WQ0044852_Return Application_20240122

INCOMPLETE APPLICATION State of North Carolina
RETURN Department of Environmental Quality
DWR Jan 22 2024 Division of Water Resources
F ST 'RACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources NOV 2 �2 FTA 06-21 &SUPPORTING DOCUMENTATION
Application Number:v vQ ( �S to be completed by DWR)
All Items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: Town of Louisburg(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:Keith Callahan per 15A NCAC 02T .010-6(h)
Title:Planning Administrator
4. Applicant's mailing address: 110 W.Nash Sreet
City: Louisburg State:NC Zip:27549-
5. Applicant's contact information:
Phone number:[phone] Email A dress:KC'alWian'a towno uisbarY.u�
II. PROJECT INFORMATION:
1. Project name:Forest Hills
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 det sled narrative description as described in Item G of the checklist.
If new construction,but part of a master plan,provide the existir g permit number:W( 00
3. County where project is located: Franklin 71X-;?/-'qO0
4. Approximate Coordinates(Decimal Degrees):Latitude: 36.114 62' Longil 1SQ0_
5. Parcel ID(if applicable): 2816-21-0562(or Parcel ID to closest ownstream sewer)
III. CONSULTANT INFORMATION: 1
1. Professional Engineer:Timothy P.Na u License Number:3033
Firm:The Nau Company,PLLC
Mailing address:PO Box$10
City:Rolesville State:NC Zip: 7571-�
Phone number: 9( 19)62 -303 Gmai Address:tnau the co c
IV. WASTEWATER TREATMENT FACILIT (WWTF)INFORM TION:
1. Facility Name:Louisburg Tar River Water Reclumation Fachity Permit Number: N0002QZ31
Owner Name:Town of Louisbure
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. Permit Number(s):WQ0042335
2. Downstream(Receiving)Sewer Information: 8 inch ®Gravity L'. Force Main
3. System Wide Collection System Permit Number(s)(if applicable):WQCS00113
Owner Name(s):Town Of Louisburg
FORM:FTA 06-21 Page I of 5

VI. GENERAL REQUIREMENTS
I. If the Applicant is a Pnvately-Owned Public Utility,has a Certificate of Public Convenience and Necessity been attached?
f ❑Yes ❑No ®N/A
2. If the Applicant is a Developer of lots to be sold,has a Develpp r';-camrational AZr0.rT=-CF0Ittii:DEV)been attached?
❑Yes ❑do ®N/A
3. If the Applicant is a Home'Property Owners'Association,has an IIUA,PUA Operajigrkal ALrecment iFU1tM:I40A1 and
supplementary documentation as required by 15A NCAC 02T.0 15(c)been attached
❑Yes ❑ o ®N/A
4. Origin of wastewater.(check all that apply):
®Residential(Individually Owned) ❑,Retail(stores,centers,malls) ❑Car Wash
❑Residential(Leased) ❑Retail with food prep ration/service ❑Hotel and/or Motels
❑School/preschool/day care ❑Medical/dental vet rinary facilities ❑Swimming Pool/Clubhouse
❑Food and drink facilities ❑Church ❑Swimming Pool/Filter Backwash
❑Businesses/offices;factories ❑,'cursing Horne ❑Other(Explain in Attachment)
5. Nature of wastewater: 100%Domestic 0%Commercial 0% ndustrial(See 15A NCAC 02T.0103(20))
If Industrial,is there a Pretreatment Program i effect?❑Yes ❑No
6. Has a flow reduction been approved under I NCAC 0 J.-.011I-M? ❑Yes ® o
➢ If a rov a co of ow r u " ""i"16".1011111CRUM
7. Summarize wastewater generated by project:
Establishment Type(see 02T.0114(f)) Daily De4ign Flow No.of Units Flow
Single family residential ttltd7 , .64 —4,b.©gg gyp$
-- /A a1r becpr /� F g� �23 oy()GPD
aU GPD
al/ GPD
al/ GPD
jai/ GPD
Total -4fr,99�GPD
a See 15A NCAf 02Ti0 14 b L j411 e 2 for cavfats to wastewater design flow rates(i.e.,minimum flow per
dwelling;proposed unknown non-residential development uses;public access facilities located near high public use areas;
and residential property located south or east of the Atlantic Intracoastal Waterway4o be used as vacation rentals as defined
b Per 15A NCAC 02T.0114(c),design flow rates for establisH rents not identified tin table 1 iN N C 2T911aa shall be
determined using available flow data,�IIvater using fixtures,occupancy or operatiop'patterns,and other measured data.
G
8. Wastewater generated by project: 16000 D(per 5] A NCA _4ll4)
➢ Do not include future flows or previou ly permitted allocati ns
If permitted flow is zero,please indicate Ilwhy:
❑Pump Station/Force Main or Gravity Selver where flow will t a 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 Pe it Number: Ir uance Date:
❑Rehabilitation or replacement of existing sewers with no new I Iflow expected
❑Other(Explain):
FORM:FTA 06-21 Page 2 of 5

