20180992 Ver 1_401 Application_20180717

Action History (UTC -05:00) Eastern Time (US & Canada)
Submit by Anonymous User 7/17/2018 8:55:36 AM (Start Event)
Accept by Montalvo, Sheri A 7/18/2018 1:30:59 PM (Non DOT Initial Review)
The task was assigned to Montalvo, Sheri A. The due date is: July 20, 2018 5:00 PM
7/17/2018 8:56 AM

DWR
Division of water Resources
Pre -Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
January 31, 2018 Ver 2.3
Please note: fields marked with a red asterisk below are required. You will not be able to submit the form until all mandatory questions are answered.
Also, if at any point you wish to print a copy of the E -PCN, all you need to do is right -click on the document and you can print a copy of the form.
Below is a link to the online help file.
https://edocs.deq.nc.govMaterResources/0/edocl6247041PCN%20Help%20File%202018-1-30.pdf
A. Processing Information
County (or Counties) where the project is located:*
Wake
Is this project a public transportation project?*
f Yes f• No
This is any publicly funded by nunicipal,state or federal funds road, rail, airport transportation project.
1a. Type (s) of approval sought from the Corps:*
V Section 404 Permit (wetlands, streams and waters, Clean Water Act)
F Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
1b. What type(s) of permit(s) do you wish to seek authorization?*
IJ Nationwide Permit (NWP)
r Regional General Permit (RGP)
r Standard (IP)
This form may be Corps to initiate the standard/individual permit process. Please contact your Corps representative for submittal of standard permits.
All required items that are not provided in the E -PCN and be added to the miscellaneous upload located at the bottom of this form.
Nationwide Permit (NWP) Number: 29 - Residential Developments
NWP Number Other:
List all IWV nurrbers you are applying for not on the drop down list.
1c. Type(s) of approval sought from the DWR:*
check all that apply
IJ 401 Water Quality Certification - Regular r 401 Water Quality Certification - Express
F Non -404 Jurisdictional General Permit IJ Riparian Buffer Authorization
r Individual Permit
*
1d. Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification:
O Yes O No
For the record only for Corps Permit: O Yes O No

1e. 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 or in -lieu fee program
f Yes C No
1f. Is the project located in anyof NC's twentycoastal counties?*
r Yes C No
1h. Is the project located in a designated trout watershed?*
t' Yes f• No
Link to trout information: http://vmw.saw.usace.army.mil/Missions/Regulatory-Permit-ProgranVAgency-Coordination/Trout.aspx
B. Applicant Information
1a. Who is the Primary Contact?*
Sean Clark
1b. Primary Contact Email:*
[e-mail]
1c. Primary Contact Phone:*
(XXX)XXX-XXXX
[phone]
1d. Who is applying for the permit?
V Owner r Applicant (other than owner) r Agent/Consultant
(Check all that apply)
2. Owner Information
2a. Name(s) on recorded deed:
S. Wake Properties, Inc.
2b. Deed book and page no.:
DB 016815; DP 01610
2c. Responsible party:
(for Corporations)
Douglas Ball
2d. Address
Street Address
1401 Aversboro Road, Suite 206
Address Line 2
city
Garner
Fbstal / Zip Code
27529
2e. Telephone Number:
(XXX)XXX-XXXX
[phone]
2f. Fax Number:
(XXX)XXX-)O=
2g. Email Address:*
[e-mail]
State/ Province/ Region
NC
Country
USA
C. Project Information and Prior Project History

1. Project Information
1a. Name of project:*
Kennebec Meadows Subdivision
1b. Subdivision name:
(if appropriate)
Kennebec Meadows Subdivision
1c. Nearest municipality / town:
*
Fuquay-Varina
1d. Driving directions*
If it is a new project and can not easily be found in a GPS napping system Please provide directions.
From Raleigh take US -401 South (Fayetteville Road) for 12.3 miles and turn left onto Hilltop Road. Continue for 2 miles on Hilltop Road and
take a right onto Kennebec Road. The site is approximately 1400 feet on the left.
2. Project Identification
2a. Property Identification Number:
(tax PIN or parcel ID)
0687-12-9879
2b. Property size:
(in acres)
48.27
2c. Project Address
Street Address
6817 Kennebec Road
Address Line 2
aty
State / Province / Region
Fuquay-Varina
NC
Phstal / Zip Code
Country
27592
USA
2d. Site coordinates in decimal degrees
Please collect site coordinates in decimal degrees. Use between 4-6 digits (unless you are using a survey -grade GPS device) after the decimal place as
appropriate, based on how the location was determined. (For example, most mobile phones with GPS provide locational precision in decimal degrees to
map coordinates to 5 or 6 digits after the decimal place.)
Latitude:* Longitude:*
35.598295 -78.724357
ex: 34.208504 -77.796371
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
UT to Terrible Creek
3b. Water Resources Classification of nearest receiving water:*
C; NSW
Surface Water Lookup
3c. What river basin(s) is your project located in?*
Neuse

