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HomeMy WebLinkAboutNOI Water Main Extension 03-16-22NOTICE OF INTENT TO CONSTRUCT WATER MAIN EXTENSION State Form 49008 (R314-15) Approved by State Board of Accounts, 2015 ffateMllain 1. Title of proposed project Jackson's Grant Village Section 2 2. County of proposed project Hamilton 3. Location of proposed project (Including nearest public intersection and nearest quarter section, Township, Range) Northwest comer of 116th Street and Spring Mill Road. A part of the Southeast Quarter of Section 34, Township 18 North, Range 3 East. 4. Name, title, e-mail address and firm of responsible person (as defined in 3271AC 8-3.5-6) 5. Telephone number of responsible person Douglas B. Wagner, Senior Vice President, dwagner@republicdev.com, Jackson's Grant Real Estate Co., ( 317 ) 770- j LLC 6. Address of responsible person (number and street, city, state, and ZIP code 13578 East 131 st Streit, Suite 220, Fishers, Indiana 46037 7. Name of Public Water System (PWS) Citizens Water 8, PWS identification number 5249004 9. Address of PWS (number and street, city, state, and ZIP code) 2150 Dr. Martin Luther King Jr. Street, Indianapolis, IN 46202 10. Telephone number of PWS ( 317 ) 924-3341 11. Name and firm of professional en sneer David J. Stoeppelwerth - en& Associates, 12. Telephone number of professional engineer Inc. 317 849-5935 13. Address (number and street, city, state, and ZIP code) and a-maif address of professional engineer 7965 East 106th Street, Fishers, Indiana 46038 14. Name and e-mail address of developer If applicable} 15. Telephone number of developer Douglas B. Wagner, dwagnercarepublicdev.com ( 317) 770-1r6IS 16. Address of developer (number and street, city, state, and ZIP code) 13578 East 131st Street, Suite 220, Fishers, Indiana 46037 17. Timing of construction (check one of the following): m The proposed construction of the water main will begin on 06/2022 and be completed on 0612023 . (Cannot begin construction less than thirty (30) days after IDEM receives a complete and sufficient N01.) ❑ The proposed construction schedule Wit be submitted separate from this NOI at least ten (10) working days before the commencement of the construction and wilt include a copy of the information on the first page of this NOI. (Cannot begin construction less than thirty (30) days after IDEM receives a complete and sufficient N01. 18. Fee Schedule: The complete NOI form may be submitted by e-mail (dwnoI@kIemJn.gov) or by oeMed rraH Lathe ❑ No fee, exempted under 327 IAC 8-3-7(a). address below. [tZ( No fee for water main extensions under 2,500 linear feet. Indiana Department of Environmental Management © $150 for water main extensions from 2,501 to 5,000 linear feet. Drinking Water Permits Section (IGCN Rm 1201) 100 North Senate Avenue © $250 for water main extensions from 5001 to 10,000 linear feet Indianapolis, IN 46204 ❑ $500 for water main extensions greater than 10,000 linear feet. 9a fee is requimd, see f &-ADns for payment opfons. 19. Certifications: Responsible Person: "I certify that I have reviewed and understand the applicability and eligibility requirements of this rule and that the water main proposed with the submission of this NOI meets the applicability and eligibility requirements of this rule. I also certify that the design and construction of this project will be performed under my direction or supervision to assure conformance with 327 IAC 8-3.5 and will meet all local rules or laws, regulations and ordinances. The Information submitted Is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false Information, including the possibility of fine and imprisonment. Signature of responsible perso Date signed (month, day, year) March 16, 2022 Professional Engineer: "I certify under the penally of law that the design of this project Wit be performed under my direction or supervision to assure conformance with 327 IAC 8- 3.5 and that the plans and specification will require the construction of said project to be performed in conformance with this rule. The design of the proposed project will meet all local rules or law, regulations and ordinances. The Information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false Information, including the possibility of fine and imprisonment." Signature of professional engineer Date slgned (month, day, year) March 16, 2022 Page 4 of 5 Developer: "I certify under the penalty of law that the construction of this project will be performed under my direction or supervision to assure conformance with 327 IAC 8-3.5. The construction of proposed project will meet all local rules or laws, regulations and ordinances. The information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment." Signature of developerz Date signed (month, day, year) March 16, 2022 PWS Representative: "I certify under the penalty of law that I have agreed to furnish water to the area in which the water main is proposed. I acknowledge the public water system's responsibility for examining the plans and specifications to determine that the proposed water main meet local rules or laws and ordinances. I also acknowledge the public water system's responsibilities as outlined in 327 IAC 8-3.5-12. 1 am aware that there are significant penalties for submitting false Information, including the possibility of fine and imprisonment" Signature of PWS representative Date signed (month, day, year) Project Design Criteria: Alternative Technical Standards (327 IAC 8.3.240) 20, Are any "Alternative Technical Standards" proposed to be used in this project? ❑ Yes, I have attached copies of the approval with the NOI. V No Public Water System Capacity Status 21. The PWS's Daily Production Firm Capacity: A. 258.8 MGD B. 178,322 GPM 22. The PWS's five (5) highest demand days in the previous two (2) years only: Demand (MGD) Date (month, day, year) 1. 182,63 August23, 2021 2 180.92 June 19, 2020 3. 178.90 August 24, 2021 4. 177,37 June 17, 2020 5. 176,35 July 17, 2020 23. Average of five (5) Peak Daily Demand (PDD) listed above: C. 179.23 MGD 24. Ratio of PDD to PWS Daily Production Capacity = (Item D = Item C / Item A 100) D. 69.79 25, Anticipated Customer Demand of Proposed Water Main Residential Customers: E. Number of homes F.Average Daily Demand times Peaking Factor (at least 0,87 G. TotalAverage Daily Demand times Peaking Factor (G = E x F) 52 gpm/home) 0.87 45.24 gpm Other (Commercial and Industriafj Customers: Description (including size of domestic meter): Average Daily Demand (the "Safe Maximum Operating Capacily"ofdomestic met" gpm gpm Sub Total: H. gpm Total Customer Demand of Proposed Water Main (gpm) _ (Item G + item H) I. 45,24 gpm Ratio of total Customer Demand of Proposed Water Main (gpm) to the PWS Daily Production Firm Capacity (gpm) (Item J = Item 1/ Item B x 100) J. 0.02537 26. Cross Connection Hazard Prevention A. Are any of the new customers included in Section 25 designated as cross connection hazards (see instructions)? ❑ Yes ❑ No ❑ N/A B. Will an air gap be constructed or a reduced pressure principal back0ow preventer be installed on the customers service line? ❑ Yes ❑ No ❑ N/A Page5of5