20050974 Ver 1_Complete File_20050606

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Michael F. Easley. Governor

William G, Ross Jr.. Seercmry
North Carolina Department ofEnvironrnenl and Natuml Resources

Alan W, Klimek. P,E. Director
Division ofWalcr Quality

July 6, 2005
DWQ# 05-0974
Union County

Project Manager
RPM Development, LLC
10590 Independence Point Pkwy" Ste. 100
Matthews, NC 28105

Subject: Wyndham Hall Plantation SID, Phase 2
APPROVAL of 401 Water Quality Certification with Additional Conditions

Dear Sir or Madam:

You have our approval, in accordance with the attached conditions and those listed below to impact
140 linear feet of an unnamed stream in order to construct the Wyndham Hall Plantation (Phase 2) Subdivision
in Union County, as described in your application received by the Division of Water Quality (DWQ) on June 6,
2005. After reviewing your application, we have determined that this project is covered by Water Quality
General Certification Number 3402, which can be viewed on our web site at
htto:/1h20.enr.state,nc.us/ncwetlands. The General Certification allows you to use Nationwide Permit Number
39 once it is issued to you by the U,S. Army Corps of Engineers. Please note that you should get any other
federal, state or local permits before proceeding with your project, including those required by (but not limited
to) Sediment and Erosion Control, Non-Discharge, and Water Supply Watershed regulations.

The above noted Certification will expire when the associated 404 permit expires unless otherwise
specified in the General Certification. This approval is only valid for the purpose and design that you described
in your application. If you change your project, you must notify us in writing, and you may be required to send
us a new application for a new certification. If the property is sold, the new owner must be given a copy of the
Certification and approval letter. and is thereby responsible, for complying with all conditions,

In addition to the requirements of the certification, you must also comply with the following conditions:

1. Deed notifications or similar mechanisms shall be placed on all lots with remaining jurisdictional wetlands and
waters or areas within 50 feet of all streams and ponds on the property. These mechanisms shall be put in
place within 30 days of the date of this letter or the issuance of the 404 Permit (whichever is later). A sample
deed notification format can be downloaded from the 401/Wetlands Unit web site at
http://h20.enr.state.nc,us/ncwetlands.

2. The planting of native vegetation and other soft streambank stabilization techniques must be used where
practicable instead of riprap or other bank hardening methods. If riprap is necessary, it shall not be placed in
the streambed, unless approved by the DWQ.

3. All wetlands, streams, surface waters, and riparian buffers located on the project site where impacts are not
allowed shall be clearly marked (example- orange fabric fencing) prior to any land disturbing activities.

4. Stormwater discharge structures at this site shall be constructed in a manner such that the potential receiving
streams/wetlands (of the discharge) will not be impacted due to sediment accumulations, scouringa!' erosion.
NorhCarolina
A/ntllrol/!!

North Carolina Division ofWala Quality 610 East Caller Ave.. Suite 301 Moorcsville, NC 28115 Phone [phone]
Internet: h20,enr,state,nc,us FAX (704) 663~040
An Equal Opportunity/Affjnnative Action Employer - 50% Recycledl10% Post Consumer Paper

Customer Service
1-S77~2J.6748

:.....~..."...J....:.....:i....;.".:..-:._:.. ._''';' .;0.:.:....,;.. ~~~.~.:...:-~...~.:.....;.....;~:,...~,!.,....__\."~.....!..,_...._.:..-~.,;~; ';.:":':':''':d4':'':'::._~_';.'..-<..:._~~:.' ;\.....> ; ,-:'~. ..~_'..:. .:.~..:.. .:_':," ~.:;.... -:~~'.;: . ':':1:" ,;,:..:~. .',"~::_.;.:::':'O ~.:.: ~,~: ,:-:...:...~;;:.:.:...~'..;~~::::.4..~<:. '."

5. No waste, spoils, solids, or fill of any kind shall be placed in wetlands, waters, or riparian areas beyond the
footprint of the impacts depicted in the Preconstruction Notification application. All construction activities
associated with this project shall meet, and/or exceed, those requirements specified in the most recent
version of the North Carolina Sediment and Erosion Control Manual and shall be conducted so that no
violations of state water quality standards, statutes, or rules occur.

6. Sediment and erosion control devices shall not be placed in wetlands or waters to the maximum extent
practicable. If placement of sediment and erosion control devices in wetlands and waters is unavoidable,
they shall be removed and the natural grade restored within two months of the date the Division of Land
Resources has released the project,

7, Upon completion of the project, the applicant shall complete and return the enclosed "Certificate of
Completion- form to the 401/Wetlands Unit of the NC Division of Water Quality and the I\'ooresvillo
Regional Office. Please send photographs of the upstream and downstream sides of each culvert site to
document correct installation, along with the Certificate of Completion form.

8. Continuing Compliance, The applicant (RPM Development, LLC) shall conduct its activities in a manner so
as not to contravene any state water quality standard (including any requirements for compliance with section
303(d) of the Clean Water Act} and any other appropriate requirements of state and federal Jaw. If DWQ
determines that such standards or laws are not being met (including the failure to sustain a designated or
achieved use) or that state or federal law is being violated, or that further conditions are necessary to assure
compliance, DWQ may reevaluate and modify this certification to include conditions appropriate to assure
compliance with such standards and requirements in accordance with 15 A NCAC 2H,0507(d}. Before
codifying the certification, DWQ shall notify the applicant and the US Army Corps of Engineers, provide public
notice in accordance with 15A NCAC 2H.0503, and provide opportunity for public hearing in accordance with
15A NCAC 2H.0504. Any new or revised conditions shall be provided to the applicant in writing, shall be
provided to the United States Army Corps of Engineers for reference in any permit issued pursuant to Section
404 of the Clean Water Act, and shall also become conditions of the 404 Permit for the project.

If you do not accept any of the conditions of this certification, you may ask for an adjudicatory hearing, You
must act within 60 days of the date that you receive this letter. To ask for a hearing, send a written petition that
conforms to Chapter 1508 of the North Carolina General Statutes to the Office of Administrative Hearings, 6714
Mail Service Center, Raleigh, N.C. 27699-6714. This certification and its conditions are final and binding unless
you ask for a hearing.

This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water Act.
If you have any questions, please telephone Mr. Alan Johnson in the Mooresville Regional Office at 704-663-
1699 or Ms. Cyndi Karoly in the Central Office in Raleigh 919-733-9721.

Sincerely,

V, ((-v je~
for Alan W. Klimek, P.E.

Attachments

cc: Anny Corps of Engineers, Asheville
Cyndi Karoly, Wetlands Unit
David Caldwell, Meek. County, Water Quality
Central Files
Toney Browder

~&@&O'i'lJ&@

JUL 12 2005
t~trr,Z~~~~1n~ QIJAuTY
AAvATeR BRM'CH

o't- WAr~1t

o~~c:.
(if Y
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~ Dll.G'l, ~~"I ::j
P "(
'~

l( \F Michael F. Easley, Governor

William G, Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources

Alan W, Klimek, P,E, Director
Division of Water Quality

July 6, 2005
DWQ# 05-0974
Union County

Project Manager
RPM Development, LLC
10590 Independence Point Pkwy., Ste. 100
Matthews, NC 28105

Subject: Wyndham Hall Plantation SID, Phase 2

APPROVAL of 401 Water Quality Certification with Additional Conditions

Dear Sir or Madam:

You have our approval, in accordance with the attached conditions and those listed below to impact
140 linear feet of an unnamed stream in order to construct the Wyndham Hall Plantation (Phase 2) Subdivision
in Union County, as described in your application received by the Division of Water Quality (DWQ) on June 6,
2005. After reviewing your application, we have determined that this project is covered by Water Quality
General Certification Number 3402, which can be viewed on our web site at
http://h20.enr.state,nc,us/ncwetlands. The General Certification allows you to use Nationwide Permit Number
39 once it is issued to you by the U.S. Army Corps of Engineers. Please note that you should get any other
federal, state or local permits before proceeding with your project, including those required by (but not limited
to) Sediment and Erosion Control, Non-Discharge, and Water Supply Watershed regulations.

