WQ0045561_Application (FTSE)_20240731

Burd, Tina J
From: Burd, Tina J
Sent: Wednesday, July 31, 2024 1:11 PM
To: [e-mail];[e-mail]
Cc: Cocanower,Jordan M;Tharrington, Tom
Subject: WQ0045661 - Avenue One - Phase 1 Townhomes Private Sewer
The Wilmington Regional Office of the Division of Water Resources, Water Quality Operations Section received the Fast
Track Sewer System Extension Application (FTA) and $600.00 fee for the subject project on July 31, 2024. The project
has been assigned to Jordon Cocanower, cc'd.
Othe.auuise,you will be,corntacted by the applicable stallf.,mernber if additional w, f
information is needed.
Staff Reviewer Counties Served Contact Information
Tyler Benson Brunswick, Columbus, Duplin & Pender [e-mail]
Jordan Cocanower Carteret, New Hanover&Onslow [e-mail]
Bryan Lievre All -ARPA Projects Only [e-mail]
Tom Tharrington All—Coordinator, Please Copy on All Emails [e-mail]
1. Please provide a copy of the entire application in digital format to your assigned reviewer indicated above. The
application and drawings should be provided as separate files.
2. Please indicate in the subject line of the email the permit number(if available), name of the project, and county
where the project is located. j
Please be advised that the construction of the proposed activities may not commence until the sewer permit is issued.
Best Regards,
Tina Burd
Administrative Associate II
Wilmington Regional Office
Division of Environmental Assistance & Customer Service
Phone [phone]
New email: tina.burd@deq,nc.gov
NCDEQ
Wilmington Regional Office
127 Cardinal Drive Ext.
Wilmington, NC 28405
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties
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AVENUE ONE SUBDIVISION
Item B: Cover Letter
Prepared for
Clayton Properties Group, Inc.
P.O. Box 4098
Maryville, TN 37802
[phone]
Prepared by
CLD Engineering, PLLC
P.O. Box 1172
Wilmington, NC 28402
(910) 254 - 9333
www.ctdeng.com
R�GENFDIt0)et4?D%VR
Date
WaterOuaNtYRe9onal July 26, 2024
Operations S�tion
Wilmington He9,ona1 OBiGe

PERMITTING OVERVIEW
Avenue One is a proposed 734-lot residential subdivision located off Sidbury Road (SR-1336) in New Hanover County,
North Carolina. The first phase of Avenue One is approximately 70 acres and will include 365 lots in the following
residential distribution and sewer classification:
• Private Sewer System(Clayton Properties Group, Inc.)
o Project Name:Avenue One-Phase 1 Townhomes
o Type I(Roadway Entry)Townhomes: 126 three-bedroom single-family lots
o Type II(Alleyway Entry)Townhomes:210 three-bedroom single-family lots
o Total Lots:336
o Average Daily Flow(ADF):75,600 gpd
• Public Sewer System(CFPUA)
o Project Name:Avenue One-Phase 1
o Three-bedroom homes:7 single-family lots
o Four-bedroom homes: 7 single-family lots
o Five-bedroom homes: 7 single-family lots
o Six-bedroom homes: 8 single-family lots
o Total Lots:29
o One Amenity Centers:2,500 gpd per 10x250 gpd plumbing fixtures
o Average Daily Flow(ADF): 12,400 gpd
The private sewer system project will contain the 6-inch diameter gravity sewer to the 336 townhome units of the
subdivision.The private sewer system will discharge 75,600 gpd into the public sewer system for this subdivision. Refer to
the public sewer system section below.
The public sewer system project will contain the gravity sewer mains, pump station, and sewer force main for the
subdivision. The public sewer system during Phase 1 will receive 12,400 gpd of sewer from the 29 lots and one amenity
center directly serviced off it as well as 75,600 gpd from the private sewer(totaling 88,000 gpd).The public sewer system
will also receive the ADF from Phase 2 which will be permitted later.The Phase 1 pump station will be the main station for
this subdivision is sized for the full buildout conditions and will operate at 540 gpm at 108 feet of head (firm capacity of
0.7776 MGD). It will pump into an existing 12-inch diameter CFPUA sewer force main located on the north side of Sidbury
Road (SR-1 336) [WQ0042271]where the sewer will be ultimately treated in the James A. Loughlin Northside WWTP (NC
0023965).
Item included with this submittal are listed below.
• A. Hardcopy of the Original Submittal
• B. Cover Letter(This Sheet)and CFPUA Approval Letter
• C. Application Fee($600.00)
• D. Fast Track Application(Form: FTA 10-23)
• E. Flow Tracking/Acceptance Form: USE 10-23)
o Note:the CFPUA issued one USE to cover both the public and private FTAs
• F. Site Maps(USGS Topographic Map and Street Level)
• J. Operational Agreements(Form: DEV 03-19)
If you have any questions or need any additional information,please feel free to contact our office.
Very ,spectfully, RAG +v�p1NGpENRIOwR
J armine, .E J�� 31 Z024
irector of Engineeringopeta Wa`e�o`o�nsseg�,o«e
Wi1mi 9lo�Fe9�ona1

