20020056 Ver 1_COMPLETE FILE_20020114

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North Carolina Department of Environ,
Alan
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Coleen H.
Div
September ,
Dare
DWQ Project #: 02-
APPROVAL of 401 Water Quality Certification and AUTHORIZATION CERTIFICATE
Mac Self
1044 Creek Road
Kitty Hawk, NC 27949
Subject Property: Lots 4 off of NC 1243, (Old Oregon Inlet Road) South Nags Head
Dear Mr. Self-.
You have our approval, in accordance with the attached conditions, to impact 0.01 acres of wetlands for
the purpose of residential development as you described in your application dated January 11, 2003 and
additional information received on August 4, 2003 and September 12, 2003. After reviewing your
application, we have decided that this fill is covered by General Water Quality Certification Number
3402, which may be viewed on our website at http://h2o.enr.state.nc.us/ncwetlands. This certification
allows you to use Nationwide Permit Number 18 when the Corps of Engineers issues it. In addition,
you should get any other federal, state or local permits before you go ahead with your proje ? including
(but not limited to) Sediment and Erosion Control, Coastal Stormwater, Non-Discharge and Water
Supply Watershed regulations. This approval will expire when the accompanying 404 or CAMA
permit expires unless otherwise specified in the General Certification.
This approval is only valid for the purpose and design that you described in your application except as
modified below. If you change your project, you must notify us and you may be required to send us a
new application. If the property is sold, the new owner must be given a copy of this Certification and
approval letter and is thereby responsible for complying with all conditions. If total wetland fills for
this project (now or in the future) exceed one acre, compensatory mitigation may be required as
described in 15A NCAC 2H .0506 (h) (6) and (7). This approval shall expire when the corresponding
Nationwide Permit expires or as otherwise provided in the General Certification. For this approval to
be valid, you must follow the conditions listed in the attached certification and any additional
conditions listed below.
Conditions of Certification:
Certification of Completion
Upon completion of all work approved within the 401 Water Quality Certification or
applicable Buffer Rules, and any subsequent modifications, the applicant is required to return
the attached certificate of completion to the 401/Wetlands Unit, North Carolina Division of
Water Quality, 1650 Mail Service Center, Raleigh, NC, 27699-1650.

N. C. 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)
[phone] (phone), 919-733-6893 (fax), (http://h2o.cur.state.nc.us/ncwetlands
Page 2
Deed of Notification
2. Deed notifications or similar mechanisms shall be placed on all retained jurisdictional
wetlands, waters and protective buffers in order to assure compliance for future wetland, water
and buffer impact. These mechanisms shall be put in place prior to impacting any wetlands,
waters and/or buffers approved for impact under this Certification Approval and Authorization
Certificate. A sample deed notification can be downloaded from the 401/Wetlands Unit web
site at http://h2o.enr.state.nc.us/ncwetlands.
Violations of any condition herein set forth may result in revocation of this Certification and may result
n criminal and/or civil penalties. This Certification shall become null and void unless the above
:onditions are made conditions of the Federal 404 and/or coastal Area Management Act Permit.
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 John Dorney at 919-733-1786 or Tom Steffens at our
Washington Regional Office at 252-946-6481.
Sincerely,
l/
Alan W. Klimek, P.E., Director
JRD/bs
Attachments
cc: Corps of Engineers Washington Field Office
Washington DWQ Regional Office
File copy
Central Files
Environmental Professionals, Post Office Box 3368, Kill Devil Hills, NC 27948-3368

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OF W R TF9 Michael F. Easley; Governor
0 William G. Ross Jr., Secretary
`O North Carolina Department of Environment and Natural Resources
Alan Klimek, P.E., Director
Pcus?:
Division of Water Quality
y: Coleen H. Sullins, Deputy Director
Division of Water Quality
August 13, 2003
DWQ # 02-0056
Dare County
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
I. R. Self and Jimmy Stallings
1044 Creek Road
Kitty Hawk, NC 27949
Subject Property: Lots 4 off of NC 1243, (Old Oregon Inlet Road) South Nags Head
Dear Mr. Self & Mr. Stallings:
On August 4, 2003 the Division of Water Quality (DWQ) was notified by receipt of your application regarding
your plan to fill wetlands or waters for the purpose of residential fill in Dare County. Approval from DWQ is
required to disturb these areas. Please provide 7 copies of the following information and refer to the DWQ #
listed above in your reply. Please show these on maps of suitable scale (for instance 1" = 100 feet) so we can
begin to determine your projects' compliance with 15A NCAC 2H.0500.
1. Please depict the proposed house and septic system location on the plot plan.
2. Please provide a more precise location map for the property.
3. Please be aware that we do not have a record of a 401 Certification being authorized for this project.
The project was considered withdrawn as per our letter dated 1/15/02..
Please telephone Bob Zarzecki at 919-733-9726 or Dave Penrose at 919-715-3481 if you have any questions or
would require copies of our rules or procedural materials. This project will remain on hold as incomplete in
accordance with 15A NCAC 2H .0505(c). The processing time for this application will begin when this
information is received. If we do not hear from you by writing or by fax at [phone] within three (3)
weeks we will assume you no longer want to pursue the project and will consider it withdrawn.
Sincerely,
JRD/bs
\f/ ?''
o " R. Dom
40 Water Quali ertification Program
cc: Washington DWQ Regional Office
Washington Corps of Engineers
Central Files
File Copy
Kendall Turnage, Environmental Professionals, Post Office Box 3368, Kill Devil Hills, NC 27948-3368
N. C. 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).
[phone] (phone), 919-733-6893 (fax), (http://h2o.enr.state.nc.us/ncwetlands)
Customer Service #: 1-877-623-6748

