20060656 Ver 1_COMPLETE FILE_20060417

p?pF W ATF9PG j Michael F. Easley, Governor
0 te William G. Ross Jr., Secretary
r-- North Carolina Department of Environment and Natural Resources
> =i
0 ^( Alan W. Klimek, P.E. Director
Division of Water Quality
August 1, 2006
DWQ Project # 06-0656
Franklin County
Mr. Fred Kostem
8401 Kempton Road
Raleigh, NC 27615
i
Subject Property: Lake Royale Lot 654
Lake Royale [030301, 28-31-(1), B, NSW]
Approval of 401 Water Quality Certification and Authorization Certificate per the Tar-Pamlico
River Buffer Protection Rules (15A NCAC 2B.0259) with Additional Conditions
Dear Mr. Kostern:
You have our approval, in accordance with the attached conditions and those listed below, to place fill
within or otherwise impact 168 square feet (ft) above the normal pool lake level and 120 square feet (ft)
below normal pool lake level to construct the boathouse, retaining wall, and wooden walkway at lot 654
in Lake Royale, as described within your application dated April 12,2006, and received by the N.C.
Division of Water Quality (DWQ) on April 17, 2006, with more information received by the DWQ on
May 17, 2006 and June 8, 2006. After reviewing your application, we have decided that the impacts are
covered by General Water Quality Certification Number(s) 3495 (GC3495). The Certification(s) allows
you to use General Permit Number 80 when issued by the US Army Corps of Engineers (USACE). This
letter shall also act as your approved Authorization Certificate for impacts to the protected riparian
buffers per 15A NCAC 213 .0259. In addition, you should obtain or otherwise comply with any other
required federal, state or local permits before you go ahead with your project including (but not limited
to) Erosion and Sediment Control, and Non-discharge regulations. Also, this approval to proceed with
your proposed impacts or to conduct impacts to waters as depicted in your application shall expire
upon expiration of the 404 or CAMA Permit.
This approval is for the purpose and design that you described in your application. If you change your
project, you must notify us and you may be required to send us a new application. If the property is sold,
the new owner must be,given a copy of this Certification and approval letter and is thereby responsible for
complying with all conditions. If total fills for this project (now or in the future) exceed one acre of
wetland or 150 linear feet of stream, compensatory mitigation may be required as described in 15A
NCAC 2H.0506 (h). This approval requires you to follow the conditions listed in the attached
certification and any additional conditions listed below.
Conditions of Certification:
1. Impacts Approved
The following impacts are hereby approved as long as all of the other specific and general
conditions of this Certification (or Isolated Wetland Permit) are met. No other impacts are
401 Oversight/Express Review Permits Unit
1650 Mail Service Center, Ralegh, North Carolina 27699-1650
2321 Crabtree Boulevard, Suite 250, Raleigh, North Carolina 27604
Phone: [phone] FAX [phone] Internet htto://h2o.enr.state.nc.us/ncwetlands
A n r-...,i CA01 0......A-AMl10% O...d l .............. 13--
Fred Kostern
Page 2 of 4
August 1, 2006
approved including incidental impacts:
Amount Approved
nits Plan Location or Reference
Open Water Lake Royale) above NPL 0.0038 acres Abbreviated Application
Open Water Lake Royale) below NPL 0.0027 acres Abbreviated Application
2. No Waste, Spoil, Solids, or Fill of Any Kind
No waste, spoil, solids, or fill of any kind shall occur in wetlands, waters, or riparian areas beyond
the footprint of the impacts depicted in the Pre-Construction Notification. All construction
activities, including the design, installation, operation, and maintenance of sediment and erosion
control Best Management Practices, shall be performed so that no violations of state water quality
standards, statutes, or rules occur.
3. Erosion and sediment control practices must be in full compliance with all specifications governing
the proper design, installation and operation and maintenance of such Best Management Practices in
order to protect surface waters standards:
a. The erosion and sediment control measures for the project must be designed, installed,
operated, and maintained in accordance with the most recent version of the North Carolina
Sediment and Erosion Control Planning and Design Manual.
b. The design, installation, operation, and maintenance of the sediment and erosion control
measures must be such that they equal, or exceed, the requirements specified in the most
recent version of the North Carolina Sediment and Erosion Control Manual. The devices
shall be maintained on all construction sites, borrow sites, and waste pile (spoil) projects,
including contractor-owned or leased borrow pits associated with the project.
c. Sufficient materials required for stabilization and/or repair of erosion control measures and
stormwater routing and treatment shall be on site at all times.
