19951088 Ver 1_COMPLETE FILE_19951012

State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Environmental Management
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
APPROVAL of 401 Water Quality Certification
Historic Bethabara Park
c/o Mr. Rod Meyer, Director
2147 Bethabara Road
Winston-Salem, N.C. 27106
Dear Mr. Meyer:
A74
?EHNR
October 18, 1995
Forsyth County
DEM Project # 951088
FILE CO-
You have our approval to place fill material in 0.20 acres of wetlands or waters for the purpose
of relocating channel in the original location at 2147 Bethabara Road, as you described in your
application dated 10 October 1995. After reviewing your application, we have decided that this fill is
covered by General Water Quality Certification Number 2665. This certification allows you to use
Nationwide Permit Number 13 when it is issued by the Corps of Engineers.
This approval is only valid for the purpose and design that you described in your application. If
you change your project, you must notify us and you may be required to send us a new application.
For this approval to be valid, you must follow the conditions listed in the attached certification. In
addition, you should get any other federal, state or local permits before you go ahead with your
project.
If you do not accept any of the conditions of this certification, you may ask for an adjudicatory
hearing. You must act within 60 days of the date that you receive this letter. To ask for a hearing,
send a written petition which conforms to Chapter 150B of the North Carolina General Statutes to the
Office of Administrative Hearings, P.O. Box 27447, Raleigh, N.C. 27611-7447. This certification and
its conditions are final and binding unless you ask for a hearing.
This letter completes the review of the Division of Environmental Management under Section 401
of the Clean Water Act. If you have any questions, please telephone John Dorney at 919-733-1786.
Attachment
cc: Wilmington District Corps of Engineers
Corps of Engineers Raleigh Field Office
Winston-Salem DEM Regional Office
Mr. John Domey
Central Files
Sincerely,
t
' r ton Howard, Jr. E
,
951088.1tr
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post-consumer paper
U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
cou"Action ID. 19400 U f7 County Forsyth

GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION
Property Owner/Agent Historic Bethabara Park, c/o Mr. Rod Meyer
Address 2147 Bethabara Road. Winston-Salem. North Carolina 27106
Telephone No.
Size and Location of project (waterway, road name/number, town, etc.) Small tributary
(Church Creek) of Monarcas Creek, located off of 2147 Bethabara Road. Historic Bathabara
Park. Winston-Salem, Forsyth County, North Carolina.
Description of Activity
Proposed stream bank stabilization project resulting in approximately 0.20 acres of impacts to
the jurisdictional waters of an above headwaters tributary of Monarcas Creek.
X Section 404 (Clean Water Act, 33 USC 1344) only.
Section 10 (River and Harbor Act of 1899) only.
Section 404 and Section 10.
NWP 26 Nationwide Permit Number.
Any violation of the conditions of the Regional General or Nationwide Permit referenced above
may subject the permittee to a stop work order, a restoration order, and/or appropriate legal
action.
This Department of the Army Regional General/Nationwide Permit verification does not relieve
the undersigned permittee of the responsibility to obtain any other required Federal, State, or
local approvals/permits. The permittee may need to contact appropriate State and local agencies
before beginning work.
Regulatory Project Manager Signature
Date October L1,1295 Expiratio ate JanuaU 21. 1997
SURVEY PLATS, FIELD SKETCH, WETLAND DELINEATION FORM, ETC., MUST BE
ATTACHED TO THE FILE COPY OF THIS FORM, IF REQUIRED OR AVAILABLE.
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DEM ID: 9 510 82 ACTION ID:
Nationwide permits applied for (Nationwide Permit #):
JOINT FORM FOR
Nationwide permits that require notification to the C.O.E.
Nationwide permits that require application for Sec. 401
Mr. John Thomas
U.S. Army Crops of Engineers
Regulatory Branch ails , ,V
6512 Falls of the Neuse Road, Suite 105
Raleigh, NC 27615 j OCT +995
[phone]
a
Please print WETLAtIlDS GPT1 P
;?`ATER U?LITY 5??, '
1. Owners Name: Historic Bethabara Park
2. Owners Address: 2147 Bethabara Road
Winston-Salem, NC 27106
3. Owners Phone Number (Home): [phone] (Work):
4. If applicable: Agent's Name or responsible corporate
official, address, phone number:
Rod Meyer, Director
2147 Bethabara Road
Winston-Salem, NC 27106
[phone]
5. Location of work (MUST ATTACH MAP) County: Forsyth
Nearest Town or City: Winston-Salem
Specific location (include road numbers, landmarks,
etc.) : Small tributary that flows into Monarcas Creek
at 2147 Bethabara Road. Stream crosses Bethabara Road
just east of the old Bethabara Chruch.
6. Name of Closet Stream/River: Monarcas Creek
7. River Basin: Yadkin
8. Is the project located in a watershed classified as
Trout, SA, HQW, ORW, WS-I, WS-II? YES [ ] NO [X]
9. Have any Section 404 permits been previously requested
for use on this property.
If yes, explain. A request has been previously
made to stabilize existing stream channel.
10. Number of acres of water of the U.S., including
wetlands and/or stream channel will be impacted by the
proposed project:
Filled: 0.20 ac.
Drained: ac.
Flooded: ac.
Excavated: ac.
Total Impacted: 0.20 ac.