The above noted Certification will expire when the associated 404 permit expires unless otherwise
specified in the General Certification. This approval is only valid for the purpose and design that you described
in your application. If you change your project, you must notify us in writing, and you may be required to send
us a new application for a new certification. If the property is sold, the new owner must be given a copy of the
Certification and approval letter; and is thereby responsible for complying with all conditions.

In addition to the requirements of the certification, you must also comply with the following conditions:

1. Deed notifications or similar mechanisms shall be placed on all lots with remaining jurisdictional wetlands and
waters or areas within 50 feet of all streams and ponds on the property. These mechanisms shall be put in
place within 30 days of the date of this letter or the issuance of the 404 Permit (whichever is later). A sample
deed notification format can be downloaded from the 401/\Netlands Unit web site at
http://h20.enr.state.nc.us/ncwetlands.

2. The planting of native vegetation and other soft streambank stabilization techniques must be used where
practicable instead of riprap or other bank hardening methods. If riprap is necessary, it shall not be placed in
the streambed, unless approved by the DWQ.

3. All wetlands, streams, surface waters, and riparian buffers located on the project site where impacts are not
allowed shall be clearly marked (example- orange fabric fencing) prior to any land disturbing activities.

4. Stormwater discharge structures at this site shall be constructed in a manner such that the potential receiving
streams/wetlands (of the discharge) will not be impacted due to sediment accumulations, scouring or erosion.
N<6'rhcarolina
..i\tilllmlly

North Carolina Division of Water Quality 610 East Center Ave" Suite 301 t>looresville, NC 28115 Phone [phone]
Intemet: h2o.enr,slate,nc,us FAX [phone]
An Equal Opportunity/Affirmative Action Employer - 50% Recycled/l 0% Post Consumer Paper

Customer Service
1-877-623-67-18

5. No waste, spoils, solids, or fill of any kind shall be placed in wetlands, waters, or riparian areas beyond the
footprint of the impacts depicted in the Preconstruction Notification application, All construction activities
associated with this project shall meet, and/or exceed, those requirements specified in the most recent
version of the North Carolina Sediment and Erosion Control Manual and shall be conducted so that no
violations of state water quality standards, statutes, or rules occur.

6, Sediment and erosion control devices shall not be placed in wetlands or waters to the maximum extent
practicable. If placement of sediment and erosion control devices in wetlands and waters is unavoidable,
they shall be removed and the natural grade restored within two months of the date the Division of Land
Resources has released the project.

7, Upon completion of the project, the applicant shall complete and return the enclosed "Certificate of
Completion" form to the 401/Wetlands Unit of the NC Division of Water Quality and the Mooresville
Regional Office. Please send photographs of the upstream and downstream sides of each culvert site to
document correct installation, along with the Certificate of Completion form.

8. Continuing Compliance. The applicant (RPM Development, LLC) shall conduct its activities in a manner so
as not to contravene any state water quality standard (including any requirements for compliance with section
303(d) of the Clean Water Act) and any other appropriate requirements of state and federal law. If DWQ
determines that such standards or laws are not being met (including the failure to sustain a designated or
achieved use) or that state or federal law is being violated, or that further conditions are necessary to assure
compliance, DWQ may reevaluate and modify this certification to include conditions appropriate to assure
compliance with such standards and requirements in accordance with 15 A NCAC 2H.0507(d), Before
codifying the certification, DWQ shall notify the applicant and the US Army Corps of Engineers, provide public
notice in accordance with 15A NCAC 2H.0503, and provide opportunity for public hearing in accordance with
15A NCAC 2H.0504. Any new or revised conditions shall be provided to the applicant in writing, shall be
provided to the United States Army Corps of Engineers for reference in any permit issued pursuant to Section
404 of the Clean Water Act, and shall also become conditions of the 404 Permit for the project.

If you do not accept any of the conditions of this certification, you may ask for an adjudicatory hearing. You
must act within 60 days of the date that you receive this letter, To ask for a hearing, send a written petition that
conforms to Chapter 150B of the North Carolina General Statutes to the Office of Administrative Hearings, 6714
Mail Service Center, Raleigh, N.C. 27699-6714. This certification and its conditions are final and binding unless
you ask for a hearing,

This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water Act.
If you have any questions, please telephone Mr. Alan Johnson in the Mooresville Regional Office at 704-663-
1699 or Ms. Cyndi Karoly in the Central Office in Raleigh 919-733-9721.

Sincerely,

for Alan W, Klimek, P,E.

Attachments

cc: Army Corps of Engineers, Asheville
Cyndi Karoly, Wetlands Unit
David Caldwell, Meek. County, Water Quality
Central Files
Toney Browder

Triage Check List

Date:

6/9/05

Project Name: Wyndham Hall Plantation SD, Ph 2
DWQ#: 05-0974
County: Union

To: Alan Johnson, Mooresville Regional Office

60-day Processing Time: 6/6/05 to 8/4/05

From: Cyndi Karoly Telephone: [phone]

The file attached is being forwarded to your for your evaluation.
Please call if you need assistance.

D Stream length impacted
D Stream determination
D Wetland determination and distance to blue-line surface waters on USFW topo maps
Minimization/avoidance issues
D Buffer Rules (Neuse, Tar-Pamlico, Catawba, Randleman)
D Pond fill
D Mitigation Ratios
Ditching
D Are the stream and or wetland mitigation sites available and viable?
D Check drawings for accuracy
D Is the application consistent with pre-application meetings?
Cumulative impact concern
D

D

D

Comments: As per our discussion regarding revision of the triage and delegation processes,
please review the attached file. Note that you are the first reviewer, so this file will need to be
reviewed for administrative as well as technical details. If you elect to place this project on hold,
please ask the applicant to provide your requested information to both the Central Office in
Raleigh as well as the Asheville Regional Office. As we discussed, this is an experimental, interim
procedure as we slowly transition to electronic applications. Please apprise me of any
complications you encounter, whether related to workload, processing times, or lack of a "second
reviewer" as the triage process in Central had previously provided. Also, if you think of ways to
improve this process, especially so that we can plan for the electronic applications, let me know.
Thanks!

