20100516 Ver 1_401 Application_20100610

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LILVJ I J L%WI11
a
PROGRAM
June 28, 2010
Amy Chapman
NC Division of Water Quality
401 /Wetlands Unit
2321 Crabtree Blvd, Suite 250
Raleigh, NC 27604
RE: PCN form and construction plan sheets
UT to Altamahaw, Alamance County
NCEEP # 92837
Dear Amy,
201005 1 6
Q?@?adr??
JUN 3 o 2010
DENR . WATER-OUALITY
WETLANDS AM STOUKA11A ISRANCN
Enclosed please find two copies, one original and one photo copy, of the completed PCN form and construction
plan sheets for the referenced project. The proposed construction activities include installation of a temporary
construction access road through active pasture, stabilization of the existing pond emergency spillway, and
construction of a modified level spreader to diffuse flow through the vegetated buffer.
Sincerely,
Kristie Corson
NCEEP Project Manager [phone]
V-M(_1 5U.JL S
Rostov... L ... Protect' OW Stag NACTA
North Carolina Ecosystem Enhancement Program, 1652 Mail Service Center, Raleigh, NC 27699-1652 / 919-715-0476 / www.nceep.net
20100516

Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.4 January 2009
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: or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps? ? Yes ? No
1d. 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 ?X 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 ?X No For the record only for Corps Permit:

? Yes ?X 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 ?X No
1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1h
below. ? Yes ?X No
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ? Yes ?X No
2. Project Information
2a. Name of project: UT to Altamahaw
2b. County: Alamance -m
2c. Nearest municipality / town: Elon
2d. Subdivision name:
2e. NCDOT only, T.I.P. or state project no:
3. Owner Information WETLANDS AND5T0RxVrATA SgMM
3a. Name(s) on Recorded Deed: Charles Hursey Sr., et al
3b. Deed Book and Page No. 1765, 523 Plat Bk 067, Pit Page 0207
3c. Responsible Party (for LLC if
applicable):
3d. Street address: 2443 Barber Road
3e. City, state, zip: Elon, NC 27244
3f. Telephone no.: 336-584-1377
3g. Fax no.: NA
3h. Email address: NA
Page 1 of 10
PCN Form - Version 1.4 January 2009
4. Applicant Information (if different from owner)
4a. Applicant is: ? Agent ?X Other, specify: owner of conservation easement
4b. Name: NC Ecosystem Enhancement Program
4c. Business name
(if applicable):
4d. Street address: 2728 Capital Boulevard, Suite 1H 103
4e. City, state, zip: Raleigh, NC 27604
4f. Telephone no.: 919-715-1954
4g. Fax no.:
4h. Email address: [e-mail]
5. Agent/Consultant Information (if applicable)
5a. Name:
5b. Business name
(if applicable):
5c. Street address:
5d. City, state, zip:
5e. Telephone no.:
5f. Fax no.:
5g. Email address:
Page 2 of 10
B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): 94-9144
1 b. Site coordinates (in decimal degrees): Latitude: Longitude:
1 c. Property size: 4.63 acres
2. Surface Waters
2a. Name of nearest body of water to proposed project: UT to Altamahaw
2b. Water Quality Classification of nearest receiving water: C
2c. River basin: Cape Fear
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:
Active pasture. Rural residential and ag land, mostly pasture.
3b. List the total estimated acreage of all existing wetlands on the property: 0.026
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property: 1,477
3d. Explain the purpose of the proposed project:
Provide cattle exclusionary fencing and alternative water for landowner. Plant buffer and stabilize existing emergency spillway to improve sediment con
0
3e. Describe the overall project in detail, including the type of equipment to be used:
Install temporary construction access road. Shape existing emergency spillway to improve sediment control conditions. Excavator and dump trucks.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /

project (including all prior phases) in the past? ? Yes ? No ? Unknown

Comments:
4b. If the Corps made the jurisdictional determination, what type
of determination was made? ? Preliminary ? Final
4c. If yes, who delineated the jurisdictional areas?
Name (if known): Agency/Consultant Company:
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
this project (including all prior phases) in the past? ?Yes ? No ? Unknown
5b. If yes, explain in detail according to "help file" instructions.
6. Future Project Plans
6a. Is this a phased project? ? Yes ?X No
6b. If yes, explain.
Page 3 of 10
PCN Form - Version 1.4 January 2009
C. Proposed Impacts Inventory
1. Impacts Summary
I a. Which sections were completed below for your project (check all that apply):
? Wetlands ? Streams -tributaries ?X 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.
Wetland impact
number
Permanent (P) or
Tem ora T 2b.
Type of impact 2c.
Type of wetland 2d.
Forested 2e.
Type of jurisdiction
Corps (404,10) or
DWQ (401, other) 2f.
Area of
impact
(acres)
W1 - Choose one Choose one Yes/No
W2 - Choose one Choose one Yes/No
W3 - Choose one Choose one Yes/No
W4 - Choose one Choose one Yes/No
W5 - Choose one Choose one Yes/No -
W6 - Choose one Choose one Yes/No
2g. Total Wetland Impacts:
2h. Comments:
No impacts to wetlands.
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.
Stream impact
number
Permanent (P) or
Temporary (T) 3b.
Type of impact 3c.
Stream name 3d.
Perennial (PER) or
intermittent (INT)? 3e.
Type of
jurisdiction 3f.
Average
stream
width
(feet) 3g.
Impact
length
(linear
feet)
S1 - Choose one -
S2 - Choose one -
S3 Choose one -
S4 - Choose one -
S5 Choose one
S6 - Choose one
3h. Total stream and tributary impacts
3i. Comments:
No impacts to streams.
Page 4 of 10
PCN Form - Version 1.4 January 2009
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 individual) list all open water impacts below.
4a.
Open water
impact number
Permanent (P) or
Temporary T 4b.
Name of waterbody
(if applicable) 4c.

Type of impact 4d.

Waterbody
type 4e.

Area of impact (acres)
01 Choose one Choose
02 Choose one Choose
03 Choose one Choose
04 Choose one Choose
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If and or lake construction proposed, then complete the chart below.
5a.
Pond ID number 5b.
Proposed use or
purpose of pond 5c.
Wetland Impacts (acres) 5d.
Stream Impacts (feet) 5e.
Upland
(acres)
Flooded Filled Excavated Flooded Filled Excavated
P1 Choose one
P2 Choose one
5f. Total:
5g. Comments:
5h. Is a dam high hazard permit required? F] 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? ? Neuse E] Tar-Pamlico ? Catawba ? Randleman ?X Other:Jordan Lake
6b.
Buffer Impact
number -
Permanent (P) or
-Temporary T 6c.
Reason for impact 6d.
Stream name 6e.
Buffer
mitigation
required? 6f.
Zone 1
impact
(square
feet 6g.
Zone 2
impact
(square
feet
B1 T reshaping existing spillway UT to Altamahaw No 300 300
B2 Yes/No
B3 Yes/No
B4 - Yes/No
B5 - Yes/No
B6 Yes/No
6h. Total Buffer Impacts: 300 300
6i. Comments: The proposed construction activities occur on an existing spillway, void of vegetation, i 01 b C_
Axo&? kcl i xA SPrcc_'t'Q, 1(2 V0Li0-' OX 4 buM' L"o occU' . 1n Win-ke,.. Z010 12.utl .
Page 5 of 10
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.

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1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
C ass f rv'(_;c,-\' en c? ? pmant wit i w? x h4.s?-Q road a nCC SeC, ,,,t exams: ??
Cowl trecouj,&S C s, it Rnc?)l( ernpl??ed .
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 gNo
2b. If yes, mitigation is required by (check all that apply): ? DWQ ? Corps

2c. If yes, w hich mitigation option will be used for this
project? ? Mitigation bank
? 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: Choose one
Type: Choose one
Type: Choose one Quantity:
Quantity:
Quantity:
3c. Comments:
4. Complete if Makin 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: Choose one
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 6 of 10
PCN Form - Version 1.4 January 2009
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 7 of 10
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 d 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 E] No
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project?
2b. Does this project require a Stormwater Management Plan? ? Yes No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why
:
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2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
2e. Who will be responsible for the review of the Stormwater Management Plan?
3. Certified Local Government Stormwater Review NA
3a. In which local government's jurisdiction is this project?
? 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 ? Yes ? No
attached.
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 8 of 10
PCN Form - Version 1.4 January 2009
F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1 a. Does the project involve an expenditure of public (federal/state/local) funds or the E 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
letter.) ? Yes ? No
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 ?lo
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. Is this an after-the-fact permit application? ?Yes ONo
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
additional develo
ment
which
ld i
t
b
d ?Yes No
A
p
,
cou
mpac
near
y
ownstream 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.
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.
Page 9 of 10
PCN Form - Version 1.4 January 2009
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or
habitat?
El Yes No

5b. Have you checked with the USFWS concerning Endangered Species Act &Yes ? No
impacts?
5c. If yes, indicate the USFWS Field Office you have contacted. -l??
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat? N A
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat? ? Yes Q""No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal
t
h
d
i
h
/
governmen
s
ave
es
gnated as
aving 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?
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain? ? Yes &3/No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did.you use to make the floodplain determination?
NC E c a sy S &n N01N 4rY%.,Uf
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p ?•(I i sh C coow\
,
'
Applicant/Agent's Printed Name Applicant/Agent
s Signature Date
4? (Agent's signature is valid only if an authorization
letter from the applicant is provided.)
Page 10 of 10
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