20201242 Ver 1_UPDATED Pre-Construction Notification (PCN) Form_20210111

Pre-Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
April 11, 2020 Ver 3.1
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://edocs.deq.nc.gov/WaterResources/0/edoc/624704/PCN%20Help%20File%202018-1-30.pdf
County (or Countie s) where the proje ct is locate d:*
Is this a NCDM S Proje ct *
Is this project a public transportation project?*
1a. Type (s) of approv al sought from the Corps:*
1b. What type (s) of pe rmit(s) do you wish to se e k authorization?*
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 numbe r be e n v e rifie d by the Corps?*
Nationwide Pe rmit (NWP) Numbe r:
NWP Numbe rs (for multiple NWPS):
1d. Type (s) of approv al sought from the DWR:*
1e . Is this notification sole ly for the re cord be cause writte n approv al is not re quire d?
*
For the re cord only for DWR 401 Ce rtification:
For the re cord only for Corps Pe rmit:
1f. Is this an afte r-the -fact pe rmit application?*
1g. Is payme nt into a mitigation bank or in-lie u fe e program propose d for mitigation of impacts?
Acce ptance Le tte r Attachme nt
A. Processing Information
Durham
Yes No
Click Yes, only if NCDMS is the applicant or co-applicant.
Yes No
This is any publicly funded by municipal,state or federal funds road, rail, airport transportation project.
Section 404 Permit (wetlands, streams and waters, Clean Water Act)
Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
Nationwide Permit (NWP)
Regional General Permit (RGP)
Standard (IP)
Yes No
29 - Residential Developments
List all NW numbers you are applying for not on the drop dow n list.
check all that apply
401 Water Quality Certification - Regular 401 Water Quality Certification - Express
Non-404 Jurisdictional General Permit Riparian Buffer Authorization
Individual Permit
Yes No
Yes No
Yes No
If so, attach the acceptance letter from mitigation bank or in-lieu fee program.
Yes No
1h. Is the proje ct locate d in any of NC's twe nty coastal countie s?*
1j. Is the proje ct locate d in a de signate d trout wate rshe d?*
Link to trout information: http://www.saw.usace.army.mil/Missions/Regulatory-Permit-Program/Agency-Coordination/Trout.aspx
1a. Who is the Primary Contact?*
1b. Primary Contact Email:*
1c. Primary Contact Phone :*
1d. Who is applying for the pe rmit?*
1e . Is the re an Age nt/Consultant for this proje ct?*
2. Owner Information
3. Applicant Information (if different from owner)
Click the upload button or drag and drop files here to attach document
FILE TYPE MUST BE PDF
Yes No
Yes No
B. Applicant Information
Deborah Shirley
[e-mail]
(xxx)xxx-xxxx
[phone]
Owner Applicant (other than owner)
(Check all that apply)
Yes No
2a. Name (s) on re corde d de e d:*
2b. De e d book and page no.:
2c. Re sponsible party:
2d. Addre ss *
2e . Te le phone Numbe r:*
2f. Fax Numbe r:
2g. Email Addre ss:*
Lu Ann Sykes
Book: 8344 Page: 191
(for Corporations)
City
Berkeley Lake
State / Province / Region
Georgia
Postal / Zip Code
30096
Country
United States
Street Address
4620 Berkley Walk Point
Address Line 2
(xxx)xxx-xxxx
[phone]
(xxx)xxx-xxxx
[e-mail]
3a. Name :*
3b. Business Name :
3c. Addre ss *
Erica Leatham
(if applicable)
M/I Homes of Raleigh, LLC
City
Raleigh
State / Province / Region
NC
Postal / Zip Code
27519
Country
United States
Street Address
1511 Sunday Drive, Suite 100
Address Line 2
4. Agent/Consultant (if applicable)
1a. Name of proje ct:*
1b. Subdivision name :
1c. Ne are st municipality / town:*
2a. Prope rty Identification Numbe r:2b. Prope rty size :
2c. Proje ct Addre ss
2d. Site coordinate s in de cimal de gre e s
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 locational precision in decimal degrees to map coordinates to 5 or 6 digits after the decimal place.)
