20030772 Ver 1_COMPLETE FILE_20030624

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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
Coleen H. Sullins, Deputy Director
Division of Water Quality
August 4, 2003
Forsyth County
DWQ Project No. 03-0772
Mr. Richard Dehart
Homestead-Riclin/Kingstree, LLC
390 Concrete Works Road
Winston-Salem, NC, 27107
APPROVAL of 401 Water Quality Certification with Additional Conditions, Wetland Restoration Program
Dear Mr. Dehart:
You have our approval, in accordance with the attached conditions, to place permanent fill in 281 linear feet of perennial streams in
order to construct the Chase at Kingstree subdivision in Forsyth County, as described in your application received by the Division of
Water Quality (DWQ) on June 24, 2003, and in additional correspondence received August 4, 2003. After reviewing your application, we
have determined that this fill is covered by General Water Quality Certification Number 3402, which can be viewed on our web site at
http://h2o.enr.state.nc.us/ncwetiands. This Certification allows you to use Nationwide Permit Number 39 when it is issued by the U.S.
Army Corps of Engineers. In addition, you should get any other federal, state or local permits before you go ahead with your project
including (but not limited to) Sediment and Erosion Control, Non-Discharge and Water Supply Watershed regulations. Also this approval
will expire when the accompanying 404 permit expires unless otherwise specified in the General Certification.
This approval is only valid for the purpose and design that you described in your application. If you change your project, you
must notify us in writing and you may be required to send us a new application for a new certification. If the property Is sold, the new
owner must be given a copy of the Certification and approval letter and is thereby responsible for complying with all conditions. If total
wetland fills for this project (now or in the future) exceed one acre, compensatory mitigation may be required as described in 15A NCAC
2H .0506 (h). For this approval to be valid, you must follow the conditions listed in the attached certification, as well as the additional
condition listed below:
1. Deed notifications or similar mechanisms shall be placed on all lots with remaining jurisdictional wetlands and waters or areas within
50 feet of all streams and ponds on the property. These mechanisms shall be put in place within 30 days of the date of this letter or
the issuance of the 404 Permit (whichever is later). A sample deed notification format can be downloaded from the 401/Wetlands Unit
web site at http://h2o.enr.state.nc.us/ncwetlands ;
2. The culverts required for this project shall be installed in such a manner that the original stream profiles are not altered (i.e. the depth
of the channel must not be reduced by a widening of the streambed). Existing stream dimensions (Including the pattern and profile)
are to be maintained above and below locations of each culvert. The culverts shall be designed and installed to allow for aquatic life
movement as well as to prevent head cutting of the streams. If any of the existing pipes are or become perched, the appropriate
stream grade shall be re-established or, if the pipes installed in a perched manner, the pipes shall be removed and re-Installed
correctly;
The Applicant must submit a plan and receive written approval from this Office to address any head cutting that will occur as a result
of this project (e.g., use of cross vanes downstream of the culvert).
Use of native vegetation and other soft stream bank stabilization techniques must be used where practicable instead of rip rap or
other bank hardening methods; If rip-rap is necessary, it shall not be placed in the stream bed, unless specifically approved by the
Division of Water Quality;
3. We understand that you have chosen to contribute to the Wetland Restoration Program in order to compensate for the impacts to
streams. In accordance with 15A NCAC 2R.0402 and 15A NCAC 2B.0242(7), this contribution will satisfy our compensatory
mitigation requirements under 15A NCAC 2H .0506(h) and 15A NCAC 26 .0233(10). Until the Wetland Restoration Program receives
and clears your check (made payable to: DENR - Wetlands Restoration Program), stream impacts (including fill) shall not occur. Mr.
Ron Ferrell should be contacted at [phone] if you have any questions concerning the Wetland Restoration Program. You
have one month from the date of this Certification to make this payment. For accounting purposes, this Certification authorizes the fill
of 281 linear feet of perennial streams in the Yadkin River Basin, Cataloging Unit 03040101, and 281 linear feet of stream mitigation Is
required. Please be aware that the Wetland Restoration Program (W RP) rules require rounding of wetland impacts to the nearest foot
(15A NCAC 2R .0503(b));
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), (htto://h2o.enr.state.nc.us/ncwetlands)
4. Upon completion of the project, the Applicant shall complete and return the enclosed "Certificate of Completion" form to notify
NCDWQ when all work included in the §401 Certification has been completed. The responsible party shall complete the attached
form and return It to the 401/Wetlands Unit of the NC Division of Water Quality upon completion of the project. Please send
photographs upstream and downstream of each culvert site to document correct installation along with the Certificate of Completion
form.
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 that conforms to Chapter 150B of the North Carolina
General Statutes to the Office of Administrative Hearings, 6714 Mail Service Center, Raleigh, N.C. 27699-6714. This certification and its
conditions are final and binding unless you ask for a hearing.
This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water Act. If you have any
questions, please contact Daryl Lamb in the DWQ Winston-Salem Regional Office at 336-771-4600 or Cyndi Karoly in Raleigh at (919)
733-9721. Questions regarding the Wetland Restoration Program may be directed to Ron Ferrell at [phone].
Si cerely,
Alan W. Klimek, P.E.
AW K/cbk
Attachments
cc: Corps of Engineers Raleigh Regulatory Field Office
Winston-Salem DWQ Regional Office
Ron Ferrell, W RP
File Copy
Central Files
Ron Linville, W RC
Denise Poulos, 6909 International Drive, Suite 103, Greensboro, NC, 27409
030772
NORTH CAROLINA-DIVISON OF WATER QUALITY
401 WATER QUALITY CERTIFICATION
SUMMARY OF PERMITTED IMPACTS AND MITIGATION REQUIREMENTS
In accordance with 15A NCAC 2 H .0500, Mr. Richard Dehart Homestead-Riclin/Kingstree, LLC has permission as outlined below to
fill 281 linear feet of perennial streams in order to construct the Chase at Kingstree subdivision in Forsyth County, North Carolina. All
activities associated with these authorized impacts must be conducted with the conditions listed in the attached certification. THIS
CERTIFICATION IS NOT VALID WITHOUT THE ATTACHMENTS.
COMPENSATORY MITIGATION REQUIREMENT
WETLAND RESTORATION PROGRAM
LOCATION: Chase at Kingstree
COUNTY: Forsyth
BASIN/SUBBASIN Yadkin (03-04-01-01)
Impacts:
281 linear feet of perennial streams
As required by 15A NCAC 2H .0506, and the conditions of this certification, you are required to compensate for the above
impacts through the restoration, creation, enhancement or preservation of wetlands as outlined below prior to conducting any activities
that Impact or degrade the waters of the state.
Mitigation:
281 linear feet of perennial streams by WRP required for the 401 Water Quality Certification. In correspondence dated July 25, 2003,
the WRP indicated that up to 562 linear feet of stream mitigation will be conducted by WRP If necessary for the 404 Permit.
Note: Linear foot requirements proposed to be mitigated through the Wetland Restoration Program must be rounded to the
nearest foot and acreage requirements must be rounded to one-quarter acre increments according to 15 2r.0503(b).
One of the options you have available to satisfy the compensatory mitigation requirements is through the payment of a fee to
the Wetlands Restoration Fund per NCAC 2R .0503. If you choose this option, please sign this form and mail it to the Wetlands
Restoration Fund at the address listed below. An invoice for the appropriate amount of payment will be sent to you upon receipt of this
