20160372 Ver 2_401 Application_20180919

Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.4 January 2009
Pre -Construction Notification (PCN) Form
A. Applicant Information
1. Processing
1a. Type(s) of approval sought from the Corps:
❑X Section 404 Permit ❑ Section 10 Permit
1 b. Specify Nationwide Permit (NWP) number: 27 or General Permit (GP) number:
1 c. Has the NWP or GP number been verified by the Corps? ❑ Yes ❑X No
1d. Type(s) of approval sought from the DWQ (check all that apply):
❑X 401 Water Quality Certification — Regular ❑ Non -404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express Q Riparian Buffer Authorization
le. Is this notification solely for the record For the record only for DWQ For the record only for Corps Permit:
because written approval is not required? 401 Certification:
❑ Yes ❑X No ❑ Yes ❑X 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.
1 g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1h
below.
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ YesX❑ No
❑ Yes Q No
❑ Yes Q No
2. Project Information
2a. Name of project:
Stony Fork Restoration Site (SFRS)
2b. County:
Johnston
2c. Nearest municipality / town:
Benson, NC
2d. Subdivision name:
NA
2e. NCDOT only, T.I.P. or state project no:
NA
3. Owner Information
3a. Name(s) on Recorded Deed:
See attached Compiled Landowner List
3b. Deed Book and Page No.
3c. Responsible Party (for LLC if
applicable):
3d. Street address:
3e. City, state, zip:
3f. Telephone no.:
3g. Fax no.:
3h. Email address:
Page 1 of 10
PCN Form —Version 1.4 January 2009

4. Applicant Information (if different from owner)
4a. Applicant is:
❑X Agent ❑ Other, specify:
4b. Name:
Lin Xu
4c. Business name
(if applicable):
NCDEQ Division of Mitigation Services
4d. Street address:
1652 Mail Service Center
4e. City, state, zip:
Raleigh, NC 27699-1652
4f. Telephone no.:
919-707-8319
4g. Fax no.:
4h. Email address:
[e-mail]
5. Agent/Consultant Information (if applicable)
5a. Name:
Timothy J. Morris
5b. Business name
(if applicable):
KCI Technologies, Inc.
5c. Street address:
4505 Falls of Neuse Road, Suite 400
5d. City, state, zip:
Raleigh, NC 27609
5e. Telephone no.:
[phone]
5f. Fax no.:
[phone]
5g. Email address:
[e-mail]
Page 2 of 10

B. Project Information and Prior Project History
1. Property Identification
1 a. Property identification no. (tax PIN or parcel ID):
See attached Compiled Landowner List
1b. Site coordinates (in decimal degrees):
ILatitude: 35.450821 Longitude: -78.519435
1c. Property size:
See attatcld acres
2. Surface Waters
2a. Name of nearest body of water to proposed project:
Stony Fork
2b. Water Quality Classification of nearest receiving water:
C
2c. River basin:
Neuse
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:
The project watershed for the SFRS is comprised of 0.78 square mile (497 acres). Current land use in the
project watershed consists of agriculture/open space, forest, rural development, residential, androads/impervious and water. The current adjacent
land use has a neciative impact on water auality of the proiect stream. Detailed descriptions of land use can be found in the attached miticlation plan.
3b. List the total estimated acreage of all existing wetlands on the property: 1,72
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property: 6,996
3d. Explain the purpose of the proposed project:
Restore an incised stream to a stable stream system with an active floodplain and a forested riparian buffer to provide bank stabilization and shading.
3e. Describe the overall project in detail, including the type of equipment to be used:
A detailed Mitigation Plan has been included in this submittal. It includes the details of the project and proposed restoration activities.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (includingall prior phases)in the past?
❑X Yes ❑ No ❑ Unknown
Comments:
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): Joseph Sullivan
Agency/Consultant Company:
Other: KCI Associates of NC
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
07/13/2016. The JD is included in Appendix 12.8 of the attached Mitigation Plan
5. Project History
5a. Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past?
❑Yes ❑x No ❑ Unknown
5b. If yes, explain in detail according to "help file" instructions.
6. Future Project Plans
6a. Is this a phased project?
❑ Yes ❑X No
6b. If yes, explain.
Page 3 of 10
PCN Form —Version 1.4 January 2009

