20120340 Ver 1_401 Application_20120412

March 23 2012
NCDENR DWQ
585 Waughtown Street
Winston Salem NC 27107
2050 Northpoint Dnve Suite A
Winston Salem NC 27106
Phone [phone]
Fax [phone]
geosci @geotec com
www geotec com
2®120340
This letter is intended to clarify our plan for stream stabilization required at 460 Creekway Drive
in Winston Salem NC Please refer to our previously submitted plans and PCN in reference to
this letter
This project is intended to repair erosion caused by an unnamed tributary of Little Creek The
erosion has occurred in a stream bend causing the stream bank to incise to near vertical
threatening an existing public sewer line as well as a single family residence
Our intention is to remove the bend which appears to have been caused by fallen trees and
subsequent entangled debris and divert the stream flow away from the sewer and the home
Compacted fill will be placed to replace lost soil and then protected using filter fabric and class I
rip rap As an alternative to rip rap we have provided at the contractor s option the ability to use
geofabric bank reinforcement instead Our calculations show that either option will work
Work will be limited to periods of dry weather to the greatest extent possible A temporary sand
bag coffer dam with pumps sufficient to pump the normal stream flow around the work site will
be provided so that equipment will not be directly in the stream
Please include this letter with our submitted plans and PCN I am sure that the contractor can
keep impacts to the stream minimized while constructing the repairs We will be providing
project testing and oversight throughout the process The risk of a sewer rupture with miles of
potential environmental catastrophic stream impact far exceeds the risk of a small amount of
localized stream impact that can be quickly repaired at the completion of the work and I hope
that this letter will serve to expedite the approval of our plans
If you have any questions please call
Thank you for allowing us to be of service
Sincerely
G cienc & Technoloo P
Joh A Butler
Project Engineer

