20151089 Ver 1_401 Application_20151015

Hugh Creed Associates, Inc. P.A.
Consulting Engineers & Land Surveyors
1306 W. WENDOVER AVENUE P.O. BOX 9623
GREENSBORO, N.C. 27408 GREENSBORO, N.C. 27429
TELE: (336) 275 -9826 OR (336) 275 -8084
FAX: [phone]
DATE:
PROJECT /CLIENT:
TO:
FROM:
NUMBER OF:
MYLAR(S)
ORIGINAL(S)
TO BE DELIVERED ❑
TO BE PICKED UP ❑
TRANSMITTAL
October 15, 2015
Linville Ridge Ph. 2 and 3 Subdivision
NC DWQ WBSCP Unit
Mary Rmith
PRINT(S) SEPIA(S)
OTHER
TO BE MAILED
OTHER
FOR REVIEW /COMMENT ❑ FOR APPROVAL
FOR SUBMITTAL ❑ AS REQUESTED ❑
COMMENTS:
Attached are: -9
5 copies of the PCN
2 Full size sets of plans
3 l l x 17 sets of plans
For your review and approval.
Thank you
Mary Smith
CADocuments and SettingsWaryWy DocumentsUransmittal.doc
OCT D
2 2015
0ENR - WAl'ER ER
401 8 BUFRSn S0U
FOR YOUR USE ❑

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�ENR wAl�� PERM�CN ti rm Version 1.4 January 2009
40``11FF�R
Pre - Construction Notification (PCN) Form
A.
Applicant Information
V 7 5 J a 8
Deed Book and Page No
I DB 7520, pg. 226
9
1.
Processing
3d.
1a.
Type(s) of approval sought from the Corps: ❑X Section 404 Permit
❑ Section 10 Permit
1 b.
Specify Nationwide Permit (NWP) number: 29 or General Permit (GP)
number:
1c.
Has the NWP or GP number been verified by the Corps? I
X❑ Yes ❑ No
1 d.
Type(s) of approval sought from the DWQ (check all that apply):
3h.
Email address:
n 401 Water Quality Certification — Regular ❑ Non -404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparian
Buffer Authorization
1e.
Is this notification solely for the record For the record only for DWQ
For the record only for Corps Permit:
because written approval is not required? 401 Certification:
❑ Yes ❑X No -
❑ Yes X❑ 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 0 No
or in -lieu fee program.
1 g.
Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
E] Yes 0 No
below.
1h.
Is the project located within a NC DCM Area of Environmental Concern (AEC)? I
❑ Yes ❑ No
2.
Project Information
2a.
Name of project: Linville Ridge Phases II & III
2b.
County: Guilford
2c.
Nearest municipality / town: Oak Ridge, NC
2d.
Subdivision name: I Linville Ridge Phases 11 & III
j 2e.
NCDOT only, T.I.P. or state project no:
3.
Owner Information
3a. Name(s) on Recorded Deed:
I Linville Oakridge LLC
3b.
Deed Book and Page No
I DB 7520, pg. 226
3c.
Responsible Party (for LLC if
applicable):
Kevan Combs
3d.
Street address:
PO Box 790 (8386 W. Harrell Rd)
3e.
City, state, zip:
I Oak Ridge, NC 27310
3f.
Telephone no.:
1 336- 686 -3279 or 336 -643 -1775
3g.
Fax no.:
1 336- 643 -4520
3h.
Email address:
I [e-mail]
Page 1 of 10
PCN Form — Version 1.4 January 2009

4. Applicant Information (if different from owner) '
4a. Applicant is: ❑ Agent ❑ Other, specify:
4b. Name:
4c. Business name 1
(if applicable): {
4d. Street address: 1
4e. City, state, zip:
4f. Telephone no.:
4g. Fax no.: 1
4h. Email address: J
5. Agent/Consultant Information (if applicable) 1
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 10

B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID):
1b. Site coordinates (in decimal degrees): I Latitude: 36.1056
1c. Property size:
2. Surface Waters
2a. Name of nearest body of water to proposed project:
2b. Water Quality Classification of nearest receiving water:
PIN #7808281061
Longitude: - 80.0034
30.7 acres
Haw River
WS III
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:
Tract is partially cleared and partially wooded with residential buildings on site. Tract is surrounded by rural single family residences, woods, and
farms.
3b. List the total estimated acreage of all existing wetlands on the property: 0
13c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property: 1,480
3d. Explain the purpose of the proposed project:
Street installation for development of 19 single family lots.
3e. Describe the overall project in detail, including the type of equipment to be used:
Street installation with 2 culverts for access to single family lots. The 2 culvert installations will require bulldozers track hoes and /or backhoes.
14. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the ❑ Yes Z No ❑ Unknown
Corps or State been requested or obtained for this property ! Comments -
project (including all prior phases) in the past?
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
b. Project History
5a. Have permits or certifications been requested or obtained for I ❑Yes X❑ No ❑ Unknown
this project (including all prior phases) in the past?
5b. If yes, explain in detail according to "help file" instructions.
6. Future Project Plans
6a. Is this a phased project?
6b. If yes, explain.
Phase ll to include streets for Il single family lots
Phase III to include street for 8 single family lots
❑ Yes ❑ No
Page 3 of 10
PCN Form — Version 1.4 January 2009

