20160573 Ver 1_401 Application_20160616

Montalvo, Sheri A
From: Montalvo, Sheri A
Sent: Tuesday, June 07, 2016 11:09 AM
To: [e-mail]
Subject: Holly Brook S/D
Attachments: SAM PLE_AGENT AUTHORIZATION_FORM.pdf
Importance: High
Follow Up Flag: Follow up
Flag Status: Flagged
Ray,
We have received the PCN and fee for the above. With your name signed to the signature page, 10 of 10, we will need an
agent authorization form to be completed. I have attached one for your use. Please email it back to me at
[e-mail] once complete and I can take the project off hold and forward it through the review process.
Thanks
Shea MovktaLVo
Administrative Assistant
401 & Buffer Permitting Branch
Division of Water Resources
Department of Environmental Quality
919-807-6303 (office)
sheri [e-mail]
Physical- 512 N. Salisbury St., Ste 942-D, Raleigh, NC 27604
Mailing: 1617 Mail Service Center, Raleigh, NC 27699-1617

Montalvo, Sheri A
From: Ray Bode <[e-mail]>
Sent: Tuesday, June 07, 2016 2 28 PM
To: Montalvo, Sheri A
Subject: RE Holly Brook S/D
Attachments: EEE NC agent authorization form docx
Hi Sheri
My apologies, please use the attached.
Ray
o [phone] x 225
c [phone]
From: Montalvo, Sheri A[mailto:[e-mail]]
Sent: Tuesday, June 07, 2016 11:09 AM
To: Ray Bode <[e-mail]>
Subject: Holly Brook S/D
Importance: High
Ray,
We have received the PCN and fee for the above. With your name signed to the signature page, 10 of 10, we will need an
agent authorization form to be completed. I have attached one for your use. Please email it back to me at
sheri.montalvo a,ncdenr.gov once complete and I can take the project off hold and forward it through the review process.
Thanks
SHert Movutci[Vo
Administrative Assistant
401 & Buffer Permitting Branch
Division of Water Resources
Department of Environmental Quality
919-807-6303 (office)
sheri montalvogricdenr Pov
Physical- 512 N. Salisbury St., Ste 942-D, Raleigh, NC 27604
Mailing: 1617 Mail Service Center, Raleigh, NC 27699-1617

r3e EEE Consulting,Inc.
J
Environmental, Engineering and Educational Solutions
Agent Authorization
I(we) authorize representatives of EEE -Consulting, Inc. to act as my (our) agent regarding the
proposed project as described below; to act on my (our) behalf; to take all actions necessary to
the processing, issuance, and acceptance of permits and any and all standard and special
conditions attached.
Project name: Holly Brook Subdivision Water and Sewer Extension; Town of Cary
Located at/in: Holly Brook Drive, Wake County, NC
Owner/applicant name: Jarrod A. Buchanan, P.E., Engineer - Town of Cary Water Resources
Signed:
s
Date: 6/7/2016
8525 Bell Creek Road, Mechanicsville, Virginia 23116 • [phone] . [phone] (fax)
201 Church Street, Suite C, Blacksburg, Virginia 24060 [phone] . [phone] (fax)
272 Bendix Road, Suite 260, Virginia Beach, Virginia 23452 • [phone] • [phone] (fax)
601 Cascade Pointe Lane, Suite 101, Cary, NC 27513 9 [phone]

v MCKIM&CREED
v
1730 VARSITY DRIVE, SUITE 500, RALEIGH, NC 27606
TEL [phone] FAX [phone]
ADDRESS: NCDEQ
3800 Barrett Drive
Raleigh, NC 27609
ATTENTION: Cherri L. Smith
LETTER OF TRANSMITTAL
DATE: June 3, 2016
PROJECT #: 03117-0011
TASK:
RE: Town of Cary - Holly Brook Water &
Sewer Extension Project
TRANSMITTAL #:
PAGE 1 OF 1
WE ARE SENDING: ® Originals ❑ Prints ❑ Shop Drawings ❑ Samples
❑ Specifications ❑ Calculations ❑ Other -
Quantity
Drawing No.
Rev.
Description Status
5
PCN Applications nn G
3
11" x 17" Sets of Drawings llu
2
Full Size Sets of Drawings
1
Town of Cary Check No. 283225 ($570.00) B F R
1
USACE Letter
C
Issue Status Code: A. Preliminary B. Fabrication Only C. For Information D. Bid
E. Construction F. For Review & Comments G. For Approval H. See Remarks
Action Status Code: 1. No Exceptions Taken 2. Make Corrections Noted 3. Other
4. Amend & Resubmit 5. Rejected - See Remarks
REMARKS:
Ms. Smith — please find attached the PCN submittal packages and supporting documentation for the above referenced
project. Let us know if you have any questions. Thanks — Dave
CC: USACE - Raleigh Regulatory Office, McKIM & CREED, INC.
w/encl
Jarrod Buchanan - Town of Cary
file (Q
Signed
Dave Malinauskas, PE

