20181579 Ver 1_401 Application_20181115

Preliminary ORM Data Entry Fields for New Actions w f�
SAW — 201 - BEGIN DATE [Received Date]:
Prepare file folder ❑ Assign Action ID Number in ORM ❑
1. Project Name [PCN Form A2a]: Rancho Cerro del Venado 2 0 1 8 1 5 7 9
2. Work Type: Private ❑v Institutional ❑ Government ❑ Commercial 11
3. Project Description / Purpose [PCN Form 133d and 133e]:
Family estate, to construct driveways to two single family residences on the estate property
4. Property Owner / Applicant [PCN Form A3 or A4]: Tomas and Marla Cruz / same
5. Agent / Consultant [PCN Form A5 — or ORM Consultant ID Number]: Atlas Environmental / Jennifer Robertson
6. Related Action ID Number(s) [PCN Form 135b]: no known previous Action ID's
7. Project Location - Coordinates, Street Address, and/or Location Description [PCN Form 61b]:
35.68724 N -80.95957 W, 472 Pineville Road, Statesville, NC 28677
8. Project Location - Tax Parcel ID [PCN Form B1a]: 471 1804744.000
9. Project Location—County [PCN Form A2b]: Iredell
10. Project Location — Nearest Municipality or Town [PCN Form A2c]: Statesville
11. Project Information — Nearest Waterbody [PCN Form [32a]: Unnamed Tributary Catawba River, WS -IV B CA
12. Watershed / 8 -Digit Hydrologic Unit Code [PCN Form 62c]: Upper Catawba, 03050101
Authorization: Section 10 ❑ Section 404
Regulatory Action Type:
RVe
Standard Permit
Nationwide Permit # ATF 29
❑ Regional General Permit #
❑ Jurisdictional Determination Request
❑✓ Section 10 & 404
Pre -Application Request
Unauthorized Activity
0 Compliance
❑ No Permit Required
Revised 20180124

-""4IRONMENTAL
US Army Corps of Engineers
Asheville Regulatory Field Office
Attn: Ms. Catherine M. Janiczak
151 Patton Avenue, Room 208
Asheville, North Carolina 28801-5006
November 13, 2018
NC Division of Water Resources
401 and Buffer Permitting Unit
Attn: Mrs. Karen Higgins
1617 Mail Service Center
Raleigh, NC 27699-1617
Re: Rancho Cerro del Venado — N 43.4 Acres
472 Pineville Road, Statesville NC, 28677
After -the -Fact NWP 29 Application
Cathy/Karen:
The applicant, Mr. Tomas and Mrs. Maria Cruz, are requesting approval of the enclosed
after -the -fact permit application. During a site visit with Mr. Randall Moore of Iredell
County Erosion Control, the permittee was informed that he had placed culverts in
streams for construction of two driveways without a 404 or 401. Mr. Cruz contacted
Atlas Environmental to help him through the permitting process. Mr. Cruz is requesting
approval for two stream impacts in order to finish construction of two driveways to two
single family home sites. Mr. Cruz plans to construct a home for himself as well as a
home for family members.
Atlas staff was onsite October 24, 2018 to access the potential impacts to streams and
observed two perennial streams with recently constructed culvert crossings. The
installed culverts appear to be undersized and installed at an angle that is creating
unstable conditions. The culverts will be replaced with larger diameter culverts to
adequately handle storm flows as well as base flow and re -positioned to avoid
backwatering and perched conditions. Woody debris in the stream is also causing flow
restrictions at the downstream side of Impact 1. This woody debris will be removed to
restore the proper channel flow and increase stability.
Impact 1 is 40 linear feet and Impact 2 is currently 20 linear feet. The permittee is
requesting an additional 10 linear feet of stream impact at Impact 2 to reduce erosion
and increase stability of the road side slopes. The steepness of the existing topography
requires a longer culvert in order to construct a more stable driveway.
ATLAS Environmental, Inc.
712 English Tudor Lane
Charlotte, North Carolina 28211
704-512-1206 (o) / 828-712-9205 (m)
www.atlasenvi.com / Offices in Asheville and Charlotte

"ON MENTAL
Enclosed are the necessary permit documents and additional information. Thank you
for your attention to the enclosed request. Please contact me if you need any
additional information.
Best regards,
�"+' d1&kztw,
Jennifer L Robertson, President
J Robertson (d)atlasenvi.com
Digital copy to: Mr. Alan Johnson, Mooresville Regional Field Office
ATLAS Environmental, Inc.
712 English Tudor Lane
Charlotte, North Carolina 28211
704-512-1206 (o) / 828-712-9205 (m)
www.atiasenvi.com / Offices in Asheville and Charlotte

