20052128 Ver 1_Complete File_20070828

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Michael F. Easley, Governor

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

Mr. Daniel Lee Miller
Honor Equipment Co., LLC
10217 Scott Gate Court
Charlotte, NC 28277

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Alan W, Klimek, PE Director
Division of Water Quality

December 15,2005
DWQ# 05-2128
Davidson County

APPROVAL of 401 Water Quality Certification with Additional Conditions

Dear Mr. Miller:

You have our approval, in accordance with the attached conditions, to place fill within, or otherwise impact
by excavation, 0.21 acre of waters for the purpose of constructing a pier on High Rock Lake at 1159
Holloway Church Road, Southmont, in Cotton Grove Township, Davidson County, as described in your
application received by the Division of Water Quality on November 28, 2005. After reviewing your
application, we have determined that this activity is covered by General Water Quality Certification Number
3492, which can be viewed on our web site at http://h2o.enr.state.nc.us/ncwetlands.This Certification allows
you to use Regional General Permit Number 198200030 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 (Regional General 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 fill for this project (now
or in the future) exceeds one acre of wetland or 150 linear feet of stream, 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 the
Certification are met. No other impacts, including incidental impacts, are approved:

Amount Approved Plan Location or Reference
Waters 0.21 acre 1159 Holloway Church Road (Lot 4, Old
Fox Run), Southmont, Cotton Grove
Township, Davidson County

N.?IthCarolina
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North Carolina Division of Water Quality
Wetlands Certification Unit 1650 Mail Service Center
2321 Crabtree Blvd.
Customer Service Number: 1-877-623-6748

Raleigh, NC 27699-1650
Raleigh, NC 27604-2260

Phone [phone] FAX [phone]
Intemet htto//: h20 .enr.state.nc.us/ncwetlands

An Equal Opportunity/Affirmative Action Employer - 50% Recycled/10% Post Consumer Paper

~1r. Daniel Lee Miller
P .., D\lrQ~ 0- ")1-/8
age ..., ,) " )-- -
December 15, 2005

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2. Appropriate sediment and erosion control measures which equal or exceed those outlined in the most
recent yersion of the North Carolina Erosion and Sediment Control Planning and Design Manual or the
Xorth Carolina Surface ~\1ining lifanual (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 \vith the North Carolina water quality standards that are
applicable to lakes and reservoirs. Such measures must equal or exceed the requirements specified in
the most recent yersion 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 the 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
unayoidable, they shall be removed and the natural grade restored within six months of the date that the
project is completed or, if applicable, \\ithin six months of the date that the project is released by the
~orth Carolina Di\ision of Land Resources.

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

5. lJpon finishing the project, the Applicant shall fill out and return the enclosed "Certificate of
Completion" to notify NCD\VQ when- all work included in the 9401 Certification has been completed.
This certificate should be returned to the 401AVetlands Unit of the NC Division of Water Quality at the
address listed on the form.

If you do not accept any of the conditions of this certification, you may ask for an adjudicatory hearing. You
must act \\ithin 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, 671~ 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 haye any questions, please telephone Daryl Lamb in the DWQ Winston-Salem Regional Office at 336-
771-4600 or Ian :McMillan in the \Vetlands/401 Central Office in Raleigh at 919-715-4631.

CiJ;d

? Alan W. Klimek, P.E.

A WKfcdl

Triage Check List

Date: 11/30/05

Project Name: Daniel Lee Miller:159 Holloway Church Rd
DWQ#: 05-2128
County: Davidson

To:

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Daryl Lamb, Winston-Salem Regional Office

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60-day processing time:

11/28/05 - 1/26/06

From: Cyndi Karoly Telephone: [phone]

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

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

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!

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November 22, 2004

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20052128

N. C. Division of Water Quality
40 1 Wetlands Unit
Davidson County
Mrs. Cindi Karoly
1650 Mail Service Center
Raleigh, NC 27699-1650
(5 each copies + $200.00 fee)

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U.S. Army Corps of Engineers
Davidson County
Mr. John Thomas, Project manager
6508 Falls of the Neuse Road
Suite 120
Raleigh, NC 27615

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Dear Gentlemen,

Please find attached the completed Pre-Construction Notification Application Form
required to get approval for an Excavation permit from Alcoa Power Generating Inc. on
High Rock Lake. The purpose of the project is to increase the water depth in order to
meet minimum depth requirements for the construction of a private pier for recreational
use.

The excavation will be done by Newsome Grading Co., LLC of Lexington, NC located
on Park Road. The material used will be hauled off site by truck by approximately 3
miles north to Park Road. The material removed will have no future impact on the lake
itself The excavation and loading of trucks will be done by a loader or back-hoe.

We would appreciate your letter of approval of the excavation plans required for our
intended pier construction to improve the recreational aspects of our L~e House and
property. If you have any questions you can contact me at anyone of the numbers
provided below.

