WQ0040015_Issuance of Permit_20180525

I
Permit Number WQ0040015
Central Files: APS _ SWP _
5/23/2018
Permit Tracking Slip
Program Category
Status
Project Type
Non -discharge
In review
New Project
Permit Type
Version
Permit Classification
Gravity Sewer Extension, Pump Stations, & Pressure Sewer Extensions
A
Individual
Primary Reviewer
Permit Contact Affiliation
ted.cashion
Government - Municipal
Coastal SWRule
K Owen Scott
Permitted Flow
0
Facility
Facility Name
Major/Minor Region
17BPA.C.2
Minor Raleigh
Location Address
County
Halifax
Facility Contact Affiliation
Owner
Owner Name
Owner Type
Town of Littleton
Government - Municipal
Owner Affiliation
K Owen Scott
Mayor
PO Box 87
Dates/Events
Littleton NC 27850
Scheduled
Orig Issue App Received Draft Initiated
Issuance Public Notice Issue Effective Expiration
5/25/2018 4/11/2018
5/25/2018 5/25/2018
Regulated Activities
Requested /Received Events
Wastewater collection
Additional information requested 519/18
Additional information received 5/15/18
Outfall
Waterbody Name
Streamindex Number Current Class Subbasin

Water Resources
ENVIRONMENTAL QUALITY
May 25, 2018
K. Owen Scott, Mayor
Town of Littleton
P.O. Box 87
Littleton, NC 27850
Subject: Permit No. WQ0040015
Town of Littleton
17BPA.C.2
Wastewater Collection System Extension Permit
Halifax County
Dear Mayor Scott:
ROY COOPER
Governor
MICHAEL S. REGAN
.Secretail
LINDA CULPEPPER
Interim Director
In accordance with your application received April 11, 2018, and additional information received on May
15, 2018, we are forwarding herewith Permit No. WQ0040015 dated May 25, 2018, to the Town of
Littleton (Permittee) for the construction and operation upon certification of the subject wastewater
collection system extension. This permit shall be effective from the date of issuance until rescinded and
shall be subject to the conditions and limitations as specified therein. This cover letter shall be considered
a part of this permit and is therefore incorporated therein by reference.
Please pay particular attention to the following conditions contained within this permit:
Condition IIA: This permit shall not be automatically transferable; a permit modification request for a
name change must first be approved by this office.
Condition IIA: Requires that the wastewater collection facilities be properly operated and maintained
in accordance with 15A NCAC 2T .0403 or any individual system -wide collection system
permit issued to the Permittee.
It shall be the responsibility of the Permittee to ensure that the as -constructed project meets the
appropriate design criteria and rules. Failure to comply may result in penalties in accordance with North
Carolina General Statute §143-215.6A through §143-215.6C, construction of additional or replacement
wastewater collection facilities, and/or referral of the North Carolina -licensed Professional Engineer to
the licensing board.
If any parts, requirements, or limitations contained in this permit are unacceptable, you have the right to
request an adjudicatory hearing upon written request within 30 days following receipt of this permit. This
request must be in the form of a written petition, conforming to Chapter 150B of North Carolina General
Statutes, and filed with the Office of Administrative Hearings, 6714 Mail Service Center, Raleigh, NC
27699-6714. Unless such demands are made, this permit shall be final and binding.
Division of Water Resources, Raleigh Regional Office, Water Quality Operations Section www.ncwaterquality.org
1628 Mail Service Center, Raleigh, NC 27699-1628 Phone: [phone]
Location- 3800 Ran•ett Drive.. Raleigh. NC 27609 Fax: [phone]

Town of Littleton
Permit No. WQ0040015
If you need additional information concerning this matter, please contact Ted Cashion at [phone]
or via e-mail at [e-mail].
Sincerely,
for Linda Culpepper
Interim Director, Division of Water Resources
by S. Daniel Smith, Regional Supervisor
Water Quality Regional Operations Section
Raleigh Regional Office
Division of Water Resources, NCDEQ
cc: Michael V. Zaccardo, P.E., Wetherill Engineering (via email: [e-mail])
Halifax County Health Department
Raleigh Regional Office Files
Water Resources Central Files
Page 2 of 8

