20091175 Ver 1_401 Application_20091109

Vg59 50 , 9
Quible I YEARS
Quible & Associates, P.C. RO. Drawer 870
Kitty Hawk, NC 27949
ENGINEERING • ENVIRONMENTAL SCIENCES • PLANNING • SURVEYING Phone: [phone]
SINCE 1959 Fax: [phone]
PRINCIPALS
Sean C. Boyle, P.E.
Joseph S. Lassiter, C.E.P.
Eduardo J. Valdivieso, P.E.
NC Division of Water Quality o 9- 1 1 7 5 ASSOCIATES
Joseph J. Anlauf, P.E.
Attn: Ian McMillan Katherine C. Marchello, RLS.
1650 Mail Service Center
Raleigh, NC 27699-1650
November 2, 2009
RE: Dances With Waves, LLC (1147 Persimmon Street) AI P
Corolla Village, Currituck County
Mr. McMillan:
Enclosed is a Nationwide 18/ 401 Water Quality Certification submission for 1147 Persimmon Street in
Corolla Village, Currituck County, North Carolina. The owner/applicant is Dances With Waves, LLC.
We have prepared this application for a Nationwide #18 Permit and 401 Water Quality Certification for
0.052 acres of Section 404 non-riparian wetland impacts. The site plan depicts the proposed residential
development plan on this existing, platted lot. The proposed wetland impact area is also depicted. The
wetland delineation was performed by Warren Eadus with Quible & Associates, P.C. and confirmed in the
field by Tom Steffens, USACE on 7/28/09.
Enclosed are 5 copies of the following:
• Site Plan NOV ? U
• Agent Authorization Letter `' X009
• PCN Application DENR. WATER KETLA • USGS Vicinity Map NDSANDSTORMWq ER9Rp?y
• EEP Acceptance Letter
• Section 404 delineation maps submitted to USACE
• Albemarle Regional Health On-Site Septic Evaluation
• Copy of the $240 Processing Fee Check to NCDENR
Please review and process this permit request. If you have any questions or require additional
information, please contact me at [phone].
Sincerely,
Quible & Associates, P.C.
Brian Rubino
CC: Roberto Scheller, DWQ
Kyle Barnes, USACE
Jonathan Summerton, Dances With Waves, LLC
Quible
5
?g59 0 z
Quible & Associates, P.C.
ENGINEERING • ENVIRONMENTAL SCIENCES • PLANNING • SURVEYING
SINCE 1959
Kyle Barnes
US Army Corps of Engineers
P.O. Box 1000
Washington, NC 27889
November 2, 2009
RE: Dances With Waves, LLC (1147 Persimmon Street)
Corolla Village, Currituck County
Mr. Barnes:
P.O. Drawer 870
Kitty Hawk, NC 27949
Phone: [phone]
Fax: [phone]
PRINCIPALS
Sean C. Boyle, P.E.
Joseph S. Lassiter, C.E.P.
Eduardo J. Valdivieso, P.E.
ASSOCIATES
Joseph J. Anlauf, P.E.
Katherine C. Marchello, P.L.S.
Enclosed is a Nationwide 18/ 401 Water Quality Certification submission for 1147 Persimmon Street in
Corolla Village, Currituck County, North Carolina. The owner/applicant is Dances With Waves, LLC.
We have prepared this application for a Nationwide #18 Permit for 0.052 acres of Section 404 non-
riparian wetland impacts. The site plan depicts the proposed residential development plan on this
existing, platted lot. The proposed wetland impact area is also depicted. The wetland delineation was
performed by Warren Eadus with Quible & Associates, P.C. and confirmed in the field by Tom Steffens on
7/28/09.
Enclosed is the following: 0
• Site Plan Oun
• Agent Authorization Letter NO V
• PCN Application v X09
USGS Vicinity Map gE
V&TLANDSANDSToR TRB
EEP Acceptance In-Lieu Payment Request RANC11
• Section 404 delineation map confirmed by USACE
• Albemarle Regional Health On-Site Septic Evaluation
• Copy of the $240 Processing Fee Check to NCDENR
Please review and process this permit request. If you have any questions or require additional
information, please contact me at [phone].
Sincerely,
Quible & Associates, P.C.
T_A?L>?
