WQ0044898_Application (FTSE)_20231215

SUMMIT
DESIGN AND ENGINEERING SERVICES
606 Broad Street, Suite C, South Boston, VA 24592
Phone // 434.575.0617 Web // www.summitde.net
SANITARY SEWER
SUBMITTAL
DOCUMENTS/
CALCULATIONS
SATTERFIELD SUBDIVISION PHASE II
OWNERAPPLICANT:
Roxboro Partners, LLC
320 Executive Court
Hillsborough, NC 27278
[phone]
[e-mail]
PROJECT#: 18-0091
PHASE I SUBMITTAL: APRIL 2023
EN G LN EE R/CON S l l LTANT :
Matt Hastings, PE
Summit Design and Engineering
606 Broad Street, Suite C
South Boston, VA 24592
P [phone]
[e-mail]

SUMMARY:
Roxboro Partners, LLC is in the process of developing a residential subdivision on a 172.2-acre
parcel on the north side of US 501 and south side of Lucy Garrett road in Person County. The
property has already been annexed into the City of Roxboro limits and has been designed to meet
their standards. The development will be roughly 400 homes but the sewer system has been
designed for 600 dwelling units. The assumed breakdown is for 300 3-bedroom units and 300 4-
bedroom units. Due to the size of the project it will be built in multiple phases. Phase II will
consist of 136 single family homes. The overall sewer design has been evaluated but the
following plans are for Phase II only. The system components consist of a gravity sewer
network that leads to a new suction lift sewer station built in phase I that will transfer waste to
the existing pump station on Billy Hicks Rd.

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources INSTRUCTIONS FOR FORM: FTA 10-23 & SUPPORTING DOCUMENTATION
This application is for sewer extensions involving gravity sewers, pump stations and force mains, or any combination that has been
certified by a professional engineer and the applicant that the project meets the requirements of 15A NCAC 02T and the Division's
Minimum Design Criteria (Gravity Sewer & Pump Stations/Force Mains) and that plans, specifications and supporting documents
have been prepared in accordance with 15A NCAC 02T, 15A NCAC 02T .0300, Division policies, and good engineering practices.
While no upfront engineering design documents are required for submittal, in accordance with 15A NCAC 02T .0305(b), design
documents must be prepared prior to submittal of a fast track permit application to the Division. This would include plans, design
calculations, and project specifications referenced in 15A NCAC 02T .0305 and the applicable minimum design criteria. These
documents shall be immediately available upon request by the Division.
Projects that are deemed permitted (do not require a permit from the Division) are explained in 15A NCAC 02T.0303.
Projects not eligible for review via the fast track process (must be submitted for full technical review):
➢ Projects that do not meet any part of the minimum design criteria (MDC) documents;
➢ Projects that involve more than one variance from the requirements of 15A NCAC 02T;
➢ Pressure sewer systems utilizing simplex septic tank -effluent pumps (STEPS) or simplex grinder pumps;
➢ Simplex STEP or simplex grinder pumps connecting to pressurized systems (e.g. force mains);
➢ Vacuum sewer systems.
General — When submitting an application, please use the following instructions as a checklist in order to ensure all required items are
submitted. Adherence to these instructions and checking the provided boxes will help produce a quicker review time and reduce the
amount of requested additional information. Failure to submit all required items will necessitate additional processing and review
time, and may result in return of the application. Unless otherwise noted, the Applicant shall submit one original and one copy of
the application and supporting documentation.
A. One Original and One Copy (second copy may be digital) of Application and Supporting Documents
® Required unless otherwise noted. Signatures on original must be "wet ink" or secure digital signatures.
Please do not submit engineering design plans with the application unless specifically requested.
B. Cover Letter/Narrative Description (Required for All Application Packages):
® List all items included in the application package, as well as a brief description of the requested permitting action.
➢ Be specific as to the system type, number of homes served, flow allocation required, etc.
➢ Include the permit number/status of any other required sewer permits (downstream/upstream)
➢ If necessary for clarity, include attachments to the application form.
C. Application Fee (All New and Modification Application Packages):
® Submit a check or money order in the amount of $600.00, dated no more than 90 days prior to application submittal.
➢ Payable to North Carolina Department of Environmental Quality (NCDEQ)
D. Fast Track Application (Required for All Application Packages, Form FTA 10-23):
® Submit the completed and appropriately executed application.
➢ If necessary for clarity or due to space restrictions, attachments to the application may be made.
❑ If the Applicant Type in Item I.2 is a corporation or company, provide documentation it is registered for business with the
North Carolina Secretary of State.
❑ If the Applicant Type in Item I.2 is a partnership or d/b/a, enclose a copy of the certificate filed with the Register of Deeds in
the county of business.
® The Project Name in Item II.1 shall be consistent with the project name on the flow acceptance letters, agreements, etc.
® The Professional Engineer's Certification on Page 5 of the application shall be signed, sealed and dated by a North Carolina
licensed Professional Engineer.
® The Applicant's Certification on Page 5 of the application shall be signed in accordance with 15A NCAC 02T .0106(b). Per
15A NCAC 02T .0106(c), an alternate person may be designated as the signing official if a delegation letter is provided from
a person who meets the criteria in 15A NCAC 02T .0106(b).
INSTRUCTIONS FOR FORM: FTA 10-23 & SUPPORTING DOCUMENTATION Page 1 of 3