ENVIRONMENTALJuIy 31, 2003
PROFESSIONALS
INC.
PLANNING FOR
A BETTER NC Division of Water Quality
ENVIRONMENT401 Wetlands Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
0
Re: Previous 401 Certifications approvals
Action ID #'s- Lot 3 #2002102267, Unknown NC DWQ #
Lot 4 Unknown Action ID, DWQ # 01-1667
To Whom It May Concern:
Please find attached two sets (two copies each) of the previously approved PCN applications for Mr.
LR.Self (Mac) and Mr. Jimmy Stallings for Lots 3 and 4 of their subdivision in south Nags Head, NC. The
original nationwide permits was issued during a period in which the nationwide permits were undergoing
changing conditions, and these permits were not given the full two-year validation period. Due to illness of
one of the applicants (Mr. Self), the fill was not accomplished before the permits expired.
We have requested re-issuance of the fill permits from Mr. Tom Walker of the USACE, and he suggested
re-notifying your Department of the re-issuance and provide your staff with 2 copies of the original
applications, general permit verifications and supporting documents for your files, to receive a
reauthorization of the 401 Certifications from your office.
We are requesting that the original 401 certifications be re-issued for the project. Mr. Walker has stated
that he is willing to re-issue the USACE Nationwide permits (without full review) for the applicants.
Please call if you have any questions.
Sincerely,
Kendall Turnage
P.O. BOX 3368 • KILL DEVIL HILLS, NORTH CAROLINA 27948-3368 • 252-441-0239
FAX: [phone] EMAIL: [e-mail]
t' U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action Id. 2 vo Z o Z G7- ?p( 00 S `P
GENERAL PERMIT (REGIONAL AND NATIONWIDE)
Property owner
_10)
CATION
Address 10 1-1 H C r. e, R o y
k; n 14?wl(- N1= z
Telephone No. /
Size.and Location of project (water body, road name/number, rtown, etc.) --t U. 3 T e,4 c - <n c 47e.
,e a s T o M(- l ?t o . -( W -C 5 T S i d r. C2?t A G s R 1 x !-(1 12,ge c ?r
51l &,tT1, a at,oJet,7' ST. AL, S ea? A)L
Description of Activity &4 ?, 1 l r ca U. I C9 A& of De 4 •,_r i A1e" o f 746
. 1 i 1 - ..
ez: I i%jdTr" I& lee 411 -e 47,
Applicable Law: ___,,-<ection 404 (Clean Water Act, 33 U.S.C. 1344). rA?
(check all that apply) Section 10 (River and Harbor Act of 1899). 67 81401 GROUP
Authorization: Regional General Permit Number. ,ei (J
I Nationwide Permit Number. C 0 4 2 003
?'?r'?RQ?A11
5?
Your work is authorized by this Regional General (RGP) or Nationwide Permit (NWP) provided it is accompoa
in strict accordance with the attached conditions and your submitted plans. If your activity is subject to Section
404 (if Section 404 block above is checked), before beginning work you must also receive a Section 401 water
quality certification from the N.C. Division of Environmental Management, telephone [phone]. For any .
activity within the twenty coastal counties, before beginning work you must contact the N.C. Division of Coastal
Management, telephone [phone].
Please read and carefully comply with the attached conditions of the RGP or NWP. Any violation of the conditions
of the RGP or the NWP referenced above may subject the permittee to a stop work order, a restoration order, and/or
appropriate legal action.
This Department of the Army RGP or NWP verification does not relieve the permittee of the responsibility to obtain
any other required Federal, State, or local approvals/permits. The permittee may need to contact appropriate State
and local agencies before beginning work.
If there are any questions regarding this authorization or any of the conditions of the General Permit or Nationwide.
Permit, please contact the Corps Regulatory Official specified below.
Date l /2 :5 /o z --'
Corps Regulatory Official ZTelephone No. Z 5 2 " `? ?Sr' &
Expiration Date of Verification Z--
L ?-
County H c-
SURVEY PLATS, FIELD SKETCH, WETLAND DELINEATION FORMS, PROJECT PLANS, ETC., MUST
BE ATTACHED TO THE YELLOW (FILE) COPY OF THIS FORM, IF REQUIRED OR AVAILABLE.
CESAW Form 591
Revised July 1995
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: 18
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: ? N/A
4. If payment into the North Carolina Wetlands Restoration Program (NCWRP) is proposed for
mitigation of impacts (see section VIII - Mitigation), check here: ? N/A
II. Applicant Information
1. Owner/Applicant Information
Name:_ Mac Self
Mailing Address: 1044 Creek Road
Kitty Hawk. NC 27949
Telephone Number: see agent info. Fax Number: N/A
E-mail Address: N/A
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: Roxanne D. Dorman
Company Affiliation: Environmental Professionals, Inc.
Mailing Address: P.O. Box 3368
Kill Devil Hills NC 27948
Telephone Number:-252-441-0239 Fax Number: 252-441-0721
E-mail Address:_ EPI l na,>,inn.net
Page 2 of 9
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: EPI#02-006
2. T.I.P. Project Number or State Project Number (NCDOT Only): N/A
3. Property Identification Number (Tax PIN): 14070912978072
4. Location
County: Dare County Nearest Town: Nags Head
Subdivision name (include phase/lot number): Parcel in South Nags Head
Directions to site (include road numbers, landmarks, etc.): Off NC1243 South (Old Oregon
Inlet Road) south west of Harvest Street, north of E. Tide Street
5. Site coordinates, if available (UTM or Lat/Long): 35°89'21" 75°58'97"
(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:
Residential (site is currently undeveloped).
7. Property size (acres): 2.0 acres
8. Nearest body of water (stream/river/sound/ocean/lake): Atlantic Ocean
9. River Basin: Pasauotank
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at htip://h2o.enr.state.nc.us/admin/maps/.)
Page 3 of 9
10. Describe the purpose of the proposed work: to prepare the site for residential construction
11, List the type of equipment to be used to construct the .project: dump truck and front end
loader
12. Describe the land use in the vicinity of this project: Residential
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.
N/A
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:
None anticipated
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 4 of 9
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***
1 404 wetland fill 0.10 ac. Yes 1700+ Freshwater 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.izov.
*** 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: 1.97 acre
Total area of wetland impact proposed: 0.10 acre
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)
N/A N/A N/A N/A N/A N/A.

