20071475 Ver 1_401 Application_20070807

Office Use Only: Form Version May 2002
USACE Action ID No. DWQ No. ~ 7- 1 4 7 5
(lf any particular item is not applicable to this project, please enter "Not Applicable" or "N/A".)
I. Processing
1. Check all of the approval(s) requested for this project:
^ Section 404 Permit ^ Riparian or Watershed Buffer Rules
^ Section 10 Permit ^ Isolated Wetland Permit from DWQ
x i 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested:~~ P g0 IQ 7~ ~~~~
l~If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: ^
N~ If payment into the North Carolina Wetlands Restoration Program (NCWRP) is proposed for
mitigation of impacts (verify availability with NCWRP prior to submittal of PCN), complete
section VIII and check here: ^
~~ If your project is located in any of North Carolina's twenty coastal counties (listed on page
4), and the project is within a North Carolina Division of Coastal Mana eme~ ea of
Environmental Concern (see the top of page 2 for further detail ~~ O
II. Applicant Information AU G 3 0 2007
l . Owner/Applicant Information DENR -WATER OtiALITY
Name: CSR R l A~ ~ CAST y ~~O w~ ~ wr:Tw+DS M1D sTOw~TER BRnNCH
Mailing Address:__734 t7.ayF'LtSw~'rl GT
VASC~ N '_ ~~S 39 y
Telephone Number: q I O Z~-t 5 6~, S q Fax Number: ~i4~.E
E-mail Address: uc~"~1ZT~tti/ ncc QAoi ,Gc~~
~ Agent/Consultant Information (A signed and dated copy of the Agent Authorization letter
,q, must be attached if the Agent has signatory authority for the owner/applicant.)
Name:
Company Affiliation:
Mailing Address:
Telephone Number:
E-mail Address:
Fax Number:
Page 5 of 12

III. 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. Both the vicinity map
and site plan must include a scale and north arrow. The specific footprints of all buildings,
impervious surfaces, or other facilities must be included. If possible, the maps and plans should
include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property
boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion,
so long as the property is cleazly defined. For administrative and distribution purposes, the
USACE requires information to be submitted on sheets no larger than 11 by 17-inch format;
however, DWQ may accept paperwork of any size. DWQ prefers full-size construction
drawings rather than a sequential sheet version of the full-size plans. If full-size plans aze
reduced to a small scale such that the final version is illegible, the applicant will be informed that
the project has been placed on hold until decipherable maps aze provided.
1. Name of project: GARR ~h1 fo~E2S / fZ I p fL~ P 2.5 ~ I O ~ P C ~~~
i~/ T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN): ~ Sy 3 ~ S ~ 9~j 2 G19
- 4. Location
County: M ©o RE Nearest Town:__ YA55
Subdivision name (include phase/lot number): W 4 ©o I-A K ~ ,~/~D ~ S~c-r I ~. ~ ,~`%~Y yS~J~-~
Directions to site (include road numbers, landmarks, etc.): :~ 5 ~. -to t.OB£L la R f) /E~
N 6R~T'1-# Dly M C / Au('~-It_ t 1 t2 F= S~- WOC~p ,o ~~E' R ~ -i h S~t~TH ON R i U F RI (JW PR
1 !~'T /'-A~ ~ ~~r~ rf~lOd1 v ~-.- » r....~- .._ ~.w , ._.. _. _.r .~ r^r~ ~
- 5. Site coordinates, if available (UTM or Lat/Long): _3 5A13'S3, 2hy(V ~q `.9.1''i 1.384 y~/
(Note - If project is lineaz, such as a road or utility line, attach a sheet that separately lists the
coordinates for each crossing of a distinct waterbody.)
