20150076 Ver 1_401 Application_20150115

CLEARWATER ENVIRONMENTAL
CONSULTANTS, INC.
224 South Grove Street, Suite F
Hendersonville, NC 28792
(828) 698 -9800
FAX [phone]
Jennifer Burdette
NC Division of Water Resources
512 N. Salisbury St.
Raleigh, NC 27604
LETTER OF TRANSMITTAL
DATE:
1.19.2015
PROJECT: 782
ATTENTION:
RE: Sunny View Lane Water Line
Polk County, NC
5
WE ARE SENDING YOU ® ATTACHED ❑ UNDER SEPARATE COVER VIA THE FOLLOWING ITEMS
COPIES
DATE
NO.
DESCRIPTION
5
1 192015
Application for 401 Certification
THESE ARE TRANSMITTED AS CHECK BELOW
® For approval
❑ For your use
❑ As requested
❑ For review and comment
REMARKS
❑ Approved as submitted
❑ Approved as noted
❑ Returned for corrections
❑ Materials returned after loan to us
❑ Resubmit copies for approval
❑ Submit copies for distribution
❑ Return corrected prints
El
Enclosed are five copies of our application We sent a courtesy copy to Andrew Moore in the Swannanoa office on December 15,
2014 However, upon further review this project will require a 401 Certification
Please do not hesitate to contact Clement at (828) 698 -9800 if you have any questions.
COPY TO
SIGNED �=
CLEARWATER ENVIRONMENTAL CONSULTANTS, INC
J

CL rWaLer
Department of the Army NCDENR
Wilrrungton District, Corps of Engineers NC DWR, Webscape Unit
Attn: Scott McLendon, Chief Regulatory Division Attn: Karen Higgins
PO Box 1890 512 North Salisbury Street
Wilmington, NC 28402 -1890 Raleigh, North Carolina 27604
I, the current landowner /managing partner of the property identified below, hereby
authorize ClearWater Environmental Consultants, Inc. (CEC) to act on my behalf as my
agent during the processing of jurisdictional determination requests and permits to impact
Wetlands and Water of the US subject to Federal jurisdiction under Section 404 of the
Clean Water Act and /or Section 10 of the Rivers and Harbors Act of 1899. CEC is
authorized to provide supplemental information as needed at the request of the USACE
or DWR.
Additionally, I authorize representatives of the Wilmington District, US Army Corps of
Engineers to enter upon the property herein described for the purposes of conducting on-
site investigations and issuing a determination associated with Wetlands and Waters of
the US subject to Federal jurisdiction under Section 404 of the Clean Water Act and /or
Section 10 of the Rivers and Harbors Act of 1899.
Property Owner of Record:
Property Owner of Address: q0 O(RArY 6A Sf. S -` e��
Phone Number:
Property Location: 4w N6 6 r-,�
Owner/Managing Partner ,�J_,
Printed Name: j' t !
Owner/Managing Partner Signature:
Date,
224 South Grove Street, Suite F
Hendersonville, NC 28792
Phone: 828 - 698 -9800
www cwenv.com

C1earWater Environmental Consultants, Inc.
www.cwenv.com
December 15, 2014
Mr. David Brown
US Army Corps of Engineers
Asheville Regulatory Field Office
151 Patton Avenue, Room 208
Asheville, North Carolina 28801 -2638
RE: Sunnyview Elementary Water Line ( +/ -5.9 miles)
Polk County, North Carolina
Dear Mr. Brown,
The attached Pre - Construction Notification (PCN) is being submitted on behalf of Polk County
represented by Mr. Marche Pittman. The proposed water line is located along NC Highway 9
between Big Level Road and NC Highway 108 in Mill Spring, Polk County, North Carolina. The
county is seeking a Nationwide Permit 12 for installation of the proposed water line.
A copy of this package has been sent to Ms. Andrea Leslie of the NC Wildlife Resources
Commission for review. A courtesy copy of this application has also been submitted to Mr. Tim
Fox of the NC Division of Water Resources, Asheville Regional Office. Please do not hesitate to
contact me at 828 - 698 -9800 if you have any questions or comments.
Respectfully,
Kevin Mitchell
Biologist
Copy Furnished:
NC Division of Water Resources, Asheville — Tim Fox
NC Wildlife Resources Commission — Andrea Leslie
224 South Grove Street, Suite F
Hendersonville, NC 28792
828 -698 -9800 Tel
828 - 698 -9003 Fax
/� a l6 9
R. Clement Riddle, P.W.S
Principal

