WQ0041067_Application (FTSE)_20190801

RCONSULTING
.KGROUPPLLC
July 22, 2019
Mr. Robert Tankard
Assistant Regional Supervisor
Division of Water Resources
Water Quality Regional Operations Section
943 Washington Square Mall
Washington, NC 27889
Subject: Fast -Track Application
Jolly Roger's Revenge
Private Sanitary Sewer Main Extensions
City of Greenville, Pitt County, North Carolina
Dear Mr. Tankard:
On behalf of Jolly Roger's Revenge, LLC we respectfully submit a Fast -Track Application for the Jolly Roger's Revenge
private dormitory project located at the northwest corner of Charles Boulevard and 14t^ Street in Greenville.
The project area consists of a 2 City block area that's bound on the east / west by Charles Boulevard and Cotanche Street
and on the north / south by 13th Street and 14th Street. There were previously 21 homes, a church and a convenience
store containing a carry -out restaurant located on the old parcels. The existing structures have all been demolished and
the old parcels have been recombined to create a single building lot bound by the four public streets.
The proposed project consists of an 804 bed privately owned dormitory building together with 10,000 sf of non-residential
space contained within the same building along with a new parking garage and ancillary site and utility improvements.
The proposed project is provided sanitary sewer service by existing Greenville Utilities (GUC) owned 8" gravity sanitary
sewer mains located within the Charles Boulevard and 10 Street public rights of way. The project proposes tying into an
existing 8" GUC sanitary sewer main located within 14th Street with the extension of a short section of new 8" public main
that GUC will own and maintain — approximately 13' of 8" main. The fast track permit application package for the new
portion of public sanitary sewer main has been submitted by GUC under separate cover (copy attached).
The attached permit application package is for the proposed extension of approximately 473' of 8" private sanitary sewer
main that will tie into the new public portion of sanitary sewer main and will provide service to the majority of the
building. The remaining portion of the building not flowing through the new 8" private sewer will flow north to an existing
GUC main located at the Charles Blvd / 13th Street intersection. The total new net flow generated by the replacement of
the prior flows by the new project flow has been allocated on the public portion of 8" main, therefore the private portion
of 8" main will not allocate new flow.
Enclosed for your use is the application fee in the amount of $480.00 for the private permit along with one original and
one copy of the documents listed below:
PHONE WEB

CONSULTING
G.RO U P,. PLC
Tankard, 07/22/19, Page 2
Private Permit (Jolly Roger's Revenge, LLC)
o Fast -Track Application for Gravity Sewers, Pump Stations and Force Mains (FTA 04-16)
o Documentation of Corporation Registration with Secretary of State
o Flow Tracking / Acceptance Form (FTSE 04-16)
o USGS TopoQuad Site Map
o Street Level Map
o Reduced size sheet C1 of construction plan set
o Copy of cover letter for Application Package for the Public Portion of new sewer main
Thank you for your assistance with this project. Should you have any questions or require additional information, please
do not hesitate to contact our office.
Respectfully submitted,
Ark Consulting Group, PLLC
Bryan C. Fagundus, P.E.
Principal

Greenville
Utilities
July 19, 2019
Mr. Allen Clark
Environmental Specialist
NCDENR
943 Washington Square Mall
Washington, North Carolina 27889
Subject: Jolly Roger's Revenge
Sewer Main Extension
Dear Mr. Clark:
We are submitting herewith one (1) original and one (1) copy of the executed Non -Discharge
Permit Application and Flow Tracking/Acceptance for Sewer Extension Permit Applications
along with a check for $480.00 for the subject project. We request your approval of the sewer
improvements.
We trust that you will find this submittal to be in order and that your approval will be
forthcoming. In the meantime, should you have any questions or require any additional
information, please let us know.
Sincerely,
Clifton H. Cahoon, PE
Construction / Contracts Engineer
Enclosures
c: Mr. Randall D. Emory, PE, Director Water Resources
Ar. Bryan C. Fagundus, PE, Ark Consulting Group, PLLC.
PO Box 1847
Greenville, NC 27835
www.guc.com
Your Local
Advantage

