19970807 Ver 1_COMPLETE FILE_19970922

State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Wayne McDevitt, Secretary
A. Preston Howard, Jr., P.E., Director
r
Q??
D E N R
December 31, 1997
DWQ Project #970807
Moore County
APPROVAL, of 401 Water Quality Certification and ADDITIONAL CONDITIONS
Mr. Michael Daley
330 McDeeds Creek Rd
Carthage NC 28327
Dear Mr. Daley
You have our approval. in accordance with the attached conditions and those listed below, to place
fill material in 0.68 acres of wetlands or waters for the purpose of constructing a pond at Y-83 CCNC as
you described in your application dated September 19, 1997. After reviewing your application, we have
decided that this fill is covered by General Water Quality Certification Number 3108. This certification
allows you to use Nationwide Permit Number 26 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 Stormw•ater, Non-Discharge and Water Supply
Watershed regulations. This approval will expire when the accompanying 404 or CAIMA 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 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.
1. Deed restrictions. conservation easements or similar mechanisms shall be placed in lots with
remaining jurisdictional wetlands and waters to restrict future wetland and/or impact. These
mechanisms shall be put in place within 30 days of the date of this letter or the issuance of the
404 Permit (whichever is later).
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 27437, 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 Dom at 919-733-1786.
iSinc rel
st How
Attachment
cc: Wilmington District Corps of Engineers
Corps of Engineers Wilmington Field Office
Fayetteville DWQ Regional Office
F,J9M_D m. qy
Thomas Blue; C.H. Blue and Associates
Central Files
970807.1tr
Division of Water Quality • Non-DischargeBranch
4401 Reedy Creek Rd., Raleigh, NC 27607 Telephone [phone] FAX # [phone]
An Equal Opportunity Affirmative Action Employer • 50% recycled/10% post consumer paper
Telephone: [phone]
www.longleafcom
C. H. Blue & Associates, P.A.
1271 Old Highway #1 South • P.O. Box 811
Southern Pines, NC 28387
September 19, 1997
Mr. John Dorney
Division of Environmental Management
N.C.D.E.H. & N.R.
4401 Reedy Creek Road
Raleigh, NC 27607
RE: Proposed Pond
Pre-Construction Notification Application
Dear Mr. Dorney,
Facsimile: [phone]
. [e-mail]
r1ECEI VED
'SEP 2 2 1997
SWIROA14iK4800CE5
Please find enclosed seven (7) copies of a Pre-Construction Notification Application for a small pond on a six acre tract in
Pinehurst, NC. The placement of this small pond has been requested by Michael Daley. No other impact has been requested
or is expected.
Thank you for your time in this matter. If you have any questions or comments, please feel free to contact me at your
convenience.
Sincerely,
Thomas S. Blue
enclosures
daleydem0l.lwp
Land Surveying • Land Planning
Environmental Consulting
\ AV
IVKMORANDUM PRINT NAMES:
Reviewer:
P0: JOHN DORNEY WQ SUPV.:
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 NO: 0000807 COUNTY: MOORE
APPLICANT NAME: MICHAEL DALEY
PROJECT TYPE: POND PERMIT TYPE: NW26
COE #: DOT #:
CDA:
RCD
FROM APP DATE_FRM_CDA: 09/22/97
_
_
REG OFFICE: FRO
ZIVER AND_SUB_BASIN_# :,r3 p 7S0 STR_INDEX NO :
STREAM-CLASS: V
WL_IMPACT?:(,,N
WL_REQUESTED:
WL_SCORE M : &,Z-
MITIGATION?: Y/N
WL TYPE :
WL_ACR_EST? 6N
WATER IMPACTED BY FILL?:ON
MITIGATION-TYPE:
m
o 0
c:
z
c
MITIGATION-SIZE: DID YOU REQUEST MORE INFO?: Y/N
IS?WETLAND RATING SHEET ATTACHED?:?N
HAVE PROJECT CHANGES/CONDITIONS BEEN DISCUSSED WITH APPLICANT?. Y N
RECOMMENDATION (Circle One): ISSUE SSUE/COND DENY