#0

TRANSMIITAL LEITER

BROWDER ENGINEERING, INt.
108 Chesney Glcn Drive
Matthews, NC 28105-5882
Phi fax: [phone]
Email: [e-mail]

fij) @ @ @ D \\17 r.2 f[;)
To: NC DIVISION OF WATER QUALITY, 401 \VctIands Unit 1M \Y IS ~
1650 Mail Service Center JUN 6 2005
Raleigh, NC 27699-1650
\'1~7NR " WATER QU/~lITY
Job Ref: WYNDHAM HALL PLANTATION SUBDIVISION-PH.2 DS/J.DSTOR.',fMTERiJ,W;CH
Corner of Joc Kcrr & Marvin School Rd., Union Co" N.C.
401 Watcr Quality Certification "after thc Fact"

Datc: Junc 2, 2005
mailcd 6/2/05 pm

Pcrsuant to notice of violation received by our client & subsequent conversations with Alan
Johnson of the Mooresville officc, I'm submitting 7 copics of the "Pre-Construction Notification"-
aftcr the fact, & am scnding samc package to thc CORP.
Intent behind work was to install bottomless culvcrts in pcrennial strcam with no impact to
the existing stream bed. During construction of the foundations apparently some disturbance
occurred, as did a minimal amowlt bcyond the immcdiate work area.
I've attached to the PCN pictures taken 5/27/05 during a site visit to observe thc present
statc of thc site, & have included a typical section proposed to "restore" thc banks to a morc natural
condition. I belicvc that the intent behind thc original design will bc achieved after thc rcstoration
of these banks & allow for "natural" passage beneath these bridge structures.
Your attention to this mattcr would be appreciatcd, upon approval of this "bank rcstoration"
plan, thc GC will be relcascd to implcmcnt immcdiately.
If any copied party should have any questions regarding this submittal, please feel free to
contact my office.

Sincerely,

Tancy O. Browder, P.E.lPrcsident

Cc: filc
Randy Poore/RPM Dcvelopment, LLC via copy oftm via fax to 704/849-7803 6/3/05 am

\o)@,@@,~~@,~
~ Jl\N G 2GGS

Office Use Only: oE}lR- ~'J!\1F~r~~1ER5iJ.J;CH Form Version May 2002
"iE1V~uS NiO SIOK .\1

USACE Action ID No. D\VQ No.
(If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A",)

I. Processing

I. ~ck all of thc approval(s) rcqucstcd for this projcct:
~ Scction 404 Pcrmit 0
Dpcction 10 Pcnnit 0
o 40 I Water Quality Certification

2. Nationwidc, Regional or General Permit Number(s) Requested: ~q

Riparian or Watcrshcd Buffcr Rules
Isolatcd Wetland Pcrmit from DWQ

3. If this notification is solely a~csy copy becausc writtcn approval for thc 401 Ccrtification
is not requircd, chcck hcrc: ~

4. If payment into the North Carolina Wctlands Restoration Program (NCWRP) is proposed for
mitigation of impacts (verify availability with NCWRP prior to submittal of PCN), completc
scction VIlI and chcck hcrc: 0

5. If your projcct is located in any of North Carolina's twcnty coastal countics (listcd on pagc
4), and thc project is within a North Carolina Division of Coastal Managcmcnt Arca of
Environmental Conecrn (sec thc top of pagc 2 for furthcr dctails), check hcrc: 0

II. Applicant Information

I.

2.

Fax Numbcr:

Telephonc Numbcr:
E-mail Addrcss:

Page 5 of 12

III. Project Information

Attach a vicinity map clearly showing the location of thc propcrty with rcspcct to local
landmarks such as towns, rivcrs, and roads. Also provide a detailed site plan showing propcrty
boundarics and dcvelopmcnt plans in relation to surrounding propcrtics. Both the vicinity map
and sitc plan must includc a scale and north arrow. Thc spccific footprints of all buildings,
impcrvious surfaccs, or other facilitics must be includcd. If possiblc, thc maps and plans should
include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the propcrty
boundarics outlincd. Plan drawings, or other maps may be included at the applicant's discrction,
so long as the property is clcarly dcfincd. For administrative and distribution purposcs, the
USACE requircs information to be submittcd on sheets no larger than 11 by l7-inch format;
however, DWQ may accept paperwork of any size. DWQ prefers full-size construction
drawings rathcr than a scquential shect version of the full-size plans. If full-sizc plans are
rcduccd to a small scale such that the final version is illegiblc, thc applicant will be informed that
thc project has bcen placed on hold until deciphcrable maps are providcd.

1. Name ofproject: W':Jlld ~~ I-/Ml (j){~:~ ~t1Se. 7.-

2. T.l.P. Project Number or State Project Number (NCDOT Only): ).( A-
3. Property Idcntification Number (Ta.x PIN): O(Pl'lOloo:3 G

4.

5. Sitc coordinatcs, if available (UTM or Lat/Long): ~ ~t;; -0 I
(Notc - If project is lincar, such as a road or utility line, attach a shcct that scparately lists thc
coordinates for eac~ crossing of a distinct waterbody.)

6. Propcrty size (acrcs): l[1A-/'rc

7. Ncarest body ofwatcr (stream/river/sound/ocean/lakc):

Sl~ Mi/~ C(l~e~

8. River Basin: CAr Aw"BA-
(Note - this must be onc of North Carolina's sevcnteen designatcd major river basins. Thc
Rivcr Basin map is available at htlp://h2(),~nr.statc.n~.lIs/admin/mars/.)

9. Describe the cxisting conditions on the site and general land use in thc vicinity of the projcct
at the timc of this application: ~U8DlVIS/o;.J JA.JFflAS1av~ &>o(JJc, /~ WADS
-g(U~ ?T c., Avi. ~t;rl.:(teS fttU:3 fl.~~ 10fCLtrtftl- ~ FiAf2)Y1
~n, .

Page 6 of 12

IV. Prior Project History

If jurisdictional determinations and/or permits have becn requested and/or obtained for this
project (including all prior phases of thc same subdivision) in the past, please explain. Include
the USACE Action ID Number, DWQ Project Numbcr, application date, and date permits and
certifications were issued or withdrawn. Provide photocopics of previously issued permits,
certifications or other useful infonnation. Describe previously approved wetland, stream and
buffer impacts, along with associated mitigation (wherc 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 schedulcs.
Lilt-.

V. Future Project Plans

Are any future permit requests anticipated for this project? If so, describe the anticipatcd work,
and provi( c justification for thc cxclusion of this work from the current application.
'0 - I ll.-L. Cff)110L SuB Of VI /Do{

VI. Proposed Impacts to Waters of the United Shltes/\Vaters of the State

It is the applicant's (or agent's) responsibility to dctcrminc, delincate and map all impacts to
wetlands, open watcr, and stream channcls associatcd with thc project. The applicant must also
provide justification for thcse impacts in Section VII below. All proposed impacts, permanent
and temporary, must be listcd hcrcin, and must be clcarly identifiablc on an accompanying site
plan. All wctlands and waters, and all streams (intermittent and pcrennial) must be shown on a
delineation map, whether or not impacts are proposed to these systems. Wetland and strcam
evaluation and dclineation forms should bc included as appropriate. Photographs may be
included at the applicant's discrction. If this proposcd impact is strictly for wetland or strcam
mitigation, list and dcscribe thc impact in Scction VIII below. If additional spacc is nceded for
listing or description, plcase attach a separate sheet.

