20020074 Ver 1_COMPLETE FILE_20020116

O?OF WAr?RQG
r
Q ?
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Gregory J. Thorpe, Ph.D.
Acting Director
U Division of Water Quality
(fu LID
April 4, 2002, APR I I M I
Mr. Phillip Brent Brewer WETLANDS GROUP
214 Smith Street y WATE' WUITY SECTION
Atlantic Beach, NC 28512
SUBJECT: Approval of 401 Water Quality and
Additional Conditions
Lot # 9 Spooner's Creek North S/D
Harbor Drive
DWQ Project # 020074
Carteret County
Dear Mr. Brewer:
You have our approval, in accordance with the attached conditions (WQC # 3375) to do the following
activity in the Spooner's Creek North Subdivision, Lot # 9 off Harbor Drive near Morehead City in Carteret
County. This approval allows you to:
1). Fill a 15' X 50' (750 sqft) of wetlands for a driveway crossing;
2). Restore remaining wetlands to original grade and revegetate;
This approval is only valid for the purpose and design that you described in your after the fact 404/401
application dated January 10, 2002 received by the Division of Water Quality (DWQ). After reviewing
your application, we have determined that General Water Quality Certification Number 3375 covers this
activity. This Certification allows you to use your Nationwide 14 Permit when the Corps of Engineers
issues it. Please keep in mind that there may be additional Federal, State or Local regulations applicable to
your project, such as (but not limited to) Sediment and Erosion Control, Non-Discharge and Water Supply
Watershed regulations and Coastal Stormwater. In addition, this approval will expire when the
accompanying 404 Permit expires unless otherwise specified in the General Certification.
This approval is only valid for the purpose and design that you described in your 404/401
application dated January 10, 2002. If you change or modify your project, you must notify the Division
(DWQ) 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. 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). For
this approval to be valid, you must follow the conditions listed in the attached certification and the
additional conditions listed below.
1). Remaining wetland fill is removed and wetlands are restored and revegetated.
2). Place remaining wetlands on site in a deed restriction/conservation and send a verified
copy from the register of Deeds.
3). The attached Certificate of Completion (COC) must be submitted to the Division upon
final construction of the site.
WWI
E
Ex127 Cardinal Drive t., Wilmington, NC 28405-3845 Telephone [phone] FAX[phone]
An Equal Opportunity Affirmative Action Employer
Page Two
Mr. Phillip Brent Brewer
April 4, 2002
Please notify this Office at the number listed below if any problem arises during the construction of the
project that may affect water quality.
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 conforming 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 DWQ Permit # 020074 under Section 401 of the Clean Water
Act. If you have any questions, please telephone Joanne Steenhuis or Rick Shiver at 910-395-3900.
Sincerely,
c? ? Qa,,J (3
Gregory J. Thorpe, Ph.D.
Acting Director, Division of Water Quality
Attachments: GC # 3375
Certificate of Completion
cc: Corps of Engineers Wilmington Field Office - Mickey Sugg
WiRO- Joanne Steenhuis
401/Wetland Unit, Central Office - Cyndi Karoly
Central Files

00F W ATFR p Michael F. Easley, Governor
William G. Ross Jr., Secretary
`Q G North Carolina Department of Environment and Natural Resources
t:
Gregory J. Thorpe, Ph.D.
Z; Acting Director
4 -C Division of Water Quality
April 4, 2002
Mr. Phillip Brent Brewer
214 Smith Street
Atlantic Beach, NC 28512
SUBJECT: Approval of 401 Water Quality and
Additional Conditions
Lot # 9 Spooner's Creek North S/D
Harbor Drive
DWQ Project # 020074
Carteret County
Dear Mr. Brewer:
You have our approval, in accordance with the attached conditions (WQC # 3375) to do the following
activity in the Spooner's Creek North Subdivision, Lot # 9 off Harbor Drive near Morehead City in Carteret
County, This approval allows you to:
1). Fill a 15' X 50' (750 sqft) of wetlands for a driveway crossing;
2). Restore remaining wetlands to original grade and revegetate;
This approval is only valid for the purpose and design that you described in your after the fact 404/401
application dated January 10, 2002 received by the Division of Water Quality (DWQ). After reviewing
your application, we have determined that General Water Quality Certification Number 3375 covers this
activity. This Certification allows you to use your Nationwide 14 Permit when the Corps of Engineers
issues it. Please keep in mind that there may be additional Federal, State or Local regulations applicable to
your project, such as (but not limited to) Sediment and Erosion Control, Non-Discharge and Water Supply
Watershed regulations and Coastal Stormwater. In addition, this approval will expire when the
accompanying 404 Permit expires unless otherwise specified in the General Certification.
This approval is only valid for the purpose and design that you described in your 404/401
application dated January 10, 2002. If you change or modify your project, you must notify the Division
(DWQ) 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. 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). For
this approval to be valid, you must follow the conditions listed in the attached certification and the
additional conditions listed below.
1). Remaining wetland fill is removed and wetlands are restored and revegetated.
2). Place remaining wetlands on site in a deed restriction/conservation and send a verified
copy from the register of Deeds.
3). The attached Certificate of Completion (COC) must be submitted to the Division upon
final construction of the site.
cc
Ex127 Cardinal Drive t., Wilmington, NC 28405-3845 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer
%L'DENR

