WQ0044901_Application (FTSE)_20231107

iec Q-j it ¢ cQ /I / 7l Zo 23 State of North Carolina
DWR Department of Environmental Quality
Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 10-23 & SUPPORTING DOCUMENTATION
Application Number: 00#44dI (to be completed byDWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: Clay Pigeon Properties. 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: Mitchell Murphy per 15A NCAC 02T .0106(b)
Title: Managing Member
4. Applicant's mailing address: 9220 Fairbanks Drive, Suite 220
City: Raleigh State: NC Zip: 27613-
5. Applicant's contact information:
Phone number: (2D 730-0784 Email Address: mitch.t.murohyQzmail.com
H. PROJECT INFORMATION:
I . Project name: Childers Court Townhomes — 6 j V d,�G
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
If a modification, provide the existing permit number: W000_ and issued date:
For modifications, also attach a detailed narrative description as described in Item G of the cbecklist.
If new construction, but part of a master plan, provide the existing permit number: W Q00_
3. County where project is located: Davidson
4. Approximate Coordinates (Decimal Degrees): Latitude: 35,834167° Longitude:-80.255278'
5. Parcel ID (if applicable): 1100600000009 & 1100600000004 (or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Patrick Murphy License Number: 036836
Firm: K2 Engineering NC. PLLC
Mailing address: 1315 Bedlington Drive NW
City: Charlotte State: NC Zip: 28269-_
Phone number: (2U44 280-5669 Email Address: umumhv(a),k2engineeringnc.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Lexington Regional Wastwater Treatment Plant Permit Number: NCO055786
Owner Name: City of Lexington
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. Permit Number(s): WO
2. Downstream (Receiving) Sewer Information: _ inch Z Gravity ❑ Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS_
Owner Name(s):
FORM: FTA 10-23 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.0I 15(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: 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(f)? ❑ 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 a,b
No. of Units
Flow
3-Bedroom Single -Family Townhomes
225 gal/day
39
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
GPD
a See 15A NCAC 02T .0114(b),(d). (e)(1) and (e)(2) for caveats to wastewater design flow rates (i.e. 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.01141 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 and G.S. 143-215.1)
➢ 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): This sewer connects to a leg of downstream sewer being permitted for the City of Lexington. The flow
is being applied to that permit.
FORM: FTA 10-23 Page 2 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: 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 .01 14(f)? ❑ 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
gat/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
GPD
a See 15A NCAC 02T .0114(b). (d), (eX 1) and (e)(2) for caveats to wastewater design flow rates (i.e. 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 and G.S. 143-215.1)
➢ 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): This sewer connects to a leg of downstream sewer being Mrmitted for the City of Lexington. The flow
is being applied to that permit.
FORM: FTA 10-23 Page 2 of 5

DowSign Envelope ID: DOE664D9-6AF2-4OA7-949D-9C959433548F
VD. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (GraN i\Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
8
612
PVC
6
448
PVC
6
34
DIP
➢ Section 11 & HI 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 & 11DC (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 (first 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.I.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)(11)_
➢ 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 10-23 Page 3 of 5

DocuSign Envelope ID: DOE684D9-8AF2-4OA7-949D-9C959433548F
IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(f)):
1. Does the project comply with all separations/altematives found in 15A NCAC 02T .0305(f) & (g)? ® Yes ❑ No
15A NCAC 02T.0305 contains minimum separations that shall be provided for sewers stems:
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below (vertical)
18 inches
'Water mains (vertical - water over sewer preferred, including in benched trenches)
18 inches
'Water mains (horizontal)
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-1 waters of Class I or
Class 11 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 W L.
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(t) or (g), see Section X.1 of this application
*15A NCAC 02T.0305(2) 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 webpaee
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/seated 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 coveragetauthorization 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)16) (additional permiWcertifications)? ® 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 Interferencelconflict 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 10-23 Page 4 of 5

DocuSign Envelope to: DOE6B4D9-6AF2-4OA7-949D-9C959433548F
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?
® Yes ❑ No
If no, for projects requiring a single variance, complete and submit the Variance/Altemative 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 oroiects requiring a variance approval may be subject to loneer
review times. For oroiects requirine two or more variances or where the variance is determined by the Division to be a
sienificant portion of the proiect• the full technical review is required.
2. Professional Engineer's Certification:
I, Patrick Murphy, P.E. , attest that this application for Childers Court Townhomes
(Professional Engineer's name from Application Item In.l.) (Project Name from Application Item It. I)
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 143-215.6B, 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)
vvsi n milli
North Carolina Professional Engineer's seal, signature, and date: CA Rod 4ii
5 iW SEAL �?
:N 036836 i
l aea ur
P/CK L
grg11111A1 1. .. .
3. Applicant's Certification per 15A NCAC 02T .0106(b):
I, Mitchell Murphy attest that this application for Childers Court Townhomes
(Signature Authority Name from Application Item 1.3.) (Project Name from Application Item 111)
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: Date:
FORM: FTA 10-23 Page 5 of 5

