20200986 Ver 1_401 Application_20200731

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?*
G Yes r No
Change only if needed.
BIMS # Assigned
20200986
Is a payment required for this project?*
r No payment required
r Fee received
r Fee needed - send electronic notification
Select Project Reviewer*
Robert Tankard:eads\rbtankard
Information for Initial Review
la. Name of project:
COURTESY COPY - 1008 Cruz Bay Lane
1a. Who is the Primary Contact?*
Brian Rubino
1b. Primary Contact Email:*
[e-mail]
Date Submitted
7/31/2020
Nearest Body of Water
Currituck Sound
Basin
Pasquotank
Water Classification
SC
Site Coordinates
Latitude: Longitude:
36.354787-75.827393
A. Processing Information
County (or Counties) where the project is located:
Currituck
Is this a NCDMS Project
r Yes r No
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*
Washington Regional Office - [phone]
1c. Primary Contact Phone:*
[phone]
L.1
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:
W 401 Water Quality Certification - Regular
r Non-404 Jurisdictional General Permit
r Individual Permit
18 - Minor Discharges
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
Letter of Credit Availability - Quible - Turnipseed 1008 Cruz Bay Lane Corolla NC 07282020.pdf
1h. Is the project located in any of NC's twenty coastal counties?
r Yes r No
1i. Is the project located within a INC DCM Area of Environmental Concern (AEC)?
r Yes r No r Unknown
11. Is the project located in a designated trout watershed?
CS Yes r No
B. Applicant Information
1d. Who is applying for the permit?
F 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:
SF Corolla Bay, LLC
2b. Deed book and page no.:
DB 1526, PG 394
2c. Responsible party:
2d.Address
Street Address
PO Box 90
Address Line 2
city
Kill Devil Hills
Postal / Zip Code
27948
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
State / Rovince / Region
NC
Country
USA
2f. Fax Number:
322.87KB
r Yes r No
r Yes r No

3. Applicant Information (if different from owner)
3a. Name:
Suzanne and Jim Turnipseed
3b. Business Name:
3c.Address
Street Address
164 Memorial Ln.
Address Line 2
City
Mount Laurel
Postal / Zip Code
08054
3d. Telephone Number:
[phone]
3f. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Brian Rubino
4b. Business Name:
4c.Address
Street Address
PO Box 870
Address Une 2
city
Kitty Flawk
Postal / Zip Code
27949
4d. Telephone Number:
[phone]
4f. Email Address:*
[e-mail]
Agent Authorization Letter*
Lot 21 Owner Authorization. pdf
Lot 21 Purchaser Authorization.pdf
State / Frmince / Pagion
NJ
Country
USA
3e. Fax Number:
State / Rwince / Rion
NC
Country
USA
4e. Fax Number:
130.25KB
139KB
C. Project Information and Prior Project History C^)
1. Project Information
1b. Subdivision name:
(d appropriate)
Corolla Bay
1c. Nearest municipality/town:
Corolla
2. Project Identification
2a. Property Identification Number:
9936-43-1061
2c. Project Address
2b. Property size:
0.37

Street Address
1008 Cruz Bay Lane
Address tine 2
CRY
Corolla
Postal / Zip Code
27927
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Currituck Sound
3b. Water Resources Classification of nearest receiving water:*
SC
3c. What river basin(s) is your project located in?*
Pasquotank
3d. Please provide the 12-digit HUC in which the project is located.
030102051305
4. Project Description and History
State / Rwince / 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:*
The site is currently undeveloped uplands and wetlands. Adjacent properties consist of single family residences and undeveloped uplands and wetlands.
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)
MOSSEY ISLANDS. pdf 1.72MB
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)
NRCS_ Soil_Map.pdf 449.41 KB
4f. List the total estimated acreage of all existing wetlands on the property:
0.23
4g. List the total estimated linear feet of all existing streams on the property:
0
4h. Explain the purpose of the proposed project:*
Fill of 0.05 ac. of wetlands to accommodate a single family residential development.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
The proposed project will consist of filling of 0.05 ac. of wetlands using dump trucks, skid steer, and silt fencing or low retaining walls to contain the proposed fill.
4j. Please upload project drawings for the proposed project.
P99006-LOT21-FILLPLAN-073120.pdf 364.93KB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes r No 6 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:
SAW-2008-00770
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made bythe Corps or DWR
03/07/2016
5d1. Jurisdictional determination upload

Corolla Bay - SAW-2008-00770.pdf 91.69KB
signed-404 corolla bay.pdf 553.27KB
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):
W Wetlands r Streams -tributaries
F Open Waters F Pond Construction
2. Wetland Impacts
F Buffers
a. Site #* (') gal Reason (?) 2b. Impact type * (?) 2c. Type of W.* 2d. W. name * 2e. Forested * 2f. Type of 2g. Impact
Jurisdicition*(?) area*
fill -residential purposes t
Estuarine Woody Wetland Wetland Yes Corps 0.050
(acres)
2g. Total Temporary Wetland Impact
0.000
2g. Total Wetland Impact
0.050
2h. Comments:
2g. Total Permanent Wetland Impact
0.050
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:
The proposed fill area has been minimized to achieve the desired single family residential development of this lot. The existing upland area is being
utilized.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Silt fencing and sloping of fill (or low retaining walls) to protect adjacent wetland areas.
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
2c. If yes, mitigation is required by (check all that apply):
7 DWR W Corps
2d. If yes, which mitigation option(s) will be used for this project?
V Mitigation bank r Payment to in -lieu fee F Permittee Responsible
program Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
Great Dismal Swamp Restoration Bank
3b. Credits Purchased/Requested (attach receipt and letter)
Type: Quantity:
Non -riparian wetland 0.1
Attach Receipt and/or letter
Letter of Credit Availability - Quible - Turnipseed 1008 Cruz Bay Lane Corolla NC 07282020.pdf 322.87KB
U
3c. Comments

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
If no, explain why:
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
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
r N/A - project disturbs < 1 acre
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)
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.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
r Yes r Nor NIA
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
5e. Is this a DOT project located within Division's 1-8?
r Yes r No
r Unknown
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
NC Natural Heritage Program database
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?*
No impacts to surface waters proposed.
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?*
National Register of Historic Places
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
8b. If yes, explain how project meets FEMA requirements:
The project is in AE and Xflood zones per FEMA. Development of this nature is allowed in AE and XZones as long as the first floor elevations exceed
base flood elevations.
8c. What source(s) did you use to make the floodplain determination?*
FEMA Flood Maps and nconemap.com
Miscellaneous
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:
Brian Rubino
Signature
Date
7/31 /2020