Re: #02-0074
Subject: Re: #02-0074
Date: Mon, 25 Mar 2002 15:51:48 -0500
From: Cyndi Karoly <[e-mail]>
To: Charles Brown <[e-mail]>, [e-mail],
[e-mail]
What a blunder. At least it's not a case of two projects having the same project
number. This time I had time to run down the paper file - which was in the wrong
place, by the way. I've scoured the file and have no idea how the file was set
up as a Wake County project; but it was, and that's why it was mailed to RRO.
Thank you for alerting me. Would you mind faxing this to Joanne Steenhuis in the
Wilmington RO at 910-350-2004. They have signatory authority, so she can prepare
the 401 or hold letter directly from that office. I'd fax it myself rather than
troubling you more, but our fax machine is dead. We've heard rumors that a new
one is on the way immimently as a permanent loan from DOT, but I won't believe it
until I see it.
Thanks for your help Charles. Joanne - sorry for the late transmission of this
file to you. The drop dead date on this one is April 11. I know that cuts the
time very close for you. I think I'll have to go over a few things again with
our new tech. Bear with us on the learning curve, please.
Cheers!
Charles Brown wrote:
> His address on the application is 214 Smith Street Atlantic Beach NC and the
> project plan is a lot near Morehead City off of Hwy 24. I would be glad to do
> a site visit if I could get overnight travel. But I do not think this would
> be allowed.
> Charles
> Cyndi Karoly wrote:
> > The database shows this project as Philip Brent Brewer in Wake County.
> > What project do you have it as?
> > Charles Brown wrote:
> > > Cyndi,
> > > We got this project from you by mistake. It needs to be sent to who has
> > > Atlantic Beach area. If you need me to fax my copy to them I can if you
> > > email back on who it is.
> > > Charles Brown
1 of 1 3/25/02 3:53 PN
??F NIA7-?C Michael F. Easley, Governor
William G. Ross Jr., Secretary
?O G North Carolina Department of Environment and Natural Resources
Gregory J. Thorpe, Ph.D.
.{ Acting Director
Q ,- -? Division of Water Quality
April 4, 2002
Mr. Phillip Brent Brewer
214 Smith Street
Atlantic Beach, NC 28512
SUBJECT: Approval of 401 Water Quality and
Additional Conditions
Lot # 9 Spooner's Creek North S/D
Harbor Drive
DWQ Project # 020074
Carteret County
Dear Mr. Brewer:
You have our approval, in accordance with the attached conditions (WQC # 3375) to do the following
activity in the Spooner's Creek North Subdivision, Lot # 9 off Harbor Drive near Morehead City in Carteret
County. This approval allows you to:
1). Fill a 15' X 50' (750 sgft) of wetlands for a driveway crossing;
2). Restore remaining wetlands to original grade and revegetate;
This approval is only valid for the purpose and design that you described in your after the fact 404/401
application dated January 10, 2002 received by the Division of Water Quality (DWQ). After reviewing
your application, we have determined that General Water Quality Certification Number 3375 covers this
activity. This Certification allows you to use your Nationwide 14 Permit when the Corps of Engineers
issues it. Please keep in mind that there may be additional Federal, State or Local regulations applicable to
your project, such as (but not limited to) Sediment and Erosion Control, Non-Discharge and Water Supply
Watershed regulations and Coastal Stormwater. In addition, this approval will expire when the
accompanying 404 Permit expires unless otherwise specified in the General Certification.
This approval is only valid for the purpose and design that you described in your 404/401
application dated January 10, 2002. If you change or modify your project, you must notify the Division
(DWQ) 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. 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). For
this approval to be valid; you must follow the conditions listed in the attached certification and the
additional conditions listed below.
1). Remaining wetland fill is removed and wetlands are restored and revegetated.
2). Place remaining wetlands on site in a deed restriction/conservation and send a verified
copy from the register of Deeds.
3). The attached Certificate of Completion (COC) must be submitted to the Division upon
final construction of the site.
Ex127 Cardinal Drive t., Wilmington, NC 28405-3845 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer
T WE
rMENR
MEMORANDUM
TO:
SUBJECT:
John Dorney
Non-Discharge Branch
Regional Contact: .1. Steenhuis
WQ Supervisor: R Shiver
Date:
WETLAND STAFF REPORT AND RECOMMENDATIONS
Facility Name Phillip Brent Brewer County Wake
Project Number 02 0074 County2
Recvd From APP Region Raleigh
Received Date 1116/02 Recvd By Region
Project Type Residential
Certificates Stream - Stream Impacts (ft.)
Permit Wetland Wetland Wetland Stream Class Acres Feet '
Type Type Impact Score Index Prim. Supp. Basin Req. Req.
14 ?
? ?
F_ P7 7-0 _N OY ON ???r?F ? ?
Mitigation Wetland
MitigationType Type Acres Feet

