20090186 Ver 1_401 Application_20090209

,9-0186
BUNN ENGINEERING CO., P.C.
CIVIL ENGINEERING, LAND SURVEYING
152 NORTH MAIN STREET MOUNT AIRY, NC 27030 336-789-6610 FAX [phone]
i ? 0
COP
February 20, 2009
N. C. Division of Water Quality
401/Wetlands Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
Dear Sir/Madam:
I am sending five (5) copies of a PCN Form for your records. This project's impacts are under
the threshold limits. The project in called "Crawford Village" and is located in Stokes County,
North Carolina.
Please contact me if you have questions or concerns.
Thank you.
Sincerely,
Eddie H. Bunn, P.E., P.L.S.
jsb
Enclosures
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Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Pre-Construction Notification (PCN) Form

A. Applicant Information q.?iw
U k`1 E .
1. Processing r,
1 a. Type(s) of approval sought from the
Corps:
? Section 404 Permit ? Section 10 Permit
1 b. Specify Nationwide Permit (NWP) number: NW 39 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps? ?x 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
le. 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: Crawford Villa
2b. County: Stokes
2c. Nearest municipality / town:
2d. Subdivision name:
2e. NCDOT only, T.I.P. or state
project no:
N/A
3. Owner Information
3a. Name(s) on Recorded Deed: Adrien Associates LLC.
3b. Deed Book and Page No. DB 548, PG 1204
3c. Responsible Party (for LLC if
applicable):
James Turpin
3d. Street address: 1075 Volunteer Road (P.O. Box 1049)
3e. City, state, zip: King, NC 27021
3f. Telephone no.: [phone]
3g. Fax no.: 336 591-1120
3h. Email address: [e-mail]
Page 1 of 10
PCN Form -Version 1.3 December 10, 2008 Version
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: Eddie H. Bunn
5b. Business name
(if applicable):
Bunn Engineering Co., P. C.
5c. Street address: 152 N. Main Street
5d. City, state, zip: Mount Airy, NC 27030
5e. Telephone no.: ( 336) 789-6610
5f. Fax no.: 336 789-5246
5g. Email address: civil bunnen ineerin corn
Page 2 of 10
B. Project Information and Prior Project History
1. Property Identification
1 a. Property identification no. (tax PIN or parcel ID): 6947-17-10-6597
1b. Site coordinats n decimal degrees): See attached
?
"
' Latitude: 36.4119° Longitude: - 80.2172°
Exhibit
A
or 1
r (DD.DDDDDD) (-DD.DDDDDD)
1c. Property size: 161.7acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
proposed project: Dan River
2b. Water Quality Classification of nearest receiving water:
Clasz C
2c. River basin: Roanoke -
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: Site is located on N.C. Hwy. 89 west of the Town of Danbury, NC. The site i
approximately 75% wooded with moderate to steep slopes. Property is undeveloped farm-
land. The Stokes Count Government Center is located near this o t
3b. List the total estimated acreage of all existing wetlands on the property: The site may have small areas of
wetlands adjacent to the two small streams, but they have not been identified.
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property: Two small
streams cro
th
ss
e property having a total length of 7200 lin. ft. as scaled from a
1
1
RGS Quad Man
-
-
3d. Explain the purpose of the proposed project: To provide access to the 161-acre site and develop a
2.3-acre parcel and build a drugstore.
3e. Describe the overall project in detail, including the type of equipment to be used: Project involves clearing &
grading a 2.3-acre tract & constructing an access road. Heavy construction equipment
such as :Itrack hoes -dozers and eem
aetAr-s will b
d
p
e use
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? [9 Yes ? No ? Unknown
Comments:
4b. If the Corps made the jurisdictional determination, what type
f
? Preliminary Final
o
determination was made?
4c. If yes, who delineated the jurisdictional areas? Agency/Consultant Company:
Name (if known): John Thomas Other: Corps of 'Engineers
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation
On
.
9/23/07 John Thomas visited site and made a classification study of stream as perennial
'
5.
FPr!;J7iLcAJ14 s ory
5a. Have permits or certifications been requested or obtained for ? Yes ® No ? Unknown
this project (including all prior phases) in the past?
5b. If yes, explain in detail according to "help file" instructions.
6. Future Project Plans
6a. Is this a phased project? Q Yes ? No
6s, explain. The initial project will possibly lead to future commercial development
could develop ten (10) or more acres of land.
Page 3 of 10
PCN Form -Version 1.3 December 10, 2008 Version
C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
? Wetlands [9 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 impact Type of wetland Forested (Corps - 404, 10 Area of impact
Permanent (P) or (if known) DWQ - non-404, other) (acres)
Temporary
W1 ? P ? T ? Yes ? Corps
? No ? DWQ
W2 ? P ? T ? Yes ? Corps
? No ? DWQ
W3 ? P ? T ? Yes ? Corps
? No ? DWQ
W4 ? P ? T ? Yes ? Corps
? No ? DWQ
W5 ? P ? T ? Yes ? Corps
? No ? DWQ
W6 ? P ? T ? Yes ? Corps
? No ? 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. 3g.
Stream impact Type of impact Stream name Perennial Type of jurisdiction Average Impact
number -
Permanent (P) or (PER) or
intermittent (Corps - 404, 10
DWQ - non-404 stream
width length
(linear
Temporary (T) (INT)? ,
other) (feet) feet)
S1 [ P ? T 404 3 14-
installation to Dan River ? NT ? DWQ
S2 ? P ? T ? PER ? Corps
? INT ? DWQ
S3 ? P ? T ? PER ? Corps
? INT ? DWQ
S4 ? P ? T ? PER ? Corps
? INT ? DWQ
S5 ? P ? T ? PER ? Corps
? INT ? DWQ
S6 ? P ? T ? PER ? Corps
? INT ? DWQ
3h. Total stream and tributary impacts 147
3i. Comments: Temporary impacts will be within the permanent impacts,
Page 4 of 10
PCN Form - Version 1.3 December 10, 2008 Version
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 open water impacts below.
4a. 4b. 4c. 4d. 4e.
Open water Name of waterbody
impact number - (if applicable) Type of impact Waterbody type Area of impact (acres)
Permanent (P) or
Temporary
01 ?P?T
02 ?P?T
03 ?P?T
04 ?P?T
41'. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If and or lake construction proposed, then complete the chart below.
5a. 5b. 5c. 5d. 5e.

