WQ0045062_Application (FTSE)_20240326

DocuSign Envelope ID: 3C72FDD4-CC88-4CEA-BD16-gD1D1FC7356C
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 Staiions/Force Mains) and that plans, specifications and supporting documents
have been prepared in accordance with 11iA 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 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):
M 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 $600.00, dated no more than 90 days prior to application submittal.
➢ Payable to North Carolina Department of Environmental Quality (NCDEQ)
D. Fast Track Application (Required for All Application Packages, Form ETA 10-23):
H Submit the completed and appropriately executed application.
➢ If necessary for clarity or due to space restrictions, attachments to the application may be made.
❑ if the Applicant Type in Item 1.2 is a corporation or company, provide documentation it is registered for business with the
North Carolina Secretary of State.
❑ If the Applicant Type in Item 1.2 is a partnership or d/b/a, enclose a copy of the certificate filed with the Register of Deeds in
the county of business.
® The Project Name in Item Ii.I shall be consistent with the project name on the flow acceptance letters, agreements, etc.
* The Professional Engineer's Certification on Page 5 of the application shall be signed, sealed and dated by a North Carolina
licensed Professional Engineer.
leer.
f$] The Applicant's Certification on Page 5 of the application shall be signed in accordance with 15A NCAC 02T .0106Ib1. 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 Pagel of3

DocuSign Envelope ID: 3C72FDD4-CC88-4CEA-BD16-9D1 D1 FC7356C
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 1 1-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 NC AU 02T .03051h)i 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 15A NCAC 02,;I, a0,1 15(a)(I ) 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):
❑ I Iome Pro? ertOwners' Associations
❑ Per I SA NCAC 02'T .01 15(c), submit the properly executed Operational Agreement (FORM: HOA ).
❑ Per 15A NCAC 02T .01 15(c), submit a copy of the Articles of Incorporation, Declarations and By-laws.
❑ Developers of lots to be sold
❑ Per 1 3A NCAC 02T .01 15(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 DOCUMCNTATION Page 2 of 3

DocuSign Envelope ID: 3C72FDD4-CC88-4CEA-BD16-9D1 D1 FC7356C
THE COMPLETED APPLICATION PACKAGE INCLDING ALL SUPPORTING INFORMATION AND
MATERIALS, SHOULD RE SENT TO THE APPROPRIATE REGIONAL OFFICE:
REGIONAL OFFICE
Asheville Regional Office,
Water Quality Section
ADDRESS
�...............
2090 US Highway 70
Swannanoa, North Carolina 28778-8211
[phone]
[phone] Fax
COUNTIES SERVED
Avery, Buncombe, Burke, Caldwell, Cherokee,
Clay, Graham, Haywood, Henderson, Jackson,
Macon, Madison, McDowell, Mitchell, Polk,
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
-ion
3800 Barrett Drive
Chatham, Durham, Edgecombe, Franklin,
Water Qualms Sect
Raleigh, North Carolina 27609
Granville, Halifax, Johnston, Lee, Nash,
[phone]
Northampton, Orange, Person, Vance, Wake,
[phone] Fax
Warren, Wlson
Washington Regional Office
Water Quality Section
Wilmington Regional Office
Water Quality Section
Winston-Salem Regional Office
Water Quality Section
943 Washington Square Mall
Washington, North Carolina 27889
[phone]
[phone] Fax
127 Cardinal Drive Extension
Wilmington, North Carolina 28405
[phone]
[phone] Fax
450 W. Hanes Mill Road
Suite 300
Winston-Salem, North Carolina 27105
[phone]
[phone] Fax
Beaufort, Bertie, Camden, Chowan, Craven,
Currituck, Dare, Gates, Greene, Hertford, Hyde,
Jones, Lenoir, Martin, Pamlico, Pasquotank,
Perquimans, Pitt, Tyrrell, Washington, Wayne
Brunswick, Carteret, Columbus, Duplin, New
Hanover, Onslow. Pender
Alamance, Alleghany, Ashe, Caswell, Davidson,
Davie, Forsyth, Guilford, Rockingham, Randolph,
Stokes, Surry, Watauga, Wilkes, Yadkin
INSTRUCTIONS FOR FORM: FTA 10-23 & SUPPORTING DOCUMENTATION Page 3 of 3

