20090787 Ver 1_401 Application_20090709

Michael Engineering, Inc.
8
- 800000 Regency Parkway
LETTER OF TRANSMITTAL
Suite 200
aker Cary, North Carolina 27518
Phone: [phone]
Fax: [phone] O O 8 PSI
TO: NC Division of Water Quality RE: Permit Application for 401 permit for the
Parkview Building Pilot Knob Golf Course SV?R R
estoration
Project Mrs 2321 Crabtree Blvd'
Raleigh, NC 27604 , E
ATTENTION: Ms. Laurie Dennison -'UL 1 r Lr?'
DATE: July 17, 2009 JOB NO. 112699 VELAR
Yr?7C,?,;?5 ' u. ?ktF?; CI?RI?TY
We are sending via:
0 Fax Regular Mail ? Pick-up OX Hand Delivered
The following items:
0 Correspondence OX Plans Specifications FX Other as listed below:
COPIES DATE NO. DESCRIPTION
5 Design Plans
5 SHPO Letter
5 PCN form
5 Maps of Project
5 Landowner Authorization Forms
5 Erosion Control Narrative and Construction Specifications
5 Sediment and Erosion Control Checklist
5 Financial Responsibility Form
1 Check for Processing Fee - $570
THESE ARE TRANSMITTED as checked below:

eX For Approval
R As Requested a Approved As Submitted 8 Returned For Corrections
For Your Use X For Permitting Approved As Noted Forward To Subcontractor
REMARKS:
Please find enclosed an application for DWQ's 401 Permit along with supporting documentation for the Pilot
Knob Golf Course Stream Restoration Site in Surry County. If you have any questions, please call me at (919)
459-9048.
COPY TO: File SIGNED: Jacob Byers, EI
Michael Baker Engineering, Inc.
8000 Regency Parkway
Suite 200
Cary, North Carolina 27518
Phone: [phone]
Fax: [phone]
Mr. Monte Matthews
Raleigh Regulatory Field Office
Department of the Army, Corps of Engineers
3331 Heritage Trade Drive, Suite 105
Wake Forest, NC 27587
Ms. Laurie Dennison
NC Division of Water Quality
401/Wetlands Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
July 17, 2009
Re: Pilot Knob Golf Course Stream Restoration Project
401/404 Pre-Construction Notification Application
Dear Mr. Matthews and Ms. Dennison:
Enclosed for your consideration and approval is the Pre-Construction Notification for the US Army Corps
nationwide permit 27 and the Division of Water Quality's general certification 3495 for stream restoration,
enhancement, and stabilization for the Pilot Knob Golf Course Stream Restoration Project. This project is
located in Surry County. Also enclosed are copies of the Pilot Knob Golf Course Stream Restoration Plan for
your reference in reviewing the PCN application. Thank you in advance for your assistance.
The project meets the DWQ definition of stream restoration activities greater than 150 feet and
funding was provided by Clean Water Management Trust Fund. Therefore a permitting fee has
been included with this package. This is not for a stream mitigation project.
If I can be of any further assistance, please contact me at [phone].
Sincerely,
I
Yn b Byers,
osu re : P NC C Construction Document, Landowner Authorization Form, Check for permitting
CC: Ron Linville
AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. PLAN NO.
STREET ADDRESS:
PARCEL ID: 5965-00-83-0757
Please print: W. Harold Boles
Property Owner:
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
Joshua White, PG Of Michael Baker Engineering, Inc.
(Contractor / Agent) (Name of consulting firm)
to act on my behalf and take all actions necessary for the processing, issuance and acceptance of
this permit or certification and any and all standard and special conditions attached.
Property Owner's Address (if different than property above):
PO Box 38 Pinnacle, NC 27043
Telephone: [phone]
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Authorized Signature
Dat
Authorized Signature
Date:
.09 0 78 7
o?oF wArF9oG
h r
O <
Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.0 November 2008
Pre-Construction Notification (PCN) Form
A. Applicant Information
1. Processing
1a. Type(s) of approval sought from the
Corps:
®Section 404 Permit ? Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: 27 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps? ® Yes ? No
id. 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
le. Is this notification solely for the record
because written approval is not required? For the record only for DWQ 401
Certification:
? Yes ® No For the record only for Corps Permit:

? Yes ® No
if. 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
1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below. ? Yes ® No
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ? Yes ® No
2. Project Information
2a. Name of project: Pilot Knob Golf Couse Stream Restoration and Enhancement Project
2b. County: Surry
2c. Nearest municipality / town: Pilot Mountain
2d. Subdivision name: N/A
2e. NCDOT only, T.I.P. or state
project no: N/A
3. Owner Information
3a. Name on Recorded Deed: See Attached W 4.. o rV14L 2),p
3b. Deed Book and Page No. See Attached 20 ti
3c. Responsible Parry (for LLC if

applicable):
N/A
:OF,.itR-WTFR.QUALITY
4V TLAr"D,? _M$TCR"MATE'kIMP
3d. Street address: See Attached
3e. City, state, zip: See Attached
3f. Telephone no.: See Attached
3g. Fax no.: See Attached
3h. Email address: N/A
* k
iJ
NCH
Page 1 of 12
PCN Form - Version 1.0 November 2008 Version
Section A. Applicant Information, continued
4. Applicant Information (if different from owner)
4a. Applicant is: ? Agent ® Other, specify: Grant Recipient
4b. Name: Charles Anderson
4c. Business name
(if applicabie): Resource Institute, Inc.
4d. Street odXas: 2714 Henning Drive
4e. Cit,state, zip: Winston-Salem, NC, 27106
4f. Telephone no.: 336-917-3060
4g. Fax no.:
4h. Email address: [e-mail]
5. Agent/Consultant Information (if applicable)
5a. Name: Joshua White
5b. Business name
(if applicable): Michael Baker Engineering, Inc.
5c. Street address: 8000 Regency Parkway Suite 200
5d. City, state, zip: Cary, NC, 27518
5e. Telephone no.: 919-463-5488
5f. Fax no.: 919-463-5490
5g. Email address: [e-mail]
Page 2 of 12
PCN Form - November 2008 Version
B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): See Attached
1b. Site coordinates (in decimal degrees): See Attached 'N - See Attached 'W
1 c. Property size: See Attached acres
2. Surface Waters
2a. Name of nearest body-of water (stream, river, etc.) to Ararat River
proposed project:
2b. Water Quality Classification of nearest receiving water: C
2c. River basin: Yadkin Pee-Dee
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 upper end of the stream emerges from a wooded area where it is slightly incised with eroding banks. The stream
then flows through the fairway of Pilot Knob Park golf course where it is narrow and grass lined with little to no habitat.
Towards the lower section, the streams begins to flow on the edge of the golf course instead of through the fairway. The
golf course is on the right bank and woods or crop fields are on the left bank. This section is incised with steep eroding
banks that are vertical in some places. Besides the grass of the fairway there is little to no vegetation to hold the right
bank in place in the lower section.
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:
3,712 linear feet
3d. Explain the purpose of the proposed project:
To restore, stabalize and/or enhance highly degraded streams and ecosystems and to establish permanent vegetative
buffers surrounding the streams to protect their integrity in the future.
3e. Describe the overall project in detail, including the type of equipment to be used:
Restoration and enhancement along approximately 3,712 linear feet of Pilot Creek which is a tributary to the Ararat River
near the city of Pilot Mountain. Work will be conducted with dozers, track hoes and other equipment typically used for
stream restoration projects.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property / ? Yes ® No ? Unknown
project (including all prior phases) in the past?
4b. If the Corps made the jurisdictional determination, what type ? Preliminary ? Final
of determination was made.
4c. If yes, who delineated the jurisdictional areas? Agency/Consultant Company:
Name (if known): 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.
Page 3 of 12
PCN Form - Version 1.0 November 2008 Version
B. Project Information and Prior Project History
6. Future Project Plans
6a. Is this a phased project? ? Yes ® No
6b. If yes, explain.
Page 4 of 12
PCN Form - November 2008 Version
C. Proposed Impacts Inventory
1. Impacts Summary
la. 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. 2b. 2c. 2d. 2e. 2f.
Wetland impact Type of jurisdiction
number - Type of Type of wetland Forested (Corps - 404, Area of impact (acres)
Permanent (P) or impact (if known) DWQ - non-404, other)
Temporary
W1 ? P ? T ? Yes ? No ? Corps
? DWQ
W2 ? PEI T ? Yes ? No ? Corps
? DWQ
W3 ? PEI T ? Yes ? No ? Corps
? DWQ
W4 ? P ? T ? Yes ? No ? Corps
? DWQ
W5 ? P ? T ? Yes ? No ? Corps
? DWQ
W6 ? P ? T ? Yes ? No ? Corps
? DWQ
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. 3b. 3c. 3d. 3e. 3f.
Stream impact Type of Stream name Perennial (PER) or Average stream width (feet) Impact
number - impact intermittent (INT)? length
Permanent (P) or (linear feet)
Temporary (T)
Restorati
S1 ® P ? T on/Enhan Pilot Creek ® PER ? INT 16.9 3,712
cement
S2 ? P ? T ? PER ? INT
S3 ? P ? T ? PER ? INT
S4 ? P ? T ? PER ? INT
S5 ? P ? T ? PER ? INT
S6 ? P ? T ? PER ? INT
3g. Total stream and tributary impacts 3,712
3h. Comments:
Page 5 of 12
PCN Form - Version 1.0 November 2008 Version
C. Proposed Impacts Inventory, continued
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 individual) list all o en water impacts below.
4a. 4b. 4c. 4d. 4e.
Open water Name of
impact number waterbody Type of impact Waterbody type Area of impact (acres)
- Permanent (if
(P) or applicable)
-Temporary
01 ?P?T
02 ?P?T
03 ?P?T
04 ?P?T
4f. Total open water impacts
4g. Comments:
Page 6 of 12
PCN Form - November 2008 Version
C. Proposed Impacts Inventory, continued
5. Pond or Lake Construction
If and or lake construction proposed, then complete the chart below.
5a. 5b. 5c. 5d. 5e.
Wetland Impacts (acres) Stream Impacts (feet) Upland
Pond ID Proposed use or (acres)
number purpose of pond
Flooded Filled Excavated Flooded Filled Excavated Flooded
P1
P2
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 an impacts require mitigation, then ou MUST fill out Section D of this form.
6a.
? Neuse ? Tar-Pamlico ? Other:
Project is in which protected basin? ? Catawba ? Randleman
6b. 6c. 6d. 6e. 6f. 6g.
Buffer impact
number - Reason Buffer Zone 1 impact (square Zone 2 impact
Permanent (P) for impact Stream name mitigation feet) (square feet)
or Temporary required?
T
B1 ?P?T ?Yes ?No
B2 ?P?T ?Yes ?No
B3 ? P ? T ? Yes ? No
6h. Tota l buffer impacts
6i. Comments:
Page 7 of 12
PCN Form - November 2008 Version
D. Impact Justification and Mitigation
1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
Proposed impacts are required to restore and enhance stream functions and bank stablility. Project will result in restoring
or enhanceing approximately 3,712 linear feet (LF) of stream along Pilot Creek which is a tributary to the Ararat River.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Contractor will work from stream banks and only enter the channel when necessary in order to reduce the impacts.
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

