20070408 Ver 2_401 Application_20070707

PAT
-~
Form: Version March OS
USACE Action ID No. DWQ No. ~'1- o'i-o 8 ue-R 2
(If 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 Permit ^ Isolated Wetland Permit from DWQ
® 401 Water Quality Certification ^ Express 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested: Nationwide 18
3. If this notification is solely a courtesy copy because written approval for the 401 Certification is
not required, check here: ^ N/A
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-V~I~; , - ,...
and check here: ® _ h'
f y
~~ ~ yY
II. Applicant Information ~~~~~ ~~~
1. Owner/Applicant Information ~°~~.~~ - ~; ;,;~;~~
Name: American Health and Human Services -Elizabeth City State
Mailing Address: 504 East Elizabeth Street
Elizabeth Citx, NC 27909
Telephone Number: see consultant info. Fax Number: see consultant info.
E-mail Address: see consultant info.
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: Doug Dorman
Company Affiliation: Atlantic Environmental Consultants, LLC
Mailing Address: P.O. Box 3266
Kitty Hawk, NC 27949
Telephone Number: 252-261-7707 Fax Number: 252-261-2965
E-mail Address: dou dorman c earthlink.net
Page 1 of 8

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 USES 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
USACE 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: Dorm Facility AEC#06-085
2. T.LP. Project Number or State Project Number (NCDOT Only): N/A
3. Property Identification Number (Tax PIN): Parcel A #891316929536 & Parcel B #891320927042
4. Location
County: Pasquotank County Nearest Town: Elizabeth City
Subdivision name (include phase/lot number): N/A
Directions to site (include road numbers, landmarks, etc. Heading south on old US 17 take
right on Halstead Blvd and go approximately 2.25 miles to Herrington Road. Take left on
Herrrington Road and property is at the intersection of Halstead Blvd and Herrington Road.
5. 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): 36° ] 6'47.86" °N 76° 13'4.04" °W
6. Property size (acres): Parcel A = 0.62 ac. & Parcel B = 1.02 ac. Total acreage = 1.64 acres
7. Name of nearest receiving body of water: Charles Creek connects to Pasquotank River
8. River Basin: Pasquotank River Basin
(Note -this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at htt~/1h2o.e~~r.state.nc.us/admin/maps/.)
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 subject property is currently undeveloped partially
forested land with a billboard at the intersection bordering the property The majorit oy f the
surrounding parcels are developed general business with some single-family residential. The
subject tract is across the street from Elizabeth City State campus and existing student
housing is to the west across Halstead Blvd.
Pagc 2 of 8

10. Describe the overall project in detail, including the type of equipment to be used: _ An
excavator and bulldozer will be used to clear the property and grade for site preparation
11. Explain the purpose of the proposed work: Proposed work is necessarv fill wetlands to
construct a dorm facility for Elizabeth City State University including student parking-
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 pcrniits, 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.LP. project, along with construction schedules.
AEC delineated the wetlands on site on 1-5-07, a Jurisdiction determination was made by USACE Josh
Pellitier on 1-31-07. No plats have been signed at this point but they have been submitted to the Cor~but
No Action ID available at this time.
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:
Future permits include permits required from Pasquotank County including but not limited to
building_permits There a no future plans that would require anXadditional permits
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 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:_Suitable fill material will trucked in from
a commercial source and placed in 0 10 acres of wetlands to prepare the site for construction of a
dorm facility and associated student parking. An elevated foot bridge (9'x 50') will be constructed a
minimum of three feet (3') in height over wetlands to access the dorm facility from the parking area
A very small portion of the parking area will be constructed within the edge of the wetlands to allow
for a fill slope.
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.
Page 3 of 8

Wetland Impact. Type of Wetland Located within Distance to Area of
Site Number T e of Im act
Yp p
(e.g., forested, marsh 100-year
Nearest Stream Impact
(indicate on map) ,
herbaceous, bog, etc.) Floodplain (linear feet) (acres)
(yes/no)
Parcel A Wetland fill Forested wetland yes 485' to Charles 0 074 ac

Creek. .

Parcel B
Wetland fill
Forested wetland
Yes 485' to Charles
0
026 ac
Creek. .
.

