WQ0045418_Application (FTSE)_20240222

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I-IAGIN TRANSMITTAL
ENGINEERING, PA
DATE: 2/19/24
TO : NCDEQ Wilmington Regional Office
127 Cardinal Dr
Wilmington NC 28405 FEB 2 2 2024
w�r3
PROJECT: Arbors at Morehead City Apartments
PLEASE FIND ATTACHED:
ITEM DATED
1 Fast Track Sewer Application 2/19/2024
1 $600 Review Fee Check 2/19/2024
1 FTSE 04-16 2/19/2024
1 Vicinity Map 2/19/2024
1 Utility Capacity Letter 2/19/2024
Note:
Tim Shaw
Hagen Engineering, PA PO Box 14851 Greensboro, NC P-336-404-9796 [e-mail]

HAGEN 3859 Battleground Ave, Suite 300 Phone: [phone]
ENGINEERING, PA Greensboro, NC 27410 [e-mail]
Wilmington Regional Office February 19, 2024
Water Quality Section
127 Cardinal Drive Extension
Wilmington NC 28405
910-796-7215
RE: Arbors at Morehead City Apartments
NCDEQ Submission
Private Sewer Permit
Cover Letter
The purpose of this cover letter is to outline the contents of this Private Sewer Permit
application package as well as to provide of a summary of the project to which is pertains. This
Arbors at Morehead City Apartments development is a 228 unit multifamily complex which will
require an estimated peak flow o 56 320 GP for utility consumption. The project will be
comprised of public gravity sewer main. In terms of public sewer, this project will be comprised
of 1,065 LF of 8" PVC. Within this submittal package you will find the following items:
1) $600 check for the Private Sewer Permit
2) One completed DWR Fast Track Sewer System Extension application
3) One executed FTSE 04-16
4) One 8.5" x 11" USGS Topo Map
5) One Utility Capacity Letter from Morehead City
6) One street level map (aerial)
Thank you,
Tim Shaw, PE �Cv� SC�
Hagen Engineering, PA -�4 v- ail _ '^kd
336-286-3350
�AA

1 v
February 16, 2024
Tim R. Shaw
Hagan Engineering, PA
3859 Battleground Ave. Suite 300
Greensboro, NC 27410
RE: WATER/SEWER AVAILABILITY FOR THE PROPOSED DEVELOPMENT
LOCATED AT 500 FRIENDLY ROAD, MOREHEAD CITY, NC 28557 PARCEL
4637613146870000.
Dear Mr. Shaw,
This letter will serve as confirmation that the Morehead City Public Utilities Department has
water and sewer services and capacity available to the above-referenced site.
If you have any fuilher questions or concerns, please do not hesitate to contact our office during
normal business hours of Monday —Friday 8:00 A.M. to 5:00 P.M. EST.
Respectfully,
DW)h Ll �
Daniel K. Williams
Public Services Director/ACM
Town of Morehead City
Morehead City is dedicated to the well-being and safety of our community through exceptional service with a warm coastal smile.
1100 Bridges Street I Morehead City,North Carolina 28557 1 Phone[phone] www.moreheadcitync.org

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State of North Carolina
Department of Environmental Quality
Division of Water Resources
DIvislon of Water Resuurcet; Flow Tracking for Sewer Extension Applications
(FTSE 10-23)
Entity Requesting Allocation: Hagan Engineering
Project Name for which flow is being requested: Arbors @ Morehead City Apartments
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: Town of Morehead City
b. WWTP Facility Permit#: NCO026611
All flows are In MGD
c. WWTP facility's permitted flow 2.5
d. Estimated obligated flow not yet tributary to the WWTP 0.174
e. WWTP facility's actual avg. flow 1.427
f Total flow for this specific request 0.031
g. Total actual and obligated flows to the facility 1.629
h. Percent of permitted flow used 65.16%
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) (F)=(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***
#10 2.664 1.064 0.585 0.143 0.728 0.336
I
i
*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):
Downstream Permit Number:
Page 1 of 8
FTSE 10-23

M. Certification Statement:
I Daniel K. Williams 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.
g rcial Signature Date
Public Services Director/ACM
Title of Signing Official
Page 2 of 8
FTSE 10-23

