20051474 Ver 1_COMPLETE FILE_20050803

0
o? wa rFq
O?; pG Michael F. Easley, Governor
`
j
10 Mal 7 William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
a Alan W. Klimek, RE. Director
Division of Water Quality
September 8, 2006
DWQ Project # 05-1474
Franklin County
Larry Voorhees
P.O. Box 190
Bunn, NC 27508
Subject Property: Larry Voorhees Property
Lake Royale [030301, 28-31-(1), B, NSW]
Approval of 401 Water Quality Certification and Authorization Certificate per the Tar-Pamlico
River Buffer Protection Rules (15A NCAC 2B.0259) with Additional Conditions - REVISED
Dear Mr. Voorhees:
You have our approval, in accordance with the attached conditions and those listed below, to place fill
within or otherwise impact 0.0275 acres of waters (Lake Royale) for the purpose of constructing a 41-foot
in length, and located no more than 35 feet from the existing shoreline (as shown on your site plan) at the
subject property, and shade 0.0068 acres of waters (Lake Royale) to build a pier and dock as shown on
your revised drawings, and as described within your application dated November 8, 2005, and received
by the N.C. Division of Water Quality (DWQ) on December 13, 2005, with revisions dated June 27,
2006, and received by the DWQ on June 30, 2006. After reviewing your application, we have decided
that the impacts are covered by General Water Quality Certification Number(s) 3495 (GC3495). The
Certification(s) allows you to use U.S. Army Corps of Engineers General Permit(s) GP80 when issued by
the US Army Corps of Engineers (USACE). This Certification replaces the Certification issued to
you on January 31, 2006. This letter shall also act as your approved Authorization Certificate for
impacts to the protected riparian buffers per 15A NCAC 2B .0259. In addition, you should obtain or
otherwise comply with any other required federal, state or local permits before you go ahead with your
project including (but not limited to) Erosion and Sediment Control, Non-discharge, and water supply
regulations. Also, this approval to proceed with your proposed impacts or to conduct impacts to
waters as depicted in your application shall expire upon expiration of the 404 or CAMA Permit.
This approval is for the purpose and design that you described in your application. If you change your
project, you must notify us and you may be required to send us a new application. If the property is sold,
the new owner must be given a copy of this Certification and approval letter and is thereby responsible for
complying with all conditions. If total fills for this project (now or in the future) exceed one acre of
wetland or 150 linear feet of stream, compensatory mitigation may be required as described in 15A
NCAC 2H.0506 (h). This approval requires you to follow the conditions listed in the attached
certification and any additional conditions listed below.
The Additional Conditions of the Certification are:
1. Impacts Approved
The following impacts are hereby approved as long as all of the other specific and general
conditions of this Certification (or Isolated Wetland Permit) are met. No other impacts are
approved including incidental impacts:
401 Oversight /Express Review Permitting Unit Caro 'na
1650 Mail Service Center, Raleigh, North Carolina 27699-1650 ,n
2321 Crabtree Boulevard, Suite 250, Raleigh, North Carolina 27604
Phone: [phone] /FAX [phone] /Internet: ft://h2o.enr.state,nc.us/ncwetiands
An Equal Opportunity/Affirmative Action Employer - 50% Recycled/] 0% Post Consumer Paper

Larry Voorhees
Page 2 of 3
September 8, 2006
Amount Approved Units Plan Location or Reference
Waters - Lake Royale 0.0275 acres - filled Application Land Plat drawing_
Waters - Lake Ro ale 0.0038 acres -shaded) Revisions dated June 27, 2006
2. Diffuse Flow
An additional condition is that all stormwater shall be directed as diffuse flow at non-erosive
velocities through the protected stream buffers and will not re-concentrate before discharging into the
stream as identified within 15A NCAC 2B .0259(5).
3. Erosion & Sediment Control Practices
Erosion and sediment control practices must be in full compliance with all specifications
governing the proper design, installation and operation and maintenance of such Best
Management Practices in order to protect surface waters standards:
a. The erosion and sediment control measures for the project must be designed, installed,
operated, and maintained in accordance with the most recent version of the North Carolina
Sediment and Erosion Control Planning and Design Manual.
b. The design, installation, operation, and maintenance of the sediment and erosion control
measures must be such that they equal, or exceed, the requirements specified in the most
recent version of the North Carolina Sediment and Erosion Control Manual. The devices
shall be maintained on all construction sites, borrow sites, and waste pile (spoil) projects,
including contractor-owned or leased borrow pits associated with the project.
c. The reclamation measures and implementation must comply with the reclamation in
accordance with the requirements of the Sedimentation Pollution Control Act.
4. No Waste, Spoil, Solids, or Fill of Any Kind
No waste, spoil, solids, or fill of any kind shall occur in wetlands, waters, or riparian areas beyond
the footprint of the impacts depicted in the Pre-Construction Notification. All construction
activities, including the design, installation, operation, and maintenance of sediment and erosion
control Best Management Practices, shall be performed so that no violations of state water quality
standards, statutes, or rules occur.
5. No Sediment & Erosion Control Measures w/n Wetlands or Waters
Sediment and erosion control measures shall not be placed in wetlands or waters to the maximum
extent practicable. If placement of sediment and erosion control devices in wetlands and waters
is unavoidable, they shall be removed and the natural grade restored within six months of the date
that the Division of Land Resources has released the project.
6. Bulkhead Construction
The bulkhead may be no longer than 41 feet in length (35 feet maximum from the eroding
shoreline at the center of the seawall) and may be no wider than two feet in width and must
follow the existing shoreline geomorphology.
r
Larry Voorhees
Page 3 of 3
September 8, 2006
7. Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification or applicable
Buffer Rules, and any subsequent modifications, the applicant is required to return the attached
certificate of completion to the 401 Oversight/Express Review Permitting Unit, North Carolina
Division of Water Quality, 1650 Mail Service Center, Raleigh, NC, 27699-1650.
Violations of any condition herein set forth may result in revocation'of this Certification and may result in
criminal and/or civil penalties. The authorization to proceed with your proposed impacts or to conduct
impacts to waters as depicted in your application and as authorized by this Certification, shall expire upon
expiration of the 404 or CAMA Permit.
If you do not accept any of the conditions of this Certification (associated with the approved wetland or
stream impacts), you may ask for an adjudicatory hearing. You must act within 60 days of the date that
you receive this letter. To ask for a hearing, send a written petition, which conforms to Chapter 150B of
the North Carolina General Statutes to the Office of Administrative Hearings, 6714 Mail Service Center,
Raleigh, N.C. 27699-6714. This certification and its conditions are final and binding unless you ask for a
hearing.
Any disputes over determinations regarding this Authorization Certificate (associated with the approved
buffer impacts) shall be referred in writing to the Director for a decision. The Director's decision is
subject to review as provided in Articles 3 and 4 of G.S. 150B.
This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water
Act. If you have any questions, please telephone Cyndi Karoly or Ian McMillan in the Central Office in
Raleigh at 919-733-1786 or Eric Kulz in the Raleigh Regional Office at 919-791-4200.
AWK/ijm
Enclosures: GC3495
Certificate of Completion
cc: USACE Raleigh Regulatory Field Office
Eric Kulz, DWQ Raleigh Regional Office
DLR Raleigh Regional Office
File Copy
Central Files
Sin erely,
Alan W. Klimek, P.E.
Filename: 051474LarryVoorhees(Frank1in)401 revised
P. O. Box 190
Bunn, NC 27508
August 28, 2006
Mr. Ian McMillan
Division of Water Quality
1650 Mail Service Center
Raleigh, NC 27699-1650
Re: DWQ Project #05-1474
Dear Mr. McMillan
Pursuant to our conversation today in connection with the above caption, enclosed are the
following:
1. Letter to you dated 6/27/06, depicting the boat dock and deck walkway on the
backside of the letter, as discussed.
2. Letter from Eric Alsmeyer indicating no objections on his end.
Thank you again for your time.
Very truly yours,
per/
Larry Voorhees
#?W@k
AUG 2
??een.?, 9 z0?6
At STTggI?QU lry
ws
EXHIBIT "A"
Blown up view (not drawn to scale) depicting the impact area as shown on my land plat,
and photos previously submitted.
V a p , -?4

