20020628 Ver 1_COMPLETE FILE_20020424

of W ATFR
`off OG
c') r
o -c
May 21, 2002
DWQ# 02-0628
Forsyth County
Mr. Bob Burleson
RiverHills Developers, Inc.
4860 Curry Road
Kernersville, NC, 27284
APPROVAL of 401 Water Quality Certification with Additional Conditions, Wetland Restoration Program
Dear Mr. Burleson: 3 3 7S-
You have our approval, in accordance with the attached conditions, to place permanent fill in 280 linear feet of unnamed tributaries
to Abbotts Creek in order to construct road crossings at the Serenity Point subdivision in Forsyth County, as described in your application
received by the Division of Water Quality on April 24, 2002. After reviewing your application, we have determined that this fill is covered
by General Water Quality Certification Number 3'(9. This Certification allows you to use Nationwide Permit Number 14 when it is 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, 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 and the additional conditions listed
below:
We understand that you have chosen to contribute to the Wetland Restoration Program in order to compensate for the impacts to
streams. In accordance with 15A NCAC 2R .0402 and 15A NCAC 2B .0242(7), this contribution will satisfy our compensatory
mitigation requirements under 15A NCAC 2H .0506(h) and 15A NCAC 2B .0233(10). Until the Wetland Restoration Program receives
and clears your check (made payable to: DENR - Wetlands Restoration Program), stream impacts (including fill) shall not occur. Mr.
Ron Ferrell should be contacted at [phone] if you have any questions concerning the Wetland Restoration Program. You have
one month from the date of this Certification to make this payment. For accounting purposes, this Certification authorizes the fill of
280 linear feet of streams in the Yadkin River Basin, Cataloging Unit 03040101, and 280 linear feet of stream mitigation is required.
Please be aware that the Wetland Restoration Program (W RP) rules require rounding of wetland impacts to the nearest foot (15A
NCAC 2R.0503(b))."
2. Deed notifications or similar mechanisms shall be placed on all lots with remaining jurisdictional wetlands and waters or areas within
50 feet of all streams and ponds. These mechanisms shall be put in place within 30 days of the date of this letter or the issuance of
the 404 Permit (whichever is later). A sample deed notification format can be downloaded from the 401/Wetlands Unit web site at
htti):Hh2o.enr.state.nc.us/ncwetiands .
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 Raleigh at 919-733-9721.
? I L
J. Thorpe, Ph.D.
Michael F. Easley
Governor
William G. Ross, Jr., Secretary
Department of Environment and Natural Resources
Gregory J. Thorpe, Ph.D., Acting Director
Division of Water Quality
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.us/ncwetiands/
rage z oT z
NORTH CAROLINA-DIVISON OF WATER QUALITY
401 WATER QUALITY CERTIFICATION
SUMMARY OF PERMITTED IMPACTS AND MITIGATION REQUIREMENTS
In accordance with 15A NCAC 2 H.0500, Mr. Bob Burleson of RiverHills Developers, Inc. has permision as outlined below to fill
280 linear feet of streams in order to construct the Serenity Point subdivision in Forsyth County, North Carolina. All activities
associated with these authorized impacts must be conducted with the conditions listed in the attached certification. THIS
CERTIFICATION IS NOT VALID WITHOUT THE ATTACHMENTS.
COMPENSATORY MITIGATION REQUIREMENT
WETLAND RESTORATION PROGRAM
LOCATION:
COUNTY:
BASIN/SUBBASIN
Impacts:
280 linear feet of streams
Serenity Point subdivision
Forsyth
Yadkin (03-04-01-01)
As required by 15A NCAC 2H .0506, and the conditions of this certification, you are required to compensate for the above
impacts through the restoration, creation, enhancement or preservation of wetlands as outlined below prior to conducting any activities
that impact or degrade the waters of the state.
Mitigation:
280 linear feet of streams by W RP
Note: Linear foot requirements proposed to be mitigated through the Wetland Restoration Program must be rounded to the
nearest foot and acreage requirements must be rounded to one-quarter acre increments according to 15 2r.0503(b).
One of the options you have available to satisfy the compensatory mitigation requirements is through the payment of a fee to
the Wetlands Restoration Fund per NCAC 2R .0503. If you choose this option, please sign this form and mail it to the Wetlands
Restoration Fund at the address listed below. An invoice for the appropriate amount of payment will be sent to you upon receipt of this
form. PLEASE NOTE, THE ABOVE IMPACTS ARE NOT AUTHORIZED UNTIL YOU RECEIVE NOTIFICATION THAT YOUR
PAYMENT HAS BEEN PROCESSED BY THE WETLANDS RESTORATION PROGRAM.
Signature Date
WETLANDS RESTORATION PROGRAM
DIVISON OF WATER QUALITY
1619 Mail Service Center
RALEIGH, N.C. 27669-1619
[phone]
0W AT?RQG Michael F. Easley, Governor
William G. Ross Jr., Secretary
0 7 North Carolina Department of Environment and Natural Resources
Gregory J. Thorpe, Ph.D.
O -? Acting Director
Division of Water Quality
Ms. Denis Poulos
Engineering Consultants
6909 International Drive, Suite 103
Greensboro, North Carolina 27409
May 10, 2002

