20051661 Ver 2_401 Application_20070629

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E1~tVIRC1NME1N7~L, INC.
Land Planning Permitting Environmental Consulting Construction Management Expert Testimony
Date
5/26/2007
LETTER OF TRANSMITTAL ~~~~Qv/ ~D
JUN 2 9 2007
Name: DENR -Division of Water Quality
Company Name: DENR -Division of Water Quality
From: Will Ratcliffe
WE ARE SENDING YOU:
Attached
wEnaros~uo~
RE: Churchill Community Greenways Project
SEI #: 200409012
Under Separate Cover via
Shop Drawings Specifications
x Letters Change Order
x Reports Computer Disk
Invoices
Reproducibles
Samples
COPIES DATE DESCRIPTION
1
1 6/25/2007
6/25/2006 PCN Cover Letter, Churchill Community PCN
THESE ARE TRANSMITTED as checked below:
x For Approval
For Your Use
As Requested
For Review & Comment
Approved as Submitted
Approved as Noted
Return for Corrections
FOR BIDS DUE
Resubmit Copies for Approval
Submit Copies for Distribution
Return Corrected Prints
Other
Please call the number below if you have any questions.
SIGNED: ~____~-~c~-• ~ CC:
Will Ratcliffe, Project Environm dentist
224 Fayetteville Street Suite 400 P.O. Box 387 Raleigh, N.C. 27602 tel [phone] fax [phone]
3961-B Market Street Wilmington, N.C. 28403 tel [phone] fax [phone]-SPANGLER www.spanglerenvironmental.com

~P'Al~ta:LEF~
ENVIRONMENTAL, INC.
Land Platmulg Permitting Environmental Consulting Construction Management Expert Testimony
June 25, 2007
NC Department of Natural Resources
Raleigh Regional Office
1628 Mail Service Center
Raleigh, NC 27699-1628
Re: Churchill Community Greenways Project
SEI Project # 200409012
To Whom It May Concern:

Spangler Environmental, Inc. (SEI) on behalf of Crosland Company proposes to construct a
Greenway Trail in the existing Churchill Community in Knightdale, Wake County, NC. The
Greenway Trail will enter Zone 2 of the Neuse Buffer regulated area. According to regulation
15A NCAC 2B .0233 (6) Greenway Trails are an allowable use within the Neuse Buffer Zone.
There are no other alternative layouts for the Greenway Trail. The residential development that
the trail goes through is already constructed, limiting the land available for construction and
alternative design layouts. The Greenway Trail is designed to connect to existing Greenway
Trails in other developments. The design layout for this trail allows for the connection to the
existing trails, while minimizing its size and thus, site disturbance. All BMP's will be utilized in
order to minimize disturbance, preserve aquatic life habitat, and protect water quality, such as
crush and run stone for trail surface within the affected Zone 2 areas to allow for permeability,
and preservation of large trees by a specific meandering trail design.
Please see the Pre-Construction Notification that accompanies this letter for further details.
Feel free to call me if you have any questions at 919-547-0754.
Regards,
SPANGLER ENVIRONMENTAL, INC.
Will Ratcliffe, Environmental Scientist
Attachments: Neuse Buffer Impact PCN
224 Fayetteville Street Mall, Suite 400 P.O. Box 387 Raleigh, N.C. 27602 tel [phone] fax [phone]
3961-B Market Street Wilmington, N.C. 28403 te1910-343-9375 fax [phone]-SPANGLER wwwspanglerenvironmental.com

Office Use Only: w U Form Version March 05
JUN 2 9 2007
USACE Action ID No. DWO No. ~5 - I Lo l0 1 V' z
(If any particular item is not applicable to this projec~g ~~le" or "N/A".)
I. Processing
1. Check all of the approval(s) requested for this project:
^ Section 404 Permit ® Riparian or Watershed Buffer Rules
^ Section 10 Permit ^ Isolated Wetland Permit from DWQ
^ 401 Water Quality Certification ^ Express 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested:
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 Ecosystem Enhancement Program (NCEEP) is proposed
for mitigation of impacts, attach the acceptance letter from NCEEP, complete section VIII,
and check here: ^
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: ^
II. Applicant Information
1. Owner/Applicant Information
Name: Crosland Company
Mailing Address:
4000 West Chase Blvd. Suite 390
Raleigh NC, 27607
Telephone Number: 919-754-8990 Fax Number:919-754-8995
E-mail Address: ewaddill(c~crosland.com
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:Span~ler Environmental. Inc.
Company Affiliation:
Mailing Address: 224 Fayetteville Street Suite 400 Raleigh NC 27601
Telephone Number: 919-546-0754 Fax Number: 919-546-0757
E-mail Address: wratcliffe(a~span~lerenvironmental com
Page 5 of 5

