20060176 Ver 1_COMPLETE FILE_20060203

Office Use Only:
Form Version March 05
20060176
USACE Action ID No. DWQ No.
(If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A".)
1.
II.
Processing
Check all of the approval(s) requested for this project:
X Section 404 Permit Riparian or Watershed Buffer Rules
Section 10 Permit Isolated Wetland Permit from DWQ
401 Water Quality Certification Express 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested: NWP - 29
3. If this notification is solely a courtesy copy because written approval for the 401
Certification is not required, check here: X
4. If payment into the North Carolina Ecosystem Enhancement Program (NCEEP) is
proposed for mitigation of impacts, attach the acceptance letter from NCEEP, complete
section VIII, and check here: No
5. If your project is located in any of North Carolina's twenty coastal counties (listed on page
4), and the project is within a North Carolina Division of Coastal Management Area of
Environmental Concern (see the top of page 2 for further details), check here: Within
Applicant Information
LEI
UYI
FEB 3 2000
1. Owner/Applicant Information
DENR - .^:PirErd QUALITY
Name: Mr. Stacy M. Davis, Sr
Mailing Address: 106 Stacy Drive
Harkers Island. NC 28531
Telephone Number: [phone] Fax Number: n/a
E-mail Address: n/a
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: n/a
Company Affiliation:
Mailing Address:
Telephone Number: Fax Number:
E-mail Address:
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.
1. Name of project: Stacy M. Davis Lot
2. T.I.P. Project Number or State Project Number (NCDOT Only): n/a
3. Property Identification Number (Tax PIN): 734513128752000
4. Location
County: Carteret Nearest Town: Harkers Island
Subdivision name (include phase/lot number): Deed Book 1060; Page 145
Directions to site (include road numberstnames, landmarks, etc.): U.S. Hwy 70 north from
Beaufort to Harkers Island Road (NCSR 1335); On Harkers Island take left on Stacy
Drive (north); Go to north end of Stacy Drive; Lot is on very north end of Stacy Drive
off partially improved right of way.
5. Site coordinates (For linear projects, such as a road or utility line, attach a sheet that
separately lists the coordinates for each crossing of a distinct waterbody.)
Decimal Degrees (6 digits minimum): 34 - 41 - 33 ON 76 - 31 - 55 °W
6. Property size (acres): 4.043 acers
7. Name of nearest receiving body of water: The Straits
8. River Basin: White Oak
(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/admiti/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: Lot is currently undeveloped in its' natural state
except for minor vegetative hand clearing within southern portion.
d
10. Describe the overall project in detail, including the type of equipment to be used: Minor
fill (0.13 acre) for one residential home area outside of all CAMA wetland areas and
CAMA 75 ft AEC zone. Fill and all development to be done with conventional dump
track, backhoe and construction equipment. Fill will be 3 ft high with 3:1 tapered
sidesloves for stabilization. Silt fencing to be placed around footprint of fill area before
construction initiates for sedimentation & erosion control purposes.
11. Explain the purpose of the proposed work: Historically deeded & recorded lot
(<19701s). Undeveloped residential lot with sienificant areas of 404 & CAMA wetlands
(+98 %). Need minor fill (0.13 acre) for one residential home area outside of all CAMA
wetland areas and CAMA 75 ft AEC zone. Minor fill (0.13 acre) for one residential
home area needed for any type building potential.
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. The USACOE (Micky Suea) has reviewed this lot and delineated all
404 wetland - upland areas (see map). There has been no other prior development, fill, or
permits issued for this historically owned and deeded/recorded lot.
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.
No other permits are anticipated for this project through NCDENR-DWO, NCDENR-
CAMA, or USACOE except for required building permits. This minor fill permit is
required prior to applying for building permits.
VI. Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. Each impact must be
listed separately in the tables below (e.g., culvert installation should be listed separately from
riprap dissipater pads). Be sure to indicate if an impact is temporary. All proposed impacts,
permanent and temporary, must be listed, and must be labeled and clearly identifiable on an
accompanying site plan. All wetlands and waters, and all streams (intermittent and perennial)
should be shown on a delineation map, whether or not impacts are proposed to these systems.
Wetland and stream evaluation and delineation forms should be included as appropriate.
Photographs may be included at the applicant's discretion. If this proposed impact is strictly for
wetland or stream mitigation, list and describe the impact in Section VIII below. If additional
space is needed for listing or description, please attach a separate sheet.
1. Provide a written description of the proposed impacts: Minor fill (0.13 acre) for one
residential home area outside of all CAMA wetland areas and CAMA 75 ft AEC zone.
Fill and all development to be done with conventional dump track backhoe and
construction equipment. Fill will be 3 ft hich with 3:1 tapered sidesloves for
stabilization. Silt fencinir to be placed around footprint of fill area before construction
initiates for sedimentation & erosion control purposes.
2. Individually list wetland impacts. Types of impacts include, but are not limited to
mechanized clearing, grading, fill, excavation, flooding, ditching/drainage, etc. For dams,
separately list impacts due to both structure and flooding.
Wetland Impact
Site Number
(indicate on
map) Type of Impact Type of Wetland
(e.g., forested, marsh,
herbaceous, bog, etc.) Located within
100-year
Floodplain
(yes/no) Distance
to Nearest
Stream
(linear
feet) Area
of
Impact
(acres)
1 404 wetland fill Forested Yes 81 ft 0.13