cc: Regional Office
Central Files

'•r3•:•:+:• ^::y':fi%:3 :c33 :r:3:: r::3ii33i'-"`
:;-r.;r.:.::.yr:.:--;;•:t•: `? ..y.: :ay: :.x.,,:-r-
...f!;;ur.:;... :, .-; \. • .?:. ..f..,:, 3:;?:y? `r%:»:yy.. :f rflry ?.?.?by ,p,,.,r,, tZ::•»; 33 :Y'.?:r.:
'?'%G:? i:;?:y+` .:•r},rr/:;E%:av.,i-k%?C{:.:.'R...'?`?:4.yc..!to::.y:.:t.;:;.,•:.y:.3:.:-:y:;r: i;;::., r: .,,.^^?C:r.:..;:?:?:??.,., ..,'°£ .y.. .),. .,
:.<•:•:::.-.,oar u`,•s3;.::.1..,.fi .. .... .. ... .......,:... ..,: .: .... ... ?xi;,•T.y?fi.•.,?`.,/!/!'%t'! %'cy ty
ara.; ..{.!{. ..:'S: ••: ?:iJG:\ ':i ' 'i!. "F'. .. r.?l??i?fc4.:. ,-'4t!::
-.v.. , a..: oyaw•::::: •::::. :3 k• 'riS'3:t;"'y ::? t3.:3S.:.{-..y:-:ir: :r3•`::31:
-::r,?3<: •{./. •{'..;:?•?ti.:r:•:;?t:•;24iii:•::::.,.,,.:::.•::..x?ia?t3:?ix.:.K.!H'.v:S.,,\•S.Cri33t::•>..•:.4•Yrv,?/..3:?\???.???ri.•'ifia'cy?..+,:?u:. .:.1:.
qp?
r)
Project Name Nearest Road
County We d Area acres Wetland Width feet
Name of evaluator Date "(-
Wetland Location
on pond or lake
,j,Sn perennial stream
on intermittent stream
within interstream divide
other
Soil series
predominantly organic - humus, muck,
or peat
predominantly mineral - non-sandy
predominantly sandy Li, 5i'
Hydraulic factors
steep topography
ditched or channelized
total wetland width a 100 feet
Adjacent land use
(within 1/2 mile upstream, upslope, or radius)
f ested/natural vegetation %
gdcultur urban/su an /? o/
impervious surface %
Dominant vegetation
(1)
(2)
(3) ?.
and wetness
' semipermanently to permanently
flooded or inundated
seasonally flooded or inundated
intermittanly flooded or temporary
surface water .
no evidence of flooding or surface water
Wetland type (select one)*
• Bottomland hardwood forest Pine savanna
Headwater forest Freshwater marsh
Swamp forest Bog/fen
Wet flat Ephemeral wetland
Pocosin Carolina Bay
Bog forest Other
*the rating system cannot be applied to salt or brackish marshes or stream channels
----- - ______M
R
A
T'
I
N
G
Water storage
Bank/Shoreline stabilization
Pollutant removal
Wildlife habitat
Aquatic life value
x
*x
x
-- x
weight
4.00 =
4.00 =
x
5.00 =
2.00 =
4.00 =
Recreation/Education Ll- x 1.00 =
t
Wetland
*Add 1 point if in sensitive watershed and >I 0% nonpoint disturbance within 1/2 mile upstream,
_ u?slopei or radius
NOV. 7.1997 2:29PM ENVIRONMENTAL MGMT;
TO
t
SU
A
Rj

V
Ct
ORANDUM
JOAN DORNEY ,
ENVIRONMENTAL S(
BJECT: WETLAND STAFF REPORT E
-lc**EACTI ITEM MUST BE AN.'
PERMIT YR: 97 PERMIT)
PPLICANT NAME: MICHAEL DALEY
PROJECT TYPE: POND
COE ??
RCD_PROM CDA: APP
REG OFFICE: no
I
VERr,AND-= BASIN :ei 5iP 754 1
ST",AM_CLASS: C/
WL-IMPACT?: V
;
w? ?E??sTEn : ? ? ?
WL S CORE M : ((.r I
I
MITIGATION?: Y/N
MITIGATION-SIZE:
I S WTLM R4
i
HAVE PROJECT CHANGES / CONDITI6
RECOMMENDATION (C1I:
??TT
OMMPJ1VTa?. ? ? „?
afflme-
f ? ? r r ?J
44
>r
Regional Office
Central Piles
S?SNT ; Lag:
Reviewer :
WQ' $UPV.
NO.229 P.5i6
I: TINCE?? DATE
i 9
RT1 I OATS
FOR
,; I ?Ia I PER
OT APPLICABLrE) ***
COUNTY: MOORE
T_TYPE: NW25
POT #:
RM CDA: 09/22/97
No:
I I
, ,
+ I I
' •
,; I ? I
'i ? fW? APE:
,
???? i ! I

