20120408 Ver 1_More Info Received_20120515

Strickland, Bev
From: Homewood, Sue
Sent: Tuesday, May 15, 2012 4:39 PM
To: Strickland, Bev
Subject: FW: Par Drive Culvert
Attachments: PCN package.pdf; 404 permit verification for Par Drive.pdf
LEE
I didn't realize the copy we had is every other page. Can you please put these documents in file 12 -0408 instead of
what's there. Thanks.
Sue Homewood
NC DENR Winston -Salem Regional Office
Division of Water Quality
585 Waughtown Street
Winston - Salem, NC 27107
Voice: (336) 771 -4964
FAX: [phone]
E -mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
disclosed to third parties.
From: Sean Clark [ mai Ito: sclark(a)falconengineers.com]
Sent: Tuesday, May 15, 2012 4:11 PM
To: Homewood, Sue
Subject: RE: Par Drive Culvert
Sue,
I've attached a PDF copy of the PCN as well as a PDF of the 404 (1 know you should have been sent a copy but I also
know that the mail doesn't always make it to the intended recipient). Let me know if you have any questions. Also I will
forward your concerns to the engineer and reiterate the importance.
Thanks
Sean Clark, PWS
Environmental Project Managei
919 -871 -0800
919 -871 -0803
919 -714 -2714
sclark a falconenaineers.com
www.falconenQineers.com
1210 Trinity Road, Suite 1 10', Raleigh, NC 27607
ENGINEERING + INSPECTION +TESTING + AGENCY CM
From: Homewood, Sue [ mailto :sue.homewoodCa)ncdenr.gov]
Sent: Tuesday, May 15, 2012 12:11 PM
To: Sean Clark
Subject: Par Drive Culvert

Sean,
Per our phone conversation, would you please email me an electronic copy of the PCN form, the hardcopy I received
only includes the odd numbered pages.
Also, please ensure that the culvert and stream alignment are carefully reviewed during /after construction so that no
downstream erosion occurs as a result of poor alignment. The General Certification /401 requires that downstream be
protected from secondary impacts that result from the culvert installation.
Sue Homewood
NC DENR Winston -Salem Regional Office
Division of Water Quality
585 Waughtown Street
Winston - Salem, NC 27107
Voice: (336) 771 -4964
FAX: [phone]
E -mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
disclosed to third parties.

U.S. ARMY CORPS OF ENGINEER NY 0 2,f,012
WILMINGTON DISTRICT S
Action ID. 201200700 County: '.111 /r, USGS Quad: Liber
Property Owner / Authorized Agent: Sandy Creek Golf, Inc. / C. Michael Whitehead
Address: 5454 Whites Chapel Road
Ism''
Staley, North Carolina 27355 F
Telephone No.: 336 625-1000
Size and location of property (water body, road name/number ' town, etc.): Sandy Creek Golf course's Par Drive
culvert site located off of Whites Chapel Road, west of Staley, in Randolph County, North Carolina. Property is
11111�1111l�jllili � I i lilli
00 1 1 0 ' •. . . . . I I . , I , . I I I I
M1 I
iurisdictional waters of Mount Pleasant Creek.
Applicable Law: M Section 404 (Clean Water Act, 33 USC 1344)
F1 Section 10 (Rivers and Harbors Act, 33 USC 403)
Authorization: Regional General Permit Number: _
Nationwide Permit Number: NW 29
Date: 05/01/2012
The Wilmington District is committed to providing the highest level of support to the public. To help us ensure we continue to do so,
please complete the attached customer Satisfaction Survey or visit hti.p://www.saw.usace.army.miI/WETLANDS//itidex.11tli)I to
complete the survey online.
rh -- ...

