20051615 Ver 1_Complete File_20050824

Michael F. Easley, Governor

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

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

August 30, 2005

DWQ Project # 05-1615
Jones County

Lynne Swanson
Safe Harbor Farm, Inc.
P. O. Box 493
Maysville, NC 28555

Subject Property:

Safe Harbor Farm Utilities
CatfIsh Lake [030407,27-101-6, NSW, C SW]

Approval of 401 Water Quality Certification with Additional Conditions

Dear Ms. Swanson:

You have our approval, in accordance with the attached conditions and those listed below, to place fill
within or otherwise impact 0.02 acres of wetlands for the purpose of obtaining water and sewer for an
animal education, adoption and activities center at the subject property, as described within your
application dated July 12,2005 and received by the N.C. Division of Water Quality (DWQ) on August
24,2005. After reviewing your application, we have decided that the impacts are covered by General
Water Quality Certification Number(s) 3374 (GC3374). The Certification(s) allows you to use
Nationwide Permit(s) NW12 when issued by the US Army Corps of Engineers (USACE). In addition,
you should obtain or otherwise cornply with any other required federal, state or local permits before you
go ahead with your project including (but not limited to) Erosion and Sediment Control, Non-discharge,
and other regulations. Also, this approval to proceed with your proposed impacts or to conduct
impacts to waters as depicted in your application shall expire upon expiration of the 404 or CAMA
Permit.

This approval is for the purpose and design that you described in your application. If you change your
project, you must notify us and you may be required to send us a new application. If the property is sold,
the new owner must be given a copy of this Certification and approval letter and is thereby responsible for
complying with all conditions. If total fills for this project (now or in the future) exceed one acre of
wetland or 150 linear feet of stream, compensatory mitigation may be required as described in 15A
NCAC 2H .0506 (h). This approval requires you to follow the conditions listed in the attached
certification and any additional conditions listed below.

The Additional Conditions of the Certification are:

1. Impacts Approved

The following impacts are hereby approved as long as all of the other specific and general
conditions of this Certification (or Isolated Wetland Permit) are met. No other impacts are
approved including incidental impacts:

404/CAMA Wetlands

Plan Location or Reference
PCN

N~IiliCarolina
/Vllfllrnll!l

401 OversighVExpress Review Permits Unit
1650 Mail Service Center, Raleigh, North Carolina 27699.1650
2321 Crabtree Boulevard, Suite 250, Raleigh, North Carolina 27604
Phone: [phone]/ FAX [phone]/lntemel: httD://h2o.enr.state.nc.us/ncwetlands

An Equal Opportunity/Affirmative Action Employer - 50% Recyclecll10% Post Consumer Paper

Safe Harbor Farm, Inc
Page 3 of3
August 30, 2005

The following specifications shall apply to class B concrete:
a) Minimum cement content, sacks per cubic yard with rounded course aggregate 5.0
b) Minimum cement content, sacks per cubic yard with angular course aggregate 5.5
c) Maximum water-cement ratio gallons per sack 6.8
d) Slump range 2" to 4"
e) Minimum strength - 28 day psi 2,500

Violations of any condition herein set forth may result in revocation of this Certification and may result in
criminal and/or civil penalties. The authorization to proceed with your proposed impacts or to conduct
impacts to waters as depicted in your application and as authorized by this Certification shall expire upon
expiration of the 404 or CAMA Permit.

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

This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water
Act. If you have any questions, please telephone Cyndi Karoly or Ian McMillan in the Central Office in
Raleigh at 919-733-1786or Kyle Barnes in the DWQ Washington Regional Office at 252-946-6481.

Sincerely,

~~-~~

y:il J Alan W. Klimek, P.E.

AWKlijm

Enclosures:

GC 3374
Certificate of Completion

cc: USACE Washington Regulatory Field Office
DWQ Washington Regional Office
DLR Washington Regional Office
File Copy
Central Files

Filename: 051615SafeHarborFarmUtilities(Jones)401

f!LE COpy

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Office Use Only:

Form Version March 05

~ 005 1 6 1 5
USACE Action ID No. DWQ No. . ~
i (If any particular item is not applicable to this project, please enter "Not APi ;~icable" or "N/A".)
. I
I.

Process~g

RECEiVED

JUt J 8 iUtiJ
Y Check all ofthe approval(s) requested for this project: ~-.... __
G(Section 404 Permit D Riparian or W~Jershedil1i~~
D Section 10 Permit D Isolated Wet1~ Peto1it.fr~!ll1?~Q.. Ii
~01 Water Quality Certification D Express 401 mter Quality Certificattori"- 11

/': Nationwide, Regional or General Permit Number(s) Requested: N-a-H ...."".,n k. l"'Z..

