19970678 Ver 1_COMPLETE FILE_19970801

State of North Carolina
Department of Environment,
Health and Natural Resources LTIN?FA
4 • •
Division of Water (duality
James B. Hunt, Jr., Governor
Wayne McDevitt, Secretary
p E H N F?
A. Preston Howard, Jr., P.E., Director
APPROVAL of 401 Water Quality Certification
Carroll Investment Properties, Inc.
Post Office Box 9846
Greensboro, North Carolina 27429
September 24, 1997
Guilford County
WQC 401 Project #970678
Dear Sirs:
You have our approval, in accordance with the attached conditions. to place fill material in 0.05 acres of wetlands or waters
for the purpose of constructing a sewer line at Vivian Lane Outfall , Wynnmere Development, Phase I as you described in your
application dated July 29, 1997. After reviewing your application, we have decided that this fill is covered by General Water
Quality Certification Number 3101 This Certification allows you to use Nationwide Permit Number 12 when it is issued by the
Corps of Engineers. 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. Also this approval will expire when the accompanying 404 or CAMA permit expires unless otherwise specified in
the General Certification.
This approval is only valid 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 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). For this approval to
be valid, you must follow the conditions listed in the attached certification. Applicant is reminded that stream relocation is Do
approved for this sewer line.
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 Domey at 919-733-1786.
Attachment
ca Wilmington District Corps of Engineers
Corps of Engineers Raleigh Field Office
Winston-Salem DWQ Regional Office
Mr. John Domey
Central Files
Kelly Hayes; Sutton - Kennerly and Associates
u)(:
Howard, Jr. P.E.
970681tr
Division of Water Quality - Environmental Sciences Branch
Environmental Sciences Branch, 4401 Reedy Creek Rd., Raleigh, NC 27607 Telephone [phone] FAX # [phone]
An Equal Opportunity Affirmative Action Employer • 50% recycled/10% post consumer paper
r"R'MORANDUM PRINT NAMES :
Reviewer: kankin
TO: JOHN DORNEY WQ SUPV.: - 5 a,,
ENVIRONMENTAL SCIENCES BRANCH DATE:-7
SUBJECT: WETLAND STAFF REPORT AND RECOMMENDATIONS
***EACH ITEM MUST BE ANSWERED (USE N/A FOR NOT APPLICABLE) **

PERMIT YR: 97 PERMIT% : 0000678 COUNTY: GUILFORD MM
APPLICANT NAME : WYNNMERE DEV ". PHASE - ---V?V LANE OUT. 90I
PROJECT TYPE: SEWER LINE PERMIT TYPE: NW12, 26 ?ENC?S
` SZ
COE # : DOT #: a
RCD_FROM CDA : APP DATE FRM . CDA : 08/01/97
REG OFFICE: WSRO
RIVER AND SUB BASIN J: 030602
STREAM CLASS: C
WL IMPACT? : Y/(N)
WL_-REQUESTED : N/A
WL__SCORE (#) : NIA
MITIGATION?: Y/(ND
STR INDEX N0: 16-11-14-2
WL_. TYPE : Str'e(-r rY)
WL_ACR__EST? : YAP)
WATER IMPACTED BY FILL?: Y/(N)
MITIGATION-TYPE: rj/(A
MITIGATION_SIZE:N//l DID YOU REQUEST MORE INFO?: Y/(g_)
IS WETLAND RATING SHEET ATTACHED?: Y/C)
HAVE PROJECT CHANGES/CONDITIONS BEEN DISCUSSED WITH APPLICANT?: Y/(N)
RECOMMENDATION (Circle One): ISSUE ISSUE/COND',•DENY
COMMENTS: ?rod Gt involves a -Ctn,?,ctr?, se_v c?- 1?Y?e_ S?0
0- C Cf-V-. 0 IOVIcI 0,5 t1)e_ CUn,? Dons L)C t-he- tiu) 12
G Olto?,?%?'c? a LI01 Ce,.?-66ca-hOn CC?r?? ?E. iSSVE?c?_ `>>r?C
im?c.?ci-; 1-•o c.r?? 1?- we_r? rn;??,?n???eel ca?? ?????r?5-? ???? t-he_r?
in(rmUt?or? 1?1`?j? wc?; ir?ccrrect the C(,Yfect
1u t 44of fyy-01 C? '(1 i S Q'ti R heck .