Fr'_
3e Consul ' , kim
L�JEmnronmental, Engmeenng and Educational Solutions
06/2/2016
Tasha Alexander
US Army Corps of Engineers
3331 Heritage Trade Drive, Suite 105
Wake Forest, North Carolina
Re: Application for Nationwide Permit 12 and Pre -Construction Notification
Holly Brook Subdivision Water and Sewer Extension
Town of Cary, Wake County, NC
Dear Ms. Alexander,
r
EEE Consulting, Inc. (EEE) has been contracted by the Town of Cary (Town) to prepare an application to impact Waters of the
United States (WOUS) under Nationwide Permit 12 (NWP 12) forthe Holly Brook Subdivision Water and Sewer Extension project
in Wake County, North Carolina. The proposed project will extend water and gravity sewer mains to the Holly Brook subdivision
along with the installation of water and sewer services for approximately 90 existing properties within the subdivision and the
connection of each home to the new water and sewer services.
EEE executed a jurisdictional waters delineation in September of 2015 and the jurisdictional features were verified by you in the
field on April 27, 2016 as a Preliminary Jurisdictional Determination (PJD). Eric Kulz of the Town attended that site visit as well,
however, representatives from NC Division of Water Resources did not attend. No revisions were made to EEE's delineated
boundaries and it was agreed that no permanent impacts to jurisdictional waters were proposed for this project. During that
site meeting, you indicated that USACE would provide the Notification of Jurisdictional Determination documentation with
approval of this NWP 12 application.
The proposed project design avoids impacting jurisdictional waters as much as is feasible by route selection and placement
within the existing utility easement. Where impacts are unavoidable, these temporary impacts will be minimized by maintaining
trench widths to the minimum width necessary utilizing low impact construction methods, implementing proper erosion and
sedimentation control measures, and restoring all temporary impacted areas to preconstruction grade and revegetating with
appropriate native species. The project proposes temporary impacts to 0.87 acres of wetland and 194.73 linear feet of stream
channel. Temporary regulated riparian buffer impacts total: Zone 1= 4,866.8 sq ft, Zone 2 = 2,006.92 sq ft, and Zone 3 = 2,712.66
sq ft. No permanent impacts are proposed.
We appreciate your consideration of this application. Please contact me with any questions or comments at rbode@eee-
consulting.com or [phone], ex 223.
Thank you,
PFA(J7NO
7'2016'
Ray Bode, PWS
Senior Environmental Scientist
EEE Consulting, Inc
enc: Application for Nationwide Permit 12 and Pre -Construction Notification Form
8525 Bell Creek Road, Mechanicsville, Virginia 23116 [phone] [phone] (fax)
201 Church Street, Suite C, Blacksburg, Virginia 24060 • [phone] • [phone] (fax)
272 Bendix Road, Suite 260, Virginia Beach, Virginia 23452 . [phone] . [phone] (fax)
601 Cascade Pointe Lane, Suite 101, Cary, North Carolina 27513 • [phone]
`Professional sennoes in North Carolina are promded by EEE Consulting of NC, PC Lic # C-3945

