20051738 Ver 1_Complete File_20050914

,-

Michael F. Easley, Governor

-l

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

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

October 19, 2005

DWQ Project # 05-1738
Polk County

Wayne Skipper
Post Office Box 5072
West Columbia, SC 29171

Subject Property: Skipper Hills Developement ~ ~ @ ~ UW~ @

OCT 2 8 2005
Approval of 401 Water Quality Certification with Additional COBBM~~ QUALITY
' WETU.Nos AND STORMWATER BRANCH
Dear Mr. Skipper:

You have our approval, in accordance with the attached conditions and those listed
below, to place fill within or otherwise impact 120 linear feet of streams for the purpose
of property developement at the subject property, as described within your application
received by the N.C. Division of Water Quality (DWQ) on September 20, 2005, After
reviewing your application, we have decided that the impacts are covered by General
Water Quality Certification Number(s) 3404 (GC3404). The Certification(s) allows you
to use Nationwide Permit(s) 14 when issued by the US Army Corps of Engineers
(USACE). In addition, you should obtain or otherwise comply 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, stormwater, and buffer
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 culverting activities described in your application. If you change
your project beyond what is authorized in your submitted information, 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:

Ng'rthCarolina
;Vntl/rn//!/

401 Wetlands Certifica~on Unit
1650 Mail Service Center, Raleigh, North Carolina 27699-1650
2321 Crabtree Boulevard, Suite 250, Raleigh, North Carolina 27604
Phone: [phone]/ FAX [phone]/lnternet httD:/Ih20,enr,state,nc,us/ncwetlands

An Equal Opportunity/Affirma~ve Action Employer - 50% Recycledl1 0% Post Consumer Paper

Skipper Hills
Page 2 of6
October 19, 2005

)

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:

Stream
Stream

Plan Location or Reference

Sk uka Creek (#1
Skyuka Creek (#2)

2. Erosion & Sediment Control Practices

Erosion and sediment control practices must be in full compliance with all
specifications governing the proper design, installation and operation and
maintenance of such Best Management Practices in order to protect surface
waters standards:

a. The erosion and sediment control measures for the project must be
designed, installed, operated, and maintained in accordance with the most
recent version of the North Carolina Sediment and Erosion Control Planning
and Design Manual.
b. The design, installation, operation, and maintenance of the sediment and
erosion control measures must be such that they equal, or exceed, the
requirements specified in the most recent version of the North Carolina
Sediment and Erosion Control Manual. The devices shall be maintained on
all construction sites, borrow sites, and waste pile (spoil) projects, including
contractor-owned or leased borrow pits associated with the project.
c. For borrow pit sites, the erosion and sediment control measures must be
designed, installed, operated, and maintained in accordance with the most
recent version of the North Carolina Surface Mining Manual.
d. The reclamation measures and implementation must comply with the
reclamation in accordance with the requirements of the Sedimentation
Pollution Control Act.

3. No Waste, Spoil, Solids, or Fill of Any Kind

No waste, spoil, solids, or fill of any kind shall occur in wetlands, waters, or riparian
areas beyond the footprint of the impacts depicted in the Pre-Construction
Notification. All construction activities, including the design, installation, operation,
and maintenance of sediment and erosion control Best Management Practices,
shall be performed so that no violations of state water quality standards, statutes,
or rules occur.

'.

Skipper Hills
Page 3 of6
October 19, 2005

4. No Sediment & Erosion Control Measures win Wetlands or Waters

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

5. Certificate of Completion

Upon completion of all work approved within the 401 Water Quality Certification
or applicable Buffer Rules, and any subsequent modifications, the applicant is
required to return the attached certificate of completion to the 401/Wetlands Unit,
North Carolina Division of Water Quality, 1650 Mail Service Center, Raleigh, NC,
27699-1650.

6. Diffuse Flow

All constructed stormwater conveyance outlets shall be directed and
maintained as diffuse flow at non-erosive velocities through the protected
stream buffers such that it will not re-concentrate before discharging into a
stream. If this is not possible, it will be necessary to provide stormwater
facilities that are considered to remove nitrogen. A constructed stormwater
treatment will require additional approval from this Office.

7. Protective Fencing

The outside buffer, wetland or water boundary and along the construction
corridor within these boundaries approved under this authorization shall be
clearly marked with orange warning fencing (or similar high visibility material) for
the areas that have been approved to infringe within the buffer, wetland or water
prior to any land disturbing activities.

8. Turbidity Standard

The turbidity standard of 50 NTUs (Nephelometric Turbidity Units) shall not be
exceeded as described in 15 A NCAC 2B. .0200. Appropriate sediment and
erosion control practices must be used to meet this standard. Daily monitoring
by a NC certified lab must be performed on a daily. basis during culvert
installation. The samples must be taken a midpoint during each installation while
active installation is occurring and sampling must follow approved protocols.