6. Property size (acres): ~ n ~ 3
7. Neazest body of water (stream/river/sound/ocean/lake): w~bDc.bkF CGRAu~s ~2c~ti
8. River Basin:. _ ~1PE ~"64R-
(Note -this must be one of North Cazolina's seventeen designated major river basins. The
River Basin map is available at http://h2o.enr.state.nc.us/admin/maps/.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application:_~,13~D ~ t/ tiS s'6kJ ~ . ~ ~~ ~~..~ >~•4n~,, ~ ~.y ti E
Page 6 of 12

10. Describe the overall project in detail, including the type of equipment to be used:
I-IAt~®PCAGC- Rlt~tzAfJ ~-' lU3~ x2'IZ.' A~~»~ SI~~Q• FLlA ~
11. Explain the purpose of the proposed work:. ~ c~ ~[<~'vF~.n- ~ rLc~ s ~ bX
~tE I ~ H F3 c~i2~ Td 13~K S~ nr~~ci.~' ~%4iki ~~'~ ~~y.~c• L,g~
IV. Prior Project History
If jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Include
the USACE Action ID Number, DWQ Project Number, application date, and date permits and
certifications were issued or withdrawn. Provide photocopies of previously issued permits,
certifications or other useful information. Describe previously approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits issued for prior segments of the same T.I.P. project, along with
construction schedules.
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application.
VI. Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. The applicant must also
provide justification for these impacts in Section VII below. All proposed impacts, permanent
and temporary, must be listed herein, and must be clearly identifiable on an accompanying site
plan. All wetlands and waters, and all streams (intermittent and perennial) must be shown on a
delineation map, whether or not impacts are proposed to these systems. Wetland and stream
evaluation and delineation forms should be included as appropriate. Photographs may be
included at the applicant's discretion. If this proposed impact is strictly for wetland or stream
mitigation, list and describe the impact in Section VIII below. If additional space is needed for
listing or description, please attach a separate sheet.
Page 7 of 12

1. Provide a written description of the proposed impacts: P REyFw ~' E ~ s i zYV f~"
~ 1 L I c~.~T~ wq j E 2 . i21 P RA (~ CiFGc ~ ~ .oZ' ~ z ~ ~i ' ~'MA ~/
_B~CC~,E ~ C-l 6 NTH Y 5U d3l~ 12GE (~ iF-Th~ ~~'`_fZ.. E%t C.rFi> S THE
AX~-2~,A t.- POc~L O~ 2 Z 4 ~ ~ s ~
2. Individually list wetland impacts below:
Wetland Impact
Site Number
(indicate on ma)
ype of Impact* Area of
Impact
(acres) Located within
100-year Floodplain**
es/no) Distance to
Neazest Stream
(lineaz feet)
Type of Wetland***

* List each impact separately and identify temporary impacts. Impacts include, but aze not limited to: mechanized clearing, grading, fill,
excavation, flooding, ditching/drainage, etc. For dams, separately list impacts due to both structure and flooding.
** 100.Year floodplains are identified through the Federal Emergency Management Agency's (FEMA) Flood Insurance Rate Maps
(FIRM), or FEMA-approved local floodplain maps. Maps are available through the FEMA Map Service Center at 1-800-358-9616, or
online at http:/iwww.fcma.~.
*** List a wetland type that best describes wetland to be impacted (e.g., freshwater/saltwater marsh, forested wetland, beaver pond,
Carolina Bay, bog, etc.) Indicate if wetland is isolated (determination of isolation to be made by USACE only).
List the total acreage (estimated) of all existing wetlands on the property: 1~T'T. " 9.20~(S F
Total area of wetland impact proposed: 1-~c~.SC ~F DR 1 uC'.~r~`/ ~5 ACS o1t7 5 ~
3. Individually list all intermittent and perennial stream unpacts below:
Stream Impact
Site Number
(indicate on ma
Type of Impact* Length of
Impact
(linear feet)
Stream Name** Average Width
of Stream
Before Im act Perennial or
Intermittent?
leases eci )

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: culverts and associated rip-rap,
dams (separately list impacts due to both structure and flooding), relocation (include linear feet before and after, and net loss/gain),
stabilization activities (cement wall, rip-rap, crib wall, gabions, etc.), excavation, ditching/straightening, etc. If stream relocation is
proposed, plans and profiles showing the linear footprint for both the original and relocated streams must be included.
** Stream names can be found on USGS topographic maps. If a stream has no name, list as UT (unnamed tributary) to the nearest
downstream named stream into which it flows. USGS maps are available through the USGS at 1-800-358-9616, or online at
www.ust~s.y;ov. Several Internet sites also allow direct download and printing of USGS maps (e.g., www.tonozone.a>m,
~~~ww.nr+pguest.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: f ~ f ~Q
Page8of12

4. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.) below:
Open Water Impact

Site Number
(indicate on ma)

Type of Impact* Area of

Impact
(acres)
Name of Waterbody
(if applicable) Type of Waterbody

(lake, pond, estuary, sound,
ba ,ocean, etc.)
tP .OQ` ~,~ tpK~

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: fill, excavation, dredging,
flooding, drainage, bulkheads, etc.
