20031473 Ver 1_COMPLETE FILE_20031121

©? W AQG
O Y
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan Klimek, P.E., Director
Division of Water Quality
Coleen H. Sullins, Deputy Director
Division of Water Quality
December 5, 2003
DWQ # 03-1473
Forsyth County
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
Phil Strupe Builders Inc.
217 Riverwood Drive
Lewisville, NC 27023
Subject Property: Lot# 2, Wellesley Place, Section 3
To Whom It May Concern
On November 21, 2003 the Division of Water Quality (DWQ) was notified by receipt of your application
regarding your plan to fill wetlands or waters for the purpose of providing a sewer connection for a home in
Forsyth County. Approval from DWQ is required to disturb these areas. Please provide 7 copies of the following
information and refer to the DWQ # listed above in your reply. Please show these on maps of suitable scale (for
instance 1" = 100 feet) so we can begin to determine your projects' compliance with 15A NCAC 2H.0500.
1. Please provide a location map for the project.
2. Please show all stream impacts including all fill slopes, dissipaters and bank stabilization on the site
plan.
3. Please indicate proposed lot layout as overlays on the site plan.
Please telephone John Dorney at 919-733-9646 if you have any questions or would require copies of our rules or
procedural materials. This project will remain on hold as incomplete in accordance with 15A NCAC 2H.0505(c).
The processing time for this application will begin when this information is received. If we do not hear from you
by writing or by fax at [phone] within three (3) weeks we will assume you no longer want to pursue the
project and will consider it withdrawn.
Sincerely,
JRD/bs
cc: Winston-Salem DWQ Regional Office
Raleigh Corps of Engineers
Central Files
File Copy
i R. Dorney
Water Qua ity C tification Program
N. C. Division of Water Quality, 401 Wetlands Certification Unit,
1650 Mail Service Center, Raleigh, NC 27699-1650 (Mailing Address)
2321 Crabtree Blvd., Raleigh, NC 27604-2260 (Location)
[phone] (phone), 919-733-6893 (fax), (http://h2o.enr.state.nc.us/newetlands
('netnmwr Crrvirr #• i.A77_R9'?_R7dR
Z-VAr

Office Use Only:
USACE Action ID No, 10 Q Ct a 0 d o
{If any particular item is not applicable to
Form Version May 2002
DWQ No.
-t, please enter "Not Applicable" or
1. Processing
1. Check all of the approval(s) requested for this project:
M'Section 404 Permit ? Riparian or Watershed Buffer Rules
? Section 10 Permit ? Isolated Wetland Permit from DWQ
0401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested: I I
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: ?
4. If payment into the North Carolina Wetlands Restoration Program (NCWRP) is proposed for
mitigation of impacts (verify availability with NCWRP prior to submittal of PCN), complete
section VIII and check here: []
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: ?
II. Applicant Information
1. O
wner/Applicant Information / WETLANDS 1401 GROUP
Name:_ - PC
Mailing Address:_ _ 1 e-woos NOV 9 80 ?
mow,°? v?,-l?? ?fL u1- 3 WAT n.
iON
Telephone Number: Fax Number: --`? ?-
E-mail Address: c le . CcJM
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: IAV
CompanyAffliation: AV_
Mailing Address: ti
Telephone Number: -
E-mail Address: Fax Number:?? -
Pau. S of S
III. 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 than i 1 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 full-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:

2. T.T.P. Project Number or State Project Number (NCDOT Only):
C
4.
3. Property Identification Number (Tax PIN): {r?X /3/C4 : % / f X L b ).
Location
County: -0 y Nearest Town:
Subdivision name (include phase/lot number): tV 0_11 ed/.
©1,
y
6. Property size (acres):

Lbw 4 S j/." Ile-
7. Nearest body of water (stream/river/sound/ocean/lake): c,.y -x
8. River Basin: 7 c-W ; W1 ? i yer
(Note - this must be one of North Carolina's seventeen designated major river basins, The
River Basin map is available at http://h2o.enr.state.nc.us/admin/ma1)s/.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application:_ 4_1?
Page 6 of 6
r - _ _ ... v , r - - r ,.-6 - 1-V r T M - J - ! -' N 0% ., Q 6
Site coordinates, if available (UTM or Lat/Lang): 36- l /) A/ 90, t 1..30 V
(Note - If project is linear, such as a road or utility line, attach a sheet that separately lists the
coordinates for each crossing of a distinct waterbody.)
10. Describe the overall project in detail, including the type of equipment to be used: vs _
/c!?,.? Gt, Crf ?? '? Gb? y? e (,7' ,?'?? ys e e vs Q? "v ?'?? ?_.?.
,-a 6e,,?.Q/ .__6 ?.?..,?
11. Explain the purpose of the proposed work /o e fi
IV. Prior Project History
V.
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 wetland, 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.
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.
.90
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. The applicant must also
provide justification for these impacts in Section VII below. All proposed impacts, permanent
and temporary, must be listed herein, and must be clearly identifiable on an accompanying site
plan. All wetlands and waters, and all streams (intermittent and perennial) must 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 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.
Page 7 of 7
Provide a written description of the proposed