III. 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 map
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 NRCS 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
USAGE requires information to be submitted on sheets no larger than 11 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: Churchill Community Greenways Project
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN):
4. Location
County: Wake Nearest Town:_ Kni~htdale
Subdivision name (include phase/lot number): Churchill Community
Directions to site (include road numbers/names, landmarks, etc.): Interstate 440 to Interstate
64 East, turn right onto Hodge Road turn left on Old Faison Road cross East Wake
Expressway, site it approximately 700 feet north of Old Faison Road
Site coordinates (For linear projects, such as a road or utility line, attach a sheet that
separately lists the coordinates for each crossing of a distinct waterbody.)
Decimal Degrees (6 digits minimum): 35deg, 46.809sec °N 78deg, 30.218 sec°W
6. Property size (acres): 188.85 Acres
7. Name of nearest receiving body of water: Mango Creek
8. River Basin: Neuse River Basin
(Note -this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at ht~%'112o.enr.statc.nc.us'ac{~~lin%m~.)
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 site is an existing residential development
Page 6 of 6

10. Describe the overall project in detail, including the type of equipment to be used:
The proiect will construct a Greenway Trail in the development connecting to existing
Greenwav Trails. Minor construction equipment will be used including Bobcats etc
11. Explain the purpose of the proposed work: The purpose is to construct a Greenwav Trail in
the existing Churchill Communty Development.
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.(ACOE General Permit, Action ID 200520199 1/5/OS) (DWQ PCN for
Nationwide 12 dated 10-18-04), (DWQ PCN Nationwide 39 dated 8-23-OS) Copies are attached
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.
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. Each impact must be
listed separately in the tables below (e.g., culvert installation should be listed separately from
riprap dissipater pads). Be sure to indicate if an impact is temporary. All proposed impacts,
permanent and temporary, must be listed, and must be labeled and clearly identifiable on an
accompanying site plan. All wetlands and waters, and all streams (intermittent and perennial)
should 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
Page 7 of 7

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.
1. Provide a written description of the proposed impacts: N/A
2. Individually list wetland impacts. Types of impacts include, but are not limited to
mechanized clearing, grading, fill, excavation, flooding, ditching/drainage, etc. For dams,
separately list impacts due to both structure and flooding.
Wetland Impact
Site Number
(indicate on map)
Type of Impact Type of Wetland
(e.g., forested, marsh,
herbaceous, bog, etc.) Located within
100-year
Floodplain
( eslno) Distance to
Nearest
Stream
(linear feet) Area of
Impact
(acres)

Total Wetland Impact (acres)
3. List the total acreage (estimated) of all existing wetlands on the property:
4. Individually list all intermittent and perennial stream impacts. Be sure to identify temporary
impacts. Stream impacts include, but are not limited to placement of fill or culverts, dam
construction, flooding, relocation, stabilization activities (e.g., cement walls, rip-rap, crib
walls, gabions, etc.), excavation, ditching/straightening, etc. If stream relocation is proposed,
plans and profiles showing the linear footprint for both the original and relocated streams
must be included. To calculate acreage, multiply leneth X width_ then divide by 4'~Sf~
Stream Impact
Number
(indicate on ma)
Stream Name
Type of Impact Perennial or
Intermittent? Average
Stream Width
Before Im act Impact
Length
(linear feet) Area of
Impact
(acres)

Total Stream Impact (by length and acreage)
Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.). Open water impacts include, but are not limited to
fill, excavation, dredging, flooding, drainage, bulkheads, etc.
Open Water Impact ~ Name of Waterbody ~ Type of Impact Type of Waterbody Area of
Page 8 of 8

Site Number
(indicate on ma) (if applicable) (lake, pond, estuary, sound, bay,
ocean, etc. Impact
acres)

Total Open Water Impact (acres)
6. List the cumulative impact to all Waters of the U.S. resulting from the nroiect:
Stream Impact (acres):
Wetland Impact (acres):
Open Water Impact (acres):
Total Impact to Waters of the U.S. (acres)
Total Stream Impact (linear feet):
7. Isolated Waters
Do any isolated waters exist on the property? ^ Yes ^ No
Describe all impacts to isolated waters, and include the type of water (wetland or stream) and
the size of the proposed impact (acres or linear feet). Please note that this section only
applies to waters that have specifically been determined to be isolated by the USACE.
8. 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 application.
Pond to be created in (check all that apply): ^ uplands ^ stream ^ wetlands
Describe the method of construction (e.g., dam/embankment, excavation, installation of
draw-down valve or spillway, etc.):
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.):
Current land use in the vicinity of the pond:
Size of watershed draining to pond:
Expected pond surface area:
VII. Impact Justification (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.
See attached Letter
Page 9 of 9

