20201631 Ver 1_Pre-Filing Meeting Request_20201028

ID#* 20201631 Version* 1
Regional Office* Washington Regional Office - [phone]
Reviewer List* Robert Tankard
Pre -Filing Meeting Request submitted 10/28/2020
.....................................................................................................................................................................................................................................................
Contact Name * Joshua Shepherd
Contact Email Address* [e-mail]
Project Name* UG Fiber Crossing of ICW
Project Owner*
Project County*
Owner Address:
Kevin Heath, Albemarle Electric Membership Corporation
Camden
Street Address
125 Cooperative Way
Address Line 2
aty
Hertford
Rbstal / Zip Code
27944
Is this a transportation project?* r Yes r No
Type(s) of approval sought from the DWR:
r- 401 Water Quality Certification - F- 401 Water Quality Certification -
Regular Express
r- Individual Permit r- Modification
r- Shoreline Stabilization
Does this project have an existing project ID#?*
r Yes r No
State / Frovince / Region
NC
Country
USA
Do you know the name of the staff member you would like to request a meeting with?
Please give a brief project description below. *

One underground fiber line will cross the Dismal Swamp canal at a depth of
15' belowthe bottom of the canal. See attached Plan/Profile project
proposal and vicinity map of the area. Horizontal Directional Drilling will
cause very little disturbance to the agricultural ground adjacent to the
canal. There is an existing underground distribution line directly adjacent to
this proposed project location.
I previously filled out a PCN, but it was denied today due to not filling out
this form first and waiting 30 days. I have attached the PCN also for
reference.
Please give a couple of dates you are available for a meeting.
10/29/2020
11 /2/2020
11 /3/2020
11 /4/2020
11 /5/2020
Please attach the documentation you would like to have the meeting about.
4479911 _PP_UG. pdf
324.92 KB
4479911 _vm. pdf
269.85KB
4479911 _usgs. pdf
1.63MB
4479911 _n res. pdf
1.66MB
Agent Auth Form.pdf
651.53KB
Endangered Species List.pdf
480.93KB
HistoricalCultural.pdf
228.16KB
Pre -Construction Notification (PCN) Form.pdf
126.16KB
pdf only
By digitally signing below, I certify that I have read and understood that per the Federal Clean Water Act Section
401 Certification Rule the following statements:
• This form completes the requirement of the Pre -Filing Meeting Request in the Clean Water Act Section 401 Certification
Rule.
• I understand by signing this form that I cannot submit my application until 30 calendar days after this pre -filing
meeting request.
• I also understand that DWR is not required to respond or grant the meeting request.
Your project's thirty -day clock started upon receipt of this application. You will receive notification regarding meeting location
and time if a meeting is necessary. You will receive notification when the thirty -day clock has expired, and you can submit an
application.
Signature
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Submittal Date 10/28/2020

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Map Unit Legend
Map Unit Symbol
Map Unit Name
Acres in AOI
Percent of AOI
AtA
Augusta fine sandy loam, 0 to
2 percent slopes
3.0
0.5%
CfA
Cape Fear silt loam, 0 to 2
percent slopes
300.3
44.6%
ChA
Chapanoke silt loam, 0 to 2
percent slopes
8.7
1.3%
NoA
Nimmo sandy loam, 0 to 2
percent slopes
1.9
0.3%
PeA
Perquimans silt loam, 0 to 2
percent slopes
108.4
16.1 %
PtA
Portsmouth fine sandy loam, 0
to 2 percent slopes
7.3
1.1 %
RoA
Roanoke silt loam, 0 to 2
percent slopes
143.3
21.3%
ToA
Tomotley fine sandy loam, 0 to
2 percent slopes
60.2
9.0%
Ud
Udorthents, loamy
21.4
3.2%
W
Water
14.0
2.1 %
YeA
Yeopim silt loam, 0 to 2
percent slopes
4.2
0.6%
Totals for Area of Interest
672.8
100.0%

Nt"
PROPERTY LEGAL DESCRIPTION:
LOT NO. N/A
STREET ADDRESS: S
AGENT AUTHORIZATION FORM
PLAN NO. N/A
Lat 36.2646, Long-76.3351
Ln, South Mills, NC
PARCEL ID: USA owned - no tax parcel #
Please print:
Property Owner: Kevin Heath, Albemarle Electric Membership Corporation
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
Joshua Shepherd of Booth & Associates, LLC
(Contractor / Agent) (Name of consulting firm)
to act on my behalf and take all actions necessary for the processing, issuance and acceptance of
this permit or certification and any and all standard and special conditions attached.
Property Owner's Address (if different than property above):
125 Cooperative Way, Hertford, NC 27944
Telephone: [phone]
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
1 mwnurzv �.�C �iazz.✓ '
thhgrized Signature Authorized Signature
Date- d—[ / zo 2111) Date:

