19970295 Ver 2_401 Application_20101029

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0 0o WATER pG Office Use Only:
Corps action ID no.
o Y DWQ project no.
Form Version 1.3 Dec 10 2008
Pre-Construction Notification (PCN) Form
A. Applicant Information IM a
1. Processing
1 a. Type(s) of approval sought from the
Corps:
®Section 404 Permit El Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: NWP 12 or General Permit (GP) number:
1 c. Has the NWP or GP number been verified by the Corps? ® Yes ? No
1 d. Type(s) of approval sought from the DWQ (check all that apply):
® 401 Water Quality Certification - Regular ? Non-404 Jurisdictional General Permit
? 401 Water Quality Certification - Express ? Riparian Buffer Authorization
1 e. Is this notification solely for the record
because written approval is not required? For the record only for DWQ 401
Certification:
? Yes ® No For the record only for Corps Permit:

? Yes ® No
1f. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in-lieu
fee program. ? Yes ® No
1 g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below. ® Yes ? No
1h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? O Yes ? No
2. Project Information
2a. Name of project: Gum Branch Outfall Repair
2b. County: New Hanover r= r= m In
2c. Nearest municipality / town: Wilmington
l
2d. Subdivision name: u O
2e. NCDOT only, T.I.P. or state
project no: CT
' ?" 20,40
3. Owner Information IIETLARDSANDSTCR..'Yk_ fi ERMICH
3a. Name(s) on Recorded Deed:
3b. Deed Book and Page No.
3c. Responsible Party (for LLC if
applicable): Matthew W. Jordan, PE, CFPUA
3d. Street address: 235 Government Center Drive
3e. City, state, zip: Wilmington, NC 28403
3f. Telephone no.: 910-332-6542
3g. Fax no.: 910-799-6066
3h. Email address: [e-mail]
Page I of 11
PCN Form - Version 1.3 December 10, 2008 Version
4. Applicant Information (if different from owner)
4a. Applicant is: ? Agent ? Other, specify:
4b. Name:
4c. Business name
(if applicable):
4d. Street address:
4e. City, state, zip:
4f. Telephone no.:
4g. Fax no.:
4h. Email address:
5. Agent/Consultant Information (if applicable)
5a. Name:
5b. Business name
(if applicable):
5c. Street address:
5d. City, state, zip:
5e. Telephone no.:
5f. Fax no.:
5g. Email address:
Page 2 of 11
PCN Form - Version 1.3 December 10, 2008 Version
B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): 4300-007-021-000
Latitude: 34.155935N Longitude: -
1 b. Site coordinates (in decimal degrees): 77.512597
(DD.DDDDDD) (-DD.DDDDDD)
1 c. Property size: 0.03 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to Smith Creek
proposed project:
2b. Water Quality Classification of nearest receiving water: C; Sw
2c. River basin: Cape Fear
3. Project Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application:
Land is used for transport of wastewater underground through sewer lines. Easements are maintained per Collection
System Permit WQCS00012, Herbaceous cover in a tidal marsh area.
3b. List the total estimated acreage of all existing wetlands on the property:
0.03 acres
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
apporximately 70 LF
3d. Explain the purpose of the proposed project:
Sewer line and manhole has been exposed due to stream channel relocation from original stream channel being blocked
due to debris and what appears to be an old beaver dam. Stream has eroded line and manhole cover leaving line
vulnerable. Sewer line and manhole will be covered with clean fill, the original slope will be returned and shored with
riprap and stream channel will be restored to its original channel.
3e. Describe the overall project in detail, including the type of equipment to be used:
The reconstruction would be from the center line of the manhole(C/L MH) toward the old creek bed 20 feet at the base
which is about the intersection of the old existing bank slope crest. The design would show a finish slope of about 60 to
50 percent which would provide us about 15 to 16 feet of workable surface space for our equipment and maintenance,
which is needed. Slope would be hardened or armored by means of installing geo-type matting that would be secured
and installing a complete covering of the slope with large Rip Rap stone installation. An excavator will be used to clean
the debris from the original channel and to add clean fill to create the bank slope. Sheet piling will be used at both ends of
the project area to divert channel flow while repairs are being performed.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
? Yes ®No ? Unknown
project (including all prior phases) in the past?
Comments:
4b. If the Corps made the jurisdictional determination, what type
? Preliminary ? Final
of determination was made?
4c. If yes, who delineated the jurisdictional areas? Agency/Consultant Company:
Name (if known): Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
Page 3 of 11
PCN Form - Version 1.3 December 10, 2008 Version
5. Project History
5a. Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past? ® Yes ? No ? Unknown
5b. If yes, explain in detail according to "help file" instructions.
The orginal USACE and DWQ permits were attained in 1997 for installation of the sewer line.
6. Future Project Plans
