20061038 Ver 1_COMPLETE FILE_20060623

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Mr. Robert Payne
807 Bullard Lane
Graham, NC 27253-9733
JUL 1 9 2006
DENR - WATER QUALITY
aiLkNDS AND STORMOTER BRANCH
APPROVAL of 401 Water Quality Certification with Additional Conditions
Dear Mr. Payne:
Alan W. Klimek, P.E. Director
Division of Water Quality
July 17, 2006
DWQ# 06-1038
Alamance County
You have our approval, in accordance with the attached conditions, to place permanent fill in 140 linear feet
of perennial stream and to flood 60 linear feet of perennial stream, 203 linear feet of intermittent stream and
0.011 acre of wetlands in order to construct a 1.68 acre recreational pond for your private residence located at
807 Bullard Lane in Graham, Alamance County, as described in your application received by the Division of
Water Quality (DWQ) on June 23, 2006. After reviewing your application, we have determined that the
proposed impacts from fill and flooding are covered by General Water Quality Certification Number 3402,
which can be viewed on our web site at htlp://www.ncwaterguality.orgjwetlands.html. This Certification
allows you to use Nationwide Permit Number 39 when it is issued by the U.S. Army Corps of Engineers. In
addition, you should secure any other applicable federal, state or local permits before you proceed with your
project, including (but not limited to) those required by Sediment and Erosion Control, Non-Discharge, and
Water Supply Watershed regulations. Also, this approval will expire when the accompanying 404 permit
expires unless otherwise specified in the General Certification.
This approval is valid only for the purpose and design that you have described in your application. If you
change your project, you must notify us in writing, and you maybe required to send us a new application for a
new certification. If the property is sold, the new owner must be given a copy of the Certification and
approval letter and is thereby responsible for complying with all conditions. If total wetland fill for this
project (now or in the future) exceeds one acre, or total fill to perennial streams equals or exceeds 150 linear
feet, compensatory mitigation may be required as described in 15A NCAC 2H .0506 (h). For this approval
to be valid, you must follow the conditions listed in the attached certification, as well as the additional
conditions listed below:
1. The following impacts are hereby approved as long as all other specific and general conditions of this
Certification are met. No other impacts, including incidental impacts, are approved:
Amount Approved Plan Location or Reference
Streams 403 linear feet Unnamed tributary to the Haw River located at 807 Bullard Lane in
Graham, Alamance County, as depicted on the site plan included with
the application

4 Carolina
Ioni`
Naturally
North Carolina Division of Water Quality
Wetlands Certification Unit 1650 Mail Service Center Raleigh, NC 27699-1650 Phone [phone] FAX [phone]
2321 Crabtree Blvd. Raleigh, NC 27604-2260 Internet http:/twww.ncwaterauality.oro
Customer Service Number: 1-877-623-6748
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
An Equal Opportunity/Affirmative Action Employer - 50% Recycled/10% Post Consumer Paper
Mr. Robert Payne
Page 2, DWQ# 06-1038
July 17, 2006

Amount Approved Plan Location or Reference
f the
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ib
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Wetlands 0.011 acre u
ary o
tr
Headwater forested wetlands adjacent to an unname
Haw River located at 807 Bullard Lane in Graham, Alamance County,
as depicted on the site plan included with the application

2. Appropriate sediment and erosion control measures which equal or exceed those outlined in the most
recent version of the North Carolina Sediment and Erosion Control Planning and Design Manual or the
North Carolina Surface Mining Manual (available from the Division of Land Resources at NCDENR
regional offices or the central office), whichever is more appropriate, shall be designed, installed and
- maintained properly to assure compliance at all times with the North Carolina water quality standards
that are applicable to Class C waters as described in 15A NCAC 02B.'0211 Fresh Surface Water Quality
Standards For Class C Waters. Such measures must equal or exceed the requirements specified in the
most recent version of the North Carolina Sediment and Erosion Control Manual. These measures must
be maintained on all construction sites, borrow sites, and waste pile (spoil) sites, including contractor
owned and leased borrow pits, which are associated with this project.
3. 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 measures in wetlands or waters is
unavoidable, they shall be removed and the natural grade restored within six months of the date that the
project is completed or, if applicable, within six months of the date that the project is released by the
North Carolina Division of Land Resources.
