20061800 Ver 1_COMPLETE FILE_20061115

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Mr. Buel B. Barker, Jr.
3632 Friedburg Church Road
Winston-Salem, NC 27127
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
U'J NO
APPROVAL of 401 Water Quality Certification- with Additional Conditions
Dear Mr. Barker:
Alan W. Klimek, P.E. Director
Division of Water Quality
January 8, 2007
DWQ# 06-1800
Davidson County
You have our approval, in accordance with the attached conditions, to place permanent fill in 140 linear feet
of stream in order to construct a road crossing for Phase 3 of the Westfield residential subdivision located on
Frye Bridge Road, near Acadia in Davidson County, as described in your application received by the Division
of Water Quality (DWQ) on November 15, 2006. After reviewing your application, we have determined that
this fill is covered by General Water Quality Certification Number 3404, which can be viewed on our web ' site
at htlp://www.ncwateLquality.org/wetlands.html. This Certification allows you to use Nationwide Permit
Number 14 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 140 linear feet Unnamed tributary to Muddy Creek located off of Frye Bridge
Road, near Acadia in Davidson County, as depicted on the site plan
included with the application

North Carolina Division of Water Quality
Wetlands Certification Unit
Customer Service Number:
1650 Mail Service Center
2321 Crabtree Blvd.
1-877-623-6748
1V 0t Carolina
Naturally
Raleigh, NC 27699-1650 Phone [phone] FAX [phone]
Raleigh, NC 27604-2260 Intemet hfp:/Mww.ncwaterouality.org
An Equal Opportunity/Affirmative Action Employer- 50% Recycledl10% Post Consumer Paper
Mr. Buel B. Barker, Jr.
Page 2, DWQ# 06-1800
January 8, 2007
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. 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. The culvert required for this project shall be installed in such a manner that the original stream profile is
not altered (i.e. the depth of the channel must not be reduced by a widening of the streambed). Existing
stream dimensions (including the pattern and profile) are to be maintained above and below the location
of the culvert. The culvert shall be designed and installed to prevent head cutting of the stream. If the
culvert becomes perched, the appropriate stream grade shall be re-established or, if the culvert is
installed in a perched manner, it shall be removed and re-installed correctly. The Applicant must submit
a plan and receive written approval from this Office to address any head cutting that will occur as a
result of this project (e.g., use of cross vanes downstream of the culvert).
6. Where riprap is required for energy dissipation and scour protection, 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 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 upstream or downstream of any crossing.
7. 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.
Mr. Buel B. Barker, Jr.
Page 3, DWQ# 06-1800
January 8, 2007
8. 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.
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 upstream and downstream of the culvert site 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, 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 Daryl Lamb in the DWQ Winston-Salem Regional Office at 336-
771-4959 or Ian McMillan in the Wetlands/401 Central Office in Raleigh at 919-715-4631.'
Sincerely,
C?e/_ -
Alan W. Klimek, P.E.
AWK/cdl
Attachments
cc: Mr. John Thomas, U. S. Army Corps of Engineers, Raleigh Regulatory Field Office
DWQ, Winston-Salem Regional Office
Central Files
Wetlands/401 File Copy
Mr. William Mitchell, William E. Mitchell Associates, 1903-C Ashwood Court, Greensboro, NC 27455
Triage Check List
Date: 11/21/06 Project Name: Windfield SD Ph. 3
DWQ#: 06-1800
County: Davidson
Daryl Lamb, Winston-Salem Regional Office
To:
60-day processing time: 11/15/06 - 1/13/07