Ski pper Hills
Page 4 of6
October 19,2005

~

.

9. No Sediment and Erosion Control Measures in Wetlands

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

10. Construction Stormwater Permit NCG01 0000

Upon the approval of an Erosion and Sedimentation Control Plan issued by the
Division of Land Resources (DLR) or a DLR delegated local erosion and
sedimentation control program, an NPDES General stormwater permit
(NCG010000) administered by DWQ is automatically issued to the project. This
General Permit allows stormwater to be discharged during land disturbing
construction activities as stipulated by conditions in the permit. If your project is
covered by this permit [applicable to construction projects that disturb one (1) or
more acres], full compliance with permit conditions including the sedimentation
control plan, self-monitoring, record keeping and reporting requirements are
required. A copy of this permit and monitoring report forms may be found at
h tto://h 20. enT. state.nc. us/su/Forms Documents.htm.

11, Deed Restrictions

Deed restrictions or conservation easements shall be placed on all retained
jurisdictional wetlands, waters and protective buffers in order to assure
compliance for future wetland, water and buffer impact. These mechanisms shall
be put in place prior to impacting any wetlands, waters and/or buffers approved
for impact under this Certification Approval and Authorization Certificate,

12. Temporary Fills

All temporary fill and culverts shall be removed and the impacted area returned
to the original grade, including each stream's original cross sectional dimensions,
planform pattern, and longitudinal bed and bed profile after construction is
complete or within 6 months of the establishment of the crossing, which ever is
sooner, and the various sites shall be stabilized with natural woody vegetation
(except for the maintenance areas of permanent utility crossings) and restored to
prevent erosion. If the crossings are not completely removed and restored as
described above within the specified time above, additional written approval from
this Office must be obtained to modify this condition.

-+

Skipper Hills
Page 5 of6
October 19,2005

13. Culvert Installation

Culverts required for this project shall be installed in such a manner that the
original stream profiles are not altered. Existing stream dimensions (including the
cross section dimensions, pattern, and longitudinal profile) must be maintained
above and below locations of each culvert. Culverts shall be designed and
installed to allow for aquatic life movement as well as to prevent head cutting of the
streams. If any of the existing pipes are or become perched, the appropriate
stream grade shall be re-established or, if the pipes installed in a perched manner,
the pipes shall be removed and re-installed correctly.

Culvert(s) shall not be installed in' such a manner that will cause aggradation or
erosion of the stream up or down stream of the culvert(s). Existing stream
dimensions (including the cross section dimensions, pattern and longitudinal
profile) shall be maintained above and below locations of each culvert. Therefore,
you must provide plans with adequate details that indicate that the current stability
of the stream will be maintained or enhanced, You must receive written approval
from this Office for the above plans before the culvert(s) is installed. Culvert(s)
must be installed according to approved plans.

The establishment of native, woody vegetation and other soft stream bank
stabilization techniques must be used where practicable instead of rip rap or
other bank hardening methods. If rip-rap is necessary, it shall not be placed in
the stream bed, unless specifically approved by the Division of Water Quality.

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 of the 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.

Skipper Hills
Page 60f6
October 19,2005

.

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 in the
Central Office in Raleigh at 919-733-9721 or Kevin Barnett in the DWQ Asheville
Regional Office at either [e-mail] or at 828-296-4657.

Sincerely,

1f~v.L.~~A

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

. AWK/khb

Enclosures: GC 3404
Certificate of Completion

cc: Polk County Planning Office
Steve Chapin, USACE Asheville Regulatory Field Office
DWQ 401 Central Office
DLR Asheville Regional Office
David McHenry, NC Wildlife Resources Commission
File Copy
Central Files

Filename: 05-1738,SkipperHills,approval

1"'.

Mlcnael r. ~Iey, (jovemor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources

Alan W. Klimek, P.E., Director
Division of Water Quality
Coleen H. Sullins, Deputy Director
Division of Water Quality

August 29, 2005
Polk County

I');~ \IF, ,1
J "~ : ! \' ~

T
,

20051 738

CERTIFIED MAIL

f~< r. (~f_

, I
f,

Wayne Skipper
PO Box 5072
West Columbia, SC 29171

FILE COpy

~~@@nwFs ~

SEP 1 4 2005

Subject: Incomplete Application

OENR - WATEH ~~ALlTY, '
.. !t:TlJ' ~ "'" ,n '0 STOi\M'ArifER BR;JxCH
~~r.;, \.ih':vl"ol'i.'

Dear Mr. Skipper:

On August 1,2005 the Wetlands/401 Unit of the Division of Water Quality received your application
for a 401 Water Quality Certification in Polk County, North Carolina. Your application package is
being returned to you. The submitted application failed to supply the Nationwide, Regional or General
Permit Number Requested (see 1. 2. under Processing). The USACE would have dictated the permit
type to request. During a conversation on August 7th with Ian McMillan, DWQ 401 Coordinator, it was
understood that the project would be resubmitted.

