the 'c\kc'
tiiphuns :[lilt scants susprudcd thrnu�;11 illIC11c'rcnc('knnllict bows require a varvanee apprm al.
- IfYe.,. include an'machilieill with (lc(ails 1,01' crrh title. including lVpe (,lerral Inx. ,Ire'" nr.11rrLll. alld Inc.lrlun)
lligh priori[,' lilies shall be inspecled 11%. the prrnril(ee or its represrnla(he al least 4111m came si.x-nunrlll,4 a1111
insprrtiurs doculncrlled per t5A \C4A 412'l.04113(a)(5) ill' (Ile permiticc's indil'idual Srslrut-�1"idc Collecliuu permil.
J Iti inches
II1 1evI
1IIiI rail
-- _._ }i) 1-:Vl
I''tsk 4 Ill �

DocuSign Envelope ID: 07709F7C-06D4-4071-B8BC-89CE6E3E3D37
X. CERTIFICATIONS:
3.
1)tra:5 the subnlitled W.41eill ct,nlply with I 5A NC C 02T. 111C Mlrllllttrrtt I)csi li C'riteri:r. for 111e 11erinirrn� t�rl'urne� S[aliwts and Force Mains lad l version :illd [lie (i[awilj+ Sl tV�r Mllti[TlRl1t I)CSl �n C'rilCria dillesl aplslirahlc"
® Yes ❑ No
It' lit). lily project+ rctpllrin4 a single variance. conlplele anti submit the Ven'iiulce+1111cr•nalil'e ik+ign Rt:qursl ig,pbt:,,llon WADC' 10-141 and suppta-tiltg (ItrelllllenlS lily review to the ('enu•:ll Office. A111roval or ille I•cr llect will he issued run urr tlil • with file a, rrowal of the tcrnlil and rro'r Is rrt uirin a variant's 1r ► row II 111,11 hr sub'ec'I to lou ,cr
r •viers' time. For lro'erts re uirin r Imp or more vari.ln •s or whcrs fllc variaa a is delsrtuined 11v the Division tip Inc a
si'Iliftcanf ► l-tion of; the Iwolect, Ilk full fcchnical re•iyw is required.
_'. I'rnfcssia,n.11 lingineer''s C"eetilirllion_
i. _krcnw \'. F inefl _ aacsl Ihal this s,l,lllac:ltic,ll iilr Re enC Subdivision - Phase 3
tl'rnl'rsa.,n:rl f nluliil' n,mw 11r1,11 AI1EtIw h.,n him IiI r t � �__y — -- - _
0"k) a\'I ti11MV (mill A11114ialig1i1 hem
has been revietvell Iry nle .Ind is accurate, complete and collsisten( with the illrormation suppiisd it, the pl:uls,
spsciticalious, Cliginecring calculations, and all oilier stippor•tini; dorumcnlaliort to the hest If illy knosiledge. I iiu-tflcr aitest Ih:u It, the hest ul'nry knowledge the proposed design hos been prepared in :Iccord:ux•c will, the applic,lhle regolminns,
Minilltunt I)esi ii C rileria l'or Cfr,vil %racers I la[t:st versir,n . and the Mininttnil Design Crileria for Ili I rack 1k Pcrnlitrink
nl'I'umn 5talians :md i:or•cc Mains talesl version . Allhough oilier professionals nrry have developed ccrt,lin pnrfilln% ill -this subnikud 1rickage, incltisitm of III ,c nlalcrials tinder illy signaluw ;old seal signifies Ihal I have revfewed (Ills nulich.11 anti have jildged 11 It) lie ronsislenl with the proposed design,
NOTl3 In acrordancc with (isner,lE Slottncs 143.20,Nf1 and 143-215,611. any person alit, knowingly niakes any false
slalernenl, rcpreserl(atiun. ur ccrliiiealioo m :ury a111litalion package shall he guilty of a Class ? till, nuanur. a��e� may
nlclutit a line hart to c,vicecd S I1►,Uf10. as well as civil penalties up Io.$25.000 eel, violation. 1lisrcpresenfulion of the applicolion inlirrrna[ion. including f;lilurc to diselose,tny design lion -compliance tvi111 the applicable Roles and design crilcrla, play stlhject
the North Carolina-licc,ucd l'ro[esstaMI I{nginccr to relerrll to the iicertsing board. i21 M AC' 50,0700
turtle Carolina 1'roftssionaf Engineer's seal, si�nalurt', aad date:
Jeremy V
Altphranl's f'erlilica[Ion per 15A NC'.A(- 02 I- .0106(bI. F�
o•i1.�1h C:au,aru,
EIil,tlelfnth�.ntlM.nlSco COP. Finch
!. __ I��ndra I). I'ar,'Isli. PI: attest that dlis application file F f'ge� Subdivision - Phase 3
atil�naunr AmhurH, X.nnc ! :qF' APplla. J4.,n Jfun L? I ---
Wit�wo Nallh• fir"111 APplicc111„11 In•n) II 11
ttttel Ih:lt Iltis nppliralioit haw been revicsell hY me .Ind is :Icsuralc a1141 c•onipletc Io the hest of nil. knossiedpe.
underst:utd Iha1 it all required parts of Illis application arc floe Completed and (hall if ail required supporting dua un,i nlntiun and allachnlenis :rrc lint included. (his application package iv stibjeel to being rclurnCtf as incomplete. I tuulcrstand that anv
discharge ol'a'asfea:der li•nm this naal-discharge ,sy.Iunl to .sill-fiac a waiers or [he hull will resufl lit till inuuediale enl'a,recilicl t
.rc•tion that play include civil pCnallic�, ifliunelit-e r•Clicf. antUor criminal prosecmfiolt- 1 will nr,IkC lit% clams att:li,lsl the Division
t.l'IValrr' Resources s11ouAi a condilion of thi. permil he 1.iolaled. I also suttlerstand t[uu (fall required earls nI IhiS applicalion
package are nol compleled and 111.1E (fall rCiµliNd supporfmg illibri ;i1toll anti anuchnlelus are not included, this application
lxickage will he reltn-netl to me as ineolliplcte.
VOTE In accordance with ('it Hera,( Statutes 143-21_.S.CA anti 143-215.613. any ptrsun who knowingly makes ailly lalsc
stalcnlenl. represenlalion. or certilicalion in ally allplicillion package shall be gttih5. t,f' a Class 2 ,nietleme:ulor. whiell may
illelude a fine not In C..Nceed S 10,000 as well as civil penalties till to S25,000 per- violation"
- Docu by,
Signature: �
03C05BE9FC94440
I),atc. 6/8/2023
F()Rivf. I'I'A 06-21

