20051592 Ver 1_Complete File_20050819

01-11-'06 14,27 FROM-Div of Water Quality 3367714630 T-130 P0042/004 F-307
V) , lVC»m l.arcinna i)(-parn titm m r'.nvrl l ninium arlU iNmut al (\GSV UtVCS
'i flan W Klimek, P.F. Bitectc•r
Division of' Vvatcl Quality
October 4, 2005
DWQP 05-t592
Davidson County
Nlr. Pe1Ty Kairis
City of HT11 Point
P. 0. Box 230
High. Point, NC 27261
APPROVAL of 401 Water Quality Certification with Additional Conditions
Dear N1r. Kairis:
The City of High Point has our approval, in accordance with the attached conditions, to place permanent fill in
120 linear feet of perennial stream and to place temporary fill in 0.645 acre of forested wetlands in order to
install a gravity sewer line along Payne Creek in Davidson County, as described in your application received by
the Division of Water Quality (DWQ) on August 19, 2005. After reviewing your application, we have
determined that this fill is covered by General Water Quality Certification Number 3374, which can be viewed
on our web site at http•//h2o.enr.state.nc.us!newetlands. This Certification allows you to use Nationwide Permit
Number 12 when it is issued by the U.S. Army Corps of Engineers. In addition, you should secure any other
applicable federal, state or local permits before you proceed with your project, including (but not limited to)
those required by Sediment and Erosion Control, Non.-Discharge, and Water Supply Watershed regulations.
Also, this approval will expire when the accompanying 404 permit expires unless otherwise specified in the
General Certification.
This approval is valid only for the purpose and design that you have described in your application. If you
change your project, you must notify us in writing and you may be required to send us a new application for a
new certification. If the property is sold, the new owner must be given a copy of the Certification and approval
letter and is thereby responsible for complying with all conditions. If total wetland fills for this project (now or
in the future) exceed one acre, compensatory mitigation may be required as described in 15A_ NCAC 21-1 .0506
(h). llor this approval to be valid, you must follow the conditions listed in the attached certification, as
well as the additional conditions listed below:
1. The following impacts are hereby approved as long as all other specific and general conditions of the
Certification are met. No other impacts, including incidental impacts, are approved:
_ Arnount Approved _Plan Location or Reference
Streams 120 linear feet Payne Creek, beginning --1,200 linear feet downstream of
Chestnut Drive and ending 3,200 linear feet upstream of
Chestnut Drive, in Davidson County
or•?
NorthCarolmz
NVatural(y
Nor.h Carolina Nvi;ion of Watcr Quality
vhllands Certification Unit 1650 Mail service Center Raleigh, NC 27699-1650 Phone [phone] PAX [phone]
2321. Crabtree Blvd. Raleigh, NC 27604-2260 Interivt hUjj :h2o enr.stale x uslrrnell::nds
Customer Service.1,lumber: 1-877-623-6748
An Equal OpprrtUmly;Af6rmative. Action Employer- 501% Recycledl10% Post Consuruer Paper
JAh1-11-2006 l•JED 13:27 TEL:[phone] NAME:DWQ-WETLANDS P. 2
t 01-11-'06 14:281 FROM-Div of Water Quality 3367714630
October 4, 2005
T-130 P003/004 F-307
Amotuit Approved Plan Location or Reference
???Vetlands 0.645 acre Payne Creek, beginning 1,200 linear feet downstream
of Clestnut Drive and ending --- 3,200 linear feet
upstream of Chestnut Drive, in Davidson County
2. Soft bank stabilization methods, such as the use of erosion control matting and the planting of
appropriate f round cover, shall be utilized to the maximum extent practicable. Riprap may only be used
below the normal high water level. The original grade and elevation of the stream's cross-section must
be maintained. Riprap placed in the stream bottom must be inserted into the bottom matrix to it depth
sufficient to provide the thickness of riprap required for scour protection. `fhe elevation of the stream
bottom must not be increased by the placement of riprap. Placement of riprap must not result itt
destabilization of the strcambed or banks upstrearn or downstream of any crossing.
3. In any area where the construction corridor must be installed parallel to and closer than 10 feet to a
stream channel, appropriate sediment and erosion control measures, which equal or exceed those
outlined in the inost recent version of the North Carolina Sediment and Erosion Control Planning and
Design X/anual or the North Carolina Surface Alining rblanual (available from the Division of Land
Resources at NCDENR regional offices or the central office), whichever is Tn.ore appropriate, shall be
designed, installed and maintained properly to assure compliance at all tintcs with the North Carolina
water quality standards that are applicable to Class C waters as described in 1511 AICAC 02B.0211 Fresh
Swface Water Quality Standards For Class C Waters. Such measures must equal or exceed the
requirements specified in the most recent version of the North Carolina Sediment and Erosion Control
Manual. 't'hese measures must be maintained on all construction sites, borrow sites, an.d waste pile
(spoil) sites, including contractor owned and leased borrow pits, which are associated with this project.
4. Permanent, maintained access corridors shall be restricted to it maximum width of 20 feet, including
manhole locations and vehicle turnaround areas.
5. Where joints must be placed in sewer lines within the foot print of the stream channel at crossings
having topographic and bedrock constraints, the jointed section shall either be completely enclosed in a
steel encasement pipe scaled at both ends, for aerial crossings, or encased in concrete from ban]< to bank,
for buried crossings.
6. If concrete is used with any fill material, it shall not be allowed to come in contact with surface waters
uniil it has cured.
7. Upon completion of the project, the Applicant shall complete and return the enclosed "Certificate of
Completion" form to notify NCDWQ when all work included in the §401 Certification has been
completed. The responsible party shall complete the attached form and return it to the 401/Wetlands
Unit of the NC Division of Water Quality upon completion of the project. Along with the Certificate of
Completion for»i, please send photographs upstream and downstream of each stream-crossing site to
clocionent correct installation.
JAN-11-2006 WED 1:3:27 TEL:[phone]AAME:DWQ-WETLAhtDS P. 3
t 01-11-'06 14;23 FROM-Div of Water Quality 3367714630 T-130 P004/004 F-307
October 4, 2005
if you do not accept any of the conditions of this certification, you may ask for an adjudicatory hearing. You
must act within 60 days of the date that you receive this letter. To ask for a hearing, send a written petition
which confonns to Chapter 150B of the North Carolina General Statutes to the Office of Administrative
Hearings, 6714 Mail Service Center, Raleigh, N.C. 27699-6714. This certification and its conditions are final
and binding unless you ask for a hearing.
This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water Act. If
you have any questions, please telephone Daryl Lamb in the DWQ Winton-Salem Regional Office at 336-771-
4600 or lan Mc iillan in the Central Office in Raleigh 919-715-4631.
Sincerely,
Alan W. Klimck, P.E.
AWK/cdl
Attachments
ce: Mr. John Thomas, U. S. Army Corps of Engineers, Raleigh Regulatory Field Office
Winston-Salem DWQ Regional Office
Central Files
Wetlands/401 File Copy
Mr. Randy McNeill, Davis-Martin-Powell and Associates, 6415 Old Plank Road, High Point, NC 27265
JAN-11-2006 WED 13:28 TEL:[phone] NAME:DWQ-WETLANDS P. 4
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Mr. Perry Kairis
City of High Point
P. O. Box 230
High Point, NC 27261
APPROVAL of 401 Water Quality Certification with Additional Conditions
Dear Mr. Kairis:
Alan W. Klimek, P.E. Director
Division of Water Quality
October 4, 2005
DWQ# 05-1592
Davidson County
The City of High Point has our approval, in accordance with the attached conditions, to place permanent fill in
120 linear feet of perennial stream and to place temporary fill in 0.645 acre of forested wetlands in order to
install a gravity sewer line along Payne Creek in Davidson County, as described in your application received by
the Division of Water Quality (DWQ) on August 19, 2005. After reviewing your application, we have
determined that this fill is covered by General Water Quality Certification Number 3374, which can be viewed
on our web site at http://h2o.enr.state.ne.us/ncwetlands. This Certification allows you to use Nationwide Permit
Number 12 when it is issued by the U.S. Army Corps of Engineers. In addition, you should secure any other
applicable federal, state or local permits before you proceed with your project, including (but not limited to)
those required by Sediment and Erosion Control, Non-Discharge, and Water Supply Watershed regulations.
Also, this approval will expire when the accompanying 404 permit expires unless otherwise specified in the
General Certification.
