20090732 Ver 1_401 Application_20090609

of wN
Office Use Only:
} r 0$)_0 (3 2 Corps action ID no.
--I
o < DWQ project no.
Form Version 1.3 Dec 10 2008
Pre-Construction Notification PCN Form
A. Applicant Information
1. Processing ` F'
1 a. Type(s) of approvals ht from the
Corps:
Allf

Section 404 Permit El Section 10 Permit
1 b. Specify Nationwide ermit (NWP) number* or General Permit (GP) number: ?P W
1 c. Has the NWP or GP number been verified by the Corps? /4//W ? Yes ? No
1 d. Type(s) of approval sought from the DWQ (check all that apply :
? 401 Water Quality Certification - Regular M/Non-404 Jurisdictional General Permit
? 401 Water Quality Certification - Express ? 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 [?/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 [P40
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ? Yes o
2. Project Information
2a. Name of project: ta,ty,?x" 4- li?,C H2 ?Q s' L ?? f?
2b. County:
2c. Nearest municipality / town:
Fgv,

V, ER
2d. Subdivision name: e Sr ??-
2e. NCDOT only, T.I.P. or stat
project no: e
1AI
3. Owner Information

TORtvI0IER @RAttCM
ANI) - S
WE?UN
NR
3a. Name(s) on Recorded Deed: 1
?
,yam ?Z,2 QC? a ?S??C?
3b. Deed Book and Page No.
3c. Responsible Party (for LLC if
applicable):
3d. Street address: a e,e(s? ??'
3e. City, state, zip: g
3f. Telephone no.:
3g. Fax no.
3h. Email address:

Page I of 10
PCN Form -Version 1.3 December 10, 2008 Version
4. Applicant Information (if different from owner)
4a. Applicant is: ? Agent ? Ot er, 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:
Page 2 of 10
PCN Form - Version 1.3 December 10, 2008 Version
B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): Uc IVY r _/1) 73
1 b. Site coordinates (in decimal degrees): Latituded,5"09 0(.)3$ Longitude:14.
(DD.DDDDDD) (-DD.DDDDDD)
1 c. Property size: acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
proposed project:
tZ-
2b. Water Quality Classification of nearest receiving water:
2c. River basin: ?. a%arz
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:
3b. List the total estimated acreage of all exi ting wetlands o he property:
I Hcn?
3c. List the total estimated linear eet of all existing streams (intermittent and perennial) on the property:
3d. Expla" ;the purp e o t e proposed project:
j r
- p 7 C?? , -,/;c
3e. Des bribe the overall project in detail, including the type of equipment to be used:
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:

O'S'es ? No ? Unknown
4b. If the Corps made the jurisdictional determination, what type
of determination was made? preliminary? Final
4c. If yes, who delineated the jurisdictional areas?
Name (if known): A_1 Agency/Consultant Company:
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
this project (including all prior phases) in the past? ? Yes 21No ? Unknown
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.
Page 3 of 10
PCN Form - Version 1.3 December 10, 2008 Version
C. Proposed Impacts Inventory
1. Impacts Summary
V hich sections were completed below for your project (check all that apply):
tlands ? 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 dP ? T t
al ? Yes ? orps
©< [R 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 i rm ttent 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 -
Permanent (P) or (PER) or
intermittent (Corps - 404, 10
DWQ - non-404 stream
width length
(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
3i. Comments:
Page 4 of 10
PCN Form - Version 1.3 December 10, 2008 Version
4. Open Water Impacts /?
If there are proposed impacts to"I es ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impacts below.
4a. 4b. 4c. 4d. 4e.
Open water Name of waterbody
impact number - (if applicable) Type of impact Waterbody type Area of impact (acres)
Permanent (P) or
Temporary T
01 ?P?T
02 ?P?T
03 ?P?T
04 ?P?T
4E Total open water impacts
4g. Comments:
6. Pond or Lake Construction / r 0
If and or lake construction proposed, t en complete the chart below.
5a. 5b. 5c. 5d. 5e.

