20051879 Ver 1_Complete File_20050104

,

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

October 31, 2005

DWQ Project # 05-1879
Craven County

James Chittick ConstructionlUtGlo Inc.
P.O. Box 357
Bridgton, NC 27519

Subject Property:

2212 Caracara Drive
Northwest Creek [030410, 27-105, SB, SW, NSW]

Approval of 401 Water Quality Certification with Additional Conditions

Dear Sir or Madam:

You have our approval, in accordance with the attached conditions and those listed below, to place fill
within or otherwise impact 0,02 acres of wetlands for the purpose of building a residence at the subject
property, as described within your application dated October 5, 2005 and received by the N.C. Division of
Water Quality (DWQ) on October 10,2005, with more information received by the DWQ on October 28,
2005. After reviewing your application, we have decided that the impacts are covered by General Water
Quality Certification Number(s) 3402 (GC3402). The Certification(s) allows you to use Nationwide
Permit(s) NW18 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, 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

Sediment and Erosion Control:

N~1ThCarolina
IVII/llmll!!

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]/lntemet: httD://h2oenr.state,ncus/ncwetlands

An Equal Opportunity/Affirmative Action Employer - 50% RecyclecV10% Post Consumer Paper

James Chittick Construction/UtGlo, Inc.
Page 2 of3
October 31,2005

,

2. 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. Sufficient materials required for stabilization and/or repair of erosion control measures and
stormwater routing and treatment shall be on site at all times.

3. 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 404/401Pennit Application. 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;

4. 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. 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 to ensure compliance with 15 NCAC 2H,
Section .0500;

6. Deed Notifications - Deed notifications or similar mechanisms 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. A sample deed notification can be downloaded from the 401/Wetlands Unit
web site at http://h2o.enr.state.nc.us/ncwetlands. The text ofthe sample deed notification may be
modified as appropriate to suit to this project;

7. Construction Stormwater Pennit NCGOI0000

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 pennit (NCGO 1 0000) administered by DWQ is automatically issued
to the project. This General Pennit allows stormwater to be discharged during land disturbing
construction activities as stipulated by conditions in the pennit. If your project is covered by this
pennit [applicable to construction projects that disturb one (1) or more acres], full compliance
with pennit conditions including the sedimentation control plan, self-monitoring, record keeping

James Chittick ConstructionlUtGlo, Inc.
Page 3 of3
October 31, 2005

and reporting requirements are required. A copy of this permit and monitoring report forms may
be found at htfp://h2o.cnr.statc.nc.us/su/Forms Documents.htm.;

8. 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 Oversight/Express Review Permitting Unit, North Carolina
Division of Water Quality, 1650 Mail Service Center, Raleigh, NC, 27699-1650.

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,

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 919-733-1786 or Kyle Barnes in the DWQ Washington Regional Office at 252-946-6481.

AWKJijm

s~. y~

t Alan W. Klimek, P.E.

Enclosures:

GC 3402
Certificate of Completion

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

Filename: 051879 _2212CaracaraDi\Craven)401

James Chittick Construction

""\'\":<<':::""'K"""''':~''='~'"

252-635-1149 office/fax
252-259-5624 cell

To: Kyle Barnes
Division of Water Quality Washington Regional Office

Re: Project #05-1879 Craven County application dated October 5

Date:October 26, 2005

In response to your request for additional information:
1, I have enclosed a map of Fairfield Harbor and a vicinity map is on the survey,
2. The survey shows the area of wetlands impacted,
3, I estimate 24% of the project to affect the imperviousness area,

Thank you for your.....90nsi :/ration,
/,0/
~. -{'
c;- ,;

James Chittick
NC General Contractors license #:1RO:17

~~@rn!UW[g~
OCT 2 0 Z005

Datm . WATr.H QUALITY
\';~T1A'J03/J!f~ Gr01UU/,\lEH [1RN,C;i1

PO Box 357 Bridgeton, NC 28519

Michael F. Easley, Governor

William G. Ross Jr., Secrctary
Nonh Carolina Department or Environment and Natural Resources

