20031407 Ver 1_COMPLETE FILE_20031110

Offi'iee Use only: 08 40
USACE Action ID No, F° Version April 2001
DWQ No.
If any particular item is not applicable to this '
leaving the space blank. proJect, please enter „Not Applicable" or "N/A" rather than
I• Processing WETLANDS 1401 G oUp
l . Check all of the approval(s) requested for this project,
,2rSection 404 Permit NOV 1 0 2003
t on 1 o Permit WATER
401 Water Quality C?fication QU'?1T1' SECTION
Riparian or Watershed Buffer Rules
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 mq check here: 4. If payment into the North Carolina Wetlands Restoration Program (IVCWRI') Proposed for
Mitigation), check here: (? -
II. Applicant Information
l - Owner/Applicant Information
Name:
Mailing Address:
Kb?. 1V G S
Telephone Number: S B 7
E-mail Address: Fax Number:
2. Agent Information (A signed and dated co
attached if the Agent has signa py of the Agent Authorization letter must be
Name.mr3' authority for the owner/applicant.)
Company Affiliation:
Mailing Address:
Telephone Number:
E-mail Addrese-
Fax Number:
Page 3 of 3
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 lan showin
boundaries and development plans in relation to surroundin
g properties. g lxy map
and site plan must include a scale and north arrow. The . Both the vicinity map
impervious surfaces, specific footprints of all buildings, other facilities must be included. If include the appropriate USES To Possible, the maps and plans should
boundaries outlined, Plan drawings, Quad Map and NRCS Soil Survey with the property
USAGso boundaries
as the or other maps may be included at the applicant's discretion,
gE Party is clearly defined. For adutin strative and distribution purposes, the
requires information to be submitted on sheets no larger than I 1 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
the version is illegible, the applicant will be informed that
project has been placed on hold until decipherable maps are provided.
1. Name of project:-L"g-v°w Gltza,,,??;i ?„
2. T.I.P. Project Number (NCDOT Only): -?
3. Property Identification Number (Tax PIN): (f 6 3 3
4. Location
County: t'ncl-"? Nearest Town: Ft -wrO t
Subdivision name (include phase/lot number):
Directions to site (`include road numbers, landmarks, etc.):
L a... 1 ..w, s.f i?_ 4 A _ _ ?,

5. Site coordinates, if available (UTM or LatlLong):
(Note -- If project is linear, such as a road or utility
coordinates for each crossing of a distinct waterbody.)? attach a sheet that separately lists the
e
b. Describe the existing land use or condition of the site at the time of this application:
' '3 A4.11 ell-qtr -- X.. -- l J _
7. Property size (acres):! ,-
8. Nearest body of water (streamlriverlsound/oceanCak ):-'?'`d2fj-p,r-*U4r-
9. River Basin:
(Note - this m be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http:/A,20.enr.state.nc.us/admi4ftaps/.)
Page 4 of 4
10. Describe the purpose of the proposed work: ,, ,
11. List the type of equipment to be used to construct the project:__ /i E'"
12. Describe the land use in the vicinity of this project:.
IV. Prior Project History
If jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Include
the US.ACE 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.
117e
V. Future Project Plans
Are any additional permit requests anticipated for this project in the future? If so, describe the
anticipated work, and provide justification for the exclusion of this work from the current
application:-
VI. Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. The applicant must also
provide justification for these impacts in Section VII below. All proposed impacts, permanent
and temporary, must be listed herein, and must be clearly identifiable on an accompanying site
plan. All wetlands and waters, and all streams (intermittent and perennial) must be shown on a
delineation map, whether or not impacts are proposed to these systems. Wetland and stream
evaluation and delineation forms should be included as appropriate. Photographs may be
included at the applicant's discretion. If this proposed impact is strictly for wetland or stream
mitigation, list and describe the impact in Section VIII below. If additional space is needed for
listing or description, please attach a separate sheet.
Page 5 of 5
I . Wetland Impacts
ter: wrrnm Distance to ftfULZ Site to on Type of Impact* Impact 1 OD year Floodplain**
I - F Nearest Stream Type of Wetland*
{indicate on map) fnrmel **
""i'UA;''ePmmery ana 1(jentily temporary
impacts Ltnpacts include, but are not limited to_ mechanized clcarirr
excavation, flooding, ditebing/dcainage, etc. For dams, separately list im g, grading, fill,
** 100-Year floodplains are identified thrcxr the Federal F due to both structure and flooding.
{FIRM), or FEMA-approved local floodphrin we y dement Agency's {FEMA) Flood Insurance Rate Maps
maps. Maps ar available though the
amine at httnJl www. fema_ av. FEMA Map Service Center at 1-800-359-9616, or
*** List anawetland Day, b pe that best describes wetland to be impacted (eg,, freshwater/saltwater marsh, forested wetland, beaver pond,
List the total acreage (estimated) of existing wetlands on the property:
Total area of wetland impact proposed:
2. Stream impacts, including all intermittent and perennial Weams
Site Number -
Type of Impact* Impact
idicate on man) n;

