20052030 Ver 1_Complete File_20050118

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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
December 14, 2005
DWQ# 05-2030
Forsyth County
Mr. Larry Callahan
CALMIT Properties
110-B Shields Park Drive
Kemersville, NC 27284
APPROVAL of 401 Water Quality Certification with Additional Conditions
Dear Mr. Callahan:
CALMIT Properties has our approval, in accordance with the attached conditions, to place permanent fill in
149 linear feet of perennial stream and in 115 linear feet of intermittent stream in order to construct three road
crossings and to provide roadbed fill for the Summerlyn Park Subdivision located on Kerner Road near
Kernersville, Forsyth County, as described in your application received by the Division of Water Quality
(DWQ) on November 8, 2005 and in additional correspondence received on December 6, 2005. After
reviewing your application, we have determined that this fill is covered by General Water Quality
Certification Number 3402, which can be viewed on our web site at http://h2o.enr.state.nc.us/ncwetlands.
This Certification allows you to use Nationwide Permit Number 39 when it is issued by the U.S. Army Corps
of Engineers. In addition, you should secure any other applicable federal, state or local permits before you
proceed with your project, including (but not limited to) those required by Sediment and Erosion Control,
Non-Discharge, and Water Supply Watershed regulations. Also, this approval will expire when the
accompanying 404 permit expires unless otherwise specified in the General Certification.
This approval is valid only for the purpose and design that you have described in your application. If you
change your project, you must notify us in writing, and you may be required to send us a new application for a
new certification. If the property is sold, the new owner must be given a copy of the Certification and
approval letter and is thereby responsible for complying with all conditions. If total wetland fill for this
project (now or in the future) exceeds one acre, or total fill to perennial streams equals or exceeds 150 linear
feet, compensatory mitigation may be required as described in 15A NCAC 2H .0506 (h). For this approval
to be valid, you must follow the conditions listed in the attached certification, as well as the additional
conditions listed below:
1. The following impacts are hereby approved as long as all other specific and general conditions of this
Certification are met. No other impacts, including incidental impacts, are approved:
Amount Approved Plan Location or Reference
Streams 264 linear feet Two unnamed tributaries to Belews Creek, located off of Kerner Road
near Kernersville, Forsyth County as depicted on the Overall Site Plan

N?o'?`hCarolina
Naturally
North Carolina Division of Water Quality
Wetlands Certification Unit 1650 Mail Service Center Raleigh, NC 27699-1650 Phone [phone] FAX [phone]
2321 Crabtree Blvd. Raleigh, NC 27604-2260 Internet http//:h2o.enr.state.nc.us/ncwetlands
Customer Service Number: 1-877-623-6748
An Equal Opportunity/Affirmative Action Employer- 50% Recycledl10% Post Consumer Paper
Mr. Larry Callahan
Page 2, DWQ# 05-2030
December 14, 2005
2. Appropriate sediment and erosion control measures which equal or exceed those outlined in the most
recent version of the North Carolina Sediment and Erosion Control Planning and Design Manual or the
North Carolina Surface Mining Manual (available from the Division of Land Resources at NCDENR
regional offices or the central office), whichever is more appropriate, shall be designed, installed and
maintained properly to assure compliance at all times with the North Carolina water quality standards
that are applicable to Class C waters as described in 15A NCAC 02B.0211 Fresh Surface Water Quality
Standards For Class C Waters. Such measures must equal or exceed the requirements specified in the
most recent version of the North Carolina Sediment and Erosion Control Manual. These measures must
be maintained on all construction sites, borrow sites, and waste pile (spoil) sites, including contractor
owned and leased borrow pits, which are associated with this project.
3. 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 measures in wetlands or waters is
unavoidable, they shall be removed and the natural grade restored within six months of the date that the
project is completed or, if applicable, within six months of the date that the project is released by the
North Carolina Division of Land Resources..
4. No waste, spoils, 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.
5. The culverts required for this project shall be installed in such a manner that the original stream profile
is not altered (i.e. the depth of the channel must not be reduced by a widening of the streambed).
Existing stream dimensions (including the pattern and profile) are to be maintained above and below the
location of the culvert. The culverts shall be designed and installed to prevent head cutting of the
stream. If a culvert becomes perched, the appropriate stream grade shall be re-established or, if a culvert
is installed in a perched manner, the culvert shall be removed and re-installed correctly. The Applicant
must submit a plan and receive written approval from this Office to address any head cutting that will
occur as a result of this project (e.g., use of cross vanes downstream of the culvert).
6. Where riprap is required for energy dissipation and scour protection, it shall be limited to the minimum
dimensions specified by appropriate engineering calculations. Riprap may only be used below the
normal high water level. The original grade and elevation of the stream's cross-section must be
maintained. Riprap placed in the stream bottom must be inserted into the bottom matrix to a depth
sufficient to provide the thickness of riprap required for scour protection. The elevation of the stream
bottom must not be increased by the placement of riprap. Placement of riprap must not result in
destabilization of the streambed or banks upstream or downstream of any crossing.
7. All construction activities associated with this project shall minimize built-upon surface area, direct
stormwater runoff away from surface waters, and incorporate best management practices to minimize
water quality impacts. If concrete is used with any fill material, it shall not be allowed to come in
contact with surface waters until it has cured. If any stormwater must be collected for discharge into a
stream channel, it shall not enter the stream as a point source, but shall be slowed and discharged as
sheet flow prior to entering the riparian buffer on either side of the stream.
Mr. Larry Callahan
Page 3, DWQ# 05-2030
December 14, 2005
8. Upon finishing the project, the Applicant shall fill out and return the enclosed "Certificate of
Completion" to notify NCDWQ when all work included in the §401 Certification has been completed.
This certificate should be returned to the Wetlands/401 Certification Unit of the NC Division of Water
Quality at the address listed on the form. Along with the Certificate of Completion, please send
photographs upstream and downstreanz of each culvert site to document correct installation.
If you do not accept any of the conditions of this certification, 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 Daryl Lamb in the DWQ Winston-Salem Regional Office at 336-
771-4600 or Ian McMillan in the Wetlands/401 Central Office in Raleigh at 919-715-4631.
Sincerely,
7 Alan W. Klimek, P.E.
AWK/cdl
Attachments
cc: Mr. John Thomas, U. S. Army Corps of Engineers, Raleigh Regulatory Field Office
Winston-Salem DWQ Regional Office
Central Files
Wetlands/401 File Copy
Mr. Jonathon R. Townsley, Soil & Environmental Consultants, 3817-E Lawndale Drive, Greensboro,
NC 27455
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O?O? W A T ?q?G
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
December 14, 2005
DWQ## 05-2030
Forsyth County
Mr. Larry Callahan
CALMIT Properties
110-B Shields Park Drive
Kemersville, NC 27284
APPROVAL of 401 Water Quality Certification with Additional Conditions
Dear Mr. Callahan:
CALMIT Properties has our approval, in accordance with the attached conditions, to place permanent fill in
149 linear feet of perennial stream and in 115 linear feet of intermittent stream in order to construct three road
crossings and to provide roadbed fill for the Summerlyn Park Subdivision located on Kerner Road near
Kemersville, Forsyth County, as described in your application received by the Division of Water Quality
(DWQ) on November 8, 2005 and in additional correspondence received on December 6, 2005. After
reviewing your application, we have determined that this fill is covered by General Water Quality
Certification Number 3402, which can be viewed on our web site at http://h2o.enr.state.nc.us/ncwetlands.
This Certification allows you to use Nationwide Permit Number 39 when it is issued by the U.S. Army Corps
of Engineers. In addition, you should secure any other applicable federal, state or local permits before you
proceed with your project, including (but not limited to) those required by Sediment and Erosion Control,
Non-Discharge, and Water Supply Watershed regulations. Also, this approval will expire when the
accompanying 404 permit expires unless otherwise specified in the General Certification.
This approval is valid only for the purpose and design that you have described in your application. If you
change your project, you must notify us in writing, and you may be required to send us a new application for a
new certification. If the property is sold, the new owner must be given a copy of the Certification and
approval letter and is thereby responsible for complying with all conditions. If total wetland fill for this
project (now or in the future) exceeds one acre, or total fill to perennial streams equals or exceeds 150 linear
feet, compensatory mitigation may be required as described in 15A NCAC 2H .0506 (h). For this approval
to be valid, you must follow the conditions listed in the attached certification, as well as the additional
conditions listed below:
1. The following impacts are hereby approved as long as all other specific and general conditions of this
Certification are met. No other impacts, including incidental impacts, are approved:
Amount Approved Plan Location or Reference
Streams 264 linear feet Two unnamed tributaries to Belews Creek, located off of Kerner Road
near Kernersville, Forsyth County as depicted on the Overall Site Plan

N rt arolma
,11atura!!y
North Carolina Division of Water Quality
Wetlands Certification Unit 1650 Mail Service Center Raleigh, NC 27699-1650 Phone [phone] FAX [phone]
2321 Crabtree Blvd. Raleigh, NC 27604-2260 Internet http//:h2o.enr.state.nc.gs/ncwetiands
Customer Service Number: 1-877-623-6748
An Equal Opportunity/Affirmative Action Employer-500"o Recycled/100"o Post Consumer Paper
Mr. Larry Callahan
Page 2, DWQ# 05-2030
December 14, 2005
2. Appropriate sediment and erosion control measures which equal or exceed those outlined in the most
recent version of the North Carolina Sediment and Erosion Control Planning and Design Manual or the
North Carolina Surface Mining Manual (available from the Division of Land Resources at NCDENR
regional offices or the central office), whichever is more appropriate, shall be designed, installed and
maintained properly to assure compliance at all times with the North Carolina water quality standards
that are applicable to Class C waters as described in 15A NCAC 02B.0211 Fresh Surface Water Quality
Standards For Class C Waters. Such measures must equal or exceed the requirements specified in the
most recent version of the North Carolina Sediment and Erosion Control Manual. These measures must
be maintained on all construction sites, borrow sites, and waste pile (spoil) sites, including contractor
owned and leased borrow pits, which are associated with this project.
3. 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 measures in wetlands or waters is
unavoidable, they shall be removed and the natural grade restored within six months of the date that the
project is completed or, if applicable, within six months of the date that the project is released by the
North Carolina Division of Land Resources.
4. No waste, spoils, 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.
5. The culverts required for this project shall be installed in such a manner that the original stream profile
is not altered (i.e. the depth of the channel must not be reduced by a widening of the streambed).
Existing stream dimensions (including the pattern and profile) are to be maintained above and below the
location of the culvert. The culverts shall be designed and installed to prevent head cutting of the
stream. If a culvert becomes perched, the appropriate stream grade shall be re-established or, if a culvert
is installed in a perched manner, the culvert shall be removed and re-installed correctly. The Applicant
must submit a plan and receive written approval from this Office to address any head cutting that will
occur as a result of this project (e.g., use of cross vanes downstream of the culvert).
6. Where riprap is required for energy dissipation and scour protection, it shall be limited to the minimum
dimensions specified by appropriate engineering calculations. Riprap may only be used below the
normal high water level. The original grade and elevation of the stream's cross-section must be
maintained. Riprap placed in the stream bottom must be inserted into the bottom matrix to a depth
sufficient to provide the thickness of riprap required for scour protection. The elevation of the stream
bottom must not be increased by the placement of riprap. Placement of riprap must not result in
destabilization of the streambed or banks upstream or downstream of any crossing.
7. All construction activities associated with this project shall minimize built-upon surface area, direct
stormwater runoff away from surface waters, and incorporate best management practices to minimize
water quality impacts. If concrete is used with any fill material, it shall not be allowed to come in
contact with surface waters until it has cured. If any stormwater must be collected for discharge into a
stream channel, it shall not enter the stream as a point source, but shall be slowed and discharged as
sheet flow prior to entering the riparian buffer on either side of the stream.
Mr. Larry Callahan
Page 3, DWQ# 05-2030
December 14, 2005
8. Upon finishing the project, the Applicant shall fill out and return the enclosed "Certificate of
Completion" to notify NCDWQ when all work included in the §401 Certification has been completed.
This certificate should be returned to the Wetlands/401 Certification Unit of the NC Division of Water
Quality at the address listed on the form. Along with the Certificate of Completion, please send
photographs upstream and downstream of each culvert site to document correct installation.
If you do not accept any of the conditions of this certification, 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 Daryl Lamb in the DWQ Winston-Salem Regional Office at 336-
771-4600 or Ian McMillan in the Wetlands/401 Central Office in Raleigh at 919-715-4631.
Sincerely,
Alan W. Klimek, P.E.
AW K/cdl
Attachments
cc: Mr. John Thomas, U. S. Army Corps of Engineers, Raleigh Regulatory Field Office
Winston-Salem DWQ Regional Office
Central Files
Wetlands/401 File Copy
Mr. Jonathon R. Townsley, Soil & Environmental Consultants, 3817-E Lawndale Drive, Greensboro,
NC 27455
Triage Check List
Date: 12/08/05 Project Name: Summerlyn Park SD
DWQ#: 05-2040
County: Forsyth
Daryl Lamb, Winston-Salem Regional Office
To:
60-day processing time: 12/06/05 - 2/03/06
From: Cyndi Karoly Telephone: [phone]
The file attached is being forwarded to you for your evaluation.
Please call if you need assistance.
? Stream length impacted
? Stream determination
Wetland determination and distance to blue-line surface waters on USFW topo maps
? Minimization/avoidance issues
? Buffer Rules (Neuse, Tar-Pamlico, Catawba, Randleman)
? Pond fill
Mitigation Ratios
? Ditching
? Are the stream and or wetland mitigation sites available and viable?
? Check drawings for accuracy
? Is the application consistent with pre-application meetings?
? Cumulative impact concern
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!
I J?L_
Soil & Environmental Consultants, PA
3817-E Lawndale Drive • Greensboro, North Carolina 27455 • Phone: (336).-5.10-8234 • Fax: [phone]
www.SandEC.com December 5, 2005
S&EC Project # 4-1461.W1
To: Mr. Ian McMillan
N.C. Division of Water Quality
Wetlands & Stormwater 401 Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
From: Jonathon Townsley
Soil & Environmental Consultants, P.A.
3817-E Lawndale Drive
Greensboro, NC 27455
Re: Kerner Road / Summerlyn Park Amended PCN
Kernersville, Forsyth County, NC
OWE
DEC 6 2005
DENR - WATER QUALITY
t'JETLANDS AND STORPMATER BRANCH
On behalf of the owner, CALMIT Properties, please find attached an amended application and
amended impact maps requesting written concurrence from the N.C. Division of Water Quality
(DWQ) that the activities proposed below may precede under General Water Quality Certification
3402. Additional information such as Agent Authorization, USGS and NRCS Maps, Vicinity Map,
etc has already been provided in the original application. Please contact me at [phone] if
you have any questions or require additional information.
PROJECT SUMMARY
Project Name Kerner Road / Summerl n Park
Project Type Residential Subdivision
Owner / Applicant CALMIT Properties
Count Forsyth
Nearest Town Kernersville
Waterbod Name Belews Creek
Basin / Sub-basin Roanoke / 03-02-01
Index Number 22-27-8-(l)
Class C
IMPACT SUMMARY
Stream Impact (acres): .0121
Wetland Impact (acres): 0
Open Water Impact (acres): 0
Total Impact to Waters of the U.S. (acres) .0121
Total Stream Impact (linear feet): 264.8
Attachments:
Pre-construction Notification (PCN) Application Form
Impact Maps
Charlotte Office: Raleieh Office:
236 LePhillip Court, Suite C 11010 Raven Rid- e Road
Charlotte, NC 28025 Raleich, INC 27614
Phone: [phone] Phone [phone]
Fax: [phone] Fax: (919) 836-')467
Office Use Only: Form Version March 05
USACE Action ID No. 200620095 DWQ No. 05-2030
kit any particular item is not applicable to tnis project, please enter "Not Applicable" or "N/A".)
I. Processing
Check all of the approval(s) requested for this project:
® Section 404 Permit ? Riparian or Watershed Buffer Rules
? Section 10 Permit ? Isolated Wetland Permit from DWQ
® 401 Water Quality Certification ? Express 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested:NWP39, WQC3402
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: ?
4. If payment into the North Carolina Ecosystem Enhancement Program (NCEEP) is proposed
for mitigation of impacts, attach the acceptance letter from NCEEP, complete section VIII,
and check here: ?
5. If your project is located in any of North Carolina's twenty coastal counties (listed on page
4), and the project is within a North Carolina Division of Coas tal ar! cit
Environmental Concern (see the top of page 2 for further details), the ?017
D
II. Applicant Information DEC 6 2005
DENR • WATER QUALITY
1. Owner/Applicant Information V.-E A MAtiD 5Tcn?,,AyATER EUjCH
Name: Larry Callahan / Leslie Mitchell CALMIT Properties
Mailing Address: 110-B Shields Park Drive, Kernersville, NC 27284
Telephone Number:336-345-1296
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: Jonathon R. Townsley
Company Affiliation: Soil & Environmental Consultants, PA
Mailing Address: 3817-E Lawndale Drive, Greensboro, NC 27455
Telephone Number: 336-540-8234, 336-669-0648 Fax Number: 336-540-8235
E-mail Address: itownsleynsandec.com
Page 5 of 12
III. Project Information
Attach a vicinity map clearly showing the location of the property with respect to local
landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property
boundaries and development plans in relation to surrounding properties. Both the vicinity map
and site plan must include a scale and north arrow. The specific footprints of all buildings,
impervious surfaces, or other facilities must be included. If possible, the maps and plans should
include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property
boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion,
so long as the property is clearly defined. - For administrative and distribution purposes, the
USACE requires information to be submitted on sheets no larger than 11 by 17-inch format;
however, DWQ may accept paperwork of any size. DWQ prefers full-size construction
drawings rather than a sequential sheet version of the full-size plans. If full-size plans are
reduced to a small scale such that the final version is illegible, the applicant will be informed that
the project has been placed on hold until decipherable maps are provided. -
1. Name of project: Kerner Road / Summerlyn Park
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN): 6887-07-7904 Forsyth County GIS
4. Location
County: Forsyth County Nearest Town:Kernersville, NC
Subdivision name (include phase/lot number):Summerl n Park
Directions to site (include road numbers/names, landmarks, etc.): From Kemersville, north
on Piney Grove Road, left on Linville Springs Road, right on Kerner Road, pass Dean Road
property +/- Imile on the right. See attached maps.
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.)
Coordinates: 36 09 20 -W, 80 04 58 o N
6. Property size (acres): 30.4 acres
7. Name of nearest receiving body of water: Belews Creek, Belews Lake
8. River Basin: Roanoke
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http://h2o.enr.state.nc.us/admin/maps/.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: The existing land use is forested, mostly loblolly and shortleaf
pines. Surrounding land use is mostly residential.
Pa-e 6 of 12
10. Describe the overall project in detail, including the type of equipment to be used: This
30.4acre project will involve construction of a subdivision road to access 18 sin le family
residential building lots.
11. Explain the purpose of the proposed work: The project purpose is to create residential
building lots. Stream impacts are necessary to access buildable uplands.
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 issued for prior segments of the same T.I.P. project, along with
construction schedules. NA
Agent met with John Thomas of USACE on site to confirm delineation and stream calls. Agent
also met with Daryl Lamb on November 30, 2005 on site.
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application.
Construction of road and driveways to access 18 houses is the extent of planned development on this
property.
Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. Each impact must be
listed separately in the tables below (e.g., culvert installation should be listed separately from
riprap dissipater pads). Be sure to indicate if an impact is temporary. All proposed impacts,
permanent and temporary, must be listed, and must be labeled and clearly identifiable on an
accompanying site plan. All wetlands and waters, and all streams (intermittent and perennial)
should be shown on a delineation map, whether or not impacts are proposed to these systems.
Wetland and stream evaluation and delineation forms should be included as appropriate.
Photographs may be included at the applicant's discretion. If this proposed impact is strictly for
wetland or stream mitigation, list and describe the impact in Section VIII below. If additional
space is needed for listing or description, please attach a separate sheet.
1. Provide a written description of the proposed impacts: Proposed impacts include one road
crossing over a perennial/important stream (Location 1)necessary to access buildable land.
Also impacts to an intermittent/unimportant stream (Location 2, 3, 4).
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,
se aratel list impacts due to both structure and flooding.

