20151201 Ver 2_PCN - Signed_20241004

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. Raleigh
❑ Asheville
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? ❑ Yes
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
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
El Yes ®No
7b What data sources did you use to determine whether your site would impact historic or archeological resources?
B. Flood Zone Designation (Corps Requirement)
Ba. Will this project occur in a FEMA-designated 100-year floodplain?
❑ Yes ® No
18b. it yes, explain how project meets FEMA requirements: I
8c. What source(s) did you use to make the floodplain determination?
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Applicant/Agent's Printed Name
t
Applicant/A ent's Signature
(Agent's signature is valid only if an authorization letter from the applicant
is provided.)
Date
Page 1 1 of 11
PCN Form — Version 1.3 December 10, 2008 Version