Page 7 of 12

2. Individually list wctland impacts bclow:

Wctland Impact Area of Located within Distance to
Site Number Type of Impact* Impact IOO-year Floodplain** Nearest Stream Type ofWctland***
(indicate on map) (acres) (yes/no) (linear feet)

* List each impact scparately and identify tcmporary impacts, Impaets includc, hut arc not limited to: mechanizcd c1caring. gmding, Jill,
excavation, Ilooding. ditching/drainagc, etc. For dams, scparatcly list impaets duc to both structure and Ilooding,
** 100- Y car Iloodplains arc idcntificd through the Fcdcml Emcrgcncy Managcment Agcncy's (FEMA) Flood Insurancc Ratc Maps
(FIRM). or FEMA-approvcd local floodplain maps, Maps arc availahle through the FEMA Map Service Ccntcr at 1-800-358-9616, or
online at LijJL~!j_\""'\.I...~~\,:JD;I,g~\.:,
*** List a wctland typc that hest dcscrihcs wctland to hc impacted (c,g" freshwater/saltwater marsh, forested wctland. hcaver pond.
Carolina Bay, hog, ete,) Indicate ifwctland is isolated (dctcrmination ofisotation to hc madc hy USACE only),

List the total acrcage (cstimatcd) of all existing wetlands on thc propcrty: 0
Total arca of wetland impact proposcd: c>

3. Individually list all intermittent and perennial stream impacts below:

Length of
Typc ofImpact* Impact Stream Name**
(lincar feet)
1I ?O'-t. uJ.I';!4mr!O

?o '1. r'

Average Width
of Stream
Beforc]m act
(P'.t

(0' ~

I'

List cach impact scparatcly and idcntity tcmporary impacts, Impaets includc, hut arc not limitcd to: culvcrts and associatcd rip-rap.
dams (separately list impaets duc to hath structurc and Ilooding). relocation (includc lincar fect beforc and aftcr, and net loss/gain),
stabilization activitics (cemcnt wall. rip-rap, crih wall, gab ions, etc,), excavation, ditching/straightcning. etc, If stream relocation is
proposcd. plans and proJilcs showing thc lincar footprint for both thc original and relocatcd streams must hc includcd,
** Stream names ean hc found on USGS topographic maps, If a stream has no name, list as UT (unnanlcd trihutal)') to thc ncarest
downstream named stream into which it flows, USGS maps arc availahlc through thc USGS at 1-800-358-9616. or onlinc at
II \\ \\11:;g~g,'2.""'. Scveral intcrnct sitcs also allow dircct download and printing of USGS maps (e.g,. ~"i.....~~J.~111(2!c,,}IC:.J.'(IIIl,
\\~~.Jll;IE(JIlc:_::-l,l'(1I1!, ete.),

*

Cumulative impacts (linear distance in feet) to all streams on site:

L./so'

Pagc 8 of 12

4. Individually list all opcn watcr impacts (including lakcs, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.) below:

Opcn Watcr Impact Arca of Name ofWatcrbody Type of Watcrbody
Sitc Number Type of Impact* Impact (ifapplicablc) (Iakc, pond, cstuary, sound,
(indicatc on map) (acres) bay, occan, etc.)
/VO/L(t3

* List cach impact scparatcly and identify tcmporary impaets, Impacts include, but an: not limited to: fill, ex caval IOn, dredgmg,
flooding, drainagc, bulkheads, ctc,

5. Pond Creation At A-- t
If construction of a pond is proposcd, associated wetland and streanl impacts should be
included above in the wetland and strcam impact sections. Also, the proposed pond should
be described hcrc and illustratcd on any maps included with this application.
Pond to be created in (check all that apply): 0 uplands 0 strcam 0 wetlands
Describc thc mcthod of construction (e.g., dam/embankment, cxcavation, installation of
draw-down valvc or spillway, ctc.):

Proposed use or purpose of pond (e.g., livcstock watering, irrigation, aesthetic, trout pond,
local stormwatcr requirement, etc.):

Sizc 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 sitc constraints such as topography, building ordinanccs, accessibility, and
financial viability of thc projcct. Thc applicant may attach drawings of altcrnativc, lower-impact
sitc layouts, and explain why thcsc dcsign options werc not fcasiblc. Also discuss how impacts
were minimized once the desircd site plan was developed. If applicable, discuss construction
techniqucs to be followcd during construction to reduce impacts.
C ~ ~ tv (2.~ 0cJc:- 0 51.J O,t,tOl,tt.
(3)(frS ~ SV B. r<ec;> D 1 hJr? 12 /2/06 ~S

1JL S/IrsIL~f4-~L~ f&(2 TU?Q~ ~S~f~'" uE-
t/J:;VA./< leSS CUI... Vl3ZZ:S 75 /2({)6r?. 0 ~()C~
;SflprZ7 1 LOA/t:P. ~ i (J1~~..5 I 1- Fet!L r-tf/S' #vIS 1Sf(3J
Mitigation /l~Ct:7W/ PillS/' ed.

VIII.

DWQ - In accordance with 15A NCAC 2H .0500, mitigation may bc required by thc NC
Division of Watcr Quality for projccts involving greater than or equal to onc acrc of impacts to
freshwater wetlands or greater than or equal to 150 linear feet of total impacts to pcrennial
streams.

Page 9 of 12

USACE - In accordance with the Final Noticc of Issuancc and Modification of Nationwide
Pcrmits, published in the Federal Registcr on March 9, 2000, mitigation will be required whcn
ncccssary to ensure that advcrsc cffccts to thc aquatic cnvironmcnt arc minimal. Factors
including size and type of proposed impact and function and relativc valuc of thc impacted
aquatic resource will be considcred in dctermining acceptability of appropriatc and practicable
mitigation as proposed. Examples of mitigation that may be appropriate and practicable includc,
but arc not limitcd to: rcducing the size of the project; cstablishing and maintaining wctland
and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of
aquatic rcsourcc functions and values by creating, restoring, enhancing, or preserving similar
functions and values, preferable in the same watcrshed.

If mitigation is required for this project, a copy of the mitigation plan must bc attachcd in ordcr
for USACE or DWQ to consider the application complete for proccssing. Any application
lacking a requircd mitigation plan or NCWRP concurrcncc shall be placed on hold as
incomplcte. An applicant may also choose to review the current guidclines for stream rcstoration
in DWQ's Draft Technical Guide for Stream Work in North Carolina, available at
hI I r:l /h2o,l:nr ,stall:,l1c ,lIs/nc\\et Iallds/slrm gi tk, htm I.

l.

2. Mitigation may also be made by paymcnt into the North Carolina Wetlands Restoration
Program (NCWRP). Please note it is the applicant's responsibility to contact the NCWRP at
[phone] to dctcrmine availability and to request written approval of mitigation prior
to submittal of a PCN. For additional information rcgarding the application process for the
NCWRP, chcck the NCWRP website at httr:l/h2o.l:nr,state,llc.lIs/wrf2lilldex.htm, If usc of
the NCWRP is proposed, please check the appropriate box on page threc and provide the
following information: .

Amount of strcam mitigation rcquested (lincar feet): ,(/ A-
Amount of buffer mitigation requested (square feet):
Amount of Riparian wetland mitigation requestcd (acres):
Amount of Non-riparian wetland mitigation requcsted (acrcs):
Amount of Coastal wetland mitigation requested (acres):

Page JO of 12

IX. Environmcntal Documcntation (rcquircd by DWQ)

Docs thc projcct involvc ;(c' pcnditurc of public (fcderal/statc)
(fcderal/statc) land?
Yes 0 No

funds or the usc of public

If ycs, docs thc projcct rcquirc prcparation of an cnvironmcntal document pursuant to thc
rcquircmcnts of thc National or North Carolina Environmcntal Policy Act (NEPA/SEPA)?
Notc: If you arc not sure whcthcr a NEP A/SEP A documcnt is rcquircd, call the SEP A
coordinator at [phone] to rcvicw currcnt thresholds for cnvironmcntal documentation.
Ycs 0 No D

I f yes, has the document rcvicw bccn finalized by thc Statc Clcaringhouse? If so, plcasc attach a
copy ofthc NEPA or SEPA final approvallcttcr.
Ycs 0 No 0

X. Propos cd Impacts on Riparian and \V~ltcrshcd Buffcrs (rcquircd by D\VQ)

It is the applicant's (or agent's) rcsponsibility to dcterminc, delineatc and map all impacts to
requircd state and local buffcrs associated with the project. The applicant must also provide
justification for these impacts in Section VII above, All proposcd impacts must bc listcd herein,
and must bc clcarly identifiablc on thc accompanying site plan. All buffcrs must bc shown on a
map, whether or not impacts arc proposed to thc buffcrs. Corrcspondcncc from the DWQ
Rcgional Officc may bc included as appropriate. Photographs may also bc included at thc
applicant's discrction.