Pond ID
Proposed use or purpose Wetland Impacts (acres) Stream Impacts (feet) Upland

number (acres)
of pond
Flooded Filled Excavated Flooded Filled Excavated Flooded
P1
P2
K 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 uffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If an impacts require miti ation, 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 -
Permanent (P) or Reason
for
Stream name Buffer
mitigation Zone 1 impact
(square feet) Zone 2 impact
(square feet)
Temporary T impact required?
B1 ?P?T ?Yes
? No
B2 ?P?T ?Yes
? No
B3 ?P?T ?Yes
? No
6h. Total buffer impacts
6i. Comments:
Page 5 of 10
PCN Form -Version 1.3 December 10, 2008 Version
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
1b. Specifically describe measures t en to avoid or minimize th 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 2<0
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

El 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 6 of 10
PCN Form - Version 1.3 December 10, 2008 Version
6. Buffer Mitigation (State Regulated Riparian Buffer Rules) - required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation? ? Yes T 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
PCN Form - Version 1.3 December 10, 2008 Version
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 2<0
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: El Yes E:1 No
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project? f?

2b. Does this project require a Stormwater Management Plan? ? Yes [v]'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 bri ef, narrative description of the plan:
? 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?
? Phase II
3b. Which of the following locally-implemented stormwater management programs ? NSW
apply (check all that apply): ? USMP
? Water Supply Watershed
? Other:
3c. Has the approved Stormwater Management Plan with proof of approval been ? Yes ? No
attached?
4. DWQ Stormwater Program Review
? Coastal counties

4a.
Which of the following state-implemented stormwater management programs apply ? HQW
? ORW
(check all that apply): ? Session Law 2006-246
? Other:
4b. Has the approved Stormwater Management Plan with proof of approval been
attached? ? Yes ? No
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 1.3 December 10, 2008 Version
F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1a. Does the project involve an expenditure of public (federal/state/local) funds or the ? Yes OR"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)?
1c. If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
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, ,?,
I? Yes ? No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. Is this an after-the-fact permit application? Yes ? No
2c. If you answ red "yes" to e r th o t e a ov auuestions, 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
i
i ? Yes [?No
add
t
onal 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.
t

Page 9 of 10
PCN Form - Version 1.3 December 10, 2008 Version
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or
habitat? ? Yes ? No
5b. Have you checked with the USFWS concerning Endangered Species Act
impacts? ? Yes ? No
5c. If yes, indicate the USFWS Field Office you have contacted. ? Raleigh
? Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
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?
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
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
? Yes ? No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain? ? Yes ? No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination?

Applicant/Agent's Printed Name ApplicanU ent's Signature
(Agent's signature is valid only if an authorization letter from the applicant
is provided.) Date
Page 10 of 10
PCN Form - Version 1.3 December 10, 2008 Version
CUMB CTY ASSESSOR: PI MINI-SHEET BASPRINF411
1 0 . -lb- - -"h
Ofte
/JJ ?II
• /' /
? L,itrvllnir
,i. COUNTY TAX ASSESSOR
EMAIL
Property Information Mini-Sheet
Click for Tax Sheet
Tax Records General Info , Phone Numbers I Real Estate ( Perso___al I County.
Date. 06/24/2009
Parcel ID:
Owner Name(s):
Owner Address:
Situs Address:
Taxing District:
Tax Bill Number:
Old Parcel ID:
Property Class:
Neighborhood:
Zoning:
Frontage:
Map & Sheet:
Plat Book & Page:
Legal Description:
COUNTY OF CUMBERLAND Tax Year: 2009
0448-48-1273- TaxVear: 2009 G_o
PARKER, LEAMON L & WIFE NELLIE G
1525 PEPPERCHASE DR FAYETTEVILLE NC 28312
001525 PEPPERCHASE DR N/A
0161 EASTOVER
8049641
0448-48-1106-
RESIDENTIAL
9738
Al -AGRI DIST
180.00 Depth: 398.85
0448-01
0085 -0063
LT 8 RIVERSIDE ESTATES (1.64 ACS)
Page I of 2
Time. 10:0747
Parcel Taxable Value: (REVALUATION 2009)
Total Land Building Misc. Date
Appraised: 349,300.00 25,000.00 310,097.00 14,203.00 06/20/2008
Land Assessment:
Land Use Land Units Land Type Land Rate Land Value
RESIDENTIAL LOT 1.00 LT 25,000.00 25,000.00
(A max of 5 sales can be shown)
Sale History Data:
Deed Book Deed Page Sale Date Sale Price
05231 00680 02/17/2000 19,000.00
04331 00356 06/27/1995 23,000.00
04040 00635 10/14/1993 0.00
(A max of 10 improvements can be shown)
Miscellaneous Improvements:
Description Type Unit Number of Units
FRAME GARAGE GRF SF 740.00
Choose the Building to Display: 01
Get Building Info
http://152.31.99.19/D21 LIB/WWW/SWMW20O.CGI?LRPARC=8049641 &TXYEAR=20... 6/24/2009
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