of WATF9 2 0 1 6 0 5 7 3
o� O� Office Use Only
Corps action ID no.
ti
o T DWQ project no
M
Form Version 1 4 uary 20 1 9J
Pre -Construction Notification (PCN) Form
A. Applicant Information
Page 1 of 10
PCN Form — Version 1.4 January 2009
1. Processing
1 a. Type(s) of approval sought from the Corps:
Q Section 404 Permit ❑ Section 10 Permit
1 b. Specify Nationwide Permit (NWP) number: 12 or General Permit (GP) number:
1c Has the NWP or GP number been verified by the Corps?
❑ Yes ❑X No
1 d Type(s) of approval sought from the DWQ (check all that apply) -
0 401 Water Quality Certification — Regular ❑ Non -404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑X Riparian Buffer Authorization
1 e. Is this notification solely for the record
because written approval is not required?
For the record only for DWQ
401 Certification:
❑ Yes ❑X No
For the record only for Corps Permit:
❑ YesX❑ 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 Q No
1 g Is the project located in any of NC's twenty coastal counties If yes, answer 1 h
below
❑ YesX❑ No
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ YesX❑ No
2. Project Information
2a. Name of project:
Holly Brook Subdivision Water and Sewer Extension
2b County-
Wake
2c Nearest municipality / town-
Town of Cary
2d. Subdivision name.
Hollybrook
2e NCDOT only, T LP or state project no:
3. Owner Information
3a Name(s) on Recorded Deed.
See Table 1. Property Owners
3b Deed Book and Page No
Ell�UN
3c. Responsible Party (for LLC if
applicable):
Jarrod Buchanan uRCFs
WATER REERM►�tNG
3d. Street address:
316 North Academy Street
3e. City, state, zip
Cary, NC 27513
3f. Telephone no -
[phone]
3g. Fax no
3h. Email address. I
jarrod buchanan@townofcary org
Page 1 of 10
PCN Form — Version 1.4 January 2009

4. Applicant Information (if different from owner)
4a. Applicant is:
Q 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:
Ray Bode
5b. Business name
(if applicable):
EEE Consulting, Inc
5c. Street address:
601 Cascade Pointe Lane, Suite 101
5d. City, state, zip:
Cary, NC 27513
5e. Telephone no.:
919-650-2463
5f. Fax no.:
5g. Email address:
[e-mail]
Page 2 of 10

B. Project Information and Prior Project History
1. Property Identification
1 a. Property identification no. (tax PIN or parcel ID):
See attached Property Owner Table 1
1 b. Site coordinates (in decimal degrees).
Latitude: 35 688418 Longitude: -78.800524
1 c. Property size.
32.72 acres
2. Surface Waters
2a. Name of nearest body of water to proposed project:
UT to Middle Creek
2b. Water Quality Classification of nearest receiving water:
QNSW
2c. River basin:
Neuse HUC: 03020201
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:
Current land use is single family residential subdivision Mixed broad-leaf deciduous and pine forested communities are predominant.
3b. List the total estimated acreage of all existing wetlands on the property: 5.26
3c List the total estimated linear feet of all existing streams (intermittent and perennial) on the property: 2,361.45
3d. Explain the purpose of the proposed project:
See attached Appendix A
3e. Describe the overall project in detail, including the type of equipment to be used:
See attached Appendix A
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
roject includin all rior hases in the ast?
❑X Yes ❑ No ❑ Unknown
Comments: The USACE toured the site and will provide PJD with
lof
4b If the Corps made the jurisdictional determination, what type
of determination was made?
❑x Preliminary ❑ Final
4c. If yes, who delineated the jurisdictional areas? jtther-
Name (if known): Ray Bode, Tina Sekula, Daniel Roberts
ency/Consultant Company: EEE Consulting, Inc
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
PJD will be issued with permit
S. Project History
5a. Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past?
El Yes Q No El Unknown
5b. If yes, explain in detail according to "help file" instructions.
6. Future Project Plans
6a. Is this a phased project?
❑ Yes ❑X No
6b If yes, explain.
Page 3 of 10
PCN Form — Version 1.4 January 2009