DocuSign Envelope ID: 3C72FDD4-CC88-4CEA-BD16-9D1 D1 FC7356C
L I I
qT L,
, J LTJ i
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 10-23 & SUPPORTING DOCUMENTATION
Application Number: WQ0045062
(to be completed by DWR)
All items must be completed or the application will he returned
I. APPLICANT INFORMATION:
1. Applicant's name: Town of Holly Springs (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State/County 2] Municipal ❑ Other
3. Signature authority's name: Kendra D. Parrish, PE 15A NCAC 02T .0106(b)
Title: Executive Director of Utilities & Infrastructure
4. Applicant's mailing address: 128 South Main Street, P.O. Box 8
City: Holly Springs State: North Carolina Zip:27540 _
5. Applicant's contact information: [e-mail]
Phone number: (919) 577_3150 Email Address: [e-mail]
II. PROJECT INFORMATION:
1. Project name: Norris Crossing Phase 1 and 2
2. Application/Project status: x❑ 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: Wake
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.6240r i.ongitude: - 78.8720 °
5. Parcel ID (if applicable): 0638-71-6536 (or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Daniel H. woods License Number: 32616
Firm: Peak Engineering & Design, LLC
Mailing address: 1125 Apex Peakway
City: Apex State: NC Zip: 27502 _
Phone number: ( 919 ) 439.0100 Email Address: dwoods(a),peakengineering.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Utley Creek Water Reclamation Faci
Owner Name: Town of Holly Springs
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. PermitNumber(s): WQ0037951M
Permit Number: NCO063096
2. Downstream (Receiving) Sewer information: 16 inch M Gravity ❑ Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS 00192
Owner Name(s): Town of Holly Springs
FORM: FTA 10-23 Page 1 of 5

DocuSign Envelope ID: 3C72FDD4-CC88-4CEA-BD16-9D1 D1 FC7356C
VI. GENERAL, REQUIREMENTS
1. I f the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience and Necessity been attached?
❑ Yes ❑ No R11 N/A
2. If the Applicant is a Developer of lots to be sold, has a Developer's Operational agreement I FORM: DEV) been attached?
❑ Yes ❑ No 0 N/A
3. If the Applicant is a Home/Property Owners' Association, has an HOA110A Operational Agreement (FORM: 1 IOA) and
supplementary documentation as required by 15A NCAC 02T.01 15(c) been attached?
❑ Yes ❑ No 0 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 02'r .0103(201)
If industrial, is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Has a flow reduction been approved under 15A NCAC 02T .01 14(f)? ® Yes ❑ No
➢ If Yes, provide a rota' of flow reduction approval letter with this application
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(f))
Daily Design Flow a,e
No. of Units
Flow
Single Family Residence
255 gal/
66
16, 830 GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal./
GPD
gal/
GPD
Total
16, 830 GPD
a See I SA NCAC 02T .01 la(b). (d). (e)(I) and (c)(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.01 14] shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 16,830 GPD (per 15A NCAC 02T .01 14 and G.S. 143-215.1)
➢ Do not include future flows or previously permitted allocations
If permitted flow is zero, please indicate why:
❑ Pump Station/Force Main or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line.
Please provide supplementary information indicating the approximate timeframe for permitting upstream sewers with flow.
❑ Flow has already been allocated in Permit Number: __ Issuance Date:
❑ Rehabilitation or replacement of existing sewers with no new flow expected
❑ Other (Explain):
FORM: FTA 10-23 Page 2 of 5

DocuSign Envelope ID: 3C72FDD4-CC88-4CEA-BD16-9D1 D1 FC7356C
VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & VIDC (Gravity Sewers):
I . Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
8
65
DIP
8
3,890
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
Vill. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & NIDC (Pump StationslFnrce 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: o Longitude: -
3. Total number of pumps at the pump station:
3. Design flow of the pump station: millions gallons per day (firm capacity)
➢ This should reflect the total GPM for the pump station with the largest pump out of service.
4. Operational point(s) per pump(s): gallons per minute (GPM) at feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches) I Length (feet) ` Material
If any portion of the force main is less than 4-inches in diameter, please identify the method of solids reduction per
MDCPSFM Section 2.01C.l.b. ❑ Grinder Pump ❑ Mechanical Bar Screen ❑ Other (please specify)
6. Power reliability in accordance with 1.5;� N(_1(' l 1T-0305.(h)[ 11:
❑ 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, shal l be provided
as part of this permit application in the case of a multiple station power outage.
FORM: FTA 10-23 Page 3 of 5