Brian Rubino
CC: Roberto Scheller, DWQ
Ian McMillan, DWQ
Jonathan Summerton, Dances With Waves, LLC
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LIN E TABLE
LINE LENGTH BEARING
L18 21.99 S46°44'43'W
L19 4.30 S39°14'17'W
L20 18.19 S39°14'17'W
L21 42.69 75°20'35'W
L22 29.60 N45°47'44'W
L23 7.25 N48°36'31'W
L28 7.29 S32°37'37'W
L29 16.11 S32°37'37'W
L30 13.91 N53°02'18'W
L31 3.98 N09°51'33'W
L32 1.4.59 09°51'33'W
L33 15.72 S19°06'52'W
L34 16.50 S19°06'52'W
L35 30.71 S70°12'30"E
L36 28.28 N87°38'02'W
L37 36.00 S11°00'30'W
L38 11.47 S11°00'30'W
L39 17.04 N02°29'17'W
L40 41.09 N02°29'17'W
L41 12.49 N06°27'15'E
L42 14.94 N06°27'15'E
-1 All MOORED SJ/RVEl' NOTES:
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REFERENCE A5 5HOM HEREON.
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OF E CLEAN NA TER ACT UNDER HE PRE5ENT LAN AND
}b bo, 1111 4041
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CAR ?4 REGUALTlONS A5 DETERMINED BY THE UNDERSIGNED ON THI5
O °°•° :DATE. UNLE55 THERE I5 A CHANGE IN THE LAN OR OUR
z,r m O?.•° FE ti «PUBLI5HE 2 REGULATIONS THIS DETERMINATION OF SECTION
I v ?: • % 404 VRI5916TION t IAY BE RELIED UPON FOR A PERIOD NOT
'TO EXCEED 5 YEAR5 FROM TH15 DATE, THI5 DETERMINATION
?. S SE L ° _j = k A5 M UTl ZING THE 1987 CORPS OF EN6INEER5
•.f:9 O: /?rETL / ATION MANUAL- C
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:NAME
A "THI5 I5 NOT A BaWARY 5MVEY TITLE 6 ? Z67'
SS 2 t C?
AND l5 NOT INTBCW FOR
ELM RECORDATION OR CONVEYANCE -DATE,.. ..... .....:...... 11 PROJECT WETLANDS LOCATION 08065 COPYRIGHT Q Zoos Quible
QUIBLE ASSOCIATES. P.C. TAX MAP 114, PARCEL 21 A
DRAWN ? A330C1atC3, P .C.
.C•
KCM THIS DOCUMENT IS THE PROPERTY OF 1147 P2IR5ZIMIMON STRBST, COROLLA, NC
QUIBLE & ASSOCIATES, PC. ALL ENGINEERING a CONSULTING • PLANNING
RIGHTS ARE RESERVED. ANY RE-
PRODUCTION OF THIS OR POSSESSION POPLAR BRANCH TOWNSHIP CURRITUCK COUNTY ENVIRONMENTAL SCIENCES * SURVEYING
CAD REF. WITHOUT PRIOR PERMISSION OF 8 JUNIPER TRAIL, PO DRAWER 870
Qeoas- CONSTIITTUT& E VVIIO ATIIOTN of CO?IGHT NORTH CAROLINA KITTY HAWK, NORTH CAROLINA 27949
LAWS. VIOLATION WILL BE SUBJECT 0 30 60 Phone: [phone]
DATE TO LEGAL ACTION Fax: [phone]
12/05/08 GRAPHIC SCALE IN FEET 1'=30 E-Mail: quible0earthiink.net
AGENT AUTHORIZATION
RE: Dances With Waves, LLC
1147 Persimmon Street
Corolla, Currituck County, NC
I authorize Quible & Associates, P,C, to act as agent on behalf of the current owner (Dances
With Waves, LLC) of the above referenced property for the purpose of environmental permitting,
including USACE and DWQ permits.