C. Proposed Impacts Inventory
1. Impacts Summary
1a. Which sections were completed below for your project (check all that apply):
❑X WetlandsX❑ Streams — tributaries ❑X 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 impact
Type of wetland
Forested
Type of jurisdiction
Area of
number
Corps (404,10) or
impact
Permanent (P) or
DWQ (401, other)
(acres)
Temporary
W1 T
Fill
Aeadwater Wetland
No
Corps
0.01
W2 T
Fill
Non-Tidal Freshwater Marsh
No
Corps
0.01
W3
Choose one
hoose one
Yes/No
W4 -
Choose one
hoose one
Yes/No
W5 -
Choose one
hoose one
Yes/No
W6 -
Choose one
hoose one
Yes/No
-
2g. Total Wetland Impacts:
0.02
2h. Comments:
The JD nomenclature is different: W1 = WA and W2 = WF
A wetland impact map is included
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 (PER) or
Type of
Average
Impact
number
intermittent (INT)?
jurisdiction
stream
length
Permanent (P) or
width
(linear
Temporary (T)
(feet)
feet)
S1 T
Restoration
Stony Fork
PER
Corps
7
4787
S2 T
Restoration
T1
INT
Corps
4
342
S3 T
Restoration
T2
INT
Corps
3
546
S4 T
Restoration
T2
PER
Corps
5
833
S5 T
Restoration
T3
INT
Corps
4
117
S6 T
Restoration
T4
INT
Corps
2
116
3h. Total stream and tributary impacts
6996
3i. Comments:
S7 (T5) will be restored for 213 feet. It is an intermittent stream with an average width of 3 feet. The impact will be temporary.
S8 (T8) will be restored for 42 feet. It is an intermittent stream with an average width of 3 feet. The impact will be temporary.
Page 4 of 10
PCN Form — Version 1.4 January 2009

4. Open Wager 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 indiv dually list all open water impacts below.
4a.
Open water
impact number
Permanent (P) or
Temporary
4b.
Name of waterbody
(if applicable)
4c.
Type of impact
4d.
Waterbody
type
4e.
Area of impact (acres)
01
Choose one
Choose
02 -
Choose one
Choose
03
Choose one
Choose
04 -
Choose one
Choose
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If pond or lake construction proposed, the complete the chart below.
5a.
Pond ID number
5b.
Proposed use or
purpose of pond
5c. 5d. 5e.
Wetland Impacts (acres) Stream Impacts (feet) Upland
(acres)
Flooded
Filled
Excavated Flooded
Filled
Excavated
P1
Choose one
P2
Choose one
5f. 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 any impacts require mitigation, then you MUST fill out Section D of this form.
6a. Project is in which protected basin?
❑X Neuse ❑ Tar-Pamlico ❑ Catawba ❑ Randleman ❑ Other:
6b.
Buffer Impact
number —
Permanent (P) or
Tem ora
6c.
Reason for impact
6d.
Stream name
6e.
Buffer
mitigation
required?
6f.
Zone 1
impact
(square
fe2D
6g.
Zone 2
impact
(square
fee
61 T
Restoration
Stony Fork
No
264830
145596
B2 T
Restoration
T2
No
61320
40880
B3 T
Restoration
T5
No
14109
6516
B4 T
Restoration
T6
No
5722
2545
B5 -
Yes/No
B6
Yes/No
6h. Total Buffer Impacts:
6i. Comments: Impact numbers account for highest possible impact
Page 5 of 10

