20020717 Ver 2_401 Application_20110929

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Mitchell Environmental, P.A.
D
SEP 2 9
2011
September 28, 2011
1 T ANGSANp STORMWg?L
BRANCH
Mr. Jamie Shern Mr. lan McMillan
US Army Corps of Engineers N.C. Department of Environment & Natural Resources
3331 Heritage Trade Drive, Suite 105 1601 Mail Service Center
Wake Forest, North Carolina 27587 Raleigh. North Carolina 27699-1601
Re: Belmont Subdivision Lots 70 & 71 (Wake County, - Neuse River Basin)
Pre-Construction Notification Application
Dear Mr. Shern & Mr. McMillan:
Attached is a complete PCN Application for lots 70 & 71 of the Belmont Subdivision (PIA. 0679388449
and 0679388349). Belmont Subdivision is located on the southeast side of Cary, along the intersection of
Optimist Farm Road and Henderson Road. When construction of the Belmont Subdivision began in 2002,
lots were developed as single-family residences. Previous wetland, stream, and open water impacts were as
follows: 0.085 acres (0.049-permanent and 0.036-temporarv), 213 linear feet (149-permanent and 64-
temporarv), and 0 acres, respectively. It should also be noted that 0.02 acres of'wetlands were delineated as
part of the West Lake Subdivision immediately west of lots 70 & 71 of the Belmont Subdivision.
In their current condition, lots 70& 71 of the Belmont Subdivision cannot be developed due to the presence
of 0.061 acres of wetlands running through both properties. These wetlands appear to have been created
following development of the West Lake Subdivision (spec fically the construction (Y 'a detention pond
crest o/'lots 70 & 71).
In order to develop lots 70 &71, the headwater wetland running through the lots will need to be cleared,
excavated, and filled resulting in a permanent, on-site wetland impact of 0.061 acres. The wetlands
immediately west of lots 70 & 71 (i.e. the 0.02 acre wetland that is part of the West Lake Subdivision) also
must be addressed. We propose installing a curtain drain along the western border of lots 70 & 71, thus
eliminating the hydrology component from this off-site wetland, resulting in a permanent, off-site wetland
impact of 0.02 acres. The proposed impacted areas are illustrated on the maps attached as part of this
application.
Impacts to these jurisdictional areas are unavoidable and have been minimized to the maximum extent
practicable. Mitigation for proposed impacts that require mitigation will be provided through payment to
the NCEEP. Both a NCEEP mitigation responsibility acceptance letter and a fee request form are attached
for your review.
Do not hesitate to call me if you have any questions or concerns regarding the attached PCN application or
if you need any additional information. Thank you.
Sincerely, -
Scott Mitchell, PF„ LSS Kim Whitlev, MS, SSI'1
PO Box 341 Fuqual -Varina, North Carolina 27526
O%l ice: 919-557-4082 Fax.
919-5 5 %-4683
o??E V n rF9Q?
(/j P
1 1 > =1
Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Pre-Construction Notification (PCN) Form
A. Applicant Information
1. Processing
1 a. Type(s) of approval sought from the
Corps:
®Section 404 Permit ? Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: 29 or General Permit (GP) number:
1 c. Has the NWP or GP number been verified by the Corps? ? Yes ® No
1d. Type(s) of approval sought from the DWQ (check all that apply):
® 401 Water Quality Certification - Regular ? Non-404 Jurisdictional General Permit
? 401 Water Quality Certification - Express ? Riparian Buffer Authorization
1 e. Is this notification solely for the record
because written approval is not required? For the record only for DWQ 401
Certification:
? Yes ® No For the record only for Corps Permit:

? Yes ® No
1f. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in-lieu
fee program. ® Yes ? No
1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below. ? Yes ® No
1h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ? Yes ® No
2. Project Information
2a. Name of project: Belmont Subdivision Lots 70 & 71
2b. County: Wake
2c. Nearest municipality / town: Cary
2d. Subdivision name: Belmont
2e. NCDOT only, T.I.P. or state
project no: N/A
3. Owner Information
3a. Name(s) on Recorded Deed: Olde South Homes, Inc.
