20071082 Ver 1_More Info Received_20070730

,~E ADAMS COMPANY ~~~
CONSTRUCTION AND DEVELOPMENT
708 Abner Phillips Road
Warsaw, NC 28398
Phone [phone]
Fax [phone]
July 27, 2007
Cyndi Karoly
401 Permitting Unit
DWQ - NCDENR
2321 Crabtree Blvd., Suite 250
Raleigh, NC 27604
Ref: DWQ Project #07-1082
Brunswick Place
Brunswick, NC 28424
Columbus County
Dear Ms. Karoly,
This memo is in follow-up to the memo sent to Charles Grant on July 2, 2007. After several
discussions with Ian McMillan it was decided to remove the Level Spreader device and put a
Wet Detention Pond in its place. Therefore, 5 copies of the following have been enclosed:
1) PCN Application, note changes on page 8 (wetland Area ofImpact-removed one of
the sewer laterals, Impact Site #2) and on page 12 (Section XIV completed)
2) NRCS Soil Map
3) Cross-section for aquatic passage on Plans (Pipe Outlet F details)
4) Plans, Page 6 (note Wet Detention Basin details and Wetland Disturbance info.)
5) BMP Worksheet for Wet Detention Basin
6) Wet Detention Basin Operation and Maintenance Agreement
7) List of Wet Detention Basin Vegetation (attached)
Please accept these updates as a completed application to disturb the minimal amount of
wetlands.
Please do not hesitate to call me at 910-293-2770 if you have any questions.
Since
Bob Mitchell
The Adams Company, Inc.
~ _.. ..
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Encl.

Brunswick Place, Columbus County Page 2
Potential Vegetation for Wet Detention Basin:
The following is a list of vegetation that will be included in the basin dependent upon local
nursery availability:
Broomsedge -around the perimeter
Cattail - in the basin
Pond Weed -submerged in the basin
Common Three-Square - in the basin
Marsh Hibiscus - in the basin
Smartweed - in the basin
Sedges - in the basin
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Project No. DWQ ©'I' ~ ~ B Z- (to be provided b>> DGt~Q)
DIV[SION OF WATER QUALITY - 401 WET DETENTION BASIN WORKSHEET
DWO Stormwater Management Plan Review
Basin Bottom Elevation 59. ~ ft. (average elevation of the floor of the basin)
Permanent Pool Clevation (oz.3 ft. (elevation of the orifice invert out)
Temporary Pool Clevation L3.5 ft. (elevation of the outlet structure invert in)
Permanen~Pool Surface Area ~~''J ~ ~ sq. ft. (water surface area at permanent pool elevation)
Drainage Area 1• ~o ac. (on-site and off-site drainage to the basin)
hnpervious Area I ~ 12 ac. (on-site and off-site drainage to the basin)
Permanent Pool Volume ~~fe c.S cu. ft. (combined volume of main basin and forebay)
Temporary Pool Volume Z~3 83 cu. ft. (volume detained on top of the permanent pool)
Forebay Volume 8So cu. ft.
SA/DA used Z•'?8 (surface area to drainage area ratio)
Diameter of Orifice 1.~ in. (draw down orifice diameter)
A complete stormwater management plan submittal includes a wet detention basin worksheet for each basin,
design calculations, plans and specifications showing all basin and outlet structure details, and a fully executed
operation and maintenance agreement. An incomplete submittal package will result in a request for additional
information and will substantially delay final review and approval of the project.
I. PROJECT INFO NATION (please complete the following information): °R ~°~ N1~+`~~ 1`
I'roj cct Name : ~,t.r~S a x110 - Z9 3 - 2'1'] O
Contact Person: e~etr ~ ~ (~ /~,t,~~- ~_ Phone Number: ~ ~j l9) sS (P . q0 ~~
For projects with multiple basins, specify which basin this worksheet applies to: ,y/q
ll. REQUIRED ITEMS CHECKLIST
The following checldist outlines design requirements per the Stonnwater Best Management Practices manual
(N.C. Department of Enviromnent, Health and Natural Resources, November 1995) and Administrative Code
Section: 15 A NCAC 2H .1008. Initial in the space provided to indicate the following design requirements have
been met and supporting documentation is attached. Ifa requirement has not been met, attach an explanation of
why.
FORM SWGI00
_The temporary pool controls runoff from the 1 inch storm event.
_The basin length to width ratio is greater than 3:1.
_The basin side slopes are no steeper than 3:1.
A submerged and vegetated perimeter shelf at less than 6:1 is provided.
-Vegetation to the permanent pool elevation is specified.
An emergency drain is provided to drain the basin.
_The permanent pool depth is between 3 and 6 feet (required minimum of 3 feet).
The temporary pool draws down in 2 to 5 days.
_The forebay volume is approximately equal to 20% of the total basin volume.
-Sediment storage is provided in the permanent pool.
,Access is provided for maintenance.
A minimum 30-foot vegetative filter is provided at the outlet.
A site specific operation and maintenance (O&M) plan is provided.
A vegetation management/mowing schedule is provided in the O&M plan.
.Semi-annual inspections are specified in the O&M plan.
A debris check is specified in the O&M plan to be performed after every storm event.
A specific sediment clean-out benchmark is listed (elevation or depth) in O&M plan.
A responsible party is designated in the O&M plan.
09/97 Page 1 of 1

