20051053 Ver 1_Complete File_20050610

01 ISSUED
r
Form Version May 2002
Offlce Use Only: 0 5 1 0 5 3
USACE Action ID No. DWQ No.
(If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A".)
I. Processing
1. Check all of the approval(s) requested for this project:
S Riparian or Watershed Buffer Rules
ection 404 Permit ? p
? Section 10 Permit ? Isolated Wetland Permit from'DWQ
? 401 Water Quality Certification
• 2. Nationwide, Regional or General Permit Niimber(s) Requested:
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: ?
4. If payment into the North Carolina Wetlands Restoration Program (NCWRP) is proposed for
mitigation of impacts (verify availability with NCWRP prior to submittal of PCN), 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 M Liu. of
Environmental Concern (seethe top of page 2 for further details),
D
IL Applicant Information JUN 1 0 2005
1. Owner/Applicant Information DENR-WATER QUALITY
4ENA/CT4 1W. c%fWSDAI WETLWS AND STORMAM BRANCH
Name:
Mailing Address: _ / Z4Z P1-F,4saA17- 64FIA/ ?pU2T
Telephone Number: 703 Fax Number:
E-mail Address:
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: EDDIE H,JY11A*J
Company Affiliation: KYMA 4- RC-
Mailing Address: 15D US ul[?NW 6g:?F
CAM D?J rib, G, 2'79 Z. I
Telephone Number: 2!52 33Q> 2913 Fax Number: Z15Z - 37E, OS
E-mail Address:
Page 5 of 12
III, Project Information
Attach a vicinity map clearly showing the location of the property with respect to local
landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing ?o mep
boundaries and development plans in relation to surrounding prop ts of
all b and site plan must include a scale and north arrow. . If spssible, fthe wraps and planuildings
should
impervious surfaces, or other facilities must beAacrl?udedand 1 RC5 Soil Survey with the property
include the appropriate USGS Topographic Qu aP lwit t discretion,
boundaries outlined. Plan drawings, or other maps may be included at the app ocre the
so long as the property is cl tol be submitted on sheets no larger thandistribution by 1 7-inch h format;
USACE requires information erwork of any size. DWQ prefers full-size construction
siz are
however, DWQ may accept pap -full
drawings rather than a sequential sheet version of the full-size plans. If
ill be i e plans that
reduced to a small scale such that the final version is illegible, the applicant wformed
the project has been placed on hold until decipherable maps are provided.
R.A4 e KP-Al JOWO
SITE
1. Name of project:
2. T.I.P. Project Number or State Project Number (NCDOT Only):
SCc?- $(`?ZCog
3. Property Identification Number (Tax PIN):
4. Location r???o `G
?Vim? S C?? Nearest Town: ? CSet[ANau 5e
County:
Subdivision name (include phase/lot munber): L.D'? D A?t3,EMAet,t= ATE ?'AI:E
Directions to site (include road numbers, landmarks, etc.): Feo? ? ?uur OPLAZ
atrgF?eLE gwC> 10 FOlor Deter
5. Site coordinates, if available (UTM or Lat/Long):
(Note - If project is linear, such as a road or utility line, attach a sheet that separately lists the
coordinates for each crossing of a distinct waterbody.)
6. Property size (acres): 3?CS O °F
7. Nearest body of water (stream/river/sound/ocean/lake):
8. River Basin:
(Note -- this must be one of North Carolina's seventeen des ienmeadm ajor river basins. The
River Basin map is available at htt ://b2o.enr.st
9, Describe the existing conditions on the site and ens land use the vicinity of the 0 project
1-6 LVC?0&z
at the time of this application: CLSt II
1.0 uik rg t= CDvrtnWl?I
COW
Pago 6 of 12
10. Describe the overall project in detail, including the type of a uipment to be used: t tt-L
4,09 AGm o1= 404- W -rLAMP Foe- P,?aEi'1t r®t* UtL-DiA!!a
IV.
V.
:54?4D DQ - C5MaZ SLMAi--N-e HLJ-- vrA4-U&*IAA _ L-A4L:F- m,=
Ru Lt. Q0Z.ltd - ACID DOMP 72LXX - t 121LA - Be- 0500ROW-
11. Explain the purpose of the proposed work: E.PAt,tD OF E?ILAZ06- (
Gt? D 70 Apt --) t/aNtC-c
t ?? t DT+4 .4-r 020
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. Jnclude
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.
Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application.
VI.
Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. The applicant must also
provide justification for these impacts in Section VII below. All proposed impacts, pennanen.t
and temporary, must be listed herein, and must be clearly identifiable on an accompanying site
plan. All wetlands and waters, and all streams (intermittent and perennial) must be shown on a
delineation map, whether or not impacts are proposed to these systems. Wetland and stream
evaluation and delineation forms should be included as appropriate. Photographs may be
included at the applicant's discretion. If this proposed impact is strictly for wetland or stream
mitigation, list and describe tho impact in Section VIII below. If additional space is needed for
listing or description, please attach a separate sheet.
Page 7 of 12
1. Provide a written description of the proposed impacts: CLF 1 Z
D
LAZ
2. Individually list wetland impacts below:
Wetland Impact
Site Number
--•- indicato on ma
Type of Impact" -Area of
Impact
acres Located within
100-year Floodplain•'
Wno Distance to
Nearest Stream
linear feet
Type of Wetland-
l t_L_ D, s 70/ fb- 0 5TeD w L

List each impact soparatcly and identify temporary impacts.
excavation, flooding, ditching/drainage, etc. For dams, sepa

:ts include, but u e not timltea to: mecnanizaa cicanng, gracing, fill,
list impacts due to both structure and flooding.
Aeencv's (FEMA) Flood Imuraneo Rate Maps
F
III. Project Information
Attach a vicinity map clearly showing the location of the property with respect to local
landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property
boundaries and development plans in relation to surrounding properties. Both the vicinity map
and site plan must include a scale and north arrow. The specific footprints of all buildings,
impervious surfaces, or other facilities must be included. If possible, the maps and plans should
include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property
boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion,
so long as the property is clearly defined. For administrative and distribution purposes, the
USACE requires information to be submitted on sheets no larger than 11 by 17-inch format;
however, DWQ may accept paperwork of any size. DWQ prefers full-size construction
drawings rather than a sequential sheet version of the full-size plans. If full-size plans are
reduced to a small scale such that the final version is illegible, the applicant will be informed that
the project has been placed on hold until decipherable maps are provided.
1. Name of project: ?JITE &e. ?,? Jom SDd
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN): 7? - s? SZ CAS
4. Location
county: PQl1tVNP 5 CrWTq Nearest Town:
Subdivision name (include phasellot number). LOT 10 ALWJOAeLa R..A4rAr' pZI&A L 58M
Directions to site (include road numbers, landmarks, etc.): Feom 6NW 'kMG'4TE V QA P-
A. ?An. r ra .ire ? 2mr? ,? P?1%i1k1T f•b???. PJ.- mar /'AJ Fh. PoWT- ppate
5. Site coordinates, if available (UTM or Lat/Long):
(Note - If project is linear, such as a road or utility line, attach a sheet that separately lists the
coordinates for each crossing of a distinct waterbody.)
6. Property size (acres): 3 i CGS OfzF Or-
I.
7. Nearest body of water (stream/river/sound/ocean/lakeFomi , 1lEvP?wt C¢??/
8. River Basin---..,PA '5& ?oTAk' r--
(Note this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http://b2o.enr.statc..nc.us/admiT.i/y.n.aps/.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: 0250C-AT1A1- '504521S/61 k) W AHLU00pep
Page 6 of 12
10. Describe the overall project in detail, including the type of
©ZA A«E DF 404 WETLAMP Foz 4EN
LL
11.
IV. Prior Project History
tom.
: to be used: C--LLt-
EyyTOF r::5ut?.DIAJ
P d..'tL RLLr=P WIN
If jurisdictional determinations and/or permits have been. r Nuested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Tnclude
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.
Q -
f:51
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application.
VI. Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. The applicant must also
provide justification for these impacts in Section VII below. All proposed impacts, permanent
and temporary, must be listed herein, and must be clearly identifiable on an accompanying site
plan. All wetlands and waters, and all streams (intermittent and perennial) must be shown on a
delineation map, whether or not impacts are proposed to these systems. Wetland and stream
evaluation and delineation forms should be included as appropriate. Photographs may be
included at the ap'plicant's discretion. If this proposed impact is strictly for wetland or stream
mitigation, list and describe tho impact in Section VIII below. If additional space is needed for
listing or description, please attach a separate sheet.
Page 7 of 12
1. Provide a written description of the proposed impacts: CLC-A
Sk- rrILL- KDr D9 A.c_ ©t= L t4D A-
2. Individually list wetland impacts below:
Wdtland Impact
Site Number
in3icato on'Ma
Type of Impact' -Area of
Impact
acres Locatod within
100-year Floodplain"
es/no Distance to
Nearest Stream
linear feet
Type of Wetland'-"
tl? D,o S t foees? w [,

* List each impact 30p2r3toly and identify temporary impacts. Impacts include, but are not limited to: mechanized clearing, grading, fill,
oxcavation, flooding, ditching/drainage, etc. For dams, separately list impacts due to both structure and flooding.
100-Year floodplalns are identified through the Fedotal Emergency Management Agency's (FEMA) Flood Insuranco Rate Maps
(FIRM), or FEMA-approved local tloodplain maps. Maps ire available through the FEMA Map Service Center at 1-800-358-9616, or
online at ://www.fema.aov,
••" List a wetland type that best describes wetland to be impacted (e.g., freshwater/saltwater marsh, forusmd, wetland, beaver pond,
Carolina Bay, bog, etc.) Indicate if wetland is isolated (determination of isolation to be made by USACE only).
List the total acreage (estimated) of all existing wetlands on the property: 0, 38 A 4C_
Total area of wetland impact proposed: d.0$ Ac--
3. Individually list all intermittent and perennial stream impacts below:
Stream Impact
Site Number
(indicate on map
Typo of Impact' Length of
Impact
linear foot
Stream Name" Average Width
of Stream
Before Impact peronnial or
Intermittent?
loaso s ecif