DocuSign Envelope ID: 3C72FDD4-CC88-4CEA-BD16-9D1 D1 FC7356C
IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(f)):
1. Does the project comply with all separations/alternatives found in 15A NCAC 02T .0.305 & ? ® Yes []No
15A NCAC 02T.0305(fl contains minimum separations that shall be provided for sewer systems:
Setback Parameter*
Separation Required
Storm sewers and other utilities not listed below (vertical)
18 inches
'Water mains (vertical - water over sewer preferred, including in benched trenches)
18 inches
'Water mains (horizontal)
10 feet
Reclaimed water lines (vertical - reclaimed over sewer)
18 inches
Reclaimed water lines (horizontal - reclaimed over sewer)
2 feet
**Any private or public water supply source, including any wells, WS-1 waters of Class I or
Class 11 impounded reservoirs used as a source of drinking water, and associated wetlands.
1.00 feet
"Waters classified WS (except WS-1 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(t) or (g), see Section X.1 of this application
*15A NCAC 02T.0,05(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 Classilications webpaue
2. Does this project comply with the minimum separation requirements for water mains? Of 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? :M Yes Basin name: Cape Fear ❑ No
If yes, does the project comply with setbacks found in the river basin rules per 15A NCAC_Q2li_,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- 02'T.0105(c)(6), directly related environmental permits or certification applications must be being prepared,
have been applied for, or have been obtained_ Issuance of this permit is contingent on issuance of dependent permits (erosion
and sedimentation control plans, stormwater management plans, etc.).
7. Does this project include any sewer collection lines that are deemed "high -priority?" ❑ Yes ® No
Per 15A NCAC 02T.0402, "high -priority sewer" means any aerial sewer, sewer contacting surface waters,
siphon, or sewers positioned parallel to streambanks that are subject to erosion that undermines or deteriorates the sewer.
Siphons and sewers suspended through interference/conflict boxes require a variance approval.
➢ If yes, include an attachment with details for each line, including type (aerial line, size, material, and location).
High priority lines shall be inspected by the permittee or its representative at least once every six -months and
inspections documented per 15A NCAC 02T.0403(a)(5) or the permittee's individual System -Wide Collection permit.
FORM: FTA 10-23 Page 4 of 5

DocuSign Envelope ID: 3C72FDD4-CC88-4CEA-BD16-9D1 D1 FC7356C
X. CERTIFICATIONS:
1. Does the submitted system comply with 15A NCAC 02T, the Minimum Design Criteria for the Permitting, of Punip Stations
and Force Mains (latest version), and the Gravity Sewer Minimum Design Criteria dales version) as applicable?
❑x Yes ❑ No
If' no, for projects requiring a single variance, complete and submit the Variance/Alternative Design Request application
(VADC 10-14) and supporting documents for review to the Central Office. .Approval of the request will he issued
concurrently with the approval of the crntit, and projects re uirinu a variance a rroyal may he subject to longer
review times. For proiecls requiring two or more variances or where the variance is determined by the Division to be a
significant portion of the proj,e_ct. the full technical review is required.
2. Professional Engineer's Certification:
1, Daniel H. Woods , attest that this application for Norris Crossing - Phase 1 and 2
(Professional Engineer's name from Application Item III l ) (Project Name from Application Item II l)
has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans,
specifications, engineering calculations, and all other supporting documentation to the best of my knowledge. I further
attest that to the best of my knowledge the proposed design has been prepared in accordance with the applicable regulations,
Minimum Design Criteria for Gravity Sewers latest version), and the Minimum Design _Cr3ler a for the Fast -Track Permittin
of Pump Stations and Force Mains ( latest version). Although other professionals may have developed certain portions of this
submittal package, inclusion of these materials under my signature and seal signifies that I have reviewed this material and
have judged it to be consistent with the proposed design.
NOTE — In accordance with General Statutes 143-215.6A and 143-2I5.6B, 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 $ t0,000, 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:
[3a�ielK,
3. Applicant's Certification per 15A NCAC 02T .0106(b):
I, Kendra D. Parrish, PE attest that this application for Norris Crossing - Phase I and 2
(Signature Authority Name from Application Item 1,3.1 (Project Name from Application Item IL 1)
attest that this application has been reviewed by me and is accurate and complete to the best of my knowledge.
I understand that if all required parts of this application are not completed and that if all required supporting documentation
and attachments are not included, this application package is subject to being returned as incomplete. I understand that any
discharge of wastewater from this non -discharge system to surface waters or the land will result in an immediate enforcement
action that may include civil penalties, injunctive relief and/or criminal prosecution. I will make no claim against the Division
of Water Resources should a condition of this permit be violated. I also understand that if all required parts of this application
package are not completed and that if all required supporting information and attachments are not included, this application
package will be returned to me as incomplete.
NOTE — In accordance with General Statutes 143-215.6A and 143-215.613, 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.
ocuSigned by:
E_�
Signature: Date:
3/4/2024
A3B6E125C87C4AE...
FORM: FTA 10-23 Page 5 of 5