Is Wetland Rating Sheet Attached? Q Y O N Did you request more info? Q Y O N
Have Project Changes/Conditions Been Discussed With Applicant? Q Y O N
Is Mitigation required? Q Y O N Recommendation: Q Issue pQ Issue/fond O Deny
Provided by Region: Latitude (ddmmss)- Longitude (ddmmss)
Comments:
This office has no objections to 12roje t as proposed. Permit written 4/4/02
cc: Regional Office
Central Office
Page Number 1
Re: #02-0074
Subject: Re: #02-0074
Date: Mon, 25 Mar 2002 15:51:48 -0500
From: Cyndi Karoly <[e-mail]>
To: Charles Brown <[e-mail]>, [e-mail],
[e-mail]
What a blunder. At least it's not a case of two projects having the same project
number. This time I had time to run down the paper file - which was in the wrong
place, by the way. I've scoured the file and have no idea how the file was set
up as a Wake County project; but it was, and that's why it was mailed to RRO.
Thank you for alerting me. Would you mind faxing this to Joanne Steenhuis in the
Wilmington RO at 910-350-2004. They have signatory authority, so she can prepare
the 401 or hold letter directly from that office. I'd fax it myself rather than
troubling you more, but our fax machine is dead. We've heard rumors that a new
one is on the way immimently as a permanent loan from DOT, but I won't believe it
until I see it.
Thanks for your help Charles. Joanne - sorry for the late transmission of this
file to you. The drop dead date on this one is April 11. I know that cuts the
time very close for you. I think I'll have to go over a few things again with
our new tech. Bear with us on the learning curve, please.
Cheers!
Charles Brown wrote:
> His address on the application is 214 Smith Street Atlantic Beach NC and the
> project plan is a lot near Morehead City off of Hwy 24. I would be glad to do
> a site visit if I could get overnight travel. But I do not think this would
> be allowed.
> Charles
> Cyndi Karoly wrote:
> > The database shows this project as Philip Brent Brewer in Wake County.
> > What project do you have it as?
> > Charles Brown wrote:
> > > Cyndi,
> > > We got this project from you by mistake. It needs to be sent to who has
> > > Atlantic Beach area. if you need me to fax my copy to them I can if you
> > > email back on who it is.
> > > Charles Brown
1 of 1 3/25/02 3:53 PA
a) Ia
Date.
To: [KR' O
?FRO
?WaRO
?WiRO
?WSRO
?ARO
?MRO
Steve Mitchell
Ken Averitte
Deborah Sawyer
Joanne Steenhuis
Jennifer Frye
Mike Parker
Pete Colwell
Triage Check List
x ?wf
v ? l I ! t Ir1? g,,? -t
` Project Nam /
/
DWQ Project Number OD 00-7
1
County ( A < c/
From. j Telephone (919)733-
The file attached is being forwarded to you for your evaluation. Please call if you need
assistance.
? Stream length impacted
? Stream determination
? "and determination and distance to blue-line surface waters on USGW topo maps
,
Minimization/avoidance issues
? Buffer Rules (Neuse, Tar-Pamilco, 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 concerns
Comments
'''C?Y _ "=.'?." ?+?i..tt??;? '?;'.' •J - ?-J-,? '.?• -?-$,?,-'? w.'??:. ? $ ?t7.v ? wr'a 2 a? e.. .? _ _:
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- yip-•+- ..e::-..f< <?,t. roc ?•s ?+,r. -5-,.r?? c 3 .rf _ •, i

JAN 17 2002
REGULATORY
WILMINGTON FIELD OFFICE
FED
Pre-Construction Notification (PCN) Application Ford
For Section 404 and/or Section 10 Nationwide, Regional and General Permits, Section 401
General Water Quality Certifications, and Riparian Buffer and Watershed Buffer Rules
This form is to be used for projects qualifying for any of the U.S. Army Corps of Engineers' (?JSACE)
Nationwide, Regional or General Permits as required by Section 404 of the Clean Water Act and/or
Section 10 of the Rivers and Harbors Act, and for the North Carolina Division of Water Quality's
(DWQ) associated General 401 Water Quality Certifications. This form is also to be used for any
project requiring approval under any Riparian Buffer Rules implemented by the N.C. Division of Water
Quality. This form should not be used if you are requesting an Individual 404 Permit or Individual 401
Water Quality Certification. The USACE Individual Permit application form is available online at
http://www.saw.usace.anny.mil/wetlands/Penn app htm.
The USACE is the lead regulatory agency. To review the requirements for the use of Nationwide,
Regional or General permits, and to determine which permit applies to your project, please go to the
USACE website at http://www.saw.usace.army.miI/wetlands/reatour.htm, or contact one of the field
offices listed on page 3 of this application. The website also lists the responsible project manager for
each county in North Carolina and provides additional information regarding the identification and
regulation of wetlands and waters of the U.S.
The DWQ issues a corresponding Certification (General or Individual), and cannot tell the applicant
which 401 Certification will apply until the 404 Permit type has been determined by the USACE.
Applicants are encouraged to visit DWQ's 401/Wetlands Unit website at
http://h2o.enr.state.ne.us/ncwetlaiids to read about current requirements for the 401 Water Quality
Certification Program and to determine whether or not Riparian Buffer Rules are applicable. The
applicant is also advised to read the full text of the General Certification (GC) matching the specific 404
Permit requested. In some cases, written approval for General Certifications is not required, provided
that the applicant adheres to all conditions of the GC. Applicants lacking access to the internet should
contact DWQ's Central Office in Raleigh at [phone].
Trout Waters Coordination - Special coordination with the North Carolina Wildlife Resources
Commission (NCWRC) is required for projects occurring in any of North Carolina's twenty-five
counties that contain trout waters. In such cases, the applicant should contact the appropriate NCWRC
regional coordinator (listed by county on page 4 of this application).
Page 1 of 12

