20090019 Ver 1_Application_20090106

Office Use Only: Form Version March 05
0 9- 0 0
USACE Action ID No. DWQ No. 1 8
(If any particular item is not applicable to this project, pie mter 'Wot Applicable" or ' ld/A"_)
1. Processing
"A I
1. Check all of the approval(s) requested for this project:
? Section 404 Permit ? Riparian or Watershed Buffer Rules
? Section 10 Permit ? Isolated Wetland Permit from DWQ
401 Water Quality Certification ? Express 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested: 14
3. If this notification is solely a courtesy copy because written approval for the 441 Certification
is not required, check here: ?
4. If payment into the North Carolina Ecosystem Enhancement Program (NCEEP) is proposed
for mitigation of impacts, attach the acceptance letter from NCEEP, complete section VIII,
and check here: R
5. If your project is located in any of North Carolina's twenty coastal counties (listed on page
4), and the project is within a North Carolina Division of Coastal Management Area of
Environmental Concern (see the top of page 2 for further details), check here:
H. Applicant Information it U
1. Owner/Applicant Information JAN 6 2009
Name: Scott W. Busbe? aI
Mailing Address: F.O. Box 333 Wye, Mµ1ATERn
pS Ate ND STOR
Buxton. NC 27920
Telephone Number: n/a Fax Number: n/a
E-mail Address: nla
2. Agent/Consultant Information (A signed and dated copy of the Agent Authorization letter
must be attached if the Agent has signatory authority for the owner/applicant.)
Name: Charles Thomas Corpeniaa
Company Affiliation: Hatteras Environmentalists
Mailing Address: P.O. Box 831
Avon NC 27915
Telephone Number: 252-305-7754 Fax Number: 252-995-5580
E-mail Address: [e-mail]
Pap5of12
IIL Project Information
Attach a vicinity map clearly showing the location of the property with respect to local
landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property
boundaries and development plans in relation to surrounding properties. Both the vicinity map
and site plan must include a scale and north arrow. The specific footprints of all buildings,
impervious surfaces, or other facilities must be included. If possible, the maps and plans should
include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property
boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion,
so long as the property is clearly defined. For administrative and distribution purposes, the
USACE requires information to be submitted on sheets no larger fl ant I I by 17 inch format;
however, DWQ may accept paperwork of any size. DWQ prefers full-size construction
drawings rather than a sequential sheet version of the frill-size plans. If full-size plans are
reduced to a small scale such that the final version is illegible, the applicant will be informed that
the project has been placed on hold until decipherable maps are provided.
1. Name of project: Busbey fill
2. T.I.P. Project Number or State Project Number (NCDOT only): n/a
3. Property Identification Number (Tax PIN): 02 0537 17 20 4265
4. Location
County. Dare Nearest Town: Buxton
Subdivision name (include phase/lot number): n/a
Directions to site (include road numbers/names, landmarks, etc.): see location sketch
5. Site coordinates (For linear projects, such as a road or utility line, attach a sheet that
separately lists the coordinates for each crossing of a distinct waterbody.)
Decimal Degrees (6 digits minimum): 35.1602 ON 75.3223 °W
6. Property size (acres): 1.49
7. Name of nearest receiving body of water: Pamlico Sound
8. River Basin: Tar-Pamlico
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at .)
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: The site is a wooded ridge iacent to the Peters Ditch. The
general use in the area is 100% residential area. Most houses in this area are for permanent
residents however there are some rentals as well.
Page 6 of 12
10. Describe the overall project in detail, including the type of equipment to be used: Fill will
be placed in the proposed area described in the permit. A silt fence will be installed along the
proposed fill line, and suitable fill material will be brow t in by dump truck and spread with
front-end loader. A wood retaininp, wall will then be placed in the area to assure that the sand
will not wash back into the wetlands.
11. Explain the purpose of the proposed work: In order to provide adequate access to the lot.
The attached survey shows the road and cross section as well as square footage for the
proposed driveway .
