20191642 Ver 1_Pre-Construction Notification (PCN) Form_20200226

DWR
mwlslon of Water Resources
Pre -Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
September 29, 2018 Ver 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.
hfps://edocs.deq.nc.gov/WaterResouroes/O/edoc/624704/PCN % 20Help / 2OFile % 202018-1-30.pdf
A. Processing Information v
County (or Counties) where the project is located:*
Buncombe
Is this project a public transportation project?*
r Yes r No
This is any publicly funded by rrunicipaistate or federal funds road, rail, airport transportation project.
1a. Type(s) of approval sought from the Corps:*
• Section 404 Permit (wetlands, streams and waters, Clean Water Act)
• Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
1b. What type(s) of permit(s) do you wish to seek authorization?*
V Nationwide Permit (NWP)
r Regional General Permit (RGP)
r Standard (IP)
This form may be used to initiate the standard/individual permit process with the Corps. Please contact your Corps representative concerning submittals for standard permits. All required items that
are not provided in the E-PCN can be added to the miscellaneous upload area located at the bottom of this form.
1c. Has the NWP or GP number been verified by the Corps?*
r Yes IT No
Nationwide Permit (NWP) Number: 12 - Utility Lines
NWP Numbers (for multiple NWPS):
List all NN nunbers you are applying for not on the drop dawn list.
1d. Type(s) of approval sought from the DWR:*
check all that apply
17 401 Water Quality Certification - Regular F' 401 Water Quality Certification - Epress
r Non-404 Jurisdictional General Permit F' Riparian Buffer Authorization
r Individual Permit
le. Is this notification solelyfor the record because written approval is not required?
*
For the record onlyfor DWR 401 Certification: O Yes r No
For the record onlyfor Corps Permit:
1f. Is this an after -the -fact permit application?*
r Yes r No
O Yes r No
1g. 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
r Yes r No
Acceptance Letter Attachment
Qick the upload button a drag and drop files hereto attach document
FILEiYFEM-STBEFDF
1h. Is the project located in any of NC's twenty coastal counties?*

r Yes r No
1j. Is the project located in a designated trout watershed?*
r Yes r No
Link to trout information: http://www..saw.usace.army.mil/Missions/Regulatory-Permit-ProgranvAgency-Coordinationrrrout.aspx
B. Applicant Information
la. Who is the Primary Contact?*
Shaun Armistead
1b. Primary Contact Email:*
[e-mail]
Ild. Who is applying for the permit?*
r- Owner
(Check all that apply)
1e. Is there an Agent/Consultant for this project?*
r Yes r No
2. Owner Information
2a. Name(s) on recorded deed:*
Buncombe County Schools
2b. Deed book and page no
2c. Responsible party:
(far Corporations)
2d.Address*
Street Address
250 Overlook Rd
Address Line 2
city
Asheville
Fbstal / Zip Code
28803
2e. Telephone Number:*
(xxx)xxx-xxxx
[phone]
2f. Fax Number:
(xxx)xxx-xxxx
2g. Email Address:*
[e-mail]
3. Applicant Information (if different from owner)
3a. Name:*
Shaun Armistead
3b. Business Name:
(if applicable)
Metropolitan Sewerage District of Buncombe County, NC
3c. Address*
Street Address
2028 Riverside Dr
Address Line 2
City
Asheville
Fbstal / Zip Code
28806
3d. Telephone Number:*
[phone]
(xxx)xxx-xxxx
3f. Email Address:*
1c. Primary Contact Phone:*
(xxx)xxx-xxxx
[phone]
V Applicant (other than owner)
State / Rovince / Fbgion
NC
Country
us
State / Rovince / Pegion
NC
Country
us
3e. Fax Number:
(xxx)xxx-xxxx
[e-mail]

C. Project Information and Prior Project History
1. Project Information U
1a. Name of project:*
Springside Rd @ Overlook Rd Sewer Rehabilitation
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality/ town:*
Asheville, NC
2. Project Identification
2a. Property Identification Number:
2b. Property size:
(tax RN parcel ID)
(in acres)
2c. Project Address
Street Address
Address tine 2
Oty
State / Rovince / legion
Postal / Zip Code
Country
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 howthe 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:*
35.489482-82.534512
ex: 34.208504-77.796371
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Lake Julian
3b. Water Resources Classification of nearest receiving water:*
C
Surface Water Lookup
3c. What river basin(s) is your project located in?*
French Broad
3d. Please provide the 12-digit HUC in which the project is located.*
060101050704
River Basin Lookup
4. Project Description and History
4a. Describe the existing conditions on the site and the general land use in the vicinityof the project at the time of this application:*
Site is developed residential and institutional usage. Portions of the creek are pipe underground.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
r Yes r 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)
Click the upload button or drag and drop files here to attach docurrent
USGS TOPO SPRINGSIDE.pdf 567.12KB
File type rust be pdf
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)
Click the upload button or drag and drop files here to attach cmurrent
Soil Map Springside.pdf 643.9KB
File type rust be pdf
4f. List the total estimated acreage of all existing wetlands on the property:
0
4g. List the total estimated linear feet of all existing streams on the property:
(interrittent and perennial)
2400