State of North Carolina
Department of Environmental Quality
DWR Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources INSTRUCTIONS FOR FORM: FTA 10-23&SUPPORTING DOCUMENTATION
This application is for sewer extensions involving gravity sewers, pump stations and force mains, or any combination that has been
certified by a professional engineer and the applicant that the project meets the requirements of 15A NCAC 02T and the Division's
Minimum Design Criteria(Gravity Sewer& Pump Stations/Force Mains) and that plans,specifications and supporting documents
have been prepared in accordance with 15A NCAC 02T,15A NCAC 02T.0300.Division policies,and good engineering practices.
While no upfront engineering design documents are required for submittal, in accordance with 15A NCAC 02T .0305(b), design
documents must be prepared prior to submittal of a fast track permit application to the Division. This would include plans, design
calculations, and project specifications referenced in 15A NCAC 02T .0305 and the applicable minimum design criteria. These
documents shall be immediately available upon request by the Division.
Projects that are deemed permitted(do not require a permit from the Division)are explained in 15A NCAC 02T.0303.
Projects not eligible for review via the fast track process(must be submitted for full technical review):
➢ Projects that do not meet any part of the minimum design criteria(MDC)documents;
➢ Projects that involve more than one variance from the requirements of 15A NCAC 02T;
➢ Pressure sewer systems utilizing simplex septic tank-effluent pumps(STEPS)or simplex grinder pumps;
➢ Simplex STEP or simplex grinder pumps connecting to pressurized systems(e.g. force mains);
➢ Vacuum sewer systems.
General—When submitting an application,please use the following instructions as a checklist in order to ensure all required items are
submitted. Adherence to these instructions and checking the provided boxes will help produce a quicker review time and reduce the
amount of requested additional information.Failure to submit all required items will necessitate additional processing and review
time,and may result in return of the application. Unless otherwise noted,the Applicant shall submit one original and one copy of
the application and supporting documentation.
A. One Original and One Copy(second copy may be digital)of Application and Supporting Documents
® Required unless otherwise noted. Signatures on original must be"wet ink"or secure digital signatures.
Please do not submit engineering design plans with the application unless specifically requested.
B. Cover Letter/Narrative Description(Required for All Application Packages):
® List all items included in the application package,as well as a brief description of the requested permitting action.
➢ Be specific as to the system type,number of homes served,flow allocation required,etc.
➢ Include the permit number/status of any other required sewer permits(downstream/upstream)
➢ If necessary for clarity, include attachments to the application form.
➢ If the project is funded by American Rescue Plan Act(ARPA) funds, please include the ARPA project number in the cover
letter and in parentheses under Project Name(Section II.1.of the application).
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 Ag1P4W1NCDENRID11
➢ Payable to North Carolina Department of Environmental Quality(NCDEQ)
D. Fast Track Application(Required for All Application Packages,Form FTA 10-23):
JUL 3 � 2024
® Submit the completed and appropriately executed application. Water oualtyRe9ionat
➢ If necessary for clarity or due to space restrictions,attachments to the application may be made. aoperatnRssection
ecti
W Office
p If the Applicant Type in Item I.2 is a corporation or company, provide documentation it is registered for business with the
North Carolina Secretary of State.
p 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.
INSTRUCTIONS FOR FORM: FTA 10-23&SUPPORTING DOCUMENTATION Page I of 3