9/24/2020 IPaC: Explore Location
IPaC U.S. Fish & Wildlife Service
IPaC resource list
This report is an automatically generated list of species and other resources such as critical habitat
(collectively referred to as trustresources) under the U.S. Fish and Wildlife Service's (USFWS)
jurisdiction that are known or expected to be on or near the project area referenced below. The list
may also include trust resources that occur outside of the project area, but that could potentially be
directly or indirectly affected by activities in the project area. However, determining the likelihood
and extent of effects a project may have on trust resources typically requires gathering additional
site -specific (e.g., vegetation/species surveys) and project -specific (e.g., magnitude and timing of
proposed activities) information.
Below is a summary of the project information you provided and contact information for the USFWS
office(s) with jurisdiction in the defined project area. Please read the introduction to each section
that follows (Endangered Species, Migratory Birds, USFWS Facilities, and NWI Wetlands) for
additional information applicable to the trust resources addressed in that section.
Location r►� )�
Camden County, North Carolina
Local office
Raleigh Ecological Services Field Office
t. [phone]
18 [phone]
MAILING ADDRESS
Post Office Box 33726
Raleigh, NC 27636-3726
PHYSICAL ADDRESS
551 Pylon Drive, Suite F
https://ecos.fws.gov/ipac/location/DABEPQ3M75BM5MZLR5X2KJ5VEM/resources 1/10

Raleigh, NC 27606-1487
IPaC: Explore Location
�o�
Foy
https://ecos.fws.gov/ipac/location/DABEPQ3M75BM5MZLR5X2KJ5VEM/resources 2/10

9/24/2020 IPaC: Explore Location
Endangered species
This resource list is for informational purposes only and does not constitute an analysis of
project level impacts.
The primary information used to generate this list is the known or expected range of each species.
Additional areas of influence (AOI) for species are also considered. An AOI includes areas outside of
the species range if the species could be indirectly affected by activities in that area (e.g., placing a
dam upstream of a fish population, even if that fish does not occur at the dam site, may indirectly
impact the species by reducing or eliminating water flow downstream). Because species can move,
and site conditions can change, the species on this list are not guaranteed to be found on or near
the project area. To fully determine any potential effects to species, additional site -specific and
project -specific information is often required.
Section 7 of the Endangered Species Act requires Federal agencies to "request of the Secretary
information whether any species which is listed or proposed to be listed may be present in the area
of such proposed action" for any project that is conducted, permitted, funded, or licensed by any
Federal agency. A letter from the local office and a species list which fulfills this requirement can
only be obtained by requesting an official species list from either the Regulatory Review section in
IPaC (see directions below) or from the local field office directly.
For project evaluations that require USFWS concurrence/review, please return to the IPaC website
and request an official species list by doing the following:
1. Draw the project location and click CONTINUE.
2. Click DEFINE PROJECT.
3. Log in (if directed to do so).
4. Provide a name and description for your project.
5. Click REQUEST SPECIES LIST.
Listed species and their critical habitats are managed by the Ecological Services Program of the U.S.
Fish and Wildlife Service (USFWS) and the fisheries division of the National Oceanic and Atmospheric
Administration (NOAA Fisheries ).
Species and critical habitats under the sole responsibility of NOAA Fisheries are not shown on this
list. Please contact NOAA Fisheries for species under their jurisdiction.
1. Species listed under the Endangered Species Act are threatened or endangered; IPaC also shows
species that are candidates, or proposed, for listing. See the listing status page for more
information.
2. NOAA Fisheries, also known as the National Marine Fisheries Service (NMFS), is an office of the
National Oceanic and Atmospheric Administration within the Department of Commerce.
The following species are potentially affected by activities in this location:
Mammals
NAME STATUS
https://ecos.fws.gov/ipac/location/DABEPQ3M75BM5MZLR5X2KJ5VEM/resources 3/10

IPaC: Explore Location
Northern Long-eared Bat Myotis septentrionalis
No critical habitat has been designated for this species.
https.//ecos.fws.gov/ecp/species/9045
Birds
NAME
Red Knot Calidris canutus rufa
No critical habitat has been designated for this species.
httpL//ecos.fws.gov/ecp/species/1864
Red -cockaded Woodpecker Picoides borealis
No critical habitat has been designated for this species.
https://ecos.fws.gov/ecp/species/7614
Reptiles
NAME
Threatened
STATUS
Threatened
Endangered
STATU S
American Alligator Alligator mississippiensis \S�AT
No critical habitat has been designated for this s ecies.
g p
https://ecos.fws.gov/ecp/species/776
0 Critical habitats
Potential effects to critical habitat(s) in this location must be analyzed along with the endangered
species themselves.6 U
THERE ARE NO CRITICAL HABITATS AT THIS LOCATION.
V4&C
Migratory birds
Certain birds are protected under the Migratory Bird Treaty Act-! and the Bald and Golden Eagle
Protection Act2.
Any person or organization who plans or conducts activities that may result in impacts to migratory
birds, eagles, and their habitats should follow appropriate regulations and consider implementing
appropriate conservation measures, as described below.
1. The Migratory Birds Treaty Act of 1918.
2. The Bald and Golden Eagle Protection Act of 1940.
Additional information can be found using the following links:
https://ecos.fws.gov/ipac/location/DABEPQ3M75BM5MZLR5X2KJ5VEM/resources 4/10