' List each impact separately and identify temporary impacts. Impacts include, but are not limited to: culverts ana assocmxu rip-cup,
dams (scpurately list impacts due to both structure and flooding), relocation (include linear feet before and after, and net loss/gain),
stabilization uctivities (cement wall, rip-tap, crib wall, gabions, etc.), excavation, dimbing/straightening, etc. If atmirn relocation is
proposed, plans and profiles showing the linear footprint for both the original and relocated streams mum bo included.
•• Stream name can be found an USGS topographic maps. If a stream has no name, list as UT (unnamed tributary) to the nearest
downstream named stream into which it flows. USCS maps are available through the USGS at 1-800-358-9616, or online at
www.us,tt. tv. Several internet sites also allow direct download and printing of USGS maps (e.g., yw+_y_.toj?o7.ooc.coin
www.maM1ttSt cnm, etc.).
Cumulative impacts (linear distance in feet) to all streams on site:
Page 8 of 12
4. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.) below:
Open Water Impact
Sito Number.
(indicate on ma
Type of Impact Area of
Impact
acres Name of Waterbody

(if applicable) Type of Waterbody
(take, pond, estuary, sound,
bay, ocean, etc.
' o Nt li

* List each impact separately and identify temporary impacts. Impacts include, bur are not limited to: fill, mcuvution, dredging,
flooding, drainago, bulkheads, eta
and Creation
If co ction of a pond is proposed, associated wetland
included abo the wetland and stream impact sections.
be described here an trated on any maps included with
Pond to be created in (check apply): ? ?upl s
Describe the method of construction embankrr
draw-down valve or spillway, etc.):
and stre acts should be
also proposed pond should
plica.tion.
0 stream ? wetlands
:nt, excavation, installation of
Proposed use or purpose and (e.g., livestock watering, aesthetic, trout pond,
local stormwa"'?rlment, etc.):
Size of ershed draining to pond: Expected pond surface area:
VII. impact Justification (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It may be useful to provide
information related to site constraints such as topography, building ordinances, accessibility, and
financial viability of the project. The applicant may attach drawings of alternative, lower-impact
site layouts, and explain why these design options were not feasible. Also discuss how impacts
were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce impacts. I
PZOPmED 4-bu,5E - Nos 5ee?J PLp&iNE- 110 AWA-l m tv??t :
E C ST1 t.1_- tai Vtev or- t j#mz . At4`f FuTCAee.. 5AI Fr- AWA,1 Fawn C4ZF_tcG
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 March 9, 2000, mitigation will be required when
necessary to ensure that adverse. effects to the aquatic environment are minimal. Factors
including size and type of proposed impact and function and relative value of the impacted
aquatic resource will be considered in determining acceptability of appropriate and practicable
mitigation as proposed. Examples of mitigation that may be appropriate and practicable include,
but are not limited to: reducing the size of the project; establishing and maintaining wetland
and/or- upland vegetated buffers to protect open waters such as streams; and replacing losses of
aquatic resource functions and values by creating, restoring, enhancing, or preserving similar
functions and values, preferable in the same watershed.
If mitigation is required for this project, a copy of the mitigation plan must be attached in order
for USACE or DWQ to consider the application complete for processing. Any application
lacking a required mitigation plan or NCWRP concurrence shall be placed on hold as
incomplete. An applicant may also choose to review the current guidelines for stream restoration
in DWQ's Draft Technical Guide for Stream Work in North Carolina, available at
httl2://h2o.enr.state.nc.iL-3/ncwetiancLs/strmgide.htm.l.
Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
N1mwk-roM , 1P ge4oi o Wttc_. A-ae,A-- P.Eh'l?in1/N(? U??TcA?IDS
2. Mitigation may also be made 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://112o.enr.state.nc.li-;/wro/index.htm, If use of
the NCWRP is proposed, please check the appropriate box on page three and provide the
following .information:
Amount of stream mitigation requested (linear feet):
Amount of buffer mitigation requested (square feet):
Amount of Riparian wetland mitigation requested (acres):
Amount of Non-riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres):
Page 10 of 12
I.X. Environmental Documentation (required by DWQ)
Does the project involve an expenditure of public (federal/state) funds or the use. of public
(federallstate) land?
Yes ? No
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 (919) 733-50.8,3 (to review current thresholds for envirottmental documentation.
Yes ? No F)
If yes, has the document review been finalized by the State Clearinghouse? If so, please attach a
copy of the NEPA or SEPA 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 riparian buffers identified within 15A NCAC 2B .0233
(Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Require ents), or other (please identify, )?
Yes ? No E If you answered "yes", provide the following information:
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.
ZoneO
Imact nte feet
s a
Multiplier
Mitq anon
] 3
2 1.5
Total
• Zone t extends out 30 feet pcrpendicular 6om near bunk of channel; 'Lone 2 extends an
additional 20 feet from the edge of Zone I.
Page 11 of 12
If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation
of Property, Conservation Easement, Riparian Buffer Restoration / Enhancement, Preservation or
Payment into the Riparian Buffer Restoration Fund). Please attach all appropriate information as
identified within 15A NCAC 2B .0242 or.0260. O
XI. Stormwater (required by DWQ)
Describe impervious acreage (both existing and proposed) versus total acreage on the site.
Discuss stormwater controls proposed in order to protect surface waters and wetlands
downstream from the property.
NO E*ISTIN ^Paiz_V"S lAp_-A Oti Lcrr
-t^ I S °k" w tE XAJ li lt,1J?1?! C? rm-m P LzT?
X.II. Sewage Disposal (required by DWQ)
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of . able wastewater generated from the proposed protect, or avat, capacity of the subject facility.
XHI. 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 n No ??
XIV. Other Circumstances (Optional):
It is the applicant's responsibility to submit the application sufficiently in advance of desired
construction dates to allow processing time for these permits. However, an applicant may
choose to list constraints associated with construction or sequencing that may impose limits on
work schedules (e.g., draw-down schedules for lakes, dates associated with Endangered and
Threatened Species, accessibility problems, or other issues outside of the applicant's control).
Ap icant/Agent's Signature Date
(Agent's l;" ature is valid only if an authorization letter from the applicant is provided.)
Page 12 of 12
2, SL 7, MAP 42
JUNE 02, 2004 REVISED JUL Y 13, 2005
GRAPHIC SCALE
60 0 30 60 120
SITE
( IN FEED)
y
I Inch - 80 M '
Pc z. a >' ?? •s N '"-FRANKS CREEK--,
?.?-----?-? VICINITY MAP
L5
Li
r
O r , ]1?t
LOT 9 M
a,
v ! W
Alit. WETLANDS SITE # 1
AREA TO BE FILLED a
3,518 SF. Q
as, .08 ACRES o
p ! !n
!
r
i 81.00'
PROPOSED
allic ' o DWELLING
d
v ?
J r '
% M ?
j1k LOT 11
ACREAGE BREAKDOWN
AREA OF UPLAND = .93 ACRES
?111c AREA OF WETLANDS = .38 ACRES
-------------------- --
TOTAL ACREAGE = 1.31 ACRES
? ? I
Office Use Only: Form Version May 2002
USACE Action ID No. DWQ No.
(If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A".)
I. Processing
1. Check all of the approval(s) requested for this project: Riparian or Watershed Buffer Rules
dQ ? ection 404 Permit
? Section 10 Permit ? Isolated Wetland Permit from DWQ
? 401 Water Quality Certification , A ,
• 2. Nationwide, Regional or General Permit Niimber(s) Requested: N-
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: ?
4. If payment into the North Carolina Wetlands Restoration Program (NCWRP) is proposed for
mitigation of impacts (verify availability with NCWRP prior to submittal of PCN), 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 here:
II. Applicant Information
1. Owner/Applicant Information J U L 2 1 2005
Name: 4ENA1,T4 Ad cbf 50A/
'Mailing Address: / Z4Z PLF45AAlT CZF.41 TWATERQUALITY
^ev,411,11 VA, Z01 7)
Telephone Number: -70 '> 3/ S A// & Fax Number:
E-mail Address:
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: EDDie `4A
Company Affiliation: K*Mg + P. C',
Mailing Address: I SD A. t)S 141&NtllA?? L o¢' ??
Telephone Number: ZSZ 575 lb Z )13 Fax Number: ZSZ. - 338' S`?Z•
E-mail Address:
Pago 5 of 12