W. Prior Project Watery
if jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Include
the USACE Action ID Number, DWQ Project Number, application date, and date permits and
certifications were issued or withdrawn. Provide photocopies of previously issued permits,
certifications or other useful information. Describe previously approved wedand, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits issued for prior segments of the same T.I.P. project, along with
construction schedules,
n/a
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application.
n/a
VI. Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. Each impact must be
listed separately in the tables below (e.g., culvert installation should be listed separately from
riprap dissipater pads). Be sure to indicate if an impact is temporary. All proposed impacts,
permanent and temporary, must be listed, and must be labeled and clearly identifiable on an
accompanying site plan. All wetlands and waters, and all streams (intermittent and perennial)
should be shown on a delineation map, whether or not impacts are proposed to these systems.
Wetland and stream evaluation and delineation forms should be included as appropriate.
Photographs may be included at the applicant's discretion. If this proposed impact is strictly for
Page 7 of 12
wetland or stream mitigation, list and describe the impact in Section VIII below. If additional
space is needed for listing or description, please attach a separate sheet.
1. Provide a written description of the proposed impacts: .09 Acres of wetland to be filled
2. Individually list wetland impacts. Types of impacts include, but are not limited to
mechanized clearing, grading, fill, excavation, flooding, ditching/drainage, etc. For dams,
senarstety list impacts due to both structure and flooding.
Wetland Impact
Site Number
(indicate on map)
Type of impact Type of Wetland
(e.g., forested, marsh,
herbaceous, bog, etc.) Located within
lWyear
Floodplain
bwjho) Distance to
Nearest
stream
inew feet Area of
impact
(acres)
I fill Non-riparian no n/a .09

Total Wetland Impact (acres)
3. List the total acreage (estimated) of all existing wetlands on the property: 50838.76 soft
4. Individually list all intermittent and perennial stream impacts. Be sure to identify temporary
impacts. Stream impacts include, but are not limited to placement of fill or culverts, dam
construction, flooding, relocation, stabilization activities (e.g., cement walls, rip-rap, crib
walls, gabions, etc.), excavation, ditching/straightening, etc. If stream relocation is proposed,
plans and profiles showing the linear footprint for both the original and relocated streams
must be included. To calculate acreag-e, multiply length X width, then divide by 43,560.
Stream Impact
Number
indicate on map)
Stream Name
Type of Impact Perennial or

Intermit#t? Average
Stream Width
Before Impact Impact
Length
feet Area of
Impact
acres

Total Stream Impact (by length and acreage)
5. Individually list all open water its (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.). Open water impacts include, but are not limited to
fill, excavation, dredging, floodin , drainage, bulkheads, etc.
Open Water Impact Name of Waterbody Type of Impact Type of Waterbody Area of
Site Number if appfical*) Oake pond, estuary, , bay I , act
Page 8 of 12
(indicate on map) ocean, etc. saes
Total Open Water Impact (acres)
b. List
the cumulative impact to ,all Waters of the U.S. result from the rD'ect:
Stream Impact (acres):
Wetland finpact acres):
Open Water Impact (acres):
Total Impact W Waters of the U.S. (acres)
Total Stream lm pact (linear feet :
7. Isolated Waters
Do any isolated waters exist on the property? ? Yes ® No
Describe all impacts to isolated waters, and include the type of water (wetland or stream) and
the size of the proposed impact (acres or linear feet). Please note that this section only
applies to waters that have specifically been determined to be isolated by the USACE.
S. Pond Creation
if construction of a pond is proposed, associated wetland and stream impacts should be
included above in the wetland and stream impact sections. Also, the proposed pond should
be described here and illustrated on any maps included with this application.
Pond to be created in (check all that apply): El uplands 0 stream 0 wetlands
Describe the method of construction (e.g., dam/embankment, excavation, installation of
draw-down valve or spillway, etc.):
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local storrawater requirement, etc.):
Current land use in the vicinity of the pond:
Size of watershed draining to pond: Expected pond surface area:
YII. Impact Justification (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It may be useful to provide
information related to site constraints such as topography, building ordinances, accessibility, and
financial viability of the project, The applicant may attach drawings of alternative, lower-impact
site layouts, and explain why these design options were not feasible. Also discuss how impacts
were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce impacts. The lot was purchased at a
premium price when the real estate market was at its highest. The buyer was at this time not
aware of the access issues. In order toter .openly access the lot this driveway/road crossing is
necessary. We have designed the shortest path with the least amount of fill necessary. We also
have used the available high ground were it is feasible.
Page 9 of 12
VIII. Mitigation
DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC
Division of Water Quality for projects involving greater than or equal to one acre of impacts to
freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial
streams.
USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on January 15, 2042, mitigation will be required when
necessary to ensure that adverse effects to the aquatic environment are minimal. Factors
including size and type of proposed impact and function and relative value of the impacted
aquatic resource will be considered in determining acceptability of appropriate and practicable
mitigation as proposed. Examples of mitigation that may be appropriate and practicable include,
but are not limited to: reducing the size of the project; establishing and maintaining wetland
and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of
aquatic resource functions and values by creating, restoring, enhancing, or preserving similar
functions and values, preferable in the same watershed.
If mitigation is required for this project, a copy of the mitigation plan must be attache in order
for USACE or DWQ to consider the application complete for processing. Any application
lacking a required mitigation plan or NCEEP concurrence shall be placed on hold as incomplete.
An applicant may also choose to review the current guidelines for stream restoration in DWQ's
Draft Technical Guide for Stream Work in North Carolina, available at
1. Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
Payment will be made to NCEEP for .25 acre of wetland
2. Mitigation may also be made by payment into the North Carolina Ecosystem Enhancement
Program (NCEEP). Please note it is the applicant's responsibility to contact the NCEEP at
[phone] to determine availability, and written approval from the NCEEP indicating
that they are will to accept payment for the mitigation must be attached to this form. For
additional information regarding the application process for the NCEEP, check the NCEEP
website at . If use of the NCEEP is proposed, please
check the appropriate box on page five and provide the following information:
Amount of stream mitigation requested (linear feet):
Amount of buffer mitigation requested (square feet):
Amount of Riparian wetland mitigation requested (acres):
Page 10 of 12
.,3ounr or Non rinarian wetland mitigation requested (acres): .25
amount oii coastal wetland mitigation requested (acres):
l3.
X
Environmental Documentation (required by DWQ)
1. Does the project involve an expenditure of public (federal/statcAocal) funds or the use of
public (federal/state) land? Yes ? No
2. If yes, does the project require preparation of an environmental document pursuant to the
requirements of the National or North Carolina Environmental Policy Act (NEPA/SEPA)?
Note: If you are not sure whether a NEPA/SEPA document is required, call the SEPA
coordinator at [phone] to review current thresholds for environmental documentation.
Yes ? No ?
3. If yes, has the document review been finalized by the State Clearinghouse? If so, please
attach a copy of the NEPA or SEPA final approval letter. Yes ? No ?
Proposed Impacts on Riparian and Watershed Buffers (required by DWQ)
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
required state and local buffers associated with the project. The applicant must also provide
justification for these impacts in Section VII above. All proposal impacts must be listed herein,
and must be clearly identifiable on the accompanying site plan. All buffers must be shown on a
map, whether or not impacts are proposed to the buffers. Correspondence from the DWQ
Regional Office may be included as appropriate. Photographs may also be included at the
applicant's discretion.
1. Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Neuse),15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 02B .0243 (Catawba) 15A NCAC
2B .0250 (Randleman Rules and Water Supply Buffer Requirements), or other (please
identify )? Yes ? No ?
2. If "yes", identify the square feet and acreage of impact to each zone of the riparian buffers.
If buffer mitigation is required calculate the required amount of mitigation by applying the
buffer multinliers.
Zones Impact Required
(square feet) Mugip ' Mitigaion
1 3 (2 for Catawba)
2 1.5
Total
# Zone 1 extends out 30 feet perpendicular from the top of the near bank of channel; Zone 2 extends an
additional 20 feet frmn the edge of Zone 1.
3. If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e.,
Donation of Property, Riparian Buffer Restoration / Enhancement, or Payment into the
Page 1 i of 12
Riparian Buffer Restoration Fund). Please attach all appropriate information as identified
within 15A NCAC 2B .0242 or _0244, or _0260.
XI. Stormwater (required by DWQ)
Describe impervious acreage (existing and proposed) versus total acreage on the site. Discuss
stormwater controls proposed in order to protect surface waters and wetlands downstream from
the property. If percent impervious surface exceeds 20°/a, please provide calculations
demonstrating total proposed impervious level. 1% existing. : retauung wall and retention
basin will be constructed in order to keep runoff out of wetlands.
XII. Sewage Disposal (required by DWQ)
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.
Property has engineered septic system approved by Dare County
XIIL Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (15A NCAC 211 .0500) or any Buffer Rules?