4. No waste, spoils, 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. Where riprap is required for energy dissipation and scour protection below the riser pipe outlet, it shall
be limited to the minimum dimensions specified by appropriate engineering calculations. Riprap may
only be used below the normal high water level. The original grade and elevation of the stream's cross-
section below the outlet must be maintained. Riprap placed in the stream bottom must be inserted into
the bottom matrix to a depth sufficient to provide the thickness of riprap required for scour protection.
The elevation of the stream bottom must not be increased by the placement of riprap. Placement of
riprap must not result in destabilization of the streambed or banks downstream of the dam.
6. All construction activities associated with this project shall minimize built-upon surface area, direct
stormwater runoff away from surface waters, and incorporate best management practices to minimize
water quality impacts. If concrete is used with any fill material, it shall not be allowed to come in
contact with surface waters until it has cured. If any stormwater must be collected for discharge into a
stream channel, it shall not enter the stream as a point source, but shall be slowed and discharged as
sheet flow prior to entering the riparian buffer on either side of the stream.
7. Upon finishing the project, the Applicant shall fill out and return the enclosed "Certificate of
Completion" to notify NCDWQ when all work included in the §401 Certification has been completed.
Mr. Robert Payne
Page 3, DWQ# 06-1038
July 17, 2006
This certificate should be returned to the Wetlands/401 Certification Unit of the NC Division of Water
Quality at the address listed on the form. Along with the Certificate of Completion, please send
photographs of the dam, outlet, and emergency spillway in order to document correct installation.
If you do not accept any of the conditions of this certification, 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.
This lettercompletes the review of the Division of Water Quality under Section 401 of the Clean Water Act.
If you have any questions, please telephone Daryl Lamb in the DWQ Winston-Salem Regional Office at 336-
771-495 9 or Ian McMillan in the Wetlands/401 Central Office in Raleigh at 919-715-4631.
Sincerely,
Alan W. Klimek, P.E.
AWK/cdl
Attachments
cc: Mr. Todd Tugwell, U. S. Army Corps of Engineers, Raleigh Regulatory Field Office
DWQ, Winston-Salem Regional Office
Central Files
Wetlands/401 File Copy
Mr. Todd Preuninger, Withers & Ravenel, 111 MacKenan Drive, Cary NC 27511
Triage Check List
Date: 6/27/06 Project Name: Bob Payne Farm Pond
DWQ#: 06-1038
County: Alamance
Daryl Lamb, Winston-Salem Regional Office
To:
60-day processing time: 6/23/06 - 8/22/06
From: Cyndi Karoly Telephone: [phone]
The file attached is being forwarded to you for your evaluation.
Please call if you need assistance.
? Stream length impacted
? Stream determination
? Wetland determination and distance to blue-line surface waters on USFW topo maps
? Minimization/avoidance issues
? Buffer Rules (Neuse, 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: As per our discussion regarding revision of the triage and delegation processes,
please review the attached file. Note that you are the first reviewer, so this file will need to be
reviewed for administrative as well as technical details. If you elect to place this project on hold,
please ask the applicant to provide your requested information to both the Central Office in
Raleigh as well as the Asheville Regional Office. As we discussed, this is an experimental, interim
procedure as we slowly transition to electronic applications. Please apprise me of any
complications you encounter, whether related to workload, processing times, or lack of a "second
reviewer" as the triage process in Central had previously provided. Also, if you think of ways to
improve this process, especially so that we can plan for the electronic applications, let me know.
Thanks !
I
WITHERS &- RAVENEL
engineers i planners i surveyors
iii MacKenan Drive
CARY, NORTH CAROLINA, 27512
[phone]
FAX (gig) 467-6oo8
To: DWQ
2321 Crabtree Blvd
Raleigh, NC 276o4
WE ARE SENDING YOU
? Shop Drawings
? Copy of Letter
COTTER OF ` RANSMnTAL
DATE 6/22/o6 SOB NO. 2o643-1.0
ATTENTION C ndi Karol
PHONE# [phone]
RE: Pond Construction on Payne Road

® Attached ? Under separate covervia _
? Prints ? Plans ? Samples
? Change order ? Diskette ?
the following items:
? Specifications
COPIES DATE NO. DESCRIPTION
7 6/22/06 1 Request for 404/401
1 6/22/o6 2 Check ($475-00)

THESE ARE TRANSMITTED as checked below:
® For approval ? Approved as submitted
? Foryour use ? Approved as noted
? As requested ? Returned for corrections
® For review and comment ?