[3runswick Place, Columbus County Page 2
Potential Vegetation for Wet Detention Basin:
The following is a list of vegetation that will be included in the basin dependent upon local
nursery availability:
Broomsedge -around the perimeter
Cattail - in the basin
Pond Weed -submerged in the basin
Common Three-Square - in the basin
Marsh Hibiscus - in the basin
Smartweed - in the basin
Sedges - in the basin
..
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C:\My Doaurems\Word~Eug~ Spacs\Bnmswidc\BnmsPlaoe\DENR.hrS.doc

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WET DETENTION .BASIN OPERATION AND MAINTENANCE AGREEMENT
The wet detention basin system is defined as the wet detention basin, pretreatment including forebays and the
vegetated filter if one is provided.
Maintenance activities shall be performed as follows:
After every significant runoff producing rainfall event and at least monthly:
a. Inspect the wet detention basin system for sediment accumulation, erosion, trash accumulation,
vegetated cover, and general condition.
b. Check and clear the orifice of any obstructions such that drawdown of the temporary pool occurs within
2 to 5 days as designed.
2. Repair eroded areas immediately, re-seed as necessary to maintain good vegetative cover, mow
vegetative cover to maintain a maximum height of six inches, and remove trash as needed.
3. Inspect and repair the collection system (i.e. catch basins, piping, swales, riprap, etc.) quarterly to
maintain proper functioning.
4. Remove accumulated sediment from the wet detention basin system semi-annually or when depth is
reduced. to ~5% of the original design depth (see diagram below). Removed sediment shall be disposed
of in an appropriate manner and shall be handled in a manner that will not adversely impact water quality
(i.e. stockpiling near a wet detention basin or stream, etc.).
The measuring device used to determine the sediment elevation shall be such that it will give an accurate
depth reading and not readily penetrate into accumulated sediments.
When the permanent pool depth reads ~ • b
When the permanent pool depth reads Sy ~
feet in the main pond, the sediment shall be removed.
feet in the forebay, the sediment shall be removed.
BASIN DIAGRAM
(fill in the blanks)
Permanent Pool Elevation 2 •3
Sediment F$emoval EI.
FOREBAY
5
6
75%
Sediment Removal Elevation .~q• g 75%
-------------------------------------------- -- o -~
Bottom Elevation S9. D 25 /°
Bottom Elevation S`9.0
MAIN POND
Remove cattails and other indigenous wetland plants when they cover 50% of the basin surface. These
plants shall be encouraged to grow along the vegetated shelf and forebay berm.
If the basin must be drained for an emergency or to perform maintenance, the flushing of sediment
through the emergency drain shall be minimized to the maximum extent practical.
All components of the wet detention basin system shall be maintained in good working order.
Level spreaders or other structures that provide diffuse flow shall be maintained every six months. All
accumulated sediment and debris shall be removed from the structure, and a level elevation shall be
maintained across the entire flow spreading structure. Any down gradient erosion must be repaired and/or
replanted as necessary.
Page 1 of 2

r .. ..
I acknowledge and agree by my signature below that I am responsible for the performance of the seven
maintenance procedures listed above. I agree to notify DWQ of any problems with the system or prior to any
changes to the system or responsible party.
Print name: ~.c~,l- ~ ('_S~~, v~'C' '~"
Title:
Addr
Phor
Sign
uate: /- / ~~. d
Note: The legally responsible party should not be a homeowners association unless more than 50% of the
lots have been sold and a resident of the subdivision has been named the president.
I, R~~e~t ~ ~ ~'+~` ~ , a Notary Public for the State of /for ,J
County of ~ rip j~ N , do herryeby certify that C~Gralr.~ ~~,r,,,~f'
personally appeared before me this _~ day of 3 bZ5 ,and acknowledge the due
execution of the forgoing wet detention basin maintenance r quirements. Witness my hand and official seal,
SEAL
My commission expires ~ 3 - Z o l ~
Page 2 of 2

