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Home My WebLink About20150645 Ver 1_Shoreline Stabilization_20150629Soil Horizons, Inc. Memo j PO Box 1063 ` Youngsville, North Carolina 27596 DATE June 24, 2015 TO NC Division of Water Resources FROM John R. Davis, Jr. LSS RE 6199 Williams Court Shoreline Stabilization and Dredging Project Tar River Reservoir in Nash County, NC The above referenced project will be completed in phases as budget permits. The first phase will be a shoreline stabilization effort. See attached 4 sets of Shoreline Stabilization Application form and associated figures and attachments. The stream feature that empties into the subject cove is not a buffered stream feature since is not on the USGS or the NRCS soil maps. The only buffers on this site are imposed on this property by the backwaters of the Tar River by the construction of the dam The second phase will be to dredge the sediment out of the water body to create enough deep water for watercraft This work is proposed to be done s3bno Ra 'N30 with the enclosed PCN under Nationwide Permit 16 and associated water S10Z 94 Nnr I quality certification. See attached 5 sets of PCN application and plans. A � O final phase will be the construction of a boat dock from the retaining wall 9q0 �� C' (� to the deep water. We understand that the placement of pilings in the water is not considered by the US Army Corps of Engineers as fill and does not require a permit on this body of water. Please review the attached documents and consider for approval Find attached a check in the amount of $240 for the application review fee. Thanks John Davis 919 - 818- 5087mb A State of North Carolina DWR Department of Environment and Natural Resources Division of Water Resources Division of Water Resources 15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization FORM: SSGP 10 -2013 Shoreline Stabilization Application Fora PAIO Four copies of the application (including attachments) and the application fee $0uld be sen t to: Division of Water Resources 401 & Buffer Permitting Unit 1617 Mail Service Center 2 0 1 5 0 6 4 5 Raleigh, NC 27699 -1617 I. Applicant Information (15A NCAC 02H .0502(a)j 1. Owner Information Name: Lisa Bazemore Mailing Address: 6177 Williams Court Rockv Mount NC 27803 Telephone Number, 252 - 904 -4960 Fax Number- E-mail Address LisabazemoreI @gmail.com 2. Agent/ Contact Person Information A signed and dated copy of the Agent Authorization letter (a form can be downloaded here: http / /www saw usace.armv. mil /Portais /59 /docs /resulatory /regdocs /Permits /SAMPLE AGENT AUTH ORIZATION FORM.pdf) must be attached if the Agent has signed this application form. Name: John Davis Company Affiliation Soil Horizons Mailing Address: PO Box 1063 Younesville, NC 27596 Telephone Number: 919 - 818 -5087 Fax Number: 919 - 554 -2363 E -mail Address soilhorizons @gmail.com Person to receive the Certification Approval: John Davis Ill. Project Information )15A NCAC 02H .0502(a) & NJ 1. Attach a vicinity map (Le street map) clearly showing the location of the property with respect to local landmarks such as towns, rivers, and roads. 2. Provide a detailed site plan showing property boundaries and proposed locations of vegetation clearing, structures (buildings, retaining walls, docks, impervious surfaces, FORM SSGP 10 -2013 Page 1 of 4 etc.), rip rap, excavation or dredging below Full Pond/ Normal Water Level elevations, and construction access corridors. You may use the diagram provided at the end of this application form 3. Attach a photograph of the shoreline/ buffer proposed to be stabilized. (Include a scale of some sort- a yard stick, shovel handle, etc ) 4 Location of the property (where work is to be conducted) County: Nash Nearest Town: Rocky Mount Subdivision name or site address (include phase /lot number): Williams Pointe Directions to site -please include road names and numbers, landmarks, etc.: From Rockv _ Mount at intersection of Hwy 301 and NC Hwy 97, travel south about 5 miles. As you approach the airport turn right onto Michael Road in Williams Pointe subdivision and then take a right onto Thomas Road and then a left onto Williams Court. Site is about 200 vards on the left. 5. Describe the existing land use or condition of the site at the time of this application (residential, undeveloped, etc.): residential water supply reservoir 