Coastal Area Management Act (CAMA) Coordination - If the project occurs in any of North Carolina's
twenty coastal counties (listed on page 4) the applicant should contact the North Carolina Division of
Coastal Management (DCM). DCM will determine whether or not the project is within a designated
Area of Environmental Concern, in which case DCM will act as the lead permitting agency. In such
cases, DCM will require a CAMA Permit and will coordinate the 404/401 Permits.
The applicant may also choose to coordinate with the United States Fish and Wildlife Service to ensure
that the proposed project will have no impact upon any endangered or threatened species or critical
habitat as regulated by the Endangered Species Act, and the State Historic Preservation Office, North
Carolina Department of Cultural Resources to ensure that the proposed project will have no impact upon
any properties listed or eligible for listing on the National Register of Historic Places. Compliance with
these regulations is required to be eligible for any Department of the Army permit. The addresses for
both agencies are listed on page 3 of this application.
USAGE Permits - Submit one copy of this form, along with supporting narratives, maps, data forms,
photos, etc. to the applicable USACE Regulatory Field Office. Upon receipt of an application, the
USACE will determine if the application is complete as soon as possible, not to exceed 30 days. This
PCN form is designed for the convenience of the applicant to address information needs for all USACE
Nationwide, Regional or General permits, as well as information required for State authorizations,
certifications, and coordination. Fully providing the information requested on this form will result in a
complete application for any of the USACE Nationwide, Regional or General permits. To review the
minimum amount of information that must be provided for a complete PCN for each USACE
Nationwide permit, see Condition 13, 65 Fed. Reg. 12893 (March 9, 2000), available at
http://www.saw.usace.army.mil/wetlands/nwpfinalFedReg.pdf. Processing times vary by permit and
begin once the application has been determined to be complete. Please contact the appropriate
regulatory field office for specific answers to permit processing periods.
401 Water Quality Certification or Buffer Rules - All information is required unless otherwise stated
as optional. Incomplete applications will be returned. Submit seven collated copies of all USACE
Permit materials to the Division of Water-Quality, 401/Wetlands Unit 1650 Mail Service Center,
Raleigh, NC, 27699-1650- If written approval is required or specifically requested fora Ol
Certification, then a non-refundable application fee is required. In brief, if project impacts include less
than one acre of cumulative wetland/water impacts and less than 150 feet cumulative impacts to
streams, then a fee of $2.00 is required. If either of these thresholds is exceeded, then a fee of $475 is
required. Ache ck-mdde out to the North Carolina Division of Water Quality, with the specific name of
the project or applicant identified, should be stapled to the front of the application package. For more
information, see the DWQ website at http://h2o.ehnr.state.nc.us/ncwetlands/fees.html. The fee must be
attached with the application unless the applicant is a federal agency in which case the check may be
issued from a separate office. In such cases, the project must be identifiable on the U.S. Treasury check
so that it can be credited to the appropriate project. If written approval is sought solely for Buffer Rules,
the application fee does not apply, and the applicant should clearly state (in a cover letter) that only
Buffer Rule approval is sought in writing. Wetlands or waters of the U.S. may not be impacted prior to
issuance or waiver of a Section 401 Water Quality. Certification. Upon receipt of a complete application
for a 401 Certification, the Division of Water Quality has 60 days to prepare a written response to the
applicant. This may include a 401 Certification, an on-hold letter pending receipt of additional
requested information, or denial.
Page 2 of 12

US Army Corps Of Engineers Field Offices and County Coverage

Asheville Regulatory Field Office Alexander Caldwell Haywood McDowell Swain
US Army Corps of Engineers Alleghany Catawba Henderson Mecklenburg Transylvania
151 Patton Avenue Ashe Cherokee Iredell Mitchell Union
Room 208 Avery Clay Jackson Polk Watauga
Asheville, NC 28801-5006 Buncombe Cleveland Lincoln Rowan Yancey
Telephone: [phone] Burke Gaston Macon Rutherford
Fax: [phone] Cabarrus Graham Madison Stanley
Raleigh Regulatory Field Office Alamance Franklin Nash Surry
US Army Corps Of Engineers Caswell Forsyth Northampton Vance
6508 Falls of the Neuse Road Chatham Granville Orange Wake
Suite 120 Davidson Guilford Person Warren
Raleigh, NC 27615 Davie Halifax Randolph Wilkes
Telephone: [phone] Durham Johnston Rockingham Wilson
Fax: [phone] Edgecombe Lee Stokes Yadkin
Washington Regulatory Field Office Beaufort Currituck Jones Pitt
US Army Corps Of Engineers Bertie Dare Lenoir Tyrrell
Post Office Box 1000 Camden Gates Martin Washington
Washington, NC 27889-1000 Carteret* Green Pamlico Wayne
Telephone: [phone] Chowan Hertford Pasquotank
Fax: [phone] Craven Hyde Perquimans *Croatan National Forest Only
on Regulatory Field Offic Anson Duplin Onslow
Corps Of Engineers Bladen Harnett Pender
e Box 1890 Brunswick Hoke Richmond
jhTu
on, NC 28402-1890 Carteret Montgomery Robeson : [phone] Columbus Moore Sampson
251-4025 Cumberland New Hance Scptland
? North Carolina Sta?Age i??'??
?/?? .i,'4/- ,,lJ
Division of Water Quality ' Division of Water Quality State Historic Preservation Office
401 Wetlands Unit Wetlands Restoration Program Department Of Cultural Resources
1650 Mail Service„Center 1619 Mail Service Center 4617 Mail Service Center
Raleigh, NC 27699-1650 Raleigh, NC 27699-1619 Raleigh, ITC 27699-4617
Telephone: [phone] Telephone: [phone] Telephone: [phone]
Fax: [phone]" Fax: [phone] Fax: [phone]
LOT
??/? S??L?????s-Itffof ?-? ?sS1A-f) 7:;;'
?? 3fAd US Fish and Wildlife Service / Nationdal Marine Fisheries Service
US Fish and Wildlife Service US Fish and Wildlife Service National Marine Fisheries Service
Raleigh Field Office Asheville Field Office Habitat Conservation Division
Post Office Box 33726 160 Zillicoa Street Pivers Island
Raleigh, NC 27636-3726 Asheville, NC 28801 Beaufort, NC 28516
Telephone: [phone] Telephone: [phone] Telephone: [phone]
_' ,
:,. 7 j??.Zj r f?;''tT°? Page 3 of 12