form. PLEASE NOTE, THE ABOVE IMPACTS ARE NOT AUTHORIZED UNTIL YOU RECEIVE NOTIFICATION THAT YOUR
PAYMENT HAS BEEN PROCESSED BY THE WETLANDS RESTORATION PROGRAM.
Signature Date
WETLANDS RESTORATION PROGRAM
DIVISON OF WATER QUALITY
1619 Mail Service Center
RALEIGH, N.C. 27669-1619
[phone]
UWU NIAKN X17 r» »ci uriou vo 1;):j7 ivu.dw uciuj
Vorth Carolina
Department of Environment and Natural. Resources
Michael F. Easley, Governor
William G. Ross Jr., Secretary
July 25, 2003
Denise M. Poulos, LLS
Engineering Consulting Services, Ltd.
6909 International Drive, Suite 103
Greensboro, NC 27409
Subject: Project: Chase at Kingstree
County: Forsyth
NCDENR
The purpose of this letter is to notify you that the North Carolina Wetlands Restoration Program (NCWRP) is
willing to accept payment for stream impacts associated with the subject project. Please note that the decision by
the NCWRP to accept the mitigation requirements of this project does not assure that this payment will be
approved by the U.S. Army Corps of Engineers and the N.C. Division of Water Quality Wetlands/401 Unit. It is
the responsibility of the applicant to contact these agencies to determine if payment to the NCWRP for impacts
associated with this project is appropriate.
This acceptance is valid for six months from the date of this letter. If we have not received a copy of the issued
404 Permit1401 Certification witbin this time frame, this acceptance will expire.
Based on the information supplied by you in a letter dated July 21, 2003 the stream restoration that is necessary to
satisfy the compensatory mitigation requirements for this project is summarized in the following table. The
maximum amount of mitigation that the NCWRP will accept for ibis proiect is also indicated in this table.
Stream
linear feet Wetlands Riparian
acres Riparian Buffer
ftz
Impacts 281
Mitigation Maximum 562
The stream mitigation will be provided as specified in the 401 Water Quality Certification and/or Section 404
Permit for impacts associated with the' ubject project in Cataloging Unit 030401.01 of the Yadkin River Basin.
The mitigation will be performed in accordance with the Memorandum of Understanding between the N.C.
Department of Environment and Natural Resources and the U.S. Army Cotps of Engineers dated November 4,
1.998.
if you have any questions or need additional information, please contact Carol Shaw at [phone].
Sincerely,
Ronald E. Ferrell.;
Program Manager
cc: Cyn.di. Karol.y, Wetlands/401 Unit
Todd TugweU., USACOE-Raleigh
Steve Mitchell, DENR Regional Office-Raleigh
file
Wetlands Restoration Program 1619 Mail Service Center Raleigh, NC 27699-1619
[phone] Fax: [phone]
O." OF wATF9QG
?? r
o ?
July 16, 2003
Forsyth County
DWO Project No. 03-0772
CERTIFIED MAIL: RETURN RECEIPT REQUESTED
Mr. Richard Dehart
Homestead-Riclin/Kingstree, LLC
390 Concrete Works Road
Winston-Salem, NC, 27107
Dear Mr. Dehart:
On June 24, 2003, the NC Division of Water Quality (DWQ) received your application for a General 401 Water Quality Certification
to impact 281 linear feet of streams in order to construct the Chase at Kingstree subdivision in Forsyth County. In accordance with 15A
NCAC 2H .0506, a thorough inspection of the site has been conducted by Mr. Dave Penrose of the DWQ Central Office and also by Mr.
Daryl Lamb of the DWQ Winston-Salem Regional Office. DWQ has determined that both of the subject streams are in fact perennial,
and that significant uses would be removed or degraded by this project. Since the perennial stream impacts associated with this project
exceed 150 linear feet, compensatory stream mitigation is required in accordance with 15A NCAC 2H .0506(h). You have the following
options for satisfying the stream mitigation requirement associated with this project:
1. Payment into the North Carolina Wetland Restoration Program (WRP), if the WRP will accept the responsibility for conducting this
mitigation work, or
2. Preparing and implementing a stream mitigation plan with a minimum of a 1:1 restoration component for 281 feet of impacts.
If you decide to pursue use of the Wetland Restoration Program in lieu of developing your own stream mitigation plan, you will
need to contact Mr. Ron Ferrell with the WRP at [phone] to see if they will accept the project. You should note that mitigation
requirements proposed to be mitigated through the Wetland Restoration Program must be rounded to the nearest linear foot increment
according to 15 2r.0503(b).
Until the information requested in this letter is provided, I will request (by copy of this letter) that the Corps of Engineers place this
project on hold. Also, this project will be placed on hold for our processing due to incomplete information (15A NCAC 2H .0507(h)).
Thank you for your attention. If you have any questions, please contact Daryl Lamb in the DWO Winston-Salem Regional Office at
336-771-4600 or Cyndi Karoly in Raleigh at [phone]. Questions regarding the Wetland Restoration Program may be directed to
Ron Ferrell at [phone].
Sincerely,
l?
John Domey
cc: Corps of Engineers Raleigh Regulatory Field Office
Winston-Salem DWQ Regional Office
Ron Ferrell, WRP
File Copy
Central Files
Ron Linville, W RC
Denise Poulos, 6909 International Drive, Suite 103, Greensboro, NC, 27409
030772
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)
ds)
[phone] (phone), 919-733-6893 (fax), (ht!p://h2o.enr.state.nc.us/ncwetlan
Customer Service #: 1-877-623-6748
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
Coleen H. Sullins, Deputy Director
Division of Water Quality
pro
O? W AT ?R Michael F. Easley, Governor
William G. Ross Jr., Secretary
O? QG North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E., Director
Division of Water Quality
O Coleen H. Sullins, Deputy Director
Division of Water Quality
July 16, 2003
Forsyth County
DWQ Project No. 03-0772
CERTIFIED MAIL: RETURN RECEIPT REQUESTED
Mr. Richard Dehart
Homestead-Riclin/Kingstree, LLC
390 Concrete Works Road
Winston-Salem, NC, 27107
Dear Mr. Dehart:
On June 24, 2003, the NC Division of Water Quality (DWQ) received your application for a General 401 Water Quality Certification
to impact 281 linear feet of streams in order to construct the Chase at Kingstree subdivision in Forsyth County. In accordance with 15A
NCAC 2H .0506, a thorough inspection of the site has been conducted by Mr. Dave Penrose of the DWQ Central Office and also by Mr.
Daryl Lamb of the DWQ Winston-Salem Regional Office. DWQ has determined that both of the subject streams are in fact perennial,
and that significant uses would be removed or degraded by this project. Since the perennial stream impacts associated with this project
exceed 150 linear feet, compensatory stream mitigation is required in accordance with 15A NCAC 2H .0506(h). You have the following
options for satisfying the stream mitigation requirement associated with this project:
1. Payment into the North Carolina Wetland Restoration Program (WRP), if the WRP will accept the responsibility for conducting this
mitigation work, or
2. Preparing and implementing a stream mitigation plan with a minimum of a 1:1 restoration component for 281 feet of impacts.
If you decide to pursue use of the Wetland Restoration Program in lieu of developing your own stream mitigation plan, you will
need to contact Mr. Ron Ferrell with the WRP at [phone] to see if they will accept the project. You should note that mitigation
requirements proposed to be mitigated through the Wetland Restoration Program must be rounded to the nearest linear foot increment
according to 15 2r.0503(b).
Until the information requested in this letter is provided, I will request (by copy of this letter) that the Corps of Engineers place this
project on hold. Also, this project will be placed on hold for our processing due to incomplete information (15A NCAC 2H .0507(h)).
Thank you for your attention. If you have any questions, please contact Daryl Lamb in the DWQ Winston-Salem Regional Office at
336-771-4600 or Cyndi Karoly in Raleigh at [phone]. Questions regarding the Wetland Restoration Program may be directed to
Ron Ferrell at [phone].
Sincerely,
John Dorney
cc: Corps of Engineers Raleigh Regulatory Field Office
Winston-Salem DWQ Regional Office
Ron Ferrell, WRP
File Copy
Central Files
Ron Linville, W RC
Denise Poulos, 6909 International Drive, Suite 103, Greensboro, NC, 27409
030772