Alan W. Klimek. P.E. Director
Division orWatcr Quality

October 19, 2005

DWQ Project it 05-1879
Craven County

CERTIFIED MAIL: RETURN RECEIPT REQUESTED

Mr. James Chittick
James Chittick ConstruetionlUtGlo, Inc.
P.O, Box 357
Bridgton, NC 28519

Subject Property:

2212 Caracara Drive
Northwest Creek [030410, 27-105, SB, SW, NSW]

REQUEST FOR MORE INFORMATION

I

Dear Mr. Chittick:

On October 10,2005, the Division of Water Quality (DWQ) received your application dated October 5,
2005, to impact 0.12 acres ofwetJands to construct the proposed residence. The DWQ has detennined
that your application was incomplete and/or provided inaccurate information as discussed below. The
DWQ will require additional information in order to process your application to impact protected
wetlands and/or streams on the subject property, Therefore, unless we receive the additional information
requested below, we will have to move toward denial of your application as required by 15A NCAC 2H
.0506 and will place this project on hold as incomplete until we receive this additional information.
Please provide the following information so that we may continue to review your project.

Additional Information Requested:

1. Please provide a location map for the project.

2, Please show all wetland impacts including fill slopes on the site plan,

Q. ~ 0/0

3, Please specify the percent of project imperviousness area (including the building footprint,
sidewalk, driveway, decks, etc.) based on the estimated built-out conditions per item "XI.
Stormwater (required by DWQ)".

Please respond within three weeks of the date of this letter by sending this information to me in writing
and Kyle Barnes of the DWQ Washington Regional Office, Ifwe do not hear from you within three
weeks, we will assume that you no longer want to pursue this project and we will consider the project as
withdrawn.

This letter only addresses the application review and does not authorize any impacts to wetlands, waters
or protected buffers. Please be aware that any impacts requested within your application are not
authorized (at this time) by the DWQ, Please call Ms, Cyndi Karoly or Mr. Ian McMillan at 919-733-
1786 if you have any questions regarding or would like to set up a meeting to discuss this matter,

N~~CaroIina
/lJntllfll//!/

40LOv=ightlExpress Re.,.iew Pennitting Unit.. '
~ ,,1.650Mail Service Cen,t~, ~lcigh., North Carolina 276~9~f650~>
2321 Crabtree Boulevard, Suite 250: RaJciglr;-NonIfCaiOliii3'-'27604
Phone: [phone]/ FAX [phone]/lntcmct: http://h2o,cnr.statenc.uslncwctlands

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Michael F. Easley, Governor

William G. Ross Jr., SecretaI)'
North Carolina Department of Environment and Natuml Resources

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

October 19,2005

DWQ Project # 05-1879
Craven County

CERTIFIED MAIL: RETURN RECEIPT REQUESTED

Mr. James Chittick
James Chittick ConstructionlUtGlo, Inc.
P.O. Box 357
Bridgton, NC 28519

Subject Property:

2212 Caracara Drive
Northwest Creek [030410, 27-105, SB, SW, NSW]

REQUEST FOR MORE INFORMATION

Dear Mr. Chittick:

On October 10,2005, the Division of Water Quality (DWQ) received your application dated October 5,
2005, to impact 0.12 acres of wetlands to construct the proposed residence. The DWQ has determined
that your application was incomplete and/or provided inaccurate information as discussed below. The
DWQ will require additional information in order to process your application to impact protected
wetlands and/or streams on the subject property. Therefore, unless we receive the additional information
requested below, we will have to move toward denial of your application as required by 15A NCAC 2H
.0506 and will place this project on hold as incomplete until we receive this additional information.
Please provide the following information so that we may continue to review your project.

Additional Information Requested:

1. Please provide a location map for the project.

2, Please show all wetland impacts including fill slopes on the site plan.

3. Please specify the percent of project imperviousness area (including the building footprint,
sidewalk, driveway, decks, etc.) based on the estimated built-out conditions per item "XI.
Stormwater (required by DWQ)".