3b. Deed Book and Page No. 11430; p. 2728-2730
3c. Responsible Party (for LLC if
applicable): N/A
3d. Street address: 3921 Sunset Ridge Road, Suite 201
3e. City, state, zip: Raleigh, N.C. 27607-6679
3f. Telephone no.: [phone]
3g. Fax no.:
3h. Email address:
Page I of 11
PCN Form - Version 1.3 December 10, 2008 Version
4. Applicant Information (if different from owner)
4a. Applicant is: ? Agent ® Other, specify: owner
4b. Name:
4c. Business name
(if applicable):
4d. Street address:
4e. City, state, zip:
4f. Telephone no.:
4g. Fax no.:
4h. Email address:
5. Agent/Consultant Information (if applicable)
5a. Name: Scott Mitchell
5b. Business name
(if applicable): Mitchell Environmental, P.A.
5c. Street address: P.O. Box 341
5d. City, state, zip: Fuquay-Varina, N.C. 27526
5e. Telephone no.: [phone]
5f. Fax no.: [phone]
5g. Email address: [e-mail]
Page 2 of 11
PCN Form - Version 1.3 December 10, 2008 Version
B. Project Information and Prior Project History
1. Property Identification
1 a. Property identification no. (tax PIN or parcel ID): 0679388349 and 0679388239
1 b. Site coordinates (in decimal degrees): Latitude: 35.6689N Longitude: - 78.7514W
(DD.DDDDDD) (-DD.DDDDDD)
1 c. Property size: 0.61 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to UT to Middle Creek
proposed project:
2b. Water Quality Classification of nearest receiving water: C; NSW
2c. River basin: Neuse
3. Project Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application:
Site is currently forested. Surrounding lots are developed as single-family residences.
3b. List the total estimated acreage of all existing wetlands on the property:
0.061
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
0
3d. Explain the purpose of the proposed project:
To clear and develop both lots (Lots 70 and 71) as single-family residences.
3e. Describe the overall project in detail, including the type of equipment to be used:
Tree clearing and grading using bulldozers and rollers will be required. Wetlands will be filled via an excavator or backhoe
and filled with additional soil and leveled. In addition, machinery/equipment will be necessary for home construction.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
®Yes ? No ? Unknown
project (including all prior phases) in the past?
Comments: JD form has been submitted to the U.S. ACE
4b. If the Corps made the jurisdictional determination, what type
? Preliminary Final
of determination was made?
4c. If yes, who delineated the jurisdictional areas? Agency/Consultant Company:
Name (if known): Scott Mitchell Other: Spaulding & Norris, PA
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
8/30/2002--AID# 200221019-1020 (for Covington Meadows, now known as Belmont Subdivision); 4/11/2005--AID#
200520688 (West Lake Subdivision)
5. Project History
5a. Have permits or certifications been requested or obtained for ® Yes ? No ® Unknown
this project (including all prior phases) in the past?
5b. If yes, explain in detail according to "help file" instructions.
Previous wetland, stream, and open water impacts were as follows: 0.085 acres (0.049-permanent and 0.036-temporary),
213 linear feet (149-permanent and 64-temporary), and 0 acres, respectively. Also note that 0.02 acres of wetlands were
delineated as part of the West Lake Subdivision, immediately west of lots 70 & 71. We do not have copies of USACE or
DWQ permits for either subdivision. However, enclosed please find two maps detailing permitted impacts for Covington
Meadows (now known as the Belmont Subdivision) entitled "Optimist Farm Cluster Subdivision" and "Covington
Meadows Subdivision", as well as the original PCN application. Also attached is a map for the West Lake Subdivision
entitled "F.B. West, et al Property".
Page 3 of 11
PCN Form - Version 1.3 December 10, 2008 Version
6. Future Project Plans
6a. Is this a phased project? ? Yes ® No
6b. If yes, explain.
Page 4 of 11
PCN Form - Version 1.3 December 10, 2008 Version
C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
® Wetlands ? Streams - tributaries ? Buffers
? Open Waters ? Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a. 2b. 2c. 2d. 2e. 2f.
