20041550 Ver 1_COMPLETE FILE_20040917

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Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P. E. Director
Division of Water Quality
Coleen H. Sullins, Deputy Director
Division of Water Quality
Asheville Regional Office
WATER QUALITY SECTION
October 20, 2004
Jeffery C. Justus
Mountain Inn Suites, LLC
640 Crest Road
Flat Rock, NC 28731
SUBJECT: Return Of Application
Mountain Inn Suites, LLC Property
Application Number: 04-1550
Project Status: On Hold
Henderson County
Dear Mr. Justus:
The Asheville Regional Office sent an Addditional Information Request to your attention on
September 23, 2004, asking that all of the requested information be submitted within 10 working
days of issuance of said letter. As of today, no additional information has been submitted.
The Division of Water Quality is hereby returning you application as incomplete in accordance with
15A NCAC 02H .0502 (c). Should you wish to proceed with this project, you must submit seven
copies of a completed application which provides for all of the requested information in the
application (and as specified in the additional information request) along with the appropriate
processing fee to the address contained within the application form.
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2090 U.S. 70 Highway Swannanoa, North Carolina 28778 Telephone [phone] F ($ 1169-'a OER QUALl,Customer Service 1-877-623-6748
AS AND SIORMyyq7?4 BRANCH
Return Of Application
Mountain Inn Suites, LLC Property
Page 2.
If you have any questions, you may contact me at kevin.barnett(a_ncmail.net or at 828.596.4657.
Sincerely,
Kevin H. Barnett,
Environmental Chemist
cc: Mr. Jon Laughter
Laughter, Austin and Associates, P.A.
131 Fourth Avenue, East
Hendersonville, NC 28792
Mr. Boyd L. Hyder
Mountain Inn & Suites, LLC
755 Upward Road
Flat Rock, N.C. 28731
Henderson County Building Inspections Office
Henderson County Health Department
Mr. Steve Chapin, US Army Corps of Engineers
Mr. Roy Davis, Division of Water Quality
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2090 U.S. 70 Highway Swannanoa, North Carolina 28778 Telephone [phone] Fax [phone] Customer Service 1-877-623-6748
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Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P. E. Director
Division of Water Quality
Coleen H. Sullins, Deputy Director
Division of Water Quality
Asheville Regional Office
WATER QUALITY SECTION
October 20, 2004
Jeffery C. Justus
Mountain Inn Suites, LLC
640 Crest Road
Flat Rock, NC 28731
SUBJECT: Return Of Application
Mountain Inn Suites, LLC Property
Application Number: 04-1550
Project Status: On Hold
Henderson County
Dear Mr. Justus:
The Asheville Regional Office sent an Addditional Information Request to your attention on
September 23, 2004, asking that all of the requested information be submitted within 10 working
days of issuance of said letter. As of today, no additional information has been submitted.
The Division of Water Quality is hereby returning you application as incomplete in accordance with
15A NCAC 02H .0502 (c). Should you wish to proceed with this project, you must submit seven
copies of a completed application which provides for all of the requested information in the
application (and as specified in the additional information request) along with the appropriate
processing fee to the address contained within the application form.
NbENR
2090 U.S. 70 Highway Swannanoa, North Carolina 28778 Telephone [phone] Fax [phone] Customer Service 1-877-623-6748
Return Of Application
Mountain Inn'Suites, LLC Property
Page 2.
If you have any questions, you may contact me at [e-mail] or at 828.596.4657.
Sincerely,
Kevin H. Barnett,
Environmental Chemist
cc: Mr. Jon Laughter
Laughter, Austin and Associates, P.A.
131 Fourth Avenue, East
Hendersonville, NC 28792
Mr. Boyd L. Hyder
Mountain Inn & Suites, LLC
755 Upward Road
Flat Rock, N.C. 28731
Henderson County Building Inspections Office
Henderson County Health Department
Mr. Steve Chapin, US Army Corps of Engineers
Mr. Roy Davis, Division of Water Quality
---*A
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2090 U.S. 70 Highway Swannanoa, North Carolina 28778 Telephone [phone] Fax [phone] Customer Service 1-877-623-6748
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P. E. Director
Division of Water Quality
Coleen H. Sullins, Deputy Director
Division of Water Quality
Asheville Regional Office
WATER QUALITY SECTION
September 23, 2004
Jeffery C. Justus
Mountain Inn Suites, LLC
640 Crest Road
Flat Rock, NC 28731
SUBJECT: Additional Information Request
Mountain Inn Suites, LLC Property
Application Number: 04-1550
Project Status: On Hold
Henderson County
Dear Mr. Justus:
The Asheville Regional Office of the Division of Water Quality is in receipt of your Water Quality
Certification application to fill 720 linear feet of Allen Branch as part of the Mountain Inn Suites, LLC
Property project. In order for this office to complete it's review of the submitted application, the
following must be addressed:
Application Item I. 1. requests the type of approval for the referenced project. A Section 10
permit is not appropriate for this project. Please review the regulations and check the
appropriate boxes.
• Application Item I. 2. requests which appropriate permit type you are seeking. No answer
was given. You must.determine the appropriate permit type and indicate said type in this
area.
• Application Item II. 1. requests the Owmer/Applicant Information. The registered agent for
Mountain Inn & Suites, LLC (the owner of the property, as verified by the Henderson County
GIS database) is a Mr. Boyd L. Hyder at 314 Hyder Street in Hendersonville. The Applicant
information must to reflect the Owner of the project as registered with the N.C. Secretary of
State.
4
PUMA
2090 U.S. 70 Highway Swannanoa, North Carolina 28778 Telephone [phone] Fax [phone] Customer Service 1-877-623-6748
Additional Information Request
Mountain Inn Suites, LLC Property
September 23, 2004
Page 2.
• Application Item II. 10. requests a narrative describing the project in detail. No such
information is provided. You must provide a description of the project, and of all equipment
and construction techniques, as they relate to the impacts (both direct and indirect)
associated with this project.
• Application Item VI. 3. requests a indicates 720 linear feet of stream impact. As this exceeds
the 150 linear foot threshold for mitigation, a complete mitigation plan must be submitted
which meets the criteria stated in http://h2o.enr.state.nc.us/ncwetlands/restore.html
• Application Item VII. requests an Impact Justification including steps taken to Avoid and
Minimize impacts. No justification was submitted. You must submit a complete justification,
which includes all avoidance and minimization included within the planning for this project.
• Application Item VIII. requests a description of the mitigation associated with these impacts.
No mitigation was proposed as part of the application. You must submit a complete mitigation
package which complies with the above referenced restoration guidance.
• Application Item XI. requests a discussion on stormwater management in relation to this
property. No discussion has been provided. Please note that this discussion is not just for
construction stormwater management, but stormwater management for the life of the project.
It is appropriate to discuss velocities, buffers, and non-discharge alternatives to manageing
stormwater.
• Application Item XI I. Requests a discussion as to how wastewater will be handled in regards
to this project. No discussion has been provided. You must discuss how wastewater will be
collected and handled by this project. This may also include what type of permits are
necessary for this project in relation to wastewater management.
An amended application must be submitted, addressing the above mentioned, missing information.
You must submit all requested information within 10 business days of receipt of this letter. Failure to
respond will result in your application being returned at incomplete. It should be noted that securing
a Water Quality Certification will not remove any liabilities associated with any installation prior to
receiving said certification.
_ A
2090 U.S. 70 Highway Swannanoa, North Carolina 28778 Telephone [phone] Fax [phone] Customer Service 1-877-623-6748
Additional Information Request
Mountain Inn Suites, LLC Property
September 23, 2004
Page 3.
Please note that the Asheville Regional Office has moved to a new location. The mailing address
and new phone number are located on the letterhead of this document.
If you have any questions, you may contact me at [e-mail] or at 828.596.4657.
Sincerely,
Kevin H. Barnett,
Environmental Chemist
cc: Mr. Jon Laughter
Laughter, Austin and Associates, P.A.
131 Fourth Avenue, East
Hendersonville, NC 28792
Mr. Boyd L. Hyder
Mountain Inn & Suites, LLC
755 Upward Road
Flat Rock, N.C. 28731
Henderson County Building Inspections Office
Henderson County Health Department
Mr. Steve Chapin, US Army Corps of Engineers
Mr. Roy Davis, Division of Water Quality
?J?GENFt
2090 U.S. 70 Highway Swannanoa, North Carolina 28778 Telephone [phone] Fax [phone] Customer Service 1-877-623-6748
Triage Check List
Date: Project Name: / ) d VO T G)'? X, h ?" cJ lit ?T?
DWQ#:
County:
P.•-,
To: "O Kevin Barnett ? WaRO Tom Steffens and Kyle Barnes
? FRO Ken Averitte ? WiRO Noelle Lutheran
? MRO Alan Johnson ? WSRO Daryl Lamb
? RRO Mike Horan
From: Telephone : (919)
The file attached is being forwarded to your for your evaluation.
Please call if you need assistance.
D S 'am length impacted
Stream determination
? W land determination and distance to blue-line surface waters on USFW topo maps
Minimization/avoidance issues
? Buffer Rules (Neuse, Tar-Pamlico, Catawba, Randleman)
? Pond fill
? Mitigation Ratios
? Ditching
? Are the stream and or wetland mitigation sites available and viable?
? Check drawings for accuracy
? Is the application consistent with pre-application meetings?
? Cumulative impact concern
Comments:

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Office Use Only: v •? Form Version May 2002
USACE Action ID No. DWQ No.
(If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A".)
1. 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:
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: ? \
5. 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 (see the top of page 2 for further details), check here: ?
II. Applicant Information
1. Owner/Applicant Information WMANDS/401 GROljp
Name: JE1=F2Ey C, JJsrus
Mailing Address: &40 CeES-r PoAt> SEP 1 7-z??nv
??AT oc% A/C Z??3/
WATER Q1
Telephone Number: 8??- 92 l 80 l Fax Number:
E-mail Address:
2. Agent/Consultant Information (A si and dated copy of the Agent Authorization letter
must be attached if the Agent has signatory authority for the owner/applicant.)
Name: LAuc,R-reP Ay57/?l ANp 4S_econrr, P. A. ?.1oa/ LAdt,IfTE2 }
Company Affiliation:
Mailing Address: 13 1 Fou&-ro Ave, 5/4.,-
t??NpER3aNV{y?E , l?lC Z$79Z
Telephone Number: 829'1y92- dB9 Fax Number: 0M-6,93-8622
E-mail Address: lxepa @ be l.sou? , net
Page 5 of 12

III. Project Information
Attach a vicinity map clearly showing the location of the property with respect to local
landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property
boundaries and development plans in relation to surrounding properties. Both the vicinity map
and site plan must include a scale and north arrow. The specific footprints of all buildings,
impervious surfaces, or other facilities must be included. If possible, the maps and plans should
include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property
boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion,
so long as the property is 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: t?&O,v7
2. T.I.P. Project Number. or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN): \ S7 ?'9 3 ??.?
4. Location. I )
County: k1_VaERSo? Nearest Town: Vt
Subdivision name (include phase/lot number): "1,4
Directions to site (include road numbers, landmarks, etc.): P? Us . t4c40? .r &,I c=g -r
VJ -5W ZN?'?ASCsG?/dN ?? S? AQcy Lq?vE qe+a DLy U. S, 414H E
5. Site coordinates, if available (UTM or Lat/Long): ? ?ZO'YS *'Al AZ®ZS ?&V
(Note 7- 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): &. 813
7. Nearest body of water (stream/river/sound/ocean/lake): A 1--L-B"NCB
8. River Basin: Xle..4 D
(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/mgs/.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: "N'
Page 6 of 12

10. Describe the overall project in detail, including the type of equipment to be used:
11. Explain the purpose of the proposed work: ?N c5v E q Np ?ELoc/?tld? e F
ADOP,..X l M,47Et.;/ 7ZB 1-F of Ae-tE.N j312A,-c11 !-©P- TNT pv2As6E- -OF
cmM EACIAL 176VEA-PMEW7 /.SNP RC9•47-9p P4041,Je, (?i4GjLl7/ES.
IV. Prior Project History
If jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Include
the USACE Action ID Number, DWQ Project Number, application date, and date permits and
certifications were issued or withdrawn. Provide, photocopies of previously issued permits,
certifications or other useful information. Describe, previously approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits issued for prior segments',\of the same T.I.P. project, along with
construction schedules.
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application.
VI. Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. The applicant must also
provide justification for these impacts in Section VII below. All proposed impacts, permanent
and temporary, must be listed herein, and must be clearly identifiable on an accompanying site
plan. All wetlands and waters, and all streams (intermittent and perennial) must be shown on a
delineation map, whether or not impacts are proposed to these systems. Wetland and stream
evaluation and delineation forms should be included as appropriate. Photographs 1hay be
included at the applicant's discretion. If this proposed impact is strictly for wetland or stream
mitigation, list and describe the impact in Section VIII below. If additional space is needed for
listing.or description, please attach a separate sheet.
Page 7 of 12
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Provide a written description of the proposed impacts:
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SCE taE 70041 L O t.11 PL A N
2. Individually list wetland impacts below:
Wetland Impact
Site Number
indicate on ma
Type of Impact* Area of
Impact
acres Located within
100-year Floodplain**
es/no Distance to
Nearest Stream
linear feet
Type of Wetland***

* List each impact separately and identify temporary impacts. Impacts include, but are 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 Man, ?ement Agency's (FEMA) Flood Insurance Rate Maps
(FIRM), or FEMA-approved local floodplain maps. Maps are available through the FEMA Map Service Center at 1-800-358-9616, or
online at ho://www.fem&g
*** List a wetland type that best describes wetland to be impacted (e.g., freshwater/saltwater marsh, forested wetland, beaver pond,
Carolina Bay, bog, etc.) Indicate if wetland is isolated (determination of isolation to be made by USACE only).
List the total acreage (estimated) of all existing wetlands on the property:
Total area of wetland impact proposed:
3. 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 Im act . Perennial or
Intermittent?
_ lease specify)
1 EN?iosu2c -7 Z 0 Fi L?EnJ ?2R?tf 3 0?' 2?NNtA ?--

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: culverts and associated rip-rap,
dams (separately list impacts due to both structure and flooding), relocation (include linear feet before and after, and net loss/gain),
stabilization activities (cement wall, rip-rap, crib wall, gabions, etc.), excavation, ditching/straightening, etc. If stream relocation is
proposed, plans and profiles showing the linear footprint for both the original and relocated streams must be included.
** Stream names can be found on USGS topographic maps. If a stream has no name, list as UT (unnamed tributary) to the nearest
downstream named stream into which it flows. USGS maps are available through the USGS at 1-800-358-9616, orbonline at
www.uses.eov. Several internet sites also allow direct download and printing of USGS maps (e.g., www.topozone.com,
www.maRguest.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: -7Zo '
Page 8 of 12
4. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.) below:
Open Water Impact
Site Number
indicate on ma
Type of Impact* Area of
Impact
acres Name of Waterbody
(if applicable) Type of Waterbody
(lake, pond, estuary, sound,
bay, ocean, etc.