Yes ? No z
Is this an after=the-fact permit application? Yes ? No
XIV. Cumulative Impacts (required by DWQ)
Will this project (based on past and reasonably anticipated future impacts) result in additional
development, which could impact nearby downstream water quality? Yes ? No Z
If yes, please submit a qualitative or quantitative cumulative impact analysis in accordance with
the most recent North Carolina Division of Water Quality policy posted on our website at
. If no, please provide a short narrative description: n/a
XV. Other Circumstances (Optional):
It is the applicant's responsibility to submit the application sufficiently in advance of desired
construction dates to allow processing time for these permits. However, an applicant may
choose to list constraints associated with construction or sequencing that may impose limits on
work schedules (e.g., draw-down schedules for lakes, dates associated with Endangered and
Threatened Spec, accessibility problems, or other issues outside of the applicant!s control).
y ->
Appl1cant1A&n1Vs Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 12 of 12
AGENT AUTHORIZATION FORM
FOR
CORPS OF ENGINEERS PERMIT APPLICATION
the undersigned authorize Charles T. Co e '
act as my agent to obtain a U. S. Army Corps Fill permit for the work as described in the to
attached application & plans.
Sincerely,
Date: 4r - '?5 ' e 'F
ag(a[gM-3r.
7?
JAN 6 2009
DENR. WATER QUALITY
VVETLANDS AND STORMWATER BRMCH

From To Bearing Distance
DA D1 N 61°09'01" E 17.57'
D1 D2 S 22°12'03" E 35.36'
D2 D3 S 6"45'26" E 13.66'
D3 D4 S 5°19'11" E 21.43'
04 DS S 57"36'50" E 13.02'
DS D6 S 87°37'46" E 28.40' -
D6 D7 N 39"37'43" E 21.15'
D7 D8 N 6°46'29" W 11.75'
D8 DO N 59°54'03" E 1.10'
DO DC N 59°54'03" E 6.75'
DC D9 N 59°54'03" E 13.33'
D9 D10 N 65°03'27" E 28.65'
D70 D11 N 80°40'31" E 23.32'
D11 D12 S 83°06'52" E 2&.81-
D12 D13 N 68°49'38" E 10.49'
D13 D14 N 89°39'37" E 28.93'
D14 DD S 69"15'48" E 15.68'
DD D15 S 69°15'48" E 3.92'
D15 D16 N 83°08'44" E 30.39'
D16 DE N 54"17'25" E 3.96'
DE D17 N 54°17'25' E 22.23'
D17 D18 N 74°21'08" E 28.77'
D18 D19 N 11°54'44' E 22.28'
D19 D20 N 4'16'04" W 26.50'
D20 D21 N 19°40'25" W 22.58'
D21 D22 N 8°55'08" W 28.32'
D22 D23 N 10'44'02" W 32.16'
D23 DF N 2'52'15" E 12.53'
I, Freddy D. Rankin, PLS, certify that this
survey is of an existing parcel or existing
8.49 sq it 15,001.01 sq ft
HIGHLAND
14,929.416q (t( _ -- -
tJ60.
parcels of land and does not create a
new street or change an existing street. 60?1?
Freddy D Rankin, PLS, L-2958 WOPo
ePN
e
5QO1ry? ti??h /?'SC \ s
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1? ! LOT 2 Ir LOT 1
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1 LOT 3 I 1 ?? ` ?' 0
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m'? 1 322 44, D23
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z N 7a"41 ? WETLAND 1
50,838.76 sq ft D22 it j
?' . HIGHLAND 18 c
• 1,661.84 sq it L
z SAMPLING PARCEL l Dzt \ .?
w
x"°'NT 64,847.98 sq ft D20 It
z (CROSSHATCHED A
m z? o AREA DEPICTS
?m
m
PROPOSED 20' ROAD HIGHLAND IA 5j475?6
Z?E?INj
?D1 FILL AREA 1,360.06 sq it
.• tiA \ 4082.13 sq ft)
°o - iDD3 la3sT 41.94'
B „
it DC N 82059'49 E 2
4 - ' D7 b WETLAND 2 PARCEL 2
-o r+ Z D4 -D6 N
? n ? T ? 1 DSi ;q
y' m v N_
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zr
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p o
'
HIGHLAND 1 18.3E
w 10,987.32 sq fl S E
G? 4
FIRM ZONE AE 7.0
FIRM ZONE EX ^A ry
12.18' O' nom.