PLANNING ASSESSMENT ADDENDUM (PAA)
Submit a planning assessment addendum for each pump station listed in Section II where Available Capacity is < 0.
Pump Station (Name or Number):
Given that:
a. The proportion and amount of Obligated, Not Yet Tributary Daily Flow (C) accounts for
% and MGD of the Available Capacity (E) in Pump Station
: and that
b. The rate of activation of this obligated, not yet tributary capacity is currently approximately
MGD per year; and that
c. A funded Capital Project that will provide the required planned capacity, namely
is in design or under construction with
planned completion in
d. The following applies:
and/or
Therefore:
Given reasonably expected conditions and planning information, there is sufficient justification to allow
this flow to be permitted, without a significant likelihood of over -allocating capacity in the system
infrastructure.
I understand that this does not relieve the collection system owner from complying with G.S. 143-
215.67(a) which prohibits the introduction of any waste in excess of the capacity of the waste disposal
system.
Signing Ofjlcial Signature
Date
Page 3 of 8
FTSE 10-23

WASTEWATER TREATMENT SYSTEM EXPANSIONS BEYOND EXISTING ALLOCATION
Complete this form and submit applicable supporting documentation if the proposed project is subject to
overallocation allowances outlined per G.S. 143-215.I(f5).
Receiving WWTP Name:
Receiving W WTP Permit Number:
Provide a copy of the active NPDES permit for the receiving W WTP.
Overallocation Criteria
1. Does the receiving W WTP's existing NPDES permit have an expansion flow tier? ❑ Yes or ❑ No.
a. If yes, provide the expansion flow tier:_ MGD; proceed to item 2.
b. If no, overallocation is not allowable for this construction until such a time that the receiving
W WTP's NPDES permit is modified for inclusion of an expansion flow tier capable of receiving
and sufficiently treating the wastewater generated by the proposed construction.
2. Is the receiving W WTP and collection system located within either (I ) a county with a projected population
growth rate above two percent annually based on a 20-year residential growth projection conducted using data
provided by the Office of State Budget and Management (OSBM) State Demographer or (2) one of the top
20% of the fastest growing counties in the State by population based on a 10-year residential growth
projection conducted using data provided by the OSBM State Demographer? ❑ Yes or ❑ No.
a. If yes, submit a residential population projection to support your claim; proceed to item 3.
b. If no, overallocation is not allowable for this construction.
3. Has the receiving W WTP received a violation for being non -compliant with any non -flow limitations
identified in the active NPDES permit in the past 5 years? ❑ Yes or ❑ No.
a. If yes, overallocation is not allowable for this construction.
b. If no, submit a limit violation report to support your claim; proceed to item 4.
4. Has the receiving W WTP exceeded its monthly average flow limitation identified in the active NPDES permit
more than once in any 12-month period in the past 10 years? ❑ Yes or ❑ No.
a. If yes, overallocation is not allowable for this construction. The receiving W WTP may not
allocate more than one hundred percent (100%) of the existing system's hydraulic capacity until
the permittee complies with the permitted monthly flow for at least 12 consecutive months.
b. If no, submit a W WTP flow report to support your claim; proceed to item 5.
5. Is completion of construction for work identified in an Authorization to Construct (ATC) permit that results in
expansion of facility to the next flow tier anticipated to occur within 24 months of the submittal date? ❑ Yes
or ❑ No.
a. If yes, allocation of one hundred ten percent (115%) of the receiving W WTP's existing hydraulic
capacity is allowable.
Provide the ATC Permit Number: _;
ii. Submit a construction timeline signed by the contactor's Project Manager;
iii. Submit a letter of agreement of timeline feasibility signed by the NC -licensed
Professional Engineer responsible for the certification of work covered under the
applicable ATC permit;
iv. Proceed to item 6.
b. If no, allocation of one hundred ten percent (110%) of the receiving W WTP's existing hydraulic
capacity is allowable. Proceed to item 6.
Page 4 of 8
FTSE 10-23

