WQ0040262_Application (FTSE)_20181009

State of North Carolina
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.. U�(pqo`�gL (to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: Mosley Park, LLC (company, municipality, HOA, utility, etc.)
2. Applicant type: [:] Individual Z Corporation ❑ General Partnership
❑ Federal ❑ State/County [:] Municipal
3. Signature authority's name: Matthew Scharf per l 5A NC.AC 02T .0.106 b)
Title: Manager
4. Applicant's mailing address: 1319 Military Cutoff, Suite CC, PMB 172
City: Wilmington State: NC Zip: 28405-
5. Applicant's contact information:
Phone number: [phone] Email Address: [e-mail]
II. PROJECT INFORMATION:
❑ Privately -Owned Public Utility
[:] Other
Li
AUG 28 2018
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1. Project name: Studio 17 Apartments pv ' tr"
2. Application/Project status: Z Proposed (New Permit) ❑ Existing Permit/Project
If a modification, provide the existing permit number: WQ00 and issued date:
If new construction but part of a master plan, provide the existing permit number: WQ00
3. County where project is located: New Hanover
4. Approximate Coordinates (Decimal Degrees): Latitude: 34.230079' Longitude:-77.926926'
5. Parcel ID (if applicable): R05407-029-012-000
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Howard Resnik License Number: 25483
Firm: CSD Engineering
Mailing address: PO BOX 4041
City: Wilmington State: NC Zip: 28406-
Phone number: [phone] Email Address: [e-mail]
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Northside WWTP Permit Number: NCO023965
Owner Name: CFPUA
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQN Downstream (Receiving) Sewer Size: 8 inch
System Wide Collection System Permit .Numbers) 01' apphcable: WQCS
Owner Name(s): CFPUA
FORM: FTA 04-16 Page 1 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?
E]Yes [:]No ®N/A
2. If the Applicant is a Developer of lots to be sold, has a Developer's er's Operational Agreement (FORM: been attached?
El Yes []No ®N/A
3. If the Applicant is a Home/Property
Owners' Association, has an Operational Agreement FORM: HO.A) been attached?
EJ Yes ❑No ®N/A
4. Origin of wastewater: (check all that apply):
® Residential Owned
Z Retail (stores, centers, malls)
❑ Car Wash
® Residential Leased
❑ Retail with food preparation/service
El Hotel and/or Motels
❑ School / preschool / day care
❑ Medical / dental / veterinary facilities
❑ Swimming Pool /Clubhouse
❑ Food and drink facilities
El Church
❑ Swimming Pool/Filter Backwash
❑ Businesses / offices / factories
El Nursing Home
❑ Other (Explain in Attachment)
5. Nature of wastewater: 100 % Domestic/Commercial % Commercial
% Industrial (See 15A NCAC 02T .01. 03 (2() j)
Is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Hasa flow reduction been approved under 1.5.A NCAC 02T .0.114(f)? ❑Yes ®No
➢ If yes, provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.114(f)
Daily Design Flow a,b
No. of Units
Flow
gal/
GPD
1-Bedroom Apartments
240 gal/day
32
7,680 GPD
Retail Space (2 Employees)
25 gal/day/shift
2
50 GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
7,730 GPD
a See 15A N'C:AC" 02T .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 .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: 7,730 GPD (per 15A NCAC o2,r .01.14)
➢ 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

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers :
1. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
Material
6
154
C-900
6
20
DIP
➢ 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 requirement is not allowed and a violation of the MDC
VIII. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC (Pump Stations/Force Main':
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. Pump station number or name:
2. Approximate Coordinates (Decimal Degrees): Latitude: 0Longitude: - °
3. Design flow of the pump station: millions gallons per day (firm capacity)
4. Operational point(s) of the pump(s): gallons per minute at feet total dynamic head (TDH)
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches) Length (feet) Material
6. Power reliability in accordance with 15A N*CAC 02T .0305(h)(1):
❑ Standby power source or pump with 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
Or if the pump station has an average daily flow less than 15,000 gallons per day:
❑ Portable power source with manual activation, quick -connection receptacle and telemetry - 15A NCAC 02T
.0305(h)(1)(C)
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry - 15A NCAC 02T .0305(h)(1)(C):
➢ It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant (draft agreement)
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
in the case of a multiple station power outage.
FORM: FTA 04-16 Page 3 of 5