Please respond within three weeks of the date of this letter by sending this information to me in writing
and Kyle Barnes of the DWQ Washington Regional Office. Ifwe do not hear from you within three
weeks, we will assume that you no longer want to pursue this project and we will consider the project as
withdrawn.

This letter only addresses the application review and does not authorize any impacts to wetlands, waters
or protected buffers. Please be aware that any impacts requested within your application are not
authorized (at this time) by the DWQ, Please call Ms. Cyndi Karoly or Mr. Ian McMillan at 919-733-
1786 if you have any questions regarding or would like to set up a meeting to discuss this matter.

N~1ThCarolina
/Yfltllrnll!!

401 OversightlExpress Review Pennitting Unit
1650 Mail SelVice Center, Raleigh, North Carolina 27699-1650
2321 Cmbtree Boulevard, Suite 250, Raleigh, North Carolina 27604
Phone: [phone]/ FAX [phone] / Internet: htto:llh2o,enr,state,ne.uslncwetlands

An Equal Opportunity/Affinnative Action Employer- 50% RecycledllO% Post Consumer Paper

James Chittick Construction/UtGlo, Inc.
Page 2 of2
October 19, 2005

Sincerely,

~,<t~

401 Oversight/Express Review Permitting Unit

CBK/ijm

cc: Kyle Barnes, DWQ Washington Regional Office
USACE Washington Regulatory Field Office
File Copy
Central Files

Filename: 051879_ CaracaraDrlve(Craven)On_Hold

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DC T 1 (j /0(1')

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Office Use Only:

DENR....-,
WETLAiJnc;, . ,,_ {,qrb~ tiUAUtr
v, ,i~'VAlER SRAIICh Form Version March 05

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

I. Processing

1. Ch04 all of the approval(s) requested for this project:
[E(S;ction 404 Permit 0 Riparian or Watershed Buffer Ru1es
Dftection 10 Permit 0 Isolated Wetland Permit from DWQ
[0' 401 Water Quality Certification 0 Express 401 Water Quality Certification

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

J~

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

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 VIII,
and check here: 0

5. If your project is located in any of North Carolina's twenty coastal COWlties (ijfiisted on ge
4), and the project is within a North Carolina Division of Coastal Management a of
Environmental Concern (see the top of page 2 for further details), check here: ~

Applicant Infonnation

II.

1. O\\TIer/ API?licant Infonnath I.
Name: ..:h~~ C"" ~L ~
Mailing Address: 'po~ 5"7

(,H1~:~t:: J}jt~~.
d- 8S I ~

Telep?OneNumber:~c:a. ~~~-~7'~ ,FaxNumber:~~
E-maIl Address: J c.. \-\ 'L ~ I '(\.~ t?..:(1c- ,

2. Agent/Consu1tant Infonnation (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:

Page 5 of 12

III. Project Infonnation

Attach a vicinity map clearly showing the location of the property with respect to local
landmarks such as to\\TIS, rivers, and roads. Also provide a detailed site plan showing property
bOWldaries and development plans in relation to SurrOWlding 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
bOWldaries outlined. Plan drawings, or other maps may be included at the applicant's discretion,
so long as the property is clearly de[med. For administrative and distribution purposes, the
USACE requires information to be submitted on sheets no larger than 11 by I7-inch format;
however, DWQ may accept paperwork of any size. DWQ prefers fuJI-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 [mal version is illegible, the applicant wi]] be informed that
the project has been placed on hold until decipherable maps are provided.

1. Nameofproject: 2..212- Lo...VtA..CAllrtL

2. T.I.P. Project Number or State Project Number (NCDOT Only):
QeJ 'aook

3. Property Identification Number (fax PIN):

~3 JJ 00'27
'PG(,cc.l TD '2 - 0 lJq - 31 t.t
4. Location &d ~
CO\IDly: c.('/).j)~V\ NearC)!.lJQwn: ~ ""VI:
Subdivision name (include phasellot number): n I'" . ~
f? \ D'recti ns to site (include roa ~umberslnames, landmarks, tc.):
~I~~ . ~
,_,

d ~
roc-4
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): "N

6. Property size (acres): /62. n )(7 ~ =: / 2.. , 'iT 7. -;- ~A::.

7. Name of nearest receiving body of water: AJorfh W~S t Cree /(

8. River Basin:--,Lt!~4 <;e... 1?r ~
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http://112o,enr,statcllcusiadrnllllrnanc. .)

ow

. 27Acr(,

9.