North Carolina Department of Environmental Quality
STATE OF NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENTAL QUALITY
WASTEWATER COLLECTION SYSTEM EXTENSION PERMIT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended, and other applicable Laws, Rules, and Regulations, permission is hereby granted to the
Town of Littleton
Halifax County
for the construction and operation of approximately 316 linear feet of 12 -inch gravity sewer to relocate
existing sewer lines as part of the 17BP.4.C.2 project, and the discharge of no additional gallons per day
of collected wastewater into the Town of Littleton's existing sewerage system, pursuant to the application
received April 11, 2018, and additional information received on May 15, 2018 and in conformity with 15A
NCAC 2T; the Division's Gravity Sewer Minimum Design Criteria adopted February 12, 1996 and updated
in March 2008, as applicable; the Division's Minimum Design Criteria for the Fast -Track Permitting of
Pump Stations and Force Mains adopted June 1, 2000 and updated March 2008, as applicable; and other
supporting data subsequently filed and approved by the Department of Environmental Quality and
considered a part of this permit. /
This permit shall be effective from the�da`te of iss�r'ance until rescinded and shall be subject to the specified
conditions,-qnd li itations cont ine therein. 1
Linda Culpepper
Interim Director, Division of Water Resources
By Authority of The Environmental Management Commission
Permit Number: WQ0040015
Permit Issued: May 25, 2018
Page 3 of 8

SUPPLEMENT TO PERMIT COVER SHEET
The Town of Littleton is hereby authorized to:
Construct, and then operate upon certification the aforementioned wastewater collection extension. The
sewage and wastewater collected by this system shall be treated in the Town of Littleton's Wastewater
Treatment Facility in accordance with Permit Number NC0025691.
Permitting of this project does not constitute an acceptance of any part of the project that does not meet
15A NCAC 2T; the Division's Gravity Sewer Minimum Design Criteria adopted February 12, 1996 and
updated March 2008, as applicable; and the Division's Minimum Design Criteria for the Fast -Track
Permitting of Pump Stations and Force Mains adopted June 1, 2000 and updated March 2008, as
applicable, unless specifically mentioned herein. Division approval is based on acceptance of the
certification provided by a North Carolina -licensed Professional Engineer in the application. It shall be the
Permittee's responsibility to ensure that the as -constructed project meets the appropriate design criteria
and rules.
Construction and operation is contingent upon compliance with the Standard Conditions and any Special
Conditions identified below.
I. SPECIAL CONDITIONS
NONE
11. STANDARD CONDITIONS
1. This permit shall not be transferable. In the event there is a desire for the wastewater collection
facilities to change ownership, or there is a name change of the Permittee, a formal permit request
shall be submitted to the Division accompanied by documentation from the parties involved, and
other supporting materials as may be appropriate. The approval of this request shall be considered
on its merits and may or may not be approved. [15A NCAC 02T.0104; G.S 143-215.1(d3)]
2. This permit shall become voidable unless the wastewater collection facilities are constructed in
accordance with the conditions of this permit; 15A NCAC 2T; the Division's Gravity Sewer Minimum
Design Criteria adopted February 12, 1996 and updated March 2008, as applicable; the Division's
Minimum Design Criteria for the Fast -Track Permitting of Pump Stations and Force Mains adopted
June 1, 2000 and updated March 2008, as applicable; and other supporting materials unless
specifically mentioned herein. [15A NCAC 02T.01101
3. This permit shall be effective only with respect to the nature and volume of wastes described in the
application and other supporting data. [15A NCAC 02T .0110]
4. The wastewater collection facilities shall be properly maintained and operated at all times. The
Permittee shall maintain compliance with an individual system -wide collection system permit for the
operation and maintenance of these facilities as required by 15A NCAC 2T .0403. If an individual
permit is not required, the following performance criteria shall be met: [15A NCAC 02T .0108(b)]:
Page 4 of 8