Total Wetland Impact (acres) = 0.10 acre
3. List the total acreage (estimated) of all existing wetlands on the property: Parcel ~ = 0.3 t ac. ~ narcel B = 0.06
Total acreaee 0.37 ac.
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 lengrth X width, then divide by 43,560.
Strean~ Impact
Site Number
indicate on ma
( P)
Stream Name
Type of Impact
Perennial o~
Intermittent Average of
Stream Width

Before Impact Impact
Length

(linear feet) Area of
Impact

(acres)
N/A N/A N/A N/A N/A N/A N/A.
N/A N/A N/A N/A N/A N/A N/A

Total Stream Impact (by length and acreage) _ -0-
5. 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
Site Number
(indicate on map)
Name of Waterbody
(if applicable)
Type of Impact Type of Waterbody
(lake, pond, estuary, sound, bay,

ocean, etc.) Area of
Impact

(acres)
N/A N/A N/A N/A N/A

Total Open Water Impact (acres)
6. List the cumulative impact to all Waters of the U.S. resulting from the aroiect:
Stream Impact (acres): N/A
Wetland Im act (acres): 0.10 ac.
Open Water Impact (acres): N/A
Total Im act to Waters of the U. S. (acres) N/A
Total Stream Impact (linear feet): N/A
Page 4 of 8

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.
N/A
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.): N/A
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.): N/A
Current land use in the vicinity of the pond
Size of watershed draining to pond: N/A
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.
The proposed impact includes fill in wetlands to construct a dorm facility the site plan was
designed to avoid as much wetland impacts as possible by constructing the majority of the dorm
facility and parking area on highground and constructing an elevated foot bride over wetlands
to access from the parkinu area to the dorm facility and stay within the General Permit by filling
a maximum of 0.10 acre of wetlands The foot brid e is proposed to avoid further wetland
impacts (a road crossing permit was avoided for this wetland issue) to the existin ditch; the
location of the building was placed as close to the property line and Herrington Road as possible
to minimize wetland fill
VIII. Mitigation
DWQ - In accordance with l5A 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.
Page 5 of 8

USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on March 9, 2000, 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 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
ht~_///h2o__enr.state_nc__u__s/nc_wetlands/strmgide,_hti7~l..
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.
The proposed miti atg ion plan for this project will be the purchase of wetland credits from
NCEEP as compensatory mitigation to offset wetland impacts proposed (Attached
acceptance letter from NCEEP dated).
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 willing 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 ht~_//}i2o enr_state.nc us/_wrP/ind_ex.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): N/A
Amount of buffer mitigation requested (square feet): N/A
Amount of Riparian wetland mitigation requested (acres): N/~
Amount of Non-riparian wetland mitigation requested (acres): 0.10
Amount of Coastal wetland mitigation requested (acres): N/~
IX. Environmental Documentation (DWQ Only)
1. Does the project involve an expenditure of public (federal/state/local) funds or the use of
public (federal/state) land? Yes ^ No
Page 6 of x

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 a NEPA/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
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.
1. Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Neuse), 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 N/A )? 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 multipliers.
Zone* Impact
(square feet) Multiplier Required
Mitigation
1 N/A 3 N/A
2 N/A 1.5 N/A
Total N/A N/A
' Gone 1 extends out 30 feet perpendicular from near bank of channel: Zone 2 extends an
additional 20 feet from the edge of Zonc 1.
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 15A NCAC 2B .0242 or .0244, or .0260.
No buffer mitigation required for this project since disturbance/fill is not within the buffer
Page 7 of 8

Xl. 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. Total acreage of site is 1.64 acres Impervious areas
do not currently exist within the subject site site is currently undeveloped forested land and open _ra~ ssed
land. Proposed built upon (impervious) areas for this site are as follows Future proposed built upon area
«~ill include high density development within a General Business (GB) zone Acres of impervious area
proposed for development is 8 100 s.f. for dorm building and 23 875 s f for parkin Total impervious
area proposed = 31,975 s.f. Proposed Disturbance includes radin~ to prepare for construction of
parking area and dorm facility and area of wetland fill = 0 l0 acre Once clearing_Prubbing and rang
takes place the disturbed area will be graded at a gradual slope towards the existing ditch then disturbed
area outside proposed construction area will be seeded according; to the tables (Permanent Vegetation &
Temporary Ve~ctation) as submitted in the Stormwater and S & E Plan submitted by Hollis Ellis with
CAE Inc. A retention pond on Parcel B is included in the S & E plans to handle Stormwater runoff from
the proposed parking area. Vegetated areas are proposed for surface runoff preventing localization of
stormwater runoff. Disturbed areas will be seeded immediately to filter surface runoff A double silt
fence will be placed along the wetland interface and graded area to prevent material runoff before grass is
established. Total land disturbance for this project will be a maximum of l 37 acres
Xll. 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.
On site wastewater systems proposed along southern portion of property
XDI. 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 an after-the-fact permit application? Yes ^ No
XIV. 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).
No constraints currently associated with this project
's Signature
Date
0
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 8 of 8

