WQ0040558_Application (FTSE)_20181127

State of North Carolina
Department of Environmental Quality
D-W,R Division of Water Resources
vw�I5A NCAC 02T.0300 -FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Division of Water Resources FTA 0416 & SUPPORTING DOCUMENTATION
Application Numbet4a W 0'� (to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION.
1. Applicant's name: Collins Ridge Lan LL (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: Paul Uter per 15A NCA 2T .0106 b
Title: Manager
4. Applicant's mailing address: 9794 Timber Circle
City: Da hne State: AL Zip: 36527-
5. Applicant's contact information:
Phone number: (215) 517-jAU1 Email Address: naul cQcriteriadevelonment.com
IL PROJECT INFORMATION: n
d
ro
1. Project name: Collins Ridge - Phase I
2. A licationlPro'ect status: ~
pp J ® Proposed (New Permit) ❑ Existing Permit/Project ti°� v cn
If modification, provide the existing permit number: WQ00 and issued date:
CD N
If new construction but part of a master plan, provide the existing permit number. WQ00 p' °
3. County where project is located: Oranize 8
4. Approximate Coordinates (Decimal Degrees): Latitude: 36.065453 Longitude: -79.098792' �O
5. Parcel ID (if applicable): 9874109993 0
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer: Brian D. Smith License Number. 27890
Firm: Urban Dcaian Partners, LC
Mailing address: 13 18 Central Avenue, Suite
City: Charlotte State: hK Zip: 28205 -
Phone number: (7Q4) 334-3303 , Emil Address: rtn
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION.
1. Facility Name: Town of Hilishorough WWTP Permit Number: NCO02033
Owner Name: Town of Hillsboroueb
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQUnkown Downstream (Receiving) Sewer Size:/tel inch
System Wide Collection System Permit Number(s)( if applicable): WQCS00077
Owner Name(s): Town of Hill boron h
FORM: FTA 04-16 Page I 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 ®NIA
2. If the Applicant is a Developer of lots tube sold, has a beveloner's Onerational Agreement FORM: DEV been attached?
® Yes ❑No [--]N/A
3. If the Applicant is a I lo= -'Property Qwncrs' fissofintican_ has an Operational Agreement f FORM: HDA) been attached?
❑ Yes ❑No ®NIA
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 ° o Domestic,'Commercial °I° Commercial
% Industrial (See 15A NCAC 02T ,0103(20))
-Is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Has a flow reduction been approved under 15A NCAC 02T .0114(f)? ❑ Yes ® No
JWs, provideo f flow reduction r v l lett r
7. Summarize wastewater generated by project:
Establishment Type (see 02 T.0 t 14f f)
Daily Design Flow' b
No. of Units
Flow
Single family homes
480 gal. -unit
94
45,120 GPD
Townhomes
360 gal/unit
110
39,600 GPD
gall
GPD
gal,`
GPD
gau
GPD
gal..
GPD
Total
84,720 GPD
a See 15A NCAC 02' .01 I t snd (c)(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 cast 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.] 5A NCAC (12T.01 141 shall
be determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 84.720 GPD (per 1.5A NCAC 02T.01 I4)
);, 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
8
4,382
SDR 35
8
3,654
SDR 26
8
2,388
DIP
SAO
/PAAV
Section 11 & III of the MDC for Permitting of Gravity Sewers contains information related to design criteria
D Section III contains information related to minimum slopes for gravitysewer(s)
Oversizing lines to meet minimum slope requirement Is not allowed and a violation of the MDC
VIII. PUMP STATION DESIGN CRITERIA (If Applicable) —±11.0 O5 & MDC (Pump Stations/Force Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
I . Pump station number or name:
2. Approximate Coordinates (Decimal Degrees): Latitude: Longitude: -
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 15.E NUAC 02T -030500(1):
❑ Standby power source or pump with automatic activation and telemetry - 15A NCAC 02T .0305(h)(1)(B),
z 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_
D 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