This approval is valid only for the purpose and design that you have described in your application. If you
change your project, you must notify us in writing and you may be required to send us a new application for a
new certification. If the property is sold, the new owner must be given a copy of the Certification and approval
letter and is thereby responsible for complying with all conditions. If total wetland fills for this project (now or
in the future) exceed one acre, compensatory mitigation may be required as described in 15A NCAC 2H .0506
(h). For this approval to be valid, you must follow the conditions listed in the attached certification, as
well as the additional conditions listed below:
1. The following impacts are hereby approved as long as all other specific and general conditions of the
Certification are met. No other impacts, including incidental impacts, are approved:
Amount Approved Plan Location or Reference
Streams 120 linear feet Payne Creek, beginning -1,200 linear feet downstream of
Chestnut Drive and ending - 3,200 linear feet upstream of
Chestnut Drive, in Davidson Count

N r hCarolina
Altura!!y
North Carolina Division of Water Quality
Wetlands Certification Unit 1650 Mail Service Center Raleigh, NC 27699-1650 Phone [phone] FAX [phone]
2321 Crabtree Blvd. Raleigh, NC 27604-2260 Internet htto//:h2o.enr.state.nc.us/ncwetlands
Customer Service Number: 1-877-623-6748
An Equal Opportunity/Affirmative Action Employer- 50% Recycled/100/6 Post Consumer Paper
.\ir. Perry Kairis
Page 2, DWQ# 05-1592
October 4, 2005
Amount Approved Plan Location or Reference
Wetlands 0.645 acre Payne Creek, beginning 1,200 linear feet downstream
of Chestnut Drive and ending - 3,200 linear feet
upstream of Chestnut Drive, in Davidson County
71
2. Soft bank stabilization methods, such as the use of erosion control matting and the planting of
appropriate ground cover, shall be utilized to the maximum extent practicable. Riprap may only be used
below the normal high water level. The original grade and elevation of the stream's cross-section must
be maintained. Riprap placed in the stream bottom must be inserted into the bottom matrix to a depth
sufficient to provide the thickness of riprap required for scour protection. The elevation of the stream
bottom must not be increased by the placement of riprap. Placement of riprap must not result in
destabilization of the streambed or banks upstream or downstream of any crossing.
3. In any area where the construction corridor must be installed parallel to and closer than 10 feet to a
stream channel, appropriate sediment and erosion control measures, which equal or exceed those
outlined in the most recent version of the North Carolina Sediment and Erosion Control Planning and
Design Manual or the North Carolina Surface Mining Manual (available from the Division of Land
Resources at NCDENR regional offices or the central office), whichever is more appropriate, shall be
designed, installed and maintained properly to assure compliance at all times with the North Carolina
water quality standards that are applicable to Class C waters as described in 15A NCAC 02B .0211 Fresh
Surface mater Quality Standards For Class C haters. Such measures must equal or exceed the
requirements specified in the most recent version of the North Carolina Sediment and Erosion Control
Manual. These measures must be maintained on all construction sites, borrow sites, and waste pile
(spoil) sites, including contractor owned and leased borrow pits, which are associated with this project.
4. Permanent, maintained access corridors shall be restricted to a maximum width of 20 feet, including
manhole locations and vehicle turnaround areas.
5. Where joints must be placed in sewer lines within the foot print of the stream channel at crossings
having topographic and bedrock constraints, the jointed section shall either be completely enclosed in a
steel encasement pipe sealed at both ends, for aerial crossings, or encased in concrete from bank to bank,
for buried crossings.
6. If concrete is used with any fill material, it shall not be allowed to come in contact with surface waters
until it has cured.
7. Upon completion of the project, the Applicant shall complete and return the enclosed "Certificate of
Completion" form to notify NCDWQ when all work included in the §401 Certification has been
completed. The responsible party shall complete the attached form and return it to the 401/Wetlands
unit of the NC Division of Water Quality upon completion of the project. Along with the Certificate of
Completion form, please send photographs upstream and downstream of each stream-crossing site to
document correct installation.
Mr. Perry Kairis
Page 3, DWQ# 05-1592
October 4, 2005
If you do not accept any of the conditions of this certification, you may ask for an adjudicatory hearing. You
must act within 60 days of the date that you receive this letter. To ask for a hearing, send a written petition
which conforms to Chapter 150B of the North Carolina General Statutes to the Office of Administrative
Hearings, 6714 Mail Service Center, Raleigh, N.C. 27699-6714. This certification and its conditions are final
and binding unless you ask for a hearing.
This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water Act. If
you have any questions, please telephone Daryl Lamb in the DWQ Winston-Salem Regional Office at 336-771-
4600 or Ian McMillan in the Central Office in Raleigh 919-715-4631.
Sincerely,
Alan W. Klimek, P.E.
AWK/cdl
Attachments
cc: Mr. John Thomas, U. S. Army Corps of Engineers, Raleigh Regulatory Field Office
Winston-Salem DWQ Regional Office
Central Files
Wetlands/401 File Copy
Mr. Randy McNeill, Davis-Martin-Powell and Associates, 6415 Old Plank Road, High Point, NC 27265
Triage Check List
8/22/05
L UP [ -::i fi=r
L Y k ?
s3 a; ? t
?
Date: Project Name: City of High Point
Lower Kindergarden Outfall
DWQ#: 05-1592
Daryl Lamb, Winston-Salem Regional Office County: Davidson
To:
60-day processing time: 8/19/05 - 10/17/05
From: Cyndi Karoly Telephone : [phone]
The file attached is being forwarded to you for your evaluation.
Please call if you need assistance.
? Stream length impacted
? Stream determination
Wetland 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: As per our discussion regarding revision of the triage and delegation processes,
please review the attached file. Note that you are the first reviewer, so this file will need to be
reviewed for administrative as well as technical details. If you elect to place this project on hold,
please ask the applicant to provide your requested information to both the Central Office in
Raleigh as well as the Asheville Regional Office. As we discussed, this is an experimental, interim
procedure as we slowly transition to electronic applications. Please apprise me of any
complications you encounter, whether related to workload, processing times, or lack of a "second
reviewer" as the triage process in Central had previously provided. Also, if you think of ways to
improve this process, especially so that we can plan for the electronic applications, let me know.
Thanks!
INEMM DAVIS-MARTIN-POWELL & ASSOCIATES, INC.
ENGINEERING • LAND PLANNING • SURVEYING
6415 Old Plank Road, High Point, NC 27265
M P [phone] • Fax [phone] • www.dmp-inc.com
2 00 5? 5 92 PAYMELNT
August 15, 2005 RECEIVED
Re: City of High Point
Lower Kindergarden Outfall Replacement
DMP Project E-3708 (BF)
Mr. John Dorney
Division of Water Quality
401/Wetlands Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
Dear Mr. Dorney:
On behalf of the City of High Point, we have enclosed seven (7) copies of the enclosed "Pre-
Construction Notification Application" along with check no. 027605 in the amount of $200.00, for a
proposed sewer line installation.
The proposed sewer line will cross five (5) sections of Payne Creek and one (1) section of an unnamed
tributary to Payne Creek. Five (5) areas of wetlands will also be impacted along sewer line route with the
total impact less than one (1) acre. We have enclosed two (2) copies of the USGS quad sheet section
for this location with stream and wetland impacts identified, two (2) copies of the Wetland and Upland
Data Forms for this project and two (2) sets of civil drawings for the proposed work.
This project was previously permitted in October 1996, however the project was never constructed. A
copy of the previous approval is also enclosed. We trust this information will allow you to make a
thorough and timely review of this project. If you have any questions or require additional information,
please call me. We appreciate your assistance with this matter and look forward to hearing from you.
Sincerely,
DAVIS-MARTIN-POWELL & ASSOCIATES, INC.
Michael Goliber, PE
C: Perry Kairis (enc)
File (enc)
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A? G ? ? 2005
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Pre-Construction Notification (PCN) Application Form
For Section 404 and/or Section 10 Nationwide, Regional and General Permits, Section 401
General Water Quality Certifications, and Riparian Buffer and Watershed Buffer Rules
This form is to be used for projects qualifying for any of the U.S. Army Corps of Engineers' (USACE)
Nationwide, Regional or General Permits as required by Section 404 of the Clean Water Act and/or
Section 10 of the Rivers and Harbors Act, and for the North Carolina Division of Water Quality's
(DWQ) associated General 401 Water Quality Certifications. This form is also to be used for any
project requiring approval under any Riparian Buffer Rules implemented by the N.C. Division of Water
Quality. This form should not be used if you are requesting an Individual 404 Permit or Individual 401
Water Quality Certification. The USACE Individual Permit application form is available online at
http://www.saw.usace.anny.mil/wetlands/Perm app.htm.
The USACE is the lead regulatory agency. To review the requirements for the use of Nationwide,
Regional or General permits, and to determine which permit applies to your project, please go to the
USACE website at http://www.saw.usace.army.mil/wetlands/regtour.htm, or contact one of the field
offices listed on page 3 of this application. The website also lists the responsible project manager for
each county in North Carolina and provides additional information regarding the identification and
regulation of wetlands and waters of the U.S.
The DWQ issues a corresponding Certification (General or Individual), and cannot tell the applicant
which 401 Certification will apply until the 404 Permit type has been determined by the USACE.
Applicants are encouraged to visit DWQ's 401/Wetlands Unit website at
http://h2o.enr.state.nc.us/ncwetlands to read about current requirements for the 401 Water Quality
Certification Program and to determine whether or not Riparian Buffer Rules are applicable. The
applicant is also advised to read the full text of the General Certification (GC) matching the specific 404
Permit requested. In some cases, written approval for General Certifications is not required, provided
that the applicant adheres to all conditions of the GC. Applicants lacking access to the internet should
contact DWQ's Central Office in Raleigh at [phone].