?- NG 1 trec,t^n r?1CCC?fiic n .?nc c Wk be c?_` }F?cr ?ecl ?r -h.
r-, tieC4,
cc: Regional Office
Central Files
SUTTON-KENNERLY & ASSOCIATES • CONSULTING ENGINEERS
300 POMONA DRIVE PHONE [phone]
GREENSBORO, NORTH CAROLINA 27407-1604 FAX [phone]
July 29, 1997 9 7 0 6 7 8
Dept. of Environment, Health and Natural Resources (D.E.H.N.R.)
Division of Environmental Management (D.E.M)
4401 Reedy Creek Road
Environment Sciences Building
Raleigh, NC 27607
Attn: Mr. John Domey
Re: Vivan Lane Outfall
Wynnmere Development, Phase I
Guilford County, NC
SKA Job No. 96-0182S
Dear John:
'P° ? FGA
Ys
C
Enclosed is the original and a copy of the pre-construction notification application for the Nationwide
Permit (#12) and seven (7) copies of the plan for the project. Please review this submittal for approval
as soon as possible.
Should you have any questions or if you require additional information, please do not hesitate to call.
Sincerely,
Y & ®SSOCIATES E %f
gKeHyE. es, PE.
ivil Engineering
KEH:jm
cc: Jenny Rankin
Al Leonard
_"Wr"
My 29, 1997
SUTTON-KENNERLY & ASSOCIATES
300 POMONA DRIVE
GREENSBORO, NORTH CAROLINA 27 407-1 604
Dept. of Environment, Health and Natural Resources (D.E.11N, K)
Division of Environwental Management (D.F,M)
4401 Reedy Creek Road.
Environment Sciences Building
Raleigh, NC 27507
Attn: Mr- John Domey
Re: Vivan Lane Outfall
Wynnmere Developmeat, Phase I
Guilford County, NC
SKA Job No. 96-0182S
Dear John:
I
CONSULTING ENGINEERS
PHONE :[phone]!=
FAX [phone]
i
RECEIVED
N.C .Dept. of EHNR
AUG - # 1997
Winston-.Salem
Regional Office
• i
Enclosed is the original and a copy of the pre-camstruc6on notification applicati for the Nationwide
Permit (#12) and seven (7) oapies of the plan for the projcct. Please review this Tubmittal for approval
as soon as possible.
Should you have any questions or if you require additional informadcm, please do > of hesitate to call
Sincerely,
S ON-KENNE Y & ASSOCIATES
?j
gKellyE. es, P.E.
ivil Engineering
KF-H:jm
cc: Zemy Rankin
Al Leonard
Post-it" Fax Note 7671 Date 4-A p#egea? I Z.
70 j?/`IN f!,40r-I,,I t=rom
co./Dept. Co.
Phone a Phone a
FeX # Fax N

w
OFM 10,
CORPS ACTION ID_
MATIoNsrZpE PCRM'T REQUESTED (PROVIDE t4A.Tl0\,rWIDE P_RMYT +*f . ?
PRE-CONSTRUCTIOX 1
rr0TT
FaR NATIONWIDE: xCATrQ?" APP `x'
PERMITS THAT PZ Q
QuzRE, _
?7 NOrIFYCATYON ?