a. The sewer system shall be effectively maintained and operated at all times to prevent discharge
to land or surface waters, and to prevent any contravention of groundwater standards or surface
water standards.
b. A map of the sewer system shall be developed and shall be actively maintained.
c. An operation and maintenance plan including pump station inspection frequency, preventative
maintenance schedule, spare parts inventory and overflow response has been developed and
implemented.
d. Pump stations that are not connected to a telemetry system shall be inspected every day (i.e. 365
days per year). Pump stations that are connected to a telemetry system shall be inspected at
least once per week.
e. High-priority sewer lines shall be inspected at least once per every six -months and inspections are
documented.
f. A general observation of the entire sewer system shall be conducted at least once per year.
g. Overflows and bypasses shall be reported to the appropriate Division regional office in accordance
with 15A NCAC 2B .0506(a), and public notice shall be provided as required by North Carolina
General Statute §143-215.1C.
h. A Grease Control Program is in place as follows:
1. For public owned collection systems, the Grease Control Program shall include at least
biannual distribution of educational materials for both commercial and residential users and
the legal means to require grease interceptors at existing establishments. The plan shall also
include legal means for inspections of the grease interceptors, enforcement for violators and
the legal means to control grease entering the system from other public and private satellite
sewer systems.
2. For privately owned collection systems, the Grease Control Program shall include at least bi-
annual distribution of grease education materials to users of the collection system by the
permittee or its representative.
3. Grease education materials shall be distributed more often than required in Parts (1) and (2)
of this Subparagraph if necessary to prevent grease -related sanitary sewer overflows.
Right-of-ways and easements shall be maintained in the full easement width for personnel and
equipment accessibility.
j. Documentation shall be kept for Subparagraphs (a) through (i) of this Rule for a minimum of three
years with exception of the map, which shall be maintained for the life of the system.
5. The Permittee shall report by telephone to a water resources staff member at the Raleigh Regional
Office, telepho.ne number [phone], as soon as possible, but in no case more than 24 hours,
following the occurrence or first knowledge of the occurrence of either of the following:
Page 5 of 8

a. Any process unit failure, due to known or unknown reasons, that renders the facility incapable
of adequate wastewater transport, such as mechanical or electrical failures of pumps, line
blockage or breakage, etc.; or
b. Any SSO and/or spill over 1,000 gallons; or
c. Any SSO and/or spill, regardless of volume, that reaches surface water
Voice mail messages or faxed information is permissible, but this shall not be considered as the initial
verbal report. Overflows and spills occurring outside normal business hours may also be reported to
the Division of Emergency Management at telephone number [phone] or [phone].
Persons reporting any of the above occurrences shall file a spill report by completing and submitting
Part I of Form CS-SSO (or the most current Division approved form) within five days following first
knowledge of the occurrence. This report must outline the actions taken or proposed to be taken to
ensure that the problem does not recur. Part II of Form CS-SSO (or the most current Division approved
form) can also be completed to show that the SSO was beyond control. [G.S. 143-215.1C(a1)]
6. Construction of the gravity sewers, pump stations, and force mains shall be scheduled so as not to
interrupt service by the existing utilities nor result in an overflow or bypass discharge of wastewater
to the surface waters of the State. [15A NCAC 02T.0108(b)]
7. Upon completion of construction and prior to operation of these permitted facilities, the completed
Engineering Certification form attached to this permit shall be submitted with the required supporting
documents to the address provided on the form. A complete certification is one where the form is
fully executed and the supporting documents are provided as applicable. Any wastewater flow made
tributary to the wastewater collection system extension prior to completion of this Engineer's
Certification shall be considered a violation of the permit and shall subject the Permittee to
appropriate enforcement actions.
If the permit is issued to a private entity with an Operational Agreement, then a copy of the Articles
of Incorporation, Declarations/Covenants/Restrictions, and Bylaws that have been appropriately
filed with the applicable County's Register of Deeds office shall be submitted with the certification.
A complete certification is one where the form is fully executed and the supporting documents are
provided as applicable. Supporting documentation shall include the following:
a. One copy of the project construction record drawings (plan & profile views of sewer lines & force
mains) of the wastewater collection system extension. Final record drawings should be clear on
the plans or on digital media (CD or DVD disk) and are defined as the design drawings that are
marked up or annotated with after construction information and show required buffers,
separation distances, material changes, etc.
b. One copy of the supporting applicable design calculations including pipe and pump sizing, velocity,
pump cycle times, and level control settings, pump station buoyancy, wet well storage, surge
protection, detention time in the wet well, and force main, ability to flush low points in force
mains with a pump cycle, and downstream sewer capacity analysis. If a portable power source or
pump is dedicated to multiple 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.
Page 6 of 8