i
List each impact separately and identity 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 losstgain),
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.¢ov. Several intemet sites also allow direct download and printing of USGS maps (e.g., www.tot)ozone.com,
www.mamiuest.com. etc.).
Cumulative impacts (linear distance in feet) to all streams on site: N/A
Page 5 of 9
1
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.
N/A N/A N/A N/A N/A

* 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 N/A
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. N/A
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.): N/A
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.): N/A
Size of watershed draining to pond: N/A Expected pond surface area: N/A
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.
Fill in necessary for this moiect, in order to meet septic setbacks to make the lot buildable. Silt
fence will be placed at the wetland/fill interface to prevent intrusion into wetland not permitted
for fill.
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 6 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
htU2://h2o.enr.state.ne.us/newetlands/stnnizide.htrnl.
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.
Miti ag tion plan is not required for this activity (0.10 ac fill)
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/=/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): N/A
Amount of buffer mitigation requested (square feet): N/A
Amount of Riparian wetland mitigation requested (acres): N/A
Amount of Non-riparian wetland mitigation requested (acres): N/A
Amount of Coastal wetland mitigation requested (acres): N/A
Page 7 of 9
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
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 N/A )?
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* s uareafeet Multiplier M tg fired
1 N/A 3 N/A
2 N/A 1.5 N/A
Total N/A N/A
" 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 8 of 9
.
XI.
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.
Buffer mitigation is not required for this project
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.
No impervious acreage is proposed at this time. Once the fill permit is obtained a site plan will
be developed for residential construction.
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.
Septic system on site
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).
N/A

Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
l-- ll--oZ
Page 9 of 9
05/10/2003 04:32 2524411042 VILLAGE REALTY PAGE 01
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SURVEY FOR.
MACK SELF
Lot in South Nags Head
Dare County, North Carolina
I• 21 ??{ ?Q? CERTIFY THAT THIS PLAT WAS DRAWN
UNDER MY SUPERVISION FROM AN ACTUAL SURVEY MADE FILE:0I-49A
UNDER MY SUPERVISION: THAT THE BOUNDARIES NOT SUR REF: SEE NOTE
VE YED ARE SHOWN AS BROKEN LINES PLOTTED FROM F.I.R.M. 37335WI41)(I2120/0I)
INFORMATION FOUND IN PO C, SLIDE 4E. THE ERROR OF FLOOD ZONE AE(I0)
CLOSURE AS CALCULATED BY LATITUAE3 AND DEPARTURES PAIN NO. 140709 [2978072
IS I' 0 0$ • THIS PLAT DOES NOT MEET'
EET RF.QLIREMENTS
OF OS 47-30 AS AMENDED FOR PLAT BOOK RECORDATION
a
r' U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action Id. Z vo Z 10 2, C
C.),^)
L ?-
County _D r c..
GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION
Property owner A A . t s e l f OR O® 5 6
Address 10 1.1 Li C r?? le, R o CII
k; n!q 14 'JI 'U C_ 2:7 -'11
Telephone No.
Size.and Location of project (water body, road name/number,/town, etc.) .1 U. i ? ti In c a ircf
_ .L AIr - .w - l? .. w.. _? - ! lii f/1 gyn..... I•• ..
r2 44 d ?? ?,?'Jt T ST. JU. 5 Coat JUL
Description of Activity / rt f -,f L It i y 0.10 k& o? Dep., r Z m es-vT O 1 74e,'
A ? . , ?
Q -e a -e 104,e$" e 47,
Applicable Law: ___,,-,S?ection 404 (Clean Water Act, 33 U.S.C. 1344).
(check all that apply) Section 10 (River and Harbor Act of 1899). Ar
Authorization: Regional General Permit Number. NET DS101 GROUP
I Nationwide Permit Number. AUC (llflfl
Your work is authorized by this Regional General (RGP) or Nationwide Permit (NWP) p?8ili68tiOUi i?V P1ON
in strict accordance with the attached conditions and your submitted plans. If your activity is subject to Section
404 (if Section 404 block above is checked), before beginning work you must also receive a Section 401 water
quality certification from the N.C. Division of Environmental Management, telephone [phone]. 'For any .
activity within the twenty coastal counties, before beginning work you must contact the N.C. Division of Coastal
Management, telephone [phone].
Please read and carefully comply with the attached conditions of the RGP or NWP. Any violation of the conditions
of the RGP or the NWP referenced above may subject the permittee to a stop work order, a restoration order, and/or
appropriate legal action.
This Department of the Army RGP or NWP verification does not relieve the permittee of the responsibility to obtain
any other required Federal, State, or local approvals/permits. The permittee may need to contact appropriate State
and local agencies before beginning work.
If there are any questions regarding this authorization or any of the conditions of the General-Permit or Nationwide
Permit, please contact the Corps Regulatory Official specified below.
Date I /2 3 / o Z
Corps Regulatory Official ?GV G'U Telephone No. Z S 2 - ?' /? fro
Expiration Date of Verification Z Li/ly Z
SURVEY PLATS, FIELD SKETCH, WETLAND.DELINEATION FORMS, PROJECT PLANS, ETC., MUST
BE ATTACHED TO THE YELLOW (FILE) COPY OF THIS FORM, IF REQUIRED OR AVAILABLE.
CESAW Form 591
Revised July 1995
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
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: 18
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: ? N/A
4. If payment into the North Carolina Wetlands Restoration Program (NCWRP) is proposed for
mitigation of impacts (see section VIII - Mitigation), check here: ? N/A
II. Applicant Information
1. Owner/Applicant Information
Name: Mac Self
Mailing Address: 1044 Creek Road
Kitty Hawk. NC 27949
Telephone Number: see agent info. Fax Number: N/A
E-mail Address: N/A
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: Roxanne D. Dorman
Company Affiliation: Environmental Professionals. Inc.
Mailing Address: P.O. Box 3368
Kill Devil Hills NC 27948
Telephone Number: 252-441-0239 Fax Number: 252-441-0721
E-mail Address:_ EPIl(@pinn.net
Page 2 of 9
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: EPT#02-006
2. T.I.P. Project Number or State Project Number (NCDOT Only): N/A
3. Property Identification Number (Tax PIN): 14070912978072
4. Location
County:_ Dare County Nearest Town: Nags Head
Subdivision name (include phase/lot number): Parcel in South Nags Head
Directions to site (include road numbers, landmarks, etc.): Off NC1243 South (Old Oregon.
Inlet Road) south west of Harvest Street, north of E. Tide Street
5. Site coordinates, if available (UTM or Lat/Long): 35°89'21" 75°58'97"
(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:
Residential (site is currently undeveloped).
7. Property size (acres): 2.0 acres
8. Nearest body of water (stream/river/sound/ocean/lake): Atlantic Ocean
9. River Basin: Pasauotank
(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/mVs/.)
Page 3 of 9
10. Describe the purpose of the proposed work: to prepare the site for residential construction
11. List the type of equipment to be used to construct the .project: dump truck and front end
loader
12. Describe the land use in the vicinity of this project: Residential
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.
N/A
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:
None anticipated
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 4 of 9
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***
1 404 wetland fill 0.10 ac. Yes 1700+ Freshwater 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 httn://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: 1.97 acre
Total area of wetland impact proposed: 0.10 acre
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)
N/A N/A N/A N/A N/A N/A.

*
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 losstgain),
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.tov. Several internet sites also allow direct download and printing of USGS maps (e.g., www.tgMzone.com,
www.mapquest.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: N/A
Page 5 of 9
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.
N/A N/A N/A N/A N/A

* List each impact sepazately and identify temporary impacts. Impacts include, but are not limited to: fill, excavation, dredging,
flooding, drainage, bulkheads, etc.
4. Pond Creation N/A
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. N/A
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.): N/A
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.): N/A
Size of watershed draining to pond: N/A Expected pond surface area: N/A
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.
Fill in necessary for this nroiect, in order to meet septic setbacks to make the lot buildable. Silt
fence will be placed at the wetland/fill interface to prevent intrusion into wetland not permitted
for fill.
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 6 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
htlp://h2o.enr.state.nc.us/ncwetlands/stnnizide.htrnl.
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.
Mitigation plan is not required for this activity (0.10 ac fill)
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 hgR://h2o.enr.state.nc.us/M/index.htrn. 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): N/A
Amount of buffer mitigation requested (square feet): N/A
Amount of Riparian wetland mitigation requested (acres): N/A
Amount of Non-riparian wetland mitigation requested (acres): N/A
Amount of Coastal wetland mitigation requested (acres): N/A
Page 7 of 9
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
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 [D I
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 N/A 1?
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* s uare feet Multiplier Mitig tion
1 N/A 3 N/A
2 N/A 1.5 N/A
Total N/A N/A
- cone i extenas out su teet perpenaicular trom near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.
Page 8 of 9
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.
Buffer mitigation is not required for this project
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.
No impervious acreage is proposed at this time. Once the fill permit is obtained a site lap n will
be developed for residential construction.
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.
Septic system on site
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).
N/A