IPaC: Explore Location
Birds of Conservation Concern http://www.fws.gov/birds/management/managed-species/
birds-of-conservation-concern.php
Measures for avoiding and minimizing impacts to birds
http://www.fws.gov/birds/management/project-assessment-tools-and-guidance/
conservation-measures.php
Nationwide conservation measures for birds
http://www.fws.gov/migratorybirds/pdf/management/nationwidestandardconservationmeasures.pdf
The birds listed below are birds of particular concern either because they occur on the USFWS Birds
of Conservation Concern (BCC) list or warrant special attention in your project location. To learn
more about the levels of concern for birds on your list and how this list is generated, see the FAQ
below. This is not a list of every bird you may find in this location, nor a guarantee that every bird on
this list will be found in your project area. To see exact locations of where birders and the general
public have sighted birds in and around your project area, visit the E-bird data mapping tool (Tip:
enter your location, desired date range and a species on your list). For projects that occur off the
Atlantic Coast, additional maps and models detailing the relative occurrence and abundance of bird
species on your list are available. Links to additional information about Atlantic Coast birds, and
other important information about your migratory bird list, including how to properly interpret and
use your migratory bird report, can be found below. %
For guidance on when to schedule activities or implement avoidance and minimization measures to
reduce impacts to migratory birds on your list, click on the PROBABILITY OF PRESENCE SUMMARY at
the top of your list to see when these birds are most likely to be present and breeding in your
project area.
NAME
�o�
American Kestrel Falco sparverius paulus
This is a Bird of Conservation Concern (BCC) only in particular Bird
Conservation Regions (BCRs) in the continental USA
Bald Eagle Haliaeetus leucocephalus
This is not a Bird of Conservation Concern (BCC) in this area, but
warrants attention because of the Eagle Act or for potential
susceptibilities in offshore areas from certain types of development
or activities.
BREEDING SEASON (IF A
BREEDING SEASON IS INDICATED
...........................................................................................................
FOR A BIRD ON YOUR LIST, THE
......................................................................................................
BIRD MAY BREED IN YOUR
.....................................................................................
PROJECT AREA SOMETIME WITHIN
..............................................................................................................
THE TIMEFRAME SPECIFIED,
..........................................................................................
WHICH IS A VERY LIBERAL
..................................................................................
ESTIMATE OF THE DATES INSIDE
........................................................................................................
WHICH THE BIRD BREEDS
...................................................................................
ACROSS ITS ENTIRE RANGE.
.........................................................................................
"BREEDS ELSEWHERE" INDICATES
.............................................................................................................
THAT THE BIRD DOES NOT LIKELY
.............................................................................................................
BREED IN YOUR PROJECT AREA.)
Breeds Apr 1 to Aug 31
Breeds Sep 1 to Jul 31
httpL.//ecos.fws.gov/ecp/species/1626
https://ecos.fws.gov/ipac/location/DABEPQ3M75BM5MZLR5X2KJ5VEM/resources 5/10

IPaC: Explore Location
Probability of Presence Summary
The graphs below provide our best understanding of when birds of concern are most likely to be
present in your project area. This information can be used to tailor and schedule your project
activities to avoid or minimize impacts to birds. Please make sure you read and understand the FAQ
"Proper Interpretation and Use of Your Migratory Bird Report" before using or attempting to
interpret this report.
Probability of Presence ( )
Each green bar represents the bird's relative probability of presence in the 10km grid cell(s) your
project overlaps during a particular week of the year. (A year is represented as 12 4-week months.)
A taller bar indicates a higher probability of species presence. The survey effort (see below) can be
used to establish a level of confidence in the presence score. One can have higher confidence in the
presence score if the corresponding survey effort is also high.
How is the probability of presence score calculated? The calculation is done in three steps:
1. The probability of presence for each week is calculated as the number of survey events in the
week where the species was detected divided by the total number of survey events for that
week. For example, if in week 12 there were 20 survey events and the Spotted Towhee was
found in 5 of them, the probability of presence of the Spotted Towhee in week 12 is 0.25.
2. To properly present the pattern of presence across the year, the relative probability of presence
is calculated. This is the probability of presence divided by the maximum probability of presence
across all weeks. For example, imagine the probability of presence in week 20 for the Spotted
Towhee is 0.05, and that the probability of presence at week 12 (0.25) is the maximum of any
week of the year. The relative probability of presence on week 12 is 0.25/0.25 = 1; at week 20 it is
0.05/0.25 = 0.2.
3. The relative probability of presence calculated in the previous step undergoes a statistical
conversion so that all possible values fall between 0 and 10, inclusive. This is the probability of
presence score.,/
t.
To see a bar's probability of presence score, simply hover your mouse cursor over the bar.
Breeding Season( )
Yellow bars denote a very liberal estimate of the time -frame inside which the bird breeds across its
entire range. If there are no yellow bars shown for a bird, it does not breed in your project area.
Survey Effort (')
Vertical black lines superimposed on probability of presence bars indicate the number of surveys
performed for that species in the 10km grid cell(s) your project area overlaps. The number of
surveys is expressed as a range, for example, 33 to 64 surveys.
To see a bar's survey effort range, simply hover your mouse cursor over the bar.
No Data ( )
A week is marked as having no data if there were no survey events for that week.
Survey Timeframe
Surveys from only the last 10 years are used in order to ensure delivery of currently relevant
information. The exception to this is areas off the Atlantic coast, where bird returns are based on all
years of available data, since data in these areas is currently much more sparse.
https://ecos.fws.gov/ipac/location/DABEPQ3M75BM5MZLR5X2KJ5VEM/resources 6/10

