20020135 Ver 1_COMPLETE FILE_20020129

sR 0 1
0 North Carolina Wildlife Resources Commission 0
Charles R. Fullwood, E,xecutlVC Director
MEMORANDUM
TO: Tim Smith, Permit Coordinator, Asheville Office
U.S. Army Corps of Engineers
FROM: Ron Linville, Regional Coordinator, Habitat Conservatib?'i is' r? 1 ar`t f , ? ?E ?'
North Carolina Wildlife Resources Commission by J. t?. i_iriv
DATE: January 30, 2002
SUBJECT: Review of an Application by Eddie W. Barbee, NWP 14, Unnamed
Tributary of Elk Creek, Watauga County
The applicant is requesting a letter of concurrence from the North Carolina
Wildlife Resources Commission (NCWRC) to obtain a 404 permit from the U.S. Army
Corps of Engineers. The NCWRC has reviewed information provided by the applicant,
and field biologists on our staff are familiar with habitat values of the project area. These
comments are provided in accordance with provisions of the Clean Water Act of 1977
(33 U.S.C. 466 et. seq.) and the Fish and Wildlife Coordination Act (48 Stat. 401, as
amended; 16 U.S.C. 661-667d).
The applicant proposes to install a driveway crossing to access his property off
Elk Creek Road. Elk Creek is Hatchery Supported water and wild brook trout are found
in tributaries in the area. Based on the information provided by the applicant and our
information on the range of trout in the project area, we do not believe this project will
cause significant effects to waters supporting trout providing the following conditions are
implemented:
Instream work and land disturbance within the 25-foot wide buffer zone
are prohibited during the brown and brook trout spawning season of
October 15 through April 15 to protect the egg and try stages of trout from
off-site sedimentation during construction.
2. Stringent erosion control measures should be installed where soil is
disturbed and maintained until project completion. Temporary or
Mailing Address:
Division of Inland fisheries • 1721 Mail Service Center • Raleigh, NC 2 7699-1 72 1
Telephone: [phone] est. 281 • tax: [phone]
Eddie W. Barbee 2 January 30, 2002
permanent herbaceous vegetation should be planted on all bare soil within
5 days of ground disturbing activities to provide long-term erosion control.
3. Culverts 48" or larger should be buried approximately 1' into the
streambed. Culverts less than 48 inches in diameter should be buried to a
depth equal to or greater than 20% their size to allow for aquatic life
passage. The installation should be accomplished in a manner that
prevents damming or drop outlets on either end of the pipe in order to
maintain aquatic life passage. No damming or freefalling waters should
occur during low flow conditions. The upstream and downstream stream
dimensions should not be modified. Native species should be used for
streambank stabilization and shade.
4. If concrete will be used, work must be accomplished so that wet concrete
does not contact stream water. This will lessen the chance of altering the
stream's water chemistry and causing a fish kill.
5. The applicant should contact Jennifer Frye at 336-771-4600 with the
Division of Water Quality to determine if a 401 Certification is needed.
Thank you for the opportunity to review and comment on this project. If you
have any questions regarding these comments, please contact me at 336/769-9453.
Cc: Jennifer Frye, DWQ
OF WATER p Michael F. Easley
\O G Governor
Cij r William G. Ross, Jr., Secretary
Department of Environment and Natural Resources
O Gregory J. Thorpe, Ph.D.
Division of Water Quality
April 1, 2002
DWQ# 02-0135
Watauga County
Eddie Barbee
1540 Dutch Road
Mt. Pleasant, NC, 28124
APPROVAL of 401 Water Quality Certification
Dear Mr. Barbee:
You have our approval, in accordance with the attached conditions, to place fill in 30 linear feet of perennial streams in
order to construct a road crossing on your property in Watauga County, as you described in your application received by the
Division of Water Quality on January 29, 2002, and in additional correspondence received February 28, 2002. After
reviewing your application, we have decided that this fill is covered by General Water Quality Certification Number 3375,
which can be viewed on our web site at http://h2o.enr:state.nc.us/ncwetlands . This Certification allows you to use
Nationwide Permit Number 14 when issued by the U.S. Army Corps of Engineers. 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 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 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
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. 27611-7447. 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 Cyndi Karoly in our Central Office at 919-733-9721.
Sincerely,
J?l
J. Thor Ph.D
Attachments
cc: Corps of Engineers Asheville Regulatory Field Office
Raleigh DWQ Regional Office
Central Files
File Copy
020135
North Carolina Division of Water Quality, 401 Wetlands Certification Unit,
1650 Mail Service Center, Raleigh, NC 27699-1650 (Mailing Address)
2321 Crabtree Blvd., Raleigh, NC 27604-2260 (Location)
919-733-1786 (phone), 919-733-6893 (fax), http://h2o.enr.state nc.usrcwetlands/