River Basin Lookup
4. Project Description
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 majority of the Site is pasture used for cattle. Several dirt farm roads are present on the Site.
4b. Attach an 8 1/2 X 11 excerpt from the most recent version of the USGS topographic map indicating the location of the project site. (for
DWR)
Click the upload button or drag and drop files here to attach docurrent
Figure 1 - USGS Site Vicinity for Kennebec Subdivision.pdf 1.06MB
File type mist be pdf
4c. Attach an 8 1/2 X 11 excerpt from the most recent version of the published County NRCS Soil Survey map depicting the project site.
(for DWR)
Click the upload button or drag and drop files here to attach document
Figure 2 - Soil Survey Site Vicinity for Kennebec Subdivision.pdf 1.9MB
File type nest be pdf
4d. List the total estimated acreage of all existing wetlands on the property:
1.238 acres
4e. List the total estimated linear feet of all existing streams on the property:
(internittent and perennial)
1,678 LF
4f. Explain the purpose of the proposed project:*
The purpose of the proposed project is to construct a residential subdivision and associated utilities to meet the
demand for housing in this part of Wake County.
4g. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
The overall project is a single-family residential subdivision with residential streets and utilities that will connect to
epsting adjacent roads and utilities in the area. The proposed impacts result from the extension of an eAsting
roadway culvert. Heavy equipment typically used for utility installation projects (e.g. back hoes, bull -dozers, etc) will
be utilized.
4h. Please upload project drawings for the proposed project.
Click the upload button or drag and drop files here to attach document
9 - Figure_3_Kennebec_Sub-R2.pdf 3.35MB
File type mist be pdf
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes r No r Unknown
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
IT Preliminary r Approved f Unknown r N/A
Corps AID Number:
Exarrple: SAW -2017-99999
SAW -2017-2370
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
Sean Clark
Sage Ecological Services, Inc.

5d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
A site meeting was held with Mr. James Lastinger of the USACE on November 7, 2017. SAW -2017-2370 corresponds to the determination. A
site meeting with the NCDWR was not held because the surface waters shown on the maps were not being contested.
5d1. Jurisdictional determination upload
Click the upload button or drag and drop files here to attach docurrent
USACE email confirming the delineation on Kennebec Subdivision.pdf 14.07KB
File type mist be FDF
6. Project History
6a. Have permits or certifications been requested or obtained for this project (including all prior phases) in the past?*
f Yes r No r Unknown
7. Future Project Plans
7a. Is this a phased project?*
f Yes r 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? This includes other separate and distant crossing for linear projects that require Department of the
Army authorization but don't require pre -construction notification.
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
r- Wetlands W Streams -tributaries rJ Buffers
r- Open Waters r Pond Construction
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. Reason for impact*3b.lmpact 3c. Type of impact*3d. Stream name*
3e. Stream
3f. Type of
3g. Stream 3h. Impact s
fe
type*
Type*
Jurisdiction*
width*
length*
S1 Road Widening
P Culvert UT to Terrible Creek
Perennial
Both
6
16
9
Ivbp label (e.g. Road Crossing
Fhrrranent (F� or
Perennial (F13F� or
Average
(linear feet)
6
1)
Temporary (T)
intermittent (INT)
(feet)
S2 Road Widening
T Other UT to Terrible Creek
Perennial
Both
6
10
6
Ivhp label (e.g. Rbad Crossing
Parrranent (P) or
Perennial (FHS or
Average
(linear feet)
0
1)
Terrporary (T)
intermttent (INT)
(feet)
** All Perennial or Intermittent streams must be verified by DWR or delegated local government
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
16
31. Total temporary stream impacts:
10
3i. Total stream and tributary impacts:
26
3j. Comments:
The 10 feet of temporary stream impact is needed for the construction of the culvert installation.

6. Buffer Impacts (for DWR)
If project will impact a protected riparian buffer, then complete the chart below. Individually list all buffer impacts below.
6a. Project is in which protect basin(s)? *
Check all that apply.
V Neuse r- Tar -Pamlico
F Catawba r- Randleman
r Goose Creek r Jordan Lake
r- Other
6b. Impact Type *
6c. Per or
6d. Stream name *
6e. Buffer mitigation
6f. Zone 1
6g. Zone 2
Temp*
required?*
impact*
impact*
Allowable
P
UT to Terrible Creek
No
978
680
Location and Exerrpt, Allowable, allowable w/ Permanent (Pj or
(square feet)
(square feet)
rritigation
Temporary (T)
6h. Total buffer impacts:
Zone 1
Zone 2
Temporary impacts:
0.00
0.00
Zone 1
Zone 2
Permanent impacts:
978.00
680.00
Zone 1
Zone 2
Total buffer impacts:
978.00
680.00
6i. Comments:
Supporting Documentation - i.e. Impact Maps, Plan Sheet, etc.
Click the upload button or drag and drop files here to attach document
Kennebec Plans.pdf 4.89MB
C-10 Kennebec Roadway Improvements. pdf 687.11 KB
File must be PDF
E. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:*
No impacts to wetlands are proposed. All other stream and riparian buffers on the Site have been avoided except
for the 26 LF of stream needed to extend an existing culvert on the adjacent Kennebec Road which will extend the
road shoulder to increase safety and meet current standards.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*
General techniques include the use of construction fencing to define the construction corridor and prevent any
accidental additional impacts. Silt fencing and temporary basins will also be used to prevent sediment runoff into
the streams and wetlands.
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?
f Yes r No