IPaC: Explore Location
probability of presence breeding season i survey effort — no data
SPECIES
American Kestrel
BCC - BCR (This is a
..............................................
Bird of Conservation
...............................................
Concern (BCC) only in
.....................................................
particular Bird
Conservation Regions
....................................................
(BCRs) in the
...............................
continental USA)
.........................................
]AN FEB MAR APR MAY 1UN JUL AUG SEP OCT NOV DEC
---- A- +- Rill L_ ill
19
Bald Eagle 1-9111 1111 1111 mill 1111 mill 1111 ----
Non-BCC Vulnerable. .000 soon soon NONE soon NONE soon An soon soon soon
(This is not a Bird of
.............
Conservation
Concern (BCC) in this
area, but warrants
............................................
attention because of
the Eagle Act or for
............................................
potential
......................
susceptibilities in
.........................................
offshore areas from
.................................................
certain types of
.....................................
development or
.............
activiti..........es.)................
Tell me more about conservation measures I can implement to avoid or minimize impacts to migratory birds.
Nationwide Conservation Measures describes measures that can help avoid and minimize impacts to all birds at
any location year round. Implementation of these measures is particularly important when birds are most likely to
occur in the project area. When birds may be breeding in the area, identifying the locations of any active nests and
avoiding their destruction is a very helpful impact minimization measure. To see when birds are most likely to
occur and be breeding in your project area, view the Probability of Presence Summary. Additional measures and/or
permits may be advisable depending on the type of activity you are conducting and the type of infrastructure or
bird species present on your project site.
What does IPaC use to generate the migratory birds potentially occurring in my specified location?
The Migratory Bird Resource List is comprised of USFWS Birds of Conservation Concern (BCC) and other species
that may warrant special attention in your project location.
The migratory bird list generated for your project is derived from data provided by the Avian Knowledge Network
(AKN'. The AKN data is based on a growing collection of survey, banding, and citizen science datasets and is
queried and filtered to return a list of those birds reported as occurring in the 10km grid cell(s) which your project
intersects, and that have been identified as warranting special attention because they are a BCC species in that
area, an eagle (Eagle Act requirements may apply), or a species that has a particular vulnerability to offshore
activities or development.
Again, the Migratory Bird Resource list includes only a subset of birds that may occur in your project area. It is not
representative of all birds that may occur in your project area. To get a list of all birds potentially present in your
project area, please visit the AKN Phenology Tool.
What does IPaC use to generate the probability of presence graphs for the migratory birds potentially
occurring in my specified location?
The probability of presence graphs associated with your migratory bird list are based on data provided by the
Avian Knowledge Network (AKN). This data is derived from a growing collection of survey, banding, and citizen
science datasets .
https://ecos.fws.gov/ipac/location/DABEPQ3M75BM5MZLR5X2KJ5VEM/resources 7/10

IPaC: Explore Location
Probability of presence data is continuously being updated as new and better information becomes available. To
learn more about how the probability of presence graphs are produced and how to interpret them, go the
Probability of Presence Summary and then click on the "Tell me about these graphs" link.
How do I know if a bird is breeding, wintering, migrating or present year-round in my project area?
To see what part of a particular bird's range your project area falls within (i.e. breeding, wintering, migrating or
year-round), you may refer to the following resources: The Cornell Lab of Ornithology All About Birds Bird Guide, or
(if you are unsuccessful in locating the bird of interest there), the Cornell Lab of Ornithology Neotropical Birds
guide. If a bird on your migratory bird species list has a breeding season associated with it, if that bird does occur
in your project area, there may be nests present at some point within the timeframe specified. If "Breeds
elsewhere" is indicated, then the bird likely does not breed in your project area.
What are the levels of concern for migratory birds?
Migratory birds delivered through IPaC fall into the following distinct categories of concern: - A
1. BCC Rangewide birds are Birds of Conservation Concern (BCC) that are of concern throughout their rang
anywhere within the USA (including Hawaii, the Pacific Islands, Puerto Rico, and the Virgin Islands),
2. "BCC - BCR" birds are BCCs that are of concern only in particular Bird Conservation Regions (BCRs) in the
continental USA; and ! }
3. "Non -BCC - Vulnerable" birds are not BCC species in your project area, but appear on your list either because of
the Eagle Act requirements (for eagles) or (for non -eagles) potential susceptibilities in offshore areas from
certain types of development or activities (e.g. offshore energy development or longline fishing).
Although it is important to try to avoid and minimize impacts to all birds, efforts should be made, in particular, to
avoid and minimize impacts to the birds on this list, especially eagles and BCC species of rangewide concern. For
more information on conservation measures you can implement to help avoid and minimize migratory bird
impacts and requirements for eagles, please see the FAQs for these topics.
Details about birds that are potentially affected by offshore projects
For additional details about the relative occurrence and abundance of both individual bird species and groups of
bird species within your project area off the Atlantic Coast, please visit the Northeast Ocean Data Portal. The Portal
also offers data and information about other taxa besides birds that may be helpful to you in your project review.
Alternately, you may download the bird model results files underlying the portal maps through the NOAA NCCOS
Integrative Statistical Modeling and Predictive Mapping of Marine Bird Distributions and Abundance on the Atlantic
Cutter Continental Shelf project webpage.
Bird tracking data can also provide additional details about occurrence and habitat use throughout the year,
including migration. Models relying on survey data may not include this information. For additional information on
marine bird tracking data, see the Diving Bird Study and the nanotag studies or contact Caleb Spiegel or Pam
Loring.
What if I have eagles on my list?
If your project has the potential to disturb or kill eagles, you may need to obtain a permit to avoid violating the
Eagle Act should such impacts occur.
Proper Interpretation and Use of Your Migratory Bird Report
The migratory bird list generated is not a list of all birds in your project area, only a subset of birds of priority
concern. To learn more about how your list is generated, and see options for identifying what other birds may be
in your project area, please see the FAQ "What does IPaC use to generate the migratory birds potentially occurring
in my specified location". Please be aware this report provides the "probability of presence" of birds within the 10
km grid cell(s) that overlap your project; not your exact project footprint. On the graphs provided, please also look
https://ecos.fws.gov/ipac/location/DABEPQ3M75BM5MZLR5X2KJ5VEM/resources 8/10