Will thc projcct impact protcctcd riparian buffers idcntified within 15A NCAC 213 .0233
(Ncusc), 15A NCAC 213 .0259 (Tar-Pamlico), 15A NCAC 213 .0250 (Randleman Rules and
Watcr Supply Buffcr Rcqu~tfunts), or other (plcasc identify )'1
Ycs D No ~ If you answcred "ycs", providc thc following information:

Idcntify thc squarc fect and acrcagc of impact to cach zonc of thc riparian buffcrs. If buffcr
mitigation is rcquircd calculatc thc requircd amount of mitigation by applying thc buffcr
multipliers.

Zonc. Impact Multiplicr Requin:d
(squarc fcet) MitiQation
I .,( / A- 3
2 L5
Total

*

lonc I extends out 30 fcet pCfTlcndicular from ncar bank of channel; Zonc 2 extcnds an
additional 20 fcct fro1l11he cdge of Zone L

Page] I of 12

If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation
of Property, Conservation Easement, Riparian Buffer Restoration / Enhancement, Preservation or
Payment into the Riparian Buffer Restoration Fund). Please attach all appropriate information as
identified within lSA NCAC 2B .0242 or .0260.

XI. Stormwater (required by DWQ)

XII. Sewage Disposal (required by DWQ)

Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from the proposed projec , or available capacity of the subject faci ity.
pu l.-(C!...? SYS lJ^-IFOA/ co, Pp{3(fC- (..>c5nt-t'S
Pt5Yl Av<.. ;L( C;W f/'tJ>>'1 F S ,

XIII. Violations (required by D\VQ)

Is this site in ~lation of DWQ Wetland Rules (I SA NCAC 2H .0500) or any Buffer Rules?
Yes ~ No D /11~M,;vt1 fF ~5"6'I'2Il> fM7V. UV[, =Pt:)oOg

Is this an aft~-fact permit application?
Yes 0 No D

XIV. Other Circumstances (Optional):

It is the applicant's responsibility to submit the application sufficiently in advance of desired
construction dates to allow processing time for these permits. However, an applicant may
choose to list constraints associated with construction or sequencing that may impose limits on
work schedules (e.g., draw-down schedules for lakes, dates associated with Endangered and
Threatened Species, accessibility problems, or other issues outside of the applicant's control).
~rzo fl5 ~ /,<ff~OeY:/ /lifT( CO //11P/K:r t!-v/tZ't!Y25JFrc{Y::L-
CbNDfftofilS 'Vt5rZFU?' BtZ{06e- p-7'l:o,II4f.8U-/!{/Z) ......
crza>ct{eo cr flC04f5~d?5 tv6f&7-(f ~ VIS lDr:<13 (J(J Wtf1eYl
Ct!)VVL,S{2: -ro /tV5T~ D~P(?Y2 Ff)d.qtYJrtzJ~. cvqtRe/I/7L'T
&/rcc IS L~ay [2{;~7OYlLEV f9~mu~4-
.) ~f. r::::?.4J.I L.s /,u "TH'P OES/b.d PIlOC(?~ 5:'j$@2 P/CV

Applicant Agent's Signature ate
(Agent's signature is valid only if an authorization letter from the applicant is provided.)

Page 12 of 12

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BROWDER Client: RPMDEVELOPMENTLLC I
.. ENG.,P.A. Proje~t: . Wyndham Hall Plantation Ph. 2
108 O1esney Glcn Dr. DescrIptIOn: Appomatox Sta.4+30 HW's 38 & 39
Matthews, N.C.28IOS-S882
PhonelFacsimile:70.m08-9597 Date: June 3, 2005

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14'x5' Bridge

Page No. 1A of 3

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BROWDER Client: RPM DEVELOPMENT LLC
... ENG.,P.A. Proje~t: . Wyndham Hall Plantation Ph. 2
103 Chesney Glen Dr. DescriptIOn: Stonehurst Dr. Sta.2+50
Matthews, N.C.2S105-5882
PhonelFacsimile:70.tn08-9597 Date: June 3, 2005

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Page No. 2A of 3

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BUTTON BUSH & SILKY DOGWOOD TO BE SPACED AT f
APPROXII.'ATELY B'o.c., STAGGER lYPES FROM SIDE T~ ~
SIDE WITHIN FIRST 5-ft OF THE 2:1 SLOPED AREA BANK C ~

PLACE BIODEGRADABLE EROSION FABRIC FRO!A BRUSH G-
FASCINE TO MIN. 6' UP THE 2:1 SIDE SLOPES & TOE IN
MIN. 6", & SEED WITH TAlL FESCUE PER SEEDING
w '-' SPECiFICATIONS.
~~
~ tii SYMMETRiCAl ABOUT 6'-0"
~ 8 DIMENSION OF SECTION ~
5'-O"MIN. (B SE IN 5"FROM FLOW LINE, & /' 5'-O"@ 3H M1N:1V
EXPAND OUT TO APPROX.12"FROM OVERFlOW BENCH
FACE/C LVERT. NO DISTURBANCE 0
EXISTlN WATERLINE \\1THIN THIS DIM.

6' 0" lAIN.
EXTEND OF EROSION FABRIC

LOW POINT OF STREA'J TO REIAAlN
UNDISTURBED, VARIES IN LOCATION IN
RElATION TO FASCINE PLACEMENT

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~5"DIA.:!: BRUSH LOG FASCINE (GROUP UVE TREE BRANCH
STRIPPINGS TOGETHER IN SAME ORIENTATION, TIGHTlY TIE
TOGETHER \\1TH DEGRADABLE TWINE) & EIABED 507. INTO
EXISTING ElABANKMENT WITH FlOW LINE EDGE 6":!: ABOVE
FlOWLINE. (SIIJ.1LAR OPPOSITE SIDE OF STREAM)

CD ~~~~~~~K RESTORATION DETAIL

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NOTE: THIS SECTION SHAll BE APPLIED AT BOTH ENDS OF
EXISTING BRIDGES & TIED INTO NATURAl UNDISTURBED STREAM
BANKS. PLACE FASClNE LOGS AlIGNING WITH EXISTING
CHmNEL, ADJUST TO IAEET SECTION REQ'MTS. & THEN TIE TO
APPROXIIJATELY 12" OF FACES OF CULVERT OPENING EACH
SIDE lYP. SEE PlANS FOR SHADED AREAS DEPICTING
APPROXIMATE BANK DISTURBED AREAS FOR RESTORATION

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Office Use Only:

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JUN 6 2005

Fonn Version May 2002

USACE Action ID No. nFNR: wi\.rtP,~~gl:N. I
(Ifany particular itcm is not applicabfiffiRfill,1#Pdr8!t~"~rJasc 'enter "Not Applicablc" or "N/A".)