Total Wetland 0.13
3. List the total acreage (estimated) of all existing wetlands on the property: 3.913 acres
4. Individually list all intermittent and perennial stream impacts. Be sure to identify
temporary impacts. Stream impacts include, but are not limited to placement of fill or
culverts, dam construction, flooding, relocation, stabilization activities (e.g., cement walls, rip-
rap, crib walls, gabions, etc.), excavation, ditching/straightening, etc. If stream relocation is
proposed, plans and profiles showing the linear footprint for both the original and relocated
streams must be included. To calculate acreage, multiply length X width, then divide by
43,560.
Stream Impact
Number
(indicate on
map) Stream Name Type of Impact Perennial
or
Intermittent
? Average
Stream
Width
Before
Impact Impact
Length
(linear
feet) Area
of
Impact
(acres)
n/a n/a n/a n/a n/a n/a n/a

Total Stream
5. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.). Open water impacts include, but are not limited to
fill, excavation, dredging, flooding, drainage, bulkheads, etc.
Open Water
Impact
Site Number
(indicate on map) Name of Waterbody
(if applicable) Type of Impact Type of Waterbody
(lake, pond, estuary, sound, bay,
ocean, etc.) Area of
Impact
(acres)
n/a n/a n/a n/a n/a

Total Open
6.
Stream Impact acres :
Wetland Impact acres : 0.13
Or)en Water Impact (acres):
Total Im act to Waters of the U.S. acres
Total Stream Impact linear feet :
7. Isolated Waters
List the cumulative impact to all Waters of the U.S. resulting from the project:
Do any isolated waters exist on the property? Yes No X
Describe all impacts to isolated waters, and include the type of water (wetland or stream) and
the size of the proposed impact (acres or linear feet). Please note that this section only applies
to waters that have specifically been determined to be isolated by the USACE.
8. Pond Creation n/a
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.):
Current land use in the vicinity of the pond:
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 impacts
were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce impacts. The 4.043 acre lot is +98%
404 or CAMA wetlands. The only upland area within this historically deeded & recorded
lot (0.0551 acre out of 4.043 acre total) is the immediate entrance contiguous with Stacy
Drive. There is insufficient building area for even one home site without this additional
minor fill request and to meet minimum building setbacks. Thus, it is impossible to avoid
any wetland impacts. The home site and subsequent fill areas have been minimized to the
least amount for a conventional size home site with minimal area for parking and -yard.
The home site and all proposed fill is being kept out of CAMA's 75 ft AEC zone to avoid
any run-off or down-gradient impacts. Fill will be 3 ft high with 3:1 tapered sidesloves for
stabilization. A 5 ft buffer will be left between any lot lines and the fill area to allow surface
run-off and avoid flooding to adiacent properties. Silt fencing to be placed around
footprint of fill area before construction initiates for sedimentation & erosion control
purposes.
VIII. Mitigation
n/a
DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC Division
of Water Quality for projects involving greater than or equal to one acre of impacts to freshwater
wetlands or greater than or equal to 150 linear feet of total impacts to perennial streams.
USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on January 15, 2002, 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 NCEEP concurrence shall be placed on hold as incomplete.
An applicant may also choose to review the current guidelines for stream restoration in DWQ's
Draft Technical Guide for Stream Work in North Carolina, available at
http://h2o.enr.state.nc.us/ncwetlands/strm?-,ide.litmi.
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.
n/a
2. Mitigation may also be made by payment into the North Carolina Ecosystem Enhancement
Program (NCEEP). Please note it is the applicant's responsibility to contact the NCEEP at
[phone] to determine availability, and written approval from the NCEEP indicating
that they are will to accept payment for the mitigation must be attached to this form. For
additional information regarding the application process for the NCEEP, check the NCEEP
website at lrttp:Hli2o.enr.state.nc.us/wrp/index.lrtin. If use of the NCEEP is proposed, please
check the appropriate box on page five and provide the following information:
Amount of stream mitigation requested (linear feet): n/a
Amount of buffer mitigation requested (square feet): n/a
Amount of Riparian wetland mitigation requested (acres): n/a
Amount of Non-riparian wetland mitigation requested (acres): n/a
Amount of Coastal wetland mitigation requested (acres): n/a
1. Environmental Documentation (required by DWQ)
1. Does the project involve an expenditure of public (federaUstate/local) funds or the use of
public (federal/state) land? Yes No X
2. If yes, does the project require preparation of an environmental document pursuant to the
requirements of the National or North Carolina Environmental Policy Act (NEPA/SEPA)?
