20140575 Ver 1_401 Application_20140614

ENGINEERING AND
ENVIRONMENTAL
June 17 2014
2 0 1 4 0 5 7 5 5104 ReagaSuite 8
Charlotte, North Carolina 28206
980.321.4100 / Fax - 980.321.4099
www.usanova.com
North Carolina Department of Cultural Resources
Division of Water Resources – Water Quality Division
4617 Mail Service Center
Raleigh, NC 27699 -4617
Attention: Mrs. Karen Higgins
401 & Buffer Permitting Unit
Subject: Shoreline Stabilization
Davidson Retirement Residence
Davidson, North Carolina
NOVA Project Number 10705- 2014003
Dear Mrs. Higgins,
FJJ.E copy
— �___ 5�'
2014
On behalf of the Davidson Retirement Residence, LLC, please find attached a Pre- Construction
Notification for the proposed stabilization techniques that we would like to use for the priority areas
of eroding shoreline at the proposed Davidson Retirement Residence. We have conducted a
comprehensive inventory and analysis of the existing shoreline conditions. The entire shoreline is
approximately 1,750 linear feet. The proposed plan calls for stabilization of 1,410 linear feet of the
total shoreline. Every effort will be made to use bio- engineered solutions as much as possible in
reference to hardened shorelines. Enhanced rip -rap will be used on 210.5 linear feet of shoreline and
rip rap alone is proposed for approximately 1, 199.5 linear feet. The techniques to be used are taken
from the Duke Energy Shoreline Management Guidelines which include rip -rap and enhanced rip -
rap. Each of the techniques have been selected dependent on the existing shoreline conditions as
described in the inventory created by David Penalva, P.E. ofNOVA Engineering and Environmental.
This stabilization will help to protect the Davidson Retirement Residence from further degradation
by erosion on the water side. Stabilization will protect Lake Norman from additional sedimentation
by erosion and may serve as a demonstration project for future shoreline stabilization projects.
Table 1: Proposed Shoreline Stabilization
Total Project
(FI)
Rip Rap
(FT)
Enhanced Rip Rap
(FI)
1410.0
1199.5
210.5
The entire project will be performed form the land side due to the location of the proposed shoreline
stabilization. We will make every effort to minimize the amount of clearing required for the access
road. Any damage incurred during the project will be repaired as part of this project.
EMPLOYEE OWNED - CLIENT DRIVEN:
Environmental Consulting — Geotechnical Engineering — Construction Materials Testing — Inspection Services
Facility Engineering — Building Envelope/Roofing Consulting — Loss Prevention — Code Compliance
Municipal & Government Support/Outsourcing — Private Provider ServicesTM

Davidson Retirement Residence Shoreline Stabilization
EMI &T
June 17, 2014
NOVA Project Number: 2014004
We have contacted several commenting agencies including ACOE, NCDWQ, NCWRC,
Mecklenburg County, Town of Cornelius, NC Natural Heritage Program, and NC State Historic
Preservation Office for input. We will continue to coordinate with these and other agencies so that
when the time comes to prepare an application for the activity it will include specific consideration
from their comments.
A complete DWQ application for shoreline work, five copies of the plans, and a check for $240,00
has been sent to NCDENR Division of Water Resources for processing.
Please review the attached documents and direct your comments to Alexander Robinson, EI. Your
comments are greatly appreciated.
Sincerely,
NOVA ENGWEEWNG AND ENVIRoNmENTAL, LLC
Alexander Robinson, EI
Project Manager
arobinson(i�us anova. com
Office: 980.321.4100 x1508
Cell: 704.719.6930
Fax: [phone]
David Penalva, P.E.
Project Engineer
Attachments: Agent Authorization
Pre - Construction Notification Form
Figure I (Site Vicinity Map)
Figure 2 (Proposed Shoreline Stabilization)
Shoreline Representative Photographs
Detail 1 (Proposed Shoreline Stabilization Plan)
Detail 2 (Enhanced Rip Rap Section)
Detail 3 (Rip Rap Section)
Page 2