I
D Based on preliminary information, there appear to be waters of the US including wetlands within the above described project area.
This preliminary determination is not an appealable action under the Regulatory Program Administrative Appeal Process
( Reference 33 CFR Part
E] There are Navigable Waters of the United States within the above described project area subject to the permit requirements of
Section 10 of the Rivers and Harbors Act and Section 404 of the Clean Water Act. Unless there is a change in the law or our
published regulations, this determination may be relied upon for a period not to exceed five years from the date of this
notification.
Z There are waters of the US and/or wetlands within the above described project area subject to the permit requirements of Section
404 of the Clean Water Act (CWA)(33 USC § 1344). Unless there is a change in the law or our published regulations, this
determination may be relied upon for a period not to exceed five years from the date of this notification.
El The jurisdictional areas within the above described project area have been identified under a previous action. Pleasereference
jurisdictional determination issued . Action ID
Ill I 9WILS101 11:190 01H 91 ill i E. I Ito] MEMO RVA 0 R •; r I v#§
I It" I ILI I W I I VAI 141 W WAW-Itq
Attached to this verification is an approved jurisdictional determination. If you are not in agreement with that approved jurisdictio
determination, you can make an administrative appeal under 33 CFR 33 1. Enclosed you will find a Notification of Appeal Pro es
(NAP) fact sheet and request for appeal (RFA) form. If you request to appeal this determination you must submit a completed 41
form to the following address:
Attn:Jean Gibby, Project Manager,
Raleigh Regulatory Field Office
t' I
,7
-3331 Heritage Trade Drive, Suite 105
Wake Forest, North Carolina 27587
In order for an RFA to be accepted by the Corps the Corps must determine that it is complete, that it meets the criteria for appeal
7
under 33 CFR part 331.5, and that it has beenreceived by the District Office within 60 days of the date of the NAP. Should you
decide to submit an RFA form, it must be received at the above address by July 1, 2012.
**It is not necessary to submit an RFA fop to the District Off/4if you do not object to the determination in this correspondence."
Corps Regulatory Official:
Date 05/01/2012 1
SURVEY PLATS, FIELD SKETC.
I
ME I I a on LOA 11- 1 a 0 1 MGM TZ91 a 11- 1! • io] I
Copy Furnished:
Sean Clark, Falcon Engineering, Inc., 1210 Trinity Road, Suite 110, Raleigh, NC 27607

April 20, 2012
Falcon Engineering Project # E12018.01
To: US Army Corps of Engineers
Raleigh Regulatory Field Office
Attn: John Thomas
3331 Heritage Trade Drive, Suite 105
Wake Forest, NC 27587
From: Sean Clark
Falcon, Engineering, Inc,
1210 Trinity Road, Suite 1 10
Raleigh, NC 27607
Re: Par Drive Culvert Extension, Randolph County, INC
N.C. Division of Water Quality
401 Oversight and Express Permits Unit
Attn: Ian McMillan
512 North Salisbury St., 9th Floor
Raleigh, NC 27604
On behalf of the owner, Sandy Creek Golf, Inc. (Attn: Mr. C. Michael Whitehead) please find attached a complete application
and supplemental information requesting written concurrence from the U.S. Army Corps of Engineers (USACE) and providing
notification to the N.C. Division of Water Quality (DWQ) that the activities proposed below may proceed under Nationwide Permit
29 and General Water Quality Certifications 3821 . Please contact me at (919) 714 -2714 if you have any questions or require
additional information.
PROJECT SUMMARY
Project Name
Par Drive Culvert Extension
Project Type
Residential Road Improvement
Owner / Applicant
Sandy Creek Golf, Inc.
County
Randolph
Nearest Town
Staley
Waterbody Name
UT to Mount Pleasant Creek
Index Number
17 -16 -3
Class
WS -III
USGS Cataloging Unit
03030003
IMPACT SUMMARY
Wetland Impact (acres):
85
Open Water Impact (acres):
0
Total Impact to Waters of the U.S. (acres)
0
Stream Impact (permanent):
85 LF
Stream Impact (temporary):
40 LF
Total Stream Impact (linear feet):
125 LF
Attachments:
Pre - construction Notification (PCN) Application Form
Agent Authorization Form
USGS Topographic Site Vicinity Map
NRCS Soil Survey Site Vicinity Map
Impact Maps (4 sheets)

