20041934 Ver 1_401 Application_20041202

Environmental Consultants, PA
Road Raleieh. North Carolina 27614 Phone: [phone] Fax: [phone]
~i`,CTtlv'~:+5 ~,;1D ST C. Z;,~ ~liiirEil Efii,tCH
NCDENR-DWQ
Attn: Ms. Cyndi Karoly
2321 Crabtree Blvd.
Parkview Boulevard
Raleigh, NC 27604
US Army Corps of Engineers
Attn: Ms. Andrea Wade
6508 Falls of the Neuse Road
Suite 120
Raleigh, NC 27615
RE: Request for NWP 39 / 401 Water Quality Certification and Buffer Compliance
Peyton Hall Residential Subdivision
Raleigh, Wake County, North Carolina
Dear Ms. Karoly and Ms. Wade:
On behalf of Helen T. Lattimore (property owner), we request authorization from the US
Army Corps of Engineers (USAGE) to utilize Nationwide Permit 39 for construction of
the proposed Peyton Hall Residential Subdivision. We also request written concurrence
from the NC Division of Water Quality (NC-DWQ) that the project complies with the
Neuse Basin Riparian Buffer Rules and GC 3402, the 401-Water Quality Certification
associated with Nationwide Permit 39. APre-construction Notification Application
(PCN) is attached, as well as an agent authorization form.
Location
The site is approximately 38-acres and is located in northeast Raleigh, Wake County, NC
immediately east of where Wedgewood Drive currently stubs off. Wedgewood Drive
intersects Hew Hope Road (SR 2036) from the east at a point approximately 2000 feet
due south of the intersection of New Hope Road and Buffalo Road (SR 2215). Figure 1
shows the location of the site on a USGS topographic quadrangle.
Proicct History
S&EC delineated the wetlands, streams, and buffers onsite in June of 2003. A site
meeting was held with Ms. Debbie Edwards of the NC-DWQ on June 26, 2003 (NBRRO
03-209). Two site meetings were held with the USAGE. The first USAGE meeting was
with Ms. Andrea Wade on July 10, 2003 and was held for the purpose of obtaining a
Charlotte Oftce: Greensboro Office:
236 LcYhillip Court, Suite C 3817-E Lawndalc Drive
Concord, NC 28025 Greensboro, NC 27455
Phonc: [phone] Phone: [phone]
Fax: [phone] Fax: [phone]
r
DEC t' '~ ' ~'!'':r December 2, 2004
S&EC Project #7726.W0

December 2, 2004
S&EC Project 7726.W0
Page 3
area between NB-3 and NB-4 is required and can not be obtained without a stream
crossing. If either crossing shown on NB-3 or NB-4 is deleted, the resulting cul-de-sac
will exceed the City's cul-de-sac length requirement and will also not allow for the
interconneetivity t}iat the City is requiring. The NB-4 impact is to an intermittent stream
that has already been impacted (i.e. gullicd and straightened) in the past from the utility
corridors that it runs through.
The proposed project will exceed 30% impervious at the completion of the project.
Although a formal stormwater plan is not being submitted with this application, one will
follow after the 401 and 404 have been issued and the project is closer to construction.
The project engineer has set aside areas for stormwater devices that should be adequate to
meet the 85% TSS removal. We ask that the 401 be issued with a special condition
that states that a stormwater management plan must be approved by the NC-DWQ
before the 401 is valid and before any site construction proceeds.
I<liti~ation
As discussed above, the purpose of the site meeting held with Ms. Jennifer Burdette of
the USACE was to determine which stream impacts would require mitigation and what
ratio would be applied to those that did require mitigation. It was deterniined that
impacts depicted on sheets NB-2 and NB-3 would require stream mitigation at a 2:1 ratio
and the impact shown on sheet NB-4 would not require mitigation. Payment to the NC-
EEP is proposed to satisfy the stream mitigation requirement. No wetland mitigation is
required because no wetland impacts are proposed. No buffer mitigation is proposed
because the buffer impacts that result from the road crossings are less than 1/3 acre each
and are therefore considered an "allowable" activity. Given the 2:1 mitigation ratio,
stream mitigation totaling 396 LF is required.
Please call or email me at SClark(a~SandEC.com if you have any questions.
Sincerely,
~~
Sean Clark
Environmental Scientist
Attachments:
Pre-construction (PCN) notification form
Agent Authorization
USGS Site Vicinity Map
Soil Survey Site Vicinity Map
Wetland Impact Maps (5 sheets)
$475 check for 401 processing