' le
WL_CR EST? 6N
i
k? l I' ? '?TED' 8IY FILL?: N
I
;I
I ICATI0x mE:
, I
DTTk
i0 I?
I
I I? I
BEST Irk INFO? : Y/N
II''
i " I
ING ?! 4
IE ;I ? ?
ACHE]) -?1 N
BEI D`, ED' WxTH APPLICANT? "U''1''

le
^?S
SS I CO DENY

14
Alp

e S I I. I ?I I t

'
i
ital d
A IM
r I I Ir
( I

11?, , I ? ,I li'' I ,
l
c
}

w?
1
NOV. 7.1997 2:29PM ENVI
Project Is
County-
'Name of
Wedand Location
on pond or WM
-4,:--Wn perennial Mom ?V
on into m ttent str m
_ within interstre m divide
other ,
Soil
T i9l ;

N0.229 P. 6/6
pnv iaaa use
1A mile upstream, upsloM or radius)
;i eStedjl?lalill'Adl etoQD- %
agricultu 'urban/su ° a
,i pirvio surface %

- predominantly organic - hums' ,ti muck
or peat
mineral - on-
r
d
inantl
I to
.
y
e
om
- p y
,

.44 predominantly dy 5i` %
' '
ling ia
Hydraulic factors
Steep topography ?i pods
ditched or chanaelixed
total wetland width a 100 feel I } ' I '
._r. afac
i n
cM

Wetland type (select one)*
Rottomlard hardwood'
• t rest
_.?,. ! '
` ' ! F
Headwater forest ! , j rts
Swamp forest i ;I BOB
wet tat 2ph
Por,oSia ?' ;; ! ' ` ' err
; Cal,

tientiy to parmaaently
inundated
t]ooded or inundated
ply Sooded or temporal
zer
oi:` ftoding or surface water
ter marsb
-al wctlimd
Day
sog 4L01'C5t 1. 1! .I' -
0
R Water storrag,? .
A B=WShorelnne stabilizatio
pollutant remova
r
Wlldlifb latbiu;
N Aquatic He vadu,,
Cy ltecreationlEducado, .... r
*Add I point if in sensitive waterst ; and
u?sloor radius

