20191518 Ver 1_401 Application_20191030

CPT
Engineering & Surveying, lnc.jj�
.�f
LETTER OF TRANSMITTAL
To:
Date 10/18/19 Job No: 1405-16
NC DWQ, WBSCP Unit
Attention:
512 North Salisbury Street
Avondale
11 Raleigh, North Carolina 27604
PCN Application & Sp2portiag Documents
RF,
We are sending you:
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® Attached ❑ Under separate cover via :
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® Plans ❑ Diskette(s) ❑ For Approval ® For Review ❑ Sp g
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❑ Other:
Quantity
Dw . No.
Description
Status
5
Preconstruction Notification forms
5
Supporting Documentation
1
Application fee check enclosed for $240.00
Remarks:
Attached is a PCN for Avondale in Greensboro, NC. A PCN package including has been sent concurrently to
USACOE in the Raleigh Regulatory Field Office in attention to David Bailey. If you have any questions, please do
not hesitate to give me a call.
Thanks.
Chuck Truby
CPT Engineering and Surveying, Inc.
4400 Tyning Street • High Point, NC 27265 Phone: [phone] ex 309 • Fax: [phone]
email: [e-mail]

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Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.4 January 2009
Pre -Construction Notification (PCN) Form
A. Applicant Information
1. Processing
1 a. 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:
1 c. Has the NWP or GP number been verified by the Corps?
❑ Yes ❑X No
1 d. Type(s) of approval sought from the DWQ (check all that apply):
X❑ 401 Water Quality Certification — Regular ❑ Non-404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑X Riparian Buffer Authorization
1 e. Is this notification solely for the record
because written approval is not required?
For the record only for DWQ
401 Certification:
❑ Yes ❑X No
For the record only for Corps Permit:
❑ 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
or in -lieu fee program.
❑ Yes ❑X No
1 g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below.
❑ Yes ❑X No
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes ❑X No
2. Project Information
2a. Name of project:
Avondale
2b. County:
Guilford
2c. Nearest municipality / town:
Greensboro
2d. Subdivision name:
Avondale
2e. NCDOT only, T.I.P. or state project no:
3. Owner Information
3a. Name(s) on Recorded Deed:
Keystone Group
3b. Deed Book and Page No.
DB 5868 PG 1863
3c. Responsible Party (for LLC if
applicable):
Scott Wallace
3d. Street address:
3708 Alliance Drive
3e. City, state, zip:
Greensboro NC 27407
3f. Telephone no.:
336-856-0111
3g. Fax no.:
336-369-1336
3h. Email address:
[e-mail]
Page 1 of 10
PCN Form — Version 1.4 January 2009

4. Applicant Information (if different from owner)
4a. Applicant is:
❑ Agent ❑X Other, specify: Owner
4b. Name:
Scott Wallace
4c. Business name
(if applicable):
Keystone Group, Inc.
4d. Street address:
3708 Alliance Drive
4e. City, state, zip:
Greensboro NC 27407
4f. Telephone no.:
336-856-0111
4g. Fax no.:
336-369-1336
4h. Email address:
[e-mail]
5. Agent/Consultant Information (if applicable)
5a. Name:
Chuck Truby
5b. Business name
(if applicable):
CPT Engineering and Surveying, Inc.
5c. Street address:
4400 Tyning Street
5d. City, state, zip:
High Point NC 27165
5e. Telephone no.:
336-812-8800 x 304
5f. Fax no.:
336-812-8780
5g. Email address:
[e-mail]
Page 2 of 10

B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID):
7852807017
1b. Site coordinates (in decimal degrees):
Latitude: 36.00062 Longitude: -79.814753
1 c. Property size:
30.668 acres
2. Surface Waters
2a. Name of nearest body of water to proposed project:
Ryan Creek
2b. Water Quality Classification of nearest receiving water:
WS-V, NSW
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:
Wooded Land surrounded by interstate highway to the north.
3b. List the total estimated acreage of all existing wetlands on the property: 0.083
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property: 2,200
3d. Explain the purpose of the proposed project:
Residential Subdivision
3e. Describe the overall project in detail, including the type of equipment to be used:
The development of a 83 lot subdivision with streets, utilities, storm sewer and wet detention ponds. Equipment Used: Track Hoes, Bull Dozers, Pans,
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (includingall prior phases)in the past?
X❑ Yes ❑ No ❑ Unknown
Comments: pending
4b. If the Corps made the jurisdictional determination, what type
of determination was made?
Preliminary ❑Final
4c. If yes, who delineated the jurisdictional areas?
Name (if known): Michael Brame
Agency/Consultant Company: Pyramid Environmental
Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
Pending
5. Project History
5a. Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past?
❑ Yes ❑X No ❑ Unknown
5b. If yes, explain in detail according to "help file" instructions.
6. Future Project Plans
6a. Is this a phased project?
❑ Yes ❑X No
6b. If yes, explain.
Page 3 of 10
PCN Form — Version 1.4 January 2009

