20081849 Ver 1_401 Application_20081208

G i U
A S S O C I A T E S
December 17, 2008
Ms. Cyndi Karoly
Division of Water Quality
Wetlands and Stormwater Branch
1650 Mail Service Center
Raleigh, North Carolina 27699-1650
Dear Ms Karoly:
08-1849 S PAID
U12@[90Y[9Y
DEC 1 9 2008
WTLANDSNAND STORMW R BRIWCH
RE: 401 Certification Request
Off-Stream Storage Reservoir
Cleveland County Water
Cleveland County, North Carolina
On behalf of Cleveland County Water, formerly Cleveland County Sanitary District,
please find enclosed the following application and supporting documentation for a proposed off-
stream storage reservoir:
¦ A check for the review fee in the amount of $570
¦ Seven copies of the fully executed PCN Application Form
¦ Seven copies of the U.S. Army Corps of Engineers General Permit Verification
¦ Seven copies of NCEEP acceptance of "in lieu of payment
Please don't hesitate to contact me if you have any questions or require additional
information.
Sincerely,
McGILL ASSOCIATES, P.A.
X ??6 1
MIC VI T. DOWD, P. .
Project Manager
Enclosures
cc: Clyde E. Smith, Jr., Manager, Cleveland County Water
M. Keith Webb, P.E., McGill Associates
Mike Waresak, P.E., McGill Associates
P:A2003\03506\Letters\ck 17dec08.doc
E n g i n e e r i n g P l a n n i n g o F i n a n c e
McGill Associates, P.A. • P.O. Box 2259, Asheville, NC 28802 55 Broad Street, Asheville, NC 28801
828-252-0575 • Fax. [phone]
o?oF wATP/? DEC 1 9 2008
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Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.0 November 2008
Pre-Construction Notification (PCN) Form p g- 8 4 9
A. Applicant Information
1. Processing
1a. Type(s) of approval sought from the
Corps:
®Section 404 Permit El Section 10 Permit
1 b. Specify Nationwide Permit (NWP) number: 39 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps? ® Yes ? No
1 d. Type(s) of approval sought from the DWQ (check all that apply):
® 401 Water Quality Certification - Regular ? Non-404 Jurisdictional General Permit
? 401 Water Quality Certification - Express ? Riparian Buffer Authorization
1e. Is this notification solely for the record
because written approval is not required? For the record only for DWQ 401
Certification:
? Yes ® No For the record only for Corps Permit:

? Yes ® No
1f. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in-lieu
fee program. ® Yes ? No
1 g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below. ? Yes ® No
1h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ? Yes ® No
2. Project Information
2a. Name of project: Cleveland County Water WaterTreatment Plant Raw Water Reservoir
2b. County: Cleveland
2c. Nearest municipality / town: Lawndale
2d. Subdivision name: N/A
2e. NCDOT only, T.I.P. or state
project no: N/A
3. Owner Information
3a. Name on Recorded Deed: Cleveland County Sanitary District
3b. Deed Book and Page No. 1123 @ 1661
3c. Responsible Party (for LLC if
applicable): Clyde E. Smith, Jr., Manager
3d. Street address: 439 Casar-Lawndale Road
3e. City, state, zip: Lawndale, North Carolina 28090
3f. Telephone no.: [phone]
3g. Fax no.: [phone]
3h. Email address: [e-mail]
Page 1 of 11
PCN Form - Version 1.0 November 2008 Version
Section A. Applicant Information, continued
4. Applicant Information (if different from owner)
4a. Applicant is: ? Agent ? Other, specify:
4b. Name:
4c. Business name
(if applicable):
4d. Street address:
4e. City, state, zip:
4f. Telephone no.:
4g. Fax no.:
4h. Email address:
5. Agent/Consultant Information (if applicable)
5a. Name:
5b. Business name
(if applicable):
5c. Street address:
5d. City, state, zip:
5e. Telephone no.:
5f. Fax no.:
5g. Email address:
Page 2 of 11
PCN Form - November 2008 Version
B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): PIN 3219 1 21; Parcel 71001
1 b. Site coordinates (in decimal degrees): 35d 44.03'N - 81d 56.78'W
1 c. Property size: 71.74 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
proposed project: First Broad River
2b. Water Quality Classification of nearest receiving water: WS IV; CA
2c. River basin: Broad
3. Project Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application:
Rural wooded tract with mixed hardwoods occupied by the Cleveland County Water Water Treatment Plant
3b. List the total estimated acreage of all existing wetlands on the property:
None
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
3,000
3d. Explain the purpose of the proposed project:
Provide 60 million gallon offstream raw water storage required by NCDENR regulations
3e. Describe the overall project in detail, including the type of equipment to be used:
Excavation, grading and dam construction with overflow and spillway using rubber tire and track earth moving equipment
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past?