P. O. Box 190
Bunn, NC 27508
June 27, 2006
Mr. Ian McMillan
Division of Water Quality
1650 Mail Service Center
Raleigh, NC 27699-1650'
Mr. Eric Alsmeyer
Regulatory Project Manager
U.S. Army Corps of Engineers
6508 Falls of the Neuse Rd., Suite 120
Raleigh, NC 27615
Re: DWQ Project #05-1474
Gentlemen:
As you are probably aware, the Lake Royale Property Owners Association has a
regulation that docks may extend no more than 10 feet from an existing, shoreline. A
dock extending that distance from my innermost shoreline would be in only four inches
of water. Thus, I sought approval from your agencies to construct a, bulkhead, back fill
and thereafter, build a dock. (See land plat and photos previously submitted.
Recently, two members of the Lake Royale Building Committee personally inspected the
impact area and noted my unusual situation. They agreed that I should not have to go to
the expense of constructing a seawall just so I can construct a boat dock in deep enough
water to accommodate the docking of my boat. They informed me that they would
recommend to the other committee members that I be allowed to construct a deck
walkway and dock as depicted on the reverse side of this letter, marked Exhibit "A."
This letter then, is to inquire if your agencies would have any objections to my
constructing a deck walkway and dock in lieu of constructing a bulkhead and back filling.
Providing you do not object, could you send me a letter of approval referring to this letter
and Exhibit "A" as depicted?
Thank you for your time and attention to this request.
Very truly yours,
Larry Voorhees
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Subject: Voorhees walkway/dock; AID 200521183
Date: Mon, 24 Jul 2006 11:00:04 -0400
"Alsmeyer, Eric C SAW" <[e-mail]>
From: Add to Address Book g Add Mobile Alert
To: L][e-mail]
CC: [e-mail]
Mr. Voorhees: In response to your June 27, 2006 letter, and per our telephone
conversation earlier today, if you construct a deck walkway and dock, as
described in your letter and shown on your drawing, using driven piles with no
bulkhead, seawall, riprap, or other fill within waters of the United States (i.e.,
Lake Royale or any streams or wetlands), then we do not regulate the activity,
and no applications to us or permits/approvals from us are necessary. This
applies to your project and any other projects in non-navigable (by use) waters,
such as Lake Royale.
You still need to check with NC-DENR, Division of Water Quality, re: their
requirements under the Tar Buffer Rules.
Thank you,
Eric Alsmeyer
Project Manager
US Army Corps of Engineers
Raleigh Regulatory Field Office
Tel: [phone], ext 23
Fax: [phone]
Regulatory xomepage: http:11www. saw_usace. army. mil/WETLANDS
Please help us better serve you! Take our brief online Customer Service
Surve . (http //www saw.usace.army.mil/scripts/rws3 pI?FORM=regulatory)
http://us.f365.mail.yahoo.com/ym/ShowLetter?Msgld=8841 _263459_62520_1905_1462_... 7/24/2006
P. O. Box 190
Bunn, NC 27508
June 27, 2006
Mr. Ian McMillan
Division of Water Quality
1650 Mail Service Center
Raleigh, NC 27699-1650
Mr. Eric Alsmeyer
Regulatory Project Manager
U.S. Army Corps of Engineers
6508 Falls of the Neuse Rd., Suite 120
Raleigh, NC 27615
Re: DWQ Project #05-1474
Gentlemen:
As you are probably aware, the Lake Royale Property Owners Association has a
regulation that docks may extend no more than 10 feet from an existing- shoreline. A
dock extending that distance from my innermost shoreline would be in only four inches
of water. Thus, I sought approval from your agencies to construct a bulkhead, back fill
and thereafter, build a dock. (See land plat and photos previously submitted.
Recently, two members of the Lake Royale Building Committee personally inspected the
impact area and noted my unusual situation. They agreed that I should not have to go to
the expense of constructing a seawall just so I can construct a boat dock in deep enough
water to accommodate the docking of my boat. They informed me that they would
recommend to the other committee members that I be allowed to construct a deck
walkway and dock as depicted on the reverse side of this letter, marked Exhibit "A."
This letter then, is to inquire if your agencies would have any objections to my
constructing a deck walkway and dock in lieu of constructing a bulkhead and back filling.
Providing you do not object, could you send me a letter of approval referring to this letter
and Exhibit "A" as depicted?
Thank you for your time and attention to this request.
Very truly yours,
Larry Voorhees
EXHIBIT "A"
Blown up view (not drawn to scale) depicting the impact area as shown on my land plat,
and photos previously submitted.

}<--- 2 o' ---?4
P. O. Box 190
Bunn, NC 27508
June 27, 2006
Mr. Ian McMillan
Division of Water Quality
1650 Mail Service Center
Raleigh, NC 27699-1650
Mr. Eric Alsmeyer
Regulatory Project Manager
U.S. Army Corps of Engineers
6508 Falls of the Neuse Rd., Suite 120
Raleigh, NC 27615
Re: DWQ Project #05-1474
Gentlemen:
QPm Q;?:4 Pm onc?p
JUN 3 0 2006
DENR - WATER QQALITY
WETLAWS AND STORMWATER BRANCH
As you are probably aware, the Lake Royale Property Owners Association has a
regulation that docks may extend no more than 10 feet from an existing, shoreline. A
dock extending that distance from my innermost shoreline would be in only four inches
of water. Thus, I sought approval from your agencies to construct a bulkhead, back fill
and thereafter, build a dock. (See land plat and photos previously submitted.
Recently, two members of the Lake Royale Building Committee personally inspected the
impact area and noted my unusual situation. They agreed that I should not have to go to
the expense of constructing a seawall just so I can construct a boat dock in deep enough
water to accommodate the docking of my boat. They informed me that they would
recommend to the other committee members that I be allowed to construct a deck
walkway and dock as depicted on the reverse side of this letter, marked Exhibit "A."
This letter then, is to inquire if your agencies would have any objections to my
constructing a deck walkway and dock in lieu of constructing a bulkhead and back filling.
Providing you do not object, could you send me a letter of approval referring to this letter
and Exhibit "A" as depicted? '
Thank you for your time and attention to this request.
Very truly yours,
Larry ?Voorhees
EXHIBIT "A"
Blown up view (not drawn to scale) depicting the impact area as shown on my land plat,
and photos previously submitted.