III. Project Information
Attach a vicinity map clearly showing the location of the property with respect to , local
landmarks such as towns, rivers, and roads. Also provide a detailed site plaa showing property
boundaries and development plans in relation to surrounding properties. Both the vicinity map
and site plan must include a scale and north arrow. The specific footprints of all buildings,
impervious surfaces, or other facilities must be included. If possible, the maps and plans should
include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property
boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion,
so long as the property is clearly defined. For administrative and distribution purposes, the
USACE requires information to be submitted on sheets no larger than 11 by 17-inch format;
however, DWQ may accept paperwork of any size. DW Q 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: S1TE ? f a17 ?? Jom soj
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN): 78CaC? - s? ?Z Cog
4. Location 9EZIED ? `G ,
County: ?QUmMa?S C lril Nearest Town:
Subdivision name (include phase/lot number): LOT 10 dl.t iV14¢t.E RAUTAV O¢u?Ndl. Spit
Directions to site (include road numbers, landmarks, etc.): Feom &4WAA 'E GATE TAI e
5. Site coordinates, if available (UTM or Lat/Long):
(Note - If project is linear, such as a road or utility line, attach a sheet that separately lists the
coordinates for each crossing of a distinct waterbody.)
6. property size (acres): i L 10friF of
Fe?an?r? C-Y.t;E?. YEa??wt cec?r-)
7. Nearest body of water (streaVm?/nver/sound/ocean/lake)•
8. River Basin' PA `" wTAM (Note - this must be one of North Carolina's seventeen designated major river basins. The
sl.)
River Basin map is available at http://b2o'.enr.statc..nc.us/adm.i,.n/map
9. Describe the existing conditions on the site and general land use in thevic?ty of project
at the time of this, application:,-P-ESc05AMAL? '5y?yr`?d'y WOOW
L?-? . tA1?TEIZ ?tzo??"'? co rn rvl? r.11'L y ,
Page 6 of 12
10. Describe the overall project in detail, including the type of
0,08 AGE OF 40¢ u)6TLANP Fog 4EN
to be used: C--tLL
9V'r0s= r-sutt.,owl0
mot! RLLFP wrru
:5A ?,AD 0e . o-pAeZ 5LmAi'3A-e Ru- Y1'1,4TbP-IAL L,ACK- 1-C)L-
11. Explain the
t:i 1 DT4-
1 .of the-proposed posed work: F-PA
pose
oe
e
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. Jnclude
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. Q -
t5l
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application.
VI. Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. The applicant must also
provide justification for these impacts in Section VII below. All proposed impacts, permanent
and temporary, must be listed herein, and must be clearly identifiable on an accompanying site
plan. All wetlands and waters, and all streams (intermittent and pereruiial) must be shown on a
delineation map, whether or not impacts are proposed to these systems. Wetland and stream
evaluation and delineation forms should be included as appropriate. Photographs may be
included at the applicant's discretion. If this proposed impact is strictly for wetland or stream
mitigation, list and describe tho impact in Section VIII below. If additional space is needed for
listing or description, please attach a separate sheet.
Page 7 of 12
1. Provide a written description of the proposed impacts: CL -AZ
EA--? r-iu- nob 4r- or-- Lprt4D A5
LAZ AMO /V Q F
2. Individually list wetland impacts below:
Wdtland Impact
Site Number
indicate on ma
Type of Impact' -Area of
Impact
acres Locatod within
100-year Floodplain"
es/no Distance to
Nearest Strcam
linear feet
Type of Wetland"'
1 w D,D S {Q12csT? w ?,

List each impact soparately and identify temporary impacts. Impacts include, but are not limited to: mechanized clearing, grading, fill,
?? excavation, flooding, ditching/drainage, etc. For dams, separately list impacts due to both structure and flooding.
100-Year ftoodpiuiris ure identified through the Federal Emergency Management Agency's (FEMA) Flood Insurance Rate Maps
(FIRM), or FNMA-approved local floodpfain maps. Maps aro avuilablo through the FEMA Map Service Contcr at 1-800-358-9616, or
online ut h_gM1/www.fema.aov.
•" List u wetland type that best describes wetland to be impacted (e.g., freshwater/saftwater marsh, forested wiYland, beaver pond,
Carolina Bay, bog, etc.) indicate if wetland is isolated (determination of isolation to be made by USACE only).
List the total acreage (estimated) of all existing wetlands on the property: 38 A L
Total area of wetland impact proposed: ,4C--
3. Individually list all intermittent and perennial stream impacts below:
Stream Impact
Site Number
(indicate on ma
Typo of Impact' Length of
Impact
linear feet
Stream Name" Average Width
of Stream
Before Im act Poronnial or
Intermittent?
lassos ecif

List each impact separately and identify temporary impacts. impacts include, but are not irmttea to: cutverrs anu aeauc:,sa:u ut,-9wi,,
dams (soparately list impacts due to both structure and flooding), relocation (include linear feet before and after, and net loss/gain),
stabilization activities (cement wall, rip-rap, crib wall, gabions, etc.), excavation, ditchinglstraightening, etc. If stroam relocation is
proposal, plans and profiles showing the linear footprint for both the original and relocated streams must bo included.
Stream names can be found on USGS topographic maps. If a stream has no name, list as UT (unnamed tributary) to the nearest
downstrvarn named stream into which it flows. USGS maps are available through the USGS at 1-800-358-9616, or online at
-
www.ustig.Irov. Several internet sites also allow direct download and printing of USGS maps (e.g., Mw&.apgzone.coin
www.marge1-s cnm, etc.).
Cumulative impacts (linear distance in feet) to all streams on site:
Page 8 of 12
4. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.) below:
Open Water Impact
Sito Number
indicate on ma
Type of Impact Area of
Impact
acres Name of Waterbody

(if applicably) Type of Waterbody
(lake, pond, estuary, sound,
bay, ocean, etc.

* List each impact separately and identify temporary impacts. Impixts include, but are not limited to: flit, exmvudon, dredging,
flooding, drainage, bulkheads, eta
Creation
If co ction of a pond is proposed, associated wetland
included abo the wetland and stream impact sections.
be described here an trated on any maps included with
Pond to be created in (check apply): ? -u I s
Describe the method of construction embankm
draw-down valve or spillway, etc.):
and stye acts should be
Uso proposed pond should
application.
Ll stream ? wetlands
;nt, excavation, installation of
Proposed use or purpose and (e.g., livestock watering, tion, aesthetic, trout pond,
local stormwater ment, etc.):
Size of ershed draining to pond: Expected pond surface area:
VII. Jf pact Justiilcatlon (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It may be useful to provide
information related to site constraints such as topography, building ordinances, accessibility, and
financial viability of the project. The applicant may attach drawings of alternative, lower-impact
site layouts, and explain why these design options were not feasible. Also discuss how impacts
were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce impacts.
PEOlip 4-bu-5e s BeeM PLAwJSD- 110 ,ArwA-l F=MA l.1 AReas
STILL- (M 0SW OF UjAT70Z , <W`f Fu-EWW. $NIFT' AWA4 FM CIZEO_r
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
Pen-nits, published in the Federal Register on March 9, 2000, mitigation will be required when
necessary to ensure that adverse. effects to the aquatic environment are minimal. Factors
including size and type of proposed impact and function and relative value of the impacted
aquatic resource will be considered in determining acceptability of appropriate and practicable
mitigation as proposed. Examples of mitigation that may be appropriate and practicable include,
but are not limited to: reducing the size of the project; establishing and maintaining wetland
and/or. upland vegetated buffers to protect open waters such as streams; and replacing losses of
aquatic resource functions and values by creating, restoring, enhancing, or preserving similar
functions and values, preferable in the same watershed.
If mitigation is required for this project, a copy of the mitigation plan must be attached in order
for USACE or DWQ to consider the application complete for processing. Any application
lacking a required mitigation plan or NCWRP concurrence shall be placed on hold as
incomplete. An applicant may also choose to review the current guidelines for stream restoration
in DWQ's Draft Technical Guide for Stream Work in North Carolina, available at
http•//h2o cnr.state.nc.ua/ncwetlands/strmeide.html.
Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
MITtI_,ATtoM , tr- gr4ui zzD WiLj_. RAeAa V;-oN141N1AICv Wzrm*V5,
C) F_ P4qrn43&tT M N -C-W-R-P --
2. Mitigation may also be made 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 htto•//h2o enr.state.nc.irs/wrp/index.htm, If use of
the NCWRP is proposed, please check the appropriate box on page three and provide the
following .information:
Amount of stream mitigation requested (linear feet):
Amount of buffer mitigation requested (square feet):
Amount of Riparian wetland mitigation requested (acres):
Amount of Non-riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres):
Page 10 of 12
I.X. Environmental Documentation (required by DWQ)
Does the project involve an expenditure of public (federal/state) funds or the use of public
(federal/state) land?
Yes ? No
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 EJ
If yes, has the document review been finalized by the State Clearinghouse? If so, please attach a
copy of the NEPA or SEPA 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 riparian buffers identified within 15A NCAC 2B .0233
(Neuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Require ents), or other (please identify V
Yes ? No V If you answered "yes", provide the following information:
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* Impact
(square feet Multplier Required
mitigation
1 3
2 1.5
Total
* Zone 1 extends out 30 feet perpendicular 87orn near bunk of channel; 'Lone 2 extends an
additional 20 feet fiom the edge of Zone 1.
Page 11 of 12
If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation
of Property, Conservation Easement, Riparian Buffer Restoration / Enhancement, Preservation or
Payment into the Riparian Buffer Restoration Fund), Please attach all appropriate information as
identified within 15A NCAC 2B .0242 or .0260. O
XI. Stormwater (required by DWQ)
Describe impervious acreage (both existing and proposed) versus total acreage on the site.
Discuss storrnwater controls proposed in order to protect surface waters and wetlands.
downstream from the property.
X.H. 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 avai)able capacity of the subject facility.
XIII. Violations (required by DWQ)
Is this site in violation of DW Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes ? No M
Is this an after-the-fact permit application?
Yes ? No ?[?
XIV. Other Circumstances (Optional):
It is the applicant's responsibility to submit the application sufficiently in advance of desired
construction dates to allow processing time for these permits. However, an applicant may
choose to list constraints associated with construction or sequencing that may impose limits on
work schedules (e.g., draw-down schedules for lakes, dates associated with Endangered and
Threatened Species, accessibility problems, or other issues outside of the applicant's control).
Ap icant/Agenes Signature r bate
(Agent's O ature is valid only if an authorization letter from the applicant is provided.)
Page 12 of 12
Y
D
a
i
n
n
D
v
T
N
m
3
v
V
n
A
3
0
0
C
C
c
0
v
n
n
v
0
c
E
ri
JUNE 02, 2004
REVISED ?UL Y 13, 2005
GRAPHIC SCALE
60 0 30 60 120
( IN FEET )
1 inch - 60 tL _
PC a s' 4AP `? N -FRANKS CREEK-_ ,-,

LOT 9
M
A&-

LINE TABLE
LINE LENGTH BEARING
L1 63.40' N 14'15'25" E
L2 28.25' N 3655'39" W
L3 39.13' N 22'14'18" W
L4 38.91' N 65'34'52" E
L5 40.99' N 16'06'41" E
NOTES:

1. PARCEL ALSO KNOWN AS
LOT 10, SECTION -0", BEECH
POINT, ALBEMARLE
PLANTATION, AS RECORDED
IN PC 2, SL 22, MAP 3
2. PROPERTY LINE RUNS o
WITH AND ALONG
SHORELINE. 1.t
Ln
3. AREAS BY COORDINATE
METHOD. z
r
,
r
r
r
NDS SITE # 1
F r
TO BE FILLED
,518 SF8 ACRES
F POSED
?11c o DWELLING
V
%
180.04'
QOF /
M
11

