20110189 Ver 3_401 Application_20111011

Kimley-Horn
and Associates, Inc.
Transmittal
Date: October 14, 2011 Job Number: 015476140
Project Name: Wal-Mart Store #3036-00 (YanceyviIle, NC)
To: Ian McMillan
401 Oversight/Express Review Permitting Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
We are sending these by
U.S. Mail ® FedEx F] Hand Deliver
Other:
??-0I89 03
Suite 300
2000 South Blvd. Ste. 440
Charlotte, North Carolina
28203
TEL [phone]
FAX [phone]
We are sending you
N Attached
? Shop Drawings
® Other: 404/401
Under separate cover via
E] Prints/Plans ? Samples
uest for Permit Modification
Copies Date No. Description
the following items:
Specifications [-I Change Orders
1 10/14/11 1 404/401 Request for Permit Modification
1 10/14/11 2 Fee Check $240

UENR - WATER QUALI r
t
ftTmus
BRP
These are transmitted as checked below:
For your use E] Approved as submitted Resubmit Copies for approval
As requested Approved as noted ® Submit Copies for distribution
® For review and comment Returned for corrections Return Corrected prints
Remarks: The permit modification request documentation and fee check are per the
instruction of the project manager (Sue Homewood). Please feel free to contact me if you
have any questions: 704-409-1802

dct?
Copy to: file Signed -?-
Chris Tinklenberg, WPIT
Can Kimley-Horn
and Associates, Inc.
October 13, 2011
Mr. Andrew Williams
Raleigh Regulatory Field Office
US Army Corps of Engineers
3331 Heritage Trade Drive, Suite 105
Wake Forest, North Carolina 27587
Ms. Sue Homewood
NC DENR Winston-Salem Regional Office
Division of Water Quality
585 Waughtown Street
Winston-Salem, NC 27107
Re: Request for Permit Modification
404 NWP #39 (SAW-2011-00258) / 401 WQC #3821 (DWQ#11-0189) V'Walmart Store #3036-00 (Yanceyville, NC)
Yanceyville, Caswell County, NC
Dear Mr. Williams and Ms. Homewood:
On behalf of Walmart Real Estate Business Trust, Kimley-Horn and Associates,
Inc. is submitting this request for permit modification from your agencies in
regards to the Section 404 NWP #39 (SAW-2011-00258) and the Section 401
WQC #3821 (DWQ#11-0189) authorizing the construction of the above
referenced retail facility and associated parking lots. The following information
is included as part of this request for permit modification:
• Revised Agent Authorization Letter
• Revised Section 3 of the Pre-Construction Notification Form
• Revised Figure 5 - Impact Area Map (NAIP 2010 Caswell Co. Aerial)
• New Stream Bank Grading and Detail Sheet
In addition to the 105 linear feet of previously authorized permanent impacts, an
additional 13 linear feet of permanent impacts are required to reduce the potential
of stream bank erosion caused by the wet detention basin outlet. A rip-rap
dissipater will be installed below the ordinary high water mark of S 1 to reduce
discharge velocities of the basin outlet. 305 linear feet of temporary impacts are
proposed for stream bank stabilization downstream of the 48" RCP and
extending to the property boundary.
¦
Suite 440
2000 South Boulevard
Charlotte, North Carolina
28203
R k !? ?I L111
1OCT 1