In addition, it is necessary to complete Section VI, Proposed Impacts items 4 and 6, indicating the
proposed impacts for the 50 ft culvert.

If you have any questions regarding this letter please do not hesitate to call me at [phone] or Ian
McMillan at [phone].

Enclosure: PCN Application
Check # 10045 for $200

Vj

CBKIljd

cc: File copy

Wayne Skipper (Polk) Retu Incomplete Appl_ Ck

6'

N. C. Division of Water Quality, 401 Wetlands Certification Unit,
1650 Mail Service Center, Raleigh, NC 27699-1650 (Mailing Address)
2321 Crabtree Blvd., Raleigh; NC 27604-2260 (Location)
[phone] (phone), 919-733-6893 (fax), (htlo:ilh2o,enr,stale,nc,uslncwctlands)
Customer Service #: 1-877-623-6748

~

~

Pl/wr>>"ip,lT
f t 1 ! \-l [~_ ( -;

fILE COP~

,- -..

RECEIVED

Office Use Only:

Form Version March 05

USACE Action In No. DWQ No.
(If any particular item is not applicable to this project. please enter "Not Applicable" or "N/ A".)

2 0 0 5 1 7 3 8

I. Processing

1. Check all of the approval(s) requested for this project:
t2}.section 404 Permit 0 Riparian or Watershed Buffer Rules
o Section 10 Permit 0 Isolated Wetland Permit from DWQ
~ 401 Water Quality Certification 0 Express 401 Water Quality Certification

2. Nationwide, Regional or General Permit Number(s) Requested: .A/. Lt../. / V

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

4. Ifpayment 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: 0

II.

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 ~~nt Area of
Environmental Concern (see the top of page 2 for further details), check/Kj"'" l.\9 @ llW@ @

Applicant Information AUG 1 -Z005

1. Owner/Applicant Information WEr&~~'lN~11~~9UALlTY
Name: t'~~A/ ~ S I< ,jt,f-er mn'ATER BRANCH
Mailing Ad ss: f.tJ. h;>>b s" 7::L ut!-Jr C41t.l~ b/i;] ("_c.;z 7/7/

Telephone Number: 8'03 -t,p~ ' if ~ tf f
E-mail Address:

Fax Number: ?~3- j2zt, -Cf.I:l~ 9
,

2. Agent/Consultant Information (A signed and dated copy of the Agent Authorization letter
must be attached if the Agent has signatory authority for the owner/applicant.)
Name:
Company Affiliation:
Mailing Address:

c~ J~~l~~ Number:
~~@gU~~dreSS:

SEP 1 <1 lOGS

r---.>-,
Ili\\ !~: (.. · ,,' ,-:" ---':;-.=.c-;---
I" I..) I \' . , . .
. i L _ / r---~~-~.~--.;:-~, > i ;"" \ \ t
Ii n\ ! Ii : 11
F N 'b' i > 1 J 1'1 ? 1 ' . ,'" J,/I'
ax ui en i J" > "-"; . ~
; k--" !

I ~:JA; [=';;,-(~~~~~=~;--;~;-;.-:-;-~~
~''''''I__'' . -'--,>---./ljCji"~
t '~~.l!.if"':~~~~~~~.~~_~Ji.~~.t:.L0= ~.__

DEI~R - WATER Q~~~ITY, r
"'E"'U,"nt.: MID STOmXWI\ld( BRf\\lvH
i~ , \\.~l,oI"" ru'i

Page 5 of 12 -

~

. .

Ill. 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 papelWork 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 ofproject: Sj( ir'l'e;' JIll I) Pc vt' 1u,r':Mr..-- "/'

2. T.I.P. Project Number or State Project Number (NCDOT Only): #.4'

3. Property Identification Number (Tax PIN):r;.,?J ::lp:tt. -r.- r {; -.r O!~~ il06/c..JJY74.s<
74-
/

4. Location .
County: ?o/ K Nearest Town: C,'{I.{ rl"J bit..>
Subdivision name (include phasellot number):
Directions to site (include road numbers/names. landmarks, etc.)::' ' r ~
fi. art ~ /< f.t. .- ~" ,,I {J~.--

A/~-

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 di,gits minimum): :3:1'" 51" :1..1 > ~
~4b 0 L1 '8-7
6. Property size (acres): :J J, !) A Lr C...,J

ow

7. Name of nearest receiving body of water:

8. River Basin: .I~('I((~rr f{ I~
(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.usladmin/maps/.)

9.