narsbos or stream ebanuda

4 = wetland
Rating
?. x 4
_
,00
x 5 ,00
=
x 2 .00 =
L.. x .00!.
L.
x 1 =
. ?t &Stu ance within 112 mile upstream,
NCWRC, HCP , FALLS LAKE TEL : 9'19-520-9839
Oct 16,97 9:47 No. 003 P.02
North ?, 6
"-- - 51z i'~,7. `=, tlis ucy Arm, Tack in, WAS Caro _" 27604-1188, 913-733-3391
Chat es r,x.'Full v , Execa*ivi . i tcar
P
'`1
161997
>•.A&C_.. 11 rL <. t_ykj i.l 4.,.+.rn,,I l?;°.?.ttt:i J.?.;:c:., :5t, a?`SA alr-fib Daley, I"„il. -G !t N f: h
t; .$!-,ina, i ? Alf i IT) # 9, °, 807 UT Aberdeen Cxeekt ? xi?r l,y} l? `
i } 7j 4:r
x7 3t P r 1 st'z} iaf' h s`,Li4?? .omra2i.;,3 OFa s a+ff hz,. E` Ie,,. ti. Vek4
+ r} a v f rp iii i tJ lai i;} ti `1tAlod tri
i TSeno b ? 't w ,t c-nAh 1. WaFa it ,b aZw ?:`:ihae: of t{le project a V4: _
4. 4?? YVac : c' .?.. 1 A asra T c ? L1Z? of he sG.3«.:t v'8it:'.r ,-t 4:t of 1
we Fish ,.i, i Aw 48 Stat, 4031, as ami5.e1'dede U. S C. 6 j -61 7 dy
? ? }.tr C.kt. t}` , ':. u ?7C1."I irripalti ag M8 acres o tdx?;c!S 3411d 41i34_.. W.
r ? to 4L:fi.''.•Ls
,r ,gat
tvt .: a ri_',ilts z,! .? _}'_ :"'een Crc'EtC.. A cha?nw- will be wonstmcted to thi (-UlflC?ii' f,', T7
t`_ g e.(4,ni " ,".. t 5¢ ftet., below the d.ai-n L?' eTe ripra, mill lie t la,-,Cd
a y
tC? Wpm energy 2% drain r51 ?h. 1b Y lloSli' 1s7. 1'.? f.. b?`l±i al??} be in l't?lled Lth the cutHo" .
li'i of :t1? ? NQ re Ali},, t ?3 ? < L i?c7Y'1S?5?er ±'tlo`'.'filg
the i uTo , of dlt_ ,.}i M'_a pipe to the 43ti70 ,fit of & co astru ted cha_', e! to bnefit from One tay,`agy
a=.isa.rrtca.^}-
er.
i! g Out An t,,..unviy },'t?Y149'.itions b incorporated into il?, ji i-, `vdt to protect "'he
is iii'! E t"9 L$ :i! E ?'i i"( it abitms!
,':6_._.,:.iy i?.igct??t±. Or ii.ris£cts to ?•'C'?„t?,i:d_ ,?_l v t.L' S: .:''.1'',.
... F: t<Ai)e'v s ~:,'
t
Ati=L11ic ?sC :> res -io ions on, al remcaini'sig'Jb`elaa` ds and stream on ?'[5¢e We to ;;.,,; tect
i. v.. i r rl i3n.14a -
[ iy dis1-,abed v ctlland Ue4,;, :Uch us
Whan Lbsocr'wL?-? S.iCiI,,Jd be minimized, Te±li}7ofa
the dr•yl>1.::hE ::how'd b(i, s<? ?? k w _`i? annual sir;? F! grains, aippro i fate, f-or t1w. s; a'so 7
i7aiM ': heW tyr c: nmv-I es'xdi a) as soon cis po,s ble and be allo-wt?? to reveii to,
Tlliin,l: U'oa for the [Y,py7:ortC,anit°,f' to review mad Ca^.'a"T'lI7 ent on this application, if l c an bee of
A rther assistance, picsasc contact nee,zt [phone].
MC/0FA/0fa
rc 1
DEM ID: (.) 0 8 11 CORPS ACTION ID:
tATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #) :
PRE-CONSTRUCTION NOTIFICATION APPLICATION
`?ECE?V?C7
FOR NATIONWIDE PERMITS THAT REQUIRE:
SEP 2 2199,7
1) NOTIFICATION TO THE CORPS OF ENGINEERS ENVIFjnN
2) APPLICATION FOR SECTION 401 CERTIFICATION MENTgLSClENCES
3) COORDINATION WITH THE NC DIVISION OF COASTAL MANAGEMENT
SEND THE ORIGINAL AND (1) COPY OF THIS COMPLETED FORM TO THE APPROPRIATE
FIELD OFFICE OF THE CORPS OF ENGINEERS (SEE AGENCY ADDRESSES SHEET). SEVEN
i7) COPIES SHOULD BE SENT TO THE N.C. DIVISION OF ENVIRONMENTAL MANAGEMENT
(SEE AGENCY ADDRESSES SHEET). PLEASE PRINT.
1. OWNERS NAME: Michael Dale
'. MAILING ADDRESS: 330 McDeeds Cree k
;CITY: Carthage
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE) : Y-83 CCNC (Cypress Point Drive)
Pinehurst, NC28374
3. TELEPHONE NUMBER (HOME): [phone] (WORK) : [phone]
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER: Agent: Thomas S. Blue C.H. Blue & Associates, P.A.
1271 Old Highway 41 South Southern Pines, NC 28387
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AERIAL PHOTOGRAPHY WITH SCALE) :
COUNTY: Moore NEAREST TOWN OR CITY: Pinehurst
SUBDIVISION NAME: McDeeds Creek
STATE: NC
SPECIFIC LOCATION (INCLUDE ROAD
ZIP CODE: 28327
NUMBERS, LANDMARKS, ETC.): Intersection of Cypress Point Drive and
Saint Andrews Drive in CCNC (subdivision)

