19980443 Ver 1_Complete File_19980518

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1'J . PRE-CONSTRUCTION NOTIFICATION

~ ~ FOR NATIONWIDE PERMITS THAT REQUIRE,

~ ~ ~' 1) NOTIFICATION '1'0 Tm1 CORPS OF ENGINX!:~
\ ~ 2) APPLICATION FOR . SECTION 401 CERTIE'ICATZON
.t ~ 3) COORDrNATION WIm THE Ne DIVXS%ON OF COASTAI:. ~~

-;c.. SEND 'I'D ORIGINAL AND (1) COpy OF 'l'HXS COMPLETED FORM ':1:0 '!'HE Al?PROP~SJ.w-it.. Q1f
~ UV FIELD OFFICi; OF :rim CORPS OF ENGINEERS (SEE AGENCY ADDRESSES SH:tm)'l}~~;e~rr. (!<<',It.AIil;Jl;t
~ ~ (7) COPIES SHOULD BE SENT TO THE N.C. DIVISION or ENVIRONMENTAL 1fAjfkG~T'R\fm;X)UlZc...~S
-I-?S (SEE AGENCY ADDRESSES SHEET). PLEASE PRINT. JUN 11 1998 .

~ ,lU- Pilot View RC&D, Inc.
~ li\ 1. OWNEaS NAME:

CORPS ACTION ID:

. ^ ...

9'6u143

NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE

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4c W(n~;\~~~~~'~~~:,~:_"
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2. MAILING ADDRESS: 2714 Henning Drive

S'I'ATE:

SUBDIVISION Nh~E:
NC

CITY:

Wins ton Salem

27106

ZIP CODE:

EROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE): Old Salem, Tanners Run & Town Creek, Winston salem, NC

,.

3. TELEPHONE NUMBER (HOME):

(WORK) :' 336-750-0~n

4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CO~PORATE' OFFICIAL, ADDRESS,
PHONE NUMBER:

N.C. DF'PT. OF
ENV[f.'C''''' , '
" ." '""'le', . tHi.:..\LTa;
(J [-{,!\ "I'trRi\L I(ir.:~~~:()u R(.'..~~

Al Engler, Chairman ( Same as above)

Contact - Charles Anderson

JUL B 1998 "

IIIVISJaN c~ E'ly!p.D~.~fml;'\..:2;,;i:HT

5. LOCATION OF WORK (PROVIDE A MAP I PREFERABLY A coPt OF OSGS~'tdi~Mim:GfHC{ .
MAP OR AERIAL PHOTOGRAPHY. WITH SCALE) : .
COrnTTY ~ CITY Winston Salem
...., : "'n~c:yt'h NEAREST TOWN 0..- :

.

Old Salem h~storic community - Tanners Run &

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Town Creek run parallel to main streetSPECIFIC LOCATION (INCLUDE ROAD

NUMBERS, LANDMARKS, ETC.):

6. IMPACTED OR NEAREST STREAM/RIVER:

Salem Creek

RIVER BASIN:

Yadkin - Pee Dee

7a. IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATE~
(SA), HIGH QUALITY WATERS (HQW), OUTSTANDING RESOURCE WATERS (ORW), WATER
SUPI?L): (WS-I OR WS-II)? YES (] NO (K) IE' YES, ~J?LAIN:

7b. IS THE ~~O~tCT LOCATED WITHIN A NORTH CAROLINA DIVISION or COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (ABC)? YES r 1 NO [X]

7c. IF THE PROJECT IS LOCATED WITHIN A COASTAL, COUNTY (SEE PAGE 7 :'OR
LIST OF COASTAL COUNTIES), WHAT IS THE LAND USE PLAN (LUP) DESIGNATION?

NO

Sa. HAVE ANY SECTION 404 I?ERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON
THIS PROPERTY? YES [) NO [xl IF YES, PROVIDE ACTION I.D. NUMBER OE'
PR~IOUS 'PERMIT AND ANY ADDITIONAL INFO~TION (INCLUDE PHOTOCOPY OF 401
CERTIFICATION) :

8b. ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROpERTY IN THE
FUTURE? YES () NO ~ J IF YES, DESCRIBE ANTICIPATED WORK:

9a. ~ST~MATED TOTAL NUMBER OE' ACRES IN TRACT OF LAND:

2 ad

9b. ESTIMATED TOTAL NUMBER OF ACRES OE' WETLANDS LOCATED ON PROJECT SITE:
o

2

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lOa. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY':

FILLING:

o

EXCAVATION:

o

FLOODING:

o

OTHER:

o

DRAINAGE:

1500

TOTAL ACRES TO BE IMPA.CTED:

1 ac

lOb. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF
RELOCATED, PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION) :

LENGTH :BEFORE:

o

FT

AFTER:

o

FT

wroTH BEfORE (based on normal high water contours):

o

FT

WIt>1'H AITER;

o

FT

AVERAGE DEPTH BEfORE:

o

FT AFTER:

. 0

FT

(2) STRE~ CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: 0 PLACEMENT OF PIPE IN CHANNEL: 0

CHANNEL EXCAVATION:

o

CONSTRUCTION OF A DAM/FLOODING:

o

OTHER:

11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE
WATERSHED DRAINING TO THE POND? NO

WHAT IS Tim EXPECTJ::D POND SURFACE AREA'?