2. Individually list wetland impacts below:

Wetland Impact
Site Number
(indicate on map)
Type of Impact* Area of
Impact
(acres) Located within
100-year Floodplain**
(yes/no) Distance to
Nearest Stream
(linear feet)
Type of Wetland***

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to. mechanized clearing, gi a ing, C ,
excavation, flooding, ditching/drainage, etc. For dams, separately list impacts due to both structure and flooding.
100-Year floodplains are identified through the Federal Emergency Management Agency's (FEMA) Flood Insurance Rate Maps
(FIRM), or FEMA-approved local floodplain maps. Maps are available through the FEMA Map Service Center at 1-800-358-9616, or
online at http://www.fema.gov.
*** List a wetland type that best describes wetland to be impacted (e.g., freshwater/saltwater marsh, forested wetland, beaver pond,
Carolina Bay, bog, etc.) Indicate if wetland is isolated (determination of isolation to be made by USACE only).
List the total acreage (estimated) of all existing wetlands on the property:
Total area of wetland impact proposed:
3. Individually list all intermittent and perennial stream impacts below:
Stream Impact
Site Number
(indicate on map)
Type of Impact* Length of
Impact
(linear feet)
Stream Name** Average Width
of Stream
Before Impact Perennial or
Intermittent?
(please specify)
/
V? 1, 1v? 1
1 +;?t r(-,a

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: culverts and associated rip-tap,
dams (separately list impacts due to both structure and flooding), relocation (include linear feet before and after, and net loss/gain),
stabilization activities (cement wall, rip-rap, crib wall, 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.
** Stream names can be found on USGS topographic maps. If a stream has no name, list as UT (unnamed tributary) to the nearest
downstream named stream into which it flows. USGS maps are available through the USGS at 1-800-358-9616, or online at
www.usg§gov. Several internet sites also allow direct download and printing of USGS maps (e.g., www.topo-/.one.corn,
www.ma guest.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site:
__( `_'_i'_ 2 I e ___?
Page 8 of 8
4. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.) below:
Jpen water Impact Area of
Site Number Type of Impact* Impact Name of Waterbody Type of Waterbody
(indicate on map) (acres) (if applicable) (lake, pond, estuary, sound,
bay, ocean, etc.)
List each impact separately and identify temporary impacts. Impacts include, but are not limited to: fill, exca vation,dredgin;
flooding, drainage, bulkheads, etc. - _di-
5. 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): D uplands stream wetl
Describe the method of construction (e. ., dam/embankment excavation, installation ation dof
draw-down valve or spillway, etc.): N
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic _
local stormwater requirement, etc.):
N trout pond,
Size of watershed draining to pond: Al
Expected pond surface area: N _
VII. 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 act
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.
L©n h Q ?.?;0„ •
n r c-A , r,
VIII. Mitigation
DWQ - In accordance with 15A NCAC 2H .0500, mitigation may
Division of Water Quality for projects involving greater than or equal
freshwater wetlands or greater than or I