C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
❑X Wetlands Q Streams — tributaries X❑ 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.
Wetland impact
number
Permanent (P) or
Temporary
2b.
Type of impact
2c.
Type of wetland
2d.
Forested
2e.
Type of jurisdiction
Corps (404,10) or
DWQ (401, other)
2f.
Area of
impact
(acres)
W1 -
Choose one
Choose one
Yes/No
-
W2 -
Choose one
Choose one
Yes/No
-
W3 -
Choose one
Choose one
YestNo
-
W4 -
Choose one
Choose one
Yes/No
-
W5 -
Choose one
Choose one
Yes/No
-
W6 -
Choose one
Choose one
Yes/No
-
2g. Total Wetland Impacts:
2h. Comments: -
See attached Wetland Impact Table 2 and Impact Maps 0-5
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
Stream impact
number
Permanent (P) or
Temporary (T)
3b.
Type of impact
3c.
Stream name
3d.
Perennial (PER) or
intermittent (INT)?
3e.
Type of
jurisdiction
3f.
Average
stream
width
(feet)
3g.
Impact
length
(linear
feet)
S1 -
Choose one
S2 -
Choose one
S3 -
Choose one
S4 -
Choose one
S5 -
Choose one
S6 -
Choose one
3h. Total stream and tributary impacts
3i. Comments'
See attached Stream Impact Table 3 and Impact Maps 0-5
Page 4 of 10
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 indiv dually list all open water impacts below.
4a
Open water
impact number
Permanent (P) or
Temporary
4b.
Name of waterbody
(if applicable)
4c.
Type of impact
4d.
Waterbody
type
4e.
Area of impact (acres)
01 -
Choose one
Choose
02 -
Choose one
Choose
03 -
Choose one
Choose
04 -
Choose one
Choose
4f Total open water impacts
4g. Comments: No impacts to open water are proposed
5. Pond or Lake Construction
If pond or lake construction proposed, the complete the chart below.
5a.
Pond ID number
5b.
Proposed use or
purpose of pond
5c.
Wetland Impacts (acres)
5d.
Stream Impacts (feet)
5e.
Upland
(acres)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
P1
Choose one
P2
Choose one
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. Project is in which protected basin?
❑X Neuse ❑ Tar -Pamlico ❑ Catawba ❑ Randleman ❑ Other:
6b.
Buffer Impact
number —
Permanent (P) or
Temporary
6c.
Reason for impact
6d.
Stream name
6e.
Buffer
mitigation
required?
6f
Zone 1
impact
(square
feet)
6g.
Zone 2
impact
(square
feet
61 -
No
B2 -
Yes/No
B3 -
Yes/No
B4 -
Yes/No
B5 -
Yes/No
B6 -
Yes/No
6h. Total Buffer Impacts:
6i. Comments: See attached Buffer Impact Table 4 and Impact Maps 0-5
Page 5 of 10

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
See attached Appendix A
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
See attached Appendix A and Details Pages 2, 3, 4, 9, and 10
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 ❑X 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
project?
El 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: Choose one
Type: Choose one
Type: Choose one
Quantity:
Quantity-
Quantity:
3c. Comments
4. Complete if Making a Payment to In-lieu Fee Pro ram
4a. Approval letter from in-lieu fee program is attached.
❑ Yes
4b Stream mitigation requested.
linear feet
4c. If using stream mitigation, stream temperature:
Choose one
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:
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 6 of 10
PCN Form — Version 1.4 January 2009

S. 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 ❑X 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 7 of 10

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
❑jC 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.
Impacts to riparian buffer will be temporary and grade and vegetation will be reestablished following
construction. No ditches or other manmade conveyances are proposed
❑ Yes ❑X No
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 0 No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why:
No impervious surfaces are proposed
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 localgovernment's jurisdiction is thisproject?
Town of Cary
❑ Phase II
3b. Which of the following locally -implemented stormwater management programs
❑ NSW
apply (check all that apply):
❑ USMP
❑ Water Supply Watershed
❑ Other: Not applicable
3c. Has the approved Stormwater Management Plan with proof of approval been
El 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):
El Session Law 2006-246
[]Other:
4b. Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ❑ No
attached?
5. 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 8 of 10
PCN Form — Version 1.4 January 2009