IPaC: Explore Location
carefully at the survey effort (indicated by the black vertical bar) and for the existence of the "no data" indicator (a
red horizontal bar). A high survey effort is the key component. If the survey effort is high, then the probability of
presence score can be viewed as more dependable. In contrast, a low survey effort bar or no data bar means a lack
of data and, therefore, a lack of certainty about presence of the species. This list is not perfect; it is simply a starting
point for identifying what birds of concern have the potential to be in your project area, when they might be there,
and if they might be breeding (which means nests might be present). The list helps you know what to look for to
confirm presence, and helps guide you in knowing when to implement conservation measures to avoid or
minimize potential impacts from your project activities, should presence be confirmed. To learn more about
conservation measures, visit the FAQ "Tell me about conservation measures I can implement to avoid or minimize
impacts to migratory birds" at the bottom of your migratory bird trust resources page.
Facilities
National Wildlife Refuge lands
< XC) 4
Any activity proposed on lands managed by the National Wildlife Refuge system must undergo a
'Compatibility Determination' conducted by the Refuge. Please contact the individual Refuges to
discuss any questions or concerns.
THERE ARE NO REFUGE LANDS AT THIS LOCATION
Fish hatcheries
THERE ARE NO FISH HATCHERIES AT THIS LOCATION.
Wetlands in the National Wetlands Inventory
Impacts to NWI wetlands and other aquatic habitats may be subject to regulation under Section 404
of the Clean Water Act, or other State/Federal statutes.
For more information please contact the Regulatory Program of the local U.S. Army Corps of
Engineers District.
Please note that the NWI data being shown may be out of date. We are currently working to update
our NWI data set. We recommend you verify these results with a site visit to determine the actual
extent of wetlands on site.
This location overlaps the following wetlands:
RIVERINE
R2UBHx
https://ecos.fws.gov/ipac/location/DABEPQ3M75BM5MZLR5X2KJ5VEM/resources 9/10

IPaC: Explore Location
A full description for each wetland code can be found at the National Wetlands Inventory website
Data limitations
The Service's objective of mapping wetlands and deepwater habitats is to produce reconnaissance level
information on the location, type and size of these resources. The maps are prepared from the analysis of high
altitude imagery. Wetlands are identified based on vegetation, visible hydrology and geography. A margin of error
is inherent in the use of imagery, thus, detailed on -the -ground inspection of any particular site may result in
revision of the wetland boundaries or classification established through image analysis.
The accuracy of image interpretation depends on the quality of the imagery, the experience of the image analysts,
the amount and quality of the collateral data and the amount of ground truth verification work conducted.
Metadata should be consulted to determine the date of the source imagery used and any mapping problems.
Wetlands or other mapped features may have changed since the date of the imagery or field work. There may be
occasional differences in polygon boundaries or classifications between the information depicted on the map and
the actual conditions on site.
Data exclusions W4 nl�k
Certain wetland habitats are excluded from the National mapping program because of the limitations of aerial
imagery as the primary data source used to detect wetlands. These habitats include seagrasses or submerged
aquatic vegetation that are found in the intertidal and subtidal zones of estuaries and nearshore coastal waters.
Some deepwater reef communities (coral or tuberficid worm reefs) have also been excluded from the inventory.
These habitats, because of their depth, go undetected by aerial imagery.
Data precautions — 1046:�O
Federal, state, and local regulatory agencies with jurisdiction over wetlands may define and describe wetlands in a
different manner than that used in this inventory. There is no attempt, in either the design or products of this
inventory, to define the limits of proprietaryjurisdiction of any Federal, state, or local government or to establish
the geographical scope of the regulatory programs of government agencies. Persons intending to engage in
activities involving modifications within or adjacent to wetland areas should seek the advice of appropriate federal,
state, or local agencies concerning specified agency regulatory programs and proprietary jurisdictions that may
affect such activities.
Np
https://ecos.fws.gov/ipac/location/DABEPQ3M75BM5MZLR5X2KJ5VEM/resources 10/10

qN
)EN
CM0018 Burnham House
1977
Sources: Esri, HER�forea,
min, USGS, Intermap, I' C EMENT P, NRCan, Esri Japan, METI, Esri China (Hong Kong), Esri
Esri (Thailand), NCc) OpenStreetMap contributors, and the GIS User Community