® Yes ? No ? Unknown
4b. If the Corps made the jurisdictional determination, what type
of determination was made?
? Preliminary ®Final
4c. If yes, who delineated the jurisdictional areas?
Name (if known): Agency/Consultant Company: NCDENR-DWQ
Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
5. Project History
5a. Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past? ® Yes ? No ? Unknown
5b. If yes, explain in detail according to "help file" instructions.
Section 404 permit obtained 10/25/05 (action ID 200531774); expired 3/18/07. Copy attached
6. Future Project Plans
6a. Is this a phased project? ? Yes ® No
6b. If yes, explain.
Page 3 of 11
PCN Form - Version 1.0 November 2008 Version
C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
? Wetlands ® Streams - tributaries ? Buffers
? Open Waters ? Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a. 2b. 2c. 2d. 2e. 2f.
Wetland impact Type of jurisdiction
number - Type of Type of wetland Forested (Corps - 404, 10 Area of impact (acres)
Permanent (P) or impact (if known) DWQ - non-404, other)
Temporary T
W1 ? P ? T ? Yes ? No ? Corps
? DWQ
W2 ? P ? T ? Yes ? No ? Corps
? DWQ
W3 ? P ? T ? Yes ? No ? Corps
? DWQ
W4 ? P ? T ? Yes ? No ? Corps
? DWQ
W5 ? P ? T ? Yes ? No ? Corps
? DWQ
W6 ? P ? T ? Yes ? No ? Corps
? DWQ
2g. Total wetland impacts
2h. Comments:
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a. 3b. 3c. 3d. 3e. 3f.
Stream impact Type of Stream name Perennial (PER) or Average stream width (feet) Impact
number - impact intermittent (INT)? length
Permanent (P) or (linear feet)
Temporary (T)
S1 ®P ? T Dam UT3 First Broad ? PER ® INT 4 480
Construct River
S2 ®P ? T Dam UT2 First Broad ? PER ® INT 4 505
Construct River
S3 ® P ? T Dam UT1 First Broad ® PER ? INT 6 500
Construct River
S4 ?P?T ?PER ?INT
S5 ? P ? T ? PER ? INT
S6 ?P?T ?PER ?INT
3g. Total stream and tributary impacts 1485
3h. Comments:
Page 4 of 11
PCN Form - Version 1.0 November 2008 Version
C. Proposed Impacts Inventory, continued
4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individual) list all o en water impacts below.
4a. 4b. 4c. 4d. 4e.
Open water Name of
impact number waterbody Type of impact Waterbody type Area of impact (acres)
- Permanent (if
(P) or applicable)
Temporary T
01 ?P?T
02 ?P?T
03 ?P?T
04 ?P?T
4f. Total open water impacts
4g. Comments:
Page 5of11
PCN Form - November 2008 Version
C. Proposed Impacts Inventory, continued
5. Pond or Lake Construction
If and or lake construction pro osed, then complete the chart below.
5a. 5b. 5c. 5d. 5e.
Wet land Impacts (acres) Stream Impacts (feet) Upland
Pond ID Proposed use or (acres)
number purpose of pond
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1 Raw Water 860 625
Storage
P2
5f. Total
5g. Comments:
5h. Is a dam high hazard permit required?
® Yes ? No If yes, permit ID no: Under Review
5i. Expected pond surface area (acres): 8.8
5j. Size of pond watershed (acres): 48.5
Mechanical excavation and grading equipment, dam construction with
5k. Method of construction:
overflow and spillway
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian bu ffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If an impacts require mitigation, then ou MUST fill out Section D of this form.
6a.
? Neuse ? Tar-Pamlico ? Other:
Project is in which protected basin? ? Catawba ? Randleman
6b. 6c. 6d. 6e. 6f. 6g.