6a. Is this a phased project? ? Yes ® No
6b. If yes, explain.
Page 4 of 11
PCN Form - Version 1.3 December 10, 2008 Version
C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
® Wetlands ® Streams - tributaries ? Buffers
? Open Waters ? Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a. 2b. 2c. 2d. 2e. 2f.
Wetland impact Type of jurisdiction
number - Type of impact Type of wetland Forested (Corps - 404, 10 Area of impact
Permanent (P) or (if known) DWQ - non-404, other) (acres)
Temporary T
W1 ®P ? T Stabilization Non - Tidal ? Yes ® Corps 0.03
Activities Freshwater Marsh ® No ® DWQ
W2 ? P ? T ? Yes ? Corps
? No ? DWQ
W3 ? P ? T ? Yes ? Corps
? No ? DWQ
W4 ? P ? T ? Yes ? Corps
? No ? DWQ
W5 ? P ? T ? Yes ? Corps
? No ? DWQ
W6 ? P ? T ? Yes ? Corps
? No ? DWQ
2g. Total wetland impacts 0.03
2h. Comments: The stabilization activity will have no significant impact on the area. The stream will be restored to its natural
channel and clean fill will be used to restore the area. Debris that is currently in the stream channel will be removed.
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.
3a. 3b. 3c. 3d. 3e. 3f. 3g.
Stream impact Type of impact Stream name Perennial Type of jurisdiction Average Impact
number - (PER) or (Corps - 404, 10 stream length
Permanent (P) or intermittent DWQ - non-404, width (linear
Temporary (T) (INT)? other) (feet) feet)
Mechanical
S1 ® P ? T Clearing,
Stabilization and Gum Branch ® PER
? INT ® Corps
® DWQ 5 70
Backfill
S2 ? P ? T ? PER ? Corps
? INT ? DWQ
S3 ? P ? T ? PER ? Corps
? INT ? DWO
S4 ? P ? T ? PER ? Corps
? INT ? DWQ
S5 ? P ? T ? PER ? Corps
? INT ? DWQ
S6 ? P ? T ? PER ? Corps
? INT ? DWQ
3h. Total stream and tributary impacts 70
3i. Comments:
Page 5 of 11
PCN Form - Version 1.3 December 10, 2008 Version
4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impacts below.
4a. 4b. 4c. 4d. 4e.
Open water Name of waterbody
impact number - (if applicable) Type of impact Waterbody type Area of impact (acres)
Permanent (P) or
Temporary T
01 ? P?T
02 ?P?T
03 ?P?T
04 ?P?T
4E Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If and or lake construction proposed, then complete the chart below.
5a. 5b. 5c. 5d. 5e.
Wetland Impacts (acres) Stream Impacts (feet) Upland
Pond ID Proposed use or purpose (acres)
number of pond
Flooded Filled Excavated Flooded Filled Excavated Flooded
P1
P2
5f. Total
5g. Comments:
5h. Is a dam high hazard permit required?
? Yes ®No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for DWO)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If an impacts require mitigation, then you MUST fill out Section D of this form.
6a.
Project is in which protected basin?
6b. 6c. 6d.
Buffer impact
number - Reason
Permanent (P) or for
Temoorarv (T) impact
61 ?P?T
B2 ?P?T
B3 ?P?T
6i. Comments:
? Neuse ? Tar-Pamlico ? Other:
? Catawba ? Randleman
6e. 6f. 6g.
Buffer
Stream name mitigation
required?
? Yes
? No
? Yes
? No
? Yes
? No
6h. Total buffer impacts
Zone 1 impact Zone 2 impact
(square feet) (square feet)
Page 6 of 11
PCN Form - Version 1.3 December 10, 2008 Version
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
The reconstruction would be from the center line of the manhole(C/L MH) toward the old creek bed 20 feet at the base which
is about the intersection of the old existing bank slope crest. The design would show a finish slope of about 60 to 50 percent
which would provide us about 15 to 16 feet of workable surface space for our equipment and maintenance, which is needed.
Slope would be hardened or armored by means of installing geo-type matting that would be secured and installing a complete
covering of the slope with large Rip Rap stone installation. All work will be performed within easemnt working
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
An excavator will be used to clean the debris from the original channel and to add clean fill to create the bank slope. Sheet
piling will be used at both ends of the project area to divert channel flow while repairs are being performed. Silt fencing will be
installed while creek bank is reestablished to minimize any claen fill entering into the creek.
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? ? Yes ® No
2b. If yes, mitigation is required by (check all that apply): ? DWQ ? Corps

2c. If yes, which mitigation option will be used for this
project? ? Mitigation bank

El Payment to in-lieu fee program
? Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter) Type Quantity
3c. Comments:
4. Complete if Making a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached. ? Yes
4b. Stream mitigation requested: linear feet
4c. If using stream mitigation, stream temperature: ? warm ? cool ?cold
4d. Buffer mitigation requested (DWQ only): square feet
4e. Riparian wetland mitigation requested: acres
4f. Non-riparian wetland mitigation requested: acres
4g. Coastal (tidal) wetland mitigation requested: acres
4h. Comments:
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
Page 7 of 11
PCN Form - Version 1.3 December 10, 2008 Version
6. Buffer Mitigation (State Regulated Riparian Buffer Rules) - required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation? ? Yes ® No
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.