Latitude :*Longitude :*
3d. Te le phone Numbe r:*
3e . Fax Numbe r:
3f. Email Addre ss:*
[phone]
(xxx)xxx-xxxx (xxx)xxx-xxxx
[e-mail]
4a. Name :*
4b. Business Name :
4c. Addre ss *
4d. Te le phone Numbe r:*4e . Fax Numbe r:
4f. Email Addre ss:*
Age nt Authorization Le tter *
Deborah Shirley
(if applicable)
Soil & Environmental Consultants, PA
City
Raleigh
State / Province / Region
NC
Postal / Zip Code
27615
Country
United States
Street Address
8412 Falls of Neuse Road, Suite 104
Address Line 2
[phone]
(xxx)xxx-xxxx
[phone]
(xxx)xxx-xxxx
[e-mail]
Please provide the Agent Authorization Letter if you are submitting this document.
SEC_Agent_Authorization_Signed by MI.pdf 844.07KB
FILE TYPE MUST BE PDF
C. Project I nformation and Prior Project History
1. Project Information
Sykes Property
(if appropriate)
Durham
2. Project Identification
(tax PIN or parcel ID)
0769-82-05-1875
(in acres)
+/-40.01
City
Durham
State / Province / Region
NC
Postal / Zip Code
27703
Country
United States
Street Address
7012 Leesville Road
Address Line 2
35.927410
ex: 34.208504
-78.770055
-77.796371
3. Surface Waters
3a. Name of the ne are st body of wate r to propose d proje ct:*
3b. Wate r Re source s Classification of ne are st re ce iv ing wate r:*
Surface Water Lookup
3c. What riv e r basin(s) is your proje ct locate d in?*
3d. Ple ase prov ide the 12-digit HUC in which the proje ct is locate d.*
River Basin Lookup
4. Project Description and History
4a. De scribe the e xisting conditions on the site and the ge ne ral land use in the v icinity of the proje ct at the time of this application:*
4b. Hav e Corps pe rmits or DWR ce rtifications be e n obtained for this project (including all prior phase s) in the past?*
4d. Attach an 8 1/2 X 11 e xce rpt from the most re ce nt v e rsion of the USGS topographic map indicating the location of the proje ct site . (for DWR)
4e . Attach an 8 1/2 X 11 e xce rpt from the most re ce nt v e rsion of the publishe d County NRCS Soil Surv e y map de picting the proje ct site . (for DWR)
4f. List the total e stimate d acre age of all e xisting we tlands on the prope rty:
4g. List the total e stimate d line ar fe e t of all e xisting stre ams on the prope rty:
4h. Explain the purpose of the propose d proje ct:*
4i. De scribe the ov e rall proje ct in de tail, including indirect impacts and the type of e quipme nt to be use d:*
4j. Ple ase upload proje ct drawings for the propose d proje ct.
5. Jurisdictional Determinations
5a. Hav e the we tlands or streams be e n de line ate d on the prope rty or propose d impact are as?*
Comme nts:
5b. If the Corps made a jurisdictional de te rmination, what type of de te rmination was made ?*
Corps AID Numbe r:
5c. If 5a is ye s, who de line ate d the jurisdictional are as?
Little Brier Creek
C;NSW
Neuse
030202010801
Existing conditions onsite consist of agricultural and forested land with structures and driveways located in the northeastern portion of the property near Leesville Road. There is one (1)
perennial stream feature (SB) that bisects the southeastern part of the property with two (2) intermittent streams (SA & SD) that flow into stream SB. Additionally, there is one (1) pond in
the center of the property with two (2) adjacent wetlands (W1 & W2). General land use in the vicinity of the project is primarily forested and agricultural land and rural development.
Yes No Unknown
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USGS.pdf 9.36MB
File type must be pdf
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SS.pdf 1.18MB
File type must be pdf
Approximately .11 acres wetland and 1.51 acres of open waters
(intermittent and perennial)
Approximately 1,886 LF
The purpose of this project is to construct a residential development and its necessary infrastructure.
The overall project consists of the construction of a single-family residential development, including but not limited to roads, utilities, storm water devices and residential structures.
Specifically, there are two (2) proposed SCM outlets that impact riparian buffers and one (1) utility crossing that impacts riparian buffers and a stream. Equipment to be used will include
excavators, bull dozers, and other typical equipment used for land clearing, grading, and excavating.