;'ar�ww
AGENT AUTHORIZATION FORM
U.S. Army Corps of Engineers, Wilmington District
Attn: Mr. Scott McLendon, Chief, Regulatory Division
PO Box 1890
Wilmington, North Carolina 28402-1890
-and-
NC Division of Water Resources, Water Quality Program
Wetlands, Buffers, Streams - Compliance and. Permitting Unit
Attn: Mrs. Karen Higgins, Supervisor
1617 Mail Service Center
Raleigh, North Carolina 27699-1650
I, the current landowner, lessee, contract holder to .purchase, right to purchase holder, or easement
holder of the property/properties Identified blow, hereby authorize Atlas Environmental Inc to act on my
behalf as my agent during the processing of permits to impact Wetlands and Waters of the US that are
regulated by the Clean Water Act and the Rivers and Harbors Act Federal and State agents are
authorized to be on said property when accompanied by Atlas Environmental Inc staff for the purpose of
conducting on-site investigations and issuing a determination associated with Waters of the US subject to
Federal jurisdIcion under Section 404 of the Clean Water Act and/or Section 10 of the Rivers and Harbors
Act of 1899 and Waters of the State Including 404 Wetlands, Isolated Wetlands, and other non -404
Wetlands subject to a permitting program administered by the State of North Carolina. Atlas
Environmental Inc Is authorized to -provide supplemental information needed for delineation approval
and/or permit processing at the request of the Corps or NC DWR Water Quality Program.
Project Name: _RQlr\< 1)n O.A r lrP_� Ve, O
Property Owner of Record: 7_0"-1a5 anA a\QLV_l , C Z
Contact Name: _O'MaS C'_ V -
Address: Aaa.Q R%Vel/ woks ZV
Address: `JeyWej NC 2.8037
Phone/Fax Number: �y" a01 - 5 s W e ell
Email Address: p`CYv, S C>TYVLSC VtoyIGYor1rl .c orv,
Project Address: ?'00=1
Project Address:
Tax PIN:
Signature: —T-nma S CxuZ
Date: ,10 2 S I -2z IS
ATLAS Environmental Inc.
712 English Tudor Lane
Charlotte, North Carolina 28211
704-512-1206 (o) / 828-712-9205 (m)
[e-mail]
. www.atiasemi.com

IREDELL COUNTY TAX COLLECTOR
o� PO BOX 1027
STATESVILLE NC 28687-1027
�.� www.coJredell.nc.us
*067665/1--S 201--B 1
,,. CRUZ TOMAS
LM CRUZ MARIA DEL CARLMEN
4920 RIVER HILLS DR
DENVER NC 28037-8495
Page 1 of 1
IREDELL COUNTY PROPERTY TAX BILL
IMPORTANT INFORMATION - PLEASE READ
INTEREST: Accrues at the rate of 2% for January & 3/4% each month thereafter.
Taxes are delinquent after January 7, 2019.
PROPERTY SOLD: Ownership is determined as of Jan. 1, 2018 (NCGS 105-285). If you
have sold the real property assessed to you, please forward this tax notice to the
new owner. The new owner will not receive a bill but will receive a notice of taxes
due.
FAILURE TO PAY: Delinquent taxes are subject to garnishment of wages, levy
on personal property, attachment of bank accounts, and foreclosure
proceedings AFTER January 7, 2019. See back of this bill for more information.
PAYMENT OPTIONS: See payment information on the back of this tax bill.
START MAKING PAYMENTS TODAY IF YOU ARE UNABLE TO PAY IN FULL BY
JANUARY 7, 2019 - SEE BACK OF TAX BILL.
APPEALS: See reverse side of this bill for more information.
SOLID WASTE FEE: This annual fee supports the construction and operation of
the Iredell County landfill. This is an availability fee charged for each home, mobile
home site, and apartment unit. The landfill charges a non-residential waste fee
by ton or load. Landfill stickers are available at the Solid Waste Facility only.
ESCROW / MORTGAGE ACCOUNTS: The property owner is responsible for
ensuring full payment of this bill. If "YES" appears in the box below, a copy of this
bill has been forwarded to an escrow company. If your taxes are escrowed, and
the box below is blank, forward this bill to your mortgage holder.
TAXES ESCROWED: O
SEE THE BACK OF THIS BILL FOR MORE INFORMATION