Trout Waters Coordination - Special coordination with the North Carolina Wildlife Resources
Commission (NCWRC) is required for projects occurring in any of North Carolina's twenty-five
counties that contain trout waters. In such cases, the applicant should contact the appropriate NCWRC
regional coordinator (listed by county on page 4 of this application) prior to submittal of the application.
l
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• t .1`, lr ?'l F * I
'0051-592

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Page 1 of 12

Coastal Area Management Act (CAMA) Coordination - If the project occurs in any of North Carolina's
twenty coastal counties (listed on page 4) the applicant should contact the North Carolina Division of
Coastal Management (DCM). DCM will determine whether or not the project is within a designated
Area of Environmental Concern, in which case DCM will act as the lead permitting agency. In such
cases, DCM will require a CAMA Permit and will coordinate the 404/401 Permits.
The applicant may also choose to coordinate with the United States Fish and Wildlife Service to ensure
that the proposed project will have no impact upon any endangered or threatened species or critical
habitat as regulated by the Endangered Species Act, and the State Historic Preservation Office, North
Carolina Department of Cultural Resources to ensure that the proposed project will have no impact upon
any properties listed or eligible for listing on the National Register of Historic Places. Compliance with
these regulations is required to be eligible for any Department of the Army permit. The addresses for
both agencies are listed on page 3 of this application.
USACE Permits - Submit one copy of this form, along with supporting narratives, maps, data forms,
photos, etc. to the applicable USACE Regulatory Field Office. Upon receipt of an application, the
USACE will determine if the application is complete as soon as possible, not to exceed 30 days. This
PCN form is designed for the convenience of the applicant to address information needs for all USACE
Nationwide, Regional or General permits, as well as information required for State authorizations,
certifications, and coordination. Fully providing the information requested on this form will result in a
complete application for any of the USACE Nationwide, Regional or General permits. To review the
minimum amount of information that must be provided for a complete PCN for each USACE
Nationwide permit, see Condition 13, 65 Fed. Reg. 12893 (March 9, 2000), available at
http://www.saw.usace.anny.mil/wetlands/nwpfinalFedRea.12df. Processing times vary by permit and
begin once the application has been determined to be complete. Please contact the appropriate
regulatory field office for specific answers to permit processing periods.
401 Water Quality Certification or Buffer Rules - All information is required unless otherwise stated
as optional. Incomplete applications will be returned. Submit seven collated copies of all USACE
Permit materials to the Division of Water Quality, 401/Wetlands Unit, 1650 Mail Service Center,
Raleigh, NC, 27699-1650. If written approval is required or specifically requested for a 401
Certification, then a non-refundable application fee is required. In brief, if project impacts include less
than one acre of cumulative wetland/water impacts and less than 150 feet cumulative impacts to
streams, then a fee of $200 is required. If either of these thresholds is exceeded, then a fee of $475 is
required. A check made out to the North Carolina Division of Water Quality, with the specific name of
the project or applicant identified, should be stapled to the front of the application package. For more
information, see the DWQ website at http://h2o.ehnr.state.nc.us/ncwetlands/fees.html. The fee must be
attached with the application unless the applicant is a federal agency in which case the check may be
issued from a separate office. In such cases, the project must be identifiable on the U.S. Treasury check
so that it can be credited to the appropriate project. If written approval is sought solely for Buffer Rules,
the application fee does not apply, and the applicant should clearly.state (in a cover letter) that only
Buffer Rule approval is sought in writing. Wetlands or waters of the U.S. may not be impacted prior to
issuance or waiver of a Section 401 Water Quality Certification. Upon receipt of a complete application
for a 401 Certification, the Division of Water Quality has 60 days to prepare a written response to the
applicant. This may include a 401 Certification, an on-hold letter pending receipt of additional
requested information, or denial.
Page 2 of 12
US Army Corps Of Engineers Field Offices and County Coverage
Asheville Regulatory Field Office Alexander Caldwell Haywood McDowell Swain
US Army Corps of Engineers Alleghany Catawba Henderson Mecklenburg Transylvania
151 Patton Avenue Ashe Cherokee Iredell Mitchell Union
Room 208 Avery Clay Jackson Polk Watauga
Asheville, NC 28801-5006 Buncombe Cleveland Lincoln Rowan Yancey
Telephone: [phone] Burke Gaston Macon Rutherford
Fax: [phone] Cabarrus Graham. Madison Stanley
Raleigh Regulatory Field Office Alamance Franklin Nash Surry
US Army Corps Of Engineers Caswell Forsyth Northampton Vance
6508 Falls of the Neuse Road Chatham Granville Orange Wake
Suite 120 Davidson Guilford Person Warren
Raleigh, NC 27615 Davie Halifax Randolph Wilkes
Telephone: [phone] Durham Johnston Rockingham Wilson
Fax: [phone] Edgecombe Lee Stokes Yadkin
Washington Regulatory Field Office Beaufort Currituck Jones Pitt
US Army Corps Of Engineers Bertie Dare Lenoir Tyrrell
Post Office Box 1000 Camden Gates Martin Washington
Washington, NC 27889-1000 Carteret* Green Pamlico Wayne
Telephone: [phone] Chowan Hertford Pasquotank
Fax: [phone] Craven Hyde Perquimans *Croatan National Forest Only
Wilmington Regulatory Field Office Anson Duplin Onslow
US Army Corps Of Engineers Bladen Harnett Pender
Post Office Box 1890 Brunswick Hoke Richmond
Wilmington, NC 28402-1890 Carteret Montgomery Robeson
Telephone: [phone] Columbus Moore Sampson
Fax: [phone] Cumberland New Hanover Scotland
North Carolina State Agencies
Division of Water Quality Division of Water Quality State Historic Preservation Office
401 Wetlands Unit Wetlands Restoration Program Department Of Cultural Resources
1650 Mail Service Center 1619 Mail Service Center 4617 Mail Service Center
Raleigh, NC 27699-1650 Raleigh, NC 27699-1619 Raleigh, NC 27699-4617
Telephone: [phone] Telephone: [phone] Telephone: [phone]
Fax: [phone] Fax: [phone] Fax: [phone]
US Fis
US Fish and Wildlife Service
Raleigh Field Office
Post Office Box 33726
Raleigh, NC 27636-3726
Telephone: [phone]
h and Wildlife Service / National IV,
US Fish and Wildlife Service
Asheville Field Office
160 Zillicoa Street
Asheville, NC 28801
Telephone: [phone]
[arine Fisheries Service
National Marine Fisheries Service
Habitat Conservation Division
Pivers Island
Beaufort, NC 28516
Telephone: [phone]
Page 3 of 12
Division of Coastal Management
1638 Mail Service Center
Raleigh, NC 27699-1638
Telephone: [phone]
Fax: [phone]
Western Piedmont Region Coordinator
3855 Idlewild Road
Kernersville, NC 27284-9180
Telephone: [phone]
Mountain Region Coordinator
20830 Great Smoky Mtn. Expressway
Waynesville, NC 28786
Telephone: [phone]
Fax: [phone]
t
CAMA and NC Coastal Counties
Beaufort Chowan Hertford Pasquotank
Bertie Craven Hyde Pender
Brunswick Currituck New Hanover Perquimans
Camden Dare Onslow Tyrrell
Carteret Gates Pamlico Washington
NCWRC and NC Trout Counties
Alleghany Caldwell Watauga
Ashe Mitchell Wilkes
Avery Stokes
Burke Surry
Buncombe Henderson Polk
Cherokee Jackson Rutherford
Clay Macon Swain
Graham Madison Transylvania
Haywood McDowell Yancey
APPLICATION FORM BEGINS ON PAGE 5. PLEASE DO NOT SUBMIT PAGES I - 4.
Page 4 of 12
--
liC?,Lt''yfC
Office Use Only: Form Version May 2002
USACE Action ID No. DWQ No. 2 0 0 5 1 5 9 2
(If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A".)
L Processing
1. Check all of the approval(s) requested for this project:
® Section 404 Permit ? Riparian or Watershed Buffer Rules
? Section 10 Permit ? Isolated Wetland Permit from DWQ
® 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested: NWP 12
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), ch ck herre:
? ((??? ??n
II. Applicant Information D
AUG 1 9 2005
1. Owner/Applicant Information
Name: City of High Point WAIF?f 14
Mailing Address: PO Box 230 "" RffiYATER SRWN
High Point, North Carolina 27261
Telephone Number: 336-883-3166 Fax Number: 336-883-1675
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: Randy McNeill
Company Affiliation: Davis-Martin-Powell and Associates
Mailing Address: 6415 Old Plank Road
High Point, North Carolina 27265
Telephone Number: 336-886-4821 Fax Number: 336-886-4458
E-mail Address: rmcneilKDdmp-inc.com
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: City of High Point, Lower Kindergarden Outfall Improvements
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN):
4. Location
County: Davidson Nearest Town: High Point
Subdivision name (include phase/lot number):
Directions to site (include road numbers, landmarks, etc.): Project area located along
Payne Creek beginning approximately 1200 linear feet (LF) downstream of Chestnut
Dr. and ending approximately 3200 LF upstream of Chestnut St.