Wetland Impact

Site Number
(indicate on map)

ype of Impact
Type of Wetland

(e.g., forested, marsh,
herbaceous, bog, etc.)
Located ed within hin

Floodplain
(yes/no)
Distance Nearest to

Stream
(linear feet) Area of

Impact
(acres)

Total Wetland Impact (acres) 0
3. List the total acreage (estimated) of all existing wetlands on the property: 0.174 acres
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 acreage, multiply length X width, then divide by 43.560.
Stream Impact
Number
indicate on ma
Stream Name
Type of Impact
Perennial or Intermittent? Average
Stream Width
Before Impact Impact
Length
linear feet Area of
Impact
acres
1 Important Permanent Perennial 2' 149.8 .0068
2 Unimportant Permanent Intermittent 2' 55 .0025
3 Unimportant Permanent Intermittent 2' 30 .0014
4 Unimportant Permanent Intermittent 2' 30 .0014

Total Stream Impact (by length and acreage) 264.8 .0121
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, dredging, flooding, drainage, bulkheads, etc.
Open Water Impact
Site Number
(indicate on ma) Name of Waterbody
Type of Impact Type of Waterbody
estuary, (lake, pond, sound, bay,
ocean, etc.) Area of
Impact
(acres)

Total Open Water Impact (acres)
Page 8 of 12
6. List the cumulative impact to all Waters of the U.S. resulting from the project:
Stream Impact (acres): .0121
Wetland Impact (acres): 0
Open Water Impact (acres): 0
Total Impact to Waters of the U.S. (acres) .0121
Total Stream Impact (linear feet): 264.8
7. Isolated Waters
Do any isolated waters exist on the property? ? Yes ® 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 USACE.
8. Pond Creation
If construction of a pond is proposed, associated wetland and stream impacts should be
included above in the wetland and stream impact sections. Also, the proposed pond should
be described here and illustrated on any maps included with this application.
Pond to be created in (check all that apply): ? uplands ? stream ? 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:
VI. 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. Road construction to
access buildable uplands on this Project is a challence_ due to steep slopes leadinu down to the
perennial stream. Several site plans were considered. The site plan was revised several times to
avoid impacting upstream riparian wetlands, and is placed in a location that minimizes
fill/culvert length. Impacts to the intermittent stream at Location s 3 & 4 are necessary to access
lot #'s 13 & 14. The driveway for lot 13 will impact a segment of the intermittent stream at a
location where an old farm road alreadv exists.
VII. 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
Page 9 of 12
freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial
streams.
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://l12o.enr.state.nc.us/ncwetiands/stnngide.html.
1. Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
The site plan for this proiect has been revised to reduce perennial stream impacts below 150
linear feet. This was difficult due to steep slopes. The site plan was also revised to avoid
any wetland impact on the project. We believe that mitigation should not be required for this
proiect as planned. Should you require mitigation, we propose payment to the NCEEP
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.en r. state.nc.us/wrp/index.htm. If use of the NCEEP is proposed, please
check the appropriate box on page five and provide the following information:
Amount of stream mitigation requested (linear feet):
Amount of buffer mitigation requested (square feet):
Page 10 of 12
Amount of Riparian wetland mitigation requested (acres):
Amount of Non-riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres):
VIII. 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 ? 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 (NEPA/SEPA)?
Note: If you are not sure whether a NEPA/SEPA document is required, call the SEPA
coordinator at [phone] to review current thresholds for environmental documentation.
Yes ? No ?
3. If yes, has the document review been finalized by the State Clearinghouse? If so, please
attach a copy of the NEPA or SEPA final approval letter. Yes ? No ?
IX. 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), 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 V Yes ? No
2. If "yes", identify the square feet and acreage of impact to each zone of the riparian buffers.
If buffer mitigation is required calculate the required amount of mitigation by applying the
buffer multipliers.
I I Zone* Impact Multiplier Required
(square feet) Mitigation
I 3 (2 for Catawba)
2 1.5
Total
* "Lone I extends out 30 feet perpendicular from the top of the near bank of channel; "Lone 2 extends an
additional 20 feet from the edge of Zone 1.
3. If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e.,
Donation of Property, Riparian Buffer Restoration / Enhancement, or Payment into the
I'abe 1 1 of 12
Riparian Buffer Restoration Fund). Please attach all appropriate information as identified
within 15A NCAC 2B .0242 or.0244, or.0260.
X. 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. Road construction will be ribbon pavement with
vegetated ditches. The size of the ditches will be reviewed by NCDOT. The Erosion Control
plan will be reviewed by the Winston-Salem Inspections Department. Total acreage = 30 4acres
Roadway impervious surface = .834acres. Impervious surface from 18 homes n 3000sf per lot
= 1.239acres. Total impervious surface on the project is 6.8%.
XI. Sewage Disposal (required by DWQ)
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from the proposed project, or available capacity of the subject facility.
Method of wastewater disposal is individual septic systems.
XII. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H.0500) or any Buffer Rules?
Yes ? No
Is this an after-the-fact permit application? Yes ? No
XIII. Cumulative Impacts (required by DWQ)
Will this project (based on past and reasonably anticipated future impacts) result in additional
development, which could impact nearby downstream water quality? Yes ? No
If yes, please submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent North Carolina Division of Water Quality policy posted on our website at
http://h2o.enr.state.nc.us/ncwetIands. If no, please provide a short narrative description: All anticipated
impacts are accounted for in this application.
Kplicant/Agent's Sigi
(A is signature is valid only
12 s of
Date
authorization letter from the applicant is provided.)
Page 12 of 12
PER 0S. 7Qi, CC. A ?y
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3?Q' IL
SURVEYORS/LAND PLANNERS v
935 E. MOUNTAIN ST., SUITE H
KERNERSMLLE, N.C. 27284
CMCE. (336)-993-9650
FAX: [phone]
a-man: triadandgWad.m.ccm
DRAWN BY: SDT/PJR
DATE: 11 30/05
PROJECT NO.: 12652-4
REVIEW BY: VWS
PROJECT NO. E- 459
SEE ENLARGED PLAN
OF IMPACT AREA 1
PROJECT
SUMMERLYN PARK
KERNER ROAD
KERNERSVILLE TOWNSHIP,
KERNERSVILLE. NORTH CAROLINA
LEGEND
GA? WETLAND
SEE ENLARGED PLAN
OF IMPACT AREAS
293AND4.
IMPACT
LOCATION TYPE SQ. FT.
CH and WL LINEAR FT.
CH only)
1 CH 299.6 sq. ft. 149.8 If.
2 CH 110 sq. ft. 55 If.
3 CH 60 sq. ft. 30 If.
4 CH 60 sq. ft. 30 If.
CH= Channel, JW= Jurisdictional Wetland,
' I'll, , \\\\
SCALE: 1"=200' HORIZ.
NAME SHT. NO
OVERALL SITE
PLAN
H AR
0263
/,',C FOR IAiIIW ?5`` ```•
OWNER/DEVELOPER:
CALMIT PROPERTIES
935 E. FOUNTAIN ST. SUITE H
KERNERSMLLE, NC 27284
CONTACT: LARRY L CALLAHAN
PHONE [phone]
FAX [phone]

71
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TRIAD LAND URVEYING P. C. DRAWN BY: SDT/PJR PROJECT SHT.- NAME SHT. NO. OWNER /DEVELOPER:
SURVEYORS LAND ?'LANN RS DATE: 11 30 05 SUMMERLYN PA CALMIT PROPERTIES
935 E. MO NTAIN ST.. SUITE H PROJECT NO
: 12652-4 ENLARGED PLAN 935
MOUNTAIN ST SURE H
KERNERSVILLE N.C. 27284
OFFICE: (-993-9650 .
KERNER ROAD
REVIEW BY: VWS r _
OF IMPACT AREA I E
KERP1ERSVItlE. NC 27284
CONTACT: LARRY L CALLAHAN
FAX: [phone] I?ERNERSVILLE TOWNSHIP, .? PHONE [phone]
a-ma7: triodlanclMdod.m.com PROJECT NO. E- 459 ICERNERSVILLE, NORTH CAROLINA FAX [phone]
71,
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OF STREAM 2 $? ` - - - _
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- - °°' 13 117,637`S:F.f
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TRIAD RAND SURVEYING P_
. C. DRAWN BY: SDT/PJR PROJECT SHT. NAME SHT. NO. dUAIM
SURYEYOROLAND PLANNERS DATE: 11 /30/05

935 E MO SUMMERLYN PARK ENLARGED PLAN
PER.
CALMIT PROPERTIES
UNTAIN ST., SUITE H PROJECT NO.: 12652-4
KERNERSVILIE, N.C. 27284 r
KERNER ROAD ®F IMPACT 935 E. MOUNTAIN ST. SUITE H
KERNERSVILLE
NC 27284
OFFICE: (338)-993-9650 REVIEW BY: VWS
FAX: [phone]
I{ERNERSVILLE TOWNSHIP, AREA 2
3 &4 .
CONTACT: LARRY L CALI.AHAN
PHONE [phone]
e-mail: tdadland0Wad.rr.cam PROECT NO. E- 459 .
i-ERNERMLLE, NORTH CAROLINA -AX [phone]
i
SCALE: 1 "=40' HORIZ.