Corps Submittal Cover Sheet
Please provide the following info:
1. Project Name: Sunny View Elementary Water Line
2. Name of Property Owner /Applicant: Polk County; Mr. Marche Pittman
3. Name of Consultant/Agent: ClearWater Environmental Consultants, Inc.
*Agent authorization needs to be attached.
4. Related/previous Action ID numbers(s):
5. Site Address: NC -9 between NC -108 and Big Level Rd.
6. Subdivision Name: n/a
7. City: Mill Spring
8. County: Polk
9. Lat: 35.331260N Long: - 82.185564W (Decimal Degrees Please
10. Quadrangle Name: Mill Spring
11. Waterway: Walnut Creek, Green River, Little White Oak, Canal Creek, and
unnamed tributaries
12. Watershed: Broad 03050105
13. Requested Action:
X Nationwide Penmit # 12
General Permit #
Jurisdictional Determination Request
Pre - Application Request
The following information will be completed by the Corps office:
AID:
Prepare File Folder Assign number in ORM Begin Date
Authorization: Section 10 Section 404
Project Description/Nature of Activity/Project Purpose:
Site/Waters Name:
Keywords:

o�0F w A rF9
h r
a()IS,I)o7l-67
Office Use Only-
Corps action ID no
DWQ project no.
ForTJVersio"�n 1f3 Dec 10 2008
Pre - Construction Notification (PCN)'Form__
—
A. Applicant Information
1. Processing
1a Type(s) of approval sought from the
Corps
®Section 404 Permit ❑Section 10 Permit
1b Specify Nationwide Permit (NWP) number 12 or General Permit (GP) number.
1c. 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
1e 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-
Sunny View Elementary Water Line
2b. County:
Polk
2c. Nearest municipality / town:
Mill Spring
2d. Subdivision name:
n/a
2e. NCDOT only, T.I.P. or state
project no:
n/a
3. Owner Information
3a. Name(s) on Recorded Deed:
See attached list (Attachment A).
3b. Deed Book and Page No.
3c Responsible Party (for LLC if
applicable):
3d. Street address:
3e City, state, zip:
3f Telephone no..
3g. Fax no.:
II J IN 2 -
3h Email address:
aot 8 8 FFER PERMITTING
Page 1 of 11
PCN Form — Version 1 3 December 10, 2008 Version

4. Applicant Information (if different from owner)
4a Applicant ►s:
❑ Agent ® Other, specify- Polk County, utility easement holder
4b. Name
Mr Marche Pittman
4c. Business name
(if applicable)-
Polk County
4d. Street address:
40 Courthouse Street
4e. City, state, zip.
Columbus, NC 28722
4f. Telephone no.:
828 - 894 -3301
4g Fax no.-
4h. Email address:
mpittman @polknc org
5. Agent/Consultant Information (if applicable)
5a. Name:
Mr Clement Riddle
5b. Business name
(if applicable):
ClearWater Environmental Consultants, Inc.
5c. Street address-
224 South Grove Street, Suite F
5d. City, state, zip:
Hendersonville, North Carolina 28792
5e. Telephone no.:
828 -698 -9800
5f Fax no.-
n/a
5g. Email address.
Clement @cwenv.com
Page 2 of 11
PCN Form — Version 1 3 December 10, 2008 Version

B. Project Information and Prior Project History
1. Property Identification
la Property identification no (tax PIN or parcel ID)
See attached list (Attachment A)
1b. Site coordinates (in decimal degrees) Attachment C
Latitude. 35.331260 Longitude - 82.185564
(DD DDDDDD) ( -DD DDDDDD)
1c. Property size:
+/ -3 5 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc ) to
Canal Creek, Little White Oak, Green River, Walnut
proposed project:
Creek, and unnamed tributaries.
2b. Water Quality Classification of nearest receiving water.
All receiving waters are class "C ".
2c. River basin
Broad 03050105
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:
Residential and commercial dwellings, as well as, agricultural fields are included in the vicinity of the proposed water line.
3b. List the total estimated acreage of all existing wetlands on the property:
0 acres
3c List the total estimated linear feet of all existing streams (intermittent and perennial) on the property.
100 linear feet
3d. Explain the purpose of the proposed project:
The purpose of this project is to provide drinking water to residents and businesses along NC Highway 9.
3e. Describe the overall project in detail, including the type of equipment to be used'
The project includes the installation of a new water line from the town of Mill Spring to Big Level Road along NC Highway
9 The project will include nine stream crossings (Figure 3)
Stream Crossings — The proposed water line will be installed using the trench -cut method. The trench -cut method
involves dewatering the work area and excavating a trench in which the water line is laid. The water line is then covered
with the native materials removed from the trench and the contours are returned to pre - existing conditions. In this
method, stream impacts are temporary Typical details for stream crossings are included for review (Attachment B).
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?
❑ Yes ® No ❑ Unknown
Comments:
4b. If the Corps made the jurisdictional determination, what type
❑ Preliminary ❑ Final
of determination was made?
4c. If yes, who delineated the jurisdictional areas?
Agency /Consultant Company
Name (if known):
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
❑ Yes ® No El Unknown
this project (including all prior phases) in the past?
5b If yes, explain in detail according to "help file" instructions
Page 3 of 11
PCN Form — Version 1 3 December 10, 2008 Version