Name: Jonathan Summerton Date f d
09- 1 1 T5
O?O,? W A TFq
r
0 Ni -c
Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.0 November 2008
Pre-Construction Notification (PCN) Form
A. Applicant Information
1. Processing
1 a. Type(s) of approval sought from the
Corps:
®Section 404 Permit ? Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: 18 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps? ? Yes ® No
1 d. Type(s) of approval sought from the DWQ (check all that apply):
® 401 Water Quality Certification - Regular ? Non-404 Jurisdictional General Permit
? 401 Water Quality Certification - Express ? Riparian Buffer Authorization
1 e. Is this notification solely for the record
because written approval is not required? For the record only for DWQ 401
Certification:
? Yes ® No For the record only for Corps Permit:

? Yes ® No
1f. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in-lieu
fee program. ® Yes ? No
1 g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below. ® Yes ? No
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ? Yes ® No
2. Project Information
2a. Name of project: Dances With Waves, LLC
2b. County: Currituck N
2c. Nearest municipality / town: Corolla
2d. Subdivision name: None STORMWATER BRANCH
2e. NCDOT only, T.I.P. or state
project no:
3. Owner Information
3a. Name on Recorded Deed: Dances With Waves, LLC
3b. Deed Book and Page No. 1100/544
3c. Responsible Party (for LLC if
applicable): Jonathan Summerton
3d. Street address: 3845 Ivy Lane
3e. City, state, zip: Kitty Hawk, NC 27949
3f. Telephone no.: [phone]
3g. Fax no.:
3h. Email address:
Page 1 of 11
PCN Form - Version 1.0 November 2008 Version
Section A. Applicant Information, continued
4. Applicant Information (if different from owner)
4a. Applicant is: ? Agent ? Other, specify:
4b. Name:
4c. Business name
(if applicable):
4d. Street address:
4e. City, state, zip:
4f. Telephone no.:
4g. Fax no.:
4h. Email address:
5. Agent/Consultant Information (if applicable)
5a. Name: Brian Rubino
5b. Business name
(if applicable): Quible & Associates, P.C.
5c. Street address: P.O. Drawer 870
5d. City, state, zip: Kitty Hawk, NC 27949
5e. Telephone no.: [phone]
5f. Fax no.: [phone]
5g. Email address: brubinoCquible.com
Page 2 of 11
PCN Form - November 2008 Version
B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): pin: 9937-22-3258
1 b. Site coordinates (in decimal degrees): 36.3804759 `N - 75.8299212'W
1 c. Property size: 0.32 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
proposed project: UT of Currituck Sound
2b. Water Quality Classification of nearest receiving water: SC
2c. River basin: Pasquotank
3. Project Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application:
The site is undeveloped with native scrub shrub-type vegetation. Nearby properties include undeveloped and developed
single family residential homes.
3b. List the total estimated acreage of all existing wetlands on the property:
.052 acres non-riparian section 404 freshwater wetlands
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
0
3d. Explain the purpose of the proposed project:
Construction of a single family residence and all associated and required infrastructure.
3e. Describe the overall project in detail, including the type of equipment to be used:
Construction of a single family residential home, on-site septic treatment system, driveway/parking access and swimming
pool; uses typical residential construction techniques and equipment.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past?
® Yes ? No ? Unknown
4b. If the Corps made the jurisdictional determination, what type
of determination was made?
? Preliminary ®Final
4c. If yes, who delineated the jurisdictional areas?
Name (if known): Warren Eadus Agency/Consultant Company: Quible & Associates, P.C.
Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
July 28, 2009
5. Project History
5a. Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past?
? Yes ®No ? Unknown
5b. If yes, explain in detail according to "help file" instructions.
NA
6. Future Project Plans
6a. Is this a phased project? ? Yes ® No
6b. If yes, explain.
NA
Page 3 of 11
PCN Form - Version 1.0 November 2008 Version
C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
® Wetlands ? Streams - tributaries ? Buffers
? Open Waters ? Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a. 2b. 2c. 2d. 2e. 2f.
Wetland impact Type of jurisdiction
number - Type of Type of wetland Forested (Corps - 404, 10 Area of impact (acres)
Permanent (P) or impact (if known) DWQ - non-404, other)
Temporary T
W1 ®P ? T Fill Non-riparian ? Yes ® No ® Corps
® DWQ
0.019
W2 ® PEI T Fill Non-riparian ? Yes ® No ® Corps
® DWQ 0.033
W3 ? P ? T ? Yes ? No ? Corps
? DWQ
W4 ? P ? T ? Yes ? No ? Corps
? DWQ
W5 ? P ? T ? Yes ? No ? Corps
? DWQ
W6 ? P ? T ? Yes ? No ? Corps
? DWQ
2g. Total wetland impacts .052
2h. Comments:
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a. 3b. 3c. 3d. 3e. 3f.