Buffer impact
number - Reason Buffer Zone 1 impact (square Zone 2 impact
Permanent (P) for impact Stream name mitigation feet) (square feet)
or Temporary required?
T
131 ?P?T ?Yes ?No
B2 ? P ? T ? Yes ? No
B3 ? P ? T ? Yes ? No
6h. Total buffer impacts
6i. Comments:
Page 6 of 11
PCN Form - November 2008 Version
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
Based on the project's location adjacent to the water treatment plant the stream impact shown is necessary. The stream
will be temporarily impounded and pumped around the construction area to minimize erosion. All slopes will be seeded
immediately after construction is complete. Temporary measures will be taken during construction to minimize erosion
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for
impacts to Waters of the U.S. or Waters of the State? ® Yes ? No
2b. If yes, mitigation is required by (check all that apply): ® DWQ ? Corps

2c.
If yes, which mitigation option will be used for this

project? ? Mitigation bank

®Payment to in-lieu fee program

? Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter) Type Quantity
3c. Comments:
4. Complete if Making a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached. ® Yes
4b. Stream mitigation requested: 500 linear feet
4c. If using stream mitigation, stream temperature: warm warm, cool, cold
4d. Buffer mitigation requested (DWQ only): square feet
4e. Riparian wetland mitigation requested: acres
4f. Non-riparian wetland mitigation requested: acres
4g. Coastal (tidal) wetland mitigation requested: acres
4h. . Comments:
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
Page 7 of 11
PCN Form - Version 1.0 November 2008 Version
D. Impact Justification and Mitigation, continued
6. Buffer Mitigation (State Regulated Riparian Buffer Rules) - required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation? ? Yes ® No
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.
Zone Reason for impact Total impact
(square feet) Multiplier Required mitigation
(square feet)
Zone 1 3 (2 for Catawba)
Zone 2 1.5
Total buffer mitigation required:
6c. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in-lieu fee fund).
6d. Comments:
Page 8 of 11
PCN Form - November 2008 Version
E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1 a. Does the project include or is it adjacent to protected riparian buffers identified ? Yes ® No
within one of the NC Riparian Buffer Protection Rules?
1 b. If yes, then is a diffuse flow plan included? ? Yes ? No
2. Determination if the Project Requires a Stormwater Management Plan
2a. Does the project require a Non-404 Jurisdictional General Permit? ? Yes ® No
2b. Is the project subject to General Certification 3704 or 3705? ? Yes ® No
3. Determination of Stormwater Review Jurisdiction
3a. Is this project subject to any of the following state-implemented stormwater ? Coastal counties
management programs (check all that apply)? ? HQW
? ORW
If so, attach one copy of the approval letter from the DWQ and one copy of the ? Session Law 2006-246
approved stormwater management plan. ? Other:
3b. In which local government's jurisdiction is this project?
3c. Is this local government certified to implement a state stormwater program? ? Yes ? No
If so, attach one copy of the approval letter from the local government and one copy
of the approved stormwater management plan (or one copy of the approved
Stormwater management plan stamped as approved).
4. Information Required for DWQ 401 Unit Stormwater Review
4a. What is the overall percent imperviousness according to the most current site plan?
4b. Does this project contain any areas that meet the criteria for "high density" per ? Yes ? No
General Certifications 3704 and 3705?
4c. If the site is over 24% impervious and/or contains high density areas, then provide a brief narrative description of the
stormwater management plan.
4d. Has a completed BMP Supplement Form with all required items been submitted ? Yes ? No
for each stormwater BMP?
Page 9 of 11
PCN Form - Version 1.0 November 2008 Version
F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1a. Does the project involve an expenditure of public (federal/state/local) funds or the ® Yes ? No
use of public (federal/state) land?
1 b. If you answered "yes" to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State ® Yes ? No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1 c. If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
letter.) ? Yes ® No
Comments:
2. Violations (DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards, ? Yes ® No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. Is this an after-the-fact permit application? ? Yes ® No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in ? Yes ® No
additional development, which could impact nearby downstream water quality?
3b. If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
Project provides for storage of untreated water for use during rain or spill events and does not provide for additional
treatment capacity.
4. Sewage Disposal (DWQ Requirement)
4a. 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.
Page 10 of 11
PCN Form - Version 1.0 November 2008 Version
F. Supplementary Information, continued
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or ? Yes ® No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act ® Yes ? No
impacts?