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01-MIH18070-EX1-OAXC.pdf 1.18MB
02-MIH18070x-EX1-OIE.pdf 1.2MB
03-MIH18070x-EX1-EX-1.pdf 608.11KB
04-MIH18070x-EX1-EX-2.pdf 603.24KB
05-MIH18070x-EX1-EX-3.pdf 576.5KB
File type must be pdf
Yes No Unknown
Preliminary Approved Not Verified Unknown N/A
Example: SAW-2017-99999
SAW-2019-01698
Name (if known):
Age ncy/Consultant Company:
Othe r:
5d. List the date s of the Corp jurisdiction de te rmination or State de te rmination if a de te rmination was made by the Corps or DWR.
5d1. Jurisdictional de te rmination upload
6. Future Project Plans
6a. Is this a phase d proje ct?*
7b. If ye s, e xplain.
Are any othe r NWP(s), re gional ge ne ral pe rmit(s), or indiv idual pe rmits(s) use d, or intende d to be use d, to authorize any part of the propose d project or re lated activ ity? This
include s othe r se parate and distant crossing for line ar proje cts that re quire De partme nt of the Army authorization but don’t re quire pre -construction notification.
1. Impacts Summary
1a. Whe re are the impacts associate d with your proje ct? (che ck all that apply):
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.Impact type *3c. Type of impact *3d. S. name *3e . Stre am Type *
(?)
3f. Type of
Jurisdiction *
3g. S. width *3h. Impact
le ngth *
S1
** All Perennial or Intermittent streams must be verified by DWR or delegated local government.
3i. Total jurisdictional ditch impact in square fe e t:
3i. Total pe rmane nt stre am impacts:
3i. Total te mporary stre am impacts:
3i. Total stre am and ditch impacts:
3j. Comme nts:
6. Buffer Impacts (for DWR)
If project will impact a protected riparian buffer, then complete the chart below. Individually list all buffer impacts below.
6a. Proje ct is in which prote ct basin(s)?*
Steven Ball
Soil & Environmental Consultants, PA
USACE: Site visit and field determination completed by Ross Sullivan on November 6, 2019.
NCDWR: Riparian Buffer determination completed by Zachery Thomas on September 20, 2019 (RRO #19-303).
***PLEASE NOTE THAT A PJD HAS NOT BEEN ISSUED TO DATE. THE PJD BOX WAS CHECKED AT C.5.b SO THAT THIS DATA BOX WOULD BE AVAILABLE. PJD PACKAGE
PROVIDED TO USACE ON 9/5/2019
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7012 Leesville Road buffer letter.pdf 3.69MB
File type must be PDF
Yes No
The project will be constructed in three (3) phases within the identified property boundaries. There are no anticipated phases beyond what is currently shown on the plans.
It is my understanding that there are no intended future phases beyond the property boundaries shown. Therefore, no additional NWP, Regional General Permits, or IP are anticipated.
D. Proposed Impacts Inventory
Wetlands Streams-tributaries Buffers
Open Waters Pond Construction
Impact 1 Temporary Other Stream B Perennial Both 8
Average (feet)
31
(linear feet)
0
0
31
31
Temporary stream impact will be brought back to pre-construction stream bed elevation and the stream banks will be stabilized.
Check all that apply.
Neuse Tar-Pamlico
Catawba Randleman
Goose Creek Jordan Lake
Other
6b. Impact Type *(?)6c. Pe r or Te mp *(?)6d. Stre am name *6e . Buffer mitigation re quire d?*6f. Zone 1 impact *6g. Zone 2 impact *
6h. Total buffer impacts:
Zone 1 Zone 2
Total Te mporary impacts:
Zone 1 Zone 2
Total Pe rmane nt impacts:
Zone 1 Zone 2
Total combine d buffe r impacts:
6i. Comme nts:
Supporting Docume ntation - i.e . Impact M aps, Plan She e t, e tc.
1. Avoidance and Minimization
1a. Spe cifically de scribe me asure s take n to av oid or minimize the propose d impacts in de signing the proje ct:*
1b. Spe cifically de scribe me asure s take n to av oid or minimize the propose d impacts through construction te chnique s:*
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Doe s the proje ct re quire Compe nsatory M itigation for impacts to Wate rs of the U.S. or Wate rs of the State ?