® The Applicant's Certification on Page 5 of the application shall be signed in accordance with 15A NCAC 02T.0106(b). Per
15A NCAC 02T.0106(c),an alternate person may be designated as the signing official if a delegation letter is provided from
a person who meets the criteria in 15A NCAC 02T.0106(b).
E. Flow Tracking/Acceptance Form (Form:FTSE 10-23)(If Applicable):
® Submit the completed and executed FTSE form from the owners of the downstream sewers and treatment facility.
➢ Multiple forms maybe required where the downstream sewer owner and wastewater treatment facility are different.
➢ The flow acceptance indicated in form FTSE must not expire prior to permit issuance and must be dated less than one year
prior to the application date.
➢ Submittal of this application and form FTSE indicates that owner has adequate capacity and will not violate G.S. 143-215.67(a).
➢ Intergovernmental agreements or other contracts will not be accepted in lieu of a project-specific FTSE.
F. Site Maps(All Application Packages):
® Submit an 8.5-inch x 11-inch color copy of a USGS Topographic Map of sufficient scale to identify the entire project area,
including the closest surface waters.
➢ General location of the project components(gravity sewer,pump stations,&force main)
➢ Downstream connection points and permit number(if known)for the receiving sewer
® Include an aerial location map showing general project area(such as street names or latitude/longitude) so that Division staff
can easily locate it in the field.
G. Existing Permit(Application Packages for Modifications to an Existing Permit):
❑ Submit a copy of the most recently issued existing permit.
❑ Include a descriptive and clear narrative identifying the previously permitted items to remain in the permit,items to be
added,and/or items to be modified(the application form itself should include only include items to be added/modified).The
narrative should also include whether any previously permitted items have been certified.
❑ The narrative should clearly identify the requested permitting action and accurately describe the sewers to be listed in
the final permit.
H. Power Reliability Plan(Required if portable reliability option utilized for Pump Station):
❑ Per 15A NCAC 02T.0305(h)(1),submit documentation of power reliability for pumping stations.
➢ This alternative is only available for average daily flows less than 15,000 gallons per day
➢ It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant and is compatible with
the station. The Division will accept a letter signed by the applicant(see 15A NCAC 02T.0106(b))or proposed contractor,
stating that"the portable power generation unit or portable, independently-powered pumping units,associated appurtenances
and personnel are available for distribution and operation of this pump station."
➢ If the portable power source or pump is dedicated to multiple pump stations, an evaluation of all the pump stations'
storage capacities and the rotation schedule of the portable power source or pump, including travel timeframes, shall
be provided in the case of a multiple station power outage.(Required at time of certification)
1. Certificate of Public Convenience and Necessity(All Application Packages for Privately-Owned Public Utilities):
❑ Per 15A NCAC 02T.0115(a)(1)provide the Certificate of Public Convenience and Necessity from the North Carolina Utilities
Commission demonstrating the Applicant is authorized to hold the utility franchise for the area to be served by the sewer
extension,or
❑ Provide a letter from the North Carolina Utilities Commission's Water and Sewer Division Public Staff stating an application
for a franchise has been received and that the service area is contiguous to an existing franchised area or that franchise approval
is expected. RECEIVED/NCDENR/DWR
.1. Operational Agreements(Applications from HOA/POA and Developers for lots to be sold): JUL 31 20A
❑ Home/Property Owners'Associations
❑ Per 15A NCAC 02T.0115(c),submit the properly executed Operational Agreement(FORM: HOA)Jy Regional
❑ Per 15A NCAC 02T.0115(c),submit a copy of the Articles of Incorporation,Declarations and�o R�eWai Office
10 Developers of lots to be sold
RJ Per 15A NCAC 02T.0115(b),submit the properly executed Operational Agreement(FORM:DEV).
For more information, visit the Division's collection systems website
INSTRUCTIONS FOR FORM: FTA 10-23& SUPPORTING DOCUMENTATION Page 2 of 3