C. Proposed Impacts Inventory
1. Impacts Summary
1a. Which sections were completed below for your project (check all that apply):
❑X 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.
Wetland impact
number
Permanent (P) or
Temporary T
2b.
Type of impact
2c.
Type of wetland
2d.
Forested
2e.
Type of jurisdiction
Corps (404,10) or
DWQ (401, other)
2f.
Area of
impact
(acres)
W1 P
Fill
Headwater Wetland
Yes
Corps
0.048
W2 -
Choose one
Choose one
Yes/No
-
W3 -
Choose one
Choose one
Yes/No
-
W4 -
Choose one
Choose one
Yes/No
-
W5 -
Choose one
Choose one
Yes/No
-
W6 -
Choose one
Choose one
Yes/No
-
2g. Total Wetland Impacts:
0.048
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.
Stream impact
number
Permanent (P) or
Temporary (T)
3b.
Type of impact
3c.
Stream name
3d.
Perennial (PER) or
intermittent (INT)?
3e.
Type of
jurisdiction
3f.
Average
stream
width
(feet)
3g.
Impact
length
(linear
feet)
S1 P
Culvert
UT of Ryan Creek
PER
Corps
2
128
S2
Choose one
S3
Choose one
_
S4 -
Choose one
-
S5 -
Choose one
S6
Choose one
3h. Total stream and tributary impacts
128
3i. Comments:
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
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 -
Choose one
Choose
O2 -
Choose one
Choose
03 -
Choose one
Choose
04 -
Choose one
Choose
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If pond or lake construction proposed, the complete the chart below.
5a.
Pond ID number
5b.
Proposed use or
purpose of pond
5c.
Wetland Impacts (acres)
5d.
Stream Impacts (feet)
5e.
Upland
(acres)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
P1
Choose one
P2
Choose one
5f. 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:
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. Project is in which protected basin?
❑ Neuse ❑ Tar -Pamlico ❑ Catawba ❑ Randleman © Other:
6b.
Buffer Impact
number —
Permanent (P) or
Temporary T
6c.
Reason for impact
6d.
Stream name
6e.
Buffer
mitigation
required?
6f.
Zone 1
impact
(square
feet)
6g.
Zone 2
impact
(square
feet
61 P
Road Crossing
UT of Ryan Creek
No
5,787
4,815
B2
No
B3 -
No
B4 -
No
B5 -
Yes/No
B6 -
Yes/No
6h. Total Buffer Impacts:
5,787
4,815
6i. Comments:
Page 5 of 10

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
The slopes are proposed to be 2:1 which is the steepest allowed. The pipe length is as short as possible to keep stream impacts to the minimum
amount possible.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
The culvert will be constructed first and then the fill will be placed. Erosion control devices will remain in place during construction.
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?
❑ Yes ❑X No
2b. If yes, mitigation is required by (check all that apply):
❑ DWQ ❑ Corps
2c. If yes, which mitigation option will be used for this
project?
❑ Mitigation bank
El 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: Choose one
Type: Choose one
Type: Choose one
Quantity:
Quantity:
Quantity:
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:
Choose one
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.
Page 6 of 10
PCN Form — Version 1.4 January 2009

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 ❑X 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 7 of 10

E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
la. Does the project include or is it adjacent to protected riparian buffers identified
❑x 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.
❑X Yes ❑ No
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project?
27.5 %
2b. Does this project require a Stormwater Management Plan?
❑X 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:
Wet Detention ponds are proposed to treat the runoff from all impervious areas. Runoff will be conveyed via storm pipes or swales.
2e. Who will be responsible for the review of the Stormwater Management Plan?
City of Greensboro
3. Certified Local Government Stormwater Review
3a. In which localgovernment's jurisdiction is thisproject?
City of Greensboro
❑X Phase 11
❑ NSW
3b. Which of the following locally -implemented stormwater management programs
USMP0
❑
apply (check all that apply):
Water Supply Watershed
❑ Other:
3c. Has the approved Stormwater Management Plan with proof of approval been
❑Yes X❑ 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
❑ Yes ® No
attached?
5. DWQ 401 Unit Stormwater Review
5a. Does the Stormwater Management Plan meet the appropriate requirements?
❑X Yes ❑ No
5b. Have all of the 401 Unit submittal requirements been met?
❑X Yes ❑ No
Page 8 of 10
PCN Form — Version 1.4 January 2009

F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1 a. Does the project involve an expenditure of public (federal/state/local) funds or the
❑ Yes
❑X No
use of public (federal/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)?
1 c. 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
❑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):
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in
El 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.
Greensboro. Greensboro
All wastewater from this development will be treated by the City of has capacity for the sewer.
Page 9 of 10
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
❑ Yes ❑X No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act
❑X Yes ❑ No
impacts?
5c. If yes, indicate the USFWS Field Office you have contacted.
Raleigh
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
USFWS website with verification by USACE. https:Hecos.fws.gov/ecpO/reports/species-by-current-range-county?fps=37081 and https://ecos.fws.gov/
ecp/
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?
❑ Yes ❑X No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
http://www.fws.gov/raleigh/species/cntylist/county.html with verification by USACE. Site is not near salt marsh, oyster reef, or sea grass beds.
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 ❑X 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?
State Historic Preservation Office
http:/twww,hpo.dcr.state.nc.us/ with verification from the USACE
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?
❑ Yes ❑X No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination?
Flood Insurance Map Panel 7851, 7852, 7861, 7862, City of Greensboro 3710785100J, 3710785200J, 3710786100J, 3710786200J, Dated June 18,
2007
S� w
Applicant/Agent's Printed Name
Date
Applicant/Agent's Signature
(Agent's signature is valid only if an authorization
letter from the applicant isprovided.)
Page 10 of 10

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ASSOCIATION COVENANTS AND
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DATE, 10/16AIR
PROJWT- 1405-16
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