6. Property size (acres): 1.5 Acres 7. Lake/ river/ ocean adjacent to property: Tar River S. Describe proposed work (include discussion as to how hardening of shoreline has been avoided, or why it is necessary): Enable water access to deep water 9. Will work be conducted from land? ® From water? ❑ 10. Total amount of disturbance (including all excavation, backfill, rip rap, retaining walls, etc.) below the normal pool lake level/ Normal Water Level in square feet or acres: Will drive sheet piping along water line and dredge 3 feet out of lake in an area 20' by 50' for a total of approximately 3000 cubic feet or 111 cubic yards 11. Total amount of disturbance (including all clearing, back fill, excavation, rip rap, retaining walls, etc.) above the normal pool lake level/ Normal Water Level and 50 feet land -ward in square feet or acres: 50' of retaining wall x 10 of fill soil = 500 sf of fill soil. Approx. 250 sf of rip rap to be placed behind sheet pilings This will be included under the 500 sf of fill soil. FORM: SSGP 10 -2013 Page 2 of 4 12. Please describe the vegetation above the normal pool lake level/ Normal Water Level and 50 feet landward to be impacted (number of trees, for instance): Vegetation above normal pool lake level is mostiv bare with few deciduous trees See Figure 4. OwnerAent's Signature' j15A N C 02H 0502(fll, Date Agent's signature is valid only if an authorization letter from the owner is provided. FORM SSGP 10 -2013 Page 3 of 4 March 19, 2015 RE: AGENT AUTHORIZATION FORM WPM ev ffq ;5',ff� 'NOW �� M ,I,`t�i'';fiff'1'S�'1 Jn`"i,F'ii u,�na�' 3737 0005 2397 Nash County PIN #: DB 2754/ PG 385 ^T'�,V'. t� l+I t• ��,..?,'< lent r,•H /,.T t�.V_r 11,�..i�.,..o -,..� �Q [3@ls t y.`Y,{�T "•"`t�� ',�:f �Bf2d�Dj(i,ap�I`� 15 (��'J�y�Orp�i;i�r.;s�� y ��'`�k.e„�� •�r , n.iil ?�.F�r*��4la;eir', +'Fla �i Eu ,va.� t.�,s5�ri �*��anr�lif f'Tt:n'�`f �-arie=,it„i ��11 � �:�cc "+�, Owner's Address: 6199 Williams Court Rocky Mount, NC 27804 As owner concerning the above referenced property, I do hereby authorize and give permission for Appian Consulting Engineers, PA, and Soil Horizons, Inc. , to represent or act as an agent on my behalf and apply for land disturbance and other permitting necessary and allow them and the COE and NCDENR to go on the property for such purposes as necessary to perform the job tasks. Slgna ure y Name /Title Date I, Ltonar -A ,a Notary Public of the County of 1 asV State of ( L, , hereby certify that 1—i!50 CF)o,7 -p appeared personally before me this day and being duly sworn acknowledged that the above form was executed by him. Wetness my hand and notarial seal, this —&D�—day of Vy� Q r C k JDOROTHY D. LEONARD NOTARY PUBLIC NASH COUNTY, N.C. Notary 20 11�> Seal My commission expires ffA(AA }qty R S4'V o n w jO x Williams Bridge s Z POSE. t N z w z LL O 4 2 W 139 t JVV "jW^'L flu 4 i Y� Of eq 0 r �p 75DOOmN 3 SONNY c, J' °D z ry s� LF .p c� c O .5 °52' 3a" 240DNmE 77 °52'30" Site: No Blue Line Stream This site has no Tar - Pamlico buffered stream feature Buffers only apply to impounded waterline of Tar River Reservoir. Nashville USGS Topo Quad Map 1:24,000 NTS SOIL HORIZONS, Inc. PO Box 1063 i` Youngsville, NC 27596 Date: June, 2015 USGS 2013 Map 6199 Williams Court Nash County, North Carolina Figure 1 14 Sheet # 8 Sheet # 12 a a H Site: No Stream Shown This site has no Tar - Pamlico buffered stream feature Buffers only apply to impounded waterline of Tar River Reservoir. NT5 SOIL HORIZONS, Inc. PO Box 1063 i Youngsville, NC 27596 Date: June, 2015 NRCS Soil Map 6199 Williams Court Nash County, North Carolina Figure 2 Y, 'UO!07 1k JL 61 9 jrK Area for Propose Wall in Black Proposed Area t Dredge in Gray f* W4. NTS SOIL HORIZONS, Inc. PO Box 1063 I Youngsville, NC 27596 Date: June, 2015 Site Photographs 6199 Williams Court Nash County, North Carolina Figure 3 4 a c J a O. 0 CL X O O. CL a BAZEMORE PROPERTY NOT TO SCALE Phase 1 Construction of Shoreline Wall. NASH COUNTY PROPERTY &I OHWM Z -1/30' i , , i ' C I , C:: Proposed Shoreline Wall Trees to be removed in shaded Area of Zone 1 and select back Fill added behind wall. It I Leaning Trees •jr* (See Photos) , , , 50' , 1 Y 1 � ♦ OPEN WATER Phase 2 Dredging and Construction of Piling or floating boat dock. Existing Shoreline Wall for Neighbor 4 RE 6199 Williams Court Rocky Mount, NC FIGURE 1 May U 11, E Lake (At Full Pond /Normal Water level) 20' 4' deep Full Pond/ OHWM Normal Water Level , ar Shoreline RIP kal _'i` 50' > 15' 10' 30' Fill Soil Z -1 20' Z -2 Sheet Pile Existing Water Depth Proposed Dredaina NITS SoilFill_ ....................... --------------------- Rip. Rap SOIL HORIZONS, Inc. PO Box 1063 Youngsville, NC 27596 Date: June, 2014 6199 Williams Court Rocky Mount, NC Nash County, North Carolina Figure 5 1t R Soil Horizons, Inc. PO Box 1063 Youngsvdle, North Carolina 27596 J� DATE June 22, 2015 I P TO Mr Craig Brown, USACE FROM John R Davis, Jr LSS Memo RE 6199 Williams Court Shoreline Stabilization and Dredging Project Tar River Reservoir in Nash County, NC The above referenced project will be completed in phases as budget permits The first phase will be a shoreline stabilization effort A Shoreline Stabilization Application form and associated figures and attachments has been submitted to the NC DWR for review and approval The second phase will be to dredge the sediment out of the water body to create enough deep water for watercraft This work is proposed to be done with the enclosed PCN under Nationwide Permit 16 and associated NC water quality certification A final phase will be the construction of a boat dock from the retaining wall to the deep water We understand that the placement of pilings in the water is not considered by the US Army Corps of Engineers as fill and does not require a permit on this body of water Please review the attached documents and consider for approval Thanks John Davis 919- 818- 5087mb 061I111IN83d 83dd O 9 OV Midnos :N 2i?jw,1 8N30 510z 9 9 Nnr ' `41 --- 0 March 19, 2015 RE: AGENT AUTHORIZATION FORM y�j,y I1, :�� ,yy i'S a -,., St +jl th y; ^ii,.t m�•y_..,�q �t� �� ihy''�'I�na�t/i`f�f i uMS1 � "� -., r' 3737 0005 2397 Nash County PIN #. DB 2754/ PG 385 i14%� or �s ».�... °t,+ ^I,QrWilirl�r`i; err t14a"ns3Ua111"d �3ZE04`�i`I 3 iD43';,`r��J ; �'?� . ! sl�'K }j'r a,, {;1;7 r.s„f i( {�ir�, �n•ti,ia i;' i�S .. , Owner's Address: 6199 Williams Court Rocky Mount, NC 27804 As owner concerning the above referenced property, I do hereby authorize and give permission for Appian Consulting Engineers. PA. and Soil Horizons, Inc. , to represent or act as an agent on my behalf and apply for land disturbance and other permitting necessary and allow them and the COE and NCDENR to go on the property for such purposes as necessary to perform the job tasks Signature Name / Title Date I, --D (?f-64k 11 Ll c o n `a t-A . a Notary Public of the County of tV as k State of +N L , hereby certify that 1. -.:50- -1�oL7 -p tmo -e- appeared personally before me this day and being duly sworn acknowledged that the above form was executed by him Witness my hand and notarial seal, this Ab+�'day of Vy (bx d-\ Seal ROTHY D. LEONARD (� NOTARY PUBLIC NASH COUNTY, N.C. Notary 20 l� 0 My commission expires ffA a it l Iq. a() IV i - O�pF�W A�TF9QG o-c A. Applicant Information Office Use Only Corps action ID no DWQ project no Form Version 1 3 Dec 10 2008 Pre - Construction Notification (PCN) Form 1. Processing 1 1a Type(s) of approval sought from the ®Section 404 Permit ❑Section 10 Permit Corps F1 b Specify Nationwide Permit (NWP) number 16, See Attached or General Permit (GP) number 1c Has the NWP or GP number been venfied by the Corps? I ® 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 le Is this notification solely for the record For the record only for DWQ 401 For the record only for Corps Permit because written approval is not required? Certification ❑ Yes ® No If 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 19 Is the project located in any of NC's twenty coastal counties If yes, answer 1 h below 1h Is the project located within a NC DCM Area of Environmental Concern (AEC)? 2. Project Information 2a Name of project 6199 Williams Court 2b County Nash 2c Nearest municipality / town Rocky Mount ` 2d Subdivision name Williams Pointe 2e NCDOT only, T I P or state NA project no 3. Owner Information 3a Name(s) on Recorded Deed Lisa Bazemore 3b Deed Book and Page No ?? 