Prc-Construction Notification (PCN) Application Form
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
http://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 army mil/wetlands/regtour 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 I
1 A
Office Use Only: Form Version October 2001
USACE Action Ill 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:
21?ection 404 Permit
? Section 10 Permit
['401 Water Quality Certification
? Riparian or Watershed Buffer Rules
2. Nationwide, Regional or General Permit Number(s) Requested: U
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 Information
Name: , , 1 Cd ?+r^ &.c
Mailing Address: I5r fp D"4Cmk Y
M? ?lr.?a?c ? nt.C. ?g ? ?.•?
Telephone Number: 76 q- 3 (.-.' W> 25 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 5
III. Project Information
Attach a vicinity map clearly showing the location of the property with respect to local
landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property
boundaries and development plans in relation to surrounding properties. Both the vicinity map
and site plan must include a scale and north arrow. The specific footprints of all buildings,
impervious surfaces, or other facilities must be included. If possible, the maps and plans should
include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property
boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion,
so long as the property is clearly defined. For administrative and distribution purposes, the
USACE requires information to be submitted on sheets no larger than 11 by 17-inch format;
however, DWQ may accept paperwork of any size. DWQ prefers full-size construction
drawings rather than a sequential sheet version of the full-size plans. If full-size plans are
reduced to a small scale such that the final version is illegible, the applicant will be informed that
the project has been placed on hold until decipherable maps are provided.
1. Name of project:
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN):
4. Location
County:_ ? " Nearest Town: P bo rl e-
Subdivision name (include phase/lot number):
5
6. Describe the existing land use or condition of the site at the time of this application:
f! ,Zr .7. Property size (acres):- /. 66 *.

8. Nearest body of water (stream/river/sound/ocean/lake): E4 Cl e e k
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 nc us/admiidmaps/.)
Page 6 of 6
Site coordinates, if available (UTM or Lat/Lorig):
(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.)
10. Describe the purpose of the proposed work: 4Eiv 40400- 4?te e-
11. List the type of equipment to be used to construct the project: 7t2! tA, #y-
12. Describe the land use in the vicinity of this project: A"Ir-
IV. Prior Project History
If jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Include
the USACE Action ID Number, DWQ Project Number, application date, and date permits and
certifications were issued or withdrawn. Provide photocopies of previously issued permits,
certifications or other useful information. Describe previously approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits issued for prior segments of the same T.I.P. _ project, along with
construction schedules.
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application:
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 7
Wetland Impacts
r
Wetland Impact
Site Number
(indicate on ma
p) Type of Impact* ;Area of
pact
res) Located within
100-year Floodplain
(yes/no) Distance to
Nearest Stream
(linear feet)
-- Type of Wetland**•k

-
._ ,.?

* List each impact se parately and identify temporary im pacts. Impacts include. but are not limiters t, , .i,,.,,.,o,
excavation, flooding, ditching/drainage, etc. For dams, separately list impacts due to both structure and floodingy1?Q1111Kt graumg, nu,
** 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 L
h

Site Number
(indicate on map)
Type of Impact* engt
of
Impact
(linear feet)
Stream Name** Average Width
of Stream
Before Im
act Perennial or
Intermittent?

(
l
p p
ease specify)

* List each impact separately and identify temporary impa cts Im act I d
p s me u e, but are not limped 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.mapgtiest.coni, etc.).
Cumulative impacts (linear distance in feet) to all streams on site:
Page 8 of 8
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
map)

Type of Impact* Area of

Impact
p
(acres)

Name of Waterbody
(if applicable) Type of
Waterbod
Y
(lake, pond, estuary, sound,

bay, ocean, etc.)