DocuSign Envelope ID 41697882.6D8A-4E36-ADFF-F6AD3029676�'C
deA? a f
�qN ,r State of North Carolina
Department of Environmental Quality
fc'a1�Division of Water Resources
itY I tacking for Sewer Extension Applications
`} (FTSE 10-23)
Entity Requesting Allocation: Town of Holly Springs
Project Name for which flow is being requested: Norris Crossing - Phase 1 and 2
More than one FTSE maybe required for a single project if the owner of the WWTP is not responsible for al! pump
stations along the route of the proposed wastewater flow
Complete this section only if you are the owner of the wastewater treatment plant
a. WWTP Facility Name: Utley Creek Wastewater Treatment Plant
b. WWTP Facility Permit #: NC 0063096
c. WWTP facility's permitted flow 6.0 All,f)'ows are in MGD
d. Estimated obligated flow not yet tributary to the WWTP 1.86 MGD
e. WWTP facility's actual avg. flow 3.077 MGD
f. Total flow for this specific request
g. Total actual and obligated flows to the facility
h
0.01683 MGD
4.955 MGD
V/
. Percent of permitted flow used 82%
11. Complete this section for each pump station you are responsible for along the route of this proposed
wastewater flow.
List pump stations located between the project connection point and the WWTP:
Pump
Pump
Station
Station
(Name or
Permit
Number)
No.
(A)
Design
Average
Daily
Firm Flow"
Capacity, * (Firm/ pf),
MGD MGD
1
Union Ridge W00031552M 1.08 0.432
(B)
(C)
(D)—(B+C)
(E)=(A-D)
Approx.
Obligated,
Total
Current
Not Yet
Current
Avg. Daily
Tributary
Flow Plus
Flow,
Daily Flow,
Obligated
Available
MGD
MGD
Flow
Capacity***
0.126
0.044
0.170
0.262
* 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): Union Ridge
Page 1 of 9
FTSE 10-23

Docu&gn Envelope ID: 41697882-608A-4E36-ADFF-F6AD302967D9
Downstream Permit Number: W00031552M
III. Certification Statement:
I Kendra D. Parrish 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.
,,���,,��fpQocuSgnad by
Tom!'
Sigl ture
Exec Director of utilities and Infrastructure
Title of Signing Official
1/4/2024
Date
Page 2 of 9
FTSE 10-23

DocuSign Envelope ID 41697882 6D8A4E36-ADFF-F6AD302967D9
PLANNING ASSESSMENT ADDENDUM (PAA)
Submit a planning assessment addendum for each pump station listed in Section If 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.
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
1)(de
Page 4 of 9
FTS E 10-23

k
Q
M
O
Q
cp
LL
LL
Q
w
Y
O
N
OD
O1
tp
0
CL
yO
C
w
c
rn
v
0
a
a
o
a�
c(A£ca°i
���•
°a
o
arvi E
ccD m
4) a�
E 0
cvc�"
o Q.
U E
t}
a
4 a C.
m•�
d a
oCi U
-
NO