Stream impact Type of Stream name Perennial (PER) or Average stream width (feet) Impact
number - impact intermittent (INT)? length
Permanent (P) or (linear feet)
Temporary (T)
S1 ? P ? T ? PER ? INT
S2 ?P?T ?PER ?INT
S3 ?P?T ?PER ?INT
S4 ? P ? T ? PER ? INT
S5 ? P ? T ? PER ? INT
S6 ?P?T ?PER ?INT
3g. Total stream and tributary impacts
3h. Comments:
Page 4 of 11
PCN Form - Version 1.0 November 2008 Version
C. Proposed Impacts Inventory, continued
4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individual) list all o en water impacts below.
4a. 4b. 4c. 4d. 4e.
Open water Name of
impact number waterbody Type of impact Waterbody type Area of impact (acres)
- Permanent (if
(P) or applicable)
Temporary T
01 ?P?T
02 ?P?T
03 ?P?T
04 ?P?T
4f. Total open water impacts
4g. Comments:
Page 5 of 11
PCN Form - November 2008 Version
C. Proposed Impacts Inventory, continued
5. Pond or Lake Construction
If and or lake construction pro osed, then complete the chart below.
5a. 5b. 5c. 5d. 5e.
Wetland Impacts (acres) Stream Impacts (feet) Upland
Pond ID
b Proposed use or (acres)
num
er purpose of pond
Flooded Filled Excavated Flooded Filled Excavated Flooded
P1
P2
5f. Total
5g. Comments:
5h. Is a dam high hazard permit required?
? Yes ? No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If an impacts require mitigation, then ou MUST fill out Section D of this form.
6a.
? Neuse ? Tar-Pamlico ? Other:
Project is in which protected basin? ? Catawba ? Randleman
6b. 6c. 6d. 6e. 6f. 6g.
Buffer impact
number - Reason Buffer Zone 1 impact (square Zone 2 impact
Permanent (P) for impact Stream name mitigation feet) (square feet)
or Temporary required?
T
131 ?P?T ?Yes ?No
B2 ?P?T ?Yes ?No
B3 ?P?T ?Yes ?No
6h. Total buffer impacts
6i. Comments:
Page 6 of 11
PCN Form - November 2008 Version
D. 'Impact Justification and Mitigation
1. Avoidance and Minimization
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
This is a relatively small previously platted lot. In order to complete residential construction and meet County setbacks,
there are unavoidable impacts to wetlands as shown on the accompanying plan.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Project construction will utilize silt fence to protect adjacent wetlands.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for
impacts to Waters of the U.S. or Waters of the State? ® Yes ? No
2b. If yes, mitigation is required by (check all that apply): ? DWQ ® Corps

2c. If yes, which mitigation option will be used for this
project? ? Mitigation bank

®Payment to in-lieu fee program
? Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter) Type Quantity
3c. Comments:
4. Complete if Making a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached. ® Yes
4b. Stream mitigation requested: linear feet
4c. If using stream mitigation, stream temperature: warm, cool, cold
4d. Buffer mitigation requested (DWQ only): Zone 1:
Zone 2: square feet
4e. Riparian wetland mitigation requested: acres
4f. Non-riparian wetland mitigation requested: .025 acres
4g. Coastal (tidal) wetland mitigation requested: acres
4h.. Comments:
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
Page 7 of 11
PCN Form - Version 1.0 November 2008 Version
D. Impact Justification and Mitigation, continued
6. Buffer Mitigation (State Regulated Riparian Buffer Rules) - required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation? ? Yes ® No
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.
Zone Reason for impact Total impact

(square feet) Multiplier
Required mitigation
(square feet)
Zone 1 3 (2 for Catawba)
Zone 2 1.5
Total buffer mitigation required:
6c. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in-lieu fee fund).
6d. Comments:
Page 8 of 11
PCN Form - November 2008 Version
E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1 a. Does the project include or is it adjacent to protected riparian buffers identified

within one of the NC Riparian Buffer Protection Rules? El Yes ® No
1 b. If yes, then is a diffuse flow plan included? ? Yes ? No
2. Determination if the Project Requires a Stormwater Management Plan
2a. Does the project require a Non-404 Jurisdictional General Permit? ? Yes ® No
2b. Is the project subject to General Certification 3704 or 3705? ? Yes ® No
3. Determination of Stormwater Review Jurisdiction
3a. Is this project subject to any of the following state-implemented stormwater ® Coastal counties
management programs (check all that apply)? ? HOW
If so, attach one copy of the approval letter from the DWQ and one copy of the E] ORW
? Session Law 2006-246
approved stormwater management plan. ? Other:
3b. In which local government's jurisdiction is this project? Currituck County
3c. Is this local government certified to implement a state stormwater program? ? Yes ® No
If so, attach one copy of the approval letter from the local government and one copy
of the approved stormwater management plan (or one copy of the approved
Stormwater management plan stamped as approved).
