19970284 Ver 1_COMPLETE FILE_19970401

State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
LT.RMAI
IT *
?A41 0
ID EHNR
April 25, 1997
Forsyth County
DWQ Project # 970284
APPROVAL of 401 Water Quality Certification and ADDITIONAL CONDITIONS
Mr. Ronnie Roberts
822 Old Winston Road
Kernersville, NC 27284
Dear Mr. Roberts:
You have our approval, in accordance with the attached conditions and those listed below, to place fill
material in 0.16 acres of wetlands or waters for the purpose of constructing a road access at Wellington
Village, as you described in your application dated 1 April 1997. After reviewing your application, we have
decided that this fill is covered by General Water Quality Certification Number 3103. This certification
allows you to use Nationwide Permit Number 14 when it is issued by the Corps of Engineers.
This approval is only valid for the purpose and design that you described in your application except as
modified below. If you change your project, you must notify us and you may be required to send us a new
application. If total wetland fills for this project (now or in the future) exceed one acre, compensatory
mitigation may be required as described in 15A NCAC 2H .0506 (h) (6) and (7). For this approval to be
valid, you must follow the conditions listed in the attached certification and any additional conditions listed
below. The stream channel on Lot 1 shall remain in place to carry stormwater flow into the pond. After road
construction, the disturbed edge of pond shall be replanted with native woody species. In addition, you should
get any other federal, state or local permits before you go ahead with your project including (but not limited
to) Sediment and Erosion Control, Coastal Stormwater, Non-Discharge and Water Supply Watershed
regulations. This approval will expire when the accompanying 404 or CAMA permit expires unless
otherwise specked in the General Certification.
If you do not accept any of the conditions of this certification, 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, P.O. Box 27447, Raleigh, N.C. 27611-7447. 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 John Dorney at 919-733-1786.
Attachment
cc: Wilmington District Corps of Engineers
Corps of Engineers Raleigh Field Office
Winston-Salem DWQ Regional Office
Mr. John Dorney
Central Files
Gerry Parker; Callahan Surveying
Sincerely,
pl4. P. E/I
970284.1tr
Division of Water Quality - Environmental Sciences Branch
Environmental Sciences Branch, 4401 Reedy Creek Rd., Raleigh, NC 27607 Telephone [phone] FAX # [phone]
An Equal Opportunity Aff irmative Action Employer • 50% recycled/10% post consumer paper
MEMORANDUM PRINT NAMES:
Reviewer: . wT PC JOHN DORNEY WQ SUPV.:
ENVIRONMENTAL SCIENCES BRANCH DATE:
SUBJECT: WETLAND STAFF REPORT AND RECOMMENDATIONS RECEIVED
***EACH ITEM MUST BE ANSWERED (USE N/A FOR NOT APPLICABLE) APR 2 11997,
PERMIT YR : 97 PERMIT NO: 0 0 0 0 2 8 4 COUNTY : FORSYTH ENVIRONMENTAL SCIENCES
APPLICANT NAME: RONNIE ROBERTS-WELLINGTON VILLAGE
PROJECT TYPE: ROAD CROSSING/SUBDIV PERMIT TYPE: NW 14
I_OE #: DOT #:
RCD_FROM _CDA: APP DATE_FRM_CDA: 04/01/97
REG OFFICE: WSRO
RIVER-AND-SUB-BASIN-#: 030704 STR_INDEX NO: 21-12-94-12-2-(0.3)
STREAM CLASS: WSIII
WL_IMPACT?: ON WL
WL REQUESTED: WL ACR
WL_SCORE(jj): WATER IMPACTED BY
MITIGATION?: Y/6 MITIGATION
MITIGATION SIZE: DID YOU REQUEST MORE
_TYPE :
FILL?: YCN)
CS
TYPE : +~ V ?.
_ INFO? : Y/19)? .
IS WETLAND RATING SHEET ATTACHED?:6y) N
HAVE PROJECT CHANGES/CONDITIONS BEEN DISCUSSED WITH APP(!U
RECOMMENDATION (Circle One): ISSUE ISSUE/COND;DENY

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Central Files
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Add 1 point if in sensitive watershed and > 10% nonpoint disturbance within 1 /2 mile upstream, upslope, or radius

57
Imp 1. Caliaban
surbepirtg companp, 3ittc.
935 East Mountain Street, Suite I
Kernersville, North Carolina 27284
[phone] 4
[phone] F11
TO / C?L-- 7 [ ff x
LETTER OF TRANSMITTAL
a )
DATE i' 1-7 1 JOB NO.
ATTEN I N
RE:
i r
?i