5. Pond Creation
If construction f a pond is proposed, associated wetland and stream impacts should be
included abov in the wetland and stream impact sections. Also, the proposed pond should
be describe ere and illustrated on any maps included with this application.
Pond to be reated in (check all that apply): ^ uplands ^ stream ^ wetlands
Des~be a method of construction (e.g., dam/embankment, excavation, installation of
draw-d valve or spillway, etc.):
Prop sed use or purpose of pond (e.g., livestock watering, imgation, aesthetic, trout pond,
loc stormwater requirement, etc.):
Size of watershed draining to pond: Expected pond surface area:
VII. Impact Justification (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It may be useful to provide
information related to site constraints such as topography, building ordinances, accessibility, and
financial viability of the project. The applicant may attach drawings of alternative, lower-impact
site layouts, and explain why these design options were not feasible. Also discuss how impacts
were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce impacts.
_~Z_~'f? tz~~2E ~ "t o i~ 2 f vFwT S ~ ~ ~2F e2v :'~ - t~ ty . R 1-~ Rio P }~_~I,v i~
1-i~VF [..~ce.~,~ sc~ i~ ~°l~} i~ r 1 fZ2lE2 1ZF1`w~E ~, t~E so ~l d- 2i p
1'204 P TO Fv~ ~-t~lZ PRE y~~rr F- 2 hs, z>,+v
VIII. Mitigation
D]I~ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC
Div' i~f Water Quality for projects involving greater than or equal to one acre of impacts to
fr shwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial
streams.
Page 9 of 12

USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on March 9, 2000, mitigation will be required when
necessary to ensure that adverse effects to the aquatic environment aze minimal. Factors
including size and type of proposed impact and function and relative value of the impacted
aquatic resource will be considered in determining acceptability of appropriate and practicable
mitigation as proposed. Examples of mitigation that may be appropriate and practicable include,
but aze not limited to: reducing the size of the project; establishing and maintaining wetland
and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of
aquatic resource functions and values by creating, restoring, enhancing, or preserving similar
functions and values, preferable in the same watershed.
If mitigation is required for this project, a copy of the mitigation plan must be attached in order
for USACE or DWQ to consider the application complete for processing. Any application
lacking a required mitigation plan or NCWRP concurrence shall be placed on hold as
incomplete. An applicant may also choose to review the current guidelines for stream restoration
in DWQ's Draft Technical Guide for Stream Work in North Cazolina, available at
http://h2o.enr.state.nc.us/ncwetlands/strmgide.html.
1. Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/lineaz feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a sepazate sheet if more space is needed.
-# _
2. Mitigation may also be made by payment into the North Cazolina Wetlands Restoration
Program (NCWRP). Please note it is the applicant's responsibility to contact the NCWRP at
[phone] to determine availability and to request written approval of mitigation prior
to submittal of a PCN. For additional information regazding the application process for the
NCWRP, check the NCWRP website at http://h2o.enr.state.nc.us/wrp/index.htm. If use of
the NCWRP is proposed, please check the appropriate box on page three and provide the
following information:
Amount of stream mitigation requested (lineaz feet):
Amount of buffer mitigation requested (squaze feet):
unt Riparian wetland mitigation requested (acres):
ofNon-riparian wetland mitigation requested (acres):
unt~f Coastal wetland mitigation requested (acres):
Page 10 of 12

IX.
X.
Environmental Documentation (required by DWQ)
Does the project involve an expenditure of public (federaUstate) funds or the use of public
(federaUstate) land?
Yes ^ No
If yes, does the project require prepazation of an environmental document pursuant to the
requirements of the National or North Cazolina Environmental Policy Act (NEPA/SEPA)?
Note: If you aze not sure whether a NEPA/SEPA document is required, call the SEPA
coordinator at [phone] to review current thresholds for environmental documentation.
Yes ^ No
If has the dacuxrnerrt review been finalized by the State Clearinghouse? If so, please attach a
copy of the NEPA or SEPA final approval letter.
