20141043 Ver 1_401 Application_20140914

of wArFq
o� oG Office Use Only:
2 0 1 4 1 0 4 3 Corps action ID no.
DWQ project no. .�
Form Version 1.4 January 2009
Page 1 of 10
PCN Form — Version 1.4 January 2009
Pre - Construction Notification (PCN) Form
A.
Applicant Information
1.
Processing
1 a.
Type(s) of approval sought from the Corps:
❑X Section 404 Permit ❑ Section 10 Permit
1 b.
Specify Nationwide Permit (NWP) number: or General Permit (GP) number: GP 30
1 c.
Has the NWP or GP number been verified by the Corps?
❑X Yes ❑ 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 NX 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 NX No
1 g.
Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below.
❑ Yes ❑X No
1 h.
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes ❑X No
2.
Project Information
2a.
Name of project:
Alan Ritchie construction Project
2b.
County:
Rowan
2c.
Nearest municipality / town:
Salisbury
2d.
Subdivision name:
Unnamed
2e.
NCDOT only, T.I.P. or state project no:
3.
Owner Information
3a.
Name(s) on Recorded Deed:
Alan L. Ritchie �9 2014
3b_
Deed Book and Page No.
pE
3c.
Responsible Party (for LLC if
applicable):
& QUFF pct o l?, �ES
3d.
Street address:
570 Scout Road
3e.
City, state, zip:
Salisbury, NC 28146
3f.
Telephone no.:
704 798 -2198
3g.
Fax no.:
3h.
Email address:
reneehtchie @bellsouth.net
Page 1 of 10
PCN Form — Version 1.4 January 2009

4. Applicant, Infonnation (if different from owner)_
4a Appliaant'is``- -
❑ Agent ❑ Other, speafy
4b Name- _ s r•
N/A `
4c Busies na'm`e -
- (if applicable) -
- - - - - --
4d Street address
4e City, `state,,zip:
4f Telephone -no
4g Faxno
- - - - - - - _ rte_ w•�
4h Email address: ? `
-i t
5. Agent/Consultant lRonnation (if applicable)„
5a Name - - -
N/A -
.5b. Business, name,
(if applicable),
5c Street,address
5d City, state, zip, t •
5e Telephone no.-:
5f Fax no..
5g Email address
. � - _ a :, •i . ' ' ` • ,, + . ',><`�` a �J �. .' .I -� 1 f.
I
_ 4
, t. . :JC'r.
,Page'2 of 10

B'.
Project Information and Prior Project History
1.
Property Identification -- - - _ -
1-a,
Property identification no (tax PIN or parcel) D)
N/A'
:' ,,
lb
Site coordinates (in decimal degrees) _
Latitude Longitude
-1c
Property size -
-acres
I
Surface Waters
'2a
Name of nearest body of watef to proposed project. '
-High' Rock Lake -
26
Water Quality Classification of nearest receiving water a'
2c , River basin , ,r.
Yadkin River r -
_3. - Project - Description
3a
Describe the existing conditions on the -site and the,general land use in the vicinity of the project at the time of-'this
application o _.
-Residential property needing boabng'access•to adjacent lake
3b
List the total estimated acreage of,all existing wetlands on the property 2
3c
List the total estimated linear feet,of,all existing streams•(intermdtent and perennial) on the, property
3d
Explain the,purpose of ;the proposed project
Residential property needing boating 'access to'adjacent lake - - _ _ _. _ _ _ _ Y. _
3e
Describe the overall project in detail, including the type of equipment to be used
Excavate lake bottom, moving spoil to high ground Bank stabilization of normal pool shoreline
4.
Jurisdictional Determinations
,4a. Havetlunsdictional.wetland.or stream determinations by'the -
[]'Yes ., • ❑ No } ®`'Unknown
Corps or State been requested or °obtained for this property /
' 'ast?
Comments Normal basm,of lake
ro ect mcludm all nor hales m the - 71 .
, pool
4b
If the Corps made the lunsdictional determination, wFiaYtype
❑ Preliminary ❑ Final
of determinat on Was made?
4c . If yes,,who delineated 'the,qunsdictional'areas? - -' -
-
Agency /Consultant Company '
R.
Name (if known) _
Other. - -- -- -
4d
If-yes, list the.dates,of the Corps lurisdictional,determmations or State.determmations and attach documentation
5.
Project History
5a
Have permits or certifications been•requested or obtained +for
- +
Yes ®No ❑,Unknown
--
this project (including' all prior,phases) in the pasty -_-
_
5b
If yes, explain in detail accoi=dmg'to °help file° instructions. -
6.
Future Project Plans - - - - -`
6a
Is this a,phased,prolect?
J ❑ Yes '® No
6b
If yes, explain
Page 3 of 10
`PCN'Form'-Version 1 4,January 2009