2) APPI.ICATtb)1 FOR r CORPS OF ENC,IN$ERS
9) COpRDYN '-SEC2'SpR 402
C?RTIFYCAT.ION
ATTON WzTg T Nc Di%rzsror4
SEND THE oF2IG COASTAL, SENT
FZEZ,D XNAY, Akt)] tz) CO.FY OF xF3TS C
OFFICE OF TN$ CORPS O o EtVGI OMPLE T WZ ]FORM
(?) COPIES SHOULD 8E SENT NEZRS TO TxE PROPA-PA[SEE To
AGENCY ADDR THEN (SEE AGENCY DR"SES
ADDRESSES SH£ S• DIVISION p ENVrROxMERT HEET)- SEVEN
ET). PLEASE P PR INS` _
MANAGEMENT
1. 01"HERS NAME- CARROLL INVES
TMENy' PROPERTIES? iNC.
2- M.AxLING
ADDRESS= P.O. BOX 9$46
SiJBUIvrSION NAME:
4c-,Ty:.
GREENSBORO
STATE: N.C.
PROTECT LOCATXON ADDRESS zrP coDE_ 27429
?ILxNG ADDRESS ASgVE). r INCZUDI'NG svBDrV
ZSIQAT NAME {IF DI FFE I N
S*UTH T F?tOM
ELM,EUGF.ETE STREW, GREENS80R0
3, , N.C_
TELEPHONE NUMBER {ROME)
4- IF APPLICABLE: AGEriT •S {WORK) _ 91027 8531
'"QNE tjUMgER_ NAME OR RESPONS18LZ CORPORATE
OPFXCIA.L1 ADbR£sS,
LOCATION of WORK (PR
?P OR AERIAL, Pff47OGRAPO I WE A MAP' PREFERABLY
'CTNTY. GUxRD ZTH SCAZ,E) . A COPY OF USGS TOP
GRAPHIC
NEAREST TOWN C R ?
R CITY: GREEN$WRO
I

LOCATION (INCLU F ROAD
"UMBERS, L AND t'1RKS, FTC.. 1 ;
--------------
6- IMPACTED OR NEAREST STREAM/RIVDR; SOUTH BUFFALO CREEK
RIVER bASXN. CAPE FEAR RIVER BASIN
7a- IS PRO,7ECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SAI,TAATE?i
(SA), HIGH QUALITY WATERS (HOW), OUTSTANDING RESOURCE WATERS (O W), WATER
SO PPLY (WS-1 OR WS-Ii)? YES ?t
1 ? NO Kh] IF ICES, EXPLAIN:
t
7b- XS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVjsXON O'r OASTAL
' MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC) 7 YES [ ] NO Dot
7c. IF TH$ PROJECT IS LOCATCD WITHIN A COASTAL COUNTY (SEE PAGE 7 FOR
LIST OF COASTAL COUNTIES), WHAT is THE I.&
.ND USE PLAN (LUP) bESx
ION?
Sa. HAVE ANY SECTION 404 PERMITS BEEN PREVaOUSLX REQUESTED FOR ISE ON
THIS PROPERTY? YES j 1 NO (X] IF YES, PROVIDE ACTION Y.D.
PRCVIQUS PERMIT AND ANY ADDITIONAL INFOTION (INCLUDE PHOTOCOP OF 461
CERTIFICATION); NONE KNOWN
8b• ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY
FUTURE? YES [ ) NO CX) IF YES, DESCRIBE ANTICIPATED WORK: ITHE
NONE KNOWiV Ax THIS TIME
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SKA AM NO, 96-01f^S i
NO. P- CI TY_OF ORE 4N S80A0
VIVIAN LANE •IOUtFALL
FROM CEDAR CREEK OUTF 70; \nv1AN LANE
740
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DEM ID: 97 067 8
------------------
CORPS ACTION ID:
NATTOMdIDE PERMIT REQUESTED (PROVIDE NATIONvijDt P::RDMITT y „) 12
PRE-CONSTRUCTION NOTIFICATION .