? Raleigh
5c. If yes, indicate the USFWS Field Office you have contacted.
® Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat? ? Yes ® No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation ? Yes ® No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain? ? Yes ® No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination? NCDEMS Floodmapping System
Clyde E. Smith, Jr. (? L
Applicant/Agent's Printed Name pplicant/Agent's Signature
(Agent's signature is valid only if an authorization letter from the applicant Date
is provided.)
Page 11 of 11
PCN Form - November 2008 Version
Y
osstem
a r .,, ir-
PROGRAM
July 11, 2008
Clyde E. Smith, Jr.
Cleveland County Water
P.O. Box 788
Lawndale, NC 28090
JR@F
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DEC r 9 ?008 .
71ANDSq?srp ? R
Expiration of Acceptance: January 11, 2009
Project: Off-stream Water Storage Reservoir County: Cleveland
The purpose of this letter is to notify you that the North Carolina Ecosystem Enhancement Program (NCEEP) is willing to accept
payment for impacts associated with the above referenced project. Please note that this decision does not assure that the payment will
be approved by the permit issuing agencies as mitigation for project impacts. It is the responsibility of the applicant to contact these
agencies to determine if payment to the NCEEP will be approved.
This acceptance is valid for six months from the date of this letter and is not transferable. If we have not received a copy of the
issued 404 Permit/401 Certification/CAMA permit within this time frame, this acceptance will expire. It is the applicant's
responsibility to send copies of the permits to NCEEP. Once NCEEP receives a copy of the permit(s) an invoice will be issued based
on the required mitigation in that permit and payment must be made prior to conducting the authorized work. The amount of the In
Lieu Fee to be paid to NCEEP by an applicant is calculated based upon the Fee Schedule and policies listed at www.nceep.net.
Based on the information supplied by you the impacts that may require compensatory mitigation are summarized in the following
table.
River
Basin CU
Location Stream (feet) Wetlands (acres) Buffer I
(Sq. Ft.) Buffer II
(Sq. Ft.)
Cold Cool Warm Riparian Non-Ri arian Coastal Marsh
Impacts Broad 03050105 0 0 500 0 0 0 0 0
Credits Broad 03050105 0 0 1,000 0 0 0 0 0
Upon receipt of payment, EEP will take responsibility for providing the compensatory mitigation. If the regulatory agencies require
mitigation credits greater than indicated above, and the applicant wants NCEEP to be responsible for the additional mitigation, the
applicant will need to submit a mitigation request to NCEEP for approval prior to permit issuance. The mitigation will be performed
in accordance with the Memorandum of Understanding between the N. C. Department of Environment and Natural Resources and the
U. S. Army Corps of Engineers dated. November 4, 1998.
If you have any questions or need additional information, please contact Valerie Mitchener at [phone].
Sincerely,
William D. Gilmore, PE
Director
cc: Cyndi Karoly, NCDWQ Wetlands/40I Unit
Steve Chapin, USACE-Asheville
Alan Johnson, NCDWQ-Mooresville
Michael Dowd, agent
File
R.t stoY1hg... 'E ... Prot", Ottr State

NCDENR
North Carolina Ecosystem Enhancement Program, 1652 Mail Service Center, Raleigh, NC 27699-1652 / 919-715-0476 / wvvw.nceep.net
3
D g@TflV[A 0?
U.S. ARMY CORPS OF ENGINEERS DEC 1 9 2008
WILMINGTON DISTRICT
DSNAtiD STORMW ?R %"w
Action ID. 200531774 County: Cleveland USGS Quad: LaFie
GENERAL PERAUT (REGIONAL AND NATIONWIDE) VERIFICATION
Property Owner / Authorized Agent: Cleveland County Sanitary District.
Address: P.O. Box 788
Lawndale, NC 28090
Telephone No.:
Size and location of property (water body, road name/number, town, etc.): Water Treatment Plant Site
located on 13.53 acre tract on Casar-LaNvndale Rd. north of Lawndale.
