20200908 Ver 1_401 Application_20200710

Staff Review
Does this application have all the attachments needed to accept it into the review process?*
r Yes r No
ID#*
20200908
Version* 1
Is this project a public transportation project?* r Yes
r No
Reviewer List:* Stephanie Goss: eads\szgoss
Select Reviewing Office:* Raleigh Regional Office - [phone]
Submittal Type:* 401 Application
Does this project require a request for payment to be sent?*
r
Yes
r
No
How much is r $240.00
owed?* r $570.00

Project Submittal Form
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.
Project Type: * 6- New Project r New Project w Existing ID
r Pre -Application Submittal r More Information Response
r Other Agency Comments r Stream or Buffer Appeal
r For the Record Only (Courtesy
Copy)
New Project - Please check the new project type if you are trying to submit a new project that needs an official approval
decision.
Pre -Application Submittal - Please check the pre -application submittal if you just want feedback on your submittal and
do not have the expectation that your submittal will be considered a complete application requiring a formal decision.
More Information Response - Please check this type if you are responding to a request for information from staff and
you have and ID# and version for this response.
Other Agency Comments - Please check this if you are submitting comments on an existing project.
Project Contact Information
Name: Mr. Salvador Garcia
Who is submitting the information?
Email Address: [e-mail]
Project Information
Project Name: Garcia Home
Is this a public transportation project?
r Yes
r No
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
r Yes r No r Unknown
County (ies)
Johnston
Please upload all files that need to be submited.
Click the upload button or drag and drop files here to attach document
Pre -Construction (PCN).pdf 5.86MB
SAW-2020-01013_173 Old Evans Road_lmpacts.pdf 520.6KB
SAW-2020-01013 173 Old Evans
513.54KB
Road_Wetlands.pdf
Only pdf or kTz files are accepted.
Describe the attachments
or comments:
USACE Visited the site and determined the extent of wetlands on June 8 to establish wetland/stream extents.
Mapping and impacts provided were prepared by Chris Hopper with the USACE.
Sign and Submit

P By checking the box and signing box below, I certify that:
o I have given true, accurate, and complete information on this form;
o I agree that submission of this form is a "transaction" subject to Chapter 66, Article 40 of the NC General Statutes (the
"Uniform Electronic Transactions Act")
o 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');
o I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature; AND
o I intend to electronically sign and submit the online form."
Signature:
�7trr.;1?
Submittal Date: 07-10-2020
Is filled in automatically.

O"Of W A �FgOG
h
MIA �
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:
® Section 404 Permit ❑ Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: 29 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps?
❑ Yes ❑ No
1 d. Type(s) of approval sought from the DWQ (check all that apply):
® 401 Water Quality Certification — Regular ❑ Non-404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ 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 ® No
For the record only for Corps Permit:
❑ Yes ® No
1f. Is payment into a mitigation bank or in -lieu fee program proposed for
mitigation or impacts? If so, attach the acceptance letter from mitigation bank
or in -lieu fee program.
❑ Yes ® No
1 g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below.
❑ Yes ® No
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes ® No
2. Project Information
2a. Name of project:
173 Old Evans Road
2b. County:
Johnston County
2c. Nearest municipality / town:
Town of Clayton
2d. Subdivision name:
2e. NCDOT only, T.I.P. or state project no:
3. Owner lnformatlon
3a. Name(s) on Recorded Deed:
Salvador Garcia Ba►ajas
3b. Deed Book and Page No.
Book 05250 Page 0103
3c. Responsible Party (for LLC if
a icabie):
3d. Street address:
5408 Massengill Court
3e. City, state, zip:
Garner, NC 27529
3f. Telephone no.:
919-696-1744
3g. Fax no..
3h. Email address:
Salvador26150gmail.com
Page 1 of 10
PCN Form — Version 1.4 January 2009

4. Applicant Information (if different from owner)
4a. Applicant is: ❑ Agent ® Other, specify: Owner
4b. Name:
4c. Business name
(if applicable):
4d. Street address:
4e. City, slate, zip:
V. Telephone no.:
4g. Fax no.:
4h. Email address*.
S. Agent/Consultant Information Of applicable)
Sa. Name:
None
5b. Business name
(if applicable):
5c. Street address:
5d. City, stale, zip:
5e. Telephone no.:
5f. Fax no.:
5g. Email address:
paw 2 d 10