3c Responsible Party (for LLC if NA applicable) 3d Street address 6199 Williams Court ` 3e City, state, zip Rocky Mount, NC 27803 3f Telephone no 252 - 904 -4960 3g Fax no NA 3h Email address Lisabazemorel(ftmad com ❑ Yes ® No ❑ Yes ® No ❑ Yes ® No ❑ Yes ® No Page 1 of 11 PCN Form — Version 1 3 December 10, 2008 Version 4 4 Applicant Information (if different from owner) f 4a Applicant is ❑ Agent ❑ Other, specify 4b Name 4c Business name (if applicable) 4d Street address 4e City, state, zip 4f Telephone no 4g Fax no 4h Email address 5. Agent/Consultant Information (if applicable) 5a Name John R Davis, Jr 5b Business name Soil Horizons (if applicable) 5c Street address 285 Dreamcatcher Trail J 5d City, state, zip Youngsvdle, NC 27596 5e Telephone no 919- 818 -5087 J 5f Fax no 919 - 554 -2363 5g Email address sodhonzons0amad com Page 2 of 11 B. Project Information and Prior Project History 1 Property Identification 1a Property identification no (tax PIN or parcel ID) Latitude 35 874977 Longitude - 1 b Site coordinates (in decimal degrees) 7788508 (DD DDDDDD) ( -DD DDDDDD) 1c Property size 11 0 acres 2 Surface Waters 2a Name of nearest body of water (stream, river, etc ) to I Tar River proposed project 2b Water Quality Classification of nearest receiving water WS -IV, B, NSW, CA 2c River basin map is available at Tar -Pam 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 project at the time of this application Residential subdivision around the Tar River Reservoir which is owned by Nash County The City of Rocky Mount manages the reservoir for water supply 3b List the total estimated acreage of all existing wetlands on the property Approximately 1/3 acre along intermittent stream above the lake cove 3c List the total estimated linear feet of all existing streams (intermittent and perennial) on the property Approximately 200 feet of intermittent stream above the lake cove 3d Explain the purpose of the proposed project In conjunction with a NC Shoreline Stabilization permit, the purpose of this PCN is to deepen the reservoir cove so watercraft can access surface waters 3e Describe the overall project in detail, including the type of equipment to be used To remove sediment from this shoreline cove, heavy excavation equipment will be hauled to the shoreline Obstructions will be removed for the equipment to work safely A haul road will be constructed for trucks to have access to excavating equipment A mechanical excavator such as dragline and long -reach excavator will be used in this kind of excavation to reach 30 or 40 feet from the shoreline to remove 2 to 3 feet of sediment Page 3 of 11 PCN Form — Version 1 3 December 10, 2008 Version 9 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 4b If the Corps made the jurisdictional determination, what type of determination was made? ® Yes ❑ No ❑ Unknown ® Preliminary ❑ Final 4c If yes, who delineated the jurisdictional areas? Agency /Consultant Company US Army Corps of Name (if known) Craig Brown Engineers Other 4d If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation NA notes in USACE office file for 6199 Williams Court 5 Project History 5a Have permits or certifications been requested or obtained for ❑ Yes ® No ❑ Unknown this project (including all prior phases) in the past? 5b If yes, explain in detail according to "help file" instructions NA 6. Future Project Plans 6a Is this a phased project? ® Yes ❑ No 6b If yes, explain This is the final phase of the project to stabilize the shoreline and dredge the sediment from the cove Page 4 of 11 16 C. Proposed Impacts Inventory 1 Impacts Summary la 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 i ❑ No ❑ DWQ W2 ❑ P ❑ T ❑ Yes ❑ Corps ❑ No ❑ DWQ j W3 ❑ P ❑ T ❑ Yes ❑ Corps 1111 ❑ No ❑ DWQ W4 ❑ P ❑ T ❑ Yes ❑ Corps ❑ No ❑ DWQ W5 ❑ P ❑ T ❑ Yes ❑ Corps ❑ No ❑ DWQ W6 ❑ P ❑ T ❑ Yes ❑ Corps ❑ No ❑ DWQ 2g. Total wetland Impacts 2h Comments NA 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 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 NA Page 5 of 11 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 mdiv dually list all open wate , 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 (f) 01 ®P ❑ T Tar River Dredging of Cove Lake 003 02 ❑P ❑T 03 ❑P ❑T 04 ❑P ❑T 4f. Total open water impacts 003 4g Comments J S. 