4. Sediment and erosion control measures shall not be placed in wetlands or waters to the maximum extent
practicable. If placement of sediment and erosion control devices in wetlands and waters is
unavoidable, they shall be removed and the natural grade restored within six months of the date that the
Division of Land Resources has released the project;
5. You will need to apply for buffer approval from the DWQ if you propose to install French drains
within the buffer.
6. Diffuse Flow (No Review)
All constructed stormwater conveyance outlets shall be directed and maintained as diffuse flow at
non-erosive velocities through the protected stream buffers such that it will not re-concentrate before
discharging into a stream as identified within 15A NCAC 2B .0233 (5). If this is not possible, it may
be necessary to provide stormwater facilities that are considered to remove nitrogen. This may require
additional approval from this Office.
7. Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification or applicable
Buffer Rules, and any subsequent modifications, the applicant is required to return the attached
certificate of completion to the 401 Oversight/Express Review Permitting Unit, North Carolina
Division of Water Quality, 1650 Mail Service Center, Raleigh, NC, 27699-1650.
Fred Kostern
Page 3 of 4
August 1, 2006
Violations of any condition herein set forth may result in revocation of this Certification and may result in
criminal and/or civil penalties. The authorization to proceed with your proposed impacts or to conduct
impacts to waters as depicted in your application and as authorized by this Certification shall expire upon
expiration of the 404 or CAMA Permit.
If you do not accept any of the conditions of this Certification (associated with the approved wetland or
stream impacts), you may ask for an adjudicatory hearing. You must act within 60 days of the date that
you receive this letter. To ask for a hearing, send a written petition, which conforms to Chapter 150B of
the North Carolina General Statutes to the Office of Administrative Hearings, 6714 Mail Service Center,
Raleigh, N.C. 27699-6714. This certification and its conditions are final and binding unless you ask for a
hearing.
This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water
Act. If you have any questions, please telephone Cyndi Karoly or Ian McMillan in the Central Office in
Raleigh at 919-733-1786 or Mike Horan in the DWQ Raleigh Regional Office at 919-7p 1-4299.
-7-- 7"'
AWK/ijm
Enclosures: Certificate of Completion
cc: Mike Horan, DWQ Raleigh Regional Office
USACE Raleigh Regulatory Field Office
File Copy
Central Files
Man W. Klimek, P.E.
Filename: 060656FredKostem(Franklin)101_TPBR
n _
Maintain Inspection
Enter s sell j Events ' ?illliatlo?n,?,?t t s':- Questions Sum a
Project Number: 20060656 Version: '1.0 Status: Receind SW Plan Location: I i
ProJject Name: Fred Kostern
i ProjectTYpa Other I
Owner: Fred Kostern Details
Inspection Date: ,0810112006
fuommenc
Need to write a more info letter requesting to be specific on what his Impacts are and to include the french drains as being the
impact
Cancel
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7-1
- - -- - --
Project Number 20060655 Version: 1.0 Status: Received SW Plan Location.
Project Name: Fred Kostern Project Type. Other
Owner: Fred Kostern _ Details JJ
Inspection Date: 08/0112006
Site Vislt ............................... ..... s Lu NA W
Do impacts described In the applicaton differ those seen In the fleld? ........ ........._............. ! Yes
#Ifyes, please describe differences
Impacts in application are conflicting and are more than what is described. The applicant said he pla
linear feet from normal pool elevation but site plan shows It being 47 linear feet Applicant also propo
all. French drains are determined as fill and where will the discharge points be?
it
Are the IntermittentfPerennlal calls different in the application? ....... .......... .... .... Yes ''-
#'If yes, please describe differences, and how mitigation ratios are affected.
