20040881 Ver 1_COMPLETE FILE_20040528

KUM
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Michael F. Easley, Governor William G. Ross, Jr., Secretary
Alan W. Klimek, P.E., Director
July 27, 2004
DWQ# 04-0881
Mecklenburg County
Ms. Tara Samander
3005 Redan Court WETLANDS 1401 GRnur
Matthews, NC 28105
AUG 0 3 2004
APPROVAL of 401 Water Quality Certification with Additional Conditions
WAFER AUTY CT0,i
Dear Ms. Samander:
You have our approval, in accordance with the attached conditions and those listed below, to impact
100 linear feet (If) of unnamed stream to McAlpine Creek in Mecklenburg County, as described in your
application received by the Division of Water Quality (DWQ) on May 28, 2004. After reviewing your
application, we have determined that this project is covered by Water Quality General Certification Number
3402, which can be viewed on our web site at http://h2o.enr.state.nc.us/ncwetlands. The General
Certification allows you to use Nationwide Permit Number 39 once it is issued to you by the U.S. Army
Corps of Engineers. Please note that you should get any other federal, state or local permits before
proceeding with your project, including those required by (but not limited to) Sediment and Erosion Control,
Non-Discharge, and Water Supply Watershed regulations.
The above noted Certification will expire when the associated 404 permits expire unless otherwise
specified in the General Certification. This approval is only valid for the purpose and design that you
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.
For this approval to be valid, you must follow the conditions listed in the attached Certification, as well as
the additional conditions listed below:
The culverts required for this project shall be installed in such a manner that the original stream profiles
are not altered (i.e. the depth of the channel must not be reduced by a widening of the streambed).
Existing stream dimensions (including the pattern and profile) are to be maintained above and below
locations of each culvert. The culverts shall be designed and installed to allow for aquatic life movement
as well as to prevent head cutting of the streams. If any of the existing pipes are or become perched, the
appropriate stream grade shall be re-established or, if the pipes are installed in a perched manner, the
pipes shall be removed and re-installed correctly.
2. No waste, spoil, solids, or fill of any kind shall occur in wetlands, waters, or riparian areas beyond the
footprint of the impacts depicted in the Preconstruction Notification application. All construction activities
shall be performed so that no violations of state water quality standards, statutes, or rules occur.
919 North Main Street, Mooresville, North Carolina 28115 One
Phone: [phone] / FAX: [phone] / Internet: h2o.enr.state.nc.us North Carolina
An Equal Opportunity/Affirmative Action Employer - 50% Recycled/10% Post Consumer Paper NatuA911f
3. Sediment and erosion control measures shall not be placed in wetlands or waters to the maximum extent
practicable. If placement of sediment and erosion control devices in wetlands and waters is unavoidable,
they shall be removed and the natural grade restored within six months of the date the Division of Land
Resources has released the project.
4. Upon completion of the project, the applicant shall complete and return the enclosed "Certificate of
Completion" form to the 401/Wetlands Unit of the NC Division of Water Quality. Please send photographs
upstream and downstream of each culvert site to document correct installation along with the Certificate of
Completion form.
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 that 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 Alan Johnson in the Mooresville Regional Office at 704-
663-1699 or Cyndi Karoly in the Central Office in Raleigh 919-733-9721.
Sincerely,
Alan W. Klimek, P.E.
AJ/aj
Attachments
cc: Army Corps of Engineers, Asheville
Cyndi Karoly, Wetlands Unit
Central Files
File Copy
030870
fflo-NAA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Michael F. Easley, Governor William G. Ross, Jr., Secretary
Alan W. Klimek, P.E., Director
July 27, 2004
DWQ# 04-0881
Mecklenburg County
Ms. Tara Samander
3005 Redan Court
Matthews, NC 28105
APPROVAL of 401 Water Quality Certification with Additional Conditions
Dear Ms. Samander:
You have our approval, in accordance with the attached conditions and those listed below, to impact
100 linear feet (If) of unnamed stream to McAlpine Creek in Mecklenburg County, as described in your
application received by the Division of Water Quality (DWQ) on May 28, 2004. After reviewing your
application, we have determined that this project is covered by Water Quality General Certification Number
3402, which can be viewed on our web site at http://h2o.enr.state.nc.us/ncwetlands. The General
Certification allows you to use Nationwide Permit Number 39 once it is issued to you by the U.S. Army
Corps of Engineers. Please note that you should get any other federal, state or local permits before
proceeding with your project, including those required by (but not limited to) Sediment and Erosion Control,
Non-Discharge, and Water Supply Watershed regulations.