j<-'" 2 C1 / --A
P. 0. Box 190
Bunn, NC 27508
May 10, 2006
Division of Water Quality
Mr. Ian McMillan
1650 Mail Service Center
Raleigh, NC 27699-1650
Re: DWQ Project #05-1474
Dear Mr. McMillan:
Pursuant to our conversation today in connection with the above caption, enclosed for
your files, per your instructions, is this letter recapping our conversation as follows:
I have contacted you, drawing your attention to a calculation error made on this end
concerning previously submitted measurements, namely, from point "A" to point "B"
(see map copy in application) is 55 ft., not 41 ft. However, if I extend the seawall
bulkhead 25 ft. from the shoreline, instead of the approved 35 ft., the total impact to
acreage will be slightly less than that originally approved.
Thank you for your verbal authorization to this requested change and for not requiring an
additional fee and re-submittal of the application.
Very t ly yours,
Larry Voorhees
Copy: Mr. Eric Alsmeyer
Regulatory Project Manager
U. S. Army Corps of Engineers
6508 Falls of the Neuse Rd., Suite 120
Raleigh, NC 27615
M/'?Y x
lM06
??'RRANCH
O?O? \ NA T ?q?G
r_
p iq -c
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
January 31, 2005
Larry Voorhees
P.O. Box 190
Bunn, NC 27508
Subject Property:
Larry Voorhees Property
Lake Royale [030301, 28-31-(1), B, NSW]
Approval of 401 Water Quality Certification with Additional Conditions
Dear Mr. Voorhees:
Alan W. Klimek, P.E. Director
Division of Water Quality
DWQ Project # 05-1474
Franklin County
You have our approval, in accordance with the attached conditions and those listed below, to place fill
within or otherwise impact 0.0275 acres of waters (Lake Royale) for the purpose of constructing a 41-foot
in length and located no more than 35 feet from the existing shoreline (as shown on your site plan) at the
subject property, and as described within your application dated November 8, 2005 and received by the
N.C. Division of Water Quality (DWQ) on December 13, 2005. After reviewing your application, we
have decided that the impacts are covered by General Water Quality Certification Number(s) 3495
(GC3495). The Certification(s) allows you to use U.S. Army Corps of Engineers General Permit(s) GP80
when issued by the US Army Corps of. Engineers (USACE). In addition, you should obtain or otherwise
comply with any other required federal, state or local permits before you go ahead with your project
including (but not limited to) Erosion and Sediment Control, Non-discharge, and water supply
regulations. Also, this approval to proceed with your proposed impacts or to conduct impacts to
waters as depicted in your application shall expire upon expiration of the 404 or CAMA Permit.
This approval is for the purpose and design that you described in your application. If you change your
project, you must notify us and you may be required to send us a new application. If the property is sold,
the new owner must be given a copy of this Certification and approval letter and is thereby responsible for
complying with all conditions. If total fills for this project (now or in the future) exceed one acre of
wetland or 150 linear feet of stream, compensatory mitigation may be required as described in 15A
NCAC 2H .0506 (h). This approval requires you to follow the conditions listed in the attached
certification and any additional conditions listed below.
The Additional Conditions of the Certification are:
1. Impacts Approved
The following impacts are hereby approved as long as all of the other specific and general
conditions of this Certification (or Isolated Wetland Permit) are met. No other impacts are
approved including incidental impacts:
Amount Approved nits Plan Location or Reference
Waters 0.0275 acres Application Land Plat drawing
401 Oversight / Express Review Permitting Unit
1650 Mail Service Center, Raleigh, North Carolina 27699-1650
2321 Crabtree Boulevard, Suite 250, Raleigh, North Carolina 27604
Phone: [phone] / FAX [phone] / Internet: http://h2o.enr.state.nc.us/ncwetlands
NonehCaro 'na
Na&rally
An Equal Opportunity/Affirmative Action Employer - 50% Recycled/ 10% Post Consumer Paper
Larry Voorhees
Page 2 of 3
January 31, 2005
2. Diffuse Flow
An additional condition is that all stormwater shall be directed as diffuse flow at non-erosive
velocities through the protected stream buffers and will not re-concentrate before discharging into the
stream as identified within 15A NCAC 2B .0259(5).
3. Erosion & Sediment Control Practices
Erosion and sediment control practices must be in full compliance with all specifications
governing the proper design, installation and operation and maintenance of such Best
Management Practices in order to protect surface waters standards:
a. The erosion and sediment control measures for the project must be designed, installed,
operated, and maintained in accordance with the most recent version of the North Carolina
Sediment and Erosion Control Planning and Design Manual.
b. The design, installation, operation, and maintenance of the sediment and erosion control
measures must be such that they equal, or exceed, the requirements specified in the most
recent version of the North Carolina Sediment and Erosion Control Manual. The devices
shall be maintained on all construction sites, borrow sites, and waste pile (spoil) projects,
including contractor-owned or leased borrow pits associated with the project.
c. The reclamation measures and implementation must comply with the reclamation in
accordance with the requirements of the Sedimentation Pollution Control Act.
4. No Waste, Spoil, Solids, or Fill of Any Kind
No waste, spoil, solids, or fill of any kind shall occur in wetlands, waters, or riparian areas beyond
the footprint of the impacts depicted in the Pre-Construction Notification. All construction
activities, including the design, installation, operation, and maintenance of sediment and erosion
control Best Management Practices, shall be performed so that no violations of state water quality
standards, statutes, or rules occur.
5. No Sediment & Erosion Control Measures w/n Wetlands or Waters
Sediment and erosion control measures shall not be placed in wetlands or waters to the maximum
extent practicable. If placement of sediment and erosion control devices in wetlands and waters
is unavoidable, they shall be removed and the natural grade restored within six months of the date
that the Division of Land Resources has released the project.
6. Bulkhead Construction
The bulkhead may be no longer than 41 feet in length (35 feet maximum from the eroding
shoreline at the center of the seawall) and may be no wider than two feet in width and must
follow the existing shoreline geomorphology.
7. Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification or applicable
Buffer Rules, and any subsequent modifications, the applicant is required to return the attached
certificate of completion to the 401 Oversight/Express Review Permitting Unit, North Carolina
Division of Water Quality, 1650 Mail Service Center, Raleigh, NC, 27699-1650.
Larry Voorhees
Page 3 of 3
January 31, 2005
Violations of any condition herein set forth may result in revocation of this Certification and may result in
criminal and/or civil penalties. The authorization to proceed with your proposed impacts or to conduct
impacts to waters as depicted in your application and as authorized by this Certification, shall expire upon
expiration of the 404 or CAMA Permit.
If you do not accept any of the conditions of this Certification (associated with the approved wetland or
stream impacts), you may ask for an adjudicatory hearing. You must act within 60 days of the date that
you receive this letter. To ask for a hearing, send a written petition, which conforms to Chapter 150B of
the North Carolina General Statutes to the Office of Administrative Hearings, 6714 Mail Service Center,
Raleigh, N.C. 27699-6714. This certification and its conditions are final and binding unless you ask for a
hearing.
Any disputes over determinations regarding this Authorization Certificate (associated with the approved
buffer impacts) shall be referred in writing to the Director for a decision. The Director's decision is
subject to review as provided in Articles 3 and 4 of G.S. 150B.
This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water
Act. If you have any questions, please telephone Cyndi Karoly or Ian McMillan in the Central Office in
Raleigh at 919-733-1786 or Eric Kulz in the Raleigh Regional Office at 919-791-4200.
AWK/gym
Enclosures: GC3495
Certificate of Completion
cc: USACE Raleigh Regulatory Field Office
Eric Kulz, DWQ Raleigh Regional Office
DLR Raleigh Regional Office
File Copy
Central Files
Sincerely,
4 1 ?- "
Alan W. Klimek, P.E.
Filename: 0514741An yV oorhees(Franklin)101
ProJO Number: 120051 7
Proj- actNa?ne: Larry''
Owgg?xer'ILarry',
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?Ouestlorisc
ion; 1 0' Stitt s IIFtBCs d f $W Plan Loc ationF7
Pro JsCtType SdhkStabllizatlon &ShoCeline 6ta611izatlon (sells rip rap
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t