B. Project Information and Prior Project History
------- --- -- ---- -- --------------- -- - - -
1. Property tdentif'ication -- - - - -----
la. Property identification no. (tax PIN or parcel 10): 163800-60-5788
1b. Site coordinates (in decimal degrees): Latitude: 35.169992 1 ongitude:-78.540079
1c_ Property size:
1.88 acres
2. Surface waters
----
2a. Name of nearest body of water to proposed project:
UT Swift Creek (27-43-(8))
2b. water Quality Classification o1 nearest receiving water:
C; NSW
2c. River basin:
Neuse River Basin
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:
The site is undeveloped and recently cleaned of woody vegetation. An intermittent tributary flows from north to south across the center of the tract, and'
feeds ruo a large emergent wetland with no discernible channel evident Land use in the vicinity of the project is residential
3b. List the total estimated acreage of all existing wetlands on the property: 0.65
3c. last the total estimated linear feet of all existing streams (intermittent and perennial) on the property: 315
3d. Explain the purpose of the proposed project:
The project would construct a residential structure on the lot- The site would be served by septic system_
3e. Describe the overall project in detail, including the type of equipment to be used:
Light construction vehicles would be utilized to construct the structure and prepare the site for devefopmenL No equipment operation within lunsdkwns
4. Jurisdictional Determinations
�
4a. Have jurisdictional wetland or stream determinations by the
❑ Yes ® No ❑ Unknown
Corps or State been requested or obtained for this property /
Comments:
project (includingall prior phases) in the st?
i 4b. If the Corps made the jurisdictional determination, what type
❑ preliminary ❑ Final
of determination was made?
4c. If yes, who delineated the jurisdictional areas?
AgencylConsultant Company: USACE
Name (R known): Chris Hopper
Other:
i 4d. If yes, List the dates of the Corps jurisdictional determinations or State determinations and attach tlgcumentauon.
Chris Hopper with the USAGE, Raleigh Regulatory Field Oltice, visited the site on June 8. 2020 to review the property and conrirm the prt-sense of
st-eam arr0 wetland resources
S. Project History -- - - - - -' - - - ---'4
5a. Have permits or certifications been requested or obtained for
[I Ye ® No ❑ Unknown
this project (including all prior phases) in the past?
5b. If yes, explain in detail according to `help file' instructions-
G. Futtre Project Plans
6a. Is this a phased project? [] Yes ®No
6b, If yes, explain.
Page 3 of 10
PC Form - Version 1 4 January 2009

C. Proposed Impacts Inventory
1. impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
❑ Wetlands ❑ Streams - tributaries ❑ 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
2b.
Type of impact
2c. --
Type of wetland
M7
Forested
2e.
Type of jurisdiction
Corps (404,10) or
DWQ (401, other)
2f.
Area of
impact
(acres)
Wl P
"I 1W
Bottomland Hardwood Forest 1W
Yes 'w
Corps W
0.08
W2
Choose one mr
Choose one qr
Yes/No IW
I
W3 7
Choose one w
Choose one 1W
Yes/Now
I
W4
Choose one w
Choose one qW
Yes/No w
WS - 1W
Choose one w
Choose one 1W
Yes/No "W
I
W6 - 1W
Choose one r
Choose one W
T Yes/No �w
I
2g. Total Wetland Impacts:
I OM
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 M
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)
S 1 1W
Choose one W
I
S2 'qr
Choose one IV
S3 -
Choose one 1W
r►
I
S4 1W
Choose one '
1W
S5 - 1W
Choose one 1W
- 1W
S6 1W
Choose one 'W
3h. Total stream- and tributary impacts
------ -
-------
3i. Comments:
None
Page 4 of 10
PCN Form - Version 1.4 January 2009

4. Open Water Impacts
If there are proposed impacts to lakes, ponds, eswaries, tributaries, sounds, the AUanlic Ocean, or any other open water of
the U.S. then indiv ually 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 W
Choose w
02
Choose one w
Choose w
03
Choose one W
choose w
04
Choose one 7
Choose w
4f. Total open water impacts
4g. Comments: None
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 w
P2
Choose one 14V
5f. Total:
59. 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):
Sk. 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 miti ation, 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
6c.
Reason for impact
6d.
Stream name
-
6e.
Buffer
mitigation
required"?
_—
6f.
Zone 1
impact
(square
feeq
6g.
Zone 2
Impact
(square
feet) I
�1
B1
Yes!NoW
B2
Yes/Phw
--
B3 - rr
--
---- ---
- Yes/Now
---
--.—
B4
-
YeslNow
B5
YtsdNow
Yes/Now
B6 W
- ---- -
--
6h Total Buffer Impacts:
61. Comments. None- Johnston CEMAKted.
Page 5 of 10