Cancel---J
-
t Ready I - ._ _ - .__ BID: INQS

?U v William G. Ross Jr., Secretary
1 r North Carolina Department of Environmcnt and Natural Rosources
O Y Alan W. Klimek, P.E. Dircctor
Division of Water Quality
May 31, 2006
DWQ Project # 2006-0656
Franklin County
CERTIFIED MAIL. RETURN RECEIPT REQUESTED
Mr. Fred Kostern
8401 Kempton Road
Raleigh, NC 27615
Subject Property: Lake Royale Lot 654
Lake Royale [030301, 28-31-(1), B, NSW]
REQUEST FOR MORE INFORMATION
Dear Mr. Kostern:
On April 17, 2006, the Division of Water Quality (DWQ) received your application dated April 12, 2006,
to impact 168 square feet (fl?) above the normal pool lake level and 120 square feet (fe) below normal
pool lake level to construct the boathouse, retaining wall, and wooden walkway at lot 654 in Lake Royale.
On May 17, 2006, the DWQ received additional information from you, however, the DWQ has
determined that your application remains incomplete and/or provided inaccurate information as discussed
below. The DWQ will require additional information in order to process your application to impact
protected wetlands and/or streams on the subject property. Therefore, unless we receive five copies of the
additional information requested below, we will have to move toward denial of your application as
required by 15A NCAC 2H.0506 and will place this project on hold as incomplete until we receive this
additional information. Please provide the following information so that we may continue to review your
project.
Additional Information Requested:
1. The Request For More Information letter sent to you on May 5, 2006, stated, "Please clearly
indicate Zone 1 and Zone 2 buffers, and impacts to these, on the site plan". We still need this
information to process your application. Please provide this information, and also show the
location of the retaining wall on the undated site plan.
'Please contact the DWQ within three weeks of the date of this letter to verify that you have received this
letter and that you remain interested in continuing to pursue permitting of your project and will be
providing.the DWQ the requested information at a later date. Please contact me, in writing and Mike
Horan of the DWQ Raleigh Regional Office. If we do not hear from you within three weeks, we will
assume that you no longer want to pursue this project and we will consider the project as withdrawn.
This letter only addresses the application review and does not authorize any impacts to wetlands, waters
or protected buffers. Please be aware that any impacts requested within your application are not
authorized (at this time) by the DWQ. Please call Ms. Cyndi Karoly or Mr. Ian McMillan at 919-733-
1786 if you have any questions regarding or would like to set up a mceting to discuss this matter.
Np?thCarolina
401 Oversight/Express Review Pcrmittine Unit AlNt'R??j?
1650 Mail Service Center,'Ralcigh, North Carolina 27699-1650
2321 Crabtree Boulevard, Suite 250. Raleigh. North Carolina 27604
Phone; 919.733.1786 /FAX [phone] / Intcmet: hUx1/h2o.enr.stnts.nc usCncwellands
An Equal Oppoi?rnld/AffirDSPONnEmploycr-50%Recycled110°/HOH 3AIlOA01AV 1d3N0 QIAVO NVS?:6 9002
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7 S N@ SI EORt"AQUALI-ty
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OFFICE USE ONLY: Date Received Request # ._...........
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
Variance Request Form - for Minor Variances
Protection and Maintenance of Riparian Areas Rules
NOTE: This form may be photocopied for use as an original.
Please identify which Riparian Area (Buffer) Protection Rule applies.
? Neuse River Basin: Nutrient Sensitive Waters Management Strategy
Protection and Maintenance of Riparian Areas Rule (15A NCAC 02B
.0233)
? Tar-Pamlico River Basin: Nutrient Sensitive Waters Management
Strategy Protection and Maintenance of Riparian Areas Rule (15A
NCAC 0213.0259)
? Catawba River Basin: Protection and Maintenance of Existing Riparian
Buffers (15A NCAC 02B .0243)
Part 1: General Information
(Please include attachments if the room provided is insufficient.)
1. Applicant's me (t a corporation, individual, etc. who owns the property):
___._ ?QS1 ern ......_..... _....__..
2. Print Owner/Signing Official (p rson legally responsible for the property and its compliance)
Name: _Ore cos rn
Title: ,n-er-
_ _..__..._._.__.-._.._._.__...__.
?QI
Street address:
.._.__...._.__..__..__
City, State, Zip: - lP,f? -------
Telephone: ?a'1A )5 6 q -- 32-10
Fax: --------
3.
