20100297 Ver 1_401 Application_20100410

o?- VN Ar?9Q? Office Use Only:
r 2-0 100 297 Corps action ID no.
o c DWQ project no.
Form Version 1.3 Dec 10 2008
Pre-Construction Notification PCN Form
A. Applicant Information
1. Processing
1 a. Type(s) of approval sought from the

Corps:
® Section 404 Permit ? Section 10 Permit
1 b. Specify Nationwide Permit (NWP) number: 14 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps? ® Yes ? No
1 d. Type(s) of approval sought from the DWQ (check all that apply):
? 401 Water Quality Certification - Regular ? Non-404 Jurisdictional General Permit
? 401 Water Quality Certification - Express ? Riparian Buffer Authorization
1 e. Is this notification solely for the record
because written approval is not required? For the record only for DWQ 401
Certification:
® Yes ? No For the record only for Corps Permit:

® Yes ? No
1f. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in-lieu
fee program. ? Yes ® No
1 g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below. ? Yes ® No
1h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ? Yes ® No
2. Project Information
2a. Name of project: Forest Creek Subdivision, Phase 1 and Phase 2
2b. County: Caldwell County , n7%. "m
2c. Nearest municipality / town: Collettsville c
2d. Subdivision name: Forest Creek (Proposed) .
2e. NCDOT only, T.I.P. or state
project no: N/A
41 RQUAIITY
3. Owner Information WETLANDS ANDMRMIWA
3a. Name(s) on Recorded Deed: See Attached:
3b. Deed Book and Page No.
3c. Responsible Party (for LLC if
applicable):
3d. Street address:
3e. City, state, zip:
3f. Telephone no.:
3g. Fax no.:
3h. Email address:
Page 1 of 11
PCN Form - Version 1.3 December 10, 2008 Version

