WQ0040645_Application (FTSE)_20190320

Central Files- APS SWID
2/13/201 9�..
WQ0040645 Permit Tracking Slip
Prograrn Categor~=r 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
Coastal SWR-4.11"o
Permitted Flow
— : I,.:,
Facility Name Major[Minor Region
TrusthDuse TDwnhomes Private Sewer Minor Wilmington
Location -Address County
New Han6ver
Facility Contact Affiliation
RM
Owner Name Owner Type
Trusthouse Investments Inc Non -Government
Owner Affiliation
Amanda Combs
401 S Tryon St
- 14 e ta ij-,- v t,
Charlotte NC 28202
Scheduled
Orig Issue App Received Draft Initiated Issuance Public Notice Issue Effective Expiration
2/12/2019
R e 111 a u I, t e d A c� t i v 11, 1 e; S P, fni L: I t 1 e; s 1."—­ ! di IR e- Ce eel v e U--- E v, e � n t s
Additional information r e q u e ste, d
Additional information received

STATE OF NORTH CAROA
COUNTY OF K,�OWTanalev,-,
Permit No. W6W -lUb 4��
DEVELOPER'S OPERATIONAL AGREEMENT
This AGREEMENT made pursuant to G.S. 143-215.1 (dl) and entered into this ay o
(kk
rn�G- - -., �) - 0 �ei , by and between the North Carolina Environmental Management
Commission, an agency of the State of North Carolina, hereinafter known as the COMMISSION; and
T V\VQ.�Wv S Sv�.�.a corporation general partnership registered/licensed to do
business in the State of North Carolina, hereinafter known as the DEVELOPER.
WITNESSETH:
1. The DEVELOPER is the owner of the certain lands lying in County, upon
which it is erecting and will erect dwelling units and other improvements, said development to be known
as firr"eoz>Ut, ,RL (hereinafter the Development).
2. The DEVELOPER desires, to construct a wastewater collection system with pumps, wastewater treatment
works, and/or disposal facilities (hereinafter Disposal System) to provide sanitary sewage disposal to serve
the Development on said lands.
3. The DEVELOPER has applied. to the COMMISSION for the issuance of a permit pursuant to G.S. 143-
215.1 to construct, maintain, and operate the Disposal System.
4. The DEVELOPER has created or shall create unit ownership in said dwellings units, other improvements
and lands through filing of a Declaration of Unit Ownership (hereinafter Declaration), pursuant to Chapter
47C or 47F of the North Carolina General Statutes.
5. The DEVELOPER has caused to be formed or will cause to be formed at the time of filing of the
Declaration, the (Unit Owners' Association) (hereinafter
Association), a non-profit corporation organized and existing under and by the virtue of the laws of the State
of North Carolina, for the purpose, among others, of handling the property, affairs and business of the
Development; of operating, maintaining, re -constructing and .repairing the common elements of the lands
and improvements subject to unit ownership, including the Disposal System; and of collecting dues and
assessments to provide funds for such operation, maintenance, re -construction andrepair.
6. The COMMISSION desires to assure that the Disposal System of the Development is properly constructed,
maintained and operated in accordance with law and permit provisions in order to protect the quality of the
waters of the State and the public interest therein.
NOW, THEREFORE, in consideration of the promises and the benefits to be derived by each of the parties
hereto, the COMMISSION and DEVELOPER do hereby mutually agree as follows:
1. The DEVELOPER shall construct the Disposal System in accordance with the permit and plans and
specifications hereafter issued and approved by the COMMISSION, and shall thereafter properly operate
and maintain such systems and facilities in accordance with applicable permit provisions and law.
2. The DEVELOPER shall not transfer ownership and/or control of the Disposal System to the Association
until construction has been completed in accordance with the permit and approved plans, and the staff of
the Division. of Water Resources has inspected and approved of the facilities. In order to change the name
of the permit holder, the DEVELOPER must request that the permit be reissued to the Association. The
request must include a copy of the Association Bylaws andDeclaration.
3. The DEVELOPER shall not transfer, convey, assign or otherwise relinquish or release its responsibility for
the operation and maintenance of its Disposal System until a permit has been reissued to the DEVELOPER's
successor.
FORM: DEV 11-17 Page 1 of 2