The above noted Certification will expire when the associated 404 permits expire unless otherwise
specified in the General Certification. This approval is only valid for the purpose and design that you
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.
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 culverts required for this project shall be installed in such a manner that the original stream profiles
are not altered (i.e. the depth of the channel must not be reduced by a widening of the streambed).
Existing stream dimensions (including the pattern and profile) are to be maintained above and below
locations of each culvert. The culverts shall be designed and installed to allow for aquatic life movement
as well as to prevent head cutting of the streams. If any of the existing pipes are or become perched, the
appropriate stream grade shall be re-established or, if the pipes are installed in a perched manner, the
pipes shall be removed and re-installed correctly.
2. No waste, spoil, solids, or fill of any kind shall occur in wetlands, waters, or riparian areas beyond the
footprint of the impacts depicted in the Preconstruction Notification application. All construction activities
shall be performed so that no violations of state water quality standards, statutes, or rules occur.
919 North Main Street, Mooresville, North Carolina 28115
Phone: [phone] / FAX: [phone] / Internet: h2o.enr.state.nc.us NorthCarohna
An Equal Opportunity/Affirmative Action Employer - 50% Recycled/10% Post Consumer Paper Natimally
3. Sediment and erosion control measures shall not be placed in wetlands or waters to the maximum extent
practicable. If placement of sediment and erosion control devices in wetlands and waters is unavoidable,
they shall be removed and the natural grade restored within six months of the date the Division of Land
Resources has released the project.
4. Upon completion of the project, the applicant shall complete and return the enclosed "Certificate of
Completion" form to the 401/Wetlands Unit of the NC Division of Water Quality. Please send photographs
upstream and downstream of each culvert site to document correct installation along with the Certificate of
Completion form.
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 that conforms to Chapter 1506 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 Alan Johnson in the Mooresville Regional Office at 704-
663-1699 or Cyndi Karoly in the Central Office in Raleigh 919-733-9721.
Sincerely,
Alan W. Klimek, P.E.
AJ/al
Attachments
cc: Army Corps of Engineers, Asheville
Cyndi Karoly, Wetlands Unit
Central Files
File Copy
030870
NORTH CAROLINA-DIVISON OF WATER QUALITY
401 WATER QUALITY CERTIFICATION
SUMMARY OF PERMITTED IMPACTS AND MITIGATION REQUIREMENTS
In accordance with 15A NCAC 2 H .0500, XXXXe of the Hinshaw-Pearson Company, Yarbrough-
Willliams-Houle Inc., has permision as outlined below to fill 0.36 acre of wetlands and 237 linear feet of
perennial streams in order to construct the Gilead Ridge residential subdivision in Mecklenburg County,
North Carolina. All activities associated with these authorized impacts must be conducted with the
conditions listed in the attached certification. THIS CERTIFICATION IS NOT VALID WITHOUT THE
ATTACHMENTS.
COMPENSATORY MITIGATION REQUIREMENT, ECOSYSTEM ENHANCEMENT PROGRAM
LOCATION:
COUNTY:
Gilead Ridge residential subdivision
Mecklenburg
BASIN/SUBBASIN Catawba (03-05-01-01)
Impacts:
0.36 acre of wetlands
237 linear feet of perennial streams
As required by 15A NCAC 2H .0506, and the conditions of this certification, you are required to compensate
for the above impacts through the restoration, creation, enhancement or preservation of wetlands as
outlined below prior to conducting any activities that impact or degrade the waters of the state.