? Resubmit copies forapproval
? Submit copies for distribution
? Return corrected prints
? FORBIDS DUE 20 ? PRINTS RETURNED AFTER LOAN TO US
REMARKS: Please feel free to call with any questions.
COPY T0:
USACE
SIGNED: Todd Preuninger
k
11 11cm-
if enclosures are not as noted, kindly notify us at once. V
JUN 3 2006
- WITH EIRS RAVEN EL
ENGINEERS I PLANNERS I SURVEYORS
June 22, 20o6
US Army Corps of Engineers
Attn: Mr. Todd Tugwell
65o8 Falls of Neuse Road, Suite 120
Raleigh, North Carolina 27615
27604
NC-Division of Water Quality
Attn: Ms. Cyndi Karoly
2321 Crabtree Blvd.
Raleigh, North Carolina
Re: Pond Construction on Payne Farm
Request for 404/401 Certification
W&R Project Number- 2o60431.00
USACE AID#: 2oo620564
Dear Mr. Tugwell and Ms. Karoly,

2Cjo),1U -3
On behalf of Robert Payne, we are requesting authorization from the USACE to use
NWP 39 for the construction of a farm pond. We are also requesting 401-certification
from the NC-DWQ.
The subject property is approximately 75 acres in size and is located immediately
west of the Haw River near the intersection of Preacher Holmes Road (SR 2116) and
Cedar Cliff Road (SR 2176) in Alamance County. Specifically, the site is located at the
Payne Residence, 807 Bullard Lane, in Graham, NC. The site contains unnamed
tributaries of the Haw River and is located in the Cape Fear River Basin at
035.97748590 N and 079.35998970 W. The Hydrologic Unit Code for this basin is
03030002. The Water Quality Classification is C; NSW, and the Stream Index is 16 -
(1).
Project History
Mr. Todd Tugwell of the USACE conducted a site visit to evaluate the proposed pond
location. Mr. Tugwell identified the stream origin point and the point at which the
channel becomes `important'. These flags are indicated on the attached impact
map. In addition, a small wetland pocket (<5oo s.f.) was identified during the site
visit and is included as an impact on the PCN form.
Proposed Impacts
The proposed impacts consist of 203 linear feet of 'unimportant' stream channel
impacted by flooding, 6o linear feet of 'important' stream channel impacted by
flooding, and 140 linear feet of 'important' stream will be impacted by the footprint
of the dam. Approximately Soo square feet of headwater forest wetland will be
flooded. The drainage area to the pond is 48.4 acres and the proposed surface area
is 1.68 acres. Impacts are summarized in the table below as well as in the PCN form.
ill MacKenan Drive i Cary, North Carolina 27511 1 tel: [phone] fax: [phone]oo8 i www.withersravenet.com
7040 Wrightsville Ave i Suite 1o1 i Wilmington, North Carolina 28403 1 tel: [phone] fax: [phone]
w..,, --0 r.rin rrn.^e.?F.!arcn rrt.^.P.C:H

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NWP # Impact # Linear Feet SF Acres
39 (flooding) Area A 20 o6 0.00
3 (flooding) Area B 6o 120 0.003
3 (dam) Area C 140 28o o.oo6
39 (flooding) Area D NA oo 0.011
Total Permanent 240 28o o.oo6
Flooded 26 1026 0.02
Grand Total 03 1,3o6 0.030
Avoidance and Minimization
In orderto minimize impacts to `important' stream channel, the footprint of the dam
was placed as far upstream as possible but based on the proposed surface area of
the pond some impacts could not be avoided. We explored using steeper slopes on
the downstream side of the dam; however, the applicant would like to be able to
maintain the lawn in this area using a riding lawn mower or tractor.
Stormwater Management Plan
Because this project is located on a single family lot approximately 75 acres in size
and the percent impervious is well below 30%, we do not believe that a stormwater
management plan should be required.
