20140375 Ver 1_More Info Received_20140421

Blue Ridge Environmental Consultants, PA
1305 S. Collegiate Drive — Wilkesboro, NC
336.844.4088
http:/ /brec.biz
LETTER OF TRANSMITTAL
TO NCDWR
1650 Mail Service Center
Raleigh, NC 27699 -1650
ATTN Laurie Dennison 1
DATE 04117/2014 JED
JOB NO 1110012013
SUBJECT Shepherds Way Farm
F
UNR R .' ' 2014
We are sending you the following
V yFir rR QUALITY
VVIOU sulc• S� �'k� rw r Branch
❑ Plans ❑ Specifications ❑ Submittals ❑ Permits
❑ Soils Report ❑ Calculations ❑ Shop drawings ® Other
❑ CD / Disk ❑ Applications ❑ Details
Copies
Descriptions
1
Fee for 401 Application for Shepherds Way Farm
For Signature /Notary
PoW L3 -V ' i G �Ib., u N6x r
❑
For Your Approval /Comments
These are transmitted
Y
Per Your Request
❑ Revised
❑
For Signature /Notary
❑ For Your Information /Records
❑
For Your Approval /Comments
❑ Please Return
❑
For Your Review /Comments
❑ Revise and Resubmit
®
For Permitting
❑ For Bidding
REMARKS: Please find enclosed the fee for the 401 Application for Shepherds Way Farm, as
mentioned in the e-mail from Derek Goddard in our office on 4117114 at 7:52AM. Please let us know
if you have any questions. Thank you! AA ,o, +V_c QCN t,-��y y.►, flu e �(�n� ��unr��l
SIGNED U�C�� %lk )t �) cc

\NA7k,�y
\911t''" 1
P �
Office Use Only
Corps action ID no
DWQ project no
Form Version 1 3 Dec 10 2008
Page 1 of 10
PCN Form — Version 1 3 December 10, 2008 Version
Pre - Construction Notification (PCN) Form
A.
Applicant Information
1
Processing
la
Type(s) of approval sought from the
Corps
X Section 404 Permit ❑ Section 10 Permit
lb
Specify Nationwide Permit (NWP) number 27 or General Permit (GP) number
1c
Has the NWP or GP number been verified by the Corpse --FE]Yes
X No
1d
Type(s) of approval sought from the DWQ (check all that apply)
X 401 Water Quality Certification — Regular ❑ Non -404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
1 e
Is this notification solely for the record
because written approval is not required?
For the record only for DWQ 401
Certification
❑ Yes X No
For the record only for Corps Permit
❑ Yes X No
1f
Is payment into a mitigation bank or in -lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in -lieu
fee program
❑ Yes
X No
1g
Is the project located in any of NC's twenty coastal counties If yes, answer 1 h
below
❑ Yes
X No
1h
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes
X No
2
Project Information
2a
Name of project
Shepherds Way Farm - Piney Branch Stream Restoration
2b
County
Ashe
2c
Nearest municipality / town
Laurel Springs
2d
Subdivision name
NA
2e
NCDOT only, T I P or state
project no
N/A
3
Owner Information
3a
Name(s) on Recorded Deed
Shepherds Way Farm, LLC
3b
Deed Book and Page No
417/370
3c
Responsible Party (for LLC if
applicable)
Jarvis Dickens
3d
Street address
540 George Shepherd Road
3e
City, state, zip
Laurel Springs, NC 28644
3f
Telephone no
704 - 437 -4554
3g
Fax no
N/A
3h
Email address
N/A
Page 1 of 10
PCN Form — Version 1 3 December 10, 2008 Version