VII. GRAN'TTY SEWER DESIGN CRITERIA(If Applicable)-q2T,0305&MDC(!Urpvity Sewers):
1. Summarize gravity sewer to be permitted:
Size(inches) Length(feet) Material.
8 3,600 PVC
8 300 DIP
➢ 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
VIH- PUMP STATION DESIGN CRITERIA(If Applicable)—02 .0 &MDC-(Pump Stations/Forte Mains):
PROVIL)E A SEPARATE COPY OF LIXS PAGE FOR E.AWT MP STATION I1V�j,UDED 1N THIS PROJECT
1. Pump station number or name:
2. Approximate Coordinates(Decimal Degrees):Latitude: Longitude:-
3. Total number of pumps at the pump station:__.__.
3. Design flow of the pump station: millions gallons per day(firm capacity)
➢ This should reflect the total GPM for the pump station with a largest pump out of service.
4. Operational point(s)per pump(s): gallons per minute, M)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.Lb.❑Grinder Pump ❑ Mechanical Bar Screen ❑Other(please specify)
6. Power reliability in accordance with 15A kAC 02T.0-1050tX1):
❑ Standby power source or ❑ Standby pump
➢ Must have automatic activation and tell metry- 15A NCAC 02T.0305(h)(1)(13):
➢ Required for all pump stations with an average daily flow g-vater 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 rCACO2T.0305(h)(1)(C):
❑ Portable power source with manual activation,quick-connection receptacle and temetry or
❑ Portable pumping unit with plugged emergency pump tonne)lion 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 4edicated to multiple pump stations,an evaluation of all the pump stations'storage
capacitics and the rotation schedule of le portable power source or pump,including travel timeframes,shall be provided
as part of this permit application in the case of a multiple station power outage.
FORM:FTA 06-21 Page 3 of 5

IX.' SETBACKS&SEPARATIONS—(02B.0200& I5A NCAC 02T.0305 :
I, Does the project comply with all separations/aftematives found'in I SA CAC ? ®Yes ❑No
_ I5A NCAC_02T.0305 contains minimum separations that all be provided for sewers stems:
Setbac+c Parameter* _ Separation Required
Storm sewers and other utilities not listed below(vertical) 18 inches
ZWater mains(vertical-water over sewer preferred,including irj 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 well,WS-I waters of Class I or
Class 11 impounded reservoirs used as a source of drinking watetf,and associated wetlands. 100 feet
**Waters classified WS(except WS-1 or WS-V),B,SA,ORW,OQW,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 class fled as WL. 10 feet
Any building foundation(horizontal) I 5 feet
Any basement(horizontal) 10 feet
Top slope of embankment or cuts of 2 feet or more vertical heigt t _ 10 feet
Drainage systems and interceptor drains _ 5 feet
Any swimming pools -- ��— 10 feet
Final earth grade(vertical)
� d
� L 36 inches
➢ If noncompliance with i)2'1'.0305{,t}or,(�,see Section X.1 of this application
*I5A NCAC QZI,0303W contains alternatives where separatiorjs in 92T 305 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 IBC Surface Water C hk44 i)tcations web129yg
2. Does this project comply with the minimum separation requirements for water mains? ®Yes ❑No ❑N/A
➢ If no,please refer to 15A NCAC I SC.0906(f)for docu entation requirements and submit a separate document,
signed/sealed by an NC licensed PE,verifying the crite is outlined in that Rule.
3. Does the project comply with separation repirements for wetlands? ®Yes ❑No ❑N/A
➢ Please provide supplementary information identifying the areas of non-conformagce.
➢ See the Division's draft_sMaration 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 subjectt to any State buffer rules? ®Yes Basin name:Tar-Pam ❑No
If yes,does the project comply with setbacl�s found in the river basin rules per 15A NCAC 02B_.,0200? ®Yes ❑No
➢ This includes Trout Buffered Streams per 15A NCAC 211_0Z02
5. Does the project require coverage/authorization under a 404 Nationwideiindividual pe its ❑Yes ®No
or 401 Water Quality Certifications?
➢ Please provide the permit number/permitting status in the cover letter if covers elauthorization is required.
g q
6. Does project comply with 02TAlOac�)(additions I permits/certifications)? ®Yes [:]No
Per 15A NCACQ2-Is. 01 5(c)L),directly re,ated environmental p rmits or certification applications must be being prepared,
have been applied for,or have been obtain e . Issuance of this pei mit is contingent on issuance of dependent permits(erosion
and sedimentation control plans,stormwate r management plans,ptc.).
7. Does this project include any sewer collecti n lines that are dee 'ed"high-priority?" ❑Yes ®No
Per l SA N_t'AC 02T.0402,"high-priority sewer'means any aerit 1 sewer,sewer contacting surface waters,
siphon,or sewers positioned parallel to streambanks that are subj ct to erosion that unlermines or deteriorates the sewer.
Siphons and sewers suspended through IQterference/conflict ores require a variance approval.
➢ If yes,include an attachment with detains for each line,incluling type(aerial line,Le,material,and location).
High priority lines shall be inspected by the permittee or its r presentative at leas once every six-months and
Inspections documented per 15A NCAC 02T.0403(a)(5)or the permittee's individ,at System-Wide Collection permit.
FORM:FTA 06-21 Page 4 of 5