ERe I {
DocilSlgn Envelope ID: F1D1578B-083B-45E8-8149-AB5c T082�8Ar-, nV11'Clil[11Cpra I Qua IjtV
JUN ` � �d2� State of North Carolinn
Department of Em-ironment,ll (?unlitv
Raleigh Regiollal Office DiVision of Water Resonree's
Flovv Tracking for Seaver Ii?xtentlion fkpplielitiolrs
blltav Reelue.slitlg i111c,c.ttiiin: T"own at Holl V Springs
Project Nallle fol which flow is being requested: Regenc Subdivision - Phase 3
.1101'e /haul one• FISE mar he refluired for• a ci"gle project if the owvner of the IVII Tl' is not re.�puusihle fin rrll pump
Vatious ulnu{ the route of the proposed Im'Wewvlret• flow.
I. Complete tills Seetion only if you are the owner of the waslowatel' tl-e lllllcllt pl:lltl.
a. WWTP Facility Name: Utley Creek Wastewater 7"1•eattllcnt Punt
h. WWTP Facility Prrnlit tt: NC 0063096
C. WW'CP filcility's permittcd flow
d. Estimated obligated 1701V not yet tributary to file WWTP
��. WWTP facilily's actual avg. flow
1: Tota1 firm• fi►- this specific request
g. Tolal actual mid obligated flows to the facility
II. Percent of permitted flow used
+1I1 Jlnnt� ar c> in AICD
6.0
2.974
0.028
4.892
81%
It. Complete 1111a WtCllon 101' each primp station Vou are re-v ,llslble for along the rottte of this propusLd
wastewillel' flo%%..
List Pttnlp stations located but-,ceell (lie prolect connection point all([ the WW1'P-
(A)
Design
1'un,h
hum p
Averaec
Daily
tiiaiiun
Station
Firm
Flow,
(Name or
Permil
Capacity. *
(Firm / pl).
Numherl
Na.
hIGD
NIOD
Rc�
W!200 }3014
0.238
0,095
IIS Bus
WQ0031620
1506
1.001
(B)
Approx
C',arenl
AVR, Daily
I lo%v,
MOD
()bli�atad.
Not Y'�i
I`ul„I Current
rrlblllany
Flom" Plus
Daily f 1mv.
C)hligmed Availnhk
_MCID
Flom'
0 0.062 0.002
0,095 0,962 0.957
0.(l3 3
0.045
w 'I'Ile Firm Capacity (design flow) of arlr' pump slaI!oll i% defined :lathe rn:lximlnrr ptnnned flo,%.
that call be.achievetl with the largest pump liken out ol'tier.'ice.
Design :\rer,lge Daily Flc►ls' is the lirnl capacfly of the pump station dis•ided by .► peaking factor
(pf) "lot lass than 2.5, per Section 2.02(A)(4)(c) of the Minimum Design Crfterfa.
*** :t+ Planning Assessment Addendum .~hall he attached for each pump station located
bet"'een the pl'olect connection point avid the MVTP trhere the .Available Capacity is _ tl.
Downtitrearn r"ility Hanle (Sewer). Regency PS
I)Ow11S11'ca ll, Permit Number WQ0043014
Page I of 0
ITti 1-' W- I :t