6. IMPACTED OR NEAREST STREAM/RIVER: Aberdeen Creek
RIVER BASIN: Lumber
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 [ ] 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 (yj
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?
non-CAMA
8a. HAVE ANY SECTION 404 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 401
CERTIFICATION):
8b. ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE
FUTURE? YES [ ] NO [X ] IF YES, DESCRIBE ANTICIPATED WORK:
9a. ESTIMATED TOTAL NUMBER OF ACRES IN TRACT OF LAND: 6.06
9b. ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
1.87
10a. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: 0.20 EXCAVATION: n/a
FLOODING: 0.46 OTHER: 0.02 (drain pipe construction)
DRAINAGE: n/a TOTAL ACRES TO BE IMPACTED: 0.68
10b. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF
RELOCATED, PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION):
LENGTH BEFORE: 400 FT AFTER: 475 FT
WIDTH BEFORE (based on normal high water contours): approx. six FT
WIDTH AFTER: varies (pond surface) six to two hundred
AVERAGE DEPTH BEFORE: 1/2
FT
AFTER: 1/2 to ten
FT
FT
(2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: X PLACEMENT OF PIPE IN CHANNEL: X
CHANNEL EXCAVATION:
CONSTRUCTION OF A DAM/FLOODING: X
OTHER: energy dissipator at outfall
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE
WATERSHED DRAINING TO THE POND? 179-ar res
WHAT IS THE EXPECTED POND SURFACE AREA? 0.69
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPMENT TO BE USED (ATTACH PLANS: 8 1/2" X 11" DRAWINGS ONLY):
construction of small pond using standard heavy equipment for
1-1Parinq, grarlinq, and structure placement
13. PURPOSE OF PROPOSED WORK: construction of small pond
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED
OUT IN WETLANDS. (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS):
Contours will not allow placement of pond in another area, size and
lacement of dam moved to minimize impact, size of pond reduced to
decrease impact
15. YOU ARE REQUIRED TO CONTACT
AND/OR NATIONAL MARINE FISHERIES
SHEET) REGARDING THE PRESENCE OF
LISTING ENDANGERED OR THREATENED
AREA THAT MAY BE AFFECTED BY THE
n/a
THE U.S. FISH AND WILDLIFE SERVICE (USFWS)
SERVICE (NMFS) (SEE AGENCY ADDRESSES
ANY FEDERALLY LISTED OR PROPOSED FOR
SPECIES OR CRITICAL HABITAT IN THE PERMIT
PROPOSED PROJECT. DATE CONTACTED:
(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: n/a
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OR THE USE OF
PUBLIC (STATE) LAND?
YES (I NO t(] (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 [I NO [j
b. IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE?
YES (I 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].
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 (INTERMITTENT AND PERMANENT) ON THE PROPERTY MUST
BE SHOWN ON THE MAP. MAP SCALES SHOULD BE 1 INCH EQUALS 50 FEET OR 1 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 subdivision
f. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
conventional septic system
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 THE TWENTY COASTAL COUNTIES ONLY), A LETTER FROM THE
NORTH CAROLINA DIVISION OF COASTAL MANAGEMENT STATING THE PROPOSED
ACTIVITY IS CONSISTENT WITH THE NORTH CAROLINA COASTAL MANAGEMENT
PROGRAM.
OWNER' /AGENT'S SIGNATURE
C? S /f? Z
DAT
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED (18g.))

BATS. Pl
C ?rt
I VICINITY MAP

JO 0 b w 40
Scale t" = 30'
Curve Oata
fi?M _
l
' 0> p? W T ' R ' LG C
1
Cf 033-
u'Iq'SJ" STOq'J5- ST?t'26? M pC1T9! E 62.83 IN.]9 119.36 110.12 1216 1.36'
C3 d'2 J 6 '21 3 OJN JS W'S? ?J M 6051 M E J4D6 1627.) M.0] Am 6)t Q]?
SJ 3 23 66 C6M 06'W 1J i6]J6 N 19J.)0. WI.)? J62.t6 JT.6? 1 Tt 14.32
i LOT Y-83 CCNC
PINEHURST, NC
JURISDICTIONAL WETLANDS
m ar ?, PREPME0 FOR:
"k-l flaky (910 295-5501)
C,r qe. NC 28327
C. H. BLUE
ASSOCIATES. P.A
I
I\,t
2
I /
SITE t ?`\ `Y

