20200095 Ver 1_PCN Form Submission_20200116

DWR
Division of Water Resources
Pre -Construction Notification (PCN) Form
September 29, 2018 Ver 3
Initial Review
Has this project met the requirements for acceptance in to the review process?*
r Yes
r No
Is this project a public transportation project?*
G Yes IT No
Change only if needed.
BIMS # Assigned
20200095
Is a payment required for this project?*
r No payment required
r Fee received
r Fee needed - send electronic notification
Reviewing Office *
Wilmington Regional Office - [phone]
Information for Initial Review
1a. Name of project:
Dante Martin Vet Clinic
1a. Who is the Primary Contact?*
Kim Williams - Land Management Group
1b. Primary Contact Email:*
[e-mail]
Date Submitted
1/16/2020
Nearest Body of Water
Ui to Mill Creek
Basin
White Oak
Water Classification
SA; HOW
Site Coordinates
Latitude: Longitude:
34.368801-77.709099
A. Processing Information
County (or Counties) where the project is located:
Pender
Is this project a public transportation project?*
r Yes r No
1a. Type(s) of approval sought from the Corps:
W 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?
* Nationwide Permit (NWP)
r- Regional General Permit (RGP)
7 Standard (IP)
Version#*
1
What amout is owed?*
IT $240.00
r $570.00
Select Project Reviewer*
Robb Mairs:eads\rlmairs2
1c. Primary Contact Phone:*
[phone]
V

1c. Has the NWP or GP number been verified by the Corps?
r Yes r No
Nationwide Permit (NWP) Number:
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
W 401 Water Quality Certification - Regular
r Non-404 Jurisdictional General Permit
r Individual Permit
39 - Commercial/Institutional Developments
le. Is this notification solely for the record because written approval is not required?
For the record only for DWR401 Certification:
For the record only for Corps Permit:
F 401 Water Quality Certification - E)press
r Riparian Buffer Authorization
1f. Is this an after -the -fact permit application?*
r Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
r Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
r Yes r No
Acceptance Letter Attachment
1h. Is the project located in any of NC's twenty coastal counties?
r Yes r No
1i. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
r Yes r No r Unknown
1j. Is the project located in a designated trout watershed?
r Yes r No
B. Applicant Information
1d. Who is applying for the permit?
W Owner r Applicant (other than owner)
le. Is there an Agent/Consultant for this project?*
r Yes r No
2. Owner Information
2a. Name(s) on recorded deed:
LFM Holdings, LLC
2b. Deed book and page no.:
2c. Responsible party:
Dante Martin, DVM
2d.Address
Street Address
785 Chadwick Shores Drive
Address Line 2
City
Sneads Ferry
Rstal / Zip Code
28460
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
State / Rovince / Fbgion
NC
Country
USA
2f. Fax Number:
r Yes r No
r Yes r No
4. Agent/Consultant (if applicable)

4a. Name:
Kim Williams
4b. Business Name:
Land Management Group
4c.Address
Street Address
3805 Wrightsville Avenue; Suite 15
Address Line 2
City
Wilmington
Postal / Zip Code
28403
4d. Telephone Number:
[phone]
4f. Email Address:*
[e-mail]
Agent Authorization Letter*
signed agent auth form.pdf
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(d appropriate)
1c. Nearest municipality/ town:
Hampstead
2. Project Identification
2a. Property Identification Number:
3282-97-5465-0000
2c. Project Address
Street Address
14810 US Hwy 17
Address Line 2
City
Hampstead
Postal / Zip Code
28443
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
UT to Mill Creek
3b. Water Resources Classification of nearest receiving water:*
SA; HOW
3c. What river basin(s) is your project located in?*
White Oak
3d. Please provide the 12-digit HUC in which the project is located.
030203020403
4. Project Description and History
State / Province / legion
NC
Country
USA
4e. Fax Number:
[phone]
2b. Property size:
0.94
State / Province / Fegion
NC
Country
USA
1.76MB
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 tract is undeveloped and mostly mowed. The majority of the site lacks a tree canopy and has a sparse shrub layer of wax myrtle. Trees are present along the northeastern,
eastern, and southeastern project boundaries. Some wetlands and a shallow swale are located in the eastern part of the tract. Another swale runs along the southeastern property line.
Adjacent land use is commercial to the north, a church to the east, undeveloped and mowed land to the south, and Highway 17 to the west.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
r Yes G No r Unknown
4d. 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)
Fig 2 Topo.pdf 232.46KB
V

