Polk Co. - Historic 401s

Michael F. Easley, Governor
OF Fq _ U 1 William G. Ross Jr., Secretary
Q(� North Carolina Department of Environment and Natural Resources.
r Alan W. Klimek, P.E., Director
—i
O Y Division of Water Quality
Coleen H. Sullins, Deputy Director
Division of Water Quality
Of T
June 30, 2003
Polk County
JUL 7 2003 , DWQ Project #: 03-0765
Town of Columbus
Post Office Box 146
Columbus, NC 28722-0146
Subject Property: Town of Columbus Wastewater Infrastructure Improvements
APPROVAL of 401 Water Quality Certification and AUTHORIZATION CERTIFICATE
To Whom It May Concern:
You have our approval, in accordance with the attached conditions, to impact 0.02 acres of wetlands
and 30 feet of stream for the purpose of installing a utility line as you described in your application
dated June 16, 2003. After reviewing your application, we have decided that this fill is covered by
General Water Quality Certification Number 3374, which may be viewed on our website at
http://h2o.enr.state.nc.us/ncwetlands. This certification allows you to use Nationwide Permit Number
12 when the Corps of Engineers issues it. 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, Coastal Stormwater, Non -Discharge and Water Supply Watershed regulations. This
approval will expire when the accompanying 404 or-CAMA 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 except as
modified below. If you change your project, you must notify us and you -may be required to send us a
new application. If the property is sold, the new owner must be given a copy of this Certification and
approval letter and is thereby responsible for complying with all conditions. If total 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) (6) and (7). This approval shall expire when the corresponding
Nationwide Permit expires or as otherwise provided -in the General Certification. For this approval to
be valid, you must follow the conditions listed in the attached certification and any additional
conditions listed below.
Conditions of Certification:
1. Upon completion of the project, the applicant shall complete and return the enclosed
"Certification of Completion Form" to notify DWQ that all the 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 Division of Water Quality.
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), (http://h2o.enr.state.nc.us/ncwetlands

Violations of any condition herein set forth may result in revocation of this Certification and may result
in criminal and/or civil penalties. This Certification shall become null and void unless the'above
conditions are made conditions of the Federal 404 and/or coastal Area Management Act Permit.
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, which conforms to Chapter TSOB' of the North Carolina General Statutes to the Office of
Administrative Hearings, P.O. Box 27447, Raleigh, N.C. 27611-7447. This certification and its
conditions are final and binding unless you ask for a hearing.
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 telephone John Dorney at 919-733-1786 or Mike.Parker at our
Asheville Regional Office at 828-251-6208.
Sincerely,
NV
Attachments
cc: Corps of Engineers Asheville Field Office
Asheville DWQ-RegionallOffice
File copy
Central Files
Britt Feldner, The Brigman Company, Inc, 900 B Main Street, Conway, SC 29526

W ATF Michael F. Easley, Governor
R . William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E., Director
CO
p 'C
Division of Water Quality
Coleen H. Sullins, Deputy Director
Division of Water Quality
June 30, 2003
0 ! Polk County
i DW Project #: 03-0765
JUL - 7 2003 Q �
Town of Columbus
Post Office Box 146
Columbus, NC 28722-0146
Subject Property`. Town of Columbus Wastewater Infrastructure Improvements
APPROVAL of 401 Water Quality Certification and AUTHORIZATION CERTIFICATE
To Whom It May Concern:
You have our approval, in accordance with the attached conditions, to impact 0.02 acres of wetlands.
and 3 feet of stream for the purpose of installing a utility line as you described in your application
dated June 16, 2003. After reviewing your application, we have decided that this fill is covered by
General Water Quality Certification Number 3374, which may be viewed on our website at
http://h2o.enr.state.ne.us/newetlands. This certification allows you to use Nationwide Permit Number
12 when the Corps of Engineers issues it. 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, Coastal Stormwater, Non -Discharge and Water Supply Watershed regulations. This
approval will expire when the accompanying 404 or CAMA 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 except as
modified below. If you change your project, you must notify us and you may be required to send us a .
new application. If the property is sold, the new owner must be given a copy of this Certification and
approval letter and is thereby responsible for complying with all conditions. If total wetland fills for
this project (now or in the future) exceed one acre, compensatory mitigation may be required as
described in 15A NCAC 211.0506 (h) (6) and (7). This approval shall expire when the corresponding
Nationwide Permit expires or as otherwise provided in the General Certification. For this approval to
be valid, you must follow the conditions listed in the attached certification and any additional
conditions listed below.
Conditions of Certification:
1. Upon completion of the project, the applicant shall complete and return the enclosed
"Certification of Completion Form" to notify DWQ that all the 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 Division of Water Quality.
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),(http://h2o.enr.§tate.nd.uslncwetlands

Violations of any condition herein set forth may result in revocation of this Certification and may result
in criminal and/or civil penalties. This Certification shall become null and void unless the above
conditions are made conditions of the Federal 404 and/or coastal Area Management Act Permit.
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, which conforms to Chapter 150B of+the North Carolina General Statutes to the Office of
Administrative Hearings, P.O. Box 27447, Raleigh, N.C. 27611-7447. This certification and its
conditions are final and binding unless you ask for a hearing.
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 telephone John Dorney at 919-733-1786 or Mike Parker at our
Asheville Regional Office at 828-251-6208.
JRD/bs
Attachments
cc: Corps of Engineers Asheville Field Office
AshevlleDWQ Regional_Office
File copy
Central Files
Sincerely,
an im, P.E., Di ctor
.
Britt Feldner, The Brigman Company, Inc, 900 B Main Street, Conway, SC 29526

ARCHITECTS ENGINEERS PLANNERS
23 June 2003
Ms. Teresa Rodriquez
Construction Grants and Loans Section
1633 Mail Service Center
Raleigh, NC 27699-1633
Re: Review Comments
Town of Columbus
Wastewater Infrastructure Improvements
Project No. E-SEL-T-03-0035
HSMM Commission No. 60194.11
Dear Ms. Rodriquez:
I. am enclosing a letter to the Corps of Engineers (COE) requesting a wetlands verification and
the issuance of a COE nationwide permit #12 for the Columbus project.
Sincerely,
HSMM
an M!P a on, P.E.
W�
Senior Project Manager
DMcP/abh
Enclosures: as noted
Copies to: Mr. Glenn Rhodes
- Foffest�W6 tall
Hayes, Seay, Mattern & Mattern, Inc. ARCHITECTS ENGINEERS PLANNERS
145 North Church Street PO Box 2646 Spartanburg SC 29304 Tel.:[phone] Fax:[phone] www.hsmm.com

+TH6C
MAN COM PANY
June 10, 2003
Mr. Steve Chapin
Asheville Regulatory Field Office
US Army Corps of Engineers ,.
151 Patton Avenue, Room 208
Asheville, NC 28801-5006
RE: Town of Columbus Wastewater infrastructure Improvements
Polk County, North Carolina
Dear Mr. Chapin:
JUN 2 3 2003
�J
The Town of Columbus is planning to Bed and Backfill 7 crossings consisting of Waters of the US
and wetlands on site. The. proposed activities will occur mostly adjacent to the existing
wastewater infrastructure near the town of Columbus, North Carolina (see Location Map).
The Brigman Company, Inc., acting as agent for the applicant, seeks a wetland verification and
the issuance of a U.S. Army Corps of Engineers Nationwide #12 Permit to accomplish the
development objective for the referenced project_
Enclosed please find a request for wetlands determination and a pre -construction notification
form along with the following:
• Project Location Maps
• USGS Topographic, Maps
• Plan View (Pages 3110 thru 9110)
• Section View (Page 10/10)
• Representative Photos
• Request For -Wetland Determination
ication or require additional information to complete
If you have any questions concerning the appl
the approval process, please do not hesitate to call me.
Sincerely,
ladner
9—
Wetland Ecologist
CC' Dan McPherson - Applicant
John Domey — NCDENR
WWW.ThEbRigMANCOMPANy.COM

41 -� wF
B R G M A N C O M-PAN Y
1 N C O R P O R A T E D -
June 10, 2003
Mr. Steve Chapin
Asheville Regulatory Field Office
US Army Corps of Engineers 4^ "NED 03 0 u �
151 Patton Avenue, Room 208 6,6 JUN 3 2003
Asheville, NC 28801-5006
RE: Town of Columbus Wastewater Infrastructure Improvements
(Polk County, North Carolina
Dear Mr. Chapin:
The Town of Columbus is planning to Bed and Backfill 7 crossings consisting of Waters of the US
and wetlands on site. The proposed activities will occur mostly adjacent to the existing
wastewater infrastructure near the town of Columbus, North Carolina (see Location Map).
The Brigman Company, Inc., acting as agent for the applicant, seeks a wetland verification and
the issuance of a U.S. Army Corps of Engineers Nationwide #12 Permit to accomplish the
development objective.forthe referenced project.
Enclosed please find a request for wetlands determination -and a pre -construction -notificatio L5 l5 tl l/
form along with the following: J1UJN 3 O M
• Project Location:Maps __
• USGS Topographic Maps WANT
• Plan View (Pages 3110 thru 9110)r-
• Section View (Page 10/10)
• Representative Photos
• Request For Wetland Determination
If you have any questions concerning the application or require additional information to complete
the approval process, please do not hesitate to call me.
Sincerely,
Britt A. Feldner
Wetland Ecologist
cc: Dan McPherson - Applicant
John Domey — NCDENR .
WWW.TliEbRigMANCOMPANy.COM
P_0. Box 1532 - CONWAY, SC 29528 .[phone] . FAX [phone]

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".)
I. Processing
1. Check all of the approval(s) requested for this project:
® Section 404 Permit ❑ Riparian or Watershed Buffer Rules
❑ Section 10 Permit ❑ Isolated Wetland Permit from DWQ
® 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested: 12
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: ❑
H. Applicant Information
1. Owner/Applicant Information
Name: Town of Columbus
Mailing Address: P.O. Box 146
Columbus_ NC 28722-0146
Telephone Number: [phone] Fax Number: [phone]
E-mail Address: bfeldner@,thebrigmanco![e-mail]
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: Britt A. Feldner
Company Affiliation: The Brigman Company Inc
Mailing Address:' 900B Main St.
Conway, SC 29526
Telephone Number: [phone] Fax Number: [phone]
E-mail Address: [e-mail]
Page 5 of 13

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: Town of Columbus Wastewater Infrastructure Improvements
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax
4. Location
County: Polk Nearest Town: Columbus
Subdivision name (include phase/lot number):
Directions to site (include road numbers, landmarks, etc.)See attached Location map 2/10
and USGS Topographic Map 1/10
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): 23751.94' x 25' = 13.63 Acres
7. Nearest body of water (stream/river/sound/ocean/lake): Horse Creek
S. River Basin: Broad River
(Note — this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at.)
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 sewer line route crosses a variety of land types including
forest/ag., pasture areas existing sewer line right-of-ways and existing road right-of-ways.
Page 6 of 13

10. Describe the overall project in detail, including the type of equipment to be used: The
Town of Columbus is proposing to make wastewater improvements and additions to their
existing system to accommodate growth in the area. The type of equipment to be used during,
construction will consist of typical land grading equipment such as back -hoes, trac-hoes and
bulldozers.
11. Explain the purpose of the proposed work: The purpose of the proposed work is to
construct and install a new 18" interceptor, 10" sewer line, 10" „rg avky line, 12" gravity line,
8" sewer line and 8" gravity line to accommodate the Town of Columbus.
IV. Prior Project History
If jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Include
the USACE Action ID Number, DWQ Project Number, application date, and date permits and
certifications were issued or withdrawn. Provide photocopies of previously issued permits,
certifications or other useful information. Describe previously approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits issued for prior segments of the same T.I.P. project, along with
construction schedules.
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application.
At this time we are unable to determine any definite future impacts to wetlands or Waters of the
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
Page 7 of 13

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.
1. Provide a written description of the proposed impacts: The proposed project will
impact approximately 30 linear feet of perennial and intermittent streams and 0.02 acres of
freshwater wetlands to make improvements to the existing sewer system in the town of
Columbus.
2. Individually list wetland impacts below:
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***
Crossing #5
Bedding & Backfill
0.02
Yes
10,
PEMI
* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: mechanized clearing, grading, till,
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://Nvx,,ryv.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: 0.10
Total area of wetland impact proposed: 0.02
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 Im ct
Perennial or
Intermittent?
(please specify)
Crossing #1
Bedding & Backfill
5'
Not Named
16.14'
Perennial
Crossing #2
Bedding & Backfill
5'
I Not Named
11.30'
Perennial
Crossing #3
Bedding & Backfill
5'
1 Not Named
11.71'
Perennial
Page 8 of 13

Crossing #4
Bedding & Backfill
5'
Not Named
11.28'
Intermittent
Crossing #6
Bedding & Backfill
5
Not Named
11.20
Perennial
Crossing #7
Bedding & Backfill
5'
Horse Creek
16.06'
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 losstgain),
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
,xww.usgs.gov. Several intemet sites also allow direct download and printing of USGS maps (e.g., www.topozone.com,
www.mapguest.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: 30'
4. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.) below:
Open Water Impact
Site Number
(indicate on ma)
Type of Impact*
Area of
Impact
(acres)
Name p Wate)
licabllee)
(if applicable)
Type of Waterbody
' pow'sue' (lake a sound,
bay, ocean, etc.)
* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: fill, excavation, dredging,
flooding, drainage, bulkheads, etc.
Pond Creation
If construction of a pond is proposed, associated wetland and stream impacts should be
included above in the wetland and stream impact sections. Also, the proposed pond should
be described here and illustrated on any maps included with this application.
Pond to be created in (check all that apply): ❑ uplands ❑ stream ❑ wetlands
Describe the"method of -construction (e.g., dam/embankment, excavation;--installation-:of
draw -down valve or spillway, etc.):
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.):
Size of watershed draining to pond: Expected pond surface area:
VII. Impact Justification (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It may be useful to provide
information related to site constraints such as topography, building ordinances, accessibility, and
financial viability of the project. The applicant may attach drawings of alternative, lower -impact
site layouts, and explain why these design options were not feasible. Also discuss how impacts
Page 9 of 13

were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce impacts.
The impacts to the intermittent and perenneal streams within the project area are unavoidable
due to the location and distribution of streams near the Town of Columbus. Also the impacts
will be temporary and in some cases will follow existing sewer line right-of-ways.
VM. 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://h2o.enr.state.nc.us/ncwetlands/strmQide.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.
No mitigation is proposed due to the fact that all impacts to wetlands and Waters of the
US will be temporary
Page 10 of 13

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.ne.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):
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
If yes, does the project require preparation of an environmental document pursuant to the
requirements of the National or North Carolina Environmental Policy Act (NEPA/SEPA)?
Note: If you are not sure whether a NEPA/SEPA document is required, call the SEPA
coordinator at [phone] to review current. thresholds for environmental documentation.
Yes ❑ No ❑
If yes, has the document review been finalized by the State Clearinghouse? If so, please attach a
copy of the NEPA or SEPA final approval letter.
Yes ❑ No ❑
X. Proposed Impacts on Riparian and Watershed Buffers (required by DWQ)
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
required state and local buffers associated with the project. The applicant must also provide
justification for these impacts in Section VII above. All proposed impacts must be listed herein,
and must be clearly identifiable on the accompanying site plan. All buffers must be shown on a
map, whether or not impacts are proposed to the buffers. Correspondence from the DWQ
Regional Office may be included as appropriate. Photographs may also be included at the
applicant's discretion:
Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Meuse), 15A NCAC 2B .0259 (Tar -Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify )?
Page 11 of 13

Yes ❑ . . No ® If you answered "yes", provide the following information:
Identify the square feet and acreage of impact to each zone of the riparian buffers. If buffer
mitigation is required calculate the required amount of mitigation by applying the buffer
multipliers.
Zone*
Impact
(s feet)
Multiplier
Required
ny tion
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 (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.
All necessary sediment and erosion control measures will be taken during project construction.
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.
Not applicable
XM. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes ❑ No
Is this an after -the -fact permit application?
Yes ❑ No
Page 12 of 13

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).-
ApplicantlAga s Signature 4 DaX,
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 13 of 13

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United States Department of the Interior „
FISH AIND WILDLIFE SERVICE
Asheville Field Office
160 alicoa Street
Asheville, North Carolina 28801
September 13, 2001
Mr. David DePratter, P.E.
Project Engineer
HSMM
145 North Church Street
Spartanburg, South Carolina 29306
Dear Mr. DePratter:
Subject: Town of Columbus Sewer Improvements (Provide Service to Approximately
120 Homes -and Update Existing Collection System), Polk County, North Carolina
In your. letter. dated August 27,:2001; you requested ouncomments. with regard to the subject
project. The following comments are provided in accordance with the provisions of the Fish and
Wildlife Coordination Act,, as amended. (16 U.S.C. 661-667e),. and Section 7 of the Endangered
Species Act of 1973, as amended (16 U.S.C. 1531-1543) (Act).
Endangered Species. Enclosed is a list of the federally endangered and threatened species known
from Polk County, North Carolina. This list also includes species of Federal concern that are
currently under status review by the U.S. Fish and Wildlife Service which may occur in the project
impact area. In accordance with the Act it is the responsibility of the appropriate Federal agency to
review its activities or programs and to identify any such activities or programs that may affect
endangered or threatened species or their habitats.
According to our records and a review of the information you provided, no listed species or their
habitats occur on the site. We concur with your determination that the proposed project will not
affect endangered or threatened species and their habitats. Therefore, we believe the requirements
under Section 7 of the Act are fulfilled. However, obligations under Section 7 of the Act must be
reconsidered if. (1) new information reveals impacts of this identified action that may affect listed
species or critical habitat in a manner not previously considered, (2) this action is subsequently
modified in a manner that was not considered in this review, or (3) a new species is listed or
critical habitat is determined that may be affected by the identified action.
Floodplain Protection. Executive Order 11988 requires Federal agencies to' consider and.protect
floodplain functions. We believe the recent examples of flooding highlight the importance of
avoiding the "... long- and short-term impacts associated with the occupancy and modification of

- v Regulatory Division — Ashville District —.Corps of Engineers -151 Patton Ave, Room 208, Ashville, NC 28801-5006
REQUEST FOR WETLANDS DETERMINATION
Date: 6/10/03
County: Polk Total Acreage of Tract: 23,751.94' x 25' = 13.63
Project Name (if applicable): Town of Columbus Wastewater Infrastructure Improvements
Property Owner Agent/Developer/Engineer'��,�
(name, address, phone): �rd up
The Brigman Company, Inc.
JUN 2 3 2003
Town of Columbus P.O. Box 1532
P.O Box 1Conway, SC 29528 3.46 ni.l i V81 0JM
Columbus, NC 28722-0146 [phone]
Status of Project (check one):
❑ On -going site work for development purposes
X Development in planning stages
❑ No specific development plans at this time
Project Type — Indicate the proposed use of the land in question or, if no specific work is planned at present,
indicate the current zoning or land use at the site. (check one):
❑ Residential ❑ Commercial. ❑ Mixed Use (Residential + Commercial)I
❑ Industrial ❑ Agriculture x Public Works
❑ Silviculture ❑ Aquacuiture ❑ Other.
Information Required to Accompany Request = Check the items submitted — forward as much information as is
available. At a minimum, the first two items must be forwarded:
X Accurate Location Map (from County Map; USGS Quad Sheet, etc.)
X Survey Plat or Tax Map of the Property iri-Question
X Soil Survey Sheet (from USDA-NRCS) or Aerial Photo (from County Assessor's Office or other source).
Property boundaries should'be shown on the soil survey/photo.
❑ Topographic Survey
X Conceptual Site Plan for the Overall Development
Endangered Species Evaluation:
Has the site been evaluated for the presence of federally protected (endangered, -threatened or proposed) species
and/or any proposed or designated critical habitat for such species? YES NO .
If Yes, has this evaluation been coordinated with the US Fish & Wildlife Service (FWS)? YES NO
If coordination has occurred, please provide the FWS Log number and enclose a copy of the report
FWS Lot Number. 9-2-01-605 Copy of Report enclosed? YES NO
If the evaluation has not been coordinated with the US FWS, enclose a copy of your report of findings.
IMPORTANT NOTE: Legible printed name and signature required. The person signing this form must be the present
property owner or have the specific authority of the property owner to authorize Corps of Engineers employees or
their agents to enter onto the property for on -site investigations if such is deemed necessary.
Do not sign this form unless you are the owner or have the specific authority of the property owner.
The signature of the owner or authorized agent on this form constitutes prior consent to disclose these records to
other federal, state or local governmental agencies and the public at large. PRINTED NAME of person signing this form, below: 19T�-+ Id let,
Signature of property Owner or Authorized Agent:

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TOTAL PROP. AREA N/A
US(73`1 TOPOGRAPHIC MAP ORIG. WETLANDS N/A
TOWN OF COLUMBUS SEWER PROJECT BEDDING BACKFILL 0.00 ACRES
POLK COUNTY, NORTH CAROLINA WETLAND EXCAVATION N/A
REQUEST FOR WETLANDS/WATERS OF THE US VERIFICATION UPLAND BUFFER N/A
DATE: 5/30/03 WETLAND PRESERVATION N/A
APPLICATION NO. WETLAND RESTORATION N/A
AGENT: THE BRIMAN COMPANY, INC., P.O. BOX 1532, CONWAY SC 29526 [phone] FAX: [phone]

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FOIL SUR VEY MAP TOTAL PROP. AREA N/A
ORIG. WETLANDS N/A
TOWN OF COLUMBUS SEWER PROJECT BEDDING & BACKFILL 0.00 ACRES
POLK COUNTY, NORTH CAROLINA WETLAND EXCAVATION N/A
REQUEST FOR WETLANDMATERS OF THE US VERIFICATION UPLAND BUFFER N/A iC
DATE: 5/30/03 WETLAND PRESERVATION N/A
APPLICATION NO. WETLAND RESTORATION N/A
AGENT: THE BRIGMAN COMPANY, INC., P.O. BOX 1532, CONWAY SC 29526 [phone] FAX: [phone]

R
CROSSING
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'ooI •
SCALE IN FEET
400' 0 400'
PLAN VIEW
TOWN OF COLUMBUS SEWER PROJECT
POLK COUNTY, NORTH CAROLINA
REQUEST FOR VERIFICATION
DATE: 5/30/03 PAGE 1/5
APPLICATION NO.

SCALE IN FEET
400' 0 400'
PLAN VIEW
TOWN OF COLUMBUS SEWER PROJECT
POLK COUNTY, NORTH CAROLINA
REQUEST FOR VERIFICATION
DATE: 5/30/03 PAGE 2/5
APPLICATION No.