5. Site coordinates, if available (UTM or Lat/Long): See Attachment No. 1
(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):
7. Nearest body of water (stream/river/sound/ocean/lake): Payne Creek
8. River Basin: Yadkin
(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: The project corridor is mainly wooded/forest area with
sparse residential throughout
Page 6 of 12
10. Describe the overall project in detail, including the type of equipment to be used:
The proposed project will consist of installation of a new sewer outfall to replace the
existing undersized/deteriorating outfall. Pipeline installation will be via trenching
methods utilizing track mounted excavators and dozers. All proposed channel
crossings will be stabilized immediately upon crossing and wetland areas crossed will be
returned to pre-construction grades and seeded w/native vegetation species.
11. Explain the purpose of the proposed work: The replacement of the existing outfall
which has surpassed it's useful life (both in capacity and condition).
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 pen-nits 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.
See Attachment No. 2
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.
None anticipated
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 (intennittent 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.
1. Provide a written description of the proposed impacts: Installation of gravity sewer via
Page 7 of 12
open-cut method. Streams will be stabilized upon completion of sewer installation &
wetlands will be restored to natural grade and allowed to reve2etate by natural means.
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***
KB Excavation 0.0740 Yes 45 Forested Wetland
KC Excavation 0.0945 Yes 39 Forested Wetland
KD Excavation 0.1410 Yes 22 Forested Wetland
KE Excavation 0.1469 Yes 23 Forested Wetland
KF Excavation 0.1879 Yes 40 Forested 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 darns, separately list impacts due to both structure and flooding.
** 100-Year floodplains are identified through the Federal Emergency Management Agency's (FEMA) Flood Insurance Rate Maps
(FIRM), or FEMA-approved local tloodplain maps. Maps are available through the FEMA Map Service Center at 1-800-358-9616, or
online at littp://www.feina.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: 0.6443 acres
3. Individually list all intermittent and perennial stream impacts below:
Stream Impact Length of Average Width Perennial or
Site Number Type of Impact* Impact Stream Name** of Stream Intermittent?
indicate on ma) (linear feet) Before Impact (please secif
1 Excavation/ 20 Tributary to Payne 18 Perennial
Stabilization Creek
2 Excavation/ 20 Payne Creek 30 Perennial
Stabilization

3 Excavation/
20
Payne Creek
25
Perennial
Stabilization
4 Excavation/ 20 Payne Creek 25 Perennial
Stabilization
5 Excavation/ 20 Payne Creek 6 Perennial
Stabilization
6 Excavation/ 20 Payne Creek 8 Perennial
Stabilization
* 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.gov. Several internet sites also allow direct download and printing of USGS maps (e.g., www.topozone.com,
www.mapquest.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: 120 L.F.
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: till, 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/embankment, 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.
Reouired stream crossings are proposed to be made as near perpendicular as possible and
alignments have been shifted where possible to minimize wetland 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
http://h2o.enr.state.nc.us/ncwetlands/strmgide.html.
1. Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
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/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
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 N
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 N
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 N
X. Proposed Impacts on Riparian and Watershed Buffers (required by DWQ)
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
required state and local buffers associated with the project. The applicant must also provide
justification for these impacts in Section VII above. All proposed impacts must be listed herein,
and must be clearly identifiable on the accompanying site plan. All buffers must be shown on a
map, whether or not impacts are proposed to the buffers. Correspondence from the DWQ
Regional Office may be included as appropriate. Photographs may also be included at the
applicant's discretion.
Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Neuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify )?
Yes ? No N 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 I extends out 30 feet perpendicular tiom near bank of channel; Gone G 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.
i
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.
N/A
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.
Proposed project is replacement of existing outfall with ultimate treatment at the
City of High Point's Westside WWTF.
XIII. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H.0500) or any Buffer Rules?
Yes ? No
Is this an after-the-fact permit application?
Yes ? No
XIV. Other Circumstances (Optional):
It is the applicant's responsibility to submit the application sufficiently in advance of desired
construction dates to allow processing time for these permits. However, an applicant may
choose to list constraints associated with construction or sequencing that may impose limits on
work schedules (e.g., draw-down schedules for lakes, dates associated with Endangered and
Threatened Species, accessibility problems, or other issues outside of the applicant's control).
Z
Applic%'nt/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 12 of 12
ja?l
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DAVIS-MARTIN-POWELL & ASSOCIATES, INC CITY OF HIGH POINT, NC
LOWER KINDERGARDEN OUTFALL IMPROVEMENTS
IMPACTED STREAMS & WETLANDS SITES
VICINITY MAP
Attachment 1
Stream Site Coordinates
Stream Impact Site Station Stream Latitude Longitude
Number
Tributary to Payne '
1 10+97 to 11+20 84°12
30" 78006'15"
Creek
2 39+28 to 39+60 Payne Creek 84°44'10" 78°28'20"
3 42+29 to 42+60 Payne Creek 84046'65" 78°40'50"
Tributary to Payne
4 47+10 to 47+57 84°50'25" 78°46'65"
Creek
5 55+13 to 55+46 Payne Creek 84°55'13" 78°50'25"
Tributary to
u
Payne
6 56+13 to 56+43 84°57'68" 78048'01"
River
D

DAVIS-MARTIN-POWELL ASSOCIATES Stream Site Coordinates E3708 - 7/29/2005
ATTACHMENT NO. 2
The proposed project, originally designed in 1995-1996, received USACE and DWQ approval in 1996.
The original applications were submitted under 1996 cover and approved by the respective agencies
as follows (approvals attached):
US Army Corps of Engineers November 1, 1996 Action ID 199700099
Division of Water Quality October 18, 1996 . DWQ Proj # 960985
The originally designed project was not built for economic reasons. A few minor changes have been
made to the alignment from the previously permitted alignment due to easement restrictions. The
changes that have been made were done in a manner to minimize impacts to wetlands and stream
crossings.

f
U.S. ARMY CORPS OF ENGINEERS --!C
WILMINGTON DISTRICT
Action ID. 199700099 County Davidson
GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION
Property Owner/Agent City of High Point
Address Post Office Box 230. Hi0h Point. North Carolina'` 27261
Telephone No. 910 883-3167
Size and Location of project (waterway, road name/number, town, etc.) City of High Point
Kool Pool and Kindergarden sewer outfall easement located from Canterbury Road to Burton
Avenue (S.R. 1784) including the Corbett sewer outfall easement located from Nottingham
Drive to Allen Drive . adjacent to Payne Creek near High Point in Davidson County North
Carolina.
Description of Activity
Proposed sewer outfall project resulting in less than an 0.42 acre of impacts to the jurisdictional
waters of the Payne Creek.
X Section 404 (Clean Water Act, 33 USC 1344) only.
Section 10 (River and Harbor Act of 1899) only.
Section 404 and Section 10.
NWP 12 Nationwide Permit Number.
Any violation of the conditions of the Regional General or Nationwide Permit referenced above
may subject the permittee to a stop work order, a restoration order, and/or appropriate legal
action.
This Department of the Army Regional General/Nationwide Permit verification does not relieve
the undersigned permittee of the responsibility to obtain any other required Federal, State, or
local approvals/permits. The permittee may need to contact appropriate State and local agencies
before beginning work. /
Regulatory Project Manager Signature 4 )-
Date November 1. 1996 Expir tion Date.
SURVEY PLATS, FIELD SKETCH, WETLAND DELINEATION FORM, ETC., MUST BE
ATTACHED TO THE FILE COPY OF THIS FORM, IF REQUIRED OR AVAILABLE.
-f9
State of North Carolina
Department of Environment,
Health and Natural Resources •
Division of Water Quality
JamesB. Hunt, Jr., Govemor
Jonathan B. hbwes, Secretary ID FE H N F1
A. Presto n Howard, Jr., P.E., Directo r
October 18, 1996
Davidson County
DWQ Project # 960985
APPROVAL of 401 Water Quality Certification and ADDITIONAL CONDITIONS
City of High Point
P.O. Box 230
High Point, NC 27261
Dear Sirs:
You have our approval to place fill material in 0.42 acres of wetlands or waters for the purpose of
constructing the Kool Pool, Kindergarten and Corbett outfalls in High Point, as you described in your
application dated 9 October 1996. After reviewing your application, we have decided that this fill is covered
by General Water Quality Certification Number 3022. This certification allows you to use Nationwide
Permit Number 12 when it is issued by the Corps of Engineers.
This approval is only valid for the purpose and design that you described in your application except as
modified below. If you change your project, you must notify us and you may be required to send us a new
application. For this approval to be valid, you must follow the conditions listed in the attached certification
and any additional conditions listed below. Applicant is reminded that stream crossings should be
perpendicular. In addition, you should get any other federal, state or local permits before you go ahead with
your project including (but not limited to) Sediment and Erosion Control, Coastal Stormwater, Non-
Discharge and Water Supply Watershed regulations.
If you do not accept any of the conditions of this certification, you may ask for an adjudicatory hearing.'
You must act within 60 days of the date that you receive this letter. To ask for a bearing, send a written
petition which conforms to Chapter 150B of the North Carolina General Statutes to the Office of
Administrative Hearings, P.O. Box 27447, Raleigh, N.C. 27611-7447. This certification and its conditions
are final and binding unless you ask for a hearing.