TRIAD LAND VRVEYING P. C.
DRAWN BY: SDT/PJR 1 "=4' VERT.
PROJECT SHT
NAME SHT
NO

SURVEYDRSILAND PLANNeRS
DATE: 11 /30/05
SUMMERLYN PARK . .
. OWNER/DEVELOPER:
CALMIT PROPERTIES
935 E. MOUNTAIN ST., SUITE H
KERNERSVILLE N.C. 27284 PROJECT NO.: 12652-4
KERNER ROAD PROFILE OF CULVERT 935 E. MOUNTAIN ST. SUITE H
KERN

OMCE: (336j-993-9650
FAX: [phone]
REVIEW BY: VANS

KERNERSVILLE TOWNSHIP
AT IMPACT AREA 1
/1
° ERSVILLE, NC 27284
CONTACT: LARRY L CAU AHAN
, T PHONE [phone]
a-mall: trladlandOtriod.rr.com PROJECT NO. E- 459 KERNERSVILLE, NORTH CAROLINA FAX [phone]
31,
Soil & Environmental Consultants, PA
3817-E Lawndale Drive • Greensboro, North Carolina 27455 • Phone: [phone] • Fax: [phone]
www.SandEC.co m. December 5, 2005
S&EC Project # 4-1461.W1
To: Mr. Ian McMillan
N.C. Division of Water Quality
Wetlands & Stormwater 401 Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
L? v
From: Jonathon T wnsle
o y U
Soil & Environmental Consultants, P.A. DEC 6 2005
3817-E Lawndale Drive
Greensboro, NC 27455 DENR-WATER QUALITY
INETLZDS /AND STMMNATER BRANCH
Re: Kerner Road / Summerlyn Park Amended PCN
Kernersville, Forsyth County, NC
On behalf of the owner, CALMIT Properties, please find attached an amended application and
amended impact maps requesting written concurrence from the N.C. Division of Water Quality
(DWQ) that the activities proposed below may precede under General Water Quality Certification
3402. Additional information such as Agent Authorization, USGS and NRCS Maps, Vicinity Map,
etc has already been provided in the original application. Please contact me at [phone] if
you have any questions or require additional information.
PROJECT SUMMARY
Project Name Kerner Road / Summerl n Park
Project Type Residential Subdivision
Owner / Applicant CALMIT Properties
Count Forsyth
Nearest Town Kernersville
Waterbod Name Belews Creek
Basin / Sub-basin Roanoke / 03-02-01
Index Number 22-27-8-(l)
Class C
IMPACT SUMMARY
Stream Impact (acres): .0121
Wetland Impact (acres): 0
Open Water Impact (acres): 0
Total Impact to Waters of the U.S. (acres) .0121
Total Stream Impact (linear feet): 264.8
Attachments:
Pre-construction Notification (PCN) Application Form
Impact Maps
Charlotte Office:
Raleigh Office:
236 LePhillip Court, Suite C 11010 Ravcn Ridge Road
Charlotte, NC 28025 Ralei-h, NC 27614
Phone: [phone] Phone [phone]
Fax: [phone] Fax: [phone]
Office Use Only: Form Version March 05
USACE Action ID No. 200620095 DWQ No. 05-2030
(!t any particular item is not applicable to this project, please enter "Not Applicable" or "N/A".)
1. Processing
1. Check all of the approval(s) requested for this project:
® Section 404 Permit ? Riparian or Watershed Buffer Rules
? Section 10 Permit ? Isolated Wetland Permit from DWQ
® 401 Water Quality Certification ? Express 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested:NWP39, WQC3402
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: ?
4. If payment into the North Carolina Ecosystem Enhancement Program (NCEEP) is proposed
for mitigation of impacts, attach the acceptance letter from NCEEP, complete section VIII,
and check here: ?
5. If your project is located in any of North Carolina's twenty coastal counties (listed on page
4), and the project is within a North Carolina Division of Coastal Management Area of
Environmental Concern (see the top of page 2 for further details), check here: ?
II. Applicant Information
1. Owner/Applicant Information E p
Name: Larry Callahan / Leslie Mitchell CALMIT Properties DEC 6 2005
Mailing Address: 110-B Shields Park Drive, Kcmersville, NC 27284
DEnN(?R - WATER QUALITY
l'Yfn ?['{?_A, 11)i I.I IY S4CC ?R,? 1rFlr Y?I ^N
Telephone Number:336-345-1296
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: Jonathon R. Townsley
Company Affiliation: Soil & Environmental Consultants, PA
Mailing Address: 3817-E Lawndale Drive, Greensboro, NC 27455
Telephone Number: 336-540-8234; 336-669-0648 Fax Number: 336-540-8235
E-mail Address: jtownsleynsandec.com
Page 5 of 12
III. Project Information
Attach a vicinity map clearly showing the location of the property with respect to local
landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property
boundaries and development plans in relation to surrounding properties. Both the vicinity map
and site plan must include a scale and north arrow. The specific footprints of all buildings,
impervious surfaces, or other facilities must be included. If possible, the maps and plans should
include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property
boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion,
so long as the property is clearly defined. - For administrative and distribution purposes, the
USACE requires information to be submitted on sheets no larger than 11 by 17-inch format;
however, DWQ may accept paperwork of any size. DWQ prefers full-size construction
drawings rather than a sequential sheet version of the full-size plans. If full-size plans are
reduced to a small scale such that the final version is illegible, the applicant will be informed-that
the project has been placed on hold until decipherable maps are provided.
1. Name of project: Kerner Road / Summerlyn Park
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN): 6887-07-7904 Forsyth County GIS
4. Location
County: Forsyth County Nearest Town:Kernersville, NC
Subdivision name (include phase/lot number): Summer] yn Park
Directions to site (include road numbers/names, landmarks, etc.): From Kemersville, north
on Piney Grove Road, left on Linville Springs Road, right on Kerner Road, pass Dean Road
property +/- Imile on the right. See attached maps.
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.)
Coordinates: 36 09 20 -W, 80 04 58 o N
6. Property size (acres): 30.4 acres
7. Name of nearest receiving body of water: Belews Creek, Belews Lake
8. River Basin: Roanoke
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http://h2o.enr.state.nc.us/admin/mans/.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: The existing land use is forested, mostly loblolly and shortleaf
pines. Surrounding land use is mostly residential.
Pave 6 of 12
10. Describe the overall project in detail, including the type of equipment to be used: This
30.4acre project will involve construction of a subdivision road to access 18 single family
residential buildine lots.
11. Explain the purpose of the proposed work: The project purpose is to create residential
building lots. Stream impacts are necessary to access buildable uplands.
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 issued for prior segments of the same T.I.P. project, along with
construction schedules. NA
Agent met with John Thomas of USACE on site to confirm delineation and stream calls. Agent
also met with Daryl Lamb on November 30, 2005 on site.
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application.
Construction of road and driveways to access 18 houses is the extent of planned development on this
property.
Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. Each impact must be
listed separately in the tables below (e.g., culvert installation should be listed separately from
riprap dissipater pads). Be sure to indicate if an impact is temporary. All proposed impacts,
permanent and temporary, must be listed, and must be labeled and clearly identifiable on an
accompanying site plan. All wetlands and waters, and all streams (intermittent and perennial)
should be shown on a delineation map, whether or not impacts are proposed to these systems.
Wetland and stream evaluation and delineation forms should be included as appropriate.
Photographs-may be included at the applicant's discretion. If this proposed impact is strictly for
wetland or stream mitigation, list and describe the impact in Section VIII below. If additional
space is needed for listing or description, please attach a separate sheet.
1. Provide a written description of the proposed impacts: Proposed impacts include one road
crossing, over a perennial/important stream (Location ])necessary to access buildable land.
Also impacts to an intermittent/unimportant stream (Location 2, 3, 4).
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,
separately list impacts due to both structure and flooding;.
Wetland Impact

Site Number
(indicate on map)

Type of Impact Type of Wetland

(e.g., forested, marsh,
herbaceous, bog, etc.) Located within

100-year
Floodplain
(yes/no) Distance to
Nearest
-
Stream
(linear feet) Area of
Impact
pact
(acres)

Total Wetland Impact (acres) 0
3. List the total acreage (estimated) of all existing wetlands on the property: 0.174 acres
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 acreage, multiply length X width, then divide by 43,560.
Stream Impact
Number
indicate on ma
Stream Name
Type of Impact Perennial or
Intermittent? Average
Stream Width
Before Impact Impact
Length
linear feet Area of
Impact
acres
1 Important Permanent Perennial 2' 149.8 .0068
2 Unimportant Permanent Intermittent 2' 55 .0025
3 Unimportant Permanent Intermittent 2' 30 .0014
4 Unimportant Permanent Intermittent 2' 30 .0014

Total Stream Impact (by length and acreage) 264.8 .0121
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, dredging, flooding, drainage, bulkheads, etc.
Open Water Impact
Site Number
(indicate on ma) Name Waterbody
(if applicable)
Type of Impact Type of Waterbody
(lake, Pand estuary, sound, bay,
ocean, etc.) Area of
Impact
(acres)

