20201181 Ver 1_401 Application_20200911

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
20201181
Is a payment required for this project?*
r No payment required
r Fee received
r Fee needed - send electronic notification
Select Project Reviewer*
Robb Mairs:eads\rlmairs2
Information for Initial Review
1a. Name of project:
COURTESY COPY - 113 SE 45th Street
1a. Who is the Primary Contact?*
Dana A. Lutheran
1b. Primary Contact Email:*
[e-mail]
Date Submitted
9/11 /2020
Nearest Body of Water
Montgomery Slough
Basin
Lumber
Water Classification
SA;HOW
Site Coordinates
Latitude:
34.912324
A. Processing Information
County (or Counties) where the project is located:
Brunswick
Is this a NCDMS Project
r Yes r No
Longitude:
-78.118884
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*
Wilmington Regional Office - [phone]
1c. Primary Contact Phone:*
[phone]
U
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 - E)press
r 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
SFMB Credit Reservation Letter.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?
P 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:
Richard and Stephanie Gilmore
2b. Deed book and page no.:
2139/1313
2c. Responsible party:
2d.Address
Street Address
1593 Knoll Road
Address Une 2
City
Coopersburg
Fbstal / Zip Code
18036
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
State / Rovince / Region
PA
Country
US
2f. Fax Number:
99.07KB
r Yes r No
r Yes r No
v

4. Agent/Consultant (if applicable)
4a. Name:
Dana A. Lutheran
4b. Business Name:
Southern Environmental Group, Inc.
4c.Address
Street Address
5315 South College Road, Suite E
Address Line 2
City
Wilmington
Postal / Zip Code
28412
4d. Telephone Number:
[phone]
4f. Email Address:*
[e-mail]
Agent Authorization Letter*
Agent Authorization.pdf
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(t appropriate)
NA
1c. Nearest municipality/ town:
Oak Island
2. Project Identification
2a. Property Identification Number:
235MF002
2c. Project Address
Street Address
113 SE 45th Street
Address Line 2
aty
Oak Island
Postal / Zip Code
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Montgomery Slough
3b. Water Resources Classification of nearest receiving water:*
SA;HQW
3c. What river basin(s) is your project located in?*
Lumber
3d. Please provide the 12-digit HUC in which the project is located.
030402080107
4. Project Description and History
State / Province / legion
NC
Country
US
4e. Fax Number:
2b. Property size:
0.15
Slate / Province / legion
NC
Country
US
386.64KB
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 wooded, with a small (-1300 SF) wetland depression positioned within the northeast portion of the property. It is believed the rest of the wetland was filled with the
development of 111 SE 45th Street. Residential is the predominant land use in the vicinity.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
O Yes 6 No F Unknown
U

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:
0.03
4g. List the total estimated linear feet of all existing streams on the property:
0
4h. Explain the purpose of the proposed project:*
The purpose of this project is to provide adequate building pad for a single family dwelling.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
The project will include removing vegetation and rootmat, from the wetland impact area, and filling the area with clean earthen soil. The work will be undertaken using typical
construction equipment, such as excavator, front end loader and dump trucks.
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:
SEGi is seeking a PJD with the submission of the PCN
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): David M. Scibetta
Agency/Consultant Company: SEGi
Other:
5d1. Jurisdictional determination upload
JD Request Package 113 SE 45th St..pdf 13.59MB
6. Future Project Plans
6a. Is this a phased project?*
r' Yes r No
Are anyother NWP(s), regional general permit(s), or individual permits(s) used, or intended to be used, to authorize any part of the proposed projector related activity?
This project has independent utilities and access and does not require additional impacts to make it viable.
D. Proposed Impacts Inventory
1. Impacts Summary
la. Where are the impacts associated with your project? (check all that apply):
W Wetlands r Streams -tributaries r Buffers
r Open Waters r Pond Construction
2. Wetland Impacts
-11
a. Site #* (?) 2a1 Reason (?) 2b. Impact type * (?) 2c. Type of W.* 2d. W. name* 2e. Forested* 2f. Type of 29. Impact
Jurisdicition*(?) area*
lot fill P Hardwood Flat A Yes Corps 0.030
(acres)
2g. Total Temporary Wetland Impact
0.000
2g. Total Wetland Impact
0.030
2h. Comments:
2g. Total Permanent Wetland Impact
0.030

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:
Due to the eAstence of a 10' utility easement, at the back of the lot, avoidance is not possible. The house has been pushed back as far as possible,
while allowing for a pool.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
The entire wetland, within the property limits, will be impacted, and the wetland feature does not extend past the lot lines. Therefore, construction
techniques are not needed to minimize or avoid the proposed impacts.
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):
r DWR W Corps
2d. If yes, which mitigation option(s) will be used for this project?
W Mitigation bank r Payment to in -lieu fee r Permittee Responsible
program Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
Stone Farm Mitigation Bank
3b. Credits Purchased/Requested (attach receipt and letter)
Type: Quantity:
Non -riparian wetland 0.06
Attach Receipt and/or letter
u
3c. Comments
A credit request email has been submitted to the Stone Farm UMB. The reservation letter will be furnished upon receipt.
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?
f Yes r No
If no, explain why:
The project is not within one of NC's Riparian Buffer River Basins.
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
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 t No
r WA - project disturbs < 1 acre
Comments:
The Town of Oak Island will administer the stormwater permit, through the local stormwater delegation authority.
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.
This project will not discharge runoff to downstream receiving waters, as all stormwater will be collected and treated prior to leaving the site.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
r Yes r Nor WA
4b. Describe, in detail, the treatment methods and dispositions (non -discharge or discharge) of wastewater generated from the proposed project. If the wastewater will be treated
at a treatment plant, list the capacity available at that plant.
Municipal sewer is available.
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
Si. 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?
This site is located within a densely populated area and did not warrant further investigation.
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?*
This site does not abut a water body that would support EFH.
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?*
This project is located within a densely developed area of Oak Island. Further investigation was not warraented.
7c. Historic or Prehistoric Information Upload
8. Flood Zone Designation (Corps Requirement)

