20200882 Ver 1_401 Application_20200707

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
20200882
Is a payment required for this project?*
r No payment required
r Fee received
r Fee needed - send electronic notification
Select Project Reviewer*
Stephanie Goss:eads\szgoss
Information for Initial Review
la. Name of project:
COURTESY COPY - West Rip Wrap
1a. Who is the Primary Contact?*
Frank Stoltmann Traditional Southern Construction
1b. Primary Contact Email:*
[e-mail]
Date Submitted
7/7/2020
Nearest Body of Water
Hyco Lake
Basin
Roanoke
Water Classification
roa
Site Coordinates
Latitude:
36.498474
A. Processing Information
County (or Counties) where the project is located:
Person
Is this a NCDMS Project
r Yes r No
Longitude:
-79.148904
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*
Raleigh Regional Office - [phone]
1c. Primary Contact Phone:*
[phone]
U
1b. What type(s) of permit(s) do you wish to seek authorization?

r Nationwide Permit (NWP)
r Regional General Permit (RGP)
W Standard (IP)
1c. Has the NWP or GP number been verified by the Corps?
r Yes r No
1d. Type(s) of approval sought from the DWR:
r 401 Water Quality Certification - Regular P 401 Water Quality Certification - Express
r Non-404 Jurisdictional General Permit r Riparian Buffer Authorization
r Individual Permit
le. Is this notification solely for the record because written approval is not required?
For the record only for DWR401 Certification: r Yes r No
For the record onlyfor Corps Permit: r Yes r No
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?
C 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:
William West
2b. Deed book and page no.:
1004 672
2c. Responsible party:
Traditional Southern Construction
2d.Address
Street Address
800 McGhees Mill rd
Address Line 2
CRY
Roxboro
Postal / Zip Code
27343
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
Frank Stoltmann
3b. Business Name:
Traditional Southern Construction
3c.Address
State / Province / Region
NC
Country
Person
2f. Fax Number:
u

Street Address
800 McGhees Mill Rd
Address Line 2
City
Roxboro
Postal / Zip Code
27343
3d. Telephone Number:
[phone]
3f. Email Address:*
[e-mail]
State / Rwince / Rion
NC
Country
Person
3e. Fax Number:
C. Project Information and Prior Project History U
1, Project Information
1b. Subdivision name:
(d appropriate)
Whetstone
1c. Nearest municipality/ town:
Roxboro
F-
2. Project Identification
2a. Property Identification Number:
A24 213
2c. Project Address
Street Address
65 Freckled Point
Address Line 2
aty
Senora
Postal / Zip axle
27343
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Hyco Lake
3b. Water Resources Classification of nearest receiving water:*
roa
3c. What river basin(s) is your project located in?*
Roanoke
3d. Please provide the 12-digit HUC in which the project is located.
030101040505
4. Project Description and History
2b. Property size:
1.02
State / Province / legion
NC
Country
Person
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 lot is located on hyco lake and was previously undeveloped. The lot is being developed and rip wrap needs to be added along the shoreline to eliminate potential erosion of bank
due to boat traffic.
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)
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)
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:
0
4h. Explain the purpose of the proposed project:*
Install rip wrap to bank along lake

41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
Stone rip wrap will be added to the shoreline to prevent erosion. The stone will be installed along with fabric using a backhoe and manual labor.
4j. Please upload project drawings for the proposed project.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes r No O 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
1a. Where are the impacts associated with your project? (check all that apply):
❑ Wetlands r Streams -tributaries r Buffers
❑ Open Waters r Pond Construction
E. Impact Justification and Mitigation U
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
Minimal machinery Wil be used to deliver and place stone
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Any and all tracks will be repaired
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:
this is typical rip wrap used for homes along Hyco Lake
F. Stormwater Management and Diffuse Flow Plan (required by DWR) u
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
If no, explain why:
It is along Hyco Lake

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 15A NCAC 02H .1003(2)?
r Yes r No
Comments:
G. Supplementary Information
1. Environmental Documentation
la. 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 21-1.0500), 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.
This is a one time only application of rip wrap
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
r Yes r Nor WA
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
5e. 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
5i. 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?
There are no identified endangered species at hyco lake
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?*
Hyco lake is not an 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 status?*
r Yes r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
Hyco lake does not have cultural preservation status
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 r No
8c. What source(s) did you use to make the floodplain determination?*
gis
Miscellaneous U
Comments
Miscellaneous attachments not previously requested.
Signature u
W 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:
Frank Stoltmann
Signature
.i� C5��I r
Date
7/7/2020