a
t L ~
Office Use Only: Form Version March OS
USACE Action ID No. DWQ No. 0 rl - t O $ 2
(If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A".)
1. 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: ,Z~
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: ^
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), ctiecl~ here: ~] .. ,
~ 'i
II. Applicant Information .. _
~- a:v i.` t U ;
1. Owner/Applicant Information , ,.
,y~. ~,
Name: ~rK-15w;c(<, l'(tice L.l.~ e.la ~4.a~ ~ e s f+ C~~'a'ri.~ °~,~,~,~w
Mailing Address: ~. O . t~ ~x l $ S~
r ~ c z~
Telephone Number: `l l ~- SS"~ - 1 073 Fax Number: `l lq - ~S'G ~ g3g5
.,
E-main A ress: c gr7v.yTt~+ tiry~ ~` ~~%= . Lc~
J
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:
Company Affiliation:
Mailing Address:
Telephone Number:
E-mail Address:
Fax Number:
Page 5 of I2

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 clearl}~ defined. For administrative and distribution purposes, the
USACE requires infotrnation 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: T3r~,tisr,~; c.~c, 1~a<<
2. T.I.P. Project Number or State Project Number (NCDOT Only): N /A
3. Property Identification Number (Tax PII~: Pro,w'tv'~ g14SZ •. Q(~ oi99. bt- o~- X965
4. Location
County: C,o ~ ~w~~ u,s Nearest Town: (3 r uns u~ ic.~ , (~-~C_
Subdivision name (include phase/lot number):. 3tw1s wi c~c Q(~ ~ ~
Directions to site (include road numbers/names, landmarks, etc.): Fror•. cJ;I~+rKt.«- - Nov 7~1 ~qC E
-tom l.Jb.l~w;ll~ ~ Ta~\ }}wy ?mil Sow•rL. -~ klwy 13~ Tnart flwy /3o So..fG- fo P
Dt~KS u~~ ~l'~ (!Tovt~r~ s~ 1 -F'e.~rr~ ~ °~ or. ~+ {M: Il Pe-.d1 !Z~(. Si~1-~ iS O ~ -x~~(a. o+. fZi4A'~
-~ J
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): 3 4 . Z 8 ~ 8 ~ °N '7 8.6 9 `~ S~ °W
6. Property size (acres): ~ . O YGCrG~
7. Name of nearest receiving body of water-..- ~1~;+~ I'Yl.ars ~. -'' L,~u~rh~.,,,, `JZQ ~e~
8. River Basin: L U W~~b e.r- ~. t V ~l
(Note -this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http://h2o.enr.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: (,J o ocQ eo~
Page 6 of 12

10. Describe the overall project in detail, including the type of equipment to be used: Cre~'c- ww
~, -F0.;( - Co rtr I~-S~ 1 ~~ o
~ccr~hyr a.r~41- E~~,~.~,'t: L.~..-.~ c~.c.x-r.1-r ~ ~:t~ c e.~n7
1 1. Explain the purpose of the proposed work: 12es f~w~~ 0 1-~0 ~ ~e~ ~
:~.
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 appro•;ed 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. ltS ~~~ - Gr"/~ly 3~Y'F n~ ~ ~«;.{;,~ ,ate-t~,,,o( e~ ~ ~~,~,~c,,..
d1~ n l0.KS; Re~i~~ 'Lt.'tFc-1^ X ~~D~Rt'aJaY~ '~Or ~.`1 'f~c.rc~ ~ ~w~ o(is~u./ ~.~WQ~
D~1R ~~e«n' ID- Cel~.w..^ 2co7-~22
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 identi_f,_able 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: ~.s~~KC'f~ a r~w~~1+, 6 k Sew-.
-L~. er `1 ~ ,~ C~{k~~~f- a r~•.~. ~ 1~, '-~ " Se ~• (~ --uz / 8 3 L F c ~....a7ir t2 o a~Q ~3 o L F~ ,
~ ~-~ ~
Page 7 of 12

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,
se aratei list im acts due to both structure and floodin
Wetland Impact
Site Number

(indicate on map)
T e of Im act
YP P Type of Wetland

(e.g., forested, marsh,
herbaceous, bog, etc.) Located within
100-year
Flood lain
p
es/no Distance to
Nearest
Stream

linear feet Area of
Impact

(acres)
~-
I EMP Sei.aci Eu
~of csT
l~
o
D.~ ~ I
~
E /'- SEcJErC Ect[K't'.
~o crt~ A/
/" ~ ,
~ crr,- Rn~ `~'(~ F~~~r~( ~~~ 0.032

Total Wetland Impact (acres) Q.ObB
3. List the total acreage (estimated) of all existing wetlands on the property: I • o G~ ~~
.'
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, erib
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 acrea~e_ multiply length x w;rlrh then ~;.,;.tP h., d2 «!1
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)
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, dred~in~, flooding. draina~e_ bulkheads etr.