DOCOSign Envelope ID: F1D157BB-063E-45E8-8149-A85B91082F8A
M. C•ertirwation statement:
certify to the best of my knowledge that the addation (11'
the volume ol'wastewaWr to be permitted in this proiect has been evaluated "lung the ]-()tilt to the receiving w•aslewater treatment fiacifily and that the flow from this proiect is not anticipated to cause any capacity
i•clated sanitary sewer overflows ur overburden any downstreaaii pump station cn roulc t() file re( iv ins! treatment plant under normal circumstances. given die implementation of the planned impnmunimil-\
identified in the planning assemmenl where applicable. This analysis has been pertiormed ill acco]-dance
with local cslahlis"e(l policies and procedures using the nest available data. This certification applies to
tho%e items listed above in Stations I ;and II plus all attaelled planning assessment addendunis for -,vlli[:Il am the responsible p.uly, Signature of this loran certifies that the receiving; collection system ur trr:itmenl
works has adequate capacity to transport and treat the proposed new wastewater.
.fir lafi11•C'
5/30/2023
Ilan,
xecutive Director of utilities & Infrastructure
7i)le of.%- i /kgfVfV-1 iryl
Page 2 of

K�4
r n-
z
i
5
I
q

DocGSign Envelope ID: F10157BB-063B-45E8-8149-AB5B91082F8A
REGENCY
USGS TOPO MAP
0 1,000 2,000 4,000 PROJECT #: TOL-20030
Feet
I utcii - 2.000 feet HOLLY SPRINGS, NORTH CAROLINA

