WQ0040632_Application (FTSE)_20190225

�r Flesourcea
FEB 2019
Water MO N neglonal Qperatlone
February 5, 2019
34 Big Bear Trail
Asheville NC 28805
Phone:[phone]
www.aceasheville.com
Mr. Tim Heim - - --
North Carolina Dept. of Environment and Natural Resources
Asheville Regional Office IWQ00406321
Division of Water Resources
2090 US Hwy 70
Swannanoa, NC 28778
RE: Fast Track Application for Gravity Sewer
Service for Howard Gap Road Subdivision
Hendersonville, NC
ACE Project #: 1795
Dear Mr. Heim:
This letter is a request for an extension of the existing sanitary sewer main located off Howard Gap Road
(SR 1006) to serve a proposed 65-lot single-family residential development. The project will consist of
approximately 3,764 linear feet of 8-inch SDR-35 pipe and seventeen (17) manholes with an estimated
discharge o£23,49DZallons per day which will then be discharged to a nearby existing City of
Hendersonville gravity sewer.
Please find the following documentation enclosed to support the requested application:
• Check for the application fee ($480.00)
• Form FTA 04-16
• Form FTSE 04-16
• 8.5"xl1"USGS Site Map
• 8.5"xl 1" Aerial Site Map
• Copy of the COH allocation approval letter
If you should have any questions or would like to discuss this in further detail, please don't hesitate to
contact our office.
Sincerely,
Mike Anderson, PE

34 Big Bear Trail
Asheville NC 28805
Phone: [phone]
www.aceasheville.com
Transmittal Letter
Date: February 5, 2019
Proiect Name: Howard Gap Road Subdivision
ACE Proiect: 1795
To: Tim Heim Division of Water Resources
NC Department of Environmental and Natural Resources
2090 US Hwy 70 Swannanoa, NC 28778
Via Mail Overnight
REMARKS:
Hand Delivered X Pick up () ACE Office
Date
------------------
02/05/19
-------------------
02/05/19
-------------------
02/05/19
-------------------
02/05/19
------
02/05/19
------
02/05/19
-------------------
Descri tion
Check for the application fee ($480)
Form FTA 04-16 -
-- --------- --- WQOO4O63 Form FTSE 04-16
----------------- . — — --
8.5"x11" USGS Site Map
---- -- ------- -- -------- -------- ---------
8.5"x11" Aerial Site Map
----------------------- ------ ------------ -------- - ------------
COH Allocation Approval Letter
---------------------------------------------------------- ----------------
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Entity Requesting Allocation:
State
Department of Envi
Division o
Flow Tracking/Acceptance for Sewer
/ of Hendersonville
Project Name for which flow is being requested: '
More than one FTSE may be required far a single project if the owner of the WWTP is not
stations along the route of the proposed wastewater flow.
I.
Complete this section only if you are the owner of the wastewater
a. W WTP Facility Name: Hendersonville Wastewater TI
b. W WTP Facility Permit #: NC 0025534
c. W WTP facility's permitted flow 4.80
d. Estimated obligated flow not yet tributary to the W WTP 0.091
e. W WTP facility's actual avg. flow 2.880
f. Total flow for this specific request 0.014
g. Total actual and obligated flows to the facility 2.98
h. Percent of permitted flow used a2.2%
F North Carolina
nmental Quality
Nater Resources
ion Applications
(FTSE 04-16)
VrVA -�
tWAA
msible for all pump
plant.
t Plan
II. Complete this section for each pump station you are responsible for along he route of this
proposed wastewater flow.
List pump stations located between the project connection point and the W TP:
(A) (B) (C) (D)I(B+C) (E)=(A-D)
Design Obligated,
Pump Average Daily Approx. Not Yet TON Cunent
Station FLrn Flow** Current Avg. Tributary I FI Plus
(Name or Capacity, * (Firm / pt), Daily Flow, Daily Flow, O +igated . Available
Number) MOD MOD MOD MOD low Capacity***
* The Firm Capacity of any pump station is defined as the maximum p
can be achieved with the largest pump taken out of service.
** Design Average Daily Flow is the firm capacity of the pump station d
factor (pf) not less than 2.5.
*** A Planning Assessment Addendum shall be attached for each pump
between the project connection point and the W WTP where the Availab
Downstream Facility Name (Sewer):
Downstream Permit Number:
flow that
by a peaking
ation located
Capacity is < 0.
Page I of 6
04-16

