20111021 Ver 1_401 Application_20111111

2 0 1 1 10 2 1
Office Use Only:
r7� Corps action ID no.
DWQ project no.
Form Version 1.4 January 2009
Pre - Construction Notification (PCN) Form
A. Applicant Information
1. Processing
1a. Type(s) of approval sought from the Corps: ❑ Section 404 Permit
❑ Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: or General Permit (GP) number.
I- Has the NWP or GP number been verified by the Corps? ❑ Yes
❑ No
1d. Type(s) of approval sought from the DWO (check all that apply):
❑ 401 Water Duality Certification — Regular ❑ Nan -404 Jurisdictional General Permit
❑ 401 Water (Quality Certification — Express ❑X Riparian Suffer Authorization
1e.
is this notification solely for the record
because written approval is not required?
For the record only for DWQ
401 Certification:
For the record only for Corps Permit:
Street address:
201 Saint Andrew St
❑ Yes ❑ No
❑ 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
[❑ Yes Q No
252 - 641 -7803
or in -lieu fee program.
Fax no.:
❑ Yes Z Na
1g. Is the project located in.any of NC's twenty coastal counties. if yes, answer 1 h
Email address:
below.
_
❑ Yes 0 No
1h. Is the project located within a NC DCM Area of Environmental Concern (AECj?
2.
Project Information
2a.
Name of project: Princeville Dike Flood Control Project
2b.
County: Edgecombe
2c.
Nearest municipality / town:. Princeville
2d.
Subdivision name: NA
NOV
2e.
3.
NCDOT only, T.I.P. or state project no:
Owner Information
ti RlVlaS qNp k4UALIrY
3a. Name(s) on Recorded Deed: Edgecombe County (Sponsor)
3b. Dead Book and Page No. Could provide if necessary (owner perpetual Right -of -Way)
3c,
Responsible Party (for LLC if
applicable):
Edgecombe County
3d.
Street address:
201 Saint Andrew St
3e.
City, state, zip:
Tarboro, NC 27886
3f.
Telephone no.:
252 - 641 -7803
3g.
Fax no.:
252- 641 -6913
3h.
Email address:
jrnedmondson @co.edgecombe.nc.us
Page 1 of 10
PCN Form — Version 1.4 January 2009

Page 2 of 10

�B. Project Information and Prior Project History
9. Property Identification.
1a. Property Identification no. (tax PIN or parcel 10);
1 b. Site coordinates (in decimal degrees): 1 Latitude:
tc. Property sire:.
2. Surface Waters
2a. Name of nearest body of water to proposed project:
2b. Water Quality Classification of nearest receiving water:
2c. River basin:
3. Project Description
NA
Longitude:
r4'7 acres
Tar River
WS -IV; NSW
Tar - Pamlico
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:
The site contains the Princeville Dike which provides flood control for the town. The Dike is a managed pervious grass surface with woodland adja
to tae of the Dike. General land use is residential with open land and some commercial use.
3b. List the total estimated acreage of all existing wetlands on the property:
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property: 0
3d, Explain the purpose of the proposed project:
To secure a vegetative free buffer from toe of Dike outward 15 ft. as required by the Army Corps of Engineers and deanup of Hurricane Irene.
3e, Describe the overall project in detail, including the type of equipment to be used:
Track hoe will remove tree overhang and debris; Skid mulcher will clear underbrush; Chain saw w III l cut trees to foot or ground; Root balls will remain
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the ❑ Yes ❑ No ❑X Unknown
Corps or State been requested or obtained for this properly 1
project (including all phases) in the past?
Comments: NA f
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: NA
Name (if known): NA Other: NA
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
NA
5. Project History
5a. Have permits or certifications been requested or obtained for ❑ Yes
this project (including all prior phases) in the past?
5b, if yes, explain in detail according to "help file" instructions.
NA
6. Future Project Plans
Ea. Is this a phased project?
6b. If yes, explain.
NA
❑ Yes
❑ No Unknown
0 No
,:: ,:.
;'FrVart7i �1e?"san4 ]an'aryD9