C. Proposed Impacts Inventory t_
1. Impacts Summary _
1a. _Which•sections were completed.below for your project (check all -that apply)
_ _❑ Wetlands Streams - tnbutanes Buffers ' ❑ _O en Wters + f -❑ •PoMnd ' Con` s tr` u 'c6on --
-2: Wetland Impacts
If there are wetland impacts proposed.on the site, then complete,this,question•for eacKwetland area,impacted'
2a
2b.
'2c.' ,•+ .
_2d.
:2e:-
F, 2f ->
Welland impad
Type ofimpact r
- Type of wetland <, ,, „,
Forested
Type_of ?lunsdiction
;,Area of, '
--- number
— _ _ ___ ___ __
,
_ _ � . _ _, . _
_ .._ _ � _
- Corps•(404 j 0) -or
r impact
Permanent (P) or
= ='} _�
DWQ (401, other)`
' ,(acres){ _
Tem'�ora _
_
_
-
W1- ' -' =
Choose one
_ - Choose;one - - --
Yes/No
W2 -
Choose one
Choose one
Yes/No
W3 -
Choose one
Choose one
fYes/No I
W4 -
Choose one
Choose one
Yes/No
-
W5 -
Choose one
- wChoose`one' - ; ;,i c1 ; s }
­,,t Yes/No .. -
a'• = " " +I..
T '
•Choose,one , L.:
5 i,. i� • ,r. Choose one,,,, <.
,Yes/No.�`
2g, Total Wetland - Impacts:,
> ff
2h Comments I.
3. Stream Impacts
'If there are perennial or intermittentstream impacts (including4brT pofary im`pacts') proposed :on,the site, then,complete this
- question -for all stream sites•impacted - -- - -- - - - - - - - - - - --
,3a y;<
+36, ,,,, '
3c. Z! ..,
3d - -' 1 •
_ r• '
3e ,, , "�,
_•_ '�s,
3f. _
3g -•,
Stream impact
Typelahmpact ,t
j ' Stream name
Perennial (PER) or i
, (,,,Type of: -
, ;Average-, +
:., Impact
-- number
°'
-`
:liriteimittent (INT)?'
-,,;jurisdiction-
i
stream -;
length
Permanent P ions
O
a i i
ti ' , ,
"'! i "
, ' '; - -
,width' � ,
,( linear'
--Temporary-(T)
- - -
- - --
- - - - - -
- -
(feet)
feet),
S1 -
Choose one
• • F ,
s� ,•
...,': �_'
,. , ,, ,
,
�. = r
S2. _ .—
- Choose -one
— - --
- -
- - _
- -
-
a
n e, < e
- �: Y r,
,,. tc -,} ^S.
SY -
ri1
S3 -
Choose one
S4 -
- - - -
Choose one
-- -
-
-
S_5
-S6
Choose one
s
- -
-
, Choose one,,
r
.r ._ ^1t ,r • s r. : °
i ' i _ _ . .
t
-,
,
,1
3h Total's and tributary
impacts
31. Comments -
Page 4 of 1b
PCN Form - Version 1.4 January 2009

