19991365 Ver 1_COMPLETE FILE_19991210

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
/ •
NC.nENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
February 3, 2000
Davidson County
DWQ Project # 991365
APPROVAL of 401 Water Quality Certification
Big Tree Development Co.
PNB 325
4642 West Market Street
Greensboro, NC 27407
Dear Sirs:
You have our approval, in accordance with the attached conditions, to place fill material 730 linear feet of streams
for the purpose of relocating a channel at Willow Creek subdivision, as you described in your application dated 9
December 1999. After reviewing your application, we have decided that this fill is covered by General Water Quality
Certification Number 3108. This Certification allows you to use Nationwide Permit Number 26 when the Corps of
Engineers issues it. In addition, you should get any other federal, state or local permits before you go ahead with your
project including (but not limited to) Sediment and Erosion Control, Coastal Stormwater, Non-Discharge and Water
Supply Watershed regulations. Also this approval will expire when the accompanying 404 or CAMA permit expires
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 and 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 wetland tills for
this project (now or in the future) exceed one acre, compensatory mitigation may be required as described in 15A NCAC
2H .0506 (h). For this approval to be valid, you must follow the conditions listed in the attached certification. This
approval shall expire when the corresponding Nationwide Permit expires or as otherwise provided in the General
Certification.
If you do not accept any of the conditions of this certification, you may ask for an adjudicatory hearing. You must
act within 60 days of the date that you receive this letter. To ask for a hearing, send a written petition which conforms to
Chapter 150B of the North Carolina General Statutes to the Office of Administrative Hearings, P.O. Box 27447, Raleigh,
N.C. 276 1 1-7447. This certification and its conditions are final and binding unless you ask for a hearing.
This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water Act. If you
have any questions, please telephone John Dorney at 919-733-9646.
Sinc ely,
Stevens
Attachment
cc: Corps of Engineers Raleigh Field Office
Winston-Salem DWQ Regional Office
File copy
Central Files
Ben Palmer; Davis-Martin-Powell and Associates
99136.5.Itr
Division of Water Quality • Non-Discharge Branch
1621 Mail Service Center Raleigh 27669-1621 Telephone [phone] FAX # [phone]
An Equal Opportunity Affirmative Action Employer • 50% recycled/10% post consumer paper
MEMORANDUM
TO: John Dorney Regional Contact:
Non-Discharge Branch WQ Supervisor:
Date:
SUBJECT: WETLAND STAFF REPORT AND RECOMMENDATIONS
Facility Name Big Tree Development Comapany
Project Number 99 1365
Recvd From APP
Received Date 12/10/99 Recvd By Region 1/21/2000
Project Type residential roadway
County Davidson
County2
Region Winston-Salem
Certificates Stream Stream Impacts (ft.)
Permit Wetland Wetland Wetland Stream Class Acres Feet ME
Type Type Impact Score Index Prim. Supp. Basin Req. Req.
?? ?'?01 ON F__ 12-119 WSIII CA 30,707. 0.03 730.00 ?- 730.00
Mitigation Wetland
MitigationType Type Acres Feet
I F-1 I F_
Is Wetland Rating Sheet Attached? 0 Y0 N Did you request more info? 0 Y 0 N
Have Project Changes/Conditions Been Discussed With Applicant? 0 Y 0 N
Is Mitigation required? 0 Y O N Recommendation: (0 Issue 0 Issue/Cond 0 Deny
Provided by Region: Latitude (ddmmss) 355842 Longitude (ddmmss) 800439
Comments:
*** This is an "after-the-fact" permit /certification application. Land Quality had noticed the channel
relocation on one of their site y9 sots and contacted this Office. A site visit/pre-application meeting
was then set up with the engineer, US ALOE, and this Office.