This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water
Act. If you have any questions, please telephone John Dorney at 919-733-1786.
Pr ston Howard, Jr. P.E.
Attachment i
cc: Wilmington District Corps of Engineers
Corps of Engineers Raleigh Field Office
Winston-Salem DWQ Regional Office
Mr. John Domey
Central Files
Keliy'Hayes; Davis=Martin=Powellarid Associates;
960985.1tr
Division of Water Quality • Environmental Sciences Branch
Environmental Sciences Branch, 4401 Reedy Creek Rd., Raleigh, NC 27607 Telephone [phone] FAX # [phone]
An Equal Opportunity Affirmative Action Employer 9 50% recycled/10% post consumer paper
DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Determination Manual)
Project / Site: Lower Kindergarden Outfall Replacement Date: 515105
Applicant / Owner: County: Davidson
Investigator: Jessi O'Neal, Robert J. Goldstein & Associates, Inc. State: NC
Do normal circumstances exist on the site? Yes X No Community ID:
Is the site significantly disturbed (Atypical situation)? Yes No x Bottomland Hardwood
Is the area a potential problem area? Yes No x Swamp
(explain on reverse if needed) Transect ID: Wetland
KA, KB, KC. KD, KE,
KF, KG, KH
VEGETATION
Dominant Plant Species Stratum Indicator Dominant Plant Species Stratum Indicator
1. Acer negundo tree FACW 9. Lonicera japonica vine FAC-
2. Fraxinus pennsylvanica tree FACW 10. Toxicodendron radicans vine FAC
3. Platanus occidentalis tree FACW- 11. Boehmeria cylindrica herb FACW+
4. Acer rubrum tree FAC 12. Geum virginianum herb FACW-
5. Liguidambar styraciflua tree FAC+ 13. Violapanilionacea herb FAC
6. Ligustrum sinense shrub FAC 14. Impatiens capensis herb FACW
7. Acer negundo shrub FACW 15. Galium tinctorium herb FACW
8. Cornus amomum shrub FACW+ 16. Carex vulpinoidea herb OBL
Percent of Dominant Species that are OBL, FACW, or FAC excluding FAC-). 94
Remarks: Wetland Vegetation Present Based Upon Greater than 50% of the Plant Species are Classified as
FAC-OBL in the National List of Plant Species that Occur in Wetlands.
HYDROLOGY-
Recorded Data (Describe In Remarks): Wetland Hydrology Indicators
_ Stream, Lake, or Tide Gauge
Aerial Photographs Primary Indicators:
_ Other _ Inundated
x Saturated in Upper 12"
No Recorded Data Available _ Water Marks
_ Drift Lines
Field Observations: _ Sediment Deposits
x Drainage Patterns in Wetlands
Depth of Surface Water: (in.) Secondary Indicators:
x Oxidized Roots Channels in Upper 12"
Depth to Free Water in Pit: (in.) x Water-Stained Leaves
Local Soil Survey Data
Depth to Saturated Soil: (in.) _ FAC-Neutral Test
_ Other (Explain in Remarks)
Remarks:
SOILS
Map Unit Name
(Series and Phase): Chewacla loam Drainage Class: somewhat poorly drained
Taxonomy (Subgroup): Fluvaquentic D shpt Confirm Mapped Type? Yes_ No
Profile Description:
Depth Matrix Colors Mottle Colors Mottle Texture, Concretions,
(inches) Horizon (Munsell Moist) ( Munsell Moist) Abundance/Contrast Structure, etc.
12 2.5Y 511
Hydric Soil Indicators:
_ Histosol _ Concretions
_ Histic Epipedon _ High Organic Content in Surface Layer in Sandy Soils
_ Sulfidic Odor Organic Streaking in Sandy Soils
-Aquic Moisture Regime Listed On Local Hydric Soils List
x Reducing Conditions Listed on National Hydric Soils List
x Gleyed or Low-Chroma Colors _ Other (Explain in Remarks)
Remarks:
WETLAND DETERMINATION
Hydrophytic Vegetation Present? Yes x No Is the Sampling Point
Wetland Hydrology Present? Yes x No Within a Wetland? Yes x No
Hydric Soils Present? Yes x No
Remarks: Location is classified as a wetland based upon the criteria set forth in the 1987 Army Corps of
Engineers Wetlands Delineation Manual.
DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Determination Manual)
Project / Site: Lower Kindersarden Outfall Replacement Date: 515105, 5/6/05
Applicant / Owner: County: Davidson
Investigator: Jessi O'Neal, Robert J. Goldstein & Associates, Inc. State: NC
Do normal circumstances exist on the site? Yes x No Community ID:
Is the site significantly disturbed (Atypical situation)? Yes No x Mesic Mixed Hardwood .
Is the area a potential problem area? Yes No x Transect ID: Wetland
(explain on reverse if needed) KA, KB, KC, KD, KE,
KF, KG, KH
VEGETATION
Dominant Plant Species Stratum Indicator Dominant Plant Species Stratum Indicator
1. Liriodendron tulipifera tree FAC 9. Lonicera japonica vine FAC-
2. Quercus alba tree FACU 10. Toxicodendron radicans vine FAC
3. Ouercus falcata tree FACU- 11. Polystichum acrostichoides herb FAC
4. Acer saccharinum tree FACU- 12. Hexastylis arifolia herb FAC-
5. Carya ovata shrub FACU 13. Vitis rotundifolia vine -FAQ
6. Fa ugs Qrandifolia shrub FACU 14. Polygonatum biflorum herb FAC-
T. Viburnum acerifolium shrub FACU 15. Podophvllum peltatum herb FACU
8. Cornus florida herb FACU 16.
Percent of Dominant Species that are OBL, FACW, or FAC excluding FAC-). 27
Remarks:. Wetland Vegetation Present Based Upon Greater than 50% of the Plant Species are not Classified as
FAC-OBL in the National List of Plant Species that Occur in Wetlands.
HYDROLOGY
_ Recorded Data (Describe In Remarks): Wetland Hydrology Indicators
_ Stream, Lake, or Tide Gauge
_ Aerial Photographs Primary Indicators:
_ Other _ Inundated
Saturated in Upper 12"
No Recorded Data Available _ Water Marks
_ Drift Lines

Field Observations: Sediment Deposits
_
Drainage Patterns in Wetlands
Depth of Surface Water: (in,) Secondary Indicators:
Oxidized Roots Channels in Upper 12"
Depth to Free Water in Pit: (in.) Water-Stained Leaves
Local Soil Survey Data
Depth to Saturated Soil: (in.) _ FAC-Neutral Test
- Other (Explain in Remarks)
Remarks:
SOILS
Map Unit Name
(Series and Phase): Chewacla loam Drainage Class: somewhat poorly drained
Taxonomy (Subgroup): Fluvaquentic Dystrudept Confirm Mapped Type? Yes_ No
Profile Description:
Depth Matrix Colors Mottle Colors Mottle Texture, Concretions,
(inches) Horizon (Munsell Moist) (Munseli Moist) Abundance/Contrast Structure, etc.
12 10YR 4/4
Hydric Soil Indicators:
_ Histosol _ Concretions
_ Histic Epipedon _ High Organic Content in Surface Layer in Sandy Soils
_ Sulfidic Odor Organic Streaking in Sandy Soils
Aquic Moisture Regime Listed On Local Hydric Soils List
_ Reducing Conditions Listed on National Hydric Soils List
_ Gleyed or Low-Chroma Colors -Other (Explain in Remarks)
Remarks:
WETLAND DETERMINATION
Hydrophytic Vegetation Present? Yes No x Is the Sampling Point
Wetland Hydrology Present? Yes No x Within a Wetland? Yes_ No x
Hydric Soils Present? Yes No x
Remarks: Location is not classified as a wetland based upon the criteria set forth in the 1987 Army Corps of
Engineers Wetlands Delineation Manual.
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Pre-Construction Notification (PCN) Application Form
For Section 404 and/or Section 10 Nationwide, Regional and General Permits, Section 401
General Water Quality Certifications, and Riparian Buffer and Watershed Buffer Rules
This form is to be used for projects qualifying for any of the U.S. Army Corps of Engineers' (USACE)
Nationwide, Regional or General Permits as required by Section 404 of the Clean Water Act and/or
Section 10 of the Rivers and Harbors Act, and for the North Carolina Division of Water Quality's
(DWQ) associated General 401 Water Quality Certifications. This form is also to be used for any
project requiring approval under any Riparian Buffer Rules implemented by the N.C. Division of Water
Quality. This form should not be used if you are requesting an Individual 404 Permit or Individual 401
Water Quality Certification. The USACE Individual Permit application form is available online at
http://www.saw.usace.army.mil/wetlands/Perm app.htm.
The USACE is the lead regulatory agency. To review the requirements for the use of Nationwide,
Regional or General permits, and to determine which permit applies to your project, please go to the
USACE website at http://www.saw.usace.anny.mil/wetlands/reZour.htm, or contact one of the field
offices listed on page 3 of this application. The website also lists the responsible project manager for
each county in North Carolina and provides additional information regarding the identification and
regulation of wetlands and waters of the U.S.