~ If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: D

~ If payment into the North Carolina Ecosystem Enhancement Program (NCEEP) is proposed
for mitigation of impacts, attach the acceptance letter from NCEEP, complete section VIII,
and check here: D

.Y 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: D

II. Applicant Information

}': Owner/Applicant Information
Name: S~Fe H AR-e.on.. FflLln. Jt.Sc
Mailing Address: P.o. e 0)( 'i 93
m"''1lSV'LLE- NC. ,,'&5"$5'

Telephone Number: 'Z.S '2.. - '"' 'L"2. - (...,"'10
E-mail Address:

Fax Number:

i Agent/Consultant Information (A signed and dated copy 0 f the Agent Authorization letter
must be attached if the Agent has signatory authority for the owner/applicant.)
Name: L"folU,.J"- S~~W&ON \)V~
Company Affiliation: \) In.. ~c.."t 0 R.
Mailing Address: AGo'., f..

Telephone Number: '"Z..5'"Z..-'-t'1..'1..-to7'> (:)
E-mail Address:

Fax Number:

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 1 'i-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.

Name ofproject:

.s ~Ft:. '-lA~o~ F~lLI'n UTI &...1"1'1 ES

y.
~

T.I.P. Project Number or State Project Number (NCDOT Only):

T. Property Identification Number (Tax PIN):

SY3"Z..-IS- 'Ylo3

~ Location
County: JON€-S Nearest Town: f1)1\....,SViLL~
Subdivision name (include phase/lot number):
Directions to site (include road numbers/names, landmarks, etc.): Fn...ol'Tl N-e.\o.) e ~a.~ ,\"O
15\)\)1.. ON RoT '7 T"~ou...", PO&.......cc.i'Svu..L.€, . J\J::il' O~J"'ClQ,.E. Eo..l~'a.\~Ca -r"~ TowiJ
Or InA"l'svlu..~ . -rl:\Io:L '" l-~F-r oew"':' '" t.Cb",'~1a };lOI'tO mAlZ.Wc.o" ''1~q~ ~~.. 1'1."

5. Site coordinates (For linear projects, such as a road or utility line, attach a sheet that
separately lists the coordinates for each crossing of a distinct waterbody.)
Decimal Degrees (6 digits minimum): oN oW

.if. Property size (acres):

<0 t "-5"

Jf. Name of nearest receiving body of water:

CS\"T'!=It>).l L~\<e

.8: River Basin: N e. \,) Sf.
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http://h2o.enr.state.nc.us/adminlmaps/.)

2. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: S" & HJ>aS 2. "i~AlLS Gt= O"";?.IaR-o,-n~ <~"'all.. Thnae.e.€'l)
t-AND. RC>"TT,Nc" -r,M6EoZ. IS I3E,~l,. b"","nlEJZ..E.O + c::.\.EAl2..20. I'o)ON- t.>>l!.Tt..~NO
~~'i.l'\S Ft"'Z. 6~'o.),," .s:i.L..Ec.r,UE&.'( c......2o'1~E.9 po~us;,:.. (A"OU....D z.o~j~ 01= S,.TE).

Page 6 of 12

J.OC Describe the overall project in detail, including the type of equipment to be used:
-r{t..~NC.'" 1 Nt.. Fo2.. WA"TE.~ + S~W"i:.a.. I-\)o.)~$ J=/?-otn Tow~ 0'1= Nl~""SUI&.t.~ .(1r14.... ~EQul~~
€.Qc.JIP'l'\~~" ~ B~<:'l<HO~ +/- 01""'" w1TCH .. BU'sH-Hcl:> mowE..:t ONe.. ml..'HI-
1FT
STJt7)ON)

X. Explain the purpose of the proposed work: 1"D 0 BT'" J~ L.UptT'~R.... + .s~\o,j,ea- F"oa..
A.....IMI\L. f:.t:lUC"'TION, flC>OPT'b~ + Ac::..T'''\TlE.S CENTE..e:.. (NON- p~cFlr)

yr: 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. fuclude
the USACE Action ill 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. Sc..O'TT ~O"'-l"i:.S OJ: AC.~ ,,.,.3 vHi,TE..O "n)t:,. SITE T\.o,))C::~
+ \S I.WO~~lJo.)l.a c:.~ "t"~"- W ~TLANbS t:>-LL-1N\A'TION P~P~~WCl2."'.