X. CERTIFICATIONS:
1. Does the submitted system comply with I SA NCAC 02T,the, intmum Design Crilpti#for the Permitting of Pump_S�a�iuns
;�rti Force Mains(lalcst v rsi n and the v er tm Ctileria(l8:eat vim' n 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. Approjal of the request will be Issued
co curre tl • with he approval of the r it and proie reamirine A vikirianor approvalmay be sub ct to longer
review times For projects reauirina two or more verinces or where the variance Is determined by the Division to be a
slf nificant portion of the protect,the fulltechnical review Is •eau red.
2. Professional Engineer's Certification:
I, Timothy P. Nau, PE attest that this application for Forest Hills
(Professional Engineer's name from Application Itcir+III.1.) (Projat A'amc from Apphcation Item II.I)
has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans,
specifications,engineering calculations, nd all other supporting documentation to the best of my knowledge. I further
attest that to the best of my knowledge thq proposed design has been prepared in accordance with the applicable regulations,
Minim utp Dcsisrl),Cri is �ayity$ w• a v4Cgi%i),a d the Mini1TlgW 1) i n ' 'teria fpr the Fast-Track It'
of Pump Stations,and Force!�lain$,ilat t ersion). Although of er professionals may have developed certain portions of this
submittal package, inclusion of these mat rials under my signs re and seal signifies that I have reviewed this material and
have judged it to be consistent with the pr posed design.
NOTE — In accordance with General St tes 143-215.6A an 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 we'1 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 E gineer to referral to she licensing board.(21 NCAC 56,0701)
�rY ...........................
North Carolina Professional Engineer's seal,signature,and date: ,.`� N FARO
�EAL
✓ 0303�3/9�//j_
? / �• `
�
/.f%
3. Applicant's Certification per,I SA NCAC 02T.0106(b): 1'1/24/2023
I, J4` ,attest that this application for Forest Hills
(Signature Authority Name from Application Item 3.) (Project Name from Application Item It.1)
attest that this application has been re sewed by me and Is accurate and cotplete 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 su ject to being returned as incomplete. I understand that any
discharge of wastewater from this non-disc arge system to surface waters or the land will result in an immediate enforcement
action that may include civil penalties,inju etive relief,and/or cr minal prosecution. I will make no claim against the Division
of Water Resources should a condition of Is permit be violated. I also understand that if all required parts of this application
package are not completed and that if all r quired supporting in ormation and attachments are not included, this application
package will be returned to me as incomplete.
NOTE — In accordance with General Statutes 143-:15.6A and 143-215.6B, any person who knowingly makes any false
statement, representation, or certification ' any application pack age shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed$10,000 as well as civil penalties up o$25,000 per violation,
J
Signature: Date: �aoa 3
FORM:FTA 06-21 Page 5 of 5