*** Intermittent channel - No mitigation required and Water Supply Buffers Rules do not apply.
*** The WSRO recommends that this certification be issued.
cc: Regional Office Page Number 1
Central Office
Facility Name Big Tree Development Comapany County Davidson
Project Number 99 1365 Regional Contact: Jennifer Frye
Date: 1/24/2000
Comments (continued from page 1):
cc: Regional Office Page Number 2
Central Office
State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
099MA,
, &I
D E N R
Division of Water Quality
Environmental Sciences Branch & Wetlands/401 Unit
Location: 4401 Reedy Creek Road
Raleigh, N,C. 27607
Mailing Address: 1621 Mail Service Center
Raleigh, N,C. 27699
FAX: [phone]
FAX TO: I FAX NUMBER:
/ T ~ 7, 7"
FROM:
PHONE:
NO. OF PAGES INCLUDING THIS SHEET:

If you receive this fax by mistake call: ESB [phone] or Wetlands [phone].
TRIAGE CHECKLIST
Project Name:
Project Number:
County:/01 U/
The attached project has been sent to you for review for the following reasons. Please consider whether a
site visit is needed to determine the impacts. Particular attention should focus on the below checked items.
Please feel free to call the central office staff member assigned to your region if you need assistance.
Stream length impacted.
Stream determination (i.e. intermittent or perennial, or any channel present).
Wetland impact and distance to blue-line surface waters on USGS topo map.
- Mini mization/avoidance options.
NW 14. (is access to highground or wetlands)?
Neuse buffer rules.
Pond (water) fill (i.e. is the pond drained or holding water)?
Pond creation (i.e. in uplands, in a drained channel, or in wetlands). Please locate streams and
channels (if any) so that the central office can determine.
Mitigation ratios.
Stormwater pond placed in wetlands.
Ditching in wetlands.
Is the applicant's proposed stream/wetland mitigation site available and viable'?
Applicant/consultant has a history of non-compliance (check drawings and application for
accuracy).
Has project been split from previous work to avoid mitigation requirements'?
Consistent with pre-application meetings'?
-? Cumulative impact concerns.
OTHER:
DAVIS - MARTIN - POWELL & ASSOCIATES, INC.
ENGINEERING LAND PLANNING • SURVEYING
218 GATEWOOD AVENUE • SUITE 102
??p HIGH POINT, NC 27262
PHONE [phone] • FAX [phone]
- Pg
December 9, 1999
Re: Big Tree Development
Utility Improvements
Willow Creek Subdivision
DMP Job No. E2733 (BF)
Mr. John Thomas
US Army Corps
6508 Falls of Neuse Road
Suite 102
Raleigh, NC 27615 9 91 :3 65
Dear Mr. Thomas:
In regards to our field meeting with Jennifer Frye (DWQ-WRSO) on November 30, 1999, we are
enclosing two (2) signed copies of a Pre-Construction Notification Application for the above
referenced project. Also enclosed are 81/2" x 11" copies of the construction plans for the area and the
USGS topographic map indicating the location of this work.
As you recall, this project involves the relocation of an intermittent channel to a residential roadside
ditch. A detail of the proposed ditch designed to carry the stormwater runoff is also included.
We trust this information is complete and will allow you to complete your review at an early date.
Should you have any question or require additional information, please contact our office.
Sincerely,
DAVIS-MARTIN-POWELL & ASSOCIATES, INC.
s'Yl 7c?--
Ben Palmer, El
BP/dd
c: Mr. John Dorney (7 copies & Application Fee)
Mr. Skip Gilliland (enc)
File (enc)
PAYMENIT ..?
RECOVED
DWQ ID: CORPS ACTION ID:
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #)
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
1. 'NOTIFICATION TO THE CORPS OF ENGINEERS
2. APPLICATION FOR SECTION 401 CERTIFICATION
3. COORDINATION WITH THE NC DIVISION OF COASTAL MANAGEMENT
SEND THE ORIGINAL AND (1) COPY OF THIS COMPLETED FORM TO THE APPROPRIATE FIELD
OFFICE OF THE CORPS OF ENGINEERS (SEE AGENCY ADDRESSES SHEET). SEVEN (7)