LOT 11
4f
N
a
,4 0
En
ACREAGE BREAKDOWN
AREA OF UPLAND = .93 ACRES
jilt AREA OF WETLANDS = .38 ACRES
TOTAL ACREAGE = 1.31 ACRES
1
LEGEND
I ?
OO EXISTING IRON PIN
• POINT (NOT MONUMENTED)
BOUNDARY LINE
- - - - -SET BACK LINE
-RIGHT OF WAY LINE
- -PROPERTY EXTENSION
- - - - - -APPROX. 404 WETLAND LINE
•0 0 0 0 0 0 -PROPOSED RETAINING WALL
WETLANDS TO BE FILLED
(TIE)
N 11'37'33" E
187.70' TO EIR
BEECH POINT DRIVE (50' R/W)
NORTH CAROL/NA, PEROUIMANS COUNTY
/, REVIEW OFFICER OF PEROI/IMANS COUNTY
CERTIFY THAT THE MAP OR PLAT TO WHICH THIS CERAF/CAAON IS AFFIXED MEETS ALL
STATUTORY REOUIR£MENrS FOR RECORDING NOTE.•._ THIS PROPERTY IS LOCATED -
- /,-EDWARD T. HYMAN W. IN FLOOD HAZARD ZONE AS NOTED
PLS-2690, CERTIFY, MAP PANEL /370315 7866 ?
REVIEW OFFICER THAT THIS PLAT IS OF DATED OCTOBER 14, 2003
AN EXIS771VG PARCEL(S) OF LAND. FIN/SHED FLOOR ELEK = N/A
I, EDWARD T. HYMAN, ?R., CERT/FY THA T
THIS PLAT WAS DRAWN FROM AN ACTUAL
FIELD LAND SURREY MADE UNDER MY
SUPERWSION.• THAT THE DEED
DESCRIPTION FOR SAID PROPERTY IS
RECORDED IN D. B. 253 PG 673 : THAT
THE ERROR OF CLOSURE IS 1.• 10, 000*:
THA T THIS MAP WAS PREPARED IN
ACCORDANCE WITH BOARD RULES,
WITNESS MY ORIGINAL SIGNATURE,
REG/STRA 77ON NUMBER AND SEAL THIS 03
DA Y OF JUNE, 2004
1111181
/.% d . 1 20
10
'•,<"? ' .O SUR. ••'' 0
Jam:
'?qRO ?;;Y??`P•
r
O
°o ?
w
ti
VICINITY MAP
150A USHWY158E
Camden, North Carolina 27921
[phone] [phone]
Office Use Only:
'USACE Action ID No.
any particular item is not
I. Processing
Form Version May 2002
DWO No.
to this project, please enter "Not Applicable" or "N/A".)
1. Check all of the approval(s) requested for this project: Riparian or Watershed Buffer Rules
[l Section 404 Permit ?
Section 10 Permit Isolated Wetland Permit from DWQ
?
? 401 Water Quality Certification
2. Nationwide, Regional or General Permit Ntimber(s) Requested: N.
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: ?
4. If payment into the North Carolina Wetlands Restoration Program (NCWRP) is proposed for
mitigation of impacts (verify availability with NCWRP prior to submittal of PCN), 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 Manageme t Area of
Environmental Concern (see the top of page 2 for -further details), check here: [?
o ?c??od?D
II. A'p'plicant Information
?UL 2 1 2005
1. Owner/Applicant Information cl?lSD?/
Name: Y??A11V.4 M• c/p _
Mailing Addreas: _ /.324Z. PLE45A/17' EaLF?f CLOU27 416imn stO-211, RAN
?.,.
Telephone Number: 703 319 4-1/ Fax Number:
E-mail Address:
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: EDl71C `444sNd
Company Affiliation: 141 Wf? 4-
t)5 NI(?1WAy P?r? ?
Mailing Address:
CAM11 G1 279 1
Telephone Number: 25Z 3352913 Fax Number: ZSZ - 338" S?Z
E-mail Address:
Page 5 of 12
III. Project Information
Attach a vicinity map clearly showing the location of the property with respect to local
landmarks such as towns, rivers, and roads. Also provide a detailed site plats 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 NR.CS Soil Survey with the property
boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion,
so long as the property is clearly defined. For administrative and distribution purposes, the
USACE requires information to be submitted on sheets no larger than 11 by 17-inch format;
however, DWQ may accept paperwork of any size. DWQ prefers full-size construction
drawings rather than a sequential sheet version of the full-size plans. If full-size plans are
reduced to a small scale such that the final version is illegible, the applicant will be informed that
the project has been placed on hold until decipherable maps are provided.
1. Name of project: SIB ??? °f© ??
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN): 74Lde - 5" '-<Z (22g
???-gyp
4. Location
County: QU?yriatil S 60AIW Nearest Town:
Subdivision name (include phase/lot number), LDT 10 ALeC-M4eLl= Pi;At 'Av
Directions to site (include road numbers, landmarks, etc.): reorvttVA 6,47E
DP1"__
5. Site coordinates, if available (UTM or Lat/Long):
(Note - If project is linear, such as a road or utility line, attach a sheet that separately lists the
coordinates for each crossing of a distinct waterbody.)
6. Property size (acres): 3C.QGS OFF of
FOAW6 Ctea-11_ YFC?' Comr-)
7. Nearest body of water (stream/river/sound/ocean/lake).
River Basin: PA3? ?OTAM
ver basins. The
(Note -- this must be one of North Carolina's seventeen designated major ri
River Basin map is available at http://b26.enr.statc..nc.us/Ldmin/rnaps/.)
9, Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application:_ OeSt06 MALL 5yMut` 0'$J LVrT4 t, oopep
i .,-rr ?? 1dTGrl Cnn? b? PnYNMu?51 ty ,
Page 6 of 12
10. Describe the overall project in detail, including the type of
0.08 4r-M OF 44¢ WETLAND 1=vtZ ?N
M
K-
11. Explain the
IGLC-
F-1
1V. 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. Jnclude
the USACE Action ID Number, DWQ Project Number, application date, and date permits and
certifications were issued or withdrawn. Provide photocopies of previously issued permits,
certifications or other useful information. Describe previously approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits issued for prior segments of the same T.I.P. project, along with
construction schedules.
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application.
VI.
Proposed Impacts to Waters of the United States/Waters of the State
it is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. The applicant must also
provide justification for these impacts in Section VII below. All proposed impacts, permanent
and temporary, must be listed herein, and must be clearly identifiable on an accompanying site
plan. All wetlands and waters, and all streams (intermittent and perennial) must be shown on a
delineation map, whether or not impacts are proposed to these systems. Wetland and stream
evaluation and delineation forms should be included as appropriate. Photographs may be
included at the applicant's discretion. If this proposed impact is strictly for wetland or stream
mitigation, list and describe tho impact in Section VIII below. If additional space is needed for
listing or description, please attach a separate sheet.
LL
to be used: C--t Lt.
Stt yogr 13ull.DIAJ10
92A.-iL EIl1Lr=P wire
Page 7 of 12
1. Provide a written description of the proposed impacts: CLF?
P
2. Individually list wetland impacts below:
Wetland Impact
Site Number
- indlcato on ma
Type of Impact' -Area of
Impact
acres Located within
100-y=Floodplain•'
es/no Distance to
Nearest Stream
linear feet
Type of Wetland"'
!w D,o s ?o?csr>? w L

• List each impact separately and identify temporary impacts. Impacts include, but are not limited to: mechanized clearing, grading, fill,
excavation, flooding, ditching/drainage, etc. For darns, separately list impacts due to both structure and flooding.
100-Ycur floodpiains are identified through the Fedoial Emergency Management Agency's (FEMA) Flood Insurance Rate Maps
(FIRM), or FEMA-approved local floodplain maps. Mope aro available through the FEMA Map Service Center at 1-800-358-9616, or
online at b(tn://www.fema.eov,
•" List u wetland type that best describes wetland to be impacted (e.g., freshwater/saltwater -marsh, forustod vmtlund, beaver pond,
Carolina Bay, bog, etc.) indicate if wetland is isolated (determinutiono f isolation to be made by US ACE only).
List the total acreage (estimated) of all existing wetlands on the property: r 33 A L
Total area of wetland impact proposed: O.0 Ac-
3. Individually list all intermittent and perennial stream impacts below:
Strata Impact
Site Number
(indicate on rrut
Typo of Impact- Length of
Impact
linear foot
Stream Name" Average Width
of Stream
Before Im act Perennial or
Intermittent?
loaso specify)

• List each impact separ tely and identify lempomry impacts. impacte ineiuae, but use not umuea co: cucuens arw aasixaau u utr,ut,,
dams (separately list impacts due to both structure and flooding), relocation (include linear feet before and after, and net loss/gain),
9tabiliz ation activities (cement wall, rip-rap, crib wall, gabions, etc.), excavation, ditching/straightening, etc. If etroam relocation is
proposed, plans and profiles showing the linear footprint for both the original and relocated streams must be included.
`• Stream namtts can be found on USGS topographic maps. If a stream has no name, list as UT (unnamed tributary) to the nearest
downstream named stream into which it flows. USGS maps are available through the USGS at 1.800-358-9616, or online at
www.u?? mow. Several internet sites also allow direct download and printing of USGS maps (c.g., Zvw%y..topozone.com,
www.murxtue5t cnm, etc.).
Cumulative impacts (linear distance in feet) to all streams on site:
Page 8 of 12
4. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.) below:
Open Water Impact
Sito Number
indicate on rna
Type of Impact* Area of
Impact
acres Name of Waterbody

(?f applicable) Type of Waterbody
(lake, pond, estuary, sound,
bay, ocean, etc.
K10 KA E:17

