WQ0045118_Withdrawal_20240522

Wilson, Susan A
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David Gorman <[e-mail]>
Wednesday, May 22, 2024 1:54 PM
Wilson, Susan A
Nick Parker; Godreau, Jessica; Frank Emery; Dillon Smith; Shawn Donovan; Jordan Fox;
Shea Cashen
[External] 710 N Estes
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Ms. Wilson -
Good afternoon. This letter shall serve as a formal request to withdraw our application for private service
(WQ0045118). The reason is "design change."
Thanks,
Dave
David Gorman, Principal
Lock7 Development
Office: 202-922-6540
[e-mail]
J
J J J J
1

W iTI-1 -1y2A (+J State of North Carolina
v"� ewho L WTOV � Department of Environmental Quality
DWR Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 10-23 & SUPPORTING DOCUMENTATION
Application Number: (t)Q Co ( 8 (to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
I. Applicant's name: 710 N Estes. LLC (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ® Corporation ❑ General Partnership
❑ Federal ❑ State/County ❑ Municipal
3. Signature authority's name: David Gorman per 15A NCAC 02T .0106tb1
Title: Principal
4. Applicant's mailing address: 2201 Wisconsin Ave NW. Suite 200
City: Washington State: DC Zip: 20007-
5. Applicant's contact information:
Phone number: [phone] Email Address: david(alock7.com
11. PROJECT INFORMATION:
❑ Privately -Owned Public Utility
❑ Other
NC Dept of E: viropnnental Qual;ty
FrR — 1 Mi,
Ralt igh Regio;laI Office
1. Project name: 710 N Estes Townhomes
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: Orange
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.936 111 : Longitude:-79.051389 l/
5. Parcel ID (if applicable): 9789-45-5646 (or Parcel ID to closest downstream sewer)
111. CONSULTANT INFORMATION:
. Professional Engineer: Dillon W. Smith License Number: 042542
Firm: Ballentine Associates, PA
Mailing address: 221 Providence Road
City: Chapel Hill State: NC Zip: 27514-
Phone number: [phone] Email Address: dillonsnballentineassociates.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Mason Farm Wastewater Treatment Plant Permit Number: NC 0025241
Owner Name: Orange Water & Sewer Authority
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. Permit Number(s): WQ(NA. installation'75)
2. Downstream (Receiving) Sewer Information: inch ❑ Gravity ❑ Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS00031
Owner Name(s): Orange Water & Sewer Authority
FORM: FTA 10-23 Pagel of 5