4. The DEVELOPER shall provide in the Declaration and Association Bylaws that the Disposal System and
appurtenances thereto are part of the common elements and shall thereafter be properly maintained and
operated in conformity with law and the provisions of the permit for construction, operation, repair, and
maintenance of the system and facilities. The Declaration and Bylaws shall identify the entire wastewater
treatment, collection and disposal system as a common element which will. receive the highest priority for
expenditures by the .Association except for Federal, State, and local taxes and insurance.
5. The DEVELOPER shall provide in the Declaration and Association Bylaws that the .Disposal System will
be maintained out of the common expenses. In order to assure that there shall be funds readily available to
repair, maintain or construct the Disposal System, beyond the routine operation and maintenance expenses,
the Declaration and Association Bylaws shall provide that a fund be created out of the common expenses.
Such fund shall be separate from the routine maintenance funds allocated for the facility and shall be part
of the yearly budget.
6. In the event the common expense allocation and separate fund are not adequate for the construction, repair,
and maintenance of the Disposal System, the Declaration and Association Bylaws shall provide for special
assessments to cover such necessary costs. There shall be no limit on the amount of such assessments, and
the Declaration and Bylaws shall provide that such special assessments can be made as necessary at any
time.
7. If a wastewater collection system and wastewater treatment and/or disposal facility provided by any city,
town, village, county, water and sewer authorities, or other unit of government shall hereinafter become
available to serve the Development, the DEVELOPER shall take such action as is necessary to cause the
existing and future wastewater of the Development to be accepted and discharged into said governmental
system, and shall convey or transfer as much of the Disposal System and such necessary easements as the
governmental unit mayrequire as condition of accepting the Development's wastewater.
8. Recognizing that it would be contrary to the public interest and to the public health, safety and welfare for
the Association to enter into voluntary dissolution without having made adequate provision for the continued
proper maintenance, repair and operation of its Disposal System, the DEVELOPER shall provide in the
Association Bylaws that the Association shall not enter into voluntary dissolution without first having
transferred its said system and facilities to some person, corporation or other entity acceptable to and
approved by the COMMISSION by the issuance of apermit.
9. The agreements set forth in numbered paragraphs 1, 2, 3, 4, 51 65 7, and 8 above shall be conditions of any
permit issued by the COMMISSION to the DEVELOPER for the construction, maintenance, repair and
operation of the Disposal System.
10. A copy of this agreement shall be filed at the Register of Deeds in the County(ies) where the Declaration is
filed and in the offices of the Secretary of State of North Carolina with the Articles of Incorporation of the
Association.
IN WITNESS WHEREOF, this agreement was executed in duplicate originals by the duly authorized
representative of the parties hereto on. the day and year written as indicated by each of the parties named below:
FOR THE ENVIRONMENTAL
MANAGEMENT COMMISSION
Linda Culpepper
Director, Division of Water Resources
(Date)
I(A S -� G� jKs4&
Name of DEVELOPER
B:
4A
(iigXature)
/ KR4A
Print Name and Title
4-1-1Y'LzO/�
(Date)
FORM: DEV 11-17 Page 2 of 2

