20040166 Ver 1_COMPLETE FILE_20040206

WA TFR
O Michael F. Easley, Governor
?'
Q William G. Ross Jr., Secretary
O
G
7 North Carolina Department of Environment and Natural Resources
?
CO
> 1
Alan Klimek, P.E., Director
U-
Division of Water Quality
Coleen H. Sullins, Deputy Director
Division of Water Quality
February 10, 2004
DWQ # 04-0166
Person County
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
Cedar Creek Land Company, LLC
Attn: Rodney Huff
711-D N. Main Street
Roxboro, NC 27573
Subject Property: Nichols Estate Subdivision
Dear Mr. Huff:
On February 6, 2004 the Division of Water Quality (DWQ) was notified by receipt of your application regarding your plan to
fill wetlands or waters for the purpose of constructing a private gravel road in Person County. Approval from DWQ is
required to disturb these areas. Please provide 7 copies of the following information and refer to the DWQ # listed above in
your reply. Please show these on maps of suitable scale (for instance 1" = 100 feet) so we can begin to determine your
projects' compliance with 15A NCAC 2H .0500.
1. Please show all stream impacts including all fill slopes, dissipaters,.and bank stabilization on the site plan.
2. Please show all wetland impacts including fill slopes on the site plan.
3. Please indicate all buffer impacts on the site plan.
4. Please indicate the location of the protected buffers as overlays on the site plan.
5. Please provide cross section details showing the provisions for aquatic life passage.
6. Please indicate proposed location of septic fields.
7. Please provide soil maps with location of road crossing and proposed septic fields.
8. Please indicate future development plans for this site including potential road crossings.
Please telephone Ed Schwartzman at 919-715-3477 if you have any questions or would require copies of our rules or
procedural materials. This project will remain on hold as incomplete in accordance with 15A NCAC 2H .0505(c). The
processing time for this application will begin when this information is received. If we do not hear from you by writing or by
fax at [phone] within three (3) weeks we will assume you no longer want to pursue the project and will consider it
withdrawn.
Program
JRD/bs
cc: Raleigh DWQ Regional Office
Raleigh Corps of Engineers
Central Files
File Copy
E
N. C. Division of Water Quality, 401 Wetlands Certification Unit,
1650 Mail Service Center, Raleigh, NC 27699-1650 (Mailing Address)
2321 Crabtree Blvd., Raleigh, NC 27604-2260 (Location)
[phone] (phone), 919-733-6893 (fax), (h://h2o.enr.state.nc.us/ncwedands)
Customer Service #: 1-877-623-6748
Sincerely,
V
-144.5°-rV4 08.54 FCM'ia -W Tt_.AWS 91973-%$93
TO: 6 ,364495441 P-6' 13
(WACO Use Only:
Fora, VoMiQD May 20t't2
Actio 11) n 11•
_...,., _? .. D
No.
(If any pat'i utar tee is not appl,"GA l o this grojeGt, plcaS-- en..ter Not P Px. licahl " nr 'NIA".)
P t. Processing '6r' 9449
Rotl
I. Check all of the apptoval(s) requested for chi, pxo ect: PCs
0 Section 404 Pen it Riparian atx hed 0, )D
i w1ules
C] Section 10 Permit Isolated i.t from DWQ
401 Water c?U ity Certification ,? /I&S r
/0
A- Nationwide, Regional or Gerer•ai permit Ntlm?r(s) R?uest?d=? I?g??o,.._N ?? p,F_ t 4
3, if this n0tlficat7ion 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 Wetlands Restoration Prograut (NCW p) is proposed for
mitigation of imPaot4 (verify availability with NCWRP prier to subn-1jttal of PC N), cornpiete
scetion VI.Ii and check here.- L7
5. If your project is located in any of North Carolina's twenty coastal counties (listed: mi page;
4), and the project is within a North Carolina Division of Coastal Management Area of
Environmental Concern (scc the top of Page; for further details), check here:
II. Applicant Information
i . Owner/Applic ant. Information
NaMe< K G?o,...LL.C_
Mailing Address:__Zj i z .D ??
Telephone Number: 33?, S ? ? 09 ? Z Pax Nux nber=-3 3.? ? ?