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 of (acres) number pond I I Flooded Filled Excavated II Flooded Filled Excavated Flooded P1 I P2 6f. Total I I 5g Comments 1 5h Is a dam high hazard permit required ❑ Yes ❑ No If yes, permit ID no 51 Expected pond surface 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 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 regwred7 B1 ®P ❑ T Stabilize Tar River ®No Shoreline 1,000 0 B2 ❑P ❑T El Yes ❑ No B3 ❑P ❑T ❑Yes ❑ No 6h Total buffer impacts 1000 0 161 Comments See attached shoreline stabilization permit Page 6 of 11 A D. Impact Justification and Mitigation 1. Avoidance and Minimization 1a Specifically describe measures taken to avoid or minimize the proposed impacts in designing project Before dredging activity will take place the shoreline will be stabilized with a retaining wall The upper reaches of the cove will be left alone where the stream and wetlands emerge from the cove open waters Silt fencing will be placed along the haul road as needed to keep erosion and drainage out of nearby wetlands and stream b Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques Before dredging activity will take place the shoreline will be stabilized with a retaining wall so the equipment can efficiently reach into the water to remove sediment Silt fencing will be installed to help control drain back into the water 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? 2b If yes, mitigation is required by (check all that apply) 2c If yes, which mitigation option will be used for this project? 3 Complete if Using a Mitigation Bank 3a Name of Mitigation Bank 3b Credits Purchased (attach receipt and letter) 3c Comments NA 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 4c If using stream mitigation, stream temperature 4d Buffer mitigation requested (DWQ only) 4e Riparian wetland mitigation requested 4f Non - npanan wetland mitigation requested 4g Coastal (tidal) wetland mitigation requested 4h Comments ❑ Yes ® No ❑ DWQ ❑ Corps ❑ Mitigation bank ❑ Payment to in -lieu fee program ❑ Permittee Responsible Mitigation Type ' Quantity ❑ Yes linear feet ❑ warm ❑ cool square feet acres acres acres ❑cold Page 7 of 11 PCN Form — Version 1 3 December 10, 2008 Version S. Complete if Using a Permittee Responsible Mitigation Plan J 5a If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan 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 E] Yes ® No buffer mitigation? If ves. you will have to fill out this entire form — olease contact the State for more information 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 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 what type of mitigation is proposed (e g , payment to private mitigation bank, permdtee responsible riparian buffer restoration, payment into an approved in -lieu fee fund) 6h Comments NA Page 8 of 11 a E Stormwater Management and Diffuse Flow Plan (required by DWQ) 1. Diffuse Flow Plan la Does the project include or is it adjacent to protected riparian buffers identified ® Yes ❑ No within one of the NC Riparian Buffer Protection Rules? 1 b If yes, then is a diffuse flow plan included? If no, explain why Comments Only upland disturbance is the temporary location of a haul road on high ❑ Yes ® No ground that will be returned to vegetation/landscaped area 2. Stormwater Management Plan 2a What is the overall percent imperviousness of this projects <1% % 2b Does this project require a Stormwater Management Plan? ❑ Yes ® No 2c If this project DOES NOT require a Stormwater Management Plan, explain why Very minimal impacts to uplands 2d If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan 2e Who will be responsible for the review of the Stormwater Management Plan? 3. Certified Local Government Stormwater Review 3a In which local government's jurisdiction is this project? 3b Which of the following locally - implemented stormwater management programs apply (check all that apply) 3c Has the approved Stormwater Management Plan with proof of approval been attached? 4. DWQ Stormwater Program Review ❑ Certified Local Government ❑ DWQ Stormwater Program ❑ DWQ 401 Unit ❑ Phase II ❑ NSW ❑ USMP ❑ Water Supply Watershed ❑ Other ❑ Yes ❑ No ❑ 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 attached? ❑ Yes ❑ No 5. DWQ 401 Unit Stormwater Review 5a Does the Stormwater Management Plan meet the appropriate requirements9 ❑ 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 Supplementary Information Environmental Documentation (DWQ Requirement) Does the project involve an expenditure of public (federal /state /local) funds or the use of ❑ Yes ® No public (federal /state) land? 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 (North ❑ Yes ❑ No Carolina) Environmental Policy Act (NEPA/SEPA)? 