20090594 Ver 1_Application_20090429

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Corps action ID no.
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a•••^?*,P,, ?,?.,y ??G'?! Form Version 1.3 Dec 10 2008
i
Pre-Construction Notificn (PCN) Form
A. Applicant Information
OT JK'_ M J-11
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1. Processing '
1 a. Type(s) of approval sought from the
Corps:
®Section 404 Permit El Section 10 Permit
1 b. Specify Nationwide Permit (NWP) number: NWP14 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps? ? Yes ® No
1d. Type(s) of approval sought from the DWQ (check all that apply):
? 401 Water Quality Certification - Regular ? Non-404 Jurisdictional General Permit
? 401 Water Quality Certification - Express ? Riparian Buffer Authorization
1e. Is this notification solely for the record
because written approval is not required? For the record only for DWQ 401
Certification:
? Yes ? No For the record only for Corps Permit:

? Yes ? No
1f. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in-lieu
fee program. ? Yes ® No
1 g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below. ? Yes ® No
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ? Yes ® No
2. Project Information
2a. Name of project: Brassfield Station
2b. County: Guilford
2c. Nearest municipality / town: Greensboro
2d. Subdivision name: Brassfield Station, Phase II
2e. NCDOT only, T.I.P. or state
project no: N/A
3. Owner Information
3a. Name(s) on Recorded Deed: D. Stone Builders, Inc.
3b. Deed Book and Page No. D.B. 6838, Pg 1372 / D.B. 166, Pg 49
3c. Responsible Party (for LLC if
applicable): Joe Gonzales
3d. Street address: 2904 Lawndale Dr.
3e. City, state, zip: Greensboro, North Carolina 27408
3f. Telephone no. [phone]
3g. Fax no.: [phone]
3h. Email address: [e-mail]
Page 1 of 11
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4. Applicant Information (if different from owner)
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:
5b. Business name
(if applicable):
5c. Street address:
5d. City, state, zip:
5e. Telephone no.:
5f. Fax no.:
5g. Email address:

B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): 3-175-792-3,14,21,22,22,24-28,34, & 35
1b. Site coordinates (in decimal degrees): Latitude: 36.0732N Longitude: -79.5136W
(DD.DDDDDD) (-DD.DDDDDD)
1 c. Property size: 32.461 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
proposed project: Unnamed tributary to Horse Pen Creek
2b. Water Quality Classification of nearest receiving water: Perennial
2c. River basin: Cape Fear
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:
Site is being developed from New Garden Rd. to west side of stream;formely wooded, with lodgebuilding with yard near
stream; remainder of tract is wooded with a few abandoned homes;stream is old pond bed, old dam remains with road.
3b. List the total estimated acreage of all existing wetlands on the property:
0.18 ( Not in the area affected by Stream Crossing )
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
1394.23
3d. Explain the purpose of the proposed project:
To provide access and utilities to a proposed 48 lot single family subdivision and a existing home presently on a private
road.
3e. Describe the overall project in detail, including the type of equipment to be used:
See Section V
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property / ® Yes ? No ? Unknown
project (including all prior phases) in the past?
Comments:
4b. If the Corps made the jurisdictional determination, what type
? Preliminary ? Final
of determination was made?
4c. If yes, who delineated the jurisdictional areas? Agency/Consultant Company: Wetlands and Natural
Name (if known): Chris Huysman Resources Consultants, Inc.
Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
5. Project History
5a. Have permits or certifications been requested or obtained for ? Yes ® No ? Unknown
this project (including all prior phases) in the past?
5b. If yes, explain in detail according to "help file" instructions.
6. Future Project Plans
6a. Is this a phased project? ® Yes ? No
6b. If yes, explain.
Phase I consisted of commerical and multifamily construction with little impact on the existing stream; Phase II willbe
single family requiring stream crossing for roadway, sidewalk and utilities.
Page 3 of 11
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B. Project Information and Prior Project History
The project will consist of a culvert and earthen embankment stream crossing to provide access for
future single-family development and also provide utilities and sidewalk access for future development.
The crossing will require bulldozers, track hoes, and/ or backhoes to place pipe, construct earthen
roadway and place erosion control measures ( rip-rap dissipater pad).

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C. Proposed Impacts Inventory
1. Impacts Summary
1 a. 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
? No ? DWQ
W2 ? P ? T ? Yes ? Corps
? No ? DWQ
W3 ? P ? T ? Yes ? Corps
? 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:
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)
STREAM
S1 ®P ? T CROSSING(CUL UT to Horsepen ® PER ® Corps 10 150
VERT, RIP-RAP Creek ? INT ? DWQ
PAD)

S2 ®P ? T PIPING
INTERMITTENT UT to Horsepen ? PER ® Corps
25
806
STREAM Creek ® 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 956
3i. Comments: ONLY 150 FEET OF PERENNIAL STREAM WILL BE DISTURBED FOR ROAD CROSSING STREAM
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 individual) list all open water impacts below.
4a. 4b. 4c. 4d. 4e.
Open water Name of waterbody
impact number- (if applicable) Type of impact Waterbody type Area of impact (acres)
Permanent (P) or
Temporary
01 ?P?T
02 ?P?T
03 ?P?T
04 ?P?T
0. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If and 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 (acres)
number of pond
Flooded Filled Excavated Flooded Filled Excavated Flooded
P1
P2
5f. Total
5g. Comments:
5h. Is a dam high hazard permit required?
? Yes ? No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If an impacts require mitigation, then you MUST fill out Section D of this form.
6a.
? Neuse ? Tar-Pamlico ? Other:
Project is in which protected basin? ? Catawba ? Randleman
6b. 6c. 6d. 6e. 6f. 6g.
Buffer impact
number - Reason Buffer Zone 1 impact Zone 2 impact
Permanent (P) or for Stream name mitigation (square feet) (square feet)
Temporary T impact required?
131 ?P?T ?Yes
? No
B2 ?P?T ?Yes
? No
B3 ?P?T ?Yes
? No
6h. Total buffer impacts
6i. Comments:

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for
impacts to Waters of the U.S. or Waters of the State? ? Yes ® No
2b. If yes, mitigation is required by (check all that apply): ? DWQ ? Corps

2c. If yes, which mitigation option will be used for this
project? ? Mitigation bank

? Payment to in-lieu fee program
? Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter) Type Quantity
3c. Comments:
4. Complete if Making a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached. ? Yes
4b. Stream mitigation requested: linear feet
4c. If using stream mitigation, stream temperature: ? warm ? cool ?cold
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 7 of 11
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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 ? 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:

E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1 a. 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.
? Yes ? No
Comments:
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project? 17.7%
2b. Does this project require a Stormwater Management Plan? ® Yes ? No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why:
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, na rrative description of the plan:
A storm runoff system that channels the runoff into wet-detention ponds with all applicable erosion controls measures
® Certified Local Government
2e. Who will be responsible for the review of the Stormwater Management Plan? ? DWQ Stormwater Program
? DWQ 401 Unit
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this project? City of Greensboro
? Phase II
3b. Which of the following locally-implemented stormwater management programs ? NSW
? USMP
apply (check all that apply): ® Water Supply Watershed
? Other:
3c. Has the approved Stormwater Management Plan with proof of approval been ? Yes ? No
attached?
4. DWQ Stormwater Program Review
? Coastal counties
? 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 requirements? ? Yes ? No
5b. Have all of the 401 Unit submittal requirements been met? ? Yes ? No
Page 9 of 11
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 ? No
(North Carolina) Environmental Policy Act (NEPA/SEPA)7
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 ® No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. Is this an after-the-fact permit application? ? Yes ® No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in ® Yes ? No
additional development, which could impact nearby downstream water quality?
3b. If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
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.
Non- Discharge ; Treated by the City of Greensboro
Page 10 of 11
S. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or ? Yes ® No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act ? Yes ® No
impacts?
? Raleigh
5c. If yes, indicate the USFWS Field Office you have contacted.
? Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
U.S. Fish and Wildlife Service Website
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat? ? Yes ® No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
U.S. Fish and Wildlife Service Website
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation ? Yes ® No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
National Trust for Historic Preservation website & National Register of Historic Places Website
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain? -Eyes ? No
8b. If yes, explain how project meets FEMA requirements: Proper bufeer zones apply and all intrusion into flood area is
designed to be minimal.
8c. What source(s) did you use to make the floodplain determination? FEMA Website
JOE GONZALES ? 4/16/09

Applicant/Agent's Printed Name i Ap is Agent's Signature Date
(Agent's sign, tune is lid glif an authorization letter from the applicant
is provided.)
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Hugh Creed Associates, Inc. P.A.
Consulting Engineers & Land Surveyors
1306 W. WENDOVER AVENUE P.O. BOX 9623
GREENSBORO, N.C. 27408 GREENSBORO, N.C. 27429
TELE: [phone] OR [phone]
FAX: [phone]
To: Andrew Williams - Project Manager
RE: Brassfield Station-Greensboro NC; Army Corp Permit
SAW-2009-00408
Andrew,
The following are the answers to the best of my ability, for the questions you submitted to me for
the project that I am working on.
1.The wetland areas were flagged by WNR and located by Survey Crew, I will supply a map with
the points on the drawing, I will also ask the Survey Crew to re-flag the wetlands area for your site visit.
2. The total amount of permanent stream channel impact by CAD calculation is 149.38 feet, the
points for the headwall, wing wall, 96" CUT and riprap dissipater pad will be staked in the field for your
site visit. The points and there corresponding geographic coordinates will be provided in a drawing.
3. The pipe crossing, rip-rap pad, and headwalls will be constructed according to a sequence:
a. Install temp diversion dams 10' above proposed end of 96" CMP and temporary 24" HDPE
diversion pipe above proposed pipe inlet and above proposed wing wall location.
b. Install base and 96" CMP ( backfill to stabilize), headwall footing and riprap pad.
c. Redirect temporary diversion pipe into 96" CUT and complete headwall, wing-wall and
back fill area to finish grade.
d. Allow headwall and wing walls to cure, seed to stabilize slopes then remove all temporary
erosion control measures associated with road crossing.
The construction of the headwalls and wing walls as well as any associated grading will have
sedimentation fencing for erosion control purposes and should have limited impact on the stream
channel.
4. The existing road being used by the single remaining resident is a single lane gravel road built
on top of the earthen and concrete dam for the old pond. To comply with city requirements the road would
have to be torn down and rebuilt to comply with subdivision design standards for the city of Greensboro.
Too comply with these standards the roadbed will have to be widened affecting either the flood way or the
wetlands area.
5. The mapped intermittent stream in question is proposed to be piped through the planned
development and an outlet will be placed at the edge of the stream buffer area to allow any water to be
released. The aforementioned stream was determined to be an intermittent - non important on 4/17/09 and
we are currently working with the city of Greensboro and NC DWQ to find the best option for proceeding
with the development.
Thanks;
Will Shaw
P:\Projects 2005\Dixon\Moose Lodge\Army Corp Permit Prop2.doc
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