Si erely

U?~~

amel Lee Miller
C/O Honor Equipment Co., LLC
Office: 704-525-3770
Home: 704-846-5264
Mobile: [phone]

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NO\}, 2, 8 2005
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DENR. WAI;;';'JW~'TER BRANCH
WEt1J'.NOS ~O 51 \JI\Ift"

Office Use Only:

Fonn Version March 05

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

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052128

I. Processing

1. Check all of the approval(s) requested for this project:
[i] Section 404 Permit 0 Riparian or Watershed Buffer Rules
o Section 10 Permit 0 Isolated Wetland Permit from DWQ
00 401 Water Quality Certification 0 Express 401 Water Quality Certification

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

GP?o

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

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

5. If your project is located in any of North Carolina's twenty coastal c~mwmlil\
4), and the project is within a North Carolina Division of Coastal 1Ai~g;ment Area oE/
Environmental Concern (see the top of page 2 for further details), check her~OflJ2 8 2005

II.

Applicant Information

DENR.WATERQUAUTY
WET1.NIDS AND STORMW.'tTfR t:lRNiCH

1. Owner/Applicant Information
Name: f)1t~/EL LEI? It/LLFt<
Mailing Address: 102.../7 S(()/T G/J-TL: COUf< r
CHit Il.. L() IT!: IVC 2 S' 2. 77

Telephone Number: tlo4) gzt t - ~2b4 Fax Number: f704) ~4 6 ~S-;2.b.s
E-mail Address: JC\.~"e/. lrn;l/eY" @ dien€5. (C'J-YI

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

Telephone Number:
E-mail Address:

Fax Number:

Page 5 of 12

m. Project Information

Attach a vicinity map clearly showing the location of the property with respect to local
landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property
boundaries and development plans in relation to surrounding properties. Both the vicinity map
and site plan must include a scale and north arrow. The specific footprints of all buildings,
impervious surfaces, or other facilities must be included. . If possible, the maps and plans should
include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property
boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion,
so long as the property is clearly defined. For administrative and distribution purposes, the
USACE requires information to be submitted on sheets no larger than 11 by 17-inch format;
however, DWQ may accept paperwork of any size. DW~ 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: II ~ OJ

I-J.ollowp\v Chl1vch ;(Ot:lJ
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2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN): 06033 E OOOOOOLf-

4. Location
County: [) 0\ v,\ cl S () V\ Nearest Town: Co fro VI Gy" lie TO L.msJ."p
Subdivision name (include phase/lot number): () (J Fo x R c.A.., . L 0 j- i..) .
Directions to site (include road numbers/names, landmarks, etc.): '-rer J.re J.I.,""~ ~
5olA.+h W"'1 L-e;(I'....e~h rAyo.... j., SOH rh n1o...f. I/Avy) -eff ol-'11D
~ / 0 IN 1\ C h.t v-c 1'1 /. fl. cr h:>$ S yo",......., Tj,() Wtc..5 tP Y1 R 't / -f. & tA~ (' '-"'1'//
b~ ~V1 rAe I~ -I- ~e....-ov~ yt!)Vl C/'O.!,J f-he.../J/;j"ds Greef 8y,'./:J~,
5. Site coordinates (For linear projects, such as a road or utility line, attach a sheet that
separately lists the coordinates for each crossing of! qistinct waterbody.) ,
Decimal Degrees (6 digits minimum): 2.. 7' 5"1' ~ $ I <N IS--. 2 b ov;:. E

6. Property size (acres):

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7. Name of nearest receiving body of water:

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8. River Basin: Y PI. / A,' n 1</ ve y
(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: Tit eO. 4 Cf t /J, "c Lo f- c u v v ~ ... -I ~ 11N S
~ L&\ k... hd'" r;) e ~ y ~ ;t..1''''~ct I-e /, Z O'l 6' ~ Ff. The
w",+-e.".- {V"V'+ does nor mep.f- m,'n,';OOIl-un we>o..fe.y cep/I,
.

+" q tU\/I.fy ~.... PI. /,'e Jr,

Page 6 of 12

10. Describe the overall project in detail, includiIJg the type of equipment to be used: The obi ed/lie'
.... dveJ (" f-A.r.>. w"fev' T'~Ylf C>~ .;-/..{! ~f olD "he venS\:,
\.A.Jt>t+ev' de ./T'h Inside c +-ht flt?!f-c-(y,," >hllY"e../,'V7e IJ...e.!.()
#\111'''' /r:J()O cycfJ. "....,-/' be rChIPVCc! -...<?..... ,-l-e 5i!e ~ 7-b'tIt, j
11. Explain the pUl;gose of the proposed work: TO ~ y, v ,'de S vf F~"c ,'e... f I-VI>,f(} Y
clerJrh -T-C::>y C&I-tSTyucf-t'tJv1. Cfr1 h~'rYH""/ U$-e ",f-' C{
p : ,. Vel -I-e f,'e.., -Fo V' 'r f. C .,eet f "0 tol &II/HI v' /<1 Se '5

IV. Prior Project History

If jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Include
the USACE Action ill Number, DWQ Project Number, application date, and date permits and
certifications were issued or withdrawn. Provide photocopies of previously issued permits,
certifications or other useful information. Describe previously approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits issued for prior segments of the same T.I.P. project, along with
construction schedules. /Y / /J

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.
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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)
$hould 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: T hi,> ,.P Y; / e t f w,' / I
lvlV e ~ ~I '~'" j.16C t'" f- t:) .., Iv & /11. 1I 0 jJe Yl l/1/ '" f-e v II
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Page 7 of 12