6. Does the overallocation identified as allowable under item 5 result in a W WTP flow rate greater than the
permitted projected capacity after expansion? ❑ Yes or ❑ No.
a. If yes, overallocation is not allowable for this construction.
b. If no, proceed to item 7.
7. Does the overallocation identified as allowable under item 5 result in a W WTP flow rate greater than 80% of
the permitted projected capacity after expansion? ❑ Yes or ❑ No.
a. If yes, overallocation is allowable. Submit an engineering evaluation of the receiving W WTP's
future wastewater treatment, utilization, and disposal needs. This evaluation shall outline plans
for meeting future wastewater treatment, utilization, or disposal needs by either expansion of the
existing system, elimination or reduction of extraneous flows, or water conservation and shall
include the source of funding for the improvements. If expansion is not proposed or is proposed
for a later date, a justification shall be made that wastewater treatment needs will be met based on
past growth records and future growth projections and, as appropriate, shall include conservation
plans or other measures to achieve waste flow reductions. This shall be provided to the Division
prior to the proposed activity. Proceed to item 8.
b. If no, overallocation is allowable.
8. Does the overallocation identified as allowable under item 5 result in a W WTP flow rate greater than 901/6 of
the permitted projected capacity after expansion? ❑ Yes or ❑ No.
a. If yes, overallocation is allowable. However, the permittee for the receiving W WTP shall obtain
all permits needed for the expansion of the wastewater treatment, utilization, or disposal system
and, if construction is needed, submit final plans and specifications for expansion, including a
construction schedule. If expansion is not proposed or is proposed for a later date, a justification
shall be made that wastewater treatment needs will be met based on past growth records and
future growth projections and, as appropriate, shall include conservation plans or other specific
measures to achieve waste flow reductions. This shall be provided to the Division prior to the
proposed activity.
b. If no, overallocation is allowable.
Signing Official Signature
Date
Page 5 of 8
FTSE 10-23

Instructions for Flow Tracking form (FTSE) and Planning Assessment Addendum (PAA)
Section I
a. WWTP Facility Name: Enter the name of the WWTP that will receive the wastewater flow.
b. WWTP Facility Permit M Enter the NPDES or Non -Discharge number for the WWTP receiving the
wastewater flow.
c. WWTP facility's permitted flow, MGD: From WWTP owner's NPDES or Non -Discharge permit.
d. Estimated obligated flow not yet tributary to the WWTP, MGD: This includes flows allocated to other
construction projects not yet contributing flow to the collection system. Flows allocated through interlocal
agreements or other contracts not yet contributing flow to the collection system are also included. For POTWs
that implement a pretreatment program, include flows allocated to industrial users who may not be using all of
their flow allocation. Please contact your Pretreatment Coordinator for information on industrial flow tributary
to your WWTP.
As of January 15, 2008 the POTW should have reviewed flow allocations made over the last two years and
reconciled their flow records, to the best of their ability, so it is known how much flow has been obligated and
is not yet been made tributary to the WWTP, in accordance with local policies and procedures employed by the
reporting entity.
e. WWTP facility's actual avg_flow, MGD: Previous 12 month average.
f. Total flow for this specific request, MGD: Enter the requested flow volume.
g. Total actual and obligated flows to the facility, MGD Equals [d + e + f]
h. Percent of permitted flow used: Equals [(g / c)• 100]
For example:
On January 15 a POTW with a permitted flow of 6.0 MGD, reported to the Regional Office that there is 0.5
MGD of flow that is obligated but not yet tributary. The annual average flow for 2007 is 2.7 MGD. There is a
proposed flow expansion of 0.015 MGD.
The first Form FTSE submitted after January 15, 2008 may have numbers like this:
c. = 6.0 MGD
d. = 0.5 MGD
e. = 2.7 MGD
f. = 0.015 MGD
g. = 3.215 MGD
h. = 53.6 %
The next Form FTSE may be updated like this with a proposed flow expansion of 0.102 MGD:
c. = 6.0 MGD
d. = 0.515 MGD
e. = 2.73 MGD
f. = 0.102 MGD
g. = 3.349 MGD
It. = 55.8 %
Each subsequent FTSE form will be updated in the same manner.
Page 6 of 8
FTSE 10-23

