20070061 Ver 1_401 Application_20070110

01!03!2007 11:00 FAX [phone] TOWN of LAIC LURE f7j006/013
Office Use Only: Fawn Yasiaa March OS
usACE Aetioe m No. DwQ No. ~ ~ ~ 7 ~ 0 6 1
~mY 1~~ >~ ih not applicable to thus praja~, plesso arses "Nat ApQ~le` az 9d/A".)
I. g P~!,l'ME-VT
~. all ofthe appoval(s) requested f~ t~ ~j~ RECEIVED
Section 404 Permit ^ Riparian or watershed Buffer Rules
^ on 10 Pernnit ^ Isoleted wetland Permit fiom DwQ
401 Water Quality Certification ^ Express 401 water Quality Certificxttion
2. Nationwide, Regional or General Permit Numbers} Requested: ~ ~ (~'' c~ w~ r ~,U ( 3
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: ^
4. If payment itrto the North Carolina Ecosystem Enhancemerrt Program (NCEEP) is,proposed
for mitigation of impacts, attach the acceptance letter from NCEEP, complete section VIII,
and check here: ^
5. If your pmect is located in any of North Carolina's twenty coa.Stal 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), chec ~ S t, ~ ~ ~-.-, ~
5 ~ w ,~
II. Appli~t Innformation ~.~~
.1~l~' _a ~ 1 ~~~~
l . Owner/Applicant Information
1~~; ROBERT AND ELIZABETH IWAOKA "~~'•~' • - ~ ~Mt:~Y~'
Mail~g A~~; 7342 GOVERNOR'S HILL LANE ~ ~wr.r,
CHARLOTTE, NC 28211
Telephone Number: `~ Q ~ c3 G 3' N `-t 2? Fax Numt~: _
&mail Address: ,8 I c./ a o ~ccr_ @ c ~ ~o 1~, ~ ~ rr • c o ~
2. AgetitlConsultant Information (A signed and dated copy of the Agent Authorization letter
must be attached if the Agent has signatory authority for the ownerlapplicant.)
Name:
Company Affiliation:
Mailing Address:
Telephone Number: Fax Number:
E mail Address:

01/03/2007 11:01 FA% 8286258371 TOWN of 1.ARE LURE C~J007/013
III. Project Iaforoiatioc~
Attach a viciniRp chap clearly showing the location of the property with respect to local
landmarks such as towns, rivets, and roads. Also provide a detailed site plan slowing ProP~Y
bauaiaties and devel plans in relation to ~ pc+oQearties. Both the vomit map
and site plan must include a scale nail north arrow. Tbre specific footprints of all buildings,
i>np o ~.s siefaces, or albs: fsplities must be incfided. If po~ible, the maps and plsos should
include the appropriate USGS Topographic Quad Map and MRCS Soil Survey with the property
boundaries outlined. Plan drawings, or oilier maps maybe included at the applicant's discx+etion,
so long as the property is clearly defined. For administrative and distn'bution purposes, the
USAGE requires information to be subtnitt~ed on sheexs no lmrger than 1 I by 17-inch format;
hov~ver, DWQ may accept paperwork of any size. DWQ prefers foil-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 fi~l version is illegible, the applicant will be informed that
the project has been placed on hold until decipherable maps ace provided.
1. Name of project: ~-~ f~G-o ~e~ .~.~ ~ r,•f k l {
2. T1 P. Project Number or State Project Number (NCDOT Only):
" 3. Property Identification Number (Tax P1N): 1 ~'U o~ 7 s ~ 2
4. Location (~ 1~.,, ~ V~e~
County: I~ V`~"h~Evrr~ ~~ Nearest Town•
Subdivision name (mclude pha9cJtot number): ~+ 1 a- .
Directions to site (inchuie mad numberslnames, landmarks, etc.):
5. Site coordinates (For linear projects, such as a road or utility line, attach a sheet that
separately lists the G~ordinates for each crossing of a distinct waterlwdy.)
Decimal Degrees (5 digits minimum): ~I °W
6. Property size (acres): S 1 A-c
7. Name of treac+est receiving body of water: ~ Q ~"fi'°'~ TJ'' G-~ ~-`~ ICc. ~- v~~,
8. River Basin• I`~ ~0 z ~ ~- ~ i~v v
(Note -this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http://h2o.enr.statg.nc.us/admin/mapsl.)
9. Describe lire existing conditions on the site and general land use in the vicinity of the project
ax the time of this application: cT ~ < <~ ~ y ~',~ ~c~' ~' o(.e.~ ~ 2 !
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I~e6o1'22