III. Certification Statement:
I ° certify to the best of my knowledge th It the addition of
the volume of wastewater to be permitted in this project has been evaluated alo �g the route to the
receiving wastewater treatment facility and that the flow from this project is of anticipated to
cause any capacity related sanitary sewer overflows or overburden any downstr iam pump station
en route to the receiving treatment plant under normal circumstances, given th implementation
of the planned improvements identified in the planning assessment where applicable. This
analysis has been performed in accordance with local established policies and rocedures 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 r �Sponsible party.
Signature of this form indicates acceptance of this wastewater flow.
Page 2 of 6
16

broi„ ion of Ur r Fiesourcae
State of North Carolina
- 82019 Department of Environmental Quality
R
y
Division of Water Resources
15ANCA 02T .0300 -FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
e 4f 3difY> osa[ O"PrationINS RUCTIONS FOR FORM: FTA 04-16 & SUPPORTING DOCUMENTATION
This application is for sewer extensions involving gravity sewers, pump stations and force mains, or any combination that has been
certified by a professional engineer and the applicant that the project meets the requirements of 15A NCAC 02T and the Division's
Minimum Design Criteria and that plans, specifications and supporting documents have been prepared in accordance with, 15A
NCA.0 02T, 15A NCAC 02T .0300 Division Policies and good engineering practices.
While no upfront engineering design documents are required for submittal, in accordance with 15A NCAC 02T .0305(b), design
doeurnents must be prepared prior to submittal of a fast track permit application to the Division. This would include plans, design
calculations, and project specifications referenced in 15A NCAC 02T .0305 and the applicable minimum design criteria. These
documents shall be available upon request by the Division.
Projects that are deemed permitted (do not require a permit from the Division) are explained in 15A NCAC 02T.0303.
Projects not eligible for review via the fast track process (must be submitted for full technical review):
➢ Projects that require an environmental assessment in accordance with 15A NCAC 1 C .0100;
➢ Projects that do not meet any part of the minimum design criteria (MDC) document;
➢ Projects that involve a variance from the requirements of 15A NCAC 2T;
➢ Pressure sewer systems utilizing septic tank -effluent pumps (STEPS) or simplex grinder pumps;
➢ STEP or simplex grinder, pumps connecting to pressurized systems (e.g. force mains); N/(]00406 h6hh,
➢ Vacuum sewer systems.
General - When submitting an application, please use the following instructions as a checklist in order to ms
are submitted. Adherence to these instructions and checking the provided boxes will help produce a quicker review time and
reduce the amount of requested additional information. Failure to submit all required items will necessitate additional
processing and review time, and may result in return of the application. Unless otherwise noted, the Applicant shall submit
one original and one copy of the application and supporting documentation.
A. One Original and One Copy of Application and Supporting Documents
e Required unless otherwise noted
B. Cover Letter (Required for All Application Packages):
Ea' List all items included in the application package, as well as a brief description of the requested permitting action.
➢ Be specific as to the system type, number of homes served, flow allocation required, etc.
➢ If necessary for clarity, include attachments to the application form.
C. Application Fee (All New and Major Modification Application Packages):
EX Submit a check or money order in the amount of $480.00 dated within 90 days of application submittal.
➢ Payable to North Carolina Department of Environmental Quality (NCDEQ)
D. Fast Track (Form: FTA 04-16) Application (Required for All Application Packages):
IZ Submit the completed and appropriately executed application.
➢ If necessary for clarity or due to space restrictions, attachments to the application may be made.
If the Applicant Type in Item I.2 is a corporation or company, provide documentation it is registered for business with
the North Carolina Secretary of State.
❑ If the Applicant Type in Item I.2 is a partnership or d/b/a, enclose a copy of the certificate filed with the Register of
Deeds in the county of business.
V The Project Name in Item II.1 shall be consistent with the project name on the flow acceptance letters, agreements, etc.
Ea' The Professional Engineer's Certification on Page 5 of the application shall be signed, sealed and dated by a North
Carolina licensed Professional Engineer.
Ea' The Applicant's Certification on Page 5 of the application shall be signed in accordance with 15A NCAC 02T .0I06(b).
Per 15A NCAC 02T .0106(c), an alternate person may be designated as the signing official if a delegation letter is
provided from a person who meets the criteria in 15A NCAC 02T .0106(b).
INSTRUCTIONS FOR FORM: FTA 04-16 & SUPPORTING DOCUMENTATION Pagel of 3