VIII. 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.
USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on January 15, 2002, 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 NCEEP 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
http:; %h2o.enr.state.nc;.u~inc~tietla~lcl~; strri~idc.hti~~l.
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 (acreage/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.
2. Mitigation may also be made by payment into the North Carolina Ecosystem Enhancement
Program (NCEEP). Please note it is the applicant's responsibility to contact the NCEEP at
[phone] to determine availability, and written approval from the NCEEP indicating
that they are will to accept payment for the mitigation must be attached to this form. For
additional information regarding the application process for the NCEEP, check the NCEEP
website at http:'%1~2c~.enr.state.nc.us/wrp%index.htm. If use of the NCEEP is proposed, please
check the appropriate box on page five and provide the following information:
Amount of stream mitigation requested (linear feet):
Page ] 0 of 10

IX.
X.
Amount of buffer mitigation requested (square feet):
Amount of Riparian wetland mitigation requested (acres):
Amount of Non-riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres):
Environmental Documentation (required by DWQ)
1. Does the project involve an expenditure of public (federal/state/local) funds or the use of
public (federal/state) land? Yes ^ No
2. 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 aNEPA/SEPA document is required, call the SEPA
coordinator at [phone] to review current thresholds for environmental documentation.
Yes ^ No
3. 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 ^
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.
1. Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 02B .0243 (Catawba) 15A NCAC
2B .0250 (Randleman Rules and Water Supply Buffer Requirements), or other (please
identify Meuse Buffer Rules )? Yes ® No ^
2. If "yes", 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 multi>Jliers.

Zone* Im act
(s uare feet)
Multiplier
Mitquadon
I 3 (2 for Catawba)
2 1 I ,000 1.5 N/A
Total 11,000 N/A
* Zone 1 extends out 30 feet perpendicular from the top of the near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.
Page 11 of 1 l

3. If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e.,
Donation of Property, Riparian Buffer Restoration /Enhancement, or Payment into the
Riparian Buffer Restoration Fund). Please attach all appropriate information as identified
within I SA NCAC 2B .0242 or .0244, or .0260. N/A
XI. Stormwater (required by DWQ)
Describe impervious acreage (existing and proposed) versus total acreage on the site. Discuss
Stormwater controls proposed in order to protect surface waters and wetlands downstream from
the property. If percent impervious surface exceeds 20%, please provide calculations
demonstrating total proposed impervious level.N/A
XII. Sewage Disposal (required by DWQ)
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.
XIII. 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 anafter-the-fact permit application? Yes ^ No
XIV. Cumulative Impacts (required by DWQ)
Will this project (based on past and reasonably anticipated future impacts) result in additional
development, which could impact nearby downstream water quality? Yes ^ No
If yes, please submit a qualitative or quantitative cumulative impact analysis in accordance with
the most recent North Carolina Division of Water Quality policy posted on our website at
http:%/h?o.enr 5tzite.~~~ pis%r~~~~~etlands. If no, please provide a short narrative description:
XV. 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).
Page 12 of 12

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(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 13 of 13