01!03/2007 11:01 FAX [phone] TOWN of LAKE LURE I~j00$/013
10. Describe the averall'project in detail, including the type of equipment to be used:
.Se~rnl~C ~ /t., ~c.(v a-F cancr'e fv a- .s'~nne
11. Fap~in the purpose of the pmpo®ed work- {"1'c~c/'c i 6 d~ ~f ~'t'F~'1'
r 'a -s ~ c 1 v'~c.7"
IV. Prior Project History
If jurisdictional determinations and/or permits have been requested and/or obtained for this
pmjed (including all prior phases of the same subdivision) is the past, please explain. Include
the USAGE Action ID Number, DWQ Project Number, ~plic~ion date, and date permits and
certifications wore issued a withdrawn. Provide photocopies of previously issued permits,
certifications ~ other usefirl information. Describe previously approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and desm'be permits isslred for prior s~egme~s of the same T.I.P. project, along with
cruction sc~edtiles.
V. Fntar+e Project Plamf
~a
Are any future permit anticipated for this project? If so, describe the anticipated war!:,
and provide justifica8on for the exclusion of this work fimn the cun~ent application.
VL Propoered Impacts to Wagers of tie Uaitod States/Watera of tie State
It is the applicant's {or ageafs) r~espoasibility to determine, delineate sad map all impacts to
wetlands, open water, anti stream camels assoaociated with the project. Each impact must be
listed separately in the tables below (e.g., cuhrat installation should be listed separately from
riprap dissipater pads). Be sure to indicate if an impact is temporary. All proposed impacts,
permanent and tempam<y, mast be listed, and must be labeled cad c>eaiiy identifiable on an
accompanying site plan. All wetlands cad waters, and all streams (iatermitteat and perennial)
should be drown on s delineation map, v~ether or not impacts are proposed to these systems.
Wetland and stream evaluation and forms should be inchr~d ag aipp:+apriate.
Photographs maybe included st the applicaar's discretion. If this proposed imp®cx is strictly for
wetland or stream mitigation, list and descn'be the impact in Section VIII below. If additional
space is needed for listing or description, please attach a separate sheet.
1. Provide a written description ofthe pr+opoaoc
~7ofIZ

01;03/2007 11:02 FAX [phone] TOWN of LAKE LURE (~j009/013
2. Individually list wetland impacts. Types of impacts inchrde, but are not limited to
mechanized clearing, grading, fill, excav~ion, flooding, ditching/drainage, etc. For dams,
seasradely list imnads due to bath stnrcttu+e and floodine.

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Total Wetlaad lugact (saes)
3. List the total acreage (estimated) of all existing wetlands on the property:
4. Individually list all intermittent and perennial strum impacts. Be sure to identify temporary
impacts. Stream impacts include, but are not limited to placement of fill or culverts, dam
caostruction, flooding, relocation, stabilization activities {e.g., cement walls, rip-rap, cn'b
walls, gabions, etc.), excavation, ditching/sttaightening, etc. If stream relocation is Proposed,
plans and pmSles showing the linear footprint for both the original and relocated streams
must be inchtded. To Mate m ' I 1 X width, then divide 43,560.
Stream Impat~ Average Impact Ara of
Nmnber Strcam Name Tape of Impact ~ dream WidA~ Length Impact
mdicaoe on Before feet saes
Total Stream Impact {by Iw+61h s'd same)
5. Individually list all open water impacts (including lakes, Ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.). Open water impacts include, but are not limited to
fiI1_ excavsetinm_ dt+~laino_ flnndinu_ ~irtnor._ Mfilri~ci4 etc_
~° w'~Or
Sine Bomber
wdicale oa Name of Watrrbody

C~~)
Type of Type of Wsletbody
(1ai:e, P~ ~. ~~, ~.
etc. Area of
Tmpa~
ears
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Tod Opea Water larpoct (sets)