c. Changes to the project that do not result in non-compliance with this permit, regulations, or the
Minimum Design Criteria should be clearly identified on the record drawings, on the certification
in the space provided, or in written summary form.
Prior to Certification (Final or Partial): Permit modifications are required for any changes resulting in
non-compliance with this permit (including pipe length increases of 10% or greater, increased flow,
pump station design capacity design increases of 5% or greater, and increases in the number/type of
connections), regulations, or the Minimum Design Criteria. Requested modifications or variances to
the Minimum Design Criteria will be reviewed on a case-by-case basis and each on its own merit.
Please note that variances to the Minimum Design Criteria should be requested and approved during
the permitting process prior to construction. After -construction requests are discouraged by the
Division and may not be approved, thus requiring replacement or repair prior to certification &
activation. [15A NCAC 02T.0116]
8. Gravity sewers installed greater than ten percent below the minimum required slope per the Division's
Gravity Sewer Minimum Design Criteria shall not be acceptable and shall not be certified until
corrected. If there is an unforeseen obstacle in the field where all viable solutions have been
examined, a slope variance can be requested from the Division with firm supporting documentation.
This shall be done through a permit modification with fee. Such variance requests will be evaluated
on a case-by-case basis. Resolution of such request shall be evident prior to completing and submitting
the construction certification. [ 15A NCAC 02T.0105(n)]
9. A copy of the construction record drawings shall be maintained on file by the Permittee for the life of
the wastewater collection facilities. [15A NCAC 02T .01161
10. Failure to abide by the conditions and limitations contained in this permit; 15A NCAC 2T; the Division's
Gravity Sewer Design Criteria adopted February 12, 1996 and updated March 2008,
as applicable; the Division's Minimum Design Criteria for the Fast -Track Permitting of Pump Station
and Force Mains adopted June 1, 2000 and updated March 2008 as applicable; and other supporting
materials may subject the Permittee to an enforcement action by the Division, in accordance with
North Carolina General Statutes §143-215.6A through §143-215.6C, construction of additional or
replacement wastewater collection facilities, and/or referral of the North Carolina -licensed
Professional Engineer to the licensing board. [15A NCAC 02T.0104; 15A NCAC 02T .0108(b -c)]
11. In the event that the wastewater collection facilities fail to perform satisfactorily, including the
creation of nuisance conditions, the Permittee shall take immediate corrective action, including those
as may be required by this Division, such as the construction of additional or replacement facilities.
[15A NCAC 02T.0110; 15A NCAC 02T .0108(b)]
12. The issuance of this permit shall not exempt the Permittee from complying with any and all statutes,
rules, regulations, or ordinances that may be imposed by the Division any other Federal, State, or Local
government agencies which have jurisdiction or obtaining other permits which may be required by
the Division or any other Federal, State, of Local government agencies. [G.S. 143-215.1(b)]
Page 7 of 8

FAST TRACK SEWER ENGINEERING CERTIFICATION
PERMITTEE: Town of Littleton
PERMIT #:
WQ0040015
PROJECT:
17BP.4.C.2
ISSUE DATE:
May 25, 2018
This project shall not be considered complete nor allowed to operate in accordance with 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
the Regional Supervisor, Water Quality Regional Operations Section at the address at the bottom.
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. A Final Certification shall be a complete set of record drawings and
design calculations regardless of whether partials have been submitted.
PERMITTEES 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.
Printed Name, Title Signature Date
ENGINEERS CERTIFICATION
I, , as a duly registered Professional Engineer in the State of North Carolina,
having been authorized to observe (❑ 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 construction 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
and updated March 2008, as applicable; the Division's Minimum Design Criteria for the Fast -Track
Permitting of Pump Stations and Force Mains adopted June 1, 2000 and updated March 2008, as
applicable; and other supporting materials.
:........................................................................
North Carolina Professional Engineer's Seal w/signature & date:
❑ Final ❑ Partial (include description)
................... .... ............. .........
..............;
Certification Comments/Qualifiers (attach if necessary):
Division ofWater Resources, Raleigh Regional 011ico, Water Quality Operation-; Section www.ncwaterqunlity.org
1628 Mail Service Center, Raleigh, NC27609-1625 Phone: [phone]
r „•%,t;,,,,• ;SMll R- - -,ft nr;,;,, NY' 1-7W10 V--- 10101 71N-71 ;q

