20120241 Ver 1_401 Application_20120312

�0i 2024 1
CALDWELL SOIL AND WATER CONSERVATION DISTRICT
120 Hospital Avenue NE• Lenoir NC 286455 • [phone]
March 5 2012
NC DWO, 401 /Wetlands Unit
1650 Mail Service Center
Raleigh NC 27699 1650
To Whom It May Concern
Please review the attached PCN form and supporting documents on behalf of Mr Gerald Bolick 3622
Hollywood Ridge Road Lenoir NC 28645
My contact information is included if further information is needed
Sincerely
KLQ, � K ck L, �
Kevin K Clark
District Soil Conservationist Caldwell SWCD
Email kevm clark @nc nacdnet net
Phone [phone]
828 439 9727 ext 3
j1R@LRp§Rj
MAR 6 2012
nANDSANO TORRNIWATER 8Wtj

0 �0� W A T �RQG
201 2024 1
Office Use Only
Corps action ID no
DWQ project no
Form Version 1 3 Dec 10 2008
Page 1 of 11
PCN Form —Version 1 3 December 10 2008 Version
Pre - Construction Notification PC Form
A Applicant Information
1
Processing
ONAIMME LT
la
Type(s) of approval sought from the
Corps
®Section 404 Permit ❑Section 10 Permit
1 b
Specify Nationwide Permit (NWP) number 27 or General Permit (GP) number
1 c
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
[:1401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
le
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
Gerald Bolick Stream Restoration Project
2b
County
Caldwell
2c
Nearest municipality / town
Lenoir
2d
Subdivision name
N/A
2e
NCDOT only T I P or state
project no
3
Owner Information
3a
Name(s) on Recorded Deed
Gerald M Bolick
3b
Deed Book and Page No
BK 1272 PG 222 YR 1999 OL99[RUMIR
n.
3c
Responsible Party (for LLC if
applicable)
Gerald Bolick
3d
Street address
3622 Hollywood Ridge Road
6 2012
3e
City state zip
Lenoir NC 28645 9061
WATER QUALITY
3f
Telephone no
828 758 9265
3g
Fax no
3h
Email address
Page 1 of 11
PCN Form —Version 1 3 December 10 2008 Version

4
Applicant Information (if different from owner)
4a
Applicant is
❑ Agent ❑ Other specify
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
Kevin Clark
5b
Business name
(if applicable)
Caldwell Sod and Water Conservation District
5c
Street address
120 Hospital Avenue NE
5d
City state zip
Lenoir NC 28645
5e
Telephone no
828 758 1111 or 828 439 9727 ext 3
5f
Fax no
828 758 7257
5g
Email address
kevin clark @nc nacdnet net
Page 2 of 11
PCN Form — Version 1 3 December 10 2008 Version

B Project Information and Prior Project History
1 Property Identification
1a Property identification no (tax PIN or parcel ID)
2842534140
lb Site coordinates (in decimal degrees)
Latitude 35 98616 Longitude 81 55039
(DD DDDDDD) (DD DDDDDD)
1c Property size
416 acres
2 Surface Waters
2a Name of nearest body of water (stream river etc ) to
Yadkin River
proposed project
2b Water Quality Classification of nearest receiving water
C Tr
2c River basin
Yadkin Pee Dee
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
The project area is a horse /cattle farm with pasture /hayland on the south side of the stream and meadow /woods on the
north side of the stream The streambanks are fading Vertical banks with sparse vegetation continues to erode during
storm events Animals currently do not have access to the stream for watering or browsing
3b List the total estimated acreage of all existing wetlands on the property
0
3c List the total estimated linear feet of all existing streams (intermittent and perennial) on the property
3 418 linear feet according to the conservation plan map
3d Explain the purpose of the proposed project
The purpose of the project is to stabilize the streambanks and implement a conservation plan to restore woody vegetation
along the stream corridor
3e Describe the overall project in detail including the type of equipment to be used
The project design was furnished by the Division of Sod and Water Conservation Engineer This design will utilize
bioengmeenng techniques for stream restoration Equipment used for the project will be a hydraulic excavator front end
loader backhoe farm tractor and dump truck
4 Jurisdictional Determinations
4a Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past
El Yes ❑ No Unknown
Comments
4b If the Corps made the jurisdictional determination what type
El Preliminary El Final
of determination was made
4c If yes who delineated the jurisdictional areas?
Agency /Consultant Company
Name (if known)
Other
4d If yes list the dates of the Corps jurisdictional determinations or State determinations and attach documentation
5 Project History
5a Have permits or certifications been requested or obtained for
❑ Yes ❑ No Unknown
this project (including all prior phases) in the past?
5b If yes explain in detail according to help file instructions
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
la 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
Page 5 of 11
PCN Form — Version 1 3 December 10 2008 Version
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
Temporary T
(if known)
DWQ —non 404 other)
(acres)
W1 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W2 ❑ P ❑ 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
2h Comments
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
Permanent (P) or
(PER) or
(Corps 404 10
stream
length
Temporary p ry (T)
intermittent
(INT)
DWQ — non -404
width
(linear
feet)
other)
(feet)
S1 ®P ❑ T
Stream bank
shaping
Yadkin River
® PER
[:1 INT
® Corps
® DWQ
55 Wbkf
725
S2 ®P ❑ T
Stream
realignment
Yadkin River
®PER
❑ INT
®Corps
® DWQ
55Wbkf
370
S3 ®P ❑ T
3 J hook Rock
vanes
Yadkin River
® PER
❑ INT
® Corps
® DWQ
55Wbkf
216
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
1 311
1 Comments
Page 5 of 11
PCN Form — Version 1 3 December 10 2008 Version