EXISTING
WASTEWATER
TREATMENT PLANT
SCALE IN FEET
400' 0 400'
PLAN VIEW
TOWN OF COLUMBUS SEWER PROJECT
POLK COUNTY, NORTH CAROLINA
REQUEST FOR VERIFICATION
DATE: 5/30/03 PAGE 3/5
APPLICATION NO.

E
IN FEET
D 400'
PLAN VIEW
TOWN OF COLUMBUS SEWER PROJECT
POLK COUNTY, NORTH CAROLINA
REQUEST FOR VERIFICATION
DATE: 5/30/03 PAGE 4/5
APPLICATION NO.

SCALE IN FEET
0 200'
PLAN VIEW
)F COLUMBUS SEWER PROJECT
K COUNTY, NORTH CAROLINA
REQUEST FOR VERIFICATION
PAGE 5/5
APPLICATION NO.

Job Number: 00296-03041
City: Columbus
termination -
Wetland Data Point: Crossing #1
nbus Sewer Line
Date: May 29, 2003
:olumbus
County: Polk
State: NC
exist on the site?
Community ID: R2S8
hydrology been disturbed?
Station ID:
)lem area?
Plot ID: 1
Ise
Common Name % Cover Indicator
Rose,Carolina
Prtvet,Chinese
Alder, Brook -Side
FACU
FAC
FACW+
Ofera ITree,Tulip FAC
:W, or FAC (except FAC-): 75 Cowardin Classification: R2SB
ria was met .
Primary Wetland Hydrology Ineffcators
Secondary Hydm/ogy Indreatois
ie in remarks)
[ ] Inundated
[ ] Oxidized root channels
ride Gage
[ ] Saturated in upper 12 inches
[ j Water -stained leaves
[X] Water marks
[ ] Local soil survey data
I remarks)
[X] Drift lines
[ ] FAC-Neutral test
[X] Sediment deposits
[ ] Other (explain in remarks )
:er (in.): 1.4
[ ] Drainage patterns in wetlands
n Pit (in.):
As (in.): 0
Mottle / 2nd Mottle
Texture,
Color Abundance Contrast
Structure, etc.
Loam
7.5YR 614 ` few distinct
Loam
10YR 411 common distinct
Loam
[ j Concretions
[ ] High Organic % in Surface Layer
[ ] Organic Streaking
list Regime [ ] Listed on Local Hydric Soils List
[X] Listed on National Hydric Soils List
ima Colors [ ] Other (explain in remarks )
Taxonomy: Fluvaquentic Dystrochrepts
Iat poorly drained [ ] Field Observations match map
ion
Present [X] This Data Point is a Wetland
Bent
vas met .
-03041
Crossing #2
D3
SB
I6 Cover Indicator
FACU
FACW
FACW+
FAC
FACU
FAC
FAC
FAC
R2SB
Hydrology Indicators
sized root channels
:er-stained leaves
Bl'soil survey data
,-Neutral test
ar (explain in remarks )

Job Number: 00296-03041
Data Form
City: Columbus
Routine Wetland Determination
Wetland Data Point: Crossing #4
Project/Site: Town of Columbus Sewer Line
Date: June 10, 2003
Applicant/Owner: Town of Columbus
County: Polk
Investigator: BAF
State: NC
[X] Do normal circumstances exist on the site?
Community ID:, R2SB
[ ] Have vegetation, soils, or hydrology been disturbed?
Station ID:
[ ] Is the area a potential problem area?
Plot ID:
Vegetation
Dominant Species
Common Name
% Cover Indicator
Shrub
X Rosa caroFina
Rose,Carolina
FACU
X Kalmia /atlfolia
Laurel,Mountain
FACU
Tree
X Liquidambarstyracillue
Gum,Sweet
FAC+
X Liriodendron t0pifera
Tree,Tulip
FAC
X Acerrubrum
Maple,Red
FAC
% Species that are OBL, FACW, or FAC (except FAC -): 60
Cowardin Classification : R2SB
Remarks
Hydrophytic vegetation criteria was met .
Hydrology
Primary Wetland Hydrology Indicators Secondary Hydrology Indicators
[ ] Recorded Data (describe in remarks)
[X] Inundated
[ ] Oxidized root channels
[ ] Stream, Lake, or Tide Gage
[X] Saturated in upper 12
inches [ ] Water -stained leaves
[ ] Aerial Photograph
[XI Water marks
[ ] Local soil survey data
[ ] Other (describe in remarks)
[XI Drift lines
[ ] FAC-Neutral test
Field Observations : [X] Sediment deposits [ ] Other (explain in remarks )
Depth of Surface.Water (in.): 4-6 [ l Drainage patterns in wetlands
Depth to Free Water in Pit (in.): NIA
Depth to Saturated Soils (in.): 0
Remarks
Hydrology criteria was met .
Soils
Depth
Hor.
Matrix
Mottle / 2nd Mottle
Texture,
(in.)
Color
Color Abdndance Contrast
Structure, etc.
0-7
A
7.5YR 414
Loam
7-16
Bwl
10YR 513.
7.5YR 614 .. few distinct
Loam
16-21
Bw2
10YR 4/3
10YR 411 few distinct
Loam
Hydric Soils Indicators
[ ] Histosol
[ ] Histic Epipedon
[ ] Sulfidic Odor
[ ] Probable Aquatic Moist Regime
] Reducing Conditions
[ ] Gleyed or Low -Chroma Colors
Unit Name: Chewacla
Drainage Class: Somewhat Poorly Drained
Remarks
Wetland Determination ' .
[X] Hydrophytic Vegetation Present
[ ] Hydric Soils Present
[XI Wetland Hydrology Present
Remarks
Waters of the US Criteria was met .
[ ] Concretions
[ ] High Organic % in Surface Layer
[ ] Organic Streaking
[ ] Listed on Local Hydric Soils List
[XI Listed on National Hydric Soils List
[ ] Other (explain in remarks )
Taxonomy: Fluvaquentic Dystrochrepts
[ ] Field Observations match map,
[X] This Data Point is a Wetland

Job Number: 00266-03041
Data Form
city: Columbus
Routine Wetland Determination
Wetland Data Point.: Crossing #5
Project/Site: Town of Columbus Sewer Line
Date: June 10, 2003
Applicant/Owner: Town of Columbus
County: Polk
Investigator: BAF - '
State: NC
[X] Do normal circumstances exist on the site? .
Community ID: PEM1
[ ] Have vegetation, soils, or hydrology been disturbed?
Station ID:
[ ] is the area a potential problem area?
Plot ID:
Vegetation
Dominant Species
Common Nam%Cover
Indicator
Herbaceous
X Onodea sensibills
Fem,SensMve
FACW
X Juncus effusus
Rush,Soit
FACW+
Shrub
X Rosa caroffna
Rose,Carolina
FACU
X Sambucus canadensis
Elder,American
FACW-
Tree
X Liriodendron tuffprfera
Tree,Tulip
FAC
X Liquidambarstyracitiva
Gum,Sweet
FAC+
X Acermbrum
Maple Red
FAC
% Species that are OBL, FACW, or FAC (except FAC -): 85
Cowardin Classification : PEM1
Remarks
Hydrophytic vegetation criteria was met .
Hydrology
Primary Wetland Hydrology Indicators Secondary Hydrology Indicators
[ ] Recorded Data (describe in remarks)
[X] Inundated
[XI Oxidized root channels
[ ] Stream, Lake, or Tide Gage
[XI Saturated in upper 12 inches [X] Water -stained leaves
[ ] Aerial Photograph
[XI Water marks
[ ] Local soil survey data
[ ] Other (describe in remarks)
[ ] Drift lines
[ ] FAC-Neutral test
[ ] Sediment deposits [ ] Other (explain in remarks )
Field Observations: [Xj Drainage patterns in wetlands
Depth of Surface Water (in.): 1-3
Depth to Free Water in Pit (in.): WA
Depth to Saturated Soils (in.): 0
Remarks
Wetland hydrology criteria was met .
Soils
Hor. Matra Mottle / 2nd Mottle Texture,
0-7 A 7.5YR 6/6 Loam
7-16 Bwl 10YR 5/3 7.5YR 614 few distinct Loam
16-21 Sw2 10YR 413 10YR 411 few distinct Loam
Hyddc Soils Indicators
[ ] Histosol
[ ] Histic Epipedon
[ ] Sulfidic Odor
[ ] Probable Aquatic Moist Regime
[ ] Reducing Conditions
[XI Gleyed or Low -Chroma Colors
Unit Name: Chewacla
Drainage Class: Somewhat Poorly Drained
Remarks
Hydric soil criteria was met
Wetland Determination
[ j Concretions
[ ] High Organic % in Surface Layer
{ j Organic Streaking
[ ] Listed on Local-Hydric Soils List
[XI Listed on National Hydric Soils List
[ ] Other (explain in remarks )
Taxonomy: Fluvaquentic Dystrochrepts
[_ ] Field Observations match map
[X] Hydrophytic Vegetation Present [X] This Data Point is a Wetland
[XI Hydric Soils Present
[XI Wetland Hydrology Present
Remarks
Jurisdictional wetland criteria was met .

Job Number: 00296-03041
Data Form
City: Columbus
Routine Wetland Determination
Wetland Data Point: Crossing #6
Project/Site: Town of Columbus Sewer Line
Date: June 10, 2003
Applicant/Owner: Town of Columbus
County: Polk
Investigator: BAF
State: NC
[X] Do normal circumstances exist on the site?
Community ID: R2SB
[ ] Have vegetation, soils, or hydrology been disturbed?
Station ID:
[ ] Is the area a potential problem area?
Plot ID:
Vegetation
Dominant Species
Common Name
°% Cover Indicator
Shrub
X Ligustrum sinense
Privet,Chinese
FAC
X Alnusserrulata
Alder,Brook-Side
FACW+
Tree
X Acerrubrum
Maple,Red
FAC
X Liriodendron tu6pdera
Tree,Tulip
FAC
Vine
X Lonicera japonica
Honeysuckie,Japanese
FAC-
% Species that are OBL, FACW, or FAC (except FAC-): 80
Cowardin Classification : R2SB
Remarks
Hydrophytic vegetation criteria was met .
Hydrology
Primary Wetland Hydrology Indicators Secondary Hydrology Indicators
[ ] Recorded Data (describe in remarks)
[X] Inundated
[ ] Oxidized root channels
[ j Stream, Lake, or Tide Gage,
[XI Saturated in upper 12 inches [ ] Water -stained leaves
[ ] Aerial Photograph
[X] Water marks
[ ] Local soil survey data
[ ] Other (describe in remarks)
[X] Drift lines
[ ] FAC-Neutral test
Field Observations: [XI Sediment deposits [ ] Other (explain in remarks )
Depth of Surface Water (in.): 1-0 [ ]Drainage patterns in wetlands
Depth to Free Water in Pit (in.): NIA
Depth to Saturated Soils (In.): 0
Remarks
Hydrology criteria was met .
Soils
Depth
Hor. Matra
Mottle / 2nd Mottle
Texture,
(in.)
Color
Color Abundance Contrast
Structure, etc.
0-7
A 7.5YR 6/6
Loam
7-16
Bwl 10YR 5/3
7.5YR 6/4 few distinct
Loam
16-21
Bw2 10YR 4/3
10YR 411 few distinct
Loam
Hydric Soils Indicators
( ] Histosal
[ ] Histic Epipedon
[ ] Sulfdic Odor
[ ] Probable Aquatic Moist Regime
[ ] Reducing Conditions
[ ] Gleyed or Low -Chroma Colors
Unit Name: Chewacla
Drainage Class: Somewhat Poorly Drained
Remarks
Wetland Determination
[X] Hydrophytic Vegetation Present
[ j Hydric Soils Present
[X] Wetland Hydrology Present
Remarks
Waters of the US Criteria was met .
[ ] Concretions
[ ] High Organic % in Surface Layer
[ ] Organic Streaking
[ ] Listed on Local Hydric Soils List
[XI Listed on National Hydric Soils List
[ ] Other (explain in remarks )
Taxonomy: Fluvaquentic Dystrochrepts
[ ] Field Observations match map
[X] This Data Point is a Wetland

Job Number: 00296-03041
Data Form
City:. Columbus
Routine Wetland Determination
Wetland Data Point: Crossing #7
Project/Site: Town of Columbus Sewer Line
Date: June 10, 2003
Applicant/Owner: Town of Columbus
County: Polk
Investigator: BAF
State: NC
[X] Do normal circumstances exist on the site?
Community ID: R2S8
[. ] Have vegetation, soils, or hydrology been disturbed?
Station ID:
[ ] Is the area a potential problem area?
Plot ID:'
Vegetation
Dominant Species
Common Name
°% Cover
Indicator
Herbaceous
X Rubus befuNdus
Blackberry
FAC
Shrub
X A/nusserru/ata
Alder,BrookSide
FACW+
X Robinia pseudoacada
Locust,Black
UPL
Tree
X Utiodendron t0pifere
Tree,Tulip
FAC
X Plafanus occidentals
SycamoreAmerican
FACW
are OBL, FACW, or FAC (except FAC -): 66 Cowardin
Remarks
Hydrophytic vegetation criteria was met .
Hydrology
Primary Weiland Hydrology Indicators
Secondary Hydrology Indicators
[ ] Recorded Data (describe in remarks)
[XI Inundated
[ ] Oxidized root channels
[ ] Stream, Lake, or Tide Gage
[XI Saturated in upper 12 inches
[ ] Water -stained leaves
[ ] Aerial Photograph
[X] Water marks
[ ] Local soil survey data
[ ] Other (describe in remarks)
[XI Drift lines
[ ] FAC-Neutral test
Field Observations :
[XI Sediment deposits
[ ] Other (explain in remarks )
Depth of Surface Water (in.): 6-18
[ ] Drainage patterns in wetlands
Depth to Free Water in Pit (in.): N/A
Depth to Saturated Soils (h): 0
Remarks
Hydrology criteria was met .
Soils
Depth
Hor. Matra
Mottle / 2nd Mottle Texture,
(in)
Color
Color Abundance Contrast Structure, etc.
0-9
Ap 10YR 5/3-
Sandy.Loam
9-18
BA 7.5YR 416
Sandy Clay Loam
Hydric Sols Indicators
[ ] Histosol
[ ] Histic Epipedon
[ ] Sulfidic Odor
] Probable Aquatic Moist Regime
[ ] Reducing Conditions
[ J Gleyed or Low -Chroma Colors
Unit Name: Masada
Drainage Class: Well drained
Remarks
Wetland Determination
[XI Hydrophy6c Vegetation Present
[ ] Hydric Soils Present
[X] Wetland Hydrology Present
Remarks
Waters of the US Criteria was met .
[ ] Concretions
[ ] High Organic % in Surface Layer
[ ] Organic Streaking -
[ ] Listed on Local Hydric Soils List
[ ] Listed on National Hydric Soils List
[ ] Other (explain in remarks )
Taxonomy: Typic Hapludults
[ ] Field Observations match map
[X].This Data Point is a Wetland

0�
.C)
T�
M�Ii-del F. E Iley, Lell,r
William G. Ross Jr., Secretary
North Carolina Department'of Environment and Natural Resources
John M. J. Ernst
2234 Portside Way
Charleston, SC 29407
January 24, 2005
Subject Property: Cotton Patch Equestrian Tract
Driveway Access
Alan W. Klimek, P.E. Director
Division of Water Quality
DWQ Project # 04-2021
Polk County
Approval of 401 Water Quality Certification with Additional Conditions
Dear Mr. Ernst:
You have our approval, in accordance with the attached conditions and those listed
below, to place fill within or otherwise impact —200 feet of shoreline for the purpose of
stabilization at the subject property, as described within your application received by the
N.C. Division of Water Quality (DWQ) on January 18, 2005. After reviewing your
application, we have decided that the impacts are covered by General Water Quality
Certification. Number(s) 3402 (GC3402). J The Certification(s) allows you to use
Nationwide Permit(s) 39 when issued by the US Army Corps of Engineers (USACE). In
addition, you should obtain or otherwise comply with any other required federal, state or
local permits before you go ahead with your project including (but not limited to) Erosion
and Sediment Control, Non -discharge, and buffer regulations. Also, this approval to.
proceed with your proposed impacts or, to conduct impacts to waters as depicted
in your application shall expire upon expiration of the 404 or CAMA Permit.
This approval is for the purpose and design that you described in your application. If
you change your project, you must notify us and you may be required to send us a new
application. If the property is sold, the new owner must be given a copy of this
Certification and approval letter and is thereby responsible for complying with all
conditions. If total fills for this project (now or in the future) exceed one acre of wetland
or 150 linear feet of stream, compensatory mitigation may be required as described in
15A NCAC 2H .0506 (h). This approval requires you to follow the conditions listed in
the attached certification and any additional conditions listed below.
The Additional Conditions of the Certification are:
1. Impacts Approved
The following impacts are hereby approved as long as all of the other specific
and general conditions of this Certification (or Isolated Wetland Permit) are met.
No other impacts are approved including incidental impacts:
401 Wetlands Certification Unit
1650 Mail Service Center, Raleigh, North Carolina 27699-1650
2321 Crabtree Boulevard,'Suite 250, Raleigh, North Carolina 27604
Phone: [phone] FAX [phone] / Internet: htto://h2o.enr.state.nc.us/ncwetiands
NorthCarolina
XirArr 4
An Equal Opportunity/Affirmative Action Employer— 50% Recycled/10% Post Consumer Paper

Nathan R. Jones.
Page 2 of 4
January 24, 2005:
Amount Plan Location or Reference
Approved (Units)
Stream —115 (feet) Site B
2. Erosion & Sediment Control Practices
Erosion and sediment control practices must be in full compliance with all
specifications governing the proper design, installation and operation and
maintenance of such Best Management Practices in order to protect surface
waters standards:
a. The erosion and sediment control measures for the project must be
designed, installed, operated, and maintained in accordance with the most
recent version of the North Carolina Sediment and Erosion Control Planning
and Design Manual.
b. The design, installation, operation, and maintenance of the sediment and
erosion control measures must be such that they equal, or exceed, the
requirements specified in the most recent version of the North Carolina
Sediment and Erosion Control Manual. The devices shall be maintained on
all construction sites, borrow sites, and waste pile (spoil) projects, including
contractor -owned or leased borrow pits associated with the project.
c. For borrow pit sites, the erosion and sediment control measures must be
designed, installed, operated, and maintained in accordance with the most
recent version of the North Carolina Surface Mining Manual.
d. The reclamation measures and implementation must comply with the
reclamation in accordance with the requirements of the Sedimentation
Pollution Control Act.
3. No Waste, Spoil, Solids, or Fill of Any Kind
No waste, spoil, solids, or fill of any kind shall occur in wetlands, waters, or riparian
areas beyond the footprint of the impacts depicted in the Pre -Construction
Notification. All construction activities, including the design, installation, operation,
and maintenance of sediment and erosion control Best Management Practices,
shall be performed so that no violations of state water quality standards, statutes,
or rules occur.
4. No Sediment & Erosion Control Measures w/n Wetlands or Waters
Sediment and erosion control measures shall not be placed in wetlands or waters
to the maximum extent practicable. If placement of sediment and erosion control
devices in wetlands and waters is unavoidable, they shall be removed and the
natural grade restored within six months of the date that the Division of Land
Resources has released the project.

Nathan R. Jones:
Page 3 of 4
January 24, 2005:
5. Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification
or applicable Buffer Rules, and any subsequent- modifications, the applicant is
required to return the attached certificate of completion to the 401/Wetlands Unit,
North Carolina Division of Water Quality, 1650 Mail Service Center, Raleigh, NC,
27699-1650.
6. Diffuse Flow (No Review)
All constructed stormwater conveyance outlets shall be directed and maintained
as diffuse flow at non -erosive velocities through the protected stream buffers
such that it will not re -concentrate before discharging into a stream. If this is not
possible, it may be necessary to provide stormwater facilities that are considered
to remove nitrogen. This may require additional approval from this Office. .
7. Turbidity Standard
The turbidity standard of 10 NTUs (Nephelometric Turbidity Units) shall not be
exceeded as described in 15 A NCAC 2B. .0200. Appropriate sediment and
erosion control practices must be used to meet this standard.
8. No Impacts Beyond those in Application
No waste, spoil, solids, or fill of any kind shall occur in wetlands, waters, or
riparian areas beyond the footprint of the impacts depicted in the Pre -
construction Notification. All construction activities, including the design,
installation, operation, and maintenance of sediment and erosion control Best
Management Practices, shall be performed so that no violations of state' water
quality standards, statutes, or rules occur.
10. Deed Notifications
Deed notifications or similar mechanisms shall be placed on all retained
jurisdictional wetlands, waters and protective buffers throughout, the
property in order to assure compliance for future wetland, water and buffer
impact. These mechanisms shall be put in place prior to impacting any wetlands,
waters and/or buffers approved for impact'under this Certification Approval and
Authorization Certificate. A sample deed notification can be downloaded from the
401/Wetlands Unit web site at http://h2o.enr.state.nc.us/ncwetlands. The text of
the sample deed notification may be modified as appropriate to suit 'to this
project.

Nathan R. Jones.
- - Page 4 of 4
January 24, 2005:
Violations of any condition herein set forth may result in revocation of this Certification
and may result in criminal and/or civil penalties. The authorization to proceed with your
proposed impacts or to conduct impacts to waters as depicted in your application and
as authorized by this Certification, shall expire upon expiration of the 404 or CAMA
Permit.
If you do not accept any of the conditions of this Certification (associated with the
approved wetland or stream impacts), you may ask for an adjudicatory hearing. You
must act within 60 days of the date that you receive this letter. To ask for a hearing,
send a written petition, which conforms to Chapter 150B of the North Carolina General
Statutes to the Office of Administrative Hearings, 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 telephone Cyndi Karoly in the
Central Office in Raleigh at 919-733-9721 or Mr. Kevin Barnett in the DWQ Asheville
Regional Office at either Kevin. Barnett(@-ncmail.net or at 828-296-4657.
AWK/khb
Sincerely,
F5AL Alan W. Klimek, P.E.
Enclosures: GC 3373
Certificate of Completion
cc: USACE Asheville Regulatory Field Office
,qdj8N!Asheville Re �onAI ®ffice
DLR Asheville Regional O ice
File Copy
Central Files
Filename: 04-2021. Cotton Patch EquastrianTracts.WQ3402.Approval

Date: 12/23/04
Triage Check List
Project Name: Cotton Patch Equestrian Tract
DWQ#: 04-2021
County: Polk
To: Kevin Barnett, Asheville Regional Office
60-day Processing Time: 12/20/04 to 2/17/05
From: Cyndi Karoly Telephone: [phone]
D CE VC
DEC 2 9 2004 01
WATER QUALITY SECTION
ASHEVILLE REGIONAL OFFICE
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
Mitigation Ratios
❑ Ditching
❑ Are the stream and or wetland mitigation sites available and viable?
❑ Check drawings for accuracy
❑ Is the application consistent with pre -application meetings?
❑ Cumulative impact concern
Comments: As per our discussion regarding revision of the triage and delegation processes,
please review the attached file. Note that you are the first reviewer, so this file will need to be
reviewed for administrative as well as technical details. If you elect to place this project on hold,
please ask the applicant to provide your requested information to both the Central Office in
Raleigh as well as the Asheville Regional Office. As we discussed, this is an experimental, interim
procedure as we slowly transition to electronic applications. Please apprise me of any
complications you encounter, whether related to workload, processing times, or lack of a "second
reviewer" as the triage process in Central had previously provided. Also, if you think of ways to
improve this process, especially so that we can plan for the electronic applications, let me know.
Thanks!