Total Open Water Impact (acres)
Page 8 of 12
6. List the cumulative impact to all Waters of the U.S. resulting from the project:
Stream Impact (acres): .0121
Wetland Impact (acres): 0
Open Water Impact (acres): 0
Total Impact to Waters of the U.S. (acres) .0121
Total Stream Impact (linear feet): 264.8
7. Isolated Waters
Do any isolated waters exist on the property? ? Yes ® 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 USACE.
8. Pond Creation
If construction of a pond is proposed, associated wetland and stream impacts should be
included above in the wetland and stream impact sections. Also, the proposed pond should
be described here and illustrated on any maps included with this application.
Pond to be created in (check all that apply): ? uplands ? stream ? 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:
VI. 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. Road construction to
access buildable uplands on this proiect is a challenge due to steep slopes leading down to the
perennial stream. Several site plans were considered. The site plan was revised several times to
avoid impacting upstream riparian wetlands, and is placed in a location that minimizes
fill/culvert length. Impacts to the intermittent stream at Location s 3 & 4 are necessary to access
lot #'s 13 & 14. The driveway for lot 13 will impact a segment of the intermittent stream at a
location where an old farm road already exists.
VII. 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
Page 9 of 12
freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial
streams.
USAGE - 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://112o.enr.state.nc.us/ncwctlands/stnngide.litml.
Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
The site plan for this project has been revised to reduce perennial stream impacts below 150
linear feet. This was difficult due to steep slopes. The site plan was also revised to avoid
any wetland impact on the project. We believe that mitigation should not be required for this
project as planned. Should you quire mitigation, we propose payment to the NCEEP
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.state.nc.us/wrp/index.litni. 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):
Page 10 of 12
Amount of Riparian wetland mitigation requested (acres):
Amount of Non-riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres):
VIII. Environmental Documentation (required by DWQ)
1. Does the project involve an expenditure of public (federaUstate/local) funds or the use of
public (federal/state) land? Yes ? 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 (NEPA/SEPA)?
Note: If you are not sure whether a NEPA/SEPA document is required, call the SEPA
coordinator at [phone] to review current thresholds for environmental documentation.
Yes ? No ?
3. If yes, has the document review been finalized by the State -Clearinghouse? If so, please
attach a copy of the NEPA or SEPA final approval letter. Yes ? No ?
IX. 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 213 .0233
(Neuse), 15A NCAC 213 .0259 (Tar-Pamlico), 15A NCAC 02B .0243 (Catawba) 15A NCAC
213 .0250 (Randleman Rules and Water Supply Buffer Requirements), or other (please
identify )? Yes ? No
2. If "yes", identify the square feet and acreage of impact to each zone of the riparian buffers.
If buffer mitigation is required calculate the required amount of mitigation by applying the
buffer multipliers.
Zone* Impact Multiplier Required
(square feet) Mitieation
1 3 (2 for Catawba)
2 1.5
Total
* Zone I extends out 30 feet perpendicular from the top of the near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.
3. If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e.,
Donation of Property, Riparian Buffer Restoration / Enhancement, or Payment into the
Page 1 1 of 12
Riparian Buffer Restoration Fund). Please attach all appropriate information as identified
within 15A NCAC 213.0242 or.0244, or.0260.
X. 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. Road construction will be ribbon pavement with
vegetated ditches. The size of the ditches will be reviewed by NCDOT. The Erosion Control
plan will be reviewed by the Winston-Salem Inspections Department. Total acreage = 30 4acres
Roadway impervious surface = .834acres. Impervious surface from 18 homes n 3000sf per lot
= 1.239acres. Total impervious surface on the project is 6.8%.
XI. Sewage Disposal (required by DWQ)
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from the proposed project, or available capacity of the subject facility.
Method of wastewater disposal is individual septic systems.
XII. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes ? No
Is this an after-the-fact permit application? Yes ? No
XIII. Cumulative Impacts (required by DWQ)
Will this project (based on past and reasonably anticipated future impacts) result in additional
development, which could impact nearby downstream water quality? Yes [:1 No
If yes, please submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent North Carolina Division of Water Quality policy posted on our website at
http://h2o.enr.state.ne.us/ncwet]ands. If no, please provide a short narrative description: All anticipated
impacts are accounted for in this application.
XKplicant/Agent's Sign
s signature is valid only I
12 r o?
Date
authorization letter from the applicant is provided.)
Page 12 of 12
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935 E. MOUNTAIN ST., SUITE H PROJECT NO.: 12652-4
KERNERSVILLE, N.C. 27284 KERNER ROAD
OFFICE: (336)-993-9650 REVIEW BY: VWS KERNERSVILLE TOWNSHIP,
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KERNERSVILLE, NORTH CAROLINA FAX [phone]
O?O? W A T ?9QG
CERTIFIED MAIL: 7003 3110 0003 6489 8223
RETURN RECEIPT REQUESTED
Mr. Larry Callahan
CALMIT Properties
110-13 Shields Park Drive
Kernersville, NC 27284
Dear Mr. Callahan:
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
November 29, 2005
DWQ# 05-2030
Forsyth County
en?@j 1V
011
t. ?gar &I ,.
<c
On November 8, 2005, the North Carolina Division of Water Quality (DWQ) received your application for a
General 401 Water Quality Certification to impact 205 linear feet of streams in the Summerlyn Park
residential subdivision, located on Kerner Road, near Kernersville, in Forsyth County. In order that we may
determine your project's compliance with 15A NCAC 2H .0500, please provide five (5) copies of the
following information:
Your project is described in the Pre-Construction Notification (PCN: Item 10, Page 7) as a 30.4 acre
subdivision containing 18 single-family lots. You indicate that the proposed stream impacts are
necessary to access buildable lots. However, your "Overall Site Plan" (reference: Sheet 1),
submitted with the PCN, does not show how the project's proposed roadway will provide access to
all buildable lots. You further indicate in Section XIV, "Cumulative Impacts" (Page 12 of the
PCN), that the 18 buildable lots constitute the extent of the project and that there are no plans for
future phases. You state that additional stream crossings will be required to access two of the 18
lots and that future landowners will be responsible for obtaining 401 authorizations for these
crossings. Please be advised that this proposal is not acceptable to the Division of Water Quality.
DWQ will not authorize multiple individual stream crossings in order to access buildable lots. Your
proposed site plan must show how access will be provided to all buildable lots and must account for
all stream and wetland impacts necessary to provide this access. Please submit a revised Site Plan,
which shows how access will be provided to all 18 buildable lots, and an amended PCN that
accounts for all stream and wetland impacts necessary to provide this access.
Until the information requested in this letter is provided, I will request (by copy of this letter) that the U.S.
Army Corps of Engineers place this project on hold. Also, this project will be placed on hold for DWQ
processing due to incomplete information (15A NCAC 2H.0507(h)). The processing of this application
will begin when the requested information is received. Please be advised that if your proposed activity is
subject to Section 404 of the Clean Water Act (33 U.S.C. 1344), you must also receive a Section 401
Water Quality Certification from the N. C. Division of Water Quality before you begin any work.
Noy` Carolina
,/ atura!!y
North Carolina Division of Water Quality .
Wetlands Certification Unit 1650 Mail Service Center Raleigh, NC 27699-1650 Phone [phone] FAX [phone]
2321 Crabtree Blvd. Raleigh, NC 27604-2260 Internet http/Ch2o enr.state.nc us/ncvetlands
Customer Service Number: 1-877-623-6748
An Equal opportunity/Affirmative Action Employer- 50% Recycled/10% Post Consumer Paper
Mr. Larry Callahan
Page 2, DWQ# 05-2030
November 29, 2005
Please send the requested information to Mr. Ian McMillan, N. C. Division of Water Quality, Wetlands/401
Certification Unit, 1650 Mail Service Center, Raleigh, NC 27699-1650. If you have any questions, please
contact Mr. Daryl Lamb, DWQ, Winston-Salem Regional Office, at [phone] extension 293.
Sincerely,
Steve W. Tedder
Regional Supervisor
DWQ Winston-Salem Regional Office
SWT/cdl
cc: Mr. John Thomas, U. S. Army Corps of Engineers, Raleigh Regulatory Field Office
Winston-Salem Regional Office
Wetlands/401 Unit File Copy
Central Files
Mr. Jonathon R. Townsley, Soil & Environmental Consultants, PA, 3817-E Lawndale Drive,
Greensboro, NC 27455
O?O? W A T ?9?G
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
November 29, 2005
DWQ# 05-2030
Forsyth County
CERTIFIED MAIL: 7003 3110 0003 6489 8223
RETURN RECEIPT REQUESTED
Mr. Larry Callahan
CALMIT Properties
110-B Shields Park Drive
Kernersville, NC 27284
Dear Mr. Callahan:
On November 8, 2005, the North Carolina Division of Water Quality (DWQ) received your application for a
General 401 Water Quality Certification to impact 205 linear feet of streams in the Summerlyn Park
residential subdivision, located on Kerner Road, near Kernersville, in Forsyth County. In order that we may
determine your project's compliance with 15A NCAC 2H .0500, please provide five (5) copies of the
following information:
1. Your project is described in the Pre-Construction Notification (PCN: Item 10, Page 7) as a 30.4 acre
subdivision containing 18 single-family lots. You indicate that the proposed stream impacts are
necessary to access buildable lots. However, your "Overall Site Plan" (reference: Sheet 1),
submitted with the PCN, does not show how the project's proposed roadway will provide access to
all buildable lots. You further indicate in Section XIV, "Cumulative Impacts" (Page 12 of the
PCN), that the 18 buildable lots constitute the extent of the project and that there are no plans for
future phases. You state that additional stream crossings will be required to access two of the 18
lots and that future landowners will be responsible for obtaining 401 authorizations for these
crossings. Please be advised that this proposal is not acceptable to the Division of Water Quality.
DWQ will not authorize multiple individual stream crossings in order to access buildable lots. Your
proposed site plan must show how access will be provided to all buildable lots and must account for
all stream and wetland impacts necessary to provide this access. Please submit a revised Site Plan,
which shows how access will be provided to all 18 buildable lots, and an amended PCN that
accounts for all stream and wetland impacts necessary to provide this access.
Until the information requested in this letter is provided, I will request (by copy of this letter) that the U.S.
Army Corps of Engineers place this project on hold. Also, this project will be placed on hold for DWQ
processing due to incomplete information (15A NCAC 2H .0507(h)). The processing of this application
will begin when the requested information is received. Please be advised that if your proposed activity is
subject to Section 404 of the Clean Water Act (33 U.S.C. 1344), you must also receive a Section 401
Water Quality Certification from the N. C. Division of Water Quality before you begin any work.
NorthCarolina
.11aturQlhf
North Carolina Division of Water Quality
Wetlands Certification Unit 1650 Mail Service Center Raleigh, NC 27699-1650 Phone [phone] FAX [phone]
2321 Crabtree Blvd. Raleigh, NC 27604-2260 Internet http//:h2o.encstate.nc.us/ncwetlands
Customer Service Number: 1-877-623-6748
An Equal Opportunity/Affirmative Action Employer-50°6 Recycled/10°6 Post Consumer Paper
Mr. Larry Callahan
Page 2, DWQ# 05-2030
November 29, 2005
Please send the requested information to Mr. Ian McMillan, N. C. Division of Water Quality, Wetlands/401
Certification Unit, 1650 Mail Service Center, Raleigh, NC 27699-1650. If you have any questions, please
contact Mr. Daryl Lamb, DWQ, Winston-Salem Regional Office, at [phone] extension 293.
Sincerely,
Steve W. Tedder
Regional Supervisor
DWQ Winston-Salem Regional Office
S WT/cdl
cc: Mr. John Thomas, U. S. Army Corps of Engineers, Raleigh Regulatory Field Office
Winston-Salem Regional Office
Wetlands/401 Unit File Copy
Central Files
Mr. Jonathon R. Townsley, Soil & Environmental Consultants, PA, 3817-E Lawndale Drive,
Greensboro, NC 27455
Triage Check List
Date: 11/09/05 Project Name: Summerlyn Park Subdivision
DWQ#: 05-2030
County: Forsyth
Daryl Lamb, Winston-Salem Regional Office
To:
60-day processing time: 11/08/05 - 1/06/0 6
From: Cyndi Karoly Telephone: [phone]
The file attached is being forwarded to you for your evaluation.
Please call if you need assistance.
? Stream length impacted
? Stream determination
Wetland determination and distance to blue-line surface waters on USFW topo maps
? Minimization/avoidance issues
? Buffer Rules (Neuse, Tar-Pamlico, Catawba, Randleman)
? Pond fill
Mitigation Ratios
? Ditching
? Are the stream and or wetland mitigation sites available and viable?
? Check drawings for accuracy
Is the application consistent with pre-application meetings?
? Cumulative impact concern
1-1
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!
.Soil & Environmental Consultants, PA
3817-E Lawndale Drive - Greensboro, North Carolina 27455 - Phone: [phone] - Fax: [phone]
www.SandEC.com November 3, 2005
S&EC Project # 4-1461.W1
To: US Army Corps of Engineers N.C. Division of Water Quality
Raleigh Regulatory Field Office Wetlands & Stormwater 401 Unit
Attn: John Thomas 1650 Mail Service Center
6508 Falls of the Neuse Road, Suite 120 Raleigh, NC 27699-1650
Raleigh, North Carolina 27615
From: Jonathon Townsley
Soil & Environmental Consultants, P.A. ? Q ll Ls D
3817-E Lawndale Drive u
Greensboro, NC 27455
Re: Kerner Road / Summerlyn Park NOV 8 - 2005,
Kernersville, Forsyth County, NC DENR - WATER QUALITY
I1ETIANDS A14D STORlyNATER 6RAPicii
On behalf of the owner, CALMIT Properties, please find attached a complete application and
supplemental information requesting written concurrence from the U.S. Army Corps of Engineers
(USACE) and the N.C. Division of Water Quality (DWQ) that the activities proposed below may
precede under Nationwide Permit 39 and General Water Quality Certification 3402. Please
contact me at [phone] if you have any questions or require additional information.
PROJECT SUMMARY
Project Name Kerner Road / Summerl n Park
Project Type Residential Subdivision
Owner / Applicant CALMIT Properties
Count Forsyth
Nearest Town Kernersville
Waterbod Name Belews Creek
Basin / Sub-basin Roanoke / 03-02-01
Index Number
-
22-27-8-(l)
Class C
IMPACT SUMMARY
Stream Impact (acres): .0093
Wetland Impact (acres): 0
Open Water Impact (acres): 0
Total Impact to Waters of the U.S. (acres) .0093
Total Stream Impact (linear feet): 204.8
Attachments:
Pre-construction Notification (PCN) Application Form
Agent Authorization
Site Vicinity Map
Figure 1. USGS Map
Figure 2. Soil Survey Map
Wetland Survey Map
Impact Map
$475.00 Application Fee to DWQ
Charlotte Office: Raleigh Office:
236 LePhillip Court, Suite C 11010 Raven Ridge Road
Charlotte, NC 28025 Ralcigh, NC 27614
Phone: [phone] Phone [phone]
Fax: [phone] Fax: [phone]
OfGCC Use Only: Form Version March OS
USACE Action ID No. DWQ No.
(If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A".)
1. Processing
1. Check all of the approval(s) requested for this project:
® Section 404 Permit ? Riparian or Watershed Buffer Rules
? Section 10 Permit ? Isolated Wetland Permit from DWQ
® 401 Water Quality Certification ? Express 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested:NWP39, WQC3402
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: ?
4. If payment into the North Carolina Ecosystem Enhancement Program (NCEEP) is proposed
for mitigation of impacts, attach the acceptance letter from NCEEP, complete section VIII,
and check here: ?
5. If your project is located in any of North Carolina's twenty coastal counties (listed on page
4), and the project is within a North Carolina Division of Coastal Management Area of
Environmental Concern (see the top of page 2 for further details), check here: ?
II. Applicant Information
1. Owner/Applicant Information (?iY D
Name: Larry Callahan / Leslie Mitchell CALMIT Properties NOV 8 -.2005
Mailing Address: 110-B Shields Park Drive, Kernersville, NC 27284
DENR -WATER QUALITY
VIETLMDSA,?n errs'' 1tERAt;CN
Telephone Number:336-345-1296
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: Jonathon R. Townsley
Company Affiliation: Soil & Environmental Consultants, PA
Mailing Address: 3817-E Lawndale Drive, Greensboro, NC 27455
Telephone Number: 336-540-8234, 336-669-0648 Fax Number: 336-540-8235
E-mail Address: jtownsle a sandec.com
Page 5 of 13
111. Project Information
Attach a vicinity map clearly showing the location of the property with respect to local
landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property
boundaries and development plans in relation to surrounding properties. Both the vicinity map
and site plan must include a scale and north arrow. The specific footprints of all buildings,
impervious surfaces, or other facilities must be included. If possible, the maps and plans should
include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property
boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion,
so long as the property is clearly defined. For administrative and distribution purposes, the
USACE requires information to be submitted on sheets no larger than 11 by 17-inch format;
however, DWQ may accept paperwork of any size. DWQ prefers full-size construction
drawings rather than a sequential sheet version of the full-size plans. If full-size plans are
reduced to a small scale such that the final version is illegible, the applicant will be informed that
the project has been placed on hold until decipherable maps are provided.
1. Name of project: Kerner Road / Summerlyn Park
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN): 6887-07-7904 Forsyth County GIS
4. Location
County: Forsyth County Nearest Town:Kernersville, NC
Subdivision name (include phase/lot number): Summerlyn Park
Directions to site (include road numbers/names, landmarks, etc.): From Kemersville, north
on Piney Grove Road, left on Linville Springs Road, right on Kerner Road, pass Dean Road,
property +/- Imile on the right. See attached maps.
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.)
Coordinates: 36 09 20 -W, 80 04 58 - N
6. Property size (acres): 30.4 acres
7. Name of nearest receiving body of water: Belews Creek, Belews Lake
8. River Basin: Roanoke
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http://h2o.enr.state.nc.us/admin/maps/.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: The existing land use is forested, mostly loblolly and shortleaf
nines. Surrounding land use is mostly residential.
Page 6 of 13
10. Describe the overall project in detail, including the type of equipment to be used: This
30.4acre project will involve construction of a subdivision road to access 18 single family
residential building lots.
11. Explain the purpose of the proposed work: The project purpose is to create residential
building lots. Stream impacts are necessary to access buildable uplands.
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 issued for prior segments of the same T.I.P. project, along with
construction schedules. NA
Agent met with John Thomas of USACE on site to confirm delineation and stream calls. The
attached wetland survey is in accordance with USACE site confirmation.
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application.
Construction of road and 18 houses is the extent of planned development on this property. Two lots will
require driveway crossings of streams. One lot will require driveway crossing of an intermittent stream.
Another lot will require a crossing of a perennial stream. The exact location and placement of these is
not known at this time. It will be the responsibility of the future land owner of these lots to comply with
current 401/404 regulations.
VI. Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. 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.
Page 7 of 13
I . Provide a written description of the proposed impacts: Proposed impacts include one road
crossing over a perennial/important stream (Location ] )necessary to access buildable land.
Also impacts to an intermittent/unimportant stream (Location 2).
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,
separately list impacts due to both structure and flooding.
Wetland Impact

Site Number
(indicate on map)

Type of Impact Type of Wetland

(e.g., forested, marsh,
herbaceous, bog, etc.)
Located within
100-year
Floodplain
( es/no)
Distance to
Nearest
Stream
(linear feet
Area of
Impact
(acres)

Total Wetland Impact (acres) 0
3. List the total acreage (estimated) of all existing wetlands on the property: 0.174 acres
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 acreage, multiply length X width, then divide by 43,560.
Stream Impact
Number
indicate on ma
Stream Name
Type of Impact
Perennial or Intermittent? Average
Stream Width
Before Impact Impact
Length
(linear feet) Area of
Impact
(acres)
1 Important Permanent Perennial 2' 149.8 .0068
2 Unimportant Permanent Intermittent 2' 55 .0025

Total Stream Impact (by length and acreage) 204.8 .0093
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, dredging, flooding, drainage, bulkheads, etc.
Open Water Impact Name Waterbody Type of Waterbody Area of
Site Number (if applicable) Type of Impact (lake, Pand estuary, sound, bay, Impact
(indicate on ma) ocean, etc.) (acres)

