20070033 Ver 1_401 Application_20070107

200Cp033
Office Use Only: Form Version March OS
USACE Action ID No. DWQ No.
(If any partiCUlar Item is 11ot applic8ble t0 t111S Dro1CCt nleace enter "Nnf Ar~nlir9l,ld~ .,. nAT/ w ~~ ~
I. Processing
.,.~ .~
~ ~ jn
1. Che,,ek all of the approval(s) requested for this project:
Section 404 Permit ^ Riparian or Watershed Buffer Rules
^ ction 10 Permit ^ Isolated Wetland Permit from DWQ
401 Water Quality Certification ^ Express 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested:~,c~;a „r,~ er! ~,
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: ^
4. If payment into the North Carolina Ecosystem Enhancement Program (NCEEP) is proposed
for mitigation of impacts, attach the acceptance letter from NCEEP, complete section VIII,
and check here: ^
5. If your project is located in any of North Carolina's twenty coastal counties (listed on page
4), and the project is within a North Carolina Division of Coastal Management Area of
Environmental Concern (see the top of page 2 for further details), check he ~]~ ~ U V
II. Applicant Information L5 ~J D
1. Owner/Applican
Name:T~
Mailing Address:
Telephone T
E-mail Addy
JAN 5 2007
;~,~ ~'
c /~ ~
QUALITY
~~IER BRANCH
ax Number:
2. Agent/Consultant Information (A signed and dated copy of the Agent Authorization letter
must be attached if the Agent has signatory authority for the owner/applicant.)
Name:
Company Affiliation:
Mailing Address:
Telephone Number: Fax Number:
E-mail Address:
Page 5 of 12

III. Project Information
Attach a vicinity map cleazly showing the location of the property with respect to local
landmazks such as towns, rivers, and roads. Also provide a detailed site plan showing property
boundaries and development plans in relation to surrounding properties. Both the vicinity map
and site plan must include a scale and north arrow. The specific footprints of all buildings,
impervious surfaces, or other facilities must be included. If possible, the maps and plans should
include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property
boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion,
so long as the property is clearly defined. For administrative and distribution purposes, the
USACE requires information to be submitted on sheets no lazger than 11 by 17-inch format;
however, DWQ may accept paperwork of any size. DWQ prefers full-size construction
drawings rather than a sequential sheet version of the full-size plans. If full-size plans are
reduced to a small scale such that the final version is illegible, the applicant will be informed that
the project has been placed on hold until decipherable maps are provided.
1. Name of project:~,~~av, , ~,~,,~_/~
2. T.I.P. Project Number or State Project Number (NCDOT Only
3. Property Identification Number (Tax PIN):
4. Location ~p I
County:~u.'{,~P~to r~ Neazest wn:
Subdivision name (include phase/lot number): 7 h: c 7
Directions to site (include road numbers/ ames landmarks, etc.
5. Site coordinates (For lineaz projects, such as a road or utility line,
separately lists the coordinates for each crossing of a distinct waterbody.)
Decimal Degrees (6 digits minimum):. ~
°W
6. Property size (acres):. 6~J
7. Name of nearest receiving body of water: ~.`Ce_.. Z.,,~.~
8. River Basin: rr~d.
(Note -this must be one of North Cazolina's seventeen designated major river basins. The
River Basin map is available at http://h2o.enr.state.nc.usladmin/maps/.)
9. Describe the existing condition on the site and general land use in the vicinity of the project
at the time of this application,-,~e~: G J ~ir~l~~~~.'.~ _ / ,_ ~.~ t: ,_ _l ~ 1~_ __ : t .
attach a sheet that
Page 6 of 12

