20090842 Ver 1_More Info Received_20091008

ALPHA & OMEGA GROUP
C I V I L & S T R U C T U R A L . E N G I N I E R 5
LETTER OF TRANSMITTAL
TO: Cyndi Karoly, Supervisor
NC DWQ, 401 / Wetlands Unit
2321 Crabtree Blvd.
Raleigh, NC, 27604
Suite 250
FROM: T. Glenn Zeblo, P.E. Z-
DATE: October 8, 2009
Telephone: [phone]
Facsimile: 919-733-6893
OCT RM k15
a Zoos
WETLANDS MND STORMWATER ERkWA
RE: PCN Application DWQ 09-0842 Wake County DENR • WATER C11ALiTY
First Assembly of God of Raleigh (City of Raleigh # SP-103-08)
WE ARE SENDING YOU:
COPIES: DATE: NO. DESCRIPTION:
5 10-8-09 1 Additional Information - PCN application and supporting
documentation
5 1/22/09 2 Field Determination Letter from DWQ
5 3 Cover Letter

5 10-8-09 4 Revised Section of Preliminary Storm-water Drainage
Report
THESE ARE TRANSMITTED: For review and approval.
COMMENTS: This PCN has been revised to reflect impacts to the NRRB where the high flow
bypass discharge has been extended per the request of Raleigh review staff. Only the revised
section of the Stormwater report has been included herewith. The remainder of the stormwater
report is unchanged.
p:\2008_000\2008_021 - first assembly church\corresp\transmittahm: dwq pcn sumittal 10-08-09.doc
4911 Green Road Suite 107 Raleigh, North Carolina 27616 Phone [phone] Fax [phone] u,tvtv.aogrotap.Com

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ALPHA & OMEGA GROUP
C I V I L & S T R U C T U R A L E N G I N E E R 5
October 8, 2009
Division of Water Quality, 401/Wetlands Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
RE: DWQ Project # DWQ 09-0842, Wake County
Subject Property: First Assembly of God
3249 Blue Ridge Road, Raleigh, Wake County
Neuse River Riparian Buffer Impact Only
DWQ Staff Persons:
Oq - W64 a-
Q?c?c?aer?
OCT 8 2009
WE WATER TLANDS AN ST ORhIWATE BWWCH
The attached PCN Application Form is being submitted for the improvement on the existing
property of First Assembly of God at 3249 Blue Ridge Road, Raleigh, Wake County, North Caro-
lina. We are seeking approval only for an allowable Neuse River Riparian Buffer impact
according to the Table of Uses contained in 15A NCAC 02B .0 100, .0200 & .0300 "Red-
book".
City of Raleigh staff has asked the property Owner to submit this PCN to NCDENR DWQ for
official review and approval of the allowable use within the NRRB of Tributary "D" to Crabtree
Creek indicated in this application. Tributary "D" to Crabtree Creek traverses the western most
portion of the property generally from south to north. Please refer to the maps contained herein
for reference.
We are proposing to discharge directly to the existing feature by means of a High Flow Bypass
from a proposed Dry Detention BMP. The discharge is for that runoff above the one inch rainfall.
We have indicated a dissipater pad be placed at the outlet of the culvert since the feature does not
have "deep" pools along its course on the property.
The accompanying plans and application form(s) illustrates the proposed improvements with di-
rect impact to the NRRB.
Contents:
1. Field Determination Letter from Mr. Martin Richmond, dated 1/22/09.
2. PCN Application Form
3. Vicinity Map
4. Existing Conditions Map at Impact Location
5. Improvement Layout & Grading Plan at Impact Location
6. Existing Aerial View with Feature indicated
4911 Green Road Suite 107 Raleigh, North Carolina 27616 Phone [phone] Fax [phone] u,ww.aogroupxonr

a
October 8, 2009
Page 2 of 2
7. Preliminary Stormwater Drainage Report dated October 8, 2009.
If you require additional information or have any questions, please do not hesitate to contact me
at 919-981-0310 or t zeblo e,aogroup. com .
Thank you for your prompt attention to this matter.
Sincerely,
-r '??
T. Glenn Zeblo, PE
Alpha & Omega Group, PC
P:\2008_000\2008_021 - First Assembly Church\corresp\letter\DWQ PCN_Cover Letter no RDWY.doc
o f W p rF9 Beverly Eaves Perdue, Governor
Q Dee Freeman. Secretary
North Carolina Department of Environment and Natural Resources
j Coleen H. Sullins, Dlrector
• P Division of Water Quality
January 22, 2009
John Picha, PE
Alpha & Omega Group
4911 Green Rd Suite 107
Raleigh, NC 27616
JAN a'r 2009
A0 -41002, av
L.AO LOT
NBRR0#08-239
Wake County BASIN:
Neuse River X Tar-Pamlico
(15A NCAC 2B .0233) (15A NCAC 213 .0259)
Project Name: First Assembly of God Church
Location/Directions: Subject property is a church located at 3249 Blue Ridge Rd in Raleigh. USGS Raleigh West,
NRCS Wake County Sheet 48;
6 Date of Determination: December 2, 2008
Subject Stream: UT to Crabtree Creek