6. Future Project Plans
6a. Is this a phased project? ❑ Yes ® No
6b If yes, explain
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
Page 4 of 11
PCN Form — Version 1 3 December 10, 2008 Version

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)
DWO — 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 ❑ PDT
❑ Yes
❑ Corps
❑ No
❑ DWQ
W5 ❑ P [:IT
❑ Yes
❑ Corps
❑ No
❑ DWQ
W6 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWO
2g. Total wetland impacts
2h. Comments: See attached table.
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) 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
DWO — non -404,
width
(linear
Temporary (T)
(INT)?
other)
(feet)
feet)
S1 ❑ P ® T
Impact S1 - Utility
Canal Creek
® PER
® Corps
10
10
Crossing
❑ INT
® DWQ
S2 ❑ P ®T
Impact S2 - Utility
Little White Oak
® PER
® Corps
8
10
Crossing
Creek
❑ INT
® DWQ
S3 ❑ P ® T
Impact S3 - Utility
UT Little White
® PER
® Corps
5
10
Crossing
Oak Creek
❑ INT
® DWQ
S4 ❑ P ®T
Impact S4 - Utility
UT Little White
® PER
® Corps
4
10
Crossing
Oak Creek
❑ INT
® DWQ
S5 ❑ P ®T
Impact S5 - Utility
Crossing
UT Green River
® PER
❑ INT
® Corps
® DWQ
12
10
S6 ❑ P ®T
Impact S6- Utility
UT Green River
® PER
® Corps
4
10
Crossing
❑ INT
® DWQ
S7 ❑ P ®T
Impact S7- Utility
Crossing
Green River
® PER
❑ INT
® Corps
® DWQ
120
20
S8 ❑ P ® T
Impact Se- Utility
UT Green River
® PER
® Corps
4
10
Crossing
❑ INT
® DWQ
S9 ❑ P ®T
Impact S9- Utility
UT Walnut Creek
® PER
® Corps
10
10
Crossing
❑ INT
® DWO
3h. Total stream and tributary impacts
100
3i. Comments:
Page 5 of 11
PCN Form — Version 1 3 December 10, 2008 Version

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 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
02 ❑P
03 ❑PEI
04 ❑P ❑T
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.
Pond ID
Proposed use or purpose
Welland Impacts (acres)
Stream Impacts (feet)
Upland
number
of pond
(acres)
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.
5i. Expected pond surface area (acres):
5j 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 MUST fill out Section D of this form.
6a.
❑ Neuse ❑ Tar - Pamlico ❑ 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)
Temporary T
impact
required?
B1 ❑P ❑T
El Yes
❑ No
B2 ❑P ❑T
❑Yes
❑ No
133 ❑P ❑T
El Yes
❑ No
6h. Total buffer impacts
61 Comments:
Page 6 of 11
PCN Form — Version 1 3 December 10, 2008 Version

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a Specifically describe measures taken to avoid or minimize the proposed impacts in designing project
The water line will be placed beneath the stream The line will be trenched in and stream contours will be returned to
preexisting conditions Stream impacts are limited to the amount necessary to install the line
1b Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques
Construction equipment will be operated from high ground during construction Coffer dams will be constructed in the stream
to allow the work to be performed in the dry Silt fencing will be installed along the entire length of the stream Coconut fiber
matting will be utilized to stabilize the stream banks The installation of the proposed water line crossing should take less than
one day to install at each crossing
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a Does the project require Compensatory Mitigation for
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 ❑ Corps
2c If yes, which mitigation option will be used for this
projects
❑ 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.
❑
4b. Stream mitigation requested:
0 linear feet
4c If using stream mitigation, stream temperature-
❑ warm ❑ cool ❑cold
4d Buffer mitigation requested (DWQ only)-
0 square feet
4e. Riparian wetland mitigation requested-
0 acres
4f. Non - riparian wetland mitigation requested:
0 acres
4g. Coastal (tidal) wetland mitigation requested:
0 acres
4h. Comments:
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.
Page 7 of 11
PCN Form — Version 1 3 December 10, 2008 Version