otal)
4a '!
f
Acres (total)
.l
4I.i

\R/Ir
rrm
Pinehurst
Medical
Clinic, inc.
PRACTICE OF INTERNAL MEDICINE
JOSEPH S. HIATT. JR.. M.D.
FOUNDER 1952
MAILING ADDRESS
AND EAST LOCATION
205 PAGE RD.. PINEHURST. NC 28374
[phone]
DAVID G. ALLEN, M.D.
ONCOLOGY
THOMAS J. BARTHOLET, MJ).
INTERNAL MEDICINE
GREG L. CLARY, M.D.
INTERNAL MEDICINE
F. FARRELL COLLINS, JR., M.D.
DISEASES OF THE CHEST
DAVID M. COWHERD, M.D.
INVASIVE CARDIOLOGY
CLAY C. DAUGHTRIDGE, JR., M.D.
INTERNAL MEDICINE
KEITH E. DAVIS, M.D.
INVASIVE CARDIOLOGY
SCOTT J. DENARDO, M.D.
INVASIVE CARDIOLOGY
ANDREW N. DENTINO, M.D.
GERIATRICS
ROBERT L. DEUCHER, M.D.
INTERNAL MEDICINE
BOBBY R. MAYNOR, JR., M D.
INTERNAL MEDICINE
PHILIP G. MONDI, M.D.
INTERNAL MEDICINE
WALTER S. MORRIS, III, M.D.
INTERNAL MEDICINE
JOSEPH L. PARRISH, M.D.
1NVASIVE CARDIOLOGY
F.M. SIMMONS PATTERSON, JR., M.D.
CARDIOLOGY
JAMES A. TART, M.D.
CARDIOLOGY
ELLEN M. WILLARD. M.D.
ONCOLOGY AND HEMATOLOGY
WEST LOCATION
112 MEMORIAL DR., PINEHURST, NC
TERRI L. CARRON, M.D.
INTERNAL MEDICINE
MICHAEL B. DALEY, M.D.
INTERNAL MEDICINE
JACKSON V. GIBSON, M.D.
INTERNAL MEDICINE
DAVID F. MARTIN, M.D.
GASTROENTEROLOGY AND ENDOSCOPY
THOMAS M. SWANTKOWSKI, M.D.
GASTROENTEROLOGY AND ENDOSCOPY
DIANE M. WILLIAMS, M.D.
GASTROENTEROLOGY AND ENDOSCOPY
NEESE LOCATION
102 GOSSMAN DR., SOUTHERN PINES, NC 28387
[phone]
DONALD K. WALLACE, M.D.
GERIATRICS AND INTERNAL MEDICINE
September 9, 1997
Mr. Thomas Blue
1271 Old Highway #1
Southern Pines, N.C. 28387
Dear Mr. Blue:
This letter is to confirm our business
arrangement. As you are aware, I have
contracted you to assist me with the process
of developing a lake on my property at the
Country Club of North Carolina, lot #Y 83. I
have asked you to assist me with obtaining
all necessary permits from regulatory
agencies, as well as the actual design of the
dam and water basin. Your assistance with
this project will be most valuable.
Your attention to this is appreciated.
Sincerely,
Michael B. Daley, M.D.
MBD/f102
JAMES R. SIKLER
CHIEF EXECUTIVE OFFICER
\\ i ? ?? n • ^<, . ? \,? ? w v ? t ? 11 ' i-' { ^_? `I ?? a \ \`1 \ , .???'?- ?? ?' iiji ` \ ?\ l?c?' .
1`ty 11f 111\\ I\ I / (.. Y3\\1 `•? ?,?? I /`~ 1as? J ;1 Iw ? ? \ ? ??`??D i \ ?1 ` -??-_ \??\\''?•.
• y/ ? \ ? _ " '" \ \,' \ -?.? { / ?__ y"\ I? o4r ?? '•? ,\, 'iii-? \. \J -?'_
Tw-
z 5 ?\
lit
//' a ncc .t /• i _ • _ , \. \ if
-1(;_ ? =.i•??===OCR
,
? '
- ------------
.? ,\• ? _ L 4 / 1: 1 ;lam ?%-- \? -- - _ ?'. l1 ?) '1/ //G ?,.
4VI
<SO
x
Z? 3/ Q I_
i lit '10
'It
IMP
ree*
?!' , ? - ?.:::='s'tV:.: ` (^-`? ???1 ,1 I? -' -jam' i(,i \ J \\ ?a :,
.AON
,
'ws
M (^1?;
I'
tit
?z ? . 1. _-_',__ l • \,\ _ ,?_? \ ?_, ??