Stream Name**
-. v-udf ,u,pa" srpararery ana Identity temporary impacts. Impacts include, but assocrmted rip-rap,
dams (separately list impacts due to both structure and flooding), relocation (include linear feet before and alter, and net losstgain),
stabilization activities (cement wall, rip-rap, crib wall, gabions, etc ), excavation, diWdng/straighter in& 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 amps. 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 though the USGS at I-800-358-9616, or online at
%,-gs.aov. Several internet sites also allow direct download and printing of USGS asps (cg., www.tapozone.com
www.mapquest.com.
Cumulative impacts (linear distance in feet) to all streams on site: -Z----° "?
Average Wid
of Stream
Before Impact Perennial or
Intermittent?
(please s)ecify)
?r

are not limited to. culverts and
Page 6 of 6
3. Open Water Impacts, including Lakes, Ponds, Estuaries, Sounds, Atlantic Ocean and any
other Water of the U. S.
Site Number Type of Impact* Impact Name of waterbody ? ype or waterbody
ndicate on map) (acres) (if applicable) (fie, pond, estuary, sound,
bay, ocean, etc,)
List each impact separately and identify temporary impacts. Impacts include, but we not limited to_ fill excavation, dredging,
flooding, drainage, bulkheads, eta
4. Pond Creation
If construction of a pond is Proposed, associated wetland and stream impacts should be
included above in the wetland and stream impact sections. .Also, the proposed pond should
be described here and illustrated on any neaps included with this application.
Pond to be created in (check all that apply): ? uplands [] stream E] 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. A F-
a
Page 7 of 7
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.
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://h2G.em.state.nc.uslncwetlan"§trmgide.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.
f'-
A-at
fYr? rf' et4-.eic. .Q del ti rye a
Page 8 of 8
2. Mitigation may also be made by payment into the North Carolina Wetlands Restoration
Program (NCWRP) with the NCWRP's written agreement. Check the box indicating that
you would like to pay into the NCWRP. Please note that payment into the NCWRP must be
reviewed and approved before it can be used to satisfy mitigation requirements. Applicants
will be notified early in the review process by the 401/Wetlands Unit if payment into the
NCWRP is available as an option. For additional information regarding the application
process for the NCWRP, check the NCWRP website at hft:/&2o.enr.state.nc.Wwrp/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): -
jX. Environmental Documentation (DWQ Only)
Does the project involve an a nditure of public funds or the use of public (federal/state/loeal)
land?
Yes n No
If yes, does the project require preparation of an environmental document pursuant to the
requirements of the National or North Carolina Environmental Policy Act (NEPA/SEPA)?
Note: If you are not sure whether a NEPA/SEPA document is required, call the SEPA
coordinator at [phone] to review current thresholds for environmental documentation.
Yes ? No n
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 n No [-]
X. Proposed Impacts on Riparian and Watershed Buffers (DWQ Only)
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
required state and local buffers associated with the project. The applicant must also provide
justification for these impacts in Section VII above. All proposed impacts must be listed herein,
and must be clearly identifiable on the accompanying site plan. All buffers must be shown on a
map, whether or not impacts are proposed to the buffers. Correspondence from the DWQ
Regional Office may be included as appropriate. Photographs may also be included at the
applicant's discretion.
Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Meuse), 15A NCAC 211 :0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Requi ments), or other (please identify )?
Yes [] No If you answered "yes", provide the following information:
Page 9 of 9
Identify the square feet and acreage of impact to each zone of the riparian buffers. Lf buffer
buffer
mitigation is required calculate the required amount of mitigation by applying the
multipliers.
Zone"
2
Total
Multiplier
1.5
near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.
If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation
of Property, Conservation Easement, Riparian Buffer Restoration / Enhancement, Preservation or
Payment into the Riparian Buffer Restoration Fund). Please attach all appropriate information as
identified, within 15A NCAC 2B .0242 or.0260.
XI. Stormwater (DWQ Only)
Describe impervious acreage (both existing and proposed) versus total acreage on the site.
Discuss stormwater controls proposed in order to protect surface waters and wetlands
downstream from the property.
A
XII. Sewage Disposal (DWQ On1Y)
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from the proposed project, or available capacity of the subject facility.
XIII. Violations (DWQ Only)
Is this site in violation of DW Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes No
Is this an after-the-fact permit plication?
Yes El No F-VT
Page 10 of 10
XTV. 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).
r -