Note: If you are not sure whether a NEPA/SEPA document is required, call the SEPA
coordinator at [phone] to review current thresholds for environmental documentation.
Yes No
3. If yes, has the document review been finalized by the State Clearinghouse? If so, please
attach a copy of the NEPA or SEPA final approval letter. Yes No
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.
1. Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 02B .0243 (Catawba) 15A NCAC
2B .0250 (Randleman Rules and Water Supply Buffer Requirements), or other (please
identify)? Yes No X
2. If "yes", identify the square feet and acreage of impact to each zone of the riparian buffers.
If buffer mitigation is required calculate the required amount of mitigation by applying the
buffer multipliers.
Zone* Impact
(square feet) Multiplier Required
Mitigation
1 3 (2 for
2 1.5
Total 1 71
* Zone 1 extends out 30 feet perpendicular from the top of the near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.
3. If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e.,
Donation of Property, Riparian Buffer Restoration / Enhancement, or Payment into the
Riparian Buffer Restoration Fund). Please attach all appropriate information as identified
within 15A NCAC 2B .0242 or .0244, or .0260.
XI. Stormwater (required by DWQ)
Describe impervious acreage (existing and proposed) versus total acreage on the site. Discuss
stormwater controls proposed in order to protect surface waters and wetlands downstream from
the property. If percent impervious surface exceeds 20%, please provide calculations
demonstrating total proposed impervious level. Total impervious area will be <4% of total lot
acreage.
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.
Waste treatment will be for 4 bedroom home (480 aal/day) to a off-site permitted NCDEH
waste treatment system.
1. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (I 5A NCAC 2H .0500) or any Buffer Rules?
Yes No X
Is this an after-the-fact permit application? Yes No X
XIV. Cumulative Impacts (required by DWQ)
Will this project (based on past and reasonably anticipated future impacts) result in additional
development, which could impact nearby downstream water quality? Yes No X
If yes, please submit a qualitative or quantitative cumulative impact analysis in accordance with
the most recent North Carolina. Division of Water Quality policy posted on our website at
http://l12o.enr.state.nc.us/ncwetIands. If no, please provide a short narrative description:
XV. Other Circumstances (Optional):
It is the applicant's responsibility to submit the application sufficiently in advance of desired
construction dates to allow processing time for these permits. However, an applicant may choose
to list constraints associated with construction or sequencing that may impose limits on work
schedules (e.g., draw-down schedules for lakes, dates associated with Endangered and
Threatened Species, accessibility problems, or other issues outside of the applicant's control).
J
"Ap c t/Agent's Signature Date
(Agent's s g ure is valid only if an authorization letter from the applicant is provided.)
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Stacy Davis Lot L_ uV 9
FEB 3 2006 _
? A
'i 1 in. = 200.0 feet DENR - WATER QUALITY
??' WETIANnS AND STORMWATFR BRANCH l
STACY M. DAVIS, Sr LOT (4.043 acres)
404 - CAMA WETLAND AREAS and PROPOSED NWP-29 WETLAND FILL AREA
Harkers Island NW Area - Harkers Island Township - Carteret County - North Carolina
PIN # 734513128752000
Deed Book 1060; Page 145
Soil & Erosion Sift Fencing
+2 ft high around perimeter of
all fill and construction areas.
3.? sw49. I3 n
Proposed NWP-29
Fill Area 0.13 acre
3 ft H with 3:1 taper
around perimeter
for stabilization and 5 It
from west P/L.
A i
Fill Area
Fill a
a
a
Ott
N
SCALE: 1 Inch = 100 Feet
December - 2005
Upland Areas
as determined by the
USACOE (M. Sugg).
Delineated in the filed with
"pink" flagging.
_ 404 Wetland Areas
as determined by the
USACOE
(M.Sugg).
CAMA Wetland Areas
------ Normal High Tide Line
as determined by upper
limits of low CAMA wetlands
(Spartina Alternaflora).
Delineated in the field with
"blue" flagging.
ft 17 Open Tidal Waters
p? of The Straits and adjacent
mosquito ditching.
?? Class S.A. Waters.
STACY M. DAVIS, Sr LOT (4.043 acres)
404 - CAMA WETLAND AREAS and PROPOSED NWP-29 WETLAND FILL AREA
Harkers Island NW Area - Harkers Island Township - Carteret County - North Carolina
PIN # 7345131287
Deed Book 1060;
N
SCALE: 1 Inch = 100 Feet
December - 2005
Soll & Erosion Silt Fencing
+2 ft high around perimeter of
all fill and construction areas.
9:3 ft
Proposed NWP-29
Fill Area 0.13 acre
3 ft H with 3:1 taper
around perimeter
for stabilization and 5
from west P/L.

-? Upland Areas
as determined by the
USACOE (M. Sugg).
Delineated in the filed with
"pink" flagging.
404 Wetland Areas
as determined by the
USACOE
(M.Sugg).
---] CAMA Wetland Areas
---- Normal High Tide Line
as determined by upper
limits of low CAM A wetlands
(Spartina Alternafl ora).
Delineated in the field with
"blue" flagging.
Open Tidal Waters
of The Straits and adjacent
mosquito ditching.
Class S.A. Waters.