20110527 Ver 1_401 Application_20110511

201 1052 T
To whom it may concern
I would like to build a 6' high retaining wal14' behind an existing seawall and I need the
forms for the permit. My land is slowly moving forwazd to the water and the proposed
retaining wall would hopefully stop this action. Attached are drawings of the proposed
retaining wall. I need to know what permits I need and where can I get the forms. You
may contact me at the following:
Chet Griffin
Mailing address: 53 Lake Royale, Lake Royale Subdivision, Louisburg NC 27549
Physical address: 731 Sagamore drive, Lake Royale Subdivision, Louisburg NC 27549
Cell: 919-610-7124
Home: 252-478-5336
Email: [e-mail]
~c~@oe~D
MAY2~2011 I

VIEW FROM WATER
~ ~
~ ~
~ HOME ~
~ ~
Land
TOP of proposed retaining wa116' high 55' long
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IIIIIII!!i!III!Iiliillliiiliilll!iilllilillllilfl!!!ililiilii!iil 6'_~IIIIIIIIIIIIIIIIiIII!illillllllilifiiiiillll(llIIIIIIIII!IIIllllllilll(illlllllllllliilllllllil
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Top of existing sea wall 61' ~
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)))))))))))))))))))))))))))))))WATER))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))

VIEW FROM SIDE
~_4'
Land between proposed
~ retaining wall & sea
~ wall
V
~F-------Existing sea wall
~ 61' long
WATER
Proposed retaining wa116' high 61' long----~ ~

View from top
House
Top of proposed retaining wall
~ ~
~ ~ ~ ~
~ ~ ( ~
~ Lexisting _ ~ ~
20' V ~_ steps ~V 35'
lllllllllJlllllllllllllllllllllllllllllllllJlllllllll~ _6'_wide_~/////I////////////!!//////////////////////////////////
Top of existing sea wall ~ ~
~ ( ~
~ ~ ~
~ ~ ~
lllllllllllllJllllllllllllllllllllllllllllllllllllll6l'llllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllllll
existing DOCK

20 ~ 1052 T
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Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.4 January 2009
Pre-Construction Notification (PCN) Form
A. Applicant Information
1. Processing
1 a. Type(s) of approval sought from the Corps: ^ Section 404 Permit
^ Section 10 Permit
1 b. Specify Nationwide Permit (NWP) number: or General Permit (GP) number.
1c. Has the NWP or GP number been verified by the Corps? ^ Yes ^ No
1 d. Type(s) of approval sought from the DWQ (check all that apply):
^ 401 Water Quality Certification -Regular ^ Non-404 Jurisdictional General Permit
^ 401 Water Quality Certification -Express ©Ripattian Buffer Authorization
1e. Is this notification solely for the record
because written approval is not required? For the record ony for DWQ
401 Certification:
^ Yes ^ No For the record only for Corps Permit:

^ Yes ^ No
1 f. Is payment into a mirtlgation bank or in-lieu fee program proposed for
mitigation of impacts? If so, attach the acx~eptance letter from mitigation bank
or in-lieu fee program.
^ Yes ®No
1g. Ibs~t~project kxated in any of NC's twerriy coastal counties. ff yes, answer 1h ^ ® ~
Yes
1 h. Is the pr+~ect kx~ted within a NC DCM Area of Environmental Concern (AEC)? ^ Yes ®No
2. Project IMorrnation
2a. Name of project: Retaining wall, Lake Royale
2b. County: Franklin
2c. Nearest muniapality !town: Bunn
2d. Subdivision name: Lake Royale Subdivision
2e. NCDOT only, T.I.P. or state project no:
3. Owner Information
3a. Name(s) on Retarded Deed: Chester Griffin
3b. Deed Book and Page No. ~ , -<
3c. Responsible Partyr (for l1C if
applicable):
~ •-~ ,p ..
3d. Street address: 731 Sagamore Drive o ,
3e. City, state, zip: Louisburg NC, 27549 -'
3f. Telephone no.: Home: 252-479-5336 Cell: 919-610-7124 a
3g. Fax no.: 252-478-5336
3h. Email address: [e-mail]
Page 1 of 10
PCN Form -Version 1.4 January 2009

4. Applicant irrfonnation (ff different from owner)
4a. Applicant is: Agent Other, specify: owner
4b. Name: Harry Lee
4c. Business name
Cf applicable): Harry Lee's Landscaping and concrete
4d. Street address:
4e. City, state, zip: Nashville NC 27856
4f. Telephone no.: 252-462-2392
4g. Fax no..
4h. Email address; [e-mail]
5. AgentfConsuitant Information (ff applicable)
5a. Name:
5b. Business name
(if applicable):
5a Street address:
5d. City, state, zip:
5e. Telephone no.:
5f. Fax no.:
5g. Email address:
Page 2 of 10