Wetland impact Type of jurisdiction
number - Type of impact Type of wetland Forested (Corps - 404, 10 Area of impact
Permanent (P) (if known) DWQ - non-404, other) (acres)
or Temporary
T
W1 ®P ? T Land Headwater ® Yes ® Corps 061
0
Clearing/Excavation/Fill wetland ? No ® DWQ .
W2 ® P ? T Drainage Headwater ® Yes ® Corps 0
020
wetland ? No ® DWQ .
W3 ? P ? T ? Yes ? Corps
? No ? DWQ
W4 ? P ? T ? Yes ? Corps
? No ? DWQ
W5 ? P ? T ? Yes ? Corps
? No ? DWQ
W6 ? P ? T ? Yes ? Corps
? No ? DWQ
2g. Total wetland impacts
2h. Comments: There are 0.061 acres of delineated wetlands on Lots 70 & 71. However, the installation of a curtain drain
along the western border of the two lots will eliminate the hydrology component of 0.020 acres of adjacent wetlands, thus
impacting a total area of 0.081 acres.
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a. 3b. 3c. 3d. 3e. 3f. 3g.
Stream impact Type of impact Stream name Perennial Type of jurisdiction Average Impact
number - PER or
404, 1
-
(Corps
0
stream
Permanent (P) intermittent DWQ
-
non-
404
, (linear
or Temporary (INT)? other) (feet) feet)
(T)
S1 ? P ? T ? PER ? Corps
? INT ? DWQ
S2 ?P?T ?PER ?Corps
? INT ? DWQ
S3 ? P ? T ? PER ? Corps
? INT ? DWQ
S4 ? P ? T ? PER ? Corps
? INT ? DWQ
S5 ? P ? T ? PER ? Corps
? INT ? DWQ
S6 ? P ? T ? PER ? Corps
? INT ? DWQ
3h. Total stream and tributary impacts
3i. Comments:
Page 5 of 11
PCN Form - Version 1.3 December 10, 2008 Version
4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impacts below.
4a.
Open water
impact number
- Permanent
(P) or
Temporary T 4b.
Name of waterbody
(if applicable) 4c.

Type of impact 4d.

Waterbody type 4e.

Area of impact (acres)
01 ?P?T
02 ?P?T
03 ?P?T
04 ?P?T
41. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If and or lake construction proposed, then complete the chart below.
5a.

Pond ID 5b.

Proposed use or purpose of 5c.
Wetland Impacts (acres) 5d.
Stream Impacts (feet) 5e.
Upland
(acres)
number pond
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
P2
5f. Total
5g. Comments:
5h. Is a dam high hazard permit required?
? Yes ? No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
Page 6 of 11
PCN Form - Version 1.3 December 10, 2008 Version
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If an impacts require mitigation, then you MUST fill out Section D of this form.
6a.
? Neuse ? Tar-Pamlico ? Other:
Project is in which protected basin? ? Catawba ? Randleman
6b. 6c. 6d. 6e. 6f. 6g.
Buffer impact
number - Reason Buffer Zone 1 impact Zone 2 impact
Permanent (P) for impact Stream name mitigation (square feet) (square feet)
or Temporary required?
T
131 ?P?T ?Yes
? No
B2 ? P ? T ? Yes
? No
B3 ?P?T ?Yes
? No
6h. Total buffer impacts
6i. Comments:
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
In order to both develop and make these lots marketable, all proposed impacts are necessary and unavoidable.
ib. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
In order to both develop and make these lots marketable, all proposed impacts are necessary and unavoidable.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for ® Yes ? No
impacts to Waters of the U.S. or Waters of the State?