COPIES MUST BE SENT TO THE NC DIVISION OF WATER QUALITY,
ATTN: JOHN DORNEY, 4401 REEDY CREEK ROAD, RALEIGH. NC
27607. PLEASE PRINT OR TYPE.
1. OWNER'S NAME: Big Tree Development Company
2. MAILING ADDRESS: PNB 325. 4642 West Market Street
SUBDIVISION NAME Willow Creek Subdivision
CITY: Greensboro STATE: NC ZIP CODE: 27407
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
Willow Creek Subdivision - Cascade Drive
3. TELEPHONE NUMBER: (HOME) (WORK) 336-299-5050
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
Mr. George F. Gilliland. President (same as above)
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC MAP
OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: vidson - NEAREST TOWN: Hi Point
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ECT.) Off SR 1756 - on
Cascade Drive
6. IMPACTED OR NEAREST STREAM/RIVER: Abbotts Creek RIVER BASIN: Yadkin Pee-Dee
7. (a) IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER, (SA),
HIGH QUALITY WATERS (HQW), OUTSTANDING RESOURCE WATERS (ORW), WATER
SUPPLY (WS-I OR WS-In? YES ? NO ® IF YES, EXPLAIN:
(b) IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES ? NO
(c) IF THE PROJECT IS LOCATED WITHIN A COASTAL COUNTY (SEE PAGE 7 FOR LIST OF
COASTAL COUNTIES), WHAT IS THE LAND USE PLAN (LUP) DESIGNATION?
8. (a) HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROJECT? YES E:1 NO ® IF YES, PROVIDE ACTION I.D. NUMBER OF PREVIOUS PERMIT AND
ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401 CERTIFICATION):
(b) ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE FUTURE?
YES ? NO ® IF YES, DESCRIBE ANTICIPATED WORK:
9. (a) ESTIMATED TOTAL NUMBERS OF ACRES IN TRACT OF LAND: 48 AC +/-
(b) ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
<1
10. (a) NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: EXCAVATION:
FLOODING: OTHER : 0.03
DRAINAGE : TOTAL ACRES TO BE IMPACTED: 0.03
(b) (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED,
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION:
LENGTH BEFORE: 730 FT AFTER: 740 FT
WIDTH BEFORE (based on normal high water contours): 2 FT
AVERAGE DEPTH BEFORE: 2 FT AFTER: 3 FT
(b) (2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: X PLACEMENT OF PIPE IN CHANNEL:
CHANNEL EXCAVATION: CONSTRUCTION OF A DAM/FLOODING:
OTHER:
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WATERSHED
DRAINING TO THE POND? WHAT IS THE EXPECTED POND SURFACE AREA?
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPMENT TO BE USED? (ATTACH PLANS; 81/2 BY 11 DRAWINGS ONLY)
Relocation of existing channel to a man-made riv-ran lined channel by means of a hoe/dozer
13. PURPOSE OF PROPOSED WORK: Construction of a residential roadway
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS)
15. YOU ARE REQUIRED TO CONTACT THE US FISH AND WILDLIFE SERVICE AND/OR
NATIONAL MARINE FISHERIES SERVICE REGARDING THE PRESENCE OF ANY FEDERALLY
LISTED OR PROPOSED FOR LISTING ENDANGERED OR THREATENED SPECIES OR CRITICAL
HABITAT IN THE PERMIT AREA THAT MAY BE AFFECTED BY THE PROPOSED PROJECT.
DATE CONTACTED: N/A
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER
(SHPO) REGARDING THE PRESENCE OF HISTORIC PROPERTIES IN THE PERMIT AREA
WHICH MAY BE AFFECTED BY THE PROPOSED PROJECT. DATE CONTACTED N/A
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OR THE USE OF PUBLIC
(STATE) LAND? YES ? NO ® (IF NO, GO TO 16)
(a) IF YES, DOES THE PROJECT REQUIRE PREPARATION OF AN ENVIRONMENTAL
DOCUMENT PURSUANT TO THE REQUIREMENTS OF THE NORTH CAROLINA
ENVIRONMENTAL POLICY ACT? YES ? NO ?
(b) IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE YES ? NO ?
IF ANSWER 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE STATE
CLEARINGHOUSE WITH THE NORTH CAROLINA ENVIRONMENTAL POLICY ACT.
QUESTIONS REGARDING THE STATE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED TO MS. CHRYS BAGGETT, DIRECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION, 116 WEST JONES STREET, RALEIGH,
NORTH CAROLINA 27603-8003, TELEPHONE [phone].
18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF PROPOSED
ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OF FILL MATERIAL INTO
WETLANDS:
(a) WETLAND DELINEATION MAP SHOWING ALL WETLANDS, STREAMS, LAKES, AND
PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14, 18, 21, 26, 29, AND 38).