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: fill, excavation, dredging,
flooding, drainage, bulkheads, etc.
5. Pond Creation
If construction 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): ? T .plands ? stream ? wetlands
Describe the method of construction (e.g., dam/; mbankment, excavation, installation of
draw-down valve or spillway, etc.):
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.):
Size of watershed draining to pond: Expected pond surface area:
VII. Impact Justification (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It may be useful to- provide
information related to site constraints such as topography, building ordinances, accessibility, and
financial viability of the project. The applicant may attach drawings of alternative, lower-impact
site layouts, and explain why these design options were not feasible. Also discuss how impacts
were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce. impacts.
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.
Page 9 of 12
USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on March 9, 2000, mitigation will be required when
necessary to ensure that adverse effects to the aquatic environment 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
hqp://h2o.enr.state.ne.us/ncwetlands/strmgide.hbnl.
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
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
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 ho://h2o.enr.state.nc.us/wrp/index.htm. If use of
the NCWRP is proposed, please check the appropriate box on page three and provide the
following information:
Amount of stream mitigation requested (linear feet):
Amount of buffer mitigation requested (square feet):
Amount of Riparian wetland mitigation requested (acres):
Amount of Non-riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres):
Page 10 of 12
r-
IX. Environmental Documentation (required by DWQ)
Does the project involve an expenditure of public (federal/state) funds or the use of public
(federal/state) land?
Yes ? No
If yes, does the project require preparation of an environmental document pursuant to the
requirements of the National or North Carolina Environmental 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 ?
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 Ihr?oject. 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 213 .0233
(Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identi fy V
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.
Zone* s Impact Multiplier Mihu t on
1 3
2 1.5
Total
* Zone 1 extends out 30 feet perpendicular from near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.

Page 11 of 12

If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation
of Property, Conservation Easement, Riparian Buffer Restoration / Enhancement, Preservation or
Payment into the Riparian Buffer Restoration Fund). Please attach all appropriate information as
identified within 15A NCAC 2B .0242 or .0260.
X1. 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.
XH. 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.
XIH. 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 K
X1V. 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).

C . F I? O
,pplicant/Agenta?ature Date
signature is vali only if an authorization letter from the applicant is provided.)
Page 12 of 12
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*****WARNING: THIS IS NOT A SURVEY! Date: 7/15/2004
This map is prepared for the inventory of real
property found within this jurisdiction, and is
compiled from recorded deeds, plats, and other
public records and data. Users of this map are
hereby notified that the aforementioned public
primary information sources should be consulted
for verification of the information. contained on
this map. The County and mapping company
assume no legal responsibility for the
information contained on this map.
Rec 1
PIN 00957968943555
PID 9973796
NAME-1 MOUNTAIN INN & SUITES LLC
NAME-2
ADDRESS_1 303 SOUTH CHURCH ST
ADDRESS 2
CITY HENDERSONVILLE
ST NC
ZIP 28792
PROP_DESC US64 E ON
ACRES 6.83
MAP SHEET 9579.02
NBR BLDGS 0
DATEREC 10/3/2003
DB_PG 1164/226
LAND VAL 715600
BLDG_VAL 0
TOTAL_VAL 715600
NBHD DESC HWY 64 E.
Subdivision
SALE PRICE 750000
LANDUSE 100
Page 1 of 1
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LOCATION MAP (NTS)
-2 Asphalt Surface
-6• Aggrega/e Stone Base
le Max. Cover
10' Reinforced Conc 51ah
61-9' vanes 2Ix21x61
,Solid Conc Blocks
-r B• Aggregdte Base
D.B. 813, PD. 855
"'a pQ DD5 R D.8 313, PG. fdd
30 0 60 100 Im
08lJAW er cer 1•¦00
WETLANDS 1401 GROUP
SEP 1 7 2004
WATER QUALITY SECTi01,
W. U. MAXWELL
D.B. 583, PG. 711
Prepared for
MOUNTAIN INN SUITES, LLC
303, SOUTH CHURCH STREET
HENDERSONVILLE, N, C. 28792
ren Juana ee1-5600
Iyy11111PPi°t' PRE-CON5MUMON N0T1f1C,A110N
FOR
SSi ` PROP05M 57RM y R&OC41701V
Nemmomue TWP Heimm50N COUNTY, M
0 q
NO. 406 = LAUGWTER, AU5771V AND A550CW95, P.A.
-, 0 "Vol NE? 131 FOURTH AWIVUE mr
WEMER501MLLE, NORM CAROLINA 29792
4 a..,.y ?QQ?} [phone]
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PROP05E0 5me" 5EM01V
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JOB N0. 04-032
Triage Check List
Date: Pro
ect Name: j
A.d V `k
DWQ#:

c'
County:
To: D ARO Kevin Barnett ? WaRO Tom Steffens and Kyle Barnes
? FRO Ken Averitte ? WiRO Noelle Lutheran
? MRO Alan Johnson ? WSRO Daryl Lamb
? RRO Mike Horan
From: Telephone : (919)
The file attached is being forwarded to ;our for your evaluation.
Please call if you need as"nce.
D S am length impacted
Stream determination
? W and determination and distance to blue-line surface waters on USFW topo maps
Minimization/avoidance issues
? Buffer Rules (Meuse, Tar-Pamlico, Catawba, Randleman)
? Pond fill
? Mitigation Ratios
? Ditching
? Are the stream and or wetland mitigation sites available and viable?
? Check drawings for accuracy
? Is the application consistent with pre-application meetings?
? Cumulative impact concern
Comments: 1 e,V
•,1.51/40) r
s
Lr?1 iS ?:
ll fL,1 b6flj
110). 1
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FILE COPY
Office Use Only: Form Version May 2002
041550
USACE Action ID No. DWQ No.
(If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A".)
1. 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:
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 NiQWRP prior to submittal of PCN), complete
section VIII and check here: ? \
5. 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 (see the top of page 2 for further details), check here: ?
II. Applicant Information
1. Owner/Applicant Information WETLANDS/ 401 GROUP
Name: JEFF(LEy C, J11sru s
Mailing Address: &40 CREST P-oq i w 2004 SEPI rLA-r R Omsk NC. ZB7.31
Telephone Number: Pz8- 92 - l So l Fax Number:
E-mail Address:
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: L???NrEe Avsri l ANS sSocrArF? P. A. (-1oN LAdyr?TEa
Company Affiliation:
Mailing Address: /31 Fou2Tr? Ave-, 64s7-
f?tND?2.saNV1LLE , MC ZS797-
Telephone Number: 8Z9 °l?qZ- dB9 Fax Number: 0Z9-6-95 -862 Z
E-mail Address: 1 as pa @ 6e l sou h, no- t
Page 5 of 12

III. Project Information
Attach a vicinity map clearly showing the location of the property with respect to local
landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property
boundaries and development plans in relation to surrounding properties. Both the vicinity map
and site plan must include a scale and north arrow. The specific footprints of all buildings,
impervious surfaces, or other facilities must be included. If possible, the maps and plans should
include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property
boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion,
so long as the property is 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: 7,4l l ,?N ?-' t ??`S , ?- -?? ?°???Y
2. T.I.P. Project Number or State Project Number *DOT Only):
3. Property Identification Number (Tax PIN): ?o\ S'?9? B`93 SSS
4. Location.
County: "C-JV RSd? Nearest Town: END?RSc?,v ?t`cE'
Subdivision name (include phase/lot number): N'/A
Directions to site (include road numbers, landmarks, etc.): dea U. 5. t{laauia j 6`1 tF"-r
W SW 1N?c?zsc?c?io? o? Si5-Agcy Lq,v,? qa?n Oj-y 'U- IS, giGtLA# J G.el. !'?7-
LA 7' 40 lvcf
1 t4/
5. Site coordinates, if available (UTM or Lat/Long): - o20 Y5 #N ?Z®25 '5'/
(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): &.25
7. Nearest body of water (stream/river/sound/ocean/lake): AL-L-
8. ? ?N?t?
r
8. River Basin: .?'??c ,3??A?
(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/.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: '.
Page 6of12
V /
10. Describe the overall project in detail, including the type of equipment to be used:
11. Explain the purpose of the proposed work: ?N c t csvr? ANp 12?tdcr?z,d?' ,F
dnr,n... I AA-rA-L4 79/l L.. E ®;= AttEN SSA.-Ca AoZ TAiE PvdtAasE ®F
0-oLAM,cQC.A. j]rV--ioP1w cw -r AA,a QeY47&p ki4P-Li AJ4 rActc[7jES.
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. Desc4v previously approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits issued for prior segments' of the same T.I.P. project, along with
construction schedules.
N /A
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application.
VI. Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. The applicant must also
provide justification for these impacts in. Section VII below. All proposed impacts, permanent
and temporary, must be listed herein, and must be clearly identifiable on an accompanying site
plan. All wetlands and waters, and all streams (intermittent and perennial) must be shown on a
delineation map, whether or not impacts are proposed to these systems. Wetland and stream
evaluation and delineation forms should be included as appropriate. Photographs )nay be
included at the appl'icant's discretion. If this proposed impact is strictly for wetland or stream
mitigation, list and describe the impact in Section VIII below. If additional space is needed for
listing.or description,. please attach a separate sheet.
Page 7 of 12
'1 V
1. Provide a written description of the proposed impacts: ke y o-A 7r,*,- 4N11, eW car r* r 4 „r Pe A N
2. Individually list wetland impacts below:
Wetland Impact
Site Number
indicate on ma
Type of Impact* Area of
Impact
acres Located within
100-year Floodplain**
es/no Distance to
Nearest Stream
linear feet
Type of Wetland***

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: mechanized clearing, grading, fill,
excavation, flooding, ditching/drainage, etc. For dams, separately list impabts due to both structure and flooding.
** 100-Year floodplains are identified through the Federal Emergency Mana ement Agency's (FEMA) Flood Insurance Rate Maps
(FIRM), or FEMA-approved local floodplain maps. Maps are available throu the FEMA Map Service Center at 1-800-358-9616, or
online at h=://www.fema-
List *** List a wetland type that best describes wetland to be impacted (e.g., freshwater/saltwater marsh, forested wetland, beaver pond,
Carolina Bay, bog, etc.) Indicate if wetland is isolated (determination of isolation to be made by USACE only).
List the total acreage (estimated) of all existing wetlands on the property:
Total area of wetland impact proposed:
3. 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 Im act . Perennial or
Intermittent?
lease specify)
ENC,oc5u2E 7Zo rt!?EiJ 131zAnlc- 4 -S + 2

