HomeMy WebLinkAbout20100212 Ver 1_401 Application_2010031020100212
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Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Pre-Construction Notification (PCN) Form
A. Applicant Information
1. Processing AtH PA u
I a. Type(s) of approval sought-from the
Corps:
FzSection 404 Permit ? Section 10 Permit
f b. Specify Nationwide Permit (NWP) number: 14 or General Permit (GP) number: r
1 c. 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
of impacts? Jf so, attach the acceptance Jetter from mitigation bank or in-Jleu
fee program. ® Yes ? No
1 g, Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below. 1Z 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: Midgett - Hatteras Pines
2b. County: Dare
2c. Nearest municipality / town: Buxton
2d. Subdivision name: Hateras Pines
2e. NCDOT only, T.I.P. or state
project no: n/A
3. Owner Information
3a. Name(s) on Recorded Deed: Thomas Midgett ,., .?
3b. Deed Book and Page No. 141/35 e \Y Ig '.,
3c. Responsible Party (for LLC if
applicable): N/A
?`?aR 1 20;,
3d. Street address: PO Box 250 DE.
3e. City, state, zip: Hatteras, NC 2T943 ILMMS AND S'ORMS A'ER MMCI1
If. Telephone no.: 252-995-6347
3g. Fax no.:
3h. Email address: dougdormanerrt;r?rnil.r;??n?
Page I of 1'l
PCN Form - Version 1.3 December 10, 2003 Version
4. Applicant Information (if different from owner)
4a. Applicant is: ® Agent ? Other, specify:
4b. Dame:
4c. Business name
(if applicable):
4d. Street address:
4e. City, state, zap:
4f. Telephone no.:
4g. Fax no.:
4h. Email address:
5. Agent/Consultant Information (if applicable)
5a. Name: Doug Dorman
5b. Business name
(if applicable): Atlantic Environmentai Consultants, LLC
5c. Street address: PO Box 3266
5d. City, state, zip: Kitty Hawk, NC 27949
5e. Telephone no.: 252-261-7707
5f. Fax no.: 252-261-7707
5g. Email address: dougdorman@embargmail.com
Page 2 of 11
PCN Form - Version 1.3 December 10, 2008 Version
B. Project Information and Prior Project History
1. Property Identification
1 a. Property identification no. (tax PIN or parcel ID): 02 0536 09 16 0526
1 b. Site coordinates (in decimal degrees): Latitude: 35.1535 Longitude: - 75.3235
(DD.DDDDDD) (-DD.DDDDDD)
1 c. Property size: 0.62 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to Pamlico Sound
proposed project:
2b. Water Quality Classification of nearest receiving water: Sc
2c. River basin: Pasquotank
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:
Undeveloped residential lot in the Hatteras Pines. The surrounding parcels are developed and undeveloped single-family
residential.
3b. List the total estimated acreage of all existing wetlands on the property:
. 0.10 acres
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
0
3d. Explain the purpose of the proposed project:
Driveway to be constructed in order to gain access to high ground area of lot for residential development.
3e. Describe the overall project in detail, including the type of equipment to be used:
Fill in Section 404 wetlands (0.018ac.) to construct an access road from subdivision road to highground. A bulkhead Silt
fence will be placed on both sides of the proposed road at the wetland interface to prevent erosion and intrusion of fill into
the adjacent wetlands. Equipment utilized for this project to include a dump truck, and front-end loader with box blade. A
bulkhead will be constructed on both sides of the road and then backfilled to create driveway. Silt fence will be placed at
the wetland interface to prevent intrusion of material into wetlands during the construction process. Road will be topped
with gravel.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
®Yes ? No ? Unknown
project (including all prior phases) in the past?
Comments:
4b. If the Corps made the jurisdictional determination, what type
Preliminary ? Final
of determination was made?
4c. If yes, who daJineated the jurjsdlctlona) areas? AgencylConsuttant Company:
Name (if known): unknown Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
A determination has been requested but we have not received documentation.