�C� AT,hq
- G"'
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 PCN Form
A. Applicant Information
1.
Processing
1a.
Type(s) of approval sought from the
Corps:
!I FORMCHECKBOX 1 Section 404 Permit ❑ Section
10 Permit
1b.
Specify Nationwide Permit (NWP) number: 29 or General Permit (GP) number:
1c.
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
1 h.
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes
® No
2.
Project Information
2a.
Name of project:
Par Drive Culvert extension
2b.
County:
Randolph
2c.
Nearest municipality / town:
Staley
2d.
Subdivision name:
Sandy Creek Golf Club
2e.
NCDOT only, T.I.P. or state
project no:
N/A
3.
Owner Information
3a.
Name(s) on Recorded Deed:
Sandy Creek Golf Inc.
3b.
Deed Book and Page No.
DB 002226, PG 00116
3c.
Responsible Party (for LLC if
applicable):
C. Michael Whitehead
3d.
Street address:
5454 Whites Chapel Road
3e.
City, state, zip:
Staley, NC 27355
3f.
Telephone no.:
(336) 625 -1000
3g.
Fax no.:
3h.
Email address:
cmwhitehead @randolphbank.com
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:
Sean Clark
5b.
Business name
(if applicable):
Falcon Engineering, Inc.
5c.
Street address:
1210 Trinity Road, Suite 110
5d.
City, state, zip:
Raleigh, NC 27607
5e.
Telephone no.:
(919) 871 -0800
5f.
Fax no.:
(919) 871 -0803
5g.
Email address:
SClark @FalconEngineers.com
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):
8714429127
1 b. Site coordinates (in decimal degrees):
Latitude: 35.78975 Longitude: - 79.61766
(DD.DDDDDD) (- DD.DDDDDD)
1 c. Property size:
201.56 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
UT to Mount Pleasant Creek
proposed project:
2b. Water Quality Classification of nearest receiving water:
WS -III
2c. River basin:
Cape Fear River Basin
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 proposed work will include the extension of an existing culvert crossing of an intermittent stream. The Par Drive road
crossing is within the Sandy Creek Golf Course Residential Community. The 18 -hole golf course and it's associated
infrastructure was begun in the early 1990's. Although originally planned for an entire large -lot residential community only
one home exists on this parcel. Sourrounding properties are forested, in agriculture or are residential.
3b. List the total estimated acreage of all existing wetlands on the property:
+/-5
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
There are approximately 6,780 linear feet of stream on the property.
3d. Explain the purpose of the proposed project:
A culverted crossing currently exists in the location of the proposed impacts however the road crossing is not paved and
has steep slopes that do not comply with current NC Dept. of Transportation standards. This crossing was likely installed
in the early to mid 1990's. In order to meet current subdivision roadway standard widths additional culvert length and fill
is required.
3e. Describe the overall project in detail, including the type of equipment to be used:
The project will involve the placement of cement culvert pipe extension pieces on both the inlet and outlet side of the
existing culvert as well as the placement of a dissipation pad on the outlet side of the culvert to reduce high - velocity
energy and reduce downstream errosion. Heavy machinery such as backhoes will be used to complete this work.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
F1 Yes ®No El Unknown
project (including all prior phases) in the past?
Comments:
4b. If the Corps made the jurisdictional determination, what type
El Preliminary ❑ 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.
Page 3 of 11
PCN Form — Version 1.3 December 10, 2008 Version

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.
* * *A search for previously issued approvals and permits was conducted by Mr. John Thomas of the USACE however no
file was found for this property. Based on a review of aerial photography it apprears that the site was developed in the
early 1990's at a time when strream impacts were measured in square footage instead of linear footage and written
approvals were not required for such impacts as those that occurred on the property.
6. Future Project Plans
6a. Is this a phased project?
® Yes ❑ No
6b. If yes, explain.
No additional permits or impacts are proposed to occur with regards to the Par Drive roadway. As stated previously the
residential portion of the Sandy Creek Golf Club has not been completed and additional permitting would likely be
required should there be an unexpected demand for such housing in this region.
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) or
(if known)
DWQ — non -404, other)
(acres)
Temporary T
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: No proposed impacts to wetlands.
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 ®P ❑ T
fill / culvert
UT to Mt. Pleasant
❑ PER
® Corps
1'
85 LF
Creek
® INT
® DWQ
S2 ❑ P ®T
Temporary "fill'
UT to Mt. Pleasant
❑ PER
® Corps
1'
40 LF
Creek
® 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
125 LF
3i. Comments: Temporary impacts listed above are requested as part of the realistic construction process. The temporarily
impacted areas will be returned to original grade after the culvert and dissipater construction has been completed.
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.
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 ❑P ❑T
02 ❑P ❑T
03 ❑P ❑T
04 ❑P ❑T
4f. Total open water impacts
4g. Comments: No proposed impacts to open waters are proposed.
5. Pond or Lake Construction
If pond or lake construction proposed, the complete the chart below.
5a.
5b.
5c.
5d.
5e.
Wetland Impacts (acres)
Stream Impacts (feet)
Upland
Pond ID
Proposed use or purpose
(acres)
number
of pond
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
P2
5f. Total
5g. Comments: No proposed pond construction is requested.
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 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.
❑ 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) or
for
Stream name
mitigation
(square feet)
(square feet)
Temporary (T)
impact
required?
B1 ❑P ❑T
F-1 Yes
❑ No
B2 ❑P ❑T
F-1 Yes
❑ No
B3 ❑P ❑T
F-1 Yes
❑ No
6h. Total buffer impacts
6i. Comments: The project is not within a riparian buffer protected basin.
Page 6 of 11
PCN Form - Version 1.3 December 10, 2008 Version

