20030298 Ver 1_COMPLETE FILE_20030312

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Michael F. Easley
Governor
William G. Ross, Jr., Secretary
Department of Environment and Natural Resources
Alan W. Klimek, P.E., Director
. Division of Water Quality
May 22, 2003
DWQ Project No. 03-0298
County: Franklin
Page 1 of 2
David Warren
1099 Lake Royale
Louisburg, Nc 27549
Subject Property: Lot 2903, Map # LR-1102-2093 Lake Royale, Bunn, NC
Lake Royale [03-03-01, 28-31-(1), B NSW (nutrient sensitive)]
APPROVAL of 401 Water Quality Certification and AUTHORIZATION CERTIFICATE per the Tar-Pamlico River
Buffer Protection Rules (15A NCAC 2B.0259) with ADDITIONAL CONDITIONS
Dear Mr. Warren:
You have our approval, in accordance with the attached conditions and those listed below, to place fill within or
otherwise impact 75 feet of lake shoreline and approximately 300 square feet (ftz) of protected riparian buffers for the
purpose of constructing the 75 foot long seawall and 140 ftz boathouse at the subject property as described within your
application dated March 8, 2003 including additional information received on March 24, 2003. After reviewing your
application, we have decided that the impacts are covered by the N.C. Division of Water Quality (DWQ) General Water
Quality Certification Number(s) 3399 (GC3399). The Certification(s) allows you to use General (Regional) Permit
197800080 when-issued by the US Army Corps of Engineers (USACE). This letter shall also act as your approved
Authorization Certificate for impacts to the protected riparian buffers per 15A NCAC 2B .0259. In addition, you should
obtain or otherwise comply with any other required federal, state or local permits before you go ahead with your project
including (but not limited to) Erosion and Sediment Control. Also, this approval will expire when the accompanying 404
permit expires unless otherwise specified in the General Certifications.
This approval is only valid for the purpose and design that you described in your application. If you change your project,
you must notify us and you may be required to send us a new application. If the property is sold, the new owner must
be given a copy of this Certification and approval letter and is thereby responsible for complying with all conditions. If
total fills for this project (now or in the future) exceed one acre of wetland or 150 linear feet of stream, 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 any additional conditions listed below.
Conditions:
1. Diffuse Flow
An additional condition is that all stormwater shall be directed as diffuse flow at non-erosive velocities through the
protected stream buffers and will not re-concentrate before discharging into the stream as identified within 15A
NCAC 2B .0259(5). No direct discharge (e.g., piping or ditching) of stormwater through the buffer and to the lake
shall occur.
2. Certificate 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.
3. Buffer Establishment around Basins
North Carolina Division of Water Quality, WETLANDS / 401 UNIT
2321 Crabtree Blvd., Raleigh, NC 27604-2260 (Location)
1650 Mail Service Center, Raleigh, NC 27699-1650 (Mailing Address)
919-733-1786 (phone), 919-733-6893 (fax), httpJ/h2o.enr.state.nc.us/ncwebands
Page 2 of 2
New boat basins (such as the one you are proposing to construct) are considered by the DWQ as a modification of
the existing shoreline. As such, a 50-foot buffer that meets the requirements of Sections (4) and (5) of 15A NCAC
02B .0259 must be established around the newly created shoreline. You are required to establish a new buffer
around the shoreline of the basin. All associated upland development (such as parking lots, buildings, etc.) and any
new impervious surfaces shall not be located within the newly established buffer or any existing protected buffers.
4. Buffer Replanting
Replanting of vegetation within disturbed areas located within 30 feet of the shoreline or coastal wetland (whichever
is more landward) associated with bulkhead and boathouse installation, repair, replacement and/or maintenance
must be done in an "in kind" manner immediately following construction. (Example: Disturbed areas with pre-
existing grassed lawns must be replanted with grass. Disturbed areas with pre-existing trees or woody vegetation
must be replanted with trees and woody vegetation. Disturbed areas with pre-existing forest vegetation must be
replanted with forest vegetation including at least two different native hardwood tree species at a density sufficient
to provide 320 trees per acre at maturity. This density can usually be achieved by planting approximately 436 (10 x
10 spacing) to 681 (8 x 8 spacing) trees per acre.)