SAMPLE AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION,
LOT NO PLAN NO. PARCEL ID 0 Z0
STREET ADDRESS '805 PENINS'UUI'c QR , �i�rvla`.��r�t, NL
Please print
Property Owner. (�►tylD SoN �tIR�MEN t �1s5iD- NG�,1 -t C
� �+- at5t1'tN��'o�.r t�lv�nti'� �t'W- C3t�c� rowtiP't� -'y
Property Owner
The undersigned, registered property owners of the above noted property, do hereby authorize
oRVt,b ��N�LV L. of ��cov� N��Nt���fr�4 t�rNP k?ayt�oNrr►trvT 'L�IN�
(Contractor / Agent) I (Name of consulting firm)
to act on my behalf and take all actions necessary for the processing, issuance and acceptance of
thrs,permrt or certification and any and all standard and special conditions attached
Property Owner's Address (if different than property above)
Jbto(n %
Telephone
3ce(--) -2t3-- 15'5e
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge
Davidson Retirement Residen , a Washington limited liability company
By Hawthorn Ma age n s Corp, a Washington corporation, its Manager
By
Barton G Colson, President
Date

i�
Office Use Only:
Corps action ID no. _____________
DWQ project no.
Form Version 1.3 Dec 10 2008
Pre - Construction Notification (PCN) Form
A. Applicant Information
1. Processing
1 a. Type(s) of approval sought from the
Corps:
®Section 404 Permit El Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: 13 or General Permit (GP) number:
1 c. Has the NWP or GP number been verified by the Corps?
® Yes
❑ No
1d. Type(s) of approval sought from the DWQ (check all that apply):
® 401 Water Quality Certification — Regular ❑ Non -404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ® Riparian Buffer Authorization
1 e. Is this notification solely for the record
because written approval is not required?
For the record only for DWQ 401
Certification:
❑ Yes ❑ No
For the record only for Corps Permit:
❑ Yes ® No
1f. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in -lieu
fee program.
❑ Yes
® No
1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1h
below.
❑ Yes
® No
1h. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes
® No
2. Project Information
2a. Name of project:
Davidson Retirement Residence
2b. County:
Mecklenburg
2c. Nearest municipality / town:
Davidson
2d. Subdivision name:
N/A
2e. NCDOT only, T.I.P. or state
project no:
NIA
3. Owner Information
3a. Name(s) on Recorded Deed:
427 Davidson LLC ILI
3b. Deed Book and Page No.
24542 -232
3c. Responsible Party (for LLC if
applicable):
N/A
3d. Street address:
9310 NE Vancouver Mail Drive, Suite 200
" WA �'`LLln
3e. City, state, zip:
Vancouver, WA 98662 -8210
3f. Telephone no.:
360- 213 -1550
3g. Fax no.:
360 -213 -1540
3h. Email address:
N/A
Page 1 of 11
PCN Form — Version 1.3 December 10, 2008 Version

4
Applicant Information (if different from owner)
4a
Applicant is
® Agent ❑ Other, specify
4b
Name
David Penalva
4c
Business name
(if applicable)
NOVA Engineering& Environmental, Inc
4d
Street address
5104 Reagain Drive, Suite 8
4e
City, state, zip
Charlotte, NC 28206
4f
Telephone no
980 - 321 -4100
4g
Fax no
980 - 321 -4099
4h
Email address
dpenalva @usanova com
5.
Agent/Consultant Information (if applicable)
5a
Name
David Penalva
5b
Business name
(if applicable)
NOVA Engineering & Environmental, Inc
5c
Street address
5104 Reagan Drive, Suite 8
5d
City, state, zip
Charlotte, NC 28206
5e
Telephone no
980 - 321 -4100
5f
Fax no
980 -321 -4099
5g
Email address
dpenalva @usanova com
Page 2 of 11

B.
Project Information and Prior Project History
1
Property Identification
1a
Property identification no (tax PIN or parcel ID)
00321120
1 b
Site coordinates (in decimal degrees)
Latitude 35 498391 'Longitude - - -80 8662
1 c
Property size
4 25 acres
2
Surface Waters
2a
Name of nearest body of,water (stream, river, etc ) to
Lake Norman (Catawba River)
proposed project
2b
Water Quality Classification of nearest receiving water
WS -IV, B, CA
2c
River basin map is available at
Catawba
http / /h2o enr state nc us /adman /maps/
3
Project Description
3a
Describe the existing conditions on the,site and the general land use in the vicinity of the protect at the time ofthis
application
Site is the shoreline of the proposed Davidson Retirement Residence on a large inland man -made reservoir The majority
of shoreline is unstabdized and eroding Upland portions of the site are mostly forested with a mix of pine and
hardwoods Limited development consists of paved roadway
3b
List the total estimated acreage of all existing wetlands on the property
00
3c
List the total estimated linear feet of all existing streams (intermittent and perennial)yon the property
00
3d
Ezplain,the purpose of the proposed project
The purpose of the project is to stabilize eroding shoreline using FERC and Duke,Energy approved methods
3e
Describe the overall project in detail, including the type of equipment to be used
18'Ton tandem axel dump,trucks will be used'to transport,the rip rap`material while a track excavator, will be used for
required clearing and placement of rip rap material Stakes will be driven through the enhanced rip rap in order to install
the live buds The disturbed area will be repaired and replanted with trees and other indigenous plant life
Page 3 of 11
PCN Form — Version 1 3 December 10, 2008 Version