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
buffer mitigation?
❑ Yes ® No
6b If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.
Zone
6c
Reason for impact
6d.
Total impact
(square feet)
Multiplier
6e
Required mitigation
(square feet)
Zone 1
3 (2 for Catawba)
Zone 2
1.5
6f. Total buffer mitigation required:
6g If buffer mitigation is required, discuss what type 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:
Page 8 of 11
PCN Form — Version 1 3 December 10, 2008 Version

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 El No
Comments
2. Stormwater Management Plan
2a What is the overall percent imperviousness of this project?
0%
2b. Does this project require a Stormwater Management Plan?
❑ Yes ® No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why. The project includes installation of a
water line and will not increase impervious surface area at the site
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan-
❑ Certified Local Government
2e Who will be responsible for the review of the Stormwater Management Plan?
❑ DWO Stormwater Program
❑ DWQ 401 Unit
3. Certified Local Government Stormwater Review
3a. In which local government's lunsdiction is this project?
City of Hendersonville
❑ Phase II
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
4a. Which of the following state - implemented stormwater management programs apply
❑ HQW
❑ ORW
(check all that apply):
❑ Session Law 2006 -246
❑ Other -
4b. Has the approved Stormwater Management Plan with proof of approval been
attached?
❑ Yes ❑ No
S. DWQ 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 9 of 11
PCN Form — Version 1 3 December 10, 2008 Version

F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1a 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 ❑ No
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 or Wetland Standards,
❑ Yes ® No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. Is this an after - 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 in accordance with the
most recent DWQ policy If you answered "no," provide a short narrative description
The water line will serve the existing residents along NC Hwy 9. Additional development in the surrounding area is
independent of the project The project will not result in additional development that could impact downstream water
quality
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.
Wastewater will not be generated as a result of this project.
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
❑ Yes ® No
habitat?
5b. Have you 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 sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
FWS County data and Natural Heritage Program GIS data.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?
❑ Yes ® No
fib. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
South Atlantic Habitat and Ecosystem IMS. Impact will not occur in a marine system
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?
National Register of Historic Places records maintained by the NC State Historic Preservation Office (SHPO) and
available on SHPO's HPOWEB GIS service There are two historic sites within two miles of the site. The Reverend
Joshua D. Jones house (HPO Site ID PL0010) is 0.5 miles from the project. The Stony Knoll Library (HPO Site ID
PL0051) is 0.7 miles from the project. It is the opinion of CEC, that the proposed activity is not likely to threaten the
integrity of these sites.
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA- designated 100 -year floodplain?
® Yes ❑ No
8b. If yes, explain how project meets FEMA requirements, The water line will be sub - surface and upon completion of
construction, contours will be returned to pre - existing conditions throughout the length of the floodplain. Installation of the
line will not result in a rise to the floodplain elevation
8c What source(s) did you use to make the floodplain determination? FEMA Map Service Center Map Panel 3710055700J,
3710055800J, 3710055900J, and 3710065000J (effective date 09/0312008)
K C �-Mt:A Q--Me-
Applicant/Agent's Printed Name
A licant/A ent's Si nature
PP 9 9
Date
(Agent's signature is valid only if an authorization letter from the applicant
is provided
Page 1 l of 11
PCN Form — Version 1 3 December 10, 2008 Version

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- Proposed Water Line
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ndersonville, North Carolina 28792
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Figure 1

Sunny View Elementary Water Line ( +/- 5.9 miles)
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Polk County, CLear�/ater USGS Topographic Map
Mill Spring Quad
North Carolina
224 South Grove Street, Suite F Figure 2
Hendersonville, North Carolina 28792

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224 South Grove Street, Suite F
Hendersonville, North Carolina 28792

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CLearWaLer Impact Map
Polk County, Sheet 3C
North Carolina 224 South Grove Street, Suite F
Hendersonville, North Carolina 28792

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North Carolina
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224 South Grove Street, Suite F
Hendersonville, North Carolina 28792
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Polk County,
North Carolina
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224 South Grove Street, Suite F
Hendersonville, North Carolina 28792
N
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FEMA Floodplain Map
FEMA Map Service Center
Figure 6