W W 41 O w-7State of North Carolina
Department of Environmental Quality
WR W000010" Division of Water Resources
15A NCAC 02T .0300 - FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
DlvLslon of Water Resources INSTRUCTIONS 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
NCAC 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
documents 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 requite 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 1C .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);
➢ Vacuum sewer systems.
General — When submitting an application, please use the following instructions as a checklist in order to ensure all required items
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
® Required unless otherwise noted
B. Cover Letter (Required for All Application Packages):
® 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):
® 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):
® 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 1.2 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.
® The Project Name in Item I1.1 shall be consistent with the project name on the flow acceptance letters, agreements, etc.
® The Professional Engineer's Certification on Page 5 of the application shall be signed, sealed and dated by a North
Carolina licensed Professional En ineer.
® The Applicant's Certification on Page 5 of the application shall be signed in accordance with 15A NCAC 02T .0106(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 Page 1 of 3

E. Flow Tracking/Acceptance Form (Form: FTSE 0446) (If Applicable):
® 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):
® Submit an 8.5-inch x 11-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
® 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 .0.115(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: DEW
For more information, visit the Division's collection systems website
INSTRUCTIONS FOR FORM: FTA 04-16 & SUPPORTING DOCUMENTATION Page 2 of 3

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: % 0 06 9 10 (n7 (to be completed by DWR)
All items must be completed or the application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: Jolly Roger's Revenge. LLC (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: Thomas A. Saieed. Jr. per I SA NCAC 02T .0106(b)
Title: Member / Manager
4. Applicant's mailing address: 3301 Benson Drive. Suite 103
City: Raleigh State: NC Zip: 27609-
5. Applicant's contact information:
Phone number: [phone] Email Address: todd.saieed(@dewittcarolinas.com
II. PROJECT INFORMATION:
1. Project name: Jolly Roger's Revenge
2. Application/Project status: ® 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: Pitt
4. Approximate Coordinates (Decimal Degrees): Latitude: 35,60110 Longitude:-77,3714'
5. Parcel ID (if applicable): 85455
(or Parcel ID to closest downstream sewer)
M. CONSULTANT INFORMATION:
1. Professional Engineer: lean C. Fagundus. P.E License Number: 31970
Firm: Ark Consulting Group. PLLC
Mailing address: 2755-B Charles Boulevard
City: Greenville State: NC Zip: 27858-
Phone number: QL2) 55 -QL88 Email Address: bryan(@arkconsultin%titroul2.com
IV. WASTEWATER TREATMENT FACILITY (WWTF) INFORMATION:
1. Facility Name: Greenville Utilities Commission
Owner Name: Greenville Utilities Commission
Permit Number: NC 0023931
V. RECEIVING DOWNSTREAM SEWER INFORMATION (if different than WWTF):
1. Permit Number(s): WQ Unknown Downstream (Receiving) Sewer Size: 8" inch
System Wide Collection System Permit Number(s) (if applicable): WQCS
Owner Name(s): Greenville Utilities Commission
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 Operational Agreement (FORM: DEV) been attached?
El Yes ❑No ®N/A
3. If the Applicant is a Home/Property Owners' Association. has an Operational Agreement (FORM: HOA) been attached?
Yes ❑No ®N/A
4. Origin of wastewater: (check all that apply):
❑ Residential Owned ❑ Retail (stores, centers, malls) ❑ Car Wash
® Residential Leased ® Retail with food preparation/service ❑ Hotel and/or Motels
❑ School / preschool / day care ❑ Medical / dental / veterinary facilities ® Swimming Pool /Clubhouse
El 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 .0103(20))
loIs there a Pretreatment Program in effect? ❑ Yes ❑ No
6. Has a flow reduction been approved under 15A NCAC 02T .0114(fl? [:]Yes Z No
➢ If *es, arovide a coax of flow reduction auproval letter
7. Summarize wastewater generated by project:
Establishment Type (see 02T.0114(fl)
Daily Design Flow'"
No. of Units
Flow
gal/
GPD
gall
GPD
gall
GPD
gal/
GPD
gall
GPD
gal/
GPD
Total
GPD
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 data, water using fixtures, occupancy or operation patterns, and other measured data.
8. Wastewater generated by project: 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
8 473 PVC
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 sewers)
➢ Oversizing lines to meet minimum slope requirement is not allowed and a violation of the MDC
VIH. 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 (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 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(f) & (g) ® Yes [:]No
D l iA WC'AC 09T 0'10'SM rnntains minimum separations that shall be 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
Too slope of embankment or cuts of 2 feet or more vertical height
10 feet
Drainajze 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(f) 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) ® 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 15A NCAC 02B .0200? ® Yes ❑ No ❑ N/A
This would include Trout Buffered Streams per 15A NCAC 213.0202
4. Does the project require coverage/authorization under a 404 Nationwide or 0 Yes E 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)(6) (additional permits/certifications)? ® Yes [:]No
Per 15A 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 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 1 SA NCAC 027', the Minimum Design Criteria -for the Permittine .of Pump Stations
and force Mains t latest versions. and the Gmi y Sewer Minimum Design Criteria I latest versions 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 supportine documents.
2. Professional Engineer's Certification:
I, t- XV 6. 1 i�, tJf4,6&X5. 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 143-215.613, 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 $10,000, as well as civil penalties up to $25,000 per violation.
.............................................................
North Carolina Professional Engineer's seal, signature, and date: ,%tggttnity
CARO
3. Applicant's Certification per 15A NCAC 02T .0106(b):
4 TOW-0 A. 54VEE-P,:M, _ MAtAA&Er, attest that this application for
(Signature Authority's name dt title froth Application Item I.3.)
a-ous( REVV-I&E
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.
Date: 6, 2 7
FORM: FTA 04-16 Page 5 of 5