Page 8 of 13
Total Open Water Impact (acres)
6. List the cumulative impact to all Waters of the U.S. resulting from the proiect:
Stream Impact (acres): .0093
Wetland Impact (acres): 0
Open Water Impact (acres): 0
Total Impact to Waters of the U.S. (acres) .0093
Total Stream Impact (linear feet): 204.8
7. Isolated Waters
Do any isolated waters exist on the property? ? Yes ® 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 USACE.
8. Pond Creation
If construction of a pond is proposed, associated wetland and stream impacts should be
included above in the wetland and stream impact sections. Also, the proposed pond should
be described here and illustrated on any maps included with this application.
Pond to be created in (check all that apply): ? uplands ? stream ? 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. Road construction to
access buildable uplands on this proiect is a challenge due to steep slopes leading down to the
perennial stream. Several site plans were considered. The site plan was revised several times to
avoid imnactint? upstream riparian wetlands, and is placed in a location that minimizes
fill/culvert length.
VIII. Mitigation
Page 9 of 13
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.
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/ncwetiands/strmgide.litm1.
Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
The site plan for this project has been revised to reduce perennial stream impacts below 150
linear feet. This was difficult due to steep slopes. The site plan was also revised to avoid
any wetland impact on the project. We believe that mitigation should not be required for this
project as planned. Should you quire mitigation, we propose payment to the NCEF_,P.
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 littp://112o.enr.state.ne.us/IW/index.htm. If use of the NCEEP is proposed, please
check the appropriate box on page five and provide the following information:
Page 10 of 13
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):
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 ? 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 (NEPA/SEPA)?
Note: If you are not sure whether a NEPA/SEPA document is required, call the SEPA
coordinator at [phone] to review current thresholds for environmental documentation.
Yes ? No ?
3. If yes, has the document review been finalized by the State Clearinghouse? If so, please
attach a copy of the NEPA or SEPA final approval letter. Yes ? No ?
X. Proposed Impacts on 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
(Meuse), 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 V Yes ? No
2. If "yes", identify the square feet and acreage of impact to each zone of the riparian buffers.
If buffer mitigation is required calculate the required amount of mitigation by applying the
buffer multipliers.
I Zone* I Impact I Multiplier I Required
(square feet) Mitication
3 (2 for Catawba)
1.5
Total
* Zone I 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.
Page 1 I of 13
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 213.0242 or.0244, or.0260.
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. Road construction will be ribbon pavement with
vegetated ditches. The size of the ditches will be reviewed by NCDOT. The Erosion Control
plan will be reviewed by the Winston-Salem Inspections Department. Total acreage = 30.4acres.
Roadway impervious surface = .834acres. Impervious surface from 18 homes n 3000sf per lot
= 1.239acres. Total impervious surface on the protect is 6.8%.
XII. Sewage Disposal (required by DWQ)
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from the proposed project, or available capacity of the subject facility.
Method of wastewater disposal is individual septic systems.
XIII. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (15A NCAC 211.0500) or any Buffer Rules?
Yes ? No
Is this an after-the-fact permit application? Yes ? No
XIV. Cumulative Impacts (required by DWQ)
Will this project (based on past and reasonably anticipated future impacts) result in additional
development, which could impact nearby downstream water quality? Yes ? No ?
If yes, please submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent North Carolina Division of Water Quality policy posted on our website at
http://h2o.cnr.state.nc.us/ncwetlands. If no, please provide a short narrative description: Construction of
road and 18 houses is the extent of planned development on this property. Two lots will require
driveway crossings of streams. One lot will require driveway crossing of an intermittent stream.
Another lot will require a crossing of a perennial stream. The exact location and placement of these is
not known at this time. It will be the responsibility of the future land owner of these lots to comply with
current 401/404 regulations.
Page 12 of 13

% ` Applicant/Agen s ignature Date
Agent's signature is val only if an authorization letter from the applicant is provided.)
Page 13 of 13
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4-1461.W1 VICINITY MAP
- -- Kerner Road / Summedyn Park d Soil & Environmental Consultants, PA
ES Project Mgr.: Lary Callahan / CALMIT Properties 3s1--E Lawndale D,.
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Project No. Figure 2 - Soil Survey Map
4-1461.w1

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Kerner Road ,
Soil & Environmental Constiltants,
PA
Project Mgr.: Larry Callahan ? I - r-:?•?'??.I•?I? rl?
Es Forsyth County, NC .itceud-of Ir,
Scale: Forsyth County Soil Survey
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WETLANDS/LINEAR WETLANDS ga
WATERS OF THE U.S.
PERENNIAL STREAMS TAX LOT 202, BLOCK 5418

BOUNDARY OR EVALUATED AREA HOYLE W. CHAMBERS
& WE MAWS T. CHAMBERS TAX LOT 14L, BLOCK 5418
V. 0. CREWS HEIRS
D.B. 1148, PG. 1718 D.B. 527, PG. 156
TT=TIE TO CH =CHANNEL CL=CENTERLINE AW=AVERAGE WIDTH

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WATERS OF THE U.S.
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TAX LOT 13C, BLOCK 5419
LAWRENCE JOSEPH CARROLL, III
do wf. MELANIE ALLEN CARROLL
D.B. 2223. PG. 298
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TAX LOT 12A, BLOCK 5419
LAWRENCE JOSEPH CARROLL, III
& wE MELANIE ALLEN CARROLL
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TAX LOT 15, BLOCK 5418
30.357 Ac.* (OUTSIDE R/W)
0.048 Ac.* INSIDE R/W)
30.405 Ac.t (TOTAL)
BY COMPUTER
CALCULATION
WATERS OF THE U.S.
PERENNIAL STREAM
(SEE SHEET 2)
WETLANDS
LINEAR WETLANDS
(SEE SHEET 3) N•
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WESLEY A. WHITEHURST
& WE SANDRA J. WHITEHURST
D.B. 2045, PG. 20
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O
a' TAX LOT 108, BLOCK 5418
d DORIS N. HAGERMAN
O D.B. 2440, PG. 840
N
J
I?
O
(D
CO
--------------
TAX LOT 14R, BLOCK 5415
V.O. CREWS HEIRS
D.B. 527, PG. 156
KERNER FARM R0.
VICINITY MAP
NOT TO SCALE
TAX LOT 14G, BLOCK 5418
JAMES LEE CREWS
& wt. MINNIE COOKE CREWS
D.B. 769, PG. 462
L1 Ala
-----
'v?
J-,. f\
ip
LINE TABLE
LINE BEARING LENGTH
L1 S84'48'20"E 90.03'
L2 N1821'49"W 130.64'
d- ?
,C)
60 C'O)
TAX LOT 19W, BLOCK 5418
CLEVELAND H. EWS
& WE PATRICIA V. EWS
D.B. 1234, PG. 643
a;This certifies that this copy of this plot accurately depicts the boundary
of the jurisdiction of Section 404 of the Clean Water Act as determined
TAX LOT 207, BLOCK 5418 by the undersigned on this dote. Unless there is a change in the low or
JAMES E. IVEY our published regulations, this determination of Section 404 jurisdiction
& wf. BARBARA H. IVEY may be relied upon for a period not to exceed five years from this date.
D.B. 1811, PG. 4099 This determination was made utilizing the 1987 Corps of Engineers
Wetlands Determination Manual.
i
/
Nome:
TAX LOT 205, BLOCK 5418 Title:
BENJAMIN E. KESLER
& wE HAZEL M. KESLER
D.B. 2257, PG. 894 Date:
(J,I VNOTE: WETLANDS DELINEATED BY SOIL & ENVIRONMENTAL CONSULTANTS, PA
s,,,Aili1111IN00WETLANDS DELINEATION MAP
LEGEND FOR SUMMERLYN PARK Graphic Scale LITY
LIGHT E P - EXIST NG OIRON PIPE PL - PROPERTTYELINE KERNERSVI/LLE, N. C. 0 100' 200' 400' 600
EIR - EXISTINGNIRONEROD EP - EDGETOFF PAVING SHEET / OF 4 Ratio of Precision 1:10,000+
CI - CURB INLET MNS - MAC NAIL SET This mop or drawing and any accompanying
0 TBC - TOP BACK OF CURB WM - WATER METER documents are furnished to the person(s) MAP
FH - FIRE HYDRANT NTS - NOT TO SCALE named thereon and no alterations or use by FOR
3 SUMMERLYN PARK
C? CB - CATCH BASIN MNS - SEWER MAN HOLE others Is permitted unless authorized by
o Y - YARD INLET Cl -CRATE INLET TRIAD LAND SURVEYING, P.C. SCALE TOWNSHIP COUNTY STATE
CO - CLEAN OUT RCP - REINF. CONC. PIPE
a
J
w
j

I CERTIFY THAT ON

o 2005
/
N _
THIS PLAT:
i
AUGUST 11th
WE SURVEYED THE PROPERTY SHOWN ON
P. L. S.
1"=200' KERNERSVILLE FORSYTH N.C.
Nate: This plat is subject to any BEING TAX LOT 15, BLOCK 5418
Ea, Agreements, AS RECORDED IN D.B. 791 PG. 430
Rights-of-Way of record prior ,
to the date of this plot, which SURVEYED: TRIAD LAND SURVEYING, P.C.
was not visible at the time of EM,BM 935 EAST MOUNTAIN ST., SUITE H
my inspection. MAPPED: OFFICE KERNERSVILLE, N.C., 27284 FAX
TAH 993-9650 s-man: trlodland0trlad. m.rnm 993-9654
DATE
8/15/05
JOB NO.
12652

POINT IN
CREEK /
(TYPICAL)
ARM R0.
VICINITY MAP
NOT TO SCALE
O?
N
0
I ?
I
?+3
<G?G PG?GN????
A
•N
L.IVP
N
'iD , W
Tn
U,G
?s G?GN3
\s?9.
srj Q?
,\OO
LINE TABLE
LINE BEARING NGTH
L1 S84'48'20"E° 90.03'
L2 N18'21'49"W 130.64'
L3 S1 5'58'45"E 4.83'
L4 S80'42'56"E 9.03'
L5 S72'01'07"E 9.82'
L6 S29'58'11 "E 10.55'
L7 S70'15'06"E 17.80'
L8 S47'03'1 7"E 20.82'
L9 S55'46'25"E 7.99'
L10 S53'56'1 1"E 16.04-
L11 S68'35'11 "E 17.68'
L12 S78'38'1 2"E 9.40'
L13 S36'02'06"E 14.67'
L14 N71'33'47"E 8.78'
L15 S71 *24'37"E 15.55'
L16 S60'24'44"E 2.96'
\\\\\ N\N ? \?I\1 \11111 I I I I IIII II, I `II !JI lD/r/ / /
`t?Ssslp''.,
SEAL`
i L-4238
WETLANDS/LINEAR WETLANDS
WATERS OF THE U.S.
PERENNIAL STREAMS
I BOUNDARY OR EVALUATED AREA
TT=TIE TO CH=CHANNEL CL=CENTERLINE AW=AVERAGE WIDTH
This certifies that this copy of this plot accurately depicts the boundary
of the jurisdiction of Section 404 of the Clean Water Act as determined
by the undersigned on this date. Unless there is a change in the law or
our published regulations, this determination of Section 404 jurisdiction
may be relied upon for a period not to exceed five years from this dote.
This determination was mode utilizing the 1987 Corps of Engineers
Wetlands Determination Manual.
Nome:
Title:
Date:
P?3
P?3
0-r-
G P?3
0
?j
0 G?2
\` C?I
GAG GGV'GN3
t'
1
GG G VGGvGN1
CV C
??G 3
`? ?>> ??`aGGN SEE SHEEZ
DO
Lo
J
E N3
MPtCH SIN ?6PL1 J 1 C2
J O
N TTAD SAP
aOtS ? BCCL?3
4Z e NOTE: WET LANDS DELINEATED BY SOIL & ENVIRONMENTAL CONSULTANTS , PA

WETLANDS DELINEATION MAP '
FOR SUMMERLYN PARK

KERNERSVILLE
N. C
'
' Graphic Scale
LEGEND
UP
UTILITY PO
E ,
.
SHEET 2 OF 4 0
15 3D 60, 9o,
-
L
EIP - EXISTING IRON PIPE
NIP - NEW IRON PIPE LP - LIGHT POLE
PL - PROPERTY LINE
RW - RIGHT-OF-WAY Ratio of Precision - 1:10,000+

EIR - EXISTING IRON ROD
Cl - CURB INLET
EP - EDGE OF PAVING
MNS - MAC NAIL SET This mop or drawing and any accompanying
documents ore furnished to the person(s)
named thereon
nd
lt
i
MAP
FOR

SUMMERLYN PARK
TBC - TOP BACK OF CURB
FH - FIRE HYDRANT WM - WATER METER
NTS - NOT TO SCALE a
no a
erat
ons or use by
others Is permitted unless authorized by

Ce - CATCH BASIN
MHS - SEWER MAN HOLE TRIAD LAND SURVEYING, P.C. SCALE TOWNSHIP COUNTY STATE DATE
YI -YARD INLET
CO - CLEAN OUT GI -GRATE INLET
RCP - REINF. CONC. PIPE
1"=30'
KERNERSVILLE
FORSYTH
N. C.
8/15/05
3
vi
0
a
J
5
0
N
N
•I CERTIFY THAT ON AUGUST 11th Note: This plat Is subject to any BEING TAX LOT 15, BLOCK 5418
_ zoos Easements, Agreements, AS RECORDED IN D.B. 791, PG. 430
WE: SURVEYED THE PROPERTY SHOVM ON Rights-of-Way of record prior THIS PLAT: to the date of this plot, which SURVEYED: TRIAD LAND SURVEYING, P.C.
was not visible at the time of EM,BM JOB N0.
p. L. S. my inspection. MAPPED: OFFICE 935 EAST MOUNTAIN ST., SUITE H
TAH 99J- 9650 KERNERSVILLE, N.C„ . 27284 FAX
_ °-man: triodlondOtdoe.co eom 993-9654 12652