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U.S. ARMY CORPS OF ENGINEERS ~~~~~- '---°r'
WILMINGTON DISTRICT RECEIVED
Action ID: 200520199 County: Wake
GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION
Property Owner: Crosland, Inc.
Attn: Jim Anderson
Mailing Address: 400 Westchase Boulevard
Raleigh, North Carolina 27607
Authorized Agent: Spangler Environmental, Inc.
Mailing Address: 224 Fayetteville Street Mall, Suite 400
Raleigh, North Carolina 27602
Telephone No.: [phone]
Telephone No.: [phone]
~. i
APR 2 ~ 2004
Location of property (road name/number, town, etc.): The project area is located on Faison Road, east of its
intersection with Hodge Road, west of Knightdale, Wake County, North Carolina.
Site Coordinates: 35.7860666 °N 78.506933 °VV
Waterway: Mango Creek
USGS Quad: Raleigh East
River Basin: Neuse HUC: 03020201
Description of projects area and activity (see page 2 for a summary of authorized impacts): This project authorizes the
placement of fill for the extensions of a sanitary sewer line.
Applicable Law: ®Section 404 (Clean Water Act, 33 USC 1344)
^ Section 10 (Rivers and Harbors Act, 33 USC 403)
Authorization: Nationwide or Regional General Permit Number(s): 12
Your work is authorized by the above referenced permit provided it is accomplished in strict accordance with the attached
conditions and your submitted plans. Any violation of the attached conditions or deviation from your submitted plans may subject the
permittee to a stop work order, a restoration order and/or appropriate legal action.
This verification will remain valid until the expiration date identified below unless the nationwide authorization is modified,
suspended or revoked. If, prior to the expiration date identified below, the nationwide permit authorization is reissued and/or
modified, this verification will remain valid until the expiration date identified below, provided it complies with all requirements of
the modified nationwide perrrut. If the nationwide permit authorization expues or is suspended, revoked, or is modified, such that the
activity would no longer comply with the terms and conditions of the nationwide permit, activities which have commenced (i.e., are
under construction) or are under contract to commence in reliance upon the nationwide permit, will remain authorized provided the
activity is completed within twelve months of the date of the nationwide permit's expiration, modification or revocation, unless
discretionary authority has been exercised on a case-by-case basis to modify, suspend or revoke the authorization.
Activities subject to Section 404 (as indicated above) may also require an individual Section 401 Water Quality Certification. You
should contact the NC Division of Water Quality (telephone [phone]) to determine Section 401 requirements.
For activities occurring within the twenty coastal counties subject to regulation under the Coastal Area Management Act (CAMA),
prior to beginning work you must contact the N.C. Division of Coastal Management .
This Department of the Army verification does not relieve the permittee of the responsibility to obtain any other required Federal,
State or local approvals/permits.
If there are any questions regarding this verification, any of the conditions of the Pemtit, or the Cotps of Engineers regulatory
program, please contact Andrea Wade at telephone [phone], ext 31.
Corps Regulatory Officia ,...~~ Date: 01/05/2005 Verification Expiration Date: 01/05/2007
Copy Furnished: Areas on this site exhibit wetland criteria as described in the 1987 Corps Wetland Delineation
Manual and are adjacent to Mango Creek. The property also contains a stream channel that exhibits an Ordinary
High Water Mark as indicated by changes in soil character and absence or terrestrial vegetation and is
hydrologically connected to the Neuse River and the Atlantic Ocean.
Page 1 of 2

Determination of Jurisdiction:
^ Based on preliminary information, there appear to be waters of the U S 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 331).
^ 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.
® 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 maybe relied upon for a period not to exceed five years from the date of this notification.
^ The jurisdictional areas within the above described project area have been identified under a previous action. Please reference the
jurisdictional determination issued on (Action ID: ).
Basis of Jurisdictional Determination:
Corps Regulatory Official ~ ~ Date: 01!05%2005 Determination Expiration Date: 01/05/2010
Summar of Authorized Im acts and Re uired Miti ation
Action ID NWP / GP O en Water (ac ~ Wetland ac) Unim ortant Steam (lf) Im ortant Stream (lf)
# # Temporary Permanent Temporary Permanent Temporary Permanent Temporary Permanent
200520199 12 .035 i 40

i
~ ~
Im act Totals 0 0 35 0 0 0 40 0
Total Loss of Waters of the U.S. (ac) ~ 0 Total Loss of Waters of the U.S. (1 0
Re uired Wetland Miti ation (ac) 0 Re uired Stream Miti ation (lf) 0
Additional Remarks and/or Special Permit Conditions:
Page 2 of 2