Contact person who
Name:
Telephone:
Fax:
Email:
4. Project Name (Subdivision, facility, or establishment name consistent with project name on
plans, specifications, letterp, operation and maintenance agreements, etc.):
Version 2: November 2002
all k?q B 1
JUN 8 2006
about the proposed project:
, i
3210
WE"Nos AND ST EORMW XTER BRANCH
5. Project Location:
Street address:
City, State, Zip:
County:
Latitude/longitude:
6. Directions to site from nearest major intersection (Also, attach an 8 Yx 11 copy of the USGS
topographic ma indicating the location of the site).
ltili l Qc 1e^ c& eviiyu v: ce/ k } '0 n Sa Jam
7. Stream to be impacted by the proposed activity:
Str am name for unnamed streams label as "UT' to the nearest named stream):
Stream classification [as identified within the Schedule of lassifications 15A NCAC 2B
.0315 (Neuse) or .0316 (Tar-Pamlico)]: 3
8. Which of the following permits/approvals will be required or have been received already for
this project?
Required: Received: Date received: Permit Type:.
CAMA Major
CAMA Minor
? i7 (7b 401 Certification/404 Permit
On-site Wastewater Permit
NPDES Permit (including stormwater)
Non-discharge Permit
Water Supply Watershed Variance
Others (specify)
Part 2: Proposed Activity
(Please include attachments if the room provided is insufficient.)
1. Description of proposed activity [Also, please attach a map of sufficient detail (such as a plat
map or site plan) to accurately delineate the boundaries of the land to be utilized in carrying
out the activity, the location and dimension of any disturbance in the riparian buffers
associated with the activity, and the extent of riparian buffers on the land. Include the area
of buff, erpact in W.]:
w
.____..._........_._..._._..._ ..............._._.........
2. State reasons why this plan for the proposed activity cannot be practically accomplished,
reduced or reconfigured to better minirrp?ize or eliminate disturbance to the riparian buffers:
'alt ekiStyr j-v)A y c_e 4M \e),.LA*er I'S Variance Request Form, page 2
Version 2: November 2000
3. Description of any best management practices to be used to control impacts associated with
the proposed activity (i.e., control of runoff from impervious surfaces to provide diffuse flow,
re-planting vegetation or enhancement of existing vegetation, etc.):
Dn"
4
(2) How these difficulties or hardships result from conditions that are unique to the property
involved.
f.
(3) If economic hardship is the major consideration, then include a specific explanation of the
eco-r?omic hardships and the proportion of the hardship to the entire value of the project.
N / 1r
Part 3: Deed Restrictions
By your signature in Part 5 of this application, you certify that all structural stormwater best
management practices required by this variance shall be located in recorded stormwater
easements,'that the easements will run with the land, that the easements cannot be changed or
deleted without concurrence from the State, and that the easements will be recorded prior to the
sale of any lot.
Part 4: Agent Authorization
If you wish to designate submittal authority to another individual or firm so that they may provide
information on your behalf, please complete this section:
Designated agent (individual or firm):
Mailing address:
City, State, Zip:
Telephone:
Fax:
Email:
Part 5: Applicant's Certification
Variance Request Form, page 3
Version 2: November 2000
Please provide an explanation of the following:
(1) The practical difficulties or hardships that would result from the strict application of this
Rule.
T.C- no r ;}Ai a i na vJg? ?'s '? P N C(a , So 1 Gt,ric?
e r o c;tin w? \1 Lo?ti Q CA-,e
r CA K,Gs4.C(print or type name of person
listed in Part I, Item 2), certify e i f anon incl d on this permit application form is
correct, that the project wIII b on tr t d confo and "th the approved plans and that the
deed •estrIctions in accords e a of this f rm will be rded with all required permit
conditions,
Signature:
Date; O
Title:
(M?
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G
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0 0.2 0.4 0.6 0.8 1 mi
M=-9.216
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G William G. Ross Jr., Secretary
1 y North Caroline Department of Environment and Natural Resources
Q Alan W. Klimek, P.E. Director
Division ofWatcir Quality
May 5, 2006
DWQ Project # 2006-0656
Franklin County
CERTIFIED MAIL: RETURN RECEIPT REQUESTED
Mr. Fred Kostern
8401 Kempton Road
Raleigh, NC 27615
Subject Property: Lake Royale Lot 654
Lake Royale [030301, 28-31-(1), $, NSW]
REQUEST FOR MORE INFORMATION
Dear Mr. Kostern:
On April 17, 2006, the Division of Water Quality (DWQ) received your application dated April 12, 2006,
to impact 168 square feet (ft2) above the normal pool lake level and 120 square feet (ft2) below normal
pool lake level to construct the boathouse, retaining wall, and wooden walkway at lot 654 in Lake Royale.