Division of Coastal Management
1638 Mail Service Center
Raleigh, NC 27699-1638
Telephone: [phone]
Fax: [phone]
Western Piedmont Region Coordinator
3855 Idlewild Road
Kernersville, NC 27284-9180
Telephone: [phone]
Mountain Region Coordinator
20830 Great Smoky Mtn. Expressway
Waynesville, NC 28786
Telephone: [phone]
Fax: [phone]
CAMA and NC Coastal Counties
Beaufort Chowan
Bertie Craven
Brunswick Currituck
Camden Dare
Carteret Gates
Hertford Pasquotank
Hyde Pender
New Hanover Perquimans
Onslow Tyrrell
Pamlico Washington
NCWRC and NC Trout Counties
Alleghany Caldwell
Ashe Mitchell
Avery Stokes
Burke Surry
Buncombe Henderson
Cherokee Jackson
Clay Macon
Graham Madison
Haywood McDowell
Watauga
Wilkes
Polk
Rutherford
Swain
Transylvania
Yancey
APPLICATION FORM BEGINS ON PAGE 5. PLEASE DO NOT SUBMIT PAGES 1 - 4.
Page 4 of 12

.
1 t
Office Use Only:
USACE Action ID No.
DWQ No.
Form Version October 2001
If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A" rather than
leaving the space blank.
1.
II.
Processing CE
1. Check all of the approval(s) requested for this project: JAN 17 2002
® Section 404 Permit
Section 10 Permit REGULATORY
401 Water Quality Certification WILMINGTON FIELD OFFICE
Riparian or Watershed Buffer Rules
2. Nationwide, Regional or General Permit Number(s) Requested: Ntnl? ??
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: ?
Applicant Information
1. Owner/Applicant Ipprmati
Name:
Mailing Address:
/,

Telephone; Number: Fax Number:
E-mail Address:
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:
E-mail Address:
Fax Number:
Page 5 of 12
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 decOerable maps are provided.
Name of project: /V/
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN):
44. Location
County: Near ,Town: ? -jlewv L/
t
Subdivision name (include phase/lot number): erAeef / ?,
Directions to site (include road numbers, landmarks, etc.): f! ;;W
4661-e-_ e4-1
5. Site coordinates, if available (UTM or Lat/Long):
(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:
7ed-- /--/- ?? eP 4,e?s- ??w?3??a© 5?. © S< ? 'i??E a?ersy s yc>,?t sue'
9?k 7. Property size (acres):
-?8. Nearest body of water (stream/river/sound/ocean/lake):
9. River
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at littp://h2o.eiir.state.nc.tis/adrnin/maps/.)
Page 6 of 12

10. Describe the purpose of the proposed work: /o
sw- C7
*11. List the type of equipment to be used to construct the proj ect:
12. Describe the land use in the vicinity of this project

/tie- 62?'V AP1///5 ,-OA1

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. A ®M e k 0 A//?y-
V!5 -
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and pCaa ro?v}'de justification for the exclusion of this work from the current application:
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. Wetland Impacts
t
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***
sld iV

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: mechanized clearing, grading, fill,
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 httu://www•fenia.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: Ol-y/Izr?-- lelk-
Total area of wetland impact proposed:
2. Stream Impacts, including all intermittent and perennial streams
Stream Impact
Site Number
indicate on ma)
Type of Impact* Length of
Impact
linear feet)
Stream Name** Average Width
of Stream
Before Impact Perennial or
Intermittent?
leases ec

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: cuiverts and associated rip-rdp,
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
%vevw.usQs.gov. Several internet sites also allow direct download and printing of USGS maps (e.g., www.topozone.com,
L%,ww.mapguest.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site:
Page 8 of 12

3. Open Water Impacts, including Lakes, Ponds, Estuaries, Sounds, Atlantic Ocean and any
other Water of the U.S.
Open Water Impact Area of Type of Waterbody
Site Number Type of Impact* Impact Name of Waterbody (lake, pond, estuary, sound,
indicate on ma acres) (if applicable)
ba , ocean, etc.)
* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: fill, excavation, dredging,
flooding, drainage, bulkheads, etc.
4. Pond Creation ?
If construction of a pond s ?posed, 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.
?D DT?//?-? X171=/?ir?.?T/t//C- T
G(/Lr9S /?7d?s /1 1/ /I
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.
Page 9 of 12

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 environmen 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.n.c.us/ncwetlands/strmgide.htm].
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 mechani.:m (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. I?
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:/ih2o.eni-.state.nc.us/wEp/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.
X.
Environmental Documentation (DWQ Only)
Does the project involve an expenditure of public funds or the use of public (federal/state/local)
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 ?
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 213 .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 ? 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
fi Gone 1 extends out sU feet perpendicular from near bank of channel; Zone 2 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
identif
ied within 15A NCAC 2B .0242 or.0260.
XI. Stormwater (DWQ Only) A
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.
XII. Sewage Disposal (DWQ Only) /v
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewatW generated fro?the proposed project, or available capacity of the subject facility.
XIII. Violations (DWQ Only)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H.0500) or any Buffer Rules?
Yes ? No ?
Is this an after-the-fact permit application?
Yes
11 1 No ?
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).
?? e.POc`-,? T lG? G l?/T/? G?•P??' o` ? /•t?F?7,2S 12c?"TG/?it?J G%GG /