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), (htto://h2o.enr.state.nc.us/ncwetlands)
Customer Service #: 1-877-623-6748
North Carolina Wildlife Resources Commission
Charles R. Fullwood, FxeCUtlve Directcn'
MEMORANDUM
TO: John R. Dorney, Division of Water Qualifyk+' 1401
Dept. of Environment and Natural ResourcesJ-1
4 0.
FROM: Ron Linville, Regional Coordinator
Habitat Conservation Program OYSE T10A
DATE: July 10, 2003 C
SUBJECT: Review of 401 Certification Application for Homestead-
Richlin/Kingstree, LLC, Perryman Branch and Unnamed Tributary,
DWQ No. 030772, Forsyth County
The applicant is requesting 401 Water Quality Certification from the North
Carolina Division of Water Quality. The NCWRC has reviewed information provided by
the applicant, and field biologists on our staff are familiar with habitat values of the
project area. These comments are provided in accordance with provisions of the Clean
Water Act of 1977 (33 U.S.C. 466 et. seq.) and the Fish and Wildlife Coordination Act
(48 Stat. 401, as amended; 16 U.S.C. 661-667d).
Impacts are proposed to Perryman Branch and an unnamed tributary. The site is
presently undeveloped and mostly wooded. Two road crossings are proposed for
separate jurisdictional streams for the single family development. Piping impacts at the
unnamed tributary are 132 linear feet and piping impacts to Perryman Branch are 149
linear feet. Total impacts will be 281 linear feet. Our site visit found that both of these
streams appear to be perennial instead of intermittent (indicated for the unnamed
tributary). Perryman Branch is a very nice stream. We also observed bedrock in the area
that may preclude pipe burial necessary to ensure aquatic life passage.
Based on our site visit and general geomorphic considerations, we are concerned
that the "intermittent" stream appears to be perennial or at least an important intermittent
channel. Although the site was visited after a rain event and the stream may have been
evaluated during the recent drought, sufficient flow, pattern and profile characteristics
appeared to be present. Additionally, we are concerned that the pipe installation on
Mailing Address: Division of Inland Fisheries • 1 721 Mall Service Center • Raleigh, NC: 27699-172 1
Telephone. [phone] ext. 281 • Fax: [phone]
Homestead-Richlin/Kingstree 2 July 10, 2003
Perryman Branch may require blasting to provide for proper installation for aquatic life
passage. As indicated earlier, we prefer that a bridge or spanning structure be used if
practicable and feasible.
If the event that the 401 Certification is issued, we recommend the following for
your consideration:
1. If bridging is not possible over Perryman Creek, natural patterns, profiles and
dimensions should be maintained in the crossing area to the maximum extent
practicable.
2. Culverts 48" or larger should be buried a foot into the streambed. Culverts
less than 48 inches in diameter should be buried to a depth equal to or greater
than 20% their size to allow for aquatic life passage during low flow
conditions. These measurements must be based on natural thalweg depths.
3. Minimum undisturbed natural 50' intermittent and 100' perennial stream
buffers should be provided and protected with deed restrictions or other
enforceable methods.
4. Floodplains should not be filled for lot improvements as this activity modifies
flood stages that can destabilize down stream streambanks.
5. If concrete will be used, work must be accomplished so that wet concrete does
not contact stream water. This will lessen the chance of altering the stream's
water chemistry and causing a fish kill.
6. Payment to the Wetland Restoration Program should be provided for
mitigation pursuant to Clean Water Act and NC Division of Water Quality
requirements. Stormwater management should be considered for high
density development. Low Impact Development (LID) techniques are
preferred and recommended. Information on LIDs may be found at
www.lowimpactdevelopment.org.
7. Stringent erosion control measures should be installed where soil is disturbed
and maintained until project completion.
Thank you for the opportunity to review and comment on this project. If you
have any questions regarding these comments, please contact me at 336/769-9453.
Cc: Todd Tugwell, USACOE
7 F?
ENGINEERING CONSULTING SERVICES, LTD.
Geotechnical - Construction Materials - Environmental
July 31, 2003
Ms. Cindy Karoly
Division of Water Quality
401 /Wetlands Unit
1650 Mail Service Center
Raleigh, North Carolina, 27699-1650
Subject: Stream Mitigation
The Chase at Kingstree
Forsyth County, Winston-Salem, North Carolina
DWQ Project No. 03-0772
ECS Project G-8071
Dear Ms. Karoly:
VL"DS/401 GROUP
AUr 0 4 uo?
NATERQUALITVSECT10
N
Enclosed is a copy of the acceptance letter from the North Carolina Wetlands Restoration Program
(NCWRP) for The Chase at Kingstree. The owner, Homestead-Riclin/Kingstree LLC, has agreed to
mitigate for 281 feet of stream impact (on a 1:1 basis) by payment to NCWRP.
Payment will be made to the NCWRP upon issuance of the 401 Water Qulaity Certificaiton and NWP 39
for this project. Please feel free to contact me at [phone] if you have any questions or if
additional information is required. Thank you in advance for your timely consideration of this matter.
Sincerely,
ENGINEERING CONSULTING SERVICES, LTD.
tse .Poulos
Principal Scientist
6909 International Drive, Suite 103 - Greensboro, NC 27409 - [phone] - Fax [phone]
'ices: Aberdeen, MD - Atlanta, GA - Austin, TX - Baltimore, MD - Chantilly, VA - Charlotte, NC - Chicago, IL - Cornelia, GA - Dallas, TX
`anville, VA - Frederick, MD - Fredericksburg, VA - Greensboro, NC - Greenville, SC - Norfolk, VA - Orlando, FL - Raleigh, NC
Richmond, VA - Roanoke, VA - San Antonio, TX - Williamsburg, VA - Wilmington, NC - Winchester, VA
OtO? W A T ?RQG
>_ y
MEMORANDUM
TO: OH. ka,d
Winston-Salem Regional Office
FROMJohn Dome#
RE: 401 Certification Review
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
Please review the enclosed 401 Certification application by the date listed for the project. Please call me if you
or your staff have any questions, or need assistance in these reviews.
1. Chase @ Kingstree
030772
Forsyth Central Office Received 06/24/03, clock expires 08/23/03
Need RO comments by 08/09/03.
The other enclosed material is for your general information and use as appropriate.
Enclosures