* List each impact deparutely and identify temporary impacta. Impiucts include, but are not limited to: fill, excavation, dredging,
flooding, drainago, bulkheads, eta
Creation
of a pond is proposed, associated wetland
If- Z
included abo the wetland and stream impact sections.
be described here an trated on any maps included with
Pond to be created in (check apply): ? upl s
Describe the method of construction embanlar
draw-down valve or spillway, etc.):
V11.
Proposed use or purpose and (e.g., livestock watering, Lion, aesthetic, trout pond,
local stormwater ment, etc.):
Size of Xafe'-rshed draining to pond: Expected pond surface area:
Justification (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It may be useful to provide
information related to site constraints such as topography, building ordinances, accessibility, and
financial viability of the project. The applicant may attach drawings of alternative, lower-impact
site layouts, and explain why these design options were not feasible. Also discuss how impacts
were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce impacts. I
PPoR'>'? f-bu5e S 81?e.M PLP; kjN?Q I 10 AWA4 FWYA W X E
STlL t_ tnl Vtsw o;= u1PTi Z , AN 11 Fv1A6F_ 5AiFIT- Aw44 Fa&K G4z EEC
VUI. 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.
and sere acts should be
also proposed pond should
rilg application.
? stream ? wetlands
mt, excavation, installation of
Page 9 of 12
USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Pen-nits, published in the Federal Register on March 9, 2000, mitigation will be required when
necessary to ensure that adverse. effects to the aquatic environment are minimal. Factors
including size and type of proposed impact and function and relative value of the impacted
aquatic resource will be considered in determining acceptability of appropriate and practicable
mitigation as proposed. Examples of mitigation that may be appropriate and practicable include,
but are not limited to: reducing the size of the project; establishing and maintaining wetland
and/or. upland vegetated buffers to protect open waters such as streams; and replacing losses of
aquatic resource functions and values by creating, restoring, enhancing, or preserving similar
functions and values, preferable in the same watershed.
If mitigation is required for this project, a copy of the mitigation plan must be attached in order
for USACE or DWQ to consider the application complete for processing. Any application
lacking a required mitigation plan or NCWRP concurrence shall be placed on hold as
incomplete. An applicant may also choose to review the current guidelines for stream restoration
in DWQ's Draft Technical Guide for Stream Work in North Carolina, available at
http•//h2o.cnr.state.nc.us/newetiands/strmaide. htm.l.
Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
Anv.-?4T(DAl , it% P.Ouiwo a-,-N14iN/NCv W?rL* 5,
2. Mitigation may also be made 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.state.nc.us/wrplindex.htm, If use of
the NCWRP is proposed, please check the appropriate box on page three and provide the
following information:
Amount of stream mitigation requested (linear feet):
Amount of buffer mitigation requested (square feet):
Amount of Riparian wetland mitigation requested (acres):
Amount of Non=riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres):
Page 10 of 12
IX. Environmental Documentation (required by DWQ)
Does the project involve an expenditure of public (federal/statc) funds or the use of public
(federal./state) land? ,,_,/
Yes ? No Ltd
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] o review. current thresholds for environmental documentation.
Yes ? No g
If yes, has the document review been finalized by the State Clearinghouse? If so, please attach a
copy of the NEPA or SEPA fi approval letter.
Yes ? No [!
X. Proposed Impacts on Riparian and Watersbed 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 riparian buffers identified within 15A NCAC 2B .0233
(Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer. Require ents), or other (please identify, 1?
Yes ? No r If you answered "yes", provide the following information:
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'
Impact
are feet
s u

Multiplier
Reuired
Mt'tq n n
] 3
2 1.5
Total
• zone 1 extends out 30 feet perpendicular 8'om neat bunk of channel: 'Lone 2 extends an
additional 20 feet from the edge of Zone 1.
Page 11 of 12

If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation
of Property, Conservation Easement, Riparian Buffer Restoration / Enhancement, Preservation or
Payment into the Riparian Buffer Restoration Fund). Please attach all appropriate information as
identified within 15A NCAC 2B .0242 or.0260.
??otJ ?
XI. Stormwater (required by DWQ)
Describe impervious acreage (both existing and proposed) versus total acreage on the site.
Discuss stortnwater controls proposed in order to protect surface waters and wetlands.
downstream from the property.
N o e?ISTIN G lr pa-[Zv(?>J S AP*--A cNI LCM
t I S>% wA LL.otla C0YYI.PLJaTe-
XU. Sewage Disposal (required by DWQ)
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from the proposed protect, or available capacity of the subject facility.
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 Q?
XIV. Other Circumstances (Optional):
Tt 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).
Ap icant/Agenes Signature Efate
(Agent's l;" azure is valid only if an authorization letter from the applicant is provided.)
Page 12 of 12

D
i
n
n
D
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T
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8
3
0
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n
3
a
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c
0
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ri
JUNE 02, 2004
REWISED ?UL Y 13, 2005 ,
GRAPHIC SCALE
60 0 30 60 120
( IN FEET )
I Inch - 60 tL _
PC 2. ?.' Mw+.2 N ``--FRANKS CREEK--,----.,

L1
O I
LOT 9 M = ,
Ak
?t
LINE TABLE
LINE LENGTH BEARING
L1 63.40' N 14'15'25" E
L2 28.25' N 36'55'39" W
L3 39.13' N 22'14'18" W
L4 38.91' N 65'34'52" E
L5 40.99' N 16'06'41" E

NOTES:
1. PARCEL ALSO KNOWN AS
LOT 10, SECTION "0", BEECH
POINT, ALBEMARLE
PLANTATION, AS RECORDED
IN PC 2, SL 22, MAP 3
2. PROPERTY LINE RUNS 6
WITH AND ALONG 'O
SHORELINE. I°
3. AREAS BY COORDINATE n I
METHOD. z
180.04'
_ ,e r
7
L
I
,
14k
Ak
LOT 11
I W
N
pa
0
ti
ACREAGE BREAKDOWN
AREA OF UPLAND = .93 ACRES
f1k. AREA OF WETLANDS = .38 ACRES
TOTAL ACREAGE 1.31 ACRES

/ LEGEND
/
OO EXISTING IRON PIN
• POINT (NOT MONUMENTED)

BOUNDARY LINE
- - -SET BACK LINE
_-RIGHT OF WAY LINE
o
? -PROPERTY EXTENSION
4 - - - - - -APPROX. 404 WETLAND LINE
-a o o ? a 0 -PROPOSED RETAINING WALL
WETLANDS TO BE FILLED

I (TIE)
I N 11'37'33" E
187.70' TO EIR

BEECH P01 _ , . ?_? _?._..?..? _,._.._..,.._... _ .
NT DRIVE `(50' R,W)
NORTH CAROLINA, PEROU/MANS COUNTY
/, REVIEW OFFICER OF PEROU/MANS COUNTY
CERAFY THAT THE MAP OR PLAT TO WHICH THIS CERAFICAAON IS AFFIXED MEETS ALL
STATUTORY REOU/REMENTS FOR RECORDING. NOTE:- .THIS PROPF.RTY.IS LOCATED - -
-- T,' EDWARD `T. HYMAN ?R. IN FL 000 HAZARD ZONE AS NOTED
PIS-2690, CERAFY, MAP PANEL /370J15 7866 ?
REVIEW OFFICER THAT THIS PLAT IS OF DATED OCTOBER 14, 2003
AN EX/SANG PARCEL(S) OF LAND. RNSHED FLOOR ELEV. = N/A
1, EDWARD T. HYMAN, JR., CERTIFY THA T
THIS PLAT WAS DRAWN FROM AN ACTUAL
FIELD LAND SURREY MADE UNDER MY
SUPERVISION.- THA T THE DEED
DESCRIPTION FOR SAID PROPERTY IS
RECORDED IN D. B. 253 PG. 673: THAT
THE ERROR OF CLOSURE IS 1. 10, 0001:
THA T THIS MAP WAS PREPARED IN
ACCORDANCE WITH BOARD RULES,
WITNESS MY ORIGINAL SIGNATURE,
REGISTRA TION NUMBER AND SEAL THIS 0.3
DA Y OF JUNE, 2004

WETLANDS SITE # 1
„?, AREA TO BE FILLED
3.518 SF.
o .08 ACRES
t
i
81.00'
PROPOSED
a
N DWELLING
v ?
i '