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
We are applying for a Nationwide 27 permit. This permit authorizes impacts to jurisdictional waters for the purpose of conducting aquatic habitat
restoration, establishment and enhancement activities. This project will provide stream mitigation credits for impacts elsewhere within this 8 -digit HUC.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
A pump around will be utilized to conduct all stream restoration work in the dry. Sediment and erosion control measures such as silt fence, straw
wattles, rock silt screens and daily stabilization will be used to minimize impacts during construction. The impacts proposed are necessary for the
proper restoration of the stream. Sediment and erosion control plans are included in the attached Mitigation Plan.
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 Q 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: Choose one
Type: Choose one
Type: Choose one
Quantity:
Quantity:
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:
Choose one
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 1.4 January 2009

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
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? If no, explain why.
❑ Yes ❑ No
2. Stormwater Mana ement Plan
2a. What is the overall percent imperviousness of this project?
0
2b. Does this pro'ect require a Stormwater Management Plan?
❑ Yes ❑X No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why:
This is a stream restoration porject. No impervious area will be created.
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?
3. Certified Local Government Stormwater Review
3a. In which localgovernment's jurisdiction is thisproject?
❑ Phase II
3b. Which of the following locally -implemented stormwater management programs
❑ NSW
apply (check all that apply):
❑ USMP
❑ Water Supply Watershed
❑ Other:
3c. Has the approved Stormwater Management Plan with proof of approval been
❑Yes ❑ No
attached?
4. DWQ Stormwater Program Review
❑Coastal counties
❑ HQW
4a. Which of the following state -implemented stormwater management programs apply
❑ORW
(check all that apply):
❑Session Law 2006-246
❑Other:
4b. Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ❑ No
attached?
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 1.4 January 2009

F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
la. Does the project involve an expenditure of public (federal/state/local) funds or the
❑x 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)?
1c. 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 Q No
A categorical exclusion report has been prepared and included in Appendix 12.9 of
Comments: the attached Mitigation Plan
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 26 .0200)?
2b. Is this an after -the -fact permit application?
❑Yes ❑X 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 ❑X 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.
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.
This is a stream restoration project, no wastewater will be generated.
Page 9 of 10
PCN Form —Version 1.4 January 2009

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or
YesX No
❑ ❑
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act
0 Yes ❑ No
impacts?
5c. If yes, indicate the USFWS Field Office you have contacted.
-Raleigh
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
-NC Wildlife Resources Commission. Carolina Wildlife Profiles. http://www.ncwildlife.org/fk index_07_conservabon.htm
-United States Fish and Wildlife Service. North Carolina's Threatened and Endangered Species. http://www.fws.gov/southeast/.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?
❑ Yes Q No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
Essential Fish Habitat Mappar v3.0 http://www.habitat.noaa.gov/protection/efh/efhmapper/index.htmi
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?
A categorical exclusion report was prepared and is included in Appendix 12.9 of the attached Mitigation Plan. This document contains
correspondence from the State Historic Preservation Office regarding the resources of concern.
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?
NC Floodmaps. https:/Ifris.nc.gov/fris/Index.aspx?FIPS=191&ST=NC&user=General%2OPublic
Division of Mitigation Services
Applicant/Agent's Signature
Applicant/Agent's Printed Name
Date
(Agent's signature is valid only if an authorization
letter from the applicant isprovided.)
Page 10 of 10