DocuSinn Envelope ID41697882-6D8A-4E36-ADFF F6AD302967D9
DO NOT SUBMIT SEWER EXTENSION APPLICATIONS UNTIL
CONSTRUCTION DRAWINGS HAVE BEEN APPROVED BY STAFF!
Sewer Design and Application Certification
Note: This form must be submitted with the Fast Tract Application fore tension to the Town of
Holly Springs Sewer System �_ Ue
af
Project: Norris Crossing - Phase 1 and 2 P1 Environment _ 81
Design Engineer: Peak En *i� neering & Design, PLLC -Daniel Woods J a2024
Address: 1125 Apex Peakway, Apex, NC 27502
c,
Phone Number: 919-439-0100 Email: dwoods@)peakengineering.com � �210Tce
Date Complete Application Package Received by Town: 1/4/2024
(� DS Da
Date Approved: — L _ (by RJ) (by KDP) — �'� _ (by CJ)
As design engineer for this project, I certify the following (please check (x) each applicable box):
I@ That the design of the project is in complete conformance with the Town of Holly
Springs Engineering Design and Construction Standards and NC DEQ Sanitary Sewer
Design Regulations;
r That each of the following items are completed and enclosed for submittal to the State for
a sewer extension permit:
r One original and one copy of a cover letter that includes a project narrative
o A check in the amount of $600.00 to NC DEQ
a A check in the amount of $200.00 to the Town of Holly Springs
0 One original and one copy of the State of North Carolina form FTA 04-16
Fast Tract Sewer System Extension Application
0 Two copies of form FTSE 10-18 Flow Tracking for Sewer Extension
Applications
0 Two color copies of an 8.5-inch by l I -inch portion of a 7.5-minute USGS
Topographic Map showing project area
0 Two copies of a street level map showing all relevant project areas
0 One copy of the locally -required Design and Application Certification (This
form)
Daniel H. Digital y signed by Daniel H.
Woods
Woods Date. 2023.12.071419:36
Design Engineer's Signature -0500' Date
Please contact Emily Koncz at [phone] oremil'.koncz&hol Ikspringsnc.gov if you have
any questions.
2003 Sewer Design Application Certification
10 25 23
Utilities and Infrastructure Services
P.O. Box 8 • 128 S. Main Street 0 Holly Springs, NC 27540 0 www.hollyspringsnc.gov

DocuSig+ Envelope ID: 41697882 6D8A-4E36-ADFF-F6AD302967D9
THE TOWN OF
November 29, 2023
Director, Division of Water Resources
Raleigh Regional Office
Water Quality Operation Section
3800 Barrett Drive
Raleigh, NC 27609
�lly cf'prings
Re: Application for Sewer Extension Permit
Project: Norris Crossing Phase 1 & 2
Dear Sir or Madam:
NC Dept of Enwonmental Quality
JAN 11 ?0?4
Raleigh Regiml Office
Please find enclosed the following items in application for a sewer extension permit to the Town
of Holly Springs existing sewer distribution system:
0 One original and one copy cover letter including a project narrative
A check in the amount of $600.00
0 One original and one copy of the State of North Carolina Fast Track Sewer System
Extension Application (FTA 10-23)
0 Two copies of FTSE 10-23 Flow Tracking/Acceptance Form
0 Two color copies of a 8.5-inch by I 1-inch portion of a 7.5 minute USGS Topographic
Map showing project area
0 Two copies of a street level map showing all relevant project areas
0 One copy of the locally -required Design and Application Certification
Feel free to contact me at 919-577-3150 should you have any questions or need additional
information in order to process this application.
Sincerely,
o«uftnee by, T
os
4 L'fi- Ir-3
&P 1f. ftrish, P.E., CFM Rachel Jones
Executive Director of Utilities and Infrastructure Catherine Jacobs
KP/ek
cc: Project Consultant Engineer, Daniel Woods, PE
Rachel Jones, Utility Engineer
Drew Johnson, Development Construction Manager
Emily Koncz, Utility Permitting Specialist
Project file/Correspondence #42146
3002
04 17.2018
Utilities and Infrastructure Services
P.O. Box 8 • 128 S. Main Street • Holly Springs, NC 27540 • www.hollyspringsnc.gov

"A PEAK
En inee-ring & Desipn
March 6, 2024
NCDEQ Division of Water Resources
3800 Barrett Drive
Raleigh, NC 27609
Re: Norris Crossing - Phase 1 and 2
Holly Springs, NC
Enclosed is the following information required for the Sewer Permit Application:
- Fast Track System Extension Application — ETA 06-23
- Fast Track System Extension Form — FTSE 10-23
- Vicinity Map with Project located on USGS QUAD Map
- Vicinity Maps with Project located on map
The following checks are also included:
- $600.00 — Sewer Extension Application
The project is located at 2205 Avent Ferry Road, Holly Springs, NC. The project consists of
construction of a new residential subdivision. Sewer construction includes 8" public sewer mains
throughout the project for sewer service to each proposed single-family home. The total proposed sewer is
3,955 LF of PVC sewer line, all gravity. Manholes are included where necessary for change in direction,
or to meet distant requirements between manholes. The proposed sewer consists of 65 LF of ductile iron
pipe and the remainder (3,890 LF) of PVC sewer pipe. This project proposes 66 single family detached
lots. The 66 lots expect to produce an average daily flow of 255 gpd each (Town of Holly Springs
Standard), totaling 16,830 gpd for the project. There are environmental permits including, but not limited
to erosion control and stormwater permits for this project's phases which will be obtained through the
appropriate authorities.
Sincerely,
Daniel H. Digitally signed by Daniel
H. Woods
Woods Date: 2024.03.06 16:02:23
-05'00'
Daniel H. Woods, P.E.
Peak Engineering & Design, PLLC
Norris Crossing Phase 1 and 2 — Holly Springs
919.439.0100 p
j roach�dpeakeneineerin-
1125 Apex Peakway II Apex, NC 27502
Page 1 www.PeakEngineering.com

