20041041 Ver 1_COMPLETE FILE_20040618

® North Carolina Wildlife Resources Commission ?
Charles R. Fullwood, Executive Director
MEMORANDUM
TO: Andrea Wade, Permit Coordinator
Raleigh Office, U.S. Army Corps of Engineers
FROM: Ron Linville, Regional Coordinator
Habitat Conservation Program 0?/
DATE: June 18, 2004
WETLANDS 1401 GROUP
JUN 2 8 2004
WATER QUAUTY WW
SUBJECT: Review of 404 Application, Christian Village, Unnamed Tributaries Crooked Run (WS-
IV), Stokes County
The applicant is requesting a letter of concurrence from the North Carolina Wildlife Resources
Commission (NCWRC) to obtain a 404 permit from the U.S. Army Corps of Engineers. The NCWRC has
reviewed information provided by the applicant, and field biologists on our staff are familiar with habitat
values of the project area. These comments are provided in accordance with provisions of the Clean Water
Act of 1977 (33 U.S.C. 466 et. seq.) and the Fish and Wildlife Coordination Act (48 Stat. 401, as amended;
16 U.S.C. 661-667d).
Based on the information provided by the applicant, we do not believe this project will cause significant
direct effects to waters. Secondary impacts should be evaluated further. Due to the commercial aspect and
imperviousness of the proposed development, we recommend a NWP 14 be issued. Stormwater
management should be required in a 401 Certification for the development. Future jurisdictional impacts
and total imperviousness from additional phases of the project should be determined before 404 Permit
issuance. Low Impact Development (LID) techniques are encouraged. Information on LID practices and
measures can be found at wwNv.lowitnitaactdeveioi)ntint.or . If a stormwater pond is required, the attached
planting schedule is recommended. Culverts 48 inches diameter or larger should be buried a foot into the
streambed. Culverts less than 48 inches diameter should be buried to a depth equal to or greater than 20%
their size to allow for aquatic life passage. These measurements must be based on natural thalweg depths.
Thank you for the opportunity to review and comment on this project. If you have any questions regarding
these comments, please contact me at 3361769-9453.
Attachment: Piedmont Stormwater Pond and Mine Planting Recommendations
Cc: Daryl Lamb, DWQ-WSRO
John Dorney, DWQ

Piedmont Stormwater Pond and Mine Planting Recommendations
Instead of using the typical fescue grasses or exotic plant species, the following mixtures should
be considered for lower elevation stormwater ponds and mine sites:
Spring/Summer Mixture, May 1- Sept. 15 Fall/Winter Mixture, Sept 15 - April 30
Browntop millet 20 Ibs/a Winter Wheat 120 Ibs/a
Kobe lespedeza 20 lbs/a Kobe lespedeza 20 lbs/a
Shrub lespedeza 1 Ib/a Shrub lespedeza 1 lb/a
Switchgrass* 5lb/a Switchgrass* 5lb/ac
Add to fall or spring plantings: `Tioga' Deertongue (Panicum clandestinum) at a rate of 7 lbs.
Pure Live Seeds (PLS) per acre.
* When possible on slopes less than 3:1 use Switchgrass instead of lespedezas and on slopes greater than
3:1 use Orchard Grass or Creeping Red Fescue. -Other native species may be appropriate depending on
soil, slope, and region. Korean lespedeza may be appropriate in colder geophysical areas. We do not
recommend Sericea lespedeza. Native plants and warm season grasses are preferred over exotic plants.
Add one of the following to the above mixture:
Creeping Red Fescue 5 lbs/acre
Ladino Clover** 5 lbs/acre
Atlantic Coastal Panic Grass 5 lbs/acre (PLS)
Alfalfa** 51bs/acre (requires fertilizer containing Boron)
** Lime & fertilize disturbed areas according to NRCS soil test results and follow planting guidelines as
appropriate and necessary. Depending on elevation and region, other native species may be appropriate.
Note that mowing should be limited to late winter or early spring. Mowing should only occur as needed to
prevent unwanted tree growth on a 2-3 year schedule.