8a. Will this project occur in a FEMA-designated 100-year flood plain?*
r Yes r No
8b. If yes, explain how project meets FEMA requirements:
The house will be pile supported to meet the minimum requirements, as per FEMA.
8c. What source(s) did you use to make the floodplain determination?*
Brunswick Co. GIS Flood Map
Miscellaneous
Comments
Miscellaneous attachments not previously requested.
113 E 45th Street PCN Attachments.pdf 566.58KB
Signature 6
FJ 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:
Dana A. Lutheran
Signature
Date
9/11 /2020

STONE FARM REGIONAL MITIGATION BANK
CREDIT REQUEST ACCEPTANCE
Date: 09/09/2020
Richard Gilmore
1893 Knoll Road
Coopersburg, PA 18036
Project Name: 113 SE 45" Street
Expiration of Acceptance: 03/09/2021
SFMB Number:
Dear Mr. Richard Gilmore:
Stone Farm Mitigation Bank, LLC
2618 New Village Way
Wilmington, NC 28405
[phone]
DRAFT
The purpose of this letter is to notify you that the Stone Farm Regional Mitigation Bank (Bank) is willing to
accept payment for impacts associated with the above referenced project. Please note that this decision
does not assure that the payment will be approved by the permit issuing agencies as mitigation for project
impacts. It is the responsibility of the applicant to contact these agencies to determine if payment to the
Bank will be approved. It is also the responsibility of the applicant to determine the appropriate credit ratios
that will be required for the corresponding wetland and/or stream impacts. You must also comply with all
other state, federal or local government permits, regulations or authorizations associated with the proposed
activity.
This acceptance is valid for six (6) months from the date of this letter and is not transferable. If we have not
received payment for the accepted credits of the issued 404 Permit/401 Certification/CAMA permit
within this time frame, this acceptance will expire. Predicated on the total payment due to the Bank, as
set forth herein, a ten (10) percent non-refundable deposit is due at the time of acceptance by the Bank. It is
the applicant's responsibility to send copies of their permits to the Bank. Once the Bank receives a copy of
the permit(s), an invoice will be issued based on the information identified Below. Payment must be made
prior to conducting the authorized work. It is the applicant's responsibility to ensure that the credit types and
amounts identified below are consistent with the compensatory mitigation requirements of the permit(s)
issued. The Bank and/or its agents are not responsible for determining the applicant's mitigation
requirements.
Based on the information supplied by the applicant, the impacts that may require compensatory mitigation
are summarized in the following table:
CLI Location Stream (ft) Wetlands (ac.)
l_ Nonriparian Riparian
Impact 03040208 .03
Credits 03040208 1
Note that the impact and credit totals above were provided by the applicant. It is the applicant's
responsibility to provide accurate information (including the requested mitigation credits). The Bank and/or
its agents are not responsible for determining the required credit amounts. The Bank's decision to accept
credits is based upon the information provided by the applicant. The Bank is not liable for any credit
shortage should the applicant's required mitigation credits exceed the amount specified in the above table.

Based upon the type and amounts of credits requested above, the following payment must be provided to
the Bank prior to issuance of credits:
Credit Type
Unit
Per Unit Credit Fee
Sub -Total
Stream
0
$558.81
$0.00
Nonriparian Wetland
0.1
$61,264.36
$6.126.44
Riparian Wetland
0
$61,264.36
$0.00
Total Payment Due
$6,126.44
Non-refundable Deposit
$612.64
Balance Due Upon Invoice
$5,513.79
Upon receipt of full payment, the Bank will take responsibility for providing the compensatory mitigation. If
the regulatory agencies require mitigation credits greater than indicated above, and should the applicant
want the Bank to provide such credits, it is the applicant's responsibility to submit an additional credit
request form to the Bank.
If you have any questions or need additional information, please contact Jordan Cline at 910-251-8543 or
[e-mail]
Sincerely,
n
�OrdaYline
Stone Farm Mitigation Bank, LLC
cc: NCDWQ-Raleigh
USACE
NCDWQ-Local
Agent

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5EGi
AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION: L-11 B-155 S-NI PLAT 6/12A
LOT NO. PLAN NO. PARCEL I.D. 235MF002
STREET ADDRESS: 113 SE 45`h Street. Oak Island
Property Owner (please print): GILMORE RICHARD ET STEPHANIE
The undersigned, registered property owner of the above noted property, does hereby authorize
Southern Environmental Group, Inc. (SEGO to act on their behalf in matters regarding areas of
environmental concern.
Applicant's Name and Address (if different than owner above):
1593 KNOLL RD
COOPERSBURG, PA 18036
Telephone:
336-345-1214
We hereby certify the above information submitted in this application is true and accurate to the best of
ur knowledge.
. f
Property Owner Authorized Signature SEGi Authorized Signature
A, a, AZg 0)l , ���Kj �,1,rv,�� David Scibetta
Print Name Print Name
q - a- 8/28/2020
Date Date