DEC 9 0 2004
Office Use Unl ' WATER QUALITY Form Version May 2002
YWETLi�NDS AND STORMWATER BRANCH
P 42021
USACE Action ID No. DWQ.
(If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A".)
I. Processing
1. Check all of the approval(s) requested for this project:
Section 404 Permit ❑ Riparian or Watershed Buffer Rules .
❑ ,Section 10 Permit ❑ Isolated Wetland Permit from DWQ
PAYMENT R401 Water Quality Certification
RECEIVED
2. Nationwide, Regional or General Permit Number(s) Requested: 3
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: ❑
4. If payment into the North Carolina Wetlands Restoration Program (NCWRP) is proposed for
mitigation of impacts (verify availability with NCWRP prior to submittal of PCN), complete
section VIII and check here: ❑
5. If your project is located in any of North Carolina's twenty coastal counties (listed on page
4), and the project is within a North Carolina Division of Coastal Management Area of
Environmental Concern (see the top of page 2 for further details), check here: ❑
II. Applicant Information
1. Owner/Applicant Information
Name: John M.J. Ernst
Mailing Address: 2234 Portside Way
Charleston, S.C. 29407
Telephone Number: 843-556-8148 Fax Number:
E-mail Address: jmiernst(acomcast.net
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:
Company Affiliation:
Mailing Address:
Telephone Number: Fax Number:
E-mail Address:
Page 5 of 13

A.
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: Cotton Patch Equestrian tract driveway culvert
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN): P48-2 (Portion)
4. Location
County: 'Polk _ Nearest Town: Landrum / Tryon
Subdivision name (include phase/lot number): Cotton Patch Equestrian tract & Residential
Tract B
Directions to site (include road numbers, landmarks, etc.): Landrum RT 14 right onto High
Farm rd right onto Old Hunt Country Rd right onto River road, left onto Scrivens road
approximately 1 mile on right
5. Site. coordinates, if available (UTM or Lat/Long): 35.2180N / 82.2150 W
(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): equestrian tract -24 acres ( 2+ acres barn site Residential tract B-
12 acres
7. Nearest body of water (stream/river/sound/ocean/lake): N. Pacolet River
8. River Basin: Broad River
(Note — this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at htti)://b2o.enr.state.nc.us/adn-lin/snqps
Page 6 of 13

9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: 22 acres pasture, 2+ acres preexisting_ graded site for farm
equipment small poplar grove with 5 gpm. seasonal spring from hill side through existing
farm trench and swales traveling approximately % mile to N. Pacolet river through pasture.
10. Describe the overall project in detail, including the type of equipment to be used:
Installation of 115 ft of 18 inch concrete culvert ( see plans ) to allow for driveways to home
site and barn site (connecting to existing loge road to minimize grading and tree removal).
This includes extension of culvert 25 ft through the Dept. of Transportation right of way to
connect to existing culvert crossing Scrivens road ( NC Dept. of Transportation
encroachment permit obtained and attached). This will eliminate an existing 25 foot long and
5 ft deep ditch that is a serious hazard to horses traveling on a path to the barn from the
pastures across Scrivens road. This will also eliminate a road hazard and a region that
frequently collects roadway refuse from highway traffic. The driveways need to
accommodate a 50 foot horse trailer turning radii and construction vehicles. Due to grade
changes, grand tree locations, fixed barn site, and turning radii the road pathways are
essentially constrained to proposed plans. General medium duty road construction
11. Explain the purpose of the proposed work: This will allow for necessary driveways to new
residence and private non commercial barn construction. Barn drive through necessary for
horse trailer access and egress
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.
Recent NC Dept of Hi way encroachment approval obtained ( copy enclosed
Page 7 of 13

i
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.
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.
1. Provide a written description of the proposed impacts: No Impact anticipated
2. Individually list wetland impacts below:
Wetland Impact
Site Number
(indicate on ma)
Type of Impact*
Area of
Impact
(acres)
Located within
100-year Floodplain**
(yes/no)
Distance to
Nearest Stream
(linear feet
Type of Wetland***
! i
* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: mechanized clearing, grading, rill,
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:/hvww.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:
Page 8 of 13

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 Im act
Perennial or
Intermittent?
(please specify)
Site B.
culvert
115 feet
Intermittent stream
6 inches
intermittent
* 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.eov. Several intemet 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: 115 feet
4. Individually list all open water impacts (including lakes, ponds; estuaries, sounds, Atlantic
Ocean and any other water of the U.S.) below:
Open Water Impact
Site Number
(indicate on ma)
Type of Impact*
Area of
Impact
(acres) _
Name
(if applicable) of Waterbody
Type of Waterbody
(lake, pond, estuary, sound,
bay, ocean, etc.)
I
,
{ 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
If construction ofa 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:
Page 9 of 13

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.
Road site constrained by existing Qrades, building siting limitations, turning design radii for
horse vehicles, and need to access existing logging road as ideal and practically only logical
access to home site.
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://h2o.elir.state.iic.us/ncwetlalids/strmgide.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
Page 10 of 13

IX.
X.
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
Proposed project should be below 150 foot threshold for mitigation. Stream is
intermittent
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://l12o.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):
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 ``�
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 ❑
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
Page 11 of 13

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 Req r }rents), or other (please identify, )?
Yes ❑ No IVI 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 charinel; 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.
A conservation easement for the Cotton Patch property of 400 acres was executed with Upstate
Forever this past year. The equestrian tract and residential tract B are 2 of 9 tracts in the Cotton
Patch Property.
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.
The barn site 4000 so. $. will be the onlv impervious addition and will have no significant
impact
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.
Page 12 of 13

None generated
XIII. Violations (required by DWQ)
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 application?
Yes � No ❑
XIV. Other Circumstances (Optional):
It is the applicant's responsibility to submit the application sufficiently in advance of desired
construction dates to allow processing time for these permits. However, an applicant may
choose to list constraints associated with construction or sequencing that may impose limits on
work schedules (e.g., draw -down schedules for lakes, dates associated with Endangered and
Threatened Species, accessibility problems, or other issues outside. of the applicant's control).
Owner advised by engineering / ecologist consultant that a 30 ft culvert to construct drive was
below 150 foot threshold and no notifications under Section 404 or 401 were required.
Contractor proceeded on this basis but installed 88 feet of culvert necessitated b. the he topography
and road design constraints. Conflicting consultations resulting in my contacting the Army Corps
of Engineers and NC DWQ for advice resulting in this. application. Civil Engineering
consultation and confirmation of design constraints attached. Work has been suspended. I would
like to proceed with barn construction in mid January following resolution of the driveway
design.
ApplicarittAgent's Signature �' `-� Date
(Agent's signature is valid or'ly if an authorization letter from the applicant is .provided.)
Page 13 of 13

Broad River Basin Map
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http://h2o.enr.state.nc.us/basinwide/Whichbasinbroad.htm 12/5/2004

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Howard Leonard.
864 234 2857 p.l
P��ITU� �iVIL. INC. ,
DQTC-- X/Ee?%.04:-----
TO: . '�. : 4.... .... �[ _� ._�I._�..... ��..��`� ..._.._.__...�...:...._......... ...................
�.
FAX WUMD
�._ TOTAL Nu M15ER OF PA(7E6M cy.....�.1.. } _....._,
. .. No1-r= + .
S110LJLD You IIAVE. ANY OUL5TION6 CONCERNltk T JL
TRAWSMTrAL PUAbLCONTACTIIMVARD LEONARD.
-------- -----
J. MV P— LEONARD. P.E.
P.O. 6OX 16146 C, P-=VILLE. g0UTI1 CAROLINA - 29606
OFFICE-[phone] FAX- (864) 234.--2857

Howard Leonard 864 234 2857 p.2
PLRJTU.-5 0\11L iNc_
laecember 15, 2004
John M. J. F—rnst
2234 Porbide -\1/ay - .
Charleston, 5C 29407
Re: Driveway design and concrete storm pipe placement
)crivens" Road at Cotton Patch (61Z 1506)
PoLk County
Tryon. North Carolina -
Dear Mr. Ernst:
This letter is to confirm that you and your contractor- have located your driveway
' in the best location based on the topography and other surrounding features.
Its location is confined to a space surrounded by Strivers road, the property Line
forthe-parceLtrees; the -barn and the high ground behind -the entrance There is
a wet weather creek'starting in the high ground and almost splits the entrance
parceL Constructing a driveway at 90-degree off of Scrivens road would be
difficult and dangerous for a horse trailer trying to make a turn between the
creek and the barn. The split driveway or half circle driveway off Scrivens road
makes the barn accessible to the truck and horse trailer without having to back
_up. __ The_splitdrive required piping the creek under- one-ley-of;Eha driveway. 'To
eliminate a dangerous hole between the drive and the road, pipe was extended
from the driveway to a catch basin beside the road The disturbed area at the
entrance is to be smoothed for landscaping at the end of the construction.
P.O. E5Ox 16146 C, REI=NVlLLE. 50uTIA CAROLINA • 29606
OFFICI=: [phone] • FAX: [phone]
MODILL (864) 270 596o

10:18a Howard Leonard
864 234 2857 p.3
In my opinion. having examined the site. I believe your contractor has roughed in
the drives correctly for a safety entrance and exit to accoate up to a 50-
foot horse trailer including the cab. i
�5incereLy.
Peritu.-A&L Inc.

December 6, 2O04
John M. J. Ernst
225.4 Portside Way
Charleston, 5C 29407
lZe: Design 18-inch concrete storm pipe
5crivens lZoad at Cotton Patch (51Z 1506)
PoLk County
Tryon, North Carolina
Dear Mr. Ernst:
On Monday November 22 a site inspection was made with Mr. Steve flyder for
the purpose of investigate the storm water piping situation at the above
referenced Location on 5crivens road. My report, concLusions and pipe design
arP c7j,-m- I in this 1_Pf+,--r
The site is Located to the Northeast of Tryon, NC on 5criven5 road (5lZ 1506).
The property is heavily wooded and has Lots of bush type shrubs. The ground is
covered with a thick bed of leaves, tree Limbs, twigs and other debris. A dry
creek bed collects storm water from a 52-acre drainage basin and funneling it
down a dry creek bed to 5crivens road. The existing pipe under 5crivens road is
an 18-inch CMP. The pipe is rusting away, and is half full of silt.
NC -DOT personal, which maintains the gravel road, told Mr..l-.lyder, that they
have never seen water overtop the road. The creek on the down streamside of
the road has a swaLe type ditch and is heavily grassed. The ditch has a 12-inch
bottom, with side slopes of 2:1. There were no signs of overtopping at the time
of my inspection.
P.o. box 16 /66 a (RP=NVILLL. 50UTJ CA-OLINA , 29606
OFFICL: (86A) 288-5512 m FAX: (864) 25L1-2857
MOE51LL: (86A) 270-5960

Upon arriving at the project to construct a driveway up the mountain Mr. flyder
found soft area of silty materiaL in the work area. The area is beside the road at
the existing 18-inch CMP. fle determined the silt was 5 to 4 feet deep and
encroaches into the new driveway area. Nor. flyder removed the silt down to
Good material and backfiLLed with acceptable materiaL
An 18-inch concrete pipe was placed under the new driveway at a 4 percent
.grade. The pipe extends from the dry creek bed above the new driveway to
below the drive. \Vhen the entrance has been completed there wiLL be a new 15-
inch concrete pipe paraLLeLing the road. An 18-inch concrete pipe wiLL attach to
the one under the driveway and extend downstream to the catch basin at the
street. From the catch basin a new 18- inch concrete pipe wiLL extend across
._the road replacing the old 18-inch CMP. The 15-inch pipe and the 18-inch pipe
connect at the catch basin to form an intersection of the system.
flydroLogic and hydraulic caLcuLations have been made to confirm the size of the
184nch concrete pipes. The design of the pipe is based on a 10 year storm. ALL
storm events in excess of a 10 year storm could overtop the new driveway and
5crivens road for a short period of time. This is not uncommon. Most systems
are designed for the 10 year event because the majority of storms are Less than
the 10 year storm.
After aLL pipes have been connected to the catch basin and new driveway shaped,
the final grading wiLL be accomplished for the Landscaping.
The above system has been approved by the NC -DOT. fee attached plan of
proposed Layout.
5incereLy.
Peritus /iL I nc.
Howard fZ. L-eonark P.F
Ot
�. SEAS. n

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P.O. -DOX 161,46 C P-F- LN1VILLL. I.C. 29606

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Do -It -Yourself: Driveway and Entrance Road Layout
Careful driveway layout reduces construction costs, min- Figure 1
Typical Complete Curve.
imizes damage to the landscape and helps control main-
tenance costs. In most cases, the_trucks bringing your logs _^
will be the largest you'll encounter If youeiect to hmu youi _� f
drive t tiller vehtcleAs,'recogmze that a large deh _ezy to tck—�
N
?;f-cauires almost as gteata;turn ng,cadius as -a -tractor -trailer:=
The procedure below explains how to lay out curves by mark- °"
ry o
ing the. inside and outside of the curve using marker flags,
ribbon or marking lime (all available at most building or ma-
sonry supply stores). Use a rope or cord —at least as long as the -
outside radius —and a stake to secure the end, locating the cen-
ter. The figures show typical layouts for curves that will ac-
commodate,a 55-f6ot tractor -trailer.
r-
I ';
1. Make a loop at one end of the rope to secure with the
stake. Trom;the loop; measure off 50 feet, and mark with a cot- .
I center of radius
ored marker or by securely tying a plastic ribbon. This will mark
I
the' outer radius of your curve. From the outer radius mark,-:;::.:.
j g
measure back toward the loop the width of the driveway (IO
feet incur example) and mark as before. This indicares the in-:
net edge of the driveway. Add marks to,indicate the inside width
I I E
of the driveway'at the 45, 90 and 135 degree (if the curve is io o
to -a°
greater than 90 degrees) points of the curve.. ...
2. At the point of your roadway where the. curve. should
- begin, lay the rope_atright angles to the roadway with the out-
er radius mark aligned with the outside of the roadbed and the
loop end toward the center of the curve. Stake the rope
through the Loop::; Figure 2 •
Typical Right -Angle Curve.
-, 3. Keeping the rope -straight (without stretching), sweep-
it in the -direction of.the curve- Estimate the 45, 90 and 135,
degree points of the curve, and mark the:outer and inner_
f'
edges of the curve with a flag, plastic ribbon or marking lime
l
4. Connect the'dots with marking lime or string to indi-
"!
,cate the entire sweep of.the-inside and outside, of the curve.
"Freehand" the sweepof the inner curve, beginning at the in- -
?
net edge of the roadbed about 30 feet before where the curve
b
of the outer edge begins, and passing through the mark to—
_ -where the curve ends and the road returns to its normal width
I
5. Have your general contractor, excavator or someone ex-
!
perienced with mane'uvening large trucks check your layout!
- center at radius
fore grading or adding stone. - ...
When laying. -out curves on a slope, the road often must
be "cut -in" to remain' fairly level as it rounds the curve.'On
=
steep slopes; this cut may be,substaritial, making itprefer
-I
able to run the, road straight up and down the'slope If your -
f
road will combine steep slopes and' curves, it's best to consult
-a surveyor. As.always, should you have questions on this or any.
construction work, turn it over to the professionals
'Jim Cooper
rr_ D ,E` .0 E M B E ,R
2 00 1
17

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STATE of NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
LYNDO TIPPETT
MICHAEL F. EASLEY
SECRETARY
GOVERNOR
October 4, 2004
Encroachment No.: 20047508
Location: SR 1506 4
County: Polk
District Engineer: M. T. Gibbs, P. E.
[phone]
John M. J. Ernst
2234 Portside Way
Charleston, SC 29407
Dear Mr. Ernst:
Attached for your files is a copy of a contract which has been properly executed for the encroachment on
NC DOT right-of-way designated as Route SR 1506, located Tryon, NC, for the construction of a catch
basin and ditch culvert pipe, and replace an existing 18" CMP under gravel road by open cut as shown on
the attached drawings.
The following and attached standard and project special provisions are conditions of this encroachment.
If you have any questions please contact Mr. M. T. Gibbs, P.E., District Engineer, whom you can reach at
the District Engineer's office at [phone].
Si ere yAw
J. B. Setzer, E.
Division Engineer
JBS/WJ/lh
cc: Manager of Right of Way
District Engineer
File

STATE OF NORTH CAROLINA
ROUTE 5� S�io PROJECT COUNTY OF
DEPARTMENT OF TRANSPORTATION RIGHT OF WAY ENCROACHMENT AGREEMENT FOR
CURB AND GUTTER, PAVEMENT WIDENING AND
-AND- STORM DRAINAGE
o ff rJ r)5
s?-y ^J
20 p , by and between the Department
THIS AGREEMENT, made and entered into this the day of ��S7
of Transportation, party of the first part; and �e ^� �'�' C
party of the second part,
WITNESSETH
THAT WHEREAS, the party of the second part desires to encroach on the right of way of the public road designated as
Route(s)
S C �' i [1 � n1 S 20 A l's , located T 2 y 0 0 (J .
G/ l� /3 RT
with the construction and/or erection of:
8 C Wl Q .. . L'3�� 2 &X/4.O f L 1�0 ' OPE.J 2� iA�Jt ����
WHEREAS; it is to the material advantage of the party of the second part to effect this encroachment, and the party of
the first part in the exercise of authority conferred upon it by statute, is willing to permit the encroachment within the limits of the
right of way as indicated, subject to the conditions of this agreement;
NOW, THEREFORE, IT IS AGREED that the party of the first part hereby grants to the party of the second part the right
and privilege to make this encroachment as shown on attached plan sheet(s), specifications and special provisions which are
made a part hereof upon the following conditions, to wit:
That the said party of the second part binds and obligates himself to install the encroaching facility in such safe
and proper condition that it will not interfere with or endanger travel upon said highway.
That the party of the second part agrees to provide during construction proper signs, signal lights, flagmen and
other warning devices for the protection of traffic in conformance with the latest Manual on Uniform Traffic Control
Devices for Streets and Highways and Amendments or Supplements thereto. Information as to the above rules and
regulations may be obtained from the Division Engineer of the party of the first part.
..That the party of the second part hereby agrees.to indemnify- and save harmless the party of the first part from all
damages and claims for damage that may arise by reason of the installation and maintenance of this encroachment.
It is clearly understood by the party of the second part that the party of the first part will assume no responsibility
for any damage that may be caused to such facilities, within the highway rights of way limits, in carrying out its
construction.
That the party of the second part agrees to restore all areas disturbed during. construction to the satisfaction of the
Division Engineer of the party of the first part. The party of the second part agrees to exercise every reasonable
precaution during construction and maintenance to prevent eroding of soil; silting or pollution of rivers, streams, lakes,
reservoirs, other water impoundments, ground surfaces or other property; or pollution of the air., There shall be .
compliance with applicable rules and regulations of the North Carolina Division of Environmental Management, North
Carolina Sedimentation Control Commission, and with ordinances' and regulations of various counties, municipalities
and other official agencies relating to pollution prevention and control. When any construction operation disturbs the
ground surface and existing ground cover, the party of the second part agrees to remove and replace the sod or
otherwise reestablish the grass cover to meet the satisfaction of the Division Engineer of the party of the first part.
That the party of the second part agrees to assume the actual cost of any inspection of the work considered to be
necessary by the Division Engineer of the party of the first part.
That the party of the second part agrees to have available at the encroaching site, at all times during construction,
a copy of this agreement showing evidence of approval by the party of the first part. The party of the first part
reserves the right to stop all work unless evidence of approval can be shown.
,., f. ino.t in thic PnrPPment is hninn nPrfnrme.d on a completed highway open to traffic; the

That the party of the second part agrees to have available at the encroaching site, at all times during construction,
a copy of this agreement showing evidence of approval by the party of the first part. The party of the first part
reserves -the right to stop all work unless evidence of approval can be shown.
P
-- - -d-- - th- --- - c g performed on a -completed -highway open to -traffic; the_-
rovidee work contained in -this agreement is being
party of the second part agrees to give written notice to the Division Engineer of the party of the first part when all
Work contained herein has been completed. Unless specifically requested by the party of the first part, written notice
of completion of work on highway projects under construction will not be required.
That in the case of noncompliance with the terms of this agreement by the party of the second part, the party of
the first part reserves the right to stop all work until the facility has been brought into compliance or removed from the
right of way at no cost to the party of the first part.
That it is agreed by both parties that this agreement shall become void if actual construction of the work
contemplated herein is not begun within one (1) year from the date of authorization by the party of the first part unless
written waiver is secured by the party of the second part from the party of the first part.
R/W (161 B) : Party of the Second Part certifies that this agreement is true and accurate copy of the form
R/W (161 B) incorporating all revisions to date.
FORM R/W 16.1 B (May, 1982)
Page 1

IN1VITNESS_WHEREOF, each of the parties to this agreement has caused the same to be executed the day and
year -first above written.
ATTEST OR WITNESS:•
-DEPART-ME . T NSP__O.RTAT_ION _ ._...__- . .
BY:
�n�oY�Y� �• �. �rI�S�
Secon¢'Party
INSTRUCTIONS
When the applicant is a corporation or a municipality, this agreement must have the corporate seal and
be attested_ by the corporation secretary or by the empowered �of official, al ison file n the waiver
Raleigh office of
'seal and attestation by the secretary or by the empowered y
on, the name of
the Manager of Right of Way. In the space provided
name'Sandreement title of all perfor exe s cns'signing the agreehment
corporation or municipality shall be typed above
should be typed directly below their signature.
When the applicant is not a corporation, then his signature must be witnessed by one personi ne
address should be included in this agreement and the names of all persons signing the agreement
should .be typed directly below their signature.
This agreement must be accompanied, in the form of an attachment, by plans or drawings showing the
following applicable information:
1. All roadways and -ramps.
2.. Right of way lines' and where applcable, the control of access lines.
i
3. Location of the proposed encroachment.
4. Length and type of encroachment.:
5. Location by highway survey station number. If station nointmsuch asna bot ridge, road,"
location
should be shown by distance from some identifiablep
intersection, etc. (To assist in preparation of the encroachment plan, the Department's
roadway plans may be seen at. the various Highway Division Offices, or at the Raleigh
office.)
6. Drainage structures or bridges if affected by encroachment.
7. Typical'section indicating the pavement design and width, anddthe tion, slopes,
widths
ever apple able.
details for either a.curb and gutter or a shoulder an applicable. 8: Horizontal alignment indicating general curve data, where
9. Vertical alignment indicated by.percent grade, P.I. station and vertical curve length, where
applicable.
10. Amount of material to be remove d and/or placed on ratio
{o'and reference byght of way, if lst lion
11. Cross=sections of all grading operations, indicating- p
where applicable. all hydraulic y pipe e sizes, structure
12. All pertinent drainage structures proposed. Include a, p
details and other related information.
13. Erosion and sediment control. wo14. Any special provisions or specifications as to the performance of the work or thesepartet sheet f
construction that may be required by the Department must b
attached to encroachment agreement provided that such information cannot be shown on
plans or drawings.
15. The Department's Division Engineer should be given notice by the. applicant prior to actual
starting of installation included in this agreement. applicable.
16. Method of handling traffic during,construction where
.-� c,--I , --F nlone north nrmVV P.tr.