2c. If ye s, mitigation is re quire d by (che ck all that apply):
2d. If ye s, which mitigation option(s) will be use d for this proje ct?
3. Complete if Using a Mitigation Bank
3a. Name of M itigation Bank:
3b. Cre dits Purchase d/Requeste d (attach re ce ipt and le tte r)
Type :Quantity:
Attach Re ce ipt and/or le tter
Impact 1: Utility Impacts P Stream B No 2,041
(square feet)
2,450
(square feet)
Impact 2: SCM Outlet P Stream B No 261
(square feet)
168
(square feet)
Impact 3: SCM Outlet P Stream B No 246
(square feet)
165
(square feet)
Impact 1: non perpendicular Zone 1 P Stream B Yes 434
(square feet)
0
(square feet)
0.00 0.00
2,982.00 2,783.00
2,982.00 2,783.00
Impacts 1, 2 & 3 added as a courtesy. Impact 1: non-perpendicular Zone 1 requires notification and written approval.
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File must be PDF
E. Impact Justification and Mitigation
S&EC completed a wetland delineation and Neuse River Buffer evaluation for the entire property in order to identify natural resources so that impacts
could be avoided & minimized to the maximum extent practicable. Impact 1 is a proposed utility crossing on an perennial stream. Impacts include
temporary stream and permanent riparian buffer impacts. The crossing has been placed at a perpendicular angle to minimize stream impacts.
Temporary stream impact will be brought back to pre-construction stream bed elevation and the stream banks will be stabilized. Riparian buffer
impacts, specifically Zone 1, have been minimized to the maximum extent practicable. In order to completely avoid Zone 1 non-perpendicular impacts,
the manhole/associated sewer would have to be shifted up the hill. In this case it would cause the sewer to be approximately 20 feet or more deep,
which would result in the width of the construction easement to increase and would require increased buffer impacts. Compensatory mitigation is
proposed for the non-perpendicular Zone 1 impacts (i.e. 434 sf). Impacts 2 & 3 are proposed riparian buffer impacts for stormwater outlets. Both
outlets are lined with riprap to minimize potential erosion of the stream channel.
For the proposed sanitary sewer outfall and stormwater facility outfalls, the erosion control plans will incorporate silt fencing, silt fence outlets,
temporary check dams, etc. where necessary to prevent sedimentation within the existing stream network.
Yes No
DWR Corps
Mitigation bank Payment to in-lieu fee
program
Permittee Responsible
Mitigation
3c. Comme nts
NC Stream Temperature Classification Maps can be found under the Mitigation Concepts tab on the Wilmington District's RIBITS website.
6. Buffer mitigation (State Regulated Riparian Buffer Rules) - required by DWR
6a. Will the proje ct re sult in an impact within a prote cte d riparian buffe r that re quire s buffe r mitigation? If ye s, you must fill out this e ntire form - ple ase contact DWR for more
information.
6b. If ye s, the n ide ntify the square fe e t of impact to e ach zone of the riparian buffe r that re quire s mitigation calculate the amount of mitigation require d in the table be low.
6c. Re ason for impact 6d. Total impact
(square fe e t)
M ultiplie r 6e . Re quire d mitigation
(square fe e t)
Zone 1
Zone 2
6f. Total buffe r mitigation re quire d
6g. If buffe r mitigation is re quire d, is payme nt to a mitigation bank or NC Div ision of M itigation Se rv ice s propose d?
6h. Attach the acce ptance le tte r from the mitigation bank or NC Div ision of M itigation Se rv ice s.
6j. Comme nts:
*** Recent changes to the stormwater rules have required updates to this section .***
1. Diffuse Flow Plan
1a. Doe s the proje ct include or is it adjace nt to prote cte d riparian buffers ide ntifie d within one of the NC Riparian Buffe r Prote ction Rule s?
1b. All buffer impacts and high ground impacts re quire diffuse flow or othe r form of stormwate r treatme nt. If the proje ct is subje ct to a state imple me nte d riparian buffe r prote ction
program, include a plan that fully docume nts how diffuse flow will be maintaine d.
All Stormwate r Control M e asure s (SCM )s must be de signe d in accordance with the NC Stormwate r De sign M anual. Associate d supple me nt forms and othe r docume ntation shall be
prov ide d.
What type of SCM are you prov iding?