The provision of shade around impounded waters can significantly reduce thermal impacts. Trees
and shrubs (1 year bare root seedlings) should be planted randomly at a minimal rate of 100 trees
per acre on the top and upper portions of the structure and at a minimal rate of 150 per acre
around the normal water elevation and littoral shelf area. The following list of tree species may
assist in providing habitat benefits:
Loblolly Pine* Red Cedar Black Gum American Holly Dogwood
Hickory Sumac White Oak Willow Oak Red Maple**
Viburnum Green Ash Ironwood Black Cherry Persimmon
Water Oak Spice Bush Willow (sp) Serviceberry Red Oak
Swamp Chestnut Silky Dogwood
Other species may be utilized depending on site requirements and native plant availability. Pines* should
not exceed 15% of the reforestation. No more than 20% of the tree species will be of a single species. An
80% success rate is acceptable over five years. Large or fast growing trees like Sycamore and Maple**
may not be appropriate near detention facility dams. Note: Non-native plants included in this list are
routinely considered beneficial and/or agriculturally established non-natives. They have been included as
they are readily available commercially and they do not exhibit many of the negative attributes of other
non-natives that tend to spread or inhibit native plant propagation and survival.
f
A,
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P. E. Director
Coleen H. Sullins, Deputy Director
Division of Water Quality
July 7, 2004
Christian Village, Inc.
Attn: Perry Craven
Post Office Box 15458
Winston-Salem, NC 27113
Subject Property: Ingram Road commercial site.
Approval of 401 Water Quality Certification with Additional Conditions
Dear Mr. Craven:
DWQ Project # 04-1041
Stokes County
Page 1 of 3
You have our approval, in accordance with the attached conditions and those listed below, to place fill
within or otherwise impact 0.001 acres of waters and 65 feet bf streams for the purpose of commercial fill
at the subject property, as described within your application dated June 11, 2004 and received by the N.C.
Division of Water Quality (DWQ) on June 18, 2004. After reviewing your application, we have decided
that the impacts are covered by General Water Quality Certification Number(s) 3402 (GC3402). The
Certification(s) allows you to use Nationwide Permit(s) 39 when issued by the US Army Corps of
Engineers (USAGE). In addition, you should obtain or otherwise comply with any other required federal,
state or local permits before you go ahead with your project including (but not limited to) Erosion and
Sediment Control, and Non-discharge regulations. Also, this approval to proceed with your proposed
impacts or to conduct impacts to waters as depicted in your application shall expire upon
expiration of the 404 or CAMA Permit.
This approval is for the purpose and design that you described in your application. If you change your
project, you must notify us and you may be required to send us a new application. If the property is sold,
the new owner must be given a copy of this Certification and approval letter and is thereby responsible for
complying with all conditions. If total fills for this project (now or in the future) exceed one acre of
wetland or 150 linear feet of stream, compensatory mitigation may be required as described in 15A
NCAC 211.0506 (h). This approval requires you to follow the conditions listed in the attached
certification and any additional conditions listed below.
The Additional Conditions of the Certification are:
1. Impacts Approved
The following impacts are hereby approved as long as all of the other specific and general
conditions of this Certification (or Isolated Wetland Permit) are met. No other impacts are
approved including incidental impacts:
Amount Approved
(Units) Plan Location or Reference
Stream 65 (feet)
Waters 0.001 (acres)
N. C. Division of Water Quality, 401 Wetlands Certification Unit,
1650 Mail Service Center, Raleigh NC 27699-1650 (Mailing Address)
2321 Crabtree Blvd., Raleigh, NC 27604-2260 (Location)
[phone] (phone), 919-733-6893 (fax), (http://h2o.enr.state.nc.us/ncwetlands)
Customer Service #: 1-877-623-6748
6TEANMR
i
Christian Village
Page 3 of 3
July 7, 2004
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 Cyndi Karoly in the Central Office in Raleigh at 919-
733-9721 or Daryl Lamb in the DWQ Winston-Salem Regional Office at 336-771-4600.
AWKIbs
Enclosures: GC 3402
Certificate of Completion
cc: Environmental Consultants, 3764 Rominger Road, Banner Elk, NC 28604
USACE Raleigh Regulatory Field Office
DWQ Winston-Salem Regional Office
File Copy
Central Files
Filename: 04-1041 Christian Village (Stokes) 401
Sincerely,
7. '
E'nV
Environmental Consulting Services Inc.