REeEIVEL)
APR 0
1 199
EWIRONMENTAi
--U
(ts
WE ARE SENDING YOU Attached ? Under separate cover via the following items:
? Shop drawings Prints ? Plans ? Samples a ? Specifications
? Copy of letter ? Change order
lie
COPIES DATE NO. DESCRIPTION
IL 1117 V r zVgZ
THESE ARE TRANSMITTED as checked below:
For approval
For your use
? As requested
? For review and comment
? FOR BIDS DUE
? Approved as submitted ? Resubmit copies for approval
? Approved as noted ? Submit copies for distribution
? Returned for corrections ? Return corrected prints
19 ? PRINTS RETURNED AFTER LOAN TO US
REMARKS
COPY TO V/ /Gr/ y
If enclosures are not as noted, kindly notify us afAnce.
9? 0284
DEM ID: CORPS ACTION ID:'
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #14
PRE-CONSTRUCTION NOTIFICATION APP?fICTION
FOR NATIONWIDE PERMITS THAT REQUIRE :ten i
APR 17
1) 22IOTI?ZG?T2ORt TO T3Z CORPS or ZNGXNZ=s ??
2) APPLICATION POR SECTION 401 C". TXPXCATION WETLANDS GROs
3) coopmnla ION F2TS TSZ NC alvlsxcN OF co"TAL ?„snra TE, R QUALIT`? S v :
SEND THE ORIGINAL AND (1) COPY OF THIS COLLETED FORM TO TEE APPROPRIATE
FIELD OFFICE OF THE CORPS OF ENGINEERS (SEE AGENCY ADDRESSES SHEET). SEVEN
(7) COPIES SHOULD BE SENT TO THE N.C. DIVISION OF ENVIRONMENTAL MANAGEbff-NT
(SEE AGENCY ADDRESSES .SHEET) . PLEASE PRINT.
1. OWNERS NAME: Ronnie Roberts
2. MAILING ADDRESS: 822 01d Winston Rd.
Kernersville SUBDIVISION NAME: -Wellington 'Village
CITY: TCarnarcvi 11 p STATE: N _ r ZIP CODE: 772$(+
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE) : Bromley Drive ( S.R. # 4265)
3. TELEPHONE NUMBER (HOME) : [phone] (WORK) : [phone]
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER: Ronne Roberts
822 01d Winston Rd
5. LOCATION OF WORK (PROVIDE A MA-0, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: Forsyth NEe3.REST TOWN OR CITY: Karnersvil l e
1

SPECIFIC LOCATION (INCLUDE ROAD
NUMBERS, LANDMARKS, ETC.): Connected or Bromleg nrivP (C_R-1 9965)
adjacent to KerneTG Mill Creek; R we n Ro=bins RnoA (S_R_ 7649)
and rbecham Dr*vP
6. IMPACTED OR NEAREST STREAM/RIVER: Kerners Dill Cree
RIVER BASIN:
7a. IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER
(SA), HIGH QUALITY WATERS .(HQW), OUTSTANDING RESOURCE WATERS (ORW), WATER
SUPPLY (WS-1 OR WS-II)? YES [X] NO [ j IF YES, EXPLAIN:
7b. IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC) ? YES_ [ j 'NO [ )d
7c. IF THE PROJECT IS LOCATED WITHIN A*COASTAL COUNTY (SEE PAGE 7 FOR
LIST OF COASTAL COUNTIES), WHAT IS THE LAND USE PLAN"(LUP) DESIGNATION?
8a. HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON
THIS ~PROPERTY? YES [ j NO [X] IF YES, PROVIDE ACTION I.D. NUMBER OF
PREVIOUS PERMIT AND ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401
CERTIFICATION):
8b. ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE
FUTURE? YES [ j NO [Xj IF YES, DESCRIBE ANTICIPATED WORK:
9a. ESTIMATED TOTAL NUMBER OF ACRES IN TRACT OF LAND: 11.875t Acres
9b. ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
40+ Acres -
2
10a. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT'BY:
FILLING: 0 16+ Arrac EXCAVATION: -N/A--
FLOODING: N/ OTHER: N/A_
DRAINAGE: NIA TOTAL ACRES TO_BE-II-LPACTED: Q 16+ Ar vac
10b. (1) STREAM CHANNEL TO BE IMPACTED-BY THE PROPOSED PROJECT (IF -
RELOCATED, PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION =
LENGTH BEFORE: - - N/A --- FT ---- AFTER: • N/A FT
WIDTH BEFORE (based on normal high water contours): N/A FT
WIDTH AFTER: N/A FT
AVERAGE DEPTH BEFORE: N/A FT AFTER: N/A FT
(2).STREAM CF--pNNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: N/A PLACEMENT OF•PIPE IN CHANNEL :. N/A
CHANNEL EXCAVATION:_ " N/A CONSTRUCTION OF A DAM/FLOODING: N/A
OTHER: N/A
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE
WATERSHED DRAINING TO THE POND? N/A
WHAT IS THE EXPECTED POND SURFACE AREA? X/A
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF
MECHANICAL EQUIPMENT TO BE USED (ATTACH PLANS: 8 1/2" X 11" DRAid:NGS
ONLY): prnnna d work inrlurlPG typical residential road construction. Motor Grader,
front end loaders back hoes, dump trucks, etc.
13. PURPOSE OF PROPOSED WORK: To construct a 23 lot subdivision.
3