Iredell County
Property Data
Parcel Number: 4711804744.000
Inquiry Date: 10/26/2018
Disclaimer: While every effort is made to keep information provided over the internet accurate and up-to-date, the County does not
certify the authenticity or accuracy of such information. No warranties, express or implied, are provided for the records and/or mapping
data herein, or for their use or interpretation by the User.
Property Map
4 — I
472m
486
.i
492 J +:
/
532 / ^^
129 •
558
J........... -y ------------
Owner/Property Info
Tax Account Number: 80043248
Old Parcel Number: 1503L0000OB021
Owner Name: CRUZ TOMAS+MARIA DC
Mailing Address: 4920 RIVER HILLS DR DENVER NC 28037
Property Location: PINEVILLE RD
Lot Number: TRACT 1
Legal Description: SURPLUS TRACT 3334 PB64-134 SR1332
Municipal Information
Township Code: 15
City Code: 00
Neighborhood Code: 15006
Value Information - Current Year Property Record Card (PRC)
Building Value: 0
Other Building Features: 0
Land Value: 225530
Tax Assessed Value: 225530
Deferred: 0
Land Information - Register of Deeds Online Search
Date Recorded Document Type Deed Book Deed Page Plat Book & Page Land Area Land Type Zoning

20170404
Tax Information
Exemption
Null
WD 2482 2109
64-134 43.372 AC RA
Tax Code 1 Tax Code 2
Tax Code 3 Tax Code 4 Tax Code 5
C ADVLTAX Null
FR05ADVLTAX Null Null
Current Zoning Contact Info.
Iredell County
704.878.3118
Harmony
704.878.3118
Love Valley
704.878.3118
City of Statesville
704.8783575
Town of Troutman
704.528.7600
Town of Mooresville
704.662.7040
Village of Davidson
704.892.7591

W A TF9pG
r
Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.4 January 2009
Page l of 10
PCN Form — Version 1.4 January 2009
Pre -Construction Notification (PCN) Form
A.
Applicant Information
1.
Processing
1 a.
Type(s) of approval sought from the
Corps:
®Section 404 Permit El Section 10 Permit
1b.
Specify Nationwide Permit (NWP) number: ATF 29 or General Permit (GP) number:
1c.
Has the NWP or GP number been verified by the Corps?
❑ Yes
® No
1d.
Type(s) of approval sought from the DWQ (check all that apply):
® 401 Water Quality Certification — Regular ❑ Non -404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
1 e.
Is this notification solely for the record
because written approval is not required?
For the record only for DWQ 401
Certification.-
ertification:❑ Yes ® No
El
For the record only for Corps Permit:
❑ Yes ® No
1f.
Is payment into a mitigation bank or in -lieu fee program proposed for
mitigation of impacts? If so, attach the acceptance letter from mitigation bank
or in -lieu fee program.
❑ Yes
® No
1 g.
Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below.
❑ Yes
® No
1 In.
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes
® No
2.
Project Information
2a.
Name of project:
Rancho Cerro Del Venado
2b.
County:
Iredell
2c.
Nearest municipality / town:
Statesville
2d.
Subdivision name:
Not a Subdivision
2e.
NCDOT only, T.I.P. or state
project no:
Not a DOT project
3.
Owner Information
3a.
Name(s) on Recorded Deed:
Tomas and Maria Cruz
3b.
Deed Book and Page No.
2482/2109
3c.
Responsible Party (for LLC if
applicable):
N/A
3d. Street address:
4920 River Hills Drive
3e. City, state, zip:
Denver, NC 28037
3f.
Telephone no.:
704-201-5514
3g.
Fax no.:
no fax number
3h.
Email address:
[e-mail]
Page l of 10
PCN Form — Version 1.4 January 2009

4. Applicant Information (if different from owner)
4a. Applicant is:
❑ Agent ❑ Other, specify:
4b. Name:
same as above
4c. Business name
(if applicable):
same as above
4d. Street address:
same as above
4e. City, state, zip:
same as above
4f. Telephone no.:
same as above
4g. Fax no.:
same as above
4h. Email address:
same as above
5. Agent/Consultant Information (if applicable)
5a. Name:
Jennifer L Robertson
5b. Business name
(if applicable):
Atlas Environmental, Inc.
5c. Street address:
712 English Tudor Lane
5d. City, state, zip:
Charlotte, NC 28211
5e. Telephone no.:
704-512-1206
5f. Fax no...
no fax
5g. Email address:
[e-mail]
Page 2 of 10
PCN Form — Version 1.4 January 2009