Attachment A
Property Owner Information

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Attachment B
Construction Typicals

1 EXCAVATE BANKS TO WATER LEVEL PLACE RE-
MOVED MATERIAL BEHIND SILT FENCE
2 INSTALL COFFER DAM
3 INSTALL WATER MAIN
x'
"x
4 REPEAT FROM OPPOSITE SIDE FOR SECOND
—�
,. j ; , 'X /I< ;
°
HALF OF PIPE INSTALLATION
'
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_
—11 Toe �'�'��J
150 LF OF DUCTED IRON
5 INSTALL COCONUT -TYPE DITCH MATTING ALONG
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STREAM BANKS WITH CORRECT SEEDING AS
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1/2 MID7N OF VEF
- II— III —II
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PLLC
152 E., M.I. S, M Fo Cl. N C 28043
p5 828 247 X "f.. 829 247 J 8
/ >
1•— 12' MIN –20' MAX
RIVER / CREEK CROSSING
TYPICAL
HM
COCONUT STRAW
MATTING
Pro
Oeo ..uer
s�.
TYPICAL RIVER CROSSING
ww
POLK COUNTY HWY 9
SUNNY VIEW SCHOOL
WATERLINE EXTENSION
GREEN RIVER CROSSING
COi'iER DAM SHALL DE 7 Hamm
TNAN El"AMON OF MATER
COCOLN7 STRAW MATTING
SEPTEMBER 22, 2014
SCALE: N.T.5.

COCONUT STRAW
� MATTING
CONCRETE DEADMAN,
PER DETAILS .
3' -0' MINIMUM FROM
BOTTOM OF CREEK
100 LF OF DUCTILE IRON PIPE WITH RESTRAINED JOINTS (MEGALUG OR
OMITS OF CREEK CROSSING
Odom
Engineerin
PLLC
152 F ft W, St-, F-i C81, N C 28041
ph 828 247 4491 4. 028 247 0498
crrrr•;r
EPAA IRON
1110 MECALUC
350 PSI RATINC
UL
WMC RATED 175 PSI
FOR USE ON DUC TILE IPON PIPE
MADE IN THE USA
TYPICAL CREEK CROSSING
NOT TO SCALE
POLK COUNTY HWY 9
SUNNY VIEW SCHOOL
WATERLINE EXTENSION
TYPICAL STREAM CROSSING
SEPTEMBER 22, 2014
SCALE: N .T.5

Attachment C
Impact Coordinates

Stream Impact Coordinates
Impact
Latitude
Longitude
S1
35.306744
- 82.164377
S2
35.313923
- 82.171124
S3
35.314931
- 82.172244
S4
35.31687
- 82.174481
S5
35.32376
- 82.183385
S6
35.327953
- 82.184908
S7
35.33331
- 82.184837
S8
35.347821
- 82.180508
S9
35.368352
- 82.184229

c �earWater
Department of the Army NCDENR
Wilmington District, Corps of Engineers NC DWR, Webscape Unit
Attn: Scott McLendon, Chief Regulatory Division Attn: Karen Higgins
PO Box 1890 512 North Salisbury Street
Wilmington, NC 28402 -1890 Raleigh, North Carolina 27604
I, the current landowner /m4naging partner of the property identified below, hereby
authorize ClearWater Environmental Consultants, Inc. (CEC) to act on my behalf aS my
agent during the processing of jurisdictional determination requests and permits to impact
Wetlands and Water of the US subject to Federal jurisdiction under Section 404 of the
Clean Water Act and /or Section 10 of the Rivers and Harbors Act of 1899. CEC is
authorized to provide supplemental information as needed at the request of the USACE
or DWR.
Additionally, I authorize representatives of the Wilmington District, US Army Corps of
Engineers to enter upon the property herein described for the purposes of conducting on-
site investigations and issuing a determination associated with Wetlands and Waters of
the US subject to Federal jurisdiction under Section 404 of the Clean Water Act and/or
Section 10 of the Rivers and Harbors Act of 1899.
Property Owner of Record:
Property Owner of Address: _I
Phone Number:
Property Location: 1tJ d I'-�
Owner/Managing Partner
Printed Name: A?14'�paw
Owner/Managing Partner Signature:
Date: S '�
224 South Grove Street, Suite F
Hendersonville, NC 28792
Phone: [phone]
www.cwenv.com