Page 6 ofl2

Triage Check List

Date: 09/19/05

Project Name: Skipper Hills Development
DWQ #:05-1738
County: Polk

To:

Kevin Barnett, Asheville Regional Office

60-day Processing Time: 9/14/05 to 11/12/05

FILE COpy

From: Cyndi Karoly Telephone: [phone]

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

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

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

..

~ .

t4Cce,jJ f'/'tJPvIY ~ Clut d
i1 I

IV. Prior Project History

If jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Include
the USACE Action 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. Descnoe previously approved wetland, stream and
buffer impacts, along with associated mitigation(where applicable). If this is a NCDOT project,
list and describe permits is:I!1 for prior segments of the same T.r.p. project, along with
construction schedules. J1./"

v. Future Project Plans

Are any future permit requests anticipated for this project? If so, describe the anticipated work,
an~y~ ~fication for the exclusion of this work from the current application.

VI. Proposed Impacts to Waters of the United StateslWaters of the State

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

1. Provide a written description ofthe proposed impacts: ;!/ /),v{/ ;"
.

Page 7 of 12

..

. .

2. Individually list wetland impacts. Types of impacts include, but are not limited to
mechanized clearing, grading, fill, excavation, flooding, ditching/drainage, etc. For dams,
Ir' d bth

separatelY 1st tmpacts ueto 0 structure and flooding.
Wetland Impact Type of Wetland Located within Distance to Area of
Site Number Type ofImpact (e.g., forested, marsh, lOO-year Nearest Impact
(indicate on map) herbaceous, bog, etc.) Floodplain Stream (acres)
(veslno) (]inear feeO
IV /t.+
,
Total Wetland Impact (acres)

3. List the total acreage (estimated) of all existing wetlands on the property: /' fJ(..y"C,.,

4. Individually list all intermittent and perennial stream impacts. Be sure to identify temporary
impacts. Stream impacts include, but are not limited to placement of fill or culverts, dam
construction, flooding, relocation, stabilization activities (e.g., cement walls, rip-rap, crib
walls, gabions, etc.), excavation, ditching/straightening, etc. If stream relocation is proposed,
plans and profiles showing the linear footprint for both the original and relocated streams
must be included. To calculate acrea e, multi lIen X width, then divide b 43,560.
Stream Impact Perennial or A vemge Impact Area of
Number Stream Name Type of Impact Stream Width Length Impact
indicate on ma Intermittent? Before I act inear feet acres
fI/'~

Total Stream Impact (by length and acreage)

:,J..p

.tJ

5. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic'
Ocean and any other water of the U.S.). Open water impacts include, but are not limited to
fill, excavation, dred' , floodin , draina e, bulkheads, etc.
Open Water Impact Name of Water body Type of Water body
Site Number (if applicable) Type of Impact (lake, pond, estuary, sound, bay,
indicate on ma ocean, etc.

Total Open Water Impact (acres)

Page 8 ofl2

->~

. .

6.

7. Isolated Waters
Do any isolated waters exist on the property? DYes .{:l] No
Describe all impacts to isolated waters, and include the type 4twater (wetland or stream) and
the size of the proposed impact (acres or linear feet). Please note that this section only
applies to waters that have specifically been determined to be isolated by the USACE.

8. Pond Creation A) ./ A
If construction 1ff'3. 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 0 wetlands
Describe the method of construction (e.g., dam/emban1anent, 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. f// ~ 4,; II ;r:::..:. / ~ I (

-r:.:~ s ",.,~ !f~ q P~'~r'<V~ ~k ....1,-.. ~ /~ J !If fi I ~ d> ,.1/
/~ . T r /lw d/.-J- ,-P 1:....1/ j

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

r-

~) ":

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/ncwetlandslstrmgide,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
andlor map, if offsite), affected stream and river basin, type and amount (acreagellinear 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. .Il./ ./;
L- ;:r-
.

2. Mitigation may also be made by payment into the North Carolina Ecosystem Enhancement
Program (NCEEP). Please note it is the applicant's responsibility to contact the NCEEP at
[phone] to determine availability, and written approval from the NCEEP indicating
. that they are will to accept payment for the mitigation must be attached to this form. For
additional information regarding the application process for the NCEEP, check the NCEEP
website at http://h20,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:

A//t+
, V /'a..
.
Amount of Riparian wetland mitigation requested (acres): ./1/'/ "IJ-
Amount of Non-riparian wetland mitigation requested (acres): /1/'/.4-
Amount of Coastal wetland mitigation requested (acres): /V / A'

Amount of stream mitigation requested (linear feet):
Amount of buffer mitigation requested (square feet):

Page 10 of]2

. ..