.y Future Project Plans

Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion ofthis work from the current application.
~~ \ou1U. 1ooA't:.t:i> ~ P1:It.o\\T l.s~O~'E.~l)~le~ FoR. \..(1:uTUi1.'i. R.\1 $'1'ES I S"i:.u"i-/Z-F'lL- (I-Li)
eV'L-&>IN~S 1- III ~JII~ "'C/L~ Pc...&> l-r"T"41- Ac:.Q..~~....l: ,... ~ "',) 8'.)1' W~ "A"E. "t~1" Te F,~o
1\ lSua.u....."tc.l?. "'131.-"1.. To 00 I't Tope .s'->~,,"2.~ "'1' T>>'$ 'T\^"t:. !~
VI. Proposed Impacts to Waters of the United States/Waters ofthe State

It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. Each impact must be
listed separately in the tables below (e.g., culvert installation should be listed separately from
riprap dissipater pads). Be sure to indicate if an impact is temporary. All proposed impacts,
permanent and temporary, must be listed, and must be labeled and clearly identifiable on an
accompanying site plan. All wetlands and waters, and all streams (intermittent and perennial)
should be shown on a delineation map, whether or not impacts are proposed to these systems.
Wetland and stream evaluation and delineation forms should be included as appropriate.
Photographs may be included at the applicant's discretion. If this proposed impact is strictly for
wetland or stream mitigation, list and describe the impact in Section VITI below. If additional
space is needed for listing or description, please attach a separate sheet.

1. Provide a written description of the proposed impacts:

N'() p"2.oL.~~...e....'t" ImPA~T.s O~ W~T,-,,\~(:)$ ~)t.,~~rE.() .p~ON\ 7\...,.s PR.OJECT.

Page 7 of 12

/ Individually list wetland impacts. Types of impacts include, but are not limited to
mechanized clearing, grading, fill, excavation, flooding, ditching/drainage, etc. F or dams,
I r' d b h dfl di

separate y 1st Impacts ueto ot structure an 00 ng.
Wetland Impact Type of Wetland Located within Distance to Area of
100-year Nearest Impact
Site Number Type ofImpact (e.g., forested, marsh, Floodplain Stream (acres)
(indicate on map) herbaceous, bog, etc.) (ves/no) (linear feet)
(\) "' t.~t-\, C. '-t.f\4l..\^, l.. >> eft.. ~ >'\(:. 'e.CN S Ne , LO.Cn..
( 1t:_M;i=><:r2...~Q......, '\
'\. -
Total Wetland Impact (acres) <.o~

7- List the total acreage (estimated) of all existing wetlands on the property: 1<1 \ \5" A c:.~ ~ ~

.K Individually list all intermittent and perennial stream impacts. Be sure to identify temporary
impacts. Stream impacts include, but. are not limited to placement of fill or culverts, dam
construction, flooding, relocation, stabilization activities (e.g., cement walls, rip-rap, crib
walls, gabions, etc.), excavation, ditching/straightening, etc. If stream relocation is proposed,
plans and profiles showing the linear footprint for both the original a nd relocated streams

must be included. To calculate acreage, multiply length X width, then divide by 43,560.
Stream Impact Perennial or Average Impact Area of
Number Stream Name Type of Impact Intermittent? Stream Width Length Impact
(indicate on map) Before Imnact (linear feet) (acres)
,
Total Stream Impact (by length and acreage)

7 illdividually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.). Open water impacts include, but are not limited to
fill f dr d' fl d' dr' b 1kh d t .

1 , excava lon, e Igmg, 00 mg, aJl1age, u ea S, e c.
Open Water Impact Name of Water body Type of Waterbody Area of
Site Number Type of Impact (lake, pond, estuary, sound, bay, Impact
(indicate on map) (if applicable) ocean, etc.) (acres)
Total Open Water Impact (acres)

Page 8 of 12

/ Listth I .

e cumu atIve rmpact to all Waters of the U.S. resulting from the project
Stream Impact (acres):
Wetland Impact (acres): '- o. D'Z.
Open Water Impact (acres):
Total Impact to Waters of the U.S. (acres)
Total Stream Impact (linear feet):

;1/'Isolated Waters
Do any isolated waters exist on the property? DYes I2fNo
Describe all impacts to isolated waters, and include the type of water (wetland or stream) and
the size of the proposed impact (acres or linear feet). Please note that this section only
applies to waters that have specifically been determined to be isolated by the USACE.