Streambank stabilization Is nee ded, I am ok to issue this project

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-- - - - - Ready 81p;-1NQ
Triage Check List
Date: Z 6 Project Name:
To: ? ARO Kevin Barnett
? FRO Ken Averitte
? MRO Alan Johnson
RRO Mike Horan
(-max VOO"
DWQ#: 22257 4W
County:
? Wa.R.O Tofu Steffens and Kyle Barnes
? WiRO Noelle Lutheran
? WSRO Daryl Lamb
From: ?- WwAy__ Telephone : (919) -7 3 3 -5'7o?
The file attached is being forwarded 40 our for your evaluation.
Please call if you need!as 'stance.
? Stream length impacted
? Stream determination
? Wetland determination and distance to blue-line surface,.waters on USFW topo maps
? Minimization/avoidance issues
Buffer Rules (Meuse, Tar-Pamlico, Catawba, Randleman)
Pond fill
? Mitigation Ratios
? Ditching
? Are the stream and or wetland mitigation sites available and viable?
? Check drawings for accuracy
? Is the application consistent with pre-application meetings?
? Cumulative impact concern
Comments:
C

A x) , hu' IA 1v_cA kxj,I It IN oftA (A Irfl.?a exiSfi w. <Wv Jiv,
fitf, DOPY
P. O. Box 190
Bunn, NC 27508
December 9, 2005
Division of Water Quality
Attention: Ian McMillan & Michael Horan
1650 Mail Service Center
Raleigh, NC 27699-1650
Re: DWQ Project 405-1474
Franklin County
Gentlemen:
Pursuant to my recent conversations with Mr. McMillan in connection with the above
captioned, and his written instructions in letter to me dated August 17, 2005, enclosed is
the requested material for your review and consideration.
I respectfully redraw to your attention that during the month of June 2005 I met with Mr.
Horan and Joe Faison, a bulkhead contractor, at the proposed work site. After thoroughly
inspecting the situation, Mr. Horan stood at point "A" (see map enclosed) looking across
to point "B." Mr. Horan agreed that the proposed seawall would curb further erosion into
the lake and would recommend to the DWQ that I be allowed to construct same. In
addition, he said he would speak to the corps in behalf of the project. He then informed
me that he would want me to plant at least two trees and some shrubs (possibly a flower
garden) in the affected area.
For your other information, Mr. Faison asked me to fill out the pre-construction
notification as much as possible and that he would complete the form and forward same
to the DWQ. Obviously, from the above-mentioned letter, he failed to fill it out in its
entirety. I apologize for my not having reviewed the application prior to his forwarding it
on.
In closing, I want to thank both of you gentlemen, as well as your staff, for your time and
attention to this matter. If I can be of further assistance, please advise.
Very truly yours,
Larry Voorhees
? 1"M
L9 ?
[)F(' a 3 2005
KR ANDS ANSTORMWATER'BRANCH

C
co
Pre-Construction Notification (PCN) Application Form
v
For Section 404 and/or Section 10 Nationwide, Regional and General Permits, Section 401
General Water Quality Certifications, and Riparian Buffer and Watershed Buffer Rules
This form is to be used for projects qualifying for any of the U.S. Army Corps of Engineers' (USACE)
Nationwide, Regional or General Permits as required by Section 404 of the Clean Water Act and/or
Section 10 of the Rivers and Harbors Act, and for the North Carolina Division of Water Quality's
(DWQ) associated General 401 Water Quality Certifications. This form is also to be used for any
project requiring approval under any Riparian Buffer Rules implemented by the N.C. Division of Water
Quality. This form should not be used if you are requesting an Individual 404 Permit or Individual 401
Water Quality Certification. The USACE Individual Permit application form is available online at
http://www.saw.usace.army.miI/wetlands/Perm app.htm.
The USACE is the lead regulatory agency. To review the requirements for the use of Nationwide,
Regional or General permits, and to determine which permit applies to your project, please go to the
USACE website at http://www.saw.usace,army.miI/wetlands/regtour.htm, or contact one of the field
offices listed on page 3 of this application. The website also lists the responsible project manager for
each county in North Carolina and provides additional information regarding the identification and
regulation of wetlands and waters of the U.S.
The DWQ issues a corresponding Certification (General or Individual), and cannot tell the applicant
which 401 Certification will apply until the 404 Permit type has been determined by the USACE.
Applicants are encouraged to visit DWQ's 401/Wetlands Unit website at
http://h2o.enr.state.nc.us/ncwetiands to read about current requirements for the 401 Water Quality
Certification Program and to determine whether or not Riparian Buffer Rules are applicable. The
applicant is also advised to read the full text of the General Certification (GC) matching the specific 404
Permit requested. In some cases, written approval for General Certifications is not required, provided
that the applicant adheres to all conditions of the GC. Applicants lacking access to the internet should
contact DWQ's Central Office in Raleigh at [phone].
Trout Waters Coordination - Special coordination with the North Carolina Wildlife Resources
Commission (NCWRC) is required for projects occurring in any of North Carolina's twenty-five
counties that contain trout waters. In such cases, the applicant should contact the appropriate NCWRC
regional coordinator (listed by county on page 4 of this application) prior to submittal of the application.
r,F W A TF,
Page 1 of 12
Office Use Only: Form Version May 2002
USACE Action ID No. DWQ No.
1.
err any pamcuiar item is not appncame to tnis project, please enter "Not Applicable- or "N/A".)
Processing PL L? S E FIR 0 C C SS A-5 ^ G P 3 0
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
2. Nationwide Regional or General Permit Number(s) Requested. • -3 0
'I" `3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: ?
t04. 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: ?
II.
5. If your project is located in any of North Carolina's twenty coastal counties (listed on page
4k, 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 herm
L Applicant Information
DFC -1 3 2005
1. Owner/Applicant Information
Name: t_ JrDS QY:aTE'' ,
L_ A R R O G k? H ? ?'Etwvuanrn
Mailing Address: P b D -4 cl /? uIV /1) C '?2 7 Yo Sl C ,6c = 7 S 5A6 M o,2 R. LoviS C /1Z 1S'
L- c- A-N 8T- ECEIv6D -r >/ A sir C ;4\ , r
Telephone NumberQ 52 y7 - 410 / y Fax Number:
E-mail Address:
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:
Company Affiliation:
Mailing Address:
Telephone Number:
E-mail Address:
Fax Number:
Page 5 of 12
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: C 2IJ-5 T"P- u c T/ v /1/ D E v EA 1AJh -
D w (], P 9 0 c _ /V (?)M 6 C-?-- ':::- 'V-5 7
?f
2. T.I.P. Project Number or State Project Number ?(NCDOT Only): / J
3. Property Identification Number (Tax PIN): It C1 0 3 1 W
4. Location
County: A /\j t- i /? Nearest Town: l? ?' N Al ti C
Subdivision name (include phase/lot number): / 5ry/-/
Directions to site (include road numbers, landmarks, etc.): J'-8
N &1Q d r S,A, CA M a/2-L-= 0? ?. ? Z- C 2 r_ /,z rS 1) k'
5. Site coordinates, if available (UTM or Lat/Long): A % Tp\c,,H 6.D
(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.)
6. Property size (acres): : C, c f A'-\ ? r L r
7. Nearest body of water (stream/river/sound/ocean/lake): t-A K=? /'?,O ?,4 L,?? N
8. River Basin: /Z - % /f#I L. (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/maps/.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: R Z S / D 4-'-' ^/ C O Al 6, L.o c'
!©o F C7 /A/t./,A;.-) fKlim 7/1e- /,nkr ? v If_VJ)Nt< i)E`cK
IS' L oceTE? A 7 'TIl t= Sfl vre ZINC PH -r-US [A)C4CU6 )
f 0275
Page 6 of 12
10. Describe the overall project in detail, including the type of equipment to be used: 0 C 7
i
To C- C,b s-rR c; /1 S c ?vh L L, t: X! ?-N D i ti 6 3? r OM 1"4
P N
77 N6 (D -T
N N L=K 0',7 C u r L l
--
r Q?, P A rti cLGSG? 7N<N ocJ? c3?0?
c%l c 1 R ?=e S N 4 ??, ck n c- c A P C A---?
R AIL AoAi) rl 6- iN M -Ac FI ?T ?i?,R/oi:? /NTC? vf1 LS - -
I I FYnlain the nnrnose of the nronosed work: i'?R?P6?2Q1?'L?0+1?? -
IV
V
Prior Project History
ko TCcT GS- 1/-7 L 1)4Tr?
-? ?- S aT«7 IJA5 4F EN on/ l?oc..U ?N
,r- A) c,6 c-D oC OAr6P A Pe --/?A T/0
Di k'7
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 schedu s
Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated wort,,
and provide justification for, f e exclusion of this work from the current application.
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 o1' 12
1. Provide a written description of the proposed impacts: T6, ol, S?K u c l /1 e /
s f.? wLLC- ._2&0 P21A A 71 PO/N? nc/? //j SCE G(_X
A-?'7A r'1-/Fh IkA,l AcICFILL/lit; i.rj /rAl ? I,DAhf trc S%LJ-
2. Individually list wetland impacts below:
Wetland Impact
Site Number
indicate on ma
Type of Impact* Area of
Impact
acres Located within
100-year Floodplain**
es/no Distance to
Nearest Stream
linear feet
Type of Wetland***
A/
n, N