10. Describe the overall project in detail, including the type of equipment to/belused: e ; ~
s~..c ~ S~ ~ A taco ~ re S~/Fc'{t~f ~~ae~ -~, ', ~„il-~CJ~ c.te d
fti'. i~: -L°XC~_yt~ir'~ Saywe L/~r IY"F~ WdI' ~~
11. Explain the purpose of the proposed work~e_~T ; ~ Q/.~~,,~,0./ ~ ~'a,~S a~'1~,~ ~~~/
IV. Prior Project History
If jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Include
the USACE Action ID Number, DWQ Project Number, application date, and date permits and
certifications were issued or withdrawn. Provide photocopies of previously issued permits,
certifications or other useful information. Describe previously approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits issued for prior segments of the same T.I.P. project, along with
construction schedules. /~.~
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and~rovide justification for the exclusion of this work from the current application.
VI. Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. Each impact must be
listed separately in the tables below (e.g., culvert installation should be listed separately from
riprap dissipater pads). Be sure to indicate if an impact is temporary. All proposed impacts,
permanent and temporary, must be listed, and must be labeled and clearly identifiable- on an
accompanying site plan. All wetlands and waters, and all streams (intermittent and perennial)
should be shown on a delineation map, whether or not impacts are proposed to these systems.
Wetland and stream evaluation and delineation forms should be included as appropriate.
Photographs may be included at the applicant's discretion. If this proposed impact is strictly for
wetland or stream mitigation, list and describe the impact in Section VIII below. If additional
space is needed for listing or description, please attach a separate sheet.
Y e a written descri tion of the proposed impacts:
Page 7 of 12

2. Individually list wetland impacts. Types of impacts include, but are not limited to
mechanized clearing, grading, fill, excavation, flooding, ditching/drainage, etc. For dams,
separately list impacts due to h~th etrn~fiirP anal flnnrl~nn
Wetland Impact
Site Number

(indicate on map)
T e of Im act
Yl~ P Type of Wetland

(e.g., forested, marsh,
herbaceous, bog, etc.) Located within
100-year
Flood lain
p
es/no Distance to
Nearest
Stream

linear feet Area of
Impact
acres
( )

Total Wetland Impact (acres)
3. List the total acreage (estimated) of all existing wetlands on the property:_ /1
4. Individually list all intermittent and perennial stream impacts. Be sure to identify temporary
impacts. Stream impacts include, but are not limited to placement of fill or culverts, dam
construction, flooding, relocation, stabilization activities (e.g., cement walls, rip-rap, crib
walls, gabions, etc.), excavation, ditching/straightening, etc. If stream relocation is proposed,
plans and profiles showing the lineaz footprint for both the original and relocated streams
must be included. To calculate acrPasrP mnltinly lanath Y :~,;.it1, tt,a„ a;.,:a~ ~., n~ acn
Stream Impact

Number
indicate on ma

Stream Name
- ------ -~ ---~-
Type of Impact
-- - v-- µ-
Perennial or
Intermittent?
.aAverageal ui
Stream Width
Before Im act
•l Impact J~J
Length
linear feet
VArea of
Impact
acres

Total Stream Impact (by length and acreage)
5. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.). Open water impacts include, but are not limited to
fill, excavation, dredging_ flonclinu tlrainaoE± hitillrhParl~ pt~
Open Water Impact
Site Number Name of Waterbody Type of Waterbody Area of

indicate on ma (if applicable) Type of Impact (lake, pond, estuary, sound, bay, Impact
ocean, etc. acres
~Gt ,.i l ~
~ IGe~ . OQ ,ct.