CSD
ENGINEERING
February 12, 2019
Dean Hunkele
North Carolina Department of
Environmental Quality
Division of Water Resources
127 Cardinal Drive Extension
Wilmington, North Carolina 28405
Re: Trusthouse
Private Sewer System Extension
New Hanover County
CSD Project No. 18-0456
Dear Mr. Hunkele:
The enclosed permit application is for +/-170 If of 6" C-900 private gravity sewer main to serve Trusthouse, a
proposed 7-unit townhome development in New Hanover Co. These will be 2-bedroom units. This line will
connect to an existing CFPUA manhole located in the right-of-way of Bladen Street. The private main will be
installed, owned and maintained by the developer. The section of the new sewer main within the right-of-way
of Bladen Street 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)
- One (1) original and one (1) copy of Developers Operational Agreement form (DEV 11-17)
- $480.00 application fee, check #18541
- Street view map
- USGS map
If you have any questions or comments, please feel free to contact me. Thank you for your assistance.
Sincerely,
Mike Broyhill
Encl.: As noted above
Cc: Trusthouse Investments, LLC
CEiNED1�C�ENRIDWR
FEB 12 2019
Water Quality Regional
Operations Section
Wilmington Regional office
3805 Cherry Avenue - Wilmington, NC 28403 - 910 7914441- www.csd-engineering.com — License # C-2710
CSD
ENGINEERING

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. �KGOqO
6(to be completed by DWR
)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:��
1. Applicant's name: Trusthouse Investments, 2<(company, municipality, HOA, utility, etc.)
2. Applicant type: El Individual Z Corporation ❑ General Partnership Ej Privately -Owned Public Utility
❑ Federal [:] State/County Ej Municipal ❑ Other
3. Signature authority's name: Amanda Combs per 1.5A NCAC 02T .0106 b
Title: President
4. Applicant's mailing address: 401 S. Tryon St. Suite 3000
City: Charlotte State: NC Zip: 28202-
5. Applicant's contact information:
Phone number: [phone] Email Address: [e-mail]
II. PROJECT INFORMATION:
1. Project name: Trusthouse f e ule -
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: 34.245898° Longitude:-77.945800'
5. Parcel ID (if applicable): R04809-037-01 1 -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): WQ - downstream (Receiving) Sewer Size: 8 inch
System Vide Collection System Permit Number(s) (if applicable); 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?
❑ 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: DEV been attached?
® Yes ❑No ❑N/A
3. If the Applicant is a Home/Property
Owners' Association has an 0 erational Agreement FORM: Hbeen attached?
E]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 El Hotel and/or Motels
❑ School / preschool / day care
El 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 .01.03(2()))
Is there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Hasa flow reduction been approved under 15A .NCAC 02T .0:1? ❑ Yes ® No
);> If ves, provide a copy of flow reduction approval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.01.14(f))
Daily Design Flow a,b
No. of Units
Flow
gal/
GPD
gal/day
GPD
2-Bedroom townhome
240 gal/day
7
19680 GPD
gal/
GPD
gal/
GPD
gal/
GPD
Total
19680 GPD
a See 15A NCAC 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 1.5A NCAC 02T.0:11.41 shall be
determined using available flow data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 1,680 GPD (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

VII. GRAVITY SEWER DESIGN CRITERIA (If Applicable) - 02T .0305 & MDC (Gravity Sewers):
1. Summarize gravity sewer to be permitted:
Size (inches) Length (feet) Material
6 170 C-900
➢ 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 NCAC 021".0305(h)(l ):
❑ 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(f) & (¢) ® Yes [:]No
1 S A 1VC A C 0'?T f qO( i(fl rnntninc minimum cPnnrntinnc that chn11 he nrnvided fnr cPwP.r cvctem&-
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
➢ 15A NCAC 02T.0305(Q) contains alternatives where separations in 02T.0305(t) cannot be achieved.
➢ **Stream classifications can be identified using the Division's NC Surface Water Classifications webpa e
➢ 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) ❑ 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 15A NCAC 2B .0202
4. Does the project require coverage/authorization under a 404 Nationwide or E]Yes ® No
individual permits or 401 Water Quality Certifications?
➢ Information can be obtained from the 401 & Buf-ler Permitting Branch
5. Does project comply with 15A NCAC 02T.0105(c 6) (additional permits/certifications)? ® Yes [:]No
Per 1.5A. NCAC 02T.0105(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.
E]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