6EM ID: g RPS ACTION ID:
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #):
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE: pr",
Vc/
1) NOTIFICATION TO THE CORPS OF ENGINEERS
2) APPLICATION FOR SECTION 401 CERTIFICATION Fi)ry?R??? 199j
3) COORDINATION WITH THE NC DIVISION OF COASTAL MANAGEMENT
NT?`
SEND THE ORIGINAL AND (1) COPY OF THIS COMPLETED FORM TO THE APPROPRIATE
FIELD OFFICE OF THE CORPS OF ENGINEERS (SEE AGENCY ADDRESSES SHEET). SEVEN
117) COPIES SHOULD BE SENT TO THE N.C. DIVISION OF ENVIRONMENTAL MANAGEMENT
(SEE AGENCY ADDRESSES SHEET). PLEASE PRINT.
1. OWNERS NAME: Michael Daley
'. MAILING ADDRESS: 330 McDeeds Creek
SUBDIVISION NAME: McDeeds Creek
-CITY: Carthage STATE: NC ZIP CODE: 28327
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE): Y-83 CCNC (Cypress Point Drive)
Pinehurst, NC28374
3. TELEPHONE NUMBER (HOME): [phone] (WORK): [phone]
1. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER: Agent: Thomas S. Blue C.H. Blue & Associates, P.A.
1271 Old Highway #l South Southern Pines, NC 28387
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AERIAL PHOTOGRAPHY WITH SCALE) :
COUNTY: Moore NEAREST TOWN OR CITY: Pinehurst
SPECIFIC LOCATION (INCLUDE ROAD
NUMBERS, LANDMARKS, ETC.) : Intersection of Cypress Point Drive and
Saint Andrews Drive in CCNC (subdivision)
i
i
6. IMPACTED OR NEAREST STREAM/RIVER: Aherr3Aen Creek
RIVER BASIN: Lumber
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 [ ] 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 [yj
7c. IF THE PROJECT IS LOCATED WITHIN A COASTAL COUNTY (SEE PAGE 7 FOR LIST
OF COASTAL COUNTIES) , WHAT IS THE LAND USE PLAN (I.UP) DESIGNATION?
non-CAMA
8a. HAVE ANY SECTION 404 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 401
CERTIFICATION):
8b. ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE
FUTURE? YES [ ] NO [X] IF YES, DESCRIBE ANTICIPATED WORK:
9a. ESTIMATED TOTAL NUMBER OF ACRES IN TRACT OF LAND: 6.06
9b. ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
1.87
10a. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: 0.20 EXCAVATION: n/a
FLOODING: _0.4h OTHER: 0.02 (drain pipe construction)
DRAINAGE: n/a TOTAL ACRES TO BE IMPACTED: 0.68
10b. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF
RELOCATED, PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION) :
LENGTH BEFORE: 400 FT AFTER: 475
FT
WIDTH BEFORE (based on normal high water contours): approx. six FT
WIDTH AFTER: varies ( pond surface) six to two hundred FT

AVERAGE DEPTH BEFORE: 1/2 FT AFTER: 1/2 to ten FT

(2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: X PLACEMENT OF PIPE IN CHANNEL: X
CHANNEL EXCAVATION: CONSTRUCTION OF A DAM/FLOODING: X
OTHER: energy dissipator at outfall
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE
WATERSHED DRAINING TO THE POND? 17A arrP?
WHAT IS THE EXPECTED POND SURFACE AREA? 0.69
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPMENT TO BE USED (ATTACH PLANS: 8 1/2" X 11" DRAWINGS ONLY) :
rnngtruc-tion of small pond using standard heavy equipment for
clear; ng-, grads nq{ and structure placement
13. PURPOSE OF PROPOSED WORK: construction of small pond
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED
OUT IN WETLANDS. (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS):
Contours will not allow placement of pond in another area, size and
lacement of dam moved to minimize impact, size of pond reduced to
decrease impact
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:
n/a (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: n/a
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OR THE USE OF
PUBLIC (STATE) LAND?
YES [I NO fC] (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 [ J NO Vj
b. IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE?
YES (I 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].
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 (INTERMITTENT AND PERMANENT) ON THE PROPERTY MUST
BE SHOWN ON THE MAP. MAP SCALES SHOULD BE 1 INCH EQUALS SO FEET OR 1 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 subdivision
f. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
conventional septic system
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 THE TWENTY COASTAL COUNTIES ONLY), A LETTER FROM THE
NORTH CAROLINA DIVISION OF COASTAL MANAGEMENT STATING THE PROPOSED
ACTIVITY IS CONSISTENT WITH THE NORTH CAROLINA COASTAL MANAGEMENT
PROGRAM.
OWNER' /AGENT'S SIGNATURE
DAT
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED (18g.))

AI,
\\ / y1
. "'...y{.
1 `\`t ` (? ? ° ?l ?? , ?? ? -_ ? - ? ?_ ? _ - ? 'tea , , . 3? ??•????-t ? --\ ` ?;? -?? ' /^?
f D-
00
'vt
---------- --
tai
/^?\? --?? a I t n
A. In.
N-A
> _ cj C ?ri-\\? ?J''` rte- , j .?'' '?? r :\ ,•p 4$Gn `r ?.
,
`? 3? ? i • °??2{7"t/ V C `mil\\ /' \.?; / ` ??\\\? _? ?',n _
F CreIc
Sim
u'
r. ,_:._ c awc
.?950CIATS. Pl
_41 ? Ly?j .
e. c?? -i.a a? 1