June 15, 2004
Mr. John Domey
NC DENR DWQ
Wetlands(401 Unit
1621 Mail Service Center
Raleigh, NC 27699-1621
RE: Christian Village:
Stokes Co., NC
Dear Mr. Domey:
3764 Rominger Road
Banner Elk, NC 28604
Ph/Fax [phone]
e-mail: adamfbenv-ecs.com
iohn0env-ecs.com
401 ISSUED.
WETLANDS 1401 GROUP
JUN 1 S 2004
WATER QUALITY SECTION
Transmitted with this letter are 3 copies of the NWP 39 permit application for the referenced project
Impact totals are 65 linear-feet of perennial stream (UT-1 Crooked Run; mapped intermittent), 0.001 ac
of pond impact, and no impacts to wetlands. UT-1 Crooked Run is undesignated, located within a WS-
IV watershed. Based on this information and the conditions of DWQ GC-3402 we have determined that
written certification is not required for this project therefore we have not included a permit fee in this
package. The applicant is Christian Village Inc., E'nV Inc has prepared this application for Christian
Village Inc. and are available to answer any questions you may have. If you need to schedule a site
visit please contact me.
If you have any questions regarding this information please call me at 828-297-6946, thank you.
Sincerely,
J :n Was
President, E'nV Environmental Consulting Services Inc.
041041
Cc: Mr. Daryl Lamb
-t
E'nv
F1rAror11' ienW COnwIlUffm S ?11C.
June 15, 2004
Ms. Andrea Wade
USACE
Raleigh Regulatory Field Office
6508 Falls of the Neuse Rd, Suite 120
Raleigh, NC 27615
RE: Christian Village Inc.:
Stokes Co, NC
Dear Andrea:
3764 Rominger Road
Banner Elk, NC 28604
Ph/Fax [phone]
e-mail: adam0env-ecs.com
iohnOenv-ecs.cDm
Enclosed is an application for NWP 39 for the referenced project. Cumulative impacts for this project
are 0.001ac of pond impact and 65 linear-ft of stream impact. The Applicant is Christian Village Inc.,
EW Inc. has prepared this application are available to answer any questions you may have. If you
need to schedule a site visit please contact me.
If you have any questions regarding this information please call me at 828-297-6946, thank you.
Sincerely,
ohn Was
President, EW Environmental Consulting Services Inc.
Cc: Mc Ron Linville, NC WRC
Mr. Perry Craven

Office Use Only: 041041 Form Version April 2001
USACE Action ID No. DWQ No.
If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A" rather than
leaving the space blank.
I. Processing
1. Check all of the approval(s) requested for this project:
X Section 404 Permit
? Section 10 Permit
401 Water Quality Certification
? Riparian or Watershed Buffer Rules
2. Nationwide, Regional or General Permit Number(s) Requested: NWP 39
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 (see section VIII - Mitigation), check here: ?
H. Applicant Information
1. Owner/Applicant Information
Name: Christian Village Inc
Mailing Address: Contact: Perry Craven
PO Box 15458
Telephone Number: [phone] Fax Number:
E-mail Address:
Alternate Contacts:
Environmental Consultants - John Vilas. Adam Williams E'nV Inc: [phone]
2. Agent 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:
Telephone Number: Fax Number:
E-mail Address:
3 of 3
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: Christian Village
2. T.I.P. Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN): 599107696120
4. Location
County: Stokes Nearest Town: King
Subdivision name (include phase/lot number):
Directions to site (include road numbers, landmarks, etc.): Take US Hwy 52 north out of
Winston Salem Exit at the Forsyth/Stokes County line bearing right Go approximately 1000
feet and take a left on Ingram Rd The project site is located on the right approximately lh
mile down !Wpm Rd.
5. Site coordinates, if available (UTM or Lat/Long): 36 16'0.6"N / 80 22'1 0.3"W
(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. Describe the existing land use or condition of the site at the time of this application: Well-
forested, pond exists near project entrance-, undeveloped site with access via temporarydirt
road.
7. Property size (acres): 28.6 +/- acres
8. Nearest body of water (stream/river/sound/ocean/lake): Crooked Run
9. River Basin: Yadkin River
(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/adnin/m".)
4 of 4
Describe the purpose of the proposed work: To create a commercial area with associated roads
and buildings.
10. List the type of equipment to be used to construct the project: Standard construction
eguipmen t: track excavator backhoe damn truck
11. Describe the land use in the vicinity of this project: Adjacent to a major highway corridor
fHwv 52): largely commercial use with some adjacent agricultural areas
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.
No_ previous USACE 404 permits or NCDENR 401 permits have been used to develop
property
V. Future Project Plans
Are any additional permit requests anticipated for this project in the future? If so, describe the
anticipated work, and provide justification for the exclusion of this work from the current
application: Currently, a small rtion (7.6 ac) of the 28.6 ac lot is proposed to be developed
Future pbases of this project are anticipated but not yet designed One or two stream crossims
are expected in the future.