The DWQ issues a corresponding Certification (General or Individual), and cannot tell the applicant
which 401 Certification will apply until the 404 Permit type has been determined by the USACE.
Applicants are encouraged to visit DWQ's 401/Wetlands Unit website at
http://h2o.enr.state.nc.us/newetlands to read about current requirements for the 401 Water Quality
Certification Program and to determine whether or not Riparian Buffer Rules are applicable. The
applicant is also advised to read the full text of the General Certification (GC) matching the specific 404
Permit requested. In some cases, written approval for General Certifications is not required, provided
that the applicant adheres to all conditions of the GC. Applicants lacking access to the internet should
contact DWQ's Central Office in Raleigh at [phone].
Trout Waters Coordination - Special coordination with the North Carolina Wildlife Resources
Commission (NCWRC) is required for projects occurring in any of North Carolina's twenty-five
counties that contain trout waters. In such cases, the applicant should contact the appropriate NCWRC
regional coordinator.(listed by county on page 4 of this application) prior to submittal of the application.
Page 1 of 12
Coastal Area Management Act (LAMA) Coordination - If the project occurs in any of North Carolina's
twenty coastal counties (listed on page 4) the applicant should contact the North Carolina Division of
Coastal Management (DCM). DCM will determine whether or not the project is within a designated
Area of Environmental Concern, in which case DCM will act as the lead permitting agency. In such
cases, DCM will require a CAMA Permit and will coordinate the 404/401 Permits.
The applicant may also choose to coordinate with the United States Fish and Wildlife Service to ensure
that the proposed project will have no impact upon any endangered or threatened species or critical
habitat as regulated by the Endangered Species Act, and the State Historic Preservation Office, North
Carolina Department of Cultural Resources to ensure that the proposed project will have no impact upon
any properties listed or eligible for listing on the National Register of Historic Places. Compliance with
these regulations is required to be eligible for any Department of the Army permit. The addresses for
both agencies are listed on page 3 of this application.
USACE Permits - Submit one copy of this form, along with supporting narratives, maps, data forms,
photos, etc. to the applicable USACE Regulatory Field Office. Upon receipt of an application, the
USACE will determine if the application is complete as soon as possible, not to exceed 30 days. This
PCN form is designed for the convenience of the applicant to address information needs for all USACE
Nationwide, Regional or General permits, as well as information required for State authorizations,
certifications, and coordination. Fully providing the information requested on this form will result in a
complete application for any of the USACE Nationwide, Regional or General pen-nits. To review the
minimum amount of information that must be provided for a, complete PCN for each USACE
Nationwide permit, see Condition 13, 65 Fed. Reg. 12893 (March 9, 2000), available at
http://www.saw.usace.army.mil/wetlands/nwl2finalFedReg.pdf. Processing times vary by permit and
begin once the application has been determined to be complete. Please contact the appropriate
regulatory field office for specific answers to permit processing periods.
401 Water Quality Certification or Buffer Rules - All information is required unless otherwise stated
as optional. Incomplete applications will be returned. Submit seven collated copies, of all USACE
Permit materials to the Division of Water Quality, 401/Wetlands Unit, 1650 Mail Service Center,
Raleigh, NC, 27699-1650. If written approval is required. or specifically requested for a 401
Certification, then a non-refundable application fee is required. In brief, if project impacts include less
than one acre of cumulative wetland/water impacts and less than 150 feet cumulative impacts to
streams, then a fee of $200 is required. If either of these thresholds is exceeded, then a fee of $475 is
required. A check made out to the North Carolina Division of Water Quality, with the specific name of
the project or applicant identified, should be stapled to the front of the application package. For more
information, see the DWQ website at http://h2o.ehnr.state.nc.us/ncwctlands/fees.litml. The fee must be
attached with the application unless the applicant is a federal agency in which case the check may be
issued from a separate office. In such cases, the project must be identifiable on the U.S. Treasury check
so that it can be credited to the appropriate project. If written approval is sought solely for Buffer Rules,
the application fee does not apply, and the applicant should clearly state (in a cover letter) that only
Buffer Rule approval is sought in writing. Wetlands or waters of the U.S. may not be impacted prior to
issuance or waiver of a Section 401 Water Quality Certification. Upon receipt of a complete application
for a 401 Certification, the Division of Water Quality has 60 days to prepare a written response to the
applicant. This may include a 401 Certification, an on-hold letter pending receipt of additional
requested information, or denial.
Page 2 of 12
US Army Corps Of Engineers Field Offices and County Coverage
Asheville Regulatory Field Office Alexander Caldwell Haywood McDowell Swain
US Army Corps of Engineers Alleghany Catawba Henderson Mecklenburg Transylvania
151 Patton Avenue Ashe Cherokee Iredell Mitchell Union
Room 208 Avery Clay Jackson Polk Watauga
Asheville, NC 28801-5006 Buncombe Cleveland Lincoln Rowan Yancey
Telephone: [phone] Burke Gaston Macon Rutherford
Fax: [phone] Cabam?s Graham. Madison Stanley
Raleigh Regulatory Field Office Alamance Franklin Nash Surry
US Army Corps Of Engineers Caswell Forsyth Northampton Vance
6508 Falls of the Neuse Road Chatham Granville Orange Wake
Suite 120 Davidson Guilford Person Warren
Raleigh, NC 27615 Davie Halifax Randolph Wilkes
Telephone: [phone] Durham Johnston Rockingham Wilson
Fax: [phone] Edgecombe Lee Stokes Yadkin
Washington Regulatory Field Office Beaufort Currituck Jones Pitt
US Army Corps Of Engineers Bertie Dare Lenoir Tyrrell
Post Office Box 1000 Camden Gates Martin Washington
Washington, NC 27889-1000 Carteret* Green Pamlico Wayne
Telephone: [phone] Chowan Hertford Pasquotank
Fax: [phone] Craven Hyde Perquimans *Croatan National Forest Only
Wilmington Regulatory Field Office Anson Duplin Onslow
US Army Corps Of Engineers Bladen Harnett Pender
Post Office Box 1890 Brunswick Hoke Richmond
Wilmington, NC 28402-1890 Carteret Montgomery Robeson
Telephone: [phone] Columbus Moore Sampson
Fax: [phone] Cumberland New Hanover Scotland
North Carolina State Agencies
Division of Water Quality Division of Water Quality State Historic Preservation Office
401 Wetlands Unit Wetlands Restoration Program Department Of Cultural Resources
1650 Mail Service Center 1619 Mail Service Center 4617 Mail Service Center
Raleigh, NC 27699-1650 Raleigh, NC 27699-1619 Raleigh, NC 27699-4617
Telephone: [phone] Telephone: [phone] Telephone: [phone]
Fax: [phone] Fax: [phone] Fax: [phone]
US Fish and Wildlife Service / National Marine Fisheries Service
US Fish and Wildlife Service US Fish and Wildlife Service National Marine Fisheries Service
Raleigh Field Office Asheville Field Office Habitat Conservation Division
Post Office Box 33726 160 Zillicoa Street Pivers Island
Raleigh, NC 27636-3726 Asheville, NC 28801 Beaufort, NC 28516
Telephone: [phone] Telephone: [phone] Telephone: [phone]
Page 3 of 12
Division of Coastal Management
1638 Mail Service Center
Raleigh, NC 27699-1638
Telephone: [phone]
Fax: [phone]
Western Piedmont Region Coordinator
3855 Idlewild Road
Kernersville, NC 27284-9180
Telephone: [phone]
Mountain Region Coordinator
20830 Great Smoky Mtn. Expressway
Waynesville, NC 28786
Telephone: [phone]
Fax: [phone]
T
CAMA and NC Coastal Counties
Beaufort Chowan Hertford Pasquotank
Bettie Craven Hyde Pender
Brunswick Currituck New Hanover Perquimans
Camden Dare Onslow Tyrrell
Carteret Gates Pamlico Washington
NCWRC and NC Trout Counties
Alleghany Caldwell
Ashe Mitchell
Avery Stokes
Burke Surry
Buncombe Henderson
Cherokee Jackson
Clay Macon
Graham Madison
Haywood McDowell
Watauga
Wilkes
Polk
Rutherford
Swain
Transylvania
Yancey
APPLICATION FORM BEGINS ON PAGE 5. PLEASE DO NOT SUBMIT PAGES 1- 4.
Page 4 of 12
Drl?t"•!"` r
'v LL
Office Use Only: 2 Q O 5 Form Version May 2002
1 5 9 2
USACE Action ID No. DWQ No.
(If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A".)