? Payment to in lieu fee program
? Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter) Type Quantity
3c. Comments:
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: warm, cool, cold
4d. Buffer mitigation requested (DWQ only): square feet
4e. Riparian wetland mitigation requested: acres
4f. Non-riparian wetland mitigation requested: acres
4g. Coastal (tidal) wetland mitigation requested: acres
4h.. 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.
Page 8 of 12
PCN Form - Version 1.0 November 2008 Version
D. Impact Justification and Mitigation, continued
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
buffer mitigation? ? Yes ® No
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.
Zone Reason for impact Total impact
(square feet) Multiplier Required mitigation
(square feet)
Zone 1 3 (2 for Catawba)
Zone 2 1.5
Total buffer mitigation required:
6c. 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).
6d. Comments:
Page 9 of 12
PCN Form - November 2008 Version
E. Stormwater Management and Diffuse Flow Plan (required by DWO)
1. Diffuse Flow Plan
la. 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? ? Yes ? No
2. Determination if the Pro'ect Requires a Stormwater Management Plan
2a. Does the project require a Non-404 Jurisdictional General Permit? ? Yes ® No
2b. Is the project subject to General Certification 3704 or 3705? ? Yes ® No
3. Determination of Stormwater Review Jurisdiction
3a. Is this project subject to any of the following state-implemented stormwater ? Coastal counties
management programs (check all that apply)? ? HOW
? ORW
If so, attach one copy of the approval letter from the DWO and one copy of the ? Session Law 2006-246
approved stormwater management plan. ? Other:
3b. In which local government's jurisdiction is this project? Town of Pilot Mountain
3c. Is this local government certified to implement a state stormwater program? ? Yes ? No
If so, attach one copy of the approval letter from the local government and one copy
of the approved stormwater management plan (or one copy of the approved
Stormwater management plan stamped as approved).
4. Information Required for DWG 401 Unit Stormwater Review
4a. What is the overall percent imperviousness according to the most current site plan? < 5%
4b. Does this project contain any areas that meet the criteria for "high density" per ? Yes ® No
General Certifications 3704 and 3705?
4c. If the site is over 24% impervious and/or contains high density areas, then provide a brief narrative description of the
stormwater management plan.
4d. Has a completed BMP Supplement Form with all required items been submitted ? Yes ? No
for each stormwater BMP?
Page 10 of 12
PCN Form - Version 1.0 November 2008 Version
F. Supplementary Information
1. Environmental Documentation (DWO Requirement)
Ia. Does the project involve an expenditure of public (federal/state/local) funds or the Y
® es ? 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
letter.) ? Yes ? No
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):
3. Cumulative Impacts (DWO 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.
Page 11 of 12
PCN Form - Version 1.0 November 2008 Version
F. Supplementary Information, continued
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?
El Raleigh
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?
NCWRC Natural Heritage website, Natural Heritage workroom
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?
USFWS, DWQ Water Bodies
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?
North Carolina Office of Archives and History website was searched. A letter was. also sent to the NC State Historic
Preservation Office. See attached SHPO approval letter.
a. Flood Zone Designation (Corps Requirement)
Be. Will this project occur in a FEMA-designated 100-year floodplain? ® Yes ? No
8b. If yes, explain how project meets FEMA requirements: enhancement occurring will not change the current dimension,
pattern, or profile of the channel. There will not be an increase in the flood levels. This was expressed in a meeting and
agreed upon with Surry County's local floodplain manager.
8c. What source(s) did you use to make the floodplain determination? North Carolina Floodplain Mapping Information System

J L" UV v F'? (f v6,
Applicant/Agent's Printed Name Ap licant/Agent's Signature
(Agent's signature is valid only if an authorization letter from the applicant
Date
is provided.)
Page 12 of 12
PCN Form - November 2008 Version

Pilot Knob Park Stream Enhancement Project
1.
Landowner Information:
Name on Recorded Deed: Pilot Knob Park INC
Deed Book No.: 0315
Page No.: 0949
Address: 450 Club House Drive Pilot Mountain, NC 27041
Phone: [phone]
Fax: [phone]
Email: N/A
Property Identification:
Parcel ID: 5965-00-75-2033
Property Size (Ac): 168.59
Site Coordinates: 36.365N, 80.471W
2.
Landowner Information:
Name on Recorded Deed: W. Harold Boles, Annis Boles
Deed Book No.: 0466
Page No.: 0901
Address: PO Box 38 Pinnacle, NC 27043
Phone: [phone]
Fax: N/A
Email: N/A
Property Identification:
Parcel ID: 5965-00-83-0757
Property Size (Ac): 58.58
Site Coordinates: 36.361N, 80.467W
03/25/2009 10:17 19194635490 MICHAEL BAKER CORP PAGE 02/02
AGENT AUTHORIZATION FORM
PROPERTY LEG. ILL DESCRIPTION:
LOT No. PLAN NO. PARCEL ID:
STREETADDREZ: 450 Clubhouse Drive, Pilot
Please print: Pilot Knob Park CC
Property Owne :
Property owe
The undersign d, registered property owners of the above noted
Joshua White, PG of Michael Baker
(Contractor / A;aent) (Name of consulting
to act on my b;!half and take all actlons necessary for the processing,
this permit or ertifleatlon and any and all standard and special condll
Property Owne is Address (if different than property above):
Telephone [phone]
, Inc.
acceptance of
We hereby cep tify the above Information submitted In this application I s true and tccurate to the
best of our krn mledge.
Authorized sly
nature--Date. 7 -?
Authorized
Date:
27041
do herkbv authorize
N
ot Mountain
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Project Location
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Figure 1 - Vicinity Map
------? Pilot Knob Country Club
? 89
Pilot Mountain, NC
Project
i 601 Location
52 0 750 1,500 3,000
Feet
Surry County, NC ) -?` ^S v i M h NB ka E Bireering lnc.
L-• J -ill $ yniSeEi,?E1'S':
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Drainage Area 1.45 mit
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-
8000
lencyP Engineering, Inc. Figure 2 - Watershed Map
8000 Regency Parkway Sure 200 0 500 1,000 2,000
mplaker Cary. North Carolina 27518 Pilot Knob Country Club
Phone. [phone] Feet Pilot Mountain, NC
Fax [phone]