C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
❑ Wetlands ❑ Streams — tributaries x❑ Buffers ❑ Open Waters ❑ Pond Construction
2. Wetland Impacts
Is u......— —.- .+Innrl imnorfc nrnnncprl nn tha city than rmmr)lata this nuestion for each wetland area impacted.
2a.'- -
2b
2c
2d.
2e.
2f.
Wetland impact
Type of impact
Type of wetland
Forested
Type of jurisdiction
Area of
number
impact
number
Corps (404,10) or
impact
Permanent (P) or
stream
length
Permanent (P) or
DWQ (401, other)
(acres)
Tem ora T
width
(linear
Temporary (T)
W1
Choose one
Choose one
Yes/No
feet)
W2 -
Choose one
Choose one
Yes/No
W3
Choose one
Choose one
Yes/No
-
W4
Choose one
Choose one
YeslNo
-
W5
Choose one
Choose one
Yes/No
W6
Choose one
Choose one
Yes/No
Choose one
1g. Total wetland impacts:
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
3a.
3b.
3c.
3d.
3e.
3f.
3g
Stream impact
Type of impact
Stream name
Perennial (PER) or
Type of
Average
impact
number
intermittent (INT)?
jurisdiction
stream
length
Permanent (P) or
width
(linear
Temporary (T)
(feet)
feet)
S1
Choose one
-
S2 -
Choose one
-
S3 -
Choose one
S4
Choose one
-
S5
Choose one
-
IS6 -
Choose one
-
I 3h. Total stream and tributary impacts
3i. Comments:
Page 4 of 10
PCN Form — Version 1.4 January 2009

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 indivii ually list all o en water Im acts below.
4a. 4b. 4c. 4d. 4e.
Open water Name of waterbody
impact number (if applicable) Type of impact Waterbody Area of impact (acres)
Permanent (P) or type
Temporary T
01 _ Choose one Choose
02 _ Choose one Choose
03 Choose one Choose
O4 Choose one lChaose
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If and or lake construction proposed, the complete the chart below.
5a. 5b. 5c.
Pond ID number Proposed use or Wetland Impacts (acres)
purpose of pond
Flooded I Filled I Excavated
Pi CP2 oose one
5f. Total:
5g. Comments:
5d. 5e.
Stream Impacts (feet) Upland
(acres)
Flooded I Filled I Excavated
5h. Is a dam high hazard permit required? ❑ Yes [❑ No If yes, permit ID no:
5i. Expected pond surface area (acres):
51. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for I3WQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below_ If any im acts re uire mitigation, then you MUST fill out Section D of this form.
6a. Project is in which protected basin? I ❑ Neuse [j" Tar - Pamlico ❑ Catawba ❑ Randleman ❑ Other:
6b.
6c.
6d.
6e.
6f.
6g.
Buffer Impact
Reason for impact
Stream name
Buffer
Zone 1
Zone 2
number —
mitigation
impact
impact
Permanent (P) or
required?
. {square
(square
Temporary T
feet )
feet
Bt P
O & M For Army Corps
Tar River
No
0
11,827
B2 P
o & M For Army Corps
Tar River
No
2,456
^ 0
B3
YesJNo
B4
Yes/No
85
YesJNo
B6
YeslNo
6h. Total Buffer Impacts:
2,456
11,827
61, Comments: The reason for imp8ct is operation and maintenance of the Princeville hike for approval by Me Army t orp$ or tngrneess dIlu w
remove debris from Hurricane Irene
Page 5 of 10

D, impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
Trees will be cut within 1 foot of ground so root systems will be left in place to avoid erosion. Once vegetation is removed area will be a managed
pervious grass surface which should help to avoid erosion as well. No soil will be disturbed. Only what is absolutely necessary for Army Corps
approval will be removed.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Machinery will not encroach further than the 15 ft. Edgecombe County is asking for vegetation removal in the buffer. Therefore. there should be
minimal if any damage to areas that are not necessary to be disturb for Army Corps approval.
2. Com ensatory Mitigation for impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for ❑ Yes ❑ No
impacts to Waters of the U.S, or Waters of the State?
2b. If yes, mitigation is required by (check all that apply): ` ❑ RWQ ❑ Corps
❑ Mitigation bank
2c. If yes, which mitigation option will be used for this 0 payment to in -lieu fee program
project?
❑ Permittee Responsible Mitigation
3. Complete if Usin a Mltl ation Bank
3a. Name of Mitigation Sank:
Type: Choose one Quantity:
3b. Credits Purchased (attach receipt and letter) Type: Choose one Quantity:
Type: Choose one 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:
Choose one
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 6 of 10
PCN Form -- Version 1.4 January 2009

6. Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by OWQ
6a. Will the project result in an impact within a protected riparian buffer that requires ❑ Yes XQ No
buffer mitigation?
Bb. 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.
6c. 6d, 5e.
Zone Reason for impact Total impact Multiplier Required mitigation
(square feet) (square feet)
Zone 1
Zone 2
NA
NA
3 (2 for Catawba) I
1.5 --
6f. Total buffer mitigation required:
5g. 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).
NA
It is our understanding that what we are requesting is an
fh. Comments:
Page 7 of 10
per approval

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
within one of the NC Riparian Buffer Protection Rules?
1 b. if yes, then is a diffuse flow plan included? If no, explain why.
NA ❑ Yes
2. Stormwater Mana ement Plan
2a. What is the overall percent imperviousness of this project?
2b. Does this project re wire a Stormwater Management Plan? ❑ Yes
2c. If this project DUES NOT require a Stormwater Management Plan, explain why:
❑ No
RI No
°lo
❑ No
2d. If this project DOES require a Stormwater Management Plan, then provide a grief, narrative description of the plan:
2e. Who will be responsible for the review of the Stormwater Management Plan?
3. Certified Local Government Stormwater Review
3a. In which local government's 'urisdiction is this project? _
3b. Which of the following locally - implemented sormwater management programs
apply (check all that apply):
3c. Has the approved Stormwater Management Plan with proof of approval been
attached?
4. DWQ Stormwater Proqram Review
4a. Which of the following state - implemented sormwater management programs apply
(check all that apply):
4b. Has the approved Stormwater Management Plan with proof of approval been
attached?
5. DWQ 401 Unit Stormwater Review
5a. Does the Stormwater Management Plan meet the appropriate requirements?
5b. Have all of the 401 Unit submittal requirements been met?
❑ Phase it
❑ NSW
❑ USMP
❑ Water Supply Watershed
❑ other:
❑Yes ❑ No
❑Coastal counties
❑ HQW
❑ ORW
❑Session Law 2006 -246
❑ Other:
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
Page 8 of 10
PCN Form —Version 1 .4 January 2009

F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1 a. Does the project involve an expenditure of public {fed era l /sta tell ocal) funds or the ❑ yes ❑ No
use of public (federallstate) 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 (NEPAISEPA)?
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 ❑X No
or Riparian Buffer Rules (15A NCAC 28 .0200)?
2b. is this an after - the -fact permit application? ❑ Yes ❑X No
2c. If you answered "yes' to one or both of the above questions, provide an explanation of the violation(s)
NA
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in ❑ Yes ❑X 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.
NA
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.
Page 9 of 10
PCN Form — Version 1.4 January 2009

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?
5c. If yes, indicate the USFWS Field Office you have contacted
5d. What data sources did you use to determine whether your site would impact Endangered Species or designated Critical
Habitat?
6. Essential Fish Habitat (Corps Requirement)
5a. 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?
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Wilt 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?
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA- designated 100 -year floodplain?
8b. If yes, explain how project meets FEMA requirements:
❑ Yes ❑ No
tic. What source(s) did you use to make the floodplain determination?
Applicant/Agent's Printed Name
Applicant/Agent's Signature QatE
{ nt's signature is valid only if an authorization.
letter from the a licant Es ravided.
Page 10 of 10

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