THE COMPLETED APPLICATION PACKAGE INCLDING ALL SUPPORTING INFORMATION AND
MATERIALS, SHOULD BE SENT TO THE APPROPRIATE REGIONAL OFFICE:
REGIONAL OFFICE ADDRESS COUNTIES SERVED
Asheville Regional Office 2090 US Highway 70 Avery, Buncombe, Burke, Caldwell, Cherokee,
Water Quality Section Swannanoa, North Carolina 28778-8211 Clay, Graham, Haywood, Henderson, Jackson,
[phone] Macon, Madison, McDowell, Mitchell, Polk,
[phone] Fax Rutherford, Swain,Transylvania, Yancey
Fayetteville Regional Office 225 Green Street Suite 714 Anson, Bladen, Cumberland, Harnett, Hoke,
Water Quality Section Fayetteville, North Carolina 28301-5095 Montgomery, Moore, Robeson, Richmond,
[phone] Sampson, Scotland
[phone] Fax
Mooresville Regional Office 610 E. Center Avenue Alexander, Cabarrus, Catawba, Cleveland,
Water Quality Section Mooresville, North Carolina 28115 Gaston, Iredell, Lincoln, Mecklenburg, Rowan,
[phone] Stanly, Union
[phone] Fax
Raleigh Regional Office 3800 Barrett Drive Chatham, Durham, Edgecombe, Franklin,
Water Quality Section Raleigh, North Carolina 27609 Granville, Halifax, Johnston, Lee, Nash,
[phone] Northampton, Orange, Person,Vance,Wake,
[phone] Fax Warren,Wilson
Washington Regional Office 943 Washington Square Mall Beaufort, Bertie, Camden, Chowan, Craven,
Water Quality Section Washington, North Carolina 27889 Currituck, Dare, Gates, Greene, Hertford, Hyde,
[phone] Jones, Lenoir, Martin, Pamlico, Pasquotank,
[phone] Fax Perquimans, Pitt, Tyrrell,Washington,Wayne
Wilmington Regional Office 127 Cardinal Drive Extension Brunswick, Carteret, Columbus, Duplin, New
Water Quality Section Wilmington, North Carolina 28405 Hanover, Onslow, 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
RECEIVED/NCDENR/DWR
JUL 31 2024
Water Quality Regional
Operations Section
Wilmington Regional Office
INSTRUCTIONS FOR FORM: FTA 10-23 & SUPPORTING DOCUMENTATION Page 3 of 3