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.
5 of 5
1. Wetland Impacts
Wetland Impact
Site Number
indicate on map)
Type of Impact* Area of
Impact
(acres) Located within
100-year Floodplain**
es/no Distance to
Nearest Stream
linear feet
Type of Wetland***

- List coc:n impact separately ana wenttry temporary impacts, impacts include, but are not limited to: mechanized clearing, grading, fill,
excavation, flooding, ditching/drainage, eta 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 h=://www.fema.gov.
*** List a wetland type that best describes wetland to be impacted (e.g., freshwater/saltwater marsh, forested wetland, beaver pond,
Carolina Bay, bog, etc.)
List the total acreage (estimated) of existing wetlands on the property: 0 ac
Total area of wetland impact proposed: 0.0 ac
2. Stream Impacts, including all intermittent and perennial streams
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)
Impact Area 1 60" CMP 55' UT-1 Crooked Run 8-15' perennial
Impact Area 2 Rip-rap
Dissa ator 10' UT-1 Crooked Run 8-15' perennial
List cum unpact separatery ana wenuty 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/pin),
stabilization activities (cement wall, rip-rap, crib wall, gabions, eta), excavation, ditching/straightening, eta 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.aov. Several internet sites also allow direct download and printing of USGS maps (e.g., www.topozone.com
www.mMuest.com, eta).
Cumulative impacts (linear distance in feet) to all streams on site: 65'
3. Open Water Impacts, including Lakes, Ponds, Estuaries, Sounds, Atlantic Ocean and any
other Water of the U.S.
6 of 6
Open Water Impact Area of
Name of Wat Type of Waterbody
Site Number Type of Impact* Impact )
(if applicable) (lake, pond, estuary, sound,
indicate on ma acres bay, ocean, etc.
Impact Area 3 60"CMP & Riser 0.001 Existing Pond Pond
" List each impact separately and identify temporary impacts. Impacts include, but are not limited to: fill, excavation, dredging,
flooding, drainage, bulkheads, eta
4. 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.
The proposed work and associated impacts are intended to allow for development of a
commercial area with minimal impacts to streams The proposed stream impact is associated
with the project entrance road accessing the commercial area (see Site plan) To minimize
impacts, the proposed road will be constructed atop the existing farm road grade A 12"x 20
linear-ft CMP exists at the proposed road crossing of UT-1 Crooked Run, the pipe serves as the
outlet for the existing pond (see Existing Site Conditions) The proposed 60"x 85 linear-ft CMP
will replace the existing 12"x 201inear-ft CMP (see Project Narrative) All unimpacted streams
will be protected through deed restrictions No mapped FEMA floodplain areas exist on the site
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.
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
7of7
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/ncwetiands/strmp,ide.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.
All uninnpacted streams will be protected through deed restrictions
2. Mitigation may also be made by payment into the North Carolina Wetlands Restoration
Program (NCWRP) with the NCWRP's written agreement. Check the box indicating that
you would like to pay into the NCWRP. Please note that payment into the NCWRP must be
reviewed and approved before it can be used to satisfy mitigation requirements. Applicants
will be notified early in the review process by the 401/Wetlands Unit if payment into the
NCWRP is available as an option. For additional information regarding the application
process for the NCWRP, check the NCWRP website at http://h2o.enr.state.nc.us/wrD/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): 0
Amount of buffer mitigation requested (square feet): 0
Amount of Riparian wetland mitigation requested (acres): 0
Amount of Non riparian wetland mitigation requested (acres): 0
Amount of Coastal wetland mitigation requested (acres): 0
IX. Environmental Documentation (DWQ Only)
Does the project involve an expenditure of public funds or the use of public (federaVstate/local)
land?
Yes ? No X
8 of 8
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 ?
X.
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 ?
Proposed Impacts on Riparian and Watershed Buffers (DWQ Only)
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
(Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify )?
Yes ? No X 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 im act " fen,,,P fAMI Multiplier Required
2 1.5
Total
Zone I extends out 30 feet perpendicular from near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.
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 (DWQ Only)
9 of 9
Describe impervious acreage (both existing and, proposed) versus total acreage on the site.
Discuss stonuwater controls proposed m order to protect surface waters and wetlands
downstream from the property.
Total acreage on the site exists as 286+1- acres with k po ous acreage <l % Proposed
in envious awe is approximately 1.6 pgc: or 5.5% of total acreage.