Mitigation
Because impacts to perennial channels are greater than 150 linear feet we believe
that the USACE will most likely require mitigation to offset impacts to the `important'
channel. In order to satisfy mitigation requirements the applicant proposes to
preserve the remaining stream channels on-site. If additional mitigation is required,
the applicant proposes payment to the NC-EEP.
As per Water Quality Certification 3402, impacts for dam footprints and flooding
count toward the threshold for stream impacts, but the flooding upstream of the dam
does not count towards mitigation requirements. Because the footprint of the dam
will impact less than 150 linear feet of stream channel and the stream channel
upstream of the dam will not be modified (other than flooding), we do not believe
that mitigation should be required by the NC-DWQ.
Please feel free to call if you have questions or require additional information.
Sincerely,
WITHERS &-RQVENEL, INC.
1
Todd Preuninger
Attachments
i) PCN Form
2) Site plans
3) Agent Authorization
4) USGS Quad
5) Aerial

Office Use Only: Form Version March 05
USACE Action ID No. DWQ No.
(If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A".)
1. Processing
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 ? Express 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested: NWP 39
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 Ecosystem Enhancement Program (NCEEP) is proposed
for mitigation of impacts, attach the acceptance letter from NCEEP, complete section VIII,
and check here:
5. If your project is located in any of North Carolina's twenty coastal counties (listed on page
4), and the project is within a North Carolina Division of Coastal Management Area of
Environmental Concern (see the top of page 2 for further details), check here: ?
II. Applicant Information
1. Owner/Applicant Information
JUN 2 ? Z?JU6
Name: Mr. Robert Payne
Mailing Address: 807 Bullard Lane DENN f^='r 7
Graham, NC 27253-9733 `"'?osrrt'ni7i?;r;;n,r?
Telephone Number: 336-376-6946 Fax Number: 336-376-0395
E-mail Address: cedarrockgmindspring.com
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: Todd Preuninger
Company Affiliation: Withers & Ravenel
Mailing Address: 111 MacKenan Drive
CM, NC 27511
Telephone Number: 919-469-3340 Fax Number: 919-238-2099
E-mail Address: tpreunin eg_rgwithersravenel.com
Page 1 of 8
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: Bob Payne Farm Pond
2. T.I.P. Project Number or State Project Number (NCDOT Only): NA
3. Property Identification Number (Tax PIN): 8891419529
4. Location
County: Alamance Nearest Town: Graham
Subdivision name (include phase/lot number): NA
Directions to site (include road numbers/names, landmarks, etc.): The subject property
approximately 75 acres in size and is located immediately west of the Haw River near the
intersection of Preacher Holmes Road (SR 2116) and Cedar Cliff Road (SR 2176) in
Alamance County. Specifically, the project is located at the Payne residence, 807 Bullard
Lane, in Graham, NC
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): 035.9774859 ON 079.3599897 °W
6. Property size (acres): - 75 acres
7. Name of nearest receiving body of water: Haw River
8. River Basin: Cape Fear
(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: The site is a mixture of agricultural land and forested
woodland and contains a single family residence.
Page 2 of 8
10. Describe the overall project in detail, including the type of equipment to be used: The
proposed project consist of the construction of a farm pond. Typical equipment used for
construction will consist of back-hoes and bull dozers.
11. Explain the purpose of the proposed work: The purpose of the project is to provide a
recreational pond for the property owners.
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. Mr. Todd Tugwell of the USACE conducted a site visit to evaluate the
proposed pond location. Mr. Tugwell identified the stream origin point and the point at which
the channel becomes `important'. These flags are indicated on the attached impact map. In
addition, a small wetland pocket (<500 s.f.) was identified during the site visit and is included as
an impact on the PCN form.
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.
None anticipated
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: The proposed impacts consist of
203 linear feet of `unimportant' stream channel impacted by flooding, 60 linear feet of
Page 3 of 8
`_important' stream channel impacted by flooding and 140 linear feet of `important' stream
will be impacted by the footprint of the dam. Approximately 500 square feet of headwater
forest wetland will be flooded. The drainage area to the pond is 48.4 acres and the proposed
surface area is 1.68 acres.