The DWQ has determined that your application was incomplete and/or provided inaccurate information
as discussed below. The DWQ will require additional information in order to process your application to
impact protected wetlands and/or streams on the subject property. Therefore, unless wo receive five
copies of the additional information requested below, we will have to move toward denial of your
application as required by 15A NCAC 2H.0506 and will place this project on hold as incomplete until we
receive this additional information. Please provide the following information so that we may continue to
review your project.
Additional Information Requested:
1. Please clearly indicate Zone I and Zone 2 buffers, and impacts to theso, on the site plan.
2. If any portion of the retaining wall is in Zone 1 (the first thirty feet from most landward limit of
the normal water level), then you must apply for a major variance. If the retaining wall is in Zone
2 of the protected riparian buffers, then you must apply for a minor variance. You may download
a copy of the variance applications from the following website:
hltp.//h2o_cnr.state.ne.us/ncwetlands/regcerthtml
Please contact the DWQ within three weeks of the date of this letter to verify that you have received this
letter and that you remain interested in continuing to pursue permitting of your project and will be
providing the DWQ the requested information at a later date. Please contact me in writing and Mike
Horan of the DWQ Raleigh Regional Office. If we do not hear from you within three weeks, we will
assume that you no longer want to pursue this project and we will consider the project as withdrawn.
401 Oversight/Expross Review Permitting Unit
1650 Mail Service Center, Raleigh, North Carolina 27699-1650
2321 Crabtree Boulevard, Suite 250. Raleigh, North Carolina 27604
Phone: [phone] FAX [phone] / InterneC lrttlr-aZo mr srere Or: 40psXelIA04S
An Equal Opportunity/Atfrmativo Action Employer- 50% Recycled110`Yo Post Consumer Paper
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This letter only addresses the application review and does not authorize any impacts to wetlands, waters
or protected buffers. Please be aware that any impacts requested within your application are not
authorized (at this time) by the DWQ. Please call Ms. Cyndi Karoly or Mr. Ian McMillan at 919-733-
1786 if you have any questions regarding or would like to sct up a mccting to discuss this matter.
S' rely,
Cyndi Karoly, Supervisor
401 Oversight/Express Review Permitting Unit
CBK/asc
cc: Eric Kulz, DWQ Raleigh Regional Office
USAGE Raleigh Regulatory Field Office
File Copy
Central Files
Filename: 060656PredKaatern(Frsa win)On_Ho)d
E 'd 6ti 'ON ONO 3AI10NOAV 1d3N0 0100 N06:01 9006 '9 Apr'!
OFFICE USE ONLY: Date Received 41? _J Request # _______,
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
Variance Request Form - for Minor Variances
Protection and Maintenance of Riparian Areas Rules
NOTE: This form may be photocopied for use as an original
Please identify which Riparian Area (Buffer) Protection Rule applies.
? Neuse River Basin: Nutrient Sensitive Waters Management Strategy
Protection and Maintenance of Riparian Areas Rule (15A NCAC 02B
.0233)
? Tar-Pamlico River Basin: Nutrient Sensitive Waters Management
Strategy Protection and Maintenance of Riparian Areas Rule (15A
NCAC 02B.0259)
? Catawba River Basin: Protection and Maintenance of Existing Riparian
Buffers (15A NCAC 02B .0243)
Part 1: General Information
(Please include attachments if the room provided is insufficient.)
1. Applicant's me (tl?e corporation, individual, etc. who owns the property):
v r? ? n??_rri 4E ? ? ZOOc
2.
3.