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
The current plans sought to utilize the existing road location as opposed to adding an additional crossing. The crossing will be
graded and sloped to meet the NCDOT standards for a subdivision road.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
In an effort to keep the surrounding ground as stable as possible, the existing culvert will not be removed and replaced with a
longer culvert but rather additional sections will be placed on either end of the culvert.
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
El Payment to in -lieu fee program
❑ Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank: N/A
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.
N/A
Page 7 of 11
PCN Form — Version 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
❑ Yes ® No
buffer mitigation?
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.
6c.
6d.
6e.
Zone
Reason for impact
Total impact
Multiplier
Required mitigation
(square feet)
(square feet)
Zone 1
N/A
N/A
3 (2 for Catawba)
N/A
Zone 2
N/A
N/A
1.5
N/A
6f. Total buffer mitigation required:
N/A
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).
N/A
6h. Comments: The proposed work is not within a buffered basin.
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.
❑ Yes ❑ No
Comments: N/A
2.
Stormwater Management Plan
2a.
What is the overall percent imperviousness of this project?
13.4%
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 project, subdrainages, as
well as the area adjacent to Par Drive is less than 24% impervious.
2d.
If this project DOES require a Stormwater Management Plan, then provide a brief, narrative
description of the plan:
N/A
❑ 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?
Randolph County
❑ Phase II
❑ NSW
3b.
Which of the following locally - implemented stormwater management programs
❑ 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: N/A
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)
1a. 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)?
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.
Construction of this project began approximately 20 years ago and although planned to have a residential component has
succeeded in only containing one residence. Although the intent of the culvert extension is to provide access to several
home lots, it is not likely that the construction on these lots will result in any additional development that would impact
nearby or downstream water quality.
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.
The future homes will be served by individual septic systems.
Page 10 of 11
PCN Form — Version 1.3 December 10, 2008 Version

5. Endangered Species and Designated Critical Habitat (Corps Requirement) I
5a. Will this project occur in or near an area with federally protected species or
habitat? I El Yes No
5b. Have you checked with the USFWS concerning Endangered Species Act El Yes No
impacts? I I
5c. If yes, indicate the USFWS Field Office you have contacted. ❑ Raleigh
El Asheville
fid. What data sources did you use to determine whether your site would impact Endangered Species or Designated Criti
Habitat? i
lei m1iWtjined bl� tll;�.-'WC �Qrjl X
ISM-714W ZME-7NIM k, RMUTBIZI M IVA I M-71"Ill R&S"'PlIAMMIL-1 -4 K— I owls I M^ ♦ M
16. Essential Fish Habitat (Corps Requirement) I
6a. Will this project occur in or near an area designated as essential fish habitat? I El Yes 0 No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
The South Atlantic Habitat and Ecosystem IS site was used.
• Resources (Corps Requirement) I
7a. Will this project occur in or near an area that the state, federal • tribal
governments have designated as having historic or cultural preservation
status
•r Historic Trust clesignation • properties significant in
I -
North Carolina history and archaeology�?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
SHPO's digital KMZ files were used to determine that there were no historic sites listed in or around the project site.
0 1 Designation (Corps Requirement) I
8a. Will this project occur in a FEMA-designated 100 -year floodplain? ❑ Yes Z No
8b. If yes, explain how project meets FEMA requirements:
Sean Clark
Applicant/Agent's Printed Name Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant
is provided.1 _
Page 11 of 11
PCN Form -- Version 1.3 December 10, 2008 Version

PR0"jECT NAME / DESCRIPTION:
PROPERTY OWNER (PRINTED):
5'm A6 'Ll Cr UIL 60 If , LA (-
OWNER ADDRESS: F0, R v I(6
REVOR
TELEPHONE 10 (9 0
W&I
0
THE UNDERSIGNED, REGISTERED PROPERTY OWNER(S) • THE ABOVE NOTED PROPERTY, D
HEREBY AUTHORIZE
I SEAN CLARK OF FALCON ENGINEERING, INC. TO ACT ON
BEHALF AND TAKE ALL ACTIONS NECESSARY FOR THE PROCESSING, ISSUANCE AN
A,-'-"CEP'fANCE OF THE PERMITOR CERTIFICATION AND ANY AND ALL STANDARD AND SPECI
CONDITIONS ATTACHED. I
NOTICE: THIS AUTHORIZATION, FOR LIABILITY AND PROFESSIONAL COURTESY REASONS, IS
VALID ONLY FOR GOVERNMENT OFFICIALS TO ENTER THE PROPERTY WHEN ACCOMPANIED BY
FALCON STAFF. PLEASE CONTACT THE ABOVE FALCON AGENT TO ARRANGE A SITE MEETING
PRIOR TO VISITING THE SITE.
FALCON JOB #: E12018
www.FalconEngineers.com
R,-jwlrjnrl Roc-id I Raleigh, North Carolina 27615 1 T 919.871.0800 I F 919.871.0803