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 Type of Wetland Located within Distance to Area of
Site Number Type of Impact (e.g., forested, marsh,
100-year
Nearest
Impact
(indicate on map) herbaceous, bog, etc.) Floodplain Stream (acres)
( es/no) (linear feet)
Area D Flooding Headwater Forest No Adjacent 0.011
Total Wetland Impact (acres) 0.011
List the total acreage (estimated) of all existing wetlands on the property: <0.5 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
Perennial or Average Impact Area of
Number Stream Name Type of Impact
Intermittent? Stream Width Length Impact
(indicate on ma) Before Impact (linear feet) (acres)
A UT to Haw Flooding Intermittent 2 203 0.009
B UT to Haw Flooding Perennial 2 60 0.003
C UT Haw Dam Perennial 2 140 0.006
Total Stream Impact (by length and acreage) 403 0.019
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 Name of Waterbody Type of Waterbody Area of
Site Number (if applicable) Type of Impact (lake, pond, estuary, sound, bay, Impact
(indicate on ma) ocean, etc.) (acres)
NA NA NA NA NA
Total Open Water Impact (acres) NA
6. List the cumulative impact to all Waters of the U.S. resulting from the project:
Stream Impact (acres): 0.019
Wetland Impact (acres): 0.011
Open Water Impact (acres): 0
Total Impact to Waters of the U.S. (acres) 0.030
Total Stream Impact (linear feet): 403
Page 4 of 8
7. Isolated Waters
Do any isolated waters exist on the property? ? Yes ® No
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.
NA
8. 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.): dam and excavation
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.): aesthetic
Current land use in the vicinity of the pond: rural
Size of watershed draining to pond: 48.4 acres Expected pond surface area: 1.68 acres
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. In order to minimize impacts to
`important' stream channel, the footprint of the dam was placed as far upstream as possible but
based on the proposed surface area of the pond some impacts could not be avoided. We explored
using steeper slopes on the downstream side of the dam, however, the applicant would like to be
able to maintain the lawn in this area using a riding lawn mower or tractor.
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.
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
Page 5 of 8
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://l12o.enr.state.nc.us/ncwetlands/strmaide.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.
Because impacts to perennial channels are greater than 150 linear feet we believe that the
USACE will most likely require mitigation to offset impacts to the `important' channel. In order
to satisfy mitigation requirements the applicant proposes to preserve the remaining stream
channels on-site. If additional mitigation is required, the applicant proposes payment to the NC-
EEP.
As per Water Quality Certification 3402, impacts for dam footprints and flooding will count
toward the threshold for stream impacts, but the flooding upstream of the dam does not count
towards mitigation requirements. Because the footprint of the dam will impact less than 150
linear feet of stream channel and the stream channel upstream of the dam will not be modified
(other than flooding), we do not believe that mitigation should be required by the NC-DWQ.
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 http://h2o.enr.state.nc.us/wrp/index.htm. 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): 200 (if needed)
Amount of buffer mitigation requested (square feet): NA
Amount of Riparian wetland mitigation requested (acres): NA
Amount of Non-riparian wetland mitigation requested (acres): NA
Amount of Coastal wetland mitigation requested (acres): NA
Page 6 of 8
IX. Environmental Documentation (required by DWQ)
Does the project involve an expenditure of public (federal/state/local) funds or the use of
public (federal/state) land? Yes ? No
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.
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
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.
I I * Impact Required
Zone r-- f A+? Multiplier AA;+a,.. +-_
1 NA 3 (2 for Catawba) NA
2 NA 1.5 NA
Total NA NA
* 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. NA
Page 7 of 8
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. Because this project is located on a single family lot approximately 75 acres in
size and the percent impervious is well below 30%, we do not believe that a stormwater
management plan should be required.
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.
NA - Permit request is for a farm pond.
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. 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 ?
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://h2o.enr.state.nc.us/ncwetlands. If no, please provide a short narrative description: Because
this project consist of constructing a farm pond within a 75 acre parcel, we do not believe that
the project will impact downstream water quality or lead to additional development in the
adjacent parcels. During construction the applicant will employ the appropriate BMP's to in
order to protect downstream water quality.
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).