Y?

? "? (( l

June 26, 2003

b,- ), -? /' //) (?'

_7/Q3 r

N. C. Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 [phone]
1

Customer Service
1 800 623-7748
f
Homestead-Riclin / Kingstree, LLC
390 Concrete Works Rd
Winston-Salem, NC 27107
March 14, 2003
To Whom It May Concern:
This letter is to authorize Denise Poulos of ECS, Ltd. To act as our agent in
wetland/stream matters, including verification and permit application, for The
Chase at Kingstree subdivision in Winston-Salem, NC.
Thank You,
Richard Dehart
Member/Manager
Date
Triage Check List
J 0 ffff.-I 7 Project Name.
-?q
DWQ#:
County:
To: ? ARO Mike Parker ? WaRO Tom Steffens
? FRO Ken Averitte ? WiRO Noelle Lutheran
? MRO Alan Johnson 9--WSRO Cyndi Karoly (Central Office)
? RRO Steve Mitchell
From: Telephone : (919) ZH tj
The file attached is being forwarded to your for your evaluation.
Please call if you need assistance.
? Stream length impacted
? Stream determination
? Wetland determination and distance to blue-line surface waters on USFW topo maps
? Minimization/avoidance issues
? Buffer Rules (Neuse, Tar-Pamlico, Catawba, Randleman)
? Pond fill
tigation Ratios
? Ditching
? Are the stre and or wetland mitigation sites available and viable?
? Check awings for accuracy
? Is a application consistent with pre-application meetings?
? umulative impact concern
Comments: Ao?? eeae.- /-k4-or--
.5 14 ULA
Office Use Only' Form Version May 2002
USACE Action ID No. DWQ No.
(If any particular item is not applicable to this project, please enter "Not Appucame or ..iN/A .)
1.
II.
Processing
1. Check all of the approval(s) requested for this project:
X Section 404 Permit ? Riparian or Watershed Buffer Rules
? Section 10 Permit ? Isolated Wetland Permit from DWQ
X 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested: NWP 39
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: ?
Applicant Information
1. Owner/Applicant Information
Rielin/K
:e Works
*7MO/401 Woop
JUN ? 4 IU03
Winston-Salem North Carolina 27107 NOV I I
Name:
Mailing Address:
Mr. Richard Dehart
Telephone Number: 336-399-2484 Fax Number: 336-775-2555
E-mail Address:
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: Denise M. Poulos
Company Affiliation: ECS Ltd.
Mailing Address: 6909 International Drive
Suite 103
Greensboro North Carolina 27409
Telephone ?4Umber: 336-856-7150 Fax Number: 336-856-7160
E-mail Ad ress:
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: The Chase at Kingstree
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN):
4. Location
County: Forsyth Nearest Town: Winston-Salem
Subdivision name (include phase/lot number): The Chase at Kingstree
Directions to site (include road numbers, landmarks, etc.): From Winston-Salem: Business
40 to Peters Creek Parkway. South on Peters Creek Parkway. Left on Sides Road.
Right on Kingstree Ride Drive
5. Site coordinates, if available (UTM or Lat/Long):
(Note - If project is linear, such as a road or utility line, attach a sheet that separately lists the
coordinates for each crossing of a distinct waterbody.)
6. Property size (acres): Approximately 24.8 Acres
7. Nearest body of water (stream/river/sound/ocean/lake): Perryman Branch
8. River Basin: Yadkin/PeeDee
(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/map-/.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: The site is undeveloped and partially wooded. The sur-
rounding_ properties contain wooded land and residential development.
Page 6 of 12
10. Describe the overall project in detail, including the type of equipment to be used: The site
is being developed with The Chase at Kingstree, a single family residential
development Trucks, pans, loaders, trackhoes, etc. will be used to construct the
project
11. Explain the purpose of the proposed work: In order to develop the site, roads must be
constructed that will cross two drainage features. One feature appears to be
unimportant/intermittent and one feature appears to be important/perennial.
IV. Prior Project History
If jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Include
the USACE Action ID Number, DWQ Project Number, application date, and date permits and
certifications were issued or withdrawn. Provide photocopies of previously issued permits,
certifications or other useful information. Describe previously approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits issued for prior segments of the same T.I.P. project, along with
construction schedules.
There have been no jurisdictional determinations or permits requested or obtained for this
project in the past V. Future Project Plans

Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application.
We do not anticipate that future permit requests will be made for this project.
VI. Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. The applicant must also
provide justification for these impacts in Section VII below. All proposed impacts, permanent
and temporary, must be listed herein, and must be clearly identifiable on an accompanying site
plan. All wetlands and waters, and all streams (intermittent and perennial) must be shown on a
delineation map, whether or not impacts are proposed to these systems. Wetland and stream
evaluation and delineation forms should be included as appropriate. Photographs may be
included at the applicant's discretion. If this proposed impact is strictly for wetland or stream
mitigation, list and describe the impact in Section VIII below. If additional space is needed for
listing or description, please attach a separate sheet.
Page 7 of 12
1. Provide a written description of the proposed impacts: The site is being developed
with a residential subdivision Roads will be constructed that will cross two drainage
features This will involve piping 132 linear feet of unimportant/intermittent channel and
149 linear feet of important/perennial channel
2. Individually list wetland impacts below: NA
Wetland Impact
Site Number
indicate on ma
Type of Impact* Area of
Impact
acres Located within
100-year Floodplain**
es/no Distance to
Nearest Stream
linear feet
Type of Wetland***

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: mechanized clearing, grading, fill,
excavation, flooding, ditching/drainage, etc. For dams, separately list impacts due to both structure and flooding.
** 100-Year floodplains are identified through the Federal Emergency Management Agency's (FEMA) Flood Insurance Rate Maps
(FIRM), or FEMA-approved local floodplain maps. Maps are available through the FEMA Map Service Center at 1-800-358-9616, or
online at http://www.fema.go .
*** 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:
3. Individually list all intermittent and perennial stream impacts below:
Stream Impact
Site Number
indicate on ma
Type of Impact* Length of
Impact
linear feet
Stream Name** Average Width
of Stream
Before Impact Perennial or
Intermittent?
leasespecify)
#1 Piping 132 if UT to Perryman Br 1-2 feet Intermittent
#2 Piping 1491f Perryman Branch 3-5 feet Perennial

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: culverts and associates rip-rap,
dams (separately list impacts due to both structure and flooding), relocation (include linear feet before and after, and net loss/gain),
stabilization activities (cement wall, rip-rap, crib wall, gabions, etc.), excavation, ditching/straightening, etc. If stream relocation is
proposed, plans and profiles showing the linear footprint for both the original and relocated streams must be included.
** Stream names can be found on USGS topographic maps. If a stream has no name, list as UT (unnamed tributary) to the nearest
downstream named stream into which it flows. USGS maps are available through the USGS at 1-800-358-9616, or online at
www.usgs.gov. Several internet sites also allow direct download and printing of USGS maps (e.g., www.topozone.com,
www.mapquest.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: 281 if
P
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: NA
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.