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NOTE:. MAP INCLUDES ONLY STATE MAINTAINED ROADS
OR IMPORTANT NON -SYSTEM ROADS.
MILEAGE NOT SNOwN ON FRCOUNTY
ONTAGE ROADS.
1�°''��' � RDADS SHOwN AS OF APR• 15. 1997
POLK
i
E AS
NORTH CAROLINA
)7`+'
nIErAAEc a THE
CGUIi'Y RO°' NUTA3 R5 NORTH CAROLINA DEPARTMENT OF TRANSPORTATIOI
_a DIVISION OF HIGHWAYS. — GIS UNIT
SCALE .
AULES IN COOrEMTION WITH THE
U.S.DEPARTMENT OF TRANSPORTATION
° °n __� J ALE FEDERAL HIGHWAY ADMINISTRATION
SCALE tuft EHWGEMENTs

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SEE NOTE
TION X-X
D
NOTES:'USE'CLASS "B" CONCRETE THROUGHOUT.
NING
j,
PROVIDE ALL CATCH BASINS OVER 3'-B" IN DEPTH WITH STEPS 12"
ON CENTER. USE STEPS WHICH COMPLY WITH STD. DRAWING 840.68.
IP SLAB
OPTIONAL CONSTRUCTION - MONOLITHIO POUR, . 2" KEYWAY, OR #4 BAR DOWELS AT
- G
12" CENTERS AS DIRECTED BY THE ENGINEER.
TOP ELEVATION
USE FORMS FOR THE CONSTRUCTION OF.THE BOTTOM SLAB.
IF REINFORCED CONCRETE PIPE IS SET IN BOTTOM SLAB OF BOX, ADD TO SLAB
AS SHOWN ON STD. NO. 8140.00. t
6„
FOR 8`-0" IN HEIGHT OR`LESS USE-S" WALLS AND BOTTOM SLAB. OVER,
8" WALLS AND BOTTOM SLAB. ADJUST
6'-O" TO 16'-0" IN HEIGHT USE
QUANTITIES ACCORDINGLY,.
8„
CONSTRUCT WITH PIPE CROWNS MATCHING.
B
I
x
INSTALL 2" WEEPHOLES AS DIRECTED BY THE ENGINEER.
.OF
INSTALL STONE DRAINS, A'MINIMUM OF 1 CUBIC FOOT OF NO. 78M STONE IN A
HOLE OR AS DIRECTED BY THE ENGINEER
POROUS FABRIC SAO OR WRAP, AT EACH WEEP
CHAMFER ALL EXPOSED CORNERS 1".
DRAWING NOT TO SCALE.
*INCREASE THE SIZE OF THE 8" OPENING TO B" MAX., A3 DIRECTED BY THE
ENGINEER BY ADDING 2" TO THE WALL HIEGHT ABOVE THE TOP ELEVATION. ADJUST
SEE NOTE
QUANTITIES ACCORDINGLY.
SECTION Y-Y
-3
-4
M
X I BARS.- Y
ENGTH I N0. LENGTI
TOP SLAB 4"
GUTTER LINE
#4 BAR Z
311.. TOP ELEVATION
PIPE WALL r
10L2"
((THICKNESS VARIES)
(MIN:)
#4 *BAR Z
4
PART.SECTION Y-Y'
SHOWING DETAILS AT OPENING.
D QUANTITIES FOR CONCRETE CATCH BASIN BASED ON
TOP 6 BOT. SLAB CU. YDS. CONC. TOTAL 0
- Z DIMENSIONS IN BOX BOX
GTH F G TOP SLAB eGi. eue RLIFT. IIT. L&1. AElti
DEDUCTION
ONE PIPE
N C.S. R.0
✓-3" 4'-8" 3'-3" 0.181 0.271 0.250 27 1.048 0.015 0.032 0.048
•1 ." at all 181 '0 271 0.250 27 1.108 0.023 0.038 0.048
0.228
0.340
0.284
35
1.379
0.033
0.049
0.053
D.226
0.340
0.284
35
1.521
0.059
0.085
0.053
0.278
0.417
0.315
43
1.918
0.092
0.127
0.053
0.340
0.510
0.352
51
2.390
0.132
0.178
0.059
0.407
0.811
0.389
84
2.914
0.180
0.243
0.088
n AAA
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O.30l
88
3.298
0.235
0.317 1
0.086
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STATE OF11-02
ENGLISH STANDARD DRAWING FOR cQ C
_ NORTH CAROLINA CONCRETE CATCH BASIN 0
DEPT....,OF.,TRANSPORTATION
DIVISION OF HIGHWAYS- W%SINGLE AND MULTIPLE .PIPES
ui
RALEIGH, N.C. 12" THRU 48" PIPE

'AIL SHOWING TYPES OF. GRATES
,E ACCORDING TO WATER FLOW.
PE ,►G,► TYPE "E!' TYPE 'IF"
'LOW - SAG WATER FLOW
- — — — — — — — — — — — — — — — — — — — — — — — - — —
Lpyy SAG WATER FLOW
'E "F" TYPE "E' TYPE "G►►
.ARROW � ^
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TYPE - F
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SECTION A -A 'o
TYPE - E
RAISED FLOW ARROW
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STATE OF ENGLISH STANDARD DRAWING FOR
NORTH CAROLINA FRMEj GRATES 5 AND HOOD
DEPT. OF TRANSPORTATION FOR USE ON STANDARD CATCH BASIN
DIVISION OF HIGHWAYS
RALEIGH, N.C.
M
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0000

It S
National Pollutant Discharge Elimination System (NPDES)
- -- - - - - -- _ ..
Stormwater Permit Compliznce Certification
I J p 11+0 EAASa duly authorized representative of
' ?iQ 104 7Z. C e r7 -e F .J
,S46 C. a-�� � requesting
attachment to a North Carolina Department of Transportation highway drainage system
at
S,f R . J It Z-s 24 A--4N
--?d L/G. County, do hereby certify the following:
in ,
The i does not require an I�'PDES stormwater permit.
The industrial facility does require an NPDES stormwater permit. The
permit has been obtained, .and a Stormwater Pollution Prevention Plan
(SPPP) is in place.
I understand if the Department of Transportation determines the industrial facility is not
in compliance with NPDES.stormwater permit requirements; the Department will report
the noncompliance to the N.C. Division of Water Quality. I also understand that
falsification of this certification may result in penalty of law against the industrial facility
and me as prescribed in the Nlorth Carolina General Statutes.
Signature:
Date:
9 /z z�in/
Note: If the applicant has a question as to whether.an IN'PDES stormwater permit is
required, he or she may contact the N.C. Division of Water Quality in Raleigh at
[phone] (ask for Stormwater and General Permits Unit).

Environmental Permit Compliance Certification
J d f�,,J �i�r�• , a duly authorized representative of
an applicant requesting permission
to encroach upon the North Carolina Department of Transportation highway
Right of Way at the location of
in'
County, do hereby certify the following:
Erosion Control Permits
The proposed area to be disturbed is in excess of 1 acre and does
require erosion control plans. Copy of approved plan and permit
are attached.
The proposed area to be disturbed is not in excess of 1 acre and
does not require erosion control plans. However all
necessary erosion control measures will be used to comply with the
laws and regulations.
Other Environmental Permits
Environmental Permits (USACE, NCDENR, NCDWQ, NCbVRC,
USFS, etc.) are required and copies of approved'permits are
attached.
z,� Other Environmental Permits are not required
I understand if the Department of Transportation determines the encroachment is not in
compliance with environmental permit requirements, the Department will report the
noncompliance to the N.C. Department of Environment and Natural Resources or other
regulatory body. I also understand that falsification of this certification may result in
penalty of law against the encro ching party and me as prescribed in North Carolina
7
General Statutes.
Signature:
Date:. 9/CZ/- 7
Note: If the applicant has a question as to whether an erosion control plan or other
environmental permit is required, he or she may contact the North Carolina'Department
of Environment and Natural Resources Asheville Regional Office at [phone] or in
Raleigh at [phone].

STANDARD SPECIAL PROVISIONS FOR ENCROACHMENTS
REVISED APRIL.2003
1. Notify the District Engineer's office at least 3 day's prior to commencing work and again upon completion of
work. (828- 891-7911)
2. Traffic control devices and procedures shall be installed to ensure public safety and shall comply with the latest
edition of the Manual on Uniform Traffic control Devices and the N.C. Department of Transportation's Standards
and Specifications for Roads and Structures.
3. Contact the appropriate Utility Company(ies) involved and make satisfactory arrangements to adjust any utilities in
conflict with the proposed work prior to construction.
4. Any drainage structure disturbed or damaged shall be restored to its original condition as directed by the District
Engineer. Drainage structures shall not be blocked with excavation, construction or other materials. In addition,
any drainage pattern that is altered must be repaired / modified. This work must meet NCDOT standards, and result
in proper and adequate drainage of disturbed area. This includes but is not limited to culverts, ditches, shoulders, or
drainage structures. The District Office is to be notified of any changes made.
5. Trenching; bore pits and/or other excavations shall not be left open or unsafe to pedestrian or vehicular traffic
overnight or during holidays and weekends and shall comply with all O.S.H.A regulations and requirements.
6. All fill areas/backfill shall be compacted to 95% density in accordance with AASHTO T99 as Modified by
NCDOT. All material to a depth of 8.0" below the finished surface of the sub -grade shall be compacted to a
density equal to at least 100.0% density in accordance with AASHTO T99 as modified by NCDOT. The sub -
grade shall be compacted at a moisture content which is approximately the required to produce the maximum
density indicated by the above test method. The contractor shall dry or add moisture to the sub -grade when
required to provide a unifonrily compacted and acceptable sub -grade.
7. Proper temporary and permanent measures shall be installed and maintained for the duration of the encroachment
to control erosion sedimentation in accordance with local, State and Federal regulations.
8. Materials and workmanship shall conform to the N.C. Department of Transportation's Standards and
Specifications for Road and Structures and Roadway Standard Drawings.
9. Strict compliance with The Policies and Procedures for Accommodating Utilities on Highway Rights of Way shall
be required.
10. Silt basins shall be removed as soon as possible and shall not infringe on the roadway or components of the
_roadway including required clear -recovery areas or any other areas_traversable by vehicles.
11. It is the encroaching parry's responsibility to determine if any permits are required by other local, state and federal
governments to perform the work described in the encroachment and to secure such permits before any
construction begins.
12. Any work requiring equipment or personnel within 5.0' of the edge of the travel lane shall require a lane closure in
accordance with NCDOT Standards and Specifications for Roads and Structures and Roadway Standard Drawings
manuals and the latest edition of the MUTCD or supplements thereof.
13. No material or equipment storage will be allowed within 30.0' of the edge of the travel lane without the permission
of the Engineer. Absolutely no material or equipment storage will be allowed within 15.0' of the edge of the travel
lane.
14. NCDOT does not guarantee the right of way on these roads, nor will it be responsible for any claim for damages
brought by any property owner by reason of this installation.
15. If any blasting is required, the maximum peak particle velocity shall be limited to 4.0 in./sec. As measured at the
closest structure extremity.

16. Any changes to the encroachment must be submitted in writing to the Engineer for review and comment. Failure
to request changes -may-result in cancellation of the encroachment agreement.-_
17. All disturbed right of way monuments shall be reset by a NC licensed Surveyor in accordance with NCDOT
Standards and Specifications for Roads and Structures and Roadway Standard Drawings manuals.
18. No lane closures will be allowed prior to 8:30 AM or after 4:30 PM. No lane closures will be allowed on
weekends or on State observed holidays.
19. All manhole lids, water valves/meters and applicable concrete encasements shall be set flush with the natural
ground elevation and should be located- so as to minimize interference with highway drainage. All fire hydrants
must be located a minimum 5.0' behind the ditch line.
20. All longitudinal installations of proposed encroachments shall be located as close to the outside edge of the Right
of Way and as far away from the outside edge of the nearest travel lane as possible to the satisfaction of the
District Engineer.
21. All manholes and vaults shall be of a design approved by the State Design Services Engineer. A list of previously
"Approved Manholes and Vaults" may be obtained from the State Design Services Engineer.
22. All driveways altered during construction shall be at a minimum returned to a state comparable with the condition
of the driveways prior to construction.
23. An Executed copy of this Encroachment agreement will be present at the construction site at all times during
construction. If safety or traffic conditions warrant such an action, NCDOT reserves the right to further limit,
restrict or suspend operations within the right of way.
24. All roadway signs which are removed due to construction shall be reinstalled as soon as possible.
25. Ingress and egress shall be maintained to all business and dwellings affected by the project. Special attention shall
be paid to police and fire stations, fire hydrants and hospitals.
26. Vegetative cover shall be established on all disturbed and damaged areas to the satisfaction of the District Engineer
in accordance with the attached Seeding and Mulching guidelines. The N.C. Department of Transportation
reserves the right to modify the guidelines for unique situations or as recommended by the Area Roadside
Environmental Engineer.
SEEDING AND MULCHING GUIDELINES
_ . MATERIAL. _.
May 1 — Aug. 3.1
Sept. 1 - April 30
Kentucky 31 Fescue
100 Lb./Ac.
100 Lb./Ac
OR
Hard Fescue
15 Lb./Ac.
15 Lb./Ac.
Fertilizer
500 Lb./Ac.
500 Lb./Ac.
Limestone
4000 Lb./Ac.
4000 Lb./Ac.
Rye grain
-----------------
25 Lb./Ac.
German Millet
25 Lb./Ac.
-----------------
Mulch with grain straw
40 bales/Ac.
40 bales/Ac.
NOTES
A. Fertilizer shall be 10-20-20' analysis. A different analysis of fertilizer may be used provided the 1-2-2 ratio is
maintained and the rate of application is adjusted to provide the same amount of nutrients as the 10-20-20
analysis.
B. Hard Fescue may be substituted for Kentucky 31 Fescue and Vice Versa however see the above table as the rate of
application for the two materials is different.
C. Seeding and mulching operations shall be adapted to various weather or soil conditions as necessary for the
successful establishment and growth of the grasses and legumes as directed by the Engineer.

!a
. 27. The encroaching party shall comply with all applicable federal, state, and local environmental regulations, and _
shall obtain all necessary federal, state, and local environmental permits, including but not limited to, those related
to sediment control, storm water, wetland, streams, endangered species, and historical sites.
28. Excavation within 1000 feet of a signalized intersection will require notification by the party of the second part to
the Division Traffic Engineer at telephone number 828-631-1185. All traffic signal or detection cables must be
located prior to excavation.
29. With directional boring, under no condition shall jetting alone or wet boring with water of utility pipelines be
allowed. Directional boring using jetting with a Bentonite (or equivalent material) slurry is'approved at a
minimum depth of ten (10) feet below the pavement surface (fifteen feet below the surface of controlled access
roads) and five (5') below any ditch line. Any parallel installation utilizing the directional boring shall be made at
a nvnimum depth of three(Y) feet (cover0 below the ground surface except where the parallel installation crosses a
paved roadway. The tip of the drill string shall have a cutter head. Any changes shall be submitted to the District
Engineer for approval prior to construction. An overbore shall not be more than two (2") greater than the diameter
of the pipe or encasement will be considered, if the encroachment agreement includes a statement signed and
sealed by a North Carolina Registered Professional Engineer, indicating that an overbore in excess of two (2")
inches of the -pipe or encasement will arch and no damage will be done to the pavement or subgrade:

<25> S 7 8' 51' 53' E 225 17
<26> N 81' 00' 36' E - 243.31
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APRIL 18, 2003
BUTLER ASSOCIATES REG. LAND SURVEYOR L-3033
0.2-60
100
P.O. BOX 1500, TRYON, N.C. 28782 POR•
ERROR OF CLOSURE 1 38.733
GRAPHIC SCALE: 1 IN. = 150 FT.
PHONE[phone]

` Ota ia'
T<OAI�
,
- o JOHN & KATHERINE ERNST
TRYON TWP., POLK CO., NO. CAR.
4Rh
op
/ trxEs 2 Fr. CONTOUR INTERVALS
FEBRUARY 9, 2004
040 BUTLER ASSOCIATES REG. LAND SURVEYOR L-3033
P.O. BOX 1500, TRYON. N.C. 28782
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_!."..aEVA T I ON

A; f w a rFR Michael F. Easley, Governor
Q William G. Ross Jr., Secretary
`Q (� North Carolina Department of Environment and;Natural Resources
CAlan W. Klimek, P. E. Director
—J Division of Water Quality
C Coleen H. Sullins, Deputy Director
Division of Water Quality
Asheville Regional Office
WATER QUALITY SECTION
November 6, 2003
Mr. Jim Fatland, Town Manager
Town of Tryon
Tryon Town Hall
Tryon, NC 28782
Subject: Additional Information Request
401 Water Quality Certification
Application Number: 03-1322
Status of Application: On Hold
Harmon Field Streambank Stabilization (phase 1)
Polk County
Dear Mr. Fatland:
The Division of Water Quality's Asheville Regional Office performed a site visit on November 5, 2003. This
office has concerns about the use of streambank hardening in order to prevent further erosion. As the adjacent
banks appear to be stable, this office requests that alternative stabilization methods be evaluated. The existing
erosion is contained to an area immediately adjacent to -an asphalt walking path where the banks are steeper
than the surrounding area and there are several discharge / hydrants located within the eroded area. The
requested alternatives should include (but not be limited to) the possibility of cutting flood plain benches and
/ or cutting a less steep slope, the extensive use of woody / herbaceous vegetative cover, etc...
A plan, including a timeline for completion of the alternative analysis, should be submitted to my attention at
the letterhead address within 10 days of receipt of this request. Failure to provide the requested information
in a timely manner may result in the return of the submitted application.
Should you have any questions, please do not hesitate to contact me at kevin.bamett@,ncmail.net or at 828-251-
6208.
Sincerely,
(A
Kevin H. Barnett,
Environmental Chemist
cc: Mr. John Dorney, Wetlands / 401 Unit
US Army Corps of Engineers, Asheville Regulatory Office
Mr. Gerald Harbinson, USDA Natural Resources Conservation Service,
Post Office Box 236, Columbus, NC 28722
1 rMa._Wanda Frazier-; Asheville-Regional-Gffice--(NC=OWQ):::3 ,
MENU
59 Woodfin Place Asheville, North Carolina 28801 Telephone [phone] Fax [phone] Customer Service 1-877-623-6748

State of North Carolina -
Department of Environment,
Health and Natural Resources
Division of Environmental Management
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
Ju 5
Polk Coun
DEM Project # 95754
APPROVAL of 401 Water Quality Certification ADDITIONAL CONDITIONS
Mr. Franklin Vick U y
Planning and Environmental Branch f JUL 2 8 19s)5
NC DOT !�
P. O. Box 25201 Vds�TER p� FLITY SECTION
Raleigh, N.C. 27611-5201 IGIO14AL OFFICE y
Dear Mr. Vick:
. You have our approval to place temporary fill material in 0.0106 hectares of wetlands or waters
for the purpose of constructing two temporary access causeways at SR 1302, Bridge # 74, as you
described in your application dated 13 July 1995. After reviewing your application, we have decided
that this fill is covered by General Water Quality Certification Number 2727. This certification allows
you to use Nationwide Permit Number 33 when it is issued by the Corps of Engineers.
This approval is only valid for the purpose and design that you described in your application. If
you change your project, you must notify us and you may be required to send us a new application.
.For this approval to be. valid, you must follow the conditions listed in the attached certification. An
additional condition is that you install silt fence around the work platform. In addition, you should get
any other federal, state or local permits before you go ahead with your project.
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 which conforms to Chapter 150B of the North Carolina General Statutes to the
Office of Administrative Hearings, P.O. Box 27447, Raleigh, N.C. 27611-7447. This certification and
its conditions are final and binding•unless you ask for a hearing.
This letter completes the review of the Division of Environmental Management under Section 401
of the Clean Water Act. If you have any questions, please telephone John Dorney at 919-733-1786.
Attachment
cc: Wilmington District Corps of Engineers
Corps of Engineers Asheville Field Office
Asheville DF-M-1Regional-Office7�,
Mr. John Dorney
Central Files
incerely,C rp 0 A,
(�
A. Presto Howard, Jr. P.E.
95754.1tr
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX 919=733-2496
An Equal opportunity Affirmative Action Employer 50% recycled/ 10% past -consumer paper