Print Owner/Signing Official
Name:'
Title:
Street address:
City, State, Zip:
Telephone:
Fax: )_
.....................
rson legally responsible for the property and its. compliance)
:DS?P rn
Contact person who c answer/ questions about the proposed project:
Name: C a C.Cf XY1
Telephone: but t°? l 3 J??i - 3210 __
Fax:
Email:
4. Project Name (Subdivision, facility, or establishment name - consistent with project name on
plans, specifications, letters, operation and maintenance agreements, etc.):
Version 2: November 2002
5. Project Location:
Street address:
City, State, Zip:
Countv:
Latitude/longitude __ 7 :i9?°
6. Directions to site from nearest major intersection (Also, attach an 8'/Z x 11 copy of the USGS
topographic ma indicating the location of the site),
k-?+ o n Su a m o re
7. Stream to be impacted by the proposed activity:
Str am name for unnamed streams label as "UT' to the nearest named stream):
u&
M
Stream classificatHn [as identified within the Schedule of lassifications 15A NCAC 2B
.0315 (Neuse) or.0316 (Tar-Pamlico)]:
8. Which of the following permits/approvals will be required or have been received already for
this project?
Required: Received: Date received: Permit Type:
CAMA Major
CAMA Minor
? = (7b 401 Certification/404 Permit
On-site Wastewater Permit
NPDES Permit (including stormwater)
Non-discharge Permit
Water Supply Watershed Variance
Others (specify)
Part 2: Proposed Activity
(Please include attachments if the room provided is insufficient.)
1. Description of proposed activity [Also, please attach a map of sufficient detail (such as a plat
map or site plan) to accurately delineate the boundaries of the land to be utilized in carrying
out the activity, the location and dimension of any disturbance in the riparian buffers
associated with the activity, and the extent of riparian buffers on the land. Include the area
of buffer impact in,ft2.]:
kc?
?oac'v_
tea- d 't.--
2. State reasons why this plan for the proposed activity cannot be practically accomplished,
reduced or reconfigured to better minirni?e or eliminate disturbance to the riparian buffers:
ck-
?ht d i s ce 4-0 4) u+-+er nee e lg''( 71]? f' r_
Q Ce
-.,_n h ar.rl ,r-ea<e cni i ectr-,l-o n . P n i no 1wY1 Lk
Variance Request Form, page 2
Version 2: November 2000
TopoZone - USGS Bunn East (NC) Topo Map Quad Page 1 of 1
Ta lkt this map
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Topo Download USGS Bunn East (NC) Topo Map Quad
View TopoZone Pro aerial photos, shaded relief, street maps,
Photo Download interactive coordinate display, and elevation data
USGS Topo Maps
o.' 1:24K/25K Series
1:100K Series
1:250K Series
Map Size
o' Small
Medium
Large
View Scale
1 : 50,000
Update Map
Coordinate Format
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Coordinate Datum
WGS841NAD83 -
R-11 Show target
Email this map
.I -
W
S! ?
Bookmark this map t1*
Print this map G
A 0 0.3 0.6 0.9 1.2 1.5 km
my?opo
0 0.2 0.4 0.6 0.8 1 roi
GET A M=-9.216
CUSTOM G=1.646
What's This?
F/I
r
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. !i-ei
E-
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httD://WWW.tODo7one.comhnan.asn97=17X n=3984191 RrP=75 5(l?Rci?e=cR?rlat„n,=n?iR?R, S/0 %,)r,n,,
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4
Please provide an explanation of the following:
(1) The practical difficulties or hardships that would result from the strict application of this
Rule.
A o r ?i? ?Lt n?1?1, aL "----
yQ r ? S ? ti n w? ?1 lC?-X1.1"1 l1(.t•? -
(2) How these difficulties or hardships result from conditions that are unique to the property
involved.
(3) If economic hardship is the major consideration, then include a specific explanation of the
eco omic hardships and the proportion of the hardship to the entire value of the project.
Part 3: Deed Restrictions
By your signature in Part 5 of this application, you certify that all structural stormwater best
management practices required by this variance shall be located in recorded stormwater
easements, that the easements will run with the land, that the easements cannot be changed or
deleted without concurrence from the State, and that the easements will be recorded prior to the
sale of any lot.