111!1111
L 26 :
SUR,..•'? ?y
?H y
20
E
0
O ?
o
? N
w
N
VICINITY MAP
150A USHWY158E
Camden, North Carolina 27921
[phone] [phone]
r
Office Use Only:
USACE Action ID No.
(If any particular item is not applicable to this
1. Processing
DWQ No.
ect, please enter "Not
Porm Version May 2002
or "N/A".)
1. Check all of the approval(s) requested for this project: Riparian or Watershed Buffer Rules
[l?Section 404 Permit 0
Section 10 Permit Isolated Wetland Permit froml)WQ
?
? 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested: N'w
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: ?
4. If payment into the North Carolina Wetlands Restoration Program (NCWRP) is proposed for
mitigation of impacts (verify availability with NCWRP prior to submittal of PCN), 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 Mann eme D
Environmental Concern (see the top of page 2 for-further details), c
H. Npplicant Information JUL ? t 2005
RQAUTY
AAR gRpNCN
1. Owner/Applicant Information e/D?itl50?/ oE?so ST E
Name: 4?A/C?? N1.
Mailing Address: / Z4Z PLF,45a/vT ?plJ,2T
& laic- 04, Z0171
Telephone Number: 70 5 31S ¢// 2 Fax Number:
E-mail Address:
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: EDDIE ` MA*1
Company Affiliation: MW 'i'
Mailing Address: 1,S0 i% US 4dl(,tlttlAy 6 F
CftM DGi?l ?.G Z'T 21
Telephone Number: Z5Z 33Z! j? Fax Number: Z?Z ' 33?' S?Z
E-mail Address:
Page 5 of 12
III. Project Information
Attach a vicinity map clearly showing the location of the property with respect to. local
landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property
boundaries and development plans in relation to surrounding properties. Both the vicinity map
and site plan must include a scale and north arrow. The specific footprints of all buildings,
impervious surfaces, or other facilities must be included. If possible, the maps and plans should
include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property
boundaries outlined. Plan drawings, or other traps may be included at the applicant's discretion,
so long as the property is clearly defined. For administrative and distribution purposes, the
USACE requires information to be submitted on sheets no larger than 11 by 17-inch format;
however, DWQ may accept paperwork of any size. DWQ prefers full-size construction
drawings rather than a sequential sheet version of the full-size plans. If full-size plans are
reduced to a small scale such that the final vorsion is illegible, the applicant will be informed that
the project has been placed on hold until decipherable maps are provided.
1. Name of project: SITE RALI rVe- Kau d©msoj
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN): ?8? - 5'1_!50(228>
4. Location ?,???.?-gyp
County: ?UIiMA? 5 Cwy{ Nearest Town:
Subdivision name (include phase/lot number): LOT lD ALe&OAeLa PVU'TArl
Directions to site (include road numbers, landmarks, etc.): reorvt 6 N? 4 &A4TE
Dol?z
5. Site coordinates, if available (UTM or Lat/Long):
(Note - If project is linear, such as a road or utility line, attach a sheet that separately lists the
coordinates for each crossing of a distinct waterbody.)
6. Property size (acres): 1, 3 1Ge?S of 1
7. Nearest body of water (stream/river/sound/ocean/lake).
8. River Basin Pd,?o?,oTAm r.•-
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http://b26.enr.statc.nc.us/adm.iln/m,aps/.)
9, Describe the existing conditions on the site and general land use in the vicinity of the project
Oe5t06'AMAL. SU45;PIVtS4 d? L rr1+ LUCOPW
at the time of this, application:
i n-rr_- ?,1 Q-TG?'7_ C*76Ckr- CD ?'1l nlu I t `/
Page 6 of 12
10. Describe the overall project in detail, including the type of
0.08 A« oa= 404- W ETLAMP Fog Ct?t
t [.nDie- . 4 064 W ttrt.- SE DC- 6'
U- YMTEOAL-
(,L 6ZZ tL?Z
SEV
11. Explain the purpose of
W T+4 4-r
-Fn HAu*e:- Ac?
ENO 'iZ? _.?
IV. Prior Project History
sed work:
oL
WI N
te,L C.
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. Jnclude
the USACE Action ID Number, DWQ Project N-wnber, 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 describo permits issued for prior segments of the same T.I.P. project, along with
construction schedules.
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application.
VI. Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. The applicant must also
provide justification for these impacts in Section VII below. All proposed impacts, permanent
and temporary, must be listed herein, and must be clearly identifiable on an accompanying site
plan. All wetlands and waters, and all streams (intermittent and perennial) must be shown on a
delineation map, whether or not impacts are proposed to these systems. Wetland and stream
evaluation and delineation forms should be included as appropriate. Photographs may be
included at the applicant's discretion. If this proposed impact is strictly for wetland or stream
mitigation, list and describe tho impact in Section VIII below. If additional space is needed for
listing or description, please attach a separate sheet.
: to be used: `tLt-
wr-cp Ott-0-1&
Page 7 of 12
2. Individually list wetland impacts below:
Wetland Impact
Site Number
-indicate on ma
Type of Impact' -Area of
Impact
acres Located within
100-year Floodplain"
es/no Distance to
Nearest Stream
(linear feet
Type of Wetland"'
(?.-? fJit? S ?Q ?? ? L

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: mechanized clearing, grading, fill,
•• excavation, flooding, ditching/drainage, etc. For dams, separately list impacts due to both structure and flooding.
100-Year floodplatns are identified through the Fedo?al Emergency Management Agency's (FEMA) Flood Insuranco Rata: Maps
(FIRM), or FEMA-approved local tloodplain maps. Mapa arc available through the FEMA Map Servicc Contcr at 1-800-358-9616, or
online at tn://www.fema.nov,
"• List it wetland type that best describes wetland to be impacted (e.g., freshwater/saltwater marsh, forested wWand, beaver pond,
Carolina Bay, bog, etc.) Indicate if wetland is isolated (determination of isolation to be made by USACE only).
List the total acreage (estimated) of all existing wetlands on the property: ?' 38 A L
Total area of wetland impact proposed: C>-,0 Ac-
3. Individually list all intermittent and perennial stream impacts below:
Stream Impact
Site Number
(indicate on ma
Typo of Impact' Length of
Impact
linear feet
Stream Names` Average Width
of stream
Before Im act Peronnial or
Intermittent?
leasespecify)_

List each impact separately and identify temporary impacts. Impacta include, but are not limited to: culverts and associated rap-rap,
dams (separately list impacts due to both structure and flooding), roloeation (include linear feet befbre and after, and net loss/guin),
stubili=tion activities (cement wall, rip-rap, crib wall, gabions, etc.), excavation, ditch inotraighten ing, etc. If etroam relocation is
proposed, plans and profiles showing the linear footprint for both the original and relocated streams must bo included.
•• Stream names can be found an USGS topographic maps. If a stream has no name, list as UT (unnamed tributary) to the nearest
downstream named stream into which it flows. USGS maps are available through the USGS at 1-800-358-9616, or online at
www.utiia. tv. Several internet sites also allow direct download and printing of lISGS maps (e.g., yW!J.oro7one.coin
www.m11rq11e5j c(Im, etc.).
Cumulative impacts (linear distance in feet) to all streams on site:
Page 8 of 12
4. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.) below:
Open Water Impact
Site Number.
indicate on ma
Type of Impact* Area of
Impact
acres Name of Waterbody

(if applicable) Type of Waterbody
(lake, pond, estuary, sound,
bay, ocean, etc.

* List each impact ecpurutely and identify tempotary impacts. Impacts include, but are not limited to: fill, excuvution, dredging,
flooding, drainage, bulkhesda, eta
Creation
If coon ction of a pond is proposed, associated wetland
included ab6V the wetland and stream impact sections.
be described here an trated on any maps included with
Pond to be created in (check t apply): ? u?pl?d
Describe the method of construction arblembanlar
draw-down valve or spillway,
Proposed use or purpose and (e.g., livestock watering, ion, aesthetic, trout pond,
local stormwater . meat, etc.):
Size of wafe'rshed draining to pond: Expected pond surface area:
V11. impact Justliieatlon (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It may be useful to provide
information related to site constraints such as topography, building ordinances, accessibility, and
financial viability of the project. The applicant may attach drawings of alternative, lower-impact
site layouts, and explain why these design options were not feasible. Also discuss how impacts
were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce impacts. t
P20 Pose© f-bu Sa: s SEA PLA J E? 110 AwALI rrfm WARE
GE STtU- tnl View OF WbTiZz , AN `f FZJT?WX- SHIFT ACVA4 F(d'/M C4Za5Z
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.
and stye acts should be
klso proposed pond should
ffsH c ation.
tream ? wetlands
:nt, excavation, installation of
Pagt 9of12
USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on March 9, 2000, mitigation will be required when
necessary to ensure that adverse, effects to the aquatic environment are minimal. Factors
including size and type of proposed impact and function and relative value of the impacted
aquatic resource will be considered in determining acceptability of appropriate and practicable
mitigation as proposed. Examples of mitigation that may be appropriate and practicable include,
but are not limited to: reducing the size of the project; establishing and maintaining wetland
and/or. upland vegetated buffers to protect open waters such as streams; and replacing losses of
aquatic resource functions and values by creating, restoring, enhancing, or preserving similar
functions and values, preferable in the same watershed.
If mitigation is required for this project, a copy of the mitigation plan must be attached in order
for USACE or DWQ to consider the application complete for processing. Any application
lacking a required mitigation plan or NCWRP concurrence shall be placed on hold as
incomplete. An applicant may also choose to review the current guidelines for stream restoration
in DWQ's Draft Technical Guide for Stream Work in North Carolina, available at
http•/lh2o.enr.state.nc.ug/newettands/strmitide. html.
1.
Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
may,>4nom , 1F 904U12ZO Wtt,t_ P.AG4-- ??-N141AIlNCv WC_7 AA4D5
2. Mitigation may also be made 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.state.ne.us/wrp/index.htm, if use of
the NCWRP is proposed, please check the appropriate box on page three and provide the
following information:
Amount of stream, mitigation requested (linear feet):
Amount of buffer mitigation requested (square feet):
Amount of Riparian wetland mitigation requested (acres):
Amount of Non-riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres):
Page 10 of 12
I.X. Environmental Documentation (required by DWQ)
Does the project involve an expenditure of public (federal/statc) funds or the use of public
(federal./state) land?
Yes ? No
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
o review current thresholds for environmental documentation.
coordinator at (919) 733-5Pr
Yes ? No If y
es, has the document review been finalized by the State Clearinghouse? If so, please attach a
copy of the NEPA or SEPA fipal approval letter.
Yes ? No F%
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 riparian buffers identified within 15A NCAC 2B .0233
(Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify )?
Yes ? No ["1 If you answered "yes", provide the following information:
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" (square feet Multiplier M tip anon
1 3
2 1.5
Total
* Zone 1 extends out 30 feet perpendicular in near bunk of channel; 'Lone 2 extends an
additional 20 feet from the odge of Zone 1.
Page I1 of 12
If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation
of Property, Conservation Easement, Riparian Buffer Restoration / Enhancement, Preservation or
Payment into the Riparian Buffer Restoration Fund). Please attach all appropriate information as
identified within 15A NCAC 2B .0242 or .0260.
l Ao N
XI. Stormwater (required by DWQ)
Describe impervious acreage (both existing and proposed) versus total acreage on the site.
Discuss stormwater controls proposed in order to protect surface waters and wetlands.
downstream from the property.
I`L n t lSTt1,,A 6;, t rn PeCz.\1/C>J S ACAS OKL Lo-r_

XU. Sewage Disposal (required by DWQ)
Clearly detail The ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from the proposed protect, or available capacity of the subject facility.
XIII. Violations (required by DWQ)
Is this site in violation of DW Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes ? No ff
Is this an after-the-fact permit application?
Yes ? No
XIV. Other Circumstances (Optional)!
TI 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).
Ap icantfAgent's Signature Date
(Agent's pature is valid only if an authorization letter from the applicant is provided.)
Page 12 of 12
Y
a
s
i
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n
V
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v
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E
of
3
0
N
n
n
0
0
V)
0
N
n

2
E
ri
JUNE 02, 2004
REVISED ?UL Y 13, 2005
GRAPHIC SCALE
60 0 30 60 120
( IN FEET )
I Inch a 60 [L _
PC A'' "'P " N _ -FRANKS CREEK-,----,
- Aft- L1
.1?c.
LOT 9
A[&-
AIL
LINE TABLE
LINE LENGTH BEARING
L1 63.40' N 14'15'25" E
L2 28.25' N 36'55'39" W
L3 39.13' N 22'14'18" W
L4 38.91' N 65'34'52" E
L5 40.99' N 16'06'41" E
o '

q ,
N

M =,
v
PETLANDS SITE # 1
,v, AREA TO BE FILLED
v, 3,518 SF.
? .08 ACRES
o
a?
,
81.00'
PROPOSED
y11it ' o DWELLING

V
? 0

o ?