* List each impact separately and identify temporary impacts. impacts mclude, but are not mmneu to: im, uxuavauun, u,uugu,g,
flooding, drainage, bulkheads, etc.
Pond Creation NA
If construction of a pond is proposed, associated wetland and stream impacts should be
included above in the wetland and stream impact sections. Also, the proposed pond should
be described here and illustrated on any maps included with this application.
Pond to be created in (check all that apply): ? uplands ? stream ? wetlands
Describe the method of construction (e.g., dam/embankment, excavation, installation of
draw-down valve or spillway, etc.):
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.):
Size of watershed draining to pond: Expected pond surface area:
VII. Impact Justification (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It may be useful to provide
information related to site constraints such as topography, building ordinances, accessibility, and
financial viability of the project. The applicant may attach drawings of alternative, lower-impact
site layouts, and explain why these design options were not feasible. Also discuss how impacts
were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce impacts.
In order to access the entire site, roads will be constructed that will cross two drainage
VIII. Mitigation
DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC
Division of Water Quality for projects involving greater than or equal to one acre of impacts to
freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial
streams.
Page 9 of 12
USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on March 9, 2000, mitigation will be required when
necessary to ensure that adverse effects to the aquatic environment are minimal. Factors
including size and type of proposed impact and function and relative value of the impacted
aquatic resource will be considered in determining acceptability of appropriate and practicable
mitigation as proposed. Examples of mitigation that may be appropriate and practicable include,
but are not limited to: reducing the size of the project; establishing and maintaining wetland
and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of
aquatic resource functions and values by creating, restoring, enhancing, or preserving similar
functions and values, preferable in the same watershed.
If mitigation is required for this project, a copy of the mitigation plan must be attached in order
for USACE or DWQ to consider the application complete for processing. Any application
lacking a required mitigation plan or NCWRP concurrence shall be placed on hold as
incomplete. An applicant may also choose to review the current guidelines for stream restoration
in DWQ's Draft Technical Guide for Stream Work in North Carolina, available at
http://h2o.enr.state.nc.us/ncwetlands/stn-ngide.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.
The impact to the perennial/important stream channel has been designed to be only
149 linear feet in length Due to the minimal impact, mitigation should not be required.
The impact to the intermittent/unimportant channel is only 132 linear feet. Due to the
nature of this channel, mitigation should not be required and none is proposed.
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/wEp/index.htm. If use of
the NCWRP is proposed, please check the appropriate box on page three and provide the
following information:
Amount of stream mitigation requested (linear feet):
Amount of buffer mitigation requested (square feet):
Amount of Riparian wetland mitigation requested (acres):
Amount of Non-riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres):
Page 10 of 12
IX. 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 X
If yes, does the project require preparation of an environmental document pursuant to the
requirements of the National or North Carolina Environmental Policy Act (NEPA/SEPA)?
Note: If you are not sure whether a NEPA/SEPA document is required, call the SEPA
coordinator at [phone] to review current thresholds for environmental documentation.
Yes ? No ?
If yes, has the document review been finalized by the State Clearinghouse? If so, please attach a
copy of the NEPA or SEPA final approval letter.
Yes ? No ?
X. Proposed Impacts on Riparian and Watershed Buffers (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
(Neuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify )?
Yes ? No X 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
* Zone 1 extends out 30 feet perpendicular from near bank of channel; Gone Z 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.
When developed, the site will contain 27% impervious surfaces.
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.
When developed, the site will be connected to the sanitary sewer system.
XIII. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes ? No X
Is this an after-the-fact permit application?
Yes ? No X
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).
co / oZ 3
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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401/Wetlands Unit, Division of Water Quality
1650 Mail Services Center
Raleigh, North Carolina 27699-1621
e-mail [e-mail], FAX [phone]
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Stream Width: Flow Co llition*4 Stream Order:
Stream Permanence Characteristics, Rating (if relev n?
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Other Observations (i.e. Presence of Iron Oxidizing bacteria):

HOMESTEAD-RICLIN/KINGSTREE, LLC,Perryman Branch, Forsyth, DWQ 030772
Subject: HOMESTEAD-RICLIN/KINGSTREE, LLC,Perryman Branch, Forsyth, DWQ
030772
Date: Thu, 3 Jul 2003 12:55:43 -0400
From: "Ron Linville" <[e-mail]>
Organization: NCWRC
To: "401 Cyndi Bell Karoly" <[e-mail]>,
"COE Tugwell, Todd" <[e-mail]. army. miI>
I looked at this site early today. We had some rain, but the intermittent tributary (crossing #1) looked like it has some
importance. It is possibly perennial although it is likely to have looked very dry during the previous drought. I will
send comments to you as soon as I can after the holiday. There is a lot of bedrock present (downstream of crossing
#2) so bridging the main tributary might be a better option if they hit solid rock. I really don't see how they can
squeeze all these houses into such a small area without some secondary impact issues with stream buffers and
long-term stream integrity. The stream is pretty.
James Ronald Linville
NC Wildlife Resources Commission
Habitat Conservation Program
336-769-9453 (W)
336-769-0031 (FAX)
There is one ocean, with coves having many names; a single sea of atmosphere, with no coves at all; a thin miracle
of soil, alive and giving life; a last planet; and there is no spare. - David R. Brower
1 of 1 7/14/03 2:52 PM
7 h?
ENGINEERING CONSULTING SERVICES, LTD.
Geotechnical • Construction Materials • Environmental
June 23, 2003
Mr. John Dorney
Division of Water Quality
401/Wetlands Unit a
1650 Mail Service Center
Raleigh, North Carolina, 27699-1650
Subject: Pre-Construction Notification Application
Request for 401 Water Quality Certification
The Chase at Kingstree
Forsyth County, Winston-Salem, North Carolina
ECS Project G-8071
Dear Mr. Dorney:
Please find seven copies of the Pre-Construction Notification Application for the above referenced
project. The site is approximately 24.8 acres in area and is located on Kingstree Ridge Drive in Winston-
Salem (Figure 1). The site is being evaluated for development with The Chase at Kingstree, a single
family residential subdivision.
An unnamed tributary to Perryman Branch is located near the southwestern boundary of the site. This
feature appears to be an unimportant/intermittent channel. It posses a defined bed and bank; however, at
the time of our assessment, neither flowing water nor aquatic organisms were present. As shown on the
attached exhibits prepared by Latham-Walters Engineering, Inc., 132 linear feet of this channel will be
impacted by the construction of Folkstone Ridge Lane (Crossing #1). The impact at this location has
been minimized with the use of a headwall and a 2:1 side slope. In addition, the pipe will be buried
approximately six inches below the bottom of the channel to facilitate movement of aquatic organism.
Based on the nature of this channel, mitigation is not proposed.
Perryman Branch crosses the eastern portion of the site. This is a perennial/important stream channel.
As shown on the attached exhibits prepared by Latham-Walters Engineering, Inc., 149 linear feet of this
stream will be impacted by the construction of Trillium Lane (Crossing #2). The impact at this location
has been minimized through the use of a headwall and a 2:1 side slope. In addition, the pipe will be
buried approximately six inches below the bottom of the channel to facilitate movement of aquatic
organisms. Based on the minimal impact of less than 150 linear feet, mitigation is not proposed.
When developed, the site will contain 27% impervious surfaces. Therefore, stormwater management is
not proposed.
*VU/N1 00P
JUN Y, 4 2003