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 Violations (DWQ Requirement) Is the site in violation of DWQ Wetland Rules (15A NCAC 2H 0500), Isolated Wetland Rules (15A NCAC 2H 1300), DWQ Surface Water or Welland Standards, or Riparian Buffer ❑ Yes ® No Rules (15A NCAC 2B 0200)? Is this an after - the -fact permit application? ❑ Yes ® No If you answered "yes" to one or both of the above questions, provide an explanation of the violabon(s) Cumulative Impacts (DWQ Requirement) Will this project (based on past and reasonably anticipated future impacts) result in I El Yes ® No additional development, which could impact nearby downstream water quality 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 This dredging activity will be the final impact to open waters, wetlands and streams for this residential property Sewage Disposal (DWQ Requirement) 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 Existing on -site septic system Endangered Species and Designated Critical Habitat (Corps Requirement) Will this project occur in or near an area with federally protected species or habitat? ❑ Yes ® No Have you checked with the USFWS concerning Endangered Species Act impacts? ® Yes ❑ No If yes, indicate the USFWS Field Office you have contacted ® Raleigh ❑ Asheville What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat? NC natural heritage program website See attached report dated May 7 2015 Page 10 of 11 PCN Form —Version 1 3 December 10, 2008 Version Essential Fish Habitat (Corps Requirement) Will this protect occur in or near an area designated as essential fish habitat? I ❑ Yes ® No What data sources did you use to determine whether your site would impact Essential Fish Habitat? NOAA website http / /www habitat noaa gov /protection /efh /efhmapper /index html Historic or Prehistoric Cultural Resources (Corps Requirement) Will this protect occur in or near an area that the state, federal or tribal governments have designated as having historic or cultural preservation status (e g , National ❑ Yes ® No Historic Trust designation or properties significant in North Carolina history and archaeology)? What data sources did you use to determine whether your site would impact historic or archeological resources? NC Natural Heritage program website No historical sites within'/ mile radius of this site, 6199 Williams Point Flood Zone Designation (Corps Requirement) Will this protect occur in a FEMA- designated 100 -year floodplain? If yes, explain how protect meets FEMA requirements No fills will be placed in the 100 -year floodplain Sediment will be removed by nature of this protect What source(s) did you use to make the floodplain determination? NC Flood Risk Information System website :) //fris nc gov /fns /Index aspx ?user - General %20Public& address = 6199% 20Wiilliams% 20Point% 20Rocky%20Mount %20NC &ST= NC &ST =1 John R. Davis, Jr Applicant/Agent's Printed Name Applicant/Agent's Signature (Agent's si ature is valid only if an authonzation letter from the applicant is provided ) Page 11 of 11 6/20/2015 Date NATIONWIDE PERMIT 16 DEPARTMENT OF THE ARMY CORPS OF ENGINEERS FINAL NOTICE OF ISSUANCE AND MODIFICATION OF NATIONWIDE PERMITS FEDERAL REGISTER AUTHORIZED MARCH 19, 2012 Return Water From Ualand Contained Disnosal Areas. Return water from an upland contained dredged material disposal area The return water from a contained disposal area is administratively defined as a discharge of dredged material by 33 CFR 323 2(d), even though the disposal itself occurs in an area that has no waters of the United States and does not require a section 404 permit. This NWP satisfies the technical requirement for a section 404 permit for the return water where the quality of the return water is controlled by the state through the section 401 certification procedures The dredging activity may require a section 404 permit (33 CFR 323 2(d)), and will require a section 10 permit if located m navigable waters of the United States (Section 404) r� NCDER North Carolina Department of Environment and Natural Resources Office of Land and Water Stewardship Pat hAcCory Bryan GcsW Donald R van der Vaart Governor Director Secretary May 7, 2015 John Davis Sod Horizons PO Box 1063 Youngsville, NC 27596 soil horizons @gmaiI com RE Williams Court Dear John Davis NCNHDE -261 The North Carolina Natural Heritage Program (NCNHP) appreciates the opportunity to provide information