Attachment 1, Land Owner Information

* * * DISCLAIMER * * *
Johnston County assumes no legal responsibility for the information represented here.
i
A Orthophoto Report
sir X Coordinate: 2140558.3472222
Y Coordinate: 617823.95833334
id: 07FO8038A
a Tag: 07FO8038A
., Tax Unique Id: 4352668
N C P i n: 164100-07-4699
a Mapsheet No: 1641
Owner Name 1: BLACKMON, SEXTON GERALD
LIFE ESTATE
Owner Name 2: BLACKMON, FATISHA BETH
REMAINDER
Mail Address 1: 2295 FEDERAL RD
Mail Address 2:
Mail Address 3: BENSON, NC 27504-0000
Site Address 1:
Site Address 2:
• Book: 03358
r Page: 0941
Market Value: 105270
Assessed Acreage: 1.2
Calc. Acreage: 1.243
Sales Price: 0
Sale Date: 2007-06-08
Township: Elevation
Water District: Elevation Water District
ETJ: N/A
City Limits: N/A
Town Zoning: N/A
County Zoning: AR
Overlay Zoning: N/A
i
JAL
N
Scale: 1:6000 - 1 in. = 500 feet
Johnston County GIS
(The scale is only accurate when printed landscape on a 8 112 x 111 size sheet with no page scaling.) April 19, 2016

t
k- .. "A.7PAX
E
* * * DISCLAIMER * * *
Johnston County assumes no legal responsibility for the information represented here.
Orthophoto Report
i
X Coordinate: 2140780.5694444
Y Coordinate: 618372.56944445
id: 07FO8028B
Tag: 07FO8028B
Tax Unique Id: 4324486
NCPin: 164100-08-6845
Mapsheet No: 1641
Owner Name 1: BENSON, GARY THOMAS
Owner Name 2:
Mail Address 1: 3836 ELEVATION RD
Mail Address 2:
Mail Address 3: BENSON, NC 27504-7361
Site Address 1: 2105 FEDERAL RD
Site Address 2: BENSON, NC 27504 -
Book: 03701
Page: 0909
Market Value: 184710
Assessed Acreage: 33.75
Calc. Acreage: 33.75
Sales Price: 0
Sale Date: 2009-05-14
Township: Elevation
Water District: Elevation Water District
ETJ: N/A
City Limits: N/A
Town Zoning: N/A
County Zoning: AR
Overlay Zoning: N/A
Scale: 1:6000 - 1 in. = 500 feet
(The scale is only accurate when printed landscape on a 8 1/2 x 11 size sheet with no page scaling.)
Johnston County GIS
April 19, 2016

* * * DISCLAIMER * * *
Johnston County assumes no legal responsibility for the
information represented here.
-
-
*4
Orthophoto Report
X Coordinate: 2143120.8472222
•
Y Coordinate: 619372.56944445
id: 07FO8025A
-
Tag: 07FO8025A
Tax Unique Id: 4324459
NCPin: 164100-29-9457
Mapsheet No: 1641
Owner Name 1: BENSON, GARY T
,ra
F
Owner Name 2:
Mail Address 1: 3836 ELEVATION RD
Mail Address 2:
Mail Address 3: BENSON, NC 27504-7361
Site Address 1: 3789 ELEVATION RD
'
Site Address 2: BENSON, NC 27504 -
Book: 01430
Page: 0674
r
Market Value: 244190
• y
Assessed Acreage: 62.49
-
Calc. Acreage: 62.509
Sales Price: 0
Sale Date: 1995-03-03
Township: Elevation
Water District: Elevation Water District
ETJ: N/A
City Limits: N/A
Town Zoning: N/A
County Zoning: AR
Overlay Zoning: N/A
Scale: 1:6000 - 1 in. = 500 feet
Johnston County GIS
(The scale Is only accurate when printed landscape on a 8 112 x 11 size sheet with no page scaling.) April 19, 2016