FOR NATIONWIDE pE AppI.,ICATION
RMITS THAT REQUIRE:
11 NOTIFICATION TO THE
21 APPLICATION CORPS OF ENGINEERS
FOR
31 SECTION 401 CERTIFICATION
COORDINATION WITH THE NC DIVISION OF COASTAL MAN
SEND THE ORIGINAL D AGEMENT (1) Copy OF FIELD OFFICE OF THE CORPS OF ENGINEERS
THIS COMPLETED FORM TO THE
(? ) COPIES SHOULD BE SENT TO THE N (SEE AGENCY A-PPROPRIATE
(SEE AGENCY ADDRESSES SHEET C- DIVISION OF ENVIRONMENTAL SHEET). SEVEN
)- PLEASE PRINT_ MANAGEMENT
I OWNERS NAME: CARROLL INVESTMENT PROPERTIES,
INC_
2- MAILING ADDRESS: P.O. BOX
9846
CITY: GREENSBORO SUBDIVISION NAME: WYNNMERE '-
STATE: N.C.
PROJECT LOCATION ZIP CODE: 27429
MAILING ADDRESS, INCLUDING ADDRESS ABOVE): SUBDIVISION NAME (IF DIFFERENT FROM
SOUTH ELM-EUGENE STREET, GREENSBORO, N.C.
-3- TELEPHONE NUMBER (HOME):
`?• IF APPLICABLE: (WORK): 910-274-8531
SHONE NUMBER: AGENT'S NAME OR RESPONSIBLE CORPORATE
OFFICIAL, ADDRESS,
Nu-1' APPLI
LOCATION OF WORK
OR AERIAL (PHOTOGRAPHY PROVIDE A MAP PREFERABLY A
?IINTY: WITH SCALE): COPY OF
GUILFORD ALE): USGS TOPOGRAPHIC
NEAREST TOWN OR CITY: GREENSBORO

NUMBERS, LANDMARKS, ETC.) :
6. IMPACTED OR NEAREST STREAM/RIVER
RIVER BASIN: CAPE FEAR RIVER BASIN
SPECIFIC LOCATION (INCLUDE ROAD
SOUTH BUFFALO CREEK
7a- IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER
(SA), HIGH QUALITY WATERS (HQW), OUTSTANDING RESOURCE WATERS (ORW), WATER
SUPPLY (WS-I OR WS-II)? YES [ j NO FXj IF YES, EXPLAIN:
7b. IS THE PROJECT LOCATED WITHIN A NORTH. CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES ( ] NO V4
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 909 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON
THIS PROPERTY? YES [ ) NO [X] IF YES, PROVIDE ACTION I.D.
PREVIOUS PERMIT AND ANY ADDITIONAL INFORMATI NUMBER OF
CERTIFICATION): NONE KNOWN ON (INCLUDE PHOTOCOPY OF 401
8b. ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE
FUTURE? YES [ ] NO [Xj IF YES, DESCRIBE ANTICIPATED WORK: _
NONE KNOWN AT THIS TIME
9a- ESTIMATED TOTAL NUMBER OF ACRES IN TRACT OF LAND: 76.01
9b- ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
± 0.05
2

10a. NUMBER OF ACRES OF WETLANDS 11-11-ACTED BY THE, PROPOSED PROJECT BY:
FILLING:
EXCAVATION:
FLOODING:
OTHER: ±0-05
DRAINAGE: -
TOTAL ACRES TO BE IMPACTED: ± p p5
10b. (1) STREAM CHANNEL TO BE IMPACTED BY
RELOCATED, PROVIDE DISTANCE BOTH BEFORE AND AFTER D PROJECT
T
REE LOLOCATION) : (IF
LENGTH BEFORE:
FT AFTER:
WIDTH BEFORE (based on normal high water Contours): T
WIDTH AFTER:
AVERAGE DEPTH BEFORE: FT
FT AFTER:
(2) STREAM CHANNEL IMPACTS WILL RESULT FROM- FT
OPEN CHANNEL RELOCATION: (CHECK ALL THAT APPLY)
PLACEMENT OF PIPE IN CHANNEL:
CHANNEL EXCAVATION:
CONSTRUCTION OF A DAM/FLOODING:
OTHER: INSTALLATION OF SANITARY SEWER PIPE ACROSS CREEK
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT
WATERSHED DRAINING TO THE POND? NOT APPLICABLEIS THE SIZE OF THE
WHAT IS THE EXPECTED POND SURFACE AREA? NOT APPLICABLE
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF
MECHANICAL EQUIPMENT TO BE USED (ATTACH PLANS: 8 1/2" X 11" DRAWINGS
ONLY): GRADING WATER SEWER DRAINAGE CURB b GUTTER PAVEMENT AND UTILITIES
EARTHMOVING PANS, BULLDOZERS, TRACK BACKHOES, ETC. ITIES
?- PURPOSE OF PROPOSED WORK: RESIDENTIAL HOUSING SUBDIVISION
3

I c • STATE REASONS Td.