I-/1_00.
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 9 of 9
05/10/2003 04:32
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SURVEY" FOR:
MACK SELF
Lot in South Nags Head
Dare County, North Carolm
I, BALD , WOOD CERTIFY THAT THIS PLAT WAS DRAWN
i1NDER MY SUPERVISION FRom AN ACTUAL supy13Y mAD$
UNDER MY SUPERVISION.- THAT THE. 8OUNDARIES NOT SUR
VEX'ED ARE SHOWN AS BROKEN LINES ?LOTTED FROP,R
IMRMATION FOUND IN PC C, SLIDE 4E. THE ERROR OF
CLOSURE
?,ryA. S CALCULATED BY LATITUDE( AND DEPARTUM
IS 1 THIS PLAT DOES NOT MEET REQUIREMENTS
OF OS 47-30 AS AMENDED FOR PLAT BOOK RECORDATION
VILLAGE REALTY
Lot 3 ?
PAGE 07
C,
se,

FILE.01-49A
RE.F: SEE NOTE
F.I.R.M. 37333titf0l4D(I212010I)
FLOOD ZONE AE(10)
PIN NO. 14070912978072
OF wATFR Michael F. Easley, Governor
Q 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 15, 2002
County Dare
DWQ Project # 02-0058
CERTIFIED MAIL- RETURN RECEIPT REQUESTED
Mac Self
1044 Creek Road
Kitty Hawk, NC 27949
Dear Mr. Self.
On January 15, 2002, the Division of Water Quality (DWQ) was notified by receipt of your application regarding your plans
to fill wetlands for the purpose of constructing a home Dare County. Approval from DWQ is required to disturb these wetlands.
Please provide seven copies of the following information and refer to the DWQ number listed above in your reply. In particular
as described in 15A NCAC 28.0502, we will require you to locate the house and drain field on the plate. Also, please provide a
more precise location map for the property.
1. The location of the proposed shoreline stabilization measures must be shown on a map.
Please call Todd St. John, Bob Zarzecki or me at [phone] if you have any questions or would require copies of our
rules or procedural materials. This project will remain on hold as incomplete in accordance with 15 A NCAC 2H .0505 (c).
The processing time for this application will begin when this information is received. If we do not hear from you within three (3)
weeks of the receipt of this letter, we will assume that you no longer want to pursue this project and will consider it withdrawn.
Sincerely yours, _
n aDomey
Cc Washington DWQ Regional Office
Washington Corps of Engineers
Central Files
File Copy Roxanne Dorman
Wetlands/401 Unit 1650 Mail Service Center Raleigh, NC 27699-165D Ph: [phone] Fax: [phone] Customer Service
1 800 623-7748
Michael F. Easley
,y Governor
s William G. Ross,Jr.Secretary
Department of Environment and Natural Resources
Kerr T. Stevens
Division of Water Quality
Ce6R? -1 J (1?IA 1L-? P,IJ ACC ?I I's 1/ ?
WQ # d2.- d0 S`
County
f, ,A
DC- )910
Dear Mr. s?4
U 2
On vi) ft DiWsion of Water Quality (DWQ was notified receipt of your
applications arding our pilau to H & for-the purpose of in _
County. Approval from DWQ is regkad to disturb these . Please provide seven copies
of the following information and refer b frz DWQ -lur fisted above in your reply. In particular as described in
15A NCAC 2B .0502, we wil r c ; ycu to locate - an?s.nn_tl, Try. Please show
these on maps of suitable scale (for V = 1 feet) so we can begin to determine your projects'
compliance with 15A NCAC 2H.0500. .
Please call me at (0-19) 733-17E ifyou have a y questions or would require copies of our rules or
procedural materials. This projed will raTgin on hold incomplete in accordance With 15A NCAC 2H
.0505(c). The processing ffine for Il & won wM beg When this information is received. If we do not
hear from you by writing within f e (y cs we wil ass a you no longer want to pursue the project and
will consider it withdrawn.

okk
Cc:
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DWQ
File CpW
Central Files
cL?r
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D"ivi ? dvadwl3makq 1-e0 Uail Service Center
Raleigh, NC 27699-1650
Wedands1401 Unit [phone]
Fax: [phone]
ENVIRONMENTAL PROFESSIONALS IN
Planning For A Better Environment ??44?? ??
P.O. Box 3368
KILL DEVIL HILLS, NORTH CAROLINA 27948
[phone]
?FAX [phone]]
TO
??0 a. wka-, 1 c.e_
7;?,? a-76 - toy l
WE ARE SENDING YOU ?ttached r separate cover via
? Shop drawings ? Prints' Plans
? Copy of letter ? Change order
D ..r t t -o L JOB NO.
A TI N
?
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RE: t V?vYIW ??

P ' N?

the following items:
? Samples
? Specifications
COPIES DATE NO. DESCRIPTION
I
F. L

W? LAC
l .?-- L e G

THESE ARE TRANSMITTED as checked below:
or approval
)?_f
For your use
? As requested
? For review and comment
? FOR BIDS DUE
REMARKS
El Approved as submitted

? Approved as noted
? Returned for corrections
?
El Resubmit copies for approval

? Submit copies for distribution
? Return corrected prints

? PRINTS RETURNED AFTER LOAN TO US
(! ?rf

cuuC

COPY TO 1 cS
SIG
If enclosures are not as noted, kindly notify us at once.

