20200936 Ver 1_401 Application_20200720

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
20200936
Is a payment required for this project?*
r No payment required
r Fee received
r Fee needed - send electronic notification
Select Project Reviewer*
Amy Annino:eads\amannino
Information for Initial Review
1a. Name of project:
COURTESY COPY - Residence
1a. Who is the Primary Contact?*
Roger Hendrick
1b. Primary Contact Email:*
[e-mail]
Date Submitted
7/20/2020
Nearest Body of Water
Lake James
Basin
Catawba
Water Classification
Lake
Site Coordinates
Latitude:
35.782169
A. Processing Information
County (or Counties) where the project is located:
Burke
Is this a NCDMS Project
r Yes r No
Longitude:
-80.793457
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)
Version#*
1
Reviewing Office*
Asheville 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?
C' Yes r No
1d. Type(s) of approval sought from the DWR:
r 401 Water Quality Certification - Regular r 401 Water Quality Certification - Express
r Non-404 Jurisdictional General Permit rJ 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?
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:
Roger Hendrick
2b. Deed book and page no.:
Burke County
2c. Responsible party:
N/A
2d.Address
Street Address
2199 Yellow Fork Trail
Address Line 2
city
Nebo
Postal / Zip Code
28761
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
State / Province / Region
NC
Country
USA
2f. Fax Number:
[phone]
u
................
C. Project Information and Prior Project History U
1. Project Information
1b. Subdivision name:
(if appropriate)
1780

1c. Nearest municipality/ town:
Nebo
2. Project Identification
2a. Property Identification Number:
2199 Yellow Fork Trail
2c. Project Address
Street Address
2199 Yellow Fork Trail
Address Une 2
City
Nebo
Fbstal / Zip Code
28761
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Lake James
3b. Water Resources Classification of nearest receiving water:*
Lake
3c. What river basin(s) is your project located in?*
Catawba
3d. Please provide the 12-digit HUC in which the project is located.
03050101
4. Project Description and History
2b. Property size:
5
State / Ftovince / Rion
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:*
Natural bank landslide
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:
Zero
4g. List the total estimated linear feet of all existing streams on the property:
Zero
4h. Explain the purpose of the proposed project:*
Not a project- bank slide on private property
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
Natural soil bank of private property.
Natural bank slide of trees and soil occurred.
Repaired bank, stabilized,and left trees on bank (appro)dmately 100 If. affected)
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 G No r Unknown
Comments:
N/A
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
r Preliminary r Approved r Not Verified r Unknown F 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 r Streams -tributaries
r Open Waters r Pond Construction
6. Buffer Impacts (for DWR)
6a. Project is in which protect basin(s)?
Check all that apply.
r Neuse
17 Catawba
r Goose Creek
C Other
r Tar -Pamlico
r Randleman
r Jordan Lake
P Buffers
6b. Impact Type 6c. Per or Temp 6d. Stream name 6e. Buffer mitigation required? 6f. Zone 1 impact 6g. Zone 2 impact
None T WA No 500 0
6h. Total buffer impacts:
Zone 1
Total Temporary impacts: 500.00
Zone 1
Total Permanent impacts: 0.00
Zone 1
Total combined buffer impacts: 500.00
61. Comments:
Bank stabilized- No further action required
Supporting Documentation
i E. Impact Justification and Mitigation
1. Avoidance and Minimization
Zone 2
0.00
Zone 2
0.00
Zone 2
0.00
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
N/A- No stream or construction work of any kind.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
NIA- Natural slide- That is all. No new disturbance or work.
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:
Natural slide- No new structures or work in buffer.
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
What type of SCM are you providing?
r Level Spreader
r Vegetated Conveyance (lower SHWT)
r Wetland Swale (higher SHWT)
r Other SCM that removes minimum 30 % nitrogen
W Proposed project will not create concentrated stormwater flow through the buffer
Diffuse Flow Documentation
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 U
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 (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
2b Provide an explanation of the violation(s):
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.
Natural landslide- not fixed and stabilized. Not a construction project or result of man made activity.
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 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
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?
N/A- Natural bank slide then repaired.
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?*
Bank unchanged except trees that slid stayed at edge of lake.
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?*
WA- Private residence
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?*
No insurance required.
Miscellaneous
Comments
Miscellaneous attachments not previously requested.
Signature
*
F 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:
Roger Hendrick
Signature
Date
7/20/2020