6909 International Drive, Suite 103 • Greensboro, NC 27409 • [phone] • Fax [phone]
Offices: Aberdeen, MD • Atlanta, GA • Austin, TX • Baltimore, MD • Chantilly, VA • Charlotte, NC • Chicago, IL • Cornelia, GA • Dallas, TX
Danville, VA • Frederick, MD • Fredericksburg, VA • Greensboro, NC • Greenville, SC • Norfolk, VA • Orlando, FL • Raleigh, NiC
Richmond, VA • Roanoke, VA • San Antonio, TX • Williamsburg, VA • Wilmington, NC • Winchester, VA
Section 401 Permitting
The Chase at Kingstree
ECS Project G-8071
On behalf of Homestead-Riclin/Kingstree LLC, I am requesting that a 401 Water Quality Certification be
issued to authorize these impacts. Please feel free to contact me at [phone] if you have any
questions concerning this request or if additional information is required. Thank you in advance for your
timely consideration of this matter.
Sincerely,
ENGINEERING CONSULTING SERVICES, LTD.
Denise M. Poulos
Principal Scientist
Attachments: Pre-Construction Notification Application
$475 Water Quality Certification Fee
2
Triage Check List
f 5 Aez,
Date: Project Name. Qi
DwQ#:
County: V_14?
To: ? ARO Mike Parker ? WaRO Tom Steffens
? FRO Ken Averitte ? WiRO Noelle Lutheran
? MRO Alan Johnson 9___WSRO Cyndi Karoly (Central Office)
? RRO Steve Mitchell
From: Telephone : (919) ZH The file attached is being forwarded to your for your evaluation.
Please call if you need assistance.
? Stream length impacted
? Stream determination
? Wetland determination and distance to blue-line surface waters on USFW topo maps
? Minimization/avoidance issues
? Buffer Rules (Meuse, Tar-Pamlico, Catawba, Randleman)
? Pond fill
tigation Ratios
? Ditching
? Are the stre and or wetland mitigation sites available and viable?
? Chec awings for accuracy
? Is a application consistent with pre-application meetings?
? umulative impact concern
Comments:

/21
Z/ _/_
72
Homestead-Riclin / Kingstree, LLC
390 Concrete Works Rd
Winston-Salem, NC 27107
March 14, 2003
To Whom It May Concern:
This letter is to authorize Denise Poulos of ECS, Ltd. To act as our agent in
wetland/stream matters, including verification and permit application, for The
Chase at Kingstree subdivision in Winston-Salem, NC.
Thank You,
4?'I' ??
Richard Dehart
Member/Manager
JUN 2 4 2003
Office Use Only' Form Version May 2002
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:
X Section 404 Permit ? Riparian or Watershed Buffer Rules
? Section 10 Permit ? Isolated Wetland Permit from DWQ
X 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested: NWP 39
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
Owner/Applicant Information
Name: Homestead-Riclin/Kingstree, LLC
Mailing Address: 390 Concrete Works Road
Winston-Salem, North Carolina 27107
Mr. Richard Dehart
Telephone Number: 336-399-2484 Fax Number: 336-775-2555
E-mail Address:
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:
ise
-wwwv1'r111 unt
Company Affiliation: ECS, Ltd.
Mailing Address: 6909 International Drive JUN
Suite 103 d
Greensboro, North Carolina 27409
Telephone Number: 336-856-7150 Fax Number: 336-856-7160
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: The Chase at Kingstree
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN):
4. Location
County: Forsyth Nearest Town: Winston-Salem
Subdivision name (include phase/lot number): The Chase at Kingstree
Directions to site (include road numbers, landmarks, etc.): From Winston-Salem: Business
40 to Peters Creek Parkway. South on Peters Creek Parkway. Left on Sides Road.
Right on Kingstree Ridge Drive
5. Site coordinates, if available (UTM or Lat/Long):
(Note - If project is linear, such as a road or utility line, attach a sheet that separately lists the
coordinates for each crossing of a distinct waterbody.)
6. Property size (acres): Approximately 24.8 Acres
7. Nearest body of water (stream/river/sound/ocean/lake): Perryman Branch
8. River Basin: Yadkin/PeeDee
(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/map-/.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: The site is undeveloped and partially wooded. The sur-
rounding_properties contain wooded land and residential development.
Page 6 of 12
10. Describe the overall project in detail, including the type of equipment to be used: The site
is being developed with The Chase at Kingstree, a single family residential
development Trucks, pans, loaders, trackhoes, etc. will be used to construct the
nroiect.
11. Explain the purpose of the proposed work: In order to develop the site, roads must be
constructed that will cross two drainage features. One feature appears to be
unimportant/intermittent and one feature appears to be important/perennial.
IV. Prior Project History
If jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Include
the USACE Action ID Number, DWQ Project Number, application date, and date permits and
certifications were issued or withdrawn. Provide photocopies of previously issued permits,
certifications or other useful information. Describe previously approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits issued for prior segments of the same T.I.P. project, along with
construction schedules.
There have been no jurisdictional determinations or permits requested or obtained for this
project in the past
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application.
We do not anticipate that future permit reguests will be made for this project.
VI. Proposed Impacts to Waters of the United States/Waters of the State.
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. The applicant must also
provide justification for these impacts in Section VII below. All proposed impacts, permanent
and temporary, must be listed herein, and must be clearly identifiable on an accompanying site
plan. All wetlands and waters, and all streams (intermittent and perennial) must be shown on a
delineation map, whether or not impacts are proposed to these systems. Wetland and stream
evaluation and delineation forms should be included as appropriate. Photographs may be
included at the applicant's discretion. If this proposed impact is strictly for wetland or stream
mitigation, list and describe the impact in Section VIII below. If additional space is needed for
listing or description, please attach a separate sheet.
Page 7 of 12
1. Provide a written description of the proposed impacts: The site is being developed
with a residential subdivision Roads will be constructed that will cross two drainage
features This will involve piping 132 linear feet of unimportant/intermittent channel and
149 linear feet of important/perennial channel
2. Individually list wetland impacts below: NA
Wetland Impact
Site Number
indicate on ma
Type of Impact* Area of
Impact
acres Located within
100-year Floodplain**
es/no Distance to
Nearest Stream
linear feet
Type of Wetland***