D
d
1
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 versions and the Gravity Sewer Minimum Design Criteria (latest version] as applicable?
EYes ❑ 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,
attest that this application for
(Professional Engineer's name from Application Item III.1.)
has been reviewed by me and is accurate, complete andL 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.
... ............................. ................ ...............
North Carolina Professional: Engineer's seal, signature, and date: CA
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..................................
3. App
Amanda Combs- PRESIDENT
Certification per 15A NCAC 02T .01.06(b):
I, 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 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
i
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'$25,006 per violation.
Signature: Date.: January 15, 2019
i
FORM: FTA 04-16 Page 5 of 5

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10
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State of North Carolina
Department of Environmental Quality
Division of Water Resources
Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: Trusthouse Investments, Inc
Project Name for which flow is being requested: Trusthouse
More than one FTSE may be required for a single project if the owner of the WWTP is not responsible for all pump
stations along the route of the proposed wastewater flow.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: James A. Loughlin (Northside) WWTP
b. WWTP Facility Permit #: NPDES NC 0023 965
All flows are in MGD
c. WWTP facility's permitted flow 16.000
d. Estimated obligated flow not yet tributary to the WWTP 2.773
e. WWTP facility's actual avg. flow 10.661
f. Total flow for this specific request 0.001680
g. Total actual and obligated flows to the facility 13.435
h. Percent of permitted flow used 84.0%
II. Complete this section for each pump station you are responsible for along the route of this proposed
wastewater flow.
List pump stations located between the project connection point and the WWTP:
(A)
(B)
(C)
(D)=(B+C)
(E)=(A-D)
Design
Obligated,
Pump
Pump
Average
Approx.
Not Yet
Total Current
Station
Station
Firm
Daily Flow* *
Current
Tributary
Flow Plus
(Name or
Permit
Capacity, *
(Firm / p f),
Avg. Daily
Daily Flow,
Obligated
Available
Number)
No.
MGD
MGD
Flow, MGD
MGD
Flow
Capacity* **
12
N/A
4.920
1.968
0.672
0.180
0.852
1.117
10
N/A
14.832
5.933
3.472
0.445
3.917
2.016
w i ne r Yrm capacity kaesign now) of any pump station is aeiinea as the maximum pumpeu tiuw
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): Cape Fear Public Utility Authority
Downstream Permit Number: Not Available
Page 1 of 6
FTSE 10-18

w 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 certifies that the receiving collection system or treatment
works has adequate capacity to transport and treat the proposed new wastewater.
Signing Official Signature
Cr_
Title of Signing Official
Date /
Page 2 of 6
PT'SE 10-1 8

• 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 a Pre -Populated Annual Report form e Print
an Amended a Annual Report form
Business Corporation
Legal Name
TrustHouse Investments, Inc.
Information
Sosld: 1589063
Status: Current -Active
Annual Report Status: Current
Citizenship: Domestic
Date Formed: 4/19/2017
Fiscal Month: December
Registered Agent: Schell, Richard K
Addresses
Reg Office Reg Mailing Mailing
401 S Tryon Street Ste 3000 401 S Tryon Street Ste 3000 4536 Fox Brook Lane
Charlotte, NC 28202 Charlotte, NC 28202 Charlotte, NC 28211
Principal Office
4536 Fox Brook Lane
Charlotte, NC 28211
Officers
Chairman
Michael J Bailey
4536 Fox Brook Lane
Charlotte NC 28211
Treasurer
Michael J Bailey
4536 Fox Brook Lane
Charlotte NC 28211
Secretary
Michael J Bailey
4536 Fox Brook Lane
Charlotte NC 28211

President
Amanda Combs
401 Hawthorne Lane, 101-181
Charlotte NC 28204
Stock
Class: Common
Shares: 1000
No Par Value: Yes

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