NA
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 8 of 8
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Phone: 33(0 - 37& - &?'i 4649
Fax: ?3&- 37&- d39S
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I hereby grant Withers and Ravenel, INC permission to conduct environmental
studies on the property described above. In addition, I authorize Withers and
Ravenel to act on my behalf as my agent when conducting site meetings and/or
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WITHERS RAVENEL

ENGINEERS I PLANNERS I SURVEYORS
June 22, 2oo6
US Army Corps of Engineers
Attn: Mr. Todd Tugwell
65o8 Falls of Neuse Road, Suite 120
Raleigh, North Carolina 27615
27604
Re: Pond Construction on Payne Farm
Request for 404/401 Certification
W&R Project Number - 2o60431.00
USACE AID#: 2oo62o564
,-oo-103r"?
NC-Division of Water Quality
Attn: Ms. Cyndi Karoly
2321 Crabtree Blvd.
Raleigh, North Carolina
QP@ 1, P
E r3
JUN 2 S 2006
Dear Mr. Tugwell and Ms. Karoly, DENT QUALITY
1'd'i RA w r l E 1 F( v g' 4 RANCH
On behalf of Robert Payne, we are requesting authorization from the USACE to use
NWP 39 for the construction of a farm pond. We are also requesting 401-certification
from the NC-DWQ.
The subject property is approximately 75 acres in size and is located immediately
west of the Haw River near the intersection of Preacher Holmes Road (SR 2116) and
Cedar Cliff Road (SR 2176) in Alamance County. Specifically, the site is located at the
Payne Residence, 807 Bullard Lane, in Graham, NC. The site contains unnamed
tributaries of the Haw River and is located in the Cape Fear River Basin at
035.97748590 N and 079.35998970 W. The Hydrologic Unit Code for this basin is
03030002. The Water Quality Classification is C; NSW, and the Stream Index is 16 -
(1) .
Project History
Mr. Todd Tugwell of the USACE conducted a site visit to evaluate the proposed pond
location. Mr. Tugwell identified the stream origin point and the point at which the
channel becomes `important'. These flags are indicated on the attached impact
map. In addition, a small wetland pocket (<500 s.f) was identified during the site
visit and is included as an impact on the PCN form.
Proposed Impacts
The proposed impacts consist of 203 linear feet of `unimportant' stream channel
impacted by flooding, 6o linear feet of `important' stream channel impacted by
flooding, and 140 linear feet of `important' stream will be impacted by the footprint
of the dam. Approximately 500 square feet of headwater forest wetland will be
flooded. The drainage area to the pond is 48.4 acres and the proposed surface area
is 1.68 acres. Impacts are summarized in the table below as well as in the PCN form.
ill MacKenan Drive i Cary, North Carolina 27511 1 tel: [phone] fax: [phone]oo8 i www.withersravenel.com
7040 Wrightsville Ave i Suite 1o1 i Wilmington, North Carolina 28403 1 tel: [phone] fax: [phone]
NWP # Impact # Linear Feet SF Acres
39 (flooding) Area A 20 o6 0.00
3 (flooding) Area B 6o 120 0.003
39 (dam) Area C 140 280 o.oo6
3 (flooding) Area D NA 500 0.011
Total Permanent 140 280 o.oo6
Flooded 26 1026 0.02
Grand Total 03 1,3o6 0.030
Avoidance and Minimization
In order to minimize impacts to `important' stream channel, the footprint of the dam
was placed as far upstream as possible but based on the proposed surface area of
the pond some impacts could not be avoided. We explored using steeper slopes on
the downstream side of the dam; however, the applicant would like to be able to
maintain the lawn in this area using a riding lawn mower or tractor.
Stormwater Management Plan
Because this project is located on a single family lot approximately 75 acres in size
and the percent impervious is well below 30%, we do not believe that a stormwater
management plan should be required.
Mitigation
Because impacts to perennial channels are greater than 150 linear feet we believe
that the USACE will most likely require mitigation to offset impacts to the `important'
channel. In order to satisfy mitigation requirements the applicant proposes to
preserve the remaining stream channels on-site. If additional mitigation is required,
the applicant proposes payment to the NC-EEP.