Subject: Project: Serenity Pointe
County: Forsyth ,h
DEW #: 020628
The purpose of this letter is to notify you that the North Carolina Wetlands Restoration Program
(NCWRP) is willing to accept payment for stream impacts associated with the subject project. Please note
that the decision by the NCWRP to accept the mitigation requirements of this project does not assure that this
payment will be approved by the U.S. Army Corps of Engineers and the N.C. Division of Water Quality
Wetlands/401 Unit. It is the responsibility of the applicant to contact these agencies to determine if payment
to the NCWRP for impacts associated with this project is appropriate.
This acceptance is valid for six months from the date of this letter. If we have not received a copy of
the issued 404 Permit and 401 Certification within this time frame, this acceptance will expire.
Based on the information supplied by you in a letter dated April 18, 2002, the stream restoration that
is necessary to satisfy the compensatory mitigation requirements for this project is summarized in the
following table. The maximum amount of mitigation that the NCWRP will accept for this project is also
indicated in this table.
Stream
(linear feet) Wetland
(ft2 or acres) Riparian Buffer
(ft)
Impact
280
Mitigation Maximum 560
The stream mitigation will be provided as specified in the 401 Water Quality Certification and/or
Section 404 Permit for impacts associated with the subject project in Cataloging Unit 03040101 of the
Yadkin River Basin. The mitigation will be performed in accordance with the Memorandum of
Understanding between the N.C. Department of 'Environment and Natural Resources and the U.S. Army
Corps of Engineers dated November 4, 1998.
If you have any questions or need additional information, please contact Crystal Braswell at (919)
733-5208.
Si rely
Ronald . Ferrell,
Program Manager
cc: Rob Ridings, Wetlands/401 Unit
Todd Tugwell, USACOE
Jennifer Frye, WSRO
file
NAW ASPA
Wetlands Restoration Program 1619 Mail Service Center Raleigh, NC 27699-1619 [phone] Customer Service
320 West Jones Street Raleigh, NC 27603 Fax: [phone] 623-7748 NTD[
ENGINEERING CONSULTING SERVICES, LTD.
Geotechnical • Construction Materials Environmental
I 1??ILI
April 18, 2002
Mr. John Dorney
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Wetland/401 Unit
1621 Mail Service Center
Raleigh, North Carolina 27699-1621 ®? Q
Subject:
Dear Mr. Dorney:
Please find seven copies of the Pre-Construction Notification Application for the above referenced
project.. The site is approximately 39.3 acres in area and is located on Serenity Point Drive in Winston-
Salem (Figure 1).: The site is being developed with Phase 3 of the Serenity Point residential subdivision.
The lots in the"subdivision are approximately one acre in-area. Upon completion, the impervious
surfaces in the development will be less than 30%.
Tributaries of Abbotts Creek cross the site. As shown on the Master Plan several roadways must be
constructed in order to develop the site. The roads will cross two tributaries of Abbotts Creek. Ms.
Cindy Karoly with NCDWQ has visited the site and determined that the streams on the site are perennial.
Crossing #1 is associated with Winterberry Place Trail. This crossing will impact approximately 135
linear feet of stream channel. ` Crossing #2 is also associated with Winterberry P1ace,Traii. This crossing
will impact approximately 145 linear feet of stream channel
The road is being built to NCDOT standards. In order to minimize impacts to the streams, headwalls and
endwalls will be used in the construction of the crossings. The rip-rap pad has been reduced to only 40
feet and a 72" pipe will be used to shorten the length of pipe in the channel In addition, the pipe will be
placed approximately one foot below the bottom of the existing stream channel.
6909 International Drive, Suite 103 • Greensboro, NC 27409 • [phone] • Fax [phone]
Offices: Aberdeen, MD • Atlanta, GA • Austin; TX • Baltimore, MD • Chantilly, VA • Charlotte, NC • Chicago, IL • Cornelia, GA `• Dallas, TX
Danville, VA • Frederick, MD - Fredericksburg, VA Greensboro-NC • Greenville, SC - Norfolk, VA Raleigh, NC • Richmond, VA
Roanoke, VA • San Antonio, TX • Williamsburg, VA+ Wilmington,;NC • Winchester, VA
Pre-Construction Notification Application
Serenity Point
Winston-Salem, Forsyth County, North Carolina
ECS Project G-6434
Section 401 Permitting
Serenity Point
ECS Project G-6439
We understand that mitigation will be, required for these impacts. We are requesting to make payment to
the NCWRP in order to satisfy the mitigation requirement.`
Please feel free to contact me at [phone] if you have any questions concerning this request or if
additional information is required Thank you in advance for your timely consideration of this matter.
Sincerely,
ENGINEERING CONSULTING SERVICES, LTD.
4?enise M. Poulos, LSS
Principal Scientist
Attachment: Pre-Construction Notification Application
$475.00 Application Fee
2
OFAT?? -
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.anny.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.arrny.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.ne.us/newetlands 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 l of 12
V
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.
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.anny.mil/wetlands/nvmfinalFedReg_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 for a 401
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 check made 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.ne.us/newetlands/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.
Wilmington Regulatory Field Office Anson Duplin Onslow
US Army. Corps Of Engineers Bladen Harnett Pender '
Post Office Box 1890 Brunswick Hoke Richmond
Wilmington, NC 28402-1890 Carteret Montgomery Robeson
Telephone: [phone] Columbus Moore Sampson
Fax: [phone] Cumberland New Hanover Scotland
North Carolina State Agencies
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, NC 27699-4617
Telephone: [phone] Telephone: [phone] Telephone: [phone]
Fax: [phone] Fax: [phone] Fax: [phone]
US Fish and Wildlife Service / National Marine Fishe ries 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]
Page 3 of 12