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

separately 1st Impacts ueto ot structure and flooding.
Wetland Impact Type of Wetland Located within Distance to Area of
Site Number Type of Impact (e.g., forested, marsh, 100-year Nearest Impact
(indicate on map) herbaceous, bog, etc.) Floodplain Stream (acres)
(yes/no) (linear feet)
-
Total Wetland Impact (acres)

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

#//J

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

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

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

1 , excavation, re I~m~, 00 mg, ramage, u ea s, e c.
Open Water Impact Name ofWaterbody Type ofWaterbody Area of
Site Number Type of Impact (lake, pond, estuary, sound, bay, Impact
(indicate on map) (if applicable) ocean, etc.) (acres)
/11110 13 L.,t if /hc.h ~I&!c L./u Re.mt?vA/ ",f - /Gfke. O. '2-0
, , C;eJC'th1~",f
-
Total Open Water Impact (acres)

Page 8 of 12

6. List the cumulative im act to all Waters of the U.S. resultin
Stream Impact (acres):
Wetland 1m act acres:
Open Water Impact (acres):
Total 1m act to Waters of the U.S. (acres)
Total Stream Impact (linear feet):

7. Isolated Waters
Do any isolated waters exist on the property? 0 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): 0 uplands 0 stream D wetlands
Describe the method of construction (e.g., dam/embankment, excavation, installation of
draw-down valve or spillway, etc.):
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.):
Current land use in the vicinity of the pond:
Size of watershed draining to pond: Expected pond surface area:

vn.

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 fqllowed during construction to reduce impacts. )} f, fA I c<..,e &\. c f
,,\) oJ,;.>/r.fc!t /(JJo' ;(90'",-,,'1/ b-e e\LOfvl'I.feJ b 2,~f..'J.S +e~-f -1-<>
V'~H'Je.. CI e t-("/~d<;), -G..-- A Vecve~f'P#tA ,'ey, IJI/ /'r"T /re.>r76Vl?'
w.-II hA"1.feJ ,,..(C~ -10 ~ ,ie tt () ,'#-/1" ~ "3 e,.n,' e
#Hr 0>1 PtY'"ks '1<01. ~e f,f,./ A"YI'U"!,, ef,',,! yerl'/o'.<€e! .s ,rJ",fe! Ix>
Mitigation et.p ~Y"~ j ; h'\ If -I e. 'l' I 00 () C "",/,,' C Yt:f I'd s .

VITI.

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

Page 9 of 12

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

If mitigation is required for this project, a copy of the mitigation plan must be attached in order
for USACE or DWQ to consider the application complete for processing. Any application
lacking a required mitigation plan or NCEEP concurrence shall be placed on hold as incomplete.
An applicant may also choose to review the current guidelines for stream restoration in DWQ's
Draft Technical Guide for Stream Work in North Carolina, available at
http://h20.enr.state. nc. us/ncwetIands/ strmgide. 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 off site), 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.

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 l:lttached to this form. For
additional information regarding the application process for the NCEEP, check the NCEEP
website at http://h2o.enr.state.nc.us/wrp/index.htm. Ifuse of the NCEEP is proposed, please
check the appropriate box on page five and provide the following information:

Amount of stream mitigation requested (linear feet):
Amount of buffer mitigation requested (square feet):
Amount of Riparian wetland mitigation requested (acres):
Amount of Non-riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres):

Page 10 of 12

IX. Environmental Documentation (required by DWQ)

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

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

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

X. Proposed Impacts on Riparian and Watershed ButTers (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 )? Yes D No ~

2. If "yes", identify the square feet and acreage of impact to each zone of the riparian buffers.
If buffer mitigation is required calculate the required amount of mitigation by applying the
buffi It" r

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

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

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

Page 11 of 12

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.

xu. 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.

xm. Violations (required by DWQ)

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

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

No D

XIV. Cumulative Impacts (required by DWQ)

Will this project (based on past and reasonably anticipated future impacts) result in additional
development, which could impact nearby downstream water quality? Yes D No IE!
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://h20.enr.state.nc.us/ncwetlands. Ifno, please provide a short narrative description: TA ~
On/v C"'I1~t-r~cf'\I"" (,1-",'/1 "'~ Ct r?Y/Vfil-4> #,/'ev -t&v- vecve~flb#e.J
lAH. /1/<:> J:) -r-,e v,' V lot S ,'"...//... eo f. . ,
, ~

XV. Other Circumstances (Optional):

It is the applicant's responsibility to submit the application sufficiently in advance of desired
construction dates to allow processing time for these permits. However, an applicant may
'choose to list constraints associated with construction or sequencing that may impose limits on
work schedules (e.g., draw-down schedules for lakes, dates associated with Endang~red and
Threatened Species, accessibility problems, or other issues outside ofthe applicant's control).

[2;/~

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

~I/. Z 2.., 2.C7">
.