0
State of North Carolina
Department of Environmental .Quality
Division of Water Resources
otvisIon of water Resources Flow Tracking/Acceptance for Sewer Extension Applications
(FTSE 04-16)
Entity Requesting Allocation: Jolly Roger's Revenge, LLC
Project Name for which flow is being requested: Jolly Roger's Revenge
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: Greenville Utilities Commission
b. WWTP Facility Permit #: NC0023,431
v All flows are in MGD
c. WWTP facility's permitted flow 17.5
d. Estimated obligated flow not yet tributary to the WWTP 2.336
e. WWTP facility's actual avg. flow 11.19
f. Total flow for this specific request 0 (Flow allocated on public
permit)
g. Total actual and obligated flows to the facility 13.614
h. Percent of permitted flow used 77.795
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***
Southside
30.2
12.08
7.288
1.143
8.431
3.649
* 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): Not Known
Downstream Permit Number: Not Known
Page 1 of 6
FTSE 04-16

III. Certification Statement:
I Clifton H. Cahoon, PE 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.
Signi g Official Signature . Date
Page 2 of 6
FTSE 04-16

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Limited Liability Company
Legal Name
Jolly Rogers Revenge, LLC
Information
Sosld: 1607954
Status: Current -Active
Annual Report Status: Current
Citizenship: Domestic
Date Formed: 7/7/2017
Registered Agent: Voltz, Elizabeth W,
Addresses
Principal Office Reg Office Reg Mailing
3301 Benson Dr Suite 703 3700 Glenwood Ave Suite 250 3700 Glenwood Ave Suite 250
Raleigh, NC 27609 Raleigh, NC 27672 Raleigh, NC 27612
Mailing
PO Box 17566
Raleigh, NC 27619
Company Officials
All LLCs are managed by their managers pursuant to N.C.G.S. 57D-3-20.
Manager Manager
Lonnie C. Poole , III Thomas A Saieed , Jr.
3301 Benson Drive, Suite103 3307 Benson Drive Suite 103
Raleigh NC 27609 Raleigh NC 27619

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