///D/1Z
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 12 of 12
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THIS CERTIFIES THAT THIS COPY OF THIS PLAT ACCURATELY
DEPTICTS THE BOUNDARY OF THE JURISDICTION OF SECTION 404 OF
THE CLEAN WATER ACT UNDER THE PRESENT LAW AND REGULATIONS AS
DETERMINED BY THE UNDERSIGNED ON THIS DATE. UNLESS THERE IS
A CHANGE IN THE LAW OR OUR PUBLISHED REGULATIONS. THIS
DETERMINATION OF SECTION 404 JURISDICTION MAY BE RELIED JJUI1PUUO?NN
FOR A PERIOD DETERMINATION NWASTMADE UTILIZING THE 19870C0 PI OF OkagTWEERS'NA""
WETLANDS EL I~NEA ION MANUAL. ?N CARD ,'Y!
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----------- - ---
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WETLANDS DATA

POINT BEARING DIST.
95

96 N 37'07'48' E
N 01' 56'48' E 3.14
22.17
97
S 85'41'30' E
7.57
98
99 N 12'11'25' E 32.98
00 N 14'54'24' W 21.09
101 N 32'03'23' W 14.15

101A N 17'08'45'W 12.39
N 17.08'45' W 7.30'
102 N 04'43'20' E 36.32'
103
N 08'52'00' E 21.80'
104;

105 N 58'04'35' E 25.32'
N 4718'50 E 12.85'
106 S 52'46'13' E 23.9
07
Iv
S 41'22'35' E
22.53'
108
S 25'51'43' E 27.84'
109
S 59.40'29' E 14.97'
110
S 00'49'23'W 16.04'
iii
S 89'34'41' W 19.36'
112
S 50'56'43' W 20.83'
113
S 19.35'20' W 14.81
114 S 01'14'08' E 22.59
115 N 89'28'35' E 31.71
116 S 36'11'23' E 28.09
117 S 84'47'17' W 39.67
,is S 17'13'36' E 13.02
119
120 N 58'12'41' W 22.82
S 02'56'48' E 27.32
121
122 S 61'22'59' W 16.09
60' 30' 0 60' 120'
SCALE: 1' = 60'
RENCES:
WETLANDS SURVEY (?
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MOREHEAD TWSP.,CARTERET COUNTY. NORTH CAROLINA
CLIENT: J. DON EVERHART SURVEYED:
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MY CO SSTON E% ES NOVEMBER 15, 2000 ?w 9 r
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'•. • MOREHEAD CITY, N.C. 28557 3/25/96
•••••
[phone]
efET 10F 1 C.O13
SCALE
ROJECT NO. PIA-812 g0'.ns?za4e'?° E. GLENN CORBETT, R.L.S. 1' = 60'
\O?QF W AT?c9oG
C11 r
o -c
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Gregory J. Thorpe, Ph.D.
Acting Director
Division of Water Quality
January 30, 2002
DWQ # 02-0074
Wake County
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
Philip Brewer
214 Smith Street
Atlantic Beach, NC 28512
Dear Mr. Brewer:
On January 16, 2002 the Division of Water Quality (DWQ) was notified by receipt of your application
regarding your plan to fill streams, wetlands or buffers for the purpose of constructing a home in Wake County.
Approval from DWQ is required to distarb these areas. The enclosed application needs to be completed and
returned to us with 7 copies of the application, supporting maps and documentation. In particular as described
in 15A NCAC 213 .0502, we will require you to:
1. Provide a location map,
2. Provide a site plan which shoes location of any wetlands, streams or buffers and the proposed
development, and
3. Complete the following items on the application form #'s: 4, 5, 6, 7, 8, 9, 10, 11, 12; IV; VI.
Please show these on maps of suitable scz'e (for i ---,tance 1" = 100 feet) so we can begin to determine your
projects' compliance with 15A NCAC 2H -0-500- We are hereby returning your application package since we
cannot process this incomplete appbcal~or;_
Please telephone me at 919-733-1756 if you have any questions or would require copies of our rules or
procedural materials. This project wU 1 mazil cr hold as incomplete in accordance with 15A NCAC 2H
.0505(c). The pr6cessing time for this aupBicaxion rill begin when this information is received. If we do not
hear from you by writing within three G) we-] - we :;gill assume you no longer want to pursue the project and
will consider it withdrawn.
Aiomn
uality rtif ation Program
cc: Raleigh DWQ Regional Office
Raleigh Corps of Engineers
Central Files
File Copy
Wedands/401 Unit 1650 Mail Service Center =? ejej r;, NC Z7699-1 e60 Ph: [phone] Fax: [phone]
Awh
ERR
Customer Service
1 800 623-7748

4
.a

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QG
3 2
j3 Pre-Construction Notification (PCN) Application Form