DWR
Division of Water Resources
Pre -Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
September 1, 2020 Ver 3.2
Please note: fields marked with a red asterisk below are required. You will not be able to submit the form until all mandatory questions are answered.
Also, if at any point you wish to print a copy of the E-PCN, all you need to do is right -click on the document and you can print a copy of the form.
Below is a link to the online help file.
https://edoes. deq. n e.gov/WaterResou rces/0/ed oc/624704/PCN % 20 Help / 20F i le / 202018-1-30. pdf
A. Processing Information (:)
County (or Counties) where the project is located:*
Camden
Is this a NCDMS Project*
r Yes C No
Click Yes, only if NCDlvS is the applicant a co -applicant.
Is this project a public transportation project?
O Yes F No
This is arty publicly funded by mnicipal,state a federal funds road, rail, airport transportatim project.
1a. Type(s) of approval sought from the Corps:*
❑ Section 404 Permit (wetlands, streams and waters, Clean Water Act)
[;Z Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
1 b. What type(s) of permit(s) do you wish to seek authorization?
P Nationwide Permit (NWP)
r Regional General Permit (RGP)
r Standard (IP)
This form may be used to initiate the standard/individual permit process with the Corps. Please contact your Corps representative concerning submittals for standard permits. All required items that
are not provided in the E-PCN can be added to the miscellaneous upload area located at the bottom of this form.
1c. Has the NWP or GP number been verified by the Corps?*
Yes r No
Nationwide Permit (NWP) Number: 12 - Utility Lines
NWP Numbers (for multiple NWPS):
List all NJVnurbers ycw are applying fa not m the drop dawn list.
1d. Type(s) of approval sought from the DWR:*
check all that apply
r 401 Water Quality Certification - Regular
IJ Non-404 Jurisdictional General Permit
r Individual Permit
le. Is this notification solelyfor the record because written approval is not required?
.............................................. .................... ....................
For the record onlyfor DWR401 Certification:
For the record onlyfor Corps Permit:
1f. Is this an after -the -fact permit application?*
r Yes F No
❑ 401 Water Quality Certification - Express
❑ Riparian Buffer Authorization
*
6 Yes 6 No
6 Yes 6 No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
If so, attach the acceptance letter from ratiga5m bank a in -lieu fee program
r Yes E No
Acceptance Letter Attachment

Click the upload button a drag and drop files here to attach docurrent
RLEiYFEMUSTBEFDF
1 h. Is the project located in any of NC's twenty coastal counties?*
F• Yes r No
1 i. Is the project located within a NC DCM Area of Environmental Concern (AEC)?*
6 Yes r,, No O Unknown
1j. Is the project located in a designated trout watershed?*
r Yes E No
Link to trout information: http://www.saw.usace.army.mil/Missions/Regulatory-Permit-Program/Agency-Coordination/Trout.aspx
B. Applicant Information
1a. Who is the Primary Contact?*
Kevin Heath
1c. Primary Contact Phone:*
1b. Pri mary Contact Email:*
(xxx)xxx-xxxx
[e-mail]
[phone]
1d. Who is applying for the permit?
r Owner
Applicant (other than owner)
(Check all that apply)
le. Is there an Agent/Consultant for this project?*
F Yes r' No
2. Owner Information
2a. Name(s) on recorded deed:*
United States of America
2b. Deed book and page no.:
Contract No. DACW65-2-13-12
2c. Responsible party:
(for Corporations)
USAED, Norfolk Real Estate Office
2d. Address*
Street Address
803 Front Street
Address Line 2
Qty
State / Aovince / Pegicn
Norfolk
VA
Fbstal / Zp Code
Country
23510
USA
2e. Telephone Number:*
(xxx)xxx-xxxx
[phone]
2f. Fax Number:
(xxx)xxx-xxxx
2g. Email Address:*
[e-mail]
3. Applicant Information (if different from owner)
3a. Name:*
Kevin Heath
3b. Business Name:
(d applicable)
Albemarle Electric Membership Corporation
3c. Address*

Street Address
125 Cooperative Way
Address Line 2
Oty
State / Aovince / Regim
Hertford
NC
Postal / Zp Code
Country
27944
USA
3d. Telephone Number:*
3e. Fax Number:
[phone]
[phone]
(xxx)xxx-xxxx
(xxx)xxx-xxxx
3f. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:*
Joshua Shepherd
4b. Business Name:
(d applicable)
Booth R Associates, LLC
4c. Address*
Street Address
5811 Glenwood Ave
Address Line 2
Suite 109
Oty
State / Aovince / Regim
Raleigh
NC
Postal / Zp Code
Country
27612
USA
4d. Telephone Number:*
[phone]
4e. Fax Number:
(xxx)xxx-xxxx
(xxx)xxx-xxxx
4f. Email Address:*
[e-mail]
Agent Authorization Letter*
Rease provide the Agent Aulhorizabw Letter if you are subrritbng the dmurrent.
Agent Auth Form.pdf
RLEiYFEMUSTBEFDF
C. Project Information and Prior Project History
1. Project Information
1a. Name of project:*
UG Fiber Crossing of ICW
1b. Subdivision name:
(d appropriate)
651.53KB
1c. Nearest municipality / town:
*
South Mills
2. Project Identification l^J
2a. Property Identification Number:
2b. Property size:
(tax RN a parcel ID)
(in acres)
USA owned- No tax parcel #
0.5
2c. Project Address
Street Address
Spence Ln
Address Line 2
Oty
State / Aovince / Regim
South Mills
NC
Postal / Zp Code
Country
27976
USA
2d. Site coordinates in decimal degrees