E. Vlow TrackingtAcceptance Form (Form: FTSE 04-16) (If Applicable):
V Submit the completed and executed FTSE form from the owners of the downstream sewers and treatment facility.
➢ Multiple forms maybe required where the downstream sewer owner and wastewater treatment facility are different.
➢ The flow acceptance indicated in form FTSE must not expire prior to permit issuance and must be dated less than one
year prior to the application date.
➢ Submittal of this application and form FTSE indicates that owner has adequate capacity and will not violate G.S. 143-
215.67 a .
➢ Intergovernmental agreements or other contracts will not be accepted in lieu of a project -specific FTSE.
F. Site Maps (All Application Packages):
V Submit an 8.5-inch x I 1-inch color copy of a USGS Topographic Map of sufficient scale to identify the entire project
area and closest surface waters.
➢ Location of the project (gravity sewer, pump stations & force main)
➢ Downstream connection points and permit number (if known) for the receiving sewer
JZ Include a street level map (aerial) showing general project area so that Division staff can easily locate it in the field.
G. Existing Permit (All Modification Packages):
❑ Submit the most recently issued existing permit.
Provide a list of any items within the permit the Applicant would like the Division to address during the permit
modification (i.e., permit description, flow allocation, treatment facility, etc.).
H. Power Reliability Plan (Required if portable reliability option utilized for Pump Station):
❑ Per 15A NCAC 02T .0305(h)(1), submit documentation of power reliability for pumping stations.
➢ This alternative is only available for average daily flows less than 15,000 gallons per day
➢ It shall be demonstrated to the Division that the portable source is owned or contracted by the applicant and is compatible
with the station. The Division will accept a letter signed by the applicant (see 15A NCAC 02T .0106(b)) or proposed
contractor, stating that "the portable power generation unit or portable, independently -powered pumping units, associated
appurtenances and personnel are available for distribution and operation of this pump 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. (Required at time of certification)
I. Certificate of Public Convenience and Necessity (All Application Packages for Privately -Owned Public Utilities):
❑ Per 15A NCAC 02T .0115(a)(1) provide the Certificate of Public Convenience and Necessity from the North Carolina
Utilities Commission demonstrating the Applicant is authorized to hold the utility franchise for the area to be served by
the sewer extension, or
❑ Provide a letter from the North Carolina Utilities Commission's Water and Sewer Division Public Staff stating an
application for a franchise has been received and that the service area is contiguous to an existing franchised area or that
franchise approval is expected.
J. Operational Agreements (Applications from HOA/POA and Developers for lots to be sold):
❑ Home/Property Owners' Associations
❑ Per 15A NCAC 02T .0115(c), submit the properly executed Operational Agreement (FORM: HOA).
❑ Per 15A NCAC 02T .0115(c), submit a copy of the Articles of Incorporation, Declarations and By-laws.
❑ Developers of lots to be sold
❑ Per 15A NCAC 02T .0115(b), submit the properly executed Operational Agreement (FORM: DEV).
For more information, visit the Division's collection systems website
INSTRUCTIONS FOR FORM: FTA 04-16 & SUPPORTING DOCUMENTATION Page 2 of 3

