20221723 Ver 1_ePCN Application_20221205

DWR
Division of Water Resources
Initial Review
Pre -Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
April 13, 2022 Ver 4.3
Has this project met the requirements for acceptance in to the review process?*
Yes
No
Is this project a public transportation project?*
Yes No
Change only if needed.
Pre -Filing Meeting Date Request was submitted on:
9/22/2022
BIMS # Assigned* Version#*
20221723 1
Is a payment required for this project?*
No payment required
Fee received
Fee needed - send electronic notification
What amout is owed?*
$240.00
$570.00
Reviewing Office* Select Project Reviewer*
Wilmington Regional Office - [phone] Holley Snider:eads\hasnider:[e-mail]
Information for Initial Review
1a. Name of project:
Fox Run
la. Who is the Primary Contact?*
Dana A. Lutheran
1 b. Primary Contact Email:* lc. Primary Contact Phone:*
[e-mail] [phone]
Date Submitted
12/5/2022
Nearest Body of Water
Shallotte Creek
Basin
Lumber
Water Classification
C;sw;HQW
Site Coordinates
Latitude:
33.963223
A. Processing Information
County (or Counties) where the project is located:
Brunswick
Is this a NCDMS Project
Yes No
Is this project a public transportation project? *
Yes No
Longitude:
-78.309745

la. Type(s) of approval sought from the Corps:
Section 404 Permit (wetlands, streams and waters, Clean Water Act)
Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
Has this PCN previously been submitted?*
Yes
No
1 b. What type(s) of permit(s) do you wish to seek authorization?
Nationwide Permit (NWP)
Regional General Permit (RGP)
Standard (IP)
lc. Has the NWP or GP number been verified by the Corps?
Yes No
Nationwide Permit (NWP) Number: 18 - Minor Discharges
NWP Numbers (for multiple NWPS):
ld. Type(s) of approval sought from the DWR:
401 Water Quality Certification - Regular
Non-404 Jurisdictional General Permit
Individual 401 Water Quality Certification
le. Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification:
For the record only for Corps Permit:
1f. Is this an after -the -fact permit application?*
Yes No
lg. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
Yes No
lg. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
Yes No
1 h. Is the project located in any of NC's twenty coastal counties?
Yes No
1 i. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
Yes No
1j. Is the project located in a designated trout watershed?
Yes No
B. Applicant Information
Id. Who is applying for the permit?
Owner Applicant (other than owner)
le. Is there an Agent/Consultant for this project?*
Yes No
2. Owner Information
2a. Name(s) on recorded deed:
GORE DAVID L JR & BRENDA B
2b. Deed book and page no.:
03362 1313
2c. Contact Person:
David Gore
401 Water Quality Certification - Express
Riparian Buffer Authorization
Unknown
Yes No
Yes No

2d. Address
Street Address
107 FARMINGTON BLVD
Address Line 2
City State / Province / Region
HAMPTON VA
Postal / Zip Code Country
23666 US
2e. Telephone Number:
[phone]
2g. Email Address: *
[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
Steve Shuttleworth
3b. Business Name:
R&S Land Development, LLC
3c. Address
Street Address
711 Carolina Beach Ave N
Address Line 2
City
Carolina Beach
Postal / Zip Code
28428
3d. Telephone Number:
[phone]
3f. Email Address: *
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Dana A. Lutheran
4b. Business Name:
Southern Environmental Group, Inc.
4c. Address
Street Address
5315 South College Road
Address Line 2
Suite E
City
Wilmington
Postal / Zip Code
28412
4d. Telephone Number:
[phone]
4f. Email Address: *
[e-mail]
C. Project Information and Prior Project History
2f. Fax Number:
State / Province / Region
NC
Country
US
3e. Fax Number:
State / Province / Region
NC
Country
US
4e. Fax Number:
1. Project Information
1b. Subdivision name:
(if appropriate)
NA
lc. Nearest municipality / town:
Shallotte
2. Project Identification

