20000654 Ver 1_COMPLETE FILE_20000519

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
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NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
June 1, 2000
Forsyth County
DWQ Project # 000654
APPROVAL of 401 Water Quality Certification
Daniel Johnson
4116 Abbotts Lake Court
Kernersville, NC 27284
Dear Mr. Johnson:
You have our approval, in accordance with the attached conditions and those listed below, to impact 20 feet of
stream channel in Forsyth County for the purpose of driveway construction as you described in your application
received by the Division of Water Quality on May 19, 2000. After reviewing your application, we have decided that
this fill is covered by General Water Quality Certification Number 3103. This certification allows you to use
Nationwide Permit Number 14 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 Water shed regulations. 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 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 wetland fills for this project (now or in the future) exceed one acre, compensatory
mitigation may be required as described in 15A NCAC 2H .0506 (h) (6) and (7). For this approval to be valid, you
must follow the conditions listed in the attached 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.
pT y,
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Attachment
cc: Corps of Engineers Raleigh Field Office
Winston-Salem DWQ Regional Office
File Copy
Central Files 000654
Division of Water Quality - Non-Discharge Branch
1621 Mail Service Center, Raleigh, NC 27699-1621 Telephone [phone] FAX # [phone]
An Equal Opportunity Affirmative Action Employer - 50% recycled/10% post consumer paper
http://h2o.enr.state.nc.us/wetlandc.htmI
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DEM ID:
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CORPS ACTION ID:
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #): --o -0
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PRE-CONSTRUCTION NOTIFICATION APPLICATION - r-m
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FOR NATIONWIDE PERMITS THAT REQUIRE:
1) NOTIFICATION TO THE CORPS OF ENGINEERS +?r ".
2) APPLICATION FOR SECTION 401 CERTIFICATION, I .n ? ?.011(1 `
3) COORDINATION WITH THE NC DIVISION OF COASTAL MANA NT
SEND THE ORIGINAL AND (1) COPY OF THIS COMPLETED FORM TO THE N
FIELD OFFICE OF THE CORPS OF ENGINEERS (SEE AGENCY ADDRESSE SEVEN
(7) COPIES SHOULD BE SENT TO THE N.C. DIVISION OF ENVIRONMENTAL MANAGEMENT
(SEE AGENCY ADDRESSES SHEET). PLEASE PRINT.
1. OWNERS 'NAME:
2. MAILING ADDRESS : 411(e A660TCS LA I?ff W UP T- /
SUBDIVISION NAME:
CITY: fee/vtest/iLLG STATE: NC. ZIP CODE:
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE) : t 1 0 T) nN 6Q2_ C2.?K_ 1 PrW I: ?Gc&) s A ULF
3. TELEPHONE NUMBER (HOME) : 334-"(0-4180 (WORK) : 536664-1
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
N/A
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AER PHOTOGRAPHY WITH SCALE) : ,????? .+
COUNTY : ?2SV'I'I? NEAREST TOWN OR CITY: KewC \J r`°"'
LEFT 1'UQ.N ?l`'?1 -r1 M65K.« SUS D I V tSt C?v a l-1 ?`? (o to
AT- 1 N'R--yCS4FM UN n r-- (kyn_Ki NS r--()LLD CD Al HW? (o P
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SPECIFIC LOCATION (INCLUDE ROAD
NUMBERS, LANDMARKS, ETC d -[ , Y 6 (M CU?'` LAN I ()
-r1 m6mcize C ? S?g??yl S? a rJ I ha KeT-wo2s/l LLO

6. IMPACTED OR NEAREST STREAM/RIVER: NO 1!`?k E - S , AU.. ST U.-
RIVER BASIN:
7a. IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER
(SA), HIGH QUALITY WATERS (HQW), OUTST ING RESOURCE WATERS (ORW), WATER
SUPPLY (WS-I OR WS-II)? YES [ ] NO X IF YES, EXPLAIN:
7b. IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES [ ] NO Yu
7c. 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?
8a. HAVE ANY SECTION 404 PERMIlk BEEN PREVIOUSLY REQUESTED FOR USE ON
THIS PROPERTY? YES [ ] NO IF YES, PROVIDE ACTION I.D. NUMBER OF
PREVIOUS *PERMIT AND ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401
CERTIFICATION) : -
8b. ARE ADDITIONAL PE IT REQUESTS EXPECTED FOR THIS PROPERTY IN THE
FUTURE? YES [ ] NO IF YES, DESCRIBE ANTICIPATED WORK:
9a. ESTIMATED TOTAL NUMBER OF ACRES IN TRACT OF LAND:
9b. ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
'I' UJ1 DE X 4Da Low, boo _ o P Atj MEE
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10a. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: EXCAVATION:
FLOODING: OTHER:
DRAINAGE: TOTAL ACRES TO BE IMPACTED: ZD t x 'WOE
? v ?'w C;2flss? N ? w ? pE'
10b. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF
RELOCATED, PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION):
LENGTH BEFORE: FT AFTER: Ste' FT
WIDTH BEFORE (based on normal high water contours): Z• FT
WIDTH AFTER: z - FT
AVERAGE DEPTH BEFORE: FT AFTER: ' FT
(2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: PLACEMENT OF PIPE IN CHANNEL: V
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? i1JIAWHAT IS THE EXPECTED POND SURFACE AREA? NLOt
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF
MECHANICAL EQUIPMENT TO BE USED (ATTACH PLANS: 8 1/2" X 11" DRAWINGS
ONLY):
niA.