* List each impact separately and identify temporary impacts. Impacts include, but are not bmtted to: mechanized ciearing, graumg, 1111,
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 hqp://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.) 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:
3. Individually list all intermittent and perennial stream impacts below:
Stream Impact
Site Number
indicate on ma
Type of Impact* Length of
Impact
linear feet
Stream Name** Average Width
of Stream
Before Impact Perennial or
Intermittent?
leasespecify)
#1 Piping 1321f UT to Perryman Br 1-2 feet Intermittent
#2 Piping 1491f Perryman Branch 3-5 feet Perennial

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: culverts and associated rip-rap,
dams (separately list impacts due to both structure and flooding), relocation (include linear feet before and after, and net loss/gain),
stabilization activities (cement wall, rip-rap, crib wall, gabions, etc.), excavation, ditching/straightening, etc. If stream relocation is
proposed, plans and profiles showing the linear footprint for both the original and relocated streams must be included.
** Stream names can be found on USGS topographic maps. If a stream has no name, list as UT (unnamed tributary) to the nearest
downstream named stream into which it flows. USGS maps are available through the USGS at 1-800-358-9616, or online at
www.usgs.gov. Several internet sites also allow direct download and printing of USGS maps (e.g., www.topozone.com,
www.mapquest.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: 281 if
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: NA
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.

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: till, excavation, dredging,
flooding, drainage, bulkheads, etc.
5. Pond Creation NA
If construction of a pond is proposed, associated wetland and stream impacts should be
included above in the wetland and stream impact sections. Also, the proposed pond should
be described here and illustrated on any maps included with this application.
Pond to be created in (check all that apply): ? uplands ? stream ? wetlands
Describe the method of construction (e.g., dam/embankment, excavation, installation of
draw-down valve or spillway, etc.):
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.):
Size of watershed draining to pond: Expected pond surface area:
VII. Impact Justification (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It may be useful to provide
information related to site constraints such as topography, building ordinances, accessibility, and
financial viability of the project. The applicant may attach drawings of alternative, lower-impact
site layouts, and explain why these design options were not feasible. Also discuss how impacts
were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce impacts.
In order to access the entire site, roads will be constructed that will cross two drainage
features In order to minimize the impacts to theses features, headwalls and 2:1 side slopes
will be used In addition, to facilitate movement of aquatic life, the pipes will be buried
approximately six inches below the bottom of the channel.
VIII. Mitigation
DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC
Division of Water Quality for projects involving greater than or equal to one acre of impacts to
freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial
streams.
Page 9 of 12
USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on March 9, 2000, mitigation will be required when
necessary to ensure that adverse effects to the aquatic environment are minimal. Factors
including size and type of proposed impact and function and relative value of the impacted
aquatic resource will be considered in determining acceptability of appropriate and practicable
mitigation as proposed. Examples of mitigation that may be appropriate and practicable include,
but are not limited to: reducing the size of the project; establishing and maintaining wetland
and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of
aquatic resource functions and values by creating, restoring, enhancing, or preserving similar
functions and values, preferable in the same watershed.
If mitigation is required for this project, a copy of the mitigation plan must be attached in order
for USACE or DWQ to consider the application complete for processing. Any application
lacking a required mitigation plan or NCWRP concurrence shall be placed on hold as
incomplete. An applicant may also choose to review the current guidelines for stream restoration
in DWQ's Draft Technical Guide for Stream Work in North Carolina, available at
http://h2o.enr.state.nc.us/ncwetlands/stnngide.html.
Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
The impact to the perennial/important stream channel has been designed to be only
149 linear feet in length Due to the minimal impact, mitigation should not be required.
The impact to the intermittent/unimportant channel is only 132 linear feet. Due to the
nature of this channel, mitigation should not be required and none is proposed.
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 X
If yes, does the project require preparation of an environmental document pursuant to the
requirements of the National or North Carolina Environmental Policy Act (NEPA/SEPA)?
Note: If you are not sure whether a NEPA/SEPA document is required, call the SEPA
coordinator at [phone] to review current thresholds for environmental documentation.
Yes ? No ?
If yes, has the document review been finalized by the State Clearinghouse? If so, please attach a
copy of the NEPA or SEPA final approval letter.
Yes ? No ?
X. Proposed Impacts on Riparian and Watershed Buffers (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
(Neuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify )?
Yes ? No X 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
* Zone 1 extends out 30 feet perpendicular from near bank of cttanncf; Lone t 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.
When developed, the site will contain 27% impervious surfaces.
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.
When developed, the site will be connected to the sanitary sewer system.
XIII. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes ? No X
Is this an after-the-fact permit application?
Yes ? No X
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).
Ca /a3
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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PROPOSED RIP
APRON
UNITED STATES POSTAL SERVICE
Flrat-Cl pea Mail
u g 6 & Fees Paid
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4 in this box •
NC DGNR Division of Water Quality
Wetlands/401 Certification Unit
2321 Crabtree Boulevard, Suite 250
Raleigh, NC 27604
¦ CompletO items 1, 2, and 3. Also complete
Wand Delivery Is desired.
¦ ' r and d address on the reverse
so that we can return the card-to you.
¦ Attach this card to the back of the mailplece,
or on the front N space permits.
1. Article AddrfsmW to:
Homestead-Riclin/Kingstree, LLC
390 Concrete Works Road
Winston-Salem, NC 27107
DWQ# 03-0772 - Forsyth
A.
X
? Agent
B. Rebelved by ( Printed Name) C. Date of Deliver
0"l- P-03 Q'
Dt Is delivery address different from Item 1? ? Yea
If YES, enter delivery address below: ? No
3. Service Type
'Certified Mail ? Express Mail
? Registered LrRetum Receipt for Merchandls
? Insured Mail ? C.O.D.
4. Restricted Delivery? (Extre Fee) ? Yes
2. Article Number 7002 2410 0003 0275 1680
Mansfer from seryke la
PS Ppan , WINK t 2001 Domestic Return Receipt 102595-02-M-15
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