-"~ ~

IX. Environmental Documentation (required by DWQ)

1. Does the project involve an expenditure of public (federallstatenocal) funds or the use of
public (federal/state) land? Yes D No ~

2. If yes, does the project require preparation of an environmental document pursuant to the
requirements of the National or North Carolina Environmental Policy Act (NEP A/SEP A)?
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 0 /v(p-

3. If yes, has the document review been finalized by the State Clearinghouse? If W/Wease
attach a copy of the NEP A or SEP A fmal approvalletter. Yes D No D / y (.a

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 vn 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 ~ '

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 I . r

er mu tip 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
additiona120 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 I Enhancement, or Payment into the
Riparian Buffer Restoration Fund). Please attach all appropriate information as identified
within 15A NCAC 2B .0242 or .0244, or .0260. ~ / J'!Y
.

Page 11 of12

.~-.~

.! '

XI. Stormwater (required by DWQ)

Describe impervious acreage (existing and proposed) versus total acreage on the site. Discuss
stormwater controls proposed in order to protect surface waters and wetlands downstream from
the property. If percent impervious surface exceeds 20%, please provide calculations
demonstrating total proposed impervious level. IV u 2,.. >,-,...c:'- S ~ , ~ / p/ 0 G.L- c;.. -;
,

XII. Sewage Disposal (required by DWQ)

Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wA'w er generated from the proposed project, or available capl:'.city of the subj~ct facility.

Will this project (based on past and reasonably anticipated future impacts) result in~dd' 'onal
development, which could impact nearby downstream water quality? Yes 0 No'
If yes, please submit a qualitative or quantitative cumulative impact analysis in aceor ance with
the most recent North Carolina Division of Water Quality policy posted on our website at
http://h20.enr.state.nc.uslncwetlands. Ifno, please provide a short narrative description:

X'"
, .

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
TInea en d Species, accessibility problems, or other issues outside of the applicant's control).

,., of

ignature Date
only if an authorization letter from the applicant is provided.)

Page 12 of 12

.'

/~

,
, ~'
~!

oJ c -::iJ
~ oCX:
~
<..~ -f. ~
· ~ c.}:- ,,~
"< -.<
, -...I
C.:J ::>-'
?~
\>:~ \f)
.. i

j.
H

I

'"
..
to
....
o ...

-
f...
~ .
0f
r~
~
'> ;:1""'"
L.
~S
<. .'
.'
o.

.
.0 . . - .
'iJ . ;r .....
:Ii" It .:+

.

t

,
I
.,
!

l~
a
I~
l~

~l:l.1J.lWl\:1 VLn'~' ,
""....... WcI6 t : t:>l1I ..,.
".,. tZ l:lO

Z'd

,

r~."....,.
~"
"\

}-i
.. .' I
m ,"
'1'\i""~ : _ '
>/;~d
, !
I
I
I
,
!
I

;.~
i.l
"

"
:

~

~

I
I ;~ H l

11__ '-- '~---"..,
: \ ,
I....'\..........~.,,'--,_..',."'_..,.,'
I" .......,
I
!

> o':'~"o.- ,.
~,~ .~

ii.: ~

, c.-,.-_,_)' ~

. "'.?u .:'"',,,

i
i
I

.-\;, :: ~

'e :
~p

~- --- -.-..-"

:;