Soil Types , N
BdD - Braddock fine sandy loam, 8-15% slopes j
BpC - Braddock-Pilot Mountain complex, 8-15% slopes, rubbly FeD2
- BpD - Baddock-Pilot Mountain complex, 15-45% slopes, rubbly
CsA- Colvard and Suches soils, 0-3% slopes, occasionally flooded
FeB2 - Fairview sandy clay loam, 2-8% slopes, moderately eroded
FeC2
FeC2 - Fairview sandy clay loam, 8-15% slopes, moderately eroded
F FeD2 - Fairview sandy clay loam, 15-25% slopes, moderately eroded
Water
WfC2 - Woolwine-Fairview-Westfield complex. 8-15% slopes, moderately eroded =
WoD - Woo lwine- Fairview-Westfield complex, 15-25% slopes, stony
g WoE - Woolwine-Fairview-Westfield complex, 25-45% slopes, stony
W
If'
? s
/_' • . ? . ? ? FeD2 ,
\?
wk?
- - WoD
W
ME
WoD
WoD y
a
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BdD>
130C BpD Woo WoD WoD WoD
-r Michael Baker Engineering, Inc. Figure 3 - Soils Map
Cary ND¢hCarol 27518 0 150 300 600 Pilot Knob Country Club
P Feet Pilot Mountain, NC
Pilot Knob Park Stream Restoration Project Photo Log
Existing Condition Photos
lilt
-XV
R ?? 1
Upstream end of reach

;1
Looking upstream from culvert at 28+56

.$A SS - aP
t _ .3ya? .. +drr A?
Narrow channel around 22+50
-
a
Grade controlled by bedrock at around 40+20
Clogged culverts and cart path crossing at 28+56
Sediment accumulation around 29+50
Eroding bank near Station 33+50
'L
?4?•Y
t3? .y ?
r
.. is
• 5 .
Mid channel bar around 36+00

Culvert at 23+25
Incised stream with unstable banks near 41+00
V&
North Carolina Department of Cultural Resources
State Historic Preservation Office
Peter B. Sandbeck, Administrator
Michael F. Easley, Governor
Lisbeth C. Evans, Secretary
Jeffrey J. Crow, Deputy Secretary
January 9, 2009
Ken Gilland
Michael Baker Engineering, Inc.
8000 Regency Parkway
Suite 200
Cary, NC 27518
Re: The Mount Airy Country Club Project, Surry County, ER 08-2869
The Tom's Creek Project, Surry County, ER 08-2870
The Pilot Knob Park Project, Surry, County, ER 08-2871
The White Sulphur Springs Site, Surry County, ER 08-2872
Dear Mr. Gilland:
Thank you for your letter of November 25, 2008, concerning the above projects.
Office of Archives and History
Division of Historical Resources
David Brook, Director
We have conducted a review of the projects and are aware of no historic resources which would be affected by
the projects. Therefore, we have no comment on the projects as proposed.
The above comments are made pursuant to Section 106 of the National Historic Preservation Act and the
Advisory Council on Historic Preservation's Regulations for Compliance with Section 106 codified at 36 CFR
Part 800.
Thank you for your cooperation and consideration. If you have questions concerning the above comment,
please contact Renee Gledhill-Earley, environmental review coordinator, at 919-807-6579. In all future
communication concerning this project, please cite the above-referenced tracking number.
Sincerely,
etcr Sandbeck
Location: 109 East Jones Street, Raleigh NC 27601 Mailing Address: 4617 Mail Service Center, l1aleigh NC 27699-4617 Telephone/Fax: [phone]-6599
P;lo+ 1 Aab (rol; Coo,'Sc. P,ro'cc+
NORTH CAROLINA DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
LAND QUALITY SECTION
EROSION and SEDIMENTATION CONTROL PLAN PRELIMINARY REVIEW CHECKLIST
The following items shall be incorporated with respect to specific site conditions, in an erosion & sediment control plan:
LOCATION INFORMATION
Project location (roads, streets, landmarks)
J? North arrow and scale JA f -1
STOR?MWATER CALCULATIONS
/
t/ Pre-construction runoff calculations for each
GENERAL SITE FEATURES (Plan elements) Z
Legend: North arrow, scat etc
Property lines Sh+ `F"7/ M''y
Existing contours (topographic lines).>h+y-7Ec3-7
Proposed contoursShr 4-7
Limits of disturbed area (provide acreage total,
delineate limits, and label) 64A, ;C 3 ? 5F
AffG Planned and existing building locations and
elevations
Planned & existing road locations & elevations
MIA Lot and/or building numbers
Geologic features: rock outcrops, seeps,
springs, wetland and their limits, streams,
lakes, ponds, dams, etc.Ski+Zi E (3-7
Easements and drainage ways sk + q.- 7, 913-7
Profiles of streets, utilities, ditch lines, etc;; 8 -A
Stockpiled topsoil or subsoil locations 11! 4 J-S
If the same person conducts the land-disturbing activity &
any related borrow or waste activity, the related borrow or
waste activity shall constitute part of the land-disturbing
activity unless the borrow or waste activity is regulated
under the Mining Act of 1971, or is a landfill regulated by
the Division of Waste Management If the land-disturbing
activity and any related borrow or waste activity are not
conducted by the same person, they shall be considered
separate land-disturbing activities and must be permitted
either thru the Sedimentation Pollution Control Act as a
one-use borrow site or through the Mining Act.
Required Army Corps 404 permit and Water Quality 401
certification (e.g. stream disturbances over 150 linear feet)

AV-
outlet from the site (at peak discharge points)
Design calculations for peak discharges of
runoff (including the construction phase & the
final runoff coefficients of the site)
Design calcs of culverts and storm sewers
Discharge and velocity calculations for open
channel and ditch flows (easement & right-of-ways)
Design calcs of cross sections and method of
stabilization of existing and planned channels
(include temporary linings)
Design calcs and construction details of energy
dissipators below culvert and storm sewer
outlets (diameters & apron dimensions)
Design calcs and dimension of sediment basins
Surface area and settling efficiency information
for proposed sediment traps and/or basins
VEGETATIVE STABILIZATION
? Area & acreage to be vegetatively stabilized E4-1
Method of soil preparation 41AO1 01?+ /SP415
Seed type & rates (temporary & permanent)
A&A Fertilizer type and rates Sht /+
Mulch type and rates M^p,srit -1 !/ Sf 'fm- IA
NOTE: Plan should include provisions for groundcover
on exposed slopes within 21 calendar days
following completion of any phase of grading;
permanent groundcover for all disturbed areas
within 15 working days or 90 calendar days
(whichever is shorter) following completion of
construction or development.
FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
EROSION ,CONTROL MEASURES (on plan)