State of North Carolina
Department of Environmental Quality
ivision of Water Resources
Flow Tracking for Selver Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: Town of Louisburg
Project Name for which flow is being requested: Fores Hills
More than one FTSE may be required for a single prof ect if the weer of the WWTP Ev not responsible for all pump
stations along the route of the proposed wastewater flo►,
I. Complete this section only if you a4 the owner of the wastewater treattr ent plant.
a. WWTP Facility Name: kygis bur Tar Ricer- U &*c gz(un F n Ft, Orf,
b. WWTP Facility Permit#: Aj L 00 20a31
All flo s are in MGD
c. WWTP facility's permitted flovi 7 _
d. Estimated obligated flow not yet tributary to the N IWTP 0, ! 58__
e. WWTP facility's actual avg. flow 5
f. Total flow for this specific request 302
g. Total actual and obligated flows to the facility
h. Percent of permitted flow used y 9 55 q S
II. Complete this section for each pump station you are rc sponsible for alor g 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 Obliga ed,
Pump Pump Average Approx. Not V et Total Current
Station Station Firm Daily Flow** Current Tribut iry Flow Plus
(Name or Permit Capacity,* (Firm!pf), A ig. Daily Daily F ow, Obligated Available
Number) No. MGD MGD Flow,MGD MGD Flow Capacity***
*The Firm Capacity(design flow)of any pump st tion is defined as a maximum pumped flow
that can be achieved with the largest pump taken o t of service.
**Design Average Daily Flow is he firm capacity of the pump station divided by a peaking factor
(pi)not less than 2.5,per Section 2.02(A)(4)(c)of the Minimum Desigil Criteria.
***A Planning Assessment Add ndum shall be atts ched for each putnp station located
between the project connection p int and the WWT P where the Avail ible Capacity is<0.
Downstream Facility Name(Sewer): QulSbu Tor $ er Wa'ief RecIN'r�'�ron ���Irby
Downstream Permit Number: wo 0 0 Y ;113
Page 1 of
FTSE 10-18

111. Certification Statement:
I e—' h G certify to the bet of my knowled a that the addition of
the volume of wastewater to be permitted in this project ha been evaluated al Dng the route to the receiving
wastewater treatment facility and that t e flow from this project is not anti ipated to cause any capacity
related sanitary sewer overflows or overburden any dowi istrearn pump station en route to the receiving
treatment plant under normal circumstances, given the mplementation of the planned improvements
identified in the planning assessment were applicable. T is analysis has been performed in accordance
with local established policies and proc dures using the test available data This certification applies to
those items listed above in Sections I an 11 plus all attach d planning asses ment addendums for which I
am the responsible party. Signature of this form certifies at the receiving dollection system or treatment
works has adequate capacity to transport and treat the proposed new waste ater.
# /a-/3-.�o�3
Signing Official Signature Date
1 �UnnP 19 A r i5 mfo r
Title of igning Official
Page 2 of
FTSE 10-18

PLANNING ASSESSMENT DENDUM(PAA)
Submit a planning assessment addendum fo each pump station listed in Section Il ( here Available Capacity is<
0..
Pump Station(Name or Number):
Given that:
a. The proportion and amount of Obligated,Not Yet Tributary Daily Flow( accounts for
%and f MGD of the Available Capacity(E)in Pump Station
an that
b. The rate of activation of this obligated,not yet tributary capacity is current y approximately
MGD per year;and that
c. A funded Capital Project that will Provide the required planned capacity, mely
is in d sign or under const ction with
planned completion in ;andh r
d. The following applies:
Therefore:
Given reasonably expected conditions and planning info ation, there is s fficient justification to allow
this flow to be permitted, without a significant likelihood of over-allo sting capacity in the system
infrastructure.
I understand that this does not relieie the collection ystem owner from complying with G.S. 143-
215.67(a) which prohibits the introduction of any waste in excess of the gapacity of the waste disposal
system.
Signing Official Signature Date
Page 3 of 6
FTSE 10-18

State of North Carolina
Department of Environmental Quality
DWR Division of Water Resources
Division of Water Resources Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: _ Town of Louisburg
Project Name for which flow is being requested: Forest Hills
More than one FTSE may be required for a single project if the owner of the WWTP is not responsible for all pump
stations along the route of the proposed wastewater flow.
1. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name. Lowsbu1'a Wafcr Ror-loma'yion Iacrlr4•1
b. WWTP Facility Permit#: +VC o0;t C);k,31
All flows are in MGD
c. WWTP facility's permitted flow /,37
d. Estimated obligated flow not yet tributary to the WWTP 0./03T
e. WWTP facility's actual avg. flow a 65
f. Total flow for this specific request 10153
g. Total actual and obligated flows to the facility , b 55"8
h. Percent of permitted flow used 0,979 47. It
I1. 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/pf), Avg. Daily Daily Flow, Obligated Available
Number) No. MGD MGD Flow,MGD MGD Flow Capacity***
Capacity***
`t}X SWUm� 0 • WO 0,34 O.a� 0 0,099 o• ;?76 MGD
*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): Lou;sbvrq WQ-fer Aacl6rn l��ycriFon Fact
e
Downstream Permit Number: -tic 00a0;t3/
Page 1 of 6
FTSE 10-18

111. Certification Statement:
I Ad.-N, ca llu Jorl 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 parry. Signature of this form certifies that the receiving collection system or treatment
works has adequate capacity to transport and treat the proposed new wastewater.
(faffd4n 10-13-aoa3
Signing Official Signature Date
PIr„nnr rill iq lmni.'s`fra+oY`
Title of igning Official
Page 2 of 6
FTSE 10-18