I. Processing

1. ~ck all of the approval(s) rcquestcd for this projcct:
~ Section 404 Permit D
D))ection 10 Pcrmit D
o 401 Water Quality Certification

') Nationwide, Regional or Gcneral Permit Number(s) Requestcd: ~q

Riparian or Watershcd Buffer Rules
Isolatcd Wetland Pcrmit from DWQ

3. If this notification is solely a ~rrtcsy copy because writtcn approval for the 401 Certification
is not rcquired, chcck here: l'{J

4. If payment into the North Carolina Wetlands Restoration Program (NCWRP) is proposcd for
mitigation of impacts (verify availability with NCWRP prior to submittal of PCN), complete
scction VIII and chcck hcre: D

5. If your projcct is locatcd in any of North Carolina's twenty coastal countics (listed on pagc
4), and thc project is within a North Carolina Division of Coastal Managcment Area of
Environmcntal Concern (see the top of page 2 for further details), check hcre: D

II. Applicant Information

l.

Telephone Number:
E-mail Address:

Fax Number:

2.

Pagc 5 of 12

III. Project Information

Attach a vicinity map clearly showing thc location of the property with respect to local
landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property
boundarics and dcvelopmcnt plans in relation to surrounding propertics. Both thc vicinity map
and site plan must include a scale and north arrow. The specific footprints of all buildings,
impervious surfaccs, 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
boundarics outlined. Plan drawings, or other maps may bc included at thc applicant's discretion,
so long as the property is clearly defined. For administrative and distribution purposes, the
USACE rcquires information to be submitted on sheets no largcr than 1 I by 17-inch format;
however, DWQ may acccpt paperwork of any size. DWQ prefers full-size construction
drawings rathcr than a sequential sheet version of the full-size plans. If full-size plans are
rcduced 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: Wljlld ~~ /-1M, (j){~:CN'1 ~~e. "2-

2. T.l.P. Projcct Number or State Project Number (NCDOT Only): I{ A-
3. Propcrty Idcntification Number (Tax PIN): OCt''20,oo:3 G

4.

5. Site coordinates, if available (UTM or Lat/Long): ~ ~t; -0 (
(Note - If project is linear, such as a road or utility line, attach a sheet that separately lists the
coordinates for eac~ crossing of a distinct waterbody.)

6. Propcrty size (acres): l[1A-/'rc

7. Ncarcst body ofwatcr (stream/river/sound/occan/lake):

Sl~ M;/~ C(lf2e~

8. River Basin: CArAw"Bfl-
(Note - this must bc one of North Carolina's seventeen designated major river basins. The
Rivcr Basin map is available at http://h2o.cnr.statc.nc.us/admin/maps/.)

9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: ~U8DlV'SIO^, JAlF'2AS1avcrvfl-G ~o(J.IC:.I1h WADS
-g(2L~ (y( 0. Ap:(. ~~l(?:.s fttlE n~t? 10lafrcftl- ~ FWZ)VJ
LPr"JJO. '

Page 6 of 12

IV. Prior Project History

If jurisdictional determinations and/or permits havc 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
ccrtifications were issued or withdrawn. Provide photocopies of previously issued permits,
certifications or othcr uscful infonnation. Describc prcviously approved wctland, stream and
buffcr impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and dcscribe permits issued for prior segments of the samc T.I.P. projcct, along with
construction schedulcs.
'11r.

V. Future Project Plans

Arc any futurc permit requests anticipatcd for this project? If so, describe the anticipated work,
and provit e justification for the exclusion of this work from the currcnt application.
o --- I 1L-L- O7/YlO[ SV Of VI I'D'.

VI. Proposed Impacts to \Vaters of the United States/\Vaters of the State

It is the applicant's (or agent's) responsibility to determine, delincate and map all impacts to
wctlands, open watcr, and stream channels associatcd with the projcct. The applicant must also
provide justification for these impacts in Section VII below. All proposed impacts, permanent
and temporary, must be listcd hcrein, and must be clearly identifiable on an accompanying site
plan. All wetlands and waters, and all strcams (intermittent and perennial) must be shown on a
delineation map, whether or not impacts arc proposcd to these systems. Wetland and stream
evaluation and delineation forms should bc includcd as appropriate. Photographs may be
included at the applicant's discrction. If this proposed impact is strictly for wetland or stream
mitigation, list and dcscribe the impact in Section VIII below. If additional space is nccdcd for
listing or description, please attach a separatc sheet.

Page 7 of 12

2. Individually list wetland impacts below:

Wetland Impact Area of Located within Distance to
Site Number Type of Impact* Impact I OO-year Floodplain** Nearest Stream Type ofWetland***
(indicate on mao) (acres) (yes/no) (linear feet)

*

**

...

List each impact separately and identity tcmporary impacts. Impacts include, but are not limited to: mechanized elearing, grading, Jill,
excavation, nooding. ditching/drainage. ete. For dams, separatcly list impacts duc to both structure and llooding.
100-Year lloodplains are identified through the Federal Emergency Management Agency's (FEMA) Flood Insurance Ratc Maps
(FIRM). or FEMA-approved local floodplain maps. Maps are available through the FEMA Map Service Ccnter at 1-800-358-9616, or
online at tIJtp~J_\~.\~~~Jc:.lll;I.~~\,.
List a wetland type that best deseribes wetland to be impaeted (e.g., freshwater/saltwater marsh, forested wetland, heaver pond,
Carolina Bay, bog, ete.) Indicate if wetland is isolated (detennination of isolation to be made by USACE only).

List the total acreage (estimated) of all existing wetlands on the property: C>
Total area of wetland impact proposed: C>

3. Individually list all intermittent and perennial stream impacts below:

Stream Impact Length of Avemge Width Perennial or
Site Number Type of lmpact* Impact Stream Name** of Stream Intermittent?
(indicatc on map) (linear fect) Bcfore Imoact (pI case soccify)
({) { L.77J. ~~ ~~ II ?o '..l- v.(/ .)l4mrFO (pI-!=. R:1""~~,a (
(2) 7c;M e:;r Pt'~. ?O/~ r, (0" 6 I'

List each impaet separately and identify temporary impacts. Impaets include, but are not limited to: culvcrts and associated rip-rap,
dams (separately list impaets duc to both strueture and llooding), relocation (include linear feet before and after, and net loss/gain),
stabilization activities (cement wall, rip-rap, crib wall, gabions, etc.), excavation, ditching/straightening, etc. If stream rclocation is
proposcd, plans and profiles showing the linear footprint lor both the original and relocatcd streanlS must be included.
** Stream names can be lound on USGS topographic maps. If a stream has no name, list as UT (unnanlcd tributary) to the nearest
downstream named stream into which it llows. USGS maps are available through the USGS at 1-800-358-9616, or online at
~~"'lc~,,~<.!l. Several intcrnet sitcs also allow dircct download and printing of USGS maps (e.g., l\..\.I.~\'L(l1'!YL'11Cl"(IJI.I,
\~~\~IIJi.'l''lJl;:,:'l.l"QI)!, ete.).

*

Cumulative impacts (linear distance in feet) to all streams on site:

L. , SO I

Page 8 of 12

4. Individually list all open water impacts (including lakes, ponds, cstuaries, sounds, Atlantic
Ocean and any other water of the U.S.) below:

Opcn Watcr Impact Arca of Name of Waterbody Type of Water body
Site Numbcr Type oflmpact* Impact (if applicable) (lake, pond, estuary, sound,
(indicate on map) (acres) bay, ocean, etc.)
/VO/t.(/3

* List each impact separately and identi(y temporary impacts. Impacts include, but are not limited to: fill, excavation, dredging,
llooding, drainage, bulkheads, etc.