XIL Sewage Disposal (DWQ Only)
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated froth the proposed project, or available.eapacity of the subject facility.
Wastewater will be rout to the City of KjM sewer system
XIO- Violations (DWQ Only)
Is this site in violation of DWQ Wetland Rules (I 5A NCAC 2H .0500) or any Buffer Rules?
Yes ? No X
Is this an after-the-fact pcnoitt application?
Yes ? No X
XIV. Other Circumstances (Optional):
It is t6c applicant's responsibility to submit the application snffrciently m advance of desired
eonsttuctioa dates to allow processmg time for these permits. However, an applicant may
Moose to 1W constraints associated with construction or sequencing that may impose bits on
work schodules (e.g., draw-down schedules for lakes, dates associated with Endangered and
Tbreakened Species, aecessilitity problems, or other issues outside of the applicaWs control).
C... Aev'c? :l x7fin0j- G/f/ /ay
AppWiWAgbk's Signature
Date
10 of 10
I'd 9VG9-LGZ-8a8 SertA eRF:TT bn TT unr
V{.V11V0 VV.? 1\V - 11111L4U1V Jvx" /
Parcels
Parcel No.: 599107696120
Acct. No.: 000000022239
Owner.
CHRISTIAN VILLAGE INC DBA
VILLAGE CARE
C/O AUTUMN CORPORATION
PO BOX 7728
ROCKY MOUNT NC
Land Units: 28.56AC
Deed Book: 00319 Pg: 0345
Deed Date: 01/1311987
Building Value: $0
Out Buildings & Site Improvements: $0
Land Value: $146,500
Special Land Value: $0
Assessed Value: $146,500
Use Model: 0100
Land Use: SFR
1 USV 1 Vl 4
Other Attributes
at point 1596637, 918775
Soils:
Soil Type: PACOLET-CECIL
School Districts:
Elementary: IGng
Middle: Chestnut Grove
High: West Stokes
Flood Zones:
Zone: X
Comm Panel No.: 370458 0004 A
Fire Districts:
District: King
Station No.: 30
Emergency Service Districts:
District PINNACLE
Station No.: 103
Law Enforcement Zones:
Feature Code: 1
Townships:
http://arcims2.webgis.nettstokes/printable.asp?process=id&x2=159663 6.57448446&y2=918... 6/3/2004
Stokes Co., NC

PROJECT NARRATIVE
Project: Christian Village
Location: Stokes County, NC
Date: 5/21/2004
General:
The project site is located in King, NC, just east of Hwy. 52, off Ingram Rd. (see
location map). The site is approximately 28.4 acres with an elevation of
approximately 1080 feet above mean sea level. Two streams exist on the project
site, one perennial (UT-1 Crooked Run; DA: 65ac), and one intermittent (UT-2
Crooked Run; DA: 27ac). The UT-1 Crooked Run is mapped as an intermittent
channel (USGS Quad). An existing in-stream pond is located on the UT- 1
Crooked Run near the project entrance. UT-Crooked Run exists within a WS-IV
watershed, located within the Yadkin River Basin.
Streams:
UT-1 Crooked Run flows south to north approximately 765 linear feet (including
pond) across the project site. Short-leaf Pine, Alder, Ironwood, Poplar, Greenbriar,
and Blackberry dominate the banks of this well-shaded channel. This perennial
channel enters the project site, intercepts spring flow, and enters the pond area (see
Photo Sheet). Silt and sand dominate the bed in this upper reach. Below the
existing pond UT-1 Crooked Run begins to coarsen with a bed dominated by
cobble and gravel. A few tolerant macroinvertebrate taxa (ie: damselfly; see
USACE Stream Quality Assessment Worksheet) as well as many frogs and
salamanders were noted in the project reach. Jurisdictional widths range from 8-15
ft. A dirt road crossing exists on the downstream end of the pond via a 12"CMP
(see Existing Site Conditions map).
UT-2 Crooked Run flows southeast to northwest approximately 700 linear feet
through the project site. Intermittent pools dominate the majority of the channel
with some dry areas present (see Photo Sheet). The bed of the channel is
dominated by silt/sand with frogs and worms (Annelids) noted in the intermittent
pools. This well-shaded channel is also located under a dense canopy (Pine,
Poplar). Jurisdictional widths range from 5-8 ft. Upon completion of a NCDWQ
Stream Classification Form, the channel was recognized as an intermittent
channel, yielding a score of 18.5.