E-mail, Ad dt' : ±rl ? ? c ??? ?____ _
2. Agent/Consultant Information (,A ft-ted and dated copy of the Agent Authorization letter
must be attached if the Agent has signatory authority for the owner:/applicant.)
r
Company Affiliation.,-
Mailing Address:-
Telephone Number:-. Fax Number,
i -nnai I A ddrress ;
Pam 5 of 12
JAN 05,2004 10:15 NORTH CAROLINA 9197336893 Page 6
JAN, S-aOO4 08:56 FROM: DWQ-WETI A 4DS 9197336893 TO: 83364495441 P:13/13
Tf buffer mitigations is required, please discuss what type of witigation is proposed (Le,, Donation
of Property, Conservation. Easement' .Riparian Buffer Restoration / Enhancement, Preservation or
Payment into the Riparian Buffer Restoration Fund). Please attach all appropriate information as
identified within 15A NCAC 2B .0242 or .0260,
XT,. Stormwater (required by DWQ)
Describe impervious acreage (both. 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.
C?32 s + O.3o AgW + ,3 Ro = 0.3 c 73. 5 TOT f=
1'70 O- A-- TO Q AhfatASE tT RE-SIGN VA[W 5 PA GE Rip RAkP
XU. Sewage Disposal (required by DWQ)
Clearly detail the ultimate treatment metbgds and disposition (uou-discharge or discharge) of
wastewater generated from the proposed project, or available capacity of the subject facility
Ca&AUrTli F LE
X111, Violations (required by DWQ)
1s this site in violation of DWQ Wetland Rules (15A NCAC 2H.0500) or any Buffer Rules?
Yes ? No Q
Is this an after-the-fact permit application?
Yes ? Net
XXV. Other Circumstances (Optionzal).-
T.t 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).
A
(Agent's signature is valid duly f an authorization letter from the applicant is provided.)
Page 12 of 12
JAN 05,2004 10:18 NORTH CAROLINA 9197336893 Page 13

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11/19/2003 11:19 336-597-8500 WES MC WIS PA6E, ' 07
7_'Alftt"1VA ?,R°1s a condition,of this purcham tbnt, the ftyer W able to obtain all approvatq
ftm requirtd FeftW, State, and. Locat aged to !e "Wer to wtbdivi& the prorerty i", a
crranner e?ta!?'by tie a?ur?`. l?:.t? event ttaat ?yex iareltte to olrtai*x such appro+.rals. or if tlxe
bttM daeer=cs that it will not be able to t its such apt , then in either such eve this
Agr ent will be null artcl void, and all deposit nioini m warned to Buyer.
$. 1NVEt "'COON- Seller agr s that the.'9uyer shall lutes the right to entersaid property fo the
purpose of survelrin, making soil and sneerin studies or fbr any other reason WMch "my be
needed to Sober ;rdbrinat on trot the purpose ofciht xl tbs. Arty and stt es sea for
stun-vM or der studies needed to obtain Federal, $ti vlr' jAc0 approval for the subdivision
Of raid property, s l`be the sole rmpons'rlaiiity of the dyer, ",Sardis--" ",Sardis--" of whether ar not such
approval is granted.
9. t,R_ S. CODYS: iler Audi deliver to the R%J?W at car prior to clo6tig a fully execMed
Cer rcate of Affidavit in oomplimce with section 1445 o£Owbit vit Revenue Setvice Code;.
iaticati that the Selter is not a "Foreign Fermata' as Stich ht; +ed by the form w Sec;tion.:
10, WASTE: To the hest: of latgwWge and belief of the° Seller, hazardous, toxic, or.,
pet4alea?nt r i#nc s have been generated. used, 4ore tr end, -or disposed of on or befew the
surfA a oft't opfrty. Furtbar rare, no knca tewAronna t. actions are pending or threatened
a$Wost jet' any partner or predec or in Otte vrrf3* re6r+etwe to eitber air, watenr, of
lta?trclc?ua't po#lttti+?rt iu ccscxncratec,n *avitla rhs 1??:.
i f . ` A.CCMANCE ? This weemeEat shall be null'atxd vokt, if not accepted by the Setter wilt:in,
f days fi-oM the date bercof
he enter and corti*te
12. UNTM ?,,EMW1*: The here, provisions r went t.
LZ r3 t i ,+a£. Seller and Buyer ate will lye b dbw upon I*rs, assigns, and represmtatives,
and way only lye att ed in writing signed by boot StRor and Buyet
p 3, FA1U" 'T'0 PERTr0KN4: Taal 0w evwtDv?w ftls to perform under the terms of this `
"it retsio tt a depositktmtwith ns;fiquidated damages and Bayer atid "let
a? have no fionber obligations tinder thi9 aXvemeW,
14, tt is 'the Buyer has made an i"Vectipfa of ow emire Subject property including the
imprc ix rts-aaa 2rX$rex'a to accept this prop" 1w its pry a dki atslaject Only to Sec:ttc,ns 7
an a ofthisVA?t.
