WQ0041584_Application (FTSE)_20230515

FAST TRACK SEWER ENGINEERING CERTIFICATION RECEIVED/NCDEQ/pyyR
M.AY 15 2023
PERMITTEE: LAKE NORMAN OWNER LP WQROS
PERMIT#: WQ0041584 MOORESVILLE REGIONAL OFFICE
PROJECT: TRILOGY LAKE NORMAN - PARCEL E&K PHASE 3 AND F2
ISSUE DATE: APRIL 6,2020
This project shall not be considered complete nor allowed to operate in accordance with standard
Condition 7 of this permit until the Division has received this Certification and all required supporting
documentation. It should be submitted in a manner that documents the Division's receipt. Send the
required documentation to the Regional Supervisor, Water Quality Regional Operations Section at the
address noted in the page footer.
Any wastewater flow made tributary to the wastewater collection system extension prior to completion
of this Certification shall be considered a violation of the permit and shall subject the Permittee to
appropriate enforcement actions. The Permittee is responsible for tracking all partial certifications up
until a final certification is received by the Division. A Final Certification shall be a complete set of
record drawings and design calculations regardless of whether partials have been submitted.
PERMITTEE'S CERTIFICATION
I,the undersigned agent for the Permittee,hereby state that this project has been constructed pursuant to
the applicable standards & requirements, the Professional Engineer below has provided applicable
design/construction information to the Permittee,and the Permittee is prepared to operate&maintain the
wastewater collection system permitted herein or portions thereof.
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Printed ame,Trtle X Signature Date
ENGINEER'S CERTIFICATION
I, NAZI�as a u y registered Professional Engineer in the State of North Carolina,
having been authorized to observe (A periodically, ❑ weekly, ❑ full time) the construction of the
project name and location as referenced above for the above Permittee hereby state that,to the best of my
abilities, due care and diligence was used in the observation of the following construction:
1,472 linear feet of 8-inch gravity sewer,; such that the construction was observed to be built within
substantial compliance of this permit; 15A NCAC 02T; the Division of Water Resources' (Division)
Gravity Sewer Minimum Design Criteria adopted February 12, 1996 as applicable; the Division's
Minimum Design Criteria for the Fast-Track Permitting of Pump Stations and Force Mains adopted June
1,2000 as applicable; and other supporting materials.
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North Carolina Professional Engineer's Seal w/signature&date: 1 `,\
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[�Final ❑ Partial(include description) 4 SEAL
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Certification Comments/Qualifiers (attach if necessary): . al�01�
NC DWR—Water Quality Regional Operations Section 610 East Center Avenue,Suite 301, Mooresville,NC 28115
Mooresville Regional Office Phone: [phone] FAX:[phone]

State of North Carolina
Department of Environmental Quality
DWR Division of Water Resources
SEWER SYSTEM PERMIT OWNERSHIP/NAME CHANGE
Division of Water Resources INSTRUCTIONS FOR FORM: PNOCF 01-16
I. EXISTING PERMITTEE INFORMATION:
1. Permittee's name: Lake Norman Owner LP
2. Signature authority's name: Eric Sauer per 15A NCAC 021.0106(b)
3. Signature authority's title:Proiect Manager-Authorized Agent
4. Permittee's mailing address: 7242 S. Little L'gypl Road
City: Stanley State:NC Gip:28164-
5. Permittee's contact information: Phone number:Q3)764-8536 Fax Number�)
Email Address: cric.sauerOlsheahomes.com
II. APPLICANT INFORMATION:
I. Applicant's name: Lincoln County Public Works
2. Signature authority's name,,3 a-,w-HMn QeJ6zui0yikper 15A NCAC 02T.0106(b)
3. Signature authority's title: _('`4147 %r►GeT
4. Applicant's mailing address: 115 W. Main Street
City:Lincolnton State:NC Zip:28092-
5. Applicant's contact information: Phone number:[phone] Fax Number 704)736-8499
Email Address:
6. Representative's name:
7. Representative's title:
8. Representative's contact information Phone number: L_)�- Fax Number �-
Email Address:
III. PERMIT INFORMATION:
1. Existing perrnit number. W00041584 and most recent issuance date:April 6.2020
2. Reason for the permit application:Change of Ownership If other, attach detailed explanation
3. Has the facility been constructed? ® Yes or❑No
4. Has the facility been certified per 15A NCAC 02T.01 l b? ® Yes or 0 No
FORM: PNOC.F 01-16

IV. CERTIFICATIONS:
Existing Permittee's Certification per 15A NCAC 02T.0106(b):
1, -0 attest that this application
ignature Authority's name&title from Application Item 1.2&3)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that prior to reissuance of the permit
into the Applicant's name, 1 will continue to be responsible for compliance with the current permit and any discharge of wastewater
from this system to surface waters or the land may result in an enforcement action that may include civil penalties, injunctive relief,
and/or criminal prosecution. I will also make no claim against the Division of Water Resources should a condition of the existing permit
be violated. I also understand that if all required parts of this application are note completed and that if all required supporting
information and attachments are not included,this application will be returned to me as incomplete.
NOTE - in accordance with General Statutes 143-215.6A and 143-27_15.6B, 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 civi enalties up to$25,000 per violation.
Signature: Date: Z z-
1 — -
Applicant's Certification per 15A NCAC 02T.0106(b):
I, �0 6�l�i � �^�� Fti+% -� attest that this application
(Signature Authority's name&title from Application Item II.2&3.)
has been reviewed by the and is accurate and complete to the best of my knowledge. I understand that after issuance of the permit into
the Applicant's name, I will be responsible for compliance with the issued permit and any discharge of wastewater from this non-
discharge system to surface waters or the land may result hi an 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.
1 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 ell as civil penalties up to$25,000 per violation.
Signature: - ' Date: Vg/2O2S
FORM: PNOCF01-16 P-1 of7