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4. Applicant Information (if different from owner)
4a. Applicant is: D? Agent © Other, specify: Equitable Owner
4b. Name: Larry Bragg
4c. Business name
(if applicable): Capital Land Group, LLC
4d. Street address: 1055 Carpenter Drive
4e. City, state, zip: Lincolnton, NC 28092
4f. Telephone no.: [phone]
4g. Fax no.: [phone]
4h. Email address: [e-mail]
5. Agent/Consultant Information (if applicable)
5a. Name: Jeffrey J. Swartz, PE, LEED AP
5b. Business name
(if applicable):
5c. Street address: 585 B and T Lane
5d. City, state, zip: Taylorsville, NC 28681
5e. Telephone no.: [phone]
5f. Fax no.: [phone]
5g. Email address: [e-mail]
Page 2 of 11
PCN Form - Version 1.3 December 10, 2008 Version
B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): See Attached:
1 b. Site coordinates (in decimal degrees): Latitude: 35.9283 Longitude: - 81.6627
(DD.DDDDDD) (-DD.DDDDDD)
1c. Property size: 285ac Ph1+79Ac Ph2 of 780 total acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to Mulberry Creek & Benbo Branch
proposed project:
2b. Water Quality Classification of nearest receiving water: C
2c. River basin: Catawba
3. Project Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application:
The parcel is mostly wooded and is developed with a paved driveway which provides access to two dwellings and a
cemetery. The area is: Forest Land; Cultivated Land; Very Low Density Residential
3b. List the total estimated acreage of all existing wetlands on the property:
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
4,791 LF in Phase 1 & 2 of 36,626 LF Total
3d. Explain the purpose of the proposed project:
The installation of a culvert and the replacement of an existing culvert for the purpose of providing access to a low density
residential subdivision.
3e. Describe the overall project in detail, including the type of equipment to be used:
The installation of boulder headwalls on two existing culverts, one culvert replacement and one new culvert. Work to be
down by excavator and pump by-pass w/ coffer dams for in-channel work.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
? Yes ®No ? Unknown
project (including all prior phases) in the past?
Comments:
4b. If the Corps made the jurisdictional determination, what type
? Preliminary ? Final
of determination was made?
4c. If yes, who delineated the jurisdictional areas? Agency/Consultant Company:
Name (if known): Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
5. Project History
5a. Have permits or certifications been requested or obtained for ? Yes ® No ? Unknown
this project (including all prior phases) in the past?
5b. If yes, explain in detail according to "help file" instructions.
Page 3 of 11
PCN Form - Version 1.3 December 10, 2008 Version
6. Future Project Plans
6a. Is this a phased project? ® Yes ? No
6b. If yes, explain.
This PCN is being submitted for Phase 1 & 2 of a 4 Phase Subdiivsion. See attached map for project phasing.
Page 4 of 11
PCN Form - Version 1.3 December 10, 2008 Version
C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
? Wetlands ® Streams - tributaries ? Buffers
? Open Waters ? Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a. 2b. 2c. 2d. 2e. 2f.
Wetland impact Type of jurisdiction
number - Type of impact Type of wetland Forested (Corps - 404, 10 Area of impact
Permanent (P) or (if known) DWQ - non-404, other) (acres)
Temporary T
W1 ? P ? T ? Yes ? Corps
? No ? DWQ
W2 ? P ? T ? Yes ? Corps
? No ? DWQ
W3 ? P ? T ? Yes ? Corps
? No ? DWQ
W4 ? P ? T ? Yes ? Corps
? No ? DWQ
W5 ? P ? T ? Yes ? Corps
? No ? DWQ
W6 ? P ? T ? Yes ? Corps
? No ? DWQ
2g. Total wetland impacts
2h. Comments:
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a. 3b. 3c. 3d. 3e. 3f. 3g.
Stream impact Type of impact Stream name Perennial Type of jurisdiction Average Impact
number - (PER) or (Corps - 404, 10 stream length
Permanent (P) or intermittent DWQ - non-404, width (linear
Temporary (T) (INT)? other) (feet) feet)
S1 ? PET Coffer Dam for Unnamed Trib ® PER ® Corps 4 8
Head/End Wall ? INT ? DWQ
S2 ®P ? T New Culvert Unnamed Trib ® PER
? INT ® Corps
? DWQ 3 39
S3 ? P ®T Coffer dam for
culvert install Unnamed Trib ® PER
? INT ® Corps
? DWQ 3 8
S4 ®P ? T Replace Culvert Benbo Branch ® PER
? INT ® Corps
? DWQ 2 31"
S5 ? P ®T Coffer dam for Benbo Branch ® PER ® Corps 2 8
culvert install ? INT ? DWQ
S6 ®P ? T New Culvert Unnamed ? PER
® INT ® Corps
? DWQ 1 49
3h. Total stream and tributary impacts 143
3i. Comments: `S4 excludes 16 feet of existing impact.
Page 5 of 11
PCN Form - Version 1.3 December 10, 2008 Version
4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impacts below.
4a. 4b. 4c. 4d. 4e.
Open water Name of waterbody
impact number - (if applicable) Type of impact Waterbody type Area of impact (acres)
Permanent (P) or
Temporary T
01 ?P?T
02 ?P?T
03 ?P?T
04 ?P?T
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If and or lake construction proposed, then complete the chart below.
5a. 5b. 5c. 5d. 5e.
Wetland Impacts (acres) Stream Impacts (feet) Upland
Pond ID Proposed use or purpose (acres)
number of pond
Flooded Filled Excavated Flooded Filled Excavated Flooded
P1
P2
5f. Total
5g. Comments:
5h. Is a dam high hazard permit required?
? Yes ? No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If an impacts require mitigation, then you MUST fill out Section D of this form.
6a.
Project is in which protected basin?
6b. 6c. 6d.
Buffer impact
number - Reason
Permanent (P) or for
Temoorarv (T) impact
61 ?P?T
? Neuse ? Tar-Pamlico ? Other:
? Catawba ? Randleman
6e. 6f. 6g.
Buffer
Stream name mitigation
required?
? Yes
? No
? Yes
? No
? Yes
? No
6h. Total buffer impacts
Zone 1 impact Zone 2 impact
(square feet) (square feet)
B2 ?P?T
B3 ?P?T
6i. Comments:
Page 6 of 11
PCN Form - Version 1.3 December 10, 2008 Version
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
'00,i, a Oi de?? ?t a?? ° 'govt CwNs Ctas .?a S ak d' 40.3 ?} la ,3ut-
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for
impacts to Waters of the U.S. or Waters of the State? ? Yes Eg No
2b. If yes, mitigation is required by (check all that apply): ? DWQ ? Corps