Zone 6c.
Reason for impact 6d.
Total impact
(square feet)
Multiplier 6e.
Required mitigation
(square feet)
Zone 1 3 (2 for Catawba)
Zone 2 1.5
6f. Total buffer mitigation required:
6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in-lieu fee fund).
6h. Comments:
Page 8 of 11
PCN Form - Version 1.3 December 10, 2008 Version
E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1 a. Does the project include or is it adjacent to protected riparian buffers identified ? Yes ® No
within one of the NC Riparian Buffer Protection Rules?
1 b. If yes, then is a diffuse flow plan included? If no, explain why.
? Yes ®No
Comments:
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project? 0%
2b. Does this project require a Stormwater Management Plan? ? Yes ® No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why: No impervious acreage
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
? Certified Local Government
2e. Who will be responsible for the review of the Stormwater Management Plan? ? DWQ Stormwater Program
? DWQ 401 Unit
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this project?
? Phase II
3b. Which of the following locally-implemented stormwater management programs ? NSW
? USMP
apply (check all that apply): ? Water Supply Watershed
? Other:
3c. Has the approved Stormwater Management Plan with proof of approval been ? Yes ? No
attached?
4. DWQ Stormwater Program Review
? Coastal counties
? HQW
4a. Which of the following state-implemented stormwater management programs apply ? ORW
(check all that apply):
? Session Law 2006-246
? Other:
4b. Has the approved Stormwater Management Plan with proof of approval been
attached? ? Yes ? No
5. DWQ 401 Unit Stormwater Review
5a. Does the Stormwater Management Plan meet the appropriate requirements? ? Yes ? No
5b. Have all of the 401 Unit submittal requirements been met? ? Yes ? No
Page 9 of 11
PCN Form - Version 1.3 December 10, 2008 Version
F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1 a. Does the project involve an expenditure of public (federal/state/local) funds or the ® Yes ? No
use of public (federal/state) land?
1 b. If you answered "yes" to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State ? Yes ® No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1 c. If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
letter.) ? Yes ? No
Comments:
2. Violations (DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards, ? Yes ® No
or Riparian Buffer Rules (15A NCAC 213 .0200)?
2b. Is this an after-the-fact permit application? ? Yes ® No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in ? Yes ® No
additional development, which could impact nearby downstream water quality?
3b. If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
4. Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility.
The existing line ties in to the Northside WWTP.
Page 10 of 11
PCN Form - Version 1.3 December 10, 2008 Version

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or ? Yes ® No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act ? Yes ® No
impacts?
? Raleigh
5c. If yes, indicate the USFWS Field Office you have contacted.
? Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
The NC Natural Heritage Program GIS layer was used to determine the presence of federally listed species. No federally
protected species in or near the site were noted.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat? ? Yes ® No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
The NOAA Fisheries Essential Fish Habitat Mapper GIS program was used to determine the presence of essential fish
habitat.
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
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 ? Yes ® No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
The Natural Trust for Historic Preservation website mapping resource was used to determine the presence of cultural
resources. No cultural resources were found.
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain? ® Yes ? No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination? The NC Floodplain Mapping Information Sysytem
website was used to determine the boundaries of the 100-year floodplain.
Matthew W. Jordan 10/26/2010

Applicant/Agent's Printed Name Applicant/Agent' i at re Date
(Agent's signature is valid only if an orization letter from the applicant
is ided.
Page 11 of 11
PCN Form - Version 1.3 December 10, 2008 Version
1. NO EXCAVATED MATERIAL SHALL BE PLACED ~ '~1 ~ .~J
IN ANY STREAM, DITCH OR DRAINAGE WAY. j ~ ~ Z~if~
2. THE CONTRACTOR 15 RESPONSIBLE FpR LOCATING ALL ~~r'~A~4°DS~1NNp~70f~~~1 ER~lCN
UNDERGROUND UTILITIES BEFORE ANY CONSTRUCTION BEGINS.
3. THE CONTRACTOR IS RESPONSIBLE FOR TEMPORARY SEDIMENT AND EROSION CONTROL MEASURES WHILE
CONSTRUCTION IS IN PROGRESS.
4. THE CONTRACTOR IS RESPONSIBLE FOR STABILIZATION
OF ALL DISTURBED AREAS..
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