_I
O�O� wAT �9QG
Office Use Only
Corps action ID no
DWQ project no
Form Version 13 Dec 10 2008
Page 1 of 11
PCN Form — Version 1 3 December 10 2008 Version
Pre - Construction Notification C Form
A Applicant Information
1
Processing
1 a
Type(s) of approval sought from the
Corps
® Section 404 Permit ❑ Section 10 Permit
1 b Specify Nationwide Permit (NWP) number 13 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 m lieu
fee program
El yes ®No
1g
Is the project located in any of NC s twenty coastal counties If yes answer 1h
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
460 Creekway Drive Stream Bank Stabilization
2b
County
Forsyth
2c
Nearest municipality / town
Winston Salem
2d
Subdivision name
NA
2e
NCDOT only T I P or state
project no
OF4
3
Owner Information Wq
k
3a
Name(s) on Recorded Deed
Russell & Janet Roseman iry
3b
Deed Book and Page No
1727 3169
3c
Responsible Party (for LLC if
applicable)
Russell P Roseman &wife Janet S Roseman
3d
Street address
1322 Titania Lane
3e
City state zip
McLean Virginia 22102
3f
Telephone no
703 356 2573
r1DENR
3g
Fax no
WATER QUALITY
3h
Email address
JBSRosebud @aol com a sn 3pwaw Branch
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
John A Butler
5b
Business name
(if applicable)
Geoscience & Technology P A
5c
Street address
2050 Northpoint Drive
5d
City state zip
Winston Salem NC 27106
5e
Telephone no
336 896 1300
5f
Fax no
336 896 1020
5g
Email address
cvi @geotec com
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)
602223
Latitude 36 04 512 Longitude 8019
1 b Site coordinates (in decimal degrees)
01 0
(DD DDDDDD) ( DD DDDDDD)
1c Property size
0 22 acres
2 Surface Waters
2a Name of nearest body of water (stream river etc ) to
Little Creek
proposed project
2b Water Quality Classification of nearest receiving water
C
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 site is approximately 0 22 acres in size Ground cover is approximately 20% impervious Its current use is single
family residential The land uses in the surrounding area are predomominantly residential as well The unnamed stream
runs from north to south and transects the property The stream is deeply incised at the repair location with near vertical
bank heights at the waters edge exceeding 6 feet in height An area in the back yard of the property approximately 230
SF in size has been lost to erosion and the top of bank has migrated to within 17 feet of the house
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
102
3d Explain the purpose of the proposed project
The purpose of this project is to replace yard area lost due to eroded soil and stabdze additional areas of significant bank
erosion before it can threaten an existing sanitary sewer manhole and the house on the property
3e Describe the overall project in detail including the type of equipment to be used
The stream will be realigned to divert the erosive forces of the stream away from the house and an existing sanitary
sewer manhole that is being washed out Land area lost to erosion will be replaced and the stream banks will be armored
to prevent aditional damage This site will require the following equipment trackhoe backhoe walk behind vibratory
roller bobcat/mini excavator
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 pasty
El ®No ❑ Unknown
Comments
4b If the Corps made the jurisdictional determination what type
❑ Preliminary Final
ry ❑
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
this project (including all prior phases) in the past?
❑ Yes ® No ❑ Unknown
5b If yes explain in detail according to help file instructions
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
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 [:IT
❑Yes
El Corps
❑ No
❑ DWQ
W2 ❑ P [IT
❑ 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
(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
Rip Rapor RECP
for Bank
Unnamed
® PER
El INT
® Corps
®pWQ
12 tob tob
77
Stabilization
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
77
31 Comments Impact length measured at existing stream centerline
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 [:1 POT
04 ❑P ❑T
4f Total open water impacts
4g Comments
5 Pond or Lake Construction
If pond or lake construction proposed 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)
51 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 Yadkin Pee
Project is in which protected basin?
Dee
❑ 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
El Yes
❑ No
B2 ❑P❑T
El Yes
❑ No
B3 ❑ P ❑ T
❑ Yes
❑ No
6h Total buffer impacts
61 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
Single equipment access point provided and no additional access points will be allowed Permanent hard reinforcement
determined to be only stable stream reinforcement technique due to existing sod conditions and flows expected Alternative
methods such as root balls considered and determined to be unstable
1 b Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques
Banks will be stabilized as fill is placed Erosion control measures per the plan
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
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 — 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
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 No Change %
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 a repair project No new
development of impervious area
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?
Winston Salem /Forsyth County
® 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)?
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
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
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
N/A
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
El Yes ®No
habitat
5b Have you checked with the USFWS concerning Endangered Species Act
❑ Yes ® No
impacts?
5c If yes indicate the USFWS Field Office you have contacted
E] Raleigh
❑ Asheville
5d What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
Physical observation of the surrounding area heavily developed residential use There is no habitat for the red
cockaded woodpecker or the bog turtle per USFWS website
6 Essential Fish Habitat (Corps Requirement)
6a Will this project occur in or near an area designated as essential fish habitat?
❑ Yes ® No
6b What data sources did you use to determine whether your site would impact Essential Fish Habitat?
This is a class C urban creek There is no essential fish habitat
7 Historic or Prehistoric Cultural Resources (Corps Requirement)
7a Will this project occur in or near an area that the state federal or tribal
governments have designated as having historic or cultural preservation
❑ 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'?
North Carolina State Historic Preservation Office Website NC list of National Historic Register sites and recent
nominations NC Office of State Archaeology website list of archaeological sites
8 Flood Zone Designation (Corps Requirement)
8a Will this project occur in a FEMA designated 100 year floodplain
FNyes ❑ No
8b If yes explain how project meets FEMA requirements This site is not in a designated FEMA floodplain
8c What source(s) did you use to make the floodplain determination? FEMA (FIRM) flood map #3710681500J
John Butler
Geoscience and d Technology PA
U4�i&aL
L1/Z �12-
Applicant/Agent s Printed Name
Date
Applicant/Agent s Signature
(Agents signat re is valid only if an authorization letter from the applicant
is provided )
Page 11 of 11
PCN Form — Version 1 3 December 10 2008 Version

Russell P and Janet Silverman Roseman.
1322 Titama Lane
McLean, Virginia 22102
29 March 2012
Ms Karen Fhggms Supervisor
North Carolina Department of Environment and Natural Resources
Division of Water Quality
1600 Mail Service Center
Raleigh, North Carolina 27699
Ms Higgins
We give authorization to Carl von Isenburg and members of his staff to act as agents for Russell
P Roseman and Janet Silverman Roseman on the stream bank stabilization protect on our
property at 460 Creekway Drive, Winston - Salem, NC
Please do not hesitate to contact us if you have further needs or questions
Thank you
'LA4'ouu�
Janet Silverman Roseman
(1 iL1L
l
Russell P Roseman
cc Carl von Isenbusg

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