C.--
be required by the NC
equa to 150 linear feet of total to one acre of impacts to
streams. perennial
Parma 0 ,.a n
USAGE - In accordance with the Final Notice of Issuance and Modifica
Permits, published in the Federal Register on March 9, 2000, miti atio teon re Nationwide
quired when
necessary to ensure that adverse effects to the aquatic environment are minimal.
including size and type of proposed impact and function and g relative n will value be of re the impacted
aquatic resource will be considered in determining acceptability of Factors
mitigation as proposed. Examples of mitigation that may be appropriate priatte aand pra and practicable
but are not limited to: reducing the size of the project; establishing and practicable include,
and/or upland vegetated buffers to protect open waters such as streams; and re
aquatic resource functions and values by creatiei restoring, maintaining wetland losses functions and values, preferable in the same watershed. enhancing, or p eserving similar
If mitigation is required for this project, a co
for USAGE or DW pY of the mitigation plan must be attached in order
Q to consider the application complete for processing. lacking a required mitigation plan or NC
incomplete. An applicant may also choose to review the cu?ence shall be p1a ed yon holdt1 as
in DWQ's Draft Technical Guide for Stream Work int NorthinC for stream restoration
htt :/p /h2o.enr.state.nc.us/newetlands/strm ide.htn?l. axolina, 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 d'
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear
of mitigation proposed (restoration, enhancement, ( erections
preservation mechanism e, creation, or preservation), a plan view)
( g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of constructs
a separate sheet if more space is needed. on. Please attach
2• Mitigation may also be made by
n may al y payment into the North Carolina Wetlands Restoration
Please note it is the applicant's responsibility to contact the NCWRp
[phone] to determine availability and to request written approval of mitigation to submittal of a PCN. at
For additional information regarding the application process fore the
NCWRP, check the NCWRp website at htt ://h2o.enr.state.nc.us/wr /index
the NCWRp is proposed, please check the appropriate box on page three and nd If use of
following information; provide the
Amount of stream mitigation requested (linear feet)
Amount of buffer mitigation requested (square feet):---
Amount of Riparian wetland mitigation requested (acres):
Amount of Non-riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres):
IX, Environmental Documentation (required by DWQ)
Does the project involve an expenditure of public (federal/state) funds or the use of public
(federal/state) land?
Yes n No
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 Q
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 n No []
X. 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 proposed 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.
Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Neuse), 15A NCAC 213 .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify ?.?, cvei 4f
Yes [ No [] If you answered "yes", provide the following information:
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
multipliers.
Zone* Impact
(square feet) Multiplier Required
Mitigation
1 3
2 1.5
Total
c.wic , cnwuus uue w iccr pcrpenuicuiar from near oanK or cnannel; zone L extends an
additional 20 feet from the edge of Zone 1.
Page 11 of i l
If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation
of Property, Conservation Easement, Riparian Buffer Restoration / Enhancement, Preservation or
Payment into the Riparian Buffer Restoration Fund). Please attach all appropriate information as
identified within 15A NCAC 213,0242 or.0260.
XI. Stormwater (required by DWQ)
Describe impervious acreage (both 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. , A
XII. Sewage Disposal (required by DWQ)
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated fro??e proposed project, or available capacity of the subject facility.
XIII. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes [] No []
Is this an after-the-fact permit application?
Yes El No 0
XIV. 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 S ecies, accessibility problems, or other issues outside oft e applicant's control).
-ass

'?Yt"+?wuwti?Glil J algnature --
(Agent's signature is valid only if an authorization letter from the applicantiis provided.)
Page 12 of 12
DWQ# ® Date Z 3 Who Reviewed: r Dw
plan Detail Incomplete
Please provide a location map for the project.
Please show all stream impacts including all fill slopes, dissipaters, and bank stabilization on the site plan.
? Please show all wetland impacts including fill slopes on the site plan.
? Please indicate all buffer impacts on the site plan.
7 Please indicate proposed lot layout as overlays on the site plan.
? Please indicate the location of the protected buffers as overlays on the site plan.
? Please locate all isolated or non-isolated wetlands, streams and other waters of the State as overlays on theaite plan.
? Please provide cross section details showing the provisions for aquatic life passage.
? Please locate any planned sewer lines on the site plan.
? Please provide the location of any proposed stormwater management practices as required by GC
? Please provide detail for the stormwater. management practices as required by GC
? Please specify the percent of project imperviousness area based on the estimated built-out conditions.
? Please indicate all stormwater outfalls on the site plan.
? Please indicate the diffuse flow provision measures on the site plan.
? Please indicate whether or not the proposed impacts already been conducted.
Avoidance and/or Minimization Not Provided
? The labeled as on the plans does not appear to be necessary. Please eliminate the or provide additional
information as to why it is necessary for this project.
? This Office believes that the labeled on the plans as can be moved or reconfigured to avoid the impacts to the
. Please revise the plans to avoid the impacts.
? This Office believes that the labeled on the plans as can be moved or reconfigured to minimise the impacts to the
. Please revise the plans to minimize the impacts.
? The stormwater discharges at the location on the plans labeled will not provide diffuse flow through the buffer because
. Please revise the plans and provide calculations to show that diffuse flow will be achieved through the entire buffer. If it
is not possible to achieve diffuse flow through the entire buffer then it may be necessary to provide stormwater management
practices that remove nutrients before the stormwater can be discharged through the buffer.
Other
? The application fee was insufficient because over 150 feet of stream and/or over 1 acre of wetland impacts were requested. Please
provide $ . This additional fee must be received before your application can be reviewed.
? Please complete Section(s) on the application.
? Please provide a signed copy of the application.
? Please provide copies of the application, copies of the site plans and other supporting information.
Mitigation
? of compensatory mitigation is required for this project. Please provide a compensatory mitigation plan. The
plan must conform to the requirements in 15 A NCAC 2H .0500 and must be appropriate to the type of impacts proposed.
? Please indicate which 404 Permit the USACE would use to authorize this project.