State of North Carolina
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/Pme Mains)and that plans,specifications and supporting documents
havebeen prepared in accordancewith 15A NCAC 021,ISA NCACDivision policies,and¢oodengineeringgfgetices.
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 IAA NCAC 02T .03055 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 I5A NC&C 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 sewersystems.
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 reduc a 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):
0 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):
0 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 1.2 is a corporation or company,provide documentation it is registered for business with the
orth Carolina Secretary of State.
O 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 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 Caml—ina
licensed ProfessionalEngjnee .
® The Applicant's Certification on Page 5 of the application shall be signed in accordance with 15A NCAC 02T.0106(2). Per
15A NCAC 02T.0106(c),an altemateperson 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 3

E. Flow Tracking/Acceptance Form(Form: FTSE 10-23)(If Applicable):
0 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 ownerhas adequate capacity and willnot 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 15ANCAC 02T.0305(hh,)(1).submit documentation ofpowerreliability forpumping stations,
➢ This alternative is only available foraverage 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 dmeframes,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 15ANCAC 02T,0115(a)(1)provide the Certificate of Public Convenience and Necessity from the North Qarolina Utilities
Cammissioq 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
fora franchise has been received and that the service area is contiguous to an existing franchised area orthat franchise ap pmval
is expected.
J. Operational Agreements (Applications from HOA/POA and Developers for lots to be sold):
❑ Home/Property Owners'Associations
❑ Per 15ANCAC 02T.0115(c),submit the properly executed Operationlal,&mement(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.011502).submit the properly executed Operational Agnement{FORM:DES.
For more information, visit the Division's collection systems we site
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 Realonal 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
Fayetteyllle Regional Office 226 Green Street Suite 714 Anson,Bladen,Cumberland,Harnett, Hoke,
Water Quallty Section Fayetteville, North Carolina 28301-5095 Montgomery,Moore,Robeson,Richmond,
[phone] Sampson,Scotland
[phone] Fax
Mooresville Realonai 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 SectloLi Raleigh,North Carolina 27609 Granville,Halifax,Johnston,Lee,Nash,
[phone] Northampton,Orange,Person,Vance,Wake,
[phone] Fax Warren,Wilson
IA_ashington Regional Office 943 Washington Square Mall Beaufort,Berne,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 Qua% Section Wilmington,North Carolina 28405 Hanover,Onslow,Pender
[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
i
INSTRUCTIONS FOR FORM: FTA 10-23 &SUPPORTING DOCUMENTATION Page 3 of 3

State of North Carolina
Department of Environmental Quality
Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 10-23&SUPPORTING DOCUMENTATION
Application Number: (to be completed by DWR)
All items mast be completed or the application will be returned
I. APPLICANT INFORMATION. Retreat at Morehead City, LLC
1. Applicant's name: __ _ (company,municipality,HOA,utility,etc.)
2. Applicant type: [9 Individual ❑ Corporation ❑ General Partnership ❑ Privately-Owned Public Utility
❑ Federal ❑ State/County ❑ Municipal ❑ Other
3. Signature authority's name: MichaelMunuy per 15ANCACO2T,0106(b)
Title: Principal
4. Applicant's mailing address: 500-D State Street
City:Greensboro State:NC Zip: 27405-
5. Applicant's contact information:
Phone number:(33§)3I5-8500 Email Address: mtkeCglbhcllc.net
U. PROJECT INFORMATION:
1. Project name:Arbors at Morehead City Apartments
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:Carteret
4. Approximate Coordinates(Decimal Degrees): Latitude: 34.7312' Longitude: -76 7 30'
5. Parcel ID(if applicable): 637613146870000(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Tim R. Shaw License Number:050770
Firm: Hagen Engineering. PA
Mailing address: 3859 Battleground Ave.Suite 300
City:Greensboro State:NC Zip: 27410-
Phone number:(336)2$b-5350 Email Address: tshaw�a,ha eg n-erg com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
Morehead City Wastewater Treatment Plant
1. Facility Name: Permit Number: NCOD26611
Owner Name: Town of Morehead City
I
V. RECEIVING DOWNSTREAM SEWER INFORMATION: !
I
1. Permit Number(s): W CQ So01 00
2. Downstream(Receiving) Sewer Information: A inch ® Gravity 0 Force Main
3. System Wide Collection System Permit Number(s)(if applicable): WQCSOO100
Owner Name(s):Town of Morehead City
FORM:FTA 10-23 Page I 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. Has a flow reduction been approved under 15A NCAC 02T.0114(f) ❑Yes ®No
➢ If yes,provide a copy of flow reduction 2Dproval 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
One bedroom Apartment Units 75 gal/day/bedroom 66 4950 GPD
Two Bedroom Apartment Units 150 gal/day/unit 162 24300 GPD
Cabana 250 gal/day/fixture 2 500 GPD
Clubhouse 25 gal/day/employee 4 100 GPD
Pool 10 gal/day/resident 50 500 GPD
Maintenance Building 250 gal/day/fixture 2 500 GPD
Total 30,850 GPD
a See 15A NCAC 02T.0114 b d . e l 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: 30,850 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.
i
❑ 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