Page 6 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
4b
4c
4d
4e
Open water
Name of waterbody
impact number —
(if applicable)
Type of impact
Waterbody type
Area of impact (acres)
Permanent (P) or
Temporary T
01 ❑ PEI T
02 ❑P ❑T
03 ❑P ❑T
04 ❑ P ❑T
4f Total open water impacts
4g Comments
5 Pond or Lake Construction
If pond or lake construction ro osed then complete the chart below
5a
5b
5c
5d
5e
Pond ID
Proposed use or purpose
Wetland Impacts (acres)
Stream Impacts (feet)
Upland
number
of pond
(acres)
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
51 Expected pond surface area (acres)
5j Size of pond watershed (acres)
5k Method of construction
6 Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer then complete the chart below If yes then individually list all buffer impacts
below If any impacts require mitigation then you MUST fill out Section D of this form
6a
[:1 Neuse El Pamlico Other
Project is in which protected basin?
❑ Catawba ❑ Randleman
El
6b
6c
6d
6e
6f
6g
Buffer impact
number —
Permanent (P) or
Reason
for
Stream name
Buffer
mitigation
Zone 1 impact
(square feet)
Zone 2 impact
(square feet)
Temporary T
impact
required?
B1 ❑P ❑T
El Yes
❑ No
B2 ❑P ❑T
El Yes
❑ No
B3 ❑P ❑T
E3 Yes
❑ No
6h Total buffer impacts
6i Comments
Page 6 of 11
PCN Form —Version 1 3 December 10 2008 Version

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
The work consist of reconstructing the stream channel on approximately 370 of stream The new channel will be built in the
dry The majority of the work will be bank shaping with the exception of three in stream rock structures 2 immediately
downstream of the new stream alignment and one near the NE corner of the property
1 b Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques
All graded areas will be seeded The new streambank profile will be protected by erosion control matting while vegetation is
being established Woody plants (livestakes and /or rooted seedlings) will be a vital part of the final stabilization
2 Compensatory Mitigation for Impacts to Waters of the U S or Waters of the State
2a Does the project require Compensatory Mitigation for
impacts to Waters of the U S or Waters of the State?
❑ Yes ® 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 Complete if Using a Mitigation Bank
3a Name of Mitigation Bank
3b Credits Purchased (attach receipt and letter)
Type
Quantity
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
acres
4f Non riparian wetland mitigation requested
acres
4g Coastal (tidal) wetland mitigation requested
acres
4h Comments
5 Complete if Using a Permittee Responsible Mitigation Plan
5a If using a permittee responsible mitigation plan provide a description of the proposed mitigation plan
Page 7 of 11
PCN Form — Vernon 1 3 December 10 2008 Version

