WI0501145_Application_20241021

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North Carolina Department of Environmental Quality — Division of Water Resources
NOTIFICATION OF INTENT TO CONSTRUCT OR OPERATE INJECTION WELLS
These wells are permitted hi' rule" and do not require an individual permit when constructed in accordance with
the rides of 15.4 NCAC 02C .0200. Tltis notice nttist be submitted prior to construction.
GEOTHERMAL AQUEOUS CLOSED -LOOP WELLS
As described it 15A NCAC 02C .0222 these wells circulate potable water only or a mixture of potable water and
performance -entrancing additives as part of a geothermal heating and cooling system.
OR
GEOTHERMAL DIRECT EXPANSION CLOSED -LOOP WELLS
As described in 15A NCAC 02C .0223 these wells circulate a refrigerant gas as part of a geothermal heating and
cooling systern.
Print Clearlj• or Tjpe Information. Illee ble Submittals Will Be Returned As Incomplete.
DATE:July 17 = 2024 PER�ITT NO.: (to be completed by DWR)
A. TYPE OF GEOTHERMAL CLOSED -LOOP WELL TO BE CONSTRUCTED (select one)
(1) FN� Aqueous (as per 15A NCAC 02C .0222) Number of wells:
(2) ❑ Direct Expansion (as per 15A NCAC 02C .0223) Number of wells: _
B. STATES OF WELL OWNER(S) (choose one)
(1) FN Single Fannily Residence Submit this form two (2) business days prior to construction.
(2) ❑ Business/Orgainization Submit this form 30 days prior to construction.
(3) _ ❑ Government: State Municipal _ County _ Federal*
*Submit this form 30 days prior to construction
C. WELL OW1ER(S) — For single family residences. list all persons listed on the property deed. For all others.
list the name of the Business/Agency and person and title with delegated signature authority:
Thomas David Mills
Mailing Address: 2702 Everett Avenue
City: Raleigh State: NC Zip Code:27607 County: Wake
Day Tele No.: 919.274.6029 _ Cell No...919.274.6029 _
EMAIL Address: [e-mail] Fax No.:
D. PHYSICAL LOCATION OF WELL SITE
(1) Parcel Identification Number (PIN) of well site: 0794.12-75-8500
County: Wake
(2)
Physical Address (if different than mailing address): 2704 Mayview Road
City: Raleigh
Closed -Loop Geothermal well Notification Rev. 3-1-2016
CounntyWake
Zip Code: 27607
Page 1
1 of 4 7/17/2024, 10:08 AM

E. REQUIRED MAPS, PLANS, AND SPECIFICATIONS
(1) A site maps must be submitted. It must be scaled or otherwise accurately indicate distances (in feet)
and orientations of features located within 250 feet of the injection well(s). Label all features clearly
and include a north arrow. Attach the site -specific map showing the wells in relation to the locations of
the following:
• Buildings • Septic systems and associated spray irrigation sites,
• Property boundaries drain fields, or repair areas, if any
• Surface water bodies, if any • Existing or potential sources of groundwater
• Water supply wells, if any contamination, if any
(2) Plans and specifications of the surface and subsurface construction details of the well system.
NOTE. In most cases, an aerial photograph and/or plat map of the property parcel showing property lines and
structures can be obtained and downloaded from the applicable county GIS website. Typically, the property can
be searched by owner name or address. The location of the wells in relation to property boundaries, houses, septic
tanks and fields, and other wells, etc. can then be drawn in by hand. Also, a `layer' can be selected showing
topographic contours or elevation data.
F. TYPES AND CONCENTRATIONS OF ADDITIVES — List any additives that will be used and their
concentrations. NOTE: Only injectants approved by the NC Division of Public Health, Department of Health
and Human Services can be injected. Approved injectants can be found online at
httn://dea.nc.2ov/about/divisions/water-resources/water-resources-permits/wastewater-branch/ground-water-
G.
H.
rotection/ground-water-approved-injectants. All other substances must be reviewed by the DHHS prior to use.
WATER
WELL DRILLER INFORMATION
Well Drilling Contractor's Name: Joshua Robertson
NC Well Drilling Contractor Certification No.:
Company Name: Triad Drillers Inc.