4.� Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic'Ocean, or any other open water of _
the U.S then. individually list all open water irr acts below
4a _
4b - -
4c -
4d -
4e "
Open water
Name�ofLwaterbodv
"
impact number
(if applicable)
Type of impact
Waterbody
Area of impact (acres)
Permanent (P) or
type
Temporary T
01, T
XX
Excavation-
Lake-
-0
02
`
'Choose one"
Choose
03 -
Choose one
Choose
04 -
Choose one
Choose
- ,4f Total• open.water impacts
f.
44" Comments _
5. Pond or Lake Construction - - - - -
If and or1ake=nstruction ro osed; then complete the-,chart below
-5a -
- 5b -
Sc
5d - -
5e -
Pond ID number
Proposed use or
Wetlandilmpacts (acres)
Stream Impacts (feet),
Upland
purpose of pond
: , •,
-
�4(ac�esp
L ii" .
Flooded
Filled
Excavated
_Flooded
Filled
Excavated
P1_
` Choose one
- -
P2
Choose one
,.
5f- Total:
5g-Comments
5h Is a dam high'hazard permit required
O' Yes ° ❑ No i 'if-yes', j*rmit ID no -
51 _Expected pond)surface areaa (acres)
5j Size of pond watershed (acres)
5k Method of construction -
-6: Buffer Impacts (for DWO)' - - -- -
If project,willPimpact a protected riparian buffer, then- complete the' chart, below, lftiyes; then {individuallydlist'all,buffer impacts
below If any impacts require mitigation, then you MUST fill out Section ;D, of this form. :1-
6a. Proiect;is in which protected basins' -- ;'
❑ Neuse ❑ Tar - Pamlico ❑ Catawba ❑ Randleman ❑Other
6b
6c
6d _' :"
- 6e -
'6f
6g'_' _
Buffer Impact
Reason for impact.-,
Stream,name
Buffer
Zone, 1,
Zone 2.
number =•
-
-- -
mitigation
} ' impact
i impacts
Permanent (P) or
required ?'
(square
(square'__,
Temporary
{ 9 _
feet),; -
feet _
B1 -
Yes/No.
62 -
- _
Yes/No
-
B3 -
- -
Yes/No
-
B4 -
-
Yes/No
-
-
B5 -
B6 -
Yes/No
6h Total Buffer Impacts:
�6i Comments
Page 5 of 10

D. Impact Justification and Mitigation A�,
1. Avoidance and Minimization
la. Specifically,describe, measures taken to avoid or minimize the proposed imOa&tsidAbsignihg project 'V,
iii 6im—ae'ffie proposed impact
2a Does the project require Compensatory Mitigation-for
E] Yes No
impacts to Waters of the U-S or Waters of-the State?,
,2b_ If yes, mitigation srequiredby_(chikr�.all th4tapply), ;,..,i,.'E]rDWQ-
[]Corps'-,
Mitigation �bank-
2q.-'If yes, which mitigation option willbe used for this
_0 Payment to in-Ii6u`fee'pr-o'gr'am'
2_ El Permiftee.Responsible Mitigation-,
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Biink:
Type Choose one
Quantity
Type Choose one
Quantity -
3c -Comments
4. Complete if Making, a- Payment toln-lieu Fee Program,%-
4b Stream mitigation re te
,4c -if,u-sing,stream,mi�g�tion,-stream temperature:
Choose one
4b -Bu#er mibgatior�requiested'(DWQ only)
square feet
4f, Non-rip@ _qgr�,Wqtland mitig#bqn requested.
acres',_
5. Complete ifUsing �-Permittee. Responsible Mitigatlon Plan.
Page G`nt1CL
' ' 'PCN Form - Version 14 January 2OOS

6. Buffer Mitigation (State Regulated Riparian Buffer Rules) -required by DWQ
6a. Will the,project result imari*impa6t within,a'Orotdctddnpanan bUftfihaflre Uirbs
Y e s '
Puffer mitidobqn?
-No.
6b If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount' 6fiiWitigaton�(eq6i-r-ed
6c
6d
6e
Zone
Reason*f6r impact
Total impact
Multiplier-
q'R6ctj. Required Vnitigaboh-
(square feet)
(sqUafe-f66Q)'1­­'),5
zah6 1
(2 for Catawba)
Zone 2
6f Total buffer mitigation required:
6g If buffer mitigation qk
- - ffe mciation i - - - - _ - qutmd,_discuss.what_type_9f mitigation is proposed (e g ,payment.to private, mitigation bank,
permittee responsible jp payment moan appirove61n-Aieu,fee fund)y ,,,,,
,apan,bufferEetstoration,
6h Comments
;.-,f 11,!! '.1vi v: a ;N, U31z
%
T. 5,
Page 7 of 10