State of North Carolina
Department of Environmental Quality
DWR Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 10-23&SUPPORTING DOCUMENTATION
Application Number: oil 6� I (to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: Clayton Properties Group, Inc.(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: Scott Bowser per 15A NCAC 02T.0106(b)
Title:Assistant Secretary
4. Applicant's mailing address: P.O. Box 4098
City: Mares State:TN Zip: 37802-
5. Applicant's contact information:
Phone number: [phone] Email Address: sbowser g,mun og_ com
II. PROJECT INFORMATION:1. Project name:Avenue One-Phase 1 Townhomes p1'1V0�2 e"r
2. Application/Project status: ®Proposed(New Permit) ❑Existing Permit/Project ❑ARPA funded
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:New Hanover
4. Approximate Coordinates(Decimal Degrees): Latitude: 34.3289' Longitude:-77.8658'
5. Parcel ID(if applicable): R02700-001-183-000(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer:Jason R.Carmine, PE License Number: 033196
Firm:CLD En ing eering PLLC
RECEIVEDINCDENRlDWR
Mailing address: P.O.Box 1172
City: Wilmington State:NC Zip:28402- JUL
Phone number: [phone] Email Address:jcarmine@cldeng com Water QualtyRegronal
rations sec"On
IV. WASTEWATER TREATMENT FACILITY(WWTF)INFORMATION' Wiirningl-se9a aioflwe
1. Facility Name: James A.Loughlin Northside W WTP Permit Number:NCO023965
Owner Name:CFPUA
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. Permit Number(s): WQ0042271
2. Downstream(Receiving)Sewer Information: 12 inch ❑ Gravity ® Force Main
3. System Wide Collection System Permit Number(s)(if applicable): WQCS
Owner Name(s):CFPUA
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.0I 15(c)been attached?
❑Yes ❑No ®N/A
4. Origin of wastewater:(check all that apply):
® Residential(Individually Owned) ❑Retail(stores,centers,malls) ❑Car Wash
❑ Residential(Leased) ❑ Retail with food preparation/service ❑ Hotel and/or Motels
❑ School/preschool/day care ❑ Medical/dental/veterinary facilities ❑ Swimming Pool/Clubhouse
❑ Food and drink facilities ❑ Church ❑ Swimming Pool/Filter Backwash
❑ Businesses/offices/factories ❑ Nursing Home ❑Other(Explain in Attachment)
5. Nature of wastewater: 100%Domestic %Commercial %Industrial See 15A NCAC 02T.0103 20
If Industrial,is there a Pretreatment Program in effect?❑Yes❑No
6. Hasa flow reduction been approved under 15A NCAC 02T.0114(t)? ❑Yes ®No
➢ If yes,provide a copy of flow reduction approval letter with this application
7. Summarize wastewater generated by project:
Establishment Type(see 02T.0114(f)) Daily Design Flow a,b No.of Units Flow
3-Bedroom Single-Family Residence 75 gal/bedroom/day 336 75,600 GPD
gal/ GPD
gal/ GPD
gal/ GPD
gal/ GPD
gal/ GPD
Total 75,600 GPD
a See 15A NCAC 02T.0114(b),(d), (e)(1)and(e)(2)for caveats to wastewater design flow rates(i.e. proposed unknown
non-residential development uses; public access facilities located near high public use areas; and residential property
located south or east of the Atlantic Intracoastal Waterway to be used as vacation rentals as defined in G.S.42A-4).
b Per 15A NCAC 02T.01 14(c),design flow rates for establishments not identified[in table 15A NCAC 02T.0114] shall be
determined using available flow data,water using fixtures,occupancy or operation patterns,and other measured data.
8. Wastewater generated by project:75,600 GPD(per 15A NCAC 02T.0114 and G.S. 143-215.1)
➢ Do not include future flows or previously permitted allocations
If permitted flow is zero,please indicate why:
❑Pump Station/Force Main or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line.
Please provide supplementary information indicating the approximate timeframe for permitting upstream sewers with flow.
❑ Flow has already been allocated in Permit Number: Issuance Date:
VOL
��G�1V�p1
El Rehabilitation or replacement of existing sewers with no new flow expected NGpEN�j
❑Other(Explain):
q4akec aions$eckk�NSce
oPe�a W-011a
FORM: FTA 10-23 Page 2 of 5

1
VII. GRAVITY SEWER DESIGN CRITERIA(If Applicable)-02T.0305&MDC(Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size(inches) Length (feet) Material
6 6,190 C-900 PVC
➢ Section II& III of the MDC for Permitting of Gravity Sewers contains information related to design criteria
➢ Section III contains information related to minimum slopes for gravity sewer(s)
➢ Oversizing lines to meet minimum slope requirements is not allowed and a violation of the MDC
VIII. PUMP STATION DESIGN CRITERIA(If Applicable)—02T.0305&MDC(Pump Stations/Force Mains):
PROVIDE A SEPARATE COPY OF THIS PAGE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name:
2. Approximate Coordinates(Decimal Degrees):Latitude: 0Longitude:- °
3. Total number of pumps at the pump station:
3. Design flow of the pump station: millions gallons per day(firm capacity)
➢ This should reflect the total GPM for the pump station with the largest pump out of service.
4. Operational point(s)per pump(s): gallons per minute(GPM)at feet total dynamic head(TDH)
5. Summarize the force main to be permitted(for this Pump Station):
Size(inches) Length(feet) Material
RECEIVED/NCDENR/DWR
JUL 31 2024
Water Qualty Regional
operations section
Wilmington Regional office
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.1.b. ❑Grinder Pump ❑ Mechanical Bar Screen ❑Other(please specify)
6. Power reliability in accordance with 15A NCAC 02T.0305(h)(1):
❑ Standby power source or ❑ Standby pump
➢ Must have automatic activation and telemetry- 15A NCAC 02T.0305(h)(1)(B)_
➢ Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
➢ Must be permanent to facility and may not be portable
Or if the pump station has an average daily flow less than 15,000 gallons per day 15A NCACO2T.0305(h)(1)(C):
❑ Portable power source with manual activation,quick-connection receptacle and telemetry-
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry:
➢ Include documentation that the portable source is owned or contracted by the applicant and is compatible with the station.
➢ If the portable power source or pump is dedicated to multiple pump stations,an evaluation of all the pump stations'storage
capacities and the rotation schedule of the portable power source or pump,including travel timeframes,shall be provided
as part of this permit application in the case of a multiple station power outage.
FORM: FTA 10-23 Page 3 of 5