IX. SETBACKS & SEPARATIONS — (02B.0200 & 15A NCAC 02T .03050):
1. Does the project comply with all separations found in 15A NCAC 02T .0305 &
> 15A NCAC 02T.0305(t) contains minimum rennrntinnc that ehnll hP nrr",vt...t
® Yes ❑ No
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 -1 waters of Class I or
Class If impounded reservoirs used as a source of drinking water
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 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
Y 15A NCAC 02T.0305 contains alternatives where separations in 02T.0305(n cannot be achieved.
"Stream classifications can be identified using the Division's N C Surface Walcr Classi ficELdtans weh a e
If noncompliance with 02T_0305(f) yr (a). see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) [--]Yes ❑ No ® N/A
D 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
D As built documents should reference the location of areas effected
3. Does the project comply with setbacks found in the river basin rules per 15A N . AC 02B .0200'? ❑ Yes ❑ No ® N'A
t This would include Trout Buffered Streams per 15A NCAC 213.0202
4. Does the project require coverage/authorization under a 404 Nationwide or ❑ Yes ® No
individual permits or 401 Water Quality Certifications?
z Information can be obtained from the 401 & Buffer Pc itting Branch
5. Does project comply with 15A NCAC 02T.0 1 05(c)(6) (additional permits/certifications)? ® Yes ❑ No
Per 15A_NCAC U2 -F.01 f15(r_)(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 15 A N C AC 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 115A NCAC 02T.0403(a)(5) or the permitee's individual System -Wide Collection permit.
FORM: FTA 04-16 Page 4 of 5

X. CERTIFICATIONS:
I. Does the submitted system comply with .I 5A NCA,C Q_?T the Minimgm_Qesigq Crit ria for Rhe Permictin of Pump Stations
and Force M;tins Ialest version),and the GraviEy Sewer UL;i mtim Design Criteriatlatest venion) as applicable?
® Yes ❑ No
If No, complete and submit the VariancelAlternative 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:
1, �X�,w d• 5tAvmk attest that this application for
(Professional Engineer's name from Application Item Ill. L)
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 143-215.613, 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 510,000, as well as civil penalties up to $25,000 per violation.
.................
North Carolina Professional Engineer's seal, signature, and date:
000 CA''�1
¢QFES
27890
�•'� o. sux U-17.7_0(5
!�a'F11'1'rTJ1'TV431. ....
3. Applicant'sC ' ication per 15A NCAC 02T .0106(b):
1, {', _Gir attest that this application for
(Signature Authority's name & title fro Application Item 1.3.)
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 143-215.6.E and 143-215.613, any person who knowingly makes any false
statement, represen certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine n to exceed 10,000 as well as civil penalties up to $25,000 per violation.
Signature: A� Bate; ~�_ f
FORM: FTA 04-16 Pages of

•Y� Lept of Environmental Qualit)
DF- C t 2018State of North Carolina
Department of Environmental Quality
Raley Division of Water Resources
D,W g Regional Offi
Dtvtslon of Water Resources ow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: Collins Ridge LandCo, LLC
Project Name for which flow is being requested: Collins Ridge Phase IA
More than one FTSE maybe required far a single project if the owner of the IVWTP is not responsible far 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: Town of Hillsborough
b. WWTP Facility Permit #: NCO026433
All flows are in MGD
c. WWTP facility's permitted flow 3,0
d. Estimated obligated flow not yet tributary to the WWTP .560
e. WWTP facility's actual avg. flow 1.10
f. Total flow for this specific request .087
g. Total actual and obligated flows to the facility .647
h. Percent of permitted flow used 58.2
H. Complete this section for each pump station you are responsible for along the route of this proposed
wastewater flow.
List pump stations Iocated between the project connection point and the WWTP:
(A) (B) (C) (D)=(B+C)
(E)=(A-D)
Design
Average Approx. Obligated,
Pump Pump Daily Current Not Yet Total Current
Station Station Firm Flow** Avg. Daily Tributary Flow Plus
(Name or Permit Capacity, * (Firm 1 pf), Flow, Daily Flow, Obligated
Available
Number) No. MGD MGD MGD MGD FIow
Capacity***
E. Brady WQ0035536 1.584 .634 .330 .161 .491
.143
*,rhe 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 located
between the project connection point and the WWTP where the Available Capacity is < 0.
Downstream Facility Name (Sewer): Town of Hillsborough
Page 1 of 6
FTSE 10-18

Downstream Permit Number: Unknown - Old
III. Certification Statement:
I Eric Peterson 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 adequape capacity to transport and treat the proposed new wastewater.
Title of Signing Official
Page 2 of 6
Date
FTSE 10-18

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Collins Ridge - Street Map
October 23, 2018 1.9,600
0 0.075 0.15 0.3 mi
0 0.125 0.25 0.5 km