E. Flow Tracking/Acceptance Form (Form: FTSE 10-23) (If Applicable):
® Submit the completed and executed FTSE form from the owners of the downstream sewers and treatment facility.
➢ Multiple forms maybe required where the downstream sewer owner and wastewater treatment facility are different.
➢ The flow acceptance indicated in form FTSE must not expire prior to permit issuance and must be dated less than one year
prior to the application date.
➢ Submittal of this application and form FTSE indicates that owner has adequate capacity and will not violate G.S. 143-215.67(a).
➢ Intergovernmental agreements or other contracts will not be accepted in lieu of a project -specific FTSE.
F. Site Maps (All Application Packages):
® Submit an 8.5-inch x 11-inch color copy of a USGS Topographic Map of sufficient scale to identify the entire project area,
including the closest surface waters.
➢ General location of the project components (gravity sewer, pump stations, & force main)
➢ Downstream connection points and permit number (if known) for the receiving sewer
® Include an aerial location map showing general project area (such as street names or latitude/longitude) so that Division staff
can easily locate it in the field.
G. Existing Permit (Application Packages for Modifications to an Existing Permit):
❑ Submit a copy of the most recently issued existing permit.
❑ Include a descriptive and clear narrative identifying the previously permitted items to remain in the permit, items to be
added, and/or items to be modified (the application form itself should include only include items to be added/modified). The
narrative should also include whether any previously permitted items have been certified.
❑ The narrative should clearly identify the requested permitting action and accurately describe the sewers to be listed in
the final permit.
H. Power Reliability Plan (Required if portable reliability option utilized for Pump Station):
❑ Per 15A NCAC 02T .0305(h)(1), submit documentation of power reliability for pumping stations.
➢ This alternative is only available for average daily flows less than 15,000 gallons per day
➢ It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant and is compatible with
the station. The Division will accept a letter signed by the applicant (see 15A NCAC 02T .0106(b)) or proposed contractor,
stating that "the portable power generation unit or portable, independently -powered pumping units, associated appurtenances
and personnel are available for distribution and operation of this pump 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 in the case of a multiple station power outage. (Required at time of certification)
I. Certificate of Public Convenience and Necessity (All Application Packages for Privately -Owned Public Utilities):
❑ Per 15A NCAC 02T .0115(a)(1) provide the Certificate of Public Convenience and Necessity from the North Carolina Utilities
Commission demonstrating the Applicant is authorized to hold the utility franchise for the area to be served by the sewer
extension, or
❑ Provide a letter from the North Carolina Utilities Commission's Water and Sewer Division Public Staff stating an application
for a franchise has been received and that the service area is contiguous to an existing franchised area or that franchise approval
is expected.
J. Operational Agreements (Applications from HOA/POA and Developers for lots to be sold):
❑ Home/Property Owners' Associations
❑ Per 15A NCAC 02T .0115(c), submit the properly executed Operational Agreement (FORM: HOA).
❑ Per 15A NCAC 02T .0115(c), submit a copy of the Articles of Incorporation, Declarations and By-laws.
❑ Developers of lots to be sold
❑ Per 15A NCAC 02T .0115(b), submit the properly executed Operational Agreement (FORM: DEV).
For more information, visit the Division's collection systems website
INSTRUCTIONS FOR FORM: FTA 10-23 & SUPPORTING DOCUMENTATION Page 2 of 3

THE COMPLETED APPLICATION PACKAGE INCLDING ALL SUPPORTING INFORMATION AND
MATERIALS, SHOULD BE SENT TO THE APPROPRIATE REGIONAL OFFICE:
REGIONAL OFFICE
ADDRESS
COUNTIES SERVED
Asheville Regional Office
2090 US Highway 70
Avery, Buncombe, Burke, Caldwell, Cherokee,
Water Quality Section
Swannanoa, North Carolina 28778-8211
Clay, Graham, Haywood, Henderson, Jackson,
[phone]
Macon, Madison, McDowell, Mitchell, Polk,
[phone] Fax
Rutherford, Swain, Transylvania, Yancey
Fayetteville Regional Office
225 Green Street Suite 714
Anson, Bladen, Cumberland, Harnett, Hoke,
Water Quality Section
Fayetteville, North Carolina 28301-5095
Montgomery, Moore, Robeson, Richmond,
[phone]
Sampson, Scotland
[phone] Fax
Mooresville Regional Office
610 E. Center Avenue
Alexander, Cabarrus, Catawba, Cleveland,
Water Quality Section
Mooresville, North Carolina 28115
Gaston, Iredell, Lincoln, Mecklenburg, Rowan,
[phone]
Stanly, Union
[phone] Fax
Raleigh Regional Office
3800 Barrett Drive
Chatham, Durham, Edgecombe, Franklin,
Water Quality Section
Raleigh, North Carolina 27609
Granville, Halifax, Johnston, Lee, Nash,
[phone]
Northampton, Orange, Person, Vance, Wake,
[phone] Fax
Warren, Wilson
Washington Regional Office
943 Washington Square Mall
Beaufort, Bertie, Camden, Chowan, Craven,
Water Quality Section
Washington, North Carolina 27889
Currituck, Dare, Gates, Greene, Hertford, Hyde,
[phone]
Jones, Lenoir, Martin, Pamlico, Pasquotank,
[phone] Fax
Perquimans, Pitt, Tyrrell, Washington, Wayne
Wilmington Regional Office
127 Cardinal Drive Extension
Brunswick, Carteret, Columbus, Duplin, New
Water Quality Section
Wilmington, North Carolina 28405
Hanover, Onslow, Fender
[phone]
[phone] Fax
Winston-Salem Regional Office
450 W. Hanes Mill Road
Alamance, Alleghany, Ashe, Caswell, Davidson,
Water Quality Section
Suite 300
Davie, Forsyth, Guilford, Rockingham, Randolph,
Winston-Salem, North Carolina 27105
Stokes, Surry, Watauga, Wilkes, Yadkin
[phone]
[phone] Fax
INSTRUCTIONS FOR FORM: FTA 10-23 & SUPPORTING DOCUMENTATION Page 3 of 3

State of North Carolina
Department of Environmental Quality
DWR Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 10-23 & SUPPORTING DOCUMENTATION
Application Number: WQ0044898 (to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: City of Roxboro (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: Brooks Lockhart per 15A NCAC 02T .0106(b)
Title: City Manager
4. Applicant's mailing address: 779 Mountain Rd
City: Roxboror State: NC Zip: 27573-
5. Applicant's contact information:
Phone number: [phone] Email Address: blockhartna,cityofroxboro.com
II. PROJECT INFORMATION:
1. Project name: Satterfield Subdivision Phase II
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: Person
4. Approximate Coordinates (Decimal Degrees): Latitude: 36.335972' Longitude:-78.967716'
5. Parcel ID (if applicable): 0904-00-80-7687 (or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Matt Hastings License Number: 38098
Firm: Summit Design and Engineering Services
Mailing address: 606 Broad Street, Suite C
City: South Boston State: VA Zip: 24592-
Phone number: [phone] Email Address: matt.hastings(a)summitde.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: City of Roxboro WWTP Permit Number: NCO021024
Owner Name: City of Roxboro
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. Permit Number(s): WQCS00048
2. Downstream (Receiving) Sewer Information: 8 inch ® Gravity ❑ Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS00048
Owner Name(s): City of Roxboro
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.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 .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
Phase I allocated sewer for 600 homes
day
0 GPD
Phase I & II combined has less than 250 homes
day
0 GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
0 GPD
a See 15A NCAC 02T .0114(b), L), (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: 57120 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: WQ001slglle Date: 1 1 /6/20
❑ Rehabilitation or replacement of existing sewers with no new flow expected
❑ Other (Explain):
FORM: FTA 10-23 Page 2 of 5