1'5, sTJRVVY: The cost ofa survey, to be cauapl d on or beftwe closing shall be borne by the
lie. ; if said survey remals is than aovIs,. the purcl l will be ati xsted toy
tim?.? tkce acxe(s deficictacy . If iowy dishes-tl fury portion. of the property
is 400444 wedand or, cri al emirotimeatal a -8u*, y tertmina?te the and all
deposks " be retmnetl.
ACCEPTED BY SELLER.
REJECTM ay:
REASON FOP, I
NOV 19,2003 12:21 336 597 8500 Page 7
11/28/2863i-712:17 336-597-8580 VE m0wis PAGE, 03
rch?s tbaat, tk?es Btty be abler to ob n'*" agprc ""-
T RO V Ali , . tt is a co dikioz? of thts pu r to subdivide the pre ty in
ccc a#red.Fwe"ata Stste,'actd item agemriaes to etable l?tsye . , rtaVals. or if the
UWA
` the eve nt *at f4yesr. is eutaclx[e to csbtairt ?+e rsP
cirl??r such ?"eta. t?tis
,hates- a by the Buyer. b
vais then in
' that it will mot be jtbte to dbtai" such cr ,
mat retEvim[ d to t t5 x.
be non aw vOid, attd all d+ wart a said <y cap ' f the
eel that the,l? "Ilr . U bave the 6 W ?rhic?i tt-my be
R. A?tSPECT A:. ellrt at r and studies or for arty at#ze? re ow
'emonewim
of su +t of crlataii n?B p > Awl and 'At ?? for
tta to, i atusn t .tomes at. Stat,?, or Local alb the s<aladivisir
slwty? or c+ her studies n0eded tea obtain the Buyer, reprdleAs of wketer of riot stzct
of d irk= slto be the sole responds Y
,roil *is W"tea. tbwpayer at or prior to closing tv Wily e"Outed
o. I'v-S, Ct'70' . Seller shalt c3e t to.
144S of tl- Inter Rellenue 45;eruioe CtAe
kaleof d.'vit in CO ROB". v it defined by t forte .smti0n,
i tl the Sauer is 110t a. "`Foxv* pame as tmcic, of
Sti..4WAS'?' To the best of kn?? and l ief of the Seller, s? i
tcetcd, or o on or belo?: the
ed, tjse?l, ;wad.. di0
have or tl?reatiner4
no known E:ttt'.tOS t tl ?Ctid s
prope"u+
f In. titiO witil rei'ereqce td Clii'' ?', yygt?!i", qC
ar any Partner or precie
hrdoug wa#e pt>lht600, in cOWiC (100 Whh the' irc,P?rty, Seth ?,rithitt.
it. A-GCiRMANCE: This agrecnaent shalt be mill a"d void if t%ot acc"ed by'
.3) days l to the datte be re-Of roNisians rope t the entire: and eompleie
12. UNTME AGWaM -i`?i'I' `the lte to P heirs., aW !s, Rftd 'resotivell,
ul stwxfi% of the Seller and .? WM be bthcC ng bpi
a r9 opli bo alkered in ivdting sigtt by bc4h Seller Buyer-Of thiO
}yarform unde?rsta ? atx! Setletr
13_ FALLUM To ?'"B?tF(3I?: Tii t# **m1RU 0r #'ails to
seller shaft rexttirr the dept t'?th 06 liquitdated da?
# zto :t x' c li lic as titer t#tis agt n
I4, It. Is agreed that the 1333tye?- l?.?c ?-an inspection ion of the Mire s,ebje?ct p??,?yr;imducing the
in its condit oil subJc.tY A sections 7
and awes to ft*C t tl?is pra rty Qcese t
$ of this ec ""d
t .. S JR Y 't'hey east of a ?a to be cctc?opte ed Ota or Wore c#OSifag s? " l??' the
t is e~r. if sand stitvey revue l tlt ?t acme, tw gwrctase pricer ?# .bi,
s t MY a? p+?ola?l
times the a e(s) defiba'ct! `. , If surm cligate t' eto a
alt
is d?_? wotUad or kcal envit meaftl arvo, l?utyes" y
.6
I& OTHM M,OVYSTONS ?