DodiSign Envelope ID- F1D1578B-063B-45E8-8149-AB5B91082FBA
�.!'T
PROJECT BOUNDARY i
ti x
cm MjqB2
0 N MKC2
Myr)
M yB
� Y
{I ,
°�A J i
V
A
Myc
cm A
ti YD - i
4
MyB2
W n
a �
myr
AMcp
�1
My8
Au Au -cw
ti
A REGENCY I�
0 275 550 1.100 SOIL MAP
Feet PROJECT #: TOL-20030
inch - 5iO feet HOLLY SPRINGS, NORTH CAROLINA

i
DoLOUSign Envelope ID FID1578B-063B-45E8-8149-AB5B91082F8A
FLOOD HAZARD INWRMATION
DOW
Noms 10 USERS SCALE
NORTH CAROLINA
PANEL LoCATOR
0
W3

DocuSign Envelope ID: F1D1578B-063B-45E8-8149-AB5B91082FBA
a
:
T H _E TOWN OF
May 30, 2023
Director, Division of Water Resources
Raleigh Regional Office
Water Quality Operation Section
3800 Barrett Drive
Raleigh, NC 27609
,-W,olly Springs
Re: Application for Sewer Extension Permit
Project: Regency Ph 3
Dear Sir or Madam:
C Dept of Envirottmertlal Quality
JUN — 5 2023
Raleigh Reg�c�n�tl office
Please find enclosed the following items in application for a sewer extension permit to the Town
of Holly Springs existing sewer distribution system:
0 One original and one copy cover letter including a project narrative
o A check in the amount of $480.00
0 One original and one copy of the State of North Carolina Fast Track Sewer -System
Extension Application (FTA 04-16)
0 Two copies of FTSE 04-16 Flow Tracking. Acceptance Form
0 Two color copies of a 8.5-inch by 11-inch portion of a 7.5 minute USGS Topographic
Map showing project area
0 Two copies of a street level map showing all relevant project areas
0 One copy of the locally -required Design and Application Certification
Feel free to contact me at 919-577-3150 should you have any questions or need additional
information in order to process this application.
Sincerely, 0S
OocuSpmA by 11__
t�j�4, F< Rachel Ingham
KendrTV9. V''a�orrish, P.E., CFM
Executive Director of Utilities and Infrastructure
KP.:ek
cc: Project Consultant Engineer, Jeremy Finch, PE
Rachel Ingham, Utility Engineering Manager
Drew Johnson, Development Construction Manager
Emily Koncz, Utility Permitting Specialist
Project file.:Correspondence 442089
300
04.17-20 1 a
Utilities and Infrastrrrcttrre Services
P.O. Box 8 - 128 S. Main Street - I lolly Springs, NC 27540 - www.hollyspringsnc.gov