PLANNING ASSESSMENT ADDENDUM (PAA)
Submit a planning assessment addendum for each pump station listed in Section 11 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 ;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.
1 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.
�, - �3 a 012
Signing Official Signature Date
Page 3 of 6
FTSE 10-18

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November 6, 2023
Wastewater Branch NOV 2 9 2023
Water Quality Permitting Section
Division of Water Resources
1617 Mail Service Center
Raleigh, NC 27699-1617
Subject: Delegation of Signature Authority
TOWN OF LOUISBURG WATER RECLAMATION FACILITY
NPDES Permit Number NCO020231
To Whom It May Concern:
By notice of this letter, I hereby delegate signatory authority to each of the following individuals for all
permit applications, discharge monitoring reports, and other information relating to the operations at
the subject facility as required by all applicable federal, state, and local environmental agencies
specifically with the requirements for signatory authority as specified in 15A NCAC 2B.0506.
Individual #1 Individual #2 (if applicable)
Name: Keith Callahan
Title: Planning Administrator
Mailing Address: 110 W Nash St. Louisburg, Ne 27549
Physical Address:
(if different)
Email Address: [e-mail]
Office Phone: 919 -497 - 1003 - -
Mobile Phone: 919 - 603 -4405 - -
If you have any questions regarding this letter, please feel free to contact me at Enter Email or Phone
Number.
Sincerely,
jke-� VA,
Sean Medlin
Town Administrator
110 W Nash St Louisburg, Nc 27549
Smedlin*Townoflouisburg.Org
919-497-10 l 5
919496-4290
CC' Raleigh Regional Office, Water Quality Permitting Section

Timothy Nau
To: [e-mail]
Cc: 'Keith Callahan'
Subject: RE: Forest Hills-Additional Information Request
NOV 2 9 2o23
Responses To Comments
Hello Keith and Jonathan,
After reviewing the Fast Track Sewer System Extension Application for Forest Hills,additional information is required in
order to further process the application. Please provide the following information by December 3.2023,and note that
the requested information must be submitted within 30 days of this request, or the applicant will be required to submit
a new application and application fee in accordance with 15A NCAC 02T.0107.
1. While reviewing the permit, I noticed that Keith Callahan is listed as the Planning Administrator with the Town of
Louisburg, however, our records do not indicate that Keith Callahan has Signatory Authority for the Town of
Louisburg. Please submit the Delegation of Signatory Authority form to the address provided on the form so
that we can ensure that Keith has the authority to sign the submitted Fast Track Application (FTA)and the Flow
Tracking for Sewer Extension Application(FTSE), please also email me a copy of the signed form so that I can
attach it to this application while NCDEQ is processing the form. DEQ Signature has been approved
Forms and Reports I NC DE Q 4 Delegation of Signatory Authority Notification Form (Fillable WORD doc)
2. Section 11.4. states that the project coordinates are located near Newbern,TN. Please update the coordinates
and resubmit Page 1 of the FTA. Coordinates have be updated
3. Section 3. states that Permit#WQC50042335 is the receiving collection system,however,this permit does not
exist. Please update Page 1 of the FTA with the correct receiving downstream sewer permit number,
WQOOxxxxx, and the receiving collection system permit number, WQCSOOxxx. Noted
4. According to Section VI.7.,the wastewater generated by the project does not match the wastewater design flow
rates according to 15A NCAC 02T.0114. Please provide detailed calculations specifying how this flow rate was
developed according to 15A NCAC 02T.0114 or update and resubmit Page 2 of the FTA. Noted
5. According to Section IX.4.,the project is located in the Tar-Pam River Basin and is applicable to State Buffer
Rules. Does this project have any stream crossings or other stream and/or wetland impacts? If so,what are the
impacts and are they temporary or permanent? No impacts
6. According to Section IX.5.,401/404 authorization is not needed for this project. Please provide an explanation
indicating why a separation requirement is not applicable to the project since there is a wooded area with
potential wetlands along the eastern side of the project area. No impacts to buffers.
7. According to Section V1.7. of the FTA and the narrative, 16,000 GPD of wastewater will be generated by the
project, however, according to the FTSE,only 15,300 GPD(0.0153 MGD). Please correct and resubmit the FTSE
form or an updated narrative and Page 2 of the FTA. Noted
8. The downstream sewer information listed on the USE should match the downstream sewer that is listed on
Section V. of the FTA. Please correct the USE form and resubmit. Noted
9. The topographical and aerial map submitted are not sufficient. According to Section F of the Application
Instructions,an 8.5-inch x 11-inch color copy of a USGS Topographic Map and an aerial map should be included
with the application. The maps need to clearly identify the project area, including the closest surface waters,
general location of the gravity sewer, pumpstations,and force mains, and the downstream connection points for
the receiving sewer. Please provide the required maps according to the application requirements. Maps have
been updated.
15A NCAC 02T.0107 Staff Review and Permit Preparation states:
1