State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Environmental Management
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
APPROVAL of 401 Water Quality Certification
Mr. J. J. Swain
District Engineer
NC DOT
Post Office Box 5189
Horse Shoe, N.C. 28742
Dear Mr. Swain:
AFI.I�FA
�Iw
14110 0
rA
1:3EHNF: It'
November 1, 1995
P6b1lk (County]
DEM-Project # 951153
You have our approval to place fill material in 0.1 acres of waters for the purpose of
extending/replacing pipe in live stream at SR 1164, Owl Hollow Road, as you described in your
application dated 18 October 1995. After reviewing your application, we have decided that this fill is
covered by General Water Quality Certification Number 2735. This certification allows you to use
General Permit Number 031 when it is issued by the Corps of Engineers.
This approval is only valid for the purpose and design that you described in your application. If
you change your project, you must notify us and you may be required to send us a new application.
For this approval to bu valid, you must follow the conditions listed in the attached certification. In -
addition, you should get any other federal, state or local permits before you go ahead with your i
project.
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 which conforms to Chapter 150B of the North Carolina General Statutes to the
Office of Administrative Hearings, P.O. Box 27447, Raleigh, N.C. 27611-7447. This certification and
its conditions are final and binding unless you ask for a hearing.
This letter completes the review of the Division of Environmental Management under Section 401
of the Clean Water Act. If you have any questions, please telephone John Dorney at 919-733-1786.
Attachment
cc: Wilmington District Corps of Engineers
Corps of Engineers Asheville Field Office
Ashemille-lalz— Relg analQfRGA
Mr. John Dorney
Central Files
951153.1tr
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal opportunity Affirmative Action Employer 50% recycled/ 10% past -consumer paper

` 7H
DEM M: y 5115 3 ACTION ID- _ Af)4 oQnl jg
Nationwide Permit Requested (Provide Nationwide Permit #);
JOINT FORM FOR
Nationwide permits that require notification to the Corps of Engineers
Nationwide permits that require application for Section 401 certification
WU24NGTON DISTRICT ENGINEER WATER QUALITY PLANNING
CORPS OF ENGINEERS - DIVISION OF ENVIRONMENTAL MA1�1A rF FNT
DEPARTMENT OF THE ARMY NC DEPARTMENT OF ENVIRO D ,
P.O. Box 1890 AND NATURAL RESOURCES '� d
Wilmington, NC 28402.1890 P.O. Box 29535
ATTN-. CESAW CO-E Raleigh. NC 27626-0535
Telephone [phone] AM: MR. JOHN DORNEY OCT 3 0 1995
��
- - - ---- -.: - -- - =- - -- - - - -- Telephone [phone]- - - • - - -I ---
WEiLANIDS GROUP
ONE (1) COPY OF THIS COWI.Zr= APPLICATION SHOULD BE SENT TO THE CORPS Q .,t NG S:=
SEVEN (7) COPIES SHOULD BE SENT TO THE N.C. DIVISION OF ENVIRONMENTAL MANAGEMENT.PLEASE PRINT.
1. Own= Name: n/ G C/ 0
2. _ Owners Address: • /30 X �7 l cr'S 9
_Te S/7,., e, , -A4 C, 087¢7-
3. Owners Phone Number (home): (Work): 70`}
4. If Applicable: -Agent's name or responsible corporate official. address, phone number:
J 7
i 91 7911
/89
Z�o b-s e 5A3 e 6742
S. 'Location of work (MUST ATTACH MAP). County:
Nearest Town or City: • 0- k e L k r
Sp,�e/cific tocation'(Include road numbers, Iad_dLmarks, etc,); �� /j`r� Q e ln7e�Sec-�o � o
_. A , �,_ 9 Q/74 5 1f4J C�O(77ii��%l/ti SCcc !07 i_1eS oi� W'�Z�' C %/le,
p�U le- c7" a `/7 e .fit?1 e i-se e G�/^7 O i Ste'//6¢ 4/7� 57/? I/1';' '5' ._ .
6. Name of Closest StreamMiver: ___/N4//7 a f "
7• River Basin: Poe17.• R11(✓er
8. U this project _located in a watershed classified as Trout, SA, HQW, •ORW, WS I, or WS in YES [ ] NO [yam
9. Have any Section 404 permits been previously requested for use on this property? YES [ ] NO [+-]�
If ycs. explain.
10. Estimated total number of acres of -waters of the U.S., including wetlands, located on project site: Q. a c r e-v
I1. Number of acres of waters of the U.S., including wetlands, impacted by the proposed project:
Filled• O • e.5
Drained:
Flooded:
Excavated:
Total Impacted: 0- % a e r e; s

` 12. Description of proposed w rk (Am ch PLANS-8 1R" X 11" drawut s onl �s� 5
OLD/` �JD`/Ot�/ R i r
00 / d �1/!%i ��/.S'PCTirL�%% /rl//./ten / f
13. Purpose of proposed work: ' Scf e iO 1Z
14. State reasons why the applicant be4gves that !, ' ity must be, carried out in wetlands. Also. note measures
taken to minimize wetland impacts. JJ e e ct . Q �n`�
-----------------
15. You are required to contact the U.S. Fish and Wildlife Service (USFWS) and/or National Marine Ftsheries
(I1MFS) regarding the preSCzscrr or any Federally listed orproposed for listing endangered or threatened species or critical
habitat in the permit area that may be affected by aI
the proposed project. Have you done so. YES [-_ NO [
- RESPONSES FROM TBE-USFWS AND/OR NNTS SHOULD SE FORWARDED TO CORPS. -
16. You are required to "contact the Stato Historic Preservation Officer (SHPO) regarding •the presence of historic
properties in the permit area which may be affected by the proposed project? Have done so? you
RESPONSE FROM THE SHPO SHOULD BE FORWARDED TO CORPS. y YES i � NO j )
17. Additional information required by DEM:
A. Wetland delineation map showing all wetlands, streams, acid lakes on the property-
B. If available, representative photograph of wetlands to be impacted by pmject.
C. If delineation was perforradd by a consultant, includ
delineation line_ e all data sheets relevant to the placement of the
D. If a stormwattr management plan is requi
E: What is land use of surrounding property
F. If applicable, what is proposed method of
M

NOR'I'11 CAROLINA DEPARTIVIEN'r OF TRANSPORTATION
IllIVISION OF HIGHWAYS
SECONDARY ROAD SURVEY
SUBJECT SR 116 y (owc Hovtow i2D)
LOCATION $E6/Iv T THcc /NTERSC
7-1oit/ OF Al.el. 9 /4/YD S/2 .116,1 /9ND CO Al T.I NLI.E IN
it soLtTH RL�/- D/1� cT�vN FOR A T07W/_
DISTANCE &c bSZ0' --o THE EiVD or THE
PRO J- CT
WORK 'TYPE
AA C, AA vE,
- ERoslow Po vTiRO Z
WORK ORDER
PRIORITY
A 96M 7 9 (7,F/4P)
10 F Awl RIq L
COUNTY
RIGHT OF WAY
poe'lor
DATE
SCALE
a'
NOTES
50'-0'
RIGHT OP WAY
18'-0'
+SHOULDER PAYEMEKT
V4 'If . I V4 ,FT.
1"PER FT.
Y �`
RESIDENTIAL COLLECTOR ROAD
6'-0' 3'-0'
SHOULDER DITCH
1'PER FT.
S`Olt
Y�
STDC OR Al

GgKE LURE, N, e. 2,97%
O
n
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RAI RUFF
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SR.1164 �c NORTH.CAROLINA
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EROSION CONTROL
DETAILS AND
SPECIFICATIONS
Pipe Outlet Dissipator ........ • 000
000
245.03 Temporary Silt Ditch • . _ . . . . . 0000
45.05 Temporary Diversion ---
893.01 Temporary Silt Fence TD
---
-------------------•-•
890:05 Temporary Slope Drain with Earth Berm F-
245.01 Silt Basin Type A -------------•--- -•-----............
•--------=----
245.02 Silt Basin Type B -0------------
.......
ora
892.04 Tem Rock
Temporary Silt Check Type -A
895-10 Temporary Rock Silt Check Type-B
892.01.............�------------
Temporary Rock Sediment Dam Type -A
. 892.02---------...
Rock -Temporary---
Sediment Dam Type-B ___________
897.01 Rock Pipe Inlet Protection .
894.01 Rock Silt Screen •--••----------------------------------- - o °o ---
245.04 --.•-.-.•-•-__..._._.
Stillin Basin -- ��-�----IBi
-
Rock' Inlet Protection:
896.01
Type A ------------------- ------ A [IOR --A)
896.02 Type B .................................
896.03
Type C................. 7 ------ --
Rip Rap Class "B" x x
x kx
Ditch Liner Class "A" ............ 0000 ",
0000
' Note: T B Silt Basins will be used in conjunction with a T
.YPe J errporary Rock Silt Check
Type B unless otherwise specified.

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NORTH CAROLINA GUIDE FOR RIP RAP AT PIPE .OUTLETS u.o c
DEPT. OF TRANSPORTATION
DIVISION OF HIGHWAYS - cc)

TEMPORARY SILT FENCE: .
A temporary silt fence is commonly used at the toe of a fill. section to prevent off -
site sedimentation. It is made of permeable filter fabric buried at the bottom,
stretched and supported by steel posts. The silt fence reduces the water flow while
retaining the sediment. They may also be used to divert water flow to protected.
outlets. Silt fences need to be checked after each significant rainfall to ensure there
effectiveness. They must be maintained on a regular basis. Silt fences shall not be
installed. across streams, ditches, or waterways.
AREAS OF USE:
At toe of fill sections where sediment runoff can be stored and contained
--- - - *-inside' the- 'project limits:- -. - - - -- - -
DESIGN- CRnTRIA:
Material With Wire
Without Wire
Fabric Type 3--Class A Type 3 CIass D'
-Steel posts length 5 ft
Post spacing 5 ft.....
IO ft. 6 ft. maximum
17 March, 1992

SILT BASIN TYPE-B:
A silt basin type-B is a temporary basin built to collect sediment flowing through a
drainage way. The silt basin is built at the base of the ditch �vith its leng th being at
least 2 times the width of the basin. The type-B silt basin is generally built in
conjunction with temporaryrock silt checks and other devices that control or slow
down water flow. This device -must be monitored closely and cleaned out on a
regular basis until grass is established along the ditch line and sedimentation is no -
longer a problem.
AREAS OF USE:
• In conjunction with temporary . p ary rock silt checks and other -devices --used in
-----------dramageditches.=-- -- - - - -:-- - ---- ---- -- ------ ------------------ --:-: -:--------
DESIGN CRITERIA: .
o See Silt Basin Sizes Typical.
23 March, 1992

Silt Basin Sizes
2- ,
Length of Disturbed,Area = 100'
Silt Basin — 1
(S.B. 7)
3
Length of Disturbed Area 200'
Silt Basin — 2.
(S.B. 14)
2I
3
2T
Silt Basin — 3
(S.B. 21)
Length of Disturbed Area = 300'
Length of Disturbed Area = 400'
Silt Basin — 4
(S.B. 28)
;Basin Sizes based on 600 cubic feet of storage per acre. Basins to be cleaned
out after every storm event and when basins are half full.

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TEMP. STONE
DITCH CHECK —
STRUCTURAL -STONE -
\ BACK.
SLOPE
ISOMETRIC VIEW
NOTES'
STRUCTURAL STONE SHALL BE STONE FOR EROSION
CONTROL CLASS "B" AND SHALL BE PAID FOR AT
THE CONTRACT UNIT PRICE PER TON 'STONE FOR
EROSION CONTROL CLASS "Bl".
THE ENGINEER MAY DIRECT THE OPTION OF
CLASS "A" STONE FOR SITES HAVING LESS THAN
ONE (1) ACRE DRAINAGE AREA AND A DITCH
GRADE LESS THAN 3%. PAYMENT SHALL BE UNIT
PRICE PER TON 'STONE FOR EROSION CONTROL
CLASS
SEDIMENT CONTROL STONE SHALL BE NO.-5 OR 57
STONE AND SHALL BE PAID FOR AT THE CONTRACT
UNIT PRICE PER TON "SEDIMENT CONTROL STONE".
SEDIMENT CONTROL STONE SHALL BE USED AS
DIRECTED BY THE ENGINEER.
1' MIN. NATURAL GROUND
I
CROSS SECTION
OF,PAVEMENT
VEE DITCH
BASE OF DITCH
1' MIN. NATURAL GROUND 12"
� SEDIMENT 12' MIN.
q
TRAP
FLOWzk RE
OPTIONAL TYPE "B" 4'-6"
CROSS SECTION SILT BASIN
-------- `12" THICK SEDIMENT
TRAPEZOIDAL DITCH CONTROL STONE
ELEVATION VIEW
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io SHALL BE PAID FOR AT THE
z CONTRACT UNIT PRICE PER
TON "STONE FOR EROSION•
(CLASS "B").
SEDIMENT CONTROL STONE
SHALL BE NO. 5 OR NO. 57
STONE AND SHALL BE PAID
FOR AT THE CONTRACT UNIT
z PRICE PER TON "SEDIMENT
H CONTROL STONE."
C cn MAXIMUM DEPTH OF DAM
0 � SHALL BE NO DEEPER THAN
1 FT. ABOVE NORMAL FLOW'
N z DEPTH.
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1 OF 1
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NORMAL EARTH FOUNDATION
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NORMAL EARTH FOUNDATION ROCK FOUNDATION UNSUITABLE MATERIAL FOUNDATION
z
PIPE
ABOVE GROUND
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GENERAL NOTES:
APPROVED SUITABLE LOCAL MATERIAL OR SELECT MATERIAL FOR FOUNDATION CONDITIONING
D T
AS DIRECTED BY THE ENGINEER.
1 0
I.D. - THE MAXIMUM HORIZONTAL INSIDE DIMENSION.
APPROVED BACKFILL OR SELECT BACKFILL MATERIAL. WHEN 'H' IS GREATER THAN '30',
SELECT MATERIAL OF THE APPROPRIATE CLASS SHALL BE USED AS FOLLOWS:
O
O.D. . THE MAXIMUM HORIZONTAL OUTSIDE DIMENSION. l'Frn= "I a-: „ UNDISTURBED EARTH MATERIAL
Z
H - THE FILL HEIGHT MEASURED VERTICALLY AT ANY POINT ALONG THE PIPE
SELECT MATERIAL H,
FROM THE TOP OF THE PIPE TO THE TOP OF THE EMBANKMENT AT THAT POINT.
CLASS IV OVER 50 FEET
CLASS III OVER 40 FEET THROUGH 50 FEET
••
CLASS II OVER 30 FEET, THROUGH 40 FEET
THE CLASS OF SELECT MATERIAL TO BE USED FOR AN INDIVIDUAL PIPE INSTALLATION WILL
i
BE BASED ON THE MAXIMUM 'H' WHICH OCCURS ALONG THE PIPE INSTALLATION. A HIGHER CLASS
.
SELECT MATERIAL, NOT TO EXCEED CLASS IV, MAY BE USED IN LIEU OF CLASS II OR III.
1 OF
SELECT MATERIAL WILL NOT BE REQUIRED AROUND THOSE PORTIONS OF AN INDIVIDUAL '
PIPE INSTALLATION LOCATED UNDER THAT PART OF THE FILL WHERE 'H' IS 30 FEET OR LESS
0.01
_
HEAVY EQUIPMENT SHALL NOT OPERATE OVER ANY PIPE CULVERT UNTIL THE PIPE CULVERT HAS
_
BEEN PROPERLY BACKFILLED AND COVERED WITH AT LEAST 3 FEET OF APPROVED MATERIAL.
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300.01

SECTION 1042
RIP RAP MATERIALS
1042-1 PLAIN RIP RAP.
Stone for plain rip rap shall 'consist of field stone or rough unhewn quarry stone. The
stone -shall be soiuid, tough, dense; resistant to the action. of air and water, and suitable in all
other respects for the purpose intended. Where broken concrete from demolished structures
or pavement is available, it may be bsed in place of stone provided that such use meets with
the- approval of the_ Engineer. However, the 'use of broken concrete which contains
reinforcing steel will not be permitted.
All stone shall meet the "approval to the Engineer. While no specific gradation is
required, the various sizes of the' stone shall be equally distributed within the required size
range. The size of an individual stone particle will be determined by measuring its` long
dimension.
Stone or broken concrete for Rip Rap shall meet the requirements of Table 1042-1 for the
class and size distribution.
TABLE 1042-1
ACCEPTANCE CRITERIA FOR RIP RAP
AND STONE FOR EROSION CONTROL
REQUIRED STONE SIZES - INCITES
CLASS
-- ' MINIMUM
MIDRANGE
MAXIMUM
A
2
4
6
B
5
8
12
1
5
10
17
2.
9
1 14
23
No more than 5.0% of the material furnished can be less than the minimum size specified
nor no more than 10.0% of the material can exceed the maximum size specified.

X8 ----:�!> WF
McGM
{
A S S O C I A T E S
January 4, 2005
Ms. Cyndi Karoly
401 Oversight / Express Review Permitting Unit
1650 Mail Service Center
Raleigh, North Carolina 27699
RE: Polk County. Recreational Complex
Impervious Surface
DWQ Project Number 04-1913
Dear Ms. Karoly:
Per our phone conversation on January 3, please find (3) copies of page 12 from the our
original Pre -Construction Notification that explains the total impervious area on the project.
If you -have any questions, please do not hesitate to call me or: Gary Wood from our
office. Thank you for your time and patience in this matter
Sincerely,
McGILL ASSOC TES, P.A.
%o 04
MICHAEL CLARK
Cc: Kevin Barnett
� Q
JAN - 6 2005
M:/projects/03198/ck1-4-05
WATER QUALITY SECTION
ASV ILLE REGIONAL OFFICE
Engineering P l a n n i n g fi n a n c e
McGill Associates, P.A. P.O. Box 2259, Asheville, NC 28802 55 Broad Street, Asheville, NC 28801
828-252-0575 FAX [phone]

fi
XI.
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.
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.
2.41 acres im ervious .versus 53 acres Pervious. Erosion control measures will be installed
and maintained: Vegetation will be established as soon as ractical.
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.
OM
XIII. Violations (DWQ Only)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H
Yes ❑ No
Is this an after -the -fact permit application?
Yes ❑ No
XIV. Other Circumstances (Optional):
0500) or any Buffer.Rules?
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
T eatened Species, accessibility problems, or other issues outside of the -applicant's control).
�O l a
Applicant/Agent's Signature v Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)-
Page 12 of 12

11
If buffer mitigation is required, please discuss what type of miti-ration' 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 (D)?VQ 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. .
2.41 acres im-pervious versus 53 acres pervious. Erosion control measures will be installed
and maintained. Vegetation. Will be established as soon as ractical.
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.-
XII-I. Violations (DWQ Only)
Is th_is.site in violation of DWQ Wetland Rules (15A NCAC 2H..0500) or any Buffer Rules?
Yes ❑ No
Is this an after -the -fact permit application?
Yes ❑ No
XIV. Other Circumstances (Optional):
It is the applicant's responsibility to submit the .application sufficiently in advance of desired
construction dates to allow processing time. for these permits. However, an applicant may
.choose to list constraints associated with construction or sequencing that.may impose limits on
work schedules (e.g., draw -down schedules for lakes, dates associated with Endangered and
F eatened Species, accessibility problems, or other issues outside of the applicant's control).
,-
1-2
cut c,_.�
Applicant/Ajent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 12 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 (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.
2.41 acres impervious versus 53 acres pervious Erosion control measures will be installed
and maintained. Vegetation will be established as soon as practical
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 DWQ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes ❑ No
Is this an after -the -fact pennit application?
Yes ❑ No
XIV., Other Circumstances (Op.tionaI):
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
T eatened Species, accessibility problems, or other issues outside of the applicant's control).
,-
/ i r
3 /
�- °emu cup a 10 l a �1O 3
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Paoe 12 of 12

Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
January 10, 2005
Alan W. Klimek, P.E. Director
Division of Water Quality
DWQ Project # 04-1913
Polk County
Polk County D E C' E L U E
Attn: Kiram Shihata
Post Office Box 308
Columbus, NC 28722 JA N 1 2 2005
0
Subject Property: Polk County Recreational Complex ' i
WATER QUALITY SECTION
Approval of 401 Water Quality Certification with Additional Con l lons ASHEVILLE REGIONAL OFFIC
Dear Mr. Shihata:
You have our approval, in accordance with the attached conditions and those listed below, to place fill
within or otherwise impact 143 feet of streams for the purpose of recreational complex construction of the
subject property, as described within your application dated November 8, 2004 and received by the N.C.
Division of Water Quality (DWQ) on November 29, 2004. After reviewing your application, we have
decided that the impacts are covered by General Water Quality Certification Number(s) 3404 (GC3404).
The Certification(s) allows you to use Nationwide Permit(s) 14 when issued by the US Army Corps of
Engineers (USAGE). In addition, you should obtain or otherwise comply with any other required federal,
state or local permits before you go ahead with your project including (but not limited to) Erosion and
Sediment Control, and Non -discharge regulations. Also, this approval to proceed with your proposed
impacts or to conduct impacts to waters as depicted in your application shall expire upon
expiration of the 404 or CAMA Permit.*
This approval is for the purpose and design that you described in your application. If you change your
project, you must notify us and you may be required to send us a new application. If the property is sold,
the new owner must be given a copy of this Certification and approval letter and is thereby responsible for
complying with'all conditions. If total fills for this project (now or in the future) exceed one acre of
wetland or 150 linear feet of stream, compensatory mitigation may be required as described in 15A
NCAC 211.0506 (h). This approval requires you to follow the conditions listed in the attached
certification and any additional conditions listed below.
The Additional Conditions. of the Certification are:
1. Impacts Approved
The following impacts are hereby approved as long as all of the other specific and general
conditions of this Certification (or Isolated Wetland Permit) are met. No other impacts are
approved including incidental impacts:
Amount Approved (Units)
Plan Location or Reference
Stream
143 (feet)
404/CAMA Wetlands
n/a (acres)
Waters
n/a (acres)
401 Oversight / Express Unit
1650 Mail Service Center, Raleigh, North Carolina 27699-1650
2321 Crabtree Boulevard, Suite 250, Raleigh, North Carolina 27604
Phone: [phone] / FAX [phone] / Internet: htto://h2o.enr.state.nc.us/ncwetiands
Nco 'Carolina
Ntundy
rnot not D...d /+.............. Dnn