2a. Property Identification Number:
19900127
2b. Property size:
50 +/- acres
2c. Project Address
Street Address
1679 Empire Road SW
Address Line 2
City
Supply
Postal / Zip Code
28462
3. Surface Waters
3a. Name of the nearest body of water to proposed project: *
Shallotte Creek
3b. Water Resources Classification of nearest receiving water: *
C;sw;HQW
3c. What river basin(s) is your project located in?*
Lumber
3d. Please provide the 12-digit HUC in which the project is located.
030402080203
4. Project Description and History
State / Province / Region
NC
Country
US
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 project site is divided into two sections, with the western side being forested and the eastern being mostly farm field, with associated NRPW and RPW ditches. Two (2) excluded Basin
wetland pockets and a jurisdictional Pocosin wetland pocket can be found within the interior of the property. Three (3) RPW ditches are located on the eastern side of the property and
there is another that runs along the southern property boundary, where it connects two (2) jurisdictional Pocosin wetland pockets. One last jurisdictional wetland pocket can be found on
the eastern side of the property. Please see the attached site plan for details on where the wetlands and ditches are located. The site is surrounded by Empire Road SW and Mt. Pisgah
Road SW, to the north and east respectively, and undeveloped land, farm land and residential development to the south and west. Land use is rural.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past? *
Yes No Unknown
4f. List the total estimated acreage of all existing wetlands on the property:
3.24
4g. List the total estimated linear feet of all existing streams on the property:
0
4h. Explain the purpose of the proposed project: *
The purpose of this project is to construct a small scale residential subdivision, with a mix of single family dwellings and duplexes, in an area where there is high demand for housing.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used: *
Impacts to Section 404 jurisdictional wetlands consist of permanently filling 1,521 LF (15,800 SF / 0.36 AC) of RPW ditches and one small Pocosin wetland pocket (0.08 AC), for the
purpose of installing roads and infrastructure and providing sufficient building pads for five duplexes. Clean earthen fill will be used to fill the ditches. Large machinery, such as a backhoe,
loader and dump truck, as well as other standard land clearing equipment will be used as needed.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
Yes
No Unknown
Comments:
SEGi met with Gary Beecher, who approved the line as flagged by SEGi. The JD has not been
issued.
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
Preliminary Approved Not Verified Unknown N/A
Corps AID Number:
SAW-2015-01222
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
David Scibetta
SEGi
5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
The action ID above was assigned by Kyle Dahl, in 2016 (see attached JD). SEGi met Gary Beecher (USACE) and Holley Snider (NCDWR) on 9/22/22, at which time the agencies
confirmed SEGi's wetland delineation and stream determination. Also, at this time, filling the ditches and wetlands was discussed.

6. Future Project Plans
6a. Is this a phased project?*
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?
The proposed project has independent utilities and access, thus meets the definition of a single and complete project. Additionally, the project is not part of a PUD and will not provide
access to property that is currently land locked.
D. Proposed Impacts Inventory
1. Impacts Summary
la. Where are the impacts associated with your project? (check all that apply):
Wetlands
Open Waters
2. Wetland Impacts
Streams -tributaries
Pond Construction
Buffers
2a. Site #*(?)
2a1 Reason (?)
2b. Impact type*(?)
2c. Type of W.*
2d. W. name
2e. Forested*
2f. Type of Jurisdicition*
(?)
2g. Impact
area*
W1
Road Crossing
P
Small -Basin Wetland
Wetland #4
No
Both
0.080
(acres)
2g. Total Temporary Wetland Impact
0.000
2g. Total Wetland Impact
0.080
2i. Comments:
4. Open Water Impacts
2g. Total Permanent Wetland Impact
0.080
4a. Site #
4a1. Impact Reason
4b. Impact type
4c. Name of waterbody
4d. Activity type
4e. Waterbody type
4f. Impact area
RPW 1
Lot fill and roads
P
RPW 1
Fill
Ditch
0.10
RPW 2
Stormwater pond
P
RPW 2
Fill
Ditch
0.06
RPW 3
Stormwater pond
P
RPW 3
Fill
Ditch
0.08
4g. Total temporary open water Impacts:
0.00
4g. Total open water impacts:
0.24
4h. Comments:
E. Impact Justification and Mitigation
1. Avoidance and Minimization
4g. Total permanent open water impacts:
0.24
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
Prior to designing the project, the Applicant had the wetlands delineated, which allowed him to avoid the most functionally valuable, jurisdictional
wetlands (i.e., Wetland #1, #2 and #3).
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Prior to land disturbing activities, silt fence and other SEC BMP will be installed, to ensure sediment does not discharge outside the approved limits of
disturbance. The measures will be inspected at least once a week and after a storm event that produces more than 1" of rain within a 24 hour period.
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 this project DOES NOT require Compensatory Mitigation, explain why:
The proposed wetland impacts do not exceed 0.10-acre. Mitigation is not required for ditches.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)