RMCTW DTI
NOV 28,2003 13:18 REALTY EXECUTZV 336 597 8500 Page 3
Somerset, North Carolina, United States
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Roseville tsornerset
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E i i # i i 078° 57" ? 0. AV' I 107~8°157',1O.6'.' V ? 1 1 € OA' ?6' PO.60-1W 1 ° [ {
Name: TIMBERLAKE Location: 036° 29 30,2" N 078° 57' 04.1" W
Elate: 10115/2003
Sraiw: 1 inch enuafst 500 feet
It/19/2003 11:19 336-F5`93°£501 W ES MOTS PAGE 04
T OW SALE,
This Agr=UWW Of SIC, "i trdo tws C'edar Grp
nd ., t...Ut. sl or Caw-qf7'S -x a
11 j- I -
T ' m d in consirdemtims of ft nmwor - ?.._ ? ctoilarR, the
Buytt agreft W6 Sr airs to "11 the IbR0ot' paay with all,tkw- .
bWkha,v aW i thereon nod all `rights of way and x0patw tc. d nto
1*10sg1 , i adi but not thnited tv mineral atki tie r rWft•
Acres, mme or Ims fromu g can and being x4ore
dvm#nd
W.CUVA*
'At
1. 1RSCR : A!! d0p0*8 9ltalt be heUby an A:tto"My, in escrow deow 8 alrc?r. f'-fir . 1 i?r ?t e4-by.
. Ohl 'J E: to lec agreft tv Vey t tc?' :Y Getz f, t Warranty
t moci tom, ('for taxes err -other V ? ) b 0*eet to ditaie ? d tm' Ove
tits =of pert au9 ,,%L-ly a tit s t IDt r'4 -of Abe ? ±W AAI s?ar?
tp ? ?p +ritt$ the Deed sod of'" recardatia:ar tax W- to gra mtors and
aW to fwivt w PG'WggiW of the'Pr6peny to Boyar Upda settI I mliou".
3. p.AJ .L1 F T U I 1? t t»l ti"t .es Provi
cl+aer. +r?hlc title to the stAi ect 1popijitr ; txye r'sha11 l6 entWd to t o tcetttlr? ctf alt
depty $its tWouad+ar; and $Kry M ail ftrea-ftet-tare 00 ittlter,6bUW under Ws,4Weement,
4. CLOSING: Settlement qba Ii be mide *eb of . k? bar buyer on or ?.
b! re ? .... `, mil' a.I S COO tbet the pmt €ffliC , mmm"A cats
be met, We exAMi t eud neoftury doc txtetits pepwod, with allowsoom of a rem., ile ume
for Soler t cow"tittle dct a reponed by the fItle exat a. tymr MW advatW4 c1 tw
with n'five dkv des tit to Sic.
5. TAXES: 'AN RJW Estate tare stall be pro-rased as csfdw date of emerat, Any and a.11 rots
hAck taxes W be by 9€11er_ Seiler to ca rJ aray And all leases cumtt y As Died to tan! p601-
tv cloxn&
. INSURANCE: All risk of loss or damW, to the property by fare, wivrdatoarzn, earutalty. or
cause as assamd by Seller 00 01 ftftl tt, i the evmt of substaitr w l or dam to the
propefty 1 e votOMmik Uuyw SW I have the option of egbor (1) tetvM #rXg the ,ASreemeto
000 rect stW deposkft Made, or (2) a ming this A 1 R s#.t1 qu c to tare damage'Dj
loss bei , susts t>0d aid. itt such o?restrC Setter AmIl a<stigp to Rtryer at; of getters ljos order aqy
PQ or policies of ia>R os"Ce app(" to rtes props t.
NOV 19,2003 1.2.19 336 597 8500 Page 4
11/19/2003 " 11:19 336-597--8500 ' WES hiC W IS PA 05
7. p tUVAL: It is cortditloo of thW pub , the Btlyer be able to obtrrio All xpprovais
' tca eroble auyw to v*divide the propes'tY to a
fmnn rewired Feder4 Statc, ar4 1? ievais. or if ti:
ie effected bY the ?. 10_tbt eveW t3tat uya?r ut a to alatm such app
b tt+et zwm ni that it r+vtit.r t be able to otattaila sucks. awov14, then eW° such tve?t> this
.tw "41 be-rwll and void, and 4 detaosit 000 i returaezd to 8uyv.