E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1.
Diffuse Flow Plan
'la
Does the, project include or is, it adjacent,,tq, prote4ed riparian ;Ouffers,ndentified,
❑Sydg No's &t '<i,
within one of the, NC Ripinan, Buffer'6roiection Rules?
"I b-
If yes,Ih6irf is,a,diW66 flow 0166:661uded?.Ilf hb-, 6xpl&ifi Whg,.
".[],.Y.es,­ 1,i[D>No
2.
{C^ 40 .1"
StormwatiirsManagement,Plan
2a
What,is•the,overA percent'imperviousnessofthis project?-,
2b
Does" this project require a Stormwater Management Plan?:
❑ Yes ❑,No
2c
Ifthis project DOES'NOT require4a'Storrnwater-Managemen't'Plan; explain Why
0
AL-, _43
2d.
If this project DOES requi e' 6 VaniageFnefit Plaini en-jrdvi6� �A'641
r' ai�f rm4k�f� 'fh" si`6ii�f rrative desdhotionthh76 plan
2e
Who will be responsible for the review of the StormwaterNanagement Plan?
3.
Certified Local Government Stormwater Review
3a
In which local government's jurisdiction is this project?
❑ Phase II
❑NSW
3b
Which of the following locally-implemented stormwater management programs
apply (check all that apply)
❑ USMP
❑ Water Supply Watershed
❑ Other.
3c.
Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ❑ No
attached?,
4. DWO Stormwater Program Review
❑Coastal counties
❑HQw
4a.
Which of the following state-implemented stormwater management programs apply
ORW
(check all that apply)
HSession Law 2006-246
❑Other
4b
Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ❑,No
attached?
S.
DWO 401 Unit Stormwater Review
5a
Does the, Stormwater Management Plan meet the appropriate requirements?
❑ Yes ❑ No
5b
Have all of the 401 Unit submittal requirements been met?
❑ Yes ❑ No
Page 8 of 10
-1 10 - ••PCN Form - Version 14 January 2009

T. -Supplementary- Information -
1.
Environmental Documentation (DWQ'Requirement)
la
Does,the,,prolect;involve,an expenditure of public'(fe'deraUstafe/local) funds�or'the
Yes Q No
use of public (federal /state) Iand?
lb
-if you answered "yes" to the above, does the pro�ect,regw�e'preparation'of an
environmental'document pursuant to the fequirements of theNational or' State
❑ Yes - El No-
- (North -'Carolinaj. Envdoninerital'Poliey Act (NEPA/SEPAj?
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
-
letter)
,� Yes No .
,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), D,WQ,Surface Water-'or Wetland Standards, _
-QYes ❑ No _
or Riparian Buffer Rules (15A NCAC 2B 0200)? -
-
,
2b
Is this an after - the -fact permit applications , r
❑Yes, , ; ONO"
,
2c
If you answered "yes" to one or 'both of the above.quesbons, provide an explanation of theAyiolatron(s)
3.
Cumulative Impacts (DWQ Requirement)
3a
Will•this,project (based on past,and.reasonably anticipated;future impacts ),result in
Yes "©FNo
additional'development „whi66 could impact'nearby downstream water quality? _
3b
If you answered "yes” to the above, submita qualitative or quant6tive. cumulative impact analysis in accordance with,the
mostsecent DWQ policy If you answered "no," provide a short 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.
-
nla
Page 9` of 10
- , �PCN Form — Version 1.4 January 2009