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: mechanized clearing, grading, till,
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.fenia.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: All
3. Individually list all intermittent and perennial stream impacts below:
Stream Impact
Site Number
indicate on ma
Type of Impact* Length of
Impact
linear feet
Stream Name** Average Width
of Stream
Before Impact Perennial or
Intermittent?
leasespecify)
/

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: culverts and associated rip-rap,
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, ditch ing/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
%vwtiv.usgs.f?ov. Several internet sites also allow direct download and printing of USGS maps (e.g., www.topozone.com,
www.maRq st.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: _A/ (?/V
Page 8 of 12
4. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.) below:
Open Water Impact
Site Number
indicate on ma
Type of Impact* Area of
Impact
acres
(if applicable) Name Waterbody Type of Waterbody
(lake, pond, estuary, sound,
bay, ocean, etc.
yq S 51 k1Aex_ a017 /z

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: fill, excavation, dredging,
flooding, drainage, bulkheads, etc.
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 ffa l acation.
Pond to be created in (check all that apply): ? uplandsstream ? wetlands
Describe the method of construction (e.g. dam/embankment, excavation, installation of
draw-down valve or spillway, etc.): A
Proposed use or purpose of pond (e.g., live tock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.): All, .
Size of watershed draining to pond: Al //J Expected pond surface area:
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
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.
i"LCATe Sf;C / G Al /C7 pit/ Pl!GL
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.
Page 9 of 12
USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on March 9, 2000, 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 attached in order
for USACE or DWQ to consider the application complete for processing, Any application
lacking a required mitigation plan or NCWRP 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
http://l12o.enr.state.nc.us/ncwetlands/strmgide.html.
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.
2. Mitigation may also be made by payment into the North Carolina Wetlands Restoration
Program (NCWRP). Please note it is the applicant's responsibility to contact the NCWRP at
[phone] to determine availability and to request written approval of mitigation prior
to submittal of a PCN. For additional information regarding the application process for the
NCWRP, check the NCWRP website at http://h2o.enr.state.nc.us/wrp/index.htm. If use of
the NCWRP is proposed, please check the appropriate box on page three 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):
Amount of Non-riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres):
Page 10 of 12
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 ? No 5d
V 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 ?
0 ? If yes, has the document review been finalized by the State Clearinghouse? If, so, please attach a
r, copy of the NEPA or SEPA final approval letter.
Yes ? 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 213 .0233
(Neuse), 15A NCAC 213 .0259 (Tar-Pamlico), 15A NCAC 213 .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify )?
Yes ? No 2 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
Zone I extends out 30 feet perpendicular from near bank of channel; Zone Z extends an
additional 20 feet from the edge of Zone 1.
Page 11 of 12
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.
,8-/ O /t/ 15
XII. Sewage Disposal (required by DWQ)
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater ge erated from the proposed project, or available capacity of the subject facility.
A/ O A
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 ? No [4N
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 Species, accessibility problems, or other issues outside of the applicant's control).
Al U / ? , Z c)c)__
/ Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 12 of 12

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FILE DOPY
Office Use Only: Form Version May 2002
USACE Action ID No. DWQ No. s - 141 1?
(If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A".)
I. Processing [JL L? s t p/Q 0 C C SS A -S A G P 30
I . Check all of the approval(s) requested for this pro ct:
? Section 404 Permit n Riparian or Watershed Buffer Rules
? Section 10 Permit ? Isolated Wetland Permit from DWQ
? 401 Water Quality Certification
2. Nationwide Regional or General Permit Number(s) ]Requested: 30
? I
/ 3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: ?
44. 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 Coasta f .
Environmental Concern (see the top of page 2 for further details), the :_: L rro
II. Applicant Information Dh. 1 ; 'MfI?
1. Owner/Applicant Information Dl= r
Name: V 0 J H WETLAN[ . ,y;,,. ,roA,v.ci0U8ANCH
?Mailing Address: P G _ /A0 -,-C / Cl /V c_?2 7 SO e
o
S/ c L= 7? S S 6 M 0P_ R. Louis v/Z 67 N >S
L- cAW 8T 1 4E C C-1 V 'r P S/ C s
Telephone Numbera 52- 417 Fr - 11" O / V Fax Number:
E-mail Address:
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:
Company Affiliation:
Mailing Address:
Telephone Number:
E-mail Address:
Fax Number:
Page 5 of 12
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 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 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: C QIV 5 TP- u c T/ 0 N D F AL4 Yet WA CC
DW n, PR0S??T/V0/V c7 -1y'`f
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN): 1, k d I N L?
4. Location
County: /? /? /? " ' i /? Nearest Town: 0 N A N C
Subdivision name (include phase/lot number): / 57?/Z-/
Directions to site (include road numbers, landmarks, etc.):??1
/?S < r/ 61Z& 0k, LOU, koi,rj /VC Iu
e_,O p a E -e- d r Sf, cn M 6'12-L- l 11 f-' ' 2 c 2 , -c-C D,e
5. Site coordinates, if available (UTM or Lat/Long): M444 A -'7-A C? E D
(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.)
6. Property size (acres): , (:, '? n `' Iv L r
7. Nearest body of water (stream/river/sound/ocean/lake): Lf? K=? 1e 61 V LZ /V C_
8. River Basin: 1-/(/` - P/- M L. ( c o
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http:/ih2o.enr.state.nc.us/admin/maps/.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: R S / D ir- IV C ? O N (.,V L y
/0-0 F' L t T /iv i z,,,v;) V7'F dig ?rle /. n k r . ? v I 1 V,),
/JF 1? F" c K
1 -5 L u c t -1- 6 h A 7111 ? r t I cR L ? tv I (_" P f l ?' rOS C" N c Z cU rz )
e 0275
Page 6 of 12
_
10. Describe the overall project in detail, including the type of equipment to be used: e ob CA-7
TO (-- Ob e c -1 A S C W h (...L ? X T /V
/NN« o ur-? L/ ti l<-N PA
AC ?e o .C'S l d S C-A wn L t f ,C oft p (J/ N . ' !1 TU P o , N1
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RAIL AOA?) -"l E.. s /N M h''AC-«? AT L//?R/ova ?tiTC? V? LS
Explain the purpose of the proposed work: AUVP.d?
IV. Prior Project History
'N /( lN(-- ti 1,/) y
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 schedu s.
k 0 3 cT GS- L17 O4 TC-?
F- G , C C7 ZJA5 Q C C N 4// N 06- D CA /
C'A) c-C cl56 D U C DA i 6P A Pe ?-/ -r- A Ti 0 -
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and VA e justification fortee exclusion of this work from the current application.
A] /J All--
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 V111 below. If additional space is needed for
listing or description, please attach a separate sheet.
Page 7 of I?
1. Provide a written description of the proposed impacts: TO 1'-01,5?1 C l
s F./\ C_ P0/A A 1 Po/ N?
A -rA rt4,;7n nA,? R,oeKF(LL lb t; Ili ITGI (-, /_DAbY GF SclL-
2. Individually list wetland impacts below:
Wetland Impact
Site Number
ndicate on ma
i
Type of Impact* Area of
Impact
acres Located within
100-year Floodplain**
es/no Distance to
Nearest Stream
linear feet
Type of Wetland***
n
/V
(? ILA -