Applicant/ ' eht's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
US Army Corps Of Engineers Field Offices and County Coverage
Asheville Regulatory Field Office, Alexander Cherokee lredell Mitchell Union
US Army Corps of Engineers Avery
Buncombe Clay
Cleveland Jackson Polk
Lincoln Rowan Watauga
Yancey
151 Patton Avenue
Room 208 Burke Gaston Macon Rutherford
Asheville, NC 28801-5006 , Cabamrs Graham Madison Stanley
Telephone: [phone]- Caldwell Haywood McDowell Swain
Fax: [phone] . " Catawba Henderson Mecklenburg Transylvania

Raleigh-Regulatory Field Office Alamance Durham Johnston Rockingham Wilson
US Army Corps Of Engineers Alleghany Edgecombe Lee Stokes Yadkin
6508 Falls of the Neuse Road Ashe Franklin Nash Surry
Suite 120 Caswell Forsyth Northampton Vance
Raleigh, NC 27615 Chatham Granville Orange Wake
Telephone: [phone] Davidson Guilford Person Warren
Fax: [phone] Davie Halifax Randolph Wilkes
Washington Regulatory Field Office Beaufort Currituck Jones Pitt
US Army Corps of Engineers Bertie Dare Lenoir
Martin Tyrrell
Washington
Post Office Box 1000 Camden Gags Pamlico Wayne
Washington, NC 27889-1000 Carterw Green
Telephone: [phone] Chowan
C Hertford
de
H Pasquotank
Perquimans
*Croatan National Forest Only
Fax: [phone] raven y
Wilmington Regulatory Field Office Anson Duplin Onslow
US Army Corps Of Engineers Bladen Harnett Pender
Richmond
Post Office Box 1890 Brunswick
Carteret Hoke
Montgomery Robeson
Wilmington, NC 28402-1890
Telephone: [phone] Columbus Moore Sampson
Fax: [phone] Cumberland New Hanover Scotland
Page 11 of 11
US Fisl
US Fish and Wildlife Service
Raleigh Field Office
Post Office Box 33726
Raleigh, NC 27636-3726
Telephone: [phone]
i and Wildlife Service / National Marine Fisheries Service
US Fish and Wildlife Service National Marine Fisheries Service
Asheville Field Office Habitat Conservation Division
160 Zillicoa Street Pivers Island
Asheville, NC 28801 Beaufort, NC 28516
Telephone: [phone] Telephone: [phone]
Division of Water Quality
401 Wetlands Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
Telephone: [phone]
Fax: [phone]

North Carolina State Agencies
Division of Water Quality
Wetlands Restoration Program
1619 Mail Service Center
Raleigh, NC 27699-1619
Telephone: [phone]
Fax: [phone]
State Historic Preservation Office
Department Of Cultural Resources
4617 Mail Service Center
Raleigh, NC 27699-4617
Telephone: [phone]
Fax: [phone]
CAMA and NC Coastal Counties
Division of Coastal Management Beaufort Chowan Hertford Pasquotank
1638 Mail Service Center Bertie Craven Hyde Pender
Raleigh, NC 27699-1638 Brunswick Currituck New Hanover Perquimans
Telephone: [phone] Camden Dare Onslow Tyrrell
Fax: [phone] Carteret Gates Pamlico Washington
NCWRC and NC Trout Counties
Western Piedmont Region Coordinator
3855 Idlewild Road
Kernersville, NC 27284-9180
Telephone: (336)7G9_- _9453
Mountain Region Coordinator ?\
20830 Great Smoky Mtn. Expressway
Waynesville, NC 28786
Telephone: [phone]
Fax: [phone]

Alleghany
Ashe
Avery
Burke
Caldwell
Mitchell
Stokes
Surry
Watauga
Wilkes
Buncombe
Cherokee
Clay
Graham
Haywood
Henderson
Jackson
Macon
Madison
McDowell
Polk
Rutherford
Swain
Transylvania
Yancey
Page 12 of 12
Z-71 *,IV
wY 7 sa
???fcs .ter

0
!S
33
c-
??? ?? ;uamal?vd . i t '?".kj???