G?GN6
GV-
v1
. LsJ.
GLG P
LINE TABLE
LINE
L17 BEARING
S69'09'15"E LENGTH
10.07'
L18 S60'35'17"E 22.34'
1-19 N71'03'41"E 12.24'
L20 N84'12'37"E 17.16'
L21 N89'48'42"E 17.12'
177 c??•?c•no r
L23 S63'49'50"E 14.75'
L24 S31'45'23"E 13.11'
L25 S02'59'04"W 10.05'
L26 N78.17'53"E 13.43'
L27 N72'1 1'32"E 17.87'
L28 S69'03'36"E 22.84'
L29 S59'25'30"E 24.46'
L30 S35'44'36"E 6.67'
L31 S62*05'31"E 12.24'
L32 N89'33'09"E 9.49
L33 N49.1 O'11 "E 20.03'
L34 S32'39'38"E 13.70'
L35 S24'34'10"E 17.46'
L36 S89'54'29"W 9.83'
L37 N85'22'39"W 12.80'
L38 N63'52'26"W 12.58'
L39 N80'()3'1 3"W 11.50'
L40 N36'41'08"W 18.18'
L41 N59'25'30"W 17.61'
L42
- N69'03'36"W
- 27.07'
L43 S72'1 1.32-W 16.46'
L44 S78'1 2'27"W 14.37'
L45 N82'05'34"W 9.54'
L46 N58*23'21"W 13.32'
L47 S46'08'57"W 19.63'
L48 S57'29'52"E 8.72'
L49 S25'43'39'* 19.58'
L50 S32'39'10"E 21.88'
L51 S66'31'13"E 18.86'
L52 S86'44'33"E 18.79'
L53 S48'34'1 7"E 10.90'
L54 S07'36'07"E 21.83'
L55 S01 *38'26"W 8.31'
L56 S18'46'O8"E 14.35'
L57 N31'28'50"W 26.24'
L58 N23'06'34"W 17.78'
L59 S52.33'13"W 20.17'
L60 N53'S3'41"W 28.78'
L61 N43'58'59"W 33.70'
L62 N24'26'O1"W 22.15'
L63 N84'49'53"W 14.23'
L64 N72'45'31"W 22.53'
L65 N57'21'32"W 28.14'
L66 N10'14*15"W 11.83'
L67 N11'13'55"W 11.53'
L68 N 10'52'29"W 16.68'
L69 S50'56'21 "E 15.33'
L70 N64'40'00"E 21.05'
L71 N80'48'55"E 3.10'
L72 S76'09'37"E 5.82'
L73 S36'35'29"E 16.86'
L74 545'45'50"E 9.82'
L75 N55'48'17"E 21.24'
L76 S7 1729"E 20.01'
This certifies that this copy of this plat accurately depicts thedbteoundary
f the jurisdiction of Section 404 of the Clean Water Act as ermined
of the undersigned on this date. Unless there is a change in the law or
our published regulations, this determination of Section 404 jurisdiction
may be relied upon for a period not to exceed five years from this date.
This determination was made utilizing the 1987 Corps of Engineers
Wetlands Determination Manual.
Name:
Title:
Date:
FARM
LC AW3
f; 10c 'L2'
MATCH LINE 17ATT1000H
SEE SHEET 2
9CCLCH3' %
v BCCLCtIXTT4p 79 A
3D
14A
7CCLCH3' 13A
2D
AREA WETLANDS?TD
< 7,560 S.F.f 12A
a' 0.174 Ac.f
1DTT6C
111A
12 119
6CCLCH3' p L47 IVA A
CIO
r 13B IDA
109 . ??
VICINITY MAP
NOT TO SCALE
A vS X26 c?a
5CCLCH3' a°(44\0°\)
14B
a?
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at
158 a
< \O 7CL4'
4CCLCH3'
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1CCL3'TT2ICLCH v 38 ?C4
21CLCH3'198 CIO
2A
28
?
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o ??1
21CLCH3'H20' IA
WETLANDS/LINEAR WETLANDS
WATERS OF THE U.S.
PERENNIAL STREAMS
-? BOUNDARY OR EVALUATED AREA
TT=TIE TO CH=CHANNEL CL=CENTERLINE AW=AVERAGE WIDTH
\\\\????\\\\\111111 I I I 11111 /////??A/,////
'4 SEAL` still,
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L75
679.07'
L-4238 F S NOTE: WETLANDS DELINEATED BY SOIL & ENVIRONMENTAL CONSULTANTS, PA
WETLANDS DELINEATION MAP
FOR SUMMERLYN PARK
KERNER S VILLE, N. C.
115.23-
I j?////uuNlunlul\\?SHEET 3 OF 4 Graphic Scale
LEGEND
UP - UTILITY POLE LP - LIGHT POLE
ElP - EXISTING IRON PIPE PL - PROPERTY LINE
NIP - NEW IRON PIPE RW - RIGHT-OF-WAY
ER - EXISTING IRON ROD EP - EDGE OF PAVING
3 CI - CURB INLET MNS - MAG NAIL SET
o TBC - TOP BACK OF CURB AU - WATER METER
N FH - FIRE HYDRANT NTS - NOT TO SCALE
Z CB - CATCH BASIN MHS - SEWER MAN HOLE
a Yl - YARD INLET GI - GRATE INLET
P'
w CO - CLEAN OUT RCP - REINF. CONC. PIPE
3
'I CERTIFY THAT ON AUGUST 11th
3
- 2005 -_-----y WE SURVEYED THE PROPERTY SHOWN ON
N THIS PLAT:
n
P.L.S.
0' 15' 30' 60' 90'
Ratio of Pre cision - 1:10,000+
This mop or drawing and any 0ccomponying
document, are and no t the person(s)
named thereon and no alterations s or or use b FOR SUMMERLYN PARK
y
others Is permitted unless authorized by
TRIAD LAND SURVEYING, P.C. SCALE TOWNSHIP COUNTY STATE DATE
1"=30' KERNERSVILLE FORSYTH N. C. 8/15/05
Note: This plat is subject to any BEING TAX LOT 15, BLOCK 5418
Rights-Way Agreement,
of record Prior
AS RECORDED IN D.B. 791, PG. 430
to the dote of this plat, which
was not visible at the time of SURVEYED:
EM,BM TRIAD LAND SURVEYING, P.C.
.IOD N0

my inspection.
MAPPED: 935 EAST MOUNTAIN ST., SUITE H
OFFICE KERNERSMLLE, N.C.
27284 FAX .
TAH ,
99J-9650 a-moil: trlodlond0tried.meom 993-9654 12652
172.18' n. co
a
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VICINITY MAP
NOT TO SCALE
o, ' a
This certifies that this copy of this plot accurately depicts the boundary
J of the jurisdiction of Section 404 of the Clean Water Act as determined
1% • by the undersigned on this date. Unless there is a change in the low or
Tr\wlL(1 our published regulations, this determination of Section 404 jurisdiction
may be relied upon for a period not to exceed five
G years from this date.
0 tDS ?? This determination was mode utilizing the 1987 Corps of Engineers
O Wetlands Determination Manual.
LINE TABLE
LINE BEARING LENGTH
L77 S14'58'41 "W 17.12'
L78 S2 1657-E 15.47'
L79 S16*14'55"W 17.00'
L80 S25'59'07"E 18.91'
L81 S27'09'59"E 17.39'
L82 S40*26'41 "E 18.05'
L83 S02*56'08"W 19.73'
L84 S44.18'36"E 15.68'
L85 S00.1 5'14"W 15.47'
F
Name:
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Title:
Date:
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UP - UTILITY POLE
EIP - EXISTING IRON PIPE
NIP - NEW IRON PIPE
ER - EXISTING IRON ROD
CI - CURB INLET
TBC - TOP BACK OF CURB
FH - FIRE HYDRANT
C8 - CATCH BASIN
Y1 - YARD INLET
CO - CLEAN OUT
0
0
Z
a
J
LJ
i
L?
0
N
'I CERTIFY THAT ON
NOTE: WETLANDS DELINEATED BY SOIL & ENVIRONMENTAL CONSULTANTS, PA
WETLANDS DELINEATION MAP
FOR SUMMERLYN PARK
KERNERSVILLE, N. C.
SHEET 4 OF 4
LP - LIGHT POLE REVISED 9/12/05-ADD IMPORTANT/UNIMPORTANT NOTE
PL - PROPERTY LINE
RW - RIGHT-OF-WAY
EP - EDGE OF PAVING
MNS - MAC NAIL SET
WM - WATER METER
NITS - NOT TO SCALE
MHS - SEWER MAN HOLE
GI - GRATE INLET
RCP - REINF. CONC. PIPE
AUGUST 11th
-_-2005_------ wE SURVEYED THE PROPERTY SHOWN ON
THIS PLAT:
P. L. S.
-il
Ratio of Precision
This map or drowtng and any accompanying
documents are furnished to the person(s)
MAP
named thereon and no alterations or use by FOR
others is permitted unless authorized by
TRIAD LAND SURVEYING, P.C. SCALE
1 "=40'
Note: This plat is subject to any
Easements, Agreements, or
Rlghts-of-Way of record prior
to the date of this plot, which SURVEYEE
was not visible at the time of EM,BM
my inspection. MAPPED:
TAH
•o
:rte
Graphic Scale
20' 40' 80' 120'
= 1:10,000+
SUMMERLYN PARK
TOWNSHIP I COUNTY I STATE
KERNERSVILLE I FORSYTH I N.C.
BEING TAX LOT 15, BLOCK 5418
AS RECORDED IN D.B. 791, PG. 430
TRIAD LAND SURVEYING, P.C.
OFFICE 935 EAST MOUNTAIN ST., SUITE H
993 OFFICE KERNERSVILLE, N.C., 27284 FAX
e-man, trlmm?nAO rhn - - 993-9654
DATE
8/15/05
" NO.
12652
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SCALE: 1"=200' HORIZ.
TRIAD LAND SURVEYING, P. C. DRAWN 8Y: SDT/PJR PROJECT SHT. NAME SHT. NO. OWNER/DEVELOPER:
SURVEYORS/LAND PLANNERS DATE: 11 /02/05
s IMERL PARK

D y
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IMPACT
LOCATION TYPE SQ. FT.
CH and WL LINEAR FT.
CH only)
1 CH 299.6 sq. ft. 149.8 If.
2 CH 110 sq. ft. 55 If.

CH= Channel, JW= Jurisdictional Wetland,
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ENLARGEDPLAN 35 F- MOUNTAIN
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.
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336
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FAX [phone]
)
: (
e-mail: triadlandViiad.m.com PROJi=CT NO. E- 459 KERNERSVILLE, NORTH CAROLINA
- - -- - - - - - - - - - - -
- - - - - - - - - - - - - - -
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935 E. MOUNTAIN ILLS ST., SUITE H PROJECT NO.: 12652-4 ENLARGED PLAN 935 E. MOUNTAIN ST. SUITE H
KERNER SVILLE , N.C. 27284 7264 I?ERNER ROAD KERNERSVIIIE, NC 27284
OFFICE: (336)-993-9650 REVIEW BY: VWS - OF IMPACT AREA 2 CONTACT. LARRY L CALLAHAN
FAX: [phone] I.ERNERS??ILLE TOWNSHIP, 3 PHONE [phone]
e-mail: triodiand6triodrr.com PROJECT NO. E- 459 IiERNERSVILLE, NORTH CAROLINA FAX [phone]
R399
NC 1 N:
I SCALE: 1"=40' HORIZ.
1"=4' VERT.
TR-TAD LAND SURVEYING P. C, DRAWN BY: SDT/PJR PROJECT SHT. NAME SHT. NO. OWNER/DEVELOPER:
SURVEYORS/ D PL4!&L-!RS DATE: 11 02 05 SUMMERLYN PA X

935 E. MOUNTAIN ST., SUITE H

KERNE2SNLLE N.C. 27284

PROJECT NO.: 12652-4

:ERNER ROAD j
PROFILE OF CULVERT

A
935 E MOUNTAIN ST. suirE w
KERNERSVILLE, NC 27284

OFFICE (336--9 0
REVIEW BY: VWS
KERNERSVILLE TOWNSHIP
AT IMPACT AREA 4 [ CONTACT: LARRY L CALLAHAN
PHONE

FAX [phone] [phone]

e-mall: trladland3triod.m.corn
PRO FCT NO. E- 459
KERNERS\/ILLE, NORTH CAROLINA FAX [phone]
i
Soil & Environmental Consultants, PA
3817-E Lawndale Drive • Greensboro, North Carolina 27455 • Phone: [phone] • Fax: [phone]
www.SandEC.coni November 3, 2005
S&EC Project # 4-1461.W1
To: US Army Corps of Engineers N.C. Division of Water Quality
Raleigh Regulatory Field Office Wetlands & Stormwater 401 Unit
Attn: John Thomas 1650 Mail Service Center
6508 Falls of the Neuse Road, Suite 120 Raleigh, NC 27699-1650
Raleigh, North Carolina 27615
From: Jonathon Townsley
Soil & Environmental Consultants, P.A.
3817-E Lawndale Drive D
Greensboro, NC 27455
- .2005
Re: Kerner Road / Summerlyn Park NO V
Kernersville, Forsyth County, NC DENR-WATER QUALITY
11ETLAt?DSAN0 STOr A%AV RMCH
On behalf of the owner, CALMIT Properties, please find attached a complete application anc?
supplemental information requesting written concurrence from the U.S. Army Corps of Engineers
(USACE) and the N.C. Division of Water Quality (DWQ) that the activities proposed below may
precede under Nationwide Permit 39 and General Water Quality Certification 3402. Please
contact me at [phone] if you have any questions or require additional information.
PROJECT SUMMARY
Project Name Kerner Road / Summerl n Park
Project Type Residential Subdivision
Owner / Applicant CALMIT Properties
Count Forsyth
Nearest Town Kernersville
Waterbod Name Belews Creek
Basin / Sub-basin Roanoke / 03-02-01
Index Number
-
22-27-8-(1)
Class C
IMPACT SUMMARY
Stream Impact (acres): .0093
Wetland Impact (acres): 0
Open Water impact (acres): 0
Total Impact to Waters of the U.S. (acres) .0093
Total Stream Impact (linear feet): 204.8
Attachments:
Pre-construction Notification (PCN) Application Form
Agent Authorization
Site Vicinity Map
Figure 1. USGS Map
Figure 2. Soil Survey Map
Wetland Survey Map
Impact Map
$475.00 Application Fee to DWQ
Charlotte Office: Raleigh Office:
236 LePhillip Court, Suite C 11010 Raven Ridge Road
Charlotte, NC 28025 Raleigh, NC 27614
Phone: [phone] Phone [phone]
Fax: [phone] Fax: [phone]

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 "N/A".)
I. Processing
1. Check all of the approval(s) requested for this project:
® Section 404 Permit ? Riparian or Watershed Buffer Rules
? Section 10 Permit ? Isolated Wetland Permit from DWQ
® 401 Water Quality Certification ? Express 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested:NWP39, WQC3402
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: ?
4. If payment into the North Carolina Ecosystem Enhancement Program (NCEEP) is proposed
for mitigation of impacts, attach the acceptance letter from NCEEP, complete section VIII,
and check here: ?
5. If your project is located in any of North Carolina's twenty coastal counties (listed on page
4), and the project is within a North Carolina Division of Coastal Management Area of
Environmental Concern (see the top of page 2 for further details), check here: ?
II. Applicant Information R[2(r--o,r=P[
L
E ?'/ ?' D
1. Owner/Applicant Information NOV F - 2005
Name: Larry Callahan / Leslie Mitchell CALMIT Properties DENR - WATER QUALITY
Mailing Address: 110-B Shields Park Drive, Kernersville, NC 27284 f?EnAN0SAt4DSTCR',fWATERBRnr4CH
Telephone Number:336-345-1296
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: Jonathon R. Townsley
Company Affiliation: Soil & Environmental Consultants, PA
Mailing Address: 3817-E Lawndale Drive, Greensboro, NC 27455
Telephone Number: 336-540-8234, 336-669-0648 Fax Number: 336-540-8235
E-mail Address: jtownsle a sandec.com
Page 5 of 13
III. Project Information
Attach a vicinity map clearly showing the location of the property with respect to local
landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property
boundaries and development plans in relation to surrounding properties. Both the vicinity map
and site plan must include a scale and north arrow. The specific footprints of all buildings,
impervious surfaces, or other facilities must be included. If possible, the maps and plans should
include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property
boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion,
so long as the property is clearly defined. For administrative and distribution purposes, the
USACE requires information to be submitted on sheets no larger than 11 by 17-inch format;
however, DWQ may accept paperwork of any size. DWQ prefers full-size construction
drawings rather than a sequential sheet version of the full-size plans. If full-size plans are
reduced to a small scale such that the final version is illegible, the applicant will be informed that
the project has been placed on hold until decipherable maps are provided.
1. Name of project: Kerner Road / Summerlvn Park
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN): 6887-07-7904 Forsyth County GIS
4. Location
County: Forsyth County Nearest Town: KernersviIle, NC
Subdivision name (include phase/lot number): Summerlvn Park
Directions to site (include road numbers/names, landmarks, etc.): From Kernersville, north
on Piney Grove Road, left on Linville Springs Road, right on Kerner Road, pass Dean Road,
property +/- 1 mile on the right. See attached maps.
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.)
Coordinates: 36 09 20 -W, 80 04 58 - N
6. Property size (acres): 30.4 acres
7. Name of nearest receiving body of water: Belews Creek, Belews Lake
8. River Basin: Roanoke
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http://h2o.enr. state.nc.us/admin/maps/.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: The existing land use is forested, mostly loblolly and shortleaf
pines. Surrounding land use is mostly residential.
Page 6 of 13
10. Describe the overall project in detail, including the type of equipment to be used: This
30.4acre project will involve construction of a subdivision road to access 18 single family
residential building lots.
11. Explain the purpose of the proposed work: The project purpose is to create residential
building lots. Stream impacts are necessary to access buildable uplands.
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 issued for prior segments of the same T.I.P. project, along with
construction schedules. NA
Agent met with John Thomas of USACE on site to confirm delineation and stream calls. The
attached wetland survey is in accordance with USACE site confirmation.
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application.
Construction of road and 18 houses is the extent of planned development on this property. Two lots will
require driveway crossings of streams. One lot will require driveway crossing of an intermittent stream.
Another lot will require a crossing of a perennial stream. The exact location and placement of these is
not known at this time. It will be the responsibility of the future land owner of these lots to comply
current 401/404 regulations.
VI. Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. 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.
Page 7 of 13
I . Provide a written description of the proposed impacts: Proposed impacts include one road
crossing over a perennial/important stream (Location 1)necessary to access buildable land.
Also impacts to an intermittent/unimportant stream (Location 2).
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,
separately list impacts due to both structure and flooding.
Wetland Impact