City: Elon State: NC
Day Tele No.:
336 421-3513
2461-A
EMAIL Address: [e-mail]
Contact Person: Joshua Robertson/Steve E
Zip Code: 272` County: Caswell
HEAT PUMP CONTRACTOR INFORMATION
Company Name: Bowman Mechanical RDU LLC
Cell No.: 336 453-4527
Fax No.: 919 779-9294
Contact Person: Joshua Robertson/Steve Bowman EMAIL Address: [e-mail]
Address: 145 Technical Ct. steveb@bowmanmechanice
City:
Garner
Office Tele No.: 919 772-2759
Zip Code: 27529 State: NC County:
Cell No.. 919 427-1425
Wake
Fax No.: 919 779-9294
Closed -Loop Geothermal Well Notification Rev. 3-1-2016 Page 2

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I. PROTECTION — Provide a brief description of how any (a.) water supply wells, (b.) surface water bodies, or
(c.) septic systems and associated spray irrigation sites, drain fields. or repair areas within 250 feet of the
proposed injection wells will be protected during constriction of the wells:
i � �� �� s'i/C p d: 9� r,��6,-, S L�f.�G, J q j r✓�.c.r-Ss�l,�'
J. VARIANCE — Pursuant to 15A NCAC 02C .0241 the Director of the Division of Water Resources may grant
a variance from applicable well construction or operation standards provided that:
(1) Use of the well(s) will not endanger lunnan health and welfare or the groundwater: and
(2) That construction or operation in accordance with the standards is not technically feasible or the
proposed construction provides equal or better protection of the groundwater.
Any variance request should accompany submittal of this notification to expedite evaluation of the request.
The variance request form can be accessed online at https://ncdenr.s3.amazoriaws.corn/s3fs-
public/WaterO/o20Quality/Agnifer%20Protection/GPU/GeothennalVariancgRequestFormFillable-
20130805.pdf
K. SIGNATURES — The following section is to be completed as required below or by that person's authorized
agent. 15A NCAC 02C .0211(e) requires signatures as follows:
(a) for a corporation: by a responsible corporate officer:
(b) for a partnership or sole proprietorship: by a general partner or the proprietor, respectively:
(c) for a municipality or a state, federal, or other public agency: by either a principal executive
officer or ranking publicly elected official:
(d) for all others: by the well owner,
_ (e) for any other person authorized to act on behalf of the applicant: documentation shall be
submitted with the notification that clearly identifies the person. grants them signature
authority, and is signed and dated by the applicant.
"1 lrerebv certify, under penaltl• of law, that I hai-e persorralli, evautirred avid am familiar ivitli the information
srtbmitted in this doc:nnent and all attachments thereto and that, based on nn' inquiry, of those individuals
inmrediately responsible for obtaining said information, 1 believe that the information is trite, accurate and
complete. I am aware that there are significant penalties, including the possibility of fines and imprisonment,
for submitting false. information. I agree to construct, operate, maintain, repair, and if applicable, abandon the
injection hell and all related appurtenances in accordance with the 1 SA NCAC 02C 0200 Rules. "
Signature of Property Owner/Applicant
Thomas David Mills
Print or Type Full Name
Signature of Authorized Agent, if any
Closed -Loop Geothermal Well Notification Rey-. 3-1-2016
Print or Type Fall vane
Page 3
3 of 4 7/17/2024, 10:08 AM

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https://outlook.office.com/mail/inbox/id/AAQkADU5YjAUZTgyLT...
Re: Horizontal loop design clarification
Tom Mills <[e-mail]>
Tue 7/23/2024 1:01 PM
To:steveb bowmanmechanicalservices.com< steveb@ bowmanmechanicaiservices.com >;Chris Harrison
<[e-mail]>
0 1 attachments (4 MB)
IMG_2146.HE1C;
Hi Steve,
For clarity, circled in the screenshot below is the proposed location for stubbing -out the sleeve ends from under the slab.
Then I will run the rest of the sleeving from there to the 2 well locations when they are ready.
Can you let me know if you think this looks OK?
I'd like to move forward with getting the sleeves in the ground.
Also, please let me know if we are now on the driller's schedule or if you need any more information from me.
Thanks!
Best Regards,
Tom
building envelope
setbacks
lot lines
driveway outline
"keep -away" from
city sewer
esidential sewer line
water mete
manhole
City sewer line
On Thu, Jul 18, 2024 at 7:38 PM Tom Mills <[e-mail]> wrote:
Hi Steve,
p-away" from
dential sewer
Ve■ owilillit 1 �Q� rl 1Cic�4
So it looks like, in order to keep away from both the city sewer line by 25', the residential sewer line by 25' and the house by 15', we
need to have the wells off to the east of the driveway.