Page 6 of 12

11. Explain the pUfP.os~ o{the proposed work: -1-0 bUJJA h f;(ML ~ t::lf'fl"O tJ<A
SlAb %J,S, un

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. Describe previously approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits i~s}l for prior segments of the same T.I.P, project, along with
construction schedules. /V,

V. Future Project Plans

Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for he exclusion o,fthisLwork r m the current application.
c::.- ,II:)'

VI. Proposed Impacts to 'Vaters of the United StatesIWaters 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 VIII below. If additional
space is needed for listing or description, please attach a separate sheet.

1. provideiwritten description of the proposed impacts: A!Jnf./l / -fi / / w ooJlAnls
lOOt) _ -t'1-. /
.

Page 7 of 12

Wetland Impact
Site Nwnbcr
(indicate on map)

2. Individually list wetland impacts. Types of impacts include, but are not
mechanized clearing, grading, fill, excavation, flooding, ditching/drainage, etc.
se uratel list im acts due to both structure and floodin .
Located within
IOO-ycar
Floodplain
( es/no)
~.s

limited to
For dams,

Area of
Impact
(acres)

Type ofImpact

Type ofWetIand
(e,g., forested, marsh.
herbaceous, bog, etc.)

(}2

Total Wetland Impact (acres)

3. List the total acreage (estimated) of all existing wetlands on the property: 0 ~ /2

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
#1 construction, flooding, relocation, stabilization activities (e.g., cement walls, rip-rap, crib
ill f L walls, gabions, etc.), excavation, ditching/straightening, etc. If stream relocation is proposed,
f 'f/ plans and profiles showing the linear footprint for both the original and relocated streams
b . I d d T caI ul uI ' I I th X 'd h, th d"d b 43560

must e mc u e . 0 c ate acreage, m tlPIY engl WI t en I VI e lY ,
Stream Impact Pcrcmllalor Average Impact Area of
Nwnbcr Stream Name Type of Impact Intcnnittcnt? Stream Width Length. Impact
(indicate on map) Before Impact (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 V.S,). Open water impacts include, but are not limited to
fill, excavation, dred in , floodin , draina e, bulkheads, etc.
Op Water Impact Name ofWatcrbody Type of Watcrbody
Site Nwnbcr (if applicable) Type ofImpact (lake, pond, estuary, sowxl, bay,
indicate on ma ocean, etc.)

Total Open Water Impact (acres)

Page 8 of 12

6. List th

ul'

all W

fth V S

ul' fr th

ecum ahve Impact to aters 0 e . . res hng om e Prol eet
Stream Impact (acres):
Wetland Impact (acres): O,Ov
Open Water Imoact (acres):
TotaIlmpact to Waters of the V.S. (acres)
Total Stream Impact Oinear feet):

7. Isolated Waters _/
Do any isolated waters exist on the property? 0 Yes lZl No
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 VSACE.

8. Pond Creation None,
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 ,,,ith 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 vaIve 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.

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
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
hllp:/ /1120. enr. slale. nC.lls/llC\\ellands/slnll!!i de. hI Illi.

1. Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreagelIinear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation casement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.

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://h2o.enr.slate.nclls!\\Tp/inde:\.l1tlll. lfuse 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

IX. Environmental Documentation (required by DWQ)

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

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 (NEPAlSEPA)?
Note: If you are not sure whether a NEPAlSEPA document is required, call the SEPA
coordinator at [phone] to review current thresholds for environmental documentation.
Yes 0 No 0

x.