Site Number
(indicate on map)

Type of Impact Type of Wetland

(e.g., forested, marsh,
herbaceous, bog, etc.)
Located within
100-year
Floodplain
( es/no)
Distance to
Nearest
Stream
(linear feet)
Area of
Impact
(acres)

Total Wetland Impact (acres) 0
3. List the total acreage (estimated) of all existing wetlands on the property: 0.174 acres
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 acreage, multiply length X width, then divide by 43,560.
Stream Impact
Number
indicate on ma
Stream Name
Type of Impact Perennial or
Intermittent? Average
Stream Width
Before Impact Impact
Length
(linear feet) Area of
Impact
(acres)
1 Important Permanent Perennial 2' 149.8 .0068
2 Unimportant Permanent Intermittent 2' 55 .0025

Total Stream Impact (by length and acreage) 204.8 .0093
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, dredging, flooding, drainage, bulkheads, etc.
Open Water Impact Name Waterbody Type of Waterbody Area of
Site Number (if applicable) Type of Impact (lake+ Pand estuary, sound, bay, Impact
(indicate on ma) ocean, etc.) (acres)

Page 8 of 13
Total Open Water Impact (acres)
6. List the cumulative impact to all Waters of the U.S. resulting from the project
Stream Impact (acres): .0093
Wetland Impact (acres): 0
Open Water Impact (acres): 0
Total Impact to Waters of the U.S. (acres) .0093
Total Stream Impact (linear feet): 204.8
7. Isolated Waters
Do any isolated waters exist on the property? ? Yes ® 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 USACE.
Pond Creation
If construction of a pond is proposed, associated wetland and stream impacts should be
included above in the wetland and stream impact sections. Also, the proposed pond should
be described here and illustrated on any maps included with this application.
Pond to be created in (check all that apply): ? uplands ? stream ? 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. Road construction to
access buildable unlands on this nroiect is a challenge due to steen slones leadine down to the
perennial stream. Several site plans were considered. The site plan was revised several times to
avoid imnactina unstream rinarian wetlands. and is placed in a location that minimizes
fill/culvert length.
VIII. Mitigation
Page 9 of 13
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. _
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
httn://li2o.enr.state.nc.us/ncwetiands/strmaide.htm1.
1. Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
The site plan for this project has been revised to reduce perennial stream impacts below 150
linear feet. This was difficult due to steep slopes. The site plan was also revised to avoid
any wetland impact on the project. We believe that mitigation should not be required for this
project as planned. Should you require mitigation, we propose payment to the NCEEP.
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.cnr.state.nc.us/,,vm/index.htm. If use of the NCEEP is proposed, please
check the appropriate box on page five and provide the following information:
Page 10 of 13
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):
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 ? 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 (NEPA/SEPA)?
Note: If you are not sure whether a NEPA/SEPA document is required, call the SEPA
coordinator at [phone] to review current thresholds for environmental documentation.
Yes ? No ?
3. If yes, has the document review been finalized by the State Clearinghouse? If so, please
attach a copy of the NEPA or SEPA final approval letter. Yes ? No ?
X. Proposed Impacts on 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
(Meuse), 15A NCAC 213.0259 (Tar-Pamlico), 15A NCAC 0213.0243 (Catawba) 15A NCAC
2B .0250 (Randleman Rules and Water Supply Buffer Requirements), or other (please
identify V Yes ? No
2. If "yes", identify the square feet and acreage of impact to each zone of the riparian buffers.
If buffer mitigation is required calculate the required amount of mitigation by applying the
buffer multipliers.
I I Zone` Impact Multiplier Required
(square feet) Mitication
I 1 I 13 (2 for Catawba)
2 1.5
Total I I I
' Zone I 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 I.
Page I I of 13
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.
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. Road construction will be ribbon pavement with
vegetated ditches. The size of the ditches will be reviewed by NCDOT. The Erosion Control
plan will be reviewed by the Winston-Salem Inspections Department. Total acreage = 30.4acres.
Roadway impervious surface = .834acres. Impervious surface from 18 homes n 3000sf per lot
= 1.239acres. Total impervious surface on the proiect is 6.8%.
XII. Sewage Disposal (required by DWQ)
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from the proposed project, or available capacity of the subject facility.
Method of wastewater disposal is individual septic systems.
XIII. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (15A NCAC 211.0500) or any Buffer Rules?
Yes ? No
Is this an after-the-fact permit application? Yes ? No
XIV. Cumulative Impacts (required by DWQ)
Will this project (based on past and reasonably anticipated future impacts) result in additional
development, which could impact nearby downstream water quality? Yes ? No ?
If yes, please submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent North Carolina Division of Water Quality policy posted on our website at
http://h2o.enr.state.nc.us/ncwet]ands. If no, please provide a short narrative description: Construction of
road and 18 houses is the extent of planned development on this property. Two lots will require
driveway crossings of streams. One lot will require driveway crossing of an intermittent stream.
Another lot will require a crossing of stream. The exact location and placement of these is
not known at this time. It will be the responsibility of the future land owner of these lots to comply with
current 401/404 regulations.
Page 12 of 13

%' Applicant/Agen s fgnature bate
Agent's signature is val only if an authorization letter from the applicant is provided.)
Page 13 of 13
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Project Mgr.: 381'-E Lawndale Dr
Es I Larry Callahan / CALMIT Properties Greensboro. NC 17-155
Forsyth County, NC [phone]
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4-1461.wl P ,
--------- Kerner Road Soil & Environmental Consultants, PA
Project Mgr.: ?I - r i.:n.'u:l•11, T?I
Es Larry Callahan
Forsyth County, NC
Scale: Belews Creek Quadrangle
1" = 2,000'
n
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Project No. Figure 2 - Soil Survey Ma
4-1461.W1 p •
------- Kerner Road 4 Soil & Environmental Consultants, PA-
Project Mgr.: Larry Callahan ?` i --F L rxii,hlr F>I
ES
Forsyth County, NC i 1161`;i,,.l,, r ' ,- i„
Scale: Forsyth County Soil Survey
May
t" = 15,840' 1976
WETLANDS/LINEAR WETLANDS
WATERS OF THE U.S.
PERENNIAL STREAMS TAX LOT 202, BLOCK 5418
HOYLE W. CHAMBERS
U BOUNDARY OR EVALUATED AREA & wf. MAYVIS T. CHAMBERS
D.B. 1148, PG. 1718
TT=TIE TO CH=CHANNEL CL=CENTERLINE AW=AVERAGE WIDTH
-----__ _ S89'19'41 "E --- 741.79'
FO ??E55 P Sj
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TAX LOT 13C, BLOCK 5419
LAWRENCE JOSEPH CARROLL, III
& wf. MELANIE ALLEN CARROLL
D.B. 2223, PG. 298
__ NAP
TAX LOT 12A, BLOCK 5419
LAWRENCE JOSEPH CARROLL. III
& wf. MELANIE ALLEN CARROLL
D.B. 2223, PG. 298 !'J
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I WATERS OF THE U.S.
PERENNIAL STREAM
(SEE SHEET 4)
TAX LOT 14L, BLOCK 5418
V. 0. CREWS HEIRS
D.B. 527, PG. 156
5/8" EIR WITH
PUNCH HOLE
1TF-__--
0
O
TAX LOT 108, BLOCK 5418
0 DORIS N. HAGERMAN
I? D.B. 2440, PC. 840
1
v
0
t°
c°
TAX LOT 14R, BLOCK 5418
V.O. CREWS HEIRS
D.B. 527, PG. 155
TAX LOT 14G, BLOCK 5418
JAMES LEE CREWS
& wf. MINNIE COOKE CREWS
D.B. 769, PG. 462
FARM
VICINITY MAP
NOT TO SCALE
WETLANDS
LINEAR WETLANDS
(SEE SHEET 3) a, J,
L1 Ala
4j`L "?' 00
O
N
O
N
J

TAX LOT 207, BLOCK 5418
\\IIIUIIIIIIIIIIIIlI/!!/ JAMES E. IVEY
\\\\\\\?St (?A r!//////// & wf. BARBARA H. IVEY
'N\O? D.B. 1811, PG. 4099
Srd
Q SEAL
' L-4238
LINE TABLE
LINE BEARING LENGTH
L1 S84'48'20"E 90.03'
L2 N18'21'49"W' 130.64'
r?
TAX LOT 19W, BLOCK 5418
CLEVELAND H. ELUS
& wf. PATRICIA V. EWS
D.B. 1234, PG. 643
°;
?
A This certifies that this copy of this plat accurately depicts the boundary
0
?6 of the jurisdiction of Section 404 of the Clean Water Act as determined
b
th
d
i
>S
If-
y
e un
ers
gned on this date. Unless there is a change in the law or
our published regulations, this determination of Section 404 jurisdiction
may be relied upon for a period not to exceed five years from this date.
This determination was made utilizing the 1987 Corps of Engineers
Wetlands Determination Manuol.
flame:
TAX LOT 205, BLOCK 5418
Title:
BENJAMIN E. KESLER
& wf. HAZEL M. KESLER
D.B. 2257, PG. 894 Date:
/// rntntt
11111111111111`\?G\?\\\\\\\ NOTE: WETLANDS DELINEATED BY SOIL L'c ENVIRONMENTAL CONSULTANTS, PA
WETLANDS DELINEATION MAP
LEGEND _ FOR SUMMERLYN PARK Graphic Scale LIGHT E P - EXISTING OIRON PIPE PL - PROPERTTYELINE KERNERSVILLE, N. C. 0 100' EN. 400' 600'
NIP NEW RW - --WAY
EIR - EXISTINGNIRONEROD EP - EDGETOFFPAVING SHEET I OF 4 Ratio of Precision - 1:10,000+
CI - CURB INLET MNS - MAG NAIL SET This map or drawing and any accompanying
0 TBC - TOP BACK OF CURB WM - WATER METER documents are furnished to the person(s) MAP
FH - FIRE HYDRANT NTS - NOT TO SCALE named thereon and no alterations or use by FOR
SUbf3fERLYN PARK
o C8 - CATCH BASIN MHS - SEWER MAN HOLE others is permitted unless authorized by
0 YI - YARD INLET GI - GRATE INLET TRIAD LAND SURVEYING, P.C. SCALE TOWNSHIP QQ
CO - CLEAN OUT RCP - REINF. CONC. PIPE
s
J
W
j 'I CERTIFY THAT ON AUGUST 11th
- 2005 WE SURVEYED THE PROPERTY SHOYM 0
N THIS PLAT:
u
01
N
3?4•
fip
TAX LOT 2, BLOCK 5418C
WESLEY A. WHITEHURST
& wf. SANDRA J. WHITEHURST
D.B. 2045, PG. 20
TAX LOT 15, BLOCK 5418
30.357 Ac.d: (OUTSIDE R/W)
0.048 AC.t(INSIDE R/W)
30.405 Ac.t (TOTAL)
BY COMPUTER
CALCULATION
WATERS OF THE U.S.
PERENNIAL STREAM
(SEE SHEET 2)
P. L. S.
hk1a /
/
/
J O\ 4'. 'I> G U ?Q? QG
i ?P1' 0e ? F,

?? r9g ?1
UNTY STATE
1200' KERNERSVILLE FORSYTH N.C.
Nate: This plat is subject to any BEING TAX LOT 15, BLOCK 5418
Easements, Agreements, AS RECORDED IN D.B. 791, PG. 430
Rights-of-Way of record prior
to the date of this plot, which SURVEYED: TRIAD LAND SURVEYING, P.C.
was not visible at the time of EM,BM 935 EAST MOUNTAIN ST., SUITE H
my inspection. MAPPED: OFFICE KERNERSVILLE, N.C., 27284 FAX
TAH 893-9650 *-moll: trlodlandOtrlad.n.enm 993-9554
DATE
8/15/05
JOB NO.
12652

0
a;
m'
a'
POINT IN
CREEK /
(TYPICAL)
00
/F?)
0
VICINITY MAP
NOT TO SCALE
/ WETLANDS/LINEAR WETLANDS
P?j3 WATERS OF THE U.S.
PERENNIAL STREAMS
BOUNDARY OR EVALUATED AREA
TT=TIE TO CH=CHANNEL CL=CENTERLINE AW=AVERAGE WIDTH
`il
N
LD • W
`ID
N
(5?.\cr
P?3
C\,G
CS G?GN'S
's
\`SO, This certifies that this copy of this plot accurately depicts the boundary
sS7 of the jurisdiction of Section 404 of the Clean Water Act as determined
j
'PO . by the undersigned on this date. Unless there is a change in the low or
APO our published regulations, this determination of Section 404 jurisdiction
may be relied upon for a period not to exceed five years from this dote.
This determination was mode utilizing the 1987 Corps of Engineers
CN6 Wetlands Determination Manual.
LINE TABLE
LINE BEARING NGTH
L1 S84'48'20"Ee 90.03'
L2 N18'21'49"W 130.64'
L3 S1 5'58'45"E 4.83'
L4 S80'42'56"E 9.03'
L5 S72'01'07"E 9.82'
L6 S29'58'11 "E 10.55'
L7 S70'11 5'06"E 17.80'
L8 S47'03'1 7"E 20.82'
L9 S55'46'25"E 7.99'
LID S53'56'11 "E 16.04'
L11 S68'35'11"E 17.68'
L12 S78'38'1 2"E 9.40'
L13 S36'02'06"E 14.67'
L14 N71*33'47"E 8.78'
L15 S71'24'37"E 15.55'
L16 S60'24'44"E 2.96'
\\\? ? \ \ \ \ \ \ \ 1111 I I I I I I I I I I I / / / / y / / / / //
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SEAL
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Title:
Date:
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NOTE: WETLANDS DELINEATED BY SOIL & ENVIRONMENTAL CONSULTANTS, PA
5,.? WETLANDS DELINEATION MAP
FOR SUMMERLYN PAR
s Ht1 K
SE vo 3
ol,10A \\NC 9G?C?? ?v \6PL19 \9P
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'
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LEGEND
UP - UTILITY POLE
LP - LIGHT POLE
SHEET 2 OF 4 0
15
30
60' 90'
EIP - EXISTING IRON PIPE
NIP - NEW IRON PIPE PL - PROPERTY LINE
RW - RIGHT-OF-WAY Ratio of Precision - 1:10,000+

EIR
- EXISTING IRON ROD
EP - EDGE OF PAVING This mop or drawing and any accompanying
_
Cl CURB INLET
TBC - TOP BACK OF CURB
MNS - MAG NAIL SET
V
'M documents are furnished to the person(s)
named thereon and no alterations or use by MAP
FOR SUMMERLYN PARK

FH - FIRE HYDRANT r
- WATER METER others is permitted unless authorized by
NTS - NOT TO SCALE TRIAD LAND SURVEYING
P
C

CB - CATCH BASIN
MHS - SEWER MAN HOLE ,
.
. SCALE TOWNSHIP COUNTY STATE DA
YI - YARD INLET GI - GRATE INLET
CO - CLEAN OUT RCP - REINF. CONC. PIPE 1"=30' KERNERSVILLF FnRCYTW N r- R /1 S
3
vi
0
a
J
w
3
U
3
i
LO
'I CERTIFY THAT ON AUGUST 11th Note: This plot is subject to any
2005 Easements, Agreements, or
-?_ WE SURVEYED THE PROPERTY SHOWN ON Rights-of-Way of record prior
THIS PLAT: to the date of this plot, which
/ - was not visible at the time of
?? "`? P. L. S. my inspection.