U(;;7 WALA rU

3
13. PURPOSE OF PROPOSED WORK: _

14. STATE REASONS
OUT IN WETLANDS.
IMPACTS):
SfAaLA_ SCEA VY\ DUNS C-LkLk (r&,6? r14 "OYfet' 9^Ay
Fz gmia e MD QANIr c mss i-c? 3u t u) 46
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15. YOU'ARE REQUIRED TO CONTACT THE U.S. FISH AND WILDLIFE SERVICE.
(USFWS) AND/OR --NATIONAL MARINE FISHERIES SERVICE (NMFS) (SEE AGENCY
ADDRESSES SHEET) REGARDING THE PRESENCE OF ANY FEDERALLY LISTED OR
PROPOSED FOR LISTING ENDANGERED OR THREATENED SPECIES OR CRITICAL HABITAT
IN THE PERMIT AREA THAT 4iXY -BE-AFFECTED BY THE PROPOSED PROJECT. DATE
CONTACTED: (ATTACH RESPONSES
FROM THESE AGENCIES.)
16. YOU AREEQU3RE,. Tom-CONTACT.-_THE STATE HISTORIC_P_RFSERVATI-0N_oEFICER
(SHPO) (SEE AGENCY ADDU?BES-SHEET) REGARDING THE PRESENCE. OF HISTORIC
PROPERTIESrIN? ERMIT AREA WHICH MAY BE AFFECTED BY THE-PROPOSED
PROJECT. DATE CONTACTED:-
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OR.THE USE OF
PUBLIC (STATE) LAND?
YES [I NO .9 (IF NO, GO TO 18)
a. IF YES, DOES THE PROJECT REQUIRE PREPARATION OF AN ENVIRONMENTAL
DOCUMENT PURSUANT TO THE REQUIREMENTS OF THE NORTH CAROLINA ENVIRONMENTAL
POLICY ACT?
YES [J NO [] lip YES, HAPS THE DMUMENT BEEN RLPVIBW0D THROUGH-THE NORTH CAIROLINh-
DEPARTMENT OF ADMINISTRATION STATE CLEARIN O ?
YES [I NO [ ]
IF ANSWER TO 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE
STATE CLEARINGHOUSE TO DIVISION OF ENVIRONMENTAL MANAGEMENT REGARDING
COMPLIANCE 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].
WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED
(INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND
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18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF
PROPOSED ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OR 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 STREAMS (INTERMITTENT AND PERMANENT) ON THE PROPERTY
MUST BE SHOWN ON THE MAP. MAP SCALES SHOULD BE 1 INCH EQUALS 50 FEET OR 1
INCH EQUALS 100 FEET OR THEIR EQUIVALENT.
b. IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE
IMPACTED BY PROJECT.
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?
12Es 1 ccw t o' L- ?rzop?S
f. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
MBA
g. SIGNED_AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE: WETLANDS OR WATERS OF THE U. S. 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
ENVIRONMENTAL MANAGEMENT (WATER QUALITY) CERTIFICATION, AND
3) (IN THE TWENTY COASTAL COUNTIES ONLY), A LETTER FROM THE
NORTH CAROLINA DIVISION OF COASTAL MANAGEMENT STATING THE PROPOSED
PROGRAM.

OWNER'S/AGENT /S/SIGNATURE
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(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED (18g.))
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May 17, 2000
NC DENR Division of Water Quality
Wetlands/ 401 Unit
1621 Mail Service Center
Raleigh, North Carolina 27699-1621
Attention: Mrs. Cyndi Bell
Dear Mrs. Bell:
PAYMENT
RECEIVED
000654
1
MAY 1 9 ?[,nn
Thank you for the advice yesterday on the attached application. I was able to find a very
good map on the Internet as you recommended. I have enclosed the $200 application fee as
requested.
Best regards,
k6A
Dan Johnson
4116 Abbots Lake Court
Kernersville, NC 27284
Work - 336-664-7516
Home - 336-996-4780