Off1CC IJSC Illy' Forn~ Version lv1ay 2002
USACE Action ID No. DWQ No.
_ nwr_. • ~~1:,.,.1_l,.rr ,.~ rr1~T/A n \
(If any part~eular item is nog appucawe iv uus Yi~~cc~, yic.~c cuwi ..~< ~,k.E ............ ... ..,. _ .~
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
® 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested: NWP 39
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: ^
4. 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 Management Area of
Environmental Concern (sec the top of page 2 for further details), check here: ^
II. Applicant Information
1. Owner/Applicant Information
Name: Helen T. Lattimore
Mailing Address: 3122 Eton Road
Raleigh, NC 27608
Telephone Number: 782-0131 Fax Number: not available
E-mail Address: not available
2. Agent/Consultant 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: Sean Clark
Company Affiliation: Soil & Environmental Consultants PA
Mailing Address: 11010 Raven Ridge Road
Raleigh NC 27614
Telephone Number:~919)846-5900 Fax Number: [phone]
E-mail Address: SClark(a~SandEC com
I'agc 1 of 9

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 maybe included at the applicant's discretion,
so long as the property is clearly 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 are
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 are provided.
1. Name of project: Penton Hall Residential Subdivision
2. T.I.P. Project Number or State Project Number (NCDOT Only):
N/A
3. Property Identification Number (Tax PIN): 173509063058 & 173509063722
4. Location
County: Wake Nearest Town: Raleigh
Subdivision name (include phase/lot number): Penton Hall
Directions to site (include road numbers, landmarks, etc.): The site is approximately 38-
acres and is located in northeast Raleigh Wake County NC immediately east of where
Wedgewood Drive currently stubs off. Wedgewood Drive intersects Hew Hope Road (SR
2036) from the east at a point approximately 2000 feet due south of the intersection of New
Hone Road and Buffalo Road (SR 2215). Figure 1 shows the location of the site on a USGS
topographic quadrangle.
5. Site coordinates, if available (UTM or Lat/Long): 035"49'37.23"N, 078"33'34.66"W (NB-2)
035"49'36.74"N 078"33'40 90"W (NB-3)
035"49'38.60"N 078"33'45 61"W (NB-4~
(Note - If project is linear, 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): +/- 38 acres
7. Nearest body of water (stream river/sound/ocean/lake): UT to Rocky Creek
8. River Basin: Neuse River Basin
(Note -this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http://h2o.enr.state.nc.us/admin/maps/.)
Page 2 of 9

Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: Currently the property is primarily wooded with a large Hower
line easement oriented north to south bisecting the property. Several ATV trails are present
on the site At the time the adjacent Rebel Acres residential subdivision was built
(proximately mid 1960's) Stonewall Drive and Wedgewood Drive were graded ~n beyond
the end of the paved surfaces These graded areas extend onto the subject property but do not
cross any_jurisdictional or buffered areas With exception to the property immediately south
of the proposed subdivision the surrounding properties are residential subdiv~s~on.
Describe the overall project in detail, including the type of equipment to be used: The
proposed project is asingle-family residential subdivision with utilities typically required by
residential subdivisions The City of Raleigh is requirinr; that the subdrv~sion's streets tie
into existing adjacent road stubs The project will require three road crossings ~n order to
connect to these existing stubs Typical heavy machinery required for gradtne etc. will be
used on this project
Explain the purpose of the proposed work: The purpose of the proposed work is to meet the
demand for additional housing in the area The project will connect the roads and utilities of
the surrounding similar residential subdivisions and will thereby provide the City of Raleigh
with interconnectivity and alternate routes for emergency vehicles.
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.LP. project, along with
construction schedules.
S&EC delineated the wetlands streams and buffers onsite in June of 2003. A site meeting was
held with Ms Debbie Edwards of the NC-DWQ on June 26 2003 (NBRRO 03-209). Two site
meetings were held with the USACE The first USACE meeting was with Ms. Andrea Wade
and was held for the purpose of obtaining a jurisdictional determination. The second site
meeting was held with Ms Jennifer Burdette to determine which stream impacts on the property
will require miti ation Ms Burdette determined that the crossings shown on the attached_NB-2
and NB 3 sheets would require stream mitigation at a 2.1 ratio The crossing shown on sheet
NB 4 was determined to be intermittent and will not require mitigation. No 401 or 404 permits
have been previouslyissued for this site.
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.
No future permits are known to be required for the subject property at this time.
Page 3 of 9