2c. If yes, which mitigation option will be used for this

project? ? Mitigation bank

El Payment to in-lieu fee program

? Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter) Type Quantity
3c. Comments:
4. Complete if Making a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached. ? Yes
4b. Stream mitigation requested: linear feet
4c. If using stream mitigation, stream temperature: ? warm ? cool ?cold
4d. Buffer mitigation requested (DWQ only): square feet
4e. Riparian wetland mitigation requested: acres
4f. Non-riparian wetland mitigation requested: acres
4g. Coastal (tidal) wetland mitigation requested: acres
4h. Comments:
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
Page 7 of 11
PCN Form - Version 1.3 December 10, 2008 Version
6. Buffer Mitigation (State Regulated Riparian Buffer Rules) - required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation? ? Yes ? No
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.

Zone 6c.
Reason for impact 6d.
Total impact
(square feet)
Multiplier 6e.
Required mitigation
(square feet)
Zone 1 3 (2 for Catawba)
Zone 2 1.5
6f. Total buffer mitigation required:
6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in-lieu fee fund).
6h. Comments:
Page 8 of 11
PCN Form - Version 1.3 December 10, 2008 Version
E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers identified ? Yes ® No
within one of the NC Riparian Buffer Protection Rules?
1 b. If yes, then is a diffuse flow plan included? If no, explain why.
? Yes ? No
Comments:
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project? 6%
2b. Does this project require a Stormwater Management Plan? ? Yes ® No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why: The project is classified as a low density
residential subdivision - impervious cover is less than 24%. Stormwater will be conveyed by grass lined swales. No
upland areas contain impervious cover greater than 24%.
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
? Certified Local Government
2e. Who will be responsible for the review of the Stormwater Management Plan? ? DWQ Stormwater Program
? DWQ 401 Unit
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this project? Caldwell County
® Phase II
3b. Which of the following locally-implemented stormwater management programs ? NSW
? USMP
apply (check all that apply): ? Water Supply Watershed
? Other:
3c. Has the approved Stormwater Management Plan with proof of approval been ? Yes ® No
attached?
4. DWQ Stormwater Program Review
? Coastal counties
? HQW
4a. Which of the following state-implemented stormwater management programs apply ? ORW
(check all that apply):
? Session Law 2006-246
? Other:
4b. Has the approved Stormwater Management Plan with proof of approval been
attached? ? Yes ? No
5. DWQ 401 Unit Stormwater Review
5a. Does the Stormwater Management Plan meet the appropriate requirements? ? Yes ? No
5b. Have all of the 401 Unit submittal requirements been met? ? Yes ? No
Page 9of11
PCN Form -Version 1.3 December 10, 2008 Version
F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1a. Does the project involve an expenditure of public (federal/state/local) funds or the ? Yes ® No
use of public (federal/state) land?
1 b. If you answered "yes" to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State ? Yes ? No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1c. If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
? Yes ? No
letter.)
Comments:
2. Violations (DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards, ? Yes ® No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. Is this an after-the-fact permit application? ? Yes ® No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in ? Yes ® No
additional development, which could impact nearby downstream water quality?
3b. If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