Section 11
List the pump station name or number and approximate pump station firm capacity, approximate design average
daily flow (A) approximate current average daily flow (B), and the obligated, not yet tributary flow through the
pump station (C) for each pump station that will be impacted by the proposed sewer extension project. Calculate
the total current flow plus obligated flow (D=B+C) and the available capacity (E=A-D). Include the proposed flow
for this project with other obligated flows that have been approved for the pump station but are not yet tributary
(C).
Firm capacity is the maximum pumped flow that can be achieved with the largest pump out of service as per the
Minimum Design Criteria.
Design Average Daily Flow is the firm capacity of the pump station divided by a peaking factor (pf) of not less than
2.5.
If the available capacity (E) for any pump station is < 0, then prepare a planning assessment for that pump station
if the system has future specific plans related to capacity that should be considered in the permitting process.
(A)
(B)
(C)
(D)=(B+C)
(E)=(A-D)
Obligated,
Design
Approx.
Not Yet
Total Current
Firm
Average
Current Avg.
Tributary
Flow Plus
Pump Station
Capacity
Daily Flow
Daily Flow,
Daily Flow,
Obligated
Available
(Name or Number)
MGD
(Firm / pf)
MGD
MGD
Flow
Capacity'
Kaw Creek PS
0.800
0.320
0.252
0.080
0.332
-0.012
Valley Road PS
1.895
0.758
0.472
0.135
0.607
0.151
Page 7 of 8
FTSE 10-23

Plannim¢ Assessment Addendum Instructions
Submit a planning assessment addendum for each pump station listed in Section II where available capacity is < 0.
A planning assessment for Kaw Creek PS (see example data above) may be performed to evaluate whether there is
significant likelihood that needed improvements or reductions in obligated flows will be in place prior to activating
the flows from the proposed sewer extension project.
If the system decides to accept the flow based on a planning assessment addendum, it is responsible to manage the
flow without capacity related sanitary overflows and must take all steps necessary to complete the project or control
the rate of flow to prevent sanitary sewer overflows.
The planning assessment may identify a funded project currently in design or construction, or a planned project in
the future not yet funded but in a formal plan adopted by the system. The system should carefully weigh the
certainty of successful timely project completion for any expansion, flow management diversion or infiltration and
inflow elimination projects that are the foundation of a planned solution to capacity tracking and acceptance
compliance.
For example:
Given that:
a. The proportion and amount of obligated, not yet tributary flow accounts for 24 % and 0.080 MGD of the
committed flow in Pump Station Kaw Creek; and that
b. The rate of activation of this obligated, not yet tributary capacity is currently approximately 0.01 MGD
per year; and that
c. A funded capital project that will provide the required planned capacity, namely
is in design or under construction with planned
completion in ; and/or
d. The following applies:
The master plan and ten year capital plan contain recommended scope and funding for a capital project entitled
Kaw Creek Pump Station upgrade with funding planned in July 2014. This project is planned to add 0.100 MGD
to the firm capacity of the pump station by October 2015. Inclusion of this proposed capital proiect as a condition
of this Flow Tracking/Acceptance for Sewer Extension Permit Application elevates this Miect's priority for
funding and construction to be implemented ahead of the activation of obligated, not yet tributary flows in amounts
that exceed the firm numn station canacities identified in Section 11 above.
Therefore:
Given reasonably expected conditions and planning information, there is sufficient justification to allow this flow
to be permitted, without a significant likelihood of over -allocating capacity in the system infrastructure.
Page 8 of 8
FTSE 10-23

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November 1, 2023
NCDEQ — Division of Water Resources
Winston-Salem Regional Office
Water Quality Section
450 W. Hanes Mill Road, Suite 300
Winston-Salem, North Carolina 27105
Re: Project Name: Childers Court Townhomes — Private Sewer
To Whom It May Concern,
e
2
ENGINEERING
NC
NC Department of
Environmental Quality
Received
NOV 0 7 2023
Winston-Salem
Regional Office
Included with this transmittal, please see full list of provided documents below for the
above referenced project:
Item #
Description
Quantity
Remarks
1
Original sewer FTA
1
2
Copy of sewer FTA
1
3
Developers Operational
Agreement
1
4
NC Secretary of State business
information
1
5
Check for $600 made payable to
NCDEQ
1
6
Completed flow tracking form
from City of Lexington
1
7
8
9
Please let me know if you have any questions or require any additional information at
this time.
Regards,
2023.11.01
21:01:4:01:48-04'00'
Patrick Murphy, PE
K2 Engineering NC, PLLC
[e-mail]
704-280-5669