73E COMPLETED APPLICATION PACKAGE INCLDING ALL SUPPORTING INFORMATION AND
MATERIALS, SHOULD BE SENT TO THE APPROPRIATE REGIONAL OFFICE:
REGIONAL OFFICE
ADDRESS
COUNTIES SERVED
Asheville Regional Office
2090 US Highway 70
Avery, Buncombe, Burke, Caldwell, Cherokee,
Water Quality Section
Swannanoa, North Carolina 28778
Clay, Graham, Haywood, Henderson, Jackson,
[phone]
Macon, Madison, McDowell, Mitchell, Polk,
[phone] Fax
Rutherford, Swain, Transylvania, Yancey
Fayetteville Regional Office
225 Green Street Suite 714
Anson, Bfaden, Cumberland, Harnett, Hoke,
WaterQuality Section
Fayetteville, North Carolina 28301-5094
Montgomery, Moore, Robeson, Richmond,
[phone]
Sampson, Scotland
[phone] Fax
Mooresville Regional Office
610 E. Center Avenue
Alexander, Cabarrus, Catawba, Cleveland,
Water Quality Section
Mooresville, North Carolina 28115
Gaston, Iredell, Lincoln, Mecklenburg, Rowan,
[phone]
Stanly, Union
[phone] Fax
Raleigh Regional Office
1628 Mail Service Center
Chatham, Durham, Edgecombe, Franklin,
Water Quality Section
Raleigh, North Carolina 27699-1628
Granville, Halifax, Johnston, Lee, Nash,
[phone]
Northampton, Orange, Person, Vance, Wake,
[phone] Fax
Warren, Wilson
Washington Regional Office
943 Washington Square Mall
Beaufort, Bertie, Camden, Chowan, Craven,
Water Quality Section
Washington, North Carolina 27889
Currituck, Dare, Gates, Greene, Hertford, Hyde,
[phone]
Jones, Lenoir, Martin, Pamlico, Pasquotank,
[phone] Fax
Perquimans, Pitt, Tyrrell, Washington, Wayne
Wilmington Regional Office
127 Cardinal Drive Extension
Brunswick, Carteret, Columbus, Duplin, New
Water Quality Section
Wilmington, North Carolina 28405
Hanover, Onslow, Pander
[phone]
[phone] Fax
Winston-Salem Regional Office
450 W. Hanes Mill Road
Alamance, Allegheny, Ashe, Caswell, Davidson,
Water Quality Section
Suite 300
Davie, Forsyth, Guilford, Rockingham, Randolph,
Winston-Salem, North Carolina 27105
Stokes, Surry, Watauga, Wilkes, Yadkin
[phone]
INSTRUCTIONS FOR FORM: FTA 04-16 & SUPPORTING DOCUMENTATION Page 3 of 3

State of North Carolina
MR
Department of Environmental Quality
DWft Division of Water Resources
15A NCAC 02 CK SEWER SYSTEM EXTENSION APPLICATION
`Division of Water Resources FTA 04-16 & SUPPORTING DOCUMENTATION
40632
Application Number: (to be completed by Dwtt)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION
City of Hendersonville
1. Applicant's name: _ (company, municipality, HOA, utility, etc.)
2. Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State/County ® Municipal ❑ Other
Lee Smith
3. Signature authority's name: _ per 15A NCAC 02T .0106(b)
Title: Utilities Director
4. Applicant's mailing address: 305 Williams Street
Hendersonville
City: _ State: NC Zip: 28792
5. Applicant's contact information:
Phone number: 6( 28)697-3073 Email Address: [e-mail]
H. PROJECT INFORMATION:
1. Project name: Howard Gap Road Subdivision
2. Application/Project status: ® Proposed (New Permit) ❑ Existing Permit/Project
If a modification, provide the existing permit number: W000_ and issued date:
If new construction but part of a master plan, provide the existing permit number: W000_
3. County where project is located: Henderson
4. Approximate Coordinates (Decimal Degrees): Latitude: 35 358835. Longitude: -82. 43951,f
5. Parcel ID (if applicable): 9670-43-2161
(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION: B
r -
water
Michael Anderson, PE -aiar Pew1. Professional Engineer: License Number: 28824Firm: Advantage CivilEngineering, PA _820'19
Mailingaddress: 34BigBearTrailCity: Asheville State: NC Zip: 28805-PeglonalOPeratlons
Phone number: 828) 582 -8970 Email Address: [e-mail]
iV. WASTEWATER TREATMENT FACILITY (W WTF) INFORMATION:
Hendersonville Wastewater
1. Facility Name. -Treatment Plant Permit Number: NCO025534
Owner Name: Ci of Hendersonville, NC
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than W WTF):
1. Permit Number(s): WQ_ Downstream (Receiving) Sewer Size: _ inch
System Wide Collection System Permit Number(s) (if applicable): WQCS_
Owner Name(s): _
FORM: FTA 04-16 Paget 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 Operational Agreement (FORM: HOA) been attached?
❑ Yes ❑No KZN/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. Natureofwastewater: too %Domestic/Commercial %Commercial
% Industrial (See 15A NCAC 02T .0103(20))
"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
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(t)
Daily Design Flow
No. of Units
Flow
Bedroom
120 gal/ day
195
23,400 JGPD
gal/ day
GPD
gal/
GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
23,400 PD
a See 15A NCAC 02T .0114(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 d((attfla,�gter using fixtures, occupancy. or operation patterns, and other measured data.
8. Wastewater generated by project 23,4GYD (per 15A NCAC 02T .0114)
➢ 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