Yes ^ No
Proposed Impacts on Riparian and Watershed Buffers (required by DWQ)
upon ' ility to determine, delineate and map all impacts to
~o 'ated with the project. The applicant must also provide
on VII above. All proposed impacts must be listed herein,
the accompanying site plan. All buffers must be shown on a
proposed to the buffers. Correspondence from the DWQ
as appropriate. Photographs may also be included at the
Will the projec 'm act rotected riparian buffers identified within 15A NCAC 2B .0233
(Meuse), 15A C .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer equire ents), or other (please identify )?
Yes ^ No If you answered "yes", provide the following information:
Identify the squ e feet d acr age of impact to each zone of the riparian buffers. If buffer
mitigation is quired calculate the required amount of mitigation by applying the buffer
multipliers.
It is the applicant's (or agent's)
required state and local buffers
justification for these impacts in
and must be cleazly identifiable
map, whether or not impacts a
Regional Office may be incl
applicant's discretion.
Zone's snare feet Multiplier Mitq a i n
1 3
2 1.5
Total
c.uiic ~ cx~cnus uui w feet perpenoicuiar rrom near banK of channel; Gone Z extends an
additiona120 feet from the edge of Zone 1.
Page 11 of 12

If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation
of Property, Conservation Easement, Riparian Buffer Restoration /Enhancement, Preservation or
Payme tin th Riparian Buffer Restoration Fund). Please attach all appropriate information as
identi a ~ithi~l SA NCAC 2B .0242 or .0260.
XI. Stormwater (required by DWQ)
Describe impervious acreage (both existing and proposed) versus total acreage on the site.
Discuss Stormwater controls proposed in order to protect surface waters and wetlands
downstream from the property.
1/~ ~'IGRb ~-O"r No~~_~F ~- DfZ-~~ way occc,d~~ v 5 a1U Sr- ~~ ,Z3,aG2F L.a-r'
n~.c, r ~v ice' lZ o~ ~v ~- i ~ -~ . ~l ~c, ~.~ c~~ - 5 ~ n So r ~ d- STa ~~ tai (,~
F-v2 5ut3i~1~-S(o~
XII. Sewage Disposal (required by DWQ)
Cleazly detail the ultimate treatment methods and disposition (non-dischazge or dischazge) of
wastewater generated from the proposed project, or available capacity of the subject facility.
ALL w~ys-~-E~vATE~!' ~~~ ~~vzc..~ ~~~ 13Y SE=wC2 C/~G?uA,~ /VO SE~F~"I~
NC.C~ F i~
XIII. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes ^ No
Is this anafter-the-fact permit application?
Yes ^ No
XIV. Other Circumstances (Optional):
It is the applicant's responsibility to submit the application sufficiently in advance of desired
construction dates to allow processing time for these permits. However, an applicant may
choose to list constraints associated with construction or sequencing that may impose limits on
work schedules (e.g., draw-down schedules for lakes, dates associated with Endangered and
Threatened Species, accessibility problems, or other issues outside of the applicant's control).
A/Lti/~ ~s ~rL 1'NowF r'o~rr/Frs.~rri~
.~ ~
~"
~~ ~~f~
-,
Zg~ v6 .~ ~
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 12 of 12

t-
3
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U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action ID. SAW-2007-02401-063 County: Moore USGS Quad: Lobelia
GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION
Property Owners: Garrin and Casey Powers
Address: 738 Dayflower Court
Vass, NC 28394
Telephone No.: [phone]
Size and location of property (water body, road name/number, town, etc.): Property is located at 738 Dayflower
Ct , in the Woodlake Country Club community, adjacent to Section 404 jurisdictional waters of
Woodlake (Lake Surf), in the town of Vass, Moore County, North Carolina.
Description of projects area and activity: This permit provides authorization to place along 103 LF of
shoreline 0.006 acres of rip-rap below the ordinary high water marls for the purpose of preventing
erosion and runoff of sediment into Woodlake.
Applicable Law: ® Section 404 (Clean Water Act, 33 USC 1344)
^ Section 10 (Rivers and Harbors Act, 33 USC 403)
Authorization: Regional General Permit Number: 197800080
Nationwide Permit Number:
Your work is authorized by the above referenced permit provided it is accomplished in strict accordance with the attached
conditions and your submitted application and plans received 7/17/07. Any violation of the attached conditions or deviation from
your submitted plans may subject the permittee to a stop work order, a restoration order and/or appropriate legal action.