Part 4: Agent Authorization
If you wish to designate submittal authority to another individual or firm so that they may provide
information on your behalf, please complete this section:
Designated agent (individual or firm):
Mailing address:
City, State, Zip:
Telephone:
Fax:
Email:
Part 5: Applicant's Certification
Variance Request Form, page 3
Version 2: November 2000
Description of any best management practices to be used to control impacts associated with
the proposed activity (i.e., control of runoff from impervious surfaces to provide diffuse flow,
re-planting vegetation or enhancement of existing vegetation, etc.):
(print or type name of person
listed in Part I, Item 2), certify e i f r atlon incl d on this permit application form is
correct, that the project will b con tr t d confo anc ith the approved plans and that the
deed •estrictions in accords e a of this f rm will be rded with all required permit
condi,done,
Signature:
Date: ! 0
Title:
tx7
f
The following is an abbreviated application form for (those applying for a 401 Water
Quality Certification to impact FERC (Federal Energy Regulatory Commission)
regulated lake shore or bottom under the U.S. Army Corps of Engineers Permit
GP30. This Application cannot be used for wetland or stream impacts. Please
provide*in (8) copies of this application and supporting information as well as a
non-refundable application fee to the Division of Water Quality of $200.00 for
impacts of to lake bottom of less than 1 acre and $475.00 for impacts to ak- e -bottom
of greater or equal to 1 acre.
Applications should be sent to:
Division of Water Quality Wetlands Unit
1650 Mail Service Center
Raleigh, NC 27699-1650

I. Applicant Information
1. Owner/Applicant Information
Name: r r e ',? V_'Q
s u
APR 1 7 2006
QUALITY
DENR0-0WSAJSR"&&MW
ftlwo
Telephone Number: c, k"la `1 f( Fax Number: i-7, '
E-mail Address:. -J-4§W I?r?n ?t," cc? w c_
2. Agent Information (A signed and dated copy of the Agent Authorization letter
must be attached if the Agent has signatory authority for the owner/applicant.)
Name:
Company Affiliation:
Mailing Address:
Telephone Number: Fax Number:
E-mail Address:
II. Project Information
Attach a vicinity map clearly showing the location of the property with respect to
local landmarks such as towns, rivers, and roads. Also provide a detailed site
plan showing property boundaries and development plans in relation to
surrounding properties. You may use the diagram below to make a hand sketch of
your project. Also, see the example below for guidance. Both the vicinity map and
site plan must include a scale and north arrow. The footprints of all buildings,
impervious surfaces, or other facilities must be included.
1. Location
County: Er-om of n Nearest Town: n
Subdivision name or site address (include phase/lot number): L-,xWG Ra
Directions to site please include road numbers, landmarks, etc. (This is not
necessary if a adequate vicini map is included): 1. a kr ?Ou at.Q.[ .P ,h tmoce ,
Al ?.r n -f o n Q a cc rn o re rm L, 4- ^ n r.ti o c4-_v ? ?.
2. Describe the existing land use. or condition of the site at the time of
r- S
3. Property size (acres): Q-
4. Nearest body of water (stream/river/sound/ocean/lake): uk-?P__ R O
5. Describe the purpose of the pro/posed work- ?Jc}11 S V? C b L1.5e,I
cnrtxtnlna ?! a_U ?.?,??PC??- i t?\n? -c,-,o u?1, rl(Y'IA 6. List the type of equipment to be used to construct the project: cfZC AJQ4-mod
S ki d 54eer
7. Amount of impact (including all excavation, backfill, rip rap, retainin walls
etc.) below the normal pool lake level in square feet or acres: ?: X O
e, xC ya?h 0n
8. a. Amount of impact (including all clearing,! back fill, excavation, rip rap,
retaining walls, etc.) above the normal pool lake level and 50 feet land-wa d in
square feet or acres: X Ca, VCS `-?'Qn?t ?-{ X 1 . dT 5 1I
b. Neasedesc?6 vegetation above the normal pool lake level and 50 feet land-
1 war to be impactes for instance): '110 'k'-,&S uJ I 1( biz,
', , /? n r??,v ? rn s t .-

Applicant/Agent's tore Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
at,
Please approximately sketch the fo®oving infannation on this ;plan
(please provide immersions for each Remy such as 10 ft. x 100 F#):
1) AN proposed vegetation clsaiing (provide dimensions)
A Location of rip rap or fill to be placed alcove the F'ul Pond elevation
3? Location of rip rap or fill to he placed below the FuO Pond elevation
4) The location of any proposed st mdures such as buildings, retaining
vraffisp dock% etc.
5) The location of any excavation or dridging below Cho Full Pond
elevation.
6) Location of construcOm access corridors,
HANG
w'ATER LINE
EXCAVATE A5 REGL'IRED-- --
. ...................................................................................................:..:...........:::..