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
8 8219 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 (Puma Stations/Force Mains):
PROVIDE A SEPARATE COPY OF THIS PAGE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name:
2. Approximate Coordinates (Decimal Degrees): Latitude: 0Longitude: - °
3. Total number of pumps at the pump station:
3. Design flow of the pump station: millions gallons per day (firm capacity)
➢ This should reflect the total GPM for the pump station with the largest pump out of service.
4. Operational point(s) per pump(s): gallons per minute (GPM) at feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches) Length (feet) Material
If any portion of the force main is less than 4-inches in diameter, please identify the method of solids reduction per
MDCPSFM Section 2.01 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 10-23 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(fl & (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
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)
36 inches
➢ If noncompliance with 02T.0305( or (g), see Section X.1 of this application
*15A NCAC 02T.0305(g) contains alternatives where separations in 02T.0305(f) cannot be achieved. Please check "yes"
above if these alternatives are used and provide narrative information to explain.
**Stream classifications can be identified using the Division's NC Surface Water Classifications webpage
2. Does this project comply with the minimum separation requirements for water mains? ® Yes ❑ No ❑ N/A
➢ If no, please refer to 15A NCAC 18C.0906(f) for documentation requirements and submit a separate document,
signed/sealed by an NC licensed PE, verifying the criteria outlined in that Rule.
3. Does the project comply with separation requirements for wetlands? ® Yes ❑ No ❑ N/A
➢ Please provide supplementary information identifying the areas of non-conformance.
➢ See the Division's draft separation requirements for situations where separation cannot be met.
➢ No variance is required if the alternative design criteria specified is utilized in design and construction.
4. Is the project located in a river basin subject to any State buffer rules? ® Yes Basin name: Neuse ❑ No
If yes, does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .0200? ®Yes ❑ No
➢ This includes Trout Buffered Streams per 15A NCAC 2B.0202
5. Does the project require coverage/authorization under a 404 Nationwide/individual permits ® Yes ❑ No
or 401 Water Quality Certifications?
➢ Please provide the permit number/permitting status in the cover letter if coverage/authorization is required.
6. Does project comply with 15A NCAC 02T.0105(c)(6) (additional permits/certifications)? ® Yes ❑ No
Per 15A NCAC 02T.0I05(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 10-23 Page 4 of 5

X. CERTIFICATIONS:
1. Does the submitted system comply with 15A NCAC 02T, the Minimum Design Criteria fur the Pennirting 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. Agyroval of the re uest will be issued
concurrently with the approval of the vermit, and ro'ects requiring a variance approval may be sub'ect to Ian er
review times. For projects reguiringttwo_ or more variances or where the variance is determined by the Division to be a
significant portion of the aroiect, the full technical review is required.
2. Professional Ens=incer's Certification: �%
1, L,�,5attest that this application for ���/fau Slit/:s;o 7k4 r v
I f'ru#i s;limal rn!inrrr . n: ae from Application Item 111.1-) (Project Name From Application Item 11.1)
has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans,
specifications, engineering calculations, and all other supporting documentation to the best of my knowledge. I further
attest that to the best of my knowledge the proposed design has been prepared in accordance with the applicable regulations,
Minimum Design Criteria tar Gravity Sewers (latest version), and the Minimum Design Criteria for the Fast -Track Pennitting
of Pump Stations and. Force Mains f 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)
North Carolina Professional Engineer's seal, signature, and date; ti��v►►�tt" a�I(i►�rf�iF f
i Q r-
3. Applicant's Certification per 15A NCAC 02T .0106(b):
attest that this application for __5A:hV 1 i'1)
(Signature Authority Name from Application Item 1.3.) (Project Name from Application Item 11.1)
attest that this application has been reviewed by me and is accurate and complete to the best of my knowledge.
[ 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 wil I 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: /27
FORM: FTA 10-23 Page 5 of 5

SU HM
DESIGN AND ENGINEERING SERVICES
SANITARY SEWER
PUMP STATION AND
FORCEMAIN
CALCULATIONS
SATTERFIELD FARMS
SUBDIVISION
PROJECT#: 18-0091
MARCH 2O20
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ENGINEER/CONSULTANT:
Matt Hastings, PE
Summit Design and Engineering
504 Meadowlands Drive
Hillsborough, NC
P [phone] / F [phone]
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State of North Carolina
Department of Environmental Quality
Division of Water Resources
Division of Water Resources Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: Roxboro Partners, LLC
Project Name for which flow is being requested: Satterfield Farms
More than one FTSE may he required for a single project if the owner of the WWTP is not responsible for allpump
stations along the route of the proposed wastewater flow
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: City of Roxboro WWTP
b. WWTP Facility Permit #: NC0021024
All flows are in MGD
c. WWTP facility's permitted flow 5
d. Estimated obligated flow not yet tributary to the WWTP 0.033
e. WWTP facility's actual avg. flow 2.03
f. Total flow for this specific request 0.057
g. Total actual and obligated flows to the facility 2.12
h. Percent of permitted flow used 42.4
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,.
(A) (B) (C) (D)=(B+C) (E)=(A-D)
Design Obligated,
Pump Pump Average Approx. Not Yet Total Current
Station Station Firm Daily Flow** Current Tributary Flow Plus
(Name or Permit Capacity, * (Firm / pfl, Avg. Daily Daily Flow, Obligated Available
Number) No. MGD MGD Flow, MGD MGD Flow Capacity***
Satterfield 0.756 0.252 .01 0.13 0.14 0.112
Duncan 1.38 0.345 0.12 .03 0.15 0.195
* The Firm Capacity (design flow) of any pump station is defined as the maximum pumped flow
that can be achieved with the largest pump taken out of service.
* * Design Average Daily Flow is the firm capacity of the pump station divided by a peaking factor
(pf) not less than 2.5, per Section 2.02(A)(4)(c) of the Minimum Design Criteria.
* * * A Planning Assessment Addendum shall be attached for each pump station located
between the project connection point and the WWTP where the Available Capacity is < 0.
Downstream Facility Name (Sewer): City of Roxboro Collection Ssytem
Downstream Permit Number: WQCS00048
Page 1 of 6
FTSE 10-18

III. Certification Statement:
I Allen Brooks Lockhart 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 assessment where applicable. This analysis has been performed in accordance
with local established policies and procedures using the best available data. This certification applies to
those items listed above in Sections I and II plus all attached planning assessment addendums for which I
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
61
Title o;
al -
/o,
Page 2 of 6
FTSE 10-18

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
[7
The rate of activation of this obligated, not yet tributary capacity is currently approximately
MGD per year; and that
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:
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 Official Signature
Date
Page 3 of 6
FTSE 10-18

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 *: 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 obli&ated floy.- not yet tributary to the WVV7P. 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. WVVTP facility's actual ayg. 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
h. = 55.8 %
Each subsequent FTSE form will be updated in the same manner.
Page 4 of 6
FTSE 10-18

Section II
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 5 of 6
FTSE 10-18

Planning Assessment Addendum Instructions
Submit a planning assessment addendum for each pump station listed in Section Il 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 carefiilly 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 PuLnp Station upgrade with fimding 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 project as a condition
of this Flo►► TrackingAcce tance for Sewer Extension Permit Application elevates this roject's priority for
funding and construction to be im lemented ahead of the activation of obli ted. not vet tributary flows in amounts
that exceed the firm pump station capacities identified in Section II 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 6 of 6
FTSE 10-18