1. Diffuse Flow Plan
la. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection Rules?
Yes No
If no, explain why:
The project site is not within one of NC's Riparian Buffer River Basins.
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250? *
Yes No
2b. Does this project meet the requirements for low density projects as defined in 15A NCAC 02H .1003(2)?
Yes No
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?
Yes No
N/A - project disturbs < 1 acre
3. Stormwater Requirements
3a. Select whether a completed stormwater management plan (SMP) is included for review and approval or if calculations are provided to document the project will not cause degradation of
downstream surface waters.*
Stormwater Management Plan Antidegradation Calculations
Comments:
The stormwater management permit is being sought concurrently, through the NC DEMLR, with this permit.
G. Supplementary Information
1. Environmental Documentation
la. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?*
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)?*
Yes No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality?*
Yes No
3b. If you answered "no," provide a short narrative description.
The proposed project will not provide access to currently land locked property. Additionally, stormwater management BMP will treat stormwater prior to it
discharging offsite. Lastly, no future impacts are necessary to make the project viable.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
Yes No N/A
4b. Describe, in detail, the treatment methods and dispositions (non -discharge or discharge) of wastewater generated from the proposed project. If the wastewater will be treated at a
treatment plant, list the capacity available at that plant.
Brunswick Co.
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?*
Yes No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
Yes No
5d. Is another Federal agency involved?*
Yes
5e. Is this a DOT project located within Division's 1-8?
Yes No
No Unknown

5f. Will you cut any trees in order to conduct the work in waters of the U.S.?
Yes No
5g. Does this project involve bridge maintenance or removal?
Yes No
5h. Does this project involve the construction/installation of a wind turbine(s)?*
Yes No
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.?
Yes No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
SEGi utilized the NC Natural Heritage Program to determine the known presence of federally listed ES and/or DCH. No federally protected ES or DCH
are know to occur on or within a 1 mile radius of the proposed project. The eastern half of the site is farm field and does not support suitable habitat for
the Red Cockaded Woodpecker (RCW) or the Northern Long-eared Bat (NLB). While the western side is forested, it is does not exhibit habitat that
would support RCW foraging or nesting.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
Yes No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat? *
The project site does not contain a waterbody that would support EFH.
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 status?*
Yes No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
A review of the NC SHPO HPOWEB 2.0 Interactive Map (see attached) revealed the site is not within a designated National Historic Place and there are
no structures on the project site.
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
Yes No
8c. What source(s) did you use to make the floodplain determination?*
Brunswick County GIS Flood Map (see attached)
Miscellaneous
Please use the space below to attach all required documentation or any additional information you feel is helpful for application review. Documents should be combined into one file when
possible, with a Cover Letter, Table of Contents, and a Cover Sheet for each Section preferred.
Click the upload button or drag and drop files here to attach document
Fox Run PCN Attachments 12-5-22.pdf 454.53KB
R and S Development.pdf 44.31 KB
Fox Run Applicant Agent Authorization Signed.pdf 289.32KB
JD Request Package 050222.pdf 4.22MB
Empire Road signed wetland survey (1).pdf 290.6KB
Empire Road JD (1).pdf 645.84KB
File must be PDF or KMZ
Comments
Signature
- By checking the box and signing below, I certify that:
• The project proponent hereby certifies that all information contained herein is true, accurate, and complete to the best of my knowledge and belief'; and
• The project proponent hereby requests that the certifying authority review and take action on this CWA 401 certification request within the applicable reasonable period of time.
• 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:
Dana A. Lutheran

Signature
Date
12/5/2022