12. Description of proposed work (ATTACHED PLANS):
Locate channel in original location.
13. Purpose of proposed work: Historic Restoration
14. State reasons why the applicant believes that this
activity must be carried out in wetlands. Also, note
measures taken to minimize wetland impacts.
No wetland impacts.
15. You are required to contact the U.S Fish and Wildlife
Service (USFWS) and/or National Marine Fisheries
Service (NMFS) regarding the presence of any federally
listed or proposed for listing endangered or threatened
species or critical habitat in the permit area that may
be affected by the proposed project.
Have you done so? YES [ ] NO [X]
Responses from the USFWS and/or NMFS should be
forwarded to the corps.
16. You are required to contact the Historic Preservation
Officer (SHPO) regarding the presence of historic
properties in the permit area which may be affected by
the proposed project?
Have you done so? YES [ ] NO [X]
Response from the SHPO should be forwarded to crops.
17. ADDITIONAL INFORMATION REQUIRED BY DEM:
A. Wetland delineation map showing all wetland,
streams, and lakes on the property.
attached
B. If available, representative photograph of wetlands
to be impacted by project.
n/a
C. If delineation was performed by a consultant,
include all data sheets relevant to the placement of
the delineation line.
n/a
D. If a stormwater management plan is required for this
project, attach copy.
n/a
E. What is the land use of the surrounding property?
Historic Park
F. If applicable, what is the proposed method of sewage
disposal?
n/a
OWNER' SIGNATURE
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40 DEM ID: 4 5)088 ACTION ID:
Nationwide permits applied for (Nationwide Permit #):
JOINT FORM FOR
Nationwide permits that require notification to the C.O.E.
Nationwide permits that require application for Sec. 401
Mr. John Thomas M
U.S. Army Crops of Engineers u
Regulatory Branch
6512 Falls of the Neuse Road, Suite 105 OCT I U W5
Raleigh, NC 27615
[phone]
Please print I WATER QUALITY SE(
1. Owners Name: Historic Bethabara Park
2. Owners Address: 2147 Bethabara Road
Winston-Salem, NC 27106
3. Owners Phone Number (Home): [phone] (Work):
4. If applicable: Agent's Name or responsible corporate
official, address, phone number:
Rod Meyer, Director
2147 Bethabara Road
Winston-Salem, NC 27106
[phone]
5. Location of work (MUST ATTACH MAP) County: Forsyth
Nearest Town or City: Winston-Salem
Specific location (include road numbers, landmarks,
etc.): Small tributary that flows into Monarcas Creek
at 2147 Bethabara Road. Stream crosses Bethabara Road
just east of the old Bethabara Chruch.
6. Name of Closet Stream/River: Monarcas Creek
7. River Basin: Yadkin
8. Is the project located in a watershed classified as
Trout, SA, HQW, ORW, WS-I, WS-II? YES [ ] NO [X]
9. Have any Section 404 permits been previously requested
for use on this property.
If yes, explain. A request has been previously
made to stabilize existing stream channel.
10. Number of acres of water of the U.S., including
wetlands and/or stream channel will be impacted by the
proposed project:
Filled: 0.20 ac.
Drained: ac.
Flooded: ac.
Excavated: ac.
Total Impacted: 0.20 ac.
I