B.
Project Information and Prior Project History
1.
Property Identification
1a. Property identification no. (tax PIN or parcel ID):
4711804744.000
1 b. Site coordinates (in decimal degrees):
Latitude: 35.68724 Longitude: - -80.95957
1 c.
Property size:
—43.4 acres
2.
Surface Waters
2a. Name of nearest body of water to proposed project:
Catawba River (Lake Norman)
2b. Water Quality Classification of nearest receiving water:
WS -IV, B, CA
2c.
River basin:
Upper Catawba 03050101
3.
Project Description
3a.
Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application: The property is mostly woody with an existing road and two culverts in streams. The vicinty consists of
mostly forested land and scattered single family residences.
3b. List the total estimated acreage of all existing wetlands on the property: 0
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property: 1942 linear feet
3d.
Explain the purpose of the proposed project: To construct two driveways to two single family residences on the family
estate.
3e.
Describe the overall project in detail, including the type of equipment to be used: Culverts have been placed at two
locations along two unnamed tributaries to the Catawba River for driveway crossings. 70 linear feet of stream impact is
requested. Bulldozers and excavators will be used to complete construction.
4.
Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past?
❑ Yes ® No ❑ Unknown
Comments:
4b.
If the Corps made the jurisdictional determination, what type
of determination was made?
❑ preliminary ❑ Final
4c.
If yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
4d.
If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
5.
Project History
5a.
Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past?
❑ Yes ® No ❑ Unknown
5b.
If yes, explain in detail according to "help file" instructions.
6.
Future Project Plans
6a.
Is this a phased project?
❑ Yes ® No
6b.
If yes, explain.
Page 3 of 10
PCN Form — Version 1.4 January 2009

C. Proposed Impacts Inventory
1. Impacts Summary
1a. Which sections were completed below for your project (check all that apply):
❑ Wetlands ® Streams - tributaries ❑ Buffers ❑ Open Waters ❑ Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a.
Wetland impact
number
Permanent (P) or
Temporary T
2b.
Type of impact
2c.
Type of wetland
(if known)
2d. 2e.
Type of jurisdiction
Forested Corps (404, 10) or
DWQ (401, other)
2f.
Area of
impact
(acres)
W1 -
Choose one
Choose one
Yes/No -
W2 -
Choose one
Choose one
Yes/No -
W3 -
Choose one
Choose one
Yes/No -
W4 -
Choose one
Choose one
Yes/No -
W5 - I
Choose one
I Choose one
Yes/No -
W6 -
Choose one
Choose one
Yes/No -
2g. Total wetland impacts:
2h. Comments:
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a.
Stream impact
number -
Permanent (P) or
Temporary (T)
3b.
Type of impact
3c.
Stream name
3d.
Perennial
(PER) or
intermittent
(INT)?
3e.
Type of jurisdiction
(Corps - 404, 10
DWQ — non -404,
other)
3f.
Average
stream
width
(feet)
3g.
Impact
length
(linear
feet)
S1 P
Culvert
CH 100; UT to
Catawba River
PER
Corps
5
40
S2 P
Culvert
CH 200; UT to
Catawba River
PER
Corps
5
30
S3 -
Choose one
-
-
S4 -
Choose one
-
-
S5 -
Choose one
-
-
S6 -
Choose one
-
-
3h. Total stream and tributary impacts:
70
3i. Comments:
Page 4 of 10
PCN Form — Version 1.4 January 2009

4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impacts below.
4a.
Open water
impact number-
Permanent (P) or
Temporary T
4b.
Name of waterbody
(if applicable)
4c.
Type of impact
4d.
Waterbody
type
4e.
Area of impact (acres)
01 -
Choose one
Choose
02 -
Choose one
Choose
03 -
Choose one
Choose
04 -
Choose one
Choose
4f. Total open water impacts:
4g. Comments: there is no open water on site
5. Pond or Lake Construction
If pond or lake construction proposed, then complete the chart below.
5a.
Pond ID
number
5b.
Proposed use or purpose
of pond
5c.
Wetland Impacts (acres)
5d.
Stream Impacts (feet)
5e.
Upland
(acres)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
P1
Choose one
P2
Choose one
5f. Total:
5g. Comments:
5h. Is a dam high hazard permit required?
❑ Yes ❑ No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If any impacts require miti ation, then vou MUST fill out Section D of this form.
6a.Project is in which protected basin?
❑ Neuse ❑ Tar -Pamlico ❑ Catawba ❑ Randleman ❑ Other:
6b.
Buffer impact
number-
Permanent (P) or
Temporary (T)
6c.
Reason for impact
6d. 6e. 6f.
Buffer Zone 1
Stream name mitigation impact
required? (square
feet)
6g.
Zone 2
impact
(square
feet
B1 -
Yes/No
B2 -
Yes/No
B3 -
Yes/No
B4 - I
Yes/No
B5 -
Yes/No
B6 -
Yes/No
6h. Total buffer impacts:
6i. Comments:
Page 5 of 10
PCN Form - Version 1.4 January 2009