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: mechanized clearing, grading, till,
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://NNnv-Nv.fenia.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: &4
Total area of wetland impact proposed: All ?k
3. Individually list all intermittent and perennial stream impacts below:
Stream Impact
Site Number
indicate on ma
Type of Impact* Length of
Impact
linear feet
Stream Name** Average Width
of Stream
Before Impact Perennial or
Intermittent?
leasespecify)

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: culverts and associated rip-rap,
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
\vwtiv.usgs.Rov. Several internet sites also allow direct download and printing of USGS maps (e.g., \Nrww.topozone.com,
www.map?c nest com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: N dN?? iN V1 C_ / /,J/-7y
Page 8 of 12
4. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.) below:
Open Water Impact
Site Number
indicate on ma
Type of Impact* Area of
Impact
acres Name of Waterbody
(if applicable) Type of Waterbody
(lake, pond, estuary, sound,
bay, ocean, etc.
i/ q q S l w>G [ ?? a c 7 L/?
LA L
?5'

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: fill, excavation, dredging,
flooding, drainage, bulkheads, etc.
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): ? uplands ? stream ? wetlands
Describe the method of construction (e.g. dam/embankment, excavation, installation of
draw-down valve or spillway, etc.): 7 _ A
Proposed use or purpose of pond (e.g., live tock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.): A4 ,I
Size of watershed draining to pond: Al //J Expected pond surface area:
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
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.
'I L C A T e Sf-: C I TEAI /0 ov P1 6G 49? 7
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.
Page 9 of 12
USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on March 9, 2000, 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 attached in order
for USACE or DWQ to consider the application complete for processing, Any application
lacking a required mitigation plan or NCWRP 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
http://h2o.enr.state.nc.us/ncwetiands/strmgide.htm].
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 n eded.
?/, 7/ a? Y?-/ ?? ?s pia ?c?s?D
2. Mitigation may also be made by payment into the North Carolina Wetlands Restoration
Program (NCWRP). Please note it is the applicant's responsibility to contact the NCWRP at
[phone] to determine availability and to request written approval of mitigation prior
to submittal of a PCN. For additional information regarding the application process for the
NCWRP, check the NCWRP website at http://h2o.enr.state.nc.us/wrp/index.htm. If use of
the NCWRP is proposed, please check the appropriate box on page three 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):_
Amount of Non-riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres):
Page 10 of 12
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?
1 Yes ? No
V 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)?
' J 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 ?
0 L 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 ?
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 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify )?
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
Zone 1 extends out 30 feet perpendicular from near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.
Page 11 of 12
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 2B .0242 or.0260.
Q1 o A/ i?7
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.
_/ O ,.
XI1. Sewage Disposal (required by DWQ)
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater ge erated from the proposed project, or available capacity of the subject facility.
Al O A/
XII1. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (I 5A NCAC 2H .0500) or any Buffer Rules?
Yes ? No
Is this an after-the-fact permit application?
Yes ? No [?
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 Species, accessibility problems, or other issues outside of the applicant's control).
A/0?. ? , -z00-!
-/ Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 12 of 12
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?OF N NA ?FRp Michael F. Easley, Governor
?0 G William G. Ross Jr., Secretary
r North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
August 17, 2005
DWQ Project # 05-1474
Franklin County
CERTIFIED MAIL: RETURN RECEIPT REQUESTED
Mr. Larry Voorhees
P.O. Box 190
Bunn, NC 27508
Subject Property: Larry Voorhees Lot 1544
755 Sagamore Road, Louisburg, NC
REQUEST FOR MORE INFORMATION
Dear Mr. Voorhees:
On August 3, 2005, the Division of Water Quality (DWQ) received your application dated June
28, 2005. The DWQ has determined that your application was incomplete and/or provided
inaccurate information as discussed below. The DWQ will require additional information in
order to process your application to impact protected waters on the subject property. Therefore,
unless we receive the additional information requested below, we will have to move toward
denial of your application as required by 15A NCAC 2H.0506 and will place this project on
hold as incomplete until we receive this additional information. Please provide five (5) copies of
the following information so that we may continue to review your project.
Additional Information Requested:
• Please complete the Pre-Construction Notification (PCN) application in its entirety. This
includes indicating on the application what permit(s) (Roman Numeral I - items 1 and 2) you
are applying for, describing the overall project in detail and how the work is to be done
(landward or from the water), the open water impacts requested, your impact justification and
the proposed riparian buffer impacts since your property is within the Tar-Pamlico River
Basin. Water Quality Certifications and Permit descriptions may viewed at this website:
http://h2o.enr.state.nc.US/ncwetlands/rd wetlands certifications.htm.
• Please submit a copy of the Franklin County Soil Survey and a copy of a portion of the
USGS Topographic Quadrangle map with the property boundaries located.
• Please submit photographic documentation of your erosion concerns. Photos should be taken
from the lakeside view of your property. Typically, the state will not issue a certification for
backfilling of the lake as indicated on your illustration. However, construction of a bulkhead
(seawall) along the existing shoreline will be evaluated for permitting.
401 Oversight/Express Review Permitting Unit
1650 Mail Service Center, Raleigh, North Carolina 27699-1650
2321 Crabtree Boulevard, Suite 250, Raleigh, North Carolina 27604
Phone: [phone] / FAX [phone] / Internet: http://h2o.enr.state.nc.us/ncwetlands
Noe tCarourallma
ly
An Equal Opportunity/Affirmative Action Employer - 50% Recycled/10% Post Consumer Paper
Larry Voorhees
Page 2 of 2
August 17, 2005
• Please provide an illustration detailing the proposed impacts for the sea wall, including open
water impacts. Depending on how the work is to be completed (landward or from the water)
you may need to include the proposed riparian buffer impacts (construction corridor).
Please respond within three weeks of the date of this letter by sending this information to me in
writing and Mike Horan of the DWQ Raleigh Regional Office. If we do not hear from you
within three weeks, we will assume that you no longer want to pursue this project and we will
consider the project as withdrawn.
This letter only addresses the application review and does not authorize any impacts to wetlands,
waters or protected buffers. Please be aware that any impacts requested within your application
are not authorized (at this time) by the DWQ. Please call Ms. Cyndi Karoly or Mr. Ian
McMillan at 919-733-1786 if you have any questions regarding or would like to set up a meeting
to discuss this matter.
Sincerely,
"
i Karoly, Superviso
1 versight/Express view Permitting Unit
CBKI ijm
cc: Mike Horan, DWQ Raleigh Regional Office
USACE Raleigh Regulatory Field Office
File Copy
Central Files
Filename: 051474VoorheesLot1544(FrankUn)hold
Date: ?J
Triage Check List
ProJ' eEt Name:
r
DWQ#:
FILE COPY
To: ? ARO Kevin Barnett
? FRO Ken Averitte
? MRO Alan Johnson
RRO Mike Horan
From:
County: -I?E
? WaRO Tom Steffens and Kyle Barnes
? WiRO Noelle Lutheran
? WSRO Daryl Lamb
TelePhone : (919) ?