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T.0300 — FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 04-16 & SUPPORTING DOCUMENTATION
Application Number: v✓(�� 0 �0 d (to be completed by DWR)
All items must be completed or the application will be returned
1. APPLICANT INFORMATION:
I . Applicant's name: Town of Littleton (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: K. Owen Scott per 15A NCAC 02T .0106(b)
Title: Mayor
4. Applicant's mailing address: 112 E. South Main Street, PO Box 87
City: Littleton State: N.C.. Zip: 27850-
5. Applicant's contact information:
Phone number: (25_J2 586-2709 Email Address: asstclerkatownoflittleton-nc.us
11. PROJECT INFORMATION:
1. Project name: 17BP.4.C.2 w d VA,)
z
2. Application/Project status:`Proposed (New Permit) ®Existin Pe oJect
CD
If a modification, provide the existing permit number: WQ00236 and ssued date:, °
If new construction but part of a master plan, provide the existing permit number: WQ00
CD
3. County where project is located: Halifax
4. Approximate Coordinates (Decimal Degrees): Latitude: 36.425328° Longitude: -77.906881'
-
5. Parcel ID (if applicable): O A
(or Parcel ID to closest downstream sewer) °
111. CONSULTANT INFORMATION:
1. Professional Engineer: Michael V. Zaccardo, PE License Number: 022321
Firm: Wetherill Engineering
Mailing address: 1223 Jones Franklin Road
City: Raleigh State: N.C.. Zip: 27606 -
Phone number: [phone] Email Address: mzaccardo(@wetherilleng.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Town of Littleton WWTP Permit Number: NCO025691
Owner Name: Town of Littleton
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ(�8�`ter � Downstream (Receiving) Sewer Size: 12 inch
lKA0 -11,
System Wide Collection System Permit Number(s) (if applicable): WQCS00236
Owner Name(s): Town of Littleton
FORM: FTA 04-16 Page I of 5

V1. 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 Operational Agreement (FORM: HOA) been attached?
❑ Yes ❑No ®N/A
4. Origin of wastewater: (check all that apply):
❑ Residential 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 % Commercial
_ % Industrial (See 15A NCAC 02T.0 103(20 )
bIs there a Pretreatment Program in effect? ® Yes [:]No
6. Has a flow reduction been approved under 15A NCAC 02T .01 140)? ❑ Yes ® No
➢ if yes, provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 021.01140
Daily Design Flow''"
No. of Units
Flow
gal/
GPD
gall
GPD
gall
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
GPD
a See 15A NCAC 021' .01 14(b), (d), (e)(1) and (e)(2) for caveats to wastewater design flow rates (i.e., minimum flow per
dwelling; 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 I �A_NCA( 0211.0 1 14] shall
be determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: _ GPD (per 15A NCAC 021T.0 1 14)
Do not include future flows or previously permitted allocations
If permitted flow is zero, indicate why:
❑ Pump Station or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line
❑ Flow has already been allocated in Permit Number:
® Rehabilitation or replacement of existing sewer with no new flow expected
❑ Other (Explain):
FORM: FTA 04-16 Page 2 of 5