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 (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: 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!
Office Use Only: Form Version October 2001
USACE Action ID No. DWQ No. 2 0 o 6 1 a 0 0
If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A" rather than
leaving the space blank.
1. Processing
1. Check all of the approval(s) requested for this project: PAYIN! ENT
Q Section 404 Permit RECEIVED
? Section 10 Permit E-
Q 401 Water Quality Certification
? Riparian or Watershed Buffer Rules
2. Nationwide, Regional or General Permit Number(s) Requested: NW? 14
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 (see section VIII - Mitigation), check here: ?
r= c r
o QTR
II. Applicant Information
NOV 1 5 2006
1. Owner/Applicant Information
Name: MK. DUEL B. $ARKECZ .1K. DENR-WA1F-RA, "B
Mailing Address: 34,32 FIF-M 3 AZa CHUIZCH IZOA'D
Wlt`1S` -01.1-SAL&M, N.G 7-712-7
'33G-655 -2oa76M)
Telephone Number: 1.44-775-L137 (o) Fax Number-'313f--775-4-689
E-mail Address:
2.
Agent 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: 0-111 MtTcK EI L
Company Affiliation: WILLIAM E. MtTCH !? LL A554? tA'I?5
Mailing Address: l 903 -e A54WboD coOR-i-
Page 5 of 12
Telephone Number: 33& -'S4-a -G0(-o Fax Number:
E-mail Address:
M. 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: WIMVREiv 5U13Dt\Astot S -MASS 3
2. T.I.P. Project Number or State Project Number (NCDOT Only): WA,
3. Property Identification Number (Tax Ply: 8 -1 - to, 17, rosm vt? 65 12
4
4. Location
County: (pAV I V 5011 Nearest Town:-AgcA3:;,tls.
Subdivision name (include phase/lot number): Wilt ttbV=tr=L-D - pHase 3
Directions to site (include road numbers, landmarks, etc.): ON Faye Btzttxt, tZVAt> -
t1CtS-C. _btztyEw?Y a &90 1 90y--n4 of GENT'Ef WN 6HURe44 KOAO FoL.t_aS
EXIST, DtztviruJA.Y 1200' ± To sTtz h+F,,t ?bIz1VV-W .Y CMSS-5S S-r9SAM)
5. Site coordinates, if available (UTM or Lat/Long): M 1.4e
(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. Describe the existing land use or condition of the site at the time of this application:
PRtVtoU5L%( FA-Mmtb /ugt E\1tr LdMt? By Qtr-UV10U5- Owkgy? (S la-
Uq1F. b14 5 (T?--EXIST, btLt L .K S61zV?S -MW Xb?! . bwNt.-1?S)
7. Property size (acres): 4-8.2 Esc .
8. Nearest body of water (stream/river/sound/ocean/lake): MUVVY GRE EK
9. River Basin: YAPK4,1 - FEE- VEG
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at httn:h2o.enr state nc.us/admin/map
s/.)
Page 6 of 12
10. Describe the purpose ofthe proposed work: KCIAVWay C.1zo5Sx*V- To &c-cS55
ptzomv--"
11. List the type of equipment to be used to construct the project: TkaGtG 15?KH21
DULL. D&ZEIZ FI2ot4T END LoA47EK
12. Describe the land use in the vicinity of this project: iZES(VF-tr tat, /AQZV- 9L"TUK&
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. Wetland Impacts 14 /A
Wetland Impact
Site Number
indicate on ma
Type of impact* Area of
Impact
acres Located within
loo-year Floodplain**
es/no Distance to
Nearest Stream
linear feet
Type of Wetland***

••••r••••• wraaawa? aqua auutuar ',-IAutuy'mPkwL% impacts Mel=, out are not limited to: mechanized clearing, grading, fill,
excavation, flooding, ditching/drainage, etc. For dams, separately list impacts due to both stricture and flooding.
100-Year floodplains am 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://ivww.fema.gov.
*•• List a wetland type that best describes wetland to be impacted (e.g., freshwater/saltwater marsh, forested wetland, beaver pond,
Carolina Bay, bog, etc.)
List the total acreage (estimated) of existing wetlands on the property:
Total area of wetland impact proposed:
2. Stream impacts, including all intermittent and perennial streams
Stream Impact Length of Average Width Perennial or
Site Number Type of Impact* Impact Stream Name** of Stream Intermittent?
ndicate on man) rt;nAnr 4"'1 _
1
UT- MUDDY C'KEEK I ? P>cfZ?NNtl.L
List each impact separately and Identify temporary impacts. Impacts include, but are not limited
dams ( to: culverts and associated rip-rap,
separately list impacts due to both structure and flooding), relocation (include linear feet before and after, and net Ioss/gain),
stabilisation activities (cemeirt wall, rip-rap, crib wall, gabions, eta), excavation, ditching(straightening, eta 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 traps are available through-the USGS at 1-800-358-9616, or online at
www.uses.eov. Several Internet sites also allow direct download and printing of USGS maps (e.g., www.topozone.c
www.manauest con etc.). om,
Cumulative impacts (linear distance in feet) to all streams on site: 14-0
Page 8 of 12
3. Open Water Impacts, including Lakes, Ponds, Estuaries, Sounds, Atlantic Ocean and any
other water of the U. S. W /A,
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,
ba ,ocean etc.