*--List each imnnot
-..,.--Y ....t,,...?. -"V"" utctuae, nut are not limited to: fill, excavation, dredging,
flooding, drainage, bulkheads, etc.
4. Pond Creation
If construction of a pond is proposed, associated wetland and stream impacts should be
included above in the wetland and stream impact sections. Also, the proposed pond should
be described here and illustrated on any maps included with this application.
Pond to be created in (check all that apply): [ uplands 0 stream wetlands
Describe the method of construction (e.g., dam/embankment, excavation, installation of
draw-down valve or spillway, etc.):
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.):
Size of watershed draining to pond: Expected pond surface area:
VII. Impact Justification (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It may be useful to provide
information related to site constraints such as topography, building ordinances, accessibility, and
financial viability of the project. The applicant may attach drawings of alternative, lower-impact
site layouts, and explain why these design options were not feasible. Also discuss how impacts
were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce impacts.
VIII. Mitigation
DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC
Division of Water Quality for projects involving greater than or equal to one acre of impacts to
freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial
streams.
Page 9 of 9
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-tis/newetiands/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 NC WRP. Please note that payment into the NC WRP 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/wrp/index,litni. 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 10

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
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 V
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 0 No [] If you answered "yes", provide the fol owing information:
Identify the square feet and acreage of impact to each zone of the riparian buffers. If ibuffer
mitigation is required calculate the required amount of mitigation by applying the buffer
multipliers.
Zone* I Impact Required
(square feet) Multiplier
Mitigation
3
2 1.5
Total
Zone 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 1 1 of 1 1

If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation
of Property, Conservation Easement, Riparian Buffer Restoration / Enhancement, Preservation or
Payment into the Riparian Buffer Restoration Fund). Please attach all appropriate information as
identified within 15A NCAC 213 .0242 or .0260.
XI. Stormwater (DWQ Only)
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)
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from the proposed project, or available capacity of the subject facility.
XIII. Violations (DWQ Only)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H.0500) or any Buffer Rules?
Yes J`am' No n
Is this an after-the-fact permit application?
Yes X No n
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).

`, , 21) , D
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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Wetland Impacts
Wetland lntpact
Site Number
(indicate on map)
Type of Impact* Area of
Impact
(acres) Located within
100-year Floodplain**
(yes/no) Distance to
Nearest Stream
(linear feet)
Type of Wetland***

I

# 7 L .
L ISL cac,l uuyact separauay and iucm.uy 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 map) Type of Impact* Length of
Impact
(linear feet) Stream Name** Average Width
of Stream
Before Impact ;(npleasespecify)
1 -it-ri b a .rte
-b lk Cr«K.

* List e t t l
ac i mipac separate y and identify temporary impacts. Impacts include, but are not limited to: culverts and associated rip-rap,
darns (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.inapgtiest.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site:
Page 8 of 8
Y
FEB
PLO
i s ?-
rJ6 //x
`?i erg ? fps' b t? ?
Grua S

/YLI
1. Wetland Impacts li', n.?
Wetland Impact
Site Number
(indicate on map)
Type of Impact* Area of
Impact
(acres) Located within
100-year Floodplain**
(yes/no) Distance to
Nearest Stream
(linear feet)
Type of Wetland***

I

-- l Oa IA uMy,aCL acha,atc,y auu ,ucnury temporary impacts. impacts include, out are not limited to: mechanized clearing, grading, till,
excavation, flooding, ditching/drainage, etc. For darns, 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 littp://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 map)
Type of Impact* Length of
Impact
(linear feet)
Stream Name** Average Width
of Stream
Before Impact
;(;Intermi
%specify)
C!N N* -{rib
L?tq
"- .Z FF
-b Lk ?«k

"' Iiste h' I
ac impact separate y 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.coni,
www.mapquestcom, etc.).
Cumulative impacts (linear distance in feet) to all streams on site:
Page 8 of 8
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JAN 2 91002