f
Legend E t Completed, signed & notarized Form
Accurate a
lication fee ( (
er acre
Location of temporary measures t e- 3 " pp
p
rounded up the next acre with no ceiling amount)
Location of permanent measures.5&* +h- 7 Certificate of assumed name, if the owner is a
Construction drawings and details forsi+ V 1D partnership
temporary and permanent measures Name of Registered Agent (if applicable)
Maintenance requirements of measures ,?. Copy of the most current Deed for the site
Contact person responsible for maintenance
ArA NOTE: For the Express Permitting Option, inquire at the
SITE DRAINAGE FEATURES local Regional Office for availability.
? Existing and planned drainage patterns (include NARRATIVE AND CONSTRUCTION SEQUENCE
off-site areas that drain through project)
Method of determination of and calculations for Narrative describing the nature & purpose of
Acreage of land being disturbed 01,&is, EG'I
? Size and location of culverts and sewers; 't-SA
Soil information: type, special characteristics,ywp;t?vt ; pr.iV
MLA Soil information below culvert storm outlets
Name and classification of receiving water
course or name of municipal operator (only
where stormwater discharges are to occur)
ArNe-,t-f Jvwrra f^ibc? P(Jlt
the construction activity
Construction sequence related to erosion and IV?fr+?? 'r??ts
sediment control (including installation of critical
measures prior to the initiation of the land-
disturbing activity & removal of measures after
areas they serve are permanently stabilized)
Bid specifications related only to erosion control
PILOT KNOB GOLF COURSE STREAM RESTORATION PROJECT
SURRY COUNTY, NORTH CAROLINA
EROSION CONTROL NARRATIVE
AND
TECHNICAL SPECIFICATIONS
Prepared for:
Resource Institute, Inc.
Prepared by:
Michael Baker Engineering, Inc.
8000 Regency Parkway, Suite 200
Cary, NC 27518
July 2009
TABLE OF CONTENTS
Introduction ............................................................................................................................... 1
Project Description .................................................................................................................... 1
Site Conditions .......................................................................................................................... 1
Erosion and Sedimentation Control Measures .......................................................................... 1
Design Standards ...................................................................................................................... 2
Maintenance Plan ...................................................................................................................... 2
TECHNICAL SPECIFICATIONS ........................................................................................... 3
A. GENERAL SPECIFICATIONS .......................................................................................... 3
B. CONSTRUCTION SURVEY .............................................................................................. 3
C. MOBILIZATION AND DEMOBILIZATION .................................................................... 3
D. POLLUTION CONTROL STRUCTURES (Temporary Silt Fence) .................................. 5
E. PUMP-AROUND OPERATIONS ..................................................................................... .. 6
F. SPECIAL STILLING BASINS ............................................................................................ 8
G. IMPERVIOUS DIKE ........................................................................................................... 8
H. POLLUTION CONTROL SEEDING AND MULCHING ................................................. 9
1. PERMANENT SEED .......................................................................................................... 10
J. EXCAVATION, FILL, AND GRADING .......................................................................... 11
K. STONE ............................................................................................................................... 13
L. INSTREAM STRUCTURES ............................................................................................. 14
M. FILTER FABRIC .............................................................................................................. 15
0. COIR FIBER MATTING .................................................................................................. 15
P. TRANSPLANTS ................................................................................................................ 17
Q. LIVE STAKING ................................................................................................................ 18
R. BARE-ROOT VEGETATION ......................................................................................... 19
S. SAFTEY FENCE ................................................................................................................ 20
T. CONSTRUCSTION SEQUENCE ..................................................................................... 20
0
INTRODUCTION
This narrative is submitted as part of the proposed Stream Restoration and Enhancement
Project Plan for the Pilot Knob Golf Course Stream Restoration Project. Construction of
the project will involve the restoration or enhancement of approximately 3,712 linear feet
(LF) of Pilot Creek, a tributary to the Ararat River (See Figure 1).
A 401 Certification from the NC Division of Water Quality has not been obtained. The
application for the 401 permit was submitted simultaneously with the Erosion Control
Permit package. Once the 401 Certification has been issued, Baker Engineering will fax
a copy to NC Division of Land Quality.
PROJECT DESCRIPTION
Baker Engineering proposes to restore or enhance 3,712 linear feet along Pilot Creek, a
tributary to the Ararat River. Pilot Creek flows through Pilot Knob Golf Course in Surry
County North Carolina near the Town of Pilot Mountain. The site lies in the Yadkin Pee-
Dee River Basin within North Carolina Division of Water Quality sub-basin 03-07-03.
The center point of the site is located at 36°21'43.71" N latitude and 80°28' 14.15" W
Longitude. The project drains 1.46 square miles (See Figure 2).
Most of Pilot Creek is open and mowed up to the stream bank except for small wooded
sections at the upper and lower ends of the reach. The lack of a riparian buffer has
created an incised stream. The project is located on Pilot Knob Park property. Pilot creek
provides little habitat and is being clogged by golf course grass. Total disturbed area for
stream and buffer restoration is approximately 8 acres.
SITE CONDITIONS
At present Pilot Creek is incised throughout most of the Reach. Also the lack of riparian
buffer is allowing the erosion of the streambank. The golf course is continually losing
area due to this erosion. This is also making the stream overly wide in places causing the
stream to be inefficient in transporting sediment resulting in the formation of mid-channel
bars. Parts of Pilot Creek are clogged with live grasses from the golf course are also
inhibiting the transport of sediment except at high flows. Pilot Creek offers little
bedform diversity throughout the section adjacent to the golf course. The lack of
bedform diversity provides no habitat for native wildlife species. The soils in the project
area are primarily Colvard and Suches soils (See Figure 3). Local relief within the
project site is approximately 50 feet. Surrounding properties are characterized primarily
by agricultural fields and wooded areas.
EROSION AND SEDIMENTATION CONTROL MEASURES
Erosion control methods to be used onsite include silt fences, temporary construction
entrances, rock dams, mulch, temporary seeding, permanent seeding, and erosion control
matting and a pump-around operation. All sediment and erosion control measures are to
be built according to the plans and specifications.
Bench grading activities will be graded away from the flowing channel. Cut material will
be stockpiled as shown on the plans. Silt fences will be used to prevent erosion of the
stockpiles toward the open stream areas on site.
Temporary rock dams will be installed on the downstream end of haul road ditch
crossings. Silt fences will be used to prevent erosion of disturbed ground toward any
flowing streams on site.
Pump around operations will be utilized.
DESIGN STANDARDS
Standard erosion control practices, methods, and procedures described in these plans and
specifications are based on those presented in the North Carolina Erosion and Sediment
Control Planning and Design Manual (2006).
MAINTENANCE PLAN
Qualified personnel on a daily basis will evaluate all temporary erosion and sediment
control practices for stability and operation. Weekly inspections will be performed and
logs kept. A rain gage will also be kept on site and rainfall amounts recorded. Any
repairs needed, will be performed immediately to maintain all practices as designed. The
selected Contractor will be responsible for the maintenance of temporary on-site erosion
control measures. The Contractor will be responsible for implementing and following the
approved Sediment and Erosion Control Plan.
Project Contacts:
Joshua White or Jake Byers
Michael Baker Engineering, Inc.
8000 Regency Parkway, Suite 200
Cary, NC 27518
[phone] Phone
[phone] Fax
2
CULVERT DESIGN CALCULATIONS
No culverts will be replaced within the Pilot Knob Golf Course Stream Restoration
Project.
TECHNICAL SPECIFICATIONS
A. GENERAL SPECIFICATIONS
1. Construction is scheduled for fall/winter 2009.
B. CONSTRUCTION SURVEY
The Contractor is not required to provide construction surveying or layout services and is
required to keep a laser level onsite and a person trained in its use for checking and
maintaining grades. The design firm will provide construction surveying or layout
services.
C. MOBILIZATION AND DEMOBILIZATION
SCOPE
The work shall consist of the mobilization and demobilization of the Contractor's forces
and equipment necessary for performing the work required under the contract. This work
shall not include mobilization and demobilization for specific items of work for which
payment is provided elsewhere in the contract. Mobilization will not be considered as
work in fulfilling requirement for commencement of work.
EQUIPMENT AND MATERIALS
Mobilization shall include all activities and costs for transportation of personnel,
equipment, and operating supplies to the site; establishment of offices, and other
necessary facilities for the Contractor's operations at the site; premiums paid for
performance and payment bonds, including coinsurance and reinsurance agreements as
applicable; and other items as specified in this specification.
Demobilization shall include all activities and costs for transportation of personnel,
equipment, and supplies not included in the contract from the site; including the
disassembly, removal and site clean up and repair of any facilities assembled on the site
for this contract.
This work includes mobilization and demobilization required by the contract at the time
of the award. If additional mobilization and demobilization activities and costs are
required during the performance of the contract as a result of the changed, deleted, or
3
added items of work for which the Contractor is entitled to an adjustment in contract
price, compensation for such costs will be included in the price adjustment for the item or
items of work changed or added.
METHODS
Items of work to be performed in conformance with these specification and construction
details therefore are:
(1) This item shall consist of all work necessary to mobilize and demobilize
construction equipment as described above.
(2) The Contractor is required to properly and safely identify and secure the
construction accesses, staging areas, and material handling areas. Prior to
construction activities, the Contractor shall identify and mark boundaries of the
staging area as directed by the Engineer. Acceptable materials for identifying the
construction areas include highly visible tape, road signs, barricades, cables, and
safety fencing.
(3) Stockpile all construction materials, including stone, riprap, gravel, erosion
control devices, etc. in the staging area. Any soil materials that are stockpiled
shall have a silt fence properly installed to ensure materials are contained. Silt
fence installation specifications are provided in the POLLUTION CONTROL
specifications and will not be bid under this section.
(4) To limit the disturbance of soils on site, the Contractor shall restrict the movement
of all construction equipment within sensitive areas. Prior to construction
activities, the Contractor shall identify the boundaries of all sensitive areas by
using a highly visible tape or orange boundary fencing, and will stake the limits of