1318 a-6 central avenue P 704.334.3303
charlotte, nc 28205 F 704.334,3305
NC Dept of Environmental Quality
URBAN DEC 132018
TRANSMITTAL D E S I G N
PARTNERS
Raleigh Regional Office
To: Jason Robinson Date: 12/7/2018
NCDEQ Water Quality
1628 Mail Service Center
Raleigh, NC 27699-1628
Phone: [phone] Project Name: Collins Ridge Ph1A
Fax: [phone] Project No: 17-055
Transmitted Via: Action:
❑
Overnight
®
For Approval
❑
Courier
❑
For Your Use
❑
Hand
❑
As Requested
®
Mail
❑
For Review & Comment
❑
Fax
❑
For Signature
Comments
Jason,
At the time the fast track application package was submitted, I only had access to a
digital copy of the FTSE. The original signed FTSE is included with this transmittal to
be combined with the submittal package and replace the printed copy. Please
contact me with any questions or concerns.
Thank you,
Lauren Thomas
[e-mail]
704.334.3303 x 105
Cc:

Re: Collins Ridge Phase 1A
UDP Project #: 17-055
To whom it may concern,
1318-e6 central ave. P 704.334.3303
charlotie, nc 28205 F 704.334.3305
urbandesignpartners.com
NC Dept of Environmental Quality
NOV 2 z 2018
R.aIeigh Regional Office
The attached Fast Track application is being submitted for a proposed residential development,
referred to as Collins Ridge Phase 1 A. The site is located near the intersection of South Churton
Street and Orange Grove Street in the Town of Hillsborough, Orange County, North Carolina.
The proposed public gravity sewer lines related to this application will serve 94 single family lots
and 110 townhomes. The flow allocation for this development is 480 GPD per single family unit
and 360 GPD per townhome unit for a total of 84,720 GPD.
The following items are included within the submittal package:
• Cover letter
• Application fee amount ($480.00)
• Documentation of registration with the NC Secretary of State
• Completed FTA 04-16 application
• FTSE 04-16 Flow Tracking/Acceptance Form
• USGS Topographic Map
• Street Level Map
• Executed DEV 11-17 form
Please feel free to contact me via email (brian@urbandEsr_4nroartners.coml or by phone at (704)
334-3303 with questions pertaining to this project.
Thank you,
Brian D. Smith, P.E.
Partner
Urban Design Partners
Fivii 9wr IN F F GI NP. 0 6Mn PI Ammme..
Date: November 21, 2018
To: NCDEQ - Fast Track Sewer Permitting
U R B A N
DESIGN
Raleigh Regional Office - Water Quality Section
PARTNERS
1628 Mail Service Center
Raleigh, NC 27699-1628
Re: Collins Ridge Phase 1A
UDP Project #: 17-055
To whom it may concern,
1318-e6 central ave. P 704.334.3303
charlotie, nc 28205 F 704.334.3305
urbandesignpartners.com
NC Dept of Environmental Quality
NOV 2 z 2018
R.aIeigh Regional Office
The attached Fast Track application is being submitted for a proposed residential development,
referred to as Collins Ridge Phase 1 A. The site is located near the intersection of South Churton
Street and Orange Grove Street in the Town of Hillsborough, Orange County, North Carolina.
The proposed public gravity sewer lines related to this application will serve 94 single family lots
and 110 townhomes. The flow allocation for this development is 480 GPD per single family unit
and 360 GPD per townhome unit for a total of 84,720 GPD.
The following items are included within the submittal package:
• Cover letter
• Application fee amount ($480.00)
• Documentation of registration with the NC Secretary of State
• Completed FTA 04-16 application
• FTSE 04-16 Flow Tracking/Acceptance Form
• USGS Topographic Map
• Street Level Map
• Executed DEV 11-17 form
Please feel free to contact me via email (brian@urbandEsr_4nroartners.coml or by phone at (704)
334-3303 with questions pertaining to this project.
Thank you,
Brian D. Smith, P.E.
Partner
Urban Design Partners
Fivii 9wr IN F F GI NP. 0 6Mn PI Ammme..

10123/2018
North Carolina Secretary of State Search Results
• 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
Collins Ridge Landco, LLC
Information
NC Dept ofBnvironmental Quality
NOV 2 7 2018
Solid: 1603354 Raleigh Regional Office
Status: Current -Active
Annual Report Status: Current
Citizenship: Domestic
Date Formed: 6/16/2017
Registered Agent: COGENCY GLOBAL INC.
Addresses
Reg Office Reg Mailing
212 South Tryon Street Suite 1000 212 South Tryon Street Suite 1000
Charlotte, NC 28281 Charlotte, NC 28281
Mailing Principal Office
4925 Greenville Ave Ste 1400 4925 Greenville Ave Ste 1400
Dallas, TX 75206 Dallas, TX 75206
Company Off iciaLs
All LLCs are managed by their managers pursuant to N.C.G.S. 57D-3-20.
Administrative Member
Wm Christopher Reeder
4925 Greenville Ave, #1400
Dallas TX 75206
https:llwww.sosnc.gov/online services/search/Business Registration Results 111