This verification will remain valid until the expiration date identified below unless the nationwide authorization is modified,
suspended or revoked. If, prior to the expiration date identified below, the nationwide permiC authorization is reissued and/or
modified, this verification will remain valid until the expiration date identified below, provided it complies with all requirements of
the modified nationwide permit. If the nationwide permit authorization expires or is suspended, revoked, or is modified, such that the
activity would no longer comply with the terms and conditions of the nationwide permit, activities which have commenced (i.e., are
under construction) or are under contract to commence in reliance upon the nationwide permit, will remain authorized provided the
activity is completed within twelve months of the date of the nationwide permit's expiration, modification or revocation, unless
discretionary authority has been exercised on a case-by-case basis to modify, suspend or revoke the authorization.
Activities subject to Section 404 (as indicated above) may also require an individual Section 401 Water Quality Certification. You
should contact the NC Division of Water Quality (telephone [phone]) to determine Section 401 requirements.
For activities occurring within the twenty coastal counties subject t~ reg~~lation under the Coastal Area Management Act (CA_MA),
prior to beginning work you must contact the N.C. Division of Coastal Management .
This Department of the Army verification does not relieve the permittee of the responsibility to obtain any other required Federal,
State or local approvals/permits.
If there are any questions regarding this verification, any of the conditions of the Permit, or the Corps of Engineers
regulatory program, please contact Emily Burton, Regulatory Specialist at 910-251-4635.
Corps Regulatory Official Date: 7/27/07
Expiration Date of Verification: 12/31 Ol
Ken Averitte NCDENR-DWQ Fayetteville Regional Office 225 Green St. Suite 714/Systel Bldg., Fayetteville, NC 28301
Debra E Ensminger Planner County of Moore, P.O Box 905, Carthage, NC 28327
Page 1 of 3

Action ID Number: SAW-2007-02401-063 County: Moore
Permittee: Mr. and Mrs. Garrin Powers
Date Permit Issued: ,Tuly 27, 2007
Project Manager: Emily Burton
Upon completion of the activity authorized by this permit and any mitigation required by the permit,
sign this certification and return it to the following address:
US ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
WILMINGTON REGULATORY FIELD OFFICE
P.O. BOX 1890
WILMINGTON, NC 28402-1890
Please note that your permitted activity is subject to a compliance inspection by a U. S. Army Corps of
Engineers representative. If you fail to comply with this permit you are subject to permit suspension,
modification, or revocation.
I hereby certify that the work authorized by the above referenced permit has been completed in
accordance with the terms and condition of the said permit, and required mitigation was completed in
accordance with the permit conditions.
A_ Y
Signature of P mittee
P
~j ~ ~~~~
.~D~ a
~~.
!1f^'~
~U/
~4aG .~~
Date
Page 2 of 3

' CESAW-RG-W
MEMORANDUM FOR RECORD
DATE: ,iu127, 2007
SUBJECT: Consideration of Compensatory Mitigation and Potential Impacts to Endangered Species, Cultural Resources
and Essential Fish Habitat.
1. Action ID. SAW-2007-02401-063
2. Project Name and Location: Powers/738 Dayflower Ct , in the Woodlake Country Club community,
adjacent to Section 404 jurisdictional waters of Woodlake (Lake Surfl, in the town of Vass, Moore
County, North Carolina.
3. Mitigation [Section 404(b)(1) Guidelines].
a. Has applicant avoided and minimized impacts to the maximum practicable extent? YES
If NO, Explain:
b. Is compensatory mitigation necessary? NO
Explain:
4. Endangered Species (Section 7 of the ESA).
a. Will any threatened or endangered species or their critical habitats be affected by this project? NO
If YES, describe steps taken to address concerns:
5. Cultural Resources (Section 106 of the NHPA).
a. Will any Cultural Resources be impacted by this project? NO
b. If YES, describe steps taken to address concerns:
6. Essential Fish Habitat (50 CFR Part 600, Magnuson-Stevens Act).
a. Is this a project that "may adversely affect essential fish habitat"? NO
b. If YES, describe steps taken to ress concerns:
Corps Regulatory Official:
Page 3 of 3

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