4
Jurisdictional Determinations
4a
Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past?
Comments
ED Yes [-I No ®Unknown
4b
If the +Corps made the jurisdictional determination, what type
of determination was made?
❑ Preliminary ❑ Final
4c
If yes, who delineated the jurisdictional areas?
Name (if known)
Agency /Consultant Company
Other
4d
If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation
5
Project History
5a
Have permits or certifications been requested or obtained for
this project, (including all prior phases) in the past?
❑ Yes ❑ No ® Unknown
5b
If yes, explain in detail according to "help file" instructions
6
Future,,Project Plans
6a
Is this a phased project?
❑ Yes ® No
6b
If yes, explain,
Page 4 of 11

C. Proposed Impacts Inventory
1 Impacts Summary
1a Which sections were completed below for your project (check all'that apply)
Wetlands ❑ Streams -tributaries ❑ Buffers
® Open Waters ❑ Pond Construction
2 Wetland Impacts
If there are wetland impacts,, proposed on the, site, then complete this question for each wetland.area impacted
2a
2b
2c
2d
2e
2f
Wetland impact
Type of jurisdiction
number —
Type of impact
Type of wetland
Forested
(Corps - 404, 10
Area of impact
Permanent (P) or
(if known)
DWQ — non -404, other)
(acres)
Temporary (T)-
W1 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W2 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W3 ❑ P ❑ T
❑ Yes
❑ Corps
_
❑ No
❑ DWQ
W4 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
E:1 DWQ _
W5 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W6 ❑ P ❑, T
❑ Yes
❑ Corps
❑ No
❑ DW,Q
2g Total wetland impacts
2h Comments
3 Stream Impacts
If there are perennial or intermittent stream impacts (including temporary, i m pacts) proposed on the site, then complete this
question for all stream sites impacted
3a
3b
3c
3d
3e
3f
3g
Stream impact
Type of impact
Stream name
Perennial
Type of jurisdiction
Average
Impact
number -
(PER) or
(Corps - 404, 10
stream
length
Permanent (P), or
intermittent
DWQ — non -404,
width
(linear
Temporary (T)
(INT)?
other)
(feet)
feet)
S1 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S2 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S3 ❑ P ❑ T
❑,PER
❑ Corps
'❑
❑ INT
DWQ
S4 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S5 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S6 ❑ P ❑ T
❑,PER
❑ Corps
❑ INT
❑ DWQ
3h Total stream and tributary impacts
31 Comments
Page 5 of 11

4 Open Water Impacts
Iftthere are proposed impacts to,lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U S then indiv ually list all o en water impacts below
4a
4b
4c
4d
4e
Open water
Name of waterbody
impact number –
(if applicable)
Type of impact
Waterbody type
Area of`impact (acres)
Permanent (P),or
Temporary (T)
01 ®P ❑ T
Lake Norman
Enhanced Rip Rap
Lake
01
02 ®P ❑ T
Lake, Norman
Rip Rap
Lake
055
03 ❑P
04 ❑P
4f Total open water impacts
4g Comments
5 Pond or Lake Construction
If pond or lake construction proposed, then complete the chart below
5a
5b
5c
5d
5e
Wetland Impacts (acres)
Stream Impacts (feet)
Upland
Pond ID
Proposed use or purpose
(acres)
number
of pond
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
P2
5f. Total
5g Comments
5h Is a dam high hazard permit required
❑ Yes ❑ No If yes, permit ID no
51 Expected pond surfac&area (acres)
51 Size of pond watershed (acres)
5k Method of construction
6 Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below If yes, then individually list all buffer impacts
below If any impacts require mitigation, then you BAUST fill out Section D of this form
6a
❑ Neuse El Tar-Pamlico El Other
Project is in which protected basin?
® Catawba ❑ Randleman
6b
6c
6d
6e
6f
6g
Buffer impact
number –
Reason
Buffer
Zone 1 impact
Zone 2 impact
Permanent (P) or
for
Stream name
mitigation
(square feet)
(square feet)
T
impact
re wred7
—Temporary
B1 ❑ P ®T
Access
Catawba
®❑ Nos
–4000
B2 ❑P
❑Yes
-
❑ No
B3 ❑P
El Yes,
❑,,No
6h Total buffer impacts
4,000
00
61 Comments
Page 6 of 11