4. Information Required for DWQ 401 Unit Stormwater Review
4a. What is the overall percent imperviousness according to the most current site plan? 26.9%
4b. Does this project contain any areas that meet the criteria for "high density" per
General Certifications 3704 and 3705? ? Yes No
4c. If the site is over 24% impervious and/or contains high density areas, then provide a brief narrative description of the
stormwater management plan.
There will be vegetated filtration prior to on-site infiltration. No stormwater to be directed off-site. No State or County
Stormwater management requirements for low density development with less than 10,000 sf built upon area.
4d. Has a completed BMP Supplement Form with all required items been submitted
for each stormwater BMP? ? Yes No
Page 9 of 11
PCN Form - Version 1.0 November 2008 Version
F. Supplementary Information
1. Environmental Documentation (DWO Requirement)
1 a. Does the project involve an expenditure of public (federal/state/local) funds or the ? Yes ® No
use of public (federal/state) land?
1 b. If you answered "yes" to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State ? Yes ? No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1 c. If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
letter.) ? Yes ? No
Comments:
2. Violations (DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards, ? Yes ® No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. Is this an after-the-fact permit application? ? Yes ® No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in ? Yes ® No
additional development, which could impact nearby downstream water quality?
3b. If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
4. Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility.
On-site septic treatment system with repair area.
Page 10 of 11
PCN Form - Version 1.0 November 2008 Version
F. Supplementary Information, continued
5. • Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or
h ® Yes
? No
abitat?
5b. Have you checked with the USFWS concerning Endangered Species Act
i ? Yes ® No
mpacts?

5c. If yes, indicate the USFWS Field Office you have contacted. ?
Raleigh
? Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Desi
nated Critical
g
Habitat?
NC Natural Heritage Program
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat? ? Yes ® No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
Mapping data and field investigation (site is not adjacent to a water body)
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation ? Yes ® No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
National Register of Historic Places
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain? ®Yes ? No
8b. If yes, explain how project meets FEMA requirements: Base Floor elevations will be above 100 yr flood elevations
8c. What source(s) did you use to make the floodplain determination? NFIP Flood Zone Maps (www.ncfloodmaps.com)

.J ?t +G r
oc"
N
Applicant/Agent's Printed Name Applicant/Agent's Signature
(Agent's signature is valid only if an authorization letter from the applicant Date
is rovided.
Page 11 of 11
PCN Form - November 2008 Version
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NORTH CAROLINA ECOSYSTEM ENHANCEMENT PROGRAM, NCEEP
IN-LIEU FEE REQUEST FORM
Revised 09/24/2009
Print this form, fill in requested information, sign and date, and either mail to NCEEP, 1652 Mail Service Center, Raleigh, NC
27699-1652, fax to 919-715-2219, or email to kellv.williams(abncdenr.gov. Attachments are acceptable for clarification purposes
(location map is required). Review meetings are held on Monday afternoons and decisions are provided within 2 weeks.
CONTACT INFORMATION APPLICANT'S AGENT (optional) APPLICANT
-- -
1. Business or Individual Name (?vr;,bl•t A Asso c . ,P.C .
2. Street Address or P O Box
3. City, State, Zip
4. Contact Person
5. Telephone Number
6. Fax Number
7. E-Mail Address (optional)
PROJECT INFORMATION
8. Project Name
Po Drotwtr %-+o
K;icy }lawl?c ? pl c, 2?q'19 K
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br?bino?gh,ble .caw,
9. Project Location (nearest town, city)
-ATTACH MAP SHOWING IMPACT LOCATION'
10. Lat-Long Coordinates (optional)
11. Project County
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WAJti, L-C
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114 '+ Pe rs i wlwl . •, C+re ct-
lk
3(. 3-6 oy--S°I °A/ -1,r .B 299 21'z°w

2. River Basin & Cataloging Unit (8-digit) 1'aS ?? Rt ?
(See Note 1) ?l
LH. 03t7?dZd S -
13. Project Type
Government ? Private Commercial
14. Riparian Wetland Impact (ac.) (e.g., 0 13)
15. Non-Riparian Wetland Impact (ac.) --
D . O S2 A C .