C. Proposed Impacts Inventory
i
1. Impacts Summary
1a Which sections were completed below for your project (check all that apply):
I
❑ Wetlands ❑X Streams — tributaries ❑X 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 impact Type of wetland Forested Type of jurisdiction
Area of
number Corps (404,10) or
impact
Permanent (P) or DWQ (401, other)
(acres)
Temporary (T)
W1 I Choose one Choose one Yes /No
W2 I Choose one I Choose one I Yes /No
W3 Choose one I Choose one
Yes /No
W4 Choose one I Choose one Yes /No
W5 Choose one I Choose one I Yes /No
W6 Choose one Choose one I Yes /No
2g. Total Wetland Impacts:
2h. Comments:
N/A
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 (PER) or Type of Average
Impact
number intermittent (INT)? jurisdiction stream
length
Permanent (P) or width
(linear
Temporary (T) (feet)
feet)
31 P I Culvert Unnamed INT I Corps I 5 I
72
S2 P
Culvert Unnamed INT I Corps I 5 I
1
74 J
i
S3
Choose one
J
S4
Choose one
S5
Choose one
S6
Choose one I f
3h. Total stream and tributary impacts
146
3i Comments:
Each stream crossing to have a 48" culvert with endwalls for street crossings.
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 f
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 Area of impact (acres)
Permanent (P) or
type
Temporary (T)
01 Choose one
Choose
02 Choose one
Choose
03 Choose one
Choose
04 Choose one
I Choose
I
4f. Total
open water impacts
f
4g. Comments:
5. Pond or Lake Construction
If pond or lake construction proposed, then complete the chart below.
5a. 5b. 5c.
5d.
5e.
Pond ID number Proposed use or Wetland Impacts (acres)
Stream Impacts (feet)
Upland
purpose of pond
(acres)
Flooded Filled
Excavated
Flooded
I Filled Excavated
` P1 Choose one I
I
II
P2 Choose one
5f. Total:
i
I
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 DWQ)
If project will impact a protected riparian buffer, then complete the chart below.
If yes, then individually list all buffer
impacts
below. if any impacts require mitigation, then you MUST fill out Section D of this form.
;
I;
6a. Project is in which protected basin's ❑ Neuse ❑ Tar - Pamlico ❑ Catawba ❑ Randleman [j 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)
B1 P Street crossing Unnamed
No 3,970
2,185
B2 P Street crossing Unnamed
No 4,055
2,280
B3 -
Yes /No
` B4
Yes /No
1 85 I
Yes /No
1
B6 I
Yes /No
}
6h. Total Buffer Impacts: 8,025
4,465
6i. Comments: Each stream crossing to have a 48" culvert with endwalls for street crossings
Page 5of10

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
Street crosses nearly perpendicular to the streams. Headwalls will be added to each end of the culverts to minimize stream impacts.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for I E] 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): I ❑ DWQ ❑ Corps
❑ Mitigation bank
2c. If yes, which mitigation option will be used for this
project? ❑ Payment to in -lieu fee program
❑ Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
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 l=ee Program
4a. Approval letter from in -lieu fee program is attached.
4b. Stream mitigation requested:
4c. If using stream mitigation, stream temperature:
4d. Buffer mitigation requested (DWQ only):
4e. Riparian wetland mitigation requested:
4f. Non - riparian wetland mitigation requested:
4g. Coastal (tidal) wetland mitigation requested:
4h. Comments:
Yes
linear feet
Choose one
5. Complete if Using a Permittee Responsible Mitigation Plan
square feet
acres
acres
acres
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
I

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 F-1 Yes (]X No
buffer mitigation?
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the I
amount of mitigation required.
6c. 6d. 6e.
Zone Reason for impact Total impact Multiplier Required mitigation
(square feet) (square feet)
Zone 1 3 (2 for Catawba)
Zone 2 1.5 {�
6f. Total buffer mitigation required: 1
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 7 of 10

E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers identified I ❑ Yes X❑ 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
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project?
2b. Does this project require a Stormwater Management Plan? ❑ Yes 0 No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why:
Preliminary Plan was approved by the Town of Oak Ridge and Guilford County without requiring a Stormwater Management Plan
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, 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 jurisdiction is this project?
i
3b. Which of the following locally - Implemented stormwater management programs
apply (check all that apply):
3c. Has the approved Stormwater Management Plan with proof of approval been
attached?
4. DWQ Stormwater Program Review
4a. Which of the following state - implemented stormwater 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?
Town of Oak Ridge, NC 1
� Phase II I
❑ NSW
❑ USMP
❑ Water Supply Watershed
❑ Other:
❑ Yes X❑ 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)
1a. Does the project involve an expenditure of public (federal /state /local) funds or the (] Yes ❑X No
use of public (federai/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)?
1c. 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 2B .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):
�I
it
3. Cumulative Impacts (DWQ Requirement)
3a. Will this protect (based on past and reasonably anticipated future impacts) result in I ❑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.
19 Lots with individual sub- surface systems
Page 9of10
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
habitat? ❑Yes ❑X No
5b. Have you checked with the USFWS concerning Endangered Species Act ❑ Yes ❑X 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)
6a. Will this project occur in or near an area designated as essential fish habitat? I ❑ Yes ❑X 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. 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?
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA- designated 100 -year floodplain? ❑ Yes
8b. If yes, e; <•,Ialn how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination?
Guilford County FIRM map #3710780800J, effective date- June 18, 2007
Kevan R. Combs
Applicant /Agent's Printed Name
Applicant/Agent's Signature
(Agent's signature is valid only if an authorization
letter from the applicant is provided.)
Page 10 of 10
L.
X❑ No
Date