In the attached drawing you can see the "keep away" boundaries from the sewer lines and subsequent proposed locations for the 2
1 of 8 7/25/2024, 10:50 AM

BOWMAN MECHANICAL BUU LLC
Contact pact person; Steve Bowman
[e-mail] 919
lei sCEO ���n> r
Address 2 v y-rea/lge r7
-Z-Well diameters- 6", 1.0 BTU thermally enhanced
grout pumped from bottom with "Trimmy" line,
factory installed u-bend at bottom, nominal pipe size
pressure tested to 100 Pi an inspected by
jurisdiction as req+
t

I VICINITY M/
REFERENCES:
IDS 17239, PG 1319
BM 2014, PG 167
OTHERS AS NOTED
mER sT.
PROPERTY OF:
THOMAS DAVID MILLS
LOT 37 JORDAN PROPERTY SUBDIVISION s
PIN: 0794.12-75-8500
&
NOTE:'
1. ALL DISTANCES ARE HORIZONTAL GROUND DISTANCES.
2. PROPERTY SUBJECT TO ALL EASEMENTS OF RECORD THAT A
SY�E
TITLE SEARCH MAY IDENTIFY. A
*'
3. SURVEY PERFORMED WITHOUT TITLE SEARCH. 3
4. ALL DASHED LINES REPRESENT LINES NOT SURVEYED.
5. AREA BY COORDINATE METHOD.
6. HOUSE DIMENSIONS/AREA ARE BASED ON FOOTPRINT.
MAYVIEW RD.
7. CONTOURS FIELD LOCATED AND TIED TO NAVD-88 VIA GPS.
8. NOT FOR SALES OR CONVEYANCES, PERMITTING ONLY.
)(NTS)
9. ALL CONSTRUCTION TO BE IN ACCORDANCE WITH CITY OF RALEIGH OR NCDOT STANDARDS AND
SPECIFICATIONS,
0 EIP EXISTING IRON PIPE
A CP CALCULATED POINT
--x-
CHAIN LINK FENCE
- E -ELECTRIC
LINE
❑E
ELECTRIC METER
co
CLEANOUT
❑W
WATER METER
©
GAS METER
Q
CAN
0
POWER PEDESTAL
$000.0'
SPOT ELEVATION
OEXISTING
SEWER
MANHOLE
IMPERVIOUS SURFACE DATA:
PROPOSED HOUSE- 1903.25 SF
PROPOSED CONCRETE DRIVEWAY= 306.59 SF
PROPOSED CONCRETE WALLS/STEPS= 427.62 SF
PROPOSED (2) AC UNITS= 8.0 SF
TOTAL IMPERVIOUS= 2,645.46 SF, 32.7% (51%) MAX
PIN: 0794.12-75-8500
LOT AREA: 8,099.36 SF, 0.19 AC
ZONING: R-6
OVERLAY DISTRICT: SRPOD
PROPERTY CURRENT USE: VACANT -RESIDENTIAL
EXISTING IMPERVIOUS: SEE TABLE
RESIDENTIAL INFTLL STATUS: N/A
ALLOWED BUILDING HEIGHT: 40' / 3 STORIES
SETBACK REQUIREMENTS: SEE SETBACK LINES
PROPOSED BUILDING SQUARE FOOTAGE: 2660 SF
COMPARATIVE SAMPLE DATA:
2700 MAYVIEW RD.= 22.9'
2706 MAYVIEW RD.= 20.2'
2708 MAYVIEW RD.= 26.8'
2712 MAYVIEW RD.= 38.6'
2716 MAYVIEW RD.= 34.7'
MEDIAN FRONT YARD SETBACK IS 26.8"
15% OF MEDIAN = 4.02'
ALLOWABLE RANGE= 22.8'-30.8'
PROPOSED 4.7'
RETAINING WALL
rA--
r375
374
of
'37,p
1-372 o
r371
ZI
/ 370
on
v
5..0'
SM 2013, PG 684/
PROPOSED AREA OF LAND
DISTURBANCE= 4689.63 SF
(22.8'X12')+380 SF= 663.6 SF
40% OF 1441.22 SF= 576.5 SF*
PROPOSED FRONTYARD
PARKING AREA= 306.59 SF. MAX- 576.5 SF
1441.22 SF
306.59 SF
LOCATION: 2704 MAYVIEW ROAD
RALEIGH, NC 27607
ox'�"""N CAROL
.4 •�FESS/p�'.
SEAL
r L-4443
cygE�•
p ' •�J�``�
N/F
THOMAS M.
CRUTCHFIELD
DB 11204, PG 1416 x/x EIP
65Z3g `
a 63 g`L \c'o
\ o. --s
Bo\ -
J
---- 380
37
8,099.36 SF/
-
_ AcCI
376.9�-PRECON
375.0'I POSTCO
�
,, ' '-PRECON
----.g
�75.0'-POSTCON
�_� e
\ STORYPROPOSED HOUSE
WITH BASEMENT
7; \
m BFE=364.5'
1
PI
Ti
6 � 3g9
367.7'-PRECON
c
EIP
PROPOSED
DRIVEWAY
WIDENjy_Q":�Z
/ 5
CONCRETE Cr
PROPOSED
p CONCRETE \
DRIVEWAY
n
\
PROPOSED
CONCRETE
RETAINING WALLS
'
AND STAIRS
8.2'-PRECON
4.5'-`POSTC9N-
1-110
co Cl
i8.0 �5 -365
EXISNG CURB 364 \
_ & GUTTER
ROAD
R/W `? s ` REVISED 2�-16-23 TO
40' PUBLIC
BM 2014, /W SHOW SRPOD CALCS
AND DRIVEWAY CHANGE
TOWNSHIP: RALEIGH ZONED: R-6
SCALE: 1 "= 20' DATE OF FIELD SURVEY:
5-25-2022
JOB# :22-207 1 COUNTY. WAKE
I, MICHAEL PRESTON TUTT, CERTIFY THAT THIS MAP WAS
DRAWN UNDER MY SUPERVISION FROM AN ACTUAL SURVEY
AND FROM REFERENCES NOTED: THAT THE BOUNDARIES NOT
SURVEYED ARE CLEARLY INDICATED AS DRAWN FROM
INFORMATION AS NOTED. THAT THE RATIO OF PRECISION AS
CALCULATED WAS 1:25,580. WITNESS MY ORIGINAL SIGNATURE,
16TH DAY OF�Y
MICHAEL P. TUTTP�L�S LL/-4443
0 10 20
( IN FEET )
LANDASURVEYIINGT PLLC
RVEYING THE PAST AND THE FUTURE TODAY
919-810-4324
NC UC. # P-0446
3008 ANDERSON DR. SUITE 160
RALEIGH, NC 27609-7787

BARMETTLER ST.
0
m
MAYVIEW RD.
VICINITY MAP(NTS)
REFERENCES:
DB 17239, PG 1319
BM 2014, PG 167
OTHERS AS NOTED
* EIP
EXISTING IRON PIPE
® Cp
CALCULATED POINT
_x-CHAIN
LINK FENCE
- E-
ELECTRIC LINE
®
ELECTRIC METER
Fc 01
CLEANOUT
E
WATER METER
@
GAS METER
CATV
POWER PEDESTAL
0000. 0' SPOT ELEVATION
0
EXISTING SEWER
MANHOLE
PROPERTY OF:
THOMAS DAVID MILLS _700
LOT 37 JORDAN PROPERTY SUBDIVISION
PIN: 0794.12-75-8500
NOTE:
1. ALL DISTANCES ARE HORIZONTAL GROUND DISTANCES.
2. PROPERTY SUBJECT TO ALL EASEMENTS OF RECORD THAT A
TITLE SEARCH MAY IDENTIFY.
3. SURVEY PERFORMED WITHOUT TITLE SEARCH.
4. ALL DASHED LINES REPRESENT LINES NOT SURVEYED.
5. AREA BY COORDINATE METHOD.
6. HOUSE DIMENSIONS/AREA ARE BASED ON FOOTPRINT.
7. CONTOURS FIELD LOCATED AND TIED TO NAVD-88 VIA GPS.
8. NOT FOR SALES OR CONVEYANCES, PERMITTING ONLY.
9. ALL CONSTRUCTION TO BE IN ACCORDANCE WITH CITY OF RALEIGH OR NCDOT STANDARDS AND
SPECIFICATIONS.
CURVE ARC LENGTH RADIUS DELTA ANGLE CHORD BEARING CHORD LENGTH4 ­6P-___ =1 138.09' 25*05'12'I N 66*08'18" W 59.98'
UA
A
IMPERVIOUS SURFACE DATA;
PROPOSED HOUSE= 1903.25 SF N/F
PROPOSED CONCRETE DRIVEWAY= 306.59 SF THOMAS M.