16. Coastal Marsh Impact (ac.)
17. Stream Impact (ft.) (e.g. 1,234) Warm Cool Cold
(See Note 2)
18. Buffer Impact (sq. ft.) (e.g. 12,345) "Zone 1. Zone 2:
(where applicable, See Note 3)
--
19. Regulatory Agency Staff Contacts
(Indicate names, if known) USACE: K. SAIZNLt DWGl: R ,Sc1kGt-t-(a
20. Other Regulatory ID Information
(e.g., USACE Action ID, if known)
IMPORTANT
Check (J) below if this request is a:
_ revision to a current acceptance, or
_ re-submission of an expired acceptance
extension of unexpired acceptance
Slaw-2oo1-01403
By signing below, the applicant is confirming they have
read and understand EEP's refund policy posted at
nceep.net.
Signature of Ap nt or Authorized Agent:
10 2?1 og
__Date:?_...._..w._._-__...____________.._---___?.__..-__..
Note 1: For help in determining the Cataloging Unit, visit:http://denrmaps ncdenr org/EEPmai)s or call EEP contact below
Note 2: For guidance on stream temperatures, go to:
http://www.saw.usace.armv.mil/WETLANDS/Mitigation/Documents/Stream/Appendices/Appendix) i)df
Note 3: Buffer mitigation applicable only in the Neuse, Tar-Pamlico and Catawba river basins, and the Randleman Lake Water
Supply Watershed.
Direct questions to Kelly Williams at 919-716-1921 or kelly.williams(a?ncdenr.gov or to EEP's front desk at 919-715-0476.
Statement of Compliance with Session Law 2009-337 An Act to Promote
the Use of Compensatory Mitigation Banks
(link to SL 2009-337)
Prior to accessing the Ecosystem Enhancement Program (EEP) In-Lieu Fee Mitigation
Program, all applicants reauestinq wetlands stream and/or riparian buffer mitigation are now
required by law to comply with Session Law 2009-337 An Act to Promote the Use of
Compensatory Mitigation Banks. All new requests submitted on or after July 24, 2009 MUST
include this form signed and dated by the permit applicant or an authorized agent. Applicants
with unexpired acceptance letters may continue with their plans to use the In-Lieu Fee
Program or withdraw their request and seek other available mitigation options.
Compliance Statement:
1 have read and understand SL-2009-337 and have, to the best of my knowledge,
complied with its requirements.
Please check all that apply:
Applicant is a Government Entity as defined in G.S. 143-214.11 and is not
required to purchase credits from a mitigation bank.
There are no known private mitigation banks with the requested credit type
located in the hydrologic unit where this impact will take place (link to DWQ list).
I have contacted the mitigation bank(s) in the hydrologic unit where the impacts
will occur and credits are not available.
The application was submitted to the regulatory agencies prior to October 1,
2008 for streams and wetland impacts or July 24, 2009 for riparian buffer
impacts.
The DWQ or the Corps of Engineers did not approve of the use of a mitigation
bank for the required compensatory mitigation for this project.
Note: It is the applicant's responsibility to document any inquiries made to private
mitigation banks regarding credit availability.
L I have read and understand EEP's refund policies (attached)
initial here
Signature of Applicant or Agent
"?-y;, 1 \?00" n 6
Printed Name
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Date
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_C6 rs,w? rh on St
rdIIc, . ?v.rr. ,,c,V. Co
Project Name Location
WOODED \
SITE Coral Ln
FAME OONNELL °
TAX MAP 114, PARCEL 23 I 1st St
1143 PER51MMON ST m Pers- Street
0 Karen's Way
OB 120, PG 250 ry' m ° Second S
OB 115, P6 222 `fl I a 1
Carotnnk Dr
?l L 2nd St
jQtti<?261?g11E vV?0 3rd St
x ?m 3rd St
(9 q.08'
--7 ? w e
6 Z Vllla9e Rd
m Corolla
1, Q) > s Strong Ct
A -
N Iv
;;D 1 I Club Rd
rri Payson Ct
t
O D I ayson
AL JL
m
D
LI.I
_AL Alc?
DB 114, PC 667
/ N O
/ AREA 2-
AIL '` / 0.033 AC. n _u) I O ?