Total Open Water Impact (acres) . OD~iG~
Page 8 of 12

6. List the cumulative impact to all Waters of the U.S, resulting from the nm;ecr•
Stream Im act (acres): ---- O - __
Wetland Im act (acres): p
O n Water Im act (acres : , 00 ~
Total Im act to Waters of the U.S. (acres) , o ,~~
Total Stream Im act (linear feet):
7. Isolated Waters /
Do any isolated waters exist on the property? ^ Yes o
Describe all impacts to isolated waters, and include the type of water (wetland or stream) and
the size of the proposed impact (acres or linear feet). Please note that this section only
applies to waters that have specifically been determined to be isolated by the USACE.
8. Pond Creation
If construction of a pond is proposed, associated wetland and stream impacts should be
included above in the wetland and stream impact sections. Also, the proposed pond should
be described here and illustrated on any maps included with this application.
Pond to be created in (cheek all that apply): ^ uplands ^ stream ^ wetlands
Describe the method of construction (e.g., dam/embanlanent, excavation, installation of
draw-down valve or spillway, etc.):
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.):
Current land use in the vicinity of the pond:
Size of watershed draining to pond: Expected pond surface area:
VII. Impact Justification (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It may be useful to provide
information related to site constraints such as topography, building ordinances, accessibility, and
financial viability of the project. The applicant may attach drawings of alternative, lower-impact
site layouts, and explain why these design options were not feasible. Also discuss how impacts
were minimized once the desired site plan was developed. If applicable, discuss construction
VIII. Mitigation
DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC
Division of Water Quality for projects involving greater than or equal to one acre of impacts to
freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial
streams.
Page 9 of 12

USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on January I5, 2002, mitigation will be required when
necessary to ensure that adverse effects to the aquatic environment are minimal. Factors
including size and type of proposed impact and function and relative value of the impacted
aquatic resource will be considered in determining acceptability of appropriate and practicable
mitigation as proposed. Examples of mitigation that may be appropriate and practicable include,
but are not limited to: reducing the size of the project; establishing and maintaining wetland
and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of
aquatic resource functions and values by creating, restoring, enhancing, or preserving similar
functions and values, preferable in the same watershed.
if mitigation is required for this project, a copy of the mitigation plan must be attached in order
for USACE or DWQ to consider the application complete for processing. Any application
tacking a required mitigation plan or NCEEP concurrence shall be placed on hold as incomplete.
An applicant may also choose to review the current guidelines for stream restoration in DWQ's
Draft Technical Guide for Stream Work in North Carolina, available at
http://h2o.enr.state.nc.uslncwetlands/stnngide html.
I. Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a se~ a sheet if more space is needed.
2. Mitigation may also be made by payment into the North Carolina Ecosystem Enhancement
Program (NCEEP). Please note it is the applicant's responsibility to contact the NCEEP at
[phone] to determine availability, and written approval from the NCEEP indicating
that they are will to accept payment for the mitigation must be attached to this form. For
additional information regarding the application process for the NCEEP, check the NCEEP
website at http://h2o.enr.state.nc us/wrp/index htm. If use of the NCEEP is proposed, please
check the appropriate box on page five and provide the following information:
Amount of stream mitigation requested (linear feet): D
Amount of buffer mitigation requested (square feet):_ d
Amount of Riparian wetland mitigation requested (acres): d
Amount ofNan-riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres): ~
Page 10 of 12

IX. Environmental Documentation (required by DWQ)
1. Does the project involve an expenditure of public (federaUsta /local) funds or the use of
public (federal/state) land? Yes ^ No
2. If yes, does the project require preparation of an environmental document pursuant to the
requirements of the National or North Carolina Environmental Policy Act (NEPA/SEPA)?
Note: If you are not sure whether a NEPA/SEPA document is required, call the SEPA
coordinator at [phone] to review current thresholds for environmental documentation.
Yes ^ No ^
3. If yes, has the document review been fmalized by the State Clearinghouse? If so, please
attach a copy of the NEPA or SEPA final approval letter. Yes ^ No ^
X. Proposed Impacts on Riparian and Watershed Buffers (required by DWQ)
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
required state and local buffers associated with the project. The applicant must also provide
justification for these impacts in Section VII above. All proposed impacts must be listed herein,
and must be clearly identifiable on the accompanying site plan. All buffers must be shown on a
map, whether or not impacts are proposed to the buffers. Correspondence from the DWQ
Regional Office may be included as appropriate. Photographs may also be included at the
applicant's discretion.
Will the project impact protected ripazian buffers identified within 15A NCAC 2B .0233
(Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC OZB .0243 (Catawba) 15A NCAC
2B .0250 (Randleman Rules and Water Supply Buffer equirements}, or other (please
identify )? Yes ^ No
2. If "yes", identify the square feet and acreage of impact to each zone of the riparian buffers.
If buffer mitigation is required calculate the required amount of mitigation by applying the
buffer multipliers.
Zone* I Impact I Multi her Required
i 3 (2 for Catawba)
2 1.5
Total
* Zone 1 extends out 30 feet perpendicular from the top of the near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.
3. If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e.,
Donation of Property, Riparian Buffer Restoration /Enhancement, or Payment into the
Riparian Buffer Restoration Fund). Please attach all appropriate information as identified
within 15A NCAC 2B .0242 or .0244, or .0260.. /V,~
Page 11 of 12