A. Pond Creation
If construction of a pond is proposed, associated wetland and stream impacts should be
included above in the wetland and stream impact sections. Also, the proposed pond should
be described here and illustrated on any maps included with this application.
Pond to be created in (check all that apply): D uplands D stream D wetlands
Describe the method of construction (e.g., dam/embankment, excavation, installation of
draw-down valve or spillway, etc.):
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.):
Current land use in the vicinity of the pond:
Size of watershed draining to pond: Expected pond surface area:

VII. Impact Justification (Avoidance and Minimization)

Specifically describe measures taken to avoid the proposed impacts. It may be useful to provide
information related to site constraints such as topography, building ordinances, accessibility, and
financial viability of the project. The applicant may attach drawings of alternative, lower-impact
site layouts, and explain why these design options were not feasible. Also discuss how impacts
were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce impacts.

t-)O f'nOa..L 01 ~~l>') b
~""T""Q... .. S E ~ E...e... i-\1'o.I €. S

YftC Mitigation

DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC
Division of Water Quality for proj ects 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 - ill accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on January 15,2002, mitigation will be required when
necessary to ensure that adverse effects to the aquatic environment are minimal. Factors
including size and type of proposed impact and function and relative value of the impacted
aquatic resource will be considered in determining acceptability of appropriate and practicable
mitigation as proposed. Examples of mitigation that may be appropriate and practicable include,
but are not limited to: reducing the size of the project; establishing and maintaining wetland
and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of
aquatic resource functions and values by creating, restoring, enhancing, or preserving similar
functions and values, preferable in the same watershed.

If mitigation is required for this project, a copy of the mitigation plan must be attached in order
for USACE or DWQ to consider the application complete for processing. Any application
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
http://h2o.enr. state.nc. us/ncwetlands/ strmcide.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.

7- Mitigation may also be made by payment into the North Carolina Ecosystem Enhancement
Program (NCEEP). Please note it is the applicant's responsibility to contact the NCEEP at
[phone] to determine availability, and written approval from the NCEEP indicating
that they are will to accept payment for the mitigation must be attached to this form. For
additional information regarding the application process for the NCEEP, check the NCEEP
website at http://h2o.enr.state.nc.us/wrp/index.htm. Ifuse of the NCEEP is proposed, please
check the appropriate box on page five and provide the following information:

Amount of stream mitigation requested (linear feet):
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

%

~
~~V1

IX. Environmental Documentation (required by DWQ)

J':' Does the project involve an expenditure 0 fpublic (federal/state/local) funds or the use 0 f
public (federal/state) land? Yes D 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 (NEP A/SEP A)?
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 D No D

,z'. If yes, has the document review been finalized b y the State Clearinghouse? I f so, please
attach a copy ofthe NEP A or SEP A final approval letter. Yes D No D

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 s tate and local buffers associated with the p roj ect. T he applicant must a Iso 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.

1. Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Neuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 02B .0243 (Catawba) 15A NCAC
2B .0250 (Randleman Rules and Water Supply Buffer Requirements), or other (please
identify )? Yes D No D

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
buffi 1 . r

er mu tIpJ lers.
Zone* Impact Multiplier Required
(square feet) Mitigation
1 3 (2 for Catawba)
2 1.5
Total

* Zone 1 extends out 30 feet perpendicular from the top of the near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.

3. If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e.,
Donation of Property, Riparian Buffer Restoration / Enhancement, or Payment into the
Riparian Buffer Restoration Fund). Please a ttach all appropriate information as identified
within 15A NCAC 2B .0242 or .0244, or .0260.

Page 11 of 12

]d. Stormwater (required by DWQ)

Describe impervious acreage (existing and proposed) versus total acreage on the site. Discuss
stormwater controls proposed in order to protect surface waters and wetlands downstream from
the property. If percent impervious surface exceeds 20%, please provide calculations
demonstrating total proposed impervious level. .

?d. Sewage Disposal (required by DWQ)

Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from the proposed project, or available capacity of the subject facility.

?Hi. Violations (required by DWQ)

Is this site in violation of DWQ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes D No g

Is this an after-the-fact permit application? Yes D

Nol8'

XIV. Cumulative Impacts (required by DWQ)

Will this project (based on past and reasonably anticipated future impacts) result in additional
development, which could impact nearby downstream water quality? Yes D 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. Ifno, please provide a short narrative description:

~ Other Circumstances (Optional):
I

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).

v ~_ ~ ,- 12:-0S
ApplicantJAg t's ignature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)

Page 12 of 12

Safe Harbor Farm, Ine (sponsor of the Kindness Clinic for Cats & Dogs)
P.O. Box 493, Maysville, NC 28555
www.safeharborfann.org
252-422-6770

July 3, 2005

U.s. Army Corps of Engineers
N.C. Department of Water Quality

To Whom It May Concern:

Lynne Swanson, as one of our Directors, is authorized to be our agent for all
matters pertaining to permits necessary for construction of and around our proposed
Animal Education, Adoption & Activities Center in Maysville, North Carolina.

Sincerely,

P/~~

Lee Fuentes
Director-Secretary
Safe Harbor Fann, Inc.