As per Water Quality Certification 3402, impacts for dam footprints and flooding
count toward the threshold for stream impacts, but the flooding upstream of the dam
does not count towards mitigation requirements. Because the footprint of the dam
will impact less than 150 linear feet of stream channel and the stream channel
upstream of the dam will not be modified (other than flooding), we do not believe
that mitigation should be required by the NC-DWQ.
Please feel free to call if you have questions or require additional information.
Sincerely,
WITHERS &-RAVENEL, INC.
I
Todd Preuninger
Attachments -
i) PCN Form
2) Site plans
3) Agent Authorization
4) USGS Quad
5) Aerial

Office Use Only: Form Version March 05 ") 11), 1 0 81
USACE Action ID No. DWQ No.
(If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A".)
1. Processing ?F i
1. Check all of the approval(s) requested for this project: . `-`J `''
® 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 39
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 Ecosystem Enhancement Program (NCEEP) is proposed
for mitigation of impacts, attach the acceptance letter from NCEEP, complete section VIII,
and check here:
5. If your project is located in any of North Carolina's twenty coastal counties (listed on page
4), and the project is within a North Carolina Division of Coastal Management Area of
Environmental Concern (see the top of page 2 for further details), check here: ?
ea W IN
II. Applicant Information
0
1. Owner/Applicant Information lj(I`
Name: Mr. Robert Payne
Mailing Address: 807 Bullard Lane
Graham, NC 27253-9733
Telephone Number: 336-376-6946 . Fax Number: 336-376-0395
E-mail Address: cedarrockkmindspring.com
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: Todd Preuninger
Company Affiliation: Withers & Ravenel
Mailing Address: 111 MacKenan Drive
Cary, NC 27511
Telephone Number: 919-469-3340 Fax Number: 919-238-2099
E-mail Address: [e-mail]
Pagel of 8
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: Bob Payne Farm Pond
2. T.I.P. Project Number or State Project Number (NCDOT Only): NA
3. Property Identification Number (Tax PIN): 8891419529
4. Location
County: Alamance Nearest Town: Graham
Subdivision name (include phase/lot number): NA
Directions to site (include road numbers/names, landmarks, etc.): The subject property
approximately 75 acres in size and is located immediately west of the Haw River near the
intersection of Preacher Holmes Road (SR 2116) and Cedar Cliff Road (SR 2176, in
Alamance County. Specifically, the project is located at the Payne residence, 807 Bullard
Lane, in Graham, NC
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): 035.9774859 ON 079.3599897 °W
6. Property size (acres): - 75 acres
7. Name of nearest receiving body of water: Haw River
8. River Basin: Cape Fear
(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: The site is a mixture of agricultural land and forested
woodland and contains a single family residence.
Page 2 of 8
10. Describe the overall project in detail, including the type of equipment to be used: The
proposed project consist of the construction of a farm pond. Typical equipment used for
construction will consist of back-hoes and bull dozers.
11. Explain the purpose of the proposed work: The purpose of the project is to provide a
recreational pond for the property owners.
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. Mr. Todd Tugwell of the USACE conducted a site visit to evaluate the
proposed pond location. Mr. Tugwell identified the stream origin point and the point at which
the channel becomes `important'. These flags are indicated on the attached impact map. In
addition, a small wetland pocket (<500 s.f.) was identified during the site visit and is included as
an impact on the PCN form.
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.
None anticipated
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: The proposed impacts consist of
203 linear feet of `unimportant' stream channel impacted by flooding, 60 linear feet of
Page 3 of 8
`important' stream channel impacted by flooding and 140 linear feet of `important' stream
will be impacted by the footprint of the dam. Approximately 500 square feet of headwater
forest wetland will be flooded. The drainage area to the pond is 48.4 acres and the proposed
surface area is 1.68 acres.