The file attached is being forwarded``,8 . our for your evaluation.
Please call if you need"" stance.
? Stream length impacted
? Stream determination
? Wetland determination and distance to blue-line surface,waters on USFW topo maps
? Minim at ion/avoidance issues
? Buffer Rules (Neese, Tar-Pamlico, Catawba, Randleman)
? Pond fill
? Mitigation Ratios
? Ditching
? Are the stream and or wetland mitigation sites available and viable?
? Check drawings for accuracy
? Is the application consistent with pre-application meetings?
? Cumulative impact concern
Comments:
June 28, 2005 `'-' " L ?
DWQ
2321 Crabtree Blvd., Suite 250
Raleigh, NC 27604
Re: Construction of a seawall, backfilling and seeding, to curb erosion at Lot #1544,
755 Sagamore Dr., Louisburg, NC (Lake Royale).
Gentlemen:
Today, Mr. Joe Faison and I met with Mr. Michael Horan, DWQ Environmental
Specialist, to make an on-site inspection of the above referenced premises, seeking
permission to perform the above captioned work. Mr. Horan concluded the work will aid-:
in preventing further erosion problems into Lake Royale, insofar as my lot is concerned.
Per Mr. Horan's instructions, I am enclosing seven (7) copies of your pre-construction
notification application form, along with my check in the amount of $200.00, and am
respectfully requesting that you approve the subject project.
Thank you for your time and attention in consideration of this matter.
Since ely,
Larry Voorhees
P. O. Box 190
Bunn, NC 27508
Phone: [phone]
1 11.

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5719
J

A545
1546

et - -
1547 (299) __ --_ - --

Office Use Only: Form Version May 2002
USACE Action ID No. DWQ No.
(If anv particular item is not applicable to this project, please enter "Not Applicable" or "N/A".)
1. Processing
J 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
X12. Nationwide, Regional or General Permit Number(s) Requested:
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 Divisi; nt Area of
Environmental Concern (see the top of page 2 for furthe 67T l. ; c ieci4 t.
.;6
II. Applicant Information 4, ?? la 7065
DENR - orA- 'i G Jg1.1 Y
1. Owner/Applicant Information WETt/.?DSA`?'?SiI_?fz g? SR,,,?CH
Name: L ARRx VooA W ZES
Mailing Address: A p , P56 XqO A Uh N /V r' Z 7.5-0
CAS/c,AL ADD ACSr 1S 757-S' SACA140k,'9 VA Lcnys8ly?
l
NC ,?_7SD ?. T cAoyNaT ACCE /vet D 111A /C A^ -,V? APIACX'X- J
Telephone Number:2„1'A '17k-Y-010 Fax Number: /J o y_g?
E-mail Address: ^2nA16?'
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:
Company Affiliation:
Mailing Address:
Telephone Number:
E-mail Address:
Fax Number:
Page 5 of 12
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 11 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.
Name of project:
2. T.I.P. Project Number or State Project Number (NCDOT Only)
Property Identification Number (Tax PIN):
4. Location
County: Fg,,, N i<L/ /V Nearest Town: 6 a /? Al
Subdivision name (include phase/lot number):
Directions to site (include road numbers, landmarks, etc.): C a mj TflR 1, s F C
. tA TCT T Ok N R 1679 T c,,,/ >;qA W .,V E C, 6 c i 6/ C. C 7(,k ('r
?e'S/ 0rli6 t G C ' 8 d- 04 -k. 1?alzN R I GlJ T 0.,V i^ (,A Al CAM E
5. Site coordinates, if available (UTM or Lat/Long):
(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.)
Property size (acres):
7. Nearest body of water (stream/river/sound/ocean/lake): LNKc? /t;?Y/?=
8. River Basin:
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http://112o.enr.state.nc.us/admin/maps/.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: IQ GS'r p Ens c,?5 a .,/,L V
Page 6 of 12
10. Describe the overall project in detail, including the type of equipment to be used:
11. Explain the purpose of the proposed work:
77J c y2? .Posy c ?? /NTd V/t k? C)-VAI.
IV. Prior Project History
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 wetl4nd, 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.
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.
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 12
1. Provide a written description of the proposed impacts:
2. Individually list wetland impacts below:
Wetland Impact
Site Number
(indicate on ma)
Type of Impact* Area of
Impact
(acres) Located within
100-year Floodplain**
(es/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, grading, fill,
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 tloodplain maps. Maps are available through the FEMA Map Service Center at 1-800-358-9616, or
online at http://\vww.1eina.ao\ .
*** 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 USAGE 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 ma
Type of Impact* Length of
Impact
linear feet)
Stream Name** Average Width
of Stream
Before Impact Perennial or
Intermittent?
(please seci )

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: culverts and associated rip-rap.
dams (separately list impacts due to both structure and flooding), relocation (include linear feet before and atler, and net loss/gain),
stabilization activities (cement wall, rip-rap, crib wall, gabions, etc.), excavation, ditching/straightening, etc. II' 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. II' 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
Several internet sites also allow direct download and printing of IISGS maps (c.g.. \%\\ \?Aopozone.co nl.
o c,ntsc o ctit.cont, etc.).
Cumulative impacts (linear distance in feet) to all streams on site:
Page 8 of 12
4. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.) below:
Open Water Impact
Site Number
indicate on ma
Type of Impact* Area of
Impact
acres Name of Waterbody
(if applicable) Type of Waterbody
(lake, pond, estuary, sound,
bay, ocean, etc.

List each impact separately and identify temporary impacts. Impacts include, but are not limited to: fill, excavation, dredging,
flooding, drainage, bulkheads, etc.
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): ? uplands ? stream ? 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 stormwater requirement, etc.):
Size of watershed draining to pond: Expected pond surface area:
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
site layouts, and explain why these design options were not feasible. Also discuss how impact'
were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce impacts.
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.
Page 9 of 12
USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on March 9, 2000, 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 attached in order
for USACE or DWQ to consider the application complete for processing. Any application
lacking a required mitigation plan or NCWRP 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
http://h2o enr.state.nc.us/ncwetlands/strmgide.htni1.
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.
2. Mitigation may also be made by payment into the North Carolina Wetlands Restoratioq.
Program (NCWRP). Please note it is the applicant's responsibility to contact the NCWRP at
[phone] to determine availability and to request written approval of mitigation prior
to submittal of a PCN. For additional information regarding the application process for the
NCWRP, check the NCWRP website at http://h2o.enr.state.nc.us/wrp/index.htm. If use of
the NCWRP is proposed, please check the appropriate box on page three 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):
Amount of Non-riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres):
Page 10 of 12
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 ? 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/SETA)'?
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 ?
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 ?
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 213 .0233
(Neuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify )?
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 buffei
multipliers.
Zone* Impact
(square feet Multiplier Required
Miti ation
1 3
2 1.5
Total
Zone I extends out 30 teet perpendicular trom near hank of cnannei; tone t extenas an
additional 20 feet from the edge of "Lone 1.
Page I I of 12
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 2B .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.
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.
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 ? No ?
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 Species, accessibility problems, or other issues outside of the applicant's control).
?. is T'// ZOOS'
plicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 12 of 12