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: culverts and associated rip-rap,
dams (separately list impacts due to both structure and flooding), relocation (include linear feet before and after, and net loss/gain),
stabilization activities (cement wall, rip-rap, crib wall, gabions, etc.), excavation, ditching/straightening, etc. If stream relocation is
proposed, plans and profiles showing the linear footprint for both the original and relocated streams must be included.
** Stream names can be found on USGS topographic maps. If a stream has no name, list as UT (unnamed tributary) to the nearest
downstream named stream into which it flows. USGS maps are available through the USGS at 1-800-358-9616, orbonline at
www.usgs.gov. Several intemet sites also allow direct download and printing of USGS maps (e.g., www.topozone.com,
www.mgpguest.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: -72-0
Page 8 of 12
r Ir
4. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.) below:
Open Water Impact

Site Number
indicate on ma
,?
Type of Impact Area of

Impact
acres Name of Waterbody

(if applicable) Type of Waterbody

(lake, pond, estuary, sound,
bay, ocean, etc.

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: fill, excavation, dredging,
flooding, drainage, bulkheads, etc.
5. Pond Creation
If construction 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 pnbaLnent, excavation, installation of
draw-down valve or spillway, etc.):
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.):
Size of watershed draining to pond: Expected pond surface area:
VII. Impact Justification (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It 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.
VIII. Mitigation
IN,
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.
Page 9 of 12
1% `V
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
htta://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 nod 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
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
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://h2o.enr.state.nc.us/wry/index.htm. If use of
the NCWRP is proposed, please check the appropriate box on page three and provide the
following information:
Amount of stream mitigation requested (linear feet):
Amount of buffer mitigation requested (square feet):
Amount of Riparian wetland mitigation requested (acres):
Amount of Non-riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres):
Page 10 of 12
r?
IX. Environmental Documentation (required by DWQ)
Does the project involve an expenditure of public (federal/state) funds or the use of public
(federal/state) land?
Yes ? No
If yes, does the project require preparation of an environmental document pursuant to the
requirements of the National or North Carolina Environmental 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 ?
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. Atl 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 V
Yes E] 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.
*
Zone Impact
(square feet
Multiplier Required
Mitigation
1 3
2 1.5
Total
* Zone 1 extends out 30 feet perpendicular from near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1. '%,.
Page 11 of 12

If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation
of Property, Conservation Easement, Riparian Buffer Restoration / Enhancement, Preservation or
Payment into the Riparian Buffer Restoration Fund). Please attach all appropriate information as
identified within 15A NCAC 2B .0242 or.0260.
XI. Stormwater (required by DWQ)
Describe impervious acreage (both existing and proposed) versus total acreage on the site.
Discuss stormwater controls proposed in order to protect surface waters and wetlands
downstream from the property.
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.
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 K
MV. 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).

(?f .
0
signature is valid only if an authorization letter from the applicant is provided.)
Page 12 of 12
Parcel Print Page
Henderson County Parcel Print Page
8+90.
3
240 026
EtE 2131
1 E a 1923
5981 5941 ?
7882 9822
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6? r rt • u s? 6 6 750 X1 ?
64 2620 53 6? H,Y
51 f 3 1524 5
249 157
35
6474 ?4 1
*****WARNING: THIS IS NOT A SURVEY! Date: 7/15/2004
This map is prepared for the inventory of real
property found within this jurisdiction, and is ,
compiled from recorded deeds, plats, and other
public records and data. Users of this map are
hereby notified that the aforementioned public
primary information sources should be consulted
for verification of the information. contained on
this map. The County and mapping company
assume no legal responsibility for the
information contained on this map.
Ree 1
PIN 00957968943555
PID 9973796
NAME _1 MOUNTAIN INN & SUITES LLC
NAME-2
ADDRESS _1 303 SOUTH CHURCH ST
ADDRESS 2
CITY HENDERSONVILLE
ST NC
ZIP 28792
PROP_DESC US64 E ON
ACRES 6.63
MAP_SHEET 9579.02
NBR BLDGS 0
DATEREC 10/3/2003
DB_PG 1164/226
LAND_VAL 715600
BLDG_VAL 0
TOTAL VAL 715600
NBHD_DESC HWY 64 E.
Subdivision
SALE PRICE 750000
LANDUSE 100
Page 1 of 1