XI. Stormwater (required by DWQ)
Describe impervious acreage (existing and proposed) versus total acreage on the site. Discuss
Stormwater controls proposed in order to protect surface waters and wetlands downstream from
the property. If percent impervious surface exceeds 20%, please provide cal/culations
demonstrating total proposed impervious level. 3 9l~ ~ s~ ~i ~ ws _ G 9 <cres, ~~~ s75i-n~.~,. ~..
XII. Sewage Disposal (required by DWQ)
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from the proposed project, or available capacity of the subject facility.
111
XIII. Violations (required by DWQ)
Is this site in violation of DW Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes ^ No [-~
Is this an after-the-fact permit application? Yes ^ No [ ~
XIV. Cumulative Impacts (required by DWQ)
Will this project (based on past and reasonably anticipated future impacts) result in addit' nal
development, which could impact nearby downstream water quality? Yes ^ No
If yes, please submit a qualitative or quantitative cumulative impact analysis in accordance with
the most recent North Carolina Division of Water Quality policy posted on our website at
htta://h2o.enr.state.nc.us/ncwetlands. If no, please provide a short narrative description:: f is
XV. Other Circumstances (Optional):
It is the applicant's responsibility to submit the application sufficiently in advance of desired
construction dates to allow processing time for these permits. However, an applicant may
choose to list constraints associated with construction or sequencing that may impose limits on
work schedules (e.g., draw-down schedules for lakes, dates associated with Endangered and
Thre/aten//ed Species, accessib/ility p/r~oble 7m~s, or oth/er irs~sues outside of the applicant's control).
~+~~ /I'rec%e~ ~R.J~n ~Pr,~~e/ %f -(/'1rti ~t ~ 1i /~/iG~ I. ~ (.~~ I~ ~ra. ,`ti, e~,.•,- I_ .. G
'~

~~~~
ApplicantlAgent's Signature '`
(Agent's signature is valid only if an authorization letter from the
provided.)
Page 12 of 12

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• Rutherford Co. Property Information - 02-29657
Page 1 of 2
PIN: 02-29657 ALT PAR NBR: 0642.12-95-5387.0000 RUTHERFORD COUNTY PROPERTY RECORD CARD AS OF 11 MAY 2005 Page 1 of 1
M/B/L: 504 1 90 A
NELON, CLAUDE R Land: 332,500 Acres: 0 YR VALUATION: 2002 T/S 2 CHIMNEY ROCK
NELON, HELEN G Bldg: 8fi,000 Sqft: 0 Zone:
270 PICNIC POINT RD Total: 41$,500 Lota: 1 Neighborhood: L30B RESIDENTIAL LAKE
LAKE LURE, NC 28746 Uee Value: 418,500 Deferred Value: 0 Description: RES PICNIC POINT RD
Property Address: Property: RTG Nbr: Vac
270 PICNIC POINT RD Previous Land: 332,500 Defer: 0 Acct Nhr: 2223855 Dell
value Bldg: 86,000 Net: 418,500 City: COS k Land Segments: 1 Imp I
LAKE LURE NC 28746 Mkt: 418,500 Fire: # of Buildings: 6 Exmp