Polk County
Page 2 of 3
January 10, 2005
2. Erosion & Sediment Control Practices
Erosion and sediment control practices must be in full compliance with all specifications
governing the proper design, installation and operation and maintenance of such Best
Management Practices in order to protect surface waters standards:
a. The erosion and sediment control measures for the project must be designed, installed,
operated, and maintained in accordance with the most recent version of the North Carolina
Sediment and Erosion Control Planning and Design Manual.
b. The design, installation, operation, and maintenance of the sediment and erosion control
measures must be such that they equal, or exceed, the requirements specified in the most
recent version of the North Carolina Sediment and Erosion Control Manual. The devices
shall be maintained on all construction sites, borrow sites, and waste pile (spoil) projects,
including contractor -owned or leased borrow pits associated with the project.
c. For borrow pit sites, the erosion and sediment control measures must be designed, installed,
operated, and maintained in accordance with the most recent version of the North Carolina
Surface Mining Manual.
d. The reclamation measures and implementation must comply with the reclamation in
accordance with the requirements of the Sedimentation Pollution Control Act.
3. No Waste, Spoil, Solids, or Fill of Any Kind
No waste, spoil, solids, or fill of any kind shall occur in wetlands, waters, or riparian areas beyond
the footprint of the impacts depicted in the Pre -Construction Notification. All construction
activities, including the design, installation, operation,. and maintenance of sediment and erosion
control Best Management Practices, shall be performed so that no violations of state water quality
standards, statutes, or rules occur.
4. No Sediment & Erosion Control Measures w/n Wetlands or Waters
Sediment and erosion control measures shall not be placed in wetlands or waters to the maximum
extent practicable. If placement of sediment and erosion control devices in wetlands and waters
is unavoidable, they shall be removed and the natural grade restored within six months of the date
that the Division of Land Resources has released the project.
5. Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification or applicable
Buffer Rules, and any subsequent modifications, the applicant is required to return the attached
certificate of completion to the 401/Wetlands Unit, North Carolina Division of Water Quality,
1650 Mail Service Center, Raleigh, NC, 27699-1650.
Violations of any condition herein set forth may result in revocation of this Certification and may result in
criminal and/or civil penalties. The authorization to proceed with your proposed impacts or to conduct
impacts to waters as depicted in your application and as authorized by this Certification, shall expire upon
expiration of the 404 or CAMA Permit.
If you do not accept any of the conditions of this Certification (associated with the approved wetland or
stream impacts), you may ask for an adjudicatory hearing. You must act within 60 days of the date that
you receive this letter. To ask for a hearing, send a written petition, which conforms to Chapter 150B of

Polk County
Page 3 of 3
January 10, 2005
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 telephone Cyndi Karoly in the Central Office in Raleigh at 919-
733-9721 or Kevin Barnett in the DWQ Asheville Regional Office at 828-296-4500.
Sincerely,
Alan W. Klimek, P.E.
AWKIbs
Enclosures: GC 3404
Certificate of Completion
cc: McGill Associates, Post Office Box 2259, Asheville, NC 28802
USACE Asheville Regulatory Field Office
CD-W- Asheville--Regional-Office
DLR Asheville Regional Office
File Copy
Central Files
Filename: 04-1913 Polk County REcreation Complex (Polk) 401

- GM
Mc
V
A S S O C I A T E S
November 16, 2004
Mr. John Dorney
Division of Water Quality
401 / Wetlands Unit
1650 Mail Service Center
Raleigh, North Carolina 27699-1650
Dear Mr. Domey:
SAS
ODEC ' 1-5'2004
N U V 2, 9 2004
DENR - WKI-ER QUA {TY
WETLANDS AND STORMWATER BRANCH
RE: Preconstruction Notification
Proposed Polk County Recreation Complex
Polk County, North Carolina
Please find enclosed a submittal package including seven (7) copies of the executed
Preconstruction Application, location map, plan sheets and details and a $200 application fee for
the subject project.
As part of the project we will be installing 70 LF of 60" RCP that will impact 125 LF of
stream realignment to provide better flow characteristics, and the addition of 18 L.F to an existing
36" CMP. The total impact to the existing streams will be 143 LF.
If you should have any questions or comments regarding this application, do not hesitate to
call me or Bill Roark. '
Sincerely,
McGILL ASSOCIATES, P
MICHAEL CLARK
Enclosure:
cc. Dale Pennell, Karim Shihata
P�l Y'I w
RECEIVED
E n g i n e e r i n g • P l a n n i n g F i n a n c e
McGill Associates, P.A. P.O. Box 2259, Asheville, NC 28802 • 55 Broad Street, Asheville, NC 28801
828-252-0575 • FAX [phone]

Office Use Only: - Form Version October 2001
♦
USACE Action ID No. DWQ No. O 4 ` 91 3
If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A" rather than
leaving the space -blank.
I. Processing
1. Check all of the approval(s) requested for this project:
® Section 404 Permit
❑ Section 10 Permit
® 401 Water Quality Certification
❑ Riparian or Watershed Buffer Rules
2. Nationwide, Regional or General Permit Number(s) Requested: 14
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 (see section VIII — Mitigation), check here: ❑
II. Applicant Information
1. Owner/Applicant Information
Name: Karim Shihata. Polk Count
Mailing Address: Polk County
Post Office Box 308
Columbus, North Carolina 28722
Telephone Number: 828-894-3301 Ext. 8 Fax Number:
E-mail Address:
2. Agent 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:
Company Affiliation:
Mailing Address:
Telephone Number: Fax Number:
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: Polk County Recreation Park Complex
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN):
4. Location
County: Polk Nearest Town: Columbus / Mill Spring
Subdivision name (include phase/lot number): I
Directions to site (include road numbers, landmarks, etc: From I-26E to US 74E, Take exit
36 toward Columbus. Merge onto 74E then take NC 108 exit # 136 towards Columbus / Mill
Spring. Turn left onto hwy 108. Site is just before Stonecutter Factory.
5. Site coordinates, if available (UTM or Lat/Long): N/A
(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. Describe the existing land use or condition of the site at the time of this application:
Wooded and partially cleared-
7.. Property size (acres): 73 Acres
8. Nearest body of water (stream/river/sound/ocean/lake): South Branch Little White Oak
Creek and Silver Creek.
9. River Basin: Broad River Basin
(Note — this must be one of North Carolina's seventeen designated major river basins.. The
River Basin map is available at littp://h2o.enr.state.nc.us/adminJmaps/.)
Page 6of12

10. Describe the purpose of the proposed work: To construct a new recreational complex with
baseball fields, playground equiptment, and walking trails.
11. List the type of equipment to be used to construct the project: Backhoe, Bulldozer,
Road grader, Frontend Loader, Dump Trucks
12. Describe the land use in the vicinity of this project: Residential, Commercial, Farming and
industrial.
IV. Prior Project History
If jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Include
the USACE Action ID Number, DWQ Project Number, application date, and date permits and
certifications were issued or withdrawn. Provide photocopies of previously issued permits,
certifications or other useful information. Describe previously approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits issued for prior ,segments of the same T.I.P. project, along with
construction schedules.
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application:
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. Wetland Impacts
Wetland Impact
Site Number
(indicate on ma)
Type of Impact*
Area of
Impact
(acres)
Located within
100-year Floodplain**
(yes/no)
Distance to
Nearest Stream
(linear feet)
Type of Wetland***
N.A.
* 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 hiip://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.) `
List the total acreage (estimated) of existing wetlands on the property: 0
Total area of wetland impact proposed: 0
2. Stream Impacts, including all intermittent and perennial streams
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?
(pleasespecify)
1
Culvert
18'
South Branch White
Oak
6'
Perennial
.2
Stream
Realignment
125'
South Branch White -
Oak
8'
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.uses.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: 143'
Page 8 of 12

3.. Open Water Impacts, including .Lakes, Ponds, Estuaries, Sounds, Atlantic Ocean and any
other Water of the U.S.
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.)
0
T List eacn impact separately ana identuy temporary impacts. impacts include, but are not limited to: fill, excavation, dredging,
flooding, drainage, bulkheads, etc.
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 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.
To the greatest extent possible, crossings have been minimized. Culverts are as short as
possible and stream revisions are only proposed as seen necessary to provide stable channel
adjacent to the proposed road embankment.
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/iicwetlands/stnn_gide.html.
1. Provide a brief description of the proposed mitigation plan: The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
2. Mitigation may also be made by- payment into the North Carolina Wetlands Restoration
Program (NCWRP) 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 http://h2o.enr.state.nc.us/wM/index.htn-L 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 (DWQ Only)
Does the project involve an expenditure 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 (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 El - 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 213 .0233
(Meuse), 15A NCAC 2B .0259 - (Tar -Pamlico); 15A NCAC 213 .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify )?
Yes ❑ No.® If you answered "yes", provide the following information:
Identify the square feet and acreage of impact to each zone of the riparian buffers. If buffer
mitigation is required calculate the required amount of mitigation by applying the buffer
multipliers.
Zone*
Impact
(square feet)
Multiplier
Required
Mitigation
1
3
2
1.5
Total
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.
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 (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 DWQ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes ❑ No ® -
Is this an after -the -fact permit application?
Yes ❑ No
XIV. Other Circumstances (Optional):
It is the applicant's responsibility to submit the application sufficiently in advance of desired
construction dates to allow processing time for these permits. However, an applicant may
choose to list constraints associated with construction or sequencing that may impose limits on
work schedules (e.g., draw -down schedules for lakes, dates associated with Endangered and
Threatened Species, accessibility problems, or other issues outside of the applicant's control).
Applicant/Agent's Signature �(/�i <!/ �� DateVtis
(Agent's signature is v d only if an authorization letter from the applicrovided.)
Page 12 of 12

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A S S 0 - C I A T E S
ENGINEERING • PLANNING • FINANCE
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FwATF
�Q RQ Mi hae F. Elly, vemor.
William G. Ross Jr., Secretary -
�-. North Carolina Department of Environment and Natural Resources
0 Alan W. Klimek, P.E. Director
Division of Water Quality
September 13, 2004
DWQ Project# 04-_1132
-P61k County
John T. Mize
Post Office Box 691
Columbus, NC 28722
Subject Property: John T. Mize-Rond
Polk Coun
Approval of 401 Water Quality Certification with Additional Conditions
Dear Mr. Mize:
You have our approval, in accordance with the attached conditions and those listed below, to place fill
within or otherwise impact no more than 140 linear feet of an unnamed tributary to Henson's Creek for
the purpose of irrigation at the subject property, as described within your application received August 23,
2004. After reviewing your application, we have decided that the impacts are covered by General Water
Quality Certification Number(s) 3402 (GC3402). The Certification(s) allows you to use Nationwide
Permit(s) 39 when issued by the US Army Corps of Engineers (USACE). ' In addition, you should obtain
or otherwise comply with any other required federal, state or local permits before you go ahead with your
project including (but not limited to) Erosion and Sediment Control, Non -discharge, and state stormwater
regulations.
This approval is for the purpose and design that you described in your application. If you change your
project, you must notify us and you may be required to send us a new application. If the property is sold,
the new owner must be given a copy of this Certification and approval letter and is thereby responsible for
complying with all conditions. If total fills for this project (now or in the future) exceed one acre of
wetland or 150 linear feet of stream, compensatory mitigation may be required as described in 15A
NCAC 2H .0506 (h). This approval requires you" to follow the conditions listed in the attached
certification and any additional conditions listed below.
The Additional Conditions of the Certification are:
1. Impacts Approved
The following impacts are hereby approved as long as all of the other specific and general
conditions of this Certification (or Isolated Wetland Permit) are met. No other impacts are
approved including4ncidental impacts:
Amount Approved
Plan Location or Reference
(Units)
Stream (Perennial)
No more than 140
Dam fill
linear (feet)
401 Wetlands Certification Unit
1650 Mail Service Center, Raleigh, North Carolina 27699-1650
2321 Crabtree Boulevard, Suite 250, Raleigh, North Carolina 27604
Phone: [phone] / FAX [phone] / Internet: http://h2o.enr.state.nc.us/ncwetiands
NorthCarolina
Naturally
An Equal Opportunity/Affirmative Action Employer— 50% Recycled/10% Post Consumer Paper

John T. Mize Pond
Page 2 of 5
September 13, 2004:
2. Erosion & Sediment Control Practices
Erosion and sediment control practices must be in full compliance with all specifications
governing the proper design, installation and operation and maintenance of such Best
Management Practices in order to protect surface waters standards:
a. The erosion and sediment control measures for the project must be designed, installed,
operated, and maintained in accordance with the most recent version of the North Carolina
Sediment and Erosion Control Planning and Design Manual.
b. The design, installation; operation, and maintenance of the sediment and erosion control
measures must be such that they equal, or exceed, the requirements specified in the most
recent version of the North Carolina Sediment and Erosion Control Manual. The devices
shall be maintained on all construction sites, borrow sites, and waste pile (spoil) projects,
including contractor -owned or leased borrow pits associated with the project.
c. For borrow pit sites, the erosion and sediment control measures must.be designed, installed,
operated, and maintained in accordance with the most recent version of the North Carolina
Surface Mining Manual.
d. The reclamation measures and implementation must comply with the reclamation in
accordance with the requirements of the Sedimentation Pollution Control Act.
3. No Waste, Spoil, Solids, or Fill of Any Kind
No waste, spoil, solids, or fill of any kind shall occur in wetlands, waters, or riparian areas beyond
the footprint of the impacts depicted in the Pre -Construction Notification. All construction
activities, including the design, installation, operation, and maintenance of sediment and erosion
control Best Management Practices, shall be performed so that no violations of state water quality
standards, statutes, or rules occur.
4. No Sediment & Erosion Control Measures w/n Wetlands or Waters
Sediment and erosion control measures shall not be placed in wetlands or waters to the maximum
extent practicable. If placement of sediment and erosion control devices in wetlands and waters
is unavoidable, they shall be removed and the natural grade restored within six months of the date
that the Division of Land Resources has released the project.
5. Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification or applicable
Buffer Rules, and any subsequent modifications, the applicant is required to return the attached
certificate of completion to the 401/Wetlands Unit, North Carolina Division of Water Quality,
1650 Mail Service Center, Raleigh, NC, 27699-1650.
6. Diffuse Flow (No Review)
ANY constructed stormwater conveyance outlets shall be directed and maintained as diffuse flow
at non -erosive velocities through the protected stream buffers such that it will not re -concentrate
before discharging into a any waters of the state. If this is not possible, it may be necessary to
provide stormwater facilities that are considered to remove nitrogen. This may require additional
approval from this Office.

John T. Mize Pond
Page 3 of 5.
September 13, 2004: -
7. Protective Fencing
The outside buffer, wetland or water boundary and along the construction corridor within these
boundaries approved under this authorization shall be clearly marked with orange warning
fencing (or similar high visibility material) for the areas that have been approved to infringe
within the buffer, wetland or water prior to any land disturbing activities to ensure compliance
with 15A NCAC 2B..0200 and GC 3402.
8. Buffer Replanting
Replanting of vegetation within disturbed areas located within 30 feet of the stream boundary not
associated with the proposed impoundment on this site must be done in an "in kind" manner
immediately following construction. (Example: Disturbed areas with pre-existing grassed lawns
must be replanted with grass. _Disturbed areas with pre-existing trees or woody vegetation must
be replanted with trees and woody vegetation. Disturbed areas with pre-existing forest vegetation
must be replanted with forest vegetation including at least two different. native hardwood tree
species at a density sufficient to provide 320 trees per acre at maturity. This density can usually
be achieved by planting approximately 436 (10 x 10 spacing) to 681 (8 x 8 spacing) trees per
acre.)
9. Written Stormwater Management Plan (No Further Approval Needed)
A final, written stormwater management plans (including a signed and notarized Operation and
Maintenance Agreement), must be implemented and the stormwater management facilities shall
be constructed and operational before any permanent building is occupied at the subject site. The
structural stormwater practices as approved by this Office as well as drainage patterns must be
maintained in perpetuity. No changes to the structural stormwater practices shall be made without
written authorization from the Division of Water Quality.
10. Turbidity Standard
The turbidity standard of 50 NTUs (Nephelometric Turbidity Units) shall not be exceeded as
described in 15 A NCAC 2B..0200. Appropriate sediment and erosion control practices must be
used to meet this standard.
11. Standard Erosion and Sediment Control Practices
Erosion and sediment control practices must be in full compliance with all specifications
governing the proper design, installation and operation and maintenance of such Best
Management Practices:
a) Erosion and sediment control measures for the project must be designed, installed,
operated, and maintained in accordance with the most ' recent version of the North
Carolina Sediment and Erosion Control Planning and Design Manual.
b) Design, installation, operation, and maintenance of the sediment and erosion control
measures must be such that they equal, or exceed, the requirements specified in the most
recent version of the North Carolina Sediment and Erosion Control Manual. The devices
shall be maintained on all construction sites, borrow sites, and waste pile (spoil) projects,
including contractor -owned or leased borrow pits associated with the project.

John T. Mize Pond
Page 4 of 5
September 13, 2004:
c) For borrow pit sites, the erosion and sediment control measures must. be designed,
installed, operated, and maintained in accordance with the most recent version of the
North Carolina Surface Mining Manual.
d) Reclamation measures and implementation must comply with the reclamation in
accordance with the requirements of the Sedimentation Pollution Control Act.
e) Sufficient materials required for stabilization and/or repair of erosion control measures
and stormwater routing and treatment shall be on site'at all times.
12. No Impacts Beyond those in Application
No waste, spoil, solids, or fill of any kind shall occur in wetlands, waters, or riparian areas beyond
the footprint of the impacts depicted in the Pre -construction Notification. All construction
activities, including the design, installation, operation, and maintenance of sediment and erosion
control Best Management Practices, shall be performed so that no violations of state water quality
standards, statutes, or rules occur.
13. No Sediment and Erosion Control Measures in Wetlands
Sediment and erosion control measures shall not be placed in wetlands or waters to the maximum
extent practicable. If placement of sediment and erosion control devices in wetlands and waters is
unavoidable, they shall be removed and the natural grade restored within six months of the date that
the Division of Land Resources or locally delegated program has released the project.
14. Construction Stormwater Permit NCGO 10000
Upon the approval of an Erosion and Sedimentation Control Plan issued by the Division of Land
Resources (DLR) or a DLR delegated local erosion and sedimentation control program, an
NPDES General stormwater permit (NCGO10000) administered by DWQ is automatically issued
to the project. This General Permit allows stormwater to be discharged during land disturbing
construction activities as stipulated by conditions in the permit. If your project is covered by this
permit [applicable to construction projects that disturb one (1) or more acres], full compliance
with permit conditions including the sedimentation control plan, self -monitoring, record keeping
and reporting requirements are required. A copy of this permit and monitoring report forms may
be found at http: //h2o. enr. state. nc. us/su/Forms Documents. htm.
Violations of any condition herein set forth may result in revocation of this Certification and may result in
criminal and/or civil penalties. The authorization to proceed with your proposed impacts or to conduct
impacts to waters as depicted in your application and as authorized by this Certification, shall expire upon
expiration of the 404 or CAMA Permit.
If you do not accept any of the conditions of this Certification (associated with the approved wetland or
stream impacts), you may ask for an adjudicatory hearing. You must act within 60 days of the date that
you receive this letter. To ask for a hearing, send a written petition, which conforms to Chapter 150B of
the North Carolina General Statutes to the Office of Administrative Hearings, 6714 Mail Service Center,
Raleigh, N.C. 27699-6714. This certification and its conditions are final and binding unless you ask for a
hearing.

John T. Mize Pond
Page 5 of 5.
September 13, 2004: -
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 telephone Cyndi Karoly in the Central Office in Raleigh at 919-
733-9721 or Mr. Kevin Barnett in the DWQ Asheville Regional Office at 828 251.6208.
Sincerely,
lan W. Klimek, P.E.
AWK/khb
Enclosures: GC 3402
Certificate of Completion
cc: Mr. Gerald Harbinson, USDA
Courthouse Amiex
Post Office Box 236
Columbus, NC 28722
USACE Asheville Regulatory Field Office
DWQ Asheville Regional Office
DLR Asheville Regional Office
Central Files
Filename: 04-1132.issued401. WQC#3402
J

`LAOTriage Check ListI2''0 4
QUALITY SECTION
Date: j� Project Name:
DWQ#:
County: -2
To: ARO Kevin Barne ❑ WaRO Tom Steffens
❑ FRO Ken Averitte ❑ WiRO Noelle Lutheran
❑ MRO Alan Johnson ❑' WSRO Daryl Lamb
❑ RRO Mike Horan
From: Telephone: (919) Gov
7
The. file attached is being forwarded to "pur 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
_E 1 inimization/avoidance issues
❑ Buffer Rules (Meuse, Tar -Pamlico, Catawba, Randleman)
❑ Pond fill
Mitigation Ratios
❑ Ditching
❑ Are the stream and or wetland mitigation sites available and viable?
❑ Check drawings for accuracy
❑ Is the application consistent with pre -application meetings?
❑ Cumulative impact concern
Comments:
15

USDA, Natural Resources Conservation Service
Courthouse Annex WETLANDS 1401 GROUP
P. O. Bog 236, Columbus, N.C. 28722
[phone] JUL 1, _2.2004
WATER QUALITY SECTION
July 9, 2004
John Dorney
Division of Water Quality
401 Wetlands Unit ,
1650 Mail Service Center . 041 1 3-2
Raleigh, NC 27699-1650
Dear Mr. Dorney,
I am assisting Mr. John Mize to construct an impoundment to capture potential
nutrient and pesticide runoff from his nursery operation here in Polk County. This is
being done though the USDA Environmental .Quality Incentives Program (EQIP).
Enclosed are 7 copies of the PCN and -the General Permit Verification from the
USACOE. Also enclosed are location maps and design information.
If you have any questions please give me a call'.
Sincerely,
Gerald Harbinson
District Conservationist

U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Action Id. 200430991 County Palk Quad EMCTFR VILLE. FAST
GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION
Property owner: John T. Mize
Address: P.O. Box 691, Columbus, NC 28722
Telephone No:
Zone: 44 UTM or LAT/LONG: North: 3898957 East: 588959
Size and Location of project (water body, road name/number, town, etc.): Pond project located 'on the Mize
greenhouse property on Tanner Road (SR 1357); north of Sandy Springs
Description of Activity: Construct a 0.9 acre water quality pond on an intermittent, unnamed tributary to
Hensons Creek. The pond will impact approx. 350 LF of stream channel by dam fill and inundation.
Applicable Law: X Section 404 (Clean Water Act, 33 U.S.C. 1344)
(check all that apply) Section 10 (River and Harbors Act of 1899)
Authorization: NW39 Nationwide Permit Number
Y
Your work is authorized by this Regional General (RGP) or Nationwide Permit (NWP) provided it is accomplished in
strict accordance with the attached conditions and your submitted plans. If your activity is subject to Section 404 (if
Section 404 block above is checked), before beginning work you must also receive a Section 401 water quality
certification from the N.C. Division of Water Quality, telephone [phone]. For any activity within the twenty
coastal counties, before beginning work you must contact the N.C. Division of Coastal Management, telephone (919)
733-2293.
Please read and carefully comply with the attached conditions of the RGP or NWP. Any violation of the conditions of
the RGP or the NWP referenced above may subject the permittee to a stop work order, a restoration order, and/or
appropriate legal action.
This Department of the Army RGP or NWP verification does not relieve the permittee of the responsibility to obtain any
other required Federal, State, or local approvals/permits. The permittee may need to contact appropriate State and local
agencies before beginning work.
If there are any questions regarding this authorization or any of the conditions of the General Permit or Nationwide
Permit, please contact the Corps Regulatory Official specified below.
Date: June 29, 2004
Corps Regulatory Official: Stephen D. Chapin
Expiration Date of Verification: June 29, 2006
cc: USDA-NRCS (Gerald Harbinson)
CESAW Form 591
Revised July 1995
Telephone No.: [phone] x 224