Wl have tt?: tW#'to Wit' said pt 'rq' £crr,the
8, IN C`1?ot+T: Seller arovi t the ftyetr 4 vtixer rea which may be
pwrose of Wmeyi , rnt? d soil and rW9 studies ar for° a? e s fet POW u r t u se of ob ?niu8 ptrmits. Any and all ?
toad to $W4,6 of t.,ocak al 'al r ? tbdirr!s
car` stud e d 3a of Federal, 0 x rcdtetra of WtkCtIW ar nOt ?-:_
of said ptop." "t be the 9de r?Ponsd+i?li rber $uye r, a ga
approval is wed .
9, t:.tt.S. CODE ? "it delivw' a'the ? at ox ? to doh -a AA.Y Code
Certificate of ANdavt ita. c ompfi a ' 9"o+n 14415 of the TA? keve? Service tag t the Self is a" For pa as saC6 is defined by,th+e
--hWficati-ew am
a}ad btalaef of the Sel?+er. no it?ta?rdOu ,
M--Lo the best Of knowvle? sed nit` anfir below
the
ve'bwe SeWoted, used, stored, ti ed, or
erfftlee pay . Fu . t??cs k wsr a hMrtm? ? are- p rng or threatened
or io title with t4? to e#* air, w r, or
+ ler`ot air pactw-mwpt'+1d
beaux waster powtlon in co .rctton v*11 thp- pr lly Selter wi?t3roi#r
It AcrmA CS. This agreement sl?ll be twit and void if ncvt accepted by the
(" days d? reaof t the ire shad"+cc?t 4
12. P-1.?'?'.F A??NT, `?bc here prtrvtsioue • xt fi r ntrxtiv ,
exeand4 of tbe-Selter and ^-"d vVM-be bitatl .aeon heirs, as*gr ,
and y o* he 4tert4its *pWd by both Seller and Buyer.
0 1R. L RP TO PERFORM: 10 t -sins Buyer fkils x0 laedom Under the terms +afthis ;
ag?rer metre„ 3bl x d 3*t herewith as H.Widted damageg and BuY0i
14. It, is aid that titer Dt? bas MOO an: i?.ot tlxe emir-: ?bj?c t p?rci?zty uxaltrtiin the
ift, y p
imp rcavetaielil "d age=to a?.? propert
s? ? eaf?t cant,rad.
I S. Tl 000::pt a', toe camplafiel, c or before closing shall t brat the
has tt1?i ,7& 6'' ac + the p rGkra price wi11 he actp ed by
tf`;ea as t eats
,., oe Cl the pf ,roperty
$ _ is tbwa d?etl?rie%x cy ,:' Wr ey-llrsGlorSm that stay p .
?etit end a!t
i.+pr grit rxavicn?m. -. may tes[t+5 y'A
d+o ? 6? ?rrnerd.
16, oT INK QVXStoKS° Alo' .? ? G ... a tJ r.i? ?`

REYOCTED 81
REASON FOR

NOV 19,2003 12:20 336 597 8500 Page 5
11/19/2003 11:19 336-59'7-8500 S MOW.IS PAGE 107
7. X"ROV.AL:': It is a cvrrclWOO of this Pumhase dw, the Buyer be We to old all approval:"
fmm required Federal, State, artad Local a8emi0s tct`mg? Buyasr to stl"vide 'rift
manner elected by the Buyer. Ih:.the m e X that Buyer to th e W obtainsuch appr ovals. or if time
buyer deterWwes that it will not be able tO Obtairi such approvals, then in eitlae r such event, this
Agrt ement will be nufi and void, and all deposit monies returned to Bum.
S. >WSPE OM Alex' agrees that the,Buyer ghstt l»e the right to enter said property for the
pt"case of Airveyin„ making sail and enoneerit studies or far any tither reason which may bes
meded to gather i4brmation ;Eat the purpose of obtaining pe:c hs. Any atW all expe w for`
sna ring on rrGw shcdiets nxeedkd to obtain'Pederal, St , or Lical approval for the subdivision
of said property, simll'be the $ Ole ":spbnsibility of-ttte Stayer, re-die" of whether or not such
approval is granted.
9. I.R..S. CODE: er all deliver to the Buyer at or prior to eloRing a fully executed
tv"fica to of Affidavit in compliance with s ion 1445 ctf ttre Tn l Revatjue Service Code
ht&ou that the Samar is not a "Foreip Pemif' as such is d ed by the foresaw suction.