Please collect site coordinates in decimal degrees. Use between 4-6 digits (unless you are using a survey -grade GPS device) after the decimal place as appropriate, based on how the location was
determined. (For example, most mobile phones with GPS provide locationaI precision in decimal degrees to map coordinates to 5 or 6 digits after the decimal place.)
Latitude:* Longitude:*
36.4626-76.3351
ex: 34.208504-77.796371
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Dismal Swamp Canal
3b. Water Resources Classification of nearest receiving water:*
C;SW 30-3-2
Surface Water Lookup
3c. What river basin(s) is your project located in?*
Pasquotank
3d. Please provide the 12-digit HUC in which the project is located.*
030102050606
River Basin Lookup
4. Project Description and History
4a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this application:*
The Dismal Swamp Canal is a federally protected recreational use area owned by the United States of America. The banks of the canal are tree -lined, and the areas adjacent to the
canal boundary are agricultural and NC DOT Right -of -Way. There is an existing underground distribution line directly adjacent to this project location.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?
f Yes r No R Unknown
4d. Attach an 8 1/2 X 11 excerpt from the most recent version of the USGS topographic map indicating the location of the project site. (for DWR)
Clickthe upload button a drag and drop files here to attach dccurrent
4479911_usgs.pdf 1.63MB
File type crust be pdf
4e. Attach an 8 1/2 X 11 excerpt from the most recent version of the published County NRCS Soil Survey map depicting the project site. (for DWR)
Clickthe upload button a drag and drop files here to attach dccurrent
447991 1 _n res. pdf 1.66MB
File type crust be pdf
4f. List the total estimated acreage of all existing wetlands on the property:
0.25
4g. List the total estimated linear feet of all existing streams on the property:
(intermittent and paenrral)
15
4h. Explain the purpose of the proposed project:*
Underground fiber line will cross the canal at a depth of 15' below the bottom of the canal.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
See attached Plan/Profile project proposal and vicinity map of the area. HDD will cause very little disturbance to the agricultural ground adjacent to the canal.
4j. Please upload project drawings for the proposed project.
Clickthe upload button a drag and drop files hereto attach dccurrent
4479911_PP_UG.pdf 324.92KB
4479911_vm.pdf 269.85KB
File type crust be pdf
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the propertyor proposed impact areas?*
C Yes 6 No O Unknown
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
O Preliminary f Approved O Not Verified ( Unknown F N/A
Corps AID Number:
Exarrple: SAW-2017-99999
5c. If 5a is yes, who delineated the jurisdictional areas?

Name (if known):
Agency/Consultant Company:
Other:
5d1. Jurisdictional determination upload
Oickthe upload button a drag and drop files here to attach docurrent
File type crust be FLF
6. Future Project Plans
6a. Is this a phased project?*
C Yes No
Are any other NWP(s), regional general permit(s), or individual permits(s) used, or intended to be used, to authorize any part of the proposed project or related activity? This
includes other separate and distant crossing for linear projects that require Department of the Army authorization but don't require pre -construction notification.
No
D. Proposed Impacts Inventory
1. Impacts Summary
la. Where are the impacts associated with your project? (check all that apply):
F Wetlands r Streams -tributaries r- Buffers
F Open Waters r- Pond Construction
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this question for all stream sites impacted.
"S." will be used in the table below to represent the word "stream".
3a. Reason for impact*(') 3b.lmpact type * 3c. Type of impact* 3d. S. name * 3e. Stream Type * 3f. Type of 3g. S. width * 3h. Impact
M Jurisdiction* length*
,1 Underground HDD Temporary Other Dismal Swamp Canal Perennial:::] � Corps h�]
(linear feet)
**All Perennial or Intermittent streams must be verified by DWR or delegated local government.
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
0
3i. Total temporary stream impacts:
15
3i. Total stream and ditch impacts:
15
3j. Comments
E. Impact Justification and Mitigation
1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:*
Underground HDD boring crossing only - will not impact stream.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*
HDD will cause very little disturbance to the agricultural ground adjacent to the canal.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for impacts to Waters of the U.S. or Waters of the State?
f Yes F No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
Not a special designation waters such as trout waters or streambed loss. Project involves no wetlands and less than 150 linear feet of stream.
NC Stream Temperature Classification Maps can be found under the Mitigation Concepts tab on the Wilmington District's RIBITS website.