Av'
------------------------------
?1 ! E
n c ? r /ry
c ---------
c??
YeA

O? QG Michael F. Easley, Governor
O?-W A ?9
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan Klimek, P.E., Director
Division of Water Quality
Coleen H. Sullins, Deputy Director
Division of Water Quality
November 25, 2003
DWQ # 03-1407
Buncombe County
On November 10, 2003 the Division of Water Quality
regarding your plan to fill wetlands or waters for the
Approval from DWQ is required to disturb these areas. P
refer to the DWQ # listed above in your reply. Please sho
feet) so we can begin to determine your projects' complia
1. Please provide a location map for the project.
ication
;ounty.
ion and
= 100
2. Please locate all isolated or non-isolated wet Overlays
on the site plan.
3. Please provide cross section details showing the provisions for aquatic life passage.
4. The application fee was insufficient because over 150 of stream and/or over 1 acre of wetland impacts
were requested. Please provide $475.00.
5. Please provide 5 copies of the application, 7 copies of the site plans and other supporting information.
e telephone Beth Barnes at 919-715-8394 if you have any questions or would require copies of our rules or
dural materials. This project will remain on hold as incomplete in accordance with 15A NCAC 2H.0505(c).
?rocessing time for this application will begin when this information is received. If we do not hear from you
riting or by fax at [phone] within three (3) weeks we will assume you no longer want to pursue the
ct and will consider it withdrawn.
Program
'e DWQ Regional Office
Corps of Engineers
les