Office Use Only: Form Version May 2002
®41142
USAGE Action ID No.' DWQ No.
(If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A".)
I. Processing
1. Ch ck all of the approval(s) requested for this project:
[Section 404 Permit ❑ Riparian or Watershed Buffer Rules
❑ Section 10 Permit ❑ Isolated Wetland Permit from DWQ
2"401 Water Quality Certification
2. Nationwide, Resional or General Permit Number(s) Requested
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: ❑
4. If payment into the North Carolina Wetlands Restoration Program (NCWRP) is proposed for
mitigation of impacts (verify availability with NCWRP prior to submittal of PCN), complete
section VIII and check here: ❑
5. If your project is located in any of North Carolina's twenty coastal counties (listed on page
4), and the project is within a North Carolina Division of Coastal Management Area of
Environmental Concern (see the top of page 2 for further details), check here: ❑
II. Applicant Information
1. Owner/Applicant Information
Name: To k n T M
Mailing Address: F O_ Box �9/
Co Iu,--,60.S NG
122,
Telephone Number: - 963 o 1�Fax Number:
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: 1 6LY "b , n S o
Company Affiliation: I 1> Naf" eso%&AGeS v;
flailing Address:__
Telephone Number:
E-mail Address: G
�. NaYb; �so►� r
Page 5 of 5
Fax Number: - 8,18
nc . KSCId . G 01/

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 shoving 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.
Name of project: I) o k-11 /J: zP pon d
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN): j�
4. Location /
County: Po Nearest Town: GO1 w.-n 6 t,-,$
Subdivision name (include phase/lot number):
Directions to site (include road numbers, landmarks, etc.): rox; M O,R M; le na-n
cif- `�` 41kiCe� aF 1 ev- CkdJ &(SrZ IAQ) c—X TN - .a, 4,4 (c'P12.Z�*7)J_
r' n d r; be 'fie rate %,v KSe.s . �o I 6R •,��
Site coordinates, if available (UTlV1 or Lat/Long): 35 0 / Y � $ " 010
S$ YD
(Note — If project is linear, such as a road or utility line, attach a sh et that separately lists the
coordinates for each crossing of a distinct waterbody.)
6. Property size (acres):
7. Nearest body of water (stream/river/sound/ocean/lake): 14"So ns C ree K
S. River Basin: 16 ►"o at d
(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 �&e/u-J 5 � �a 4 `i�`� re o-F C..
W �� % s, czcAe s h a ve
T,ts �� `f bra,, �� . Y' .e oKe srha irP �re�s/sue
Page 6 of 6

10. Describe the overall project in detail, including the tyy
oMd kJ : I ! be Cep S-� Cfic1 CIO w-n s d2p— <
CIO/sect ea-, -1= ra-1 c � -1% r- � t CanA
Te VJ5Z, (J; I f be cox- I -, 721- d -Fg-, , r ,g6-J: 9,1 .
a 4y-ac. K l� b A cloy, w', 6 6e. u
11. 7 Expllain/ L the purpose of the proposed
C 0-4 ; 4 r ✓h �C�' Y,J M h.t
IV. Prior Project History
of equipment to be used 6 CAe
b*,4 ci d es
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.
60 -n,-: M hS�O Y%/
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.
O
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 Iisted 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 7

1. Provide a written description of the proposed impacts:
he, Ge�,s-,',ru c �� 4 CA a o-,., d
Individually list wetland impacts below:
Wetland Impact I
Site Number Type of Impact*
(indicate on man) I
Area of
Impact
(acres)
Located Nrithin
100-year Floodplain**
(yes/no)
Distance to
Nearest Stream
(linear feet)
Type of Wetland***
I I I
I
I
I
I 1 I
1
1
List each impact separately and identiA• temporary impacts. Impacts include, bui are not limited to: mechanized clearing, grading, til,
excavation, flooding, dirchins/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 (FELLA) Flood Insurance Rate Maps
(FIRM), or FENL4-approved local doodplain maps. Mats are available through the FEIN1A Map Service Center at 1-800-358-9616, or
online at htto:/hvw-,v.fema.gov.
List a wetland t`pe 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 map)
Type of Impact*
Length of
Impact
(linear feet)
Stream Name**
Average Width
of Stream
Before Impact
Perennial or
Intermittent?
(please specify)
E
/ -
I� P ►�1.�,ti.1
I� ! O r
I (.C7" •�° o� C✓� K
3�
�nfe('M i -f-f- I
yyI
I
I
I
I
1
I
1
I
I
l
I
List each impact separately and identih• 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 %all, rip -rap. crib wa1L 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 Wraps. If a stream has no name. list as UT (unnamed tributary) to the nearest
dov.nstream named stream into which it flows. liSGS maps are available through the USGS at 1-300-363-9616. or online at
ti1�u.usQs.gov. Several intemet sites also allow direct da aitlead and printing of USGS maps (e.g., w x-w.toaozone.com.
%1--1tw.maoouest.com7 etc.).
Cumulative impacts (linear distance in feet) to all streams on site: /uo
Page 3 of 8

4. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.) below:
Open Water Impact
Site Number
(indicate on map)
Type of Impact*
area of
Impact
(acres)
Name of Waterbody
(if applicable)
Type of Waterbody
(lake, pond, estuary, sound,
bay, ocean, etc.)
* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: fill, excavation, dredging,
flooding, drainage, bulkheads, etc.
PondCreation
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.): ec2da' 1 / em bcz•-r►►�+
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.): i rrig az� / Cam, t,�Ja�¢, q
IC4fC'_+s
of watershed draining to pond: `fZ• S Expected pond surface area: 0.9
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.
VIEL 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 toy150 linear feet of total impacts to perennial
streams.
Page 9 of 9

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
htto://h2o.enr.state.nc.us/ncwetlands/strm!aide.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.
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 htti)://h2o.enr.state.nc.us/wm/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 10

LY. Environmental Documentation (required by DWQ)
Does the project involve an expenditure of public Oederatate) funds or the use of public
(federal/state) land?
Yes '4 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 [4 No ❑
If yes, has the document review been finalized by the State Clearinghouse? If so, please attach a
copy of the NEPA or SEPA final approval letter.
Yes ❑ No ❑
X. Proposed Impacts on Riparian and Watershed Buffers (required by DWQ)
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
required state and local buffers associated with the project. The applicant must also provide
justification for these impacts in Section VII above. All proposed impacts must be listed herein,
and must be clearly identifiable on the accompanying site plan. All buffers must be shown on a
map, whether or not impacts are proposed to the buffers. Correspondence from the DWQ
Regional Office may be included as appropriate. Photographs may also be included at the
applicant's discretion.
Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Meuse), 15A NCAC 2B .0259 (Tar -Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify )?
Yes ❑ No If you answered "yes", provide the following information:
Identify the square feet and acreage of impact to each zone of the riparian buffers. If buffer
mitigation is required calculate the required amount of mitigation by applying the buffer
multipliers.
Zone*
Impact
(square feet)
Multiplier
Required
Mitisation
I
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.
Page 11 of 11

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. ; 1 �J rn
►ti,�l�ie'�t (�/�.�•-.�'-a,.ses �..d ��sZl. UI wvwJ�" Jy; /► b-E
ra ICerJW d Dw\d
XH. 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.
XM. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes ❑ No 21
Is this an after -the -fact permit application?
Yes ❑ Nof�T
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).
S- 2-z) - D
Applicant/ ent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 12 of 12

:\=: _ : -� .. t rl `' �l ` `; � tt ( (. rf � � .f � � __ _ /,•- .lf r` ! f .
j
,r
IQ
Lak
EE
1 t �. C-� t} S / 1 ,t�f //;
r, ��< < �: John Mize Pond Site
Location Map f
"Al
-� �--� /� - ,r �.�' `� � 1 ) �f ".,• pond
site
� ��.' •
41
Ir
Ile,
t
r I
�•�� `yt- A
4l
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Al
aq
i
J+

130
1104
................
In
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..........
IX

John Mize "Water Quality Pond"
Polk County, NC
Approximately 8 acres of nursery area and greenhouses will drain into the proposed
pond.
Summar of Design
Top of Dam - 995
Emergency Spillway - 992
Normal Pool 990.6
Total Storage - 9.9 acre feet
Storage - 4.9 acre feet
=1,596,000 gallons
Top of Dam width - 12 feet
Emergency Spillway width. - 30 feet
All side slopes of embankment - 3:1
Side slopes of emergency spillway - 2:1
Embankment Fill - 5,130 cubic yards
+ 5% - 256
5,386 cubic yards
Rough Estimate Cutoff Treanch - 600 cubic yards
Samuel C. Bingham
Civil Engineer
USDA, NRCS
J

I ; .
U.S. DEPARTIIENT OF AGRICULTURE
SOIL CONSERVATION SERVICE
NC-ENG-16
POND DESIGN - WORK SHEET
(Not Flood Routed)
Pond Owner lylIZ-e Address
County ��� Telephone No.
Location Code
DETERMINATION OF RUNOFF CURVE NUMBER FOR ANTECEDENT SOIL MOISTURE CONDITION II
I (Ch•nnter 7 - FnvinePrino Field Mnminl)
10-85
Land Use Or
Cover
Treatment Or
Practice
Hydrologic
Condition
Hydrologic
Soil Group
Acres
Curve
No.
Curve No.
x Acres
S
t ,mac
� GL
�'✓L�'SL
Sum of Acres ISum
of Product =
Weighted Curve No. = Sum or curve No.Sum of Total No
GENERAL DATA
Hazard Class - tiQ+� (NEM•520.21(e))
Drainage Area Ac.
Average Watershed Slope - % z- %
Slope Interpolating (Correction)
(EFM Page 2-8.1) Factor - N/,
Normal Pool Surface Area - 8Cj Ac.
x Acres _
Acres
Effective Height -/� j Ft. (NEM 520.21(d)
s1�s-r� yz
Storage - '7, Z Ac. Ft. (NEM 520.21�b))
Effective Height x Storage - /� 77
Engineering Job Class - (NEB[ NC 501.09
Use CN
SUMMARY
Normal Water Level Elev. -q0. (;-
Required Storage (Ft. ) 5�2 .�a + �, Z
O1/l"1
Crest Emergency Spillway Elev. Q 9 z,�,
Emergency Spillway Stage,( p) (Ft.) 1, Z
Design High Water Elev. '),?Y.p
Freeboard (Ft.) + 1,0
Settled Top of Dam Elev. gc?.57:
Est. Storage to Top of Dam Ac Ft
Overall Height (NEM 520.21(c)) r' Ft.
Dam Safety fqt^ Inventory Size t4 o
(NEM NC 501.09) (NEM 520.21(f))
ZEQUIRED DETENTION STORAGE (PS-378) (EFM - Chapter 2, Rainfall Data Maps)
I Yr - j Day = 3_ Inches Rainfall = b,(o(p Inches Runoff (EFM - Page 2-51a)
tequired _ ( In. Runoff)( Ac. DA) Ac.Ft. _ s-e�e 1-c"-
3torage 12 In./Ft. Ac.Ft. Ac.(Pool) Ft. Use Ft.
:MERGENCY SPILLWAY DESIGN (PS-378) (EFM - Chapters 2 & 11)
Yr - Day _7&IV Inches Rainfall = ( CFS)( ^) = Q = CFS
,EFM 11-53 to 11-54h) Retardance: Maximum Velocity: fps Length Control Section: Ft
)ischarge (q) = CFS/ft. Stage (Hp) = ft. Outlet Slope ange Min Max
;ottom Width = Q q = - = Ft. Use L Ft. Use Outlet Slope =
:omputed By Date 1 —03
;hecked By Date

I r
Volume in Dam without Cutoff
Trench and Topsoil Removal
Prismoidal Volume Results
❑riginal Surface Model;
or_
Final Surface Model:
dam
Cut Compaction Factor:
0,00
Fill Compaction Factor:
0,00
Raw Cut Volume:
1,44 cu
yd
Compacted Cut Volume:
0,00 Cu
yd
Total Cut Volume:
1,44 -cu
yd
Raw Fill Volume:
4472.56
cu yd
Compacted Fill Volume:
0.00 cu
yd
Total Fill Volume:
4472.56
cu vd
C

50 0 50 100 150
Scale 1" = 50'
y
ter ductile iron Pipe
nd 6' slide gate
onstruct Emergency Spillway
his side of Stream
lev. 992,8
lidth - 30'
S - 2:1
01013.14 0
1015,850
1016.76
1015.21
- 995,0
Width - 12'
pes - 3:1
Aize Nursery and Greenhouse:
Polk County, North Carolina
Plan View
Farm Pond
U.S. DEPARTMENT OF AGRICULTURE
NATURAL RESOURCES CONSERV N SE VICE
Date rL %
App
B roved 9y
S
Oesiyned CB � 5-03
Title
Drawn SCB 5-03 .
Checked
mize200

USDA, Natural Resources,Conservation Service
Courthouse Annex
P. O. Box 236, Columbus, N.C. 28722
[phone]
August 11, 2004
John Dorney
NCDENR
Division of Water Quality
401 Wetlands Certification Unit
1650 Mail Service Center
Raleigh, North Carolina 27699-1650
Dear Mr. Dorney,
This refers to DWQ Project # 04-1132, Polk County and 401 permit applicant John T.
Mize. I am assisting Mr. Mize in this project.
As requested the additional information has been included on page 8 of the PCN form.
A check for $475 for the application fee is enclosed.
Sincerely,
Gerald Harbinson
District Conservationist
E ._;Kevin -Barnett Asheville Regional Office
John Mize

Office Use Only:
E C E, � V El D
AUG 1 2 2004
E REGIONAL OFFICE
Form Version Mav 2002
USACE Action ID No.' DWQ No.' 42 / lIS2—
(If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A".)
I.
Processing
1. Ch ck all of the approval(s) requested for this project:
Section 404 Permit ❑ Riparian or Watershed Buffer Rules
El Section 10 Permit ❑ Isolated Wetland Permit from DWQ
2"'401 Water Quality Certification
2. Nationwide, Regional or General Permit Numbers) Requested:
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: ❑
4. If payment into the North Carolina Wetlands Restoration Program (NCWRP) is proposed for
mitigation of impacts (verify availability with NCWRP prior to submittal of PCN), complete
section VIII and check here: ❑
5. If,your project is located in any of North Carolina's twenty coastal counties (listed on page
4), and the project is within a North Carolina Division of Coastal flanagement Area of
Environmental Concern (see the top of page 2 for further details), check here: ❑
II. Applicant Information
1. Owner/Applicant Information
Name: k n
Mailing Address: P O. box 69
Go NC
,2L
Telephone Number: - Y63 o `f Fax Number:
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: 1 c�Y� "ns o
Company Affiliation: 1> Nai— esowtce5 cov;
Mailing Address: d X ,I
Telephone Number
E-mail Address: C
a/A. NCcYbI0fov, �
Page 5 of 5
Fax Number:
n� . KSCJlG . 'n nil

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 lone, 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: o) /1�: zP Pond
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN): j� 130 _ •Z
4. Location /
County: �o I K Nearest Town: c ( U,-n S
Subdivision name (include phase/lot number):
Directions to site (include road numbers, landmarks, etc.): �ox� D.r�i m; le ,��
6� fie, ;nksect� of Lee- C,,dd Kcl (sk i3 .L) _- d (EC 135 z)
r ram,, �KSe.r.
-rye 5 ►ree,,1-ouze5 . P&­d S : �P_ ; S d Y-� ho ws
5. Site coordinates, if available (UTM or Lat/Long): 35 / y � 8 r� OI "r-$ Yo
(Note — If project is linear, such as a road or utility line, attach a sh et that separately lists the
coordinates for each crossing of a distinct waterbody.)
6. Property size (acres): 5_0
7. Nearest body of water (stream river/sound/ocean/lake): f1"So r1s C ree
8. River Basin: 13 Y,o Q d
(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/maps/.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application:_ Be/u,J soV,. h �a �` , c re'n a-�, u F
J a1-r ca of t/ / &I7 Se aCAe_5 Ala Vey.
`f4e 6,*cl�s n �r�.,c_ 7� �z c�•e s.ti, 4 ems/ s
01�
n
Page 6 of 6

10. Describe the overall project in detail, including the type of equipment to be used: 'A O, T k vAe
a
Go 1 lecf
7µ1o`�v, ,J;II be c-1;I;-4e- -�a't, ;f ,g ;�. tEeAvy e9 SUc�•As
a-f-racK 1-oe a-.,,c bA2 cloy w' II fie. .se,
11. Explain the purpose of the proposed
":�-, -Fro —i na
d h,&4� c.; des
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.
_1J, o :P -:M Ns�Or/
V. Future Project -Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
anWO
rovide 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 Iisted 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 7

Provide a written description of the proposed impacts:
Individually list wetland impacts below:
�.•✓Z ,r-mac#- `v: I
Wetland Impact
Site Number
(indicate on mao)
1
T,, e of Impact*
I
Area of
Impact
(acres)
Located within
IOU -year Floodp1mal
(yes/no)
Distance'to
Nearest Stream
(linear feet)
Type of Wetland***
II
I
I
I
I
I
I I
I
I
I
I
1
I
1
I
1
* List each impact separately and identifV temporary impacts. Impacts include, but are not limited to: mechanized clearing, grading, till,
excavation, flooding, dirchinz/drainage, etc. For dams, separately list impacts due to both structure and flooding.
100-Year tloodplains are identified through the Federal Emeraenev Management Agency's (FEVLA) Flood Insurance Rate Maps
(FIRM), or FE'LA-approved loeaI doodplain maps. Maps are available through the FE'LA'Map Service Center at 1-800-368-9616, or
online at httD://w%vzv.fema.gov.
List a wetland type that best describes wedand to be impacted (e.s., freshwater/saltwater marsh, forested wetland, beaver pond,
Carolina Bav, 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:
I Individually list all intermittent and perennial stream impacts below:
Stream Impact
Site Number
('indicate on map)
Type of Impact*
Length of
Impact
(linear feet)
Stream dame**
Average Width
of Stream
Before Impact
Perennial or
Intermittent?
(please specify)
E
I C/ k '_-> .►
2
to r, K diss: 6%
I
aQ.I<
1
�Elovdn-dboo'
I T SGzek
I
I
1
I
l
I
* 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 shoving 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 U I (unnamed tributary) to the nearest
dox nstream named scream into which it flows. USGS maps are available through the USGS at 1-800-368-9616, or online at
U�.�ZL'.11sos.o0y. Several intemet sites also alloy direct dov.nload and printing of USGS maps (e.g, vvww.t000zone.com,
Li1lly.maDQuest.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site:
Page 8 of 8

4. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.) below:
Open Water Impact
Site Number
(indicate on map)
Ty e of Impact*
F p
Area of
Impact act
(acres)
Name p Waterbody
(if applicable)
Type of Waterbody
(lake, pond, estuary, sound,
bay, ocean, etc.)
List each impact separately and identify temporary impacts. Impacts include, but are not limited to: fill, excavation, dredging,
flooding, drainage, bulkheads, etc.
Pond Creation
If construction of a pond is proposed, associated wetland and stream impacts should be
included above in the wetland and stream impact sections. Also, the proposed pond should
be described here and illustrated on any maps included with this application.
Pond to be created in (check all that apply): ❑ uplands 2 stream ❑ wetlands
Describe the method of construction (e.g., dam/embankment, excavation, installation of
draw -down valve or spillway, etc.): eG�t` •d,4­� / en
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.): i r'ri ct aZc� / '_"
eize of watershed draining to pond: Expected pond surface area: 0.9
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.
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 9

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/strmEzide.html.
1. Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement,- creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation . easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
2. Mitigation may also be made by payment into the North Carolina Wetlands Restoration
Program (NCWRP). Please note it is the applicant's responsibility to contact the NCWRP at
[phone] to determine availability and to request written approval of mitigation prior
to submittal of a PCN. For additional information regarding the application process for the
NCWRP, check the NCWRP website at httT)://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 10

.I P
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. rn
,��x; w- �► J cazo- a^e ; ,jaiv.&,, c ( 6ixaa,-. L�,s es �d L.o v se). /Rc,- FP kJ,'/ 1 �
o'ro n os e.
XH. 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.
XM. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes ❑ No M
Is this an after -the -fact permit application?
Yes ❑ No�
XIV. Other Circumstances (Optional):
It. is the applicant's responsibility to submit the application sufficiently in advance of desired
construction dates to allow processing time for these permits. However, an applicant may
choose to list constraints associated with construction or sequencing that may impose limits on
work schedules (e.g., draw -down schedules for lakes, dates associated with Endangered and
Threatened Species, accessibility problems, or other issues outside of the applicant's control).
.-` 2--e - D
0 Applicant/*ent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 12 of 12

MM
Volume in Dam without Cutoff
Trench and Topsoil Removal
Prismoidal Volume Results
Original Surface Model: o,
Final Surface Model: d
Cut Compaction Factor: 0
Fill Compaction Factor: 0
Raw Cut Volume: 1,
Compacted Cut Volume: 0 Spillway
Total Cut Volume: 1,I diameter ductile iron Pipe
Raw Fill Volume: 4iser and 6' slide gate
Compacted Fill Volume: 0.
Total Fill Volume: 4
TBM - E onstruct Emergency Spillway
Stake Beside Elev,
his side of Stream
992,8
Width - 30'
SS - 2:1
01013,14 0
007.02 1015,850
1016,7&
1015.21
i'
srline
11m
f Dam - 995.0
of Dam Width - 12'
o ode Slopes - 3:1
0
0
Mize Nursery and Greenhouse!
Polk County, North Carolina
Plan View
Farm Pond
U.S. DEPARTMENT OF AGRICULTURE
NATURAL RESOURCES CONSERV N SE VICE
Date ib '
roved By
Designed `S B 5-03 App�
Title
Drawn SCB 5-03
Title
Traced Sheet No. Drawing File Name:
Checked ^r mize!