VIL GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
I. Summarize gravity sewer to be permitted:
Size (inches)
Length (feet)
-
Material
8.1
+/- 3,764
SDR-35
➢ Section II & III of the MDC for Permitting of Gravity Sewers contains information related to design criteria
➢ Section ID 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
VHI. PUMP STATION DESIGN CRITERIA (If Applicable) — 02T .0305 & MDC (Pump Stations/Force Mains):
COMPLETE FOR EACH PUMP STATION INCLUDED IN THIS PROJECT
1. 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 (TDM
5. Summarize the force main to be permitted (for this Pump Station):
Size (inches) Length (feet) Material
6. Power reliability in accordance with 15A NCAC 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 15A NCAC 02T .0305(fl & (a) ® Yes [:],No
➢ 15A NCAC 02T.0305 contains minimum separations that shall be provided for sewersystems:
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, W S-I waters of Class I or
Class 11 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 IX2
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
➢ 15A NCAC 02T.0305(g) contains alternatives where separations in 02T.0305(fl cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water Classifications webnage
➢ If noncompliance with 02T.0305(f) or (g), see Section X of this application
2. Does the project comply with separation requirements for wetlands? (50 feet of separation) 54es ❑ No ❑ N/A
➢ . Seethe 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. Dees the project comply with setbacks found in the river basin rules per 15A NCAC 02B .02009 ® Yes ❑ No ❑-N/A
➢ This would include Trout Buffered Streams per 15A 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 401 & Buffer Permitting Branch
5. Does project comply with 15A NCAC 02T.0105(c)(61(additional permits/certifications)? 0 Yes ® No.
Per 15A NCAC 02T.0 I 05(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 15A 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 NCAC 02T, 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
IfNo, complete and submit the Variance/Alternative Design Request application (VADC 10.14) and supporting documents for
review. Approval of the reauest is required prior to submittal of the Fast Track Application and supporting documents.
2. Professional Engineer's Certification. -
name from Application Item III.1.)
application for
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, anyperson who knowingly makes any false
statement, representation, or certification in any application package shall be guiltyof 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.
North Carolina Professional Engineer's seal, signature, and date:
3. Applicant's Certification per 15A NCAC 02T .0106(b):_
I, Lee Smith attest that this application for
(Signature Authority's name &title from Application Item I.3.)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all requited parts of
this application are not completed and that if all required supporting documentationand attachments are not included, this
application package is subject to being retamedas 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.
s
Signature: s Date:
gning OcOTAgnature
FORM: PTA 04-16 Page 5 of 5

CITY OF HENDERSONVILLE
ARBARA G. VOLK
JOHN F.CONNET
Mayor
The City of Four Season
City Manager
STEVE CARAKER
SAMUEL H. FRITSCHNER
Mayor Pro Tem
City Attorney
RON STEPHENS
ENGINEERING DEPARTMENT
TAMMIE K. DRAKE
JESMITH, JR.
Brent G. Detwiler, P.E.
City Clerk
JEFF FF MILLER
LER
City Engineer
November 2, 2017
Mike Anderson, P.E.
Advantage Civil Engineering, PA
Mailing Address: 34 Big Bear Trail
Asheville, NC 28895
[e-mail]
RE: HOWARD GAP ROAD SUBDIVISION
PARCEL IDENTIFICATION NUMBER (PIN) 9670422817
WATER AND SEWER AVAILABILITY
Dear Mr. Anderson:
We have received and reviewed your request, dated October 25, 2017, regarding water and sewer availability for the
above referenced property located along Howard Gap Road. We have determined that City water and sewer are
available to the site, specifically, a 12" DIP water line and a 24" PVC gravity main sewer line, as shown on the attached
PDF capture of our City GIS.
This letter is intended to serve as information only and should not be regarded as an approval for the above referenced
project to connect to the City's applicable utility systems. If you have any questions or require additional information
regarding this correspondence, please don't hesitate to contact me at the contact information below.
Sincerely,
Marlee Page
Development Review Engineer
City of Hendersonville
305 Williams Street
Hendersonville, NC 28792
[phone] (office)
[phone] (cell)
moageCcahvinc.gov
www. hendersonvillenc.gov
Attachments:
• Availability Request
• Infrastructure Availability Map
cc: Lee Smith, Utilities Director
Rhonda Wiggins, Project Coordinator
Brent Detwiler, City Engineer
Brendan Shanahan, Engineer
305 Williams Street [e-mail] Phone: [phone]
Hendersonville, NC 28792-4461 www.hendersonvillenc.gov Fax: [phone]