5. Temporary Access Corridors
The proposed access corridor(s) must be the minimum width required to get the construction equipment to the
shoreline and shall not exceed ten (10) .feet. The number of access corridors should be limited to the minimum
number required to get the construction equipment to the shoreline (many times only a single corridor is required)
and shall not exceed one (1) corridor(s). The access corridor(s) should cross the buffer as close to perpendicular
as practicable and disturbance to existing vegetation should be minimized.
Violations of any condition herein set forth may result in revocation of this Certification and may result in criminal and/or
civil penalties. This Certification shall become null and void unless the above conditions are made conditions of the
Federal 404 and/or coastal Area Management Act Permit. This Certification shall expire upon expiration of the 404 or
CAMA permit.
If you do not accept any of the conditions of this Certification (associated with the approved wetland or stream impacts),
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.
Any disputes over determinations regarding this Authorization Certificate (associated with the approved buffer impacts)
shall be referred in writing to the Director for a decision. The Director's decision is subject to review as provided in
Articles 3 and 4 of G.S. 150B.
This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water Act and the Tar-
Pamlico riparian buffer protection rule as described within 15A NCAC 213.0259. If you have any questions, please
telephone John Dorney at 919-733-9646 or Bob Zarzecki at 919-733-9726.
Sincerely,
,f
Ian W. Klimek, P.E.,
NC DWQ, Director
Attachments: Certificate of Completion
GC 3399
Cc: Joe Faison / Dana Mayberry, Affordable Landscaping, PO Box 369, Bunn, NC 27508
USACE Raleigh Regulatory Field Office
DWQ Raleigh Regional Office
File Copy
MEMORANDUM
TO: John Dorney
Non-Discharge Branch
Regional Contact: Steve Mitchell
WO Supervisor:
Date:
SUBJECT: WETLAND STAFF REPORT AND RECOMMENDATIONS
Facility Name David Warren
Project Number 03 0298
Recvd From APP
Received Date 3/24/03
RecvdBy Region
Project Type shoreline stabilization
County Franklin
County2
Region Raleigh
Certificates Stream Stream Impacts (ft.)
Permit Wetland Wetland Wetland Stream Class Acres Feet
Type Type , Impact Score Index Prim. Supp. Basin- Req. Req.
GP 30 WatCr'? O Y O N F- 28-3To) F B NSw 30,301. 0.00
F_ F_
TPBR BufCcrs O? ON7T'- 30,301:????
Mitigation Wetland
MitigationType Type Acres Feet
F__ I
Is Wetland Rating Sheet Attached? O Y ON Did you request more info? O Y ON
Have Project Changes/Conditions Been Discussed With Applicant? 0 Y - 0 N
Is Mitigation required? 0 Y 0 N
Recommendation: 0 Issue 0 Issue/Cond 0 Deny
Provided by Region: Latitude (ddmmss) Longitude (ddmmss)
Comments:
April 7, 9003
Issue with standard language relative to water dependant activity and boat house for the storage of
boat and boating related egunpment not a living space, Application mentions seal wall but there are
no plans??????????
cc: Regional Office
Central Office Page Number 1
Triage Check List
Date: 3/2 3/? 3 Project Name: Daui, A?,"`g?
DWQ#: 030 2 q6, 97, 7?
County: Fr-Ah K11
To: ? ARO Mike Parker ? WaRO Tom Steffens
? FRO Ken Averitte ? WiRO Noelle Lutheran
? MRO Alan Johnson ? WSRO Cyndi Karoly (Central Office)
RRO Steve Mitchell
From: Larry E din Telephone : (919) 733 - gG6f`
The file attached is being forwarded to your for your evaluation.