2b. If yes, mitigation is required by (check all that apply): ? DWO ® Corps
? Mitigation bank
2c. If yes, which mitigation option will be used for this project? ® Payment to in-lieu fee program
? Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter) Type Quantity
Page 7 of 11
PCN Form - Version 1.3 December 10, 2008 Version
3c. Comments:
4. Complete if Making a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached. ® Yes
4b. Stream mitigation requested: linear feet
4c. If using stream mitigation, stream temperature: ? warm ? cool ?cold
4d. Buffer mitigation requested (DWQ only): square feet
4e. Riparian wetland mitigation requested: 0.25 acres
4f. Non-riparian wetland mitigation requested: acres
4g. Coastal (tidal) wetland mitigation requested: acres
4h. Comments: There are 0.061 acres of delineated wetlands on Lots 70 & 71. However, since the impacts are permanent
and cumulative, the 0.061 acres on the lots, as well as 0.020 acres west of the lots and the original 0.049 acres permanently
impacted when the subdivision was originally developed shall all be used when calculating the amount of acreage that needs
to be mitigated. Using a multiplier of 2, we have calculated -0.25 acres of wetlands that need to be mitigated.
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
6. Buffer Mitigation (State Regulated Riparian Buffer Rules) - required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation? ? Yes ® No
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.

Zone 6c.
Reason for impact 6d.
Total impact
(square feet)
Multiplier 6e.
Required mitigation
(square feet)
Zone 1 3 (2 for Catawba)
Zone 2 1.5
6f. Total buffer mitigation required:
6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in-lieu fee fund).
6h. Comments:
Page 8 of 11
PCN Form - Version 1.3 December 10, 2008 Version
E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1 a. Does the project include or is it adjacent to protected riparian buffers identified ? Yes ® No
within one of the NC Riparian Buffer Protection Rules?
1 b. If yes, then is a diffuse flow plan included? If no, explain why.
El Yes [:1 No
Comments:
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project? 16%
2b. Does this project require a Stormwater Management Plan? ? Yes ® No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why: The overall percent imperviousness of
this project (Belmont Subdivision) is less than 25%.
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
? Certified Local Government
2e. Who will be responsible for the review of the Stormwater Management Plan? ? DWO Stormwater Program
? DWQ 401 Unit
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this project? Town of Cary
® Phase II
3b. Which of the following locally-implemented stormwater management programs ® NSW
? USMP
apply (check all that apply): ? Water Supply Watershed
? Other:
3c. Has the approved Stormwater Management Plan with proof of approval been ? Yes ® No
attached?
4. DWQ Stormwater Program Review
? Coastal counties
? HOW
4a. Which of the following state-implemented stormwater management programs apply ? ORW
(check all that apply): ? Session Law 2006-246
? Other:
4b. Has the approved Stormwater Management Plan with proof of approval been
? Yes ? No
attached?
5. DWQ 401 Unit Stormwater Review
5a. Does the Stormwater Management Plan meet the appropriate requirements? ? Yes ? No
5b. Have all of the 401 Unit submittal requirements been met? ? Yes ? No
Page 9 of 11
PCN Form - Version 1.3 December 10, 2008 Version
F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1 a. Does the project involve an expenditure of public (federal/state/local) funds or the ? Yes ® No
use of public (federal/state) land?
1 b. If you answered "yes" to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State ? Yes ? No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1c. If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
? Yes ? No
letter.)
Comments:
2. Violations (DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards, ? Yes ® No
or Riparian Buffer Rules (15A NCAC 26 .0200)?
2b. Is this an after-the-fact permit application? ? Yes ® No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
3. Cumulative Impacts (DWO Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in ? Yes ® No
additional development, which could impact nearby downstream water quality?
3b. If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
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.
All wastewater will be directed to city sewer lines.
Page 10 of 11
PCN Form - Version 1.3 December 10, 2008 Version
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or ®Yes Q No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act --? -__?
impacts? , El Yes ® No
? Raleigh I
5c. If yes, indicate the USFWS Field Office you have contacted.
j ? Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
NC Natural Heritage Program Virtual Worksroom
6. Essential Fish Habitat (Corps Requirement) j
6a. Will this project occur in or near an area designated as essential fish habitat? I ? Yes ® No
j 6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
NC Natural Heritage Program Virtual Workroom
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation ? yes No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
I
submitted an environmental review to the N.C. Department of Cultural Resources j
8. Flood Zone Designation (Corps Requirement)
8a Will this project occur in a FEMA-designated 100-year floodplain? ?Yes ®No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination? NCfloodmaps.com
I _
r '
r' Applicant/Agent's Signature Date
Applicant/Agent's Printed Name
j (Agent's signature is valid only if an authorization letter from the applicant
i is provided.)