51DE ELEVATION
SGALE 1/4' - 1' 0'
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DWQ# C) to t to J l{ Date 57/ZS /'& Co Who Reviewed:
Plan Detail Incomplete ,
? Please provide a location map for the project.
? Please show all stream impacts including all fill slopes, dissipaters, and bank' stabilization on the site plan.
? Please show all wetland impacts including fill slopes on the site plan. ?'x r c ` n
Please indicate all buffer impacts on the site plan. 0 e a , k:) 5
Lill, /1 I eac5 c Cl'rar k`1 ln?l CJ 2
? Please indicate proposed lot layout as overlays on the site plan. T
Please indicate the location of the protected buffers as overlays on the site plan.
? Please locate all isolated or non-isolated wetlands, streams and other waters of the State as overlays on the site plan.
? Please provide cross section details showing the provisions for aquatic life passage. (Y1 '? r Yar of r
V- L wC, }- ,- - . S e
? Please locate any planned sewer lines on the site plan. rt s e,r„'S e ,
? Please provide the location of any proposed stormwater management practices as required by GC y? ;n^ ?• Y'
? Please provide detail for the stormwater management practices as required by GC
? Please specify the percent of project imperviousness area based on the estimated built-out conditions. j „ 0 e Y "?
? Please indicate all stormwati outfails on the site phut. ,r P tr ?`i rev `'?
? Please indicate the diffuse flow provision measures on the site plan. y b V, r /
? Please indicate whether or not the proposed impacts already been conducted Y• < ci .k `
Avoidance,and/or Minimization Not Provided 1 4
a El The labeled as on the plans does not appear to be necessary. Please eliminate the br ditional Wpn
information as to why it is necessary for this project.
? This Office believes that the labeled on the plans as can be moved or reconfigured to avoid the impacts to the
. Please revise the plans to avoid the impacts.
? This Office believes that the labeled on the plans as can be moved or reconfigured to minimize the impacts to the
Please revise the plans to minimize the impacts.
? The stormwater discharges at the location on the plans labeled will not provide diffuse flow through the buffer because
. Please revise the plans and provide calculations to show that diffuse flow will be achieved through the entire buffer. If it
is not possible to achieve diffuse flow through the entire buffer then it may be necessary to provide stormwater management
practices that remove nutrients before the stormwater can be discharged through the buffer.
Other
? The application fee was insufficient because over 150 feet of stream and/or over 1 acre of wetland impacts were requested. Please
provide $ This additional fee must be received before your application can be reviewed.
? Please complete Section(s) on the application.
? Please provide a signed copy of the application.
? Please provide copies of the application, copies of the site plans and other supporting information.
? Please submit electronic CAD files showing , via email to ian.,[e-mail] and CD.,
Mitigation
r. of compensatory mitigation is required for this project. Please provide a compensatory mitigation plan. The
plan must conform to the requirements in 15 A NCAC 2H .0500 and must be appropriate to the type of impacts proposed.
? Please indicate which 404 Permit the USACE would use to authorize this project.
II Complete items 1, 2, and 3. Also complete A. tun&-
1 item 4 If Restricted Delivery Is desired.
Print your name and address on the reverse
so that we can return the card to you. 11 B. Rea v by (Prlnfed Name) C.
Attach this card to the back of the mailpiece,
or on the front if space permits.
6.. Is delivery add item 1'
I . Article Addredtd to: If YES, en9
ITT
Mr. Fred;Kostern
8401 Kempton Road
Raleigh,NC 27615
DWQ# 2006-0656-Franklin
? Agent
of Delivery
0 No
thY0
3. Se ce pe \
Cerdfl ?-I ? ail
Registered Receipt for Merchandise
? Insured Mail C.O.D.
4. rtestnctea ueirveryr (Exva Fee) ? Yes
>. Article Number -
(Tmnsferfrom service fabeo ?005 1160 0000 9954 6 3 7 5
)c i onne n... o?rt oot .., 0-ai ., ., ??.
RESEARCH TRIANI
UNITED STATES POSTAL SERVICE "a......... .......
ostage &
.. USP•
4V 12006 11
IL16 MA
• Sender: Please print your name, address, and ZIP+4 in this box •
NC DENR Division of Water Quality
401 Oversight/Express , Unit
2321 Crabtree Boulevard, Suite 250
Raleigh, NC 27604