4h. Explain the purpose of the proposed project:*
This project will replace an aging 6" and 8" clay sewer pipe line in poor shape with a new 8" and 12" ductile iron sewer pipe. This project aims to reduce the number of sanitary sewer
overflows experienced in the area.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
This project will be replacing a sanitary sewer pipe line via dig and replace method, using tracked mechanical digging equipment.
4j. Please upload project drawings for the proposed project.
pick the upload button or drag and drop files here to attach docur ent
Springside @ Overlook - 2012127_Signed 3-22-2019.pdf 32.18MB
File type rust be pdf
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes r No G Unknown
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
r Preliminary r Approved r Not Verified r Unknown r N/A
Corps AID Number:
Ea,ple: SAW-2017-99999
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
5d1. Jurisdictional determination upload
Qick the upload button a drag and drop files hereto attach docurrent
File type rust be P7
6. Future Project Plans
6a. Is this a phased project?*
r 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 projector 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 r 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.
"S." will be used in the table below to represent the word "stream".
3a. Reason for impact* (?)
3b.lmpact type *
3c. Type of impact*
3d. S. name*
Stream Type *
3f. Type of *
3g. S. width*
3h. Impact
S1
seIS11wer line crossing STA 19+00
Temporary
Excavation
:J
unnamed
I
Intermittent
Both
10
Average (fed)
10
feet)
(linear
S2
sewer line crossing STA 20+g0
Temporary
Excavation
unnamed
Intermittent
Both
10
Aver feet
10
linear feet
S3
sewer line crossing STA 28+80
Temporary
Excavation
unnamed
Intermittent
Both
10
10
Average feet
Inearfeet
S4
sewer line construction
Temporary
Excavation
unnamed
Intermittent
Both
10
Aver a feet
10
linearfeet
"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:
20
31. Total temporary stream impacts:

31. Total stream and ditch impacts:
20
3j. 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:*
Creek crossings were kept to a minimum by keeping the proposed sewer line on one side of the creek where possible.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*
Construction crewwjll be bypassing any creek water around the job site to avoid contamination. Coir matting will be installed to restore the creek
banks after construction is complete.
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:
Below size limits
NC Stream Temperature Classification Maps can be found under the Mitigation Concepts tab on the Wilmington District's RIBITS website.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
*** Recent changes to the storn inter 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?
r Yes r No
For a list of options to meet the diffuse Flow requirements, click here.
If no, explain why:
It is not located in the riparian buffer protection area.
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
To look up low density requirement click here 15A NCAC 02H .1003(2).
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
Hint: projects that have vested rights, exemptions, or grandrathering fro nttate a locally implemented stormaater programs or projects that satisfy state a locally-irrplenwted stanwater programs through use of oammnity in -lieu programs should answer no
to this question.
3. Stormwater Requirements
3a. Select whether a completed stormwater management plan (SMP) is included for review and approval or if calculations are provided to document the project will not cause
degradation of downstream surface waters.*
r Stormwater Management r Antidegradation
Plan Calculations
3b. Stormwater Management Plan: If submitting a SMP for review and approval, it shall complywith the high -density development requirements set forth in 15A NCAC 02H .1003.
Include all appropriate stormwater control measure supplemental forms and associated items.
Click the upload button or drag and drop files here to attach document
FILETYFEM13TBEFCF
3c. Antidegradation Calculations: If submitting calculations to document the project will not cause degradation of downstream surface waters, the documentation shall include a
detailed analysis of the hydrological impacts from stormwater runoff when considering the volume and velocity of stormwater runoff from the project built upon area and the size
and existing condition of the receiving waterbody(ies).
Click the upload button or drag and drop files here to attach docum3l
RLETYFEM15TIBERIT
Comments:

G. Supplementary Information u
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 (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
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?*
r Yes r No
3b. If you answered "no," provide a short narrative description.
Area is already developed, and replacement of this sever line is unlikely to increase development.
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
5d. Is another Federal agency involved?*
r Yes IT No
5e. Is this a DOT project located within Division's 1-8?*
r Yes r No
5f. Will you cut anytrees 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_ NLEBSLOPES&apps.pdf
Sh. Does this project involve the construction/installation of a wind turbine(s)?**
r Yes r No
r Unknown
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 website, including GIS map of critical habitats and a check of potential endangered species' locations.
Consultation Documentation Upload
dick the upload button or drag and drop files here to attach docunent
Critical Habitat for Threatened & Endangered Species [USFWSj.pdf 526.45KB
Re type rust be PCF
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?*
https://www.fisheries. noaa. gov/natio na I/habitat-conservation/essential-fish-habitat#esse ntial-fish-habitat-mappe r
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/hpomb/
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?*
hftp://gis.ncdcr.gov/hpovveb/
7c. Historic or Prehistoric Information Upload
dick the upload button or drag and drop files here to attach document
Historical Preservation map.pdf
File rrust be FOF
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-yearfloodplain?*
r Yes r No
8c. What source(s) did you use to make the floodplain determination?*
FEMA Floodplain map
Miscellaneous
Comments
Miscellaneous attachments not previously requested.
Oick the upload button a drag and drop files here to attach document
Fie crust be FCFa KNE
Signature
*
W By checking the box and signing below, I certify that:
845.67KB
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:*
Shaun Armistead
Signature
Aga 4vk w
Date
11/27/2019
u