CHILDERS COURT TOWNHOMES
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
PACKAGE FOR DEVELOPER -MAINTAINED SYSTEM
Y; 2'
ENGINEERING
N r-
Prepared By:
Patrick Murphy, PE
K2 ENGINEEERING NC, PLLC
1315 Bedlington Dr. NW
Charlotte, NC 28269
PROJECT NARRATIVE
This full project consists of approximately 1,248 LF of gravity sewer main
extension and will serve 39 total 3-bedroom townhome dwelling units. The first
154 LF leg of sewer will be owned & maintained by the City of Lexington. The
remaining 1,094' will be owned & maintained by the Developer and is included
with this application. The project is expected to generate approximately 8,775
wastewater gallons per day, based on 225 gal/day for each unit. All the flow is
being applied on the City of Lexington portion of the project. This private sewer
application is being permitted as zero flow. This Fast Track Sewer System
Extension Application submittal package includes the items below.
• APPLICATION FEE ($600.00)
• ORIGINAL FAST TRACK APPLICATION + 1 COPY
• FLOW TRACKING APPLICATION (COMPLETED BY CITY OF LEXINGTON)
• SITE MAPS (LISGS TOPOGRAPHIC MAP & AERIAL MAP)
• DEVELOPERS OPERATIONAL AGREEMENT

STATE OF NORTH CAROLINA
COUNTY OF Permit No.
DEVELOPER'S OPERATIONAL AGREEMENT
This AGREEMENT made pursuant to G.S. 143-215.1 (dl) and entered into this day of
by and between the North Carolina Environmental Management
Commission, an agency of the State of North Carolina, hereinafter known as the COMMISSION; and
Clay Pigeon Properties, LLC , a corporation/general partnership registered/licensed to do
business in the State of North Carolina, hereinafter known as the DEVELOPER.
WITNESSETH:
The DEVELOPER is the owner of the certain lands lying in Davidson County, upon
which it is erecting and will erect dwelling units and other improvements, said development to be known
as Childers Court Townhomes (hereinafter the Development).
2. The DEVELOPER desires, to construct a wastewater collection system with pumps, wastewater treatment
works, and/or disposal facilities (hereinafter Disposal System) to provide sanitary sewage disposal to serve
the Development on said lands.
3. The DEVELOPER has applied to the COMMISSION for the issuance of a permit pursuant to G.S. 143-
215.1 to construct, maintain, and operate the Disposal System.
4. The DEVELOPER has created or shall create unit ownership in said dwellings units, other improvements
and lands through filing of a Declaration of Unit Ownership (hereinafter Declaration), pursuant to Chapter
47C or 47F of the North Carolina General Statutes.
5. The DEVELOPER has caused to be formed or will cause to be formed at the time of filing of the
Declaration, Childers Court Townhomes NC HOA (hereinafter
Association), a non-profit corporation organized and existing under and by the virtue of the laws of the State
of North Carolina, for the purpose, among others, of handling the property, affairs and business of the
Development; of operating, maintaining, re -constructing and repairing the common elements of the lands
and improvements subject to unit ownership, including the Disposal System; and of collecting dues and
assessments to provide funds for such operation, maintenance, re -construction andrepair.
6. The COMMISSION desires to assure that the Disposal System of the Development is properly constructed,
maintained and operated in accordance with law and permit provisions in order to protect the quality of the
waters of the State and the public interest therein.
NOW, THEREFORE, in consideration of the promises and the benefits to be derived by each of the parties
hereto, the COMMISSION and DEVELOPER do hereby mutually agree as follows:
I. The DEVELOPER shall construct the Disposal System in accordance with the permit and plans and
specifications hereafter issued and approved by the COMMISSION, and shall thereafter properly operate
and maintain such systems and facilities in accordance with applicable permit provisions andlaw.
2. The DEVELOPER shall not transfer ownership and/or control of the Disposal System to the Association
until construction has been completed in accordance with the permit and approved plans, and the staff of
the Division of Water Resources has inspected and approved of the facilities. In order to change the name
of the permit holder, the DEVELOPER must request that the permit be reissued to the Association. The
request must include a copy of the Association Bylaws andDeclaration.
3. The DEVELOPER shall not transfer, convey, assign or otherwise relinquish or release its responsibility for
the operation and maintenance of its Disposal System until a permit has been reissued to the DEVELOPER's
successor.
FORM- TWV(11-10 paaa 1 nf7