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
Kernersville, 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

If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A" rather than
leaving the space blank.
T. Processing
1. Check all of the approval(s) requested for this project:
X Section 404 Permit
? Section 10 Permit
X 401 Water Quality Certification
? Riparian or Watershed Buffer Rules
2. Nationwide, Regional or General Permit Number(s) Requested: NWP 14
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: X
II. Applicant Information
1. Owner/Applicant Information
Name: Mr. Bob Burleson, RiverHills Developers, Inc.
Mailing Address: 4860 Curry Road
Kernersville, NC 27284
Telephone Number: 336-869-6939 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: Denise M. Poulos
Company Affiliation: ECS, Ltd.
Mailing Address: 6909 International Drive, Suite 103
Greensboro, NC 27409
Telephone Number: 336-856-7150 Fax Number: 336-856-7160
E-mail Address: dpoulos(a)ecslimited.com
Page 5 of 12
TII. 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: Serenity Point
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN):
4. Location
County: Forsyth Nearest Town: Winston-Salem
Subdivision name (include phase/lot number): Serenity Point
Directions to site (include road numbers, landmarks, etc.): From I-40: south on Hwy 68;
north on Main Street; cross Abbotts Creek; right on Serenity Point Drive.
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: The site
is currently undeveloped pasture/wood land.
7. Property size (acres): 39.3 Acres
8. Nearest body of water (stream/river/sound/ocean/lake): Abbotts Creek
9. River Basin: Yadkin River
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http://h2o.enr.state.nc.us/admin/mgps/.)
Page 6 of 12
10. Describe the purpose of the proposed work:. The site is being developed with Phase 3 of
the Serenity Point subdivision. Roadways must be constructed to allow access to the
property.
11. List the type of equipment to be used to construct the project: Trucks, loaders, pans,
and trackhoes will be used to construct the project.
12. Describe the land use in the vicinity of this project:-Residential/Agricultural
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.
There have been no previous impacts to streams or wetlands associated with this project.
No 404/401 permits have been issued for the project.
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.
We do not anticipate that additional permits will be requested for this project.
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 Provide a brief written description of the proposed impacts: A road will be constructed
that will cross two tributaries of Abbotts Creek. The road is necessary to develop the
property with Phase 3 of the Serenity Point residential subdivision
2. Individually list wetland impacts below:
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 athttp://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 all existing wetlands on the property:
Total area of wetland impact proposed: NA
3. Individually list all intermittent and perennial stream impacts below:
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)
#1 Pipe 135 UT to Abbotts Creek 4-6 ft Perennial
#2 Pipe 145 UT to Abbotts Creek 4-6 ft Perennial

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.uses.Rov. Several internet sites also allow direct download and printing of USGS maps (e.g., www.topozone.com,
www.mapquest.com. etc.).
Cumulative impacts (linear distance in feet) to all streams on site: 280 linear feet
Page 8 of 12
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.