Mitigation:
237 linear feet of perennial streams is required by the WRP for the 401 Water Quality Certification.
In correspondence dated July 8, 2003, the WRP indicated that up to 474 linear feet of stream
mitigation will be accepted by the WRP if necessary for the 404 Permit.
Note: Linear foot requirements proposed to be mitigated through the Ecosystem Enhancement Program
(EEP) must be rounded to the nearest foot and acreage requirements must be rounded to one-quarter acre
increments according to 15 2r.0503(b).
One of the options you have available to satisfy the compensatory mitigation requirements is through the
payment of a fee to the Ecosystem Enhancement Fund per NCAC 2R .0503. If you choose this option,
please sign this form and mail it to the Ecosystem Enhancement Fund at the address listed below. An
invoice for the appropriate amount of payment will be sent to you upon receipt of this form. PLEASE NOTE,
THE ABOVE IMPACTS ARE NOT AUTHORIZED UNTIL YOU RECEIVE NOTIFICATION THAT YOUR
PAYMENT HAS BEEN PROCESSED BY THE EEP.
Signature Date
ECOSYSTEM ENHANCEMENT PROGRAM
DIVISON OF WATER QUALITY
1619 Mail Service Center
RALEIGH, N.C. 27669-1619
[phone]
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Triage Check List
Date: TU'1'0-? Project Name:
- fo'm "D C), 0q andC?-
DWQ#: 04 --- o,-s"9 /
County:
To: ? ARO Mike Parker
? FRO Ken Averitte
ff MRO Alan Johnson
? RRO Steve Mitchell
? WaRO Tom Steffens
? WiRO Noelle Lutheran
? WSRO Daryl Lamb
From: 11i SAViOrIz?-mayl Telephone : (919)

The file attached is being forwarded to your 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
Uf Minimization/avoidance issues
? Buffer Rules (Meuse, Tar-Pamlico, Catawba, Randleman)
? Pond fill
? Mitigation Ratios
? Ditching
? Are the stream and or wetland mitigation sites available and viable?
? Check drawings for accuracy
? Is the application consistent with pre-application meetings?
? Cumulative impact concern
Comments: Vu"[ [QoCA 0? r1 ?0. 6_'a 6 -1 z C-? 0
e, aon14 c ?c?l
Z `-a 6 4-Q.0 (z_- (O 0 f Q 1 f d cal I Vp ??
0 ? WETLANDS/ 401 (-,ROUp
U.S. ARMY CORPS OF ENGINEERS WATEk QUALITY SECTION
WILMINGTON DISTRICT
.
Action Id. 200430783 County Mecklenburg Quad MINT 14111
GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION
Property owner: Tara Samander
Address: 3005 Redan Court Matthews, NC 28105
Telephone No: 704-537-1622
Zone: 44 UTM or LAT/LONG: North: 35.1764517 East: 80.7166507
Size and Location of project (water body, road name/number, town, etc.): The project is located at 3005 Redan Court,
in Callaway Plantation, Charlotte, Mecklenburg County, North Carolina. The project proposes 100 linear feet of stream
impacts associated with the replacement of an existing 24' culvert in an unnamed tributary to McAlpine Creek.
Description of Activity: This permit authorizes the installation of 100 linear feet of culvert, rock riprap aprons, and
placement of soil over the culvert pipe.
Applicable Law: _X_ Section 404 (Clean Water Act, 33 U.S.C. 1344)
(check all that apply) Section 10 (River and Harbors Act of 1899)
Authorization: NW39 Nationwide Permit Number
Your work is authorized by this Regional General (RGP) or Nationwide Permit (NWP) provided it is accomplished in
strict accordance with the attached conditions and your submitted plans. If your activity is subject to Section 404'(if
Section 404 block above is checked), before beginning work you must also receive a Section 401 water quality
certification from the N.C. Division of Water Quality, telephone [phone]. For any activity within the twenty
coastal counties, before beginning work you must contact the N.C. Division of Coastal Management, telephone (919)
733-2293.