OUT IN W T HY IT IS BELIEVED H-^
E LANDS. (INCLUDE T r' THIS ACTIVITY MUST
IMPACTS): ANY MEASURES TAEEN TO BE CARRIED
MINZE
EWER LINES GENERALLY FOLLOW CR
EEKSAINWETLAND
D STREAMS AND
OCCASIONALLY N
HAVF Tn lnnn., ...._-
15. YOU ARE REQUIRED TO CONTACT THE U.S. r
(USFWS) AND/OR NATIONAL FISH C AND WILDLIFE SERVICE
ADDRESSES SHEET) REGARDINGR THE PRESENCE FISHERIES OF EF1vYFE(N )
PROPOSED FOR LISTING (SEE AGENCY
RAI,
IN THE ENDANGERED OR THREATENED p LY LISTED OR
PERMIT AREA THAT MAY S.ECIES OR CRIT_CA
CONTACTED= BE AFFECTED BY TEE PROPOSED PROJ£YT L HABITAT
FROM THESE AGENC_T?S.) DATE
(ATTACH RESPONSES
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION
(SHPO) (SEE AGENCY ADDRESSES SHEET) REGARDING THE PRESENCE
.OFFICER -- -
PROPERTIES IN THE PERMIT AREA WHICH OF HISTO
PROJECT. DATE CONTACTED:. MAY BE AFFECTED BY THE PROPOSEDRIC
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUN
PUBLIC (STATE) LAND?
DS OR THE USE OF
YES [) NO (a] (IF NO, GO TO 1 g )
a_ IF YES, DOES THE PROJECT REQUIRE PREPARATION OF
DOCUMENT PURSUANT TO THE REQUIREMENTS OF THE NORTH CAROLIN
POLICY ACT? NA ENVIRONMENTAL
A ENVIRONMENTAL
YES ( ] NO [ )
b- IF YES HAS THE DOCUMENT BEEN
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE?
REVIEWED THROUGH THE NORTH CAROLINA
YES [ ) NO []
IF ANSWER TO 17b is YES THEN SUBMIT APPROPRIATE DOCU14EN
STATE CLEARINGHOUSE TO DIVISION OF ENVIRONMENTAL MANAGEMENT REGARDING
COMPLIANCE WITH THE NORTH CAROLINA ENVIRONMENT TATION FROM THE
QUESTIONS REGARDING THE STATE CLEARINGHOUSE REVI POLICY ACT.
DIRECTED TO MS. CHRYS BAGGETT, EA PROCESS SHOULD BE
CAROLINA DEPARTMENT OF DIRECTOR STATE
03 A MINfSTRATION T JONEt?STRE E, NORTH
NORTH CAROLINA M
116 WEST JONES STREET, RALEIG}l,
TELEPHONE [phone].
4

I'.- THE FOLLOWING ITEMS S
PROPOSED ACT IV HE BE INCLUDED WITH THIS APPLICATION
ITY INVOLVES THE .., ,.?„ IF
INTO WETLANDS: :' -i OR FILL
MATERIAL
a. WETLAND DELINEATION MAP SHOWING ALL WETLANDS
AND PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERSTRgAMS, LAKES
29, AND 38)- ALL STREAMS (INTERMITTENT AND
MUST BE SHOWN ON THE MAP_ PERt4ANENT) ON THE 10, 21, PROPERTY6?