4e. 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)
Fig 4 Soils.pdf 258.27KB
4f. List the total estimated acreage of all existing wetlands on the property:
0.25
4g. List the total estimated linear feet of all existing streams on the property:
N/A
4h. Explain the purpose of the proposed project:*
The purpose of the project is to construct a veterinary clinic to serve the needs of the community. Wetland impacts are needed to construct an emergency turn -around area.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
The project includes the construction of a 50' x 70' veterinary clinic, a 24-ft wide driveway, and 15 parking spaces behind the building. Note that parking cannot be located in front of the
building because of an existing billboard in this area. Additionally, a detention pond and emergency turn -around area will be located behind the building.
The building, parking, and emergency turn -around footprint will be cleared of vegetation and fill material will be brought into the site to level the area of disturbance. The pond,
structure, road, and parking area will then be constructed. Track hoe, loader, dump truck, bob cat, and other standard construction equipment will be used.
4j. Please upload project drawings for the proposed project.
WETLAND EXHIBIT 1.8.20.pdf 473.77KB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes C No C Unknown
Comments:
_MG delineated the site and submitted a JD request package to the USACE on
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
r Preliminary C Approved r Not Verified r Unknown C N/A
Corps AID Number:
_MG submitted a data package on 10/29/19 (Crestwood) and it was assigned SAW-2019-02091.
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Nick Howell
Agency/Consultant Company: Land Management Group
Other:
5d1. Jurisdictional determination upload
6. Future Project Plans
6a. Is this a phased project?*
C 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?
No
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
W Wetlands r Streams -tributaries r Buffers
r Open Waters r Pond Construction
2. Wetland Impacts
!a. Site #* (?) 2a1 Reason M 2b. Impact type * M f�e of W. 2d. W. name * 2e. Forested * 2f. Type of 2g. Impact
Jurisdicition * M area*
_11
Fill for road P Non-Riverine Swamp Forest WA No Both 0.160
(acres)
2g. Total Temporary Wetland Impact 2g. Total Permanent Wetland Impact
0.000 0.160
2g. Total Wetland Impact
0.160
2h. Comments:

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:
Because of the small size of the parcel, wetland avoidance was not possible. The proposed building and parking had to be pushed back off of Highway
17 because of an eAsting billboard. This put the turn -around area partially in wetlands. The number of parking spaces was minimized. Additionally, the
size of this turn -around area was minimized as much as possible while still leaving a large enough radius for vehicles.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
A stormwater plan and erosion control plan will be implemented to minimize secondary impacts from run off and erosion.
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
2c. If yes, mitigation is required by (check all that apply):
r DWR fJ Corps
2d. If yes, which mitigation option(s) will be used for this project?
W Mitigation bank r Payment to in -lieu fee r Permittee Responsible
program Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
Northeast Cape Fear Umbrella Mitigation Bank
3b. Credits Purchased/Requested (attach receipt and letter)
Type: Quantity:
Non -riparian wetland 0.2
Attach Receipt and/or letter
NECFUMB_Credit Reservation —Dante Martin Vet.pdf
159.98KB
3c. Comments
A ratio of just over 1:1 is proposed because the wetland impact area is degraded. A review of aerial photos shows that the site has been in a mowed
state since the early 1980s. Additionally, shallow swales along the southern and western project boundaries likely affect hydrology. Adjacent land use
is mostly developed and/or cleared.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
1. Diffuse Flow Plan
la. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection Rules?
r Yes r No
If no, explain why:
Site is located within the White Oak River Basin.
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 15ANCAC 02H .1003(2)?
r Yes r No
2c. Does this project have a stormwater management plan (SMP) reviewed and approved under a state stormwater program or state -approved local government stormwater
program?
r Yes r No
2d. Which of the following stormwater management programs) apply:
r Local Government V State
State Stormwater Programs
r Phase II FJ Coastal Counties
F HWQ or ORW r Other
Comments:
Engineer is currently preparing a store-mrater plan.