Please call if you need assistance.
0 Stream length impacted
? Stream determination
? Wetland determination and distance to blue-line surface waters on USFW topo maps
? Minimi ation/avoidance issues
Buffer Rules (Meuse ar-Pamlic) Catawba, Randleman)
? Pond fill
Mitigation Ratios.
? Ditching
? Are the stream and or wetland mitigation sites available and viable?
? Check drawings for accuracy
? Is the application consistent with pre-application meetings?
? Cumulative impact concern
Comments:
_. ,
Lake (Full Pond)
Full Pond
Shoreline
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Please approximately sketch the following information on this plan
{please provide dimensions for each item, such as 10 ft. x 100 ft):
1) All proposed vegetation clearing (provide dimensions)
2) Location of rip rap or fill to be placed above the Full Pond elevation
3) Location of rip rap or fill to be placed below the Full pond elevation
4) The location of any proposed structures such as-buildings, retaining
walls, docks, etc.
5) The location of any excavation or dredging below the Full Pond
elevation.
6) Location of construction access corridors.
your project. Also, see the example below for guidance. Both the vicinity map and
site plan must include a scale and north arrow. The footprints of all buildings,
impervious surfaces, or other facilities must be included.
Location
County: s h ?l Nearest Town: rZ(.t.-) n
Subdivision name or site address (include phase/lot number): L_O_Le 2oyaU_ Lot "?
Directions to site please include road numbers, landmarks, etc. (This is not o'2 fl?1
necessary if an adequate vicinity map is included):
2. Describe the existing land use or condition of the site at the time of this
application: P_tSi CE _n+-,GZQ
3. Property size (acres): I" 0 •3 aC-
4. Nearest body of water (stream/river/sound/ocean/lake): o_Xe,
5. Describe the purpose of the proposed work: TO n-- S? na_c
6. List the type of equipment to be used to construct the roject: A,-, ?? CGL Ja-??
? ' t ? ? t,v3ec? -? Pxc.a?t?- r o' x? -? ? ??0.-ts IY V?•
7. Amount of impact (including all excavation, backfill, rip rap, retaining walls,
etc.) below the normal pool lake level in square feet or acres:
I D' x._? t ` e\4 C6vO_-h Q, rya u\
U LA O -V+ 2) 1 s5c 2
8. a. Amount of impact (including all clearing, back fill, excavation, rip rap,
retaining wails, etc.) above the normal pool lake level and 50 feet land-ward in
square feet or acres:
11 i rnG?
b. Please describe vegetation above the normal pool lake level and 50 feet land-
ward to be impacted (number of trees for instance):
ra n c 4,47/-1 N/a/I 4-/1 -*.; . , rf-, -??? PC I J I I 1 be- v P_11rii?iFC
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
APPROX. SCALE IN MILES 7 r
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Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
March 12, 2003
Joe Faison / Dana Mayberry
Affordable Landscaping
P.O. Box 369
Bunn, NC 27508
Re: Fee request for the following applications:
David Warren : DWQ# 03-0298
Greg & Pam Miller: DWQ# 03-0296
Doug Abbott: DWQ# 03-0297
To Whom It May Concern:
On 3/12/2003, The N.C. Division of Water Quality received your application for 401 Water Quality Certification for the
purpose of constructing a boathouse, seawall and a dock in Franklin County. Your application is being put on hold since
you did not include the application fee. Please note that beginning January 1, 1999, the N.C. General Assembly passed
legislation requiring payment of a fee for all 401 applications, as indicated on page two of the PCN application form. The
fee for applications is $200 for projects impacting less than an acre of wetland and less than 150 linear feet of
streams. For projects impacting one or more acres of wetland or 150 or more feet of streams, the fee is $475. In order
for DWQ to review and process your request, you must send a check in the appropriate amount made payable to the N.C.
Division of Water Quality attached to your application.