* L h
ist eac impact separately and identify temporary impacts. Impacts include, but are not limited to: fill, excavation, dredging,
flooding, drainage, bulkheads, etc.
5. 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.
In order to minimize impacts, end walls and headwalls will be used The rip pad has
been reduced to approximately 40 feet. A 72" diameter pipe will be used to shorten the
length of stream that will be piped. The bottom of the pipe will be placed one foot below
channel bottom to allow normal passage of water and aquatic organisms
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/ncwetlands/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.
We are proposing payment to NCWRP as mitigation for the proposed impacts Ms
Cyndi Karoly with NCDWQ has visited the site and stated that payment to NCWRP
would be an acceptable form of mitigation
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/M/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): 280 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 (federal/state) funds or the use of public
(federal/state) land?
Yes ? No X
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 required amount of mitigation by applying the buffer
multipliers.
Zone* Impact
(square feet` Multiplier Required
Mitigation
1 3
2 1.5
Total
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)
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.
The site _is_beine developed with a residential subdivision. The lots are approximately one
acre in area. Impervious surfaces will be less than 30%0.
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.
Each lot will have a private septic system.
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).
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 12 of 12
SOURCE:
USGS TOPOGRAPHIC MAP,
KERNERSVILLE NC LTD
QUADRANGLE DA'Z'ED 1969 AND REVISED 1994 rEN G INF:ERING
SCALE: I" = 2,000- N S U LTI N G
RN'ICES.LTD
FIGURE I
SITE LOCATION MAP
SERENITY POINT
SERENITY POINT DRIVE
WINSTON-SALEM, NC
ECS PROJECT G-6434
eugaeZ) t pioN •.o:) tp,Ssfo l
ty 5488 1kE o+l
1
48ISs8r)EE am19d N
l rape^ is
7?v•??Id J3^lsG (?y?
@?^'??'?/N NNkiMIL .rap^^N ia+4 A
Fj t p? ,.r tg8m11 rta •inx^^I•.n
u*c3??'•?, 3itm
?..,t.5 Iutod A'l tuaTas luls(01-Alxrd
sunoatu+q+ixr.}goz4 ^+^:pp+n NxiUx.r[a'^I^a
i. ---I s ' r / :," .._ •'-sT \ t •-t ??: ? ? Wis.-?°,,,?`x._!?.
t ! I
1 # , \ 1\ S \
' 1• i + i 4 1 _ 1 '\ / 1 / "y - F ' Ir A f'
?.?{'ii
"?.,- a ``}?;r{?fy? l -,? l •/ -?lyr?-•.,` ,. ..? ?, t > , /t ?p?;-"r•?, ,` ?, • `? ,ww,c
- ? \ ?, ? ;?€IS?f• ' ?i ??,??II` j °,,,;??? :f3i I f e; ? f? :I~ ?;? ? ... \
ky: 55 ????{YS. r? J? { / y 1?' )J 111 ;d"'.
-- ? . f ? ? ? it (.\II ( ?vf ? -+? Y a -'? / .? . /i ? l •y(f '- y .
,;• ;rf t; \
,/{ J / __ry?. ?•?4 J.\?`. "I it ?d"?? r ,? k`\ \y` 'I ?wy,
e&W
k _?` 1aq `?\`? ,, F•. ? tf .?. e i'?t,,?•i w fi. \ `?,j?+j, i ??. _ •? f r/
- •??i?},?rl ?` ?,',?., -?`')`ti``??. ?:°??^j},\,, I fi, \ir`Rk`?`,ji\`i77? k ? ../'C \? \?`r,O ftti'`yryl''1? y_ '??3? `a?\.,,,,,.,t ? s..
7,t,t
-.? Y \ ?, t t\?k `\, ???`\. iN lfr! rl1? r! ?0 {Jr,•
/ r Y - 1 \ \ \t? } \t \ \?`?-:\\, ! ? i ;%\t i •? yHy• `•\' ` 0:?y' a JJr' / Q ? ?.
1 r -. .,?\ i \ l .\ IN
/ lei l , '!? d v ? ? ta?.t l ? 1 k. 1 ?\.
r '{ i ?. ' t \ 1 ` I ? / ? -./ III •yyr /.. .. - 1 i l;.t{.J. }rT,'t?i 4
''??` ,h\ `? ? 1 t4 '? :? ,.\`. ?', •' ?'``! /• /.: /.`.']i. ?`?` \ ? :ti }li:". JIJ?' i? r `
?•t r \t ?r ,?. j +9>•rj,? ?,?' '?/ri / `' t l ltltt{'1 ?il>i li\ r '
, 1 E4 - ? t 4 e
1 / 4 '! -k?•?,' • r , il ! 1r f, ,f `t i'i :``s, '•'1 1 1 ' y
..r.+' ...-?t' 1, 1Lh,t? k ''. t7, 4 r? ? '/ ? r ? / /I ? } ;'?it? '
'A c 1 f ce
.. \V\ ,/? :L'am' , ? i I ? ,'I7 t i' ?"''• r ,' ?? ..;'. -
t \I '. \\4 it 1 i ' t ,,
N i z r
i 1 1 1 1 } ?`
r
• r? 4,
CIO
l 862 s
\. 4
A iP
f tt `•' Rt `'` t . `Rai, y ^. ?? t'..? \ _ , `4 \ ,....?
A i l END WAIL4 ` \ • \ f ` ':`
(NCDOT r', 838 39 \ w,.
'INV. OUT %?39 QO
R1PRA0 OUTt•E'f
APRON'';) ENG1 H= 40' ??.
1 S -APRON WIDTHS )8'X46r 1 ;
r i THICKNESS= 30" ! j `\
f 3 CLA5S-,III PqPRAP
+ i\ i P
,o 01
Plane SS-100 TOW Creek &IurbW - 135 IF
SCALE: 1"=40'
LanbDeSi n , Inc. Seren i t
y Point
1208 EASTCHESTER DRIVE, SUITE 200
HIGH POINT, NC 27265 Flan
SS - 100
? n
PHONE[phone] FAX[phone] C` DATE: 04/1io12002
860 , -7 . .
850
840