Impact Description:
The proposed work and associated impacts are intended to allow for development
of a commercial area with minimal impacts to streams. An existing dirt road
extends from Ingram Rd east toward an existing on-line pond. A piped crossing
exists downstream of the pond (see Existing Conditions map), acting as the pond
outlet. This existing dirt road as well as the piped crossing is to be utilized in
Christian Village
Project Narrative 1 ofd
5/21/2004
J
construction of the new commercial road. The existing 12"X 20 linear-ft CMP is
to be extended and upgraded to a 60"X 85 linear-ft CMP under the proposed road.
An upstream riser (see Impact Area map & Riser Detail) is proposed to maintain a
consistent pond elevation. Riprap is proposed downstream of the 60"CMP
(approx.10 linear-ft) to dissapate energy before discharging into UT-1 Crooked
Run. Below is a table describing existing and proposed conditions:
Existing
Jurisdictional Pipe Length Proposed Pipe Proposed
Area Type of Impact credit Length Impact
UT-Crooked
Run (perennial) 60°CMP 20' 75' 55 linear ft
UT-Crooked Riprap
Run erennial Dissa ator N/A N/A 10 linear ft
On-line Pond 60"CMP + Riser N/A N/A 0.001 ac
TOTAL STREAM IMPACT = 65 linear feet
TOTAL POND IMPACT = 0.001 ac
Christian Village
Project Narrative 2 of 2 5/21/2004
Christian Village Photo Sheet
King, NC 5/20/04
upstream of pond
UT-1 Crooked Run (UT-1) flows on-site
Well-vegetated banks of UT-1;
Pond located near project entrance
UT-1 Head-cut located just downstream of pond
Persistent pools of UT-2 Crooked Run (UT-2)
Silt dominated bed of UT-2
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USAEE AID# DWQ # Site # (indicate on attacam maps
STREAM QUALITY ASSESSMENT WORKSHEET
0
Noride tke fa6wing idormaboa fer the streaa reach WMIer asm ssawat: O
`- .s- Applicant's name: C?S'c?? . 2. Evaluator's name: (? ?-?•t '"j
Date of evaluations .5 a 4_ Time of evaluWan: e , , •?? ? ''?
5.14ame of stream: U? & River basin: J D -, ?-
7. ApproAmate drainage area: ?°`L 8. Stream order: T J s
9. Length ofreach evaluated: ^- I a 0 lA. County: 5 `k'4
11. Site coordinates (if known): prefer in decimal degrees. 12. Subdivision name (if any):
l.atituc (ax.34.SM312): 3 (D ° f 6''0" : Lo 1ex.-rts56611 AQ ?0 4 10
Method location dclumined(circle) OPS opo Orm4 (Aerial) Photo/GIS Other GIS Other
13. Location of reach under evaluation (na!E roads and landmarks and attach map identifying stt+aoe(s) location):
See LA) " op r Lo ,? o n ?^^?`-?
14. Proposed channel work (if any): Q t
15. Recent weather conditions: M 6 e sk-
16. Site Conditions at time
AD,I
17. Identify any special waterway classifications known: -Section. 10 Tidal Waters Essential Fisheries Habitat
Trout Waters Outstanding Resource Waters _Nutrient Sensitive Waters -& Hater supply Watexshedig:( V)
1& Is there a pond or lake located upstream of the evaluation point? YES (& if yes, estimate the water surface area.
19. Does channel appear on USGS quad map? (J?j)NO 20. Does channel appear on USDA Soil Survey? (S? NO
21. Estimated watershed land use: % Residential
.?/. Forested
22. Banlydirll width: c3 "ts
24. Channel slope down center of stream: Flat (0 to 2%)
2S. Channel sinuosity. Shaigtrt Oaasieernal bends
-,ZQ/o Commercial % Industrial % Agricultural
Cleared / Logged % Other ( _ r? )
23. Banks height (from bed to top of bade) ^' of t
-Gentle (2 to 4%) Moderate (4 to 10%) 3toep (>100/9)
Frequent meander Very sinuous Braided channel
Inshmedoos for compktisa of wwhokeet (located an pqp 2): Begin by determining the most appropriate ecoregion based on
location, terrain, vegctabon, stream, dassificatioo, coo. Every chacacteiistic must be scored osmg the same oooregion. Assign points
to each characteristic- within the range shown for the acracgion. Page 3 provides a brief dmicriprtion of how to review the
characteristics identified in the waikshert Scores should reflect arc overall assessment of the stream roach under evaluation If a
characteristic cannot be evaluated doe to site or weather cmd tiaas, eatce 0 in the woriog box and provide an explanation in the
comment section. Where there are obvious changes in the character of a stream under review (C-F, the stream flows from a pasture
into a forest), the stream may be divided onto smaller reaches that display more eu y, and a separate form used to evaluate each
reach. The total score assigned to a stream rester must range between 0 and 100, with a score of 100 representing a stream of the
highest quality.