L Processing
1. Check all of the approval(s) requested for this project:
® Section 404 Permit ? Riparian or Watershed Buffer Rules
? Section 10 Permit ? Isolated Wetland Permit from DWQ
® 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested: NWP 12
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
u R@ 12? Lfw19 11
1. Owner/Applicant Information AU(i I :) LUUn
Name: City of High Point
Mailing Address: PO Box 230 rm"Ivw., rc!=
High Point, North Carolina 27261
Telephone Number: 336-883-3166 Fax Number: 336-883-1675
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: Randy McNeill
Company Affiliation: Davis-Martin-Powell and Associates
Mailing Address: 6415 Old Plank Road
High Point North Carolina 27265
Telephone Number: 336-886-4821 Fax Number: 336-886-4458
E-mail Address: rmcneill-dmn-inc.com
Page 5 of 12
Ill. 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: City of High Point, Lower Kinderuarden Outfall Improvements
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN)
4. Location
County: Davidson Nearest Town: High Point
Subdivision name (include phase/lot,number):
Directions to site (include road numbers, landmarks, etc.): Project area located along
Payne Creek beginning approximately 1200 linear feet (LF) downstream of Chestnut
Dr. and ending approximately 3200 LF upstream of Chestnut St.
5. Site coordinates, if available (UTM or Lat/Long): See Attachment No. 1
(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):
7. Nearest body of water (stream/river/sound/ocean/lake): Payne Creek
8. River Basin: Yadkin
(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: The project corridor is mainly wooded/forest area with
sparse residential throughout
Page 6of12
10. Describe the overall project in detail, including the type of equipment to be used:
The proposed project will consist of installation of a new sewer outfall to replace the
existing undersized/deteriorating outfall. Pipeline installation will be via trenching
methods utilizing track mounted excavators and dozers. All proposed channel
crossings will be stabilized immediately upon crossing and wetland areas crossed will be
returned to pre-construction grades and seeded w/native vegetation species.
11. Explain the purpose of the proposed work: The replacement of the existing outfall
which has surpassed it's useful life (both in capacity and condition).
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 pen-nits 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 pen-nits issued for prior segments of the same T.I.P. project, along with
construction schedules.
See Attachment No. 2
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.
None anticipated
VI. Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to detennine, 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, pennanent
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.
1. Provide a written description of the proposed impacts: Installation of gravity sewer via
Page 7 of 12
open-cut method. Streams will be stabilized upon completion of sewer installation &
wetlands will be restored to natural grade and allowed to.reve2etate by natural means.
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***
KB Excavation 0.0740 Yes 45 Forested Wetland
KC Excavation 0.0945 Yes 39 Forested Wetland
KD Excavation 0.1410 Yes 22 Forested Wetland
KE Excavation 0.1469 Yes 23 Forested Wetland
KF Excavation 0.1879 Yes 40 Forested 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 tloodplains are identified through the Federal Emergency Management 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 littp://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: 0.6443 acres
3. Individually list all intermittent and perennial stream impacts below:
Stream Impact Length of Average Width Perennial or
Site Number Type of Impact* Impact Stream Name** of Stream Intermittent?
(indicate on ma (linear feet) Before Impact leasespecify)
I Excavation/ 20 Tributary to Payne 18 Perennial
Stabilization Creek
2 Excavation/ 20 Payne Creek 30 Perennial
Stabilization
3 Excavation/ 20 Payne Creek 25 Perennial
Stabilization
4 Excavation/ 20 Payne Creek 25 Perennial
Stabilization
5 Excavation/ 20 Payne Creek 6 Perennial
Stabilization
6 Excavation/ 20 Payne Creek 8 Perennial
Stabilization
* 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
downstreamn named strewn into which it flows. USGS maps are available through the USGS at 1-800-358-9616, or online at
Www.useS.ROV. Several intemet sites also allow direct download and printing of USGS maps (e.g., www.topozone.com,
www.mapduest.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: 120 L.F.
Page 8of12
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 map).
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/embankment, 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.
Required stream crossings are proposed to be made as near perpendicular as possible and
alignments have been shifted where possible to minimize wetland 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
http://h2o.enr.state.nc.us/newetlands/strmgide.html.
1. Provide a brief description of the proposed mitigation plan. The description should provide
as much infonnation 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 infonnation 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
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. All proposed impacts must be listed herein,
and must be clearly identifiable on the accompanying site plan. All buffers must be shown on a
map, whether or not impacts are proposed to the buffers. Correspondence from the. DWQ
Regional Office may be included as appropriate. Photographs may also be included at the
applicant's discretion.
Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Neuse), 15A NCAC 213 .0259 (Tar-Pamlico), 15A NCAC 213 .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify )?
Yes ? No ® If you answered "yes", provide the following information:
Identify the square feet and acreage of impact to each zone of the riparian buffers. If buffer
mitigation is required calculate the required amount of mitigation by applying the buffer
multipliers.
Zone* Impact
(square feet) Multiplier Required
Miti ration
1 3
2 1.5
Total
* Zone 1 extends out 30 teet perpendicular trom near bank of channel; Gone G extenos an
additional 20 feet from the edge of Zone I.
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 213.0242 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.
N/A
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.
Proposed protect is replacement of existing outfall with ultimate treatment at the
City of High Point's Westside WWTF.
XIII. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes ? No
Is this an after-the-fact permit application?
Yes ? No
XIV. Other Circumstances (Optional):
It is the applicant's responsibility to submit the application sufficiently in advance of desired
construction dates to allow processing time for these pen-nits. 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).
?/?/6s_
Appli ant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 12 of 12
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??/L ..' ?? ' ?'•l,? 4/ ' .? I? ? i,??it?? ??%ir(_ ?, J tr??.?Y?l(/ ) ?S• ) / ?r7)? ??`I-? ?, (//? ?. ? C?J'7 ? ?: "" I4'?.??I' ??/ ?/'•? +/ %"
DAVIS-MARTIN-POWELL & ASSOCIATES, INC CITY OF HIGH POINT, NC
LOWER KINDERGARDEN OUTFALL IMPROVEMENTS
IMPACTED STREAMS & WETLANDS SITES
' mp VICINITY MAP
COME= I
Attachment 1
Stream Site Coordinates
Stream Impact Site Station Stream Latitude Longitude
Number
1 10+97 to 11+20 Tributary to Payne 84°12'30" 78°06'15"
Creek
2 39+28 to 39+60 Payne Creek 84°44'10" 78°28'20"
3 42+29 to 42+60 Payne Creek 84046'65" 78°40'50"
Tributary to Payne '
"
4 47+10 to 47+57 84050
25 78°46'65"
Creek
5 55+13 to 55+46 Payne Creek 84055'13" 78°50'25"
Tributary to Payne

6
56+13 to 56+43 a
84 57 68 o „
78 48 O1
Dee River

DAVIS-MARTIN-POWELL ASSOCIATES Stream Site Coordinates E3708 - 7/29/2005
ATTACHMENT NO. 2
The proposed project, originally designed in 1995-1996, received USACE and DWQ approval in 1996.
The original applications were submitted under 1996 cover and approved by the respective agencies
as follows (approvals attached):
I US Army Corps of Engineers November 1, 1996 Action ID 199700099
Division of Water Quality October 18, 1996 DWQ Proj # 960985
The originally designed project was not built for economic reasons. A few minor changes have been
made to the alignment from the previously permitted alignment due to easement restrictions. The
changes that have been made were done in a manner to minimize impacts to wetlands and stream
crossings.

J
U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT.

Action ID. 199700099 County Davidson
GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION
Property Owner/Agent City of High Point
Address Post Office Box 230. High Point. North Carolina` 27261
Telephone No. .910883-3167
Size and Location of project (waterway, road name/number, town, etc.) _ City of High Point
Kool Pool and Kindergarden sewer outfall easement located from Canterbury Road to Burton
Avenue (S.R. 1784) including the Corbettsewer outfall easement located from Nottingham
Drive to Allen Drive . adjacent to Payne Creek near High Point in Davidson County North
Carolina.
Description of Activity
Proposed sewer outfall project resulting in less than an 0.42 acre of impacts to the jurisdictional
waters of the Payne Creek.
X Section 404 (Clean Water Act, 33 USC 1344) only.
Section 10 (River and Harbor Act of 1899) only.
Section 404 and Section 10.
NWP 12 Nationwide Permit Number.
Any violation of the conditions of the Regional General or Nationwide Permit referenced above
may subject the permittee to a stop work order, a restoration order, and/or appropriate legal
action.
This Department of the Army Regional General/Nationwide Permit verification does not relieve
the undersigned permittee of the responsibility to obtain any other required Federal, State, or
local approvals/permits. The permittee may need to contact appropriate State and local agencies
before beginning work.
Regulatory Project Manager Signature S
Date November 1. 1996 Expir tion Date
SURVEY PLATS, FIELD SKETCH, WETLAND DELINEATION FORM, ETC., MUST BE
ATTACHED TO THE FILE COPY OF THIS FORM, IF REQUIRED OR AVAILABLE.
%9-IT1
State of North Carolina
Department of Environment, 009?E
Health and Natural Resources 1 0 •
Division of Water Quality
James B. Hunt, Jr., Governor
Jonathan B. Ho w e s, Secretary ®FE ?--? N F1
A. Preston Howard, Jr., P.E., Director'
October 18, 1996
Davidson County
DWQ Project # 960985
APPROVAL of 401 Water Quality Certification and ADDITIONAL CONDITIONS
City of High Point
P.O. Box 230
High Point, NC 27261
Dear Sirs
You have our approval to place fill material in 0.42 acres of wetlands or waters for the purpose of
constructing the Kool Pool, Kindergarten and Corbett outfalls in High Point, as you described in your
application dated 9 October 1996. After reviewing your application, we have decided that this fill is covered
by General Water Quality Certification Number 3022, This certification allows you to use Nationwide
Permit Number 12 when it is issued by the Corps of Engineers.