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
the only impacts requested are those necessary to gain access to high ground areas on the property, 1,872 linear feet of
stream has been avoided, impacts are proposed to less than 4% of the streams on site
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
the two culverts are the most minimal length in order to construct stable driveways while taking into account the existing
topography, the existing culverts will be replaced with larger culverts to handle the stream flows, these new culverts will be
buried during construction to allow for aquatic life passage
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for
impacts to Waters of the U.S. or Waters of the State?
❑ Yes ® No
2b. If yes, mitigation is required by (check all that apply):
❑ DWQ ❑ Corps
2c. If yes, which mitigation option will be used for this
project?
❑ Mitigation bank
ElPayment to in -lieu fee program
❑ Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank: none
3b. Credits Purchased (attach receipt and letter)
Type: Choose one
Type: Choose one
Type: Choose one
Quantity none
Quantity none
Quantity none
3c. Comments: none
4. Complete if Making a Payment to In -lieu Fee Program
4a. Approval letter from in -lieu fee program is attached.
❑ Yes
4b. Stream mitigation requested:
linear feet
4c. If using stream mitigation, stream temperature:
Choose one
4d. Buffer mitigation requested (DWQ only):
none square feet
4e. Riparian wetland mitigation requested:
none acres
4f. Non -riparian wetland mitigation requested:
none acres
4g. Coastal (tidal) wetland mitigation requested:
none acres
4h. Comments: no comments
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
not applicable
Page 6 of 10
PCN Form — Version 1.4 January 2009

6. Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires
❑ Yes ® No
buffer mitigation?
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.
6c.
6d.
6e.
Zone
Reason for impact
Total impact
Multiplier
Required mitigation
(square feet)
(square feet)
Zone 1
none
none
3 (2 for Catawba)
none
Zone 2
none
none
1.5
none
6f. Total buffer mitigation required:
none
6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in -lieu fee fund).
not applicable
6h. Comments: no comments
Page 7 of 10
PCN Form — Version 1.4 January 2009

E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers identified
❑ Yes ® No
within one of the NC Riparian Buffer Protection Rules?
1 b. If yes, then is a diffuse flow plan included? If no, explain why.
❑ Yes ❑ No
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project?
<24% %
2b. Does this project require a Stormwater Management Plan?
❑ Yes ® No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why: <24%, driveways and two homes on 43.4
acres
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
2e. Who will be responsible for the review of the Stormwater Management Plan?
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this project?
❑ Phase II
3b. Which of the following locally -implemented stormwater management programs
❑ NSW
❑ USMP
apply (check all that apply):
❑ Water Supply Watershed
❑ Other:
3c. Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ❑ No
attached?
4. DWQ Stormwater Program Review
❑ Coastal counties
❑ HQW
4a. Which of the following state -implemented stormwater management programs apply
❑ ORW
(check all that apply):
❑ Session Law 2006-246
❑ Other:
4b. Has the approved Stormwater Management Plan with proof of approval been
attached?
❑ Yes ® No
5. DWQ 401 Unit Stormwater Review
5a. Does the Stormwater Management Plan meet the appropriate requirements?
❑ Yes ❑ No
5b. Have all of the 401 Unit submittal requirements been met?
❑ Yes ❑ No
Page 8 of 10
PCN Form — Version 1.4 January 2009

F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1a. Does the project involve an expenditure of public (federal/state/local) funds or the
❑ Yes ® No
use of public (federal/state) land?
1 b. If you answered "yes" to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State
❑ Yes ❑ No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1 c. If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
❑ Yes ❑ No
letter.)
Comments:
2. Violations (DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards,
® Yes ❑ No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. Is this an after -the -fact permit application?
® Yes ❑ No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s): The land owner
was not aware of the criteria that determines a jurisdictional stream and during a site visit with Iredel County erosion control
the land owner was informed that he installed culverts in streams. Atlas Environmental was immediately contacted.
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in
❑ Yes ® No
additional development, which could impact nearby downstream water quality?
3b. If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
4. Sewage Disposal (DWQ Requirement)
4a. 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.
septic systems
Page 9 of 10
PCN Form — Version 1.4 January 2009