.t
Total score (from ore): Cots: <,, t-? AV^ "V\m LC L, ? o crI,J
EvaluamesSig -,we 5A 1 { This eiai ael evalaatiea farm is hA mded to be and ealy as a garde to assist hadawae s aa`oaivir+ cwtal professionals in
gadoft the data regmkvd by the UDaited Stales Arhus carps .oaf Sr s to asate a preNiodmary a emrt of stream
quality. The total score remadtiag from the cearpw= of tku fitiia is sowed to USAcz approval and does slat imply a
particular mitigation ratio or requireaneax Form subject to changer= version 06/03. To Comment, please call 919-876-8441 x 26.

I D19
t
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STREAM QUALITY ASSESSMENT WORKSHEET
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.? USACE AM# DWQ # Site # (indicate on attachea map)
M STREAM QUALITY ASSESSMENT WORKSHEET
Provide the feet bwm k&rmtioa for tie stream reach Hader assessment:
1. Applicant's name: C V S-- CA fl&, 2. Evaluator's name:
3. Date of evaluatim: .5-120401 4. Trine of evaluation 3.3
5. Name of stream: {.i T - 6. River basic: tt "?
? 7. Approximate drainage area: a ?' °` & Stream order. ?
9. Length of reach evaluated: 1 S2 0 10. County: ?S
Il. Site coordinates (if known): prefer in decod dereges. 12. Subdivision name (if any):
Latitude (cL 34.872312): 3 (D 1(0 t 0 " A Longitude (ez 77.556611): V 0
Method kxxtion determined (circle): GPS Q j] Ortho (Aerial) Photo/GIS Other (M Other
13. Location of reach under evaluation (note nearby roans and landmarks and attach map identifying stream(s) location):
Se=e Q G ? -gyp a ? L? ?? or. w-K,p
E
14. Proposed channel work (if any): N 0,,V
15. Recent weather conditions: 41100
16. Site coudit:ions at time of visit:
17. Identify any special waterway classifications known: Section 10 Tidal Waters Essential Fisheries Habitat
ester Supply Watershed(I-lam
Trout Waters Outstanding Resource Waters - Nutrient Sensitive Waters __!LW
18. Is there a pond or lake located upstream of the evaluation point? YES Q If yes, estimate the water surface area:
19. Does channel appear on USGS quad map? YES Q 20. Does channel appear on USDA Soil Survey? YES Q
21. Estimated watershed land use: 9Ye Residential ? P% C vial % Industrial % Agricultural
c ,L% Forested Cleared / Logged % Other ( r )
22. Bankfull width: 23. Bank height (from bed to top of bankx n"
24. amn el slope down center of stream: (0 to 2%) _Geotle (2 to 4%) Moderate (4 to 10%) Steep (>10%)
25. (?? sinuosity: Straight Occasional bends Frequent meander Very sinuous Braided dcannel
lastraeams for completlo>t of work&v t (loeeted on page 2k Begin by ding the most appropriate "gil baised on
location, =am, vqptauon, stream duo, etc. Every characteristic must be soared using the same ecaregmxL Assign points
to each ebaracterisbc within the range shown for the aoocegioo. Page 3 movides a brief deuexiptienn of how to review the
chi x nffied in the wo&sheoL Scorns should reflect an overall asst of the stream reach under evaluation. If a
characteristic cannot be evaluated due to site or weather conditions, enter 0 in the searing box and provide an explanation in the
comment section. Where these are obvious d=ges m the dwactet of a sitcom under review (e.& the stream flows from a pasture
into a farest), the stream may be divided into smaller reaches that display mere eonthwhy, and a separate farm used to evaluate each
reach. The total score assigned to a stream teach must range baween 0 and 100, with a sor" of 100 repm=ting a stream of the
highest quality.