Page 12 of 12

Excise Tax $650.00

Recerding Time, Book and Page

Tax Lot No. 4
Verified by

Parcel Identifier No. 06033E0000004
County on the _ day of

, 20_by

Mail after recording to Dan Miller, 10217 Scott Gate Court, Charlotte, NC 28277
This instrument was prepared by Jeffrey J. Berg, Attorney, Lexington, NC
: Brief Description for the index I Lot 4, Old Fox Run, Plat Book 16, Page 43 I
NORTH CAROLINA GENERAL WARRANTY DEED

THIS DEED made October 13,2005, b and between
GRANTOR

GRANTEE

Jerry \Vayne Leamon, Jr. and wife, Shelia B. Leamon

Honor Equipment, LLC
[)('n,'~1 L~e /tf,'//e..- -Gel1e",..t/'1.""'yt'r

Enter in appropriate block for each party: name, address, and, if appropriate, character of entity, e.g., corporation or partnership.

The designation Grantor and Grantee as used herein shall include said parties, their heirs, successors, and assigns, and shall include
singular, plural, masculine, feminine or neuter as required by context.

WI1NESSETH, that the Grantor, for a valuable consideration paid by the Grantee, the receipt of which is hereby acknowledged, has
and by these presents does grant, bargain, sell and convey unto the Grantee in fee simple, all that certain lot or parcel of land situated in
the City of ,Cotton Grove Township, Davidson County, North Carolina and more particularly described as follows:

Being all of Lot No.4 as the same is- shown and designated on Aluminum Company of America plan of
lots entitled OLD FOX RUN, dated May 1972 as recorded in Map Book 16, Page 43, in the Office of the
Register of Deeds for-Davidson County, North Carolina.

N. C. Bar Assoc. Form No.3 @ 1977
Printed by Agreement with the N.C. Bar Assoc.#003

The property hereinabove described was acquired by Grantor by instrument recorded in Book 1135, Page 1543.

A map showing the above described property is recorded in Plat Book 16, Page 43..

- TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to the Grantee in
fee simple.

And the Grantor covenants with the Grantee, that Grantor is seized of the premises in fee simple, has the right to convey the same in fee
simple, that title is marketable and free and clear of all encumbrances, and that Grantor will warrant and defend the title against the
lawful claims of all persons whomsoever except for the exceptions hereinafter stated.

Title to the property hereinabove described is subject to the following exceptions:

IN WITNESS WHEREOF, the Grantor has hereWlto set his hand and seal, or if corporate, has caused this instrument to be signed in
its corporate name by its duly authorized officers and its seal to be hereWlto affixed by authority of its Board of Directors, the day and
year fIrst above written.

..,..~~===~:::=~]
~...,.____=' ~~...,.,-.-;.,-w..-
_.- - -. OFFICIAL SEAL
~8.. Nolary Public' North Caroll".
H\ .. ~ COUNTY OF DAVIDSON \
DEBRA C. TEAGUE
..."..-'..,....".
~.....,..~..."-...."....."......",,..
----

T ~ tJa, =~=q:;: (SEAL)
Jerry \Vay Ie Leal~on, Jr.

.SZR ,:...tJPl E>$?~ (SEAL)
Shelia B. Leamon

SEAL-STAMP

NORTH CAROLINA, Davidson COWlty.
I, the Wldersigned, a Notary Public of the COWIty and State aforesaid, certify that Jerry \Vayne
Leamon, Jr. and wife, Sheila B. Leamon, Grantor, personally appeared before me this day and
ackn<?~edged the execution of the foregoing instrument. Witness my hand and official stamp or seal,
this 12.. day of October, 2005.

My commission expires: 7/14/06

The foregoing certificate of is/are certifIed to be
correct. This instrument and tIIis certificate are duly registered at the date and time and in the Book and Page shown on the fIrst page
hereof.

REGISTER OF DEEDS FOR

COUNTY
Deputy/Assistant-Register of Deeds.

By

N. C. Bar Assoc. Form No.3 @ 1977
Printed by Agreement with the N.C. Bar Assoc.#003

Davidson Co., NC -- Printable Map

,

Page 1 of 1

Davidson Co., NC

Parcels

Parcel Number: 06033E0000004
Pin Id: 6720-04-82-0708 D l\ h " ~ / Lee N,'I/e y
Owner: c/() HOlle.,. J::ir..,'th..e.. f
LEAMON JERRY WAYNE JR CtJ, LLc..
1159 HOLLOWAY CHURCH ROAD
LEXINGTON NC 27292-0000
Property Address:
1159 HOLLOWAY CHURCH RD
AddltlonallnfonnatJon :
\ P=16-43 L4 BK1135-1543
OLD FOX RUN

Land Units: 1.00 L T
Deed Book: 01135 Pg: 1543
Deed Date: OS/20/1999
Account Number: 000009043142
Township: 06
Exempt Code:
Building Value: $151,290
Other Building Value: $2.740
Land Value: $85,000
Market Value: $239.030
Assessed Value: $239.030
Deferred Value: $0

DISCLAIMER: The infonnation contained on this page is NOT to be construed or used as a "legal descriptior
Map infonnation is believed to be accurate but accuracy is not guaranteed.

http://www.webgis.net Anderson & Associates, Inc. http://www.anclassoc.com

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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".)