June 28, 2005
DWQ
2321 Crabtree Blvd., Suite 250
Raleigh, NC 27604
Re: Construction of a seawall, backfilling and seeding, to curb erosion at Lot #1544,
755 Sagamore Dr., Louisburg, NC (Lake Royale).
Gentlemen:
Today, Mr. Joe Faison and I met with Mr. Michael Horan, DWQ Environmental
Specialist, to make an on-site inspection of the above referenced premises, seeking
permission to perform the above captioned work. Mr. Horan concluded the work will:aid.,
in preventing further erosion problems into Lake Royale, insofar as my lot is concerned.
Per Mr. Horan's instructions, I am enclosing seven (7) copies of your pre-construction
notification application form, along with my check in the amount of $200.00, and am
respectfully requesting that you approve the subject project.
Thank you for your time and attention in consideration of this matter.
Since ely,
Larry Voorhees
P. O. Box 190
Bunn, NC 27508
Phone: [phone]

?g??-
??
11
J
iI
i

A545

N
1546
1547 (299) --- - --- -
Y ?
A\ Y L
Office Use Only: Form Version May 2002
USACE Action ID No. DWQ No.
(If any particular item is not applicable to this project, please enter root Rppncaoie Or 1VtA .)
1. Processing
J 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
X12. Nationwide, Regional or General Permit Number(s) Requested:
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 Coas I anagement Area of
Environmental Concern (see the top of page 2 for further details), c, p
??US
ll. Applicant Information AUG
l . Owner/Applicant Information DENR - S.'VF rER QUALITY
Name: L A R R:y V O 0 R H F E -S' WETLANDS A14D 5TORA MA i F.,3 BRANCH
Mailing Address: P, d , 6,0 X / C14 oh N W r 2754
C_ P.HyS/C+4L AbDRCSt tS 75'- S' SACAAOkI?' VA Lc78yle?
A/C 94 5-0 < 6V7 CANN`T AECEiu4. 2 /NAX A-;' rlyAT AAFACss-.
Telephone Number: s'a 417Sr-`/010 Fax Number: it/ div,
E-mail Address: »A/e'
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:
Company Affiliation:
Mailing Address:
Telephone Number: Fax Number:
E-mail Address:
Page 5 of 12
10. Describe the overall project in detail, including the type of equipment to be used:
11. Explain the purpose of the proposed work:
IV. Prior Project History
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 o1' 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
USAGE requires information to be submitted on sheets no larger than 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 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.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN):
4. Location
County: FPf?Nj;<L-l N Nearest Town:_-6o ?? l?
Subdivision name (include phase/lot number):
Directions to site (include road numbers, landmarks, etc.): Co m 71Yk L, X F C.:, GATC t TUkN R t CH 7' c,il :, - A ?NNf= E G c r It/C C 7-c ,,R IV LF('T
c ^/ CJ a'A N R I Gli T 0,-/ (LA M en- E _
5. Site coordinates, if available (UTM or Lat/Long):
(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.)
6. Property size (acres):
7. Nearest body of water (stream/river/sound/ocean/lake): LAKE
8. River Basin:
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http://li2o.cnr.state.nc.us/admin/maps/.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: /Q L:S'r p Ens C-Z;,:' a r,?c.f
Page 6 of 12
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 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 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.
Name of project:
2. T.I.P. Project Number or State Project Number (NCDOT Only):
Property Identification Number (Tax PIN):
Location
County: fii2?N p<L /N Nearest Town: 6 o ? !?
Subdivision name (include phase/lot number):
Directions to site (include road numbers, landmarks, etc.)
C, `/
Car.?r 7,41k y s f CZ,R/T°/
C; r- ; /4 / C C TC,:R N L?F ('T
0 ,11 CI iV G. G Q J_8 1, " I -k i % L' C N R t G'hl r 0,N 5'^ (t-/4 M V 'r- F
5. Site coordinates, if available (UTM or Lat/Long):
(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.)
6. Property size (acres):
7. Nearest body of water (stream/river/sound/ocean/lake): LN1KE?/?L?=
8. River Basin:
(Note - this must be one of North Carolina's seventeen designated major river basins. Hie
River Basin map is available at http://li2o.enr.statc.nc.us/admin/maps/.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: /F &rt p EA-1 GZ,:r a VL V
Pagc 6 of' 12
10. Describe the overall project in detail, including the type of equipment to be used:
11. Explain the purpose of the proposed work:
nd9n?s ??nm;.i AtYD.i/p?e ? tirD?A?mOp??.?,?woo?.[,D?f??/sal?'
IV. Prior Project History
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.
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.
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 12
1. Provide a written description of the proposed impacts:
2. Individually list wetland impacts below:
Wetland Impact
Site Number
(indicate on ma
Type of Impact* Area of
Impact
(acres) Located within
100-year Floodplain**
(es/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, grading, till,
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 httn://www.1ema.vov.
*'* List a wetland type that best describes wetland to be impacted (e.g., freshwater/saltwater marsh, lorested wetland, beaver pond,
Carolina Bay, bog, etc.) Indicate if wetland is isolated (determination of isolation to be made by USAGE 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 ma
Type of Impact* Length of
Impact
linear feet
Stream Name** Average Width
of Stream
Before Impact Perennial or
Intermittent.'
(please specify)

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: culverts and associated rip-rap,
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. It' a stream has no name, list as UT (unnamed tributary) to die nearest
downstream named stream into which it flows. USGS maps are available through the USGS at 1-800-358-9616, or online at
\\\?\?.usgs?gov. Several internet sites also allow direct download and printing of USGS maps (e.g.. upuunr_ um.
\\ w\\,nuip( ucst com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site:
Page 8 of 12
4. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.) below:
Open Water Impact
Site Number
indicate on ma
Type of Impact* Area of
Impact
acres Name of Waterbody
(if applicable) Type of Waterbody
(lake, pond, estuary, sound,
bay, ocean, etc.

' List each impact separately and identify temporary impacts. Impacts include, but are not limited to: fill, excavation, dredging,
flooding, drainage, bulkheads, etc.
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): ? uplands ? stream ? 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 stormwater requirement, etc.):
Size of watershed draining to pond: Expected pond surface area:
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
site layouts, and explain why these design options were not feasible. Also discuss how impact'
were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce impacts.
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.
Page 9 of 12
USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on March 9, 2000, 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 attached in order
for USACE or DWQ to consider the application complete for processing. Any application
lacking a required mitigation plan or NCWRP 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
http://h2o.enr.state.nc.us/ncwetlands/strmgide.html.
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.
Mitigation may also be made by payment into the North Carolina Wetlands Restoratioq.
Program (NCWRP). Please note it is the applicant's responsibility to contact the NCWRP at
[phone] to determine availability and to request written approval of mitigation prior
to submittal of a PCN. For additional information regarding the application process for the
NCWRP, check the NCWRP website at http://h2o.enr.state.nc.us/wrp/index.litin. If use of
the NCWRP is proposed, please check the appropriate box on page three 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):
Amount of Non-riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres):
Page 10 of 12
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 ? 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 ?
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 ?
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 213 .0233
(Meuse), 15A NCAC 213 .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify )?
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
Miti ation
I 3
2 1.5
Total
Zone I extends out 30 feet perpendicular trom near bank of channel; Lone z extenas an
additional 20 feet from the edge of Zone 1.
Page I I of 12
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 2B .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.
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.
XIII. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (I 5A NCAC 2H .0500) or any Buffer Rules?
Yes ? No ?
Is this an after-the-fact permit application?
Yes ? No ?
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 Species, accessibility problems, or other issues outside of the applicant's control).
TN Zoos
4plicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 12 of 12