Please read and carefully comply with the attached conditions of the RGP or NWP. Any violation of the conditions of
the RGP or the NWP referenced above may subject the permittee to a stop work order, a restoration order, and/or
appropriate legal action.
This Department of the Army RGP or N WP verification does not relieve the 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.
If there are any questions regarding this authorization or any of the conditions of the General Permit or Nationwide
Permit, please contact the Corps Regulatory Official specified below.
Date: May 7, 2004
Corps Regulatory Official: Amanda D. Jones Telephone No.: [phone] x 231
Expiration Date of Verification: May 7, 2006
SURVEY PLATS, FIELD SKETCH, WETLAND DELINEATION FORMS, PROJECT PLANS, ETC., MUST BE
ATTACHED TO THE FILE COPY OF THIS FORM, IF REQUIRED OR AVAILABLE.
C-)
! , i ^?A
'C rrl
CESAW Form 591
Revised July 1995
Office Use Only: Form Version May 2002
USACE Action ID No. DWQ No.
(If any particular item is not applicable to this project, please enter "Not Appucaoie or NCH .)
1. Processing
c?
6 ?. Check all of the approval(s) requested for this project:
Section 404 Permit ?
Section 10 Permit ?
401 Water Quality Certification
Riparian or Watershed Buffer Rules
Isolated Wetland Permit from DWQ
CPI
2. Nationwide, Regional or General Permit Number(s) Requested:
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: ?
4. If payment into the North Carolina Wetlands Restoration Program (NCWRP) is proposed for
mitigation of impacts (verify availability with NCWRP prior to submittal of PCN), complete
section VIII and check here: ?
5. If your project is located in any of North Carolina's twenty coastal counties (listed on page
4), and the project is within a North Carolina Division of Coastal Management Area of
Environmental Concern (see the top of page 2 for further details), check here: ?
II. Applicant Information
1. Owner/Applicant Information
Name: 1'l1 A N Q&
Mailing Address: C1° J eghA M 0 3pule-_T
IM WMEWS , MC_ 7-8105
Telephone Number:rlC4 - S- ?-7 - I (o 2-L
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:
Company Affiliation:
Mailing Address:
Fax Number:
Telephone Number:
E-mail Address:
Fax Number:
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.
a-t C,t l f! -V? /'x-1
1. Name of project: CZl.e t? T 01R_
2. T.I.P. Project Number or State Project Number (NCDOT Only): /? LA
3. Property Identification Number (Tax PIN): -* eojzc ?.? = I Cl ?> ` L418 Z--.
8
4. Location
County: ki a a f1.k k Nearest Town: 1,-5 "A V- L
Subdivision name (include phase/lot number): C-AL-l U P ? -Z? l T
erections to site (include road numbers, landmarks, etc.): `I -
5. Site coordinates, if available (UTM or Lat/Long): bAAJ emtuo?U)
(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): AL?`:?
7. Nearest body of water (stream/river/sound/ocean/lake): pl l 1?
River Basin:(,, /A I H (,,UnH V-- Yj. k 1--j" D fu
(Note - this must be one of North Carolina's seventeen designated mayor river basins.
River Basin map is available at http://h2o.enr.state.nc.us/admin/maps/.)
The
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application:
Page 6 of 12
III Project Information:
Q.9.: The city stormwater drainage stream that is the object of this permit request
currently holds 0" to 4" of water in the proposed culvert area. The site is located in the
midst of a 330+ unit Centex home development, surrounded by other housing
developments, bounded by Margaret Wallace Road and Idlewild Road. Therefore, the
land in the area surrounding (and including) the site of this proposal has been subdivided
into residential plots and a commons area.