y,.
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A
pplicant: Crosland, Inc. Attn: Jim File Number: 200520199 Date: 01/05/2005
Anderson
Attached is: See Section below
INITIAL PROFFERED PERMIT (Standard Permit or Letter of A
ermission) ~
PROFFERED PERMIT (Standard Permit or Letter of ermission) B
PERMIT DENIAL C
X APPROVED JURISDICTIONAL DETERMINATION D
PRELIMINARY JURISDICTIONAL DETERMINATION E
SECTTONI`=`"T e follo«T%ng~ident~`es yourrighfs-`arid options`regarding an admistrative`appea~ of the aba;ti e
decision. Additional'informationmay be found at http:/i«~u~w.usace,army.mil/inei/functions/cw/ceewo/reg'or
Co s rc ulatioiis at 33 CFR Part 331. ''
A: INITIAL PROFFERED PERMIT: You may accept or object to the permit.
• ACCEPT: If you received a Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your signature
on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all rights to appeal the
permit, including its terms and conditions, and approved jurisdictional determinations associated with the permit.
• OBJECT: If you object to the permit (Standard or LOP) because of certain terms and conditions therein
you may request that the
,
permit be modified accordingly. You must complete Section II of this form and return the form to the district engineer. Your
objections must be received by the district engineer within 60 days of the date of this notice, or you will forfeit your right to appeal
the permit in the future. Upon receipt of your letter, the district engineer will evaluate your objections and may: (a) modify the
permit to address all of your concerns, (b) modify the permit to address some of your objections, or (c) not modify the permit
having determined that the permit should be issued as previously written. After evaluating your objections, the district engineer
will send you a proffered permit for your reconsideration, as indicated in Section B below.
B: PROFFERED PERMIT: You may accept or appeal the permit
• ACCEPT: If you received a Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your signature
on the Standard Pernvt or acceptance of the LOP means that you accept the permit in its entirety, and waive all rights to appeal the
permit, including its terms and conditions, and approved jurisdictional determinations associated with the permit.
• APPEAL: If you choose to decline the proffered permit (Standard or LOP) because of certain terms and condirions therein, you
may appeal the declined permit under the Corps of Engineers Administrative Appeal Process by completing Section II of this form
and sending the form to the division engineer. This form must be received by the division engineer within 60 days of the date of
this notice.
C: PERMIT DENIAL: You may appeal the denial of a permit under the Corps of Engineers Administrative Appeal Process by
completing Section II of this form and sending the form to the division engineer. This form must be received by the division engineer
within 60 days of the date of this notice.
D: APPROVED JURISDICTIONAL DETERMINATION: You may accept or appeal the approved JD or
provide new information.
• ACCEPT: You do not need to notify the Corps to accept an approved JD. Failure to notify the Corps within 60 days of the date of
this notice, means that you accept the approved JD in its entirety, and waive all rights to appeal the approved JD.
• APPEAL: If you disagree with the approved JD, you may appeal the approved JD under the Corps of Engineers Administrative
Appea] Process by completing Section II of this form and sending the form to the division engineer. This form must be received by
the division engineer within 60 days of the date of this notice.

E: PRELIMINARY JURISDICTIONAL DETERMINATION: You do not need to respond to the Corps
regarding the preliminary JD. The Preliminary JD is not appealable. If you wish, you may request an approved
JD (which maybe appealed), by contacting the Corps district for further instruction. Also you may provide new
information for further consideration by the Corps to reevaluate the JD.
SECTION`II =-RE UEST FOR APPEAL'or OBJECTIONS TO ~' INITIAL PROFFERED PERMIT ~~
REASONS FOR APPEAL OR OBJECTIONS: (Describe your reasons for appealing the decision or your
objections to an initial proffered permit in clear concise statements. You may attach additional information to
this form to clarify where your reasons or objections are addressed in the administrative record.)
ADDITIONAL INFORMATION: The appeal is limited to a review of the administrative record, the Corps
memorandum for the record of the appeal conference or meeting, and any supplemental information that the
review officer has determined is needed to clarify the administrative record. Neither the appellant nor the Corps
may add new information or analyses to the record. However, you may provide additional information to clarify
the location of information that is already in the administrative record.
'POINT OF`CONTACT'FOR UESTIONS OR INFORMATION:
If you have questions regarding this decision If you only have questions regarding the appeal process you
and/or the appeal process you may contact: may also contact:
Andrea Wade Mr. Michael Bell, Administrative Appeal Review Officer
Raleigh Regulatory Field Office CESAD-ET-CO-R
US Army Corps of Engineers U.S. Army Corps of Engineers, South Atlantic Division
6508 Falls of the Neuse Road, Suite 120 60 Forsyth Street, Room 9M15
Ralei h, North Carolina 27615 Atlanta, Georgia 30303-8801
RIGHT OF ENTRY: Your signature below grants the right of entry to Corps of Engineers personnel, and any
government consultants, to conduct investigations of the project site during the course of the appeal process. You
will be provided a 15 day notice of any site investigation, and will have the opportunity to participate in all site
investigations.
,~ Date: Telephone number:
Signature of appellant or agent. I
ll1V1J1V1V L~1V(illV~L~'K:
Commander
U.S. Army Engineer Division, South Atlantic
60 Forsyth Street, Room 9M15
Atlanta, Georgia 30303-3490