Open Water Impact
Site Number
indicate on
Name of Waterbody
(if applicable)

Type of Impact --, ----
Type of Waterbody
(lake, pond, estuary, sound, bay,

ocean, etc.
Area of
Impact

acres
nl F~-

Total Open Water Impact (acres)
Page 8 of 12

6. List the cumulative impact to all Waters of the i1 S- resulting from the nmiect
Stream Impact (acres): ~- o -
Wetland Im act (acres): D.D82
Open Water Impact (acres): - o-
Total Impact to Waters of the U.S. (acres) - o -
_
Total Stream Impact (linear feet): , o--
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 (~c~etland or stream) and
the size of the proposed impact (acres or linear feet). Please note that this section only
applies tot1 waters that have specifically been determined to be isolated by the USACE.
L.~.Ni.~JJ1.uyJ .. /b~S- E~`i~~y~~...r~.-- y~:-~ /Job ~cSl(o~ ~ wri`~i'rf .
8. Pond Creation (-v ~'~~
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 ^ wetla~is ,~ ~>
Describe the method of construction (e.g., dam/embankment; excavation, instal.latton ~"% _ r
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 .Iustification (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
techniq/ues to be followedndiu-ing construction to reduce i/mpa~cts. ~e~ ~~e~'fia-l 3(~ .. cue
/6Y~f/~ O~ ~ G.~Jeid 4.~~ C'c11..~2.Cf ~.~/ ~(.~.~tl~t~J lid/ i~ h~ri.,.Q ri-~,rr:,~e
_ ~-] wL1 Ga.~ .:! rti.o s l h ~ r ro W P ~ il=l Y rLa v erg( r~ c.J Gr- / i ,1. e~ -fe rn.os' 1 d`::.r e
b k=
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.
Page 9 of 12

USACE - In accordance with the Final Notice of Issuance and Modification of Natiomvide
Permits, published in the Federal Register on Januar}~ 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
f~inctions 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 ma_y also choose to review the current guidelines for stream restoration in D~zJQ's
Draft Technical Guide for Stream Work in North Carolina, available at
http://h2o.enr.state.nc us/nc~vetlands/strm~ride 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.
m ; ~, ~ ~..fi ~. ,moo Y' rerr we-a-7' c~a Ya orn. ~ y b ~ B /4 ~re.e a rL a-~e.e?`a~
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://h2o.enr_state.nc us/wrp/index l~tm. 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):
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):
Page 10 of 12

I~. 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 cutTent 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 oit Riparian and ~4'atershed Buffers (r~-•I~lir~>ri by I)~uQl
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.
I. 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 )? 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 multinliers_
* Im act
Zone (sctua e feet) Multiplier ~Requifed
I l _ _ _ 3 (2 for Catawba)
2 1.5 +
Total
* 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.
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.
Page 1 I of 12

Xl. StormEVater (required by DWQ)
Describe impervious acreage (existing and proposed) versus total acreage on the site. Discuss
stornlwater 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 i/mpervious level. 2.1 creo Z„-. e~v,~o~ 3S ?.~
f31oL4s ~a~(~d-ta /o~``s I~s,P~.-~.1~ ro~ ~~ 1..~.1~`J 'l~ rn~~ c~
III. 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.
_F111 SeWws~ 01.3 nds~.Q urn 1l lot l~wr.oQ~~ `y '~.~ ~ I,JIu'~-vil~`S '~uc.: ~,~I-t.
XIII. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (1SA NCAC 2H .OS00) or any Buffer Rules?
Yes ^ No
Is this an after-the-fact permit application? Yes ^ No
DIV. 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:~///1~2o.enr.state.ncnus/ncnwetlands. If no, please provide.a shonrt narrative description:
/ Y O /~1't-t~r~ iJ~-III-t C..rvl~w. n ~l' ~ . _ ,. ~- ~~ // i7 _ .-~, t ~G
XV. Other Circumstances (Optional):
it is t:he applicant`s responsibility to submit the application sufficient}y 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).
~7 -07
/ z9,o~
pplican Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 12 of 12

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