I
VICINITY MAP

w9••e PuM
?\ , ?•
?..?
?4 ro
177.65 1
G 1 ?
a 1
2.11
m;
2 7
i?
?N
2.1
t
6-06 Acres (total)
.nvn•rJaw w ?) 1 f •'. 1 I
""" a•9.ro °"' / != Wet:C-d !,MCC.tL 0.68 Acres (total)
i
\ T
V ?1
-. x - o So so 90
? Scale 30'
Curve Data
pv p. CA T ' R ' ? It C
u'f0'SJ" u10'33" ST00'35" ST,t'Te' N eS,Y53- E 62d! t31.A 1196 116.sI t)39 M1 Je
G MZ1 tJ .0?')I IJ f63, ]0 DY31U M6S31 >d E J9O9 103).0 ILO) m.0e 0.]s 0.],
G ]St10?)51101 06'Ce 0.S 06'W 11 1f3 M v 10.1)• WI.>• Je2U Sr9, 19.)] 19.J3
LOT Y-83 CCNC
PINEHURST, NC
JURISDICTIONAL WETLANDS
PREPARED FOR:
.._1 Ovk] (910 295-55C`)
330 M,0••e9 Cook
CaM9pe. NC 29327
C. H. BLUE
x
ASSOCIATES. P.A
Pinehurst
Medical
Clinic, inc.
PRACTICE OF INTERNAL MEDICINE
JOSEPH S. HIATI; JR.. M.D.
FOUNDER 1952 -
MAILING ADDRESS September 9, 1997
AND EAST LOCATION
205 PAGE RD., PINEHURST, NC 28374
[phone]
DAVID G. ALLEN, M.D.
ONCOLOGY
THOMAS J. BARTHOLET, M.D. Mr. Thomas Blue
INTERNAL MEDICINE 1271 Old Highway #1
GREG L.CLARY,M.D. Southern Pines, N.C. 28387
INTERNAL MEDICINE
F. FARRELL COLLINS, JR., M.D.
DISEASES OF THE CHEST
DAVID M. COWHERD, M.D. Dear Mr. Blue:
INVASIVE CARDIOLOGY
CLAY C.DA GE,JR.,MD.
This letter is to confirm our business
INTERNAL MEDICINE ICINE
KEITH E. DAVIS, M.D. arrangement. As you are aware, I have
INVASIVE CARDIOLOGY contracted you to assist me with the process
SCOTT J•DENARDO,M.D.
INVASIVE CARDIOLOGY of developing a lake on my property at the
ANDREW N.DENTINO,M.D. Country Club of North Carolina, lot #Y 83. I
GERIATRICS have asked you to assist me with obtaining
ROBERT L.DEUCHER,M.D. all necessary permits from regulatory
INTERNAL MEDICINE agencies, as well as the actual design of the
BOBBY R. MAYNOR, JR., M.D.
INTERNAL MEDICINE dam and water basin. Your assistance with
PHILIP G.MONDI,M.D. this project will be most valuable.
INTERNAL MEDICINE
WALTER S. MORRIS, III, M.D.
Your attention to this is appreciated.
INTERNAL MEDICINE ICINE
JOSEPH L. PARRISH, M.D.
INVASIVE CARDIOLOGY Sincerely,
F.M. SIMMONS PATTERSON, JR., M.D.
CARDIOLOGY
JAMES TART, M.D.
CARDIOLOGY
ELLEN M. WILLARD. M.D. Michael B. Daley, M.D.
ONCOLOGY AND HEMATOLOGY
MBD/f102
WEST LOCATION
112 MEMORIAL DR., PINEHURST, NC
TERRI L. CARRON, M.D.
INTERNAL MEDICINE
MICHAEL B. DALEY, M.D.
INTERNAL MEDICINE
JACKSON V. GIBSON, M.D.
INERNAL MEDICINE
DAVID F. MARTIN, M.D.
GASTROENTEROLOGY AND ENDOSCOPY
THOMAS M. SWANTKOWSKI, M.D.
GASTROENTEROLOGY AND ENDOSCOPY
DIANE M. WILLIAMS, M.D.
GASTROENTEROLOGY AND ENDOSCOPY
NEESE LOCATION
102 GOSSMAN DR., SOUTHERN PINES, NC 28387
[phone]
DONALD K. WALLACE, M.D.
GERIATRICS AND INTERNAL MEDICINE
JAMES R. SIKLER
CHIEF EXECUTIVE OFFICER