F. Stormwater Management and Diffuse Flow Plan (required by DWR) u
*** Recent changes to the stormwater rules have required updates to this section .***
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection Rules?
6 Yes r No
1 b. All buffer impacts and high ground impacts require diffuse flow or other form of stormwater treatment. If the project is subject to a state implemented riparian buffer protection
program, include a plan that fully documents how diffuse flowwill be maintained.
All Stormwater Control Measures (SCM)s must be designed in accordance with the NC Stormwater Design Manual. Associated supplement forms and other documentation shall be
provided.
What type of SCM are you providing?
❑ Level Spreader
❑ Vegetated Conveyance (lower SHWT)
❑ Wetland Swale (higher SHWT)
❑ Other SCM that removes minimum30% nitrogen
W Proposed project will not create concentrated stormwater flowthrough the buffer
(check all that apply)
For a list of options to meet the diffuse flow requirements, click here.
Diffuse Flow Documentation
Oickthe upload button a drag and drop files hereto attach dccurrent
File type crust be FLF
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
r Yes F No
2b. Does this project meet the requirements for low density projects as defined in 15A NCAC 02H .1003(2)? *
r Yes G No
To look up lowdensity requirement click here 15A NCAC 02H .1003(2).
2c. Does this project have a stormwater management plan (SMP) reviewed and approved under a state stormwater program or state -approved local government stormwater
program?
r Yes No
6 N/A - project disturbs < 1 acre
Hint: projects that have vested rights, exerrlAo s, a grandrathering fran state a locally inplerented stamvater programs a projects that satisfy state a locally-inplerrentei stamvater programs through use of ccr rrnity in -lieu programs should answer no
to this question.
Comments
G. Supplementary Information
1. Environmental Documentation
1a. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land? *
r Yes (- No
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification Rules (15A NCAC 2H .0500), Isolated Wetland Rules (15A NCAC 2H .1300), or DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15A NCAC 2B .0200)? *
f Yes (- No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in additional development, which could impact nearby downstream water quality?*
r Yes (-- No
3b. If you answered "no," provide a short narrative description.
Project is a utility addition, not residential development. As such, it is a standalone project that will not bring more people to the area or require
e)pansion.
4. Sewage Disposal (DWR Requirement)
4a.Issewage disposal required by DWR for this project?*
r Yes r Nor N/A

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or habitat?*
6 Yes C No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
r Yes (-- No
5d. Is another Federal agency involved?*
r Yes No
5e. Is this a DOT project located within Division's 1-8?*
f Yes F No
5f. Will you cut anytrees in order to conduct the work in waters of the U.S.?*
r Yes F No
5g. Does this project involve bridge maintenance or removal?*
O Yes C No
Link to the NLEB SLOPES document: http://saw-reg.usace.army.mil/NLEB/1-1,0-17-signed_NLEB-SLOPESRapps.pdf
5h. Does this project involve the construction/installation of a wind turbine(s)?'*
f Yes F No
r Unknown
5i. Does this project involve (1) blasting, and/or (2) other percussive activities that will be conducted by machines, such as jackhammers, mechanized pile drivers, etc.? *
r Yes C No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?*
https://ecos.fws.gov/ipac/location/DABEPQ3M75BM5MZLR5X2 KJ5VEM/resou rces
See attached.
Consultation Documentation Upload
Oickthe upload button a drag and drop files hereto attach docurrent
Endangered Species List.pdf 480.93KB
File type rust be FLF
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
r Yes E No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
Any endangered fish species were included in the Biological Assessment report and the project will have no impact on aquatic species. (See
attached). https://ecos.fvs.gov/ipac/location/DABEPQ3M75BM5MZLR5X2KJ5VEM/resources
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
Link to the State Historic Preservation Office Historic Properties Map (does not include archaeological data: http://gis.neder.gov/hpoweb/
7a. Will this project occur in or near an area that the state, federal or tribal governments have designated as having historic or cultural preservation status (e.g., National Historic
Trust designation or properties significant in North Carolina historyand archaeology)?*
r Yes F No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
https://mm. neder.g ov/a bout/h istory/division-historical-resou rces/g is -maps -and -data.
See attached.
7c. Historic or Prehistoric Information Upload
Click the upload button a drag and drop files here to attach docurrent
HistoricaICu Itu ra I. pdf
File must be FLF
8. Flood Zone Designation (Corps Requirement)
Link to the FEMAFIoodplain Maps: https://rrse.fema.gov/portal/search
8a. Will this project occur in a FEMA-designated 100-year floodplain?
6 Yes r No
8b. If yes, explain how project meets FEMA requirements:
The canal portion of the project (aerial crossing only) lies within the Special Flood Hazard
Area 1 % area. Panel attached
228.16KB
8c. What source(s) did you use to make the floodplain determination?*

FEMA Panel 7989; Map Number 3720798900J
Miscellaneous U
Comments
FEMA map attached
Miscellaneous attachments not previously requested.
Oickthe upload button a drag and drop files hereto attach docurrent
3720798900J.pdf
File mst be FLF a IQvZ
Signature
By checking the box and signing below, I certify that:
20AMB
• I have given true, accurate, and complete information on this form;
• I agree that submission of this PCN form is a "transaction" subject to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act');
• I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act');
• I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature; AND
• I intend to electronically sign and submit the PCN form.
Full Name:*
Joshua Shepherd
Signature *
e
i
Date
10/7/2020