DocuSign Envelope ID: F1D1578B-063B-45E8-8149-AB5B91t)82F8A
5
DO NOT S1111MI'1' SENNIFR EXTEASION APPLIC',1TIONS UNTIL
CONSTRUCTION DRAWINCS 11AVE. BEEN f1PPl OVED BYSTAFF!
Dept of Fnvirc�tttnet)tal
Sep ,e!- 1)esign and Application C*e!'tlflCMl011 Quality
Noic: ThI. liu•nl nitrtit be stlbnlival with the Fast ;Tract Application fin' exlenwioll to tllc Town ul
Ilofly Springs Sewer sy"Mil JUN - 5 2023
}'rojecl: Regency Subdivision - Phase 3
_—�<ilcihh�Lz"no')jii Office
Design Fnginccr: Jeremy Finch
Address: 2905 Meridian Parkway, Durham, NC 27713
Phone Number 919-361-500 F:nlnil: [e-mail]
Date Complele Application 1',rckagc Recelvrd by 05-05-2023
Dale Approved: (by R1) Y
As design cnginecr 161. Ihi, proiecl. I ccrllfy the following (/Verne chech (.►-) caclt rrlrl>licr,hlc Ix�tJ.
C1 That the clesi m of the project Is In colnplcle cunlilrm:mec wilh the 'In+vn of holly
Sprrngs ialginert'in- Design an<I Conslr•uctiun Standards and NC DI (> 5anital� Sc+�wr
Design Regillolions:
lxJ TI o:Ich utthe 10111LA'in0 Item. a]c completed 111 l rnelosed lot. subnliIIal I the Slate for
e\Icllsiun permit:
5xj Otic ul•Iglllill ,tnJ one copv ot,a eoael- letter th;u inclut{cs ,I prujcct nrll*r,Itive
Fx] A check in the amount of S480,00 to NC' 1)}-. )
Ll A check in the ulrlourlt of ti200.00 to the •Town of I lolly Sprints
U ()Ile original and one copy of` 111c Slalc ol' Norlh C`tlrolina litl•m FTA 04- 1h
1•ir.vf I r uc / .ti'c'lr rr ,til;.Ic �tr l; rlrrt�inu --pplivalwil
(j •1-,Lao collie, of` fol'nt FTS1: 10-18 /4wr 1'ruc•kim Jim - Setrcr h:►�rrr�ruii
.-fPIVIC(Hiwt,s
(� TWO color copies ofan 8.5-1neh by I I -inch portion ofa 7.5-minute U-SciS
Topographic NI,111 showing project area
n Two copies of it street excel slap tihowing all relealult pt')jcct areas
G] Onc copy or the totally -required Design and r\pplication Certification 11111ti
litl'111)
Desioll I:.11 Illeel'�s Signature
I; Dr[tc
Please conlact 1:tnily Konen at (919 55 ?c) rxr etluly.kunci�r boil s,rn sni'.Iai1 i1' \ou have
;Inv question%.
=rtirh a•r Pie mvn Al,r,lrc;Yt4mbY ktirrrw,ru.n
•+r I I.'I
1 dilir%aar!IrrJrrrclrarlarr,4r+,ricer
l'.U, f?'" 8 • 12-T S. ,11dif, StiWel • Ilu111•,1j1•i1fg%. V ''S4o r, �,•rr•.Irnllr.�lrrir{t snc..4�n,

DocuSign Envelope ID- F1D15786-063B45E8-8149-AB5B91082F8A
�J McADAMS
May 8, 2023
NCDENR - DWR
Raleigh Regional Office
1628 Mail Service Center
Raleigh, North Carolina 27699-1628
Re: Regency Subdivision - Phase 3
Holly Springs, North Carolina
TOL-20030
NC Dept of Environlneettal Quality
JUN - 5 2023
Raleigh Regional Office
The accompanied Fast -Track Application (FTA 06-21) includes 2,614 lineal
feet of 8" PVC and 1,298 lineal feet of 8" DIP of gravity sanitary sewer
system for the proposed Regency Subdivision - Phase 3 development located
off New Hill HollySprin s R ad in_HdIy Springs, The gravity sewer
system will a pub is y of wed and operated by the Town of Holly Springs.
Phase 3 of the project will consist of approximately 109 residential. units. The
total wastewater flow generated by Phase 3 of the project is 27,795 GPD. The
NCDENR 401 permit has been obtained for the project under permit
#WQC004484 and the US Army Corps 404 permit has been obtained for the
project under permit #fSAW-2019-01637. Please find the following attached
information in support of this permit request:
• Cover letter with project narrative
• Fast Track Sewer System Extension Application (FTA 06-21)
• Flow Tracking for Sewer Extension Application (FTSE 10-18)
• USGS Topo Map
• Aerial Photo Map
• NRCS Soils Map
• FEMA Firm Map
Sincerely,
THE JOHN R. A MS COMPANY, INC.
The John R. McAdams L 5 %}
Company, Inc, llr
Raleigh I Durham, NC
2905 Meridian Parkway
Durham North Carolina 27713 Group Manager, Residential
19191361-5000
Enclosures
Charlotte, NC
11301 Carmel Commons Blvd.
Sude 111
Charlotte Noith Carolina 28226
[phone]
McAdamsCo.com Desrgning Tomorrow's Infrastructure & Communrtes