3. If yes, has the document review been finalized by the State Clearinghouse? If so, please
attach a copy of the NEPA or SEPA final approval letter. Yes 0 No D

Proposed Impacts on Riparian and Watershed BulTers (required hy DWQ) j1J 1ft

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 \\ithin 15A NCAC 2B .0233
(Neuse), 15A NCAC 2B .0259 (Tar-PamIico), 15A NCAC 02B .0243 (Catawba) 15A NCAC
2B .0250 (Randleman Rules and Water Supply Buffer Requirements), or other (please
identify )? Yes 0 No 0

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
bufIi ul . r

erm tlpl1ers.
Zone- Impact Multiplier Required
(square fcct) Mitigation
I 3 (2 for Catawba)
2 1.5
Total

· Zonc 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 I Enhancement, or Payment into the
Riparian Buffer Restoration Fund). Please attach all appropriate information as identified
\vithin 15A NCAC 2B .0242 or .0244, or .0260.

Page 11 of 12

, .,

.

XI. Stonnwater (required by DWQ)

{11~

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 20010, please provide calculations
demonstrating total proposed impervious level.

XII. Sewage Disposal (required by DWQ)

Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from/~e proposed project, or availa~le capacity of the subject facility.
n\ ~'r .dJ H(A(bor tYL~~~+' PO \
Luo.i5~_jJrA+(..\ -tr(r::....-tt'c.l -f21--- I \

XIII. Violations (required by DWQ)

Is this site in violation of ~ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes 0 No~

Is this an after-the-fact permit application? Yes 0 No ~

XIV. Cumulative Impacts (required by DWQ)

Will this project (based on past and reasonably anticipated future impacts) result in~dditi nal
development, which could impact nearby dO\'ffistream water quality? Yes 0 No
If yes, please submit a qualitative or quantitative cumulative impact analysis in accor with
the most recent North Carolina Division of Water Quality policy posted on our website at
hltp:l/h2o.enrslale.nc.lls/nC\\etlallds. Ifno, please provide a short narrative description:

XV. 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).

Appl cant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)

Page 12 of 12

I- +
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J
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I
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+ -, k 'J,

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-

-

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~

I. iJ'
I.~ -J'/1
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1-
l.U ~~ _[ St. II.
-.J 7- 59,860 SF I

pf ~ ~l: ': ~'f','t:

:{J ,..
V/ 'xddV'> (jJ 1- J' I I
v b~ 1/ 'I-
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L f- ! 1,,! 01 Iv: J"I?

z~~/
~ ! f- ______

II

'I.

----

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----

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o

, ....

Office Use Only:

Fonn Version March 05

USACE Action ID No. DWQ No.
(If any particular item is not applicable to this project, plcasc cntcr "Not Applicable" or "NIA".)

I. Processing

1. ch04 all of the approval(s) requested for this project:
I!JS;ction 404 Permit 0 Riparian or Watershed Buffer Rules
Dftection 10 Permit 0 Isolated Wetland Permit from DWQ
uzr 401 Water Quality Certification 0 Express 401 Water Quality Certification

2. Natiomvide, Regional or General Permit Number(s) Requested:

J'X

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

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 VIII,
and check here: 0

5. If your project is located in any of North Carolina's twenty coastal counties (ijjisted on ge
4), and the project is within a North Carolina Division of Coastal Management a of
Environmental Concern (see the top of page 2 for further details), check here: r.A-

Applicant Information

II.

I. O\\nerl Applicant InfOnn~~ I.
Name: -1:..~~ ~L, d~
Mailing Address: . 0; 5"7

(nY1~t..~l~ /1ttG-IyJl7;;-'
,:l8 ~ \ q

Telep~oneNumber:?v:...~ '~~-~ifi? ,Fax Number:~~
E-maIl Address: J c-\-\ 'L ~ I '{\.fuo..Vt=-.

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:

Page 5 of 12

III. Project Infonnation

Attach a vicinity map clearly showing the location of the property with respect to local
landmarks such as to\'ms, rivers, and roads. Also provide a detailed site plan showing property
boundaries and development plans in relation to surrOlmding 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 defmed. For administrative and distribution purposes, the
USACE requires information to be submitted on sheets no larger than 11 by l7-inch format;
however, DWQ may accept papenvork of any size. DWQ prefers full-size construction
drawings rather than a sequential sheet version of the fuIl-sizc 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 project has been placed on hold until decipherable maps are provided.