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
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification Rules (15ANCAC 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
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality?*
r Yes r No
3b. If you answered "no," provide a short narrative description.
Project will not provide access or utilities to adjacent properties. No additional wetland impacts are anticipated on the site.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
r Yes r Nor N/A
4b. Describe, in detail, the treatment methods and dispositions (non -discharge or discharge) of wastewater generated from the proposed project. If the wastewater will be treated
at a treatment plant, list the capacity available at that plant.
Project will tie into municipal wastewater treatment system.
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?*
r Yes r No r Unknown
Se. 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
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?
The NC Natural Heritage Program website was reviewed to determine the known presence of federally listed species. No federally protected species
are known to occur on or within a one -mile radius of this site. Since the lot is mostly cleared, it would not provide suitable habitat for the red -cockaded
woodpecker. A few trees exist on the perimeter of the site, which may support appropriate roosting habitat for the northern long-eared bat. Since no
hibernacula or roosting trees are known to occur in close proximity to the site, any effect to the species from tree clearing would be exempt per the
4(d) rule.
Consultation Documentation Upload
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?*
NOA EFH Mapper
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?*
r Yes
f• No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
The SHPO HPOWEB GIS website was reviewed. No historic or cultural resources were identified on or adjacent to the site. Two surveyed structures
were noted just north of the site. These structures were listed as ineligible for listing.
7c. Historic or Prehistoric Information Upload
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-yearfloodplain?*
r^ Yes IT No
8c. What source(s) did you use to make the floodplain determination?*
FEMA Flood Map Service Center website
Miscellaneous
Comments
Miscellaneous attachments not previously requested.
Fig 1 Vicinity Map.pdf 223.79KB
Fig 6 2016.pdf 251.83KB
Fig 7 Wetland Map.pdf 314.88KB
Signature
P 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:
Kimberlee C Williams
Signature
v� -,a ,was �foW., Pae.6
Date
1/16/2020

LMG
LAND MANAGEMENT GROUP
a GAkW#- company
AGENT AUTHORIZATION FORM
TO WHOM IT MAY CONCERN:
Uwe, the undersigned, hereby authorize Land Management Group to act as our agent in the determination
of jurisdictional wetland boundaries on the subject property, Crestwood Traci By way of this form, I/we
additionally authorize access to the site by representatives of the US Army Corps of Engineers and/or the
NC Division of Coastal Management for the purpose of reviewing the flaggedwetland boundary and
providing a final jurisdictional determination. Any questions regarding the jurisdictional wetland
determination should be directed to Land Management Group —A Davey Company.
Please provide the following information:
Property Address and Parcel ID Number: 1481OUS Highway 17• Hampstead, NC; 3282-97-5465-0000
Current Property Owner Name: LFM Holdings LLC c/o Dante Martin, DVM
Owner Address, Phone Number, & Email Address: 785 Chadwick Shores Drive; Sneads Ferry,
NC 28460• f910}526-3480• dante.martin.dvm(a,hotmail.cotn
Notice: This authorization, for liability & professional courtesy reasons, is valid only for government officials to enter th e
property when accompanied by Land Management Group staff. Please call LMG to arrange a site meeting prior to
visiting the site.
-DikIA t,C �A Nf LT l to
Print Owner's Name
Owner's Signature
10 12211°l
Date
www.lmtiroup.net -Phone: [phone] -Fax: [phone]
3805 Wrightsville Avenue, Suite 15, Wilmington, NC 28403

PROJECT AREA
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NORTHEAST CAPE FEAR UMBRELLA MITIGATION BANK
Agent: Land Management Group 3805
Wrightsville Avenue, Suite 15 Wilmington,
NC 28403
Credit Reservation Letter
January 16, 2020
LFM Holdings, LLC
785 Chadwick Shores Drive
Sneads Ferry, NC 28460
Project: Dante Martin Vet Clinic — Pender County, INC
Dear LFM Holdings, LLC:
Per the request submitted by agent Kim Williams of Land Management Group dated January 16, 2020, the
Northeast Cape Fear Umbrella Mitigation Bank (Bank) is providing preliminary acceptance to supply
mitigation credits for proposed impacts to non -riparian wetlands associated with the Dante Martin Vet
Clinic project located in Pender County, NC (conditional upon receipt of payment as outlined below).
Please refer to the table below depicting the type and quantity of credits requested and reserved for your
project.
Mitigation Type
Stream
Credit Source
Credits Reserved
Fee Per Unit Fee
$525.65 $0.00
N/A
0.0
Non- Riparian Wetland
Holly Shelter Bay
0.2
$52,273.99
$10,454.80
Riparian Wetland
N/A
0.0
$52,273.99 $0.00
Total $10,454.80
Based upon receipt of the credit request, the Bank will reserve 0.2 non -riparian wetland credits for a period
of up to 90 days from the date of this letter. Note that requests to reserve credits beyond 90 days will
require a deposit. Please contact us if you need a reservation to extend beyond the 90-day period.
Upon request for credit transfer, the Bank will issue an invoice in the amount of $10,454.80. Upon receipt
of payment, the Bank will provide an executed Transfer of Credit Certificate for the total amount of credits
invoiced and paid for. If you have any questions or need additional information, please contact me by
phone at [phone] or by email at [e-mail].
Sincerely,
Northeast Cape Fear Umbrella Mitigation Bank
-0
Christian Preziosi
Land Management Group (agent)
Northeast Cape Fear Umbrella Mitigation Bank 1
c/o Land Management Group
3805 Wrightsville Avenue, Suite 15
Wilmington NC 28403