• "(2) (e) If an application is accepted and later found to be incomplete, the applicant shall be advised how the
application or accompanying supporting information may be modified to make it complete.The staff shall advise
the applicant:
(2) if all required information is not submitted within 30 days,the project will be returned as incomplete.
Any resubmittal of a returned application shall be accompanied with a new application fee."
Please contact me with any questions that you may have regarding this request.
*Please note that the fee for fast track sewer extension permits has Increased to$600 as of October3,2023[as
stipulated In the 2023 House Appropriations Act, House Bill 259, Water Quality and Stormwoter Fees,Section
12.14(a)].
Sincerely,
Elaine Wlld
Environmental Engineer
Division of Water Resources- Raleigh Regional Office
North Carolina Department of Environmental Quality
919.791.4254 Office
[e-mail]
D_EQ
Email correspondence to and A,=lhrs address is sv4W to the,Wh
Carobna Public Records U--v and may be drsdosed to thrd panes
Sewer Extension Permitting I INC DEQ
subchapter t rules.pdf(state.nc.us)
Email correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to third parties by an authorized
state official.
2

The Nau Company
Consulting Civil Engineers
NOV 2 9 �Q?
November 24, 2023
NC Department of Environmental Quality
Division of Water Resources
Raleigh Regional Office
RE. Forest Hills Sanitary Sewer Permit
To whom it may concern:
Attached are the required documents for the permitting of the gravity sanitary sewer line
required for the Forest Hills project located in Louisburg, NC. Below is a summary of the system
to be permitted:
System Name: Forest Hills
Homes served: 64
Flow allocation required: 23,040.00 GPD
Pipe data: 3,600 LF of 8" PVC gravity sanitary sewer
300 LF of 8" DIP gravity sanitary sewer
The following items are included with this submittal package:
• $600 application fee
• Flow Tracking/Acceptance Form (Form USE 04-16)
• 8.5x11 USGS topo map of the project area
• 8.5x11 aerial image of the project area
If you have any questions or concerns, please let me know.
Sincerely,
The N u Company,PLLC
Timothy P. Nau
[e-mail]
PO Box 810/Rolesville, North Carolina 27571/[phone]

The Nau Company PO Box810
Consulting Civil Engineers Rolesville NC 27571
NOV 2 9 ''i ':' 919-435-6395
TRANSMITTAL
Deliver Sender
NCDENR - Raleigh Regional Office Timothy P. Nau, PE
3800 Barrett Drive 919-625-3090
Raleigh NC 27609 [e-mail]
Elaine Wild Date November 28, 2023
919-791-4254 Delivery method Hand Delivered
Project name Forest Hills
Submittal type Sanitary Sewer Permit
Project number
Quantity Date Description
1 11/27/23 Cover Letter
2 11/27/23 Fast Track Application (FTA)
1 10/13/23 DEQ Signature
1 11/27/23 Flow Tracking/Acceptance Form
1 11/27/23 USGS Quad Map
1 11/27/23 Aerial Map
1 11/27/23 Response to Comments
Comments/Notes

The Nau Company cV.k?NQkY4V`Y
N
Consulting Civil Engineers C pcpt of f'XAVITO'L•
September 29, 2023
NC Department of Environmental Quality
Division of Water Resources
Raleigh Regional Office
RE: Forest Hills Sanitary Sewer Permit
To whom it may concern:
Attached are the required documents for the permitting of the gravity sanitary sewer line
required for the Forest Hills project located in Louisburg, NC. Below is a summary of the system
to be permitted:
System Name: Forest Hills
Homes served: 64
Flow allocation required: 16,000 GIRD
Pipe data: 3,600 LF of 8" PVC gravity sanitary sewer
300 LF of 8" DIP gravity sanitary sewer
The following items are included with this submittal package:
• $480 application fee
• Fast Track Form (Form FTA 04-16)
• Flow Tracking/Acceptance Form (Form FTSE 04-16)
• 8.5x11 USGS topo map of the project area
• 8.5x11 aerial image of the project area
If you have any questions or concerns, please let me know.
Sincerely,
The Nau Company,PLLC
Jonathan Eakins, PE
[e-mail]
PO Box 810/Rolesville, North Carolina 27571/[phone]