D Impact Justification and Mitigation
1 Avoidance and Minimization
la Specifically describe measures taken to avoid or minimize the proposed impacts in designing project
A detailed inventory of the existing shoreline and conditions has been conducted Stabilization methods will be applied to
avoid and minimize impacts Specific access points that minimize disturbances wdl'be flagged during the pre -
construction meeting
b Specifically describe measuresdaken to avoid or minimize the proposed impacts through construction techniques
Construction access points will be flagged to prevent larger trees from being disturbed Tracked equipment will be used
to prevent ground disturbance Access roads will be constructed to no more than 15' wide to prevent unnecessary
damage
2. Compensatory Mitigation for Impacts to Waters of the U S or Waters of the State
2a Does the project require Compensatory Mitigation fo"r
impacts to Waters of the U S or Waters of the State?
❑ Yes ®' No
2b If yes, mitigation is required by (check all that apply)
❑ DWQ El Corps
2c If yes, which mitigation option will be used for this
project?
❑ 'Mitigation bank
❑ Payment to in -lieu fee program
❑ Permittee Responsible Mitigation
3 Complete if Using a Mitigation Bank
3a Name of Mitigation Bank
3b Credits Purchased (attach receipt and letter)
Type
Quantity
3c Comments
4. Complete if Making a Payment to In -lieu Fee Program
4a Approval letter from in -lieu fee program is attached
❑ Yes
4b Stream mitigation requested
linear feet
4c If using stream mitigation, stream temperature
❑ warm ❑ cool' ❑cold
4d Buffer mitigation requested (DWQ only)
square feet
4e Riparian wetland mitigation requested
acres
4f Non - riparian wetland mitigation requested
acres
4g Coastal (tidal) wetland mitigation requested
acres
4h Comments
Page 7of11
PCN Form — Version 1 3 December 1,0, 2008 Version

5. Complete if Using a Permittee Responsible Mitigation Plan
5a If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan
The permittee will provide a survey of the disturbed areas and replaced any disturbed areas with trees of equal
magnitude
6 Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a Will the project result in an impact within a protected riparian buffer that requires
El Yes ® No
buffer mitigation) If yes, you will have to fill out this entire form,— please
contact the State for more information
6b If yes, then identify the square feet of impact to each zone of`thetnpanan buffer that requires,mitigation Calculate the
amount of mitigation required
6c
6d
6e
Zone
Reason for impact
Total impact
Multiplier
Required mitigation
(square feet)
(square feet)
Zone 1
3 (2 for Catawba)
Zone 2
15
6f Total buffer mitigation required
6g If buffer mitigation is required, discuss whatjtype�of mitigation is proposed (e g , payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in -lieu fee fund)
6h Comments Rip rap placement within the riparian mitigation zone is considered allowable
Page 8 of 11

E.
Stormwater Management and Diffuse Flow Plan (required by DWQ)
1
Diffuse Flow Plan
1a
Does the project include,or is it adjacent to protected riparian buffers identified
® Yes ❑ No
within one of the NC Riparian Buffer Protection Rules?
lb
If yes, then is a diffuse flow plan included? If no, explain why
❑ Yes 0 N
Comments Project will not generate stormwater run -off
2.
Stormwater Management Plan
2a
What is the overall percent imperviousness of this project?
0%
2b
Does this project;regwre a Stormwater Management Plan?
® Yes ❑ No
2c
If this project DOES NOT require a Stormwater Management Plan, explain why
2d
If this project DOES require a Stormwater Management Plan, then provide�a,bnef, narrative
description of,the plan
Sediment barriers will placed around the proposed work zone and every effort will be
made to construct while the lake`is
at or below normal pool Silt fence will placed around the perimeter of any access roads to help prevent sediment laden
run -off
® Certified Local Gi overnment
2e
Who will be responsible,for the review of the Stormwater Management Plan?
® DWQ Stormwater Program
❑ DWQ 401 Unit
3
Certified Local Government Stormwater Review
3a
In which local government's jurisdiction is this project?
Mecklenburg County
❑ Phase- I I
3b
Which of the following locally - implemented stormwater management programs
❑ NSW
❑ USMP
apply (check all that apply)
® Water Supply Watershed
❑ Other -
3c Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ® No
attached?
4
DWQ Stormwater Program Review
❑ Coastal counties
❑ HQW
4a
,Which of the following state - implemented stormwater management programs;apply
❑ ORW _
(check all that apply)
❑ Session Law 2006 -246
❑ Other
4b
Has,the approved Stormwater Management Plan with proof of approval been
❑ Yes ❑i No
attached? _,_
5
DWQ 401 Unit Stormwater Review
5a
Does the Stormwater Management Plan meet the appropriate requirements?
® Yes ❑ No
56
Have all of the 401 Unit submittal requirements been met?
® Yes ❑ No
Page 9 of 11
PCN Form — Version 1 3 December 10, 2008 Version