Land Assessed Square Grade Eff Eff Depth Adjustments Market Deferred Soil
Method Segment Type Ac rea FooC Cond Front Depth Factor Lot Unit $ Rd# Tot Lo# Size Oth Value Value Class Type
LOTS HOMES ITE 0.69 1 250000.00 0 -5 90 V 332,500
Uae: 37 SINGLE FAMILY UNIT
Method: R RESIDENTIAL
Base Value: 72,946 Building: 75,000
Year Built: 1946 EffYrBl[: 1960
Style: T TWO OR MO B1dgClas: wF WOOD FRAME
Deacript~n: HOUSE
k of St rye: 1.B wall Hgt:
Ext. Wall e: WOOD SIDING #ExCWall: 100
Qlty grade: AVERAGE Condition: AVERAGE
Y of Uni ta:
Atea sect: 1,634 Net: 1634 Total: 2300
Perimeter: Sprinkl r:
Bamnt Area: 456 Finish #: 0
Attic Area: Finish #:
Heating: 5 ELECTRIC Heated #: 100 Fuel: ELECTRIC
Type A/C: 0 NO AIR CO AC #:
Rooms: 8 Bedlooma: 4
Botha: 2 Half: 0 AdFx: 2
FP Stacks: 1 Openings:
Cnt: 1
Quality Int: Q1tyEx:
Occupancy: 1 SINGLE FAMILY
Roof type: GABLE Wall Str: WOOD
Roof cover: ASPHALT/FIB Roof Str: wOOD JOIST
Floor Stru: WOOD FRAME
Ploor tour: SOFTWOOD #P1 rCovr: 50
VINYL 50
Foundation: BLOCK/BRICK
Inter Wall: DRYWALL #Int Fin: 100
Design #: # Complete: 100
Physical #; 44• Reval Baee Rate: 45
Function #: Functional code:
Economic #: Economic code:
- General Remarks -----
2002 REVAL INFOMRAL CHANGE,BDRMS,GD/COND SEAWALL
BOAT COVER FOA 04 PERMIT B03-00168
Sale Date Instrument Book/Page Valid Sale Price Land Uae:
335/335 ROdd: S PAVED SECONDARY
Topo: R ROLLING
Utilitles: T,W
Landscape: A AVERAGE
Census Tr: N
Addltiona: ActYr EffYr Nbr
SA Type Deac Built Bult Cond Story
1 RES RESIDENCE BASE 1.8
2 WDK WOOD DECK
3 OFP OPEN FRAME PORCH
Accessory Structures
B# Use Deac
2 BOA BOAT HOUSE ENCLOSED
3 PIE PIER
4 SEAWSEA WALLS
5 BOS BOAT HOUSE SHELTER
6 PIE PIER
ActYr EffYr Nbr
Built Built Cond Story
1986 1986 AV 0
1986 1986 AV 0
1966 1968 PR 0
2003 2003 GD 0
2003 2003 GD 0
O[her Features
Type Desc Count
Sect
Area Grade Rep COet Dep# Depr Value
1,634 130,260 44 72,946
636 3,949 44 2,211
3~ 564 44 316
dW~ 134,773 75,473
_ _ _ _ _ _ _ _ _ _ _ _ _Bldg _ _ _ _ _ _
Area Grade Rep Cost Dep# Depr Value
312 AV 6,240 53 2,900
SSB AV 2,790 75 600
400 LW 16,000 75 4,000
250 AV 3,100 0 3,100
84 AV 420 0 400
~/Fj O 1. 28, 550 11, 000
http://arcims.webgis.net/nc/rutherford/propcards.asp?pid=02-29657 1/2/2007

Rutherford Co. Property Information - 02-29657 Page 2 of 2
PIN: 02-29657 ALT PAR NBR: 0642.12-95-5387.0000 M/8/L: 509 1 90 A
Approximate eCale i9 1:101 Letter Type
A RES RESIDENCE BASE
+____________________________H3B ____________________________ + B WDK WOOD DECK
C OFP OPEN FRAME PORCH
B12
__________________________+_____A43___________B26_________ _________+
WDK B 27
636
B15
+________B12 _______ +
3B RES A3R
1634 ~
CS OFP CS
30
+________________________________A43 ________________________.
http://arcims.webgis.net/nc/rutherford/propcards.asp?pid=02-29657 1/2/2007

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