Note on Unnamed Streams (15A NCAC 0213.0301[i])
Any stream which is not named in the schedule of stream classifications carries the same classification
as that assigned to the stream segment to which it is tributary except:
unnamed streams specifically described in the schedule of classifications;
unnamed freshwaters tributary to tidal saltwaters will be classified "C"; or
after November 1, 1986, any newly created areas of tidal saltwater which are connected to Class
SA waters by approved dredging projects will be classified "SC" unless case -by -case
reclassification proceedings are conducted.
The following river basins have different policies for unnamed streams entering other states or for specific
areas of the basin:
HIWASSEE RIVER BASIN
Streams entering Georgia or Tennessee shall be classified
"C Tr."
LITTLE TENN RIVER BASIN AND SAVANNAH RIVER
Streams entering Georgia or Tennessee shall be classified
DRAINAGE AREA
"C Tr." Such streams in the Savannah River drainage area
entering South Carolina shall be classified "B Tr."
FRENCH BROAD RIVER BASIN
Streams entering Tennessee will be classified "B."
Streams entering the State of Tennessee are classified "C."
WATAUGA RIVER BASIN
BROAD RIVER BASIN
Streams entering South Carolina are classified "C."
NEW RIVER BASIN
Streams entering the State of Tennessee are classified "C."
CATAWBA RIVER BASIN
Streams entering South Carolina are classified "C."
YADKIN-PEE DEE RIVER BASIN
Streams entering Virginia are classified "C," and such
streams entering South Carolina are classified "C."
LUMBER RIVER BASIN
Streams entering South Carolina are classified "C Sw."
ROANOKE RIVER BASIN
Streams entering Virginia are classified "C." Except that all
backwaters of John H. Kerr Reservoir and the North
Carolina portion of streams tributary thereto not
otherwise named or described shall carry the classification
"B," and all backwaters of Lake Gaston and the North
Carolina portion of streams tributary thereto not
otherwise named or described shall carry the classification
"C and B."
CHOWAN RIVER BASIN
Streams entering Virginia are classified "C."
TAR-PAMLICO RIVER BASIN
All drainage canals not noted in the schedule are classified
"C Sw," except the main drainage canals to Pamlico Sound
and its bays which shall be classified "SC."
PASQUOTANK RIVER BASIN
All drainage canals not noted in the schedule are classified
11C 11
"Note that these instructions do not need to be submitted"

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Watershed Classification Attachment (WSCAS 01-15)
Along with this form, submit a color copy of a USGS Topographic Map to identifythe project area and waterbodies.
Each map or maps must show the location of the sewer system and include location identifiers where the system
traverses over or near waterbodies. The map should have location ID's for each different waterbody and
corresponding classifications should be recorded.
Include the completed form and map portions with the permit application for submittal to the appropriate review
agency. A list of the Division's regional offices, their county coverage, and contact information can be obtained from:
http://Portal.ncdenr.org/web/wo/home/ro
Location
ID
Name of Waterbodyl
River
Basin
Waterbody Stream
Index No.
Waterbody
Classification
1
North Flat River
Neuse
27-3-2
WS-III, NSW
If unnamed, indicate "unnamed tributary to X", where X is the named waterbody to which the unnamed tributary joins
I certify that as a Registered Professional Engineer in the State of
North Carolina that I have diligently followed the Division's instructions
for classifying waterbodies and that the above classifications are
inclusive of the stated project, complete and correct to the best of my
knowledge and belief.
PE Seal, Signature and Date

MISCELLANEOUS
SUPPORTING
DOCUMENTS

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December 12, 2023
Susan Wilson
NCDEQ
Water Quality Regional Operations
1634 Mail Service Center
Raleigh, NC 27699
Subject: Comment Response Letter
Project Name: Satterfield Farm Subdivision Phase II
Dear Mrs. Wilson,
The purpose of this letter is to provide written response and address the items listed in the email from you,
dated December 11, 2023. The list of comments from the letter referenced above have been attached with
responses in red under each comment.
Please feel free to call or email me with questions or clarifications that you may have using the following
contact information: [e-mail] and (434)-579-4604.
Sincerely,
SUMMIT DESIGN AND ENGINEERING SERVICES
Matt Hastings, PE
Project Manager/Engineer
Project Name: Satterfield Farm Subdivision Phase II

1. Reconfirm the flow allocation and correct VI.7. of the application to indicate 0 gpd (and under V1.8. — check
that flow has already been allocated under WQ0041941, issued 11/6/20).
Correct. We permitted all 600 homes in phase 1 because the PS was collecting everything.
2. Also just reconfirm that with Phase II, Satterfield Subdivision will need an additional 8219 LF of 8 inch gravity
sewer (from what was permitted with Phase 1).
Correct. The 8219 is in phase 11.
The sewer flow diagram is still unclear to me. I see a green line and I can't determine much else. Show
basically where Phase I GS, PS, and FM will go and how this GS length ties in (and how it ties into the Roxboro
(Duncan) pump station.
See the revised map.
4. 1 may have a follow up question on the 401. 1 need to check with our folks a little more on that.
Understood.
5. Before any sewerage flow from any homes can be tied in and put in operation, DWR will need PE
Certification/checklist (and a partial certification may be submitted). See Part 11. 7. Of the permit (just FYI).
We have not received any certification for Phase I, as I mentioned.
Understood.

u ra nte
Yates Homes
Homes
Station
J9
ping Ai Unusual
rs()fft(IL Person
,(Vision Financial Fcu
MW-SYSTEM
ity,',.Nurch
satterfi elff
- Satterfield' Farm
AI
REGIL
E�- GIF-�S-1;4,NPY SERVICES
NS&

ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
S. DANIEL SMITH
Dfrcclor
May 6, 2020
Roxboro Partners, LLC
Attn: James Parker
504 Meadowland Drive
Hillsborough, NC 27278
NORTH CAROLINA
Environmental Quallty
DWR #20-0269
Person County
Subject: APPROVAL OF 401 WATER QUALITY CERTIFICATION WITH ADDITIONAL CONDITIONS
AUTHORIZATION CERTIFICATE PER THE NEUSE RIVER BASIN RIPARIAN BUFFER
PROTECTION RULES (15A NCAC 02B .0233) WITH ADDITIONAL CONDITIONS
Satterfield Farm
Dear Mr. Parker:
You have our approval for the impacts listed below for the purpose described in your
application received by the Division of Water Resources (Division) on February 17, 2020 with
payment received on February 20, 2020 and additional information received on May 1, 2020.
These impacts are covered by the attached Water Quality General Certification Number 4139
and the conditions listed below. This certification is associated with the use of Nationwide
Permit Number 29 once it is issued to you by the U.S. Army Corps of Engineers. Please note
that you should get any other federal, state or local permits before proceeding with your
project, including those required by (but not limited to) Sediment and Erosion Control, Non -
Discharge, and Water Supply Watershed regulations.
This approval requires you to follow the conditions listed in the enclosed certification and the
following additional conditions:
1. The following impacts are hereby approved provided that all of the other specific and
general conditions of the Certification and Buffer Rules are met. No other impacts are
approved, including incidental impacts. [15A NCAC 02B .0506(b)(c) and 15A NCAC 02B
.0233(8))
QNaiy-d, Cir'olina pcp�rtmu,t of �n4irur�mcnta[ Quality D,cisim, of Watcr�csourtts
e:!54D—E�O>1 Paleigh ftcgiun l Office 3500I3,irrettDi itc Raleigh, NorIh Carolina 21o0ll•