D. Impact Justification and Mitigation
1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minlmi7e the proposed irnpacts in designing project.
The home site m being hlnnncd to minimize nnluico to wellnnd nrens while also lair wrvinq likely ijilabin cepirc arras requirad lot ire or this lot
Impacts have been kept below 0.1 acre of wetlnnd, and nil stream impnct . linep been avoided try Itw'k-sign
1b. Specifically describe measures taken to avoid or minimize the proposed impacts Through construction techniques
Fill maRnal bought in to construct the hone will be gtoded and Stabilized. Erosion and sediment contrnl measrwes will Ir rn•.tntlncf Ancl maintained
until vegetation is established to stabilize disturbed soil- No consiniclion equipment would be nllowed to operate in jurisdictional mens
2. ComL)ensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
—
2a. Does the project require Compensatory Mitigation for ❑ Yes ® No
impacts to Waters of the U.S. or Waters of the State?
2b. If yes, mitigation is required by (check all that apply):
❑ DWQ ❑ Caps
❑ Mitigation bank
2c. If yes, which mitigation option will be used for this
ElPayment to in -lieu fee program
!
pry
❑ Permittee Responsible Mitigation
3. lete if Using a Miti atign Bank
3a- Name of Mitigation Bank:
Type: Choose one 'w Quantity:
3b. Credits Purchased (attach receipt and letter) Type: Choose one 1w Quantity:
i
Type: Choose one 'w Quantty:
3c. Cornrnents:
i
4, CoMilete if Making a PayMent to In -lieu Fee Pr ram
J
4a. Approval letter from in -lieu fee program is attached.
❑ Yes
4b Stream mitigation requested:
linear feet
a-s+ng stream mitigation. stream temperature: Choose one
-4-c-.-rf
14o titarrer mm"ion requested (DWO only}: square feel
- -
— - - - -- - -
4Q Riparian wetland rnaigation requested: acre
4f Non -riparian wetland mitigation requested- acres
----�
4g Coastal (tidaQ wetland mitiWilmn requested: dcreS -- --.-_----_.__�
4h Comments
5. CotmpIete if Using a Permutes Responsible Mitigation Man _
5a. If using a perminee responsible nutigation plan. provide a dwscnptron of the prupo,.�ed mdKjatarn plan
4
paw 6 of 10
PCN i urm - Vef%min 1 4 )artudry 20M

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 ❑ 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
❑ Yes
❑ No
within one of the NC Riparian Buffer Prolecllon Rules?
1b.
If yes, then is a diffuse flow plan included? If no, explain why.
❑ Yes
❑ No
2.
Stormwater Manag_ernent Plan
2a.
What is the overall percent imperviousness of this project?
%
j 2b.
Does this nj2ct require a Stormwater Management Plan?
❑ Yes
❑-No
2c.
tf this project DOES NOT require a Stormwater Management Plan, explain why:
1
2d.
If this project DOES require a Stormwater Management Plan, then provide a brief, narrative
description of the plan:
11
1
12e.
Who w o be responsible for the review of the Stormwater Management Plan?
—i
3.
certified Local Government Stormwater Review
3a.
In which local qavemment's murisdicdon is this project?
_
❑ Phase II
3b.
Which of the following locally -implemented stormwater management programs
❑ NSW
USMP
i
apply (check all that apply)_
Water Supply Watershed
❑ Other
3c-
Has the approved Stormwater Management Plan with proof of approval been
❑ Yes
❑ No
attached?
I} 44, DWQ Stormwater Pro am Review
—_----_--- -- --#
❑Caastal counbes
❑i-+uW
4a.
Which of the foKa"q state -implemented stormwater management programs apply
ORW
85r7s�un
(check all that apply):
Law
2006-246
❑(Ah
4b-
Has Vw approved Stormwater Management Plan with prod of approval been
❑ Ye.,
❑ Wo !
attaclrwd7
-- - - -
- - - - i
5. DWQ 401 Unit Stormwater Review
i
5a.
Does the Stnrrnwater Managerry nt Plan meel the apprupnate regkwuffents?
— -
❑ Yc,'s
❑ Nu
5b.
Have all of the 401 Una submital n.4girremerts barn and ?
0 Y4's
❑ No
Page a vl 10
PCN Fcom - Versxm 1 4 Janwy 2009

F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
la. Does the project involve an expenditure of public (federallstate/local) funds or the
❑ Yes X❑ No
use of public (federal/state) land?
1b. 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)?
1c. 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 ❑ No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. Is this an after -the -fact permit application?
® Yes ❑ No
2c. If you answered 'yes' to one or both of the above questions, provide an explanation of the violation(s):
Clearing and fill within 0.08 acre of wetland has occurred. The landowners were unaware of regulations protecting these resources, have self -reported,
and are working with agencies to bring the site into compliance. Impacts will be limited to only the minimum necessary to construct the home site, and
would not exceed mitigation thresholds (0.1 acre of wetland). No stream impact has occurred or will be required.
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in
❑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.
The sire would be servedJby an individual on -site septic system. Designs to secure County approval are currently being finalized.
Page 9 of 10
PC 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 ❑ No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act
® 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 IPaC (Information for Planning and Consultation) website. httpsJlecos.fws.gov/iipac
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?
❑ Yes ® No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
https:/Iwww.habitaLnoaa.gov/applicaUorVefhrnapperfindex.htmi
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 ❑ 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?
INC SHPO HPOWEB 2.0 (httpsl/nc.maps.arcgis.cwwapps/webappviewer)
B. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?
❑ Yes ® No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the tloodplain determination?
North Carolina Flood Risk Information System (fds.nc.govlfris) Map Number 3120163800 K, Panel 1638
&,flrcl n at Ir",
Applicant/AgeriVs Printed Name
Applicant/Agent's Signature
Date
(Agent's signature is valid only if an authorization
letter from the applicant is
Page 10 of 10

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to be removed or
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+ Approximate Fill Area:
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