NOTES:
1. PARCEL ALSO KNOWN AS
LOT 10, SECTION -0-, BEECH
POINT, ALBEMARLE
PLANTATION, AS RECORDED
IN PC 2, SL 22, MAP 3
2. PROPERTY LINE RUNS o
WITH AND ALONG
SHORELINE. I
3. AREAS BY COORDINATE^,O?
METHOD. z
180.04'

11k

l
0
-- M
T TBL
I I
'1111 LOT 11
W
N
a
Q
0
N
ACREAGE BREAKDOWN
AREA OF UPLAND = .93 ACRES
J?1k AREA OF WETLANDS = .38 ACRES
TOTAL ACREAGE 1.31 ACRES
LEGEND
I ?
' OO EXISTING IRON PIN
• POINT (NOT MONUMENTED)
BOUNDARY LINE
- - - - -SET BACK LINE
-RIGHT OF WAY LINE
- - -PROPERTY EXTENSION
- - - - - -APPROX. 404 WETLAND LINE
V 0 0 ? ? ? -PROPOSED RETAINING WALL
WETLANDS TO BE FILLED
(TIE)
N 11'37'33" E
187.70' TO EIR
BEECH POINT DRIVE ;(50',R,W)
NORTH CAROLINA, P£ROU/MANS COUNTY
/, RENEW OFFICER OF PEROUIMANS COUNTY
CER7I7Y THAT THE MAP OR PLAT TO WHICH THIS CERRF/CAAGYV IS AFFIXED MEETS ALL
STATUTORY REOU/REMENTS FOR RECORDING. NOTE. Rd/S PROPERTY /S LOCATED _
4-EDWARD T. HYMAN JR. _ -- --- -- /N FLOOD HAZARD"ZONE AS NOTED y
PLS-2690, CERRFY, MAP PANEL 1370315 7866 ?
REVIEW OFFICER THAT THIS PLAT IS OF DATED OCTOBER 14, 2003
AN EXIS77NG PARCEL(S) OF LAND. FINISHED FLOOR ELEV. = N/A
/, EDWARD T. HYMAN, ?R., CERTIFY THAT
THIS PLAT WAS DRAWN FROM AN ACTUAL
FIELD LAND SURVEY MADE UNDER MY
SUPERVISION.- THAT THE DEED
DESCRIPTION FOR SAID PROPERTY IS
RECORDED IN D.B. 253 PG. 673: THAT
THE ERROR OF CLOSURE /S 1: 10,000+:
THAT THIS MAP WAS PREPARED /N
ACCORDANCE WITH BOARD RULES,
WITNESS MY ORIGINAL SIGNATURE,
REG/STRA RON NUMBER AND SEAL THIS 03
DA Y OF JUNE, 2004
11111
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L- W97V)r.-'.
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VICINITY MAP
150A USHWY158E
Camden, North Carolina 27921
[phone] [phone]

Office Use Only:
Form Version May 2002
DWQ No.
USACE Action ID No.
(If any particular item is not applicable to this project, please enter "Not Applicable" or "NIA".)
I. Processing
1. Check all of the approval(s) requested for this project:
?V Riparian or Watershed Buffer Rules
Section 404 Permit ?
? Section 10 Permit ? Isolated Wetland Permit from DWQ
? 401 Water Quality Certification
• 2. Nationwide, Regional or General Permit Ndmber(s) Requested:
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: ?
4. If payment into the North Carolina Wetlands Restoration Program (NCWRP) is proposed for
mitigation of impacts (verify availability with NCWRP prior to submittal of PCN), 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 Divisi Coastal lvlanageme t Area of
101
Environmental Concern (see the top of page 2 for-further 1?5
H. Applicant Information JUL 2 1 2005
1. Owner/Applicant 1.rtformation oENR - WATER QUALITY
Name: 4ENA/t5T4 M. cADfI/USOA/ WETLAhDSANDSTORM&TERB a??u
Mailing Address: _ t 24Z PLE45AAlT C-,Z ? !?221)2T
.... . . ?A ? '-, /"7 /
Telephone Number: 703 3L_?-??? Fax Number:
E-mail Address:
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: EDDIE '4a4A4\AJ
Company Affiliation: N1 fAA -'1' Rcl,
Mailing Address: ( _ 0. US w&,NWAJ 666 e
Telephone Number: Z5Z 338 Z°113 Fax Number: Z157- - -5 8S SZ
E-mail Address:
Page 5 of 12
III. Project Information
Attach a vicinity map clearly showing the location of the property with respect to , local
landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property
boundaries and development plans in relation to surrounding properties. Both the vicinity map
and site plan must include a scale and north arrow. The specific footprints of all buildings,
impervious surfaces, or other facilities must be included. If possible, the maps and plans should
include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property
boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion,
so long as the property is clearly defined. For administrative and distribution purposes, the
USACE requires information to be submitted on sheets no larger than 11 by 17-inch format;
however, DWQ may accept paperwork of any size. DWQ prefers full-size construction
drawings rather than a sequential sheet version of the full-size plans. If full-size plans are
reduced to a small scale such that the final version is illegible, the applicant will be informed that
the project has been placed on hold until decipherable maps are provided.
1. Name of project: SI'CE R'W f at? Kau Jom soj
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN): 7844v - 57 -6Z (og
4. Location I '
County: F Roll p'kt 6 caxlw Nearest Town:
Subdivision name (include phase/lot number): Lox 10 ALCiEMAP,LE, RAttrAV OWc?NaL 5
Directions to site (include road numbers, landmarks, etc.): Feom Eu'tw¢.AkM &Wre' 7At:e:
A. P7r• AABI r a . ?r? ?,? Q.GfJ P^> IL JT r7ts??1? la;..xr ! M/ 9Powr
5. Site coordinates, if available (UTM or Lat/Long):
(Note - If project is linear, such as a road or utility line, attach a sheet that separately lists the
coordinates for each crossing of a distinct waterbody.)
6. Property size (acres): (GQ?S ?rF of
1
1CFI 0?1 t
?Pa4?11? Cam- Ce??)
7. Nearest body of water (stream/river/sound/ocean/lake):
8. River Basin: FA 3o\.o Am r-.-
(Note - this must be one of North Carolina's seventeen designated major river basins. The
s/.)
River Basin map is available at http://b26.L-nr.statc.nc.us/admill/.M..ap
9. Describe the existing conditions on the site and general land use in thevicinity of project
at the time of this, application: ?5t0?A'flAL 5y*DlVt`d?
W ?-TE2 Corn Murk I't Y ,
L0715
Page 6 of 12
10. Describe the overall project in detail, including the type of
0.08 AG?S OF 404- W ETLANP f bR-
IV.
V.
to be used: C--LLL
9V'r ®4= 15U RID/Itl l?
P2AriL RLLEP WjT"
5ANIn D!Z ' C?t}lE2 SLMAt?N-e RLL- ?1'14T6:V-(AL. L-44C - HOL-,
PULL CMUl 2_ AM_D ] >JMP 72sXX- rJUttJ- Ke, 05E512 tOt'
11. Explain the purpose of the-proposed work: 0-PA^D OF
r L) i DT44 4-r ?O,'50D ?? 'To
Prior Project History
t_LO-L) Ar VaL4(C LC-
5i D? ? !_ ?.lC1YVl,E
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.
Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application.
VI. Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. The applicant must also
provide justification for these impacts in Section VII below. All proposed impacts, permanent
and temporary, must be listed herein, and must be clearly identifiable on an accompanying site
plan. All wetlands and waters, and all streams (intermittent and perennial) must be shown on a
delineation map, whether or not impacts are proposed to these systems. Wetland and stream
evaluation and delineation forms should be included as appropriate. Photographs may be
included at the applicant's discretion. If this proposed impact is strictly for wetland or stream
mitigation, list and describe the impact in Section VIII below. If additional space is needed for
listing or description, please attach a separate sheet.
Page 7 of 12
1. Provide a written description of the proposed
Sd ' e1_l_. tom,08 At= ©r f
LAz A--TIC A P
2. Individually list wetland impacts below:
Wdtland Impact
Site Number
4indicate on ma
Type of Impact" -Area of
Impact
acres Located within
100-yearFloodplain"
es/no Distance to
Nearest Stream
linear feet
Type of Wetland**'
lLZ Dio S t 09:EST w L

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: mechanized cica ring, gracing, 'tut,
excavation, flooding, ditching/drainage, etc. For dams, separately list impacts due to both structure and flooding.
100-Year floodplains ure identified through the Federal Emergency Manugernent Agency's (FEMA) Flood Insurance Rate Maps
(FIRM), or FEMA-approved local tloodpiain maps. Mapa are available through the FEMA Map Service Contcr at 1.800-358-9616, or
onlute at bt: /www.fema.aov.
List u wetland type that best describes wetland to be impacted (e.g., freshwaterlsaltwater marsh, forustod wetland, beaver pond,
Carolina Bay, bob, etc.) indicate if wetland is isolated (determination of isolation to be made by USACE only).
List the total acreage (estimated) of all existing wetlands on the property: ?' 38 A L
Total area of wetland impact proposed: Oro Ac--
3. Individually list all intermittent and perennial stream impacts below:
Stream Impact
Site Number
(indicate on M11
Typo of Impact' Length of
Impact
linear feet
Stream Names' Average Width
of strearn
Before Impact Peronnial or
Intermittent?
lassospecify)