01/03/2007 11:02 FAX [phone] TOWN of LAKE LURE f~j010/013
6. List the cwnulative impact to all Waters of the U.S. resulting fmm the nnniret~
Stresnn arras - - - - - -
Weuand acres}:
Water acres : - . , a o Z e
Total to Waters of the U_S. acres * • et a ~, o
Total Stream (linear feet}: ~j
7. Isolates waters
Do any isolated wagers exist on the property? ^ Yes No
Descn'be all ®pacts to isolated waters, and include the type of water (wetland or stream) sad
the size of the proposed impact (acres or linear feet). Please note thax this section only
applies to waters that have specifically been deter to be iso~ted by the USAGE.
8. Pond Creation
If construction of a pond is proposed, associated vvetlrmd and stream impacts should be
inchrded abaFVe in the wetland and stream impact sections. AL~o, the proposed pond should
be described here and filuslrated on any maps included with this application.
Pond tp be created inn (deck all that apply): ^ uplands ^ stream ^ wetlands
Destxibe the metlad of canstructio® (eg., dbm/embankment, excavation, installation of
draw-down valve or spillway, etc.}:
Propo~d use or purpose of pond (eg., livestock watering, irrigation, aesthetic, trout pond,
local srormwatea recgru+ement, etc.):
Cun~eut land use in the v;~aity of the pond:
Size of water^~ed draining to pond: Expected pond surface area:
VII. Impact Jnsti6catioa (Avoidance and Minimizitioa)
SpeciScally describe measures taken to avoid the proposed impacts. It may be useful to provide
infonnatian related to site con~rsints such as topography, building ~, ac~si'bility, and
financial viability of the project. The applicant may attadr drawings of alternative, lower-impact
site layouts, and explain why these design c~tians w~ea+e not fease'(rle. Also discuss how impacts
were minimized once the dGSined site plea was developed. II applicable, discuss eoastivction
te~niques to be followed during coa~tnrcbm to redone imps.
Mn ~t 4 ~ rt 60.1 C-. ~ ~1 -~"'l.t~.r' t /( C ~ll n ~f / ~ h'. ~va~~ _
~Vo-IC, - C o11.7'tW di"u7 rilLltc y f0 6e.J r-~ccai-~,~ i%••~..~L t'l cJn ..~ (eKs~ ciV't ..~! ^ c:1 a rJ~f ~
Vl1II. Mitigation
DWQ - in aocordaal~ w~ i5A NCAC 2H .0500, mitigation nzay be required by the NC
Division of Water Quality fur projects involving greater than or eq~ral to one acre of impacts to
freshwater wetlands or gamer than or equal to 150 Ii~ar feet of total impacts to perennial
streams.
Page 9 of 12

USACE - In accordance with the Final Notice of lssuarrce and Modification of Nationwide
Permits, published in the Federal Register on January I5, 20t)2, mitigation will be required when
necessary to ensure that averse 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 accility 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 protetx open warns such as strernns; and replacing losses of
aquatic resource functions and values by creating, restoring, enhancing, or preserving similar
fiux;tions 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 NCEEP concurrence shall be placed on hold as incomplete.
An applicant may also choose to review the current guidelines for stream restoration in DWQ's
Draft Technical Guide for Stream Work in North Carolina, available at
htta:JJh2o.enr.state.nc.us/ncwetlands/strm ide 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/iinear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a p}an view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.}, and a
description of the curnexrt site conditions and proposed method of construction. Please attach
a separate sheet if ire space is needed.
Yl 1
_.
2. 14fetiigation may also be made by payment iMo the North Carolina Ecosystem Enhancement
Program (NCEEP). Please Hate it is the applicant's responsibility to contact the NCEEP at
[phone] tQ determine availability, and written approval from the NCEEP indicating
that they are will to accept payment for the mitigation must be attached to this form. For
additional information regarding the application process for the NCEEP, check the NCEEP
website at httpJ/h2o.enr.state.nc.us/wrplindex.htm. If use ofthe NCEEP is proposed, please
check the appropriate box on page five and provide the following information:
Amount of stream mitigation requested (linear feet}:
Amount of buffer mitigation requested (square feet): S')
Amount of Riparian wetland mitigation requested {acres): d
Amount ofNon-riparian wetland mitigation requested (acres}: C?
Amount of Coasts! warlord mitigation requested (acres):. t)
Page 10 of 12
.JAN-G3-2J07 12:80Pf~ FAX:[phone] ID:MMG SOUTHPARK PAGE:011 R=97%