Description of projects area and activity: This permit authorizes construction of a raw water storassg
pond on an unnamed tributarv to the First Broad River. The pond will impound approtfmately
1,680 LF of intermittent stream channel. The Cleveland County Sanitary District is required by
the State by "Rules Governing Public Water SuPDly Svstems" as published by the NC Public Water
Sunnly Section to provide for off-stream storage of raw water prior to treatment
Applicable Law: ?X Section 404 (Clean Water Act, 33 USC 1314)
? Section 10 (Rivers and Harbors Act, 33 USC 403)
Authorization: Regional General Permit Number:
Nationwide Perniit Number: 39
Your work is authorized by the above referenced permit provided it is accomplished in strict accordance with the
attached Nationwide conditions, your submitted plans, and the following SPECIAL CONDITION: OUTSIDE OF
THE AREA BELOW THE DAM AND THE WATER PLANT AREA, THE IMPOUNDMENT WILL BE
SURROUNDED BY AN AT LEAST 50 FOOT WIDE FORESTED BUFFER AS DEPICTED IN THE
MCGILL ASSOCIATES DOCUMENT ENTITLED "OFF-STREAM STORAGE RESERVOIR" DATED
10/5105.
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 is valid until the NWP is modified, reissued, or revoked. All of the existing NWP's are
scheduled to be modified, reissued, or revoked prior to March 18, 2007. It is incumbent upon you to remain
informed of the changes to the NWT's. We will issue a public notice when the NWP's are reissued. Furthermore, if
you commence or are under contract to commence this activity before the date that the relevant nationwide permit is
modified or revoked, you will have twelve (12) months from the date of the modification or revocation of the NWP
to complete the activity under the present terms and conditions of this nationwide permit.
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 to regulation under the Coastal Area
Management Act (CAMA), 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 Steve Chapin at 828-271-7980 x224.
Corps Regulatory Official Steve Chapin Date: October 25, 2005
Expiration Date of Verification: March 18, 2007
-2-
Determination of Jurisdiction:
? Based on preliminary information, there appear to be waters of the US including wetlands within the above
described project area. This preliminary determination is not an appealable action under the Regulatory
Program Administrative Appeal Process (Reference 33 CFR Part 331).
? There are Navigable Waters of the United States within the above described project area subject to the permit
requirements of Section 10 of the Rivers and Harbors Act and Section 404 of the Clean Water Act. Unless
there is a change in the law or our published regulations, this determination may be relied upon for a period not
to exceed five years from the date of this notification.
® There are waters of the US and/or wetlands within the above described project area subject to the permit
requirements of Section 404 of the Clean Water Act (CWA)(33 USC § 1344). Unless there is a change in the
law or our published regulations, this determination may be relied upon for a period not to exceed five years
from the date of this notification.
? The jurisdictional areas within the above described project area have been identified under a previous action.
Please reference jurisdictional determination issued-. Action ID
Basis of Jurisdictional Determination: First Broad River>Broad R.
Corps Regulatory Official: Steve Chapin
Date October 25. 2005
Copy Furnished:
McGill Assoicates, P.A.
Permit Number: 200531774
Pennit Type: NW39
Name of County: Cleveland
Name of Permittee: CCSD
Date of Issuance: October 25, 2005
Project Manager: Steve Chapin
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:
U.S. Aimy Corps of Engineers
Attention: CESAW-RG-A
151 Patton Avenue, Room 208
Asheville, North Carolina 28801-5006
Please note that your permitted activity is subject to a compliance inspection by an 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 pen-nit has been completed in
accordance with the terms and conditions of the said permit, and required mitigation was
completed in accordance with the pennit conditions.
Signature ofPennittee
Date
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Applicant: Cleveland Co. Sanitary District File Number: 200531774 Date: October 25, 2005
At tached is: See Section below
INITIAL PROFFERED PERMIT (Standard Permit or Letter of A
permission)
PROFFERED PERMIT (Standard Permit or Letter of permission) B
PERMIT DENIAL C
X APPROVED JURISDICTIONAL DETERMINATION D
PRELIMINARY JURISDICTIONAL DETERMINATION E
_............ ...•
;.SECTION I Tlie fol7owmg idenf?fies your nghts and opttons regardtng an aduun?strattve. appeal oFtl?e aboye

i. I.
decision 4ddrttonal mfor1hat, may be
found at http lLwww usace a=my roil/tnetJfimctions/cw%cecwo/rep or.
Go .s..regLuatibns at 3.3 GFR Part 33.1
!: 1
A: INITIAL PROFFERED PERMIT: You may accept or object to the permit.