¦
TEL [phone]
FAX [phone]
DENR - WATER QUALITY
WETLANDS AND STORMWATER BRANci
Kirnley-Horn
and Associates, Inc.
Please feel free to contact me at [phone] if you have any questions, or if
additional information is necessary.
Sincerely,
KIMLEY-HORN AND ASSOCIATES, INC.
Chris Tinklenberg, WPIT
Attachments
Cc: Steve Mitchael, Walmart Real Estate Business Trust
Austin Watts, Kimley-Horn and Associates, Inc.
AGENT AUTHORIZATION FORM
Name: Steve Mitchael (Walmart Real Estate Business Trust)
Address: 2001 SE I& Street, Bentonville, AR 72716
Phone: [phone]
Project Name/Description: Wal-Mart Store #3036-00 (Yanceyville. NC)
Date: October 11, 2011
The Department of the Army
U.S. Army Corps of Engineers, Wilmington District
Attention: Andrew Williams
Field Office Raleigh Field Office
Re: Wetland Related Consulting and Permitting
To Whom It May Concern:
I, the current property owner, hereby designate and authorize Kimley-Horn and
Associates, Inc. to act in my/our behalf as my/our agent solely for the purpose of
processing of Section 404 permits and Section 401 Water Quality Certifications
applications and to furnish upon request supplemental information in support of
applications, etc. from this day forward until successful completion of the permitting
process or revocation by the owner. Z-\
Authorized this the (1-*- _ day of 06/Por-iEF, , 20L
k&evw L. Mitchael
Print Property Owner's Name Property Owner's S
CC: Ian McMillan,
N.C. Wetlands Unit
1621 Mail Service Center
Raleigh, N. C. 27699-1621
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a. 2b. 2c. 2d. 2e. 2f.
Wetland impact Type of jurisdiction
number - Type of impact Type of wetland Forested (Corps - 404, 10 Area of impact
Permanent (P) or (if known) DWQ - non-404, other) (acres)
Temporary T
W 1 ? P ? T ? Yes ? Corps
? No ? DWQ
W2 ? PEI T ? Yes ? Corps
? No ? DWQ
W3 ? P ? T ? Yes ? Corps
? No ? DWQ
W4 ? P ? T ? Yes ? Corps
? No ? DWQ
W5 ? P ? T ? Yes ? Corps
? No ? DWQ
W6 ? P ? T ? Yes ? Corps
? No ? DWQ
2g. Total wetland impacts NA
2h. Comments: NA
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a. 3b. 3c. 3d. 3e. 3f. 3g.
Stream impact Type of impact Stream name Perennial Type of jurisdiction Average Impact
number - (PER) or (Corps - 404, 10 stream length
Permanent (P) or intermittent DWQ - non-404, width (linear
Temporary (T) (INT)? other) (feet) feet)
S1-Impact 1 Replace/realign UT to South Fork ® PER ® Corps

® PEI T
48" CMP
Rattlesnake Creek
? INT
? DWQ 5 81
S1-Impact 2 Installation of Rip- UT to South Fork ® PER ® Corps

®P ? T
Rap Dissipater
Rattlesnake Creek
? INT
? DWQ 5 24
S1-Impact 3 Installation of Rip- UT to South Fork ® PER ® Corps

® P ? T
Rap Dissipater
Rattlesnake Creek
? INT
? DWQ 5 13
S1-Impact 4 Installation of
pump around and
UT to South Fork
®PER
®Corps
5
15
El P ® T sand bags Rattlesnake Creek El INT El DWQ

S1-Impact 5 Installation of
impervious stone
UT to South Fork
PER
®Corps
5
20
El P ®T Rattlesnake Creek E] INT ? DWQ
ring
S1-Impact 6
? P ®T
Bank Stabilization UT to South Fork
Rattlesnake Creek ® PER

? INT ® Corps

?DWQ
5
305
S6 ? P ? T ? PER ? Corps
? INT ? DWQ
3h. Total stream and tributary impacts 458
3i. Comments: 118 LF of Permanent Impacts; 35 LF of Temporary Impacts for construction; 305 LF of Bank
Stabilization.
Page 6 of 12
PCN Form - Version 1.3 December 10, 2008 Version
77
V fll
116
>f? S1 UT to South Fork Rattlesnake Creek '
(Perennial RPW) 4
S1-Impact 4 (Temporary) - 15 If
s
Sandbag placement a
and pump around
s•
a
u
,
158
S1-Impact 1 (Permanent) - 81 If X42
Rein stillation/Realignment*??
of 48" CMP
S1-Impact 2 (Permanent) 24 If
....... .. o Installation of Rip-Rap Dissipater
r
f 51-Impact 6 (Temporary) 305 If r
Stream Bank Stabilization
g ?_2rr
S1-Impact 5 (Temporary) 20 If k
Pate ?
Placement of impervious
.. f „
stone ring in stream ?t,?;??'
c ?
Wet Detention
Basin Location o t.
r pie, -
r S1-Impact 3 (Permanent) j. It
Installation of Rip-Rap Dissipater v
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Figure 5 - Impact Area Map (NAIP 2010 Caswell Co. Aerial) Legend:
IJ Project Area Proposed Slormwater Pipe Network
C Proposed 48" CMP Stream Bank Stabiliation (305 LF)
Hom 50 100 ? Proposed Retaining Wall - Surveyed Stream Centerline
and C Assodatm Irc Feet ' N Proposed Site Plan Surveyed Top of Bank
-- Existing 48" CMP I I Proposed Stormwater Inlets/Outlets
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