Jan 11 02 10:45a Joel Patton 252-441-6930 P•2
01/11/2002 09:11 2524410721 ENVIRONMENTAL PRUFtS rAUt. bL
I'.
Mac Self
1044 Creek Road
Kitty Hawk, NC 27949
i, Mac Self authorize Environmental Professionals, Inc. (EPI) to pursue
environmental permits on my behalf for prop" located in Nags Mead,
County, Nbrtb. Carolina.
I ll
ow-'?L
AUTH RIZATION DAT
n
Office Use Only: Form Versipn 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.
I. Processing
1. Check all of the approval(s) requested for this project: /l-
Section 404 Permit
? Section 10 Permit
® 401 Water Quality Certification
? Riparian or Watershed Buffer Rules
2. Nationwide Regional or General Permit er(s)?YqtO64p. Y 18
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: ? N/A
4. If payment into the North Carolina Wetlands Restoration Program (NCWRP) is proposed for
mitigation of impacts (see section VIII - Mitigation), check here: ? N/A
II. Applicant Information
1. Owner/Applicant Information
Name: Mac Self
Mailing Address: 1044 Creek Road
Kitty Hawk, NC 27949
Telephone Number: see agent info. Fax Number: N/A
E-mail Address: N/A
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: Roxanne D. Dorman
Company Affiliation: Environmental Professionals. Inc.
Mailing Address: P.O. Box 3368
Kill Devil Hills NC 27948
Telephone Number: 252-441-0239 Fax Number: 252-441-0721
E-mail Address: EPI1 aa,pinn.net
Page 2 of 9
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: EPI#02-006
2. T.I.P. Project Number or State Project Number (NCDOT Only): N/A
3. Property Identification Number (Tax PIN): 14070912978072
4. Location
County: Dare County Nearest Town: Nags Head
Subdivision name (include phase/lot number): Parcel in South Nags Head
Directions to site (include road numbers, landmarks, etc.): Off NC1243 South (Old Oregon
Inlet Road) south west of Harvest Street, north of E. Tide Street
5. Site coordinates, if available (UTM or Lat/Long): 35°89'21" 75°58'97
(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:
Residential (site is currently undeveloped).
7. Property size (acres): 2.0 acres
8. Nearest body of water (stream/river/sound/ocean/lake): Atlantic Ocean
9. River Basin: Pasquotank
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at htip://h2o.enr.state.nc.us/admin/maDs/.)
Page 3 of 9
10. Describe the purpose of the proposed work: to_prgpare the site for residential construction
11. List the type of equipment to be used to construct the project: dump truck and front end
loader
12. Describe the land use in the vicinity of this project: Residential
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.
N/A
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:
None anticipated
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 4 of 9
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***
1 404 wetland fill 0.10 ac. Yes 1700+ Freshwater 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 httn://w".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: 1.97 acre
Total area of wetland impact proposed: 0.10 acre
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)
N/A N/A N/A N/A N/A N/A

* 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.usas.gov. Several internet sites also allow direct download and printing of USGS maps (e.g., www.inozone.com,
www.magguest.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: N/A
Page 5 of 9
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.
N/A N/A N/A N/A N/A

* 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 N/A
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. N/A
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.): N/A
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.): N/A
Size of watershed draining to pond: N/A Expected pond surface area: N/A
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.
Fill in necessary for this project, in order to meet septic setbacks to make the lot buildable. Silt
fence will be placed at the wetland/fill interface to prevent intrusion into wetland not permitted
for fill.
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 6 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
htip://h2o.enr.state.nc.us/ncwetlands/stnnp-ide.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.
Mitigation plan is not required for this activity (0.10 ac fill)
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 httv://h2o.enr.state.nc.us/mV/ind".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): N/A
Amount of buffer mitigation requested (square feet): N/A
Amount of Riparian wetland mitigation requested (acres): N/A
Amount of Non-riparian wetland mitigation requested (acres): N/A
Amount of Coastal wetland mitigation requested (acres): N/A
Page 7 of 9
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
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 N/A )?
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* s uareact
feet) Multiplier M ttq fired
igation
1 N/A 3 N/A
2 N/A 1.5 N/A
Total N/A N/A
* 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 8 of 9
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.
Buffer mitigation is not required for this project
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.
No impervious acreage is proposed at this time. Once the fill permit is obtained a site plan will
be developed for residential construction.
XIL 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..
Septic system on site
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).
N/A
t-0 Q,
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 9 of 9
DA A FORM Environmental-Frofessionals, -Inc.
ROUTINE-WETLAND DETERMINATION PO Box 3368
(1987 COE Wetlands' delineation Manual) Kill Devil Hills,-N.C 27948
Project/Site: Pam - of NG I;z_q3 t'ot d OreSo?, -tom kCF Date: . f7 !T-? ?? ,
M c. c S e 1-? ` N S County: ,
Applicant/Owner ' . ....
State: NC,
Investigator: j-ZbXcLrN rl_
(] ?
Do Normal Circumstances exist on the site? Yes No Community ID:
Is the site significantly disturbed (Atypical Situation)? YesJ No Transect ID:
Is the area a potential Problem Area? ? Yes 23 No Plot ID: ;
If needed, a lain on reverse.
gETATYON?
Dominant Plant S
. 2. ?

bidimtor Dominant Plant
+- 9.
10..
11.
r 12.
13
S .
.
6. 14.
7.
8. 16.
Percent of Dominant Species that are OBL, FACW, or FAC
(excluding FAC•)•
Remarks: U- 2- ?bk l s ti K S

.HYDROLOGY
Recorded'Data'(Doscribc. in Remarks):
(] Streamxake, or Tide Gauge
[l Aerial Photographs ,
Other
151 No Recorded Data Available
Field Observations:
Depth of Surface Water : (in.)
Depth to Free Water in Pit: (in.)
Depth to Saturated Soil: (in.)
Wetland Hydrology Indicators:
Primary Indicators:
? Inundated
? Saturated in upper 12 Inches
? Water Marks
? Drift.Lines
Sediment Deposits
Drainage Patterns .in-we0Pds:
Secondary Indicators (2 or morerequued)`
? Oxidized Root'Channels:nn Upper 12'Inch0s-
? Water:SWned Leaves
?local Soil Survey`Data
FAC-Ncutral Test
r1 Other (Exolain in Remarks)
no.