v
For Section 404 and/or Section 10 Nationwide, Regional and General Permits, Section 401
General Water Quality Certifications, and Riparian Buffer and Watershed Buffer Rules
This form is to be used for projects qualifying for any of the U.S. Army Corps of Engineers' (USACE)
Nationwide, Regional or General Permits as required by Section 404 of the Clean Water Act and/or
Section 10 of the Rivers and Harbors Act, and for the North Carolina Division of Water Quality's
(DWQ) associated General 401 Water Quality Certifications. This form is also to be used for any
project requiring approval under any Riparian Buffer Rules implemented by the N.C. Division of Water
Quality. This form should not be used if you are requesting an Individual 404 Permit or Individual 401
Water Quality Certification. The USACE Individual Permit application form is available online at
htt2://www.saw.usace.army.mil/wetlands/Perm app htm.
The USACE is the lead regulatory agency. To review the requirements for the use of Nationwide,
Regional or General permits, and to determine which permit applies to your project, please go to the
USACE website at http://www.saw.usace.an-ny.mil/wetlands/r"tour.htm, or contact one of the field
offices listed on page 3 of this application. The website also lists the responsible project manager for
each county in North Carolina and provides additional information regarding the identification and
regulation of wetlands and waters of the U.S.
The DWQ issues a corresponding Certification (General or Individual), and cannot tell the applicant
which 401 Certification will apply until the 404 Permit type has been determined by the USACE.
Applicants are encouraged to visit DWQ's 401/Wetlands Unit website at
http://h2o.enr.state.nc.us/ncwetlands to read about current requirements for the 401 Water Quality
Certification Program and to determine whether or not Riparian Buffer Rules are applicable. The
applicant is also advised to read the full text of the General Certification (GC) matching the specific 404
Permit requested. In some cases, written approval for General Certifications is not required, provided
that the applicant adheres to all conditions of the GC. Applicants lacking access to the internet should
contact DWQ's Central Office in Raleigh at [phone].
Trout Waters Coordination - Special coordination with the North Carolina Wildlife Resources
Commission (NCWRC) is required for projects occurring in any of North Carolina's twenty-five
counties that contain trout waters. In such cases, the applicant should contact the appropriate NCWRC
regional coordinator (listed by county on page 4 of this application).
Page 1 of 12
n ( ?
Coastal Area Management Act (LAMA) Coordination - If the project occurs in any of North Carolina's
twenty coastal counties (listed on page 4) the applicant should contact the North Carolina Division of
Coastal Management (DCM). DCM will determine whether or not the 'proj ect is within a designated
Area of Environmental Concern, in which case DCM will act as the lead permitting agency. In such
cases, DCM will require a CAMA Permit and will coordinate the 404/401 Permits.
The applicant may also choose to coordinate with the United States Fish and Wildlife Service to ensure
that the proposed project will have no impact upon any endangered or threatened species or critical
habitat as regulated by the Endangered Species Act, and the State Historic Preservation Office, North
Carolina Department of Cultural Resources to ensure that the proposed project will have no impact upon
any properties listed or eligible for listing on the National Register of Historic Places. Compliance with
these regulations is required to be eligible for any Department of the Army permit. The addresses for
both agencies are listed on page 3 of this application.
USACE Permits - Submit one copy of this form, along with supporting narratives, maps, data forms,
photos, etc. to the applicable USACE Regulatory Field Office. Upon receipt of an application, the
USACE will determine if the application is complete as soon as possible, not to exceed 30 days. This
PCN form is designed for the convenience of the applicant to address information needs for all USACE
Nationwide, Regional or General permits, as well as information required for State authorizations,
certifications, and coordination. Fully providing the information requested on this form will result in a
complete application for any of the USACE Nationwide, Regional or General permits. To review the
minimum amount of information that must be provided for a complete PCN for each USACE
Nationwide permit, see Condition 13, 65 Fed. Reg. 12893 (March 9, 2000), available at
http://www.saw.usace.army.mil/wetlands/nwpfinalFedReg_pdf. Processing times vary by permit and
begin once the application has been determined to be complete. Please contact the appropriate
regulatory field office for specific answers to permit processing periods.
401 Water Quality Certification or Buffer Rules - All information is required unless otherwise stated
as optional. Incomplete applications will be returned. Submit seven collated copies of all USACE
Permit materials to the Division of Water Quality, 401/Wetlands Unit 1650 Mail Service Center,
Raleigh, NC, 27699-1652 If written approval is required or specifically requested for a-701
Certification, then a non-refundable application fee is required. In brief, if project impacts include less
than one acre of cumulative wetland/water impacts and less than 150 feet cumulative impacts to
streams, then a fee of $200 is required. If either of these thresholds is exceeded, then a fee of $475 is
required. A checker lade out to the North Carolina Division of Water Quality, with the specific name of
the project or applicant identified, should be stapled to the front of the application package. For more
information, see the DWQ website at http://h2o.chnr.state.nc.us/ncwetlands/fees.html. The fee must be
attached with the application unless the applicant is a federal agency in which case the check may be
issued from a separate office. In such cases, the project must be identifiable on the U.S. Treasury check
so that it can be credited to the appropriate project. If written approval is sought solely for Buffer Rules,
the application fee does not apply, and the applicant should clearly state (in a cover letter) that only
Buffer Rule approval is sought in writing. Wetlands or waters of the U.S. may not be impacted prior to
issuance or waiver of a Section 401 Water Quality Certification. Upon receipt of a complete application
for a 401 Certification, the Division of Water Quality has 60 days to prepare a written response to the
applicant. This may include a 401 Certification, an on-hold letter pending receipt of additional
requested information, or denial.
Page 2 of 12

fvfq
US Army Corps Of Engineers Field Offices and County Coverage
Asheville Regulatory Field Office Alexander Caldwell Haywood McDowell Swain
US Army Corps of Engineers Alleghany Catawba Henderson Mecklenburg Transylvania
151 Patton Avenue Ashe Cherokee Iredell Mitchell Union
Room 208 Avery Clay Jackson Polk Watauga
Asheville, NC 28801-5006 Buncombe Cleveland Lincoln Rowan Yancey
Telephone: [phone] Burke Gaston Macon Rutherford
Fax: [phone] Cabarrus Graham Madison Stanley
Raleigh Regulatory Field Office Alamance Franklin Nash Surry
US Army Corps Of Engineers Caswell Forsyth Northampton Vance
6508 Falls of the Neuse Road Chatham Granville Orange Wake
Suite 120 Davidson Guilford Person Warren
Raleigh, NC 27615 Davie Halifax Randolph Wilkes
Telephone: [phone] Durham Johnston Rockingham Wilson
Fax: [phone] Edgecombe Lee Stokes Yadkin
Washington Regulatory Field Office Beaufort Currituck Jones Pitt
US Army Corps Of Engineers Bertie Dare Lenoir Tyrrell
Post Office Box 1000 Camden Gates Martin Washington
Washington, NC 27889-1000 Carteret* Green Pamlico Wayne
Telephone: [phone] Chowan Hertford Pasquotank
Fax: [phone] Craven Hyde Perquimans *Croatan National Forest Only
Wilmington Regulatory Field
US Army Corps Of Engineers
Post Office Box 1890
Wilmington, NC 28402-1890
Telephone: [phone]
Fax: [phone]_/-'
-Vwlt ` "S
W
Division of Water Quality
401 Wetlands Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
Telephone: [phone]
Fax: [phone] /
Anson Duplin Onslow
Bladen Harnett Pender
Brunswick Hoke Richmond
Carteret Montgomery Robeson
Columbus Moore Sampson
Cumberland Scotland
New Hang
`