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WETLANDS 1401 GROUP
SEP 17 2004
WATER QUALITY SECTION
LOCATION MAP (NTS)
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PROP OWD 57)MAM WC770N
N.T.S.
W. At. MAXWELL
D.B. 583, PG. 711
Prepared for
MOUNTAIN INN SUITES, LLC
303 SOUTH CHURCH STREET
HENDERSONVILLE, N.C. 28792
Jeff Justus 691-6500
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FILE COPY
Jon H. Laughter
Donald J. Austin
Thomas P. Welbourn
James D. Chambless, Sr.
Laughter, Austin and Associates, P.A.
Engineering • Planning • Land Surveying
131 FOURTH AVENUE EAST
HENDERSONVILLE, NORTH CAROLINA 28792
September 15, 2004
Ms. Cyndi Karoly
Division of Water Quality
401/Wetlands Unit
2321 Crabtree Blvd., Suite 250
Raleigh, NC 27604
Dear Ms. Karoly:
[phone]
Fax[phone]
WATS 1-800-858-LAND
WETLANDS/ 401 GROUP
041550 SEP 1 7 2004
WATER QUALITY SECTION
Enclosed please find 7 copies of Pre-Construction Notification (PCN) Application Form and drawings
and a check for $475.00 for the proposed relocation and enclosure of a portion of Allen Branch located
on U.S. Highway 64 East in the southwest intersection of Searcy Lane and Old U.S. Highway 64 East
in Henderson County, North Carolina. This submission is for your review and approval.
Thank you for your consideration.
Sincerely,
Laughter, Austin and Associates, P.A.
?'A?k--
Jon Laughter, P.E.
Pq RtJV 7
RECEDED
r.
Office Use Only: Form Version May 2002
041550
USACE Action ID No. DWQ No.
(If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A".)
1. 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:
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 Retstoration Program (NCWRP) is proposed for
mitigation of impacts (verify availability with NQWRP prior to submittal of PCN), complete
section VIII and check here: ? \
5. 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 (see the top of page 2 for further details), check here: ?
II. Applicant Information
1. Owner/Applicant Information e n
Name: JEFF2EY C , JJSTU 5 YirT1 AN - 1401 CROUP
Mailing Address: 6,0 C REST P og j
?Lf1 T R ao? AI C Z S ?3 / SEp?T994
........r, nm ITV WON
Telephone Number: OZ8-Zo92 - l So l Fax Number:
E-mail Address:
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: LRu4HT6e. Avs-rlq ,qm,, SSoet,4 ?S P. A. ?Jo,v LA yNTE/L
Company Affiliation:
Mailing Address: /3 / Fova-ro Ave,. 5/4ST
??NDE"2.3cNVtL?E , lUC z$79Z
Telephone Number: 8Z6-lagZ- 069 Fax Number: 82B°l?93 -8?2 2
E-mail Address: l as pa @ 6,e ? sou not
Page 5 of 12
*4
III. Project Information
Attach a vicinity. map clearly showing the location of the property with respect to local
landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property
boundaries and development plans in relation to surrounding properties. Both the vicinity map
and site plan must include a scale and north arrow. The specific footprints of all buildings,
impervious surfaces, or other facilities must be included. If possible, the maps and plans should
include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property
boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion,
so long as the property is 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: t4oorv7,41N L?,?N _45;c-st7A'S , Lb-- -Ae&#PARTY
2. T.I.P. Project Number or State Project Number (1 CDOT Only):
3. Property Identification Number (Tax PIN):© -? 79? x'93 S'S
4. Location.
County: CaU?RS?.,r Nearest Town: Nt?ND?2?? ?t? E
Subdivision name (include phase/lot number): "J'4
Directions to site (include road numbers, landmarks, etc.): Oej U. -S. t{cak-rsa I &I 4F"-r
IV SW Jo-rrgs.`??idN OF S.C- ADCJ LAelE AMD DLD U_ _C- ?-aAU LEAs
LAT A14
5. Site coordinates, if available (UTM or Lat/Long): 3 aZO'Ys aN ?Z°Z5 ?SY?V?
(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): ICI -'85
7. Nearest body of water (stream/river/sound/ocean/lake): At-L- P-A,04
8. River Basin: ?.yc?gn
(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/.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: . 'N.
Page 6 of 12
F, r
10. Describe the overall project in detail, including the type of equipment to be used:
11. Explain the purpose of the proposed work: nr c LnSo A y,> 12ELvc?t?m.v -,F
4nnowox I AAA`r&-1.4 7Zo z. F eF A??N 019.40-c84 r--'R T#i- P11RA5sE of
Q141 AJA r4 e-! L L 7,
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. Describ, P previously approved wetland, stream and
buffer impacts, along with associated mitigation (wh4e applicable). If this is a NCDOT project,
list and describe permits issued for prior segments` of the same T.I.P. project, along with
construction schedules /A
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application.
VI. Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. The applicant must also
provide justification for these impacts in. Section VII below. All proposed impacts, permanent
and temporary, must be listed herein, and must be clearly identifiable on an accompanying site
plan. All wetlands and waters, and all streams (intermittent and perennial) must be shown on a
delineation map, whether or not impacts are proposed to these systems. Wetland and stream
evaluation and delineation forms should be included as appropriate. Photographs may be
included at the applicant's discretion. If this proposed impact is strictly for wetland or stream
mitigation, list and describe the impact in Section VIII below. If additional space is needed for
listing.or description,. please attach a separate sheet.
Page 7 of 12
iM
1. Provide a written description of the proposed impacts: ; e oe,4 7 P u .4,wa
SG F 1: uF'74 t L d M Pt. AV
2. Individually list wetland impacts below:
Wetland Impact
Site Number
indicate on ma
Type of Impact* Area of
Impact
acres Located within
100-year Floodplain**
es/no Distance to
Nearest Stream
linear feet
Type of Wetland***

* List each impact separately and identify temporary impacts. Impacts include, but are 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 Mana?ement Agency's (FEMA) Flood Insurance Rate Maps
(FIRM), or FEMA-approved local floodplain maps. Maps are available through the FEMA Map Service Center at 1-800-358-9616, or
online at h=://www.fema.gov. \
*** List a wetland type that best describes wetland to be impacted (e.g., freshwater/saltwater marsh, forested wetland, beaver pond,
Carolina Bay, bog, etc.) Indicate if wetland is isolated (determination of isolation to be made by USACE only).
List the total acreage (estimated) of all existing wetlands on the property:
Total area of wetland impact proposed:
3. 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 Im act . Perennial. or
Intermittent?
lease specify)