INCH EQUALS 100 FEET OR MAP SCALES SHOULD BE 1 INCH EQUALS 50 FEET OR
b• IF AVAILABLE, REPRESENTATVALEWT_
IMPACTED BY PROJECT. ZVE PHOTOGRAPH OF WETLANDS TO BE
C. IF DELINEATION WAS PERFORMED
SHEETS RELEVANT TO THE PLACEMENT OFTHEYDELINEATIONNLINE-
INCLUDE ALL DATA
d- ATTACH A COPY OF THE STORMy,1ATER MANAGE
e- WHAT IS LAND USE OF SURROUNDING P OPERTYNT PLAN IF REQUIRED.
RURAL RESIDENTIAL,
I
f- IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
PROPOSED PUBLIC SANITARY SEWER
9- SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE: WETLANDS OR WATERS OF THE U-S -
1) ISSUANCE OF A SECTION 404 U.S. MAY NOT BE IMPACTED PRIOR TO:
2) EITHER THE ISSUANCE OR WAIVE CORPS
A 401IDIVISION PERMI,
OFT
ENVIRONMENTAL MANAGEMENT (WATER QUALI
3) (-TN THE TWENTY COASTAL COUNTIES) ONLRT I FI CAT ION , AND vORTH CAROLINA DIVISION OF COASTAL ? ? A LETTER FROM THE
%CTIVITY IS CONSISTENT WITH THE NORTTHNAROLIN STATING THE PROPOSED
?ROGRAM- CAROLINA COASTAL MANAGEMENT
WNER'S/ GENT'S SIGNATURE
AGENT'S SIGNATURE VALID ONLY
F AUTHORIZATION LETTER FROM
IiE OWNER IS PROVIDED (lgg_)?
-;;?` 'f e-1-?- 7
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DEM ID: 7z) & CORPS ACTION ID:
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONYiIpE P?F u
MIT „ 12
PRE -CONSTRUCTION NOTIF.IC
FOR NATIONWIDE PE ATION APPLICATION
RMITS THAT RE4UIRE: _
I) NOTIFICATION TO T
2) APPLICATION FOR HE CORPS OF ENGINEERS
3) COORDINATION WITH THE SECTION NC 40, DIVISION OF SEND OF COASTALN
THE ORIGINAL AND
MANAGEMENT
FIELD OFFICE OF (Z) COPY OF THIS CO
(7) COPIES S)IOULDHE S CORPS OF MPI-EYED FORM TO THE
ENGINEERS (SEE AGENCY APPROPRIATE
(SEE AGENCY ADDRESSES SHEET) THE N_C_ DIVISION ADDRESSES SHEET
• PLEASE OF ENVIRONMENTAt, ) - SEVEN
PRINT_ MANAGEMENT
I OWNERS NAME_ CARROLL INVESTMENT PROPERTIES, INC
2• MAILING ADDRESS: P.0_
- BOX 9846
CITY: GREENSBORO SUBDIVISION NAME: WYNNMERE
STATE: N.C.
PROJECT LOCATION ZIP CODE: 27429
MAILING ADDRESS, INCLUDING
ADDRESS ABOVE): SUBDIVISION NAME
(IF DIFFERENT FROM
SOUTH ELM-EUGENE STREET
GREENSBORO, N. C.
3. TELEPHONE NUMBER (HOME):
1- I F APPLICABLE: (WORK): 910-274-8531
AGENT'S NUMBER: NAME OR RESPONSIBLE CORPORATE OFFICIAL,
ADDRESS,
LOCATION OF WORK
P OR AERIAL (PROVIDE A MAP, PREFERABLY A
PHOTOGRAPI?y WITH SC COPY OF
P OR GUILFORD ALE): USGS TOPOGUNTY:
RAPHIC
NEAREST TOWN OR CITY: GREENSBORO
I

NUMBERS, LANDMARKS, ETC.
