20181288 Ver 1_PCN Form Submission_9/18/2018 3:19 PM

Action History (UTC -05:00) Eastern Time (US & Canada)
Submit by Anonymous User 9/18/2018 3:19:30 PM (Start Event)
Accept by Montalvo, Sheri A 9/21/2018 2:31:27 PM (Non DOT Initial Review)
The task was assigned to Montalvo, Sheri A. The due date is: September 21, 2018 5:00 PM
9/18/2018 3:20 PM

DWR
Dfutston 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.gov/WaterResources/0/edoc/624704/PCN%20Help%20File%202018-1-30. pdf
A. Processing Information
County (or Counties) where the project is located:*
Harnett
Is this project a public transportation project?*
r Yes G No
This is any publicly funded by rrunicipal,state or federal funds road, rail, airport transportation project.
1a. Type(s) of approval sought from the Corps:*
PF Section 404 Permit (wetlands, streams and waters, Clean Water Act)
r Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
1b. What type(s) of permit(s) do you wish to seek authorization?*
r% 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: 39 - Commercial/Institutional Developments
NWP Number Other:
List all WV nun-bers you are applying for not on the drop dow n list.
1c. Type(s) of approval sought from the DWR:*
check all that apply
401 Water Quality Certification - Regular r 401 Water Quality Certification - Express
r Non -404 Jurisdictional General Permit r Riparian Buffer Authorization
r Individual Permit
*
1d. Is this notification solelyfor the record because written approval is not required?

For the record only for DWR 401 Certification:
For the record only for Corps Permit:
b Yes b No
O Yes a No
1e. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
V so, attach the acceptance letter from mitigation bank or in -lieu fee program
r Yes r No
1f. Is the project located in anyof NC's twenty coastal counties?*
r Yes r No
1h. Is the project located in a designated trout watershed?*
r Yes r No
Link to trout information: http://wuwv.saw.usace.army.miI/Missions/Regulatory-Permit-Program/Agency-Coordination/Trout.aspx
B. Applicant Information
1a. Who is the Primary Contact?*
Amanda Lee Bader. P.E.
1b. Primary Contact Email:*
[e-mail]
1c. Primary Contact Phone:*
(XXX)XXX-XXXX
1d. Who is applying for the permit?
rJ Owner r- Applicant (other than owner) rJ Agent/Consultant
(Check all that apply)
2. Owner Information
2a. Name(s) on recorded deed:
Harnett County
2b. Deed book and page no.:
1711:0807
2c. Responsible party:
(for Corporations)
2d. Address
Street Address
102 East Front Street
Address Line 2
City
Lillington
Fbstal / Zip Code
27524
2e. Telephone Number:
(XXX)XXX-XXXX
2f. Fax Number:
(XM)XM-XXM
2g. Email Address:*
[e-mail]
/ Province / Pegion
NC
Country
USA

4. Agent/Consultant (if applicable)
4a. Name:
Philip May
4b. Business Name:
(if applicable)
Carolina Ecosystems Inc
4c. Address
Street Address
3040 NC Hwy 42 West
Address Line 2
City
State/ Province / tagion
Clayton
NC
Fbstal / Zip Code
Country
27520
USA
4d. Telephone Number:
[phone]
(XXX)XXX-XXXX Fax Number:
(XXX)XXX-XXXX Email Address:*
[e-mail]
Agent Authorization Letter`
Pease provide the Agent Authorization Letter if you are submitting this docurrent.
Ponderosa Rd_AgentAuth_signed.pdf 27.99KB
PLETYP= MJST BE PDF
C. Project Information and Prior Project History
1. Project Information
1a. Name of project:*
Ponderos Road Convenience Center and Park
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality / town:
*
Cameron NC
1d. Driving directions*
V it is a new project and can not easily be found in a GPS crapping system Pease provide directions.
From the intersection of NC 87 and NC 27, travel west on NC 27 then turn right onto Ponderosa Road. The site will be on the left
approximately 3/4 mile from NC 27.
2. Project Identification
2a. Property Identification Number:
(tax PN or parcel ID)
9566-41-6276.000

2b. Property size:
(in acres)
18.9
2c. Project Address
Street Address
721 Ponderosa Road
Address Line 2
City
Cameron
Postal / Zip Code
28326
2d. Site coordinates in decimal degrees
State / Province / Region
NC
Country
USA
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:*
35.2921 -79.1184
ex: 34.208504 -77.796371
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
UT to Neills Coon Branch
3b. Water Resources Classification of nearest receiving water:*
C
Surface Water Lookup
3c. What river basin(s) is your project located in?*
Cape Fear
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 site is forested and recently timbered, with an existing Solid Waste Convenience Center on the portion closest
to Ponderosa Road. General land use in the area is forest/undeveloped, with some residential and industrial (sand
mine).
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)
nick the upload button or drag and drop files here to attach docurrent
Ponderosand_Fig2.pdf 521.19KB
File type rust be pd'
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 docurrent
Pon derosa_Figure4_NRCS.pdf 838.99KB
File type rust be pdf
4d. List the total estimated acreage of all existing wetlands on the property:

1.68
4e. List the total estimated linear feet of all existing streams on the property:
(intermittent and perennial)
367
4f. Explain the purpose of the proposed project:*
The purpose of the project is to provide recreational opportunities to the citizens of Harnett County on epsting
County -owned land, specifically two ball fields and associated access road and parking.
4g. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
The project entails the construction of a road access from the eAsting solid waste convenience center adjacent to
Ponderosa Road to construct two ball fields on the remainder of the property. Standard construction equipment is
anticipated to complete the project.
4h. Please upload project drawings for the proposed project.
Click the upload button or drag and drop files here to attach docurrent
HC PN Phase 2 Site Plan (HARNETT-D0101) 2018-08-28 PRELIM.pdf 1.31 MB
HARNETT-BO164- Layout 1.pdf 267.3KB
File type rrust 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?*
O Preliminary
Corps AID Number:
Exarrple: SAW -2017-99999
SAW -2016-01900
r Approved
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
r Unknown
Chris Hopper
Carolina Ecosystems, Inc.
r N/A
5d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
Preliminary Jurisdictional Determination was Feld verified on 12/13/16.
5dl. Jurisdictional determination upload
Click the upload button or drag and drop files here to attach docurrent
eSAW-2016-01900.pdf 533.77KB
File type rrust be FDF
6. Project History
6a. Have permits or certifications been requested or obtained for this project (including all prior phases) in the past?*
r Yes r No r Unknown
7. Future Project Plans
7a. Is this a phased project?*
M Yes f No

7b. If yes, explain.
A solid waste convenience center was established on the front portion of the site, closest to Ponderosa Road, with
no impacts to jurisdictional resources. The proposed project is for Phase 2 to establish ball fields in the back of the
site.
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.
No
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
V Wetlands
r Open Waters
F Streams -tributaries
r Pond Construction
F Buffers
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a. Site # - Reason for impact* 2b. Impact type * 2c. Type of wetland * 2d. Wetland name *2e. 2f. Type of 2g. Impact
Forested* Jurisdicition* area*
Road Crossing P
IVbp label (e.g. Fvad Crossing 1 - CLlvert, Permanent (P) or
dewatering, etc) Temporary (T)
2g. Total Temporary Wetland Impact
0.000
2g. Total Permanent Wetland Impact
0.098
2g. Total Wetland Impact
0.098
2h. Comments:
Headwater Forest WB Yes Both 0.098
(404, 10) or DhR(401, (acres)
other)
All wetland impacts are proposed as permanent. A small amount will be clearing adjacent to the roadway on the
north side, but will be maintained and therefore was included in the permanent impact calculation above.
Permanent fill for the roadway will be slightly over 0.09 acres.
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:*
The proposed road crossing has been shifted as far down (northwest) along the wetland drainage as possible to
cross at the thinnest practicable location. Due to the location of the entrance road and convenience center it is not
practicable to switch the location of the first ball field and the road as the downstream wetland. The road and ball
fields have been designed to avoid the larger "bulb" of the headwater wetland, while providing controlled
stormwater flow to retain the hydrology of the system. The pipe has been embedded to allow natural surface
hydrology to be maintained. The remaining areas have been designed to avoid all other wetlands on site.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*
Sediment and erosion control measures including silt fences, skimmer basins, and outlet protection will be
implemented to prevent sedimentation and erosion within the wetland areas. Non -impacted wetlands will be
protected with tree protection fencing or other similar devices.

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?
r Yes r No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
Wetland impacts have been reduced below 0.10 acres to avoid compensatory mitigation.
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 r No
For a list of options to meet the diffuse flow requirements, click here.
If no, explain why:
The project is located downstream of Jordan Lake in the Cape Fear River Basin and therefore not subject to the Jordan Lake Rules.
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
r Yes r No
2b. Does this project meet the requirements for low density projects as defined in 15A NCAC 02H .1003(2)?
r Yes
r No
To look up 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?*
r Yes r No
1b. 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 (North Carolina) Environmental Policy Act (NEPA/SEPA)?*
r Yes r No
Comments:*
This is a county funded project and does not require a document under SEPA. No federal funds are being used
for the project.
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)? *
r Yes r No
2b. Is this an after -the -fact permit application?*
r Yes r 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 presence of a solid waste convenience center and two ball fields is not likely to increase development in the
area or influence downstream water quality.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?
r 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
5c. If yes, indicate the USFWS Field Office you have contacted.
Raleigh
5d. Is another Federal agency involved?*
r Yes r No r Unknown
5e. Is this a DOT project located within Division's 1-8?*
r Yes r No
5f. Will you cut any trees in order to conduct the work in waters of the U.S.?
r 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)?*
r Yes r No
51. 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.?
r Yes r No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
USFWS County Species lists. NHP Element Occurrence 2018 data. Site review for suitable habitat for red -
cockaded woodpecker and rough -leaved loosestrife. No suitable habitat was present on the site for rough -leaved
loosestrife. Pine stands were of marginal age and the site was reviewed for the presence of RCW and/or cavities -
none were observed.
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?*
NOAA EFH Mapper
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/hpovieb/
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)?*
r Yes r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
State Historic Preservation Office HPOWeb application.
7c. Historic or Prehistoric Information Upload
nick the upload button or drag and drop files here to attach docurrent
File rrust 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 FEMA -designated 100 -year floodplain?*
r Yes F No
8c. What source(s) did you use to make the floodplain determination?*
NC Flood Mapping Program
Miscellaneous
Miscellaneous attachments not previously requested.
nick the upload button or drag and drop files here to attach docurrent
File rrust 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:*
Philip May
Signature
Sign
Date Submitted:
9/18/2018
Initial Review

Is this project a public transportation project?*(?)
f Yes r No
Change only if needed.
Has this project met the requirements for acceptance in to the review process?*
t: Yes
r No
BIMS # Assigned
20181288
Version#*
1
Reviewing Office*
Fayetteville Regional Office - [phone]
Select Project Reviewer*
Chad Turlington:eads\ccturlington
Is a payment required for this project?*
r No payment required
r Fee received
r Fee needed - send electronic notification
What amout is owed?*
C $240.00
* $570.00