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 Type of Wetland Located within Distance to Area of
Site Number Type of Impact (e.g., forested, marsh, 100-year Nearest Impact
(indicate on map) herbaceous, bog, etc.) Floodplain Stream (acres)
( es/no) (linear feet)
Area D Flooding Headwater Forest No Adjacent 0.011
Total Wetland Impact (acres) 0.011
3. List the total acreage (estimated) of all existing wetlands on the property: <0.5 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 ma)
Stream Name
Type of Impact Perennial or
Intermittent? Average
Stream Width
Before Impact Impact
Length
(linear feet) Area of
Impact
(acres)
A UT to Haw Flooding Intermittent 2 203 0.009
B UT to Haw Flooding Perennial 2 60 0.003
C UT Haw Dam Perennial 2 140 0.006
Total Stream Impact (by length and acreage) 403 0.019
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 Name of Waterbody Type of Waterbody Area of
Site Number (if applicable) Type of Impact (lake, pond, estuary, sound, bay, Impact
(indicate on ma ocean, etc.) (acres)
NA NA NA NA NA
Total Open Water Impact (acres) NA
6. List the cumulative impact to all Waters of the U.S. resulting from the protect:
Stream Impact (acres): 0.019
Wetland Impact (acres): 0.011
Open Water Impact (acres): 0
Total Impact to Waters of the U.S. (acres) 0.030
Total Stream Impact (linear feet): 403
Page 4 of 8
7. Isolated Waters
Do any isolated waters exist on the property? ? Yes ® No
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
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.): dam and excavation
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.): aesthetic
Current land use in the vicinity of the pond: rural
Size of watershed draining to pond: 48.4 acres Expected pond surface area: 1.68 acres
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. In order to minimize impacts to
`important' stream channel, the footprint of the dam was placed as far upstream as possible but
based on the proposed surface area of the pond some impacts could not be avoided. We explored
using steeper slopes on the downstream side of the dam; however, the applicant would like to be
able to maintain the lawn in this area using a riding lawn mower or tractor.
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.
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
Page 5 of 8
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/newetlands/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.
Because impacts to perennial channels are greater than 150 linear feet we believe that the
USACE will most likely require mitigation to offset impacts to the `important' channel. In order
to satisfy mitigation requirements the applicant proposes to preserve the remaining stream
channels on-site. If additional mitigation is required, the applicant proposes payment to the NC-
EEP.
As per Water Quality Certification 3402, impacts for dam footprints and flooding will count
toward the threshold for stream impacts, but the flooding upstream of the dam does not count
towards mitigation requirements. Because the footprint of the dam will impact less than 150
linear feet of stream channel and the stream channel upstream of the dam will not be modified
(other than flooding), we do not believe that mitigation should be required by the NC-DWQ.
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 http://h2o.enr.state.ne.us/wm/index.htm. 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): 200 (if needed)
Amount of buffer mitigation requested (square feet): NA
Amount of Riparian wetland mitigation requested (acres): NA
Amount of Non-riparian wetland mitigation requested (acres): NA
Amount of Coastal wetland mitigation requested (acres): NA
Page 6 of 8
IX.
X.
Environmental Documentation (required by DWQ)
1. Does the project involve an expenditure of public (federal/state/local) funds or the use of
public (federal/state) land? Yes ? No
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 ?
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 213 .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 V Yes ? No
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 NA 3 (2 for Catawba) NA
2 NA 1.5 NA
Total NA NA
* 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.
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. NA
3. If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e.,
Page 7 of 8
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. Because this project is located on a single family lot approximately 75 acres in
size and the percent impervious is well below 30%, we do not believe that a stormwater
management plan should be required.
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.
NA - Permit request is for a farm pond.
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. 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 ?
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://h2o.enr.state.nc.us/ncwetlands. If no, please provide a short narrative description: Because
this project consist of constructing a farm pond within a 75 acre parcel, we do not believe that
the project will impact downstream water quality or lead to additional development in the
adjacent parcels. During construction the applicant will employ the appropriate BMP's to in
order to protect downstream water quality.
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).
NA
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 8 of 8
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Property Owner/Contract Purchaser:
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I hereby grant Withers and Ravenel, INC permission to conduct environmental
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WITHERS & RAVENEL, INC.
28834
Invoice Number Date Voucher Amount Discounts Previous Pay Net Amount
206431.Payne Dam 6122/06 0030698 475.001 0.00 0.00 475.00
NC DENR-DWQ
Totals 475.00 0.00 0.00 475.00
CCBCheckin 2 NCWATER
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JUN 2 2005
DENTi-'1-vATERc J=,?1TY
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