1. Nameofproject: 2..21 2- {fiVACAvr~

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

3. Property Identification Number (Tax PIN):

23 JJ 0(:)27
'PC.l{'cc.l TD '2 - 0 Y q _ '3 I 't
4, Location &d ~
COIIDty: C"ewe", N~9W11: ~ V'V!:
Subdivision name (include phaseIJot number): n I , .
Q. \ D'rec i ns to site (include ro ~umbers/names, landmarks, tc.):
~I~n . ~
I _,

tJ "k

o rot-t;f
5. Site coordinaies (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): "N

6. Property size (acres): /62. s-t )(7 ~ = I 2... , 'If 7. ~ srA-

7. Name of nearest receiving body of water: AJorfh W~$ 1- C t"ee /(

8. River Basin:--tL!e.q <;e.. r:;?{ ~
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at httJ)://h20enr.statencus/aol11Jnlf1WJL .)

ow

. 27 ;} ifc:..5
9.

Page 6 of 12

11. Explain the PUfP.os: o{the proposed work: -I-D bf,{_i.lA h ~ {h c:tppt"O U<d
SlA..b (!/JjJ,S I LIYl

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. Describe previously approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits i~sF for prior segments of the same T.I.P. project, along with
construction schedules. /V,

V. Future Project Plans

Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for he exclusion o,fthisLwork r m the current application.
c::..- ,I O'

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

It is the applicant's (or agent's) rcsponsibility 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 sho\'m 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 i written description of the proposed impacts: A4.nt ~ / Ii 1/ It.J oodlAlIls
IOOe) !f!- +" f. /

Page 7 of 12

Wetbnd Impact
Site Nwnbcr
(indicate on map)

2. Individually list wetland impacts. Types of impacts include, but are not
mechanized clearing, grading, fill, excavation, flooding, ditching/drainage, etc.
se aratel list im acts due to both structure and floodin .
Located within
lOO-year
Floodplain
( eslno
<:S

limited to
For darns,

Area of
Impact
(acres)

Type ofImpact

Type of Wctland
(e.g., forested, marsh.
herbaceous, bog, cte.)

02.

Total WctIand Impact (acres)

3. List the total acreage (estimated) of all existing wetlands on the property: 0 () /2

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
~I construction, flooding, relocation, stabilization activities (e.g., cement walls, rip-rap, crib
1fI. t r i walls, gabions, etc.), excavation, ditching/straightening, etc. If stream relocation is proposed,
f Vf/ plans and profiles shO\ving the linear footprint for both the original and relocated streams

must be included. To calculate acreage, multiply length X width, then divide by 43,560.
Stream Impact Pcrcnn.iaI or Average Impact Area of
Nwnbcr Stream Name Type ofImpact Intermittent? Stream Width Length Impact
(indicate on map) Before Impact (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 in , floodin , draina e, bulkheads, etc.
Op Water Impact Name of Water body Type of Water body
Site Nwnbcr (if applicable) Type ofImpact (lake, pond, estuary, sotmd, bay,
indieate on ma ) ocean, ctc.

Total Open Water Impact (acres)

Page 8 ofl2

6. List th

ul'

all W

fth US

uI' fr th

ecum atIvc Impact to aters 0 c . . res tmg om e pro] ect:
Stream Impact (acres):
Wetland Impact (acres): O.Ov
Open Water Impact (acres):
Total Impact to Waters of the U.S. (acrcs)
Total Stream Impact Oinear fcct):

7. Isolated Waters /
Do any isolated waters exist on the property? 0 Y cs IZJ No
Describe all impacts to isolated waters, and include the type ofwatcr (wetland or stream) and
the size of the proposed impact (acres or linear feet). Please note that this section only
applies to waters that havc specifically been detennined to be isolated by the USACE.

