20200808 Ver 1_401 Application_20200617

DWR
mrlslon of Water Resources
Pre -Construction Notification (PCN) Form
April 11, 2020 Ver 3.1
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?*
C Yes r No
Change only if needed.
BIMS # Assigned
20200808
Is a payment required for this project?*
r No payment required
r Fee received
r Fee needed - send electronic notification
Select Project Reviewer*
Kaylie Yankura:eads\kyankura
Information for Initial Review
la. Name of project:
COURTESY COPY - Tillery - Walkingstick Road
1a. Who is the Primary Contact?*
Julie Tillery
1b. Primary Contact Email:*
[e-mail]
Date Submitted
6/17/2020
Nearest Body of Water
Big Creek
Basin
Savannah
Water Classification
C;Tr,ORW
Site Coordinates
Latitude:
35.022915
A. Processing Information
County (or Counties) where the project is located:
Macon
Is this a NCDMS Project
r Yes r No
Longitude:
-83.163094
Is this project a public transportation project?*
r Yes r No
la. 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)
Version#*
1
Reviewing Office*
Asheville Regional Office - [phone]
1c. Primary Contact Phone:*
[phone]
1b. What type(s) of permit(s) do you wish to seek authorization?

W Nationwide Permit (NWP)
r Regional General Permit (RGP)
r Standard (IP)
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:
F 401 Water Quality Certification - Regular
r Non-404 Jurisdictional General Permit
W Individual Permit
le. Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification:
For the record only for Corps Permit:
F- 401 Water Quality Certification - Express
F- 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
1j. Is the project located in a designated trout watershed?
r Yes r No
B. Applicant Information
1d. Who is applying for the permit?
R Owner W 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:
Highlands Hospitality LLC
2b. Deed book and page no.:
2 parcels - V-39/1487
2c. Responsible party:
David King
2d.Address
Street Address
PO Box1154
Address Line 2
city
Highlands
Postal / Zip Code
28741
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
State / Rovince / legion
NC
Country
USA
2f. Fax Number:
r Yes r No
r Yes r No
3. Applicant Information (if different from owner)

3a. Name:
Julie Tillery
3b. Business Name:
3c.Address
Street Address
PO Box2313
Address Line 2
City
Highlands
Postal / Zip Code
28741
3d. Telephone Number:
[phone]
3f. Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(d appropriate)
1c. Nearest municipality/ town:
Highlands
Project Identification
2a. Property Identification Number:
7458397349,7458490407
2c. Project Address
Street Address
Walkingstick Road
Address Line 2
City
Highlands
Postal / Zip Code
28741
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Big Creek
3b. Water Resources Classification of nearest receiving water:*
C;Tr,ORW
3c. What river basin(s) is your project located in?*
Savannah
3d. Please provide the 12-digit HUC in which the project is located.
030601020202
4. Project Description and History
State / Province / F bgion
NC
Country
USA
3e. Fax Number:
2b. Property size:
5.3
State / Province / legion
NC
Country
USA
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:*
This is vacant wooded land adjacent to residential homes and National Forest. The permit is sought so a driveway to a house site can be installed.
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)
Map for Water Permit.pdf
253.25KB
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)
IMG_3624(5).pdf 175.7KB
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:
800
4h. Explain the purpose of the proposed project:*
To install a culvert for a driveway to reach house site.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
We are installing a driveway which will require a culvert (proposed 4' x 20') to cross a small creek in order to reach a house site. Large rocks will also be used on either side of the
culvert. The process requires the removal of trees and shrubs in the driveway area. The creek bed is approbmately 3' deep allowing the culvert to be imbedded 1' into the ground. The
culvert will allow cars and construction vehicles access so that building can take place.
4j. Please upload project drawings for the proposed project.
Site Map for Water Permit.pdf 180.6KB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes r No M 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:
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
5d1. Jurisdictional determination upload
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 project or related activity?
D. Proposed Impacts Inventory
1. Impacts Summary
la. Where are the impacts associated with your project? (check all that apply):
r Wetlands W Streams -tributaries
r Open Waters r Pond Construction
3. Stream Impacts
r Buffers
U
3a. Reason for impact (?) 3b.lmpact type * 3c. Type of impact * 3d. S. name * 3e. Stream Type * 3f. Type of 3g. S. width * 3h. Impact :1
(?) Jurisdiction* length*
1
Culvert installation Permanent Culvert JUT1 Perennial DWR 5 24 Average(feet) (linearfeet)
31. Total jurisdictional ditch impact in square feet:
0
31. Total permanent stream impacts:
24
31. Total stream and ditch impacts:
24
3j. Comments:
31. Total temporary stream impacts:
0
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:
As there is only one way onto the property, crossing creek(s) cannot be avoided. The driveway was designed so that it only crosses one creek.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Silt fences backed by straw bales will be installed to avoid debris going into the water.
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 f• No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
We will not be disturbing more than 10 % of the length of the creeks.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
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
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
Comments:
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)
U
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 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.
A single building site is planned and we want to make sure water quality is not impaired.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
r Yes r No r 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 r No 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?
U.S. Fish & Wildlife Service, ECOS (Environmental Conservation Online System), studied ECOS maps in detail.
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?*
NOAA Habitat Conservation
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 r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
Local Historical Society
7c. Historic or Prehistoric Information Upload
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
r Yes r No
8c. What source(s) did you use to make the floodplain determination?*
Online FEMA maps
Miscellaneous
Comments
I am unsure of howto answer 1b-e and F1a.
We look forward to maintaining the land and water qualities, as we love the natural beauty of the place.
Miscellaneous attachments not previously requested.
Signature
*
PJ 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:
Julie Tillery
Signature
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Date

6/17/2020

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