"Fr` PEAK
March 6, 2024
NCDEQ — Environmental Engineering
Attn. Richard Simpson
3800 Barrett Drive
Raleigh, NC 27609
Re: Application WO0045062: Norris Crossing - Phase 1 and 2 Sewer Permit
Holly Springs, NC
The Following comments were provided by NCDEQ for the noted sewer permit application.
1) Is this an ARPA funded proiect? If so, please include the DWI assigned ARPA
nroiect number in your response. No, this is not an ARPA funded Project.
2) Section I1.2 was not checked. Section now checked as a new permit.
3) Section III.I email is incorrect. I got a bounce back. Please correct it. Email was reviewed
and should be correct.
4) For Section VI.7, please provide the Town of Holly Springs letter that allows a single-
family residence to have a maximum flow of 255 gallons per day. Approval letter from
the Town of Holly Springs, and the Town's standards (provided by the Town) is included
with the package.
5) Section IX.S indicates the proposed project does not need a 404/401
authorization. Portions of the property location appears to: have two ponds, borders two
streams, be in Cary Branch that enters Shearon Harris Reservoir, and be in a FEMA
regulatory floodway hazard zoned AE. Please verify why you would not need 404/401
authorization. Though the project is adjacent to a nearby FEMA stream, all construction
for this phase remains outside of the associated buffer and floodplains. Future phases will
impact the nearby creek and all necessary permits will be obtained. Including 401/404
permits and a CLOMR.
6) Section IX.6 is checked yes for additional environment permits per 15A NCAC 02T
.0105(c)(6). However, your narrative states: "There are no required environmental permits
for this project's phases." Please clarify. Other permits such as land disturbance and
stormwater control requirements are being met, and permits are being obtained through the
appropriate authorities. The cover letter was adjusted accordingly.
Should you have any questions regarding the information provided please do not hesitate to contact us.
Sincerely,
Daniel H. Digitally signed by Daniel H.
Woods
Woods Date: 2024.03.06 16:16:57
-05'00'
Daniel H. Woods, P.E.
Peak Engineering & Design, PLLC
919.439.0100 p
j roach�dpeakeneineerin_
1125 Apex Peakway II Apex, NC 27502
Norris Crossing Phase 1 and 2 — Holly Springs Page 1 www.PeakEngineering.com

6c T
State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Environmental Management
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
March 31, 1995
Stepanie L. Sudano, P.E., Town Engineer
Town of Holly Springs
Post Office Bost 8
Holly Springs, North Carolina 27540
RE: Town of Holly Springs
Request for Adjusted Daily Wastewater Flow
Wake County
Dear Ms. Sudano:
On March 15,1995, the Division received your wastewater flow reduction request and supporting
documentation concerning wastewater flows associated with present residences within the Town of Holly
Springs. Your letter requested the Division allow the reduction of wastewater flows from 120 GPD per
bedroom as required in required by North Carolina Administrative Code to 255 GPD per household for
single family residential units, In support of your request, water consumption data and wastewater
information was supplied from households located in Holly Springs.
An evaluation was completed by the Division in accordance. with 15A NCAC .0219(l)(3) using the
water consumptiorl.data submitted, twelve (12) months of data starting from January 1994. The peak
month was determined to be January 1994 based on average wastewater generated per customer. Using
the upper 10°lo of the water consumption data for the month of January, eliminating industries, commercial
properties and several inaccurate residential readings, Division staff verified the flow rate of 255 GPD per
household.
In view of the information submitted, the Division of Environmental Management hereby approves
the use of 255 GPD per single family residence in all applicable non -discharge permit applications for
future wastewater collection extensions which will be made tributary to the Town of Holly Springs
Wastewater Treatment Plant (Permit No. NC0063096), This consideration applies to any applicable future
projects submitted to this Division as well as any projects which are presently under review. Wastewater
flows presently tributary to the wastewater treatment facilities can be adjusted upon negotiations between
the Town of Holly Springs and the Raleigh Regional Office.
If you have any questions or comments regarding this matter, please contact Mr. Michael D. Allen
at [phone] ext; 547,
Sincer .y,
�A. Preston Howard, Jr., P.E.
cc: Raleigh Regional Office„ Water Quality Section
State Engineering Review Group
P.O. BOX 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FA}f_919-733-2496
An Equai Opportunity Affirmative Action Employer 50% recycled/ f o% past -consumer paper