5. Project History
5a. Have permits or certifications been requested or obtained for ? Yes ? No ? Unknown
this project (including all prior phases) in the past?
5b. If yes, explain in detail according to "help file" instructions-
Page 3 of 11
PCNt Form -- Version 1.3 December 10, 2008 Version
6. Future Project Plans
6a. Is this a phased project? EJ Yes No
6b. If yes, explain.
Page 4 of 11
PGN Form - Version 1.3 December 10, 2008 Version
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. 2b. 2c. 2d: 2e. 2f.
Wetland impact Type of jurisdiction
number - Type of impact Type of wetland Forested (Corps - 404, 10 Area of impact
Permanent (P) or (if known) DWQ - non-404, other) (acres)
Temporary (T
W1 ®P ? T Driveway fill ? Yes
0 No ® Corps
® DWQ 0.018
W2 ?P?T Yes
?No ? Corps
?DWQ
W3 ?P?T ? Yes
?No ? Corps
?DWQ
W4 ? P ? T ? Yes
?' No ? Corps
? DWQ
W5 ? P ?T F1 Yes El Corps
? No ?DWQ
W6 ? P ? T ? Yes ? Corps
'
No DWQ
?
2g. Total wetland impacts 0.018
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. 3b. 3c. 3d. 3e. 3f. 3g.
Stream impact Type of impact Stream name Perennial Type of jurisdiction Average Impact
number - (PER) or (Corps - 404, 10 stream length
Permanent (P) or intermittent DWQ - non-404; width (linear
Temporary (T) (INT)? other) (feet) feet)
S1 ?P?T ?PER ?Corps
? INT ? DWQ
S2 ? P ? T ? PER ? Corps
? INT ? DWQ
S3 ? P ? T ? PER ? Corps
? INT ? DWQ
S4 ? P ? T ? PER ? Corps
? INT ? DWQ
S5 ? PEI T ? PER ? Corps
? INT ? DWQ
S6 ? P ? T ? PER ? Corps
? INT ? DWQ
att. Total stream and tributary impacts
3i. Comments:
Page 5 of 11
PCN Form - Version 1.3 December 10, 2008 Version
4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impacts below.
4a. 4b. 4c. 4d. 4e.
Open water Name of waterbody
impact number - (if applicable) Type of impact Waterbody type Area of impact (acres)
Permanent (P) or
Temporary )
01 ?P?T
02 ?P?T
03 ?P?T
04 ?P?T
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If and or lake construction proposed, then complete the chart below.
5a. 5b. 5c. 5d. 5e.
Wetland Impacts (acres) Stream Impacts (feet) Upland
Pond ID Proposed use or purpose (acres)
number of pond
Flooded
Filled'
Excavated
Flooded
Filled'
Excavated
Flooded
P1
P2
5f. Total:
5g. 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):
5k. 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 an impacts require mitigation, then you MUST fill out Section D of this form..
6a.
? Neuse ? Tar-Pamlico ? Other:
Project is in which protected basin? ? Catawba ? Randleman
6b. 6c. 6d. 6e. 6f. 6g.
Buffer impact
number - Reason Buffer Zone 1 impact Zone 2 impact
Permanent (P) or for Stream name mitigation (square feet) (square feet)
Temporary (T) impact required?
131 ? P ? T ?'Yes
? No
B2 ? PEI T ? Yes
? No
B3 ?P?T ?Yes
? No
6h. Total buffer impacts
6i. Comments:
Page 6 of 11
PCN Form - Version 1.3 December 10, 2008 Version
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
Wetlands are to be crossed at the narrowest point and impacts were limited to a total of 0.018 acres, which is covered under a
USACE Nationwide 14 General Permit. Proposed placement of wetand fill will allow the property owner to access highground
on his property and residence to be constructed.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
A bulkhead is to be constructed along driveway to eliminate any side slope of fill and help reduce impacts to the wetlands
onsