WQ0045864_Weddington_Place_Apartments_&_Townhomes_FTSSE_App_20241021

N C D' "'menl `, State of North Carolina
D Environtal Quali%y
Received Department of Environmental Quality
OCT 18 2024 Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources Winston-Salem FTA 10-23 & SUPPORTING DOCUMENTATION
Application Number: W41% �(p & y (to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: City of Lexington (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: Thomas D. Johnson per 15A NCAC 02T .0106(b)
Title: Water Resources Utility Director
i
4. Applicant's mailing address: 28 West Center St.
City: Lexington' State: NCB Zip: 27292-_
5. Applicant's contact information:
Phone number: [phone]� Email Address: TDJohnson(a exingtonNC.gov
II. PROJECT INFORMATION:
1. Project name: Weddington Place Apartments & Townhomes,
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project ❑ ARPA funded
If a modification, provide the existing permit number: W000_ 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: W000
3. County where project is located: Davidson'
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.7809' Longitude:-80.2649'
5. Parcel ID (if applicable): 6724-03-41-4529 (or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Joseph V. O'Buch License Number: 29999
Firm: Green Mountain Engineerine. PLLC
Mailing address: 1A Wendy Court
City: Greensboro State: NC Zip: 27409-2247
Phone number: 3( 36) 294-9394 Email Address:ioe(a)rareenrrountainengineers.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Lexington Regional Wastewater Treatment Plant Permit Number: NC0055786
Owner Name: City of Lexington
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
PermitNumber(s): WQ_
2. Downstream (Receiving) Sewer Information: 8 inchr N Gravity ❑ Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS00042 l
Owner Name(s): City of Lexington
FORM: FTA 10-23 Pagel of 5

NC Department of
Environmental Quality
Received
VI. GENERALREQUIREMENTS OCT 2 1 2024
1. If the Applicant is a Privately -Owned Public Utility, has a Certificate of Public Convenience a*Nrssit
Safemattached?
❑Yes ❑No ®N/A' Regional Office
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 i
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 ❑otel 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: 96_68 %Domestic 3.32 % 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(f)? ❑ Yes S l`o
➢ If Yes, provide a copy of flow reduction aonroval letter with this application
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(f))
Daily Design Flow O,b
No. of Units
Flow
Residential: 1 bedroom
75 gal bedroom '
96
7,200 GPD
Residential: 2 bedroom
75ga1/bedroom'
354"
53,100GPD
Residential: 3 bedroom -
75 galibedroom -
42
9,450 GPD '
Office ,
25 gal/person/shift
1
25 GPD
Club House/Swimming Pod
10 gal/person .
117'
1,170 GPD —
Caz Wash/
1,200 gal/bay1
1,200 GPD
Tonal
72,145 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: 72 145 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:
❑ Rehabilitation or replacement of existing sewers with no new flow expected
❑ Other (Explain):
FORM: FTA 10-23 Page 2 of 5

NC Department of
Env;
ronrnental Quality
Received
VI. GENERAL REQUIREMENTS OCT 18 202tl
1. If the Applicant is a Privately -Owned Public Utility, has a Certificamnon Salem
,f Public Convenience and Necessity been attached?
t
❑Yes ❑No 0al Office
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 Ey N/A
4. Origin of wastewater: (check all that apply)
® Residential (Individually Owned) ❑ Retail (stores, centers, malls) ®tar Wash
❑ Residential (Leased) ❑ Retail with food preparation/service ❑ Ijotel and/or Motels
❑ chooi / 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: 82_32 % Domestic 17_68 % 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(fl? ❑ Yes ® No
➢ If yes, provide a cony of flow reduction approval letter with this application
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(f))
Daily Design Flow e,b
No. of Units
Flow
Residential: 1 bedroom
75 gal/bedroom
96 -
7,200-GPD
Residential: 2 bedroom -
75 gal/bedroom
758
53,106GPD
Residential: 3 bedroom '
75 gal bedroom
126
9,450 GPD
Office
25 gal/person/shift
1
25 GPD
Club House/Swimming Pool
10 gal/person
117
1,170 GPD
Car Wash
1,200 galfbay
1
1,200 iiPD
Total
72,145 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 .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: 72 145 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:
❑ Rehabilitation or replacement of existing sewers with no new flow expected
❑ Other (Explain):
FORM: FTA 10-23 Page 2 of 5

VIL GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
8
2,821 `
PVC
8 '
2,132
DIP
NC Department of
Environmental Quality
Received
UCT 18 2024
Winston-Salem
Regional Office
➢ 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
Vlll. 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: 1
2. Approximate Coordinates (Decimal Degrees): Latitude: 35.46.809' Longitude:-80.16.095'
3. Total number of pumps at the pump station: 2 '
3. Design flow of the pump station: 0.27795 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): 19Ygallons per minute (GPM) at 40 feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches)
Length (feet)
Material
6 `
233 '
DIP
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.Lb. ❑ Grinder Pump ❑ Mechanical Bar Screen ❑ Other (please specify)
6. Power reliability in accordance with 15A NCAC 02T .0305(h)(1):
® fStandby 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

1"L F)rp'l mien[oP
Environmental Quality
Received
IX, SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T.0305(f)): OCT 18 2024
1. Does the project comply with all separations/altematives found in 15A NCAC 02T .03 5(fl & (¢)? ® Yes [I No
ms on -Salem
MA NCAC 02T.0305(f) contains minimum separations that shall be Drovided.for sewer, systems:
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
'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 11 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, HOW, 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)
36 inches
➢ If noncompliance with 02T.0305(f) or (g), see Section X.1 of this application
*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 webpaee
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.
➢ Seethe 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: _ ® Flo
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 213.0202
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.0I05(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

NC Department of
Environmental Quality
Received
OCT 18 2024
X. CERTIFICATIONS:
V'1
I. Does the submitted system comply with 15A NCAC �T �)Ilc Sliniotuut�Design Criteria for the Permitting of Pump Stations
and Force Mains (latest version), and the Grave v Sewerlvtinitnum Design Criteria (latest version) as applicable?
® Yes i ❑ No
If no, for prgiects requiring a single variance, complete and submit the Variance/Altemative Design Request application
(VADC 10-14) and supporting documents for review to the Central Office. Approval of the request will be issued
2. Professional Engineer's Certification:
I, ebspJE •• /JJY� ( , attest that this application for 44n 4Jw>< ow d AVIPA O
(Professional Engineer's name from Application Item Ill. 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. 1 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 Permittina
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 — fit accordance with General Statutes 143-215.6A and 143.215.6131, any person who knowingly makes any false
statement, representation, or cenification 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:
3. Applicant's Certification per 15A NCAC 02T .0106(h):
1 Thomas D. Johnson attest that this application for KArt71PA1 0 /Try MEAft il
(Signature Authority Name from Application Item 1.3.) (Project Name from Application Item II.I )
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. 1 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 pans 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.
Digitally signed by Thomas
Thomas Johnson Johnson ,
Signature: Date: 2024.10.16 14:47:15 -04'00' Date:
FORM: FTA 10-23 Page 5 of 5

NC Department of
Environmental Quality
DW Received
Division of Water Resources SEP 2 7 2024
State of North Carolina
Department of Environmental Quality
Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 10-23 & SUPPORTING DOCUMENTATION
Winston-Salem
Regional Office
Application Number: 94040�SyL1� (tobecompletedbyDWR) '� vt
o , 'Zo Z'f /on a 36
All items must be completed or the application will be returned
1. APPLICANT INFORMATION:
I. Applicant's name: City of Lexington (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership
❑ Federal ❑ State/County ® Municipal
3. Signature authority's name: Thomas D. Johnson per 15A NCAC 02T .0106(b)
Title: Water Resources Director'
4. Applicant's mailing address: 28 W. Center Street
City: Lexington' State: NC Zip: 27292
5. Applicant's contact information:
Phone number: 3( 36) 243-2489 Email Address: TDJohnson(t,LexinetonNC.Rov
IL PROJECT INFORMATION:
❑ Privately -Owned Public Utility
❑ Other
e
1. Project name: Weddinaton Place Apartments & Townhomes
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project ❑ ARPA funded
If a modification, provide the existing permit number: W000_ 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: W000_
3. County where project is located: Davidson
4. Approximate Coordinates (Decimal Degrees): Latitude: 35.7809- Longitude:-80.2649'
5. Parcel ID (if applicable): 6724-03-414529 (or Parcel ID to closest downstream sewer)
Ill. CONSULTANT INFORMATION:
Professional Engineer: Joseph V. O'Buch License Number: 29999
Finn: Green Mountain Engineering. PLLC
Mailing address: 1 A Wendy toort
i
City: Greensboro State: NC Zip: 27409-2247
Phone number: [phone] Email Address: ioe(& reenmountainengineers.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION: /
1. Facility Name: Lexington Regional Wastewater Treatment Plant Permit Number: NCO055786
Owner Name: City of Lexington �
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
I. Permit Number(s): WQ0019462'
2. Downstream (Receiving) Sewer Information: 8 inch' M Gravity ❑ Force Main
3. System Wide Collection System Permit Number(s) (if applicable): WQCS00042�
Owner Name(s): City of Lexington '
FORM: FTA 10-23 Paget of 5

"I
NC Deoartt-lent of
Environmental Quality
Received
GENERAL REQUIREMENTS OCT 2 1 2024
1. If the Applicant is a Privately -Owned Public Utility, has a COR�Ie4QRlIfn�?WConvenience and Necessity been attached?
[I Yes E E�Or1� W*ce
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):
el
® Residential (Individually Owned) ❑ Retail (stores, centers, malls)
® Car Wash
❑ Residential (Leased) ❑ Retail with food preparation/service
❑ Hotel and/or Motels
❑ S hoot / preschool / day care ❑ Medical / dental / veterinary facilities
ood
® Swimming Pool/Clubhouse
®1 and drink facilities ❑ Church
❑ Swimming Pool/Filter Backwash
❑ Businesses / offices / factories ❑ Nursing Home
❑ Other (Explain in Attachment)
i
5. Nature of wastewater: 96.68 % Domestic 3.32 °Commercial _ % Industrial (See 15A NCAC 02T .0103(20))
If Industrial, is there a Pretreatment Program in effect? ❑ Yes El No
6. Hasa flow reduction been approved under 15A NCAC 02T .0114(f)? ❑ Yes ®No
➢ If yes, provide a cony of flow reduction approval letter with this application
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0I14(f))
Daily Design Flow ° ^
No. of Units
Flow
Residential: 1 bedroom F
75 gal/bedroom `
961,
7,200"GPD
Residential: 2 bedroom '
75 gal bedroom
354
53,100'GPD
Residential: 3 bedroom
75 gal/bedroom `
42
9,450 GPD
Office
25 gal/person/shift /
I
25 IiPD
Club House/Swimming Pool
10 gal/person i
117`
1,170 &PD
Car Wash
1,200 gal/bay
1
1,200 GPD
Total
72,145 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 .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: 72 145 `GPD (per 15A NCAC 02T .0l 14 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:
❑ Rehabilitation or replacement of existing sewers with no new flow expected
❑ Other (Explain):
FORM: FTA 10-23 Page 2 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 ® Switfiming Pool/Clubhouse
❑ Food and drink facilities ❑ Church ❑ Swimming Pool/Filter Backwash
❑ Businesses / offices / factories ❑ Nursing Home ❑ Other (Explain in Attachment)
W
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
i
6. Hasa flow reduction been approved under 15A NCAC 02T .01 14(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
114(f))
Daily Design Flow ° s
No. of Units
Flow
Residential (per bedroom)
75 gal/bedroom
930
69,750 GPD/'
Residential '?
25 gal/per person/per shift
1
25 GPD /
Club House/Swimming Pool
10 gal/per person
117
1,170 GPD
Car Wash
1,200 gal/bay
1
1,200 GPD '
gal/
GPD
gal/
GPD
Total
72,145 G PD '
a See 15A NCAC 02T .01 14(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 .0114(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: 72.145/GPD (per 15A NCAC 02T .01 14 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:
❑ Rehabilitation or replacement of existing sewers with no new flow expected
❑ Other (Explain):
FORM: FTA 10-23 Page 2 of 5

' VIL GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
8
2,821
PVC
8 (
---------------
2,132
DIP
953
➢ Section 11 & 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: I
i
2. Approximate Coordinates (Decimal Degrees): Latitude: 35.46.809' Longitude:-80.16.095'
3. Total number of pumps at the pump station: 2 � 0
3. Design flow of the pump station: 0.072 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): 193 gallons per minute (GPM) at 40 feet total dynamic head (TDH) Ali,
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches)
Length (feet)
Material
6
233
DIP
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.I.b. ❑ Grinder Pump ❑ Mechanical Bar Screen ❑ Other (please specify) _
6. Power reliability in accordance with 15A NCAC 023.0305(h)(1):
i
® 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)):
1. Does the project comply with all separations/alternatives found in 15A NCAC 02T .0305(�f & (g)?
15A NCAC 02T.0305(fl contains minimum separations that shall be provided for sewer systems:
® Yes [—]No
Setback Parameter's
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
2Water 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, W S-1 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 W L.
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)
36 inches
➢ If noncompliance with 02T.0305(t) of ( see Section X.I of this application
"I5A NCAC 02T.0305(e) 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 ❑ 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 drab 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.
i
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(cX6) (additional permits/certifications)? ® Yes ❑ No
Per 15A NCAC 02T.0I05(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 02r.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:
I. Does the submitted system comply with 15A NCAC 02'f, 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
2. Professional Engineer's Certification:
I, rXsrri� Y• 0,3�cµ ' , attest that this application for WL00U4rlu f la, /�✓�6A4w Afro r
(Professional Engincer's name from Application Item 111.1.) (Project Name from Application Item 11 1 �NNy-raj
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 1 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 he 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:
Applicant's Certification per 15A NCAC 02T .0106(b):
1, Thomas D. Johnson , attest that this application for Weddington Place Apartments & Townhomes
(Signature Authority Name from Application Item L3.) (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.
t 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. 1 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 $10,000 as well as civil penalties up to $25,000 per violation.
Thomas JohnsonDigitallysignedpyThomasJohnson
Date: 2024.09.2414:20:35-04'00'
Signature: _ Date:
FORM: FTA 10-23 Page 5 of 5

NlL DC'f),1;
Environm nt;i q ,,,li,y
Received
State of North Carolina
OCT 18 2024 Department of Environmental Quality
DWR Winston-Salem Division of Water Resources
DM,Ion (if water Rv%ourcvs Regional Office Flow Tracking for Sewer Extension Applications
(FTSE 10-23)
Entity Requesting Allocation: City of Lexington
Project Name for which flow is being requested: Weddington Apartments & Townhomes '
More than one FTSE maybe 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.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a.
b.
C.
d.
e.
WWTP Facility Name: Lexington Regional Wastewater treatment Plant
WWTP Facility Permit #: NCO055786
All flows are in d1GD
WWTP facility's permitted flow 6.50
Estimated obligated flow not yet tributary to the WWTP .1982
WWTP facility's actual avg. flow 2.4
f. Total flow for this specific request
g. Total actual and obligated flows to the facility
h. Percent of permitted flow used
0.072
2.6702 "
41.0%
II. 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)
(E)=(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***
Sea Mountain Lane
.324 .1296
.002783,
.072 .07478 -
.05482 `
Woodlands -Osprey
.216 .0864 "
.01104 -
.072 .08304-
.00336
Brown St -Swearing Ck 5.91 2.36 1.5 •2702" 1.7702 ' .5898
* The Firm Capacity (design now) of any pump station is defined as the maximum pumped Bow 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): Lexington Regional Wastewater treatment Plant
Downstream Permit Number: NCO055786
Page 1 of 6
FTSE 10-23

N: Deparir., I c u
Environmental Quality
Received
OCT 18 2024
Winston-Salem
III. Certification Statement: Regional Office
I Thomas D. Johnson 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.
Thomas Joi1C1SOC1 Digitally signed by Thomas Johnson
Date: 2024.10.11 09:15.49 -04'00'
Signing Official Signature
Water Resources Utility Director
Title of Signing Official
Date
Page 2 of 6
FTSE 10-23

State of North Carolina
-` Department of Environmental Quality
k: Division of Water Resources
Diviclon of 0?;, ;,.., ;,, .. Flow Tracking for Sewer Extension Applications
(FTSE 10-23)
Entity Requesting Allocation: City of Lexington
Project Name for which flow is being requested: Weddington Apartments & Townhomes
More than one FTSE maybe required for a single project if Cite owner of the WWTP is not responsible for all pump
stations along the route of the proposed wastewater flow.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Lexington Regional Wastewater treatment Plant
b. WWTP Facility Permit #: NCO055786
c. WWTP facility's permitted flow
d. Estimated obligated flow not yet tributary to the W WTP
e. WWTP facility's actual avg. flow
f. Total flow for this specific request
g. Total actual and obligated flows to the facility
It. Percent of permitted flow used
All flows are in MGD
6.50 '
.1982
2.4
0.072 `
2.6702
41.0%
II. 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:
Pump
Pump
Station
Station
(Name or
Permit
Number)
No.
Sea Mountain Lane
(A)
Design
Average
Firm Daily Flow**
Capacity, * (Firm / pf),
MGD MGD
.324 .1296
Woodlands -Osprey .216 .0864
Brown St -Swearing Ck 5.91 2.36
(B)
(C)
Obligated,
Approx.
Not Yet
Current
Tributary
Avg. Daily
Daily Flow,
Flow, MGD
MGD
.002783
.072
.01104
.072
(D)=(B+C) (E)=(A-D)
Total Current
Flow Plus
Obligated
Available
Flow
Capacity*** �A
07478
k ? b.
e,b, .0556
3v
.0834
003 0.6�
1.5 .268 ' 1.768 .592
* 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 ldca[ed between the
project connection point and the WWTP cit is < 0.
Downstream Facility Name (1
Downstream Permit Number:
Page 1 of 6
FTSE 10-23 .�

III. Certification Statement:
I Thomas D. Johnson 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.
i Digitally signed/byThomas Johnson
I
Thomas �ohnsOn Date: 2024.09.24 14:18:26 -04'00'
Signing Of Signature
Water Resources Utility Director e
Title of Signing Official
Date
Page 2 of 6
FTSE 10-23

\ Green Mountain Engineering, PLLC
Civil Engineering Consultants
Land Surveyors
Envlronrnen��i tivalit,
Rt+t -iw
TRANSMITTAL SEP 2 7 2024
Winston-Salem
To: NCDEQ — Water Quality Section Regional Office
Address: 450 W. Hanes Mill Rd., - Suite 300, Winston-Salem, NC 27127
From: Joseph V. O'Buch, PE, Green Mountain Engineering, PLLC
Date: 2024 — September 27
Re: Weddington Place Apartments -Lexington, NC
Messages
Attached please find application packages for public sewer extension for the Weddington
Place Apartments, located in Lexington, NC off Brown Street to serve the residential
housing proposed by the Weddington Place Apartments Subdivision. Included are one(I)
original and one (1) copy of the Application Package, and one (1) check for $600.00.
Please let us know if you have any questions or require additional information. I can be
reached via email ioena greenmountainengineers.com or by cell phone [phone] at
your convenience.
Best Regards,
Afilllll/011/4�
Joseph V. O'Buch, P.E.
1A Wendy Court - Greensboro, NC 27409 - [phone]
Page 1 of 1

Green Mountain Engineering, PLLC
Civil Engineering Consultants
Land Surveyors
Project Narrative For
Weddington Apartments & Townhomes
Located in Lexington, NC
September 20, 2024
To Whom It May Concern:
Weddington Apartments & Townhomes is a proposed 15 apartments, 24
units/building apartment complex and 132 townhomes subdivision with a club house,
pool and pool house, 1 bay-carwash, and 1 sales office. The proposed sewer system
serving Weddington Apartments & Townhomes will tie into a proposed lift station,
which will pump into an existing sewer main located in Bill Medlin Rd. right of way.
Approximately 4,953 linear feet of new 8 inch sewer mains with new services will be
installed, as well as new lift station and 233 linear feet of force main. There is a total
of 264 new units are planned for this complex.
The design and plan review was done in accordance with NCDEQ's Gravity Sewer
Minimum Design Criteria and the City of Lexington's standards and specifications.
Work on the sewer installation is planned to begin once the permit has been obtained.
Please contact me if you require additional information. You can reach me via email
ioeggreenmountainengineers.com or by telephone [phone] at your
convenience.
Respectfully submitted,
'v 441
Q%�
Joseph V. O'Buch, P.E.
Green Mountain Engineering, PLLC
1A Wendy Court - Greensboro, NC 27409 - [phone]
Page 1 of

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