4. The DEVELOPER shall provide in the Declaration and Association Bylaws that the Disposal System and
appurtenances thereto are part of the common elements and shall thereafter be properly maintained and
operated in conformity with law and the provisions of the permit for construction, operation, repair, and
maintenance of the system and facilities. The Declaration and Bylaws shall identify the entire wastewater
treatment, collection and disposal system as a common element which will receive the highest priority for
expenditures by the Association except for Federal, State, and local taxes and insurance.
5. The DEVELOPER shall provide in the Declaration and Association Bylaws that the Disposal System will
be maintained out of the common expenses. In order to assure that there shall be funds readily available to
repair, maintain or construct the Disposal System, beyond the routine operation and maintenance expenses,
the Declaration and Association Bylaws shall provide that a fund be created out of the common expenses.
Such fund shall be separate from the routine maintenance funds allocated for the facility and shall be part
of the yearlybudget.
6. In the event the common expense allocation and separate fund are not adequate for the construction, repair,
and maintenance of the Disposal System, the Declaration and Association Bylaws shall provide for special
assessments to cover such necessary costs. There shall be no limit on the amount of such assessments, and
the Declaration and Bylaws shall provide that such special assessments can be made as necessary at any
time.
7. If a wastewater collection system and wastewater treatment and/or disposal facility provided by any city,
town, village, county, water and sewer authorities, or other unit of government shall hereinafter become
available to serve the Development, the DEVELOPER shall take such action as is necessary to cause the
existing and future wastewater of the Development to be accepted and discharged into said governmental
system, and shall convey or transfer as much of the Disposal System and such necessary easements as the
governmental unit mayrequire as condition of accepting the Development's wastewater.
8. Recognizing that it would be contrary to the public interest and to the public health, safety and welfare for
the Association to enter into voluntary dissolution without having made adequate provision for the continued
proper maintenance, repair and operation of its Disposal System, the DEVELOPER shall provide in the
Association Bylaws that the Association shall not enter into voluntary dissolution without first having
transferred its said system and facilities to some person, corporation or other entity acceptable to and
approved by the COMMISSION by the issuance of apermit.
9. The agreements set forth in numbered paragraphs 1, 2, 3, 4, 5, 6, 7, and 8 above shall be conditions of any
permit issued by the COMMISSION to the DEVELOPER for the construction, maintenance, repair and
operation of the Disposal System.
10. A copy of this agreement shall be filed at the Register of Deeds in the County(ies) where the Declaration is
filed and in the offices of the Secretary of State of North Carolina with the Articles of Incorporation of the
Association.
IN WITNESS WHEREOF, this agreement was executed in duplicate originals by the duly authorized
representative of the parties hereto on the day and year written as indicated by each of the parties named below:
FOR THE ENVIRONMENTAL
MANAGEMENT COMMISSION
S. Daniel Smith
Director, Division of Water Resources
(Date)
(t IAv PiaPc)n Pro.1krNs. LL
Name of DEVELOPER
B:
(Signat
Mitchell Murphy, Managing Member
Print Name and Title
I I -- Z - z n-a
(Date)
FORM: DEV 03-19 Page 2 of 2

11/6/23, 11:43AM
North Carolina Secretary of State Search Results
• File an Annual Report/Amend an Annual Report • Upload a PDF Filing • Order a Document Online
Add Entity to My Email Notification List • View Filings • Print a Pre -Populated Annual Report form • Print
an Amended a Annual Report form
Limited Liability Company
Legal Name
Clay Pigeon Properties LLC
Information
Sosld: 2020016
Status: Current -Active O
Date Formed: 7/31/2020
Citizenship: Domestic
Annual Report Due Date: April 15th
Currentpnnual Report Status:
Registered Agent: Murphy, Mitchell T.
Addresses
Principal Office
9220 Fairbanks Drive Suite 220
Raleigh, NC 27613
Mailing
PO Box 90427
Raleigh, NC 27675
Company Officials
Reg Office
9220 Fairbanks Drive Suite 220
Raleigh, NC 27613
Reg Mailing
9220 Fairbanks Drive Suite 220
Raleigh, NC 27613
All LLCs are managed by their managers pursuant to N.C.G.S. 57D-3-20.
Managing Member
Carla Sevilla
PO Box 90427
Raleigh NC 27675
Managing Member
Mitchell T Murphy
9220 Fairbanks Dr
Raleigh NC 27613
Managing Member
Thomas Quackenbush
PO Box 90427
Raleigh NC 27575
https://sosnc.gov/online_services/search/Business_Registmtion_Results 1 /1