Satterfield Farm
DWR #20-0269
401 AND BUFFER APPROVAL
Page 2 of 5
Type of Impact
Amount Approved
(units)
Permanent
Amount Approved
(units)
Temporary
Wetland
W1-Lot Fill
0.030 (acres)
0 (acres)
W2-Lot Fill
0.060 (acres)
0 (acres)
W3-Road Grading & Lot Fill
0.030 (acres)
0 (acres)
W4-Road Grading & Lot Fill
0.050 (acres)
0 (acres)
Stream
S1-Road Crossing: Culvert
104 (linear feet)
0 (linear feet)
53-Road Crossing: Culvert
0 (linear feet)
56 (linear feet)
53-Road Crossing: Culvert
95 (linear feet)
0 (linear feet)
S4-Road Crossing: Culvert
0 (linear feet)
42 (linear feet)
S5-Road Crossing: Culvert
86 (linear feet)
i 0 (linear feet)
S6-Road Crossing: Culvert
0 (linear feet)
45 (linear feet)
Buffers — Zone 1
131-Road Crossing
9,135 (square feet)
0 (square feet)
62-Road Crossing
7,024 (square feet)
0 (square feet)
133-Road Crossing
7,656 (square feet)
0 (square feet)
Buffers — Zone 2
131-Road Crossing
6,510 (square feet)
0 (square feet)
132-Road Crossing
5,396 (square feet)
0 (square feet)
B3-Road Crossing
4,301(square feet)
0 (square feet)
2. Stormwater Management Plan (SMP) Approval from Local Community Reciuired
The stormwater management plan (SMP) must be approved by the City of Roxboro and
meet the requirements of this Certification. The SMP may not be modified without prior
written authorization from the City of Roxboro. [15A NCAC 02H .0506(b)(3)]
3. Compensatory Mitigation Using a Private Mitigation Bank
Mitigation must be provided for the proposed impacts as specified in the table below. The
Division has received an acceptance letter from Wildlands Engineering, Inc. or more
specifically Wildlands Holdings V, LLC to meet this mitigation requirement. Until Wildlands
Engineering, Inc. receives and clears your payment, and proof of payment has been
provided to this Office, no impacts specified in this Authorization Certificate shall occur. For
accounting purposes, this Authorization Certificate authorizes payment to Wildlands
Engineering, Inc. to meet the following compensatory mitigation requirement [15A NCAC
02H .0506 (b)(6)]:

Satterfield Farm
DWR #20-0269
401 AND BUFFER APPROVAL
Page 3 of 5
Compensatory Bank Sponsor River & Sub -basin Number
Mitigation Required
Buffer -Zone 1 27,405 (square feet) Wildlands Holdings V, LLC 03020201-1n Falls Lake
Watershed
4. The permittee shall report to the Raleigh Regional Office any noncompliance with this
certification, any violation of stream or wetland standards [15A NCAC 02B .0200] including
but not limited to sediment impacts, and any violation of state regulated riparian buffer
rules [15A NCAC 02B .0200]. Information shall be provided orally within 24 hours (or the
next business day if a weekend or holiday) from the time the applicant became aware of the
circumstances. A written submission shall also be provided within 5 business days of the
time the applicant becomes aware of the circumstances. The written submission shall
contain a description of the noncompliance, and its causes; the period of noncompliance,
including exact dates and times, if the noncompliance has not been corrected, the
anticipated time compliance is expected to continue; and steps taken or planned to reduce,
eliminate, and prevent reoccurrence of the noncompliance. The Division may waive the
written submission requirement on a case -by -case basis.
5. Protective Fencing
The outside buffer, wetland or water boundary and along the construction corridor within
these boundaries approved under this authorization shall be clearly marked with orange
warning fencing (or similar high visibility material) for the areas that have been approved to
infringe within the buffer, wetland or water prior to any land disturbing activities to ensure
compliance with 15 NCAC 02H .0500. [15A NCAC 02H .0506 (b)(2) and (c)(2) and 15A NCAC
02H .0507 (c)]
6. This approval is for the purpose and, design described in your application. The plans and
specifications for this project are incorporated by reference as part of the Certification and
Buffer Authorization. If you change your project, you must notify the Division and you may
be required to submit a new application package with the appropriate fee. If the property is
sold, the new owner must be given a copy of this approval letter and General Certification
and is responsible for complying with all conditions. [15A NCAC 02B .0507(d)(2)]
7. This approval and its conditions are final and binding unless contested. [G.S. 143-215.5]
This Certification and Buffer Authorization can be contested as provided in General Statute
150E by filing a written petition for an administrative hearing to the Office of Administrative
Hearings (hereby known as OAH) within sixty (60) calendar days.

Satterfield Farm
DWR #20-0269
401 AND BUFFER APPROVAL
Page 4 of 5
A petition form may be obtained from the OAH at htto://www.ncoah.com or by calling the OAH
Clerk's Office at [phone] for information. A petition is considered fled when the original
and one (1) copy along with any applicable OAH filing fee is received in the OAH during normal
office hours (Monday through Friday between 8:00am and 5:00pm, excluding official state
holidays).
The petition may be faxed to the OAH at [phone], provided the original and one copy of
the petition along with any applicable OAH filing fee is received by the OAH within five (5)
business days following the faxed transmission.
Mailing address for the OAH:
if sending by First Class Mail
via the US Postal Service:
Office of Administrative Hearings
6714 Mail Service Center
Raleigh, NC 27699-6714
if sending via delivery service
(e.g. UPS, FedEx):
Office of Administrative Hearings
1711 New Hope Church Road
Raleigh, NC 27609-6285
One (1) copy of the petition must also be served to Department of Environmental Quality:
William F. Lane, General Counsel
Department of Environmental Quality
1601 Mail Service Center
Raleigh, NC 27699-1601
Please send one (1) copy of the petition to DWR:
if sending by First Class Mail
via the US Postal Service:
Paul Wojoski
NC DWR — 401 & Buffer Permitting
Branch
1617 Mail Service Center
Raleigh, NC 27699-1617
If sending via delivery service
(e.g. UPS, FedEx):
Paul Wojoski
NC DWR — 401 & Buffer Permitting
Branch
512 N. Salisbury Street
Raleigh, NC 27604