T ;.f
_____W -__ UUl WIP 1101 IIIIIIle11 10: 1111, excavauon, areaguig,
flooding, drainage, bulkheads, eta
4. Pond Creation t-1/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 a placation.
Pond to be created in (check all that apply): M 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 impacts
were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce impacts.
W6 e>TUSk 4.cct?SS -ro mopm-N- V E Puz:?S V--wSTt"a S-(Vu5A.M CR1>S5-1W.
W1' 4 PUBZ.IG FROG • UMtTVV H3_ LDCAMo4 Cftlez$ pY i'7t6Pl=1z-M LANE f r7-V%Z;-
PONO ; USIISG !?N'
Mta r 'FLU, -1b fto
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VIII. Mitigation KI /A
(VG KEV V . cov
To loo t EaiL F1
MIND ME GULVEICT L 444TA , 1)51,4( ,
DVEtt plztipoSBtp e4X-Vbk-T - Prof S1
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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.
S. AT 1=X
EM
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
httr)://h2o.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. RSA _ 16t-SIT PEEL. MIZI C.,ka i tS
ivs,nF-l s p - mNtm tzQPI D, TD GRoss sTRca-&m Wr T7,? p tmuc.
$ZoAV . AiJW oMls Loc-A'1?o?S "yt-D M 1rS (? Pl oDn?1,atiS Aim
VJWUt GZbAT45 MOtzZ t t?rt< .
2. Mitigation may also be made by payment into the North Carolina Wetlands Restoration
Program (NCWRP) with the NCWRP's written agreement. Check the box indicating that
you would like to pay into the NCWRP. Please note that payment into the NCWRP must be
reviewed and approved before it can be used to satisfy mitigation requirements.. Applicants
will be notified early in the review process by the 401/Wetlands Unit if payment into the
NCWRP is available as an option. For additional information regarding the application
process for the NCWRP, check the NCWRP website at httn://h2o.enr state - ushwrp/index ham. If
use of the NCWRP is proposed, please check the appropriate box on page three and provide
the following information: N /A
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 (DWQ Only)
Does the project involve an expenditure of public funds or the use of public (federal/state/local)
land?
Yes ? No El
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 El
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 (DWQ Only) 9/A
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 ?x If you answered "Yes"'. provide the following information:
Identify the square feet and acreage of impact to each zone of the riparian buffers. Lf buffer
mitigation is required calculate the required amount of mitigation by applying the buffer
multipliers.
Zone* Multiplier
(square fc?tl 2
Total
1.5
• 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.
f I/A - t>pWT FEEL AIZ%f Mrfl"110" tS NEGESSAt?{
Xl. Stormwater (DWQ Only)
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,
TOTAL AKEA =48.2 Ae-, 3 I E,03'r. Ho MS ? A55UMra, MAX. 400b Sal V. 1MMiWtotJ S
A1zI5A ILOT X 50 TOT. t,csTS c 4,6ac. = 2) % 1eUW0Vr PMECT1:p THROUGH a zxss
tsNb?s'i'tSVMEP OR 131r'ORI. MEAsTA LAw SS - Na p
XII. Sewage Disposal (DWQ Only)
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.
1mtxvt0vA.L some- 5YST?MS Folz E7Ct4Lam'
XM. Violations (DWQ Only)
Is this site in violation of DWQ Wetland Rules (I SA NCAC 2H .0500) or any Buffer Rules?