I
FJ? ?CSU RC -7
! Z o L/1L
3k Q A,?C-ei
-S' t

7 G L?ItJ A/{Q"4.

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: culverts and associated rip-rap,
dams (separately list impacts due to both structure and flooding), relocation (include linear feet before and after, and net loss/gain),
stabilization activities (cement wall, rip-rap, crib wall, gabions, etc.), excavation, ditching/straightening, etc. If stream relocation is
proposed, plans and profiles showing the linear footprint for both the original and relocated streams must be included.
** Stream names can be found on USGS topographic maps. If a stream has no name, list as UT (unnamed tributary) to the nearest
downstream named stream into which it flows. USGS maps are available through the USGS at 1-800-358-9616, or-,online at
www.usgs.¢ov. Several internet sites also allow direct download and printing of USGS maps (e.g., www.io oozone.com,
www.maRguest.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: 7Za '
Page 8 of 12

4. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.) below:
Open Water Impact
Site Number
indicate on ma
Type of Impact* Area of
Impact
acres Name of Waterbody
(if applicable) Type of Waterbody
(lake, pond, estuary, sound,
bay, ocean, etc.

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: fill, excavation, dredging,
flooding, drainage, bulkheads, etc.
5. Pond Creation
If construction 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): ?`?,epIands ? stream ? wetlands
Describe the method of construction (e.g., dam/mbankment, excavation, installation of
draw-down valve or spillway, etc.):
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.):
Size of watershed draining to pond: Expected pond surface area:
VII. Impact Justification (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It 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.
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.
Page 9of12

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. i
I. 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
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
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://h2o.enr.state.nc.us/wm/index.htm. If use of
the NCWRP is proposed, please check the appropriate box on page three and provide the
following information:
Amount of stream mitigation requested (linear feet):
Amount of buffer mitigation requested (square feet):
Amount of Riparian wetland mitigation requested (acres):
Amount of Non-riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres):
Page 10 of 12
r r
IX. Environmental Documentation (required by DWQ)
Does the project involve an expenditure of public (federal/state) funds or the use of public
(federal/state) land?
Yes ? No
If yes, does the project require preparation of an environmental document pursuant to the
requirements of the National or North Carolina Environmental 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 ?
X. Proposed Impacts on Riparian and Watershed Buffers (required by DWQ)
It is the applicant's (or agent's) responsibility to de*Mine, delineate and map all impacts to
required state and local buffers associated with the p oject. The applicant must also provide
justification for these impacts in Section VII above. A.1 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
(Neuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify V
Yes ? No a 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.
*
Zone Impact
(square feet
Multiplier Required
Mitigation
1 3
2 1.5
Total
* Zone 1 extends out 30 feet perpendicular from near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.
Page 11 of 12

If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation
of Property, Conservation Easement, Riparian Buffer Restoration / Enhancement, Preservation or
Payment into the Riparian Buffer Restoration Fund). Please attach all appropriate information as
identified within 15A NCAC 2B .0242 or.0260.
XI. Stormwater (required by DWQ)
Describe impervious acreage (both existing and proposed) versus total acreage on the site.
Discuss stormwater controls proposed in order to protect surface waters and wetlands
downstream from the property.
XH. Sewage Disposal (required by DWQ)
Clearly detail the ultimate treatment methods and ??sposition (non-discharge or discharge) of
wastewater generated from the proposed project, or available capacity of the subject facility.
XM. 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 14
NW. 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).

C .
O
signature is vali&6nly if an authorization letter from the applicant is provided.)
Page 12 of 12
Parcel Print Page
Henderson County Parcel Print Page
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*****WARNWG: THIS IS NOT A SURVEY! Date: 7/15/2004
This map is prepared for the inventory of real
property found within this jurisdiction, and is '
compiled from recorded deeds, plats, and other
.public records and data. Users of this map are
hereby notified that the aforementioned public
primary information sources should be consulted . "'
for verification of the information. contained on
this map. The County and mapping company
assume no legal responsibility for the
information contained on this map.
Ree 1
PIN 00957968943555
PID 9973796
NAME _1 MOUNTAIN INN & SUITES LLC
NAME -2
ADDRESS-1 303 SOUTH CHURCH ST
ADDRESS -2
CITY HENDERSONVILLE
ST NC
ZIP 28792
PROP_DESC US64 E ON
ACRES 6.83
MAP-SHEET 9579.02
NBR BLDGS 0
DATEREC 10/3/2003
DB_PG 1164/226
LAND_VAL 715600
BLDG_VAL 0
TOTAL_VAL 715600
NBHD_DESC HWY 64 E.
Subdivision
SALE PRICE 750000
LANDUSE 100

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PROPOWD 5? 5?C1lON
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D.B. 593, PO. 711
Prepared for

MOUNTAIN INN SUITES, LLC
303 SOUTH CHURCH STREET
HENDERSONVILLE, N. C. 28792
Jeff Justus 691-5500
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