ALL STREAM (INTERMITTENT AND PERMANENT) ON THE PROPERTY MUST BE SHOWN ON
THE MAP. MAP SCALES SHOULD BE 1 INCH EQUALS 50 FEET OF 1 INCH EQUALS 100 FEET
OF THEIR EQUIVALENT.
(b) IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE IMPACTED BY
PRODUCT.
(c) IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA SHEETS
RELEVANT TO THE PLACEMENT OF THE DELINEATION LINE.
(d) ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
(e) WHAT IS LAND USE OF SURROUNDING PROPERTY?
(f) IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE: WETLANDS OR WATERS OF THE US MAY NOT BE IMPACTED PRIOR TO:
1. ISSUANCE OF A SECTION 404 CORPS OF ENGINEERS PERMIT,
2. EITHER THE ISSUANCE OR WAIVER OF A 401 DIVISION OF WATER QUALITY
CERTIFICATION, AND
3. (IN THE TWENTY COASTAL COUNTIES ONLY), A LETTER FROM THE NORTH
CAROLINA DIVISION OF COASTAL MANAGEMENT STATING THE PROPOSED
ACTIVITY IS CONSISTENT WITH THE NORTH CAROLINA COASTAL MANAGEMENT
PROGRAM,
Ulsc, 3 f9?"7
x- -
OWNS ' AGENT SIGNATURE DATE
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED).
HIGH POINT WEST, 1987
1% 2000'
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PA?t?I'c C?R?CEtV?-?
DWQ ID: CORPS ACTION ID:

NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #)

PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
1. NOTIFICATION TO THE CORPS OF ENGINEERS
2. APPLICATION FOR SECTION 401 CERTIFICATION
I. COORDINATION WITH THE NC DIVISION OF COASTAL MANAGEMENT
SEND THE ORIGINAL AND (1) COPY OF THIS COMPLETED FORM TO THE APPROPRIATE FIELD
OFFICE OF THE CORPS OF ENGINEERS (SEE AGENCY ADDRESSES SHEET). SEVEN (7)
COPIES MUST BE SENT TO THE NC DIVISION OF WATER QUALITY,
ATTN: JOHN DORNEY, 4401 REEDY CREEK ROAD, RALEIGH, NC
27607. PLEASE PRINT OR TYPE.
1. OWNER'S NAME: Big Tree Development Comp
anv
2. MAILING ADDRESS: PNB 325. 4642 West Market Street
SUBDIVISION NAME Willow Creek Subdivision
CITY: Greensboro STATE: NC ZIP CODE: 27407
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
Willow Creek Subdivision - Cascade Drive
3. TELEPHONE NUMBER: (HOME) (WORK) 336-299-5050
4. IF APPLICABLE: AGENTS NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
Mr. George F. Gilliland. President (same as above)
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC MAP
OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: Davidson - NEAREST TOWN: i Point
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ECT.) Off SR 1756 - on
Cascade Drive
6. IMPACTED OR NEAREST STREAM/RIVER: Abbotts Creek RIVER BASIN: Yadkin Pee-Dee
7. (a) IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER, (SA),
HIGH QUALITY WATERS (HQW), OUTSTANDING RESOURCE WATERS (ORW), WATER
SUPPLY (WS-I OR WS-II)? YES ? NO ® IF YES, EXPLAIN:
(b) IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES ? NO
(c) IF THE PROJECT IS LOCATED WITHIN A COASTAL COUNTY (SEE PAGE 7 FOR LIST OF
COASTAL COUNTIES), WHAT IS THE LAND USE PLAN (LUP) DESIGNATION?
8. (a) HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROJECT? YES ? NO ® IF YES, PROVIDE ACTION I.D. NUMBER OF PREVIOUS PERMIT AND
ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401 CERTIFICATION):
(b) ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE FUTURE?