F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1 a. Does the project involve an expenditure of public (federal/state/local) funds or the
Yes ❑ No
use of public (federal/state) land?
1 b. 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 Q No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1 c. 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), DWQ Surface Water or Wetland Standards,
❑ Yes Q No
or Riparian Buffer Rules (15A NCAC 2B.0200)?
2b. Is this an after-the-fact permit application?
❑Yes Q 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 Q 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.
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
The purpose of the project is to upgrade and improve the existing sewer pipeline capacity within the Holly Brook subdivision. Wastewater from the
subdivision is currently conveyed Trough the existing pipeline to the South Cary WWTP (NPDES Permit No. NC0065102) for treatment and that
will continue to be the treatment method. Additionally, there are currently 17 homes in the subdivision using septic systems for treatment. The
project will connect those homes to the system and discontinue the current use of septic.
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 an area with federally protected species or
❑ Yes ❑X No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act
ED Yes El No
impacts
5c. If yes, indicate the USFWS Field Office you have contacted.
Raleigh
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
USFW and NHP web based data resources
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?
7 ❑ Yes Q No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
DEQ interactive maps http //portal.ncdenr org/web/wq/dwr-home-page#tab-6 and http-//portal ncdenr.org/web/mf/afsa-maps
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 X❑ 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?
Natural Heritage Program and Historic Preservation Office interactive maps https //ncnhde natureserve org/content/map and http://gis ncdcr gov/
hpoweb/
8. Flood Zone Designation (Corps Requirement)
—7—
8a Will this project occur in a FEMA -designated 100 -year floodplain?
❑ Yes ❑X No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination?
Federal Emergency Management Agency. May 2006 Flood Map Service Center Flood Insurance Rate Map Panel 0750J, Map Number 3720075000.1
Map Revised May 02, 2006
Ray Bode, PWS
Applicant/Agent's Printed Name
5/17/2016
Applicant/Agent's Signature
Date
(Agent's signature is valid only if an authorization
letter from the applicant is provided
Page 10 of 10

Appendix A
PCN Attachments
6.3.d.
The Holly Brook Subdivision Water and Sewer Extension project proposes to extend water and sewer
mains to the Holly Brook subdivision, along with the installation of water and sewer services for the
approximately 90 properties within the subdivision and the connection of each of the homes to the new
water and sewer services.
6.3.e.
The gravity sewer construction will be performed by open cut trench excavation through jurisdictional
streams and wetlands primarily because of the requirement to meet constant slope installations from
manhole to manhole. Trenches and the work area will be backfilled and properly compacted to the
original (pre -construction) ground elevation, and the re-established grade will be stabilized with a seed
mix made up of native species appropriate for restoration and stabilization of wetland and upland soils.
Species will include big bluestem (Andropogon gerardii), little bluestem (Schizachyrium scoparium),
indiangrass (Sorghostrum nutans), deertongue (Panicum clandestinum), switchgrass (Panicum
virgotum), eastern gamagrass (Tripsacum dactyloides), rye grain (Secale cereale), and browntop millet
(Urochloa ramosa). Straw mulch will be applied to all seeded areas.
The water main installations will be maintained within the existing road rights-of-way with exception to
the crossing of UT to Middle Creek where the water main will be installed in the same utility and
pipeline easement with the gravity sewer. In this location the water main will be installed by open cut
alongside the gravity sewer and properly backfilled with the trench restored to the original (pre -
construction) grade. The same mitigation measures will be employed as with the gravity sewer
installation as described above.
Both the gravity sewer and water mains will be installed by rubber tire backhoe or track hoe mechanical
equipment as required by the depth of the installation. All areas denuded by the excavation equipment
will be restored following installation of the utility mains such that original ground contours are re-
established and seeded and mulched as described above.
D.l.a.
Avoidance of impacts to wetlands, buffers and streams is accomplished through route selection within
the existing utility easement.
Minimization of unavoidable impacts is accomplished by:
1. Maintaining trench widths at a minimum to adequately backfill and compact the pipe bedding and
embedment.
2. All impacted areas will be restored to preconstruction grade and revegetated as described in B.3.a.