1,0. WASTE: To the best: of knowledge an& belief of the Seller',,no hazardous, toxic'. or
petroleum %ibstauces hime teen generated, used, tatwed, treat ; or disposed of on ai below the
sEa 6cc of t1w Property, Furthetraaare, no kno "wviroa? Acticnns are pending or threatened
v#xhartt gdWor• partner or predere"ar in Oft wft t ' ce to eitber air, water, or
taus wave pvlhttiton, in connection with the party.
11. " At`".+ MAOM Ths seetr?ent shall be citalt and' • if not accepted by the Setter within
4.,J days Avm ft darts bereot'. -
1 EN1`1 ;A RI SIN i : Tbe herein prov-i4em rapr t t the er"'e. and conaplete-
undWata lit g o£-tfix+a Seller and Bayer aW will be binding upon hem, afji6gns, and reptesentatives,
and away Daly be 4ttered isr w€iting rid by ball} Sa. e?r:aad Buyer.
13 - FAIL .E TO PERFORM- - in the even Buyer falls tin perfbrm under the terms of tkais>
agrea ew, ga r shalt retaio the deposit hereritth as, ligrati sted da rnages and BuyO acid Seller
shall have no filer Qbktptionx hinder ihia apvemeta .
14. ft is aWoied *at the Buyer has made an iaWwtion of the entire avieet property including the
? t t =d:MW'Ws to act fI>is property k its°present CoRd t n subject only to sections 7
acrd tl of this rrtr=c
IN. a .VE`Y: The crest of a survey, to be connAeted tarp or Wore c losing slWl be borne by the
ac m, the`purtM? price will be adjrsstr by
ye r, . tf said surrey reveals less than %
tmaes the scre(s) deficiency . if sumy disel6am dwt y portion of the property
is dot ci mod or critical enviror mental araaa?, Buyer way to note the AV"W and all,
depo shell be Wcri;d:
16. C1R C CVI51C1fS A s :W r. t f "t--ft
ACCEPTED BY, SfLL,I : C1 .AR. ?C,' L , C(),.
Uft
REJECTED 5Y
REASON :pOR t 1?. _
JAk°€ a5--2004 08:54 FROM: U4Q-WETLP& 9197336893 TO., 8 3364495441 P-. 7* 13,
U
UL m'o 't Ixaforrrlation
Attach a vicWtty p clearly showing time location of the property with zrspect to local
landmarlcs such as towns, rivers, and roads, Also provide a detailed site pba showing property
boundaries and development plans in relation to surrounding prapeyfies. Both the vicinity map
and site plan must include a scale artd north arrow. The specific footprints of all buildings,
irnpcrvious surfaces, or other facilities must be included. T?f possible, the maps and plans should
include the appropriate USES Topographic Quad Map and NRC,S Soil Survey with the. property
boundaries oufted.. Plan drawings, or other maps may be included at the applicant's discretion,
so long as the property is clearly defined.. For adrWnistrahve and distribution purposes, the
LISA.CE requires information to be submitted on sheets no larger than l I by 17-inch format,
however, DWQ may kept paperwork of any size. DWQ prefirs full-size construction
drawings rather than a sequential sheet version of the full-size plans. If full-sim plans are
reduced to a small scale such that the final versroan is illegible, the applicant will be informed that
the project has been placed on bold until decipherable wraps am provided,
1. Name of project: N 1 r t4 E) L_5, E S TA T E
4 T.I.P. Project Number or State lit-9jec-t Number (NC DOT Only):
I Property Identification Number (Tax PIN): t 2 J 20
4. Location
County: PERso nt Nearest Town: 'lox acs 2
Subdivision name (include phasW).ot number): N1ealot- F-sTA
,s __
Directions to site (include read numbers, landmarks, etc.): 6to ox 40 4> TAKE NwY
0.3 14tx..1£5 cMµ t_EFT
5. Site coordinates, if available (1„71M. or W- Long):. 3c_ ° 201 gQ. 9s° 0-7a° 54? I 59.4s 1 w
(Note -If project is linear, such as a road or utility luxe, attach a sheet that separately lists the
coordinates for each crossing of a distinct waterbody.)