Please also list all water and buffer impacts above and below full pond. For each project all impacts shall be measured in
square feet or acres, except for stream impacts. Each project must have a vicinity map, site plan (showing
footprints of all impacts as proposed on lot layout) and an application fee of $200.
Please call me at 919-733-3575 or visit our web site at http://h2o.enr.state.nc.us/ncwetlands if you have any
questions regarding this letter.
Sincerely,
Michael Horan
Environmental Tech.
Enclosure or Attachments:
CC:
N. C. Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 [phone] Customer Service
1 800 623-7748
WETLANDS/ 401 GROUP
MAR 1 2 2003
IAieTF-R QUALITY SECTION
Office Use Only: o Version May 2002
0398
USACE Action ID No. DWQ No.
(If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A".)
1. Processing
1. Check all of the approval(s) requested for this project:
© Section 404 Permit ? Riparian or Watershed Buffer Rules
? Section 10 Permit ? Isolated Wetland Permit from DWQ
2] 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested:
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: ?
4. If payment into the North Carolina Wetlands Restoration Program (NCWRP) is proposed for
mitigation of impacts (verify availability with NCWRP prior to submittal of PCN), complete
section VIII and check here: ?
5. If your project is located in any of North Carolina's twenty coastal counties (listed on page
4), and the project is within a North Carolina Division of Coastal Management Area of
Environmental Concern (see the top of page 2 for further details), check here: ?
II. Applicant Information
1. Owner/Applicant
Name.
Mailing Address:
Telephone Number: -I d - LA1$. S`1 C13 Fax Number:
E-mail Address: , i. A, Q S;?rm "of# Com
2. Agent/Consultant 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: :To e Po-ASDr7 / -pck y-)a OL-O- W Ise Y t,f
Company Affiliation: f1 r d Q 1Z:1e . LOA r,d 'i'Q p n !E?
Mailing Address: PO eu)(, 2,t oGi
?i? r-, r-, ?u cr a-"?So?
Telephone Number: a 5Q - H-i 9? - 3OLo9 Fax Number: a5 1,?) - 9-111b- 1Z-51SU 1
E-mail Address:_
Page 5 of 12
III. Project Information
Attach a vicinity map clearly showing the location of the property with respect to local
landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property
boundaries and development plans in relation to surrounding properties. Both the vicinity map
and site plan must include a scale and north arrow. The specific footprints of all buildings,
impervious surfaces, or other facilities must be included. If possible, the maps and plans should
include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the.property
boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion,
so long as the property is clearly defined. For administrative and distribution purposes, the
USACE requires information to be submitted on sheets no larger than 11 by 17-inch format;
however, DWQ may accept paperwork of any size. DWQ prefers full-size construction
drawings rather than a sequential sheet version of the full-size plans. If full-size plans are
reduced to a small scale such that the final version is illegible, the applicant will be informed that
the project has been placed on hold until decipherable maps are provided.
1. Name of project:
2. T.I.P. Project Number or State Project Number (NCDOT Only):
XA o 3
3. Property Identification Number (Tax PIN): C/O+ 1 L e - t {o - a b`t3
4. Location
County: F-r0.?1c--1 + +n Nearest Town:
Subdivision name (include phase/lot number): t? ya t e
Directions to site (include road numbers, landmarks, etc.):
5. Site coordinates, if available (UTM or Lat/Long): i-) /Q
(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. Property size (acres): - a
7. Nearest body of water (stream/river/sound/ocean/lake): I Ck-Y-c (l oLiC e 2?ya-1
8. River Basin: Tc-.r - ILexY,
(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/maus/.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: IZesicU n-t-i
Page 6 of 12
10. Describe the overall project in detail, including the type of equipment to be used:
S i I e both o Lu,e- ca Y--) CA S ect wa-1 I Io 1?e C) StYU CA eci .
I w i ra % 1 n. 4-, !l/1 I r) ' x 1 -4 1 n C n- 4 d n -k C i r o.