2b. If this project DOES NOT require Compensatory Mitigation, explain why:
Buffer impacts are considered "allowable". There are no wetland impacts. Stream impacts have been minimized to only 26 LF of which only
16 LF are permanent.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
*** Recent changes to the stormwater rules have required updates to this section .***
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?
F Yes f No
1b. All buffer impacts and high ground impacts require diffuse flow or other form of stormwater treatment. If the project is subject to a
state implemented riparian buffer protection program, include a plan that fully documents how diffuse flow will be maintained.
All Stormwater Control Measures (SCM)s must be designed in accordance with the NC Stormwater Design Manual. Associated
supplement forms and other documentation shall be provided.
What type of SCM are you providing?
r- Level Spreader
r- Vegetated Conveyance (lower SHWT)
r- Wetland Swale (higher SHWT)
rJ Other SCM that removes minimum 30% nitrogen
(check all that apply)
For a list of options to meet the diffuse flow requirements, click here.
Diff us Flow Documentation
Click the upload button or drag and drop files here to attach docurrent
File type rust be RDF
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?
f Yes C No
2b. Does this project meet the requirements for low density projects as defined in 15A NCAC 02H .1003(2)?*
r Yes
f No
To lookup low density requirement click here 15A NCAC 02H .1003(2).
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? *
f Yes G 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)? *
f Yes r No
2b. Is this an after -the -fact permit application?*
f Yes C No

3. Cumulative Impacts (DWR Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in additional development, which could impact
nearby downstream water quality?*
f Yes r No
3b. If you answered "no," provide a short narrative description.
The project will utilize utilities that already ebst in the area. This project in and of itself will not attract future
development.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
f Yes r Nor N/A
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?*
r Yes r No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
r Yes r No
5d. Is another Federal agency involved?*
t' Yes r No r Unknown
5e. Is this a DOT project located within Division's 1-8?*
f Yes r No
5f. Will you cut anytrees in order to conduct the work in waters of the U.S.?
f Yes r No
5g. Does this project involve bridge maintenance or removal?
r Yes r No
Link to the NLEB SLOPES document: http://saw-reg.usace.army.mil/NLEB/1-30-17-signed_NLEB-SLOPES&apps.pdf
5h. Does this project involve the construction/installation of a wind turbine(s)?*
t' Yes r 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.?
t' Yes r No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
The NC Natural Heritage Data Base (2018) was referenced and an updated report (dated July 16, 2018) was
received from NCNHP which identified no recorded federally threatened or endangered species on the project site
or within a 1 -mile radius.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
r Yes r No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
The proposed project takes place in Wake County which is not near any coastal or tidal habitat that would support
EFH (i.e. salt marshes, oyster reefs, etc.).
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
Link to the State Historic Preservation Office Historic Properties Map (does not include archaeological data: http://gis.ncdcr.gov/hpo\teb/

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)?*
f Yes r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
http://gis.ncdcr.gov/hpo\teb/ *Records check at the State Historic Preservation Office or the Office of State
Archeology was not performed. According to the SHPO website there are no recorded structures on the site. No
structures were observed during the fieldwork effort. The project is located approxmately 250 feet northeast from
the Charles Rowland House (WA1127) which is labeled as ineligible.
7c. Historic or Prehistoric Information Upload
Click the upload button or drag and drop files here to attach docurrent
File must be FDF
8. Flood Zone Designation (Corps Requirement)
Link to the FEMA Floodplain Maps: https://msc.fema.gov/portal/search
8a. Will this project occur in a FEMXdesignated 100 -year floodplain?*
f Yes r No
8c. What source(s) did you use to make the floodplain determination?*
FEMA Flood Map Service Center (https://msc.fema.gov/portal/search) FEMA DFIRM Panel # 3720068700J,
effective May 5, 2006.
Miscellaneous
Miscellaneous attachments not previously requested.
Click the upload button or drag and drop files here to attach docurrent
1 - Kennebec Subdivision Cover Letter for PCN.pdf 89.75KB
2 - signed Agent Authorization Form.pdf 350.98KB
NCNHP report for Kennebec Meadows.pdf 823.67KB
File must be FDF or KNE
Signature
V By checking the box and signing below, I certify that:
■ 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:*
Sean Clark
Signature
Date Submitted:
7/17/2018
Initial Review

Is this project a public transportation project?*(?
r Yes r No
Change only if needed.
Has this project met the requirements for acceptance in to the review process?*
r Yes
f No
BIMS # Assigned*
20180992
Version#*
Reviewing Office*
Raleigh Regional Office - [phone]
Select Project Reviewer*
Stephanie Goss:eads\szgoss
Is a payment required for this project?*
f No payment required
f Fee received
r Fee needed - send electronic notification
What amout is owed?*
r $240.00
f $570.00