kOl Wetlands Certification Unit,
NC 27699-1650 (Mailing Address)
7604-2260 (Location)
393 (fax), (http://h2o.enr.state.nc.us/ncwetlandsl
-oG3-6748
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
William A. Allan
Post Office Box 545
Montreat, NC 28757
Subject Property: Lakeview Condominiums
Dear Mr. Allan:
Sincerely,
Office Use Only:
USACE A Form version Agri! 2001
cfion ID Na.
DWQ No.
If any Particular item is not applicable to this '
leaving the space blank. Project, please enter „Not Applicable" or "N/A„ rather than
I- Processing 11 40 "T WE71ANDS / 401 GROUP
1. Check all of the approval(s) requested for this project:
Section 404 Permit NO V 1 0 2003
Lion 10 Permit
401 Water Quality Certification WATER QUALITY SECTION
Riparian or Watershed Buffer Rules
2• NWonwide, Regional or General Permit Number(s) Requested:
3 • if this notification is solely a courtesy copy because written approval for the 401 is not requite check here:-JjJ certification
4. If payment into the North Carolina Wetlands Resto
Program (NC WRP) is Proposed for
mitigation of impacts (see section 'VIII - Mitigation), ration check here: E3
-
u- Applicant ftformation Mitigation), check here: E3
1- Owner/Applicant Information
Name:
Mailing Address:
N C
Telephone Number: 8 6 6
6 ot)
E-mail Address: `?---`-- Fax Number:
2. Agent Information (A sfgned and
attached if the Agent has si dated G°PY of the Agent Authorization letter must be
Name: gnatory authority for the owner/applicant.)
Company Affiliation:
Mailing Address:
Telephone Number:
E-mail Address:
Fax Number:
Page 3 of 3
III. Project Information
Attach a vicinity map clearly showing the location of the
landmarks such as towns, rivers, and roads. Also provide a detailed property with respect to local
boundaries and development plans in relation to surrounding properties. Both the vicinity ma
and site plan must include a scale and north arrow. The specific map
nd pl plbuildings,
impervious surfaces, or other facilities must be included. If possible, aof all
include the appropriate USGS To , the maps anans should
boundaries outlined. Plan drawings, >?P?c Quad Map and NR.CS Soil Survey with the property
so nd as the or other maps may be included at the applicant's discretion,
long 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 forn?at;
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 inf
the project has been placed on hold until decipherable maps are provided. ormed that
1. Name of project: kwxryw'w c.y +w vt vin
2. T.I.P. Project Number (NCDOT Only): A _
3. Property Identification Number (Tax PIN): { f ?t t} q a 7 31 - 3
4. Location
county: &rn?t Nearest Town: 4-ex -*TO
Subdivision name (include phase/lot number): -
Directions to site (include road numbers, landmarks, etc.):
- - E,.
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 watutwy.)
5. Describe the existing land use or condition of the site at the time of this application:
7. Property size (acres):
8. Nearest body of water (stream/nverlsound/oc=Cak:_ ' npr?Y,?
9. River Basin:_
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http:l/h2o.enr.state.nc.usladmin/mand.)
Page 4 of 4
10. Describe the purpose of the proposed work: - ?i? .
11. List the type of equipment to be used to construct the project:
12. Describe the land use in the vicinity of this project:. ee6
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 additional permit requests anticipated for this project in the future? If so, describe the
anticipated work, and provide justification for the exclusion of this work from the current
application:
VI. Proposed Lnpacts 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 5 of 5
I . Wetland Impacts
Site Number Type of Impact* Im ''"?"'* wrutm Distance to
idieate on map) l lQ0.year Fiotxlplain*# N(li ea Stream Type of Wetlands**
(ate) t"yes/no) (linear fret)
excexc ?_ :? x ry ant tdemity temporary impacts inc ude, but are not limmited to nnc hanized clcaritt
avation, flooding, dit ditching/drainage, etc. For dams, separately list im grading, fill,
«« 100-Year fl pacts due to both structure and flooding.
oodpWW ate identified through the Federal Emergency Management Agency's (FEMA) Flood Insurance Rate Maps
(FIRM), or FEMA-approved local floodplain maps, Maps are available
online at httj) ww_f through the FEMA
ema aov. Map Scrvict Center at I-NO-35&9616, or
««* List a wetland type that best describes wetland to be impac
Carolina Bay, bog, etc.) ted (e-g, fwatcr/saltwater m pond,
arsh, forested wetkn beaver
List the total acreage (estimated) of existing wetlands on the property:
Total area of wetland impact proposed:
2. Stream Impacts, including all intermittent and perennial streams
itrveatrt Impact Length of Average W Perennial or
Site Number Type of impace impact Stream Name**
idicate on map) (linear feet) of Stt?.artr Intermittent?
Before Impact (please specify
:,4 ,r unpacr separately and identify temporary impacts, iirr
darns (separate list impacts (separately due to both strucfitre and flcwding), relocion (include linear feet before and after, and lossfWgain),
stabilization activities (current wall, rip-rap, crib net
wail, gabians, etc ), excavation, ditt3,ittgtstraightcating, etc. If stream
SW
relocation i
proposed, plans and profiles showing the linear footprint far both the ortgirtat and relocaDead stt earns must be included.
Stream names can be found an 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 i-800-35&9616, or online at
tivww.us .ROv. Several internet sites also allow direct download and printing of USGS maps (eg., www.touazone.com
,
?+ww.maaauest.cam, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: -7-
Page 6 of 6
3. Open Water Impacts, including Lakes, Ponds, Estuaries, Sounds, Atlantic Ocean and any
other Water of the U.S.
Site Number Type of Impact* Impact Name of waterbody i yPc or waierooay
(lake, pond, estuary, sound,
mlicaie an map) (acres) (if applicable)
bay, ocean, etc.)
List impact separately and identify temporary impacts Impacts dude; but arc not limited to: fill, excavation, dredging,
g, drainage, buftaKls, etc.
4. Pond Creation
If construction of a pond is proposed, associated wetland and stream impacts should be
included above in the wetland and strearn 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 El stream, 0 wetlands
Describe the method of construction (e.g., damlembankmenrt excavation, installation of
draw-down valve or spillway, etc.):
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stonnwater 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 imnactc IV-
Page 7 of 7