Q.10.: The proposed project would include first removing an existing 24' culvert from
the stormwater drainage stream, and then inserting a 100' foot pipe in its place. This pipe
would be covered with dirt, and some naturalistic material (e.g., stones) would surround
each end of the pipe as rip-rap to prevent or retard erosion. Some type of grate may be
placed at each end of the pipe for safety. The stream may need to be straightened
(minimally) for pipe to be laid. It is anticipated that the straightening work may be done
by hand. Heavy equipment (trucks) would probably be required to remove the existing
pipe, to lay the replacement pipe, and preferably to dump new soil (though this may be
done by hand).
Q.11.: The primary purposes of this project include:
(1) Providing safety for our young daughter: Currently the approximately 8-foot
drop-off into the ditch that the stormwater drainage stream runs through is
located just 10-feet from our backyard deck. As we watch our 11-month old
starting to toddle around, the inherent dangers of this arrangement are
obvious.
(2) Stopping considerable erosion threatening our property's largest tree and other
trees in this area: The roots of our 100+ foot tulip are exposed on the ditch-
side due to erosion. This tree is actually leaning noticeably now. Building the
soil back up in this area would provide much-needed support for this tree and
for others along the bank of the stream.
(3) Extending the usable area of our property: As mentioned above, the ditch that
the stormwater drainage stream runs through limits the usable area behind our
home to as little as 10 feet across much of our backyard. This project would
allow us to access up to an additional 45' in length, including the gap across
the stream ditch.
(4) Eliminating hazards associated with erosion over the current pipe: Because
the ends of the existing pipe were never built up or secured to prevent erosion,
much of the dirt over the pipe has washed away. There are sink-holes in the
dirt on top of the pipe as well as exposed pipe on both ends. Anti-erosion
measures of the proposed project would improve safety. Additionally,
proposed grates on each end of the new pipe would eliminate the possibility of
curious children crawling in.
vN\
&v of
10. Describe the overall project in detail, including the type of equipment to be used:
11. Explain the purpose of the proposed work:
IV. Prior Project History
If jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Include
the USACE Action ID Number, DWQ Project Number, application date, and date permits and
certifications were issued or withdrawn. Provide photocopies of previously issued permits,
certifications or other useful information. Describe previously approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits issued for prior segments of the same T.I.P. project, along with
construction schedules.
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application.
m- ier h r5T-? AtE t o - 174 l5 ?7 94F
VI. Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. The applicant must also
provide justification for these impacts in Section VII below. All proposed impacts, permanent
and temporary, must be listed herein, and must be clearly identifiable on an accompanying site
plan. All wetlands and waters, and all streams (intermittent and perennial) must be shown on a
delineation map, whether or not impacts are proposed to these systems. Wetland and stream
evaluation and delineation forms should be included as appropriate. Photographs may be
included at the applicant's discretion. If this proposed impact is strictly for wetland or stream
mitigation, list and describe the impact in Section VIII below. If additional space is needed for
listing or description, please attach a separate sheet.
Page 7 of 12
1. Provide a written description of the proposed impacts:
OIL-
T? -
2. Individually list wetland impacts below: M 1A
Wetland Impact
Site Number
(indicate on ma)
Type of Impact* Area of
Impact
(acres) Located within
100-year Floodplain**
(es/no) Distance to
Nearest Stream
(linear feet)
Type of Wetland***

* List each impact separately and identify temporary impacts. impacts mctuae, but are not nnuieu to: mecnautzeu c,caa,,,g, S,au,„g, ,,
excavation, flooding, ditching/drainage, etc. For dams, separately list impacts due to both structure and flooding.
** 100-Year floodplains are identified through the Federal Emergency 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 htto•//www.fema.gov.
*** List a wetland type that best describes wetland to be impacted (e.g., freshwater/saltwater marsh, forested wetland, beaver pond,
Carolina Bay, bog, etc.) Indicate if wetland is isolated (determination of isolation to be made by USACE only).