Satterfield Farm
DWR 920-0269
401 AND BUFFER APPROVAL
Page 5 of 5
This letter completes the review of the Division under section 401 of the Clean Water Act and
the Neuse Riparian Buffer Rules as described in 15A NCAC 02B .0233. Please contact Stephanie
Goss at 919-791-4256 or step hanie.eoss0ncdenr.yov if you have any questions or concerns.
Sincerely,'
rJ Scott Vinson, Regional Supervisor
f Water Quality Regional Operations Section
Raleigh Regional Office
Division of Water Resources, NCDEQ
Enclosure: GC 4139
cc: U.S. Army Corps of Engineers; Raleigh Regulatory Field Office; 3331 Heritage Trade Dr.,
Ste. 105; Wake Forest, NC 27597
DWR RRO 401/Riparian Buffer file
DWR 401 & Buffer Permitting Unit via Laserfiche
Scott Mitchell via e-mail at scoff(@mitchellenvironmental.com

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AM DISTURBANCE 104 •11 / I �w.. �\,1 I � 1 13 / c �� _ . II \ \ f �\ � C -^-•
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DISTURBANCE \ i \ w
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\ � ,� I � � �. 0.03 AC - �'f�'
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PROJECT NO.
18-0091
DRAWING NAME:
18-0091-XC.dwg
SHEET NO.
C-3A

LIMITS OF
-- DISTURBANCE
(TYP. )
W
�
� \ � -
OF BANK ---L
:
I
LEGEND
.
- �►ZONE
1 PERMANENT BUFFER IMPACT:
ZONE 2 PERMANENT BUFFER IMPACT: 6,510 SF
_- �-
gill
•��.�-.-
i� �����e� arm.,/,�
�.
r
C1ZONE1
BUFFER
r ZONE2
BUFFER
BRIARFIELD STREET
1
mg,
5-2-Am 129ARI
a / a
a n
a /
a
- 100' PERENNIAL
STREAM BUFFER _
BOUNDARY \
�� LD
I �o
SCALE
1"=20'
FIRST ISSUE DATE
XX/XX/2019
PROJECT NO.
18-0091
SHEET NO.
1
COPYRIGHT (Z) 2019
SUMMIT DESIGN AND
ENGINEERING SERVICES
DRAWING ALTERATION
IT IS A VIOLATION OF LAW FOR ANY PERSON,
UNLESS ACTING UNDER THE DIRECTION OF
LICENSED ARCHITECT, PROFESSIONAL
ENGINEER, LANDSCAPE ARCHITECT, OR
LAND SURVEYOR TO ALTER ANY ITEM ON
THIS DOCUMENT IN ANY WAY. ANY LICENSEE
WHO ALTERS THIS DOCUMENT IS REQUIRED
BY LAW TO AFFIX HIS OR HER SEAL AND THE
NOTATION "ALTERED BY" FOLLOWED BY HIS
OR HER SIGNATURE AND SPECIFIC
DESCRIPTION OF THE ALTERATIONS.
01 SATTERFIELD FARMS
STREAM CROSSINGS
4235 DURHAM ROAD & LUCY GARRET ROAD
ROXBORO, NC 27574
8-0091 BC-11 x17
3RIAR FIELD STREET - CULVERT #1
SUM IT
DESIGN AND ENGINEERING SERVICES
Creatively Inspired - Technically Executed
License #: P-0339
504 Meadowland Drive
Hillsborough, NC 27278-8551
Voice: [phone] Fax: [phone]
www.summit-engineer.com

45-Y
602
60�
60�
606
607
60b
610
h11 0 �9 608 b07 606 g05 y04 �603 b02
ALUMINUM
HEADWALL (TYP.)
BRIAR FIELD STREET CULVERT #1
54.0'
TOP OF STREAM y
BANK
BOTTOM OF
STREAM BANK
GRAPHIC SCALE
20 0 10 20 40 80
( IN FEET)
I inch = 40 ft.
STA:0+10.62
W ELEV:604.46
STA:0+10.62
ELEV:595.46
STA:1 +06.11
ELEV:603.43
MINUM
,DWALL (TYP.)
FA:1 +06.11
_EV:594.43
0+00 0+50 1 +M09.41

�
a
100' PERENNIAL
STREAM BUFFER
BOUNDARY
LIMITS OF
DISTURBANCE
(TYP.)
SCALE
ill =20'
FIRST ISSUE DATE
xx/xw2019
PROJECT NO.
18-0091
SHEET NO.
2
�/ n Y n a
1TOE OF BANK' LEGEND
TOP OF BANK ZONE 1 PERMANENT BUFFER IMPACT: 7024 SF
�/J
TEMPORARY:ZONE 2 PERMANENT BUFFER IMPACT: 5396 SF
STREAM IMPACT -
OWN1
- ANS
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-loom 005RA
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000
HEADWALL (TYP.)
WELDED ALUMINUM
�� \I
Q
( \ I 32'L X 12'W X 24" D CLASS
I _ 1 MED. RIP RAP APRON TO
Lu LD BE BURIED (LENGTH
I I \ I I MEASURED ALONG THE
a co CENTERLINE)
SUMMIT ©AI9 / SATTERFIELD FARMS
SUMMIT DESIGN AND
ENGINEERING SERVICES STREAM CROSSINGS
DRAWING ALTERATION
IT IS A VIOLATION OF LAW FOR ANY PERSON,
UNLESS ACTING UNDER THE DIRECTION OF 4235 DURHAM ROAD & LUCY GARRET ROAD
LICENSED ARCHITECT, PROFESSIONAL ROXBORO, NC 27574
ENGINEER, LANDSCAPE ARCHITECT, OR
LAND SURVEYOR TO ALTER ANY ITEM ON
THIS DOCUMENT IN ANY WAY. ANY LICENSEE
WHO ALTERS THIS DOCUMENT IS REQUIRED 18 0 0 91 BC-1 1 x 17
BY LAW TO AFFIX HIS OR HER SEAL AND THE
NOTATION "ALTERED BY" FOLLOWED BY HIS _
OR HERRIPTIONOFTEANTERATIFIC BRIAR FIELD STREET — CULVERT #2
DESCRIPTION OF THE ALTERATIONS.
I
I
I
I
SUM IT
DESIGN AND ENGINEERING SERVICES
Creatively Inspired - Technically Executed
License #: P-0339
504 Meadowland Drive
Hillsborough, NC 27278-8551
Voice: [phone] Fax: [phone]
www.summit-engineer.com