Pond ID
Proposed use or purpose Wetland Impacts (acres) Stream Impacts (feet) Upland

number (acres).
of pond
Flooded Filled Excavated Flooded Filled Excavated Flooded
P1
P2
Sf. Total
5g. Comments:
5h. Is a dam high hazard permit required?
? Yes ? No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If an impacts require mitigation, then you 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 -
Permanent (P) or Reason
for
Stream name Buffer
mitigation Zone 1 impact
(square feet) Zone 2 impact
(square feet)
Temporary impact required.
61 ?P?T ?Yes
No
B2 ?P?T ?Yes
? No
B3 ?P?T ?Yes
? No
6h. Total buffer impacts
6i. Comments:
Page 5 of 10
D. Impact Justification and Mitigation
1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
See attached sheet.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
The one stream crossing will provide the only access planned or anticipated for the
entire tract of land.
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

F1 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: linear feet
4c. If using stream mitigation, stream temperature: ? 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 6 of 10
PCN Form - Version 1.3 December 10, 2008 Version
D. Impact Justification and Mitigation (Continued from Page 6)
Ia. This project is the first phase in development of a larger tract of land. A small perennial
stream funs parallel with Highway 89 along the North side of the property. The stream must be
crossed to gain access to the property from the main road. In order to minimize impacts to the
stream, we are proposing to use block retaining walls to reduce the length of the culvert beneath
the proposed road. All utilities (water, sewer, electric and telephone) will be placed in the
proposed road to reduce the need for future stream crossings.
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 6c.
Reason for impact 6d.
Total impact
(square feet)
Multiplier 6e.
Required mitigation
(square feet)
Zone 1 3 (2 for Catawba)
Zone 2 1.5
6f. Total buffer mitigation required:
6g. 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).
6h. Comments:
Page 7 of 10
E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
I 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? If no, explain why.
Comments: ? Yes ? No
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project? 3%
2b. Does this proje require a Stormwater Management Plan? Site coverage El Yes No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why:
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:

2e. Who will be responsible for the review of the Stormwater Management Plan? ? Certified Local Government
? DWQ Stormwater Program
No approvals required. ? DWQ 401 Unit
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this project?
Town of Danbury

? Phase 11
3b. Which of the following locally-implemented stormwater management programs ? NSW
apply (check all that apply): ? USMP
? Water Supply Watershed
® Other: None
3c. Has the approved Stormwater Management Plan with proof of approval been ? Yes [x] No
attached?
4. DWQ Stormwater Program Review
? Coastal counties
4a. Which of the following state-implemented stormwater management programs apply [] HQW
? ORW
(check all that apply): ? Session taw 2006-246
Other: None
4b. Has the approved Stormwater Management Plan with proof of approval been
attached? ? Yes No
5. DWQ 401 Unit Stormwater Review
5a. Does the Stormwater Management Plan meet the appropriate requirements? ? Yes ? No
5b. Have all of the 401 Unit submittal requirements been met? ? Yes ? No
Page 8 of 10
PCN Form - Version 1.3 December 10, 2008 Version
F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1 a. 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
? Yes ? No
letter.)
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 x? 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
mopt recegt DWQ policy. If you answered "no," provide a short narrative description. This site could develop
i
nto a larger commercial tract of approximately 10 acres w/small commercial sites of
which 4.5 acres is antici ted to impervious. This Would put the total site
0
-aver at less rv M- ;;Pv]= 1
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. The Stokes county pSA has capacity to
treat waste from this site. See Flow Tracking/Acceptance Data - Exhibit B.
Page 9 of 10
PCN Form - Version 1.3 December 10, 2008 Version
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?
E] 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?
website: http://www.saw.usace.mil/WETLANDS/esa
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?
NCWRC
3855 Idlewild Road, Kernersville, NC 27284-9180
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?
website: http://www.hpo.ncdcr.gov.nrlist.htm
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? Flood Map

Applicant(Age,nt's Printed Name / Applicant/Agents Signature Date
(Age s sign ure is valid only if an authorization letter from the applicant
is mvided.
Page 10 of 10
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Department u(Environment and Natural Resources
Division of Witter Quality
Flow Tracking/Acceptance for Sewer Extension Permit Applications
(FTSE -10/07)
Project Applicant Name: ? Tb tti EJ COO
Project Name for which flow is being requested: S+bKeS COO 47?y_
More than one PA'.--0/07 may he required for a single project if the owner of the WWTP a nut rmponsible for all
pump stations along the route of the proposed wastewater flow.
1. Complete this section only if you are the owner of the wastewater treatment plant.
a, W W'1'P Facility Name: S+o KPH Co+ #4y W W T P
b. WWTPP Facility Permit t Ne,
All flows are in MGD
c. WWTP fnility's permitted, flaw 01 /60 _
® Estimated obligated flow not yet tributary to the W WTP Q o 03
c. WWTP facility's actual avg. flow 5f 0
)kl'otal flow for this specific request - --
g. Total actual and obligated flown to the Ca(;ility a a
h. Percent of permitted flow used
H. Complete this section for each pump station yoti are responsible for along the route of this
proposed wastewater flow.
List pump stations located betweeZ, _(,e ,roject con cciion ovn t Lind the WWTP
Pump Station Name Approx. Capacity, MGD Approx. Current Avg.
rn? V (Finn/Design) Daily Flow, MGD
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III. Certifcatio statement:1
I, M a 'rg ele Ila - , certily that, to the best of my knowledge, the addition of tl)e
volume of wastewater to be permitted in this project has been evaluated along the route to the receiving
wastewater treatment facility and that the flow from this project is not anticipaLud to cause any capacity
related sanitary sewer overflows or overburden any downstream pump station en route to the receiving
treatment plant under normal circumstances. This analysis has been performed in accordanpa with local
established policies and procedures using the best availablo data. This certification applies to those itums
listed above in Sections land 11 for which I am the responsible party. Signature of this torm indicates
acceptance of this wastewater flow. /M 1 f\ A 1 L
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.fficial Signature
Date
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