D.i.b.
Construction and Restoration Methods:
1. Utilizing rubber tired excavating equipment where possible.
2. The work area will be restored to preconstruction grade and revegetated as described in B.3.a.
3. Proper erosion and sedimentation control measures will be implemented as proposed and
approved by the NC Division of Land Resources. Proposed measures include super silt fence
along stream banks and wetland perimeters, stone relief outlets, and compost socks adjacent to
wetlands and/or streams.
4. Impacted stream banks will be stabilized with temporary biodegradable mat lining or rip -rap as
required to provide proper stabilization and protection against erosion. Rip -rap will be keyed
into the stream banks such that the original cross-section of the stream is maintained. Details
for temporary liner (Sheet D2) and rip -rap stream bank stabilization (Sheet D9) are attached.
Stream Crossings:
Prior to excavating jurisdictional streams, rip -rap coffer dams will be installed upstream and
downstream of the excavation area to isolate the disturbed area and contain sediment. Stream flow on
the upstream side of the excavation will be pooled above the coffer dam and pumped around the
excavation area. The pumped water will be discharged on the downstream side of the excavation below
the lower coffer dam through sediment bags to filter the discharge water of sediment before allowing
the water to be returned to the stream channel. A bypass pump detail (Sheet D10) is attached.
Wetland Crossings:
Wetlands will be crossed using wood mats in wet areas to minimize rutting and excessive denuding of
the wetland vegetation. Wetland areas that must be excavated for installation of the utility mains will
be returned to their original (pre -construction) contours and revegetated as described in B.3.a.