IX. SETBACKS& SEPARATIONS—(02B.0200& 15A NCAC 02T.0305(f)):
I. Does the project comply with all separations/alternatives found in 15A NCAC 02T.0305(f)&(g)? ®Yes ❑No
15A NCAC 02T.0305 contains minimum separations that shall be provided for sewers stems:
Setback Parameter* Separation Required
Storm sewers and other utilities not listed below(vertical) 18 inches
'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-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-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) Water Qualty Regional 36 inches
➢ If noncompliance with 02T.0305(f)or(g),see Section X.1 of th1& 00ai orrice
*15A NCAC 02T.0305(g)contains alternatives where separations in 02T.0305(f)cannot be achieved. Please check"yes"
above if these alternatives are used and provide narrative information to explain.
**Stream classifications can be identified using the Division's NC Surface Water Classifications webnaQe
2. Does this project comply with the minimum separation requirements for water mains? ❑Yes ❑No ® N/A
➢ If no,please refer to 15A NCAC 18C.0906(f)for documentation requirements and submit a separate document,
signed/sealed by an NC licensed PE,verifying the criteria outlined in that Rule.
3. Does the project comply with separation requirements for wetlands? ® Yes ❑ No ❑N/A
➢ Please provide supplementary information identifying the areas of non-conformance.
➢ See the Division's draft separation requirements for situations where separation cannot be met.
➢ No variance is required if the alternative design criteria specified is utilized in design and construction.
4. Is the project located in a river basin subject to any State buffer rules? ❑Yes Basin name: ®No
If yes,does the project comply with setbacks found in the river basin rules per 15A NCAC 02B .0200? ❑Yes ❑No
➢ This includes Trout Buffered Streams per 15A NCAC 2B.0202
5. Does the project require coverage/authorization under a 404 Nationwide/individual permits ❑Yes ®No
or 401 Water Quality Certifications?
➢ Please provide the permit number/permitting status in the cover letter if coverage/authorization is required.
6. Does project comply with 15A NCAC 02T.0105(c)(6)(additional permits/certifications)? ❑Yes ®No
Per 15A NCAC 02T.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

X. CERTIFICATIONS:
1. Does the submitted system comply with 15A NCAC 02T, the Minimum Design Criteria for the Permitting of Pump Stations
and Force Mains(latest version) and the Gravity Sewer Minimum Design Criteria(latest version)as applicable?
® Yes ❑No
If no, for projects requiring a single variance, complete and submit the Variance/Alternative Design Request application
(VADC 10-14) and supporting documents for review to the Central Office. Approval of the request will be issued
concurrently with the approval of the permit and projects requiring a variance approval may be subject to longer
review times.For Proiects requiring two or more variances or where the variance is determined by the Division to be a
significant portion of the project,the full technical review is required
2. Professional Engineer's Certification:
I, J4$00 IZ• CAfZMIkS, PE ,attest that this application for C?IVE lazaNm nR5,
(Professional Engineer's name from Application item 111.1.) (Project Name from Application Item 11.1)
has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans,
specifications,engineering calculations,and all other supporting documentation to the best of my knowledge. I further
attest that to the best of my knowledge the proposed design has been prepared in accordance with the applicable regulations,
Minimum Design Criteria for Gravity Sewers(latest version),and the Minimum Design Criteria for the Fast-Track Permitting
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 143-215.6B, 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 S25,000 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: ARD.//i,
4oFESS/0y9k9
RECEIVED/NCDENR/DWR �.�►•'
JUL 31 2024
`t
Water OualtyRegional '// C•' Gv����\\
Operations Section
Wilmington R Office / r�
n9 Regional
3. Applicant's Certification per 15A NCAC 02T.0106(b):
I, SClgit (30W Se r ,attest that this applicat on for 6,4c nUe,0M-R ) Sc.•` TO(NV1h0VwS
(Signature Authority Name from Application Item 1.3.) (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 143-215.6B, 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 S 10,000 as well as civil penalties up to S25,000 per violation.
Signature: Date: ZI�
FORM: FTA 10-23 Page 5 of 5