; t t t I t?-? ? ?

_ i
t - ? r..
} i I ?it•-- I ! r-•?

i
? ?
?
j t t i + Ms
' {
:'

00.

i i N1/ 840 00
10' BQ;OW EC ; Ari
-

-r f
-
-

,

_ __- -----a ; '
...1.._x...1_ .-....e?_

0+00 1+00
PROFILE SS-100
SCALE r-40' H, 1"-4' V
LanbDeSl n Inc. 6eren i t Point
,208 EASTa*SaR DRM, SLM zoo i?rof i Ie
FlCH POW, NC 27265
PHOW336) 885-5785 FAX[phone] DATE: 04/16/2002
Rook s _ ..
fill
06
1 648 PCI
d r-r ++ 854
n • -,?`' ? '? „?'. _ ;^?"?.• ., '?: ."°• fir, `' t Via..
• '' 854 854 s SF?iy
j 8 846
Ali
// ENDWALL #2 i )
(f ; I , a t i` (NCDOjT STD 838.39) I !
1 /. II '. .L INV. OUT= 833.00 '
r 1 ? r
i (f I RIPRAP OUTLET i i .
r s APRON LENGTH= 40'
t s I r APRON WIDTH= 18')46'
t '? 1 r I j T"CKNESS- 30" J
?ii ?(! } CJASS II RIPRAP
r I rr ( !t { jj r r. ?/ co f
'f
Plan SS-200 Total Leek dsturbM 145 IF
SCALE: 1"=40,
LanbDesi n.I Inc.
s
ran i t? fi?o it?t
1208 EASTGfSTM DRIVE, SLATE 200 i= I a n SS - 2 00
F KH POINT, NC 27265
PHONE[phone] FAX[phone] DATE: 04/I/o/2002
860
850
840

i s - PROPO-FMH

- ;-- ? ....E _ E ? - _ t :...?....?.?_...; ._.. .. •"""Y----

?
?
_ .?_.. ._. T _x.,... ?.. r_ _.. -
...f....
f- E 6 1

t t 1 f i = 1 3 t E i ? ? { E

! ; i
I i {
f # ?
3 i

EX GkADE'

. ._
'- ?
;
wv 83500
10t BELOW `EX
(2 QE?
E
+ 90 LF 72", RCP @ 5 i

0+00 1+00
PROFILE SS-200
SCALE 1"=40' H, 1"=4' V
LanbDeS1 Y1 Inc. Serenity Foint
1208 EASTCHFSTER DRIVE, SLUE 200 ?r O f I 1 e
HGH POW, NC 27265
PHONE[phone] FAX[phone] DATE: 04/16/?002