PROPOSED CONCRETE WALLS/STEPS= 427.62 SF PROPOSED (2) AC UNITS= 8.0 SF CRUTCHFIELD
TOTAL IMPERVIOUS= 2,645.46 SF, 32.7% (51%) MAX DB 11204, PG 1416 EIP
1-1
26
SITE DATA TABLE:
PIN: 0794.12-75-8500
LOT AREA: 8,099.36 SF, 0.19 AC
ZONING: R-6
OVERLAY DISTRICT: SRPOD
PROPERTY CURRENT USE: VACANT -RESIDENTIAL
EXISTING IMPERVIOUS: SEE TABLE
RESIDENTIAL INFILL STATUS: N/A
ALLOWED BUILDING HEIGHT: 40' / 3 STORIES
SETBACK REQUIREMENTS: SEE titItIACK LINES
PROPOSED BUILDING SQUARE FOOTAGE: 2660 SF
COMPARATIVE SAMPLE DATA:
2700 MAYVIEW RD.= 22.9'
2706 MAYVIEW RD.= 20.2'
2708 MAYVIEW RD.= 26.8'
2712 MAYVIEW RD.= 38.6'
2716 MAYVIEW RD.= 34.7'
MEDIAN FRONT YARD SETBACK IS 26.8 13
15% OF MEDIAN = 4.02'
ALLOWABLE RANGE= 22.8-30.8'
375
37.4
tf'3;'3
1-37.2
IP
1.160
a>9
I'll 380
.0)
� 3,,� 533
7
cp�
8)099.36 SFI
376 cil
7.2' G-r- P_ 'RO P 0 S E D C'7 7 1,9--A-c
AC UNITS
376.9 -PRECON
41,.2'\
375.0'- POSTCON
I ,
74.3'-PRECON
�375.01-POSTCON
190
Ln
r-n
/-371 PROPOSED 2
STORY HOUSE 100
WITH BASEMENT .7 I'll37® tv I
BFE=,364.5' 6. 7'
c_n0 - (-T mt
00-
'0)
m
5.
PROPOSED 4.7'
RETAINING WALL
36
BM 2013, PG 684
PROPOSED AREA OF LAND
DISTURBANCE= 4689.63 SF
SRPOD CALCULATION:
(22.8-'X12')+380 SF= 653.6 SF
40% OF 1441.22 SF= 576.5 SF*
PROPOSED FRONTYARD
PARKING AREA= 306.59 SF, MAX= 576.5 SF
FRONT YARD DATA:
EXISTING FRONT YARD AREA= 1441.22 SF
PROPOSED CONC DRIVEWAY= 306.59 SF
7TOTAL PROPOSED= 21.3%
(SITE LOCATION- 2704 MAYVIEW ROAD
RALEIGH, NC 27607
EIP
PROPOSED
DRIVEWAY
WIDENING
C-1
367.7'-PRECON
369.2'-POSTCON
5.2,
SED DEMO,` '368.2'-- PREdON
PROPO
CONCRETE o 364.5'-P0STCqN
j-
N PROPOSED
. 00 CONCRETE
DRIVEWAY
0 Cl
18 . 0
PROPOSED
CONCRETE
RETAINING WALLS
AND \ STAIRS
­365
EXislN -364
--CURB & GUTTER
r� v�� � lZ
ROAD
40' PUBLIC R/W REVISED 2-16'----23 TO
ul SHOW SRPOD CALCS
BM 2014, PG 167
AND DRIVEWAY CHANGE
TOWNSHIP: RALEIGH ZONED,: R-6
SCALE: 1"= 20' DATE OF FIELD SURVEY:
5-25-2022
CARD
a 0
JOB# 22-207
1, MICHAEL PRESTON TUTT, CERTIFY THAT THIS MAP WAS
SEAL
DRAWN UNDER MY SUPERVISION FROM AN ACTUAL SURVEY
AND FROM REFERENCES NOTED; THAT THE BOUNDARIES NOT
L- 4443
SURVEYED ARE CLEARLY INDICATED AS DRAWN FROM
INFORMATION AS NOTED. THAT THE RATIO OF PRECISION AS
CALCULATED WAS 1:25,580. WITNESS MY ORIGINAL SIGNATURE,
sug 14\
16TH DAY OF FEBRUQY A.D., 2023.
%
P - ���`�`
_______ _ _ __ _ __ _ _____
MICHAEL P. TUTT, PLS L-4443
COUNTY: WAKE
0 10 20
IN FEET
ANGLE RIGHT
LAND SURVEYING, PLLC
SURVEYING THE PAST AND THE FUTURE TODAY
919-810-4324
NC LIC. # P-0446
3008 ANDERSON DR. SUITE 160
RALEIGH, NC 27609-7787