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.
Provide a written description of the proposed impacts: The proposed impacts that will result from
the project will result solely from road crossinl;s. The road crossings will impact stream
channels and their associated buffers. The project does not propose any wetland impacts. Total
Stream impacts will total 293 linear feet of which 198 linear feet are perennial (i.e. require
stream mitigation) and 95 linear feet are intermittent (i.e. do not require stream mitigation).
1. Individually list wetland impacts below:
Wetland Impact
Site Number
(indicate on map)
Type of Impact* Area of
Impact
(acres) Located within
100-year Floodplain**
(yes/no) Distance to
Nearest Stream
(linear feet)
Type of Wetland***
N/A N/A N/A N/A N/A N/A

* List each impact separately and identify temporary impacts. Impacts include, but arc 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-approval local floodplain maps. Maps are available through the FEMA Map Service Center at I-800-358-9616, or
online at htty://www.fcma.eov.
*** List a wetland type that best describes wetland to be impacted (e.g., freshwater/saltwater marsh, forestal 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: +/- 0.2 acre
Total area of wetland impact proposed: 0
2. Individually list all intermittent and perennial stream impacts below:
Stream Impact
Site Number
(indicate on ma)
Type of Impact* Length of
Impact
(linear feet)
Stream Name** Average Width
of Stream
Before Impact Perennial or
Intermittent?
(please specify)
NB-2 Culvert 103 UT to Rocky Creek +/-5 perennial
NB-3 Culvert 95 UT to Rocky Creek +/- 5 perennial
NB-4 Culvert 95 UT to Rocky Creek +/- 3 intermittent

* List each impact separately and identify temporary impacts. Impacts include, but arc 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),
Page 4 of 9

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 arc available through the USGS at 1-800-358-9616, or online at
www.us~s.~ov. Several interact sites also allow direct download and printing of USGS maps (c.g., www.topozone.com,
www.mapqucst.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: 293 LF (198 LF to
perennial and 95 LF to intermittent)
3. 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
* Arca of
I
Name of Waterbody Typc of Waterbody
sound
estuary
pond
lake
(

Site Number
Type of Impact
mpact
(if applicable) ,
,
,
,
(indicate on ma) (acres) bay, ocean, etc.)
N/A N/A N/A N/A N/A
d'
* List each impact separately and identify temporary impacts. Impacts include, but arc not bm~ted to: fill, excavation, dre gmg,
flooding, drainage, bulkheads, etc.
4. Pond Creation
If construction of a pond is proposed, associated wetland and stream impacts should be
included above in the wetland and stream impact sections. Also, the proposed pond should
be described here and illustrated on any maps included with this application.
Pond to be created in (check all that apply): ^ uplands ^ stream ^ wetlands
Describe the method of construction (e.g., dam embankment, excavation, installation of
draw-down valve or spillway, etc.): N/A
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.): N/A
Size of watershed draining to pond: N/A Expected pond surface area: N/A
VII. Impact Justiiication (Avoidance and 1\Iinimization)
Specifically describe measures taken to avoid the proposed impacts. It maybe 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.
The impacts that will result from the proposed residential subdivision will result from the
installation of required roads No general lot fill is proposed. The site contains very little
wetland area and-what is present has been avoided completely The three road crossings that are
being requested will connect to existing road stubs on adtacent properties The City of Raleigh is
requirint; that the roads on the property connect to these existing stubs for interconnectivity
purposes All three crossings have minimized impacts by crossing at pemendicular ans;les and
by using headwalls to decrease the footprint of the road crossings.
Page 5 of 9