For a list of options to meet the diffuse flow requirements, click here.
Diffuse Flow Docume ntation
2. Stormw ater Management Plan
2a. Is this a NCDOT proje ct subje ct to compliance with NCDOT’s Indiv idual NPDES pe rmit NCS000250?*
2b. Doe s this proje ct me e t the re quire me nts for low de nsity proje cts as de fine d in 15A NCAC 02H .1003(2)?*
To look up low density requirement click here 15A NCAC 02H .1003(2).
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FILE TYPE MUST BE PDF
Yes No
Non-perpendicular Utility 434 3 1,302
0 0
1,302
Yes No
Buffer SOA - Sykes Property.pdf 131.12KB
(PDF only)
F. Stormwater M anagement and Diffuse Flow Plan (required by DWR)
Yes No
Level Spreader
Vegetated Conveyance (lower SHWT)
Wetland Swale (higher SHWT)
Other SCM that removes minimum 30% nitrogen
Proposed project will not create concentrated stormwater flow through the buffer
(check all that apply)
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MIH-18070-POST.pdf 1.44MB
File type must be PDF
Yes No
Yes No
2c. Doe s this proje ct hav e a stormwate r manage me nt plan (SM P) re v ie we d and approv e d unde r a state stormwate r program or state-approv e d local gov e rnme nt stormwate r
program?*
2d. Which of the following stormwate r manage me nt program(s) apply (che ck all that apply):*
Local Gov e rnme nt Stormwate r Programs *
Ple ase ide ntify which local gov e rnme nt stormwate r program you are using.*
Comme nts:
1. Environmental Documentation
1a. Doe s the proje ct inv olv e an e xpe nditure of public (fe de ral/state /local) funds or the use of public (fe de ral/state ) land?*
2. Violations (DWR Requirement)
2a. Is the site in v iolation of DWR Wate r Quality Ce rtification Rule s (15A NCAC 2H .0500), Isolate d We tland Rule s (15A NCAC 2H .1300), or DWR Surface Wate r or We tland Standards or
Riparian Buffe r Rule s (15A NCAC 2B .0200)?*
3. Cumulative Impacts (DWR Requirement)
3a. Will this proje ct (base d on past and re asonably anticipate d future impacts) re sult in additional de v e lopme nt, which could impact ne arby downstre am wate r quality?*
3b. If you answe re d “no,” prov ide a short narrativ e de scription.
4. Sewage Disposal (DWR Requirement)
4a. Is se wage disposal re quire d by DWR for this proje ct?*
4b. De scribe , in de tail, the tre atme nt me thods and dispositions (non-discharge or discharge ) of waste wate r ge ne rate d from the propose d proje ct. If the waste wate r will be treate d
at a tre atment plant, list the capacity av ailable at that plant.
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this proje ct occur in or ne ar an are a with fe de rally prote cte d spe cie s or habitat?*
5b. Hav e you che cke d with the USFWS conce rning Endange re d Spe cie s Act impacts?*
5d. Is anothe r Fe de ral age ncy inv olv e d?*
5e . Is this a DOT proje ct locate d within Div ision's 1-8?*
5f. Will you cut any tre e s in orde r to conduct the work in wate rs of the U.S.?*
Yes No
N/A - project disturbs < 1 acre
Hint: projects that have vested rights, exemptions, or grandfathering from state or locally implemented stormw ater programs or projects that satisfy state or locally-implemented stormw ater programs through use of community in-lieu programs should answ er no
to this question.
Local Government State
If you have a local government approval please include the SMP on their overall impact map.
Phase II NSW
USMP Water Supply
City of Durham
G. Supplementary Information
Yes No
Yes No
Yes No
We have reviewed the “Draft Internal Policy, Cumulative impacts and the 401 Water Quality Certification and Isolated Wetlands Programs” document
prepared by the NC Division of Water Quality on April 10, 2004, version 2.1. The draft states that many private developments are unlikely to cause
cumulative impacts, including projects such as urban in-fill, most residential subdivisions and small commercial developments as well as agricultural
and silvicultural operations. The Sykes Property project is a residential development. Additionally, the project is located within the city of Durham ETJ,
therefore the adjacent properties that have potential for development will have the following regulations to protect downstream waters: 1) the Neuse
River Basin Riparian Buffer Protection regulations, these regulations require limited development within the riparian buffer area, in addition Best
Management Practices may be required that control nitrogen if diffuse flow cannot be achieved; 2) the Phase II NPDES Stormwater Permit Program,
this program includes permitting requirements for Municipal Separate Storm Sewer Systems (MS4s) in addition to post-construction stormwater
management requirements. We anticipate that the DWR will advise us if any additional information is needed.