List each impact separately and identify temporary impacts. Impacts include, but ure not limited to: culverts and associated rip-rap,
dawns (3eparately list impacts due to both structure and flooding), rclociuion (include linear feet before and after, and net loss/gain),
stabilization uctivities (cement wall, rip-rap, crib wall, gabions, etc.), excavation, ditcbing/straightening etc. If stream relocation is
proposed, plans and profiles showing the linear footprint for both the original and relocated streams must bo included.
"• Strrum names can be found on USGS topographic maps. If a stream has no name, list as UT (unnamed tributary) to the nearest
downstream named stream into which it flows. USGS maps are available through the USGS at 1-800-358-9616, or online at
www.uer;a.?;nv. Several internet sites also allow direct download and printing of USGS maps (c.g., Zvw&,tnpozone.com,
www.maM1tt,;i.cnm, etc.).
Cumulative impacts (linear distance in feet) to all streams on site:
Page 8 of 12
4. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.) below:
Open Water Impact

Site Number.
indicate on ma

Type of Impact Area of

Impact
acres
Name of Waterbody

(if applicable) Type of Waterbody

(like, pond, estuary, sound,
bay, ocean, etc.

* List each impact eepurately and identify temporary impacts. Impacts include, bur are not limited to: fill, oxcavution, dredging,
flooding, drainage, bulkheads, etc.
and Creation
If co ction of a pond is proposed, associated wetland
included abo the wetland and stream impact sections.
be described here an trated on any maps included with
Pond to be created in (check apply): ? -a ds
Describe the method of construction embankm
draw-down valve or spillway, etc.):
and stye acts should be
also proposed pond should
rit application.
? stream ? wetlands
;nt, excavation, installation of
Proposed use or purpose and (e.g., livestock watering, aesthetic, trout pond,
local stormwater ment, etc.):
Size of ershed draining to pond: Expected pond surface area:
'V'11. impact Justification (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It may be useful to provide
information related to site constraints such as topography, building ordinances, accessibility, and
financial viability of the project. The applicant may attach drawings of alternative, lower-impact
site layouts, and explain why these design options were not feasible. Also discuss how impacts
were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce impacts-
Pee? Pmec) ?-bv Sa~ HAS l5eeM PL Aw N 60 110 AwALI FOom ttJMi?E
G C STlt.t... tm Vtew OF tuoTEz , ANY FuTACZ_ 5AIF- AWA,4 Fet,-/K G2E6C
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
Pen-nits, published in the Federal Register on March 9, 2000, mitigation will be required when
necessary to ensure that adverse. effects to the aquatic environment are minimal. Factors
including size and type of proposed impact and function and relative value of the impacted
aquatic resource will be considered in determining acceptability of appropriate and practicable
mitigation as proposed. Examples of mitigation that may be appropriate and practicable include,
but are not limited to: reducing the size of the project; establishing and maintaining wetland
and/or. upland vegetated buffers to protect open waters such as streams; and replacing losses of
aquatic resource functions and values by creating, restoring, enhancing, or preserving similar
functions and values, preferable in the same watershed.
If mitigation is required for this project, a copy of the mitigation plan must be attached in order
for USACE or DWQ to consider the application complete for processing. Any application
lacking a required mitigation plan or NCWRP concurrence shall be placed on hold as
incomplete. An applicant may also choose to review the current guidelines for stream restoration
in DWQ's Draft Technical Guide for Stream Work in North Carolina, available at
http•//h2o.cnr.state.nc.us/nowetiands/strmeide. htm.l.
Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
mrrv*kT1o#4 , jr- g54-Ut2zD wi tr A.Aft J Eom4wlAlCv It VrLM(D5
2. Mitigation may also be made 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 httn•//h2o enr.state.nc.rts/wrg/index.htm, If use of
the NCWRP is proposed, please check the appropriate box on page three and provide the
following information:
Amount of stream mitigation requested (linear feet):
Amount of buffer mitigation requested (square feet):
Amount of Riparian wetland mitigation requested (acres):
Amount of Non-riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres):
Page 10 of 12
IX. Environmental Documentation (required by DWQ)
Does the project involve an expenditure of public (federallstate) funds or the use of public
(federal/state) land?
Yes ? No
If yes, does the project require preparation of an environmental document pursuant to the
requirements of the National or North Carolina Environmental Policy Act. (NEPA/SEPA)?
Note: If you are not sure whether a NEPA/SEPA document is required, call the SEPA
coordinator at [phone]/to review, current thresholds for environmental documentation.
Yes ? No
If yes, has the document review been finalized by the State Clearinghouse? If so, please attach a
copy of the NEPA or SEPA f1jiW approval letter.
Yes ? No [fl
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 riparian buffers identified within 15A NCAC 2B .0233
(Meuse), 15A NCAC 213 .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify, )?
Yes ? No M If you answered "yes", provide the following information:
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" s I
quare feet) mpact
Multiplier
Req d n
1 3
2 1.5
Total
Zone 1 extends out 30 feet perpendicular erom near bunk of channel: Zone 2 extends an
additional 20 feet from the edge of Zone 1.
Page 11 of 12

If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation
of Property, Conservation Easement, Riparian Buffer Restoration I Enhancement, Preservation or
Payment into the Riparian Buffer Restoration Fund). Please attach all appropriate information as
identified within 15A NCAC 2B .0242 or.0260.
N,oN ?
XI. Stormwatcr (required by DWQ)
Describe impervious acreage (both existing and proposed) versus total acreage on the site.
Discuss stormwater controls proposed in order to protect surface waters and wetlands.
downstream from the oronerty.
XH. Sewage Disposal (required by DWQ)
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from the proposed pro"ect, or available capacity of the subject facility.
?tV4TF, ?- 5Src_E:?m -
XIII. Violations (required by ]DWQ)
Is this site in violation of DW Wetland Rules (15A NCAC 2H.0500) or any Buffcr Rules?
Yes ? No [
Is this an after-the-fact permit application?
Yes ? No Q?
XIV. Other Circumstances (Optional):
Tt 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).
Ap icant/Agent's Signature bate
(Agent's ature is valid only if an authorization letter from the applicant is provided,)
Page 12 of 12
JUNE 02, 2004 REMISED JUL Y 13, 2005
GRAPHIC SCALE
60 0 30 60 120 y
! ;SITEJ
IN FEET)
I Inch - 60 ft
P` S-" ""°'2 N ```--FRANKS CREEK, 3
0
0
c
C
0
v
n
n
c
E
n
11

LOT 9
a
J?jk
,1k
LINE TABLE
LINE LENGTH BEARING

NOTES:
1. PARCEL ALSO KNOWN AS
LOT 10, SECTION "0", BEECH
POINT, ALBEMARLE
PLANTATION, AS RECORDED
IN PC 2, SL 22, MAP 3
2. PROPERTY LINE RUNS o
WITH AND ALONG +'o
SHORELINE. I.
to
3. AREAS BY COORDINATE"'
METHOD. z
Jw
180.04'

I
\ lLk
J lk
VICINITY MAP
''1 LOT 11
I W
a
N
a
P
0
N
ACREAGE BREAKDOWN
AREA OF UPLAND = .93 ACRES
J1 k AREA OF WETLANDS = .38 ACRES
-----------------------
TOTAL ACREAGE = 1.31 ACRES

/ LEGEND
/

? / OO EXISTING IRON PIN
• POINT (NOT MONUMENTED
)
BOUNDARY LINE
/ - - - - -SET BACK LINE
QO / RIGHT OF WAY LINE
o
-PROPERTY EXTENSION
- - - - - -APPROX. 404 WETLAND LIN
•0 0 0 0 0 0-PROPOSED RETAINING WALL
WETLANDS TO BE FILLED
/
T TBL _
I I (TIE)
N 11'37'33" E
_ 187.70' TO EIR
-" -?
S 11'37 33 W
BEECH POINT DRIVE (50"' R V)
NORTH CAROLINA, PEROU/MANS COUNTY
4 REVIEW OFFICER OF PEROUIMANS COUNTY
CERTIFY THAT 7HE MAP OR PLAT TO WHICH THIS CER77FICA27ON IS AFFIXED MEETS ALL
STATUTORY REOUIREMENTS FOR RECORDING NOTE.- THIS PROPERTY 1S LOCATED
- - - v . _ _ /, EDWARD T. HYMAN R. IN FLOOD HA2ARD-2ONE°AS'NOTED"-"
PLS-2690, CERTIFY, MAP PANEL ,xJ70315 7866 ?
REVIEW OFFICER THAT THIS PLAT IS OF DATED OCTOBER 14, 2003
AN EXISTING PARCEL(S) OF LAND. FINISHED FLOOR ELEK = N/A
I, EDWARD T. HYMAN, ?R., CERTIFY THA T
THIS PLAT WAS DRAW FROM AN ACTUAL
FIELD LAND SURVEY MADE UNDER MY
SUPERVISION.- THAT THE DEED
DESCRIPTION FOR SAID PROPERTY IS
RECORDED IN D. B. 253 PG. 673: THAT
THE ERROR OF CLOSURE IS 1: 10,000*:
THAT THIS MAP WAS PREPARED IN
ACCORDANCE WITH BOARD RULES,
WITNESS MY ORIGINAL SIGNA7ZIRE,
REGISTRA77ON NUMBER AND SEAL THIS 03
DA Y OF JUNE, 2004
WETLANDS SITE # t
AREA TO BE FILLED
u, 3,518 SF.
o? .08 ACRES
a?
81.00'
PROPOSED
8 DWELLING
i N
d '

L- M91:
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CFO . SURD
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:
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ti
150A USHWY158E
Camden, North Carolina 27921
[phone] [phone]