01;03/2007 11:03 FAX [phone] TOWN of LAKE LURE ~ 012/013
IX. Environmental Dowmentation (required lry DWQ)
1. Does the project involve an expel-diture of public {federaU oval) fiu~ds or the use of
public (federaUstate) land? Yes ^ No
2. If yes, does the project require preparation of an envir~mental 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/SF.PA doc~tmeat is required, call the SEPA
coordinator at [phone] to review cutrettt thresholds for envimtumental doctatlentation.
Yes ^ No ^
3. if yes, has the document review been finalized by the State Clearinghouse? If so, please
attach a copy of the NEPA or SEPA final approval letter. Yes ^ No ^
X. Proposed Impacts on Ripat~an and Watershed Baffers (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 impat~.s are proposed to the buffets. Cotrespond~ce from the DWQ
Regional Office may be included as appropriate. Photographs may also be included at the
applicant's discretion.
1. Will the project impact protected riparian buffets identified within 15A NCAC 2B .0233
(Meuse), 15A NCAC 2B .0259 (Tar~amlico), 15A NCAC 02B .0243 (Catawba)15A NCAC
2B .0254 (Randleman Rules and Water Supply Buffer ants), or other {please
ide~ify )? Yes ^ No
2. If "yes", identify the square feet and acreage of impact to each zone of the riparian buffers.
If buffer mitigation is required calculate the required amount of mitigation by applying the
buffer multipliers.
Zone, Im~ct
beet ~ n
1 3 (2 ~C,afaiob4)
2 1.5
Total
• Zone 1 eadends out 3o fat papeadits~Lr fiom the top of the ear baoic ofchame>; Znoe 2 tat~ends ao
additional 20 feet from the ~ ofZoa 1.
3. ff buffer mitigation is requited, please discuss what type of mitigation is proposed (i.e.,
Donation of Property, Riparian Buffer Restoration /Enhancement, or Payment into the
Riparian Buffer Restoration Fund). Please attach all appropriate information as identified
within l SA NCAC 2B .0242 or .0244, or .0260. r~ lI ti
Page 11 of 12

XI. Stormwater (required by DWQ)
Describe impervious acreage (existing and propped) versos total ac~+eage ~ die site. Discuss
`~ ~, ~ stormwater oo~+ols proposed in order to pmtecx surface waters and wetlands downstream from
~ ~ ~,~ the property. If percent impervious stuf~e exceeds ZO%, please pd+ovide calculations
~ ° demonstrating total proposed impervious level. l p so rg • ~ ~~ , S 1 c~ c .-~
~ S ~ Z 0 ~0, !`~ C~Vr*~: ~ 4/ C (~l`f+v`r 'Ton .!"'F-n!», cJ!'t "~'C•J CC*n fiL^ i~
!IIL Sewage Disposal (required by DWQ)
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from the proposed pmject, or available capacity of the subject facility.
XIIT. Viohtions (required h7' DWQ)
Is this site in violation of DW Wetland Rules (15A NCAC 2H .0500} or any Buffer Rules?
Yes ^ No [~
Is this an after-the-fact permit application? Yes ^ No
XIV. Cmm~lative Impacts (required b'9 DWQ)
Will this project (ba.~ed on past and reasonably aaticipated future impacts) result in additional
development, which could impact nearby downstream water quality? Yes ^ No
If yes, please submit a qualitative or quantitative cumulative impact analysis in accordance with
the most recent North Carolina Division of Water Quality policy posted on our website at
http://h2o.enr.state.nc.us/ncwetlands. If no, please pr8vide a short narrative description:
/Y-, ~F-t1 ! ~ Kam.
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XV. Otl.ar Circn~.oes (Uptioa~:
It is the applicant's responsr'bility 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 (eg., draw-down schedules for lakes, dates associated with Endangered and
Threatened Species, accessr'bility problems, or other issues outside of the applicant's control).
9~'
_ ~~~
Applicant/Agient's 3ignatare Date
(Agent's signature is valid only if an aurihorixation letter from the applicant is provided.)
Page 12 of 12
JAN-03-2007 12:01PM FAX:[phone] ID:MMG 50UTHPARK PAGE:013 R=97%

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PROFESSIONAL SURVEYING SERVICES
NATHAN OOOM -REGISTERED LAND SURVEYOR - L-27t8
218 N. MAIN STREET - RUTHERFOROTON. N C 28+39
TELEPHONE: 7D4r287-7059 I C 12889S
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WATERS OF LAKE LURE
N O T E S
i. Thera on no enetooCAments across property lines
ellcept es eh0lrn.
2. This propKtTl is not in o flood hazard oreo ee dsstxibed
by HUD J FI A flood map.
3. Ref. ~ 569 / 561 , Toa Mop 502 - I - 6.
4. Subject to nll rights of The town of Loke Lure to the 995
Con tour.
ROBERT I WAOKA and wife ELIZABETH 0. IWAOKA I AREA
0.51 AC.
N C ~RUTHERFORO~CHIMNEY ROCKROCK
STATE COVNTY TOWNSHIP
8 / 28 / 9t 8. McLAIN R. EVANS
DATE PARTY CHIEF unoocn o
EXHIBIT "A"
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