Feature(s) Not
Subject Subject Start @ stop@ Stream
Form Pts. Soil Survey USGS
Topo
A X Throughout X X
Explanation: The feature(s) listed above has or have been located on the Soil Survey of Wake County, North
Carolina or the most recent copy of the USGS Topographic map at a 1:24,000 scale. Each feature that is checked
"Not Subject" has been determined not to be a stream or is not present on the property. Features that are checked
"Subject" have been located on the property and possess characteristics that qualify it to be a stream. There may be
other streams located on your property that do not show up on the maps referenced above but, still may be
considered jurisdictional according to the US Army Corps of Engineers and/or to the Division of Water Quality.
•
This on-site determination shall expire five (5) years from the date of this letter. Landowners or affected
parties that dispute a determination made by the DWQ or Delegated Local Authority that a surface water
exists and that it is subject to the buffer rule may request a determination by the Director. A request for a
determination by the Director shall be referred to the Director in writing c% Cyndi Karoly , DWQ
Wetlands/401 Unit, 2321 Crabtree Blvd., Raleigh, NC 27604-2260. Individuals that dispute a determination
by the DWQ or Delegated Local Authority that "exempts" a surface water from the buffer rule may ask for
an ad judicatory hearing. You must act within 60 days of the date that you receive this letter. Applicants are
hereby notified that the 60-day statutory appeal time does not start until the affected party (including
downstream and adjacent landowners) is notified of this decision. DWQ recommends that the applicant
conduct this notification in order to be certain that third party appeals are made in a timely manner. To ask
for a hearing, send a written petition, which conforms to Chapter 150B of the North Carolina General
Statutes to the Office of Administrative Hearings, 6714 Mail Service Center, Raleigh, N.C. 27699-6714. This
determination is final and binding unless you ask for a hearing within 60 days.
North Carolina Division of Water Quality Raleigh Regional Office Surface Water Protection Phone [phone] Customer Service
Internet: h2o.ennstate.nc.us 1628 Mail Service Center Raleigh, NC 27699-1628 FAX [phone]
An Equal Opportunity/Affirmative Action Employer - 50% Recycied/10% Post Consumer Paper
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First Assembly Church of God
"Will" Alake County
January 22, 2009
Page 2 of 2
• The (owner/future owners) should notify the Division of Water Quality (including any other Local, State, and
Federal Agencies) of this decision concerning any future correspondences regarding the subject property
(stated above). This project may require a Section 404/401 Permit for the proposed activity. Any inquiries
should be directed to the Division of Water Quality (Central Office) at (919)-733-1786, and the US Army
Corp of Engineers (Raleigh Regulatory Field Office) at (919)-876-8441.
Respectfully,
Martin Ric and
Environmental Specialist
CC: Wetlands/ Stormwater Branch, 2321 Crabtree Blvd, Suite 250, Raleigh, NC 27604
RRO/SWP File Copy
•
1?1?..O,,? Carolina
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North Carolina Division of Water Quality Raleigh Regional Office Surface Water Protection Phone [phone] Customer Service
Intemet: h2o.enr.state.ne.us 1628 Mail Service Center Raleigh, NC 27699-1628 FAX [phone]
An Equal Opportunity/Affirmative Action Employer - 50% Recycled/10% Post Consumer Paper
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Form Version 1.3 Dec 10 2008
Pre-Construction Notification (PCN) Form
A. Applicant Information
1. Processing
1a. Type(s) of approval sought from the
Corps:
El Section 404 Permit El Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps? ? Yes ? No
1 d. Type(s) of approval sought from the DWQ (check all that apply):
? 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
because written approval is not required? For the record only for DWQ 401
Certification:
? Yes ® No For the record only for Corps Permit:

? Yes ® 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 or in-lieu
fee program. ? Yes ® No
1 g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below. ? Yes ® No
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ? Yes ® No
2. Project Information
2a. Name of project: First Assembly of God
2b. County: Wake
2c. Nearest municipality / town: Raleigh
2d. Subdivision name: N/A
2e. NCDOT only, T.I.P. or state
project no: N/A
3. Owner Information
3a. Name(s) on Recorded Deed: First Assembly of God of Raleigh
3b. Deed Book and Page No. DB: 02461 DP: 0590
3c. Responsible Party (for LLC if
applicable): First Assembly of God (Attn: David Allsbrook)
3d. Street address: 3249 Blue Ridge Road
3e. City, state, zip: Raleigh, NC 27612
3f. Telephone no.: [phone]
3g. Fax no.. [phone]
3h. Email address: [e-mail]
Page 1 of 11
PCN Form - Version 1.3 December 10, 2008 Version
4. Applicant Information (if different from owner)
4a. Applicant is: ? Agent ? Other, specify:
4b. Name:
4c. Business name
(if applicable):
4d. Street address:
4e. City, state, zip:
4f. Telephone no.:
4g. Fax no.:
4h. Email address:
5. Agent/Consultant Information (if applicable)
5a. Name: T. Glenn Zeblo, P.E.
5b. Business name
(if applicable): Alpha & Omega Group
5c. Street address: 4911 Green Road
5d. City, state, zip: Raleigh, NC 27616
5e. Telephone no.: [phone]
5f. Fax no.: [phone]
5g. Email address: [e-mail]
Page 2 of 11
PCN Form - Version 1.3 December 10, 2008 Version
B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): 0785-85-9551
Latitude: 35.492863 Longitude: -
1 b. Site coordinates (in decimal degrees): 78.415573
(DD.DDDDDD) (-DD.DDDDDD)
1 c. Property size: 13.88 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to Crabtree Creek
proposed project:
2b. Water Quality Classification of nearest receiving water: Crabtree Creek/ c and b nsw
2c. River basin: Neuse River Basin
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:
The site has two church buildings and two parking lots. The land use is category 1.03.03. The site is 37% covered with
impervious surfaces. The surrounding properties include Medium Density Residential (1.01.01.03) Medium Density
Multi-family (1.01.03.02) and Commercial office (1.02.02.0).
3b. List the total estimated acreage of all existing wetlands on the property:
unknown
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
256 If
3d. Explain the purpose of the proposed project:
Construct a new building addition to the two existing buildings on the property and add additional parking.
3e. Describe the overall project in detail, including the type of equipment to be used:
The property Owner wishes to construct additional educational space to be added to the existing buildings on the upslope
area of the property. Additional parking is desired between the existing buildings and Blue Ridge Road upslope from the
water feature.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
®Yes ? No ? Unknown
project (including all prior phases) in the past?
Comments: Field Determination by DWQ Staff (attached)
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.
5. Project History
5a. Have permits or certifications been requested or obtained for ?Yes ? No Unknown
this project (including all prior phases) in the past?
5b. If yes, explain in detail according to "help file" instructions.
Page 3 of 11
PCN Form - Version 1.3 December 10, 2008 Version
6. Future Project Plans
6a. Is this a phased project? ? Yes ® No
6b. If yes, explain.
Page 4 of 11
PCN Form - Version 1.3 December 10, 2008 Version
C. Proposed Impacts Inventory
1. Impacts Summary
1a. Which sections were completed below for your project (check all that apply):
? Wetlands ? Streams - tributaries ® 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 jurisdiction
number- Type of impact Type of wetland Forested (Corps - 404, 10 Area of impact
Permanent (P) or (if known) DWQ - non-404, other) (acres)
Temporary T
W1 ? P ? T ? Yes ? Corps
? No ? DWQ
W2 ? P ? T ? Yes ? Corps
? No ? DWQ
W3 ? P ? T ? Yes ? Corps
? No ? DWQ
W4 ? P ? T ? Yes ? Corps
? No ? DWQ
W5 ? P ? T ? Yes ? Corps
? No ? DWQ
W6 ? P ? T ? Yes ? Corps
? No ? DWQ
2g. Total wetland impacts
2h. Comments:
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 Type of jurisdiction Average Impact
number - (PER) or (Corps - 404, 10 stream length
Permanent (P) or intermittent DWQ - non-404, width (linear
Temporary (T) (INT)? other) (feet) feet)
S1 ? P ? T ? PER ? Corps
? INT ? DWQ
S2 ? P ? T ? PER ? Corps
? INT ? DWQ
S3 ? P ? T ? PER ? Corps
? INT ? DWQ
S4 ? P ? T ? PER ? Corps
? INT ? DWQ
S5 ? P ? T ? PER ? Corps
? INT ? DWQ
S6 ? P ? T ? PER ? Corps
? INT ? DWQ
3h. Total stream and tributary impacts
3i. Comments:
Page 5 of 11
PCN Form - Version 1.3 December 10, 2008 Version
4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impacts below.
4a.
Open water
impact number
- Permanent (P)
or Temporary
(T) 4b.
Name of waterbody
(if applicable) 4c.

Type of impact 4d.

Waterbody type 4e.

Area of impact (acres)
01 ?P?T
02 ?P?T
03 ?P?T
04 ?P?T
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If pond or lake construction proposed, then complete the chart below.
5a.