The project does propose new roads to serve a low density residential subdivision. Total impervious area is proposed to
be less than 6% of the total project area. Streams are Class C. No additional regulatory measures are required due to
the low density nature of the subdivision.
4. Sewage Disposal (DWQ Requirement)
4a. 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.
On-site sewage disposal areas are being proposed. No septic permits or building layouts have been determined at this
time since this is a low density subdivision.
Page 10 of 11
PCN Form - Version 1.3 December 10, 2008 Version
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or ? Yes ® No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act ® Yes ? No
impacts?
?
Raleigh
5c. If yes, indicate the USFWS Field Office you have contacted. ® Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
USFWS County map and phone call to USFWS field office on 3/30/10. Spoke with Bryan Tompkins.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat? ? Yes ® No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
Ocean.floridamarine.org - Interactive map viewer
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation ? Yes ® No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
www.hpo.dcr.state.nc.us - NC-National Register-Points-2010-01-01.kmz - Google Earth points current Jan 2010
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain? ? Yes ® No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination? FEMA Panels 37102800J; 3710280100J;
3710281000J; 3710281100J - Dated July 7, 2009
Larry Bragg
Capital Land Group, LLC 2L,
3) ftphJ
Applicant/Agent's Signature Date
Applicant/Agent's Printed Name (Agent's signature is valid only if an authorization letter from the applicant
is provided.)
Page 11 of 11
PCN Form - Version 1.3 December 10, 2008 Version
Forest Creek Subdivision, Caldwell County, NC
A.3 Current Owners List
3a. Name(s) on Recorded Deed:
3b. Deed Book and Page No.:
3c. Responsible Party (for LLC if applicable):
3d. Street Address:
3e. City, state, zip:
3f. Telephone no.:
3g. Fax no.:
3h. Email address:
3a. Toye E. Holden c/o Alex Holden
3b. DB 334 PG 260
3c. n/a
3d. 219 Norwood St SW
3e. Lenoir, NC 28645
3f. 828-295-6745
3g. Fax no.: not available
3h. Email address: not available
3a. James F. & Paula Bryson cto Steven Hamby, Agent
3b. DB 546 PG 467
3c. n/a
3d. 4025 Collettsville Road
3e. Lenoir, NC 28645
3f. 828-292-0118
3g. Fax no.: not available
3h. Email address: not available
3a. Rocky Springs Baptist Church
3b. DB 1633 PG 122
3c. Rev. Joseph Greer
3d. 4391 Collettsville Road
3e. Lenoir, NC 28645
3f. 828-754-2595
3g. Fax no.: not available
3h. Email address: not available
3a. Rocky Springs Baptist Church
3b. Part of DB 1519 PG 1614
3c. Responsible Party for LLC?
3d. 4391 Collettsville Road
3e. Lenoir, NC 28645
3f. 828-754-2595
3g. Fax no.: not available
3h. Email address: not available
3a. Wildcat Land & Timber, LLC; Mary's Grove, LLC; Old Oaks, LLC
3b. DB 1714 PG 474
3c. Tye Bishop, Member-Manager
3d. PO Box 1826
3e. Lenoir, NC 28645
3f. 828-758-5353
3g. Fax no.: not available
3h. Email address: not available
3a. David P. Barrier Go Anita Barrier, Executor of Estate
3b. DB 716 PG 337
3c. n/a
3d. 2240 John Wilson Ln
3e. Lenoir, NC 28645
3f. 828-754-9791
3g. Fax no.: not available
3h. Email address: not available
B. Project Identification
1.a Tax PIN/Parcel ID:
9W-125-55A; 9W-125-46C; 9W-125-53A; 9W-125-52;
9W-125-23A; 9W-125-56A
E. Stormwater Management and Diffuse Flow Plan
2a. Percent of impervious cover calculation:
Total Subdivision Area: 780 Acres
Number of Total Lots: 195
Total Linear Feet of New Roads: 48,250 LF
Width of proposed pavement: 18 FT
Estimated impervious cover per lot: 6,000 SF
{[(195X6000)+(48250x18)]/43560)/780 = 0.0600x100 = 6% = Low Density
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