'X. CER,rIFICATIO\S:
1. Does the submitted system comph \with 15A \CAC0 I. the Minimum i)e•ign Criteria for the Perniatint-, of Purim Stations
and I orce \lama i lawt ! \ er>lon ). and the Ora\ It% Sc\\ Cr Minimum De>rgn t_ r)terin ( 131c;t \cr,,ion) as applicable"
®�e5 �No
If No. complete and submit the Variance Alternative Design Request application (VADC 10-14) and supporting documents
for rc%ic\%. Approval of the request is required prior to submittal of the Fast Track Application and supporting
documents.
2. Professional Enaineer's Certification:
44 U, z A&eo
attest that this application t6r
(Professional Er aineer.s na ne from Application Item I11.1.)
P TS /-7"P, 4,e, 2 -
has been re\iev%ed b\ me and is accurate. complete and consistent (\ith the intormation supplied in the plans. specifications.
engineering calculations. and all other supporting documentation to the best of m% knowledge. I further attest that to the best
of ntN knowledge the proposed design has been prepared in accordance v%ith the applicable regulations. Gravity Sc\\cr
Minimum Design Criteria for Gra\it\ Sewers (latest version). and the Minimum Design Criteria for the Fast -Track
Pertaining of Pump Stations and Force Mains (latest version). Although other professionals ma\ have developed certain
portions of this submittal package. inclusion of these materials under nl\ signature and seal signifies that I have revie\\ed this
material and have judged it to be consistent with the proposed design.
NOTE — In accordance %%ith General Statutes 1.13-215.6A and 141-21;.613. an\ person \\ho kno\%ingl\ makes any false
statement. representation. or certification in am application package shall be Quilt\ of a Class 2 misdemeanor. \which ma\
include a tine not to exceed $10.000, as well as ci\if penalties up to 525.000 per violation.
............ ...................... -.....-- -
North Carolina Professional Engineer's seal. signature. and date: .a��\=y`4 ` :� `�•;
�v
00
dd,�
Applicant's Certification per 15A NCAC 021 .0106(b):
_attest that this application for
(Signature Authority's name &.: title from Application Iter 1.3.)
has been re0ev%ed b} me and is accurate and complete to the best of in\- knov%ledge. 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 am discharge of wastewater from this non-
discharee s%stem to surface waters or the land will result in an innnediate enforcement action that may include civil penalties.
i»iuncti\e relief. and or criminal prosecution. I v%ill make no claim against the Division of Nater Resources should a
condition of this permit be \iolated. 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 %rill be returned to
me as incomplete.
NOTE In accordance \\ith General Statutes 1{',_-'1 ,6A and 1413-215.6I;, am person v%ho knov\inel% makes am false
statement. representation. or certification in any application package shall be guilt\ of a Class '_ misdemeanor. v\hick ma\
include a fine not to exceed 510.000 as \%\ell assi\ it penalt-ies..up l0 525.000 per violation.
ShinatUrC: — Date:
FOR�,i: FTA 04-16 Page ; of

�s
ETHERILL
ENGINEERING
WE Design Your Tomorrow.. .
April 11, 2018
Engineers Report
Gravity Sewer Main Relocation
SR 1001 Justice Branch Road
NCDOT Project # 17BP.4.C.2
Halifax County, NC
Sewer System Owner /Applicant:
Town of Littleton
112 E. South Main Street
P.O. Box 87
Littleton, NC 27850
252-586-2709
K. Owen Scott
Project Description
Raleigh
Transportation
Planning Wilmington
Bridge/Structural Surveying
Civil/Site
Construction Observation
Surveying
The purpose of this 316' +/- LF sanitary gravity sewer main relocation is due to the fact that
NCDOT will be replacing the existing drainage pipes at Butterwood Creek and the existing
gravity sewer line will be in conflict with the new pipe construction. The location of this work is
along Justice Branch Road between Ferguson Street SR 1301 and Bowers Road SR 1300.
The improvements include the construction of approximately 96 LF of 12" CL51 DIP
(Protecto 401 ceramic lined) and 220 LF of 12" SDR 35 PVC gravity sewer which will be
placed via open cut method. This work will be performed in accordance with the
NCDOT BMP for Construction and Maintenance Activities dated August 2003.
The new relocated 12" sanitary gravity sewer main will be owned, operated, and
maintained by Town of Littleton Sewer Department. All construction will be in
accordance with the latest standards and specifications of the NCDOT, North Carolina
Department of Transportation and the NCDEQ, Division of Water Resources, Water
Quality Permitting, PERCS Unit.
1223 Jones Franklin Road Phone: [phone] Floral Parkway
Raleigh, NC 27606 Fax: [phone] Wilmington, NC 28403

1000' 0' 1000' 2000' 3000'
1223 Jo—s Franklin Rd.
ETHER
Raleigh, N.C. 27606
WENGINEERING License No. F-0377
Bus: 919 851 8077
PROJECT 17BP.4.C.2 USGS TOPOGRAPHIC MAP 3= Fax [phone]
HALIFAX COUNTY 03222018 T E I" � O � S