20230972 Ver 1_ePCN Application_20230706

i DWR
Division of Water Resources
Pre -Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
April 13, 2022 Ver 4.3
Initial Review
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:
5/9/2023
BIMS # Assigned
20230972
Is a payment required for this project?*
No payment required
Fee received
Fee needed - send electronic notification
Reviewing Office*
Winston-Salem Regional Office - (336) 776-
9800
Information for Initial Review
la. Name of project:
Farmington Road
la. Who is the Primary Contact?*
Richard Denier of C2C Land Development LLC
1b. Primary Contact Email: *
[e-mail]
Date Submitted
7/6/2023
Nearest Body of Water
Dutchman Creek
Basin
Yadkin-PeeDee
Water Classification
Class C
Site Coordinates
Latitude:
Longitude:
35.962041 °
-80.534186'
A. Processing Information
Is this project connected with ARPA funding?
Yes No
County (or Counties) where the project is located:
Davie
Is this a NCDMS Project
Yes No
Version#*
1
What amout is owed?*
$240.00
$570.00
Select Project Reviewer*
Seren Homer:[e-mail]
1c. Primary Contact Phone: *
[phone]
O

Is this project a public transportation project?*
Yes No
1a.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
1b. What type(s) of permit(s) do you wish to seek authorization?
Nationwide Permit (NWP)
Regional General Permit (RGP)
Standard (IP)
1c. Has the NWP or GP number been verified by the Corps?
Yes No
Nationwide Permit (NWP) Number:
Nationwide Permit (NWP) Number:
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
401 Water Quality Certification - Regular
Non-404 Jurisdictional General Permit
Individual 401 Water Quality Certification
29 - Residential Developments
18 - Minor Discharges
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
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
Yes No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
Yes No
1h. Is the project located in any of NC's twenty coastal counties?
Yes No
1j. Is the project located in a designated trout watershed?
Yes No
B. Applicant Information
1d. 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:
Robert & Kae Hendrix
2b. Deed book and page no.:
895 / 870
2c. Contact Person:
401 Water Quality Certification - Express
Riparian Buffer Authorization
Yes No
Yes No

2d. Address
Street Address
392 Farmington Road
Address Line 2
city
Mocksville
Postal / Zip Code
27028
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
Richard Denier
3b. Business Name:
C2C Land Development LLC
3c.Address
Street Address
PO Box 4628
Address Line 2
city
Mooresville
Postal / Zip Code
28117
3d. Telephone Number:
[phone]
3f. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Jennifer Robertson
4b. Business Name:
Atlas Environmental Inc.
4c.Address
Street Address
338 S. Sharon Amity Road #411
Address Line 2
city
Charlotte
Postal / Zip Code
28211
4d. Telephone Number:
[phone]
4f. Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(if appropriate)
Hendrix Village
1c. Nearest municipality / town:
Mocksvil le
State / Province / Region
NC
Country
USA
2f. Fax Number:
State / Province / Region
NC
Country
USA
3e. Fax Number:
State / Province / Region
NC
Country
USA
4e. Fax Number:
O
2. Project Identification

2a. Property Identification Number:
5840583409
2b. Property size:
19.02
2c. Project Address
Street Address
405 Farmington Road
Address Line 2
city
Mocksville
Postal / Zip Code
27028
3. Surface Waters
3a. Name of the nearest body of water to proposed project:"
Dutchman Creek
3b. Water Resources Classification of nearest receiving water:'
Class C
3c. What river basins) is your project located it *
Yadkin-PeeDee
3d. Please provide the 12-digit HUC in which the project is located.
030401011403
4. Project Description and History
State / Province / Region
NC
Country
USA
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 current land use of the review area is mostly cleared with sparse forested areas located in the Western portion of the review area. The property has been cleared since at least 1983
according to Google Earth aerial imagery.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?
Yes No Unknown
If yes, please give the DWR Certification number or the Corps Action ID (exp. SAW-0000-00000).
SAW-2023-00694
4f. List the total estimated acreage of all existing wetlands on the property:
0.230
4g. List the total estimated linear feet of all existing streams on the property:
1,395
4h. Explain the purpose of the proposed project:*
The project purpose is for the construction of a residential development consisting of up to 72 individual units that will be developed for townhomes as well as the installation of a sanitary
sewer line.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used: *
The project will require mechanized land clearing and grading to remove existing vegetation. The development will require two permanent and one temporary unavoidable impacts to
Waters of the United States. Impact W1 consists of 0.150 acre of fill to WL 2000. Impact W1 is necessary for grading side slopes, the installation of an access road, and grading for the
townhome lots. Impact W2 is a temporary impact to the Southern section of WL 2000 and is necessary for the installation of a sanitary sewer line. Impact W3 consists of 0.035 acre of fill to
WL 2100. Impact W3 is necessary for grading one of the townhome lots. In total, there are approximately 0.185 acre of permanent wetland impacts proposed.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
Yes No
Comments:
03/15/2023
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-2023-00694
5c. If 5a is yes, who delineated the jurisdictional areas?
..............................
Name (if known): Atlas Environmental Inc. Staff
Agency/Consultant Company: Atlas Environmental Inc.
Other:
O Unknown
5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
The Corp issued a delineation concurrence on May 09, 2023.