• ACCEPT: If you received a Standard Permit, you may sign the permit document and return it to die district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your signature
on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all rights to appeal the
permit, including its terms and conditions, and approved jurisdictional determinations associated with the permit.
• OBJECT: If you object to the permit (Standard or LOP) because of certain terms and conditions therein, you may request that the
permit be modified accordingly. You must complete Section H of this form and return the form to the district engineer. Your
objections must be received by the district engineer within 60 days of the date of this notice, or you Nvill forfeit your right to appeal
the permit in the future. Upon receipt of your letter, the district engineer will evaluate your objections and may: (a) modify the
permit to address all of your concerns, (b) modify the permit to address some of your objections, or (c) not modify the permit
having determined that the permit should be issued as previously written. After evaluating your objections, die district engineer
will send you a proffered permit for your reconsideration, as indicated in Section B below.
B. PROFFERED PERMIT: You may accept or appeal the permit
• ACCEPT: If you received a Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized, Your signature
on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all rights to appeal the
permit, including its terms and conditions, and approved jurisdictional determinations associated with the permit.
• APPEAL: If you choose to decline the proffered permit (Standard or LOP) because of certain terms and conditions therei
n, you
may appeal the declined permit under the Corps of Engineers Administrative Appeal Process by completing Section II of this form
and sending the form to the division engineer. This form must be received by the division engineer within 60 days of the date of
this notice.
C: PERMIT DENIAL: You may appeal the denial of a permit under the Corps of Engineers Administrative Appeal Process by
completing Section II of this form and sending the form to the division engineer, This form must be received by the division engineer
within 60 days of the date of this notice.
D: APPROVED JURISDICTIONAL DETERMINATION: You may accept or appeal the approved JD or
provide new information.
• ACCEPT: You do not need to notify the Corps to accept an approved JD. Failure to notify the Corps within 60 days of the date of
this notice, means that you accept the approved JD in its entirety, and waive all rights to appeal the approved JD.
• APPEAL: If you disagree with the approved JD, you may appeal the approved JD under the Corps of Engineers Administrative
Appeal Process by completing Section II of this form and sending the form to the division engineer. This form must be received by
die division engineer within 60 days of the date of this notice.
E: PRELRv NARY JURISDICTIONAL DETERMINATION: You do not need to respond to the Corps
regarding the preliminary JD. The Preliminary JD is not appealable. If you wish, you may request an approved
JD (which may be appealed), by contacting the Corps district for further instruction. Also you may provide new
information for further consideration by the Corps to reevaluate the JD.
SECTION'II REQUEST FORABPEAL of 0$JECTIQNS TO.AN:II?ITIAL PROFFERED PERIVIIT..`:_ .
REASONS FOR APPEAL OR OBJECTIONS: (Describe your reasons for appealing the decision or your
objections to an initial proffered permit in clear concise statements. You may attach additional information to
this form to clarify where your reasons or objections are addressed in the administrative record.)
ADDITIONAL INFORMATION: The appeal is limited to a review of the administrative record, the Corps
memorandum for the record of the appeal conference or meeting, and any supplemental information that the
review officer has determined is needed to clarify the administrative record. Neither the appellant nor the Corps
may add new infornmation or analyses to the record. However, you may provide additional information to clarify
the location of information that is already in the administrative record.
..:...:
P:OINT.:OI,':: CONTACT.:FOR.QUl;S:.....................................................
If you have questions regarding this decision If you only have questions regarding the appeal process you
and/or the appeal process you may contact: may also contact:
Steve Chapin Mr. Michael F. Bell, Administrative Appeal Review
151 Patton Ave Officer
RM 208 CESAD-ET-CO-R
Asheville, NC 28806 U.S. Army Corps of Engineers, South Atlantic Division
828-271-7980 60 Forsyth Street, Room 9M15
Atlanta, Georgia 30303-8801
RIGHT OF ENTRY: Your signature below grants the right of entry to Corps of Engineers personnel, and any
government consultants, to conduct investigations of the project site during the course of the appeal process. You
will be provided a 15 day notice of any site investigation, and will have the opportunity to participate in all site
investigations.
Date: Telephone number:
Signature of appellant or agent.
DIVISION ENGINEER:
Commander
U.S. Army Engineer Division, South Atlantic
60 Forsyth Street, Room 9M15
Atlanta, Georgia 30303-3490