8. Project Informatlon Ind Prior Project History
1. Properly IdaMification
1a. Property identification no. (tax P!N or parcel ID): lot 1532
1 b. Site ooordinaths (in decimal degrees}: Latitude: Longitude:
1 c. Property she: 0.5 awes
2. Surface Wagers
2a. Name of near+e~ body of water to proposed project: Lake Royale
2b. Water Quality Ciassificaaon of nearest receiving water.
2c. River basin:
3. Project Description
3a. Descxibe the existing c~rtditions on the site and the general land use in the vianity of the project at the time of this
application:
Land is shifting toward the water. I need retaining wall to stop the shift. this is a residential lot.
3b. List the total estimated acreage of all existing wetlands on the property:
3c. List the total estirrfated linear feet of a!I existing streams (intermittent and perenniaq on the property:
3d. Explain the purpose of the proposed project:
To keep land from moving towards the water
3e. Describe the overaN project in detail, inducting the type of equipment to be used:
I'm proposing a 6' high and 61' long retaining wall back filled with dirt. Wall vwll be tongue and groove
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property t
indudin all ses in the ^Yes ®No ^ Unknown

Gommertts:
4b. tf the Corps made the jurisdictional determination, what type
of determination was made? ^ preliminary ^ Final
4c. If yes, who delineated the jurisdictional areas?
Name (if known): Agency/Consultant Company:
Other:
4d. If yes, fist the dates of the Corps jurisdictional determinations or State detemtinations artd attach documentation.
5. Project History
5a. Have permits or oertificatiorts been requested or obtained for
this project (indud'mg aN prior phases) in the past?
^Yes ©No ^ Unknown
5b. if yes, explain in detail aa:ording to `help file' instructions.
6. future Project Plans
6a. Is this a phased project? ^Yes ®No
lib. If yes, explain.
Page 3 of 10
PCN Form -Version 1.4 January 2009

C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
^ Wetlands ^ Streams -tributaries ®Buffers ^ Open Waters ^ Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impaled.
2a.
Wetland impact
number
Permanent (P) or
Tem ora 2b.
Type of impact 2c.
Type of wetland 2d.
Forested 2e.
Type of jurisdiction
Corps (404,10) or
DWQ (401, other) 2f.
Area of
impact
(acres)
W1 - Choose one Choose one YesMo -
W2 - Choose one Choose one YesMo -
W3 - Choose one Choose one Yes/No -
W4 - Choose one Choose one Yes/No
W5 - Choose one Choose one Yes/No -
W6 - Choose one Choose one YesMo
2g. Total Wetland Impacts:
2h. Comments:
3. Stream Impacts
If there are perennial or intermittent stream impals (inGuding temporary impacts) proposed on the site, then complete this
question for alt stream sites impaled.
3a.
Stream impact
number
Permanent (P) or
Temporary ('~ 3b.
Type of impact 3c.
Stream name 3d.
Perennial (PER) or
intermittent (INT)? 3e.
Type of
jurisdiction 3f.
Average
stream
width
(feet) 3g.
Impal
length
(linear
feet)
S1 - Choose one
S2 - Choose one -
S3 - Choose one
S4 - Choose one -
S5 - Choose one
S6 - Choose one
3h. Total stream and tributary impacts
3i. Comments:
Page 4 of 10
PCN Form -Version 1.4 January 2009

4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individual) list all o n water im ads below.
4a.
Open water
impact number
Permanent (P) or
Tem ra 4b.
Name of waterbody
(if applicable) 4c.

Type of impact 4d.

Waterbody
type 4e.

Area of impact (acres)
01 - Choose one Choose
02 - Choose one Choose
03 - Choose one Choose
04 - Choose one Choose
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If nd or lake construction ro sect, then com lete the chart below.
5a.
Pond ID number 5b.
Proposed use or
purpose of pond 5c.
Wetland Impacts (acres) 5d.
Stream Impacts (feet) 5e.
Upland
(acres)
Flooded Filled Excavated Flooded Filled Excavated
P1 Choose one
PZ Choose one
5f. Total:
5g. Comments:
5h. Is a dam high hazard permit required? ^ Yes ^ No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for t')WQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If an im ads r uire miti ation, then ou MUST fill out Section D of this form.
6a. Project is in which protected basin? ^ Neuse ^Tar-Pamlico ^ Catawba ^ Randleman ^ Other.
6b.
Buffer Impact
number -
Permanent (P) or
Tem 6c.
Reason for impact 6d.
Stream name 6e.
Buffer
mitigation
required? 6f.
Zone 1
impact
(square
feet 6g.
Zone 2
impact
(square
feet
B 1 - Yes/No
B2 - YesMo
B3 - YesMo
~ - Yes/No
65 - YesMo
B6 - YesMo
6h. Total Buffer Impacts:
6i. Commenrts:
Page 5 of 10

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
none
1 b. Speafically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
none
2. Com nsato Miti anon for Im cts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for
impacts to Waters of the U.S. or Waters of the State? ^ Yes ^ No
2b. If yes, mitigation is required by (check all that apply): ^ DWQ ^ Corps