about natural heritage resources from our database that have been compiled for the project referenced above A query of the NCNHP database, based on the project area mapped with your request, indicates that there are no records for rare species, important natural communities, natural areas, or conservation /managed areas within the proposed project boundary The attached 'Potential Occurrences' table summarizes rare species and natural communities that have been documented within a one -mile radius of the property boundary The proximity of these records suggests that these natural heritage elements may potentially be present in the project area if suitable habitat exists and is included for reference Please note that although there may be no documentation of natural heritage elements within the project boundary, it does not imply or confirm their absence, the area may not have been surveyed The results of this query should not be substituted for site - specific surveys where suitable habitat exists In the event that rare species are found within the project area, please contact the NCNHP so that we may update our records Tables of natural areas and conservation /managed area within a one -mile radius of the project area, if any, are also included in this report Please note that natural heritage element data are maintained for the purposes of conservation planning, project review, and scientific research, and are not intended for use as the primary criteria for regulatory decisions Information provided by the NCNHP database may not be published without prior written notification to the NCNHP, and the NCNHP must be credited as an information source in these publications Maps of NCNHP data may not be redistributed without permission The NC Natural Heritage Program may follow this letter with additional correspondence if a Dedicated Nature Preserve (DNP), Registered Heritage Area (RHA), or Federally - listed species are documented near the project area Thank you for your inquiry If you have questions regarding the information provided in this letter or need additional assistance, please contact Allison Schwarz Weakley at allison.weaklev anncdenr oov or 919 707 8629 Sincerely, NC Natural Heritage Program Page 1 of 3 Natural Heritage Element Occurrences, Natural Areas, and Managed Areas Within a One -mile Radius of the Project Area Williams Court May 7, 2015 NCNHDE -261 Element Occurrences Documented Within a One -mile Radius of the Project Area TaI "_, , , s _ - °mic' EO_ID;,_. Scientific „Name'; ry "3 CommonName=_,'.:x � , Last° v "Element Accuracygy Federal n "State, v Global4`State 0a 6 'sr O' ccurrence rL+ Status ' Rank � - Rank Group au q Date Freshwater Fish 4695 Ambloplites cavifrons Roanoke Bass 1971 -PRE Historical 3- Medium Species of Significantly G3 S2 Concern Rare Mammal 24389 Corynorhinus rafinesquii Rafinesque's Big -eared 2006 -PRE Current 5 -Very Species of Special G3G4T S3 macrotis Bat - Coastal Plain Low Concern Concern 3 subspecies No Natural Areas are Documented Within a One -mile Radius of the Project Area No Managed Areas are Documented Within a One -mile Radius of the Project Area Definitions and an explanation of status designations and codes can be found at https.// ncnhde .natureserve.ora /contenVhelp Data query generated on May 7, 2015, source NCNHP, Q2 April 2015 Please resubmit your information request if more than one year elapses before project initiation as new information is continually added to the NCNHP database Page 2 of 3 NCNHDE -261: Williams Court May 7, 2015 ❑ Project Boundary E] Buffered Project Boundary Page 3 of 3 1:20,706 0 0.175 0.35 0.7 mi r 0 0.275 055 1.1 km Sources. Es, HERE, DeLoone. T=Tom. Imerrnap, inwement P Cwp. GEBCO, USGS. FAO, NPS. NRCAN, Ge Base. IGN, Kadaster NL. Lake (At Full Pond /Normal Water level) 20' ( 50, 4' deep Full Pond/ OHWM Normal Water Level Shoreline "` Rip ria s' 30' Z -1 n 20' v Z -2 Sheet Pile Existing Water Depth Proposed Dredging NTS SOIL HORIZONS, Inc. PO Box 1063 Youngsville, NC 27596 Date: June, 2014 6199 Williams Court Rocky Mount, NC Nash County, North Carolina Figure 5 V- a, f '� 6;•35 6199 .11 Area for Proposed!'`' Wall in Black A Proposed Area t6� Dredge in Gray ° k. t. AA f NTS SOIL HORIZONS, lnc. PO Box 1063 ` Youngsville. NC 27596 Date: June, 2015 Site Photographs 6199 Williams Court Nash County, North Carolina Figure 3