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?
No
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
Wetlands Streams -tributaries O Buffers
Open Waters Pond Construction
2. Wetland Impacts
U
2a1 Reason (?)
2b. Impact type* (?)
2c. Type of W.
2d. W. name
2e. Forested*
2f. Type of Jurisdicition"
29• Impact
?)
area
W1
Roads, slopes, units
P
Seep
WL 2000
No
Both
0.141
(acres)
W2
slopes
P
Seep
WL 2100
No
Both
0.035
(acres)
W3
sewer
P
Seep
Both
0.006
(acres)
W4
sewer
T
Seep
WL 2000
E�]E
0.007
acres)
2g. Total Temporary Wetland Impact
0.007
2g. Total Wetland Impact
0.189
2i. Comments:
W 1 and W 2 are for NWP 29
W3 and W4 are for NWP 18
E. Impact Justification and Mitigation
1. Avoidance and Minimization
2g. Total Permanent Wetland Impact
0.182
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
The project designed residential lots to avoid and minimize proposed impacts. The design incorporates four common open spaces to reduce further
impact. None of the streams located on site are proposed to be impacted, including Dutchman Creek.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
A 100-year FEMA floodplain is located within the Western region and the Southern region of the review area. A sanitary sewer is proposed to be
installed within this floodplain as well as side slopes. The impacts from the sanitary sewer are temporary. The project engineers are working with the
proper authorities regarding this floodplain.
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
2c. If yes, mitigation is required by (check all that apply):
D W R Corps
2d. If yes, which mitigation option(s) will be used for this project?
Mitigation bank Payment to in -lieu fee program Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
KCI Technologies Inc.
3b. Credits Purchased/Requested (attach receipt and letter)
O
Type: Quantity:

Riparian wetland 0.182
3c. Comments
A ratio of 1:1 is appropriate for the wetland impacts. The quality of the wetlands have been degraded due to the agricultural and pastoral use of the site.
The wetlands are located within cow pasture areas.
6. Buffer mitigation (State Regulated Riparian Buffer Rules) - required by DWR
6a. Will the project result in an impact within a protected riparian buffer that requires buffer mitigation? If yes, you must fill out this entire form - please contact DWR for more information.
Yes No
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
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?
Yes No
If no, explain why:
The proposed impacts are not within State protected riparian buffers.
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
2d. Which of the following stormwater management program(s) apply:
Local Government State
Local Government Stormwater Programs
Phase II NSW USMP Water Supply
Please identify which local government stormwater program you are using.
Not a Phase II Stormwater area; No Stormwater Program
Comments:
No program identified
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?
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.
This is a single project which will not result in additional development.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?
Yes No N/A
O
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.
connecting and extending sanitary sewer line

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
5c. If yes, indicate the USFWS Field Office you have contacted.
Asheville
5d. Is another Federal agency involved?"
Yes No
5e. Is this a DOT project located within Division's 1-8?
Yes No
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
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.?
Yes No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
IPaC, NHP, and Field assessment.
6. Essential Fish Habitat (Corps Requirement)
Ga. 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?
NOAA Essential Fish Habitat Mapper
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?"
HPO Buffer Map. There were no archeological site located in or adjacent to the property. No archeological investigation be conducted in connection with
this project.
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:
The project engineers are working with the proper authorities regarding this floodplain.
8c. What source(s) did you use to make the floodplain determination?
FEMA NFHL Google earthAml layer
Miscellaneous
n
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
Farmington Road NWP 29 and 18 compressed.pdf 5.61MB
File must be PDF or KMZ
Comments
Signature
0 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:
Allyson Sinclair
Signature
Date
7/6/2023