Total Scene (from reverse): Comments: S t h r"''"
Evaluator's Sigmdure ?? , •?? D'ft AQ I ` 0
This eland evaluation form is bonded to be used a ly as a Eaide to assist landowners and &Kvi-Amental professionals in
p&aft tie data required by tie Uditd States Army Carps of Enngmeers to make a ptrol'meWn7 amt of dream
quality. The total score resWOog fires the amPktiea of rim faro is sabject to USACS approval and does rsot imply a
particular mitigation ratio or requiremeaL Form subject to change - version 06103. To Comment, please call 919-8764441 x 26.

STREAM QUALITY ASSESSMENT WORKSHEET
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(nu.fIaw or saturafion 0; siron =lhaic
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water dise)iai ge 0-3 ; 0-4
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LUSACE AID# DWQ # Site # (indicate on attacnea map) '
STRF.AM QUALITY ASSFSSMEIVT WORKSHEET
.. A
Provide the w wing iadorusatisu for the stream reach nude assessumd:
1. Applicant's name*_ c ( S?n 2. Evaluator's name:
,. 4?- G7 & Time of evaluation o? -- ( ©?
3. Date of evaluation:' _
S. Name of stream l?,r+ 6. River basin: ? j'o-A4 ? r
7. Approximate drainage arcs:. 4 L0, C & Stream order ?N (S+
. 9. Length of reach evaluated: ` 10c- ` 10. County. si4w
11. Site coordinates (if known): prefer in deck d dom. 12. Subdivision name (if any):
Latitude (m 34.872312): 3 ? 16 0 /v i ong;aude (. 77.55Mi I . 9 ? -a- 'a- ? I o
_ AMA
Modred location determined (circk): (3PS opo ( Plhoto/GIS OtherGIS
13. Location of reach under evaluation (note roads and landmarks and attach map identifying stems) locations
?,rGc?or"s c? 4P0• SeG to-. 8;I
14. Proposed channel work (if any): 1 (- ,
15. Recent weather conditions- / -. -01-
16. Site conditions at time of visit: /2't o `
Total Score (from reverse):
17. Identify any special. waterway classificafkm known: Sortie 10 Tidal W Essential Fisheries Habitat
Trout Waters Outs ding Resource Waters ,Nutrient Sensitive waters later supply Watersh(I-M
1& Is them a pond or lake located upstream of the evaluation point? ?No If yes, estimate the water surface arm-n=20, a 0,C-
19. Does channel appear on USGS quad maK?PNO 20. Does channel appear on USDA Sail Survey? (iii)NO
21. Estimated watershed land use: =9o Residential ?TDi6 Coun eroW % Industrial Agricultural
o Forested % Cleared / Logged _% Other
22. Bankfull width: 8 -1S =b*bt (fine bed to top of24` Chamel slope down center of stream: (0 to 2%) (2 to 4%) Moderate (4 to 10%) Steep (>10'/.) _VM 25. (2tannd sincerity: Straight l? bends Frequent meander. Very, sinuous Braided channel
Instructions fow eomphtion of wotkoa t (!seated on page 2k' Begin by determining the mad appropriate eeareq ion based an
tacs? min, vegetation, stream taon, cac. Every cMtacowistic incur be scored using the same oocregioo. Assign points
to each deistic within the range shown for at eooregwn. Page 3 provides a brief destaiptM of law to review the
characteristics identified in do warksboet Scares sbodd reflect m overall assessmot of at stream Hach under evaluation. If a
characteristic on" be evaluated due to site or weadrrr OOnMOINS, enter 0 in rtes soaring boos and provide an eMbnation iu the
comment sechom Where there are obvious dMOM m the chw&ckF of a sham under review (e g., the stream flows from a pasture
into a fa a), the stream may be divided into smdkr reacbes that display rase eantn uity, and a separate form used to evaluate each
reach. The total score assigned to a, I ream reach must range between 0 and 100, with a so= of 100 representing a stream of the
highest quality. r n t n -
?._??__.... Ini? a,rov?C. ?- ,cab OC??•N t
p?uim' mrti?thorh

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Evaluator's Sure ?' -- - _ „ _ n
This channel evaluation foam is intended to be quad ostr as a guide to assist landowners and environmental pref'esdanals is
;abusing the data required by the United States Army Caps of Regomierd to mate a prelhaainary assessmest of stream
quality. The total sate resulting from the completion of tiffs form is soNect to USACB approval and does not Imply a
ratio a regoireme? Form subject to change - version 06M3. To Comte please call 919-876-8441 x 26.
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% STREAM QUALITY ASSESSMENT WORKSHEET

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