5? I m p I
Ed? ? ? I I Q
1 LEGEND
0 W I PROP05ED 5EGTION 404 NON-RIPARIAN
k k E'TZ AND FILL: 0.052 AG
I
N p r°z?i I I 0 PROPOSED DRIVEM)"
Z ON I o I PROP05ID OPEN DECK
z I
ufr' C I
Q I r?I
v
III`
AREA 1:
0.019 AC.y?
6 E
4- - ?? AIlc_ x`94"" e ?j °0y
1(91,
46
- S? G
-3- rr1 / Pc?? NO?AREA:
TOTAL: 13,753 SQ.FT. (0.32 AC.)
/ ?QL1'? ?T) \ - WELTLAND:12 260 SQ.FT.
GO P' 2. SECTION 404 (NON-COASTAL) IMPACT.
2,260 SQ.FT (0.052 AC.)
3. COMPENSATORY MITIGATION:
- NCEEP IN LIEU PAYMENT (0.25 AC.)
/ 4. COVERAGES:
- TOTAL BUILT UPON AREA: 3,706 SQ.FT. (26.9 %)
* BUILDING (ROOFED AREA): 1,969 SQ.FT.
* DRIVEWAY: 1,737 SQ.FT.
/ 4. FIELD NOTES:
"THlS PLAN l5 FOR NATIONWIDE l8 AND - SECTION 404 WETLANDS HAVE BEEN DELINEATED BY
QUIBLE-CONFIRMED BY TOM STEFFENS,
401 WATER OVAL I7Y CERTIFICATION ONLY USACE ON JULY 28, 2009.
["-_7THE5E ARE NOT ENGINEERED 5PEG5.
PROJECT NATIONWIDE #9
COPYRIGHT C Quible SINCE 1959
o 2008
QUIBLE & ASSOCIATES, P.C. DANCES WITH WA VES, LLC
DRAWN
THIS & Associates P.C.
KCM/BDR QU B DOCUMENT PC. ALL OF n47 PERSII1 MON STREET, COROLLA, NC
RIGHTS ARE RESERVED. ANY RE- ENGINEERING * CONSULTING * PLANNING
CAD REF. PROWITHOUT PRIOR THIS PERMISSON OF ION POPLAR BRANCH TOWNSHIP CURRITUCK COUNTY ENVIRONMENTAL SCIENCES * SURVEYING
QUIBLE & ASSOCIATES, PC WILL NORTH CAROLINA 8 JUNIPER TRAIL, PO DRAWER 870
CONSTITUTE VIOLATION OF COPYRIGHT KITTY HAWK, NORTH CAROLINA 27949
LAWS. VIOLATION WILL BE SUBJECT
DATE TO LEGAL ACTION 0 30 60 Phone: [phone]
10/26/09 mm" Fax: [phone]
GRAPHIC SCALE IN FEET 1'=30 E-Mail: qulble0earthlink.net
0'1-06 OJ lo; su rtsU"J-UAML)LN UUUN'TY HEALTH 93384475
a
T-119 P002/006 F-121
ALBEMARLE REGIONAL HEALTH SERVICES 40911 --?.,
Applicant. QUIBLE AND ASSOCIATES Owner: TWIDDY FAMILY PARTNERSHIP
PO BOX. 870 PO BOX 369
KITTY HAWK, NC 27949 COROLLA, NC 27927
Site Location: 1147 PERSIMMON STREET
Texture: S Mineralogy. SEXP GPD: Overall
Structure: GR Wetness (In.): 18 LTAR• 0 8 Lot Class US
If unsuitable, the site may be reclassified to provisionally suitable with the following modification:
-Fill Area OR. by Oft, with 24in. of sand
-Fill dimensions will be based on site plan and gallons per day for this septic system.
Fill Mqun
- 4-mu5t be inspected before permit can be issued.
To obtain an. Authorization to Construct:
Submit a plat or scale drawing of the lot, showing location and dimensions of all property lines, proposed
structures and driveways
-Pay Permit Fee of $225
-Pen-nit fee will be based on exact gallons per fay. Permit fee may be more than the $225 minimum.
Comments:
Date: 03/EHS:
26/2009
David Swinney
THIS APPROVAL WILL ]BECOME VOID AFTER 12 MONTHS AND A NEW APPLICATION WILL DE
NECESSARY
Bertie [phone] Camden [phone] Chowan [phone] Cutrituck [phone]
Gates [phone] Pasquotank [phone] Percluimans [phone]

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