WAT,
Pre-Construction Notification (PCN) Application Form
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
http://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
USAGE website at http://www.saw.usace.army.mil/wetlands/regtour.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 1
.. R
Office Use Only:
Form Version October 2001
USACE Action Ill 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.
II.
Processing
1. Check all of the approval(s) requested for this project:
[?ection 404 Permit
n Section 10 Permit
[]'401 Water Quality Certification
Riparian or Watershed Buffer Rules
2. Nationwide, Regional or General Permit Number(s) Requested: y
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 Information
Name: . r- W
Mailing Address:
Telephone Number: 7e 4- 3 L-a. Lp Z> 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 5
III. Project Information P
Attach a vicinity map clearly showing the location of the property with respect to local
landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property
boundaries and development plans in relation to surrounding properties. Both the vicinity map
and site plan must include a scale and north arrow. The specific footprints of all buildings,
impervious surfaces, or other facilities must be included. If possible, the maps and plans should
include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property
boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion,
so long as the property is clearly defined. For administrative and distribution purposes, the
USACE requires information to be submitted on sheets no larger than 11 by 17-inch format;
however, DWQ may accept paperwork of any size. DWQ prefers full-size construction
drawings rather than a sequential sheet version of the full-size plans. If full-size plans are
reduced to a small scale such that the final version is illegible, the applicant will be informed that
the project has been placed on hold until decipherable maps are provided.
1. Name of project:
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN):
4. Location
County: R' R
-- W -?
Nearest Town:
Subdivision name (include phase/lot number):
Directions to site (include road numbers, landmarks, etc.;pop.. &0, .r- eft l L
5. Site coordinates,, if available (UTM or Ldt/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): (. 6 6 ,*.
8. Nearest body of water (stream/river/sound/ocean/lake): Eft C le e- e
9. River Basin:
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at htil)://h2o.eiir.state.iic.us/admiii/n-iaps/.)
Page 6 of'6

10. Describe the purpose of the proposed work: Ew 1Ar4a&. ?7G
11. List the type of equipment to be used to construct the project:_ 7t21rAA#
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 provide 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 7
1. Wetland Impacts
..'uauu IliiYact Area of Located within Distance to
Site Number Type of Impact* Impact 100-year Floodplain* * Nearest Stream
(indicate on map) (acres)
(yes/no) (linear feet)
**

"Type of Welland* * *
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 darns, 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
Site Number I Type of Impact* I Impact
dicate on map) (linear fet

-. ll iuiNttu 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, eta If stream relocation is
proposed, plans and profiles showing the linear footprint for both the original and relocated streams must be included.
Stream names can be found on USGS topographic maps. If a stream has ito manic, 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 usas goy. Several internet sites also allow direct download and printing of USGS maps (e.g., www.topozone com,
www_m-LPaLtiest.coni, etc.).
_.._
Cumulative impacts (linear distance in feet) to all streams on site:

ream Name** Average Width
of Stream
Before Impact Perennial or
Intermittent?
(please specify)

Page 8 of 8
Y
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 map)
Type of Impact* Area of
Impact
(acres)
Name of Waterbody
(if applicable) Type of Waterbod
y
(lake, pond, estuary, sound,
bay, ocean, etc.)

* List each impact se parately and identify tempora ry impacts Im acts ' 1 d
flooding, drainage, bulkheads, etc. Out p me u e, ut are not limited to, fill, excavation, dredging,
.
4. Pond Creation
If construction of a pond is proposed, associated wetland and stream impacts should be
included above in the wetland and stream impact sections. Also, the proposed pond should
be described here and illustrated on any maps included with this application.
Pond to be created in (check all that apply): [] uplands [] stream [] wetlands
Describe the method of construction (e.g., dam/embankment, excavation, installation of
draw-down valve or spillway, etc.):
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.):
Size of watershed draining to pond: Expected pond surface area:
VII. Impact Justification (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It may be useful to provide
information related to site constraints such as topography, building ordinances, accessibility, and
financial viability of the project. The applicant may attach drawings of alternative, lower-impact
site layouts, and explain why these design options were not feasible. Also discuss how impacts
were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce impacts.
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 9
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.ne.tis/ncwetlaiids/strmgide.html.
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
NC WRP is available as an option. For additional information regarding the application
process for the NCWRP, check the NCWRP website at hup://h2o.enr.state.nc.us/wrD/itidex.litm. If
use of the NC WRP 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):_
Y
Page 10 01' 10