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or
❑ Yes ® No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act
® Yes ❑ No
impacts?
5c. If yes, indicate the USFWS Field Office you have contacted.
Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
[PAC and NCDENR Natural Heritage Program Map Viewer and GIS Layer
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?
❑ Yes ® No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation
❑ Yes ® No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
NCHPO GIS Service
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA -designated 100 -year floodplain?
F[:l es ® No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination? FEMA floodmaps GIS layer
Jennifer L Robertson
11/12/2018
Applicant/Agent's Printed Name
G�GK+
Date
Applicant/Agent's Signature
(Agent's signature is valid only if an authorization letter from the applicant
isprovided.)
Page 10 of 10
PCN Form — Version 1.4 January 2009

Go gle Maps
8430 University Executive Park Dr to 472 Drive 40.9 miles, 1 h
Pineville Rd, Statesville, NC 28677
Corps Driving Directions
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Map data ©2018 Google 5 mi a
8430 University Executive Park Dr
Charlotte, NC 28262
Get on 1-85 N from University Executive Park Dr and W
W.T.Harris Blvd
5 min (1.1 mi)
t 1. Head south toward University Executive Park Dr
472 ft
1♦ 2. Turn right onto University Executive Park Dr
0.3 mi
41 3. Turn left onto W W.T.Harris Blvd
0.4 mi
A 4. Turn right onto the Interstate 85 N ramp
0.3 mi
Take 1-485 Outer and 1-77 N to NC -115 N/US-21 N in
Barringer. Take exit 42 from 1-77 N
29 min (31.4 mi)
5. Merge onto I-85 N
2.0 mi

6. Use the right 2 lanes to take exit 48 toward
Huntersville
1.5 mi
A 7. Merge onto 1-485 Outer
4.6 mi
8. Use the right 2 lanes to take exit 23 C -A for I-77
toward Statesville/Charlotte
1.1 mi
9. Keep right at the fork to continue on Exit 2313,
follow signs for Interstate 77 N/Statesville and
merge onto 1-77 N
21.9 mi
10. Take exit 42 for US-21/NC-115 toward Troutman
0.2 mi
Continue on NC -115 NMS -21 N. Take Talley St to Pineville
Rd in Fallstown
14 min (8.4 mi)
'1 11. Use the left 2 lanes to turn left onto NC -115
N/US-21 N (signs for 1-77 S)
0
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3.2 mi
'1 12. Turn left onto Talley St
2.1 mi
41 13. Turn left onto E Monbo Rd
2.1 mi
F* 14. Turn right onto Pineville Rd
Destination will be on the left
1.0 mi
472 Pineville Rd
Statesville, NC 28677
These directions are for planning purposes only.
You may find that construction projects, traffic,
weather, or other events may cause conditions to
differ from the map results, and you should plan
your route accordingly. You must obey all signs or
notices regarding your route.

Go gle Maps 610 East Center Avenue, Mooresville, NC Drive 16.5 miles, 27 min
to 472 Pineville Rd, Statesville, NC 28677
DWR driving directions
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610 E Center Ave
Mooresville, NC 28115
Take NC-115 N, Cornelius Rd and Perth Rd to Hicks Creek
Rd in Fallstown
20 min (11.4 mi)
t 1. Head west on E Center Ave toward Cedar St
0.2 mi
N 2. Turn right onto N Maple St
0.2 mi
*1 3. Turn left onto E Iredell Ave
0.3 mi
r' 4. Turn right onto NC-115 N/N Broad St
0 Continue to follow NC-115 N
2.1 mi
41 5. Turn left onto Connector Rd
0.8 mi
t 6. Continue onto Cornelius Rd
2.4 mi

N 7. Turn right onto Judas Rd
r' 8. Turn right onto Perth Rd
*1 9. Turn left onto State Park Rd
r► 10. Turn right onto Hicks Creek Rd
1.2 mi
3.0 mi
1.1 mi
3 min (2.0 mi)
Continue on E Monbo Rd. Drive to Pineville Rd
4 min (3.1 mi)
41 11. Turn left onto E Monbo Rd
2.1 mi
r' 12. Turn right onto Pineville Rd
4) Destination will be on the left
1.0 mi
472 Pineville Rd
Statesville, NC 28677
These directions are for planning purposes only.
You may find that construction projects, traffic,
weather, or other events may cause conditions to
differ from the map results, and you should plan
your route accordingly. You must obey all signs or
notices regarding your route.