". ~ ,~.~.
--,,~.,~
,:^'; ~.
'-. ... /"~; . .rJ, 6/C
"l ">./7 C--"h ~
~~~.;;;0t~.Z~<:,\
.~~;;~~~;,~~~;!':~ !

,;~:",... ~
~<..{

~
:i.
~;!.
~ ~;-
<

~:

----1IIJiIJr

'~'

'1

..

!.- #

PAYMENT
RECEIVED

Office Use Only:

2 0 0 SF;rm 7c3on Barch os

USACE Action In No. DWQ No.
(If any particular item is not applicable to this project, please enter "Not Applicable" or ''NI A".)

I. Processing

1. Check all of the approvaI(s) requested for this project:
~ Section 404 Pennit D Riparian or Watershed Buffer Rules
1J Section 10 Pennit D Isolated Wetland Pennit from DWQ
~ 401 Water Quality Certification D Express 401 Water Quality Certification

2. Nationwide, Regional or General Permit Number(s) ReqUested:;tJ u.J / i

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

4. If payment into the North Carolina Ecosystem Enhancement program (NCEEP) is proposed
for mitigation of impacts, attach the acceptance letter from NCEEP, complete section vm,
and check here: D '

ll.

5. If your project is located in any of North Carolinats 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 de~ilS). ~heck here: ~ @ [g OW [g ~

Applicant Information Ii\ J..:::::I l!!J
AUG 1 - 2005
1. Owner/Applicant Information
Name: t~~A/ ~ ,f K '(feY" DENR - WATER QUALITY
Mailing Ad ss: f.p. ?,;>,b S, 7:2.... uur cd/~~ b/i:;J ,"_c- .zt~~slm3TOf\MwATERBRANcH

Fa"{Number: f?tJ3- 7-l.~ -O4&? 9
.

Telephone Number: /(tJ3 -~tlll ''i;lQ j
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:
Company Affiliation:
Mailing Address:

r~-""""'--:-----------~...
II \ r' 1('" "'~ '1 " oJ ~-'r";~ 1
., ',1 ..~\ !e \.., I~ 1 \V !~. ~o .\ i
!t r-

I

I - '\!J':'"T;::C~ nf~I_-'\1 J7V 0"---"",- -....;
- '. ,- , \' -.' ' ~ ~~' . -
Df.'C:Hrl"1 L~ R~G ' ' "
""-.--' '1..~,,'L-_ t: "it: :dONf\L C,'

Telephone Number:
E-mail Address:

Fax Number:

Page 5 of 12

fD)~@~;D\::7~ rm
~ u
SFP J 4 {OU5

OENH"
VlEll1J~L~:.1 f\~{!)

r

,

~ \:.

III. Project Information

A~h 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 putposes, 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
reducoo 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 ofproject: Sj( 'fr''''''' 11/' I) Pc vr /pp;t~;____r
v

2. T.I.P. Project Number or State Project Number (NCDOT Only): A/4'

3. Property Identification Number {Tax PIN):r;" ::tJ;!l:tt ~ r 6 - J ;;kc# ilt:1tJ/c..JJY74.S(
?.:<,-
/

4. Location -:"7
County: r of K Nearest Town: C(JI,-{ I'll bit..>
Subdivision name (include phase/1ot number):
,f) Directions to site (include road numbers/names, landmarks, etc.): "--.' .
f... A. - , · ' /;-.0_ ~/< ~~- ~., .jJ~.-

A/ l!,,-

'j(yt-t1J.4 J

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): ~;., j 1" 2.1 . 'N
~lfb 041 J7
6. Property size (acres): :J JI /) ALrC;...J

ow

7. Name of nearest receiving body of water:

8. River Basin: (h (,1((t,1'1 f{ I'V-t/
(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.usladminlmaps/.)

9.

Page 6 of12

~ '
~~

ACCe.JJ ?r"~,pvl'1' -r 7,u{ d
fI I .~ Q;

IV. Prior Project History

If jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Include
the USACE Action ID Number, DWQ Project Number, application date, and date permits and
certifications were issued or withdrawn. Provide photocopies of previously issued permits,
certifications or other useful information. Descnbe previously approved wetland, stream and
buffer impacts, along with associated mitigation(where applicable). If this is a NCDOT project,
list and ?escribe permi/f}:If 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,
an~7 ~fication for the exclusion of this work from the current application.

VI. Proposed Impacts to Waters of the United StateslWaters of the State

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

1. Provide a written description of the proposed impacts: ;Ii PIVt/ ;"
.

Page 7 of12

;

t ,

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

separately 1st impacts due to both structure and flooding.
Wetland Impact Type of Wetland Located within Distance to Area of
Site Number Type of Impact (e.g., forested, marsh, IOO-year Nearest Impact
(indicate on map) herbaceous, bog, etc.) Floodplain Stream (acres)
(ves/no) (linear feeO
IV/A--
, .
Total Wetland Impact (acres)

3. List the total acreage (estimated) of all existing wetlands on the property: /' fJ(.,..c,

4. Individually list all intermittent and perennial stream impacts. Be sure to identify temporary
impacts. Stream impacts include, but are not limited to placement of fill or culverts, dam
construction, flooding, relocation, stabilization activities (e.g., cement walls, rip-rap, crib
walls, gabions, etc.), excavation, ditching/straightening, etc. If stream relocation is proposed,
plans and profiles showing the linear footprint for both the original and relocated streams
must be included. To calculate acrea e, multi lIen X width, then divide b 43,560.
Stream Impact Perennial or Average Impact Area of
Number Stream Name Type ofImpact Intermittent? Stream Width Length Impact
indicate on ma Before 1m act linear feet acres

Total Stream Impact (by length and acreage)

5. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.). Open water impacts include, but are not limited to
fill, excavation, dred 'n , floodin , draina e, bulkheads, etc.
Open Water Impact N fW terb d Type of Water body
S. N b ame 0 a 0 y I d, b
Ite urn er ('f r bl) Type ofImpact (ake, pond, estuary, SOWl ay,
indicate on ma 1 app Ica e ocean, etc.

Area of
Impact
acres)

Total Open Water Impact (acres)

Page 8 of 12

6.

acres)

7. Isolated Waters
Do any isolated waters exist on the property? 0 Yes {2] No