6. Propez-ty size (acres); 73. 5b Ac.
7. Nearost body of water (streauVrtverlsoundloceaMake): Ur4NAM r T R.4 -rte ?o0aH Fez RtvER
8, River Basin, , fie s e
(Note - this must be one of North Carolina's seventeen designated major, river basins. 1'he
River Bask) map is available at hair°lfh2c ern stag +al?/adm??n/xnaosf.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application:
a??aE_?,?„ Low t7E,astT?stD
Page. 6 of 12
JAN 05,,2004 10:15 NORTH CAROLINA 9197336893 Page 7
Tf?: i s 1 't3 lm
T447;5- 06:5A FRf:MEX -1ETL.fdND5 919-733E0193
M Msc:ribe the overall project in detail, including the type of equipment to he uscd.._g>ks kpeti T t AL
StNGt.F F?t???t-v sU6a??ttStor?1 Ac?ESSE? t3y GR vE? PRIVATE RoAO
BUILT i'rt-t
11. Explain the purpose of the proposed work: To Acc E sS 8 SINGLE FAmtLY RES tD ENGES
WIT" R.A L Pitt TE
XV, Prior Project H1.+ wr-v
it jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including all prior phasds of the same subdivision) in the past, please explain. Include
the USACaaE Action' lD Number, DWQ Project Number, application date, and date permits and
certifications were issued or withdrawn. Provide photocopies of previously issued permits,
certifications or other usual information, l:,>'escribe, previously approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a TNCDOT projecct,
list and describe permits issued for prier segments 'of the same T.I.P. project, along with
ccarmstauction schedules.
V. Future Project Flans
Are any future permit requests anticipated for this project? If so, describe tine anticipated work,
and provide justification for the exclusion of this work, from the current application..
VT. proposed facts to Wate r$ of the United StaWs/Waters of the State
it is the applicant's (or agent's) responsibility to determine, delineate and reap all impacts to
wetlands,, open, water, w-tti stream channels associated with the project. The appl cant must also
provide .justification for these impacts in Section VII below. All proposed impacts, permanent
and tew4+arary, must be listed herein, and must be clearly identifiable can an accoropa°nyi,ng site
plan,. All wetlands and waters, and all streams (intermittent and perennial) must be shown on a
delineation map, whether or not impacts are proposed to these systems, Wetland and sham
evaluation and delineation fomas should be included as appropri=ate. Photographs inay 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 VTR below. If additiional. space is needed for
listing or description, please attach. a separate sheet.
Pagc 7 of U,
JAN 05,2004 10:15 NORTH CAROLINA 9197336893 Page 8
Jf44,5--2004 08:154 FROM. DK4-4CT'I_R# _ 91 9t 5'E ..3 TO: 833644915,441 P: 9 1 7?
1. Provide a wdtteu descriptican of the proposed
i ??av?? wA7 i cRosst?.?? 3' PEt?t_ sT2t_Ace.?..__....._,?,.,,,_.__._.__Me.m__._.._,_._ _,.?_.?..._..__..,,,.,.,
2. Individually list wetland impacts below:
_ Wcdand UVact
Site Mumber
ndicat* on -map)
Type Of Impact's
_ Area of
Impact
(? resl :Located within
100-year fF1vodAlairi"
(Yes/0) Dri t to
+ Nearest Stream
ttrtM Wit)
` "hype of Wedand*'", i
1 MS.c.N, ct- c, 0.25 tto
_ ctxosstrcca Foax.es-r
i Fitt _ 0 i {
_ NO ?2osstr+G Fo2EST t?

U%t each inTact topmtely and identify temporary imvacu. Impacts include, but are riot Nmited to_ raAdulnized ck . grading, all,
e ce-fion, f1904 ft, dit? buattgldxa r, etc, For dataas. wmraklg list impacts due to bcsth strut turc aaad amdit,
lilt)-'dear ,rlplai are wonti-ficd tt ough the federal Ernegency MMIagement Agenev's (FMK) Mood in=aace blase Maps
(FIRM), or M*4A-apK-md local floc>dptain w,aps. Maps are available thrrrugh the FEMA Map Scrvice Center at 1.804-358-961& or
online at baaj ? '
I.,ist a wetland blot best dcseribes wetland to t>c impacted (e.g., fresh-aw/Aaltwater Marsh, fwostcd wctlmd, heaver pond.
Carolina Bay, big, ete,) lmdicatc if wettand is ificzlatcd (determination of isolation to be tirade by USA.c„F only).