F
Supplementaryinformation
1.
Environmental Documentation (DWQ Requirement)
la
Does the project involve an expenditure of public (federal /state /local) funds or the
❑ Yes ® No
use of public (federal /state) land?
lb
If you answered "'yes" to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State
❑ Yes- ❑, No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1c
If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
❑ Yes ❑FNo
letter)
Comments
2
Violations (DWQ Requirement)
2a
Is the site in violation of DWQ Wetland Rules (15A NCAC 2H 0500), Isolated
Wetland Rules (15A NCAC 2H 1300), DWQ Surface Water orWetland Standards,
❑ Yes ®No
or Riparian Buffer Rules}(15A NCAC 213 0200)?
2b
Is this awafter- the -fact permit application?
❑ Yes ® No
2c
If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s)
3.
Cumulative Impacts (DWQ Requirement)
3a
Will this project (based on past and reasonably anticipated future impacts) result in
❑ Yes ®: No
additional, development, which could impact nearby downstream water quality?
3b
If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis imaccordance with the
most recent DWQ policy If you answered "no,," provide aishort°narrative description,
4
Sewage Disposal (DWQ Requirement)
4a Clearly detail the ultimate treatment methods and disposition (non - discharge or discharge) of wastewater generated from
the,proposed project, or available capacity of the subject facility
Project will not generate new wastewater
Page 10 of 11
PCN Form — Version 1 3 December 10, 2008 Version

5 Endangered Species and Designated Critical Habitat (Corps Requirement)
5a Will this project occur in or near an area with federally protected species or
El Yes ®No
habitat?
5b Havwyou checked with the USFWS concerning Endangered Species Act
® Yes ❑ No
impacts?
El Raleigh
5c If yes, indicate the USFWS Field Office you have contacted
® Asheville
5d What data sourcesAid you use to determine whether your site would Impact Endangered Species or Designated Critical
Habitat?
NC,Natural Heritage, Inventory Database
6- Essential Fish Habitat (Corps Requirement)
6a Will this project occur'in or near an area designated as essential fish habitat?
❑ Yes ® No
6b What data sources did you use to determine whether your site would Impact Essential Fish Habitat?
Project does not occur near coastal area or trout waters
7 Historic or Prehistoric Cultural Resources (Corps Requirement)
7a Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation
❑ Yes ® No
status (e g , National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b What data sources did you use to determine whether your site would'impact historic or archeological resources?
NC State Historic Preservation Office Database
8 Flood Zone Designation (Corps Requirement)
,8a WIII this project occur in a FEMA - designated 100 -year floodplain?
❑ Yes ® No
8b 'If yes; explainihow proje&meets FEMA requirements
8c What source(s),did yowuseto make the floodplain determination?
Alexander B Robinson
v!
Applicant/Agent's Printed Name
Date
Applicant/Agenfs Signature
(Agent's signature is valid only if an authorization letter from the applicant
is provided
Page 11 of 11

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Photo 3: Existing Shoreline— Station 5 +00
Photo 4: Existing Shoreline — Station 7 +50

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Photo 5: Existing Shoreline — Station 10+00
Photo 6: Existing Shoreline — Station 13+00

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CHARLOTTE NC, 28262
NOVA Project No: 10705- 2014003
ENVIRONMENTAL
5104 Reagan Drive, Sulte 8
Charlotte, NC 28206
Office: 980 -321 -4100
DRAWN BY S.SABOOREE
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