Describe all impacts to isolated waters, and include the type 4twater (wetland or stream) and
the size of the proposed impact (acres or linear feet). Please note that this section only
applies to waters that have specifically been determined to be isolated by the USACE.

8. Pond Creation A) / A- '
If construction &"'a ~OIid 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): 0 uplands 0 stream 0 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. f.I./ ~ tv; I ( :r;..... / IP II
-ct~ S""'~;j': ~.o ~'~;' w~ ~ :t: '" 1,,-,. x.- ,? J (If ;'1 / ~ .rP #1
j~ . rr /)~ ","'~J- ,-1).. t:....1f~)

VIII. Mitigation

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

Page 9 of 12

USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on January 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
aCJ.u~tic. resource will be considered in .d~tex:mining acceptability of appropriate and practicable
nutigation 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/ncwetlandslstnngide.html.

1. Provide a brief description of the proposed mitigation plan. The description should provide
as much infonnation as possible, including, but not limited to: site location (attach directions
andlor map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preseIVation), 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.~ ./;:r-

.

2. Mitigation may also be made by payment into the North Carolina Ecosystem Enhancement
Program (NCEEP). Please note.it is the applicant's responsibility to contact the NCEEP at
[phone] to determine availability, and written approval from the NCEEP indicating
that they are will to accept payment for the mitigation must be attached to this fonn. For
additional infonnation regarding the application process for the NCEEP, check the NCEEP
website at http://h20,enr.state.nc.us/wm/index.htm. If use of the NCEEP is proposed, please
check the appropriate box on page five and provide the following infonnation:

A//A-
, V /',a,
.
Amount of Riparian wetland mitigation requested (acres): .A/ / ~
Amount of Non-riparian wetland mitigation requested (acres): /II' /,4-
Amount of Coastal wetland mitigation requested (acres): ./f/ / ;flY'

Amount of stream mitigation requested (linear feet):
Amount of buffer mitigation requested (square feet):

Page 10 of 12

;

~

.! ..:~,

.
, . ~.J <'

IX. Environmental Documentation (required by DWQ)

1. Does the project involve an expenditure of public (federal/state/local) funds or the use of
public (federal/state) land? Yes 0 No ~

2. If yes, does the project require preparation of an environmental document pursuant to the
requirements of the National or North Carolina Environmental Policy Act (NEP NSEP A)?
Note: If you are not sure whether a NEP NSEP A document is required, call the SEP A
coordinator at [phone] to review current thresholds for environmental documentation.
Yes 0 No 0 /v(p-

3. If yes, has th,e document review been finalized by the State Clearinghouse? If WtWease
attach a copy of the NEP A or SEP A fmal approval letter. Yes 0 No 0 I f (.a

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.

1. Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Neuse), lSA 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 0 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
buffi lti r

er mu Jpners.
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
additiona120 feet from the edge of Zone I.

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

Page 11 ofl2

t '! J.

-
, ,...

XI. Stormwater (required by DWQ)

Describe impervious acreage (existing and proposed) versus total acreage on the site. Discuss
stormwater controls proposed in order to protect surface waters and wetlands downstream from
the property. If percent impervious surface exceeds 20%, please provide calculations
demonstrating total proposed impervious level. III t) -:[,.. ~...,..,-- S ~ ,.:" /,::/ 0 G~: c;.. r:
I

XII. Sewage Disposal (required by DWQ)

Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wA'w generated from the proposed project, or availa~le cap~.city ofthe subject facility.

XIll. Violations (required by DWQ)

Is this site in violation of DWQ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes 0 N;IISl

Is this an after-the-fact permit applicati.on? Yes 0 N~

XIV. Cumulative Impacts (required by DWQ)

Will this project (based on past and reasonably anticipated future impacts) result in~add. 'onal
development, which could impact nearby downstream water quality? Yes 0 No'
If yes, please submit a qualitative or quantitative cumulative impact analysis in accor ance with
the most recent North Carolina Division of Water Quality policy posted on our website at
htto://h20.enr.state.nc.us/ncwetlands. Ifno, please provide a short narrative description:

X'-I. 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
Threa en d Species, accessibility problems, or other issues outside of the applicant's control).

...

,,-0 (

ignature Date
only if an authorization letter from the applicant is provided.)

Page 12 of 12

(

'~':'7~.;:t-"

ilIiiIlI.-

'"
~ <'~3:
~.., '--".,-'

,i ~: ,~~~~;~\~~";<,,

~~ "0,<,-,",: 'Gi.t,.~ '."~'}'J 1.'.

"

//9'r C '...< ",
. )"~

~

I
I
I
I:;;
I-

>.......,
~-

'~~. ..~

;:;; "'.i

i
l

,
I
I
.... (
<;'~ ~ ",

,;' ~c~
II. :~L.;l..:l s

':" ~ j;

'~
,"'"
,. ~
~,

;t'

,. ''''_0.;<) .,;t.~ .

~ ~,' 'i:.>~ ,

c.
~
I;;
.,

. : ~

~~.

111'9' ,\_

I
I
I
-0 I
..
I
I
!
I

I
I
I
!
I
I

I
i
!
I
I
I
I
;
~

.,~...l

.. . -~ ..
...... tl. ; f'

'!.

/~

\.
,~
~!

oJ
~
~~~,.. ~. ..~
""-.Y ....,!
.......... ' -'
c.::, ::,.....
~.~
~~ \f)