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Office Use Only:

2 0 0 Form Version March 05
51615
USACE Action ID No. DWQ No. ~
(If any particular item is not applicable to this project, please enter "Not Ap ;~cab1e" or "N/A".)

I.

Processing

RECEiVED

~.~

JUt i 8 ~utiJ
Y. Check all ofthe approval(s) requested for this project: W:-:-'7--~:"-'" ~
GrSection 404 Permit 0 Riparian or Wa~ersheSg~~
o Section 10 Permit D Isolated W et1~ PeQJJjtJr.QmJ?cY,V.Q...............
~01 Water Quality Certification 0 Express 401 ~ter Quality Certification

I

7 Nationwide, Regional or General Permit Number(s) Requested:

~ If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: 0

N" a-H ."'''~ k ~"l..

K. If payment into the North Carolina Ecosystem Enhancement Program (NCEEP) is proposed
for mitigation of impacts, attach the acceptance letter from NCEEP, complete section Vill,
and check here: 0

j/ 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), che~, h~Y.r:dLl], n"',f1r::::l., r'
l.i) Lc.~, \ U', 11:.-', iI' \'( / 1 c? Wn
-.Ii. ~ ...........;! <"', \.J 1.0,.=.:::1 lli
Applicant Information I
AUG 2 4 2005

II.

1': Owner/Applicant Information
Name: S~Fe H ~R..e.on.. F'fl<Un. Ito.Ic
Mailing Address: P.o. B 0)( '-t CY 3
f'n1'\'tl5V'L.L..E. Ne ,gS"ss

'. DENR. VVATER QUA.L1TY
\4ETlANi:$ M,}f') STn~~~/~,V~Tr:P r.::r t,_ ~-~""H

Telephone Number: US '2.. - '1"2.."2. - (.p""'O
E-mail Address:

Fax Number:

i. Agent/Consultant Information (A signed and dated copy 0 f the Agent Authorization letter
must be attached if the Agent has signatory authority for the owner/applicant.)
Name: L..'t-ut.u;... S\.o.l~"'SON s)VN'>
Company Mfiliation: 01 R. 2.C.:T 0 R
Mailing Address: A BO'., E..

Telephone Number: &..~'L-"n.:l_-tc7') 0
E-mail Address:

Fax Number:

Page 5 of 12

m. 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 1 7-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 fmal version is illegible, the applicant will be informed that
the proj ect has been placed on hold until decipherable maps are provided.

Name of project:

S~F~ '-lACU!>o~ F'A~ U'T.....'1"'ES

y.
7-

T.I.P. Project Number or State Project Number (NCDOT Only):

T. Property Identification Number (Tax PIN):

S'-I 3-z... -IS - '~<a3

~ Location

County: Jo N as Nearest Town: Ji) I\"'tSVI ~~

Subdivision name (include phase/lot number):

Directions to site (include road numbers/names, landmarks, etc.): \='(l.om to.I'Z.W 13 ~IU-.) , be

1$1>\,1111 ON RT 1, T"IZ.C.I.H...... Pc.t.'-oc.~s"u..'-a . JUST Q~,:'CQ..E. ~o..l"t'LR-\J..U'" "T"~ -rOwl<l
, '"" l' , "
ei=" InA"IS V'U2. . "Tq/l:e '" L~FT Dc:.w~ A &.ol.:>c.:."..H~ ....Ol'tO mRa.~c.o ~ \4\.o1'i '1.

5. Site coordinates (For linear projects, such as a road or utility line, attach a sheet that
separately lists the coordinates for each crossing of a distinct waterbody.)
Decimal Degrees (6 digits minimum): ON oW

.if. Property size (acres):

<0 l. bS

?f. Name of nearest receiving body of water:

C~-rFl1H~ L~\<.e

.8: River Basin: N e \,) s ~
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http://h2o.enr.state.nc.us/admin/maps/.)

Jf. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: S 1"1 & HI\S Z '1~All..S <OF O\l'2..l.ba.own4 e:.'\1~1a. TlmBE.2€'l)
~F\ND. (Z.O"TT'/N"" "r'MGt:.z. IS 8~J~,," b.o\T>>EIl.~O T c::. \..EA~'20. NGN- 1...,a<l.-r&.........,O
~l'l..~~'S A-~"L 6~/>-J,," .s:i.t..~~.nu1O&."f C.....2tl4.E.9 p.:.rc. I.JS~ (AIZ.DLI.....I) 'Z.oc;/~ 0): .::s,..rE).