14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED
OUT IN WETLANDS. (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND
IMPACTS): Wetlands boundary not delineated at this time.
15. YOU ARE REQUIRED TO CONTACT THE U.S. FISH AND WILDLIFE SERVICE
(USFWS) AND/OR NATIONAL MARINE FISHERIES SERVICE (NMFS) (SEE AGENCY
ADDRESSES SHEET) REGARDING THE PRESENCE OF ANY FEDERALLY LISTED OR
PROPOSED FOR LISTING ENDANGERED OR THREATENED SPECIES OR CRITICAL HABITAT
IN THE PERMIT AREA THAT MAY BE AFFECTED BY THE PROPOSED PROJECT. DATE
CONTACTED: No contact has been made at this time. (ATTACH RESPONSES
FROM THESE AGENCIES.)
16. _YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER
(SHPO) (SEE AGENCY ADDRESSES SHEET) REGARDING THE PRESENCE OF HISTORIC
PROPERTIES IN THE PERMIT AREA WHICH MAY BE AFFECTED BY THE PROPOSED
PROJECT. DATE CONTACTED: No contact has been male at this time.
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OR THE USE OF
PUBLIC (STATE) LAND?
YES El NO C k (IF NO, GO TO 18)
a. IF YES, DOES THE PROJECT REQUIRE PREPARATION OF AN ENVIRONMENTAL
DOCUMENT PURSUANT TO THE REQUIREMENTS OF THE NORTH CAROLINA ENVIRONMENTAL
POLICY ACT?
YES [ ] NO [ ]
b. IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE?
YES [ ] NO [ ]
IF ANSWER TO 17b IS YES,'THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE
STATE CLEARINGHOUSE TO DIVISION OF ENVIRONMENTAL MANAGEMENT REGARDING
COMPLIANCE WITH THE NORTH CAROLINA ENVIRONMENTAL POLICY ACT.
QUESTIONS REGARDING THE STATE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED TO MS. CHRYS BAGGETT, DIRECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION, 116 WEST JONES STREET, RALEIGH,
NORTH CAROLINA 27603-8003, TELEPHONE [phone].
4

18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF
PROPOSED ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OR FILL MATERIAL
INTO WETLANDS: -'
_.a. -WETLAND -DELINEATION MAP SHOWING ALL.WETLANDS, STREAMS, LAKES
AND PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14, 18, 21, 26,
29, AND.38) .-ALL STREAMS _(INTERMITTE`1T_AND PERMANENT) ON THE PROPERTY
MAST BE SHOWN ON THE MAP. MAP SCALES SHOULD BE 1 INCH EQUALS 50 FEET OR
_ _ _ _ _.. • __ • _ _ _
INCH EQUALS -100 FEET _OR -THEIR EQUIVALENT.
b. IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE
IMPACTED BY -PROJECT..--
c. IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA
SHEETS RELEVANT.TO.THE PLACEMENT _OF THE DELINEATION LINE.
d. ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
e. WHAT IS LAND USE OF SURROUNDING PROPERTY?
Residential (RS())-
f.' IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?_
To connect to existing nnhli"r avetam
g. SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE: WETLANDS OR WATERS OF THE U.S. MAY NOT BE IMPACTED PRIOR TO:
1) ISSUANCE OF A SECTION 404 CORPS OF ENGINEERS PERMIT,
2) EITHER THE-ISSUANCE OR WAIVER OF A 401 DIVISION OF
ENVIRONMENTAL MANAGEMENT (WATER QUALITY) CERTIFICATION, AND
3) (IN TIM n-MTTY COASTAL COUNTIES ONLY) , A LETTER FROM THE
NORTH CAROLINA DIVISION OF COASTAL MP"NAGEMENT STATING THE PROPOSED
ACTIVITY IS CONSISTENT WITH THE NORTH CAROLINA COASTAL KAY E-MNT
PROGRAM.
6
0 r. S/PLNT'S SIGNATURE
DATE
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED (18g.))
1
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