Yes ? No 0
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).
Applicant/Agent's Signature
(Agent's signature is valid only if an
11-13--o6
Date
letter from the applicant is provided.)
Page 12 of 12
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Office Use Only: Form Version October 2001
20061!`O')
USACE Action ID No. DWQ No.
If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A" rather than
leaving the space blank.
I . Check all of the approval(s) requested for this project:
? Section 404 Permit
? Section 10 Permit
Q 401 Water Quality Certification
? Riparian or Watershed Buffer Rules
L Processing
2. Nationwide, Regional or General Permit Number(s) Requested: N`'JP 14
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 (see section VIII - Mitigation), check here: ?
?tg t r--..% P
U. Applicant Information
D
NIjV 1 5 "Z006
1. Owner/Applicant Information
Name: mr- . Duel- E5, 15AvZ9E1z AV,. EK QUALITY
Mailing Address: 3&32 F1z1Ed8U1K6 C1-1U1~GH 96AP
V?11NSToN -SAL1?M, N.C. Z7127
33?-?55 -2a27CM) _
Telephone Number: 1346 - 775-1137 Co) Fax Number: 33(-- 775 - 46 89 -
E-mail Address:
2.
Agent 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: & ILL M1TC-H ELl
Company Affiliation: \NI LLIAM E. M1TCHELL_ ASSc>Gts,'rE5
Mailing Address:-_ (9c>3-r- Ast lwmd rn1 -r-
Telephone Number: 33&-13 -6060 Fax Number:
E-mail Address:
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.
1. Name of project: WlgVRsUV 5U50\JlStots -PH,e\Ss 3
2. T.I.P. Project Number or State Project Number (NCDOT Only): ??/Q•
3. Property Identification Number (Tax PIN): 6 -1 -1D, 17, ft" ok-1 of I2
4. Location
County: PAV l b sots Nearest Town: AV_CA.t2%4,
Subdivision name (include phase/lot number): wtubi=tr_-LV - PRAsy 3
Directions to site (include road numbers, landmarks, etc.): bN FWgE 131zttx16 rzraat> -
tX15T, VZt\(EWA-,J a &90 1 t4MTH of GENTEf-?Aell GHUR" ROA4?, FoLLaj?
Ey-ISM, p1ZI%JE A.Y I ZW' t To 5' f2LJE?A,1A ft){Z11.JLWA.Y Gz65S-ES S[Y_C: M )
5. Site coordinates, if available (UTM or Lat/Long): W /A
(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. Describe the existing land use or condition of the site at the time of this application:
FF-tVtouSL`( FA.RMVb ?U1SbEVIE LoMtb F`/ Ftr_tvt6U5, OWt4twR(SML -
L_1\JG 6-t,1 S I-M -EYLGT, -IVEU .`{ SEtZVf:S 'THtrTd 1&DJ • OWWEf_S)
7. Property size (acres): 48.2 44 .
8. Nearest body of water (stream/river/sound/ocean/lake): MUPPY GKE EK
9. River Basin: Yap 4,1 - Mr-_ pE E
(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/.)
Page 6 of 12
10. Describe the purpose of the proposed work: F-0A47WA,4 ctzOssk*,S6 To Qc?Sss
Ptzort zw
11. List the type of equipment to be used to construct the project: 71Z ..GK V,&cKHpi
D U L.L. too Z E tZ , F RO t-W 1=.h1D LOAV51Z
12. Describe the land use in the vicinity of this project: lZEStuEN?? lA?iz?crs?TUlzE
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.
N ?A
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:
N/,4
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. Wetland Impacts 14 /A
Wetland Impact
Site Number
(indicate on ma)
Type of Impact* Area of
Impact
acres Located within
100-year Fooodplain**
es/no Distance to
Nearest Stream
linear feet
Type of Wetland***