SPECIFIC LOCATION (INCLUDE ROAD
6. IMPACTED OR NEAREST STREAM/RIVER: SOUTH BUFFALO CREEK
RIVER BASIN: CAPE FEAR 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-I OR WS-II) ? YES ( J NO ({X] IF YES, EXPLAIN:
7b. IS THE PROJECT LOCATED WITHIN A NORTH. CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES ( ] NO DM
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 909 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON
THIS PROPERTY? YES ( ] NO [X] IF YES, PROVIDE ACTION I-D. NUMBER OF
PREVIOUS PERMIT AND ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 901
CERTIFICATION): NONE KNOWN
8b- ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE
FUTURE? YES ( ] NO (X] IF YES, DESCRIBE ANTICIPATED WORK: _
NONE KNOWN AT THIS TIME
9a- ESTIMATED TOTAL NUMBER OF ACRES IN TRACT OF LAND: 76.01
9b- ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
± 0.05
2
r '
10a- NUMBER OF ACRES OF WETLP_NDS iNDACTED BY THE PROPOSED PROJECT BY:
FILLING:
`XCAVATION:
FLOODING:
OTHER: ± 0.05
DRAINAGE: -
TOTAL ACRES TO BE-IMPACTED: + Q 05
10b. (1) STREAM CHANNEL TO BE IMPACTED By
RELOCATED, PROVIDE DISTANCE BOTH BEFORE PROPOSED CT (IF
LENGTH BEFORE:
AFTER:
WIDTH BEFORE (based on normal high water contours):
WIDTH AFTER: FT
AVERAGE DEPTH BEFORE: FT
FT AFTER:
(2) STREAK] CHANNEL IMPACTS WILL RESULT _
FROM
OPEN CHANNEL RELOCATION: ? (CHECK ALL THAT APPLY)
PLACEMENT OF PIPE IN CHANNEL:
CHANNEL EXCAVATION: ----
CONSTRUCTION OF A DAM/FLOODING:
OTHER: INSTALLATION OF SANITARY SEWER PIPE ACROSS CREEK
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT
WATERSHED DRAINING TO THE POND? NOT APPLICABLEIS THE SIZE OF THE
WHAT IS THE EXPECTED POND SURFACE AREA? NOT APPLICABLE
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF
MECHANICAL EQUIPMENT TO BE USED (ATTACH PLANS
DNLY): : g
GRADING WATER SEWER DRAINAGE CURB &1GUTTER 1 PAVEMENT NAND UT
UTILITIES
-- EARTHMOVING PANS, BULLDOZERS, TRACK BACKHOES, ETC.
3_ PURPOSE of PROPOSED WORK: RE__ SIDENTIAL HOUSING SUBDIVISION
3

lc - STATE REASONS IaH.
CUT IN WETLANDS. Y IT IS BELIEVED TH
( INCLUDE T - EN T H INIMIY MUST BE CP.RRIED
IMPACTS) :
ANY ?`!EASURES -_'F'
gANITAgy WETLAND
EWER LINES GENERALLY FOLLOW CREEKSAND STREAMS AND
OCCASIDRALLY HAVF ern r ----
15_ YOU ARE REQUIRED TO CONTACT THE U.S. r
(USFWS) AND/OR NATIONAL MARINE F-SH AND IaILDLIF?