12. DESCRI?TION OF ?RO?OSED WORK INCLUDING DISCUSSION OF TYPE OF
MECHANICAL EQUIPMENT TO BE USED (ATTACH PLANS: a 1/2" X'll" DRAWINGS
ON!.. Y) :

Please see the attached specifications & Design

13. PURPOSE OF PROPOSED WORK:

Strp~m Rank Sr~n;';7~r;nn

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14. STATE REASONS WHY IT IS BELIEVED THAT THIs ACTIVITY MUST SE CARRIED
OUT IN WETLANDS. (INCLUDE ANY MEASURES TAKEN TO MINIM1ZE WETLAND
IMPACTS) :

Work to be conducted is along stream banks and access to these areas may

involve channel crossing, etc.

.

15. YOU~ARE REQUIRED TO CONTACT THE U.5. FISH AND WILDLIrE SERVICE i/~ '
(USFWS) AND/OR,...N.~TIONAL MARINE FISHERIES SERVICE (NMFS) (SEE AGENCY /'<<!?-Qt~tJ;/~
ADDRESSEs SHEET) REGARDING THE PRESENCE OF ANY FEDERALLY LISTED OR ~ '
PROPOSED' FOR LISTING~END~GERED OR THREATENED SPECIEs OR CRITICAL HABITAT
IN THE PERMIT AREA Tr:.AT"M~Y-BE-AFFECTED BY THE PROPOSED PROJECT. DATE
CONTACTED: ,/ (ATTACH RESPONSES
FROM THESE AGENCIES.)

16. YOU ARE-REQU~REI:r-T0,-cON'!AC~., THE 5TAT~ HI5T9.~Ig,.-P..RESERv.ATJ:ON-O.FE'ICER !J~~. .-PiP
(SHPO) (SEE AGENg_~.s..s.ES__SHEET}",'REGARDING THE I?RESE~~E OF HISTORIC 'i7~fS!J.LA"-:o'-'
PROPERTIES,--I-N---rHE Pl::RMIT AREA 'WHICH MAY BE AFFECTED BY THE "'PROPOSED nl:'
PROJECT. DATE CONTACTED: .

17 . DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OR THE USE OF
PUBLIC (STATE) LAND?

YES pg NO' () (IF NO, GO TO lS)

a. IF YES, DOES THE PROJECT REQUIRE PREPARATION OF AN ENVIRONMEN
DOCUMENT ~ORSUANT TO THE REQUIREMENTS OF THE NORTH CAROLINA ENVIRO TAL
POLICY ACT'?

YES (] NO QO

Y.e-s
~7~

b. IF y~S, HAS THE DOCUMENT BEEN REVIEWED THROOGH THE NORTH C
DEPARTMENT OF ADMINISTRATION STAIE CLEARINGHOUSE,?

YES (] NO [J

IF ANSWER TO 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE
STATE CLEARINGHOUSE TO DIVISION OF ENVIRONMENTAL MANAGEMENT REGARDING
COMPLIANCE WITH THE NO~TH CAROLINA ENV!RONMENTAL POLICY ACT.

QUESTIONS REGARDING ,THE STATE CLEARINGHOOSE REVIEW PROCESS SHOULD BE
DIRECTED TO MS. CHRYs BAGGETT, DIRECTOR STATE CLEARINGHOOSE, NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION, ~~6 WEST JONES STREET, RALEIGH,
NORTH CAROLINA 27603-8003, TELEPHONE [phone].

4

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18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF
PROPOSED ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OR FILL MATERIAL
INTO WETLANDS:

a. WETLAND DELINEATION MAP SHOWING ALL WETLANDS, STREAMS, LAKES
AND PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14, 18, 21, 26,
29, AND 38). ALL STREAMS (INtERMITTENT AND PERMANENT) ON THE PROPERTY
l<roST BE SHOWN ON THE MAl'. MAP SCALES SHOULD BE 1 INCH EQUALS SO FEET OR 1
INCH EQUALS 100 FEET OR THEIR EQUIVALENT.
b. IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE
IMPACTED BY PROJECT.
c. IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA
SHEETS RELEVANT TO THE PLACEMENT OF THE DELINEATION LINE.
d. ATTACH A COpy OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
e. WHAT IS LAND USE OF SURROUNDING PROPERTY?

Condominiums, open space, Historic Old Salem, Winston Salem strollway

f. !E' APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?

q. SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.

NOTE: WETI.&tDS OR WATERS OF THE U.S. MhY NOT EE IMPACTED PRIOR TO:
1) ISSUANCE OF A SECTION 404 CORPS OF ENGINEERS PERMIT,
2) EITHER THE ISSUANCE OR WAIVER OF A 401 DIVISION OF
ENVIRONMENTAL MANAGEMENT (WA.TER QUALITY) CERTIFICATION, AND
3) (IN XHE TWENT'j( COASTAL COWrIES ONL'j(), A LETTER FROM THE
NORTH CAROLINA DIVISION OF COASTAL MANAGE~NT STATING THE PRO~OSED
ACTIVITY IS CONSISTENT WITH THE NORTH CAROLINA COAST.AL MANAGEMENT
PROGRAM.

)

OWNER'S/AGENT'S SIGNATURE

DATE

(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED (lag.))

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