50 0 50 100 150
v
,ter ductile iron Pipe
nd 6' slide gate
onstruct Emergency Spillway
his side of Stream
lev, 992,8
lidth - 30'
S - 2:1
01013,14 0
1015.850
1016,76
1015,21
- 995,0
i Width - 12'
pes - 3:1
Oize Nursery and Greenhouse!
Polk County, North Carolina
Plan View
Farm Pond
U.S. DEPARTMENT OF AGRICULTURE
NATURAL RESOURCES CONSERVA N SE VICE
Date
SCB 5-03 Approved By
Designed
Title
Drawn SCB 5-03 r `
Scale 1" = 50'
Traced
Checked
rawing File Name:
mize200

IM
Volume in Dam without Cutoff
Trench and Topsoil Removal
Prismoidal Volume Results
❑riginal Surface Model;
or
Final Surface Model;
dare
Cut Compaction Factor;
0,00
Fill Compaction Factor;
0.00
Raw Cut Volume;
1.44 cu
yd
Compacted Cut Volume;
0.00 cu
yd
Total Cut Volume;
1.44 cu
yd
Raw Fill Volume;
4472.56
cu yd
Compacted Fill Volume;
0.00 cu
yd
Total Fill Volume;
4472,56
cu yd
TBM -
Elev, 1000,00
Stake Beside White
Oak--

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality.
Michael F. Easley, Governor William G. Ross, Jr., Secretary
Alan W. Klimek, P.E., Director
July 27; 2004
CERTIFIED MAIL: RETURN RECEIPT REQUESTED
John T. Mize
Post Office Box 691
Columbus, NC 28722
REQUEST FOR MORE INFORMATION
DWQ Project # 04-1132
Polk County
TEJ
F0�1�
2 8 2004 0
WATER QUALITY SECTION
ASHEVILLE REGIONAL OFFICE
Dear Mr. Mize:
On July 12, 2004, the Division of Water Quality (DWQ) received your application dated May
20, 2004 to impact 140 feet of streams to construct the proposed pond. The DWQ has determined
that your application was incomplete and/or provided inaccurate information as discussed below.
The DWQ will require additional information in order to process your application to impact
protected wetlands and/or streams on the subject property. Therefore, unless we receive the
additional information requested below, we will have to move toward denial of your application
as required by 15A NCAC 2H .0506 and will place this project on hold as incomplete until we
receive this additional information. Please provide the following information so that we may
continue to review your project.
Additional Information Requested:
1. Plan Details
Please show and list on page 8 of the PCN form all stream impacts including all fill slopes,
dissipaters and bank stabilization spillways, and flooded areas on the site plan
2. Application Fee
Please provide the revised application fee as discussed in the PCN Form.
Please respond within three weeks of the date of this letter by sending this information to me in
writing and Kevin Barnett of the DWQ Asheville Regional Office. If we do not hear from you
within three weeks, we will assume that you no longer want to pursue this project and we will
consider the project as withdrawn.
401 Wetlands Certification Unit
1650 Mail Service Center, Raleigh, North Carolina 27699.1650 One
2321 Crabtree Boulevard, Suite250, Raleigh, North Carolina 27604 NorthCaTolina
Phone: [phone] /FAX [phone] /Internet: http://h2o.enr.state.nc.us/ncwetlands Natarallff
An Equal Opportunity/Affirmative Action Employer —50% Recycled/10% Post Consumer Paper

John Mize
Page 2 of 2.
July 27, 2004
This letter only addresses the application review and does not authorize any impacts to wetlands,
waters or protected buffers. Please be aware that any impacts requested within your application
are not authorized (at this time) by the DWQ. Please call Cyndi Karoly or Mr. John Domey at
919-733-1786 if you have any questions regarding or would like to set up a meeting to discuss
this matter.
Sincerely,
�..
John Dorney,
DWQ, Wetlands / 401 Unit
JRD/bs
cc: Kevin B ffleft; DVVQ-Asheville-Region. al- ffice
USACE Asheville Regulatory Field Office
File Copy
Central Files
USDA, Natural Resources Conservation Services, Post Office Box 236 Columbus, NC
28722 \
Flename: 04-1132 - John Mize (Polk) on hold

Wf
�OF VdA%Q - is F. ley, or GovernE
L_
William G. Ross Jr., Secretary -
r North Carolina Department of Environment and Natural Resources
p t `C Alan W. Klimek, P.E. Director
Division of Water Quality
September 13, 2004
DWQ Project # 04-1132
Polk County
John T. Mize
Post Office Box 691
Columbus, NC 28722
Subject Property: John T. Mize Pond
Polk County
Approval of 401 Water Quality Certification with Additional Conditions
Dear Mr. Mize:
You have our approval, in accordance with the attached conditions and those listed below, to place fill
within or otherwise impact no more than 140 linear feet of an unnamed tributary to Henson's Creek for
the purpose of irrigation at the subject property, as described within your application received August 23,
2004. After reviewing your application, we have decided that the impacts are covered by General Water
Quality Certification Number(s) 3402 (GC3402). The Certification(s) allows you to use Nationwide
Permit(s) 39 when issued by the US Army Corps of Engineers (USACE). ' In addition, you should obtain
or otherwise comply with any other required federal, state or local permits before you go ahead with your
project including (but not limited to) Erosion and Sediment Control, Non -discharge, and state stormwater
regulations.
This approval is for the purpose and design that you described in your application. If you change your
project, you must notify us and you may be required to send us a new.application. If the property is sold,
the new owner must be given a copy of this Certification and approval letter and is thereby responsible for
complying with all conditions. If total fills for this project (now or in the future) exceed one acre of
wetland or 150 linear feet of stream, compensatory mitigation may be required as described in 15A
NCAC 2H .0506 (h). This approval requires you to follow the conditions listed in the attached
certification and any additional conditions listed below.
The Additional Conditions of the Certification are:
1. Impacts Approved
The following impacts are hereby approved as long as all of the other specific and general
conditions of this Certification (or Isolated Wetland Permit) are met. No other impacts are
approved including incidental impacts:
Amount Approved
Plan Location or Reference
(Units)
Stream (Perennial)
No more than 140
Dam fill
linear (feet)
401 Wetlands Certification Unit
1650 Mail Service Center, Raleigh, North Carolina 27699-1650
2321 Crabtree Boulevard, Suite 250, Raleigh, North Carolina 27604
Phone: [phone] / FAX [phone] / Internet: http://h2o.enr.state.nc. us/ncwetlands
NoorthCarolina
Natura!!Y
An Equal Opportunity/Affirmative Action Employer— 50% Recycled/10% Post Consumer Paper

John T. Mize Pond
Page 2 of 5
} September 13, 2004:'
2. Erosion & Sediment Control Practices
Erosion and sediment control practices must be in full compliance with all specifications
governing the proper design, installation and operation and maintenance of such Best
Management Practices in order to protect surface waters standards:
a. The erosion and sediment control measures for the project must be designed, installed,
operated, and maintained in accordance with the most recent version of the North Carolina
Sediment and Erosion Control Planning and"Design Manual.
b. The design, installation, operation, and maintenance of the sediment and erosion control
measures must be such that they equal, or exceed, the requirements specified in the most
recent version of the North Carolina Sediment and Erosion Control Manual. The devices
shall be maintained on all construction sites, borrow sites, and waste pile (spoil) projects,
including contractor -owned or leased borrow pits associated with the project.
c. For borrow pit sites, the erosion and sediment control measures must.be designed, installed,
operated, and maintained in accordance with the most recent version of the North Carolina
Surface Mining Manual.
d. The reclamation measures and implementation must comply with the reclamation in
accordance with the requirements of the Sedimentation Pollution Control Act.
3. No Waste, Spoil, Solids, or Fill of Any Kind
No waste, spoil, solids, or fill of any kind shall occur in wetlands, waters, or riparian areas beyond
the footprint of the impacts depicted in the Pre -Construction Notification. All construction
activities, including the design, installation, operation, and maintenance of sediment and erosion
control Best Management Practices, shall be performed so that no violations of state water quality
standards, statutes, or rules occur.
4. No Sediment & Erosion Control Measures w/n Wetlands or Waters
Sediment and erosion control measures shall not be placed in wetlands or waters to the maximum
extent practicable. If placement of sediment and erosion control devices in wetlands and waters
is unavoidable, they shall be removed and the natural grade restored within six months of the date
that the Division of Land Resources has released the project.
5. Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification or applicable
Buffer Rules, and any subsequent modifications, the applicant is required to return the attached
certificate of completion to the 401/Wetlands Unit, North Carolina Division of Water Quality,
1650 Mail Service Center, Raleigh, NC, 27699-1650.
6. Diffuse Flow (No Review)
ANY constructed stormwater conveyance outlets shall be directed and maintained as diffuse flow
at non -erosive velocities through the protected stream buffers such that it will not re -concentrate
before discharging into a any waters of the state. If this is not possible, it may be necessary to
provide stormwater facilities that are considered to remove nitrogen. This may require additional
approval from this Office.

John T. Mize Pond
Page 3 of 5.
September 13, 2004: -
7. Protective Fencing
The outside buffer, wetland or water boundary and along the construction corridor within these
boundaries approved under this authorization shall be clearly marked with orange warning
fencing (or similar high visibility material) for the areas that have been approved to infringe
within the buffer, wetland or water prior to any land disturbing activities to ensure compliance
with 15A NCAC 2B .0200 and GC 3402.
8. Buffer Replanting
Replanting of vegetation within disturbed areas located within 30 feet of the stream boundary not
associated with the proposed impoundment on this site must be done in an "in kind" manner
immediately following construction. (Example: Disturbed areas with pre-existing grassed lawns
must be replanted with grass. Disturbed areas with pre-existing trees or woody vegetation must
be replanted with trees and woody vegetation. Disturbed areas with pre-existing forest vegetation
must be replanted with forest vegetation including at least two different. native hardwood tree
species at a density sufficient to provide 320 trees per acre at maturity. This density can usually
be achieved by planting approximately 436 (10 x 10 spacing) to 681 (8 x 8 spacing) trees per
acre.)
9. Written Stormwater Management Plan (No Further Approval Needed)
A final, written stormwater management plans (including a signed and notarized Operation and
Maintenance Agreement), must be implemented and the stonnwater management facilities shall
be constructed and operational before any permanent building is occupied at the subject site. The
structural stormwater practices as approved by this Office as well as drainage patterns must be
maintained in perpetuity. No changes to the structural stormwater practices shall be made without
written authorization from the Division of Water Quality.
10. Turbidity Standard
The turbidity standard of 50 NTUs (Nephelometric Turbidity Units) shall not be exceeded as
described in 15 A NCAC 2B..0200. Appropriate sediment and erosion control practices must be
used to meet this standard.
11. Standard Erosion and Sediment Control Practices
Erosion and sediment control practices must be in full compliance with all specifications
governing the proper design, installation and operation and maintenance of such Best
Management Practices:
a) Erosion and sediment control measures for the project must be designed, installed,
operated, and maintained in accordance with the most recent version of the North
Carolina Sediment and Erosion Control Planning and Design Manual.
b) Design, installation, operation, and maintenance of the sediment and erosion control
measures must be such that they equal, or exceed, the requirements specified in the most
recent version of the North Carolina Sediment and Erosion Control Manual. The devices
shall be maintained on all construction sites, borrow sites, and waste pile (spoil) projects,
including contractor -owned or leased borrow pits associated with the project.

John T. Mize Pond
Page 4 of 5
September 13, 2004:
c) For borrow pit sites, the erosion and sediment control measures mustbe designed,
installed, operated, and maintained in accordance with the most recent version of the
North Carolina Surface Mining Manual.
d) Reclamation measures and implementation must comply with the reclamation in
accordance with the requirements of the Sedimentation Pollution Control Act.
e) Sufficient materials required for stabilization and/or repair of erosion control measures
and stormwater routing and treatment shall be on site at all times.
12. No Impacts Beyond those in Application
No waste, spoil, solids, or fill of any kind shall occur in wetlands, waters, or riparian areas beyond
the footprint of the impacts depicted in the Pre -construction Notification. All construction
activities, including the design, installation, operation, and maintenance of sediment and erosion
control Best Management Practices, shall be performed so that no violations of state water quality
standards, statutes, or rules occur.
13. No Sediment and Erosion Control Measures in Wetlands
Sediment and erosion control measures shall not be placed in wetlands or waters to the maximum
extent practicable. If placement of sediment and erosion control devices in wetlands and waters is
unavoidable, they shall be removed and the natural grade restored within six months of the date that
the Division of Land Resources or locally delegated program has released the project.
14. Construction Stormwater Permit NCGO 10000
Upon the approval of an Erosion and Sedimentation Control Plan issued by the Division of Land
Resources (DLR) or a DLR delegated local erosion and sedimentation control program, an
NPDES General stormwater permit (NCGO10000) administered by DWQ is automatically issued
to the project. This General Permit allows stormwater to be discharged during land disturbing
construction activities as stipulated by conditions in the permit. If your project is covered by this
permit [applicable to construction projects that disturb one (1) or more acres],. full compliance
with permit conditions including the sedimentation control plan, self -monitoring, record keeping
and reporting requirements are required. A copy of this permit and monitoring report forms may
be found at http://h2o.enr.state.nc.uslsulFoi-ms Documents.htm.
Violations of any condition herein set forth may result in revocation of this Certification and may result in
criminal and/or civil penalties. The authorization to proceed with your proposed impacts or to conduct
impacts to waters as depicted in your application and as authorized by this Certification, shall expire upon
expiration of the 404 or CAMA Permit.
If you do not accept any of the conditions of this Certification (associated with the approved wetland or
stream impacts), you may ask for an adjudicatory hearing. You must act within 60 days of the date that
you receive this letter. To ask for a hearing, send a written petition, which conforms to Chapter 150B of
the North Carolina General Statutes to the Office of Administrative Hearings, 6714 Mail Service Center,
Raleigh, N.C. 27699-6714. This certification and its conditions are final and binding unless you ask for a
hearing.

John T. Mize Pond
Page 5 of 5.
September 13, 2004: -
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 telephone Cyndi Karoly in the Central Office in Raleigh at 919-
733-9721 or Mr. Kevin Barnett in the DWQ Asheville Regional Office at 828.251.6208.
AWK/khb
Enclosures: GC 3402
Certificate of Completion
cc: Mr. Gerald Harbinson, USDA
Courthouse Annex
Post Office Box 236
Columbus, NC 28722
USACE Asheville Regulatory Field Office
ODWQ—ATh'MIIU'R-Z"g-i nari oe
DLR Asheville Regional Office
File Copy
Central Files
Sincerely,
Ian W. Klimek, P.E.
Filename: 04-1132.issued401. WQC#3402

F W A;rF. Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan Klimek, P.E., Director Division of Water Quality
0
October 3, 2002
DWQ # 02-1471
Polk County
CERTIFIED MAIL —RETURN RECEIPT REQUESTED
Ivan Robinson
Post Office Box 805
Columbus, NC 28722
Dear Mr. Robinson:
On September 6, 2002 the Division of Water Quality (DWQ) was notified by receipt of your
application regarding your plan to fill wetland for the purpose of a road crossing in Polk County:
Approval from DWQ is required to disturb these streams. Please provide 7 copies of the following
information and refer to the DWQ # listed above in your reply. In particular as described in 15A NCAC
2B .0502, we will require you to locate all streams and ponds on the property. Please show these on
maps of suitable. scale (for instance 1" = 100 feet) so we can begin to determine your projects'
compliance -with 15A NCAC 2H .0500.
1. Please provide a location map for the project.
2. Please provide cross-section details of the pipe installation.
3. Has this project been completed?
Please telephone me at 919-733-1786 if you have any questions or would require copies of our rules
or procedural materials. This project will remain on hold as incomplete in accordance with 15A
NCAC 2H .0505(c). The processing time for this application will begin when this information is
received. If we do not hear from. you by writing within:three (3) weeks we will assume you no longer
want to -pursue the project and will consider it withdrawn.
L R. Dorney
Water Quality Certification Program
cc: Asheville DWQ Regional Office
Asheville Corps of Engineers
Central Files
File Copy
lI�i:
N. C. Division of Water Quality, 401 Wetlands Certification Unit, i' I
1650 Mail Service Center, Raleigh, NC 27699-1650 (Mailing Address) = J `
2321 Crabtree Blvd., Raleigh, NC 27604-2260 (Location) !1 Wlts Lfi fjlJf�Li E �` StiC'i 1�1 i
[phone] (phone), 919-733-6893 (fax),,(http://h2o.enr.state.nc.usincwetlgnds P'SHEVfII-1`�REI ?"If". '=

Rpr 08 03 02:02p
DWQ USER
[phone]
P. 1
Action m 200330610
U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Notification of Unauthorized Activity/Pei
Responsible Party:
Telephone Number:
Mr. Bill Davis
315 Timberbrook Ln.
Tryon, NC 28782
County: Polk
POSL 0.1. a of paw:
Fax Note R7673
To Qk d ig z.%er
Fax# ,A . v
From� n ai. 44
Phone#
Size and Location of Property (waterbody, Highway name/number, town, etc.):
Site located south of SR 1005, just downstream from the bridge on the Green River, north of the
community of Cox Store.
Description of Unauthorized Activity/Permit Noncompliance:
Unauthorized installation of an irrigation line on the bed of the Green River and deposition of approx. 20
cubic yards of spoil material on the edge of the river upstream from the line.
Indicate which of the following apply:
X Unauthorized Activity River & Harbor Act, Section 10 (33 USC 403)
Noncompliance with Permit X Clean Water Act, Section 301 (33 USC 131 1)
Unless you have a Department of the Army permit for the above -described activity, it is a violation of federal law as
specified above. You have agreed to do no further work in waters or wetlands without the required Department of the
Army permit. Any further unauthorized work in waters or wetlands will be considered an intentional violation of
federal law.
If you do no further work in waters or wetlands, and perform the remedial action requested below, the Corps of
Engineers will take no further action in this matter. If you continue to work in waters and wetlands without the
required authorization, and/or fail to perform the requested remedial action, the Corps will take further administrative
action, and may request U.S. Attorney to file suit against you. If you need further information about the Corps of
Engineers regulatory program, please contact
Steve Chapin at [phone] X5.
Remedial Action Requested:
(1) Complete removal of irrigation pipe or re -installation of the pipe under the bed of the river;
(2) Complete removal of above referenced spoil material to a contained, high ground location.
ALL WORK MUST BE DONE WITHIN 30 DAYS OF THE DATE OF THIS NOTICE.
Your signature acknowledges receipt of this notification.
Property Owner/Responsible Party Signature
Project Manager Signature,
Date: March 31., 2003
cc: Wanda Frazier,NCDENR-DWQ,59 Woodfin Place, Asheville, NC 28801-
2482
CESAW Form 607 1 OCT 12

J -JQ
Action ID: 200330610
U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
County: Polk
Pos[ It Date # of pages
Fax NjjoteeR�R76731
To Wr�i1 Cl Ct �%� ZI e✓
From
�Hy
Phone#
Notification of Unauthorized Activity/Permit Noncompliance
Responsible Party:
Telephone Number:
Mr. Bill Davis
315 Timberbrook Ln.
Tryon, NC 28782
Size and Location of Property (waterbody, Highway name/number, town, etc.):
Site located south of SR 1005, just downstream from the bridge on the Green River, north of the
community of Cox Store.
Description of Unauthorized Activity/Permit Noncompliance:
Unauthorized installation of an irrigation line on the bed of the Green River and deposition of approx. 20
cubic yards of spoil material on the edge of the river upstream from the line.
u t5 l+� � � �l i y � �•
Indicate which of the following apply:
AM
a Ji
JX Unauthorized Activity River & Harbor Act, Section 10 (33 USC 4 3)
Noncompliance with Permit X Clean Water Act, Section 301 (33 USC 13
Unless you have a Department of the Army permit for the above -described activity, it is a violation of federal law as
specified above.. You have agreed to do no further work in waters or wetlands without the required Department of the
Army permit. Any further unauthorized work in waters or wetlands -will be considered an intentional violation of
federal law.
If you do no further work in waters or wetlands, and perform the remedial action requested below, the Corps of
Engineers will take no further action in this matter. If you continue to work in waters and wetlands without the
required authorization, and/or fail to perform the requested remedial action, the Corps will take further administrative
action, and may request U.S. Attorney to file suit against you. If you need further information about the Corps of
Engineers regulatory program, please contact
Steve Chapin at [phone] X5.
Remedial Action Requested: `
(1) Complete removal of irrigation pipe or re -installation of the pipe under the bed of the river;
(2) Complete removal of above referenced spoil material to a contained, high ground location.
ALL WORK MUST BE DONE WITHIN 30 DAYS OF THE DATE OF THIS NOTICE.
Your signature acknowledges receipt of this notification.
Property Owner/Responsible Party Signature
Project Manager Signature 5
Date: March 31, 2003
cc: Wanda Frazier,NCDENR-DWQ,59 Wood£in Place., Asheville, NC 2.8801-
2482
^ CESAW Form 607 1 OCT 12

Action ID: 200330040
U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
County: Polk
Notification of Unauthorized Activity/Permit Noncompliance
Responsible Party: Mr. Jack Edwards'
White Oak Mountain, 474 Serpentine Dr. �� D{r
Columbus, NC 28722 OCT 2 1 2002.'
Telephone Number:
Size and Location of Property (waterbody, Highway name/number, town, etc.): ~ '�
Edwards Property located at White Oak Mountain development, Serpentine Drive, north of Columbus.
Description of Unauthorized Activity/Permit Noncompliance:
Installation of 5 small dams along approximately 75 linear feet of stream channel in the headwaters of
Horse Creek for aesthetic purposes. The total amount of fill placed in- the channel for the dams is
approximately 25 linear feet.
Indicate which of the following apply:
X Unauthorized Activity River & Harbor Act, Section 10 (33 USC 403)
Noncompliance with Permit X Clean Water Act, Section 301 (33 USC 131 1)
Unless you have a Department of the Army permit,for the above -described activity, it is a violation of federal law as
specified above. You have agreed to do no further work in waters or wetlands without the required Department of the
Army permit. Any further unauthorized work in waters or wetlands will be considered an intentional violation of
federal taw.
If you do no further work in waters or wetlands, and perform the remedial action requested below, the Corps of
Engineers will take no further action in this matter. If you continue to work in waters and wetlands without the
required authorization, and/or fail to perform the requested remedial action, the Corps will take further administrative
action; and may request U.S. Attorney to file suit against you. If you need further information about the Corps of
Engineers`regulatory program, please contact
Steve Chapin at (828) ,271-7980 X5.T
Remedial Action Requested:
Submit the enclosed after -the -fact permit application to this office for approval.
Your signature acknowledges receipt of this notification.
Property Owner/Responsible•Party Signature , X
Project Manager Signature_
Date: October 17, 2002
cc: Wanda Frazier (NCDENR—DWQ);59 Woodfin P1.,Asheville,NC 28801-2482
CESAW Form 607
1 OCT 12