Table 1: Property Owners
ID OWNER
1 HUSKISSON, ROBBIE V HUSKISSON, TRICIA T
2 GRAZIOSO, THOMAS E GRAVOSO, GRETCHEN K
3 ROWLEY, WILLIAM H ROWLEY, SHIRLEY P
4 WARREN, DOUGLAS G WARREN, UUNG L
5 SCHAD, MICHAEL GENE
6 LEMIRE, MARC S QUATTLEBAUM, KARA L -
7 JOHNSON, MATTHEW H JOHNSON, FRANCES A
8 GADZIALA, PETER J JR LACOMBE, MARCIE
9 COOKE, CHARLOTTE REID
10 DIEFFENDERFER, JAMES N DIEFFENDERFER, MARY R
11 ROGERS, ANNA LYON
12 SICARD, ADAM J
13 INKROTE, KENNETH L INKROTE, SANDRA GAIL W
14 MONSERRATE, CARLOS A MONSERRATE, CHRISTINE
15 AKINS, MICHAEL 8 AKINS, JENNIFER A
16 HEASLEY, BETH ANN HEASLEY, RANDY 5
17 MORGAN, MARK C HALL, CHRISTY R
18 CLAUSEN, GARY NILES CLAUSEN, EKATERINI
19 OUTHWAITE, JOHN OUTHWAITE, SHEILA
20 ROADLTIP, RICKY R ROADCUP, KATHRYN A
21 BRADLEY, ZITA H JR
22 DICKENS, DESHAWN A DICKENS, NIKKI Y
24 DUNN, CHERYL PARRIS DUNN, DAVID L
25 BALDWIN, JOHN C BALDWIN, DONNA L
26 HUTTO, JODY J HUTTO, PAIGE S
27 TROIANO, RAYMOND 1 TROIANO, CATHERINE
28 QUICK, REINHOLD QUICK, SUZANNE 5
29 CROMPTON, JOHN R JR CROMPTON, PHYLLIS K
30 LEWIS, YOLANDA C BURTON, SUSAN L
31 ERBEZNIK, FRANK J ERBEZNIK, VERONICA L
32 DEXTER, BRIAN K DEXTER, MARIE C
33 FULCHER, ROBERT
34 WRIGHT, DONALD M WRIGHT, JULIE G
35 BOETTCHER, EDGAR
36 BAGGIO, YVONNE
37 DIXON, J CHRISTIAN DIXON, AMANDA E
38 YAKABOSKI, GREGORY F YAKABOSKI, KAREN A
39 GEROLEMON, DAVID A GEROLEMON, MICHELLE L
40 YAN, DE YAN ZHANG, SAO QIN
41 SWANN, LINDA K
42 WALSH, WILLIAM L WALSH, ANN
43 BORRELLI, WANDA
44 FABBRI, LINDA K
45 LEMMON, THOMAS PAUL LEMMON, JODIE R
46 MORRIS, ADAM VANDRONGELEN, KATEWNE
47 WILLIAMS, DAVID WILLIAMS, ANGELA
48 SPEIDEL, WAYNE D SPEIDEL, ELIZABETH J
49 RAKOSKI, ROBERT
50 SPEARS, ROBERT SPEARS, PATRICIA P
51 SHEEDY, JAMES M SHEEDY, GAIL A
52 HOLLY BROOK SEWER LLC
53 PRICE, BURT L PRICE, PAMELA A
54 AIKEN, MARK A AIKEN, ELLEN W
55 WALTERS, CHAD C WALTERS, ELIZABETH W
56 WOLF, BARRY ADELSPERGER, TONYA
57 CHURCH, KATHLEEN ELAINE TRUSTEE CHURCH, STEPHEN MICHAEL TRUSTEE
58 BOYLE, LEONARD
59 GILBERT, ROBERT ANDREW GILBERT, SUSAN R
60 SHANKIN, STEVEN 1 SHANKIN, ANNMARIE W
61 PALUMBO, RALPH P CLARK, DEBORAH K
62 JOHNSON, EDWARD W III JOHNSON, VICTORIA 5
63 TUOZZO, CHRISTOPHER ANDREVCISK, MELISSA
64 BRITT, VICTOR W BRITT, PATRICIA C
65 FORD, JANET PATRICIA
66 WILLOWS, TERENCE GONZALEZ, LOUISE H
67 SQUERI, WALTER L JR SQUERI, ANNA
68 MANAWI, MAIDI A
69 WALKER, PATRICK T
70 WOLSKI, MARK WOLSKI, LAURA
71 BROWN, DANIEL B BROWN, EVA D
72 HOLLY BROOK SEWER LLC
73 LOVGREN, BRIAN W
74 LANZER, JOHN K ULNZER, SUZANNE K
75 HOLLY BROOK HOMEOWNERS ASSOC INC
76 WHITLEY, SUSAN
77 MESSER, DEREK S MESSER, AMY
78 RATTRAY, WILLIAM 1 RATTRAP, NANCY M
79 JENKINS, FLOYD THOMAS JR JENKINS, CHERYL M
80 KURTZ. JAMES M KURTZ, ANN B
81 ROGERS, JAMES C ROGERS, HELEN
82 WASNIAK, LEONARD P WASNIAK, BONNIE L
83 CARTLEDGE, TONY WALTER
84 BROYLES-LEWIS, THOMAS BROYLES-LEWIS, MYRANDA
85 DAVIS, KEITH I DAVIS, MARGARET L
86 KNETSCH, MARK A KNETSCH, HEATHER 1
87 NORTH CAROLINA HOMEBUYERS LLC
88 BENZICK, MARK E BENZICK, ELISABETH C
89 SHERWIN, JON CHRISTOPHER
90 MOODLEY, TYRONE V QUEZADA, MARTHA K PARADA
91 BAKER, SUSAN C MILLER, GARY
ADDRI
4604 HOLLY BROOK DR
4608 HOLLY BROOK DR
4612 HOLLY BROOK OR
4616 HOLLY BROOK OR
4620 HOLLY BROOK DR
4624 HOLLY BROOK DR
4628 HOLLY BROOK DR
4636 HOLLY BROOK OR