North Carol ina StaA?e ies? 7?
greL?/K/1 /11 7??0'l4l-
Division of Water Quality
Wetlands Restoration Program
1619 Mail Service Center
Raleigh, NC 27699-1619
Telephone: [phone]
Fax: [phone]
State Historic Preservation Office
Department Of Cultural Resources
4617 Mail Service Center
Raleigh, NC 27699-4617
Telephone: [phone]
Fax: [phone]
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US Fish and Wildlife Service / National Mariue? her es Servie1 Wr,4?
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US Fish and Wildlife Service US Fish and Wildlife Service National Marine Fisheries Service
Raleigh Field Office Asheville Field Office Habitat Conservation Division
Post Office Box 33726 160 Zillicoa Street Pivers Island
Raleigh, NC 27636-3726 Asheville, NC 28801 Beaufort, NC 28516
Telephone: [phone] Telephone: [phone] Telephone: [phone]
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CAMA and NC Coastal Counties
Division of Coastal Management Beaufort Chowan Hertford Pasquotank
1638 Mail Service Center Bertie Craven Hyde Pender
Raleigh, NC 27699-1638 Brunswick Currituck New Hanover Perquimans
Telephone: [phone] Camden Dare Onslow Tyrrell
Fax: [phone] Carteret Gates Pamlico Washington
NCWRC and NC Trout Counties
Western Piedmont Region Coordinator Alleghany Caldwell Watauga
3855 Idlewild Road Ashe Mitchell Wilkes
Kemersville, NC 27284-9180 Avery Stokes
Telephone: [phone] Burke Surry
Mountain Region Coordinator Buncombe Henderson Polk
20830 Great Smoky Mtn. Expressway Cherokee Jackson Rutherford
Waynesville, NC 28786 Clay Macon Swain
Telephone: [phone] Graham Madison Transylvania
Fax: [phone] Haywood McDowell Yancey
APPLICATION FORM BEGINS ON PAGE 5. PLEASE DO NOT SUBMIT PAGES 1 - 4.
Page 4 of 12
Office Use Only: Form Version October 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.
1. Processing
1. 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
2. Nationwide Regional or General Permit Number(s) Requested: Nfn?P ??
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: ?
II. Applicant Information
1. Owner/Applicant Ipprmation 12 r ?
Name: l1161/O tir
Mailing Address: /
2
Telephone Number:
E-mail Address:
Fax Number:
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:
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 dec?pherable maps are provided.
1. Name of proj
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN):
4. Location
County:_
Nearest Town:
Subdivision name (include phase/lot number):
Directions to site (include road numbers, landmarks, etc
Site coordinates, if available (UTM or Lat/Long):
(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:
7. Property size (acres):
8. Nearest body of water (stream/river/sound/ocean/lake):
9. River Basin:
(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.ne.us/admin/maps/.)
Page 6 of 12
10. Describe the purpose of the proposed work:
11. List the type of equipment to be used to construct the project:
12. Describe the land use in the vicinity of this project:
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 pro,v}de justification for the e? ?clusion of this work from the current application:
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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. Wetland Impacts
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 include, but are not limited to: mechanized clearing, grading, fill,
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 http://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:
Total area of wetland impact proposed:
2. Stream Impacts, including all intermittent and perennial streams
Stream Impact
Site Number
indicate on ma
Type of Impact* Length of
Impact
linear feet
Stream Name** Average Width
of Stream
Before Impact Perennial or
Intermittent?
leasespecify)

* List each impact separately and identify 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/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.usgs.,gov. Several internet sites also allow direct download and printing of USGS maps (e.g., www.topozone.com,
www.mapguest.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site:
Page 8 of 12
3. Open Water Impacts, including Lakes, Ponds, Estuaries, Sounds, Atlantic Ocean and any
other Water of the U.S.
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,
bay, ocean, etc.
y

---- ...i...... ....F... --y -u "i u.y w LIPUlaiy uuNacw. uttpccLs mciuae, out are not nmited to: till, excavation, dredging,
flooding, drainage, bulkheads, etc.
4. Pond Creation /y
If construction of a pond 's 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 duringg construction to reduce impacts.
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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.
Page 9 of 12
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/newetlaiids/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) 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/wM/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 (DWQ Only)
Does the project involve an expenditure of public funds or the use of public (federal/state/local)
land?
Yes ? No e
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 (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 ? 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
Gone 1 extends out 30 feet perpendicular from near bank of channel; Zone 2 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 (DWQ Only) Al
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.
XII. Sewage Disposal (DWQ Only) /v
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from, e proposed project, or available capacity of the subject facility.
XIII. Violations (DWQ Only)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes ? No ?
Is this an after-the-fact permit application?
Yes ? No ?
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).
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Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
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