IX. SETBACKS & SEPARATIONS — (02B .0200 & 15A NCAC 02T .0305(f)):
1. Does the project comply with all separations found in 1.5 A .NCAC 02T .0305 (1) & (C.) ❑ Yes ® No
➢ 15A NCAC 02T_0305(f) contains minimum separations that shall he nrovided for sewer systems_
Setback Parameter`
Separation Required
Storm sewers and other utilities not listed below (vertical)
24 inches
Water mains (vertical -water over sewer including in benched trenches)
18 inches
Water mains (horizontal)
10 feet
Reclaimed water lines (vertical - reclaimed over sewer)
18 inches
Reclaimed water lines (horizontal - reclaimed over sewer)
2 feet
"Any private or public water supply source, including any wells, WS-I waters of Class I or
Class II impounded reservoirs used as a source of drinking water
100 feet
"Waters classified WS (except WS-I or WS-V), B, SA, ORW, HQW, or SB from normal
high water (or tide elevation) and wetlands (see item IX.2)
50 feet .
"Any other stream, lake, impoundment, or ground water lowering and surface drainage
ditches
10 feet
Any building foundation
5 feet
Any basement
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
➢ 1.5.A. NCAC 02T,0305(;) contains alternatives where separations in 02T.0305 lw cannot be achieved.
➢ "Stream classifications can be identified using the Division's NC Surface eater Classifications webpage
➢ If noncompliance with 02T.0305(f) or (o)4 see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) El Yes ❑ No ® N/A
➢ See the Division's draft separation requirements for situations where separation cannot be meet
➢ No variance is required if the alternative design criteria specified is utilized in design and construction
➢ As built documents should reference the location of areas effected
3. Does the project comply with setbacks found in the river basin rules per 1.5A NCAC 02B .0200 ? El Yes [-] No ® N/A
➢ This would include Trout Buffered Streams per .15 A NCAC 2B .0202
4. Does the project require coverage/authorization under a 404 Nationwide or ❑ Yes ® No
individual permits or 401 Water Quality Certifications?
➢ Information can be obtained from the 40*1 & Bul`[er Permittanor Branch
5. Does project comply with 15A NCAC 02T.0105(c)(6) (additional permits/certifications)? ® Yes [:]No
Per 1.5A NCAC: 02T.0:105(c 6 , directly related environmental permits or certification applications are 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.).
6. Does this project include any sewer collection lines that are deemed "high -priority?"
Per -1.5A .NCAC 02T.0402, "high -priority sewer" means "any aerial sewer, sewer contacting surface waters, siphon, or sewer
positioned parallel to streambanks that is subject to erosion that undermines or deteriorates the sewer.
[:] Yes ® No ❑ N/A
➢ 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 permitee's individual System -Wide Collection permit.
FORM: FTA 04-16 Page 4 of 5

X. CERTIFICATIONS:
1. Does the submitted system comply with 15A N' AC 02.1 the Minimum Desi g Criteria for the 'Permitting of Punip Stations
and Force'Mains latest version . and the' Grayijy Sewer- Minimum Design. Criteria latest version as applicable?
0 Yes ❑ No
If No, complete and submit the Variance/Alternative Design Request application (VADC 10-14) and supporting documents for
review. Approval of the request is required prior to submittal of the Fast Track Application and supporting documents.
2. Professional Engineer's Certification:
I, Howard Resnik, P.E. attest that this application for
(Professional Engineer's name from Application Item III.1.)
has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans, specifications,
engineering calculations, and all other supporting documentation to the best of my knowledge. I further attest that to the best
of my knowledge the proposed design has been prepared in accordance with the applicable regulations, Gravity Sewer
Minimum Design Criteria for Gravity Sewers (latest version), and the Minimum Design Criteria for the Fast -Track Permitting
of Pump Stations and Force Mains (latest version). Although other professionals may have developed certain portions of this
submittal package, inclusion of these materials under my signature and seal signifies that I have reviewed this material and
have judged it to be consistent with the proposed design.
NOTE — In accordance with General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed $10,000, as well as civil penalties up to $25,000 per violation.
..................................................................................... ti
North Carolina Professional Engineer's seal, signature, and date: ���►r. A
3. Applicant's Certification per 15A NCAC 02T .0106(b):
I,
Matthew Scharf, Manager
(Signature Authority's name & title from Application Item I.3.)
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attest that this application for
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required parts of
this application are not completed and that if all required supporting documentation and attachments are not included, this
application package is subject to being returned as incomplete. I understand that any discharge of wastewater from this non -
discharge system to surface waters or the land will result in an immediate enforcement action that may include civil penalties,
injunctive relief, and/or criminal prosecution. I will make no claim against the Division of Water Resources should a condition
of this permit be violated. I also understand that if all required parts of this application package are not completed and that if
all required supporting information and attachments are not included, this application package will be returned to me as
incomplete.
NOTE — In accordance with General Statutes '143-215.6A and 143-215.6B, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed $10,000 as well as civil penalties up to $25,000 per violation.
Signature: C4z,7::;7&� Date: � Z � •- / v
FORM: FTA 04-16 Page 5 of 5

Central Files. APS SWP
8/29/2018
Permit Number WQOO4O262
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
dean.hunkele
r
Coastal SWRule
Permitted Flow
i
Facility
Facility Name
Major/Minor Region
Studio 17 Apartments Private Sewer
Minor Wilmington
'i
Location Address
County i
New Hanover
i
i
.
Facility Contact Affiliation
i
Owner
i
Owner Name
Owner Type
Mosley Park LLC
Non -Government
Owner Affiliation
Matthew Scharf
i
i
i
1319 Military Cutoff Rd
Dates/Events
Wilmington NC 28405
Scheduled
Orig Issue App Received Draft Initiated Issuance
Public Notice Issue Effective Expiration �
8/28/2018
Regulated Activities
Requested /Received Events