Pond ID 5b.

Proposed use or purpose of 5c.
Wetland Impacts (acres) 5d.
Stream Impacts (feet) 5e.
Upland
(acres)
number pond
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
P2
5E Total
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:
Page 6 of 11
PCN Form - Version 1.3 December 10, 2008 Version
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.
6a.
® Neuse ? Tar-Pamlico ? Other:
Project is in which protected basin? ? Catawba ? Randleman
6b. 6c. 6d. 6e. 6f. 6g.
Buffer impact
number- Reason for Buffer Zone 1 impact Zone 2 impact
Permanent (P) impact Stream name mitigation (square feet) (square feet)
or Temporary required?
(T)
New
61 ®P ? T Stormwater
discharge Trib. D to Crabtree Creek ? Yes
® No 674 616
thru NRRB
B2 ?P?T ?Yes
? No
B3 ?P?T ?Yes
? No
6h. Total buffer impacts 0 0
6i. Comments:
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
DWQ BMP Manual Section 8.3.1 High Flow Bypass indicates that the bypass should discharge direclty to the stream.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
A 20-foot wide path is delineated to allow for the construction of the discharge pipe and minimize disturbance to the NRRB.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for ? 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): ? 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:
3b. Credits Purchased (attach receipt and letter) Type Quantity
Page 7 of 11
PCN Form - Version 1.3 December 10, 2008 Version
3c. Comments:
4. Complete if Making a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached. ? Yes
4b. Stream mitigation requested: linear feet
4c. If using stream mitigation, stream temperature: ? warm ? cool ?cold
4d. Buffer mitigation requested (DWQ only): square feet
4e. Riparian wetland mitigation requested: acres
4f. Non-riparian wetland mitigation requested: acres
4g. Coastal (tidal) wetland mitigation requested: acres
4h. Comments:
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
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
buffer mitigation? ? Yes ® No
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.

Zone 6c.
Reason for impact 6d.
Total impact
(square feet)
Multiplier 6e.
Required mitigation
(square feet)
Zone 1 3 (2 for Catawba)
Zone 2 1.5
6f. Total buffer mitigation required:
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 8 of 11
PCN Form - Version 1.3 December 10, 2008 Version
E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1 a. Does the project include or is it adjacent to protected riparian buffers identified ® Yes ? 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
Comments:
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project? 52.67%
2b. Does this project require a Stormwater Management Plan? ® Yes ? No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why:
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
An open dry detention pond is located upslope from the stream to meet the requirements of Raleigh for attenuating post
construction discharge, Nitrogen Export and TSS. A level spreader is located to capture some of the discharge along
with a filter strip below the level spreader.
® Certified Local Government
2e. Who will be responsible for the review of the Stormwater Management Plan? ? DWQ Stormwater Program
? DWQ 401 Unit
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this project? City of Raleigh
? Phase II
3b. Which of the following locally-implemented stormwater management programs ? NSW
? USMP
apply (check all that apply): ? Water Supply Watershed
? Other:
3c. Has the approved Stormwater Management Plan with proof of approval been ? Yes ? No
attached?
4. DWQ Stormwater Program Review
? Coastal counties
? HQW
4a. Which of the following state-implemented stormwater management programs apply ? ORW
(check all that apply):
? Session Law 2006-246
? Other:
4b. Has the approved Stormwater Management Plan with proof of approval been
attached? ? Yes ? No
5. DWQ 401 Unit Stormwater Review
5a. Does the Stormwater Management Plan meet the appropriate requirements? ? Yes ? No
5b. Have all of the 401 Unit submittal requirements been met? ? Yes ? No
Page 9 of 11
PCN Form - Version 1.3 December 10, 2008 Version
F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1a. Does the project involve an expenditure of public (federal/state/local) funds or the ? Yes ® No
use of public (federal/state) land?
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 ? 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
? Yes
? No
letter.)
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 ® No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. Is this an after-the-fact permit application? ? Yes ® No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in ? 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.
Public Sanitary Sewer service is available to the property and will be utilized.
Page 10 of 11
PCN Form - Version 1.3 December 10, 2008 Version
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?

Raleigh
®
5c. If yes, indicate the USFWS Field Office you have contacted. ? A
h
ill
ev
s
e
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
Contacted USFWS office and web site.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?
Yes ? No
T
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 ® No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination? Per Fema map # 37200785500J Dated 5/02/06.

T. Glenn Zeblo 7 /A / ?7ep
Applicant/Agent's Printed Name icant/Agent's nature Date
(Agent's signature is valid only if an autho za ion letter from the applicant
is provided.
Page 11 of 11
PCN Form - Version 1.3 December 10, 2008 Version
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