The crossing shown on sheet NB-2 is required to connect to the existing road stub on the
northern property line. This crossing also connects the northeastern portion of the property to the
rest of the project.
The crossings shown on sheets NB-3 and NB-4 are required to connect the existing Stonewall
Drive to the rest of the proposed project. In order to avoid additional impacts to a perennial
stream and or impacts to the confluence of two streams (area south of the NB-4 impact) the
alignment of Stonewall Drive as it enters the property was shifted to the north of the previously
recorded easement, which is depicted on the USGS man and was partially_Braded in during the
Rebel Acres construction in the 1960's. Access to the area between NB-3 and NB-4 is required
and can not be obtained without a stream crossing. If either crossing shown on NB-3 or NB-4 is
deleted, the resulting cul-de-sac will exceed the City's cul-de-sac len tg h requirement and will
also not allow for the interconnectivity that the City is requiring. The NB-4 impact is to an
intermittent stream that has already been impacted (i.e. Bullied and straightened) in the past from
the utility corridors that it runs through.
VIII. Mitigation
DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC
Division of Water Quality for projects involving greater than or equal to one acre of impacts to
freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial
streams.
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 are 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 are 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 Carolina, 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/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
Page 6 of 9

description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
As discussed above the purpose of the site mectin~ held with Ms. Jennifer Burdette of the
USACE was to determine which stream impacts would require mit~~aUon and what ratio
would be applied to those that did require mitigation It was determined that impacts
depicted on sheets NB-2 and NB-3 would require stream mitigation at a 2:1 ratio and the
impact shown on sheet NB-4 would not require mitigation Payment to the NC-EEP ~s
proposed to satisfy the stream mitigation requirement No wetland mrt~gat~on ~s required
because no wetland impacts are proposed No buffer m~t~~at~on is proposed because the
buffer impacts that result from the road crossings arc less than 1 /3 acre each and are therefore
considered an "allowable" activity
2. Mitigation may also be made by payment into the North Carolina 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 regarding the application process for the
NCWRP, check the NCWRP website at http•/lh2o.enr.state.nc.ushvrp/index.htm. If use of
the NCWRP is proposed, please check the appropriate box on pate three and provide the
following information: _
,~
_ ,l.
Amount of stream mitigation requested (linear feet): ' 396 LF
Amount of buffer mitigation requested (square feet): 0
Amount of Riparian wetland mitigation requested (acres): 0
Amount ofNon-riparian wetland mitigation requested (acres)
Amount of Coastal wetland mitigation requested (acres): 0
0
IX. Environmental Documentation (required by D`VQ)
Does the project involve an expenditure of public (federal/state) funds or the use of public
(federal/state) land?
Ycs ^ No
If yes, does the project require preparation of an environmental document pursuant to the
requirements of the National or North Carolina Envirommental Policy Act (NEPA/SEPA)?
Note: If you are 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 yes, has the document review been finalized by the State Clearinghouse? If so, please attach a
copy of the NEPA or SEPA final approval letter.
Yes ^ No ^
I'a~c 7 of 9

X. Proposed Impacts on Riparian and Watershed Buffers (required by DWQ)
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
required state and local buffers associated with the project. The applicant must also provide
justification for these impacts in Section VII above. All proposed impacts must be listed herein,
and must be clearly identifiable on the accompanying site plan. All buffers must be shown on a
map, whether or not impacts are proposed to the buffers. Correspondence from the DWQ
Regional Office may be included as appropriate. Photographs may also be included at the
applicant's discretion.
Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify )?
Yes ® No ^ If you answered "yes", provide the following information:
Identify the square feet and acreage of impact to each zone of the riparian buffers. If buffer
mitigation is required calculate the required amount of mitigation by applying the buffer
multipliers.
NB-2
Zone* Impact
(s uare feet) Multiplier Required
Mitigation
1 7,155 3 0
2 5,277 1.5 0
Total 12,432 0
N B-3
Zone* Impact
(square feet) Multiplier Required
Mitigation
1 5,865 3 0
2 3,990 1.5 0
Total 9,855 0
N B-4
Zone* Impact
(s uare feet) Multiplier Required
Mitigation
1 5,225 3 0
2 3,005 1.5 0
Total I 8,230 I 0
"` Zone 1 extends out 30 feet perpendicular from near bank of channel; Zone 2 extends an
additiona120 feet from the edge of Zone 1.
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
Payment into the Riparian Buffer Restoration Fund). Please attach all appropriate information as
identified within 15A NCAC 2B .0242 or .0260.
Page 8 of 9