List the teal acreage (estimated) of all existing wetlands ou the property: 18.5.5 A,,-
Total area of wetland impact proposed: 4- 2 5 Ac
3. Individually list: all intermittent and perennial stream impacts below:
Strc*mt act
Site 1Vurnber
indicate eta. cite 1
T)Tc of Impacts
_ I.en tla of
Impact
linear pct`
Strum Nam-** Average Width
of Stream
13efoxc Im t Fereaniai or
Intermittent?
lease specify)
{.?-. _._ , C 70 ?T To N FLAT Rey _?.31 ?_ p '4 t?tLal9L

last cnctt ttMar.t SOP tCiy anti identify tetYtlxrary impacts. . Impacts include. but are nett limited to: culverts and iatrtl rip-rap,
dam (separately list irnpacts due to troth auucturc and tlt>vtiing), relocation (include linear fret be>z= and aiicr, and act lo331gana),
st?riilyaa?m activit:tcs {ctFmens wall, rip-rap, trite wall, gabions, etc.), eatcavatic?n, cittcltiat}ytslrai lxtcating etc. If stream relocation is
ltr<sp ,titans and profik& showing ttte linear fWtprint tot hpth the c>rWnab and rclcx d strcatntt must be included.
Ro StMM names can be found on USGS toM.graphic map. If a stream has no Miami, list as UT (ututwmd tributary) to the ncamst
downstrcnm named smam into which it flows. US(IS snaps are available through the USGS at 1-K -358-9616, or online. at
W.._w t .,4V,.X. SeveW internee sites also-all+ow direct dQwOmd and ptirtiog of USGS amps tc,g. urvc .tt>p txe.sc?n?,
Yt_ 'VLar .u5%(_0'P' 00,
Cumulative impacts (linear distance in feet) to all streams can -ite:__^- 70f.
Page 8 of i
JAN 05,2009 10:1.6 NORTH CAROLINA 9197336893 Page 9
•3A W 5-2004 08.-55 FK 1.,G*JQ-WF_TL_t* 9197333 TO:8 336449'5441 P: 10- 13
4. hidividually list all open watct- impacts (including lakes, ponds, estuaries, sounds. Atlantic
Ocean and any other water of the U. a.) below:
Opon Water l?npact _ _ _. ._ of _ -- 't }p? of v+?°sterboc y
Sim Number ? Type of Lnpacul: impact Name of Waterbody
(if applicable) (la t.e, pon1, csuztary, sound, ?
indicate on m f

" list MKh impaa swo mcly KW identify temporary impacts. Impacts include, but are not, limited to: fill, excavation, dredging,
flooding, dt*nsp, bulkhrAds, stc.
5. Pond Creation
If construction of a pond is proposed, associated wetland and stream impacts should be
included alcove in the wetland and stream impact sections. Also, the proposed pond should
be described here and illustrated on any m. aps included with. this a plxc:atxon.
Pond to be created in (check all that apply): Q uplands stream Q wetlands
I)ecsibe the method of construction (c.g., dam/embankmcnt, excavation, installation of
draw-down valve or spillway, .).'AIIA
Proposed use or purpose of pond (e.g., livestcack watering, irrigation, aesthetic, trout pond,
local stonmwa.ter requirement, etc.),
Size of watershed draining to pond: ______ Expected pond surface area:______,__ _ -_
V11, bnpact ,lust dieation (Avoidance and lYlltn nfl=0on)
Specifically describe measures taken to avoid the proposed impacts, It may bc- useful to provide.
infoTmativli 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 captions were not feasible;. Also discuss how impacts
were minimized once the desired site plan was developed. If applicable, discuss constniction
techniques to be fobowe during construction to reduce impacts.
To
QS l9 f_ LW.__ oP TtAvs -rFt g GT T_HE r-ek r e, bus T „?,? eK ?SSEfl -M
ACC.ES,S TuE 5UITAti_. ?1 NOR SEPT?c lEt [>S _ : To_i.
SOIL AT_xFS : rb A"b trs-Toftago ME 6g&U T0P*4MA2A%CAt. AREA.
VUL lViiffigation
DWQ - Iri accordance with 15x1 NCAC 2H .0500, mitigation may be required by the NC
Division of Water Quality for project; involving greater than or equal to one ache of impacts to
fxcshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial
streams.
Page. 9 of CZ
JAN 05,2004 10:17 NORTH CAROLINA 9197336893 Page 10
3'W75-2Oe4 W-155 F"1*-r -4ETi_R`VS 9197 893 VO-.8:33E44955441 P.- 11 ,13
USAGE - In accordance with tho Final Notice of Issuance and Ulodifieation of Nationwide
Permits, published, in the Federal Register on March 9. 2000, mitigation will be requite when
necessary to ensure that Wverse effects to the aquatic environment are nvniimal. Factom
including size and type of proposed impact and function and relative value of the impacted

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