BRIAR FIELD STREET CULVERT #2
605
STA:0+18.9
ALUMINUM ELEV:601.3
HEADWALL (TYP.)
I
600
45.0' J��/
597 598 599 600 �
_ E'n.. 602 603 604
STA:0+18.96
ELEV:594.36
595
0 69P 693
595 596 597 59a 599 ��
36.0'
590
OF STREAM
BANK I
BOTTOM OF I
STREAM BANK 585
GRAPHIC SCALE
20 0 10 20 40 80
( IN FEET)
I inch = 40 ft.
0+00 0+50 1+00+10.65
TA:0+93.76
_EV:599.72
JMINUM
%DWALL (TYP.)
STA:0+93.76
ELEV:592.72

\ \ ) TOP OF BANK
\ �\
\� TOE OF BANK
SCALE
1"=20'
FIRST ISSUE DATE
XX/XX/2019
PROJECT NO.
18-0091
SHEET NO.
5
COPYRIGHT Q 2019
SUMMIT DESIGN AND
ENGINEERING SERVICES
DRAWING ALTERATION
IT IS A VIOLATION OF LAW FOR ANY PERSON,
UNLESS ACTING UNDER THE DIRECTION OF
LICENSED ARCHITECT, PROFESSIONAL
ENGINEER, LANDSCAPE ARCHITECT, OR
LAND SURVEYOR TO ALTER ANY ITEM ON
THIS DOCUMENT IN ANY WAY. ANY LICENSEE
WHO ALTERS THIS DOCUMENT IS REQUIRED
BY LAW TO AFFIX HIS OR HER SEAL AND THE
NOTATION "ALTERED BY" FOLLOWED BY HIS
OR HER SIGNATURE AND SPECIFIC
DESCRIPTION OF THE ALTERATIONS.
LEGEND
\ \ ° ZONE 1 PERMANENT BUFFER IMPACT: 7,655.76 SF
\ / G J \ ® ZONE 2 PERMANENT BUFFER IMPACT: 4,301.36 SF
STREAM IMPACT - PERMANENT: 86 LF
da
/ STREAM IMPACT - TEMPORARY: 45 LF
LN
WELDED ALUMINUM /`L$xOo \ / �'
HEADWALL (TYP.)
i V V /✓ /, -
28 LF OF EX. 24"
RCP @ 0.37% \
TO BE
REMOVED AND
DISPOSED OF
R �I
,�/
i
1 �,
20' `LJ
ZONE 2
BUFFER'
\ \
r
SATTERFIELD FARMS
STREAM CROSSINGS
4235 DURHAM ROAD & LUCY GARRET ROAD
,,ROXBORO, NC 27574
18-0091 -BC- 11 x17
CROW FIELD ST.
��X,
1000, 1-1�
TEMPORARY PUMP
STATION ACCESS ROAD
/ p
/p�pV
ppp \ p
\ ppp\pp0�p
/ 83 LF OF 48"
CMP @ 2.16% 9
/ I
\ \ LIMITS OF
' DISTURBANCE
(TYP.)
\ 32L X 12' W X 24" D CLASS \
1 MED. RIP RAP APRON TO
BE BURIED (LENGTH
' I MEASURED ALONG THE
CENTERLINE)
A X
I 100' PERENNIAL \
/ STREAM BUFFER
BOUNDARY
Su iml
DESIGN AND ENGINEERING SERVICES
Creatively Inspired - Technically Executed
License #: P-0339
504 Meadowland Drive
Hillsborough, NC 27278-8551
Voice: [phone] Fax: [phone]
www.summit-engineer.com

State of North Carolina
Department of Environmental Quality
DWR Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources INSTRUCTIONS FOR FORM: FTA 10-23 & SUPPORTING DOCUMENTATION
This application is for sewer extensions involving gravity sewers. pump stations and force mains. or any combination that has been
certified by a professional engineer and the applicant that the project meets the requirements of 15A NCAC 02T and the Divisions
Minimum Design Criteria (Gravity Sewer & Pump Stations. Force yNlains) and that plans, specifications and supporting documents
have been prepared in accordance with 15A NCAC 02T. 15A NCAC 02T.0300, Division policies, and food engineering practices.
While no upfront engineering design documents are required for submittal, in accordance with 15A NCAC 02T .0305(b). design
documents must be prepared prior to submittal of a fast track permit application to the Division. This would include plans. design
calculations. and project specifications referenced in 15A NCAC 02T _0335 and the applicable minimum design criteria. These
documents shall be immediately available upon request by the Division.
Projects that are deemed permitted (do not require a permit from the Division) are explained in 15A NCAC 02T.0303
Projects not eligible for review via the fast track process (must be submitted for full technical review);
Projects that do not meet any part of the minimum design criteria (MDC) documents:
Projects that involve more than one variance from the requirements of 15A NCAC 02T.
r Pressure sewer systems utilizing simplex septic tank -effluent pumps (STEPS) or simplex grinder pumps,
ow Simplex STEP or simplex grinder pumps connecting to pressurized systems (e.g. force mains):
i Vacuum sewer systems.
General When submitting an application, please use the following instructions as a checklist in order to ensure all required items are
submitted. Adherence to these instructions and checking the provided boxes will help produce a quicker review time and reduce the
amount of requested additional information. Failure to submit all required items will necessitate additional processing and review
time, and may result in return of the application. Unless otherwise noted, the Applicant shall submit one original and one copy of
the application and supporting documentation.
A. One Original and One Copy (second copy maybe digital) of Application and Supporting Documents
® Required unless otherwise noted. Signatures on original must be "wet ink" or secure digital signatures.
Please do not submit engineering design plans with the application unless specifically requested.
B. Cover Letter/Narrative Description (Required for All Application Packages):
® List all items included in the application package, as well as a brief description of the requested permitting action.
Be specific as to the system type, number of homes served, flow allocation required, etc.
Include the permit number. status of any other required sewer permits (down stream upstream)
i If necessary for clarity, include attachments to the application form.
C. Application Fee (All New and Modification Application Packages):
® Submit a check or money order in the amount of S600.00, dated no more than 40 days prior to application submittal.
> Payable to North Carolina Department of Environmental Quality (NCDEQ)
D. Fast Track Application (Required for All Application Packages, Form FTA 10-23):
® Submit the completed and appropriately executed application.
f necessary for clarity or due to space restrictions, attachments to the application may be made.
❑ If the Applicant Type in Item 1.2 is a corporation or company, provide documentation it is registered for business with the
North Carolina Secrem of Slate.
❑ I f the Applicant Type in Item 1.2 is a partnership or d/b/a, enclose a copy of the certificate filed with the Register of Deeds in
the county of business.
® The Project Name in Item 11.1 shall be consistent with the project name on the flow acceptance letters, agreements, etc.
® The Professional Engineer's Certification on Page 5 of the application shall be signed, sealed and dated by a North Carolina
licensed Professional En itr neer.
® The Applicant's Certification on Page 5 of the application shall be signed in accordance with 15A NCAC 02T .0106(b). Per
15A NCAC 02T .0106(c), an alternate person may be designated as the signing official if a delegation letter is provided from
a person who meets the criteria in 15A NCAC 02T .0106(b).
INSTRUCTIONS FOR FORM: FTA 10-23 & SUPPORTING DOCUMENTATION Page I of