/?Z 136.18'
148.36' i-- N 89°22'49" W
N 89°37'14" E --109.03'
79°35'13" W
138.58' Nir Y11, RPER
IupNITA PPAGE AS
O81441,
BUXTON, NC 27920
County State
A' DARE N..
File Number Scale
8 4744 WS3X 1' 100'
ber
F Average Ground Elevation
W N A
eference FB/Pg
W 134 18;41
Pin Number
SEE BELOW
FIRM ZONE DATA X & AE
Base Flood Elevation Community/Panel/Suffix
N/A (X) & 7.0' (AE) 375348 0537 I
I, Freddy D, Rankin, Professional Land Surveyor,
certify that this plat was drawn from an actual
field land survey and that the error of closure as
calculated by latitudes and departures is at least
1:10,000. ,:,,,,1,?
Witness rn)6W ZaLkOhji day of
dr;
FreddkD?taFr»Iin,
50232 S. Buccaneer Dr., PO Box 121
Frisco, NC 27936-0121
[phone] Fax [phone]
lJ
U
100 75 50 25 0 100
i
i
l 7.5 ?v is' 2.5
i ; 7.5 i 7.5,
6'
) i 'sTDNE
SLOPE
24" FILL
CROSS-SECTION Or GRAVEL ROAD
60°27'23" (NOT TO SCALE)
R=739.40'
L=5.89'
LC=5.89'
LCB=S 20°45'39" E
?33?f
626°50'09"
R=316.61'
L=148.29'
LC=146.94'
LCB=S 7°34'16" E
&1'27'54-
R=316.61'
L=8.10'
LC=8.09'
LCB=S 6°34'45' W
t;; 20°26'53"
R=288.00'
L=102.78'
LC=102.24'
LCB=S 2°54'45' E
1
1 66°58'02'
R=288.00'
L=35.02'
LC=35.00
LCB-S 16°37'13" E
J
LOT PIN # PARCEL # STREET ADDRESS RECORDED REFERENCE
NORTH LOT 02 0537 17 20 4265 016766001 CROSS WAY ROAD MB 2, PAGE 192; DB 1704
PAGE 215
SW LOT 02 053718 20 5009 016768000 47220 CROSS WAY ROAD ,
DB 1704, PAGE 216
SE LOT 02 053718 20 6005 016767000 47228 CROSS WAY ROAD DB 1706, PAGE 72
LEGEND
O EXISTING CONIC MONUMENT
0 GEODETIC MONUMENT
O EXISTING IRON STAKE
0 FIRE HYDRANT
O PK NAIL
® WATER METER
0 CABLE TV BOX
O UTILITY POLE
TO PED-LOCK
0 SET IRON STAKE
' 404 POINT
& WATER VALVE
10 WATER VALVE MONUMENT
LOCATION SKETCH, NOT TO SCALE
1MLICo SOUND
o „
oA
4
t1 SITE Zeg
BUXTON, NC
f5
BUXTON enac aoAP 11
? g

NOTES:
1. This survey is subject to any facts that may be disclosed by
a full and accurate title search.
2. Minimum Building Lines (MBL) shown hereon must be
verified. The surveyor makes no certification as to zoning
and/or restrictive covenant setbacks.
3. Survey based upon physical evidence fouled as shown.
Meridian for survey based upon recorded bearing
S 74°25'16" W for line A-B per
PC 'E', SLIDE 354.
WETLAND CERTIFICATION
This certifies that this copy of this plat accurately depicts the
boundary of the jurisdiction of the section 404 of the clean
water act under the present law and regulations as determined
by the undersigned on this date. Unless there is a change in
the law or our published regulations, this determination of
section 404 jurisdiction may be relied upon for a period not to
exceed five years from this date. This determination was made
utilizing the 1987 Corps of Engineers Wetland Delineation
Manual.
Name:
Tide:
Date:
0
D15 WETLAND 2C Sl
63.11 sq fl ?'
5 A6 "" ? <r
,ti H
X SAMPLING
i N 82°59149" E POINT
ss PARCEL 3
`
14'7 ?'?9\7a, 16,435.16 sq ft
PARCEL 4
15,197.55 sq ft 1
1
WETLAND SURVEY FOR
SCOTT WINKLER BUSBY
CAROL CARTLAND BUSBY