052128

I. Processing

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

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

GP?o

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

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

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: D

II. ApplicaotInfonnation ~rg@mDWrg ~

NOV 2 8 2005
1. Owner/Applicant Information I
Name: f) It# / E L LC F 111 L L F I<. DFNR _ WATER QIlf.L.llY
Mailing Address: 102../7 ScoTT GrJ-TF ('OfA~ r WETl.ANDSANDSTORMWATERBRANCH
C /fit i1.. l..v ,T;: IVC 2. E' 2.. 77

Telephone Number: t;tJ4) gLt t - ~2.b4 Fax Number: f704) f46 -S-2t ~
E-mail Address:dcutie/.1m ; lie yo @ d; e n€ 5 . (CJ J.-Y\

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

Telephone Number:
E-mail Address:

Fax Number:

Page 5 of 12

ID. 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 I7-inch format;
- however, DWQ may accept paperwork of any size. DWQprefers 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: J I )" <1

).)0//0 WPlV Chit vc h ;(Ot:l J
,

2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN): 060:3 3 E OOOOCJOL,f

4. Location
County: DOlV,\J S D Vl Nearest Town: {ofhVl Gr(Jv~ Tit.,.vl-lsh'f:>
Subdivision name (include phase/lot number): 0 ( J Fe X R VI i'1 , L 0 1- '-J. .
,
Directions to site (include road numbers/names, landmarks, etc.): rq Ire J../-w" ~
SOCAt-1" w...., L~;("r1.cf"", t-A'roLA h SOl-<rhmo",f, flAv", -ef! onl/:>
b/ OWl\. Chw~.,h I. I'ta"~s.s y",......., Tj,OMC. tPYI .Q-c/-I-. OlA~e f.A.,'//
b~ (IV! rt.e I~ .f ~e"'rc'ye Yc)Vl CYO..$S -f-4e.-lJJ,h#is Gree,f Elh~~.
5. Site coordinates (For linear projects, such as a road or utility line, attach a sheet that
separately lists the coordinates for each crossing of a distinct waterbody.) ,
Decimal Degrees (6 digits minimum): 2..7' S-I' ~ $-' , "N IS-. 2. (; ov;:. E

6. Property size (acres):

o , t..t OJ b

If c ye .s

7. Name of nearest receiving body of water:

I/,'j ), ;<0 c/r lfl ke

8. River Basin: YPI. / ).'\1 ;{/ ve yo
(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
atthe time of this application: rA e 0.40/ t IJ" "c Lc f- C fA Vy~,., ilv Art S
G\ L",Ja. Fr"... rJ e + Y'()J..,'V!1A t-el. Z Oq{ ~ 'f'f; The
w ....+-e v"" ~v" VI + d () e s no f- h1ee";' m ,'n /,./t.u.., W&>t Ie.. y c ep/i,

fc/ C{lu\/,.fy ~y ^ /"er, .

Page 6 of 12

10. ~escribe the overall project in detail, includiIlB the type of equipment to be used: TAe objedille'
dveJ (> t-I..rz wnfev ~'.-t)V1f 0.(' I-/~ ~f -ID "he VeCl$E'
lA.}t?tfev de ,,;-'j, {vts,de " -I-hc Y/Pl'h/y,,- S-ht?re..//ne IJ~e.J. Q
#If/fto /000 cy,.{J. ",...;11 be. r<!....1lli'v('ef ~".... ,Ie :;i/~ 41y -{-,<<qA, j
11. Explain the pUI;gose of the proposed work: To C y, ",'de !; vt F~/c,'f! ...f I,VI>I-!-f? Y
cI e tJ rA -;--b y Ccfh1 S fyuc f/'t} VI. Ct;o1 VI ~ Y~11'f / use oJ; t::t
19 ;'-Vet1-e {J /e 't' -For' recv{"ett,'ol"&ll pl., tt'".,.:?dSe $
I' ,

IV. Prior Project History

If jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Include
the US ACE Action ill Number, DWQ Project Number, application date, and date permits and
certifications were issued or withdrawn. Provide photocopies of previously issued permits,
certifications or other useful information. Describe previously approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits issued for prior segments of the same T.I.P. project, along with
construction schedules. H / /9

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.
IVI/f

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

It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. Each impact must be
listed separately in the tables below (e.g., culvert installation should be listed separately from
riprap dissipater pads). Be sure to indicate if an impact is temporary. All proposed impacts,
permanent and temporary, must be listed, and must be labeled and clearly identifiable on an
accompanying site plan. All wetlands and waters, and all streams (intermittent and perennial)
$hould 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: TIll'> L)YI} e t f :V,'! I
h~tV~ ~vl """'P~rf t:)",lv t?M IIO~en W:"I-e'vll
, ,

Page 7 of 12

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

separately 1st Impacts ueto ot structure an 00 mg.
Wetland Impact Type of Wetland Located within Distance to Area of
Site Number Type of Impact (e.g., forested, marsh, lOO-year Nearest Impact
(indicate on map) herbaceous, bog, etc.) Floodplain Stream (acres)
(yes/no) (linear feet)
- -
Total Wetland Impact (acres)

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

/1////

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
b . I d d Tall I . I I h X od h, h d' od b 43 560

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

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 0 d d 0 fl d' d' b lkh d t

1 , excavatIon, re IglJ!g, 00 mg, ramage, u ea S, e c.
Open Water Impact Name ofWaterbody Type ofWaterbody Area of
Site Number Type of Impact (lake, pond, estuary, sound, bay, Impact
(indicate on map) (if applicable) ocean, etc.) (acres)
!l1AD , 3 L.,ti/ /hc,h I? 1& k L./1I: R e. >>tiP wJ c>"\-' IPlke. O. '2-0
. . c;edt/1h1~.,f
Total Open Water Impact (acres)

Page 8 of 12

6. List the cumulative im act to all Waters of the u.s. resultin
Stream Impact (acres):
Wetland 1m act (acres):
Open Water Impact (acres):
Total 1m act to Waters of the U.S. (acres
Total Stream 1m act (linear feet):

7. Isolated Waters
Do any isolated waters exist on the property? D 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): D uplands D stream D wetlands
Describe the method of construction (e.g., dam/embankment, excavation, installation of
draw-down valve or spillway, etc.):
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.):
Current land use in the vicinity of the pond:
Size of watershed draining to pond: Expected pond surface area:

VB.