* * * DISCLAIMER * * *
Johnston County assumes no legal responsibility for the information represented here.
.. C\
1%
"Ef
k.
U
Orthophoto Report
X Coordinate:
2141447.2361111
Y Coordinate:
618643.40277778
id:
07FO8027
Tag:
07FO8027
Tax Unique Id:
4324498
NCPin:
164100-19-1598
Mapsheet No:
1641
Owner Name 1:
PARRISH, JERRY W
Owner Name 2:
Mail Address 1:
4141 ELEVATION RD
Mail Address 2:
Mail Address 3:
BENSON, NC 27504-0000
Site Address 1:
4139 ELEVATION RD
Site Address 2:
BENSON, NC 27504 -
Book:
01447
Page:
0287
Market Value:
187490
Assessed Acreage:
27.91
Calc. Acreage:
27.562
Sales Price:
0
Sale Date:
1996-01-22
Township:
Elevation
Water District:
Elevation Water District
ETJ:
N/A
City Limits:
N/A
Town Zoning:
N/A
County Zoning:
AR
Overlay Zoning:
N/A
Scale: 1:6000 - 1 in. = 500 feet
(The scale is only accurate when printed landscape on a 8 112 x 11 size sheet with no page scaling.)
Johnston County GIS
April 19, 2016

* * * DISCLAIMER * * *
Johnston County assumes no legal responsibility for the information represented here.
Orthophoto Report
Scale: 1:6000 - 1 in. = 500 feet
Johnston County GIS
(The scale is only accurate when printed landscape on a 8 112 x 11 size sheet with no page scaling.) April 19, 2016
X Coordinate: 2141662.5138889
Y Coordinate: 617567.0138889
id: 07FO8040A
Tag: 07FO8040A
>,
Tax Unique Id: 4393687
NCPin: 164100-17-2357
-
Mapsheet No: 1641
Owner Name 1: MAXINE K MEDLIN
`.
TESAMENTARY TRUST
- +I71
Owner Name 2: BARBOUR, DEVAN III
Mail Address 1:
Mail Address 2: PO BOX 295
Mail Address 3: BENSON, NC 27504-0000
Site Address 1:
Site Address 2:
Book: 03734
Page: 0001
Market Value: 429760
Is
Assessed Acreage: 111.96
-
Calc. Acreage: 113.41
Sales Price: 0
_
`
Sale Date: 2009-07-28
Township: Elevation
Water District: Elevation Water District
_ �►
ETJ: N/A
IF
*
City Limits: N/A
_ -
Town Zoning: N/A
-
County Zoning: AR
Overlay Zoning: N/A
Scale: 1:6000 - 1 in. = 500 feet
Johnston County GIS
(The scale is only accurate when printed landscape on a 8 112 x 11 size sheet with no page scaling.) April 19, 2016

* * * DISCLAIMER * * *
Johnston County assumes no legal responsibility for the information represented here.
Ortho h p oto Report
r `•'rte '' #I •� /, y. �'t r
X Coordinate: 2142211.125
YCoordinate: 618692.0138889
id: 07F08026A
-.f Tag: 07F08026A
Tax Unique Id: 4425795
1 fi NCPin: 164100-28-7593
Scale: 1:6000 - 1 in. = 500 feet
(The scale is only accurate when printed landscape on a 8 112 x 11 size sheet with no page scaling.)
Johnston County GIS
April 19, 2016
Mapsheet No: 1641
Owner Name 1: SHERRILL FARM, LLC
Owner Name 2:
.
Mail Address 1: 5160 NC HIGHWAY 42 W
Mail Address 2:
±
Mail Address 3: GARNER, NC 27529-8417
Site Address 1:
f
Site Address 2:
Book: 04702
Page: 0505
Market Value: 326580
Assessed Acreage: 98.1
Calc. Acreage: 98.1
Sales Price: 400000
Sale Date: 2015-12-31
Township: Elevation
Water District: Elevation Water District
ETJ: N/A
City Limits: N/A
Town Zoning: N/A
r
County Zoning: AR
Overlay Zoning: N/A
Scale: 1:6000 - 1 in. = 500 feet
(The scale is only accurate when printed landscape on a 8 112 x 11 size sheet with no page scaling.)
Johnston County GIS
April 19, 2016

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AM: Project Easement Intermittent Streams'
Jurisdictional Wetlands Perennial Stre