Buffer mitigation is not required because the buffer impacts that result from the road crossings
are less than 1/3 acre each and are therefore considered an "allowable" activrty.
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.
The proposed project will exceed 30% impervious at the completion of the project. Although a
formal stormwater plan is not being submitted with this application one will follow after the 401
and 404 have been issued and the project is closer to construction. The project engineer has set
aside areas for stormwater devices that should be adequate to meet the 85% TSS removal. We
ask that the 401 be issued with a special condition that states that a stormwater management plan
must be approved by the NC DWQ before the 401 is valid and before anv site construction
roceeds.
XII. Sewage Disposal (required by DWQ)
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from the proposed project, or available capacity of the subject facility.
The project will tie into the City of Raleigh sanitary sewer lines that are adjacent to the property
for sewer dis osal.
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 an after-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).
er 2
Applicant/Agcnt's Sibnaturc Datc
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 9 of 9

Environmental Consultants, PA
;Road Raleigh, North Carolina 27614 Phone: [phone] Fax: [phone]
www.SandEC.com
AGENT AUTHORIZATION FORM
All Blanks To Be Filled In By The Current Landowner
Name: 6~C ICIJ ~ ` G~~'~'~~M O / C
~.
Address: 3 i a a ~f +v~ ~) ~~.le . 9 h a ~~ 0 8
Phone: ~~ -' O / ~ ~
Project Nanne/Description: ~C~J ~~D C. ~. Q ~ 1
Date: loo ~o~ ~ !>~
The Department of the Ariony
U.S. Army Corps of Engineers, Wilmington Distzict
P.O. Box 1890
Wilmington, NC 28402.
Attn: ~ ~~~ ~~
Field Office: ~
Re: Wetlands Related Consulting and Permitting
To Whom It May Concern:
T, the current ro owner, hereby designate and authvz-ize Soil & Environmental Consultants, PA to
actin my behalf as my agent in the processing of permit applications, to furnish upon request
supplemental information in support of applications, etc. from this day forward. The _._ ~ ?day of
J~. ~
This notification supersedes any previous correspondence concerning the agent for this project.
NOTICE: This authorization, for liability and professional courtesy reasons, is valid only for
government officials to enter the property when accompanied by S&EC staff. You should call S&EC
to arrange a site meeting prior to visiting the site.
/ ~ ~
~~
Print Property Owner's Name
cc: Mr. John Dorney
NCDENR - DWQ
2321 Crabtree Boulevazd
Raleigh, NC 27604
Pro erty Owner's Signature
cc: Mr. Sean Clark
Soil dz Environmental Consultants, PA
Hi .trn ~C~
r'harlotte Oftire: C',reensboro Office_ 62Z Loan MOUntain Lane
236 I,ePhillip Court, Suite C 3817-8 Lawndale Drive Zy,ylorsville, NC 2868]
Concord, NC 28025 Greensboro, NC 27455
Phone: [phone] Fhone: [phone] Phone [phone]
Fax: [phone] Fax: (33ti)540-8235 Fax: [phone]
' 06/26/2003 17:32 7875147 HOMEPLACES ., PAGE 02
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Project #:
7726
Figure 1 -Location Map
Project Mgr.: ® Soil & Environmental Consultants, PA
sc Rebel Acres Subdivision NC 27614
• Raleigh
11010 Raven Ridge Rd
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Piedmont Land Design [phone] • [phone]
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