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.
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://h2G.enr.state.ne_ustnewetlands/sumpr_ide.htud.
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 (acreagellinear 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.
Page 8 of 8
I-er a.-e.,, ? e i7 fi tl?
2. Mitigation may also be made by payment into the North Carolina Wetlands Restoration
Program (NCWRP) with the NCWRP's written agreement. Check the box indicating that
you would like to pay into the NCWRP. Please note that payment into the NCWRP must be
reviewed and approved before it can be used to satisfy mitigation requirements. Applicants
will be notified early in the review process by the 401/Wedands Unit if payment into the
NCWRP is available as an option. For additional information regarding the application
process for the NCWRP, check the NCWRP website at http:ago.enr.state.nc.us/wn)Andex 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):
TX. Environmental Documentation (DWQ Only)
Does the project involve an expe ture of public funds or the use of public (federal/state/local)
land?
Yes No
if yes, does the project require preparation of an environmental document pursuant to the
requirements of the National or North Carolina Environmental Policy Act MPA/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 E] No
If yes, has the document review been finalized by the State Clearinghouse? If so, please attach a
copy of the NEPA or SEPA final approval letter.
Yes ? No ?
X. Proposed Impacts on Riparian and Watershed Buffers (DWQ Only)
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
required state and local buffers associated with the project. The applicant must also provide
justification for these impacts in Section VII above. All proposed impacts must be listed herein,
and must be clearly identifiable on the accompanying site plan. All buffers must be shown on a
map, whether or not impacts are proposed to the buffers. Correspondence from the DWQ
Regional Office may be included as appropriate. Photographs may also be included at the
applicant's discretion.
Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Require or other (please identify,
)?
Yes El No If you answered 'W', ', provide the following information.:
Page 9 of 9
Identify the square feet and acreage of impact to each zone of the riparian buffers-the ff buffer
buffer
mitigation is required calculate the required amount of mitigation by applying
multipliers.
Zone*
Multiplier
1 3
2 1.5
Total -
Zone 1 extends out 30 feet perpendicular from near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.
If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation
of Property, Conservation Easement, Riparian Buffer Restoration / Enhancement, Preservation or
Payment into the Riparian Buffer Restoration Fund). Please attach all appropriate information as
identified within 15A NCAC 2B .0242 or .0260.
XI. Stormwater (DWQ Only)
Describe impervious acreage (both existing and proposed) versus total acreage on the site.
Discuss stormwater controls proposed in order to protect surface waters and wetlands
downstream from the property.
XII. Sewage Disposal (DWQ Only)
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from the proposed project, or available capacity of the subject facility.
XIII. Violations (DWQ Only)
Is this site in violation of DW Wetland Rules (15A NCAC 211.0500) or any Buffer Rules?
Yes [] No
Is this an after-the-fact permit plication?
Yes ? No
Page 10 of 10
DWQ# 0 2 1 4 0
Plan Detail Incomplete
Date ?? 18 v 3 Who Reviewed: &_41 &? 5
Please provide a location map for the project.
? Please show all stream impacts including all fill slopes, dissipaters, and bank stabilization on the site plan.
? Please show all wetland impacts including fill slopes on the site plan.
? Please indicate all buffer impacts on the site plan.
? Please indicate proposed lot layout as overlays on the site plan.
? Please indicate the location of the protected buffers as overlays on the site plan.
P Please locate all isolated or non-isolated wetlands, streams and other waters of the State as overlays on the site plan.
['741 Please provide cross section details showing the provisions for aquatic life passage.
? Please locate any planned sewer lines on the site plan.
? Please provide the location of any proposed stormwater management practices as required by GC
? Please provide detail for the stormwater management practices as required by GC
? Please specify the percent of project imperviousness area based on the estimated built-out conditions.
? Please indicate all stormwater outfalls on the site plan.
? Please indicate the diffuse flow provision measures on the site plan.
? Please indicate whether or not the proposed impacts already been conducted.
Avoidance and/or Minimization Not Provided
? The labeled as on the plans does not appear to be necessary. Please eliminate the or provide additional
information as to why it is necessary for this project.
? This Office believes that the labeled on the plans as can be moved or reconfigured to avoid the impacts to the
. Please revise the plans to avoid the impacts.
? This Office believes that the labeled on the plans as can be moved or reconfigured to minimize the impacts to the
. Please revise the plans to minimize the impacts.
? The stormwater discharges at the location on the plans labeled will not provide diffuse flow through the buffer because
. Please revise the plans and provide calculations to show that diffuse flow will be achieved through the entire buffer. If it
is not possible to achieve diffuse flow through the entire buffer then it may be necessary to provide stormwater management
practices that remove nutrients before the stormwater can be discharged through the buffer.
Other ?-
e applicat' fee was insufficient because over 150 feet of stream and/or over 1 acre of wetland impacts were requested. Please
rovide $ This additional fee must be received before your application can be reviewed.
3 q7_5
? Please complete Section(s) on the application.
? Please provide a signed copy of the application.
? Please provide 5 copies of the application, 7 copies of the site plans and other supporting information.
Mitigation
? of compensatory mitigation is required for this project. Please provide a compensatory mitigation plan. The
plan must conform to the requirements in 15 A NCAC 2H .0500 and must be appropriate to the type of impacts proposed.
? Please indicate which 404 Permit the USACE would use to authorize this project.