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
la
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
❑ Yes ❑ No
Comments
2
Stormwater Management Plan
2a
What is the overall percent imperviousness of this project?
0%
2b
Does this project require a Stormwater Management Plan?
❑ Yes ® No
2c
if this project DOES NOT require a Stormwater Management Plan explain why This is on agricultural land
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?
❑ DWQ Stormwater Program
❑ DWQ 401 Unit
3
Certified Local Government Stormwater Review
3a
In which local government s jurisdiction is this project?
❑ Phase II
3b
Which of the following locally implemented stormwater management programs
❑ NSW
❑ USMP
apply (check all that apply)
❑ Water Supply Watershed
❑ Other
3c
Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ❑ No
attached?
4
DWQ Stormwater Program Review
❑ Coastal counties
❑ HQW
4a
Which of the following state implemented stormwater management programs apply
❑ ORW
(check all that apply)
❑ Session Law 2006 246
❑ Other
4b
Has the approved Stormwater Management Plan with proof of approval been
attached?
❑ Yes ❑ No
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)
la
Does the project involve an expenditure of public (federal /state /local) funds or the
® Yes
❑ No
use of public (federal /state) land?
lb
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
letter)
❑ Yes
❑ No
Comments
2
Violations (DWQ Requirement)
2a
Is the site in violation of DWQ Wetland Rules (15A NCAC 2H 0500) Isolated
Wetland Rules (15A NCAC 2H 1300) DWQ Surface Water or Wetland Standards
❑ Yes
® No
or Riparian Buffer Rules (15A NCAC 2B 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 (DWQ 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
This work is on agricultural land No new impervious surfaces are planned
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
No wastewater being generated
Page 10 of 11
PCN Form — Version 1 3 December 10 2008 Version

6 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
❑ Raleigh
® 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 Workroom
6 Essential Fish Habitat (Corps Requirement)
6a Will this project occur in or near an area designated as essential fish habitat?
F_1 Yes ® No
6b What data sources did you use to determine whether your site would impact Essential Fish Habitat?
NOAA Essential Fish Habitat Mapper
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
El Yes No
North Carolina history and archaeology)?
7b What data sources did you use to determine whether your site would impact historic or archeological resources?
Request for Cultural Review CRS NRCS 1835 Assembley Street Room 950 Columbia SC 29201 Trip report =
11/8/11
8 Flood Zone Designation (Corps Requirement)
8a Will this project occur in a FEMA designated 100 year floodplain?
®Y es ® No
8b If yes explain how project meets FEMA requirements The project will stabilize the stream banks and add correct
dimension and profile back to the channel
8c What source(s) did you use to make the floodplain determination? NC Floodplain Mapping Program
Gerald Bolick
Applicant/Agent s Signature
Applicant/Agent s Printed Name
Date
(Agents signature is valid only d an authorization letter from the applicant
is rovided
Page 11 of 11
PCN Form — Version 1 3 December 10 2008 Version

Driving Directions from 120 Hospital Ave NE Lenoir North Carolina 28645 to 3622 Hol Page 2 of 2
Total Travel Estimate 6 55 miles about 9 minutes
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content road conditions or route usability You assume all nsk of use View Terms of Use
http / /www mapquest com /print ?a =app core e I 9bdd56301449d4ade72330 12/6/2011

Driving Directions from 120 Hospital Ave NE Lenoir North Carolina 28645 to 3622 Hol Page 1 of 2
� ® � Notes
+6 a >
Trip to
3622 Hollywood Ridge Rd
Lenoir NC 28645 9061
6 55 miles
9 minutes
120 Hospital Ave NE Miles Per Miles
Lenoir NC 28645 4416 Section Driven
C 1 Start out going southwest on Hospital Ave NE toward Blowing Go 0 2 Mi 0 2 mi
Rock Blvd / US 321
2 Take the 1 st right onto Blowing Rock Blvd / US 321 N
OW If you are on Hospital Ave NW and reach Woodland PI NW you ve gone a little too far
3 Turn right onto NC 268 / Charles A Suddreth Memorial Hwy
NC 268 is 01 miles past Wistena Way
http / /www mapquest com/prmt ?a =app core eI9bdd56301449d4ade72330
Go52Mi
if you reach Flatwood Rd you ve gone about 0 4 miles too far
Go05Mi
4 Turn sharp right onto Hollywood Ridge Rd
Go06Mi
Hollywood Ridge Rd is 0 1 miles past Tranquil Hills Dr
If you reach Windswept P1 you ve gone about 0 4 miles too far
65mi
5 3622 HOLLYWOOD RIDGE RD is on the left
If you reach Walsh Rd you ve gone about 0 7 miles too far
3622 Hollywood Ridge Rd
Lenoir NC 28645 9061
http / /www mapquest com/prmt ?a =app core eI9bdd56301449d4ade72330
Go52Mi
54mi
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12/6/2011

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Name LENOIR Location 035 58 43 8 N 081 33 017 W
Date 7/28/111 Caption Gerald Bolick
Scale 1 inch equals 2000 feet NCACSP
Streambank and Shoreline Protection

Conservation Plan Map Date: 5/19/2011
Customer(s): GERALD BOLICK Field Office: LENOIR PROGRAM DELIVERY POINT
Agency: Caldwell Soil and Water Conservation District
District: GALDWELL COUNTY SOIL &WATER CONSERVATION DISTRICT Assisted By: Kevin Clark
Approximate Acres: 41.6
11
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