4640 HOLLY BROOK DR
40001NKSERRY CT
4004 INKBERRY CT
4009 INKSERRY CT
4009 INKBERRY CT
4005 INKBERRY CT
4700 HOLLY BROOK OR
4704 HOLLY BROOK DR
4708 HOLLY BROOK OR
4016 BROOK CROSS OR
4020 BROOK CROSS DR
4024 BROOK CROSS OR
4028 BROOK CROSS OR
4032 BROOK CROSS DR
4037 BROOK CROSS OR
4033 BROOK CROSS DR
4029 BROOK CROSS OR
4804 CROSSVINE CT
4808 CROSSVINE CT
4809 CROSSVINE CT
4805 CROSSVINE CT
4801 CROSSVINE CT
4021 BROOK CROSS DR
4800 HOLLY BROOK OR
4804 HOLLY BROOK DR
1321 CURFMAN ST
4812 HOLLY BROOK OR
4816 HOLLY BROOK DR
4820 HOLLY BROOK DR
4824 HOLLY BROOK DR
4828 HOLLY BROOK DR
4832 HOLLY BROOK DR
4836 HOLLY BROOK OR
4840 HOLLY BROOK DR
38 ASPEN MILL RD
4708 CORALBERRY CIR
4712 CORALBERRY OR
4720 CORALBERRY OR
4724 CORALBERRY CIR
5028 HOLLY BROOK DR
5032 HOLLY BROOK DR
5036 HOLLY BROOK DR
4637 HOLLY BROOK DR
5037 HOLLY BROOK DR
5033 HOLLY BROOK DR
5029 HOLLY BROOK DR
5025 HOLLY BROOK OR
5021 HOLLY BROOK DR
5013 HOLLY BROOK OR
4721 CORALBERRY OR
4709 CORALBERRY OR
5001 HOLLY BROOK OR
4921 HOLLY BROOK DR
3909 PERNEY CT
3905 PERNEY CT
3901 PERNEY CT
39W PERNEY CT
3904 PERNEY CT
3908 PERNEY CT
3912 PERNEY CT
4837 HOLLY BROOK DR
4833 HOLLY BROOK DR
40091NKSERRY CT
4825 HOLLY BROOK DR
4817 HOLLY BROOK DR
4000 WAKE FOREST RD STE 119
4705 HOLLY BROOK DR
3913 INKBERRY CT
3909 INKBERRY CT
3905 INKBERRY CT
3901 INKBERRY CT
3900 INKBERRY CT
3904 INKBERRY CT
39121NKBERRY CT
4641 HOLLY BROOK OR
4637 HOLLY BROOK DR
4629 HOLLY BROOK OR
1310 OLDE WALKER MILL RD
4617 HOLLY BROOK DR
4613 HOLLY BROOK DR
4609 HOLLY BROOK DR
4605 HOLLY BROOK DR
ADDR2
APEX NC 27539-8864
APEX NC 27539.9864
APEX NC 27539-8664
APEX NC 275394MM
APEX NC 27539-8864
APEX NC 27539-8864
APEX NC 27539-9864
APEX NC 27539-8864
APEX NC 27539-9864
APEX NC 27539-9868
APEX NC 27539-9868
APEX NC 27539-8868
APEX NC 27539-8868
APEX NC 27539-8868
APEX NC 2753948865
APEX NC 2753944
APEX NC 27539-8865
APEX NC 27539-8869
APEX NC 2753948869
APEXNC 27539-8869
APEX NC 275398869
APEX NC 27539 -SM
APEX NC 27539-9870
APEX NC 27539-8870
APEX NC 27539-8870
APEX NC 27539-8876
APEX NC 275398876
APEX NC 27539-8876
APEX NC 27539.8876
APEX NC 275398876
APEX NC 27539.8870
APEXNC 27539-9866
APEX NC 27539-8866
RALEIGH NC 27603-2207
APEX NC 27539-8866
APEX NC 2753948866
APEX NC 27539.8866
APEX NC 27539-8866
APEX NC 275394866
APEX NC 27539-8866
APEX NC 275398866
APEX NC 2753941866
RIDGEFIELD CT 06877-1901
APEX NC 27539,9737
APEX NC 275399737
APEX NC 275399737
APEX NC 275399737
APEX NC 275396307
APEX NC 27539-6307
APEX NC 275393307
APEX NC 27539-8864
APEX NC 275393307
APEX INC 275393307
APEXNC 275393307
APEX NC 275393307
APEX NC 275396307
APEX NC 275393307
APEX NC 275399750
APEX NC 27539,9750
APEX NC 27539-6307
APEX NC 275393306
APEXNC 27539-6304
APEX NC 27539-6304
APEX NC 27539.6304
APEX NC 275394871
APEX NC 275394871
APEX NC 275394871
APEX NC 27539-8871
APEX NC 27539-8866
APEX NC 275394866
APEX NC 275394868
APEX NC 275394866
APEX INC 275394866
RALEIGH NC 276093859
APEX NC 275394865
APEX NC 27539-9867
APEX NC 27539-8867
APEX NC 275394867
APEX NC 2753948867
APEX NC 275394867
APEX NC 27539-8867
APEX NC 275394867
APEX NC 27539-9864
APEX NC 27539-8864
APEX NC 27539-8864
APEX NC 27502-4811
APEX NC 275394864
APEX NC 27539-8864
APEX NC 275394864
APEX NC 275394864

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