Page 6 of 12

}6:' Describe the overall project in detail, including the type of equipment to be used:
1t't.."LNC.H'NI... Fo~ WA-.E.~ + S~w<L.2.. L..\~~S 'F1U)>'1\ TOWIoo1 O~ m~""sulw..2.LIT14..,~eQUlaE
~QU1PI"~t-lT t 8!:tc::.l<:HO~ +/- tH'1'C.H ....lTC.H ... B~~H-HCl:> mcwE..it OWfi., ~'Nl-
..1FT
$T4710N)

yr. Explain the purpose of the proposed work: "To 0 13"'" J~ WptT'<"1L. ~ <S'<L.\o,\€.a.. F'oa.
A...,. MI\ L- f:.D\)C.~TION." C>oPT\ t> r..a .... fllC. T '" '''\E..S CE ...."t"t:.L (NON - P~OF IT)

Yr: Prior Project History

If jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Include
the USACE Action ID Number, DWQ Project Number, application date, and date permits and
certifications were issued or withdrawn. Provide photocopies of previously issued permits,
certifications or other useful information. Describe previously approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits issued for prior segments of the same T.I.P. project, along with
construction schedules. Sc..o-rT .Jc-.,)E,.S OF ACE. ,,,I\;:S VISI"Tt:.O T>>t.. .sl-r~ T\.,))C.~
+ \5 '-WO~~lJoo>>U. ON "t"\-\~ W ~TLANbS t>~1..1N\A'TI04l.l P~P"JaWCl42.".

y: 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.
~'l. \.Ul\.l.. t.1'LEj) ~ P1:Il."\T l.s~o-+'E~O~'c,}, Fell. 1..(1:IJTlJo'J."l. R.V ~)1'ES I St..u"E-tz.FlI.. ('-&of)
(3\J\\...O'....bS + fll <tho ~ClLt.. Pc:.o.lD (-re.TJ41.. Ac.a.t..l3ltaE ,... $ ~c.) B'-'1' "'-'''" "A"E.. 'l~" 'To F\I'olD
1\ cSUa."'i.."tClL f:le...., '(eo Dc f:l Topo .suo.."~'1 ~T -r>>lS T,^'t:. !~
VI. Proposed Impacts to Waters of the United StateslWaters ofthe State

It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. Each impact must be
listed separately in the tables below (e.g., culvert installation should be listed separately from
riprap dissipater pads). Be sure to indicate if an impact is temporary. All proposed impacts,
permanent and temporary, must be listed, and must be labeled and clearly identifiable on an
accompanying site plan. All wetlands and waters, and all streams (intermittent and perennial)
should be shown on a delineation map, whether or not impacts are proposed to these systems.
Wetland and stream evaluation and delineation forms should be included as appropriate.
Photographs may be included at the applicant's discretion. If this proposed impact is strictly for
wetland or stream mitigation, list and describe the impact in Section VIII below. If additional
space is needed for listing or description, please attach a separate sheet.

1. Provide a written description of the proposed impacts:

N'() pt..<L.~"ll...e....'T" ImPAG-r.s OIV ......-e.T~.....b$ t:,.><P.:..G'C'E.O .p~eN\ ~I..s p~cJEC'r.

Page 7 of 12

./ Individually list wetland impacts. Types of impacts include, but are not limited to
mechanized clearing, grading, fill, excavation, flooding, ditching/drainage, etc. For dams,
t I r' t d b h d fl d'

separa e y 1St rmpac s ue to ot structure an 00 mg.
Wetland Impact Type of Wetland Located within Distance to Area of
Site Number Type of Impact (e.g., forested, marsh, IOO-year Nearest Impact
Floodplain Stream (acres)
(indicate on map) herbaceous, bog, etc.) (yes/no) (linear feet)
G "' I.c.~. c.'-~~A.\..I.J "" >>f..R.11 >,\c:. ~ S NQ ~ 'o.C:?1..
( leM.;'f>~l>rQ....t'\
'" ..
Total Wetland Impact (acres) < _ 0'2..

7- List the total acreage (estimated) of all existing wetlands on the property: N \ 5" AC.~~~

/ Individually list all intermittent and perennial stream impacts. Be sure to identify temporary
impacts. Stream impacts include, but are not limited to placement of fill or culverts, dam
construction, flooding, relocation, stabilization activities (e.g., cement walls, rip-rap, crib
walls, gab ions, etc.), excavation, ditching/straightening, etc. If stream relocation is proposed,
plans and profiles showing the linear footprint for both the original and relocated streams
b . I d d T I I I . I I gth X 'd h th d"d b 43560

must e mc u e . o ca cu ate acreage, mu tIply en WI t , en IV! e y ,
Stream Impact Perennial or Average Impact Area of
Number Stream Name Type of Impact Intermittent? Stream Width Length Impact
(indicate on map) Before Impact (linear feet) (acres)
Total Stream Impact (by length and acreage)

~ Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.). Open water impacts include, but are not limited to
fill . dr d' fl d' dr' b 1kh d