From: Wild,Elaine
To: "Keith Callahan"; "ieakins(thenauco.com";"tnau(athenau.com"
Cc: "Neal,Chris";Simpson,Richard; Pasha,Tanvir;Wilson,Susan A
Subject: RE: [External]RE: Forest Hills—Additional Information Request
Date: Monday,January 22,2024 12:21:00 PM
Attachments: imaae001.png
image002.pnng
Hello Keith, Jonathan, and Tim,
An email was sent on December 14, 2023 indicating that additional information was needed for the
Forest Hills project in order to further process the application for a Fast Track Sewer Extension
Permit. As of today's date, the Division of Water Resources has not received the additional
information requested, therefore, in accordance with 15A NCAC 02T .0107, the project application is
being returned as incomplete. If you wish to pursue permitting for this project, please submit a
completed application accompanied by a new application fee.
15A NCAC 02T .0107 Staff Review and Permit Preparation states:
• "(2) (e) If an application is accepted and later found to be incomplete, the applicant shall be
advised how the application or accompanying supporting information may be modified to
make it complete. The staff shall advise the applicant:
(2) if all required information is not submitted within 30 days, the project will be
returned as incomplete. Any resubmittal of a returned application shall be accompanied
with a new application fee."
*Please note that the fee for fast track sewer extension permits has increased to$600 as of
October 3, 2023[as stipulated in the 2023 House Appropriations Act, House Bill 259, Water
Quality and Stormwater Fees,Section 12.14(a)].
Sewer Extension Permitting I INC DEQ
Sincerely,
Elaine Wild
Environmental Engineer
Division of Water Resources - Raleigh Regional Office
North Carolina Department of Environmental Quality
919.791.4254 Office
[e-mail]
D E Q��
Qpar[rMwl W knwaenwW Oua1R,�
Email correspondence to and from this address is subject to the North
Carolina Public Records Law and may be disclosed to third parties.
Sewer Extension Permitting I INC DEQ

subchapter t rules.pdf(state.nc.us)
From: Wild, Elaine
Sent:Thursday, December 14, 2023 9:38 AM
To: Keith Callahan <[e-mail]>;[e-mail]
Cc: Neal, Chris <[e-mail]>
Subject: RE: [External] RE: Forest Hills—Additional Information Request
Hello Keith and Jonathan,
Upon reviewing the additional information received on November 29, 2023, further clarification is
needed on some items. Please see my additional comments below in red.
Please provide this information by December 27, 2023, and note that the requested information
must be submitted by this date, or the applicant will be required to submit a new application and
application fee in accordance with 15A NCAC 02T.0107.
If you have any questions, please feel free to reach out to me.
Best Regards,
Elaine Wild
Environmental Engineer
Division of Water Resources - Raleigh Regional Office
North Carolina Department of Environmental Quality
919.791.4200 Office
elaine.wild(@deq.nc.gov
awrtme.i o tnrvmmeW owi�
Email correspondence to and from this address is subject to the North
Carolina Public Records Law and may be disclosed to third parties.
Sewer Extension Permitting I NC DEO
subchapter t rules.pdf(state.nc.us)
From: Keith Callahan <KCallahanPtownoflouisburg.org>
Sent:Thursday, November 16, 2023 9:14 AM
To: Wild, Elaine <elaine.wild(@deq.nc.gov>;jeakins(@thenauco.com
Cc: Neal, Chris <mayorneal�townoflouisburgorg>
Subject: [External] RE: Forest Hills—Additional Information Request
CAUTION: External email. Do not click links or open attachments unless verified. Report suspicious emails with the
Report Message button located on your Outlook menu bar on the Home tab.