2c. If yes, which mitigation option will be used for this
project? ^ Mitigation bank
^ payment to in-lieu fee program

^ Permittee Responsible Mitigation
3. Com lets if Usin a Miti ation Bank
3a. Name of Mitigation Bank:

3b. Credits Purchased (attach receipt and letter) Type: Choose one
Type: Choose one
Type: Choose one Quantity:
Quantity:
Quantity:
3c. Comments:
4. Com lets if Makin a Pa ment to In-lieu Fee P ram
4a. Approval letter from in-lieu fee program is attached. ^ Yes
4b. Stream mitigation requested: linear feet
4c. If using stream mitigation, stream temperature: Choose one
4d. Buffer mitigation requested (DWQ only): square feet
4e. Riparian wetland mitigation requested: acres
4f. Non-riparian wetland mitigation requested: acres
4g. Coastal (tidal) wetland mitigation requested: acres
4h. Comments:
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a pennittee responsible mitigation plan, provide a description of the proposed mitigation plan.
Page 6 of 10
PCN Form -Version 1.4 January 2009

6. Buffer Ntitlgation (Stabs Regulated Riparian Butner Rules) -required by DVMKZ
6a. Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation?
^ Yes Q No
6b. If yes, then identify the square feet of impact to each cone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation squired.

Zone tic.
Reason for impact 6d.
Total impact
(square feet}
Multiplier t3e.
Required mitigation
(square feet)
Zone 1 3 (2 for Catawba)
Zone 2 1.5
6f. Total buffer mitigation required:
6g. If buffer mitigation is squired, discuss what type of rrtitigation is proposed (e.g., payment m private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved iMieu fee fund).
6h. Comments:
Page 7 of 10

E. Stormwater Management and Diffuse Flow Plan (required by DWQj
1. Diffuse flow Plan
1 a. Does the project include or is it adjacent to protected riparian buffers identified
within ane of the NC Ri rian Buffer Protection Rules? ^ Yes Q No
1 b. ff yes, then is a diffuse flow plan included? If no, explain why.
^ Yes ^ No
2. Stortnwater Mana ment Plan
2a. What is the overall percent imperviousness of this project?
2b. Dces this ro'ect re uire a Stormwater Mana ement Plan? ^ Yes ^ No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why:
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
2e. Who will be responsible for the review of the Stormwater Management Plan?
3. Certified Local Government Stormwater Review
3a. In which local ovemment's 'urisdidion is this ro'ed?

3b. Which of the following locally-implemented stormwater management programs
apply (check all that apply): ^ Phase II
^ NSW
^ USMP
^ Water Supply Watershed
^ Other:
3c. Has the approved Stormwater Management Plan with proof of approval been
attached? ^Y~ ^ No
4. DWQ Stormwater P ram Review

4a. Which of the following state-implemented stomiuvater management programs appty
(check all that apply): Coastal counties
^HQW
~ORW
Session Law 2006-246
^Other:
4b. Has the approved Stormwater Management Plan with proof of approval been
attached? ^ Yes ^ No
5. DWQ 401 Unit Stortnwater Review
5a. Does the Stormwater Management Plan meet the appropriate requirements? ^ Yes ^ No
5b. Have all of the 401 Unit submittal requirements been met? ^ Yes ^ No
Page 8 of 10
PCN Form -Version 1.4 January 2009

F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1 a. Does the project involve an expenditure of public (federallstatellocal) funds or the ^Yes ^ No
use of public (federal/state) land?
1 b. If you answered "yes" to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State ^Yes ^ No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1 c. If you answered "yes' to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
^Yes ^ No
letter.)
Comments:
2. Violations (DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards, ^Yes ©No
or Riparian Buffer Rues {15A NCAC 2B .8200)?
2b. is this an after-the-fact permit application? ^Yes ©No
2c. If you answered "yes' to one or both of the above questions, provide an exptanation of the vidation(s):
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably antiapated future impacts) result in
^Yes ©No
additional development, which could impact nearby downstream water quaMy?
3b. If you answered "yes' to the above, submit a qu~itative or quar>titahive cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered `no; provide a short narrative description.
4. Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility.
Page 9 of 10
PCN Form -Version 1.4 January 2009

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or
habitat? ^ Yes ^ No
5b. Have you checked with the USFWS concerning Endangered Species Act
impacts? ^ Yes ^ No
5c. If yes, indicate the USFWS Field Office you have contacted. -
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
6. Essential Fish Habitat (Corte Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat? ^ Yes ^ No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
^ Yes ^ No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in aFEMA-designated 100-year floodplain? ^ Yes ^ No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination?

Chester Griffin ,.
° ~
05-23-2011
ApplicanUAgenYs Printed Name Applir,:anUAgent's Sign r
(Agerrt's signature is va~d ordy if a
letter from the a nt is ed. Date
Page 10 of 10