List the total acreage (estimated) of all existing wetlands on the property:
Total area of wetland impact proposed:
3. Individually list all intermittent and perennial stream impacts below:
Stream Impact 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
I (u a-.1IV) I tIJ
41 P- ge 0-v LYFV_rLM )s

_
fuLykl f l

L
_J
* List each impact separately and identify temporary impacts. impacts mctuae, but are not nmrteu to: curvens anu aaavc,aLcu „y-,at,,
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.usras.eov. Several internet sites also allow direct download and printing of USGS maps (e.g., www.topozone.com,
www.mavQt est.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: O t
Page 8 of 12
VI Proposed Impacts
Q.1.: The proposed project would have four permanent impacts to the stormwater
drainage stream and surrounding ditch area. First, though minimal, some digging in the
ditch to straighten the stream would probably be necessary. Second, approximately 76
linear feet of standing water that is currently uncovered would be covered by the new
culvert (24' is currently covered by a culvert that would be removed). Third, new soil
would be introduced to the site. Fourth, some smaller trees (<6" trunk diameter) in the
ditch area would probably have to be removed. We do not anticipate lasting impacts
from the equipment (e.g., trucks) that would be involved in laying the pipe.
4. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.) below: N /A
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,
ba ,ocean, etc.)

L..• .. ? i: -;t 4 #.,• fill avrnvatinn drertoinv_
List each impact separately and identity temporary impacts. impacts include, but are not .,nu....
flooding, drainage, bulkheads, etc.
5. Pond Creation
If construction of 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.
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. kane- ? ?.-
V l Il 1?j?T 1-l?zr
Page 9 of 12
VII Impact Justification (Avoidance and Minimization) Impact minimization incorporated into this proposal includes: (1) no loss of large trees
on site; (2) length of culvert will be limited to the stretch of water that is closest to the
ditch. Our original plan included a culvert across the entire property, but we realized that
the greatest hazard to our toddler is falling in the ditch and landing in water, so we
eliminated that part of the plan where the stream water veers away from the drop-off
point of the ditch.
VIII Mitigation
Our sense is that this project would not require mitigation measures a ed by 15A
NCAC 2H .0500. However, we think our usage plans for the site qua if s
mitigation. These plans include: (1) covering the new culvert with a hig -grade soil/
compost/etc. mixture that will be suitable for (2) incorporating native plants and trees into
the naturalistic landscape using organic gardening techniques, thereby (3) enhancing
safety and (4) preventing future erosion into the stormwater drainage stream. We believe
these measures will mitigate the impact of the longer culvert in the stormwater drainage
stream. If this project is approved, we would also eagerly entertain additional mitigation
recommendations from your office.
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
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) k
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 ? If you answered "yes", provide the following information:
Identify the square feet and acreage of impact to each zone of the riparian buffers. If buffer
mitigation is required calculate the required amount of mitigation by applying the buffer
multipliers.
Zone* Impact
(square feet) Multiplier Required
Mitigation
1 3
2 1.5
Total
Zone 1 extends out 30 feet perpendicular from near bank of channel; Gone [ extends an
additional 20 feet from the edge of Zone 1.
Page 11 of 12
If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation
of Property, Conservation Easement, Riparian Buffer Restoration / Enhancement, Preservation or
Payment into the Riparian Buffer Restoration Fund). Please attach all appropriate information as
identified within 15A NCAC 2B .0242 or.0260.
XI. Stormwater (required by DWQ)
Describe impervious acreage (both existing and proposed) versus total acreage on the site.
Discuss stormwater controls proposed in order to protect surface waters and wetlands
downstream from the property.
ItilOl?ia'? S ?? IO ?(? 1frGT
XII. Sewage Disposal (required by DWQ)
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from the proposed project, or available capacity of the subject facility.
XIII. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes ? No AT'
Is this an after-the-fact permit application?
Yes ? No A
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).

App]icant/A ent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 12 of 12
,I VIClNny YAP 1, JAYaS LYNN SrROYS CZRTIFY MT THIS YIP WAS DRAWN FROM AN AC7UAL SURVEY YIDI' UNDER
1VO SCALE MY DIAXCr SUPSRVISION• AND THAr THE lRROR OF CLDSURB IS 1':10,000+ BEFORE IDJUSTIfERM.
'01111111181""'r,
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