This approval is only valid for the purpose and design that you described in your application except as
modified below. If you change your project, you must notify us and you may be required to send us a new
application. For this approval to be valid, you must follow the conditions listed in the attached certification
and any additional conditions listed below. Applicant is reminded that stream crossings should be
perpendicular. In addition, you should get any other federal, state or local permits before you go ahead with
your project including (but not limited to) Sediment and Erosion Control, Coastal Stormwater, Non-
Discharge and Water Supply Watershed regulations.
If you do not accept any of the conditions of this certification, you may ask for an adjudicatory hearing.
You must act within 60 days of the date that you receive this letter. To ask for a bearing, send a written
petition which conforms to Chapter 150B of the North Carolina General Statutes to the Office of
Administrative Hearings, P.O. Box 27447, Raleigh, N.C. 27611-7447. This certification and its conditions
are final and binding unless you ask for a hearing.
This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water
Act. If you have any questions, please telephone John Domey at 919-733-1786.
Pr stop Howard, Jr. P.E.
Attachment ' i
cc: Wilmington District Corps of Engineers
Corps of Engineers Raleigh Field Office
Winston=Salem DWQ Regional Office
Mr. John Dorney
Central Files
Kelly Mayes, Davis Nlar;d Powell. and.Associates
960985.1tr
Division of Water Quality - Environmental Sciences Branch
Environmental Sciences Branch, 4401 Reedy Creek Rd., Raleigh, NC 27607 Telephone [phone] FAX TM 733-9959
An Equal Opportunity Affirmative Action Employer - 50% recycled/10% post consumer paper
DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands. Determination Manual)
Project 1 Site: Lower KinderQarden Outfall Replacement Date: 515105
Applicant / Owner: County: Davidson
Investigator: Jessi O'Neal, Robert J. Goldstein & Associates, Inc. State: NC
Do normal circumstances exist on the site? Yes X No Community ID:
Is the site significantly disturbed (Atypical situation)? Yes No x Bottomland Hardwood
Is the area a potential problem area? Yes No x Swamp
(explain on reverse if needed) Transect ID: Wetland
KA, KB, KC, KD, KE,
KF, KG, KH
VEGETATION
Dominant Plant Species Stratum Indicator Dominant Plant Species Stratum Indicator
1. Acer negundo tree FACW 9. Lonicera japonica vine FAC-
2. Fraxinus pennsylvanica tree FACW 10. Toxicodendron radicans vine FAC
3. Platanus occidentalis tree FACW- 11. Boehmeria cylindrica herb FACW+
4. Acer rubrum tree FAC 12. Geum virginianum herb FACW-
5. Liquidambar styraciflua tree FAC+ 13. Viola papilionacea herb FAC
6. Ligustrum sinense shrub FAC 14. Impatiens capensis herb FACW
7. Acer negundo shrub FACW 15. Galium tinctorium herb FACW
8. Cornus amomum shrub FACW+ 16. Carex vulpinoidea herb OBL
Percent of Dominant Species that are OBL, FACW, or FAC excluding FAC-). 94
Remarks: Wetland Veget ation Present Based Upon Greater than 50% of the Plant Species are Classifi ed as
FAC-OBL in the National List of Plant Species that Occur in Wetlands.
HYDROLOGY-
Recorded Data (Describe In Remarks): Wetland Hydrology Indicators
_ Stream, Lake, or Tide Gauge
_ Aerial Photographs Primary Indicators:
_ Other _ Inundated
x Saturated in Upper 12"
No Recorded Data Available _ Water Marks
_ Drift Lines
Field Observations: _ Sediment Deposits
X Drainage Patterns in Wetlands
Depth of Surface Water: (in.) Secondary Indicators:
x Oxidized Roots Channels in Upper 12"
Depth to Free Water in Pit: (in.) x Water-Stained Leaves
_ Local Soil Survey Data
Depth to Saturated Soil: (in.) _ FAC-Neutral Test
Other (Explain in Remarks)
Remarks:
SOILS
Map Unit Name
(Series and Phase): Chewacla loam Drainage Class: somewhat poorly drained
Taxonomy (Subgroup): Fluvaquentic Dv strudept Confirm Mapped Type? Yes_ No
Profile Description:
Depth Matrix Colors Mottle Colors Mottle Texture, Concretions,
inches Horizon (Munsell Moist) (Munsell Moist) Abundance/Contrast Structure, etc.
12 2.5Y 5/1
Hydric Soil Indicators:
_ Histosol _ Concretions
Histic Epipedon _ High Organic Content in Surface Layer in Sandy Soils
_ Sulfidic Odor Organic Streaking in Sandy Soils
-Aquic Moisture Regime Listed On Local Hydric Soils List
x Reducing Conditions Listed on National Hydric Soils List
x Gleyed or Low-Chroma Colors -,Other (Explain in Remarks)
Remarks:
WETLAND DETERMINATION
Hydrophytic Vegetation Present? Yes x No Is the Sampling Point
Wetland Hydrology Present? Yes x No Within a Wetland? Yes x No
Hydric Soils Present? Yes x No
Remarks: Location is classified as a wetland based upon the criteria set forth in the 1987 Army Corps of
Engineers Wetlands Delineation Manual.
DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Determination Manual)
Project / Site: Lower Kindergarden Outfall Replacement Date: 5/5/05, 516105
Applicant / Owner: County: Davidson
Investigator: Jessi O'Neal, Robert J. Goldstein & Associates, Inc. State: NC
Do normal circumstances exist on the site? Yes x No Community ID:
Is the site significantly disturbed (Atypical situation)? Yes No x Mesic Mixed Hardwood .
Is the area a potential problem area? Yes No x Transect ID: Wetland
(explain on reverse if needed) KA, KB, KC, KD, ICE,
KF, KG, KH
VEGETATION
Dominant Plant Species Stratum Indicator Dominant Plant Species Stratum Indicator
1. Liriodendron tulipifera tree FAC 9. Lonicera japonica vine FAC-
2. Quercus alba tree FACU 10. Toxicodendron radicans vine FAC
3. Quercus falcata tree FACU- 11. Polvstichum acrostichoides herb FAC
4. Acer saccharinum tree FACU- 12. Hexastvlis arifolia herb FAC-
5. Carva ovata shrub FACU 13. Vitis rotundifolia vine FAC
6. Fasus erandifolia shrub ' FACU 14. Polveonatum biflorum herb FAC-
7. Viburnum acerifolium shrub FACU 15. Podophvllum peltatum herb FACU
8. Cornus florida herb FACU 16.
Percent of Dominant Species that are OBL, FACW, or FAC excluding FAC-). 27
Remarks:. Wetland Vegetation Present Based Upon Greater than 50% of the Plant Species are not Classified as
FAC-OBL in the National List of Plant Species that Occur in Wetlands.
HYDROLOGY
_ Recorded Data (Describe In Remarks): Wetland Hydrology Indicators
- Stream, Lake, or Tide Gauge
_ Aerial Photographs Primary Indicators:
_ Other _ Inundated
Saturated in Upper 12"
No Recorded Data Available _ Water Marks
_ Drift Lines
Field Observations: Sediment Deposits
- Drainage Patterns in Wetlands
Depth of Surface Water: (in.) Secondary Indicators:
Oxidized Roots Channels in Upper 12"
Depth to Free Water in Pit: (in.) Water-Stained Leaves
- Local Soil Survey Data
Depth to Saturated Soil: FAC-Neutral Test
Other (Explain in Remarks)
Remarks:
C -,
SOILS
Map Unit Name
(Series and Phase): Chewacla loam Drainage Class: somewhat poorly drained
Taxonomy (Subgroup): Fluvaguentic Dystrudg pt Confirm Mapped Type? Yes_ No
Profile Description:
Depth Matrix Colors Mottle Colo rs Mottle Texture, Concretions,
(inches) Horizon (Munsell Moist) (Munseli Moist) Abundance/Contrast Structure, etc.
12 10YR 4/4
Hydric Soil Indicators:
_ Histosol _ Concretions
_ Histic Epipedon - High Organic Content in Surface Layer in Sandy Soils
_ Sulfidic Odor Organic Streaking in Sandy Solis
_ Aquic Moisture Regime Listed On Local Hydric Soils List
_ Reducing Conditions Listed on National Hydric Solis List
Gleyed or Low-Chroma Colors - Other (Explain in Remarks)
Remarks:
WETLAND DETERMINATION
Hydrophytic Vegetation Present? Yes No x Is the Sampling Point
Wetland Hydrology Present? Yes No x Within a Wetland? Yes_ No x
Hydric Soils Present? Yes No x
Remarks: Location is not classified as a wetland based upon the criteria set forth in the 1987 Army Corps of
Engineers Wetlands Delineation Manual.
027605
401 Water Quality Certification
City of High Point E-3708 #529 200.00
F@THWIRP
AUG i q ZOOS
DE14r. - WATER QUALITY
WETLANDS AND STORMtiVATER BRANCH