6&

j
R

i

-
f...
~ .
/.~
.u cJ)
r~
~
-;::... ;;r-
"
,J..
~s
-::;.. ;'
<-- ,.

..
..
o
I..
,......

.0
.p
:i'
,

..
.j;
~

.:: - -
. ~ . .
.: +

.

l~
I~
Ii!

.,

~~.J.Nl;:jt\Cltl Xl:lW3CI Wd6t:170 tria. t2 1:)0

2"d

-r

., cot( W A r~1y
O~ Oc..
~ ~
> -
- -;
o "(

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
Coleen H. Sullins, Deputy Director
Division of Water Quality

August 29, 2005
Polk County

CERTIFIED MAIL

Wayne Skipper
PO Box 5072
West Columbia, SC 29171

Subject: Incomplete Application

Dear Mr. Skipper:

On August 1, 2005 the Wetlands/401 Unit of the Division of Water Quality received your application
for a 401 Water Quality Certification in Polk County, North Carolina. Your application package is
being returned to you. The submitted application failed to supply the Nationwide, Regional or General
Permit Number Requested (see I. 2. under Processing). The USACE would have dictated the permit
type to request. During a conversation on August 7th with Ian McMillan, DWQ 401 Coordinator, it was
understood that the project would be resubmitted.

In addition, it is necessary to complete Section VI, Proposed Impacts items 4 and 6, indicating the
proposed impacts for the 50 ft culvert.

If you have any questions regarding this letter please do not hesitate to call me at [phone] or Ian
McMillan at [phone].

Enclosure: PCN Application
Check # 10045 for $200

~

CBK/ljd

cc: File copy

Wayne Skipper (polk) Retu Incomplete Appl_Ck

"

N. C. Division of Water Quality, 401 Wetlands Certification Unit,
1650 Mail Service Center, Raleigh, NC 27699-1650 (Mailing Address)
2321 Crabtree Blvd., Raleigh, NC 27604-2260 (Location)
[phone] (phone), 919-733-6893 (fax), (hlln:l/h2o.enr.state.nc.uslncwetlands)
Customer Service #: 1-877-623-6748

'.1.:0 5 ~ 200 bbbl: ~ ~08 2 ~O 28 ~Obll'

~ ."' ,.

Office Use Only:

Form Version March 05

USACE Action ID No~ DWQ No.
(If any particular item is not applicable to this project, please enter "Not Applicable" or ifNI A" .)

I. Processing

1. . Check all of the approva1(s) requested for this project:
o Section 404 Permit 0 Riparian or Watershed Buffer Rules
o Section 10 Permit 0 . Isolated Wetland Permit from DWQ .
~ 401 Water Quality Certification 0 Express 401 Water Quality Certification

2. Nationwide, Regional or General Permit NumberCs) Requested:

3. If this notification is solely a courtesy copy because written approval for the 401 Certification
jsnot, required, check here: 0 '

00J)) ~~

~o loL C'"'Q.-k>

\" 0 M..$-~~ . project is located in any of North Carolina's twenty coastal counties (listed on page
1 the project is within a North Carolina Division of Coastal Management Area of
f6 \ 1 \ oS . nmental Concem(see the top of page 2 for further d~~S)'9heCk here: ~ @ [g OW~ ~

ll. Applicant Information ~ L=:J l!lj
AUG 1 -,2005
1. Owner! Applicant Information
Name: ~~ ~ rf I<' '(fer DENR 0 WATER QUALITY
Mailing Ad s: f'.P.~~~ &'7:1- k/e-Jr C,//,e,.bn, ".c.o .:i1'~1m5'fORMWATERBRANCH

lent into the North Carolina Ecosystem Enhancement program (NCEEP) is proposed
igation of impacts, attach the acceptance' letter from NCEEP, complete section VIII,
:ck here: 0

Telephone Number: StJ3 -iB", - '1.:l" j
E-mail Address:

FaxNumber: ?~3- Zl~-6d~ 9
.

2. Agent/Consultant Information (A signed and dated copy of the Agent Authorization letter
must be attached if the Agent has signatory authority for the owner/applicant)
Name:
Company Affiliation:
Mailing Address:

Telephone Number:
E-mail Address:

Fax Number:

", ......:i-

, l~,/

Wi.... r:: ,: f.;-;~-;--;:::-_J
ASHE\fll.LE REGIONflL ;:~~

Page 5 of 12

1I1~00'" Sill Ii: 0 5 ~ 200bbbl:~ 30a 2 ~O 2a~Oblll
: 1i