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12. Description of proposed work (ATTACHED PLANS):
Locate channel in original location.
13. Purpose of proposed work: Historic Restoration
14. State reasons why the applicant believes that this
activity must be carried out in wetlands. Also, note
measures taken to minimize wetland impacts.
No wetland impacts.
15. You are required to contact the U.S Fish and Wildlife
Service (USFWS) and/or National Marine Fisheries
Service (NMFS) regarding the presence of any federally
listed or proposed for listing endangered or threatened
species or critical habitat in the permit area that may
be affected by the proposed project.
Have you done so? YES [ ] NO [X]
Responses from the USFWS and/or NMFS should be
forwarded to the corps.
16. You are required to contact the Historic Preservation
Officer (SHPO) regarding the presence of historic
properties in the permit area which may be affected by
the proposed project?
Have you done so? YES [ ] NO [X]
Response from the SHPO should be forwarded to crops.
17. ADDITIONAL INFORMATION REQUIRED BY DEM:
A. Wetland delineation map showing all wetland,
streams, and lakes on the property.
attached
B. If available, representative photograph of wetlands
to be impacted by project.
n/a
C. If delineation was performed by a consultant,
include all data sheets relevant to the placement of
the delineation line.
n/a
D. If a stormwater management plan is required for this
project, attach copy.
n/a
E. What is the land use of the surrounding property?
Historic Park
F. If applicable, what is the proposed method of sewage
disposal?
n/a
OWNER' SIGN URE
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DEM ID: 951088 ACTION ID:
Nationwide permits applied for (Nationwide Permit #):
JOINT FORM FOR
Nationwide permits that require notification to the C.O.E.
Nationwide permits that require application for Sec. 401
Mr. John Thomas U.S. Army Crops of Engineers E r Q
Regulatory Branch
6512 Falls of the Neuse Road, Suite 105 ?r
Raleigh, NC 27615 W OCT 010
[phone] A
i?laTR QULI7Y ScCTfC23
Please print
1. Owners Name: Historic Bethabara Park
2. Owners Address: 2147 Bethabara Road
Winston-Salem, NC 27106
3. Owners Phone Number (Home): [phone] (Work):
4. If applicable: Agent's Name or responsible corporate
official, address, phone number:
Rod Meyer, Director
2147 Bethabara Road
Winston-Salem, NC 27106
[phone]
5. Location of work (MUST ATTACH MAP) County: Forsyth
Nearest Town or City: Winston-Salem
Specific location (include road numbers, landmarks,
etc.): Small tributary that flows into Monarcas Creek
at 2147 Bethabara Road. Stream crosses Bethabara Road
just east of the old Bethabara Chruch.
6. Name of Closet Stream/River: Monarcas Creek
7. River Basin: Yadkin
8. Is the project located in a watershed classified as
Trout, SA, HQW, ORW, WS-I, WS-II? YES [ ] NO [X]
9. Have any Section 404 permits been previously requested
for use on this property.
If yes, explain. A request has been previously
made to stabilize existing stream channel.
10. Number of acres of water of the U.S., including
wetlands and/or stream channel will be impacted by the
proposed project:
Filled: 0.20 ac.
Drained: ac.
Flooded: ac.
Excavated: ac.
Total Impacted: 0.20 ac.

12. Description of proposed work (ATTACHED PLANS):
Locate channel in original location.
13. Purpose of proposed work: Historic Restoration
14. State reasons why the applicant believes that this
activity must be carried out in wetlands. Also, note
measures taken to minimize wetland impacts.
No wetland impacts.
15. You are required to contact the U.S Fish and Wildlife
Service (USFWS) and/or National Marine Fisheries
Service (NMFS) regarding the presence of any federally
listed or proposed for listing endangered or threatened
species or critical habitat in the permit area that may
be affected by the proposed project.
Have you done so? YES [ ] NO [X]
Responses from the USFWS and/or NMFS should be
forwarded to the corps.
16. You are required to contact the Historic Preservation
Officer (SHPO) regarding the presence of historic
properties in the permit area which may be affected by
the proposed project?
Have you done so? YES [ ] NO [X]
Response from the SHPO should be forwarded to crops.
17. ADDITIONAL INFORMATION REQUIRED BY DEM:
A. Wetland delineation map showing all wetland,
streams, and lakes on the property.
attached
B. If available, representative photograph of wetlands
to be impacted by project.
n/a
C. If delineation was performed by
include all data sheets relevant
the delineation line.
n/a
D. If a stormwater management plan
project, attach copy.
n/a
a consultant,
to the placement of
is required for this
E. What is the land use of the surrounding property?
Historic Park
F. If applicable, what is the proposed method of sewage
disposal?
n/a
OWNER' SIGN URE?? ??
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