I have attached the signature sheet as requested :Thanks
From: Wild, Elaine [mailto:elaine.wild(@deq.nc.gov]
Sent: Friday, November 3, 2023 4:05 PM
To: Keith Callahan <KCallahan(@townoflouisburg.org>; jeakins(@thenauco.com
Cc: Neal, Chris<mayornealPtownoflouisburg.org>
Subject: Forest Hills—Additional Information Request
Hello Keith and Jonathan,
After reviewing the Fast Track Sewer System Extension Application for Forest Hills, additional
information is required in order to further process the application. Please provide the following
information by December 3, 2023, and note that the requested information must be submitted
within 30 days of this request, or the applicant will be required to submit a new application and
application fee in accordance with 15A NCAC 02T.0107.
1. While reviewing the permit, I noticed that Keith Callahan is listed as the Planning
Administrator with the Town of Louisburg, however, our records do not indicate that Keith
Callahan has Signatory Authority for the Town of Louisburg. Please submit the Delegation of
Signatory Authority form to the address provided on the form so that we can ensure that
Keith has the authority to sign the submitted Fast Track Application (FTA) and the Flow
Tracking for Sewer Extension Application (FTSE), please also email me a copy of the signed
form so that I can attach it to this application while NCDEQ is processing the form.—complete
Forms and Reports I NC DEQ 4 Delegation of Signatory Authority Notification Form
(Fillable WORD doc)
2. Section 11.4. states that the project coordinates are located near Newbern,TN. Please update
the coordinates and resubmit Page 1 of the FTA.—corrected
3. Section 3. states that Permit#WQCS0042335 is the receiving collection system, however, this
permit does not exist. Please update Page 1 of the FTA with the correct receiving
downstream sewer permit number, WQOOxxxxx, and the receiving collection system permit
number, WQCSOOxxx.—corrected
4. According to Section V1.7., the wastewater generated by the project does not match the
wastewater design flow rates according to 15A NCAC 02T .0114. Please provide detailed
calculations specifying how this flow rate was developed according to 15A NCAC 02T .0114 or
update and resubmit Page 2 of the FTA.
- Please provide an updated page 2 of the FTA and updated narrative. According to the
revised wastewater table in Section V1.7. of the FTA, there are 192 units at 120 GPD/BR.
However, the narrative states that there are 64 homes being proposed, this means that
there are 64 three-BR homes at a flow rate of 360 GPD. Please provide the design flow rate
for each establishment type (one-BR, two-BR, three-BR, four-BRs), the number of units for
each establishment type, and the total flow.
-Additionally, ensure that Section V1.7. and V1.8. of the FTA match.
- If the total flow on Page 2 of the FTA is different than 23,040 GPD, please provide an
updated FTSE from Louisburg WRF.

5. According to Section IX.4., the project is located in the Tar-Pam River Basin and is applicable
to State Buffer Rules. Does this project have any stream crossings or other stream and/or
wetland impacts? If so, what are the impacts and are they temporary or permanent?—"No
impacts," per your 11/29/23 Response to Comments.
6. According to Section IX.5., 401/404 authorization is not needed for this project. Please
provide an explanation indicating why a separation requirement is not applicable to the
project since there is a wooded area with potential wetlands along the eastern side of the
project area.—"No impacts," per your 11/29/23 Response to Comments.
7. According to Section V1.7. of the FTA and the narrative, 16,000 GPD of wastewater will be
generated by the project, however, according to the FTSE, only 15,300 GPD (0.0153 MGD).
Please correct and resubmit the FTSE form or an updated narrative and Page 2 of the FTA.—
corrected
8. The downstream sewer information listed on the FTSE should match the downstream sewer
that is listed on Section V. of the FTA. Please correct the FTSE form and resubmit.—corrected
9. The topographical and aerial map submitted are not sufficient. According to Section F of the
Application Instructions, an 8.5-inch x 11-inch color copy of a USGS Topographic Map and an
aerial map should be included with the application. The maps need to clearly identify the
project area, including the closest surface waters, general location of the gravity sewer,
pumpstations, and force mains, and the downstream connection points for the receiving
sewer. Please provide the required maps according to the application requirements.—Topo
and aerial maps are still not sufficient. The maps need to clearly identify the project area,
including the closest surface waters, general location of the gravity sewer, pumpstations, and
force mains, and the downstream connection points for the receiving sewer. Please provide
the required maps according to Section F of the Application Instructions.
15A NCAC 02T.0107 Staff Review and Permit Preparation states:
• "(2) (e) If an application is accepted and later found to be incomplete, the applicant shall be
advised how the application or accompanying supporting information may be modified to
make it complete.The staff shall advise the applicant:
(2) if all required information is not submitted within 30 days, the project will be
returned as incomplete. Any resubmittal of a returned application shall be accompanied
with a new application fee."
Please contact me with any questions that you may have regarding this request.
*Please note that the fee for fast track sewer extension permits has increased to$600 as of
October 3, 2023(as stipulated in the 2023 House Appropriations Act, House Bill 259, Water
Quality and Storm water Fees, Section 12.14(a)).
Sincerely,
Elaine Wlld
Environmental Engineer
Division of Water Resources- Raleigh Regional Office

North Carolina Department of Environmental Quality
919.791.4254 Office
elaine.wild(@deq.nc.gov
D_EQ>
. .. Mr
Emad correspondence to and from ttns address is sutyect to the North
Carolina Public Records Law and may be disclosed to thud paives
Sewer Extension Permitting I INC DEQ
subchapter t rules.pdf(state.nc.us)
Email correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to third
parties by an authorized state official.