E. Flow Tracking/Acceptance Form (Form: FTSE 10-23) (If Applicable):
® Submit the completed and executed FTSE form from the owners of the downstream sewers and treatment facility_
r Ivtultipie forms maybe required where the downstream sewer owner and wastewater treatment facility are different.
The flow acceptance indicated in form FTSE must not expire prior to permit issuance and must be dated less than one year
prior to the application date.
Submittal of this application and form FTSE indicates that owner has adequate capacity and will not violate G.S_ 14 -2I . 7 a _
Intergovernmental agreements or other contracts will not be accepted in lieu of a project -specific FTSE.
F. Site Maps (All Application Packages):
El Submit an 8.5-inch x t 1-inch color copy of a ( S(i STopographic flap of sufficient scale to identify the entire project area.
including the closest surface waters.
P" General location of the project components (gravity sewer. pump stations. & force main)
Downstream connection points and permit number (if known) for the receiving sewer
® Include an aerial location map showing general project area (such as street names or latitude. longitude) so that Division staff
can easily locate it in the field.
G. Existing Permit (Application Packages for Modifications to an Existing Permit):
❑ Submit a copy of the most recently issued existing permit.
❑ Include a descriptive and clear narrative identifying the previously permitted items to remain in the permit, items to be
added, and/or items to be modified (the application form itself should include only include items to be addedimodifiedl. The
narrative should also include whether any previously permitted items have been certified.
❑ The narrative should clearly identify the requested permitting action and accurately describe the sewers to be listed in
the final permit.
H. Power Reliability Plan (Required if portable reliability option utilized for Pump Station):
❑ Per 15A NCAC 02T .0,305ihit I ), submit documentation of power reliability for pumping stations.
This alternative is only available for average daily Flows less than 15,000 gallons per day
It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant and is compatible with
the station. The Division will accept a letter signed by the applicant (see 15A NCAC 02T .0106(b)) or proposed contractor,
stating that "the portable power generation unit or portable, independently -powered pumping units, associated appurtenances
and personnel are available for distribution and operation of this pump 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 in the case of a multiple station power outage. (Required at time of certification)
I. Certificate of Public Convenience and Necessity (All Application Packages for Privately -Owned Public Utilities):
❑ Per l5.A NCAC 02T .O 1 15(a)(1) provide the Certificate of Public Convenience and Necessity from the North Carolina Etilities
Commission demonstrating the Applicant is authorized to hold the utility franchise for the area to be served by the sewer
extension, or
❑ Provide a letter from the North Carolina Utilities Commission's Water and Sewer Divisign Public S14 stating an application
for a franchise has been received and that the service area is contiguous to an existing franchised area or that franchise approval
is expected.
J. Operational Agreements (Applications from HOA/POA and Developers for lots to be sold):
❑ HomerProperty Owners' Associations
❑ Per 13$A.N!�"A(_02T ,Q l I , submit the properly executed Operational Agreement (FORM: HOA}.
❑ Per 15A NCAC 02T .0l 15(c), submit a copy of the Articles of Incorporation, Declarations and By-laws.
❑ Developers of lots to be sold
❑ Per 15A NCAC 02T .0I 15(b), submit the properly executed Operational Agreement ( FORM: DEVt.
For more information, visit the Division's collection systems websire
INSTRUCTIONS FOR FORM: FTA 10-23 & SUPPORTING/DOCUMENTATION
Page 2 of 3

State of North Carolina
Department of Environmental Quality
DWR Division of Water Resources
NOV 2 ZUB FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 10-23 & SUPPORTING DOCUMENTATION
Application Number: "_0D4(Fq6 Ito-lxcampletcdbvDWR�
All items must be completed or the application will be returned
I. APPLICANT INFORMATION-
1. Applicant's name: City of Roxboro (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership
❑ Federal ❑ State;'County ®Municipal
3. Signature authority's name: Brooks Lockhart per 15A NCAC 02T 01 b
Title: City Manager
4. Applicant's mailing address: 779 Mountain Rd
City: Roxboror State: NC Zip: 27573-
5. Applicant's contact information:
Phone number: [phone] Email Address: blockhartt<citvofroxboro.com
IL PROJECT INFORMATION:
❑ Privately -Owned Public Utility
❑ Other
1. Project name: Satterfield Subdivision Phase 11
2. Application. -Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
If 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: Person
4. Approximate Coordinates ( Decimal Degrees): Latitude: 36.335972 Longitude:-78.967716
5. Parcel ID (if applicable): 0904-00-80-7687 (or Parcel I to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Matt Hastings License Number: 38098
Firm: Summit Design and Engineerina Services
Mailing address: 606 Broad Street, Suite C
City: South Boston State: VA Zip: 24592-
Phone number: [phone] Email Address: man.hastints cr,summitde.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
I. Facility Name: City of Roxboro WWTP Permit Number: NCO021024
Owner Name: City of Roxboro
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
I. Permit Numbcr(s): WQCS00048
2. Downstream (Receiving) Sewer Information: 8 inch 5Z Gravity Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS00048
Owner Name(s): City of Roxboro
FORM: FTA 10-23 Page 1 of 5

SUMMIT
DESIGN AND ENGINEERING SERVICES
606 Broad Street, Suite C. South Boston, VA 24592
Phone .! 434.575.0617 Web www.summitde.net
NOV 2 2923
RilttrighIke ion?1Off"
TO NC Dept of Environmental Quality
Division of Water Resources
3800 Barrett Drive
Raleigh, NC 27609
ATTN Jason Robinson
WE ARE SENDING YOU:
Letter of Transmittal
DATE 10/30/23 1 PRO.I. NO. 18-0091
RE: Saftertield Farms Subdivision Phase II
■ Attached ❑ Under Separate Cover ■ Transmitted Via USPS
❑ Prints ❑ Reproducible ■ Specifications ❑ Shop Drawings
■ Application for Permit ❑ Change Order
COPIES
DRAWING
DATE
DESCRIPTION
1
Satterfield Farms Subdivision Phase II Application
1
Check $600
TRANSMITTED:
■ For Approval n As Requested ❑ For Your Use ❑ For Review and Comment
COMMENTS
COPY TO
SIGNATURE:— _
Matt Hastings