8. Pond Creation {I/o nt,
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 \vith this application.
Pond to be created in (check all that apply): 0 uplands 0 stream D wetlands
Describe the method of construction (c.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 ofthc pond:
Size of watershed draining to pond: Expected pond surface area:

VII. Impact Justification (Avoidance and Minimization)

Specifically describe measures taken to avoid thc proposed impacts. 11 may bc useful to provide
information related to site constraints such as topography, building ordinanccs, accessibility, and
financial viability of the project. The applicant may attach drawings of altemative, lower-impact
site layouts, and explain why these design options were not fcasible. 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.

VIII. Mitigation

DWQ - In accordance \vith 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 \vith the Final Notice of Issuance and Modification of Natiomvide
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 wi)] 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
Draf1 Technical Guide for Stream Work in North Carolina, available at
http://1120em.state.llc.us/nc\\ellands/stml!!idehtmJ .

I. 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 (acreagelIinear 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.

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 \vill 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.enrstate.llc.lls/\\Tp/inde:\.htlll. 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

',' ,

IX. Environmental Documentation (required by DWQ)

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

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 AlSEP A)?
Note: If you are not sure whether a NEP AlSEP A document is required, call the SEP A
coordinator at [phone] to review current thresholds for environmental documentation.
Yes 0 No 0

x.

3. If yes, has the document review been finalized by the State Clearinghouse? If so, please
attach a copy of the NEPA or SEPA final approval letter. Yes 0 No D

Proposed Impacts on Riparian and Watershed BolTers (reqnired hy DWQ) j1J 1ft

It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
required state and local buffers associated \vith 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), 15A NCAC 2B .0259 (Tar-PamIico), 15A NCAC 02B .0243 (Catawba) 15A NCAC
2B .0250 (Randleman Rules and Water Supply Buffer Requirements), or other (please
identify )? Yes 0 No 0

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
bufIi .

er multIpliers.
Zone- Impact Multiplier Required
(square feet) Mitigation
1 3 (2 for Catawba)
2 1.5
Total

- Zone 1 ell.1ends out 30 feet perpendicular from the top of the near bank of channel; Zone 2 extends an
lIdditional 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 attach all appropriate information as identified
within 15A NCAC 2B .0242 or .0244, or .0260.

Page 11 of 12

. .

XI. Stonnwater (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 20010, please provide calculations
demonstrating total proposed impervious level.

XII. Sewage Disposal (required by DWQ)

Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from/~e proposed project, or availa~le capacity of the subject facility.
~.r .dJ HMbo~ ~";:~' pc, I
(VI), I s~ ;vi fl + ~ >. -r r 0, of t' l.l IA I '

XIII. Violations (required by DWQ)

Is this site in violation of ~ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes 0 NO?,\

Is this an after-the-fact permit application? Yes 0 No ~

XIV. Cumulative Impacts (required by DWQ)

Will this project (based on past and reasonably anticipated future impacts) result in~dditi nal
development, which could impact nearby downstream water quality? Yes 0 No
If yes, please submit a qualitative or quantitative cumulative impact analysis in accor; c with
the most recent North Carolina Division of Water Quality policy posted on our website at
htlP:l/h2o. enr.statc. nc lIs/nc\\ellallds. If no, please provide a short narrative description:

XV. 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).

Appl cant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)

Page 12 of 12

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Date

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Plan Detail Incomplete
...uY 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 indicate all buffer impacts on the site plan.

Please indicate proposed lot layout as overlays on the site plan.

Please indicate the Ibcation of the protected buffers as overlays on the site plan.

Please locate all isolated or non-isolated wetlands, streams and other waters of the State as overla~s on the site plan.

Please provide cross section details showing the provisions for aquatic life passage.

Please locate any planned sewer lines on the site plan.

~e,( ~\'XT-/
;\ ~cN

Please indicate all stormwater outfalls on the site plan.

o
o
o

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

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

Avoidance and/or MinimIzation Not Pr~vided

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 minimi7.e the impacts.

can be moved or reconfigured to minimize the impacts to the

D. 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. Ifit
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 andlor 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 info~on.

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. .