, excavation, e 19m9, 00 mg, amage, u ea s, etc.
Open Water Impact Name of Water body Type of Water body Area of
Site Number Type of Impact (lake, pond, estuary, sound, bay, Impact
(indicate on map) (if applicable) ocean, etc.) (acres)
Total Open Water Impact (acres)

Page 8 of 12

./I.' List the cumulative im act to all Waters ofthe U.S. resultin
Stream Impact (acres):
Wetland Impact (acres):
en Water Impact (acres):
Total Impact to Waters ofthe U.S. (acres)
Total Stream Impact (linear feet):

~solated Waters
Do any isolated waters exist on the property? D Yes I2fNo
Describe all impacts to isolated waters, and include the type of water (wetland or stream) and
the size of the proposed impact (acres or linear feet). Please note that this section only
applies to waters that have specifically been determined to be isolated by the USACE.

'- O. D'Z.

A. Pond Creation
If construction of a pond is proposed, associated wetland and stream impacts should be
included above in the wetland and stream impact sections. Also, the proposed pond should
be described here and illustrated on any maps included with this application.
Pond to be created in (check all that apply): D uplands D stream D wetlands
Describe the method of construction (e.g., dam/embankment, excavation, installation of
draw-down valve or spillway, etc.):
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.):
Current land use in the vicinity of the pond:
Size of watershed draining to pond: Expected pond surface area:

VII. Impact Justification (Avoidance and Minimization)

Specifically describe measures taken to avoid the proposed impacts. It may be useful to provide
information related to site constraints such as topography, building ordinances, accessibility, and
fmancial 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.

NO f'n01l.L Dlbbl~~ '-"n..&- BL
W'i'oT E.~ + S E \.oolo ElIL i-l/'oo.l E. S

~ Mitigation

DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC
Division of Water Quality for projects involving greater than or equal to one acre of impacts to
freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial
streams.

Page 9 of 12

USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on January 15,2002, mitigation will be required when
necessary to ensure that adverse effects to the aquatic environment are minimal. Factors
including size and type of proposed impact and function and relative value of the impacted
aquatic resource will be considered in determining acceptability of appropriate and practicable
mitigation as proposed. Examples of mitigation that may be appropriate and practicable include,
but are not limited to: reducing the size of the project;. establishing and maintaining wetland
and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of
aquatic resource functions and values by creating, restoring, enhancing, or preserving similar
functions and values, preferable in the same watershed.

If mitigation is required for this project, a copy of the mitigation plan must be attached in order
for USACE or DWQ to consider the application complete for processing. Any application
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
http://h2o.enr.state.nc. us/ncwetlands/strmgide.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.

J'. Mitigation may also be made by payment into the North Carolina Ecosystem Enhancement
Program (NCEEP). Please note it is the applicant's responsibility to contact the NCEEP at
[phone] to determine availability, and written approval from the NCEEP indicating
that they are will to accept payment for the mitigation must be attached to this form. For
additional information regarding the application process for the NCEEP, check the NCEEP
website at http://h2o.enr.state.nc.us/wrp/index.htm. If use of the NCEEP is proposed, please
check the appropriate box on page five and provide the following information:

Amount of stream mitigation requested (linear feet):
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

~

~.
~~\1

IX. Environmental Documentation (required by DWQ)

A'.' Does the project involve an expenditure 0 fpublic (federal/state/local) funds or the use of
public (federal/state) land? Yes D No [)f

7 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 NEP A/SEP A document is required, call the SEP A
coordinator at [phone] to review current thresholds for environmental documentation.
Yes 0 No D

,i'. If yes, has the document review been finalized b y the State Clearinghouse? I f so, please
attach a copy of the NEPA or SEPA final approval letter. Yes 0 No D

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 s tate and local buffers associated with the project. T he 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.

1. Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Neuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 02B .0243 (Catawba) 15A NCAC
2B .0250 (Randleman Rules and Water Supply Buffer Requirements), or other (please
identify )? Yes D No D

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
buffl If r

er mu lp lers.
Zone * Impact Multiplier Required
(square feet) Mitigation
1 3 (2 for Catawba)
2 1.5
Total

* Zone 1 extends out 30 feet perpendicular from the top of the near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.

3. If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e.,
Donation of Property, Riparian Buffer Restoration / Enhancement, or Payment into the
Riparian Buffer Restoration Fund). Please a ttach all appropriate information as identified
within 15A NCAC 2B .0242 or .0244, or .0260.

Page 11 of 12

-po Stormwater (required by DWQ)

Describe impervious acreage (existing and proposed) versus total acreage on the site. Discuss
stormwater controls proposed in order to protect surface waters and wetlands downstream from
the property. If percent impervious surface exceeds 20%, please provide calculations
demonstrating total proposed impervious level.