Yes No N/A
Non-discharge wastewater will be collected by the proposed gravity sanitary sewer systems and diverted to the pump station located in the Andrews
Chapel development to the southwest which will eventually be treated at the North Durham Water Reclamation Facility with a capacity of 20 MGDs.
Yes No
Yes No
Yes No Unknown
Yes No
Yes No
5g. Doe s this proje ct inv olv e bridge mainte nance or re mov al?*
Link to the NLEB SLOPES document: http://saw-reg.usace.army.mil/NLEB/1-30-17-signed_NLEB-SLOPES&apps.pdf
5h. Doe s this proje ct inv olv e the construction/installation of a wind turbine (s)?**
5i. Doe s this proje ct inv olv e (1) blasting, and/or (2) othe r pe rcussiv e activitie s that will be conducte d by machine s, such as jackhamme rs, me chanize d pile driv e rs, e tc.?*
If ye s, ple ase prov ide de tails to include type of pe rcussiv e activ ity, purpose , duration, and spe cific location of this activ ity on the prope rty.
5j. What data source s did you use to de te rmine whe the r your site would impact Endange re d Spe cie s or De signate d Critical Habitat?*
Consultation Docume ntation Upload
6. Essential Fish Habitat (Corps Requirement)
6a. Will this proje ct occur in or ne ar an are a de signate d as an Esse ntial Fish Habitat?*
6b. What data source s did you use to de te rmine whe the r your site would impact an Esse ntial Fish Habitat?*
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.ncdcr.gov/hpoweb/
7a. Will this proje ct occur in or ne ar an are a that the state , fe de ral or tribal gov e rnme nts hav e de signate d as hav ing historic or cultural pre se rv ation status (e .g., National Historic
Trust de signation or prope rtie s significant in North Carolina history and archae ology)?*
7b. What data source s did you use to de te rmine whe the r your site would impact historic or arche ological re source s?*
7c. Historic or Pre historic Information Upload
8. Flood Zone Designation (Corps Requirement)
Link to the FEM A Floodplain M aps: https://msc.fema.gov/portal/search
8a. Will this proje ct occur in a FEM A-designate d 100-ye ar floodplain?*
8b. If ye s, e xplain how proje ct me e ts FEM A require me nts:
8c. What source (s) did you use to make the floodplain de te rmination?*
Comme nts
M isce llane ous attachme nts not pre v iously re que ste d.
Yes No
Yes No
Yes No
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File must be PDF
The NC Natural Heritage Programs Data Explorer Map was used to search for elemental occurrences of federally protected species listed within and
within 1-mile of the project boundaries. It was determined based on the search that there are no elemental occurrences that are listed as federally
Threatened/Endangered within or within 1-mile of the project boundaries. References: NC Natural Heritage Program. 2020. Geographic Information
System (GIS) data. NCDNCR, Raleigh, NC. Available at http://www.ncnhp.org/. (Accessed: April 21, 2020).
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File type must be PDF
Yes No
The NOAA Habitat Conservation/Habitat Protection: National Marine Fish Service; Essential Fish Habitat Mapper website was referenced. No Essential
Fish Habitat was identified near the project.
Yes No
The NC State Historic Preservation Office HPOWEB GIS Service interactive map was referenced on April 21, 2020, no historic listings or study list
entries or determined eligible listings were identified within the property boundaries.
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File must be PDF
Yes No
The riprap-lined outfall channel from the proposed onsite stormwater control measure (SCM) impacts the FEMA floodplain. A floodplain development
permit application for the proposed impacts to the FEMA floodplain has already been submitted to the City of Durham for review/approval prior to
construction.
NC Flood Risk Information System Floodplain Mapping Program and confirmation from the project engineer.
M iscellaneous
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File must be PDF or KMZ
Signature
*
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 :*
Signature *
Date
By checking the box and signing below, I certify that:
Deborah E. Shirley
11/13/2020