Page 1 I of 11
PCN Form - Version 1.3 December 10. 2008 Version
September 10, 2002
Covington Meadows PCN
Office Use Only:
USACE Action ID No.
(If any parties
I. Processing
H.
Form Version May 2002
DWQ No.
is not applicable to this project please enter "Not Applicable" or
1. Check all of the approvaks) requested for this project:
® Section 404 Permit ® Riparian or Watershed Buffer Rules
? Section 10 Permit ? Isolated Wetland Permit from DWQ
N 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested: Nationwide Permit # 39
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: ?
Applicant Information
1. Owner/Applicant Information
Name: Majewski E s T
Mailing Address: 282 1 Drive
Raleigh. NC 2 FM
Telephone Number:_ 919-852-5661_ Fax Number-M7854-2932
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: Scott Mitchell
Company Affiliation: S u in &NoLdl PA
Mailing Address; 72 ' ' Road
k NC 27607
Telephone Number:919-854-79% Fax Number:-2-12-854-7225
E-mail Address:--ott crg ul !WM ris corn
Page 5 of 12
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 trap
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 MRCS 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 l I 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:-.-. Covineton Meadows
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN): 01 47- 452 0679-01474705,
..0679.01-37-983-7.-0679.01-38-9346 , 79.01-48-3292
4. Location
County-: Wak Nearest Town: C
Subdivision name (include phase/lot number): C ' o do
Directions to site (include road tnunbers, landmarks, etc.): From inters ction of Sunset Lake
Road and Optimist Farm Read travel east on Qptbjg Farm Road 1V%xim&1v 2.5 miles
Site is on north side of OptiMig Farm Road approx. 0.3 miles Mg West Lake Road
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): 53 acres
7. Nearest body of water (stream/river/sound/ocean/lake): UT to iddle Creek
8. River Basin: Neu
(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 M,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:-- The majority of the site is covered y forest vegetation
roads a been rough d' t USACE and DLVQp=b sued in 2000.
The tnaiority of the site is surrounded by low-density residential, rennaitlder is forest
Page 6 of 12
10. Describe the overall project in detail, including the type of equipment to be used:
11e_uroposed mic9 will create a res' ential subdivision on this site 8mLmjr d _
mftastructure includes the installation of new ro c storm and Wg= sewer ste and
ml r systems necesM for a residential develo t EauiD=nt that may be used on this
Mica includes. but js not limited to trade- hoe excavators. ??11-d rs front-end loaders
etc
11. Explain the purpose of the proposed work: p=se of the VMMsed work is to provide
struct t0 3UDport a residential subdivision of single-family hQmes on this site
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.
Please we attached cover letter for explanation of 'or 'ect M for 9g site
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.
JUN Town of Cary and/or the NCDOT may require t rxistir pQ M poles alon,?ftimist
Farm Road be moved further north of the propose widening of Optimist Farm Road At this
Wig in tune it is unknown where these?oles yyoukl be relocated to and whether this move
wouldmegnire Rztbq impacts to Neuse Buffers than resented in this 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 wetWWs 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. Provide a written description of the proposed impacts:_ ProooFA ina is jmlude two
road crossina of streams with Neuse Buffers one road _ ening that will impact & stream with
a Neese $ r, one 'tare sewer crossing that Will MMM& impact a stream with a New
Buffer as well as tenmorarilyiMpgging wgland Apd one sa ' = sewer Basemen -that will
impact pQrtlons of Zone 2 of tit N use Buffer.
2. Individually list wetland impacts below: -
.....,(...u ,...rxsu
Site Number
Type of Impact'" area oI
Impact Located ithin
100-year Floodplain'"* Distance to
Nearest Stream
Type of Wetland***
(mdtcate on trier (acres) no linear feet
I (Permitted) Road Crossing 0.049 No 0 F?