~. Sewage Disposal (required by DWQ)

Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from the proposed project, or available capacity ofthe subject facility.

?Hi. Violations (required by DWQ)

Is this site in violation of DWQ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes D No B

Is this an after-the-fact permit application? Yes 0

No.[8"

XIV. Cumulative Impacts (required by DWQ)

Will this project (based on past and reasonably anticipated future impacts) result in additional
development, which could impact nearby downstream water quality? Yes D 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. Ifno, please provide a short narrative description:

~ 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).

v ~ ,- 12.;-05"

Applicant/Ag t's ignature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)

Page 12 of 12

Safe Harbor Farm, Ine (sponsor of the Kindness Clinic for Cats & Dogs)
P.O. Box 493, Maysville, NC 28555
www.safeharborfarm.org
252-422-6770

July 3, 2005

U.S. Army Corps of Engineers
N.C. Department of Water Quality

To Whom It May Concern:

Lynne Swanson, as one of our Directors, is authorized to be our agent for all
matters pertaining to permits necessary for construction of and around our proposed
Animal Education, Adoption & Activities Center in Maysville, North Carolina.

Sincerely,

b7/~~

Lee Fuentes
Director-Secretary
Safe Harbor Fann, Inc.

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DWQ# 200S \u '6

Who Reviewed: cxn B

Date ~ - 25~- O'8A

Plan Detail Incomplete

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Please provide a location map for the project.

Please show all stream impacts including all fill slopes, dissipaters, and bank stabilization on the site plan. ,

Please show all wetland impacts including fill slopes on the site plan. M<'Lho..n\ l.,td C\ f.IA\iffi o..rJ IJ-S!j ~f \1\ w'tch
. . . . e..ChR\Om<J\.t &\,lUr\ 0..& 'o'\lt~(, ~ ~ G\d-(,l \ \
Please mdicate all buffer Impacts on the sIte plan. afc..- ~\- CO~\~t(<.t\ -ttmfUfttvy~m~a.L+5.

Please indicate proposed lot layout as overlays on the site plan. \' \ u\ & e ~ -\ 'l l 0.\ (Y\ tn~" Ol\ So. 0 ~ tR \ te-y, (\. & w t \ \ tt5

Please indicate the location of the protected buffers as overlays on the site ~'W'. V'\JtS \o(,\~ \~to..\\<.~. - J 1._ ..-d
"!-\- G\. VU ffitl,()ln:\(j (H..(~~ UJmOOl W\ l\ ~
PI~ase locate all isolated or non-isolated wetlands, streams and other waters of the State as overlays on the site plan. 1\\A.,,'\\im<.~"

Please provide cross section details showing the provisions for aquatic life passage. p \ ~ t &\t~ (){\ P \D. 0.$

Please locate any planned sewer lines on the site plan.

Please provide the location of any proposed stormwater management practices as required by GC

Please provide detail for the stormwater management practices as required by GC

Please specify the percent of project imperviousness area based on the estimated built-out conditions.

Please indicate all stormwater outfalls on the site plan.

Please indicate the diffuse flow provision measures on the site plan.

Please indicate whether or not the proposed impacts already been conducted.

A voidance and/or Minimization Not Provided

o The _labeled as _ on the plans does not appear to be necessary. Please eliminate the _ or provide additional
information as to why it is necessary for this project.

o This Office believes that the _labeled on the plans as
. Please revise the plans to avoid the impacts.

can be moved or reconfigured to avoid the impacts to the

o This Office believes that the _labeled on the plans as
. Please revise the plans to minimize the impacts.

can be moved or reconfigured to minimize the impacts to the

o The stormwater discharges at the location on the plans labeled will not provide diffuse flow through the buffer because
. Please revise the plans and provide calculations to show that diffuse flow will be achieved through the entire buffer. If it
is not possible to achieve diffuse flow through the entire buffer then it may be necessary to provide stormwater management
practices that remove nutrients before the stormwater can be discharged through the buffer.

Other

o The application fee was insufficient because over 150 feet of stream and/or over 1 acre of wetland impacts were requested. Please
provide $ . This additional fee must be received before your application can be reviewed.

o Please complete Section(s) on the application.
o Please provide a signed copy of the application.
o Please provide _ copies of the application, _ copies of the site plans and other supporting information.

Mitigation

o of compensatory mitigation is required for this project. Please provide a compensatory mitigation plan. The
plan must conform to the requirements in 15 A NCAC 2H .0500 and must be appropriate to the type of impacts proposed.

o Please indicate which 404 Permit the USACE would use to authorize this project.