where construction equipment is permitted to travel, as directed by the Engineer/
Project Manager.
(5) The Contractor shall provide watertight tanks or barrels sealed with plastic sheets
to be used to dispose of chemical pollutants, such as drained lubricating or
transmission oils, greases, soaps, concrete mixer wash water, asphalt, etc.,
produced as a by-product of the construction work. At the completion of
construction, facilities shall be disposed of without causing pollution.
(6) Chemical toilets shall be placed 100 feet from streams and in the staging area
away from heavy equipment. At the completion of construction work, facilities
shall be disposed of without causing pollution.
(7) The Contractor will identify all underground and aboveground utilities and is
responsible for ensuring that these utilities are not damaged during construction.
The Contractor will promptly notify the project engineer if there are conflicts
between the utilities and the design.
4
(8) The Contractor will install construction accesses per specification 6.06 in the
North Carolina Erosion and Sediment Control Planning and Design Manual
(2006) and shown on the drawing.
(9) The Contractor shall properly remove and discard debris and trash.
D. POLLUTION CONTROL STRUCTURES (TEMPORARY SILT FENCE)
SCOPE
The work shall consist of installing structural measures or performing work to control
erosion and minimize the production of sediment and other pollutants to water during
construction operations.
This item shall consist of all work necessary to control soil erosion and minimize the
introduction of sediment and other pollutants to waterways. Pollution control for any
disposal area is the responsibility of the Contractor unless the area is within the work
limits of this project.
Pursuant to NC Department of Environment and Natural Resources, Division of Water
Quality regulations, the Contractor shall follow the approved Sediment and Erosion
Control Plan for the site, as provided in the plans and these specifications. A copy of
General Permit No. NCGO10000 (General Permit To Discharge Stormwater Under the
National Pollutant Discharge Elimination System) will be supplied to the Contractor prior
to commencement of site work. The Contractor is required to follow the requirements of
permit NCGO10000, which includes the following conditions:
Weekly inspection of sediment and erosion control devices and documentation of
their condition. Sediment and erosion control devices shall also be inspected
within 24 hours following any rainfall event greater than 0.5 inches of rain per 24
hour period. Any devices which are not functioning adequately shall be
immediately reported to the Project Engineer/Manager and repaired.
A rainfall gage shall be maintained on the site and a record of rainfall amounts and
dates shall be kept.
A copy of the approved Sediment and Erosion Control Plan for the site, General
Permit No. NCG010000, log of control device inspections, and log of rainfall
events and amounts shall be kept in an accessible location on-site at all times
during the construction project.
The Contractor is responsible for following the approved Sediment and Erosion Control
Plan for the site and for following the requirements of General Permit No. NCG010000,
and assumes liability for any fines or regulatory actions that may be imposed by failure to
do so.
EQUIPMENT AND MATERIALS
Refer to the North Carolina Sediment and Erosion Control Manual (2006).
METHODS
The measures and works shall include, but are not limited to, the following:
Diversions and Temporary Sediment Traps - Diversions are used to divert water away
from work areas and to collect runoff from work areas for treatment by temporary
sediment traps. Temporary sediment traps will be installed at the end of the each new
section of stream channel as the section is being constructed. These works are temporary
and shall be removed and the area restored to its original state when they are no longer
needed or permanent measures are installed. Refer to practice 6.20 "Diversion" and 6.60
"Temporary Sediment Trap" in the North Carolina Sediment and Erosion Control Manual
(2006).
Sediment Fence (Silt Fence) - Geotextile sediment fences shall be used to trap sediment
from areas of limited runoff. Sediment filters shall be properly anchored to prevent
erosion under them. These works are temporary and shall be removed and the area
restored to its original state when they are no longer needed or permanent measures are
installed. Locations for sediment filters are shown on the plans. Refer to sediment fence
specifications (6.62) in the North Carolina Sediment and Erosion Control Manual (2006).
Other - Additional work as required by the Federal, State, or Local Government.
All pollution control measures and works shall be adequately maintained in a functional
condition as long as needed during the construction operation. All temporary measures
shall be removed and the site restored to as nearly original conditions as practical.
E. PUMP-AROUND OPERATIONS
SCOPE
The work covered by this section consists of furnishing, installing, maintaining and
removing any and all temporary channel diversions used on this project in conjunction
with the stream restoration construction. The contractor shall use a pump-around method
to accomplish this. The contractor is responsible for determining the location of the
impervious dikes. All grading, in-stream structures, and stabilization must be completed
in the work areas between the dikes. The pump-around shall provide a passageway for
the normal stream flow through the work site.
PUMP-AROUND PUMP
A pump shall be used to convey the base stream flow around the work area during
channel excavation, installation of structures, and stabilization. The pump used must be
6
able to convey 1 cubic feet per second (450 gallons per minute)*. The pump includes
temporary pipe in sufficient length to pump the water from the upstream side of the
upstream impervious dike to the special stilling basin or existing culvert as shown on the
plans.
x The required conveyance discharge shown is an estimate; the Contractor is responsible for the actual
pump size. The discharge is a baseflow estimate and does not include an additional requirement for
drawdown.
DEWATERING PUMP
A second pump shall be used to dewater the work area between the dikes. The pump
must be of sufficient size to dewater the work area and pump water from the bottom of
the work area to the special stilling basin as shown on the plans. The pump includes
temporary flexible hose in sufficient length to accomplish this task.
IMPERVIOUS DIKES
The work covered by this section consists of furnishing, installing, maintaining, and
removing an impervious dike for the purpose of diverting normal stream flow around the
working area. The Contractor shall construct an impervious dike in such a manner
approved by the Engineer/ Project Manager. The impervious dike shall not permit
seepage of water into the working area or contribute to siltation of the stream. The
impervious dike shall be constructed of an acceptable material as directed by the
Engineer/ Project Manager.
MATERIALS
Acceptable materials shall include but not be limited to sheet piles, sandbags, and/or the
placement of an acceptable size stone lined with polypropylene or other impervious
fabric.
CONSTRUCTION METHODS
Earth material shall not be used to construct an impervious dike when it is in direct
contact with the stream unless vegetation can be established before contact with the
stream takes place.
SPECIAL STILLING BASINS
MATERIALS
The special stilling basins shall be a water permeable fabric bag that traps sand, silt, and
fines as sediment laden water is pumped into it. The filter fabric shall meet the
requirements of Section 1056 for Type 2 Fabric.
7
CONSTRUCTION METHODS
The special stilling basin shall be a bag constructed to a minimum size of 10' x 15' (3m x
4.6m) made from a nonwoven fabric. It shall have a sewn-in 8 in. (20.3cm) (maximum)
spout for receiving pump discharge. The bag seams shall be sewn with a double needle
machine using a high strength thread. The seams shall have minimum wide width
strength as follows:
Test Method Minimum Specifications
ASTM D-4884 60 lb/in (10.7 kg/cm)
The fabric used to construct the bag shall be stabilized to provide resistance to ultra-
Violet degradation and meet the following specifications for flow rates, strength, and
permeability:
Property Test Method Minimum Specifications
English Metric
Weight ASTM D-3776 8.0 oz/yd 248.03 g/m
Grab tensile ASTM D-4632 200.0 lb 90.72 kg
Puncture ASTM D-4833 130.0 lb 58.97 kg
Flow rate ASTM D-4491 80.0 gal/min/sf 0.471/s/sm
Permittivity ASTM D-4991 1.5 1/sec
UV Resistance ASTM D-4355 70.0%
The special stilling basins shall be placed so the incoming water flows into and through
the bag without causing erosion. The bag will sit on Nonwoven Type 2 filter fabric on the
bottom. The contractor will grade the bed to ensure that the filtered water will exit at the
desired location. The exit location shall be chosen to prevent erosion. The neck or spout
of the bag shall be tied off tightly to stop the water from flowing out of the bag without
going through the walls. The special stilling basins shall be replaced and disposed of
when it is 3/4 full of sediment, when it is impractical for the bag to filter the sediment out
at a reasonable flow rate, or when it becomes punctured or torn. Prior approval from the
Engineer must be received before removal and replacement. The Contractor shall be
responsible for providing a sufficient quantity of bags to contain silt from pumped
effluent during construction..
F. SPECIAL STILLING BASINS
The special stilling basins are covered in detail under the "Pump-Around Operations"
section.
G. IMPERVIOUS DIKE
The impervious dikes are covered in detail under the "Pump-Around Operations" section
H. POLLUTION CONTROL SEEDING AND MULCHING
SCOPE
The work shall consist of installing measures or performing work to control erosion and
minimize the production of sediment and other pollutants to water and air during
construction operations. Temporary seeding will be used on all areas susceptible to
erosion, including, but not limited to ditch banks, access areas, steeper slopes, and areas
where excess soil will be spread over upslope fields. Seeding will take place
immediately after construction activities are completed in the disturbed areas. The work
shall consist of preparing the area, furnishing and placing seed and mulch, and anchoring
mulch in the designated areas as specified.
EQUIPMENT AND MATERIALS
Temporary Seeding
For temporary seeding, apply the following vegetation at the listed rates and times. A
combination of the two seed types shall be used during the boundary months of March,
April, August and September to ensure survival.
Temporary Seeding (September to March):
Rye grain 1301bs per acre
Temporary Seeding (April to August):
Browntop Millet 401bs per acre
Mulching
Mulching shall be used to provide temporary protection of soil surfaces from erosion.
Mulching should be performed within 48 hours of seeding. Grain straw mulch should be
applied on seeded areas at a rate of 130 bales per acre. Apply mulch uniformly.
METHODS
On sites where equipment can be operated safely, the seedbed shall be adequately
loosened. Disking may be needed in areas where soil is compacted. Steep banks may
require roughening, either by hand scarifying or by equipment, depending on site
conditions. The Engineer will determine condition needs onsite. If seeding is done
immediately following construction, seedbed preparation may not be required except on
compacted, polished or freshly cut areas.
Mulching is used to provide temporary protection of soil surfaces from erosion. Mulching
should be performed within 48 hours of temporary seeding. Grain straw mulch should be
applied on temporary seeded areas at a rate of 3 bales per 1,000 ft2 (130 bales per acre).
Mulch shall NOT be applied on streambanks when coir fiber matting matching C7
specifications is used. Apply mulch uniformly.
1. PERMANENT SEED
SCOPE
The work shall consist of applying permanent seeding on the site for the purposes of
establishing stream buffer, wetland vegetation and controlling erosion. Permanent
seeding will be placed on all disturbed areas targeted for stream buffer, or where grading
and earthmoving activities have left exposed soil when construction in the area is
completed. Seeding will take place immediately after construction activities are
completed. The work shall consist of furnishing and placing seed in designated areas.
EQUIPMENT AND MATERIALS
Apply the following vegetation at the listed rates. Species may be substituted or removed
from the specified mixtures upon approval of the Project Manager.
Seed Mixture:
Percent Seeding