Environmental
Quality
MEMORANDUM:
TO: Summer Lowe
FROM: Lin Xu
SUBJECT: Payment of Permit Fee
401 Permit Application
DATE: September 19, 2018
ROY COOPER
The Division of Mitigation Services (DMS) is implementing a mitigation project for
Stony Fork Restoration Site Mitigation Project in Johnston County (DMS IMS # 97085).
The activities associated with this restoration project involve stream restoration related
temporary stream and wetland impact. To conduct these activities, the DMS must
submit a Pre -construction Notification (PCN) Form to the Division of Water Resources
(DWR) for review and approval. The DWR assesses a fee of $570.00 for this review.
Please transfer $570.00 from DMS Fund # 2984, Account # 535120 to DWR as
payment for this review. If you have any questions concerning this matter I can be
reached at 919-707-8319. Thanks for your assistance.
cc: Karen Higgins, DWR
State of North Carolina I Environmental Quality
217 West Jones Street 11601 Mail Service Center I Raleigh. North Carolina 276991601
919 707 8600

Environmental
Quality
September 19, 2018
Danny Smith, Regional Supervisor, Water Quality Regional Operations Section
NC DEQ Raleigh Regional Office
3800 Barrett Drive
Raleigh, NC 27609
ROY COOPER
Re: Permit Application — Stony Form Restoration Site Mitigation Project, Johnston County
(DMS Full Delivery Project)
Dear Mr. Smith:
Attached for your review is 404/401 permit application package for the subject project. Please
feel free to contact me with any questions regarding this plan (919-707-8319).
Thank you very much for your assistance.
Sincerely
Lin Xu
Attachment: 404/401 Permit Application Package
Final Mitigation Plan
State of North Carolina I Environmental Quality
217 West Jones Street 11601 Mail Service Center I Raleigh, North Carolina 2769 9-16 01
919 707 8600

Environmental
Quality
September 19, 2018
Karen Higgins, 401 & Buffer Permitting Unit Supervisor
Division of Water Resources
401 & Buffer Permitting Unit
1617 Mail Service Center
Raleigh, NC 27699 - 1617
ROY COOPER
Governor
Re: Permit Application- Stony Fork Restoration Site Mitigation Project, Johnston County
(DMS Full Delivery Project)
Dear Ms. Higgins:
Attached for your review is 404/401 permit application package for the subject project. Another
copy has been sent to the Raleigh Regional Office for review. A memo for the permit
application fee is also included in the package. All electronic files have been uploaded to NC
DWR's file system. Please feel free to contact me with any questions regarding this plan (919-
707-8319).
Thank you very much for your assistance.
Sincerely
Lin Xu
Attachment: 404/401 Permit Application Package
Final Mitigation Plan
Permit Application Fee Memo
State of North Carolina I Environmental Quality
217 West Jones Street 1 1601 Mail Service Center I Raleigh. North Carolina 276941601
919 707 8600

D# * 20160372
Version* 1
Select Reviewer:* Mac Haupt
Mitigation Project Submittal - 9/19/2018
Type of Mitigation Project:*
V Stream r Wetlands r Buffer r Nutrient Offset
(Select all that apply)
Is this a Prospectus, Technical Proposal or a f Yes r No
New Site? *
Project Contact Information
Contact Name:* Lin Xu
Email Address:* [e-mail]
Project Information
Existing (DWR) ID#:* 20160372
(nun-bers only... no dash)
Existing Version:* 1
(nurrbers only)
Project Name:* Stony Fork Restoration SSite
County:* Johnston
Document Information
Mitigation Document Type:*
Mitigation Plan
File Upload: StonyFork_97085_MP_2018.pdf
34AMB
401 PermitFee-StonyFork.pdf
39.5KB
StonyFork401 COffice.pdf
39.32KB
StonyFork401 Raleigh.pdf
34.51 KB
StonyForkPCN.pdf
1.33MB
Rease upload only one RDF of the complete file that needs to be submitted...
Signature
Print Name:* Lin Xu

Signature:*