YES ? NO ® IF YES, DESCRIBE ANTICIPATED WORK:
9. (a) ESTIMATED TOTAL NUMBERS OF ACRES IN TRACT OF LAND: 48 AC +/-
(b) ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
<1
10. (a) NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: EXCAVATION:
FLOODING: OTHER : 0.03
DRAINAGE : TOTAL ACRES TO BE IMPACTED: 0.03
(b) (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED,
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION:
LENGTH BEFORE: 730 FT AFTER: 740 FT
WIDTH BEFORE (based on normal high water contours): 2 FT
AVERAGE DEPTH BEFORE: 2 FT AFTER: 3 FT
(b) (2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: X PLACEMENT OF PIPE IN CHANNEL:
CHANNEL EXCAVATION: CONSTRUCTION OF A DAM/FLOODING:
OTHER:
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WATERSHED
DRAINING TO THE POND? WHAT IS THE EXPECTED POND SURFACE AREA?
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPMENT TO BE USED? (ATTACH PLANS; 81/2 BY 11 DRAWINGS ONLY)
Relocation of existine channel to a man-made rin-ran lined channel by means of a hoe/dozer
13. PURPOSE OF PROPOSED WORK: Construction of a residential roadway
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS)
15. YOU ARE REQUIRED TO CONTACT THE US FISH AND WILDLIFE SERVICE AND/OR
NATIONAL MARINE FISHERIES SERVICE REGARDING THE PRESENCE OF ANY FEDERALLY
LISTED OR PROPOSED FOR LISTING ENDANGERED OR THREATENED SPECIES OR CRITICAL
HABITAT IN THE PERMIT AREA THAT MAY BE AFFECTED BY THE PROPOSED PROJECT.
DATE CONTACTED: N/A
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER
(SHPO) REGARDING THE PRESENCE OF HISTORIC PROPERTIES IN THE PERMIT AREA
WHICH MAY BE AFFECTED BY THE PROPOSED PROJECT. DATE CONTACTED N/A
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OR THE USE OF PUBLIC
(STATE) LAND? YES ? NO ® (IF NO, GO TO 16)
(a) IF YES, DOES THE PROJECT REQUIRE PREPARATION OF AN ENVIRONMENTAL
DOCUMENT PURSUANT TO THE REQUIREMENTS OF THE NORTH CAROLINA
ENVIRONMENTAL POLICY ACT? YES ? NO ?
(b) IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE YES ? NO ?
IF ANSWER 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE STATE
CLEARINGHOUSE WITH THE NORTH CAROLINA ENVIRONMENTAL POLICY ACT.
QUESTIONS REGARDING THE STATE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED TO MS. CHRYS BAGGETT, DIRECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION, 116 WEST JONES STREET, RALEIGH,
NORTH CAROLINA 27603-8003, TELEPHONE [phone].
18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF PROPOSED
ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OF FILL MATERIAL INTO
WETLANDS:
(a) WETLAND DELINEATION MAP SHOWING ALL WETLANDS, STREAMS, LAKES, AND
PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14, 18, 21, 26, 29, AND 38).
ALL STREAM (INTERMITTENT AND PERMANENT) ON THE PROPERTY MUST BE SHOWN ON
THE MAP. MAP SCALES SHOULD BE 1 INCH EQUALS 50 FEET OF I INCH EQUALS 100 FEET
OF THEIR EQUIVALENT.
(b) IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE IMPACTED BY
PRODUCT.
(c) IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA SHEETS
RELEVANT TO THE PLACEMENT OF THE DELINEATION LINE.
(d) ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
(e) WHAT IS LAND USE OF SURROUNDING PROPERTY?
(D IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE: WETLANDS OR WATERS OF THE US MAY NOT BE IMPACTED PRIOR TO:
1. ISSUANCE OF A SECTION 404 CORPS OF ENGINEERS PERMIT,
2. EITHER THE ISSUANCE OR WAIVER OF A 401 DIVISION OF WATER QUALITY
CERTIFICATION, AND
3. (IN THE TWENTY COASTAL COUNTIES ONLY), A LETTER FROM THE NORTH
CAROLINA DIVISION OF COASTAL MANAGEMENT STATING THE PROPOSED
ACTIVITY IS CONSISTENT WITH THE NORTH CAROLINA COASTAL MANAGEMENT
PROGRAM,
OWNE AGENT SIGNATURE DATE
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED).
HIGH POINT WEST, 1987 i
11102000,

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E-2733 Big Tree Development