7 (Propond - Temp) San. Sewer 0.036 No 60 Forested
Last each impact separately and identify temporary Impacts. Impacts include, brit so not ted to: mechanized clearing. grading, ifl),
** excavation, flooding. ditching/chainage, etc. For dams, shy list impacts doe to bold Amchre and flooding.
100-Year floodplains are identified though the Federal Emergency Management Agency's (FEMA) Flood Itisunnice Rate Maps
(FIRM, or FEMA-approved local floodplain maps. Maps are available through the FEMA Map Service Center at 14M358-9616, or
online at J/www. fta go -Y.
•'• List a wetland type that best describes wetland to be impacted (e.gr, freshwater/saltwater marsh, forested wellan4 beaver pond,
Caroline Bay, bog, eta) Indicate if wetland is isolated (determination of isolation to be made by USAGE only).
List the total acreage (estimated) of all existing wetlands on the property: 2 um
Total area of wetland impact proposed: .085 acres - .049 acres Perm. and 036 acres Tem,
3. Individually list all intermittent and nPrP.nn;at atroav" ;,,...a..?? i-i-....
Stream Impact Length of --?-- Average Width Pa mtial or
Site Number Type of Impact- Impact Stream Name** of Stream Intermittent?
indicate on map) linear feet Before lm lease Vecify)
I (Permitted) Road Crossing 63 UT to Middle Creek 4 feet Intermittent'
4 (Proposed - Perm) Road Crossing 61 UT to Middle Creek 3 fret Intermittent
4 (Proposed -Temp) Road Crossing 24 UT to Middle Creek 3 feet Intermittent
5 (Proposed - Perm) Road Widening 25 UT to Middle Creek 11 feet Perennial
5 (PvPosed-Tamp) Road Widening 15 UT to Middle Creek I 1 feet Perennial
6 (Proposed - Temp) San. Sewer 25 UT to Middle Creek 1 I feet Perennial

- ------ ----r---- --r?•••••v •••••• ....•....y .w.rrnno?? '114-. ggr?g 1nwu(M Out am not limited to: culverts and associated *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 walk gabions, etc.), excavation, ditchiug/straightening. etc. If stream relocation is
proposed, plans and profdes showing the Imear footprint for both the original and relocated strearns 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_? .wU.eov. Several intemet sites also allow direct download and printing of USGS maps (e.g., www 2pWone.ecm
www,magquest .com1 etc.).
Cumulative impacts (linear distance in feet) to all streams on site: 21 If Total (149 If
Permanent 641 Tem
Page 8 of 12
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 m
None
Type of Impact* Area of
Impact
acres Name of Waterbody
(ifapplicable) Type of Waterbody
(I" mod, estuary, sound,
bay. TMetc.

r:.. -L
?.... -«-v -- --&y -porary unpam. unpam include, but are not limited to: fill, excavation, &vVn&
flooding, drainage, bulkheads, etc.
5. 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 li cation. app
Pond to be created in (check all that apply): E] uplaixis stream ? wetlands
Describe the method of construction (e.g., dam/embankment, excavation, installation of
draw-down valve or spillway, etc.): N/A
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 JustiQcation (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.
Proposed impacts are unavoidable due to pMRmV configuration and stream / Neuse Buffer
locations. Both §Uom / Neuse Buffer crosgs are as Flose to perpendicular as is pry
Road wideWN impacts on Optiuu Farm Road are aired by the To= o C Log&n of
the proposed sanitary sewer is dictated by site topQ&Wlhy and crosses stream near pnodiculaz
VIIL 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
htt :/o.enr.state,nc.us(noyAlands/strmgide ht].
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 (acreago(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 for Mpgsed hgRacts.
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.gate,.nc,uaLv,=Ltndex.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): 0
Amount of buffer mitigation requested (square feet): 0
Amount of Riparian wetland mitigation requested (acres): 0
Amount of Non-riparian wetland mitigation requested (acres):_ 0
Amount of Coastal wetland mitigation requested (acres): 0
Page 10 of 12
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 NEPAISEPA 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
(Neese), 15A NCAC 2B .0259 (Tar-Pamfico), 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.