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 fqllowed during construction to reduce impacts. l} f, ht I Cl ye &\. c f
A.I o,.;."r.+t>f, /fPO' ;Lq()/..v,'/I b-e ev.oevAfe) P 2,S-fv'),S- ~e4+ +'"
'r()~t'Jf.... ~Je ?t"/<c J~ I}, , ..... A vec ve#'1I,~1"t1'T ,'er, IlI/ /'rt jrf.>r10/,;l?
w,-II .t ).uudeJ ,""<Ck -10 e'l ,. e Ct ()J<,';/I"-~. '3 i4'1,' e
Af.,Yt' Oil #Irks ,I<el. Tje ,..,f,./ ~"Y1Ht..f o"'t J,'y-t ye..v)(}II€J s ,~,.,(eI Jx:,
Mitigation t:l.Pf7Y~11"Y1'1+br; 1000 c",..Ji7,'C YpC~Js. _

VIII.

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

Page 9 of 12

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

If mitigation is required for this project, a copy of the mitigation plan must be attached in order
for USACE or DWQto 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://Oo.enr.state.nc.us/ncwetIands/strmgide.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 off site), 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.

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

Amount of stream mitigation requested (linear feet):
Amount of buffer mitigation requested (square feet):
Amount of Riparian wetland mitigation requested (acres):
Amount of Non-riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres):

Page 10 of 12

IX. Environmental Documentation (required by DWQ)

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

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

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

X. Proposed Impacts on Riparian and Watershed ButTers (required by DWQ)

It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
required state and local buffers associated with the project. The applicant must also provide
justification for these impacts in Section vn above. All proposed impacts must be listed herein,
and must be clearly identifiable on the accompanying site plan. All buffers must be shown on a
map, whether or not impacts are proposed to the buffers. Correspondence from the DWQ
Regional Office may be included as appropriate. Photographs may also be included at the
applicant's discretion.

1. Will the project impact protected riparian buffers identified within I5A NCAC 2B .0233
(Neuse), I5A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 02B .0243 (Catawba) I5A NCAC
2B .0250 (Randleman Rules and Water Supply Buffer Requirements), or other (please
identify )? Yes 0 No ~

2. If "yes", identify the square feet and acreage of impact to each zone of the riparian buffers.
If buffer mitigation is required calculate the required amount of mitigation by applying the
buffi If r

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

- Zone 1 extends out 30 feet perpendicular from the top of the near bank of channel; Zone 2 extends an
additiona120 feet from the edge of Zone 1.

3. If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e.,
Donation of Property, Riparian Buffer Restoration / Enhancement, or Payment into the _
Riparian Buffer Restoration Fund). Please attach all appropriate information as identified
within I5A NCAC 2B .0242 or .0244, or .0260.

Page 11 of 12

XI. Stormwater (required by DWQ)

Describe impervious acreage (existing and proposed) versus total acreage on the site. Di~cuss
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,

XU. 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.

xm. Violations (required by DWQ)

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

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

No 0

XIV. Cumulative Impacts (required by DWQ)

Will this project (based on past and reasonably anticipated future impacts) result in additional
development, which could impact nearby downstream water quality? Yes D No [gl
If yes, please submit a qualitative or quantitative cumulative impact analysis in accordance with
the most recent North Carolina Division of Water Quality policy posted on our website at
http://h2o.enr.state.nc.us/ncwetlands. If no, please provide a short narrative description: T), e
/7..,11 C~>1:t-rlAcl-'\IV1 ,-,,,,'II J,~ &I rY,'vMf.-4> ;~/e v .f'z,.... vecVe~/'Orlcrl
lA s-e . /1/ <!I r.J Y ~ v,' V ,,< S I' ~.... //.... t f .
, ~

XV. Other Circumstances (Optional):

It is the applicant's responsibility to submit the application sufficiently in advance of desired
construction dates to allow processing time for these permits. However, an applicant may
. choose to list constraints associated with construction or sequencing that may impose limits on
work schedules (e.g., draw-down schedules for lakes, dates associated with Endangered and
Threatened Species, accessibility problems, or other issues outside of the applicant's control).

!Z/~

Applicant/Agent's Signature Date
(Agent's signature is valid only ifan authorization letter from the applicant is provided.)

~~. Z 2, 2...(::1",-
.