Va
i P h
jj
wre
k
w
1
r
d {
e ` f "All
"
Par rive Crossing
fI A
a
p
,
{
�t
y
W lo
f {1ffr f
�h
! _ t
af
'i Au
Ll

Project #:
Figure 2
E12018
Par Drive Culvert Extension
(Fairways @ Ferguson Farms)
Project Mgr.:
Sean Clark
Soil Survey Site Vicinity Map
Date: 04 -20 -2012
Randolph County, NC
Scale: NTS
Sandy Creek Golf, Inc.
-�O?A
1210 Trinity Road I Raleigh, North Carolina 27607
T 919.871.0800 1 F 919.871 .0803

n
D
r
m
u
0
0
0
N
V)
m
O
a
INTERMITTENT STREAM
IMPACT MAP
FOR PAR DR.
FAIRWAYS @ FERGUSON FARMS, RANDOLPH CO.
OVERALL SITE VICINITY MAP
w
0
�1
c Ix
�.wnn
V
�cooe(77�
^ys
N
N
O

SqZ
N
O
O
n
D
r
O
m
u
N
O
O
O O
=. O_
O
0
/ I
m
m
z
Z <
O n
z
o
U
D
m a
�i
of
1 �
� O
i
r r
-rl co
o u,
M m
O y
D m
X m
X m
D D
0 0
cnw
=
RAMSEUR
INTERMITTENT
JULIAN RD.
p" S
CC '�
°
,m,-,
Z
I M
P
0
0."
O
®
m zF,s 4s41'1ti4 Vii;
W t
(Q ^ O +� fts �i i4 x�
� -TL
c bi`s
SOAPSTONE
N
O
MOUNTAIN RD.
I-
711
nalNnoo 1HDIaIN
_\as
O A /J
2
�i
of
1 �
� O
i
r r
-rl co
o u,
M m
O y
D m
X m
X m
D D
0 0
cnw
=
INTERMITTENT
STREAM
°
,m,-,
z
I M
PACT MAP
:�=Amn
onz
� R
O
®
(Q ^ O +� fts �i i4 x�
� -TL
iv
FOR PAR DR.
O
=
FAIRWAYS @ FERGUSON FARMS,
RANDOLPH CO.
ewe L�
T
' 1
STREAM
IMPACT MAP KEY SHEET
N
0
r
a
11
v
r
E
a
11
r
a
V
i;

w
0
G) z
� C) rri m
map r r5 �_ X
CD Cl)
n Cn
80 0) cl) D z z
Cn
<m
m cn cn
o -u M m
D m
0 c K
'' TI TI ^
z m� o D D m
0
cn o �To �'�� Dm
C)
^
Z zm I 1+ �D
u'Dm
N N II
0 0 -n v -n
N - ^ oW m
o I (0,
_ m 629
II �
X -4 G)
cn n cn
zz c —lr
Gi r
Ow0 rn n 1+
CTI
R�,4�i c�Z9
9Z9
OZ9
o Q
--4 Z o �
6) m m�
T � Z 1 1.31 n z
CA) z <M —�z
cm C�
cf) -n < cn o 0 0 ,.
o�M
cf) m= rCD I +mm
w � m x � o
�m m � IV rm�
° o� -u °_ �'�° n n C6
„o xo� �>
77 F
77 Z m� Nm�
�C)y n n
E) cn m _ _-j -b
z 0y
cn — m
°
z� mm� m p –• '�
�
z� >�z Z `' n (� rn
p C
��m m� yam Ny
m m g = O ♦_`
W
n n n m
D
00-4
n c� �

w
o_
=gym
mmo�
,
CD
N
0
W
0
Cl) cn
D
0
mm z
O
I� T
(o
2
(D O W
M. O
.� N
n-
C)
C)
0
CD
v♦
z o� mo
�00 m rX� n n
=y �OCn
M m --I O @ ► 5
Z C n n
�rn
m c cl m
< Z z ^ rn —i
��a
>�
O�
00-4
nccn rri