Zane' uapact
fed) Multiplier Required
twat
1 13,420 (Perm) 3 None
2 8,344 (Perm) 1.5 None
Total 21,764 (Perm) Norte
cone i extends out 30 teat pexpenmcular from new bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.
Page 1 i 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 1SA NCAC 2B .0242 or.0260.
Mitigation ' not mguired Msed bpcts
XL Stormwater (required by DWQ)
Describe impervious acreage (both existing and prof
Discuss stormwater controls proposed in order to
downstream from the property.
Qg=Iy no imp?yr . us aereage exists on the site excel
Level spr w will be constructed at the outlets of all
sheet -flow prior to entry into Neuse Buffers AWroxi
will bUpnstructed on this site, exclusive of m sod hr
XII. Sewage Disposal (required by DWQ)
bsed) versus total acreage on the site.
protect surface waters and wetlands
it for dirt or grovel vehicular 090..-
stomlwgerr pipe discharges to establish
roately 3.0 acres of impervio a?
'v mtios. etc.
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.
Wastowater e ed at it " 1 collected by the T of Cary sari sewer m
and sub entl treated rel t `-,
Xffi. 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
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/Agents Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 12 of 12
Current EEP In-Lieu Fee Request Form
Statement of Compliance with Session Law 2009-337 An Act to Promote
the Use of Compensatory Mitigation Banks and SL 2011-343.
(link to SL 2009-3371 (link to SL 2011-343)
Prior to accessing the Ecosystem Enhancement Program (EEP) In-Lieu Pee Mitigation Program, all
applicants requesting wetlands, stream and/or riparian buffer mitigation are now required by law to
comply with Session Law 2009-337 An Act to Promote the Use of Compensatory Mitigation Banks as
well as Session Law 2011-343, which made changes to the operation of the NCEEP. All new requests
submitted on or after June 27, 2011 MUST include this form signed and dated by the permit applicant
or an authorized agent. Please rcfer to t.)J "ti r? ltt',ii!,t+.)i.?yit iti,,?? l' h. v for more detailed guidance.
Compliance Statement:
I have read and understand SL-2009-337 and SL-2011-343 and have, to the best of my
knowledge, complied with their requirements. I understand that participation in the
NCEEP is voluntary.
Please check all that apply:
Applicant is a Federal or State Government Entity or a unit of local government
meeting the requirements set forth in G.S. 143-214.11 (as amended by SL 2011-
343) and is not required to purchase credits from a mitigation bank.
There are no known mitigation banks with the requested credit type located in
the hydrologic unit where this impact will take place (link to QWQ list) y-
it.( 1k _ xi e- 0)! X I have contacted the mitigation bank(s) in the hydrologic unit where the impacts
will occur and credits are not available.
The DWQ or the Corps of Engineers did not approve of the use of a mitigation
bank for the required compensatory mitigation for this project.
Note: It is the applicant's responsibility to document any inquiries made to private
mitigation banks regarding credit availability.
I have read and understand ESP's refund policies (attached)