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Date: October 12, 2018

,q"VERQNMENTAL
Project Name: Tomas Cruz Pineville Road
Location: 472 Pineville Roa, Statesville NC 28677
For: Tomas Cruz
Coordinates: 35.68742, -80.95696
Date: October 12, 2018

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Project Name: Tomas Cruz Pineville Road
Location: 472 Pineville Roa, Statesville NC 28677
For: Tomas Cruz
Coordinates: 35.68742, -80.95696
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Date: October 12, 2018

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Location: 472 Pineville Roa, Statesville NC 28677
For: Tomas Cruz
Coordinates: 35.68742, -80.95696
Date: October 12, 2018

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Project Name: Tomas Cruz Pineville Road
Location: 472 Pineville Roa, Statesville NC 28677
VIRONMENTAL For: Tomas Cruz
Coordinates: 35.68742, -80.95696
11171 �� ft
Date: October 12, 2018

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VIRQNMENTAL
0
Project Name: Tomas Cruz Pineville Road
Location: 472 Pineville Roa, Statesville NC 28677
For: Tomas Cruz
Coordinates: 35.68742, -80.95696
Date: October 12, 2018
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0 0.5 1 1.5 2 Miles

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Project Name: Tomas Cruz Pineville Road
Location: 472 Pineville Roa, Statesville NC 28677
For: Tomas Cruz
Coordinates: 35.68742, -80.95696
Date: October 12, 2018

Legend
Boundary
HUC 8
VIRONMENTAL
HUC 8
Upper Catawba03050101
Project Name: Tomas Cruz Pineville Road
Location: 472 Pineville Roa, Statesville NC 28677
For: Tomas Cruz
Coordinates: 35.68742, -80.95696
South Yadkin03040102
fDat"ctober 12, 2018
0 0.5 1 1.5 2 Miles

35° 41'23" N
35° 41' 3" N
j Soil Map—Iredell County, North Carolina
w a
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Map Scale: 1:4,430 K printed on A brds:ape (11" x 8.5") sheet
Metas
8 NN0 50 100 20D 30D
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0 2DD 400 800 120D
Map prgec ion: Web Menafrlr Comer o3ordiret s: WGS84 Edge tib: UrM Zane 17N WGS84
LNatural Resources Web Soil Survey
Conservation Service National Cooperative Soil Survey
A 31'(9 1', L El'
Project Name: Tomas Cruz Pineville Road
ILocation: 472 Pineville Roa, Statesville NC 28677
For: Tomas Cruz
Coordinates: 35.68742, -80.95696
Date: October 12, 2018
35° 41'23"N
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10/15/2018
Page 1 of 3

Iff-11M*04N01
Area of Interest (AOI)
7
Area of Interest (AOI)
Soils
Very Stony Spot
Soil Map Unit Polygons
rH„I
Soil Map Unit Lines
Other
Soil Map Unit Points
Special
Point Features
Blowout
Borrow Pit
Xt
Clay Spot
O
Closed Depression
Gravel Pit
o.
Gravelly Spot
0
Landfill
Lava Flow
Marsh or swamp
Mine or Quarry
®
Miscellaneous Water
0
Perennial Water
%,
Rock Outcrop
,+,
Saline Spot
Sandy Spot
Severely Eroded Spot
Sinkhole
Slide or Slip
Sodic Spot
USDA Natural Resources
Conservation Service
Soil Map—Iredell County, North Carolina
(Boundary)
Transportation
}+{ Rails
ti Interstate Highways
US Routes
Major Roads
Local Roads
Background
. Aerial Photography
Web Soil Survey
National Cooperative Soil Survey
Project Name: Tomas Cruz Pineville Road
Location: 472 Pineville Roar Statesville NC 28677
For: Tomas Cruz
Coordinates: 35.68742, -80.95696
MAP INFORMATION
The soil surveys that comprise your AOI were mapped at
1:12,000.
Warning: Soil Map may not be valid at this scale.
Enlargement of maps beyond the scale of mapping can cause
misunderstanding of the detail of mapping and accuracy of soil
line placement. The maps do not show the small areas of
contrasting soils that could have been shown at a more detailed
scale.
Please rely on the bar scale on each map sheet for map
measurements.
Source of Map: Natural Resources Conservation Service
Web Soil Survey URL:
Coordinate System: Web Mercator (EPSG:3857)
Maps from the Web Soil Survey are based on the Web Mercator
projection, which preserves direction and shape but distorts
distance and area. A projection that preserves area, such as the
Albers equal-area conic projection, should be used if more
accurate calculations of distance or area are required.
This product is generated from the USDA-NRCS certified data as
of the version date(s) listed below.
Soil Survey Area: Iredell County, North Carolina
Survey Area Data: Version 23, Sep 10, 2018
Soil map units are labeled (as space allows) for map scales
1:50,000 or larger.
Date(s) aerial images were photographed: Apr 8, 2015—Nov 28,
2017
The orthophoto or other base map on which the soil lines were
compiled and digitized probably differs from the background
imagery displayed on these maps. As a result, some minor
shifting of map unit boundaries may be evident.
Date: October 12, 2018
10/15/2018
Page 2 of 3
Spoil Area
Stony Spot
Very Stony Spot
t
Wet Spot
Other
.�
Special Line Features
Water Features
Streams and Canals
Transportation
}+{ Rails
ti Interstate Highways
US Routes
Major Roads
Local Roads
Background
. Aerial Photography
Web Soil Survey
National Cooperative Soil Survey
Project Name: Tomas Cruz Pineville Road
Location: 472 Pineville Roar Statesville NC 28677
For: Tomas Cruz
Coordinates: 35.68742, -80.95696
MAP INFORMATION
The soil surveys that comprise your AOI were mapped at
1:12,000.
Warning: Soil Map may not be valid at this scale.
Enlargement of maps beyond the scale of mapping can cause
misunderstanding of the detail of mapping and accuracy of soil
line placement. The maps do not show the small areas of
contrasting soils that could have been shown at a more detailed
scale.
Please rely on the bar scale on each map sheet for map
measurements.
Source of Map: Natural Resources Conservation Service
Web Soil Survey URL:
Coordinate System: Web Mercator (EPSG:3857)
Maps from the Web Soil Survey are based on the Web Mercator
projection, which preserves direction and shape but distorts
distance and area. A projection that preserves area, such as the
Albers equal-area conic projection, should be used if more
accurate calculations of distance or area are required.
This product is generated from the USDA-NRCS certified data as
of the version date(s) listed below.
Soil Survey Area: Iredell County, North Carolina
Survey Area Data: Version 23, Sep 10, 2018
Soil map units are labeled (as space allows) for map scales
1:50,000 or larger.
Date(s) aerial images were photographed: Apr 8, 2015—Nov 28,
2017
The orthophoto or other base map on which the soil lines were
compiled and digitized probably differs from the background
imagery displayed on these maps. As a result, some minor
shifting of map unit boundaries may be evident.
Date: October 12, 2018
10/15/2018
Page 2 of 3