5. Pond Creation ;({ A-- r
If construction of a pond is proposed, associated wetland and stream impacts should be
includcd abovc in the wetland and strcam impact sections. Also, the proposed pond should
be dcscribed here and illustratcd on any maps includcd with this application.
Pond to be crcated in (check all that apply): D uplands D stream D wetlands
Describc thc method of construction (e.g., dam/embankment, excavation, installation of
draw-down valve or spillway, etc.):

Proposed usc or purpose of pond (c.g., livestock watcring, irrigation, aesthetic, trout pond,
local stormwater requircmcnt, etc,):

Size of watershed draining to pond:

Expected pond surface area:

VII.

Impact Justification (Avoidance and Minimization)

Specifically describe mcasures taken to avoid the proposcd impacts. It may be uscful to provide
information relatcd to site constraints such as topography, building ordinances, accessibility, and
financial viability of the projcct. Thc applicant may attach drawings of alternative, lower-impact
site layouts, and explain why these dcsign options wcrc not feasible. Also discuss how impacts
were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reducc impacts,
C ~ t; tv, rz.~ 0tJC:- 0 StJ O,-ttOl,l/.
BXrrS ~ SVB. r<J?{JD ~ tvr? t? /2r06FS

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~M< SS CLlLVazz:s 'B/2(06r?. 0 ~()Ct:
sl!Pa? t U)A./tP. ~ I M~4C?S I 1- Fel2L -rtf/$' IMS 5fl3./
Mitigation /j-C:Cen>1 IJllt5h ed,

VIII.

DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC
Division of Watcr Quality for projects involving greatcr than or cqual to one acre of impacts to
freshwatcr wctlands or grcater than or equal to 150 linear feet of total impacts to pcrennial
streams.

Page 9 of 12

USACE - In accordance with the Final Noticc of Issuancc and Modification of Nationwidc
Permits, published in the Fedcral Register on March 9, 2000, mitigation will be required when
nccessary to cnsure that adverse effects to the aquatic environment are minimal. Factors
including size and type of proposed impact and function and relative value of thc 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 limitcd to: reducing thc size of the projcct; cstablishing and maintaining wetland
and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of
aquatic resourcc functions and values by creating, restoring, enhancing, or prescrving similar
functions and values, preferable in the same watershed.

If mitigation is requircd for this project, a copy of thc mitigation plan must be attached in ordcr
for USACE or DWQ to consider the application completc for processing. Any application
lacking a required mitigation plan or NCWRP concurrence shall be placed on hold as
incomplete. An applicant may also choose to review the current guidelines for stream restoration
in DWQ's Draft Technical Guide for Stream Work in North Carolina, available at
lillJ1 :I/h 2( u:n r.stalc.ne .us/neWel lands/slrrngidc. hIm I.

I.

2. Mitigation may also be madc by payment into the North Carolina Wetlands Restoration
Program (NCWRP). Please note it is the applicant's responsibility to contact the NCWRP at
[phone] to determine availability and to request written approval of mitigation prior
to submittal of a PCN. For additional information regarding the application process for the
NCWRP, check the NCWRP website at http://h2o.enr.stak.ne.us/wrr/indcx.htrn. If use of
the NCWRP is proposed, please check the appropriate box on pagc threc and provide the
following information: .

Amount of strcam mitigation requested (lincar feet): J.j 4-
Amount of buffer mitigation requested (square feet):
Amount of Riparian wetland mitigation requested (acres):
Amount of Non-riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres):

Page 10 of 12

IX. Environmcntal Documentation (required by DWQ)

Does the project involve ;;c. penditure of public (federal/state)
(fedcral/statc) land?
Ycs D No

funds or the usc of public

If yes, does the projcct require preparation of an environmental documcnt pursuant to the
rcquircments of thc National or North Carolina Environmental Policy Act (NEPA/SEPA)'1
Note: If you are not surc whethcr a NEPA/SEPA documcnt is required, call the SEPA
coordinator at [phone] to review current thresholds for environmental docwnentation.
Yes D No D

I f yes, has thc document review been finalized by the State Clearinghouse? If so, pleasc attach a
copy of the NEP A or SEP A final approval letter.
Yes D No D

X. Propos cd Impacts on Riparian .md Watcrshed Buffers (rcquircd by DWQ)

It is the applicant's (or agent's) responsibility to detcrmine, delineatc and map all impacts to
requircd state and local buffers associated with the project. The applicant must also providc
justification for these impacts in Section VII above. All proposed impacts must bc listed herein,
and must be clearly identifiablc on the accompanying site plan. All buffcrs must be shown on a
map, whether or not impacts are propos cd to thc buffers. Correspondcnce from thc DWQ
Regional Office may bc included as appropriate. Photographs may also be included at the
applicant's discretion.

Will the project impact protectcd riparian buffers identified within 15A NCAC 2B .0233
(Ncusc), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randlcman Rules and
Water Supply Buffer Requir~nts), or othcr (please identify )'1
Ycs D No ~ If you answercd "ycs", providc the following information:

Idcntify the squarc fcet and acreage of impact to each zonc of the riparian buffers. If buffer
mitigation is required calculate the required amount of mitigation by applying the buffer
multipliers.

Zonc. Impact Multiplicr Rcquircd
(squarc feet) MitiQation
I ~ /LJ- 3
2 1.5
Total

.

lone I extends out 30 feet perpendicular from near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone I.

Page II of 12

If buffer mitigation is requircd, pleasc discuss what type of mitigation is proposcd (i.c., Donation
of Property, Conservation Easement, Riparian Buffer Restoration / Enhancement, Preservation or
Payment into the Riparian Buffer Restoration Fund). Please attach all appropriatc information as
identified within 15A NCAC 2B .0242 or .0260.

XI. Stormwater (required by DWQ)

o SC!'OI/he.rt'rir/O ~S
/N (?-S ~
Ct'fI,Jt!"Lt!>{/F;f. <?J..fr, 1- J'1rl8t-5
fltJ:7, 70 S '{IZI!nlV1~ t.l:f:F-r)..Vr(LfYlh-.

XII. Sewage Disposal (required by DWQ)

Clearly detail the ultimatc treatment methods and disposition (non-discharge or discharge) of
wastcwatcr generated from the proposed projec , or available capacity of the subject faci ity.
pu l.-(C!...? S't'$ lJA./FOA/ CO, Pp{3({C- t.>c5nt-t'S
Pt>Yl Av<.. ;L( C;W f/'tJ>>'1 F S ,

XIII. Violations (required by DWQ)

Is this site in ~lation of DWQ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes ~ No D /11~M,;~ fF ~5"&JI'2Il> fM7V. UV[, =Pt:)oOg

Is this an aft~-fact permit application?
Yes 0 No D

XIV. Other Circumstances (Optional):

It is the applicant's responsibility to submit the application sufficiently in advance of desired
construction dates to allow processing timc for thcsc pcrmits. 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, datcs associated with Endangered and
Threatened Species, aC,cessibility problems, or other issues outside of thc applicant's control).
~rzo fl5 ~ /,<ff~OeY:/ /lIUT CO .!/I1P/K:r t!-v/tZ't!Y2~Fr~_
CbNDfftofilS Vt5rZFU?' BtZ{06e- p-7'l:o,II4f.8U-/!{/Z) .. .' - .
crza>ct{eo CrflC04f5~d?5 tv6f&7-(i ~ VtS lDr:<13 (J(J Wtf1eYl
~S{2: -ro I tV5T~ D~P(?Y2 FtJd.qtYJraJ,t/S. cvqrfieJI/7L'T
&/rccls L~ay [2{;~7OYlLEV f?iZ~A?Pt~4-
.) ~f. r::::LmI L.s l,u ~ OES/b.d PIlOC(?~5:'j$@2 P/CV

Applicant Agent's Signature ate
(Agent's signature is valid only if an authorization letter from thc applicant is providcd.)