From: Daniel Woods
To: Simpson, Richard; Jeff Roach; Fred Soinnenweber
Cc: Koncz, Emily; Jones, Rachel
Subject: [External] RE: Norris Crossing Phase 1 and 2 Sewer System Extension Additional Information Request
Date: Wednesday, March 6, 2024 4:46:08 PM
Attachments: imaae001.pna
Sewer Cover Letter-Revised.pdf
Sewer Fast Track FFA-10-23-Updated 3-4-2024.pdf
Town Sewer Standard - 7.00 Supp#8 2023.pdf
Sewer Permit Apo Attachment Flow Reduction.odf
NCDEO Sewer Response to Comments.pdf
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.
Good afternoon Richard,
Thank you again for the follow up call the other day. I have been able to gather the necessary
information for a resubmittal to address your comments. Attached to this email are the
following items.
1. Response letter to your comments below
2. Updated sewer application, signed by Holly Springs
3. Town of Holly Springs Approval for sewer flow reduction
4. Reference to the Town Standards and Specifications noting their standard flow rate.
5. Updated Sewer Cover letter indicating other environmental permits are required such as
erosion control ([and disturbance) and stormwater control. Which will be obtained as
applicable.
Should you have any questions please do not hesitate to call,
Thankyou,
Daniel Woods, PE
Peak Engineering & Design, PLLC
[phone]
1125 Apex Peakway
Apex, NC 27502
From: Simpson, Richard <[e-mail]>
Sent: Monday, February 19, 2024 2:41 PM
To: Daniel Woods <dwoods@pea kengineering.com>; Jeff Roach <[e-mail]>
Cc: Simpson, Richard <[e-mail]>
Subject: Norris Crossing Phase 1 and 2 Sewer System Extension Additional Information Request
Hello Daniel,
After reviewing the Fast Track Sewer System Extension Application for Norris Crossing Phase 1 and

2 (Application Number WQ0045062), additional information is required in orderto further process
the application. Please provide the following information by March 20, 2024, 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- Is this an ARPA funded project? If so, please include the DWI assigned ARPA project
number in your response.
2 - Section 11.2 was not checked.
3 - Section 111.1 email is incorrect. I got a bounce back. Please correct it.
4 - For Section VI.7, please provide the Town of Holly Springs letter that allows a single-family
residence to have a maximum flow of 255 gallons per day.
5 - Section IX.5 indicates the proposed project does not need a 404/401 authorization. Portions of
the property location appears to: have two ponds, borders two streams, be in Cary Branch that
enters Shearon Harris Reservoir, and be in a FEMA regulatory floodway hazard zoned AE. Please
verify why you would not need 404/401 authorization.
6 — Section IX.6 is checked yes for additional environment permits per 15A NCAC 02T .0105(c)(6).
However, your narrative states: "There are no required environmental permits for this project's
phases." Please clarify.
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 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,
Richard Simpson
Environmental Engineering
Office of Continuous Improvement (OCI)
Division of Water Resources - Raleigh Regional Office
North Carolina Department of Environmental Quality
richard.simpson(Mcleq.nc.gov
919.791.4239 Office

1 .1 .Q_E
Emaii correspondence to and from this address is subject to the North
Carolina Public Records Law and may be disclosAd to third parties.
• Get info on ARPA Project Permitting: ARPA Env. Permitting
• Search DEQ Permits: vQ DEQ Permit Directory
• Applyfor Funding: I Need Funding I NQ DEQ
• Sewer Extension Permitting I NC DEQ
o Subchapter 2T 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.