LINE TABLE
LINE BEARING LENGTH
L17 _S69'09'1 5"E 10.07'
L18 S60'35'1 7"E 22.34'
L19 N71'03'41"E 12.24'
L20 N84'1 2'37"E 17.16'
L21 N89'48'42"E 17.12'
L22 S77'55'28"E 21.11'
L23 S63'49'50"E 14.75'
L24 S31 *45'23"E 13.11'
L25 S02'59'04"W 10.05'
L26 N78*17'53"E 13.43'
L27 N72'1 1'32"E 17.87'
L28 S69'03'36"E 22.84'
L29 S59'25I30"E 24.46'
1-30 S35'44'36"E 6.67'
1-31 S62'05'31 "E 12.24'
L32 N89'33'09"E 9.49
L33 N49'10"1"E 20.03'
L34 S32'39'38"E 13.70'
L35 S24'34'10"E 17.46'
L36 S89'54'29"W 9.83'
L37 N85'22'39"W 12.80'
L38 N63'52'26"W 12.58'
1-39 N80'03'13"W 11.50'
L40 N36'41'08"W 18.18'
L41 N59'25'30"W 17.61'
L42 N69'03'36"W 27.07'
L43 S72'1 1'32"W 16.46'
L44 S78'1 2'27"W 14.37'
L45 N82'05'34"W 9.54'
L46 N58'23'21"W 13.32'
L47 S46'08'57"W 19.63'
L48 S57'29'52"E 8.72'
L49 S25'43'39"E 19.58'
L50 S32'39'1 0"E 21.88'
L51 S66'31'13"E 18.86'
L52 S86'44'33"E 18.79'
L53 S48'34'1 7"E 10.90'
L54 S07'36'07"E 21.83'
L55 S01'38'26"W 8.31'
L56 S1 8'46'08"E 14.35'
L57 N31'28'50"W 26.24'
L58 N23'06'34"W 17.78'
L59 S52'33'1 3"W 20.17'
L60 N53'53'41 "W 28.78'
L61 N43'58'59"W 33.70'
L62 N24'26'01 "W 22.15'
L63
- N84'49'53"W 14.23'
L64 N72'45'31 -W 22.53-
L65 N57'21'32"W 28.14'
L66 N10'14'15"W 11.83'
L67 "
5 W
11.53'
L68 "W
16.68'
L69 "E 15.33'
L70 W
.
"E 21.05'
L 71 .
"E 3.10'
L72 .
"E 5.82'
L73 .
"E E
E 16.86'
L74 S45'45'50"E 9.82'
L75 N55'48'17"E 21.24'
L76 S75'1 7'29"E 20.01'
This certifies that this copy of this plat accurately depicts the boundary
of the jurisdiction of Section 404 of the Clean Water Act as determined
or
tpublishedsiregulations, I this tdeterjmlination there of Section 404 jurisdiction
our may be relied upon for a period not to exceed five years from this date.
This determination was made utilizing the 1987 Corps of Engineers
Wetlands Determination Mcnual.
Name:
Title:
Date:
RD.
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TT=TIE TO CH=CHANNEL CL=CENTERLINE AW=AVERAGE WIDTH
\\\\\\?\\\\\\\\11I I I I I I I I I I I/////// j/////
L-4238
\ U
All i I 111110
884/ti LEGEND

UP - UTILITY POLE
EIP - EXISTING IRON PIPE
NIP - NEW IRON PIPE
EIR - EXISTING IRON ROD
3 Cl - CURB INLET
o TBC - TOP BACK OF CURB
v FH - FIRE HYDRANT

Z
° CB - CATCH BASIN
YI - YARD INLET
CO - CLEAN OUT
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679.07'
NOTE: WETLANDS DELINEATED BY SOIL & ENVIRONMENTAL CONSULTANTS, PA
WETLANDS DELINEA TION MAP
FOR SUMMERLYN PARK
KERNER S VILLE, N. C.
SHEET 3 OF 4
LP - LIGHT POLE
PL - PROPERTY LINE
RW - RIGHT-OF-WAY
EP - EDGE OF PAVING
MNS - MAG NAIL SET
WM - WATER METER
NTS - NOT TO SCALE
MHS - SEWER MAN HOLE
GI - GRATE INLET
RCP - REINF. CONC. PIPE
.I CERTIFY THAT ON AUGUST 11th
- 2005 -_-----y w£ SURVEYED THE PROPERTY SHOYM ON
THIS PLAT:
N
?,!!Lf^7t.rL?//
??? P.L.S.
?Lc
L75
115.23'
Graphic Scale
0' 15' 30' 60' 90'
Ratio of Precision - 1:10,000+
This map or drawing and any accompanying
documents are furnished to the person(s) MAP
named thereon and no alterations or use by FOR
others is permitted unless authorized by
TRIAD LAND SURVEYING, P.C. SCALE
1"=30'
Note: This plot is subject to any
Ecsements, Agreements, or
Rights-of-Way of record prior
to the date of this plat, which
was not visible at the time of SURVEYEE
EM,BM
my inspection. MAPPED:
TAH
VICINITY MAP
NOT TO SCALE
SUMMERLYN PARK
TOWNSHIP COUNTY I STATE
KERNERSVILLE I FORSYTH I N. C.
BEING TAX LOT 15, BLOCK 5418
AS RECORDED IN D.B. 791, PG. 430
TRIAD LAND SURVEYING, P.C.
OFFICE 935 EAST MOUNTAIN ST.. SUITE H
KERNERSVILLE. N.C., 27254 FAX
993-9650 a-man: 1rladlanAOtrlnArrrrvn 993-9654

DATE
8/15/05
" NO.
12652
a
172.18' ?. ak
569.60' SITE

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NOT To SCALE
\
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\
WETLANDS/LINEAR WETLANDS
.O WATERS OF THE U.S.

111CLCH3 PERENNIAL STREAMS
BOUNDARY OR EVALUATED AREA
C*O" TT=TIE TO CH=CHANNEL CL=CENTERLINE AW-AVERAGE WIDTH
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P of the jurisdiction of Section 404 of the Clean Water Act as determined
•
M
?\ by the undersigned on this date. Unless there is a change in the law or
our published regulations, this determination of Section 404 jurisdiction
C??
a0
o as p? may be relied upon for a period not to exceed five years from this date.
This determination was made utilizing the 1987 Corps of En
ineers
6?S g
Wetlands Determination Manual.

Nome:

Title:
Date:

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LINE TABLE
LINE BEARING LENGTH
L77 S1458'41 "W 17.12'
L78 S22'1657"E 15.47'
L79 S16'14'55"W 17.00'
L80 S25'59'07"E 18.91'
L81 S27'09'59"E 17.39'
L82 S40'26'41 "E 18.05'
L83 S02'56'08"W 19.73'
L84 S44'18'36"E 15.68'
L85 S00'15'14"W 15.47'
\\\\\\\xx\?tt1111111111111? pff??////
.0Fgssr '1111
Q SEAL
L-4238
--% ,'"'',--1S1
'iluau1IIIIIumlu???
NOTE: WETLANDS DELINEATED BY SOIL & ENVIRONMENTAL CONSULTANTS, PA
WETLANDS DELINEATION MAP
FOR SUMMERLYN PARK
KERNERSVILLE, N. C.
SHEET 4 OF 4
UP - UTILITY POLE LEGEND LP - LIGHT POLE REVISED 9/12/05-ADD IMPORTANT/UNIMPORTANT NOTE
EIP - EXISTING IRON PIPE PL - PROPERTY LINE
NIP - NEW IRON PIPE RW - RIGHT-OF-WAY
EIR - EXISTING IRON ROD EP - EDGE OF PAVING
CI - CURB INLET MNS - MAG NAIL SET
TBC - TOP BACK OF CURB WM - WATER METER
FH - FIRE HYDRANT NTS - NOT TO SCALE
CB - CATCH BASIN MHS - SEWER MAN HOLE
YI - YARD INLET GI - GRATE INLET
CO - CLEAN OUT RCP - REINF. CONC. PIPE
c?
3
0
Z
a
J
3
3
O
/
N
'I CERTIFY THAT ON AUGUST 11th
-_ 2005_------ WE SURVEYED THE PROPERTY SHOWN ON
THIS PLAT:
P. L. S.
/
n
rn
A
00 :
4'?
00.
J?O
Ratio of Preci.sio-rL
-.01
0
Graphic Scale
20' 40' 80' 120'
1:10,000+
This mcp or drawing and any accompanying
documents are furnished to the person(s)
named thereon and no alterations or use b MAP
FOR SUMMERLYN PARK
y
others Is permitted unless authorized by
TRIAD LAND SURVEYING, P.C. SCALE TOWNSHIP COUNTY STATE DATE
1"=40' KERNERSVILLE FORSYTH N.C. 8

/15/05
T
Note: This plat Is subject to any BEING TAX LOT 15, BLOCK 5418
Easements, Agreements,
Rights-of-Way of record prior
t
th AS RECORDED IN D.B. 791, PG. 430
o
e date of this plat, which
was not visible at the time of SURVEYED:
EM,BM TRIAD LAND SURVEYING, P.C.
JOB N0.
my inspection. MAPPED: 935 EAST MOUNTAIN ST., SUITE H
OFFICE KERNERSVILLE
N
27284 FAX
C
TAH ,
.
.,
993-9650 e_m„n. tHOe?a?eO?.rlnd.rr.ccm 993-965 4 12652
0
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SEE ENLARGED PLAN
OF IMPACT AREA 1
++++tnnunq?
14ti .
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26139 G'' F E`?
+S?,P ?.
flies,
SCALE: 1"=200' HORIZ.
TRIAD LAND SURVEYING, P.C. DRAWN BY: SDT/PJR PROJECT SHT. NAME SHT. NO. OWNER/DEVELOPER:
SURVEYORS/LAND PLANNERS DATE: 11 /02/05 SUIVIMER i 1V PARK CALMIT PROPERTIES
935 E. MOUNTAIN SL, SUITE H
PROJECT NO.: 12652-4 KERNER ROt1D OVERALL SITE 935 E. MOUNTAIN ST. SUITE H
KERNERSVILIF, NC 27264
KERNERSVILLE, N.C. 27284
OFFl (336)-9
G
REVIEW BY: VWS KERNERSVILLE TOWNSHIP
PLAN CONTACT: LARRY L CALLAHAN
PHONE [phone]

9654
36)-9933--9654
FAX: (3
1r-mail: trfadlanc0triad.m.com
,
PROJECT NO. E 459 ! K-ERNERSVILLE, NORTH CAROLINA

FAX [phone]
IMPACT
LOCATION TYPE SQ. FT.
CH and WL LINEAR FT.
CH only)
1 CH 299.6 sq. ft. 149.8 If.
2 CH 110 sq. ft. 55 If.

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.
.
SURjrEYORSLAND PLANI1r RS DATE: 11 02 05 SUMMERLYN PARK
ENLARGED PLAN 935 E. MOUNTAIN
935
FOUNTAIN ST. SUITE H
935 E. MOUNTAIN ST., SUITE H
27284
C
ERNERSVILLE N PROJECT NO.: 12652-4 KERNER ROAD
OF IMPACT AREA I E
CONTACT. LA NC 27264
CONTACT: LARRY L CALLAHAN
.
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OFFICE (3365-993-9650
9654
3 REVIEW BY: VWS KERNEP.S\fILLE TMN'SHIP, Ld PHONE [phone]
FAX [phone]
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FAX. (336)-99
e-ma4: triodlandVriad.m.com PR0.1_CT NO. E- 459 KERNERSVILLE NORTH CAROLINA
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TRIAD LAND SURVEYING, P. C. DRAWN BY: SDT/PJR PROJECT SHT. NAME SHT. NO.
SUFVEYOROLAND PLANNERS DATE: 11/02/05 OWNER/DEVELOPER: PARK CALMIT PRPERTIES
935 E MOUNTAIN ST., SUITE H SUV MER PROJECT NO.: 12652-4 ENLARGED PLAN 935 E MOUNTAIN ST. SUITE H
KERNERSVILLE, N.C. 27294 KERNER ROAD KMNERSMUE, NC 27284
OFFICE: (336)-993-9650 REVIEW BY: 1MJS IiERNER$VILLE TOWNSHIP, 0? IMPACT AREA 2
3 CONTACT: LARRY L CALLAHAN
FAX: [phone] PHONE [phone]
e-mail: triodland®triad.rr.com PROJECT NO. E- 459 KERNERSVILLE, NORTH CAROLINA FAX [phone]
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DATE: 11/02/05 SUMMERI CAWIT PROPERTIES
935 E MOUNTAIN ST., SUITE H

ICERN?iSVI(
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PROJECT NO.: 12652-4
KERNER ROAD PROFILE OF CULVERT 935 E MOUNTAIN ST. SUITE H
KERNERSVILLE, NC 27284
.
.
.
.
OFFICE: (336j-993-9650
REVIEW BY: VWS I:ERNERS??ILLE TOWNSHIP
AT IMPACT AREA I
4 CONTACT: LARRY L CALLAHAN

PHONE [phone]
FAX: [phone]
e-mail: trladlandCtrlad.rr.com ,
PROJECT NO. E- 459 KERNERSVILLE, NORTH CAROLINA FAX [phone]
SOIL & ENVIRONMENTAL CONSULTANTS, PA
NCDWQ Wetlands 6 Sormwater 401 Unit Surmerlyn Park/Kerner Road Check Number:
Date: 11/3/2005 Check Amt:
Tran # Invoice Type Date Reference Balance Discount
8636 110305G Invoice 11/03/05 Permit Application $475.00 $0.00
[9 k@ H 0 V1
J
NOV 8 - 2005
519
$475.00
Pay Amount
$475.00
DENR - WATER QUALITY
10IAND3 AND STORWwYATER BRANCH