SOILS
Map Unit Name Co-,-o l t c R)-V?4_ Sa4, - ---
(Series and Phase): Drainage Class:
Field Observations
Taxonomy (Subgroup):' Confimt Ma d'T e Yes., No
Profile Description
Depth_ Matrix Color Mottle Colors Moule Textures, Concretions,
inche -Horizon Mun cll Moist Munsell Moist`? Abend ncc/Contr st S::ructure etc.
A ^ -;t & t"?,rf ?In
Hydric Soil Indicators:
D' Mstosol (?$ Concretions
Histic Epipedon ? High Organic Content in Surfface'Layer in Sandy,Soils
® SulSdic Odor. :
? Organic Streaking in Sandy Soils -: •
Q Aquic Moisture rRegime ? Listed-on Local Hydric Soils List
r I Reducing Conditions ® Listed on National Hydric Soils List
Q Gleycd or Low-Cliroma Colors Other (Explain in Remarks)
Remarks:
U-3 c4A a-'?S
WETIAAND DETERMINATION
j Hydrophytic Vegetation'Prescnt Yes No
Wetland Hydrology Present? ® Yes No
H? dricSdils Present?. Yes No as this Sampling Pointwidun a Wedand? Yes No
Remarks:
a'(
Approved by;HQUSACE,2/92 ;.,.•

l?
DATA FORM
ROUTINE'WETLAND DETERMINATION
(1987 COE Wetlands delineation Manual)
Environmental? role 4ionals. -Inc.
PO Box 3368
Kill Devil Hills, N.C. 27948
Project/Site: Q?v c e Q o-E? PC, a 4 3 o Lci ° K-s-,a*
Applicaat(Owner: (V-c-, 5 e l 5 . t4-5s k-r-e - Kd)
Investi ator• IG?CN?iIEw? Date: -9 - 7_-cl -k
County: Do/Lk
State:

Do Normal Circumstances exist on the site? Yes ? No _Community ID:
Is the site significantly disturbed (Atypical Situation)?
Is the area a potential Problem Area? n Yes EKNo
? Yes RNo Transect ID:
Plot ID:
If needed, a lain on reverse.
VEGETATION'.
HYDROLOGY
a

Recorded'Data'(Describc in Remarks): Wetland Hydrology Indicators: • • `.
E]'$tream,• Lake, or Tide Gauge Primary Indicators:
? Aerial-Photographs ? Inundated
? Other Saturated in Upper 12 Inches
'PNo Recorded Data Available ? Water Marks
? Drift.Lines
Field Observations: ? Sediment Deposits
Drainage Patterns .in-Wetlands.
Depth of Surface Water : (in.)
01 Secondary. Indicators (2 or more required)::' ..?
?I

? (2
® Oxidized Root Channels in Uppec 12?Inches
Depth to Free Water in Pit: (in.) Water-Stained Leaves.
U

Local Soil Survey:Data
L4CJ
Depth to Saturated Soil: (in.) FAC-Neutral Test
Other Ex lain in Remarks
Remarks:
Dominant Plant Species Strattun Indicator Dominant Plant Species ' Stratum' 'Indicator
1. L_a 9.
2. lp• • .. .. ..
3, Tc 11. ., .
4. PAcw4- 12.
55' c ' r-04' ccws C-,1 13.
6. 14.
7.
15.
8. 16.
Percent of Dominant Species that are OBL, FACW, or FAC
(excluding FAC-).
Remarks:

_ -
o-C

C
SOILS C
map Unit Nanne C (CS-{? Drainage Class:
(Series and Phase): -t- field Observations
Confirm Ma d•T e 47 Yes No
rrou c G.h? t`^ a Uevd5
Taxonomy Sub
Description Textures, Concretions,
Dcpth_ Matrix Color Mottle Colors Ivlotdc
inche Horizon Mun Cl) Moist Munsell Moist Aliund ncc/Contr st Stnichnre 'etc.
All
0 - 3 14. ?fl ? 3 Z !
Hydric Soil Indicators:
Hastosol ? Concretions
I nigh Organic Content ill Surface Laycr in Sandy Soils
[]`Histic Lpipedon Organic Streaking in Sandy Soils
? ' •
Sulfidic Odor Listed on Local Hydric Soils List
? Aquic MoistureAel irm
[Q Conditions Listed on National Hydric Soils List
Reducing Conditions
Other (Explain in Remarks)
Q Gleyed or Low-Chroma Colors
Remarks: _
d try G S
WETLAND DETERMINATION
` Hydrophytic Vegetation Present Yes No
Yes No
Wetland Hydrology Present?
•
H• Brie Soils'P resent? Yes No Is this Saul lip Point witlan a V?etiand? • ?? No
Remarks:
w?
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SURVEY FOR:
MACK SELF
Lot in South Nags Head
Dare County, North Carolina
I, DONALD E. WOOD CERTIFY THAT THIS PLAT WAS DRAWN
UNDER MY SUPERVISION FROM AN ACTUAL SURVEY MADE
UNDER MY SUPERVISION: THAT THE BOUNDARIES NOT SUR-
VEYED ARE SHOWN AS BROKEN LINES PLOTTED FROM
INFORMATION FOUND IN PC C, SLIDE 4E. THE ERROR OF
CLOSURE AS CALCULATED BY LATITUDES AND DEPARTURES
IS 1:10,000+; THIS PLAT DOES NOT MEET REQUIREMENTS
OF GS 47-30 AS AMENDED FOR PLAT BOOK RECORDATION
WITNESS MY ORIGINAL SIGNATURE, REGISTRATION NUMBER
AND SEAL THIS 15n{. DAY OF DE_ 1rM"%0I,
P.L.. L-1 24 ; a SEAL
•. _ L-1324 Q
FILE:01-49A
REF: SEE NOTE
F.I.R.M. 3753560014D(12/20/01)
FLOOD ZONE AE(10)
PIN NO. 14070912978072
ti lvp.R OPMENT SERVICES
P. 2 TTY HAWK, N. C. 27949
252-441- 52-202-9443, FAX-252-441-9424
?1' "f
N
D ,r
WQ# Date Who Reviewed: ? z !n

Pla
? n Detail Incomplete
Please provide a location map for the project.
a.,
r
pl ?
? Please show all stream impacts including all fill slopes, dissipaters, and bank stabilization on the site plan. 1 C
? Please show all wetland impacts including fill slopes on the site plan.

?
?
Please indicate all buffer impacts on the site plan.
Please indicate proposed lot layout as overlays on the site plan. i-O
-
41
d b
ff
l
h
i
l
f
h ?"'
? . ers as over
e protecte
u
ays on t
e s
te p
an.
Please indicate the location o
t (Y)
? t
? Please locate all isolated or non-isolated wetlands, streams and other waters of the State as overlays on the site plan.
? Please provide cross section details showing the provisions for aquatic life passage. ` a
? Please locate any planned sewer lines on the site plan. P?
? Please provide the location of any proposed stormwater management practices as required by GC
? Please provide detail for the stormwater management practices as required by GC
? Please specify the percent of project imperviousness area based on the estimated built-out conditions.
? Please indicate all stormwater outfalls on the site plan.
? Please indicate the diffuse flow provision measures on the site plan.
? Please indicate whether or not the proposed impacts already been conducted.
Avoidance and/or Minimization Not Provided
? The labeled as on the plans does not appear to be necessary. Please eliminate the
information as to why it is necessary for this project.
.
or provide additional 3
? This Office believes that the labeled on the plans as can be moved or reconfigured to avoid the impacts to the
Please revise the plans to avoid the impacts.
? This Office believes that the labeled on the plans as can be moved or reconfigured to minimize the impacts to the
Please revise the plans to minimize the impacts. y
? The stormwater discharges at the location on the plans labeled will not provide diffuse flow through the buffer because
. Please revise the plans and provide calculations to show that diffuse flow will be achieved through the entire buffer. If it
is not possible to achieve diffuse flow through the entire buffer then it may be necessary to provide stormwater management
practices that remove nutrients before the stormwater can be discharged through the buffer.
Other
? The application fee was insufficient because over 150 feet of stream and/or over 1 acre of wetland impacts were requested. Please
provide $ . This additional fee must be received before your application can be reviewed.
? Please complete Section(s) on the application.
? Please provide a signed copy of the application.
? Please provide copies of the application, copies of the site plans and other supporting information.
Mitigation
? of compensatory mitigation is required for this project. Please provide a compensatory mitigation plan. The
plan must conform to the requirements in 15 A NCAC 2H.0500 and must be appropriate to the type of impacts proposed.
? Please indicate which 404 Permit the USACE would use to authorize this project.
C„ t\.A '5e - s?s'4v v?

I J., F-
_ I - II _ - --- .
¦ Complete items 1, 2, and 3. Also complete A.
Item 4 if Restricted Delivery is desired. X
¦ Print your name and address on the reverse
so that we can return the card to you. B.
¦ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
I R. Self & Jimmy Stallings
1044 Creek Road
Kitty Hawk, NC 27949
DWQ# 02 - 0056 - Dare
C] Agent
le deltmy eddfese dI fereM from item 1? ? Ye!
If YES, enter delivery address below: E3 No
3. Service type
2r&w lfled Mail O Express Mail
? Registered Eeturn Reoelpt for Merchandise
13 Insured Mail ? C.O.D.
4. Restricted Delivery? (Extra Fee)', 0 yes
2. Article Number 7002 2 410 0003 0275 1901
(nen8W float WVfW tees
3s Form 3811, August 2001 Domestic Retum Receipt 1026s6 02 M 16a
I i
UNITED ?TATES POSTAL SERVICE First-Class Mail
Postage & Fee Paid
USPS
Permit No. G-1
'Sender: Please print your name, address, and ZIP+4 in this box •
NC DENR Division of Water Quality
Wetlands/401 Certification Unit
2321 Crabtree Boulevard, Suite 250
Raleigh, NC 27604
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