Page 12 of 12

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BROWDER Client: RPM DEVELOPMENT LLC I
ENG.,P.A. Proje~t: . Wyndham Hall Plantation Ph. 2
108 O1csncyGlcn Dr. DescrIptIOn: Appomatox Sta.4+30 H\Y's 38 & 39
Matthews, N.C.28105-S882
PhonelFacsimile:70.m08-9597 Date: June 3, 2005

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14'x5' Bridge

Page No. 1A of 3

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BROWDER Client: RPl\1 DEVELOPMENT LLC
ENG.,P.A. Proje~t: . Wyndham Hall Plantation Ph. 2
103 Chesney Glen Dr. DeSCrl phon: Stonehurst Dr. Sta.2+50
Matthews, N.C.28lOS-SSS2
PhonclFacsimilc:70.m03-9597 Date: June 3, 2005

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Page No. 2A of 3

. rrrr"

BUTTON BUSH &: SILKY DOGWOOD TO BE SPACED AT c('
APPROXII.IATELY B'o.c., STAGGER TYPES FROM SIDE T~ ~
SIDE WITHIN FIRST 5-ft OF THE 2:1 SLOPED AREA BANK C ~

PLACE BIODEGRADABLE EROSION FABRIC FROM BRUSH ~
FASClNE TO MIN. 6' UP THE 2:1 SIDE SLOPES &: TOE IN
MIN. 6", &: SEED WITH TALL FESCUE PER SEEDING
w c.:> SPECIFICATIONS.
~~
~ tii SYMMETRiCAl ABOUT 6'-0"
~ (5 DIMENSION OF SECTION ~
6' -O"MIN. ( SE IN 6"FROM FLOW LINE, & / 5' -0" @ 3H M1N:1V
EXPAND OUT TO APPROX.12.FROM OVERflOW BENCH
FACE/C LVERT. NO DISTURBANCE 0
EXIST1N WATERLINE \\1THIN THIS DiM.

6' -0" MIN.
EXTEND OF EROSION FABRIC

LOW POINT OF STREAM TO REMAIN
UNDISTURBED, VARIES IN LOCATION IN
RElATION TO FASCINE PLACEMENT

6"DIA.:! BRUSH LOG FASClNE (GROUP LIVE TREE BRANCH
STRIPPINGS TOGETHER IN SAIJE ORIENTATION, TIGHTlY TIE
TOGETHER \\1TH DEGRADABLE miNE) &: EMBED 507. INTO
EXISTING EMBANKMENT WITH flOW LINE EDGE 6":!: ABOVE
flOWLINE. (SIMILAR OPPOSITE SIDE OF STREAM)

GL) ~~~~~~~K RESTORATION DETAIL

NOTE: THIS SECTION SHAll BE APPLIED AT BOTH ENDS OF
EXlsnNG BRIDGES &: TIED INTO NATURAl UNDISTURBED STREAM
BANKS. PLACE FASCINE LOGS AlIGNING WITH EXISTING
CHf.NNEL, ADJUST TO MEET SECTION REQ'MTS. &: THEN TIE TO
APPROXIIiATELY 12" OF FACES OF CULVERT OPENING EACH
SIDE TYP. SEE PLANS FOR SHADED AREAS DEPICTING
APPROXIMATE BANK DISTURBED AREAS FOR RESTORATION

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Winston-Salemlforsyth County Sc~ools
P. O. Boxlm
Winston-Salem. HC mOl-lm
0)Wll-2B16 rax 0)6)]l1-1008
we~site: wsfcs,m.nc.us

Board of [ducation

Geneva B. Brown
A. L. (Buddy) Collins
Janl~ D. Goins
Victor Johnson, Jr.
Donny C. Lambeth (Chair)
Jeannie A. Metcalf
Marilyn A. Parker
Jill A. Tackabery
Lynn S. Thrower

Donald L. Martin, Jr.
Superintendent

o..:r F I

~ l\- -D q 1 4-
~LLCl

November 15,2005

~ethJ

40l/Wetlands Unit
North Carolina Division of Water Quality f?) @@@O\/-
1621 Mail Service Center L\\ J ,
Raleigh, North Carolina 27699-1621 \;_,Ij 1 8 20lh

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Re: East Forsyth Middle School
Certificate of Completion

.'__ ~:-' ", ':.',',.TERCU.'u,
\l:l!...""o.-,,, _i ~IC;:.',L'.':\TL'~Lj-",,\,.'':H

Dear Sir/Madam:

Please find enclosed the Certificate of Completion for the
above referenced project. If you have any questions, please
call.

Sincerely,

~

p

Jim Moorefield

JM/sw

Enclosure

Certificate of Completion

DWQ Project No.:

04-0974

County:

Forsyth

Applicant:

Winston-Salem/Forsyth County Schools

Project Name:

East Forsyth Middle School

Date of Issuance of 401 Water Quality Certification:

July 27, 2004

Upon completion of all work approvcd within the 401 Water Quality Certification and Buffer Rules, and any
subscquent modifications, the applicant is rcquircd to return this certificate to the 401lWetlands Unit, North
Carolina Division of Water Quality, 1621 Mail Service Center, Raleigh, NC, 27699-1621. This form may be
returned to DWQ by the applicant, the applicant's authorized agent, or the project engineer. It is not
neccssary to send certificatcs from all of these.

Applicallt's Certificatioll

I, Jim Moorefield , hereby statc that, to the best of my abilities, duc care and
diligence was used in the observation ofthc construction such that the construction was observed to bc built
within substantial compliancc and intent of the 401 Water Quality Certification and Buffcr Rules, the
approved plans and specifications, and other supporting materials.
Winston-Salem/~rsyth County B qrd 0 ducation
Signature: B : Date: 6/22/05

I, Chr is Hay , hereby state that, to the best of my abilities, due care and
diligence was used in thc obscrvation of the construction such that the construction was observcd to be built
within substantial compliance and intent of the 401 Water Quality Certification and Buffer Rules, the
approved plans and specifications, and other supporting materials. ,\\'~l'cIA"""1
TrigO~ngin~. ring l ,"~i\,.......110""
I / .1 "r re:::- ..' 0..... . ... E.SS ". <': "
Signature: Bv: l111 Datc: ~ 'L, utJ f~...~'<<-O~ IO~..~~
Chris ay g ! SEAL <" y~ ~
: i 12283 i :
.. . . ..
"'1;.- . ...
Ifthis project was desiglled by a Certified Professiollal -:. ~... ~ ~ ...,~ ~
-:., ~:..tGINE.'C:....~,(j ..::
" '7 V ........ ~~" ,"
I, Ke i th Broder i ck , as a duly rcgistered Professional Eng i ne't!rt',;,~.FfJ:2\\\\\""
Engineer, Landscape Architect, Surveyor, etc.) in the State of North Carolina, having been authorized to
observe (periodically, wecld.y, fulHime) the construction of the project, for the Permittce hereby state that,
to the best of my abilities, due care and diligcnce was used in the observation of the construction such that
the construction was obscrved to be built within substantial compliancc and intent of the 401 Water Quality
Certification and Buffer Rules, the app oved plans and specifications, and other supporting matcrials.
Cj ~lDe i
Signature: B .//,)( Registration No.: a...c0~ Date: 1-1'0~
Keith Bro