August 28, 2018
Dean Hunkele
Forth Carolina Department of
Environmental Quality
Division of Water Resources
'127 Cardinal Drive Extension
Wilmington, North Carolina 28405
Re: Studio 17 Apartments
Private Sewer System Extension
New Hanover County
CSD Project No. 17-0434
Dear Mr. Hunkele:
CSD
ENGINEERING
VED/h, COEN ON
AUG. 2 8 '
Na tej- Qua l i4j Regional
f�Per{'f 'OPS, ,potion
�.v
AUG 2 8 2018
}
The enclosed permit application is for +/-154 If of 6" C-900 and 20 If of 6" DIP private gravity sewer main to
Serve. Studio 17 Apartments, a proposed 32-unit townhome development in New Hanover Co. These will be 1-
bedroom units. -This line will connect to an existing CFPUA sewer main located in the right-of-way of South 17th
..Street by installing a new drop -in manhole. The private main will be installed, owned and maintained by the
developer. Per our previous discussions regarding this project, the section of the new sewer main within the
right-of-way of S. 17t" St. will be conveyed to CFPUA. Enclosed please find:
- One (1) original and one (1) copy of Fast Track Sewer Application (FTA 04-16)
- One (1) original and one (1) copy of Flow Tracking/Acceptance form (FTSE 04-16)
- $480.00 application fee, check #136
- Street view map
- USGS map
If you have any questions or comments, please feel free to contact me. Thank you for your assistance.
Sincerely,
f�
Mike Broyhill
Encl.: As noted above
Cc: Mosley Park, LLC
3805 Cherry Avenue - Wilmington, NC 28403 - 910 7914441- www.csd-engineering.com — License # C-2710
CSD
ENGINEERING

• File an Annual Report/Amend an Annual Report • Upload a PDF Filing • Order a Document Online •
Add Entity to My Email Notification List • View Filings • Print an Amended a Annual Report form • Print a
Pre -Populated Annual Report form
Limited Liability Company
LegaL Name
Mosley Park, LLC
Information
Sos1d: 0714903
Status: Current -Active
Annual Report Status: Current
Citizenship: Domestic
Date Formed: 3/17/2004
Registered Agent: Scharf, Matthew L
Addresses
Mailing
1319 Military Cutoff Road, Suite .CC PMB 172
Wilmington, NC 28405
Reg Off ice
1319 Military Cutoff Road, Suite CC PMB 172
Wilmington, NC 28405
Company Officials
Principal Office
1319 Military Cutoff Road, Suite CC PMB 172
Wilmington, NC 28405
Reg Mailing
1319 Military Cutoff Road, Suite CC PMB 172
Wilmington, NC 28405
All LLCs are managed by their managers pursuant to N.C.G.S. 57D-3-20.
Manager
Louise K Scharf
1319 Military Cutoff Road, Suite CC PMB 172
Wilmington NC 28405
Manager
Matthew L Scharf
1319 Military Cutoff Road, Suite CC PMB 172
Wilmington NC 28405

Entity Requesting Allocation: Mosley Park, LLC
Project Name for which flow is being requested: Studio 17 Apartments
More than one FTSE may be required for a single project if the owner of the WWTP is not responsible for allpump
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: James A. Loughlin (Northside) WWTP
b. WWTP Facility Permit #: NPDES NC 0023965
All flows are in MGD
c. WWTP facility's permitted flow 16.000
d. Estimated obligated flow not yet tributary to the WWTP 2.615
e. WWTP facility's actual avg. flow 10.661
f. Total flow for this specific request 0.007730
g. Total actual and obligated flows to the facility 13.283
h. Percent of permitted flow used 810%
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 Average Daily Approx. Not Yet Total Current
Station Firm Flow* * Current Avg. Tributary Flow Plus
(Name or Capacity, * (Firm / pf), Daily Flow, Daily Flow, Obligated Available
Number) MGD MGD MGD MGD Flow Capacity***
10 14_912 _5.911 1-472 0_392 1_R_51 2_079
* The Firm Capacity 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.
* * * 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): Cape Fear Public Utility Authority
Downstream Permit Number: Not Available
Page 1 of 6
FTSE 04-16

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III. Certification Statement:
I Matthew Tribett, CFPUA Eng. Mgr certify to the best of my knowledge that the addition of
the volume of wastewater to be permitted in this project has been evaluated along the route to the
receiving wastewater treatment facility and that the flow from this project is not anticipated to
cause any capacity related sanitary sewer overflows or overburden any downstream pump station
en route to the receiving treatment plant under normal circumstances, given the implementation of
the planned improvements identified in the planning assessment where applicable. This analysis
has been performed in accordance with local established policies and procedures using the best
available data. This certification applies to those items listed above in Sections I and II plus all
attached planning assessment addendums for which I am the responsible party. Signature of this
form indicates acceptance of this wastewater flow.
Signing Official Signature
ate
Page 2 of 6
FTSE 04-16

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