State of North Carolina
I
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
(FTSE 10-23)
Entity Requesting Allocation: Clayton Properties Group, Inc.
Project Name for which flow is being requested. Avenue One
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: James A. Loughlin (Northside) WWTP
b. WWTP Facility Permit#: NPDES NC 0023965
All flows are in MGD
c. WWTP facility's permitted flow 16.000
d. Estimated obligated flow not yet tributary to the WWTP 5.104
e. WWTP facility's actual avg. flow 10.661
f. Total flow for this specific request 0.088000
g. Total actual and obligated flows to the facility 15.853
h. Percent of permitted flow used 99.1
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:
E
(A) (B) (C) (D)=(B+C) (E)=(A-D) j
Design Obligated,
Pump Pump Average Approx. Not Yet Total Current E
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***
AV N/A 0.778 0.215 0.000 0.088 0.088 0.127
*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.
i
**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.
I
Downstream Facility Name (Sewer): Cape Fear Public Utility Authority
Downstream Permit Number:
Page 1 of 6
FTSE 10-23

`!E
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III. Certification Statement:
I Jeff Theberge, CFPUA Eng. Mgr. 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 1I 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
I
works has a-I tdequatte capacity to transport and treat the proposed new wastewater.
eft e 07/30/2024
Jeff Theberge(Jul 30,202 3:29 EDT)
Signing Official Signature Date
Engineering Manager
Title of Signing Official
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Page 2 of 6
FTSE 10-23

Flow Tracking for Sewer Extension Permit I
I
Application I
Final Audit Report 2024-07-30 !
s
Created: 2024-07-30 1
By: Jeff Theberge([e-mail])
Status: Signed
Transaction ID: CBJCHBCAABAAuTQnclehzmsHwToNpjexeizJeS3_GocN
"Flow Tracking for Sewer Extension Permit Application" History
�r II
Document created by Jeff Theberge ([e-mail])
2024-07-30-12:28:41 PM GMT
r Document emailed to Jeff Theberge ([e-mail])for signature
2024-07-30-12:28:45 PM GMT
U Document e-signed by Jeff Theberge ([e-mail])
E-signature obtained using URL retrieved through the Adobe Acrobat Sign API
Signature Date:2024-07-30-12:29:12 PM GMT-Time Source:server
Agreement completed.
2024-07-30-12:29:12 PM GMT
Q Adobe Acrobat Sign

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ACTION BY WRITTEN CONSENT OF
THE BOARD OF DIRECTORS OF
CLAYTON PROPERTIES GROUP, INC.
November 1,2019
The undersigned, being all of the members of the Board of Directors (the "Board") of
Clayton Properties Group, Inc., a Tennessee corporation (the "Company"), acting by written
consent as permitted by Section 48-18-202 of the Tennessee Business Corporation Act and
Section 3.6 of the Bylaws of the Company, hereby consent to the adoption of the following
resolutions without a meeting and agree that such actions are taken with like effect and validity
as though duly taken by the affirmative vote of the Board at a meeting duly called and legally
held as of the date first written above:
Appointment of Officers
WHEREAS, the Board believes it to be advisable and in the best interests of the
Company and its shareholders for the Company to appoint certain individuals as officers of the
Company.
NOW, THEREFORE, BE IT RESOLVED, that the Board hereby appoints each of the
following individuals to serve as an officer of the Company until such individual's successor is
duly appointed or until such individual's earlier death, resignation, retirement,disqualification or
removal:
Dawn Hall Assistant Secretary
Ann Locklair Assistant Secretary
April Peeler Assistant Secretary
Scott Bowser Assistant Secretary
Anthony Mills Assistant Secretary
John Putney Assistant Secretary
Removal of Officers
WHEREAS, the Board believes it to be advisable and in the best interests of the
Company and its shareholders for the Company to remove certain individuals as officers of the
Company.
NOW, THEREFORE, BE IT RESOLVED, that the Board hereby removes the
following individual as an officer of the Company:
Leon O'Rourke
General Resolutions
RESOLVED, that the Board hereby authorizes and empowers each of the officers of the
Company (the "Authorized Officers"), on behalf and in the name of the Company to prepare or
cause to be prepared and to execute, deliver, verify, acknowledge, file or record any documents,
i