* r .ot -1,
. ..« ..
....«..,. _? .??..:c.
?+..+ ...'k- u..k-"Zt] m1u .uu.u,y toutputury 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 floodplain maps. Maps are available through the FEMA Map Service Center at 1-800-358-9616, or
online at htti):H/ vww. fema. , og_v.
*** List a wetland type that best describes wetland to be impacted (e.g., freshwater/saltwater marsh, forested wetland, beaver pond,
Carolina Bay, bog, etc.)
List the total acreage (estimated) of existing wetlands on the property:
Total area of wetland impact proposed:
2. Stream Impacts, including all intermittent and perennial streams
Stream Impact
Site Number
(indicate on ma
1
Type of Impact*

CU P Length of
Impact
linear feet
140
Stream Name**

UT- MUDDY CKEEK Average Width
of Stream
Before Impact
-7% Perennial or
Intermittent?
leasespecify)

Pt=1Z1?t ttiltxt_

* List each imnart c enArntrly -A ;.;,.. .'4;, «e.. _ _.
--r----? --- •- -•-•., -IFO,wy „upatas. impacts mcluae, 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 andetc. If, and stream net relocaation loction i,
stabilization activities (cement wall, rip-rap, crib wall, gabions, etc.), excavation, ditchingfstraightening, s
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
'Al"'W.usas aov. Several internet sites also allow direct download and printing of USGS maps (e.g., mvwtouozone com,
www.maoquest.coi etc.).
Cumulative impacts (linear distance in feet) to all streams on site: 14-0
Page 8 of 12
3. Open Water Impacts, including Lakes, Ponds, Estuaries, Sounds, Atlantic Ocean and any
other Water of the U.S. N /A.
Open Water Impact
Site Number

indicate on ma
Type of Impact* Area of
Impact

acres
(if Name p Waterbody
applicable) Type of Waterbody

(lake, pond, estuary, sound,
bay, ocean, etc.)

LIaL ] ?11 uuNau scpunuely and identify temporary impacts. impacts include, but are not limited to: fill, excavation, dredging,
flooding, drainage, bulkheads, etc.
4. Pond Creation NSA
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 a plication.
Pond to be created in (check all that apply): ? uplands f 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 impacts
were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce impacts.
Nb C)-Nsp- A-cGtss To M-OP?127 r- KZ PLd.G.t-;? S >rXLSTU.iG S-tR?as,nn rnncc?
Wl-n4 PUBtrtc- 9DA4D . -
- FLU-
t-mv ls\ L.OeAwRaS G1a1e-CS
AT EA-r-R E- MD Tb $4WIm

Rib 6? bJlc-?1?sT To 100 -? EQi? F'LUDi7j?L?.itS - hS£?D -?
VIII. Mitigation M /A
t_t NE £ l? st:
L5 14TFt . Usu is
-t - t-<<oM54
DuY OF -ruts
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.ne.us/newetlands/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. NSA _ 11-5ts'T PEEL MITI GA.Tlc?1 is
JVST1?1 ? p - owN?lz Iz?lst D. To G?oSs s-t1z??r,r1 Wry PU'buc
2. Mitigation may also be made by payment into the North Carolina Wetlands Restoration
Program (NCWRP) with the NCWRP's written agreement. Check the box indicating that
you would like to pay into the NCWRP. Please note that payment into the NCWRP must be
reviewed and approved before it can be used to satisfy mitigation requirements, Applicants
will be notified early in the review process by the 401/Wetlands Unit if payment into the
NCWRP is available as an option. For additional information regarding the application
process for the NCWRP, check the NCWRP website at http://b2o.enr..qtite.nc.us/ivM/iiidex.ht m. If
use of the NCWRP is proposed, please check the appropriate box on page three and provide
the following information: N /A
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
VL Environmental Documentation (DWQ Only)
Does the project involve an expenditure of public funds or the use of public (federal/state/local)
land?
Yes 0 No 0
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 (DWQ Only) 9/A
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 2B .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify_________ ??
Yes ? No ?x If you answered "yes", provide the following information:
Identify the square feet and acreage of impact to each zone of the riparian buffers. Lf buffer
mitigation is required calculate the required amount of mitigation by applying the buffer
multipliers.
Zone* I Impact I
(square feet) Multiplier
2
Total
1.5
Zone 1 extends out 30 feet
perpendicular from new bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.
Page 1 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.
Nla - DotS'T FEEL AIQsf MMC.,e.-ICWS t5 t4SCE%#4L-t'
Xl. Stormwater (DWQ Only)
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,
Tv"IA?L AKEA 4S.2 Ae-, r t E-A%sr- MOMS ) ^OSUMra MAx, 40Cab S.F: IMPEtzvto05,
APMA /LeT X 50 TcT, LISTS = 4 ,(, Ac. = 3.5%. Ieutiorr PIP-ECTgDMP*Ur,1i -V-Ass
utJa? sTCStZ6Ed M Or: OR1s?: MEisraL LA w S Na R.usoPF cot3i?oi5 u £b
XII. Sewage Disposal (DWO Only)
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.
1NDIVtGub.L SE"e, 5`IST?MS FOR t:, cN LtSr
X M- Violations (DWQ Only)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H.0500) or any Buffer Rules?
Yes ? No 0
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).
• , ?,• : . ? ,-L - 13 --off
Applicant/Agent's Signature
(Agent's signature is valid only if an authorization letter from the applicant is provided.) Date
Page 12 of 12
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