ChP
Map Unit Legend
Map Unit Symbol Map Unit Name Acres in AOI Percent of AOI
Chewacla loam 0 to 2 percent
44
10 1%
Natural Resources
Conservation Service
Web Soil Survey
National Cooperative Soil Survey
Project Name: Tomas Cruz Pineville Road
Location: 472 Pineville Roa, Statesville NC 28677
For: Tomas Cruz
Coordinates: 35.68742, -80.95696
Date: October 12, 2018
10/15/2018
Page 3 of 3
slopes, frequently flooded
Madison-Udorthents complex,
MaD4
1.3 2.9%
2 to 15 percent slopes,
gullied
3.1 7.1%
MaE4
Madison-Udorthents complex,
15 to 25 percent slopes,
gullied
MaF4
Madison-Udorthents complex,
0.1
0.2%
25 to 45 percent slopes,
gullied
PaF
Pacolet sandy loam, 25 to 45
10.2
23.3%
percent slopes
PcB2
Pacolet sandy clay loam, 2 to 6
0.0
0.0%
percent slopes, moderately
eroded
PcC2
Pacolet sandy clay loam, 6 to
2.8
6.5%
10 percent slopes,
moderately eroded
PcD2
Pacolet sandy clay loam, 10 to
6.3
14.4%
15 percent slopes,
moderately eroded
PcE2
Pacolet sandy clay loam, 15 to
11.7
26.7%
25 percent slopes,
moderately eroded
PrE
Poindexter -Rowan complex,
0.9
2.0%
15 to 25 percent slopes
PrF
Poindexter -Rowan complex,
2.7
6.1%
25 to 45 percent slopes
RiF Rion sandy loam, 15 to 45 0.3
0.7%
percent slopes
Totals for Area of Interest 43.8
100.0%
Natural Resources
Conservation Service
Web Soil Survey
National Cooperative Soil Survey
Project Name: Tomas Cruz Pineville Road
Location: 472 Pineville Roa, Statesville NC 28677
For: Tomas Cruz
Coordinates: 35.68742, -80.95696
Date: October 12, 2018
10/15/2018
Page 3 of 3

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Project Name: Tomas Cruz Pineville Road
Location: 472 Pineville Roa, Statesville NC 28677
For: Tomas Cruz
Coordinates: 35.68742, -80.95696
Project Location
Date: October 12, 2018
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Project Name: Tomas Cruz Pineville Road
Location: 472 Pineville Roa, Statesville NC 28677
For: Tomas Cruz
Coordinates: 35.68742, -80.95696
Project Location
Date: October 12, 2018
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