Common Name
Scientific Name
of
Density Wetness
Mixture (lbs/acre) Tolerance
Redto A rostis alba 10% 1.5 FACW
Virginia

Wildr e
El mus vir inicus
15%
2.25 FAC
Switch grass Panicum vir inicus 15% 2.25 FAC+
Eastern Gamma Tripsacum
Grass dact loides 5% 0.75 FAC+
Pennsylvania Polygonum
Smartweed enns lvanicum 5% 0.75 FACW
Schizachyrium
Little Blue Stem sco arium 5% .75 FACU
Soft Rush Juncus e tsus 10% 1.5 FACW+
Lance-Leaved Coreopsis
Tick Seed lanceolata 10% 1.5 FAC
Tioga Deer Dichanthelium
Tongue clandestinum 15% 2.25 FACW
Indian Grass Sor astrum nutans 5% .75 FACU
Andropogon
Big Blue Stem erardii 5% .75 FACU
10
METHODS
It is anticipated that the soil will be sufficiently loosened after construction to allow for
immediate planting of seed. Disking may be needed in areas where soil is compacted.
Disking will be paid for under item J. Excavation, Fill, and Grading. The Engineer will
determine condition needs onsite.
Due to the small size of some permanent seed species and the low application rates, it
may be necessary to mix the permanent seed with temporary seed or sand to distribute the
seed at the stated application rate. If permanent seed is mixed with temporary seed, the
temporary seed shall not be applied at a greater application rate than stated under the
"POLLUTION CONTROL SEEDING AND MULCHING" specification without the
permission of the Engineer.
J. EXCAVATION, FILL, AND GRADING
SCOPE
The Contractor shall excavate and grade the Channel and floodplain areas according to
the design plans and as directed by the Engineer. Cross sections and contours are
provided in the drawings. The excavated materials will be placed in the stockpile areas
noted on the plans along the streams.
Some of the excavated material shall be used to fill and reshape banks as the design notes
or direction of the engineer. The fill should be compacted with heavy equipment and does
not have to meet specific compaction standards.
In areas where excavation depths will exceed one (1) foot, approximately 8 inches of
topsoil from the area will be stockpiled, and design grades should be cut 8 inches deeper
than shown on the plans. Topsoil will then be placed back over these areas to a depth of
approximately 8 inches to achieve design grades.
METHODS
GENERAL GRADING
The Contractor shall ensure that final grades on all floodplain and open field areas are
within 0.2 foot of the design contours shown on the plans. Bed elevations within the new
stream channel and elevations of instream structures shall be within 0.03 foot of the
design grades, unless otherwise directed by the Engineer.
SITE ROUGHING
Soil in the area of tree plantings shall be loosened to a depth of at least 8 to 10 inches.
This is necessary only on compacted soil.
11
CLEARING
Clearing will be necessary in some areas of the site. These areas are shown on the plans.
Prior to the clearing of these areas, vegetation appropriate for transplanting shall be
removed and either placed along the newly constructed channel, or stockpiled in an area
where the roots will remain wet until the transplants may be placed along the newly
constructed channel. These areas for stockpiling transplant material will be determined by
the Project Engineer.
Any cleared trees, snags, roots, stumps, etc. not used to stabilize the new stream channel
shall be removed from the site.
GRUBBING
Grubbing will be necessary in some areas of the site. Grubbing shall include satisfactory
removal and disposal of all trees, brush, stumps and other objectionable material. These
areas are shown on the plans. Prior to the grubbing of these areas, vegetation appropriate
for transplanting shall be removed and either placed along the newly constructed channel,
or stockpiled in an area where the roots will remain wet until the transplants may be
placed along the newly constructed channel. These areas for stockpiling transplant
material will be determined by the Project Engineer.
Any cleared trees, snags, roots, stumps, etc. not used to stabilize the new stream channel
shall be removed from the site.
DITCH PL UGS
Ditch plug areas will be constructed according to the detail located in the plans. Fill
material used for ditch plugs shall be free of debris, rocks, trash, etc. and shall consist of
compactable soil material. Fill shall be placed in the ditch plugs areas and compacted in
lifts of no more than 12 inches per lift. The completed ditch plugs shall be free of voids
and shall be impermeable to water flow through the block.
FILLED CHANNEL
The old channel will be filled with material from onsite. Fill material shall be placed in
the channel and compacted with construction equipment. Areas of channel which have
been filled shall have additional material mounded over the top of the fill to a depth of
approximately 6 inches to offset future settling. If debris, tree limbs, roots, etc. are
placed in the channel sections for burial, this material shall be placed at least 100 feet
from any junction, channel block, or channel which will receive flowing water after
construction. Under no circumstances will the Contractor place trash into filled channel
sections.
12
K. STONE
SCOPE
The work covered by this section consists of furnishing, stockpiling, placing and
maintaining an approved stone to be utilized to construct constructed riffle structures, silt
checks, and for use in other locations as directed by the Engineer.
EQUIPMENT AND MATERIALS
Stone for "Stone, Gravel" shall consist of uncrushed gravel. It shall be composed of
clean, tough, durable fragments free from fines, organic matter and deleterious
substances.
Stone for "Gravel (57)", "Class A", "Class B", "Class II," and "Boulders" shall consist of
blasted granite quarry stone stockpiled onsite and approved by the Engineer. The stone
shall be sound, tough, dense, resistant to the action of air and water, and suitable in all
other respects for the purpose intended.
All stone shall meet the approval of the Engineer. While no specific gradation is required,
the various sizes of the stone shall be equally distributed within the required size range.
The size of an individual stone particle will be determined by measuring its long
dimension.
REQUIRED STONE SIZES-INCHES
CLASS MINIMUM AVERAGE MAXIMUM
GRAVEL 57 0.25 0.5 1.5
CLASS A 2 4 6
CLASS B 5 8 12
CLASS II 6 10 14
BOULDERS 24 30 36
No more than 5.0% of the material furnished can be less than the minimum size
specified. No more than 10.0% of the material can exceed the maximum size specified.
METHODS
The Contractor shall place stone in locations shown on the plans or as directed by the
Engineer, to the thickness, widths, and lengths as shown on the plans and described in the
specifications, or directed by the Engineer. All stone shall be placed to form an erosion
control device or an instream structure in accordance with the plans, neatly and
uniformly, and shall meet the approval of the Engineer.
13
L. INSTREAM STRUCTURES
SCOPE
The work covered by this section consists of the construction of instream structures to
stabilize streambanks and improve aquatic habitats. Instream structures include cross
vanes, log and rock grade control j-hook vanes, log vanes, geolifts, single wing deflectors
and root wads. The quantity of instream structures to be constructed will be affected by
actual conditions that occur during the construction of the project. The type and quantity
of structures may be increased or decreased at the direction of the Engineer. Such
variations in quantity will not be considered as alterations in the details of construction or
a change in the character of the work.
MATERIALS
Logs and root wads will be produced onsite, if available. Onsite rootwads will be
selected by the Engineer. The tree shall have been alive when recently removed from the
ground. Logs shall be cut approximately 15 - 20 feet in length. Root wads shall consist of
the root mass and at least 8 feet of trunk. Tree basal diameter shall be a minimum of 10
inches. Root mass shall be dense and at least 2' in diameter.
Filter fabric for sealing structures shall be Type 2 non-woven, at least 75 mils thick with
a minimum weight of 6 oz/sq yd. Filter fabric will be nailed to the log to create an
adequate seal behind the log.
All stone materials shall meet the requirements given in the STONE section.
METHODS
Items of work to be performed in conformance with this specification and the
construction details therefore include:
a. Excavation of Instream Structures (cross vanes, log and rock grade control j-hook
vanes, log vanes, geolifts, single wing deflectors and root wads).
(1) This item shall consist of the excavation, placement of rock and wood materials,
and backfill associated with the installation of bid item instream structures.
(2) The Engineer may adjust the excavation limits to improve the channel foundation
conditions during construction.
(3) Excavated material shall be placed on the upstream side of the structures or
transported to a stockpile location as directed by the Engineer.
(4) Unless otherwise approved by the Engineer, excavation to prepare subgrade for
the installation of instream structures shall be consecutive and continuous. Once
the excavation of a structure has begun, the structure will be completed by the end
14
of the workday. All equipment shall be removed from the stream at the end of
each workday.
(5) Any accumulation of sediment in the channel shall be cleaned as needed during
construction and at the end of construction. No separate payment will be made for
this clean-up work.
Any disturbed soil shall be seeded utilizing temporary and permanent seeding methods.
M. FILTER FABRIC
SCOPE
Filter fabric is needed for the instream structures and silt checks.
METHODS
Filter fabric for sealing structures shall be Type 2 non-woven, at least 75 mils thick with
a minimum weight of 6 oz/sq yd.
0. COIR FIBER MATTING
SCOPE
Furnish materials, install and maintain Coir Fiber Matting in locations shown on the plans
or in locations as directed by the Engineer. Work includes providing all materials,
excavating and backfilling, and placing and securing Coir Fiber Matting.
Coir Fiber Matting will only be used in locations specified in the plans or by the Project
Engineer/Manager. Locations will primarily be on new streambanks. Other problem areas
may also require the placement of coir fiber matting.
EQUIPMENT AND MATERIALS
Ecostakes: Provide ecostakes made from wood not less than 12 in. (300 mm) in length
with a notch cut 1 in. (25 mm) from the top. These stakes shall be used to stake the
matting along the slopes. Wooden 3 ft. stakes spaced approximately 4 ft. apart shall be
used to secure the matting at the toe of slope. The toe stakes shall have a minimum f-
inch by 1-inch cross-section and shall be designed so that the matting can not slide past
the exposed end of the stake.
Matting: Provide coir fiber matting to meet the specifications of the C 7 or comparable
matting. Matting material MUST be biodegradable.
The erosion control blanket/channel lining shall be a machine-produced mat of 100%
coconut fiber with the following properties:
15
Matrix
Weight
Tensile Strength
Elongation
Open Area (measured)
Thickness
Flexibility (mg -cm)
Recommended Flow
Size
"C" Factor
Property
Thickness
Resiliency
Mass per Unit Area
Water Absorption
Swell
Stiffness/Flexibility
Light Penetration
Smolder Resistance
MD Tensile Strength
MD Elongation
TD Tensile Strength
TD Elongation
METHODS
100% Coconut Fiber
20 oz/SY (678 gm/m2)
1348 x 626 lb/ft minimum (1650.5 x 766.5 kg/m)
34% x 38%
50%
0.30 in minimum (7.6 mm)
65030 x 29590
11 feet/second (3.35 m/s)
6.6 x 164 ft (120 SY) or (100 SM)
0.002
Test Method
ASTM D5199/ECTC
ECTC Guidelines
ASTM D5261
ASTM D1117/ECTC
ECTC Guidelines
ASTM D1388/ECTC
ECTC Guidelines
ECTC Guidelines
ASTM D5035
ASTM D5035
ASTM D5035
ASTM D5035
Typical
0.26 in (6.60 mm)
85%
10.72 oz/yd2 (360 g/m2)
155%
40%
0.11 oz-in (1,218 mg-cm)
16.40%
Yes* *
342.00 lbs/ft (4.98 kN/m)
7.60%
211.00 lbs/ft (3.08 kN/m)
11.10%
Provide a smooth soil surface free from stones, clods, or debris that will prevent the
contact of the matting with the soil. Place the matting immediately upon final grading.
Take care to preserve the required line, grade, and cross section of the area covered.
Apply fertilizer, seed, and lime prior to installing blankets.
Unroll the matting and apply without stretching such that it will lie smoothly but loosely
on the soil surface. Bury the top slope end of each piece of matting in a narrow trench at
least 6 in. (150 mm) deep and tamp firmly. Where one roll of matting ends and a second
roll begins, overlap the end of the upper roll over the buried end of the second roll so
there is a 6 in. (150 mm) overlap. Construct check trenches at least 12 in. (0.3 m) deep
every 50 ft. (16 m) longitudinally along the edges of the matting or as directed by the
Engineer/ Project Manager. Fold over and bury matting to the full depth of the trench,
close and tamp firmly. Overlap matting at least 6 in. (150 mm) where 2 or more widths
of matting are installed side by side.
Place stakes across the matting at ends, junctions, and check trenches approximately 1 ft.
(90.3 m) apart with notch facing upslope.
16
Place stakes along the outer edges and down the center of each strip of matting 3 feet (1
meter) apart. Place stakes along all lapped edges 1 ft. (0.3 m) apart. Refer to details in the
plan sheets.
The Engineer/ Project Manager may require adjustments in the trenching or staking
requirements to fit individual site conditions.
P. TRANSPLANTS
SCOPE
The work shall consist of the removal, transport, and placement of available on-site
vegetative material for the purpose of streambank stabilization and enhancement of
stream habitat.
EQUIPMENT AND MATERIALS
The Contractor shall provide a rubber tired or track loader for the excavation, transport
and installation of transplanted vegetation. The Contractor must have approval from the
Engineer before using any other type of equipment for installing transplants.
METHODS
Shrub and trees less than 3 inches in diameter shall be salvaged onsite in areas designated
for construction, access areas, and other sites that will necessarily be disturbed.
Vegetation to be transplanted will be identified by the Engineer personnel. Transplanted
vegetation shall carefully be excavated with rootballs and surrounding soil remaining
intact. Care shall be given not to rip limbs or bark from the shrub and tree transplants.
Vegetation should be transplanted immediately, if possible. Otherwise, transplanted
vegetation shall be carefully transported to designated stockpile areas and heeled-in in
constantly moist soil or sawdust in an acceptable manner appropriate to weather or
seasonal conditions. The solidity of the plants shall be carefully preserved. Individual
transplants shall range in size from 0.5 to 2 square yards in size.
Installation of shrub and tree transplants shall be located in designated areas along the top
of the stream bank or in floodplain restoration areas as directed by Engineer. Soil in the
area of vegetation transplants shall be loosened to a depth of at least 1 foot. This is only
necessary on compacted soil. Transplants shall be replanted to the same depth as they
were originally growing. The planting trench or hole shall be deep and wide enough to
permit the roots to spread out and down without J-rooting. The plant stem shall remain
upright. Soil shall be replaced around the transplanted vegetation and tamped around the
shrub or tree firmly to eliminate air pockets.
Spacing and location of vegetation transplants will be determined onsite by the Engineer.
17
Q. LIVE STAKING
SCOPE
The work shall consist of the planting of live stakes on ditch banks to be protected from
erosion. The Contractor will be responsible for identifying a source for live stakes near
the project site, collecting and delivering the live stakes to the project site, and
installation of the live stakes. Staking must take place during the dormant season
(December - February).
EQUIPMENT AND MATERIALS
Live stakes may be of the following species:

Common Name
Scientific Name Percentage of
Total Wetness
Tolerance
Elderberry Sambucus canadensis 15% FACW-
Silk Dogwood Cornus amonum 25% FACW+
Silk Willow Salix sericea 25% OBL
Ninebark Ph socar us o uli olius 25% FAC-
Black Willow Salix ni ra 10% OBL
METHODS
Live stake materials should be dormant and gathered locally or purchased from a
reputable commercial supplier. Stakes should be '/2 to 2 inches in diameter, 2 to 3 feet in
length, and living based on the presence of young buds and green bark. Stakes shall be
angled on the bottom and cut flush on the top with buds oriented upwards. All side
branches shall be cleanly trimmed so the cutting is one single stem. Stakes should be kept
cool and moist to improve survival and to maintain dormancy.
Planting shall take place during the months of December - February. Stakes should be
installed 2 to 3 feet apart along the stream banks on the outside of meander bends and 6
to 8 feet apart along the stream banks on the inside of meander bends and through tangent
sections. Live stakes shall be installed along streambanks above the base flow water
surface elevation. Site variations may require slightly different spacing. Stakes shall be
driven into the ground using a rubber hammer or by creating a hole and slipping the stake
into it. The stakes should be tamped in at a right angle to the slope with 415 of the stake
installed below the ground surface. At least two buds (lateral and/or terminal) shall
remain above the ground surface. The soils shall be firmly packed around the hole after
installations. Split stakes shall not be installed. Stakes that split during installations shall
be replaced.
18
R. BARE-ROOT VEGETATION
SCOPE
The work shall consist of the planting of bare-root tree species. The Contractor will be
responsible for the purchase of the trees. Bare-root tree species will be planted in areas as
shown in the vegetation planting plan. Planting must take place during the dormant
season (November 22°d - March 4th).
EQUIPMENT AND MATERIALS
Plant the following shrub species.
Shrubs - (60%) planted
12' X 12' spacing. 308
shrubs/acre