a~ ment
PROGRAM
July 2, 2007
American Health and Human Services
c/o/ Doug Dorman
PO Box 3266
Kitty Hawk, NC 27949
0`1-008 ~2.
Project: ECSU Dorm Facility
County: Pasquotank
The purpose of this letter is to notify you that the North Carolina Ecosystem Enhancement Program (NCEEP) is willing to
accept payment for impacts associated with the above referenced project. Please note that this decision does not assure that
the payment will be approved by the permit issuing agencies as mitigation for project impacts. it is the responsibility of the
applicant to contact these agencies to determine if payment to the NCEEP will be approved.
This acceptance is valid for six months from the date of this letter and is not transferable. If we have not received a copy of
the issued 404 Permit/401 Certilication/CAMA permit within this time frame, this acceptance wil! expire. It is the
applicant's responsibility to send copies of the permits to NCEEP. Once NCEEP receives a copy of the permit(s) an invoice
will be issued based on the required mitigation in that permit and payment must be made prior to conducting the authorized
work. The amount of the In Lieu Fee to be paid to NCEEP by an applicant is calculated based upon the Fee Schedule and
policies listed at www.nceep.net.
Based on the information supplied by you the impacts that may require compensatory mitigation are summarized in the
followine table.
Pasquotank
03010205 Stream (feet) Wetlands (acres) Buffer I
(Sq. Ft.) Buffer II
(Sq. Ft.)
Cold Cool Warm Ri arian Non-Ri arian Coastal Marsh
Impacts 0 0 0 0 0.10 0 0 0
Credits 0 0 0 0 0.20 0 0 0
Upon receipt of payment, EEP will take responsibility for providing the compensatory mitigation. If the regulatory agencies
require mitigation credits greater than indicated above, and the applicant wants NCEEP to be responsible for the additional
mitigation, the applicant will need to submit a mitigation request to NCEEP for approval prior to permit issuance. The
mitigation will be performed in accordance with the Memorandum of Understanding between the N. C. Department of
Environment and Natural Resources and the U. S. Army Corps of Engineers dated November 4, 1998.
If you have any questions or need additional information, please contact Kelly Williams at (919} 716-1921.
cc: Cyndi Karoly, NCDWQ Wetlands/401 Unit
Josh Pelletier, USACE-Washington
Kyle Barnes, NCDWQ-Washington
File
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North Carolina Ecosystem Enhancement Program, 1652 Mail Service Center, Raleigh, NC 27699-1652 / 919-715-0476 / www.nceep.net

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Amsrican Health & Human 8erviaee, Ina
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~:~'~~~~, ' PROPOSED 404 WETLAND FILL (4,250 SF) /
----~-~- 404 WETLAND LINE
-•••-~~~-~~~-~~~- EDGE OF DITCH/STREAM
~~ /
* THERE WILL BE NO IMPACTS TO THE
EXISTING DITCH/STREAM.
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WETLAND SUBSTRATE
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0.06 ACRES WETLANDS
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NATIONWIDE #18 FILL PERMIT
AMERICAN HEALTH & HUMAN SERVICES
ELIZABETH CITY - PASQUOTANK COUNTY -NORTH CAROLINA
„ ,4TG4NT/C ENV/RONa1ENTAL CONSULT,4NTS, LLC
GRAPHIC SCALE 1 = 40 Po. aor ~~s6 aim HA~r Nc. 27949
~252~ZS1-7707, a moi/ roxdormon®oo%com
DATE: 6/29/07 REVISED: FILE: 06-028 DRAWN BY: DOUG D