~rnN ' nt>Cl .~rrlTMln/Arn,...
Office Use Only: Form Version May 2002
USACE Action ID No. DWQ No.
(tf any particular item is not applicable to this project. please enter "Not Applicable" or "N!A".)
I. Processing
1. Check all of the approval(s) requested for this project:
^ Section 404 Permit ~ Riparian or Watershed Buffer Rules
^ Section 10 Perniit ^ Isolated Wetland Permit from DWQ
^ 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested: Nationwide 39
~. tf this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: ^X
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: ^
II. Applicant Information
Owner/Applicant Information
Name: Crosland, Inc.
Mailing Address: Edmund Waddill
Crosland, Inc.
4000 Westchase Blvd, Suite 390
Raleigh North Caro_li_na 27607
Telephone Number: 754-8990 Fax Number: 754-8995
E-mail Address: ewaddill~crosland.com
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: Jim Spangler y
Company Affiliation: Spangler Environmental Inc.
Mailing Address:_ 224 Fayetteville Street Mall Suite 400
_ Raleigh, NC 27601
Telephone Number: 919-546-0754 Fax Number: 919-546-0757
E-mail Address: jspangler~~r7spanglerenvironmental.com
Pa~~e 5 of 12

during rain events. This drainage has been confirmed NOT to be subject to Neuse Buffer
Rules by DWQ-RRO on June 15 ?004 (NBRRO 04-191).
9. Describe the overall project in detail, including the type of equipment to be used:
Mechanical equipment to be used for establishint; grading contours, clearing vegetation
mstalling utility lines, and installing storm water and roadway infrastructure
i 0. Explain the purpose of the proposed work: The purpose of the proposed work is to develop
the subject property into amulti-home residential neighborhood. The proposed impacts and
will allow for the installation of storm water infrastructure.
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 USAGE 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.
Jurisdictional determination: Action ID # 20042 1 1 34. NWP 12: Action ID# 200520199. Neuse
Buffer consistency determination made by DW RRO on June 15, 2004 (NBRRO 04-191)
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.
No future permits are anticipated for this project.
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. Ali wetlands 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.
l . Provide a written description of the proposed impacts: Impact 1 includes the discharge of fill
material into 0.015 acres of wetland in order- to grade and install storm water infrastructure
Page 7 of 12

east of proposed lots 228 and 229 (Figure 2) Impact 2 includes the discharge of fill into 105
linear feet of non-significant ephemeral/intermittent stream also for the purpose of installing
stormwater infrastructure (Figure 3).
2. Individually list wetland impacts below:
Wetland Impact
Site Number
(indicate on map) Area of
Type of Impact* i impact
{acres) Located within Distance to
100-year Floodplain** Nearest Stream
(yes/no) i (linear feet)
Type of Wetland*** ~'
Impact Area 1 Fill 10.015 No j Headwater Forested headwater
- _
I

i
* I ist etch i t ~l d
c.. mpae sc,paratc y an idt.nhfy temporary impacts. Impacts include, but are not limited to: mechanized clearing. grading. till.
excavation, flooding, ditching/drainage. etc- For dams. separateay list impacts due to both structure and flooding.
** 100-Year floodplains are identif-icd through the Federal f:mergenc~ Management A2encv~s (FE;VIA) Flood Insurance Rate Maps
(FIRM). or FEMA-approved local floodplain maps- Maps arc available through the FE;MA Map Sen-ice Center at 1-800-3?8-9616, or
online at htt~ii~sw~_fema.to~_.
*** List a wetland type that best describes wetland to be impacted fe.g.. freshwater/saltwater marsh. forested wetland. beaver pond.
Carolina E3av. bog. etc.) Indicate if wetland is isolated tdetcrniination of isolation to be made b~ L~SACE only).
List the total acreage (estimated) of all existing wetlands on the property:
Total area of wetland impact proposed: 0.015 acres
3. Individually list all intermittent and perennial stream impacts below:
1.927 acres
Stream Impact
Site Number
(indicate on map)
Impact 2 Length of '; Average Width
Type of Impact* i Impact ~ Stream Name** ! of Stream
j (linear feet) Before Impact
Temporary;'Fill i Max. l OSIf ' UT to Man~~o Creek ~ ~ feet Perennial or
Intermittent?
(please specify)
EphJlnt.
~_ i _ Unimportant
'~
i i
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* List each impact c. -naratt.l., ~ti,a ;,a.....:r,. .
- ~ -- --~ ----•-•; ••••-• •~~~~~~~•. ~~~~~}~,~~«~. ~iiit,acu. impacts inciuae. but are not limited to: culverts and associated ri ra
dams (separately list impacts due to both structure and tloodin,~). relocation (include linear feet bef<~re and after, and net loss/gain).
stabilization activities (cement wall, rip-rap, crib wail. gabions~etc.). excavation, ditching/straightening, etc. If stream relocation is
proposed. plans and profiles showing the linear footprint for both the original and relocated streams must be included.
"* Stream names can be found on l.fS(;S It,pographic maps. If a stream has no name. list as iJ"f (unnamed tributar}~) to the nearest
downstream named stream into which it tlows. I'SGS rnaps an available through the USGS at 1-800-3~8-9616. or online at
««~~~.mt~ttt>~. Several Internet sites alto allo~i direct do~snload and printing of f!SCiS maps (e.g.. w~i~~ ~o~oionr.coitt
~.5t coin. etc.). ---_--
- ----~?.L-'-----
Cumulative impacts (linear distance in feet) to all streams on site: Max. 105 if
Page 8 of 12

4. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the L1.S.) below:
Open Water Impact
Site Number

(indicate on map)
Ty e of Im act*
p p Area of
~
, Impact
~ (acres) ~
Name of Waterbody

(if applicable) Type of Waterbody

i (lake, pond, estuary, sound,
~~ bay, ocean, etc.) ~'
N/A N/A N!A NiA N/A

i

,. '~ i
~~~~ ~a~~~ uuE,aci ~cpa~aieq anu iaenur. umporan impacts. Impacts include. but are not limited to: till. excavation. dredging.
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 application.
Pond to be created in (check all that apply): ~ uplands ~ stream ~ wetlands
Describe the method of construction (e.g., dam/embankment, excavation, installation of
draw-down valve or spillway, etc.):
Proposed use or purpose of pond (e.g., livestock watering. irrigation. aesthetic, trout pond.
local stormwater requirement, etc. ):
Size of watershed draining to pond:_ ___ F,xpected pond surface area:
VII. Impact Justification (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. "I~he 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 constriction
techniques to he followed during construction to reduce impacts.
Both impacts are the result of the construction of storm water pipe infrastructure and drainage
easement on a steep slope. Fteld construction techniques will minimize stream length impacts to
a less than 105 It much of which may become temporary depending on grade considerations
Retatmng wall wtll be used to reduce permanent impacts to the greatest extent practicable based
on engmeertng considerations. Further minimization of impacts resulted from shifting the
impact location to the `unimportant section of the drainage. No other impacts are proposed for
this 544-1ot_residential subdivision.
VIII. Mitigation
DWQ - In accordance with i SA NCAC 2H .Oj00, mitigation may be required by the NC
Division of Water Quality for projects involving greater than or equal to one acre of impacts to
Page 9 of 12

freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial
streams.
USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on March 9, ?000, 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. E~camples 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
fimctions 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 tom://h2o.enr.state.nc.us/n~wetlands/strm~.;ide.html.
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 (acreage/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 required for the proposed impacts. No streams designated as subiect to
Neuse Riparian Buffer Rules will be impacted.
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 htt~/!h?o.enr.state.nc.us/w~r /inde~.htm. If use of
the NCWRP is proposed, please check the appropriate boy on page three and provide the
following information:
Amount of stream mitigation requested {linear feet): N/A
Amount of buffer mitigation requested (square feet): N/A
Amount of Riparian wetland mitigation requested (acresj: N/A
Amount ofNon-riparian wetland mitigation requested (acres): N,/A
Amount of Coastal wetland mitigation requested (acres): NIA
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 Y
If yes, does the project require preparation of an environmental document pursuant to the
requirements of the National or North Carolina Em~ironmental Policy Act (NEPA/SEPA)?
Note: If you are not sure whether aNEPA/SEPA 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 NF.,PA or SF,PA 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 2H .0233
(Meuse), 15A NCAC 2B .0259 (Tar-Pamlico). I SA NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify )~
Yes ~ No X If ~rou answered "ves", 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.
Zone* ~ impact ! Multiplier { Required
I (square feet)
I Mitigation
1
~
_ l.~ ~
Total

--- - - ---. ~.-. ~.~....~.,,,<„ ,..,... ucai vane to Cfl3flilCl: /.OI1C L exrend5 3n
additional 20 fret from the ed~c of7,one 1.
Page 1 1 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 1 SA NCAC 2B .0242 or .0260.
N/A
XI. Stormwater (required by DWQ}
Describe impervious acreage (both existing and proposed) versus total acreage on the site.
Discuss stonnwater controls proposed in order to protect surface waters and wetlands
downstream from the property.
The proposed project will create approximately 20 acres of impervious surface, which includes
roadway infrastructure only. Stormwater controls include wet detention ponds, rock check dams,
inlet protection and catch basins.
XII. Sewage Disposal (required by DWQ)
Cleazly 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.
Sewage disposal provided via the existing Wake County sewer utility line present on the north
side of Mango Creek. Prior NWP 12 (AID 200421134)
XIII. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes [1 No X
Is this anafter-the-fact permit application?
Yes ~ No X
XIV. Other Circumstances (Optional):
No other circumstances exist at this time.
~-~.1k+~Tt_e~ ~Tt v r ~, N ~~ctlyd't , '3~! c
RS ttb~ir'r' ~jlG CR-t~Si.Et-~~; tIJG.
SEE A{~T dtv7u• rN A:t.D. 2A0~21134) ~ 2 jj~
/Agent's Signature Dat
s signature is valid only if an authorization letter from the applicant is provided.)
Page 12 of l2

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Office Use Only:
USACE Action ID No.
any parncu
DWQ No.
not applicable to this project, please enter
I. Processing
Form Version May 2002
or
1. Check all of the approval(s) requested for this project:
^ Section 404 Permit ^ Riparian or Watershed Buffer Rules
^ Section 10 Permit ^ Isolated Wetland Permit from DWQ
^ 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested
Nationwide 12
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 ~yithin a North Carolina Division of Coastal Management Area of
Environmental Concern (see the top of page 2 for further details), check here: ^
II. Applicant Information
1. Owner/Applicant Information
Name: Crosland Inc. c/o Jim Anderson
Mailing Address: 400 Westchase Boulevard
Raleigh, NC 27607
Telephone Number: (919)-960-3641 Fax Number: (919)-754-8995
E-mail Address: janderson(a,crosland.com
2. AgentlConsultant 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: Jim Spangler
Company Affiliation: Spangler Environmental, Inc.
Mailing Address: 224 Fayetteville Street Mall, Suite 400
Raleigh, NC 27602
Telephone Number: [phone] Fax Number: [phone]
E-mail Address:jspangler~aspanglerenvironmental.com
Page 5 of 13

commenced on this property. The East Wake Expressway will run along the west border of
the future development, and it is under construction. Property to the north is single-family
residential development.
11. Describe the overall project in detail, including the type of equipment to be used: The
sewer line will be installed using mechanized excavation equipment. The utility easment
includes the maintenance roadway. Sewer line trench will be back filled with the excavated
soil. Impacts will be temporary, and the areas will be returned to original grade.
12. Explain the purpose of the proposed work: The purpose of the project is to extend the
existing sanitary sewer line from the single-family residential neighborhood, located on the
north side of Mango Creek, south to provide sewer access to the future development.
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.
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.
No future permits will be requested for this project.
VI. Proposed Impacts to Waters of the United States/Waters of the State
Page 7 of 13

" List each impact separately and identify temporary impacts. impacts include. but are not limited to: culverts and associated rip-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 wall, gabions. etc.), excavation. ditching/straightening, etc. If stream relocation is
proposed, plans and profiles showing the linear footprint for both the original and relocated streams must be included.
** Stream names can he found on USGS topographic maps. if a stream has no name. list as t1'I~ (unnamed tributary) to the nearest
downstream named stream into which it flows. I~SGS maps are available through the l1SGS at 1-800-358-9616, or online at
www.usLS,Kov. Several Internet sites also allow direct download and printing of USGS maps (e.g.. www.tonozone_c<~m,
www.map~uest.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: 40 lineaz feet
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 Area of Type of Waterbody
Site Number Type of Impact* ~ Impact Name of Waterbody (lake, pond, estuary, sound,
(indicate on map) (acres) (if applicable) bay, ocean, etc.)
N/A N/A N,~A N/A NIA
N/A N/A N!A N!A N/A
N/A N/A N/A N/A N/A
NIA N/A N/A N!A NIA
N/A N/A N/A N/A N/A
List each impact separately and identify temporary impacts. Impacts include. but are not limited to: fill, excavation. dredging,
flooding. drainage, bulkheads, etc.
4. 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 application.
Pond to be created in (check all that apply): ~ uplands ~ stream
Describe the method of construction (e.g., dam/embankment, excavation,
draw-down valve or spillway, etc.): N/A
wetlands
installation of
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.): N/A _
Size of watershed draining to pond: N/A Expected pond surface area: N/A
VII. Impact Justification (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.
All impacts are temporary. Proposed utility extensions cross the stream at 90 degree an>?les
to mtntmtze temporary Impacts.
Page 9 of 13

the NC WRP is proposed, please check the appropriate box on page three and provide the
following information:
Amount of stream mitigation requested (linear feet): NIA
Amount of buffer mitigation requested (square feet): N/A
Amount of Riparian wetland mitigation requested (acres): NIA
Amount ofNon-riparian wetland mitigation requested (acres):_
Amount of Coastal wetland mitigation requested (acres): NIA
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 0/
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 NEPA/SEPA 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
(Neuse), 15A NCAC 2B .0259 (;Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify: 15A NCAC 2B .0223)
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.
N/A
Pagel 1 of 13

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).
N/A

App[ic~nt/Agent's Signature ~ Date
(Agent's sign~#ure is valid only if an authorization letter from the applicant is provided.)
Page 13 of 13

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