ADDRESSES SHEET FISHERIES SERVICE D E , SERVICE
REGARDING THE PRESENCE OF ANY FE RAL) (SEE AGENCY
PROPOSED FOR LISTING ENDANGERED
IN THE D r OR THREATENED SPEDI S LISTED OR
RMIT AREA THAT MAY BE CRIT_CA T
CONTACTED. AFFECTED BY THE PROPOSED PROJE._T L A.yBITAT
FROM THESE AGENCI?S_) DATE
(ATTACH RESPONSES
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION
(SHPO) (SEE AGENCY ADDRESSES SHEET) REGARDING THE PRESENCE
.OFFICER -
PROPERTIES IN THE-PERMIT AREA WHICH MAY BE AFFECTED BY THE PROPOSED
PROJECT. DATE CONTACTED:- OF HISTORIC
17. DOES THE PROJECT INVOLVE
PUBLIC (STATE) LANDS AN EXPENDITURE OF PUBLIC
• FUNDS OR THE USE OF
YES ( ) NO P9 ( I F NO, GO TO 18 )
a. IF YES, DOES THE PROJECT REQUIRE PREPARATION OF
DOCUMENT PURSUANT TO THE REQUIREMENTS OF THE NORTH CAROLIN
POLICY ACT? NA ENVIRONMENTAL
A ENVIRONMENTAL
YES [ ] NO ( )
b- IF YES HAS THE DOCUMENT BEEN REVIEWE DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE?
THROUGH THE NORTH CAROLINA
YES () NO [)
IF ANSWER TO 17b IS YES THEN SUBMIT APPROPRIATE DOCUMENT
STATE CLEARINGHOUSE TO DIVISION OF ENVIRONMENTAL MANAGEMENT REGARDING
AT. FROM THE
COMPLIANCE WITH THE NORTH CAROLINA ENVIRONMENT POLICY ACT.
QUESTIONS REGARDING THE STATE CLEARINGHOUSE REVI
DIRECTED TO MS_ CHRYS BAGGETT, Eh PROCESS SHOULD BE
CAROLINA DEPARTMENT OF DIRECTOR STATE
NORTH CAROLINA ADMINISTRATION T JONEI?STRE E, NORTH
27603-8003, 116 WEST JONES STREET RALEIGH,
TELEPHONE [phone].

I°- THE FOLLOWING ITEMS SHOULD BE
PROPOSED F LWI , E INCLUDED WITH THIS APPLICATION
ACTVITY INVOLVES THE .., IF
_TNTO WETLANDS: Ok FILL MATERIAL
a• WETLAND DELINEATION MAP SHOWING ALL WETLANDS, LAKES
AND PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERST14 , 1.0, 21,
29, AND 33). ALL STREAMS
MUST N
BE .
SHOWN ON THE A (INTERMITTENT AND PERMANENT) ON THE PROPERTY6,
INCH EQUALS 100 FEET OR THEIRPEQSCALES UIVALENTOULD BE 1 INCH EQUALS SO FEET OR
b- IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE
IMPACTED BY PROJECT.
C. IF DELINEATION WAS PERFORMED
SHEETS RELEVANT TO THE PLACEMENT OFTHEYDELINEATIONNLINE-
d- ATTACH A COPY OF THE STORMyiATER INCLUDE ALL DATA
MANAGEM
e. WHAT IS LAND USE OF SURROUNDING P OPERTYNT PLAN IF REQUIRED_
RURAL RESIDENTIAL
I
f- IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
PROPOSED PUBLIC SANITARY SEWER
----- ----------
9- SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE: WETLANDS OR WATERS OF THE U.S.
1) ISSUANCE OF A SECTION qpq MAY NOT BE IMPACTED PRIOR TO:
2) EITHER THE ISSUANCE OR WAIVERP OF A 401IDIVISION OFT
ENVIRONMENTAL MANAGEMENT (WATER
QUALITY) 3) (IN THE QUALITY) CERTIFICATION, AND
vORTH CAROLINA DIVI IONCOFSCOASTAL ANA ONL
A TING LETTER FROM THE
\CTIVITy IS CONSISTENT WITH THE NORTH GEMENT STATING THE PROPOSED
'ROGRAM_ CAROLINA COASTAL MANAGEMENT
,WNER' S/ GENT' S SIGNATURE
DATE
AGENT'S SIGNATURE VALID ONLY
F AUTHORIZATION LETTER FROM
HE OWNER IS PROVIDED (Igg•))

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