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable)-02T.0305& (Gravity
1. Summarize gravity sewer to be permitted:
Size(inches) Length(feet) Material
8 1065 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
VM. PUMP STATION DESIGN CRITERIA (If Applicable)—02T.0-3- &MDC (PumQ Stations/Force Mains):
PROVIDE A SEPARATE COPY OF THIS PAGE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name:
2. Approximate Coordinates(Decimal Degrees): Latitude: ° Longitude:
3. Total number of pumps at the pump station:
3. Design flow of the pump station: millions gallons per day(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)
b. Power reliability in accordance with 15ANCAC 02T.0305(h)(1):
❑ Standby power source or ❑ Standby pump
➢ Must have automatic activation and telemetry -ISA 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 theportable source is owned or contractedby the applicant and iscompatible with the station.
➢ If the portable power source orpump is dedicated to multiple pump stations,an evaluation of allthe pump stations'storaW
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 poweroutage.
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(f)&(a)? 0 Yes ❑ No
15ANCAC 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
2Water mains(vertical-water over sewer preferred, including in benched trenches) 18 inches
2Watermains(horizontal) 10 feet
Reclaimed water lines (vertical-reclaimed over sewer) 18 inches
Reclaimed water Panes (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 otherstream,lake,impoundment,orground 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 orcuts 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.0305M or "see Section X.1 of this application
*I SA NCAC 02T.0305(g) contains alternatives where separations in 02T.0305(fl 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 ❑ NIA
➢ 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 forwetlands? ® Yes ❑ No ❑ N/A
➢ Please provide supplementary information identifying the areas of non-conformance.
➢ See the Division's draft separation requirementg 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:White Oak ❑ No
If yes,does the project comply with setbacks found in the riverbasin rules per 15A NCAC 02B.0200? ❑ Yes ❑ No
➢ This includes Trout Buffered Streams per 1 SA NCAC 2B.0202
5. Does the project require coverage/authorization under a 404 Nationwide/individual permits ❑ Yes ®No
or401 Water Quality Certifications?
➢ Please provide the permit number/pemaitting 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 021.0105C 6),directly related environmental permits orcertification applications must be beingprepared, E
have been applied for,or havebeen 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 0 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 Pane,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.
I
FORM:FTA 10-23 Page 4 of 5

X. ' CERTIFICATIONS:
1. Does the submitted system comply with 15A NCAC 02T,the Minimum Design Criteria for the PermittinQ of PumV Stations
and force Mains(latest version),and the Gravity Seiner Minimum Design Criteria(latest�ersionl 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. Approval of the reunest_will be Issued
concurrent_i_r: 44th the approval of the permit, and proicets requiring a variance approval may be subject to longer
review Times.For iproiects requirine two or m re variances or where the variance is determined by the Division to be a
significant Bortion of the ro'ect the full technical review is re uired
2. Professional Engineer's Certification:
�,L J ,attest that this application for, wby5 nt' /w C-4� Any.— rn�A-��
(Professional Engineer's name from Application Item IIL1.) (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 for Gravity Servers latest version and the Minimum_Design Criteria for the Fast-Track Permittins
of Pump Slations 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 sea] 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 143-215.613, 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.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: i `.� '� CAR Q(
=O�oFESS1 9
q
SEAL 1
050770
r
3 55
111,R.
..�•.i t`�-,jam_......__.
3. Applicant's Certification per 15A NCAC 02T.0106(b): !/
Mike Murray
Arbors at Morehead City
,attest that this application for_Apartments
(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.
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 than may include civil penalties,injunctive relief,and/or criminal prosecution. I will make no claim against the Division
of Water Resources should a condition of this permit be violated. I also understand that if all required parts of this application
package are not completed and that if all required supporting information and attachments are not included,this application
package will be returned to me as incomplete.
NOTE — In accordance with General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed$10,000 as well as civil penalties up to$25,000 per violation.
Signature: '`a }Rx-.. Date: 2- `11
1 a
FORM:FTA 10-23 Page 5 of 5