Page 12 of 12

Excise Tax $650.00

I Recording Time, Book and Page

Tax Lot No. 4
Verified by

Parcel Identifier No. 06033E0000004
County on the _ day of

, 20_by

Mail after recording to Dan Miller, 10217 Scott Gate Court, Charlotte, NC 28277
This instrument was prepared by Jeffrey J. Berg, Attorney, Lexington, NC
Brief Description for the index I Lot 4, Old Fox Run, Plat Book 16, Page 43 I
NORTH CAROLINA GENERAL WARRANTY DEED

THIS DEED made October 13, 2005, b and between
GRANTOR

GRANTEE

Jerry Wayne Leamon, Jr. and wife, Shelia B. Leamon

Honor Equipment, LLC
Dt',,,"'~ I L~ e /VI,./lt:.... - G...'1e..... ( ~1.J"7 t',.,.

Enter in appropriate block for each party: name, address, and, if appropriate, character of entity, e.g., corporation or partnership.

The designation Grantor and Grantee as used herein shall include said parties, their heirs, successors, and assigns, and shall include
singular, plural, masculine, feminine or neuter as required by context.

WITNESSETH, that the Grantor, for a valuable consideration paid by the Grantee, the receipt of which is hereby acknowledged, has
and by these presents does grant, bargain, sell and convey unto the Grantee in fee simple, all that certain lot or parcel of land situated in
the City of ,Cotton Grove Township, Davidson County, North Carolina and more particularly described as follows:

Being all of Lot No.4 as the same is shown and designated on Aluminum Company of America plan of
lots entitled OLD FOX RUN, dated May 1972 as recorded in Map Book 16, Pag~ 43, in the Office of the
Register of Deeds for Davidson County, North Carolina.

N. C. Bar Assoc. Form No.3 @ 1977
Printed by Agreement with the N.C. Bar Assoc.#003

The property hereinabove described was acquired by Grantor by instrument recorded in Book 1135, Page 1543.

A map showing the above described property is recorded in Plat Book 16, Page 43..

TO HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to the Grantee in
fee simple.

And the Grantor covenants with the Grantee, that Grantor is seized of the premises in fee simple, has the right to convey the same in fee
simple, that title is marketable and free and clear of all encumbrances, and that Grantor will wan-ant and defend the title against the
lawful claims of all persons whomsoever except for the exceptions hereinafter stated.

Title to the property hereinabove described is subject to the following exceptions:

IN WITNESS WHEREOF, the Grantor has hereWlto set his hand and seal, or if corporate, has caused this instrument to be signed in
its corporate name by its duly authorized officers and its seal to be hereunto affixed by authority of its Board of Directors, the day and
year first above written. -

-....,..~;::::::::::=~::::=~J
~~~~::. _...-~.
_.- - OFFICIAL SEAL
r=:~ P blic. North Catoll..
\\ ~ . ~ C;~~;~ OF DAVIDSON \
DEBRA C. TEAGUE,
.,.,....."...........,..
-""...,--""".."........"...""'-""""
----

.--r tJo. ~ '~
' .. 0?A~ .ll\^oa ~
Jerry Way e Lembon, Jr.

(SEAL)

.SZRP'JJA 3~~'J'-
Shelia B. Leamon

(SEAL)

SEAL-STAMP

NORTH CAROLINA, Davidson COWlty.
I, the undersigned, a Notary Public of the COUllty and State aforesaid, certifY that Jerry Wayne
Leamon, Jr. and wife, Sheila B. Leamon, Grantor, personally appeared before me this day and
ackn<?~edged the execution of the foregoing instrument. Witness my hand and official stamp or seal,
this h day of October, 2005.

My commission expires: 7/14/06

The foregoing certificate of is/are certified to be
con-ect. This instrument and this certificate are duly registered at the date and time and in the Book and Page shown on the first page
hereof.

REGISTER OF DEEDS FOR

COUNTY
Deputy/Assistant-Register of Deeds.

By

N. C. Bar Assoc. Form No.3 (Q 1977
Printed by Agreement with the N.C. Bar Assoc.#003

Davidson Co., NC - Printable Map

Page 1 of 1

Davidson Co., NC

Parcels

Parcel Number: 06033E0000004
Pin Id: 6720-04-82-0708 D t\ 11 ,'-e / Lee H// Ie y
Owner: c/o Hou",.,... Eq'i l'IJI41~" f
LEAMON JERRY WAYNE JR C(l/ LLC
1159 HOLLOWAY CHURCH ROAD
LEXINGTON NC 27292-0000
Property Address:
1159 HOLLOWAY CHURCH RD
AdditionallnfonnatJon:
P=16-43 L4 BK1135-1543
OLD FOX RUN

Land Units: 1.00 L T
Deed Book: 01135 Pg: 1543
Deed Date: 05120/1999
Account Number: 000009043142
Township: 06
Exempt Code:
Building Value: $151,290
Other Building Value: $2,740
Land Value: $85,000
Market Value: $239,030
Assessed Value: $239,030
Deferred Value: $0

DISCLAIMER: The Infonnation contained on this page Is NOT to be construed or used as a "legal descrlptior
Map infonnation Is believed to be accurate but accuracy is not guaranteed.

http://www.webgis.net Anderson & Associates, Inc. http://www.andassoc.com

I certify that this map ",as dralYll under my direct supervision from
an actual survey made under my direct supervision. The ratio of
precision as calculated by latitude and departure before adjustment
is 1:10,000+. The boundaries not surveyed are shown as broken L f ' /)
lines plotted from information found in books as referenced. C X Ct/t. II ~I I g VI I-t v-e cr
:-,\\\\\\\\\IIIII1/I/IIIII/. A . -! I' /
#\\-n CARo/~ If Yo x I J}1~+e y 00 J<.. Cf 0

I~:;~~~ssi'o;/~ /I~K ~ 9000 +-f '2. ~ 0,20 /tcye
'" 'ro~ ~/ . ~. ,,/
..:::::: ." \.......-: :::"'\
! [ SEAL ) i Y/1-'5/~ ~~/ / "
% \ <' L-S9S9 ~f ~ ~-- ~,.. I Approx. Location or 655 Contour
~ ....-1.10/ ..1(;;).... $J ~----- -- ~ /.. ~ (Height or High Rock Dam)
:::::: .,./'1 ,'~~. ~ / .____
~ ~.. v SUR~v"'t\ ~ /'\.. / ,- En'
~ '7;;r-.........:\~~ ~ "'- 0 0 ) .--....- ~ /
~I. D K. C\J:-,~ ~-.-'^~.
1///IIII/1/lIll1\l\\\\\\\'\ . /
l ~/
~~~ !