Common name

Scientific name Percent
planted by
species

OTY
Redbud Cercis canadensis 20 431
S icebush Lindera benzoin 25 539
Tag Alder Alnus serrulata 20 431

Serviceberr Amelanchier
Canadensis
15
324
Silk Dogwood Corms amomum 20 431
Total 100 2156
Plant the following treespecies.
Trees - (40%) planted 12'
X 12' spacing. 308
trees/acre

Common name

Scientific name Percent
planted by
species

OTY
River Birch Betula nigra 20 289
Tull Poplar Liriodendron tulipifera 20 289
Sycamore Platanus occidentalis 20 289
Southern Red Oak uercus rubra 20 289
Willow Oak Quercus phellos 20 289
Total 100 1445
METHODS
Planting shall take place during the months of November - March. Soil in the area of tree
plantings shall be loosened to a depth of at least 5 inches. This is necessary only on
compacted soil. Rootstock shall be planted in a vertical position with the root collar
19
approximately '/z inch below the soil surface. The planting trench or hole shall be deep
and wide enough to permit the roots to spread out and down without J-rooting. The plant
stem shall remain upright. Soil shall be replaced around the transplanted vegetation and
tamped around the shrub or tree firmly to eliminate air pockets.
S. SAFTEY FENCE
No safety fence will be needed within the Pilot Knob Golf Course Stream Restoration
Project.
T. CONSTRUCSTION SEQUENCE
A Baker Engineering Project Manager will provide construction observation during the
construction phase of this project. The following construction sequence shall be used
during implementation of the plan.
GENERAL CONSTRUCTION SEQUENCE
The following construction sequence shall be followed by the Contractor.
1. Prior to beginning any land disturbing activities, notification and approval
must be granted from NCDENR Division of Land Resources - Land Quality
Section, US Army Corp of Engineers, and NC Division of Water Quality.
2. The Contractor shall contact North Carolina "One Call" Center
(1.800.632.4949) before any excavation.
3. The Contractor will mobilize equipment and materials to the site using the
construction entrance (as shown on the plans) along Stone Haven Drive.
4. The Contractor will utilize the haul roads and stream crossing as shown on the
plans. The Contractor shall not use the existing culvert crossing as their stream
crossing. The contractor must use a timber mat crossing.
5. Contractor will store all equipment and materials in staging areas as shown on
the plans.
6. Contractor will setup pump-around operations as shown on the plans.
7. Rock dams / silt checks will be installed downstream of the work area prior to
bank grading or in-stream structure construction.
8. Immediately upon completion of bank grading, the slope will be reseeded and
matted with erosion control fabric.
9. New channel sections shall be graded while pump-around is working.
Structures shall be installed and the banks protected prior to receiving "live"
stream flow. Bank protection includes transplants and seeding with matting.
Silt fence shall be placed between stockpiles and the existing channel.
10. Upon completion of the channel repair, all disturbed floodplain areas including
staging areas and haul roads, shall be seeded and covered with mulch. Any
fairway that is disturbed shall be seeded with 419 Hybrid Bermuda grass seed.
Trees shall be planted in accordance with the planting plan. Permanent
seeding mixtures shall be applied as shown on the vegetation plan. Temporary
seeding shall be applied in all areas susceptible to erosion (i.e. disturbed ditch
20
banks, steep slopes, and spoil areas) such that ground cover is established
within 21 working days following completion of any phase of grading.
Permanent ground cover shall be established for all disturbed areas within 15
working days or 90 calendar days (whichever is shorter) following completion
of construction.
11. Prior to seeding and mulching the haul road, the new cart path shall be built as
shown on the plans and in the details.
12. All areas should be seeded and mulched before leaving the project reach.
Remove temporary stream crossings and any in-stream temporary rock dams.
All waste material must be removed from the project site.
13. The Contractor shall plant woody vegetation and live stakes, according to
planting details and specifications. They should complete the reforestation
(bare root and B&B planting) phase of the project and apply permanent
seeding at the appropriate time of the year.
14. The Contractor shall ensure that the site is free of trash and leftover materials
prior to demobilization of equipment from the site.
21
FINANCIAL RESPONSIBILITY/OWNERSHIP FORM
SEDIMENTATION POLLUTION CONTROL ACT
No person may initiate any land-disturbing activity on one or more acres as covered by the Act before this
form and an acceptable erosion and sedimentation control plan have been completed and approved by the
Land Quality Section, N.C. Department of Environment and Natural Resources. (Please type or print and, if
the question is not applicable or the e-mail and/or fax information unavailable, place N/A in the blank.)
Part A.
1. Project Name Pilot Knob Golf Course Stream Restoration and Enhancement Project
2. Location of land-disturbing activity: County Surr City or Township Pilot Mountain
Highway/Street Club House Drive Latitude 3021'43.71 "N Longitude 80°28'14.15"W
3. Approximate date land-disturbing activity will commence: Fall/UVinter 2009
4. Purpose of development (residential, commercial, industrial, institutional, etc.): Stream Restoration and Enhancement
5. Total acreage disturbed or uncovered (including off-site borrow and waste areas): 8 acres
6. Amount of fee enclosed: $ 520.00 . The application fee of $65.00 per acre (rounded
up to the next acre) is assessed without a ceiling amount (Example: a 9-acre application fee is $585).
7. Has an erosion and sediment control plan been filed? Yes No Enclosed X
8. Person to contact should erosion and sediment control issues arise during land-disturbing activity:
Name Joshua White E-mail [e-mail]
Telephone [phone] Cell # N/A Fax # [phone]
9. Landowner(s) of Record (attach accompanied page to list additional owners):
See Attached See Attached See Attached
Name Telephone Fax Number
See Attached See Attached
Current Mailing Address Current Street Address
See Attached 27041 See Attached
City State Zip city State Zip
10. Deed Book No. See Attached Page No. See Attached Provide a copy of the most current deed.
Part B.
Person(s) or firm(s) who are financially responsible for the land-disturbing activity (Provide a
comprehensive list of all responsible parties on an attached sheet):
Resource Institute, Inc. [e-mail]
Name E-mail Address
2714 Henning Drive 2714 Henning Drive
Current Mailing Address Current Street Address
Winston Salem NC 27106 Winston Salem NC 27106
City State Zip City State Zip
Telephone [phone] Fax Number 336-750-0177
2. (a) If the Financially Responsible Party is not a resident of North Carolina, give name and street address
of the designated North Carolina Agent:
Name E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Telephone Fax Number
(b) If the Financially Responsible Party is a Partnership or other person engaging in business under an
assumed name, attach a copy of the Certificate of Assumed Name. If the Financially Responsible
Parry is a Corporation, give name and street address of the Registered Agent:
Name of Registered Agent E-mail Address
Current Mailing Address Current Street Address
City State Zip City State Zip
Telephone Fax Number
The above information is true and correct to the best of my knowledge and belief and was provided
by me under oath (This form must be signed by the Financially Responsible Person if an individual
or his attorney-in-fact, or if not an individual, by an officer, director, partner, or registered agent with
the authority to execute instruments for the Financially Responsible Person). I agree to provide
corrected information should there be any change in the information provided herein.
V'/ ?r 'tc r
Typ r i e Title or Authority
f POM 130/0
Signature Date
----------------------------------------------------------------- - -------- ------------------ ------------------
a Notary Public of the County of State of North Carolina, hereby certify that appeared
personally before me this day and being duly sworn acknowledged that the above form was
executed by him.
Witness my hand and notarial seal, this'??bw\ day of 2009
w,0? , ".
Notary
Seal
My commission expires
U
0
Financial Responsibility Form Attachment
9. Landowner Information
Name: Pilot Knob Park
Telephone: [phone]
Fax: [phone]
Current Mailing Address: 450 Club House Drive
City, State, Zip: Pilot Mountain, NC, 27041
Current Street Address: Same as mailing address
Deed Book No.: 0315
Page No.: 0949
Name: Harold W. Boles
Telephone: [phone]
Fax: N/A
Current Mailing Address: PO Box 38
City, State, Zip: Pinnacle, NC, 27043
Current Street Address: Same as mailing address
Deed Book No.: 0466
Page No.: 0901
Personal Account Information Redacted
Personal Account Information Redacted
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