I? 1?eeS 0.?t?P -1o be
11. Explain the purpose of the proposed work: -TD ?.nSi?,fct a l: +" LA.,ee ,
IV. Prior Project History
If jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Include
the USACE Action ID Number, DWQ Project Number, application date, and date permits and
certifications were issued or withdrawn. Provide photocopies of previously issued permits,
certifications or other useful information. Describe previously approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits issued for prior segments of the same T.I.P. project, along with
construction schedules.

V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application.
lcl
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 written description of the proposed impacts: n
2. Individually list wetland impacts below:
Wetland Impact
Site Number
(indicate on map)
Type of Impact* Area of
Impact
(acres) Located within
100-year Floodplain**
(yes/no) Distance to
Nearest Stream
(linear feet)
Type of Wetland***

* 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://Nvww.fema.eov.
*** List a wetland type that best describes wetland to be impacted (e.g., freshwater/saltwater marsh, forested wetland, beaver pond,
Carolina Bay, bog, etc.) Indicate if wetland is isolated (determination of isolation to be made by USACE only).
List the total acreage (estimated) of all existing wetlands on the property:
Total area of wetland impact proposed: rl IQ
3. Individually list all intermittent and perennial stream impacts below:
Stream Impact
Site Number
(indicate on map)
Type of Impact* Length of
Impact
(linear feet)
Stream Name** Average Width
of Stream
Before Impact Perennial or
Intermittent?
lease specify)

* 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.Qov. Several internet sites also allow direct download and printing of USGS maps (e.g., www.topozone.com,
NynAy.mMuest.com- etc.).
Cumulative impacts (linear distance in feet) to all streams on site: 1-1/69
Page 8 of 12
4. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.) below:
Open Water Impact
Site Number
(indicate on map)
Type of Impact* Area of
Impact
(acres) Name of Waterbody

(if applicable) Type of Waterbody
(lake, pond, estuary, sound,
bay, ocean, etc.)

* List each 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.
nlq
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/'ncwetlandsistrmgide. html.
1. Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
2. Mitigation may also be made by payment into the North Carolina Wetlands Restoration
Program (NCWRP). Please note it is the applicant's responsibility to contact the NCWRP at
[phone] to determine availability and to request written approval of mitigation prior
to submittal of a PCN. For additional information regarding the application process for the
NCWRP, check the NCWRP website at http://h2o.enr.state.nc.us/wrp/index.htm. If use of
the NCWRP is proposed, please check the appropriate box on page three and provide the
following information:
Amount of stream mitigation requested (linear feet):
Amount of buffer mitigation requested (square feet):
Amount of Riparian wetland mitigation requested (acres):
Amount of Non-riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres):
Page 10 of 12
IX. Environmental Documentation (required by DWQ)
Does the project involve an expenditure of public (federal/state) funds or the use of public
(federal/state) land?
Yes ? No FXI
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 (required by DWQ)
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 El No ® If you answered "yes", provide the following information:
Identify the square feet and acreage of impact to each zone of the riparian buffers. If buffer
mitigation is required. calculate the required amount of mitigation by applying the buffer
multipliers.
Zone* Impact
(square feet) Multiplier Required
Mitigation
1 3
2 1.5
Total
Gone 1 extends out SV feet perpendicular Min near banK of channel; Gone 2 extends an
additional 20 feet from the edge of Zone 1.
Page 11 of 12
If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation
of Property, Conservation Easement, Riparian Buffer Restoration / Enhancement, Preservation or
Payment into the Riparian Buffer Restoration Fund). Please attach all appropriate information as
identified within 15A NCAC 2B .0242 or .0260.
XI. Stormwater (required by DWQ)
Describe impervious acreage (both existing and proposed) versus total acreage on the site.
Discuss stormwater controls proposed in order to protect surface waters and wetlands
downstream from the property.
XII. Sewage Disposal (required by DWQ)
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.
r)
XIII. Violations (required by DWQ)
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).
yZe
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 12 of 12
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