High

Rock

Lake
N 2751'55"E

15.26' ~
tV/
l\. .I /
0;)

~
~

~

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co -:"\
~ ~ ,lU
co ~
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~
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....
t:l
c..

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W

E

S

ABBOTTS CREEK SURVEYING, INC.

1515 East Center Street Ext.
Lexington, N.C. 27292
[phone]
Brad K. Curry, FLS #3989
E-Mail: [e-mail]

;;;f~ I Se c/ &! WI R H f / /1e. f~ v;,. /
f()- ip '( e ..n 0 vPc! ,'s
V1jl)'Yl7;<; ~M"" f~ Iy
C( f (;t V1 C{ /Ie y (t ? e
'3 I () vll Y' I /~ c{ v -e (l

1000 c..t,'c ycn.d~
de t' I-/. c'+
c+

E X cc< Vel I- /0 '1

@

CI',de Oldham
DB 727 PC 46

I
I
I
I
I
I
I
I
Iii!
I~
;-
e
/ \0-

~
So>.
0><9_
0.9__ ~
~ -2/
. ~./
'-2>_

Approx. Location of 660 Contour
(Flooding RighlJl for High Rock Lalce)
Note: Thb Property Mayor May Not Be
Subject To The 660 Contour.

@)

.f",
~l' ~
/;'/ ""
("'" 'I
/:;:
/~. .
<Proposed House~ N 36'59'09"E 10.76' (Tie)
, f'" 0.496 Ar;.
C>'<b' DB 1135 PC 1543
. ). ...... "Old Fox Run" /
(~ ~) PB 16 PC 43 .I
,/ /
'~~. . <,i /"/
"./" / .
//
/
~
.I
/~'V
~
~

/

/

Approx. Location or Flood tine Per
Flood Insurance Rate Map (FIRM)
Community Panel Number 370307-0150 D
Ertective Date May 1.1980.

/

/

/

'.

Lines along the lake are for reference only.
Property line is the 655' contoul', Yadkin, Inc.
Datum.

50' O'
ffEitiffBJ1

50'

GRAPHIC SCALE

FEET

f

/

LEGEND:

Symbols used, if location of such is required in this Survey.

Ac.
Bldg.
B\C
Ch.
C.M.
Cone.
C.P.
C&:G
CIL
Culv.
DB.
DR.
EIP
EsmL
EIP
F.H.

NOTES:

Acres
Building
Back of Curb
Chord
Concrete Marker
Concrete
Computed Point(not set)
Curb and Gutler
Center Line
Culvert
Deed Book
Drive
Existing Iron Pipe
Easement
Edge of Pavement
Fire Hydrant

MBL
M.H,
NGS
NIP
N.L.
NTS
PE.
PG.
Plo
P.P.
Ret.
R.R.
RIP(
RCP
Sq.FL
--u--

Minimum Bldg Line
Man Hole
National Geodetic Survey
New Iron Pipe (1/2" Rebar)
Night Light
Not to Scale
Plat Book
Page
Part Of
Power Pole
Retaining
Railroad
Right of Way
Reinforced Cone. Pipe
Square Feet
.utility Line

This property is in a special flood hazard as determined
by F.E.M.A.

This property is subject to any prior easements and conveyances of
record or agreement that may be disclosed by a full and accurate
tHle search.

No NGS monuments found within 2000 Ft.

Area By Coordinates

OVt 11 t' c / L..e-e /-1 //Ie~

cI 0 //0'7 c y J;::, c, 1/ In ~n I (0./ L LC

Drive

Stephen Denny Et Als
DB 624 PC 617

Vicinity Map (N.T.S.)

PLAT OF SURVEY
JERRY 'Vi\. Yl'JE

SCALE: 1 "= 50'
DATE: 4/25/00

FOR:
LEi\.~10N

JR"

DRAWN BY: LDW
REVISED: ------

COTTON GROVE TOWNSHIP. DAVIDSON COUNTY. NORTH CAROLINA

TAX MAP# 33E. BLOCK# --. PARCEL# 4

JOB# 000314JL