initial here
Signature of Applicant or Agent
Date
r(/,, ,? Z,rx 7 * ?l
Project Name
C-4) 1-4 f
Printed Name
tlra[r V4;?-I f 7
Location
NORTH CAROLINA ECOSYSTEM ENHANCEMENT PROGRAM, NCEEP
IN-LIEU FEE REQUEST FORM
Re'vfsfd 8+11 1'2011
CONTACT INFORMATION APPLICANT'S AGEN"? APPLICANT
1. Business or Individual Name Mitchell Environmental, P.A. Olde South Homes, Inc.
2. Street Address or P 0 Box P.O. Box 341 3921 Sunset Ridge Rd., Suite 201
3. City, State, Zip Fuquay-Varina, N.C. 27526 Raleigh, N.C. 27607
4. Contact Person Scott Mitchell Mr. Frank Wiesner
5. Telephone Number [phone] [phone]
6. Fax Number (919)557-4 683
7. E-Mail Address (optional) [e-mail]
PROJECT INFORMATION
s. Project Name Belmont Subdivision Lots 70 & 71
9. Project Location (nearest town, city)
-ATTACH MAP ;iHOWiNG !h9P ACT Lf.)`_;AT!r`N -
10. Lat-Long Coordinates (optional) 35.6689N -78.7514W
11. Project County Wake
12. River Basin & Cataloging Unit (8-digit) Neuse 03020201
(See Note 1)
13. Project Type "specify o?,?vner type; a., 'd Government X Private
write in. project type (e.g. schocs, church, retall, residential S/D
residenttai 3u. 3partments. rnadl !Atii tse:s
military, etc')-
14. Riparian Wetland Impact (ac.) (e.g., 0.13) 0.081 + 0.049 (previously permitted) = 0.13
15. Non-Riparian Wetland Impact (ac.)
16. Coastal Marsh Impact (ac.)
17. Stream Impact (ft.) (e.g. 1,234)
18. Riparian Buffer Impact (sq. ft.)
(where applicable)
19. Regulatory Agency Staff Contacts
(indicate names, if known)
20. Other Regulatory ID Information
(e.g., USACE Action ID, if known)
IMPORTANT
_ revision to a current acceptance, or
_ re-submission of an expired acceptance
_ extension of unexpired acceptance
None
None
Warm Cool Cold
None None None
Zone 1: None Zone 2: None
USACE: Jamie Schem DWQ: Ian McMillan
Not known
By signing below, the applicant is confirming they have
read and understand EEP's refund policy posted at
nceep.net.
Signature of plican!,?Authorized Agent:
Date: e ? ? Zo ) i
Note 1: For help in determining the Cataloging Unit, visit: or contact EE
Direct questions to Kelly Williams at 919-716-1921 or ___ _;- or to EEP's front desk at 919-715-0476.
Refund Policv for Fees Paid to EEP's In-Lieu Fee Programs (9/21/2009
Purpose: The purpose of this policy is to make clear the circumstances and process under which a
permittee can obtain a refund while simultaneously balancing customer service and responsible
business practices. This policy applies to all refund requests made on or after the publication date of
this policy.
1. All refund requests must be made in writing to EEP's In-Lieu Fee Program Coordinator at
kelly.williams(aJ_)ncdenr.gov.
2. All refund requests are subject to fund availability. EEP does not guarantee fund availability for
any request.
3. The request must either come from the entity that made the payment or from an authorized agent.
Third parties requesting refunds must provide written authorization from the entity that made the
payment specifying the name and address of the authorized refund recipient.
4. Refund requests related to unintended overpayments, typographical errors or incorrect invoices
should be brought the attention of the In-Lieu Fee Program Coordinator as soon as possible. Such
requests are typically approved without delay.
5. Payments made under EEP's incremental payment procedure are not eligible for refunds.
6. Refund requests made within nine months of payment to EEP will only be considered for requests
associated with projects that have been terminated or modified where the permittee's mitigation
requirements have been reduced. Such requests must be accompanied by written verification from the
permitting agency that the project has been cancelled, the permits have been rescinded or have been
modified, or the mitigation requirements have been reduced.
7. Refund requests made more than nine months from the payment date will only be considered for
permits that were terminated or modified to not require any mitigation. Such requests must be
accompanied by written verification from the permitting agency that the project has been cancelled, the
permits have been rescinded and/or mitigation is no longer required.
8. Refund requests not meeting the criteria specified above are not eligible for a refund.
9. Refund requests that meet the criteria above will be elevated to EEP Senior Management for
review. The following considerations apply to all refund requests:
a. availability of funds after consideration of all existing project and regulatory obligations
b. the date the payment was made
c. the likelihood EEP can use the mitigation procured using the payment to meet other
mitigation requirements
10. Once a refund has been approved, the refund recipient must provide a completed W-9 form to
EEP's In-Lieu fee Program Coordinator within two weeks in order to process the refund though the
State Controller's Office.
11. All decisions shall be final.
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DETERMINED BY THE UNDERSIGNED ON THIS LTATE. UNLESS THERE IS A CHANGE
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