5. - Endangered Species and.Designated `Critical Habitat (Corps Requirement)
5a_ Will this,project occur, in.or near, anlarea with,federally, protected species or-
Ye "s " ❑X ' No
habitat?
5b. Have you _checked with the USFWS conceming,Endangered,Species,Act
•:,
_
' - -' �iYes� ' ®'No= r ,
impacts?
5c If yes, indicate the USFWS Field Office you have contacted
f i .. • j i it s -. , _ ,r : �'. ,t _t(r - :, j � +r`.' r e- ,� 's: • j, ttr :" i
5d. What data sources did you use to determine whether your site, Wouid,impact.Endangered•Spectes or Designated -Critical
- Habitats - -- - - - - -- - - - - - - - --
�t. _, '9• _.,.i - t. - �' l• � � r ` -• 'S ,rte ..
6. Essential' Fish Habitat (Corps Requirement) -`
.6a Will this project occur, in.or near -an area designate6as essential fish habitat?
- Yes - ® No
6b What data sources didyouu.use to determine whether-your site.would impact- Essential,Fish- Habitat? - - —
' 1K'�-,..- .4 »I r• rt. ti' t.•'' r ',*S l "Air " :'�'� 'r .•tC f "- ,r: /i'
T h ` . : ,. ,— 1R •i L
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a Will this project occur in br- `nearfan area that the state, federal or tribal ''
' - r ` ' e'
govemmerit's have desigrated'as having historic of cultural`preservation -
-
' (] Yes,
status (e.g., National Historic Tnist'designation or propeities`sigrnficant in "
North Carolina history and archaeology)?
7b What data sources did you use to determine whether your site would impact historic or archeological resources?
8. Flood Zone,Designation (Corps Requirement) n."'• rv. '' • _3
8a Will this, project occup ri a-FEMA- desigriated'1001year floodplain? -" ' 4
-` -y-es ! f X❑ No " z"
i, t - „r . t, O•
1if_t., r}r” ,.P — 1 'Iv
81i If ye "s, explain how project meets FEMA re`quiremerits
Y ,�• r r• , „J. . r ivy. wf vii4z ,,{ 1 �1•'f a ..a . ''J - .. < _ _''. ,. , t + Z _ f, .i, -. .its
8c. What source(s) did you use to make the floodplain determination?
Alan L Ritchie
���°� 1 /lj � -
Sept - 25';2014 '
Applicant/Agent's Printed Name
Date
Applicant/Agent's Signature
(Agent's signature is valid only if'an authorization
letter from the applicant is provided
_� �� Page 10 of 10

Page 1 of 1
Print
Date: Thursday, September 25, 2014 2:51 PM
From: Homewood, Sue <sue.homewood @ncdenr.gov>
To: britchie99856 @roadrunner.com <britchie99856@ roadrunner. com>
Subject: FW: application information
Sue Homewood
NC DENR Winston -Salem Regional Office
Division of Water Resources — Water Quality Programs
585 Waughtown Street
Winston- Salem, NC 27107
Voice: (336) 771 -4964
FAX: [phone]
E -mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
disclosed to third parties.
From: Homewood, Sue
Sent: Monday, September 22, 2014 1:44 PM
To: 'britchie @roadrunner.com'
Subject: application information
Please send 2 copies of the form and here:
NC DWQ, WBSCP Unit
1650 Mail Service Center
Raleigh, NC 27699 -1650
The following is important information to include with your application:
• A check made out to NCDWR for $240
• Some type of site map so that someone unfamiliar with the area can locate your project. A county map or USGS
topographic map indicating the project location is usually sufficient.
• A site plan showing the location of the shoreline. location of the impacts to the shoreline and/or lake bottom and the location
and any vegetated areas that will be impacted.
o In most cases the site plans do not have to be professionally prepared. However, if you intend to conduct hydraulic
dredging, professionally prepared drawings will likely be required for the spoil structures.
Sue Homewood
NC DENR Winston -Salem Regional Office
Division of Water Resources — Water Quality Programs
585 Waughtown Street
Winston- Salem, NC 27107
Voice: (336) 771 -4964
FAX: [phone]
E -mail correspondence to and from this address may be subject to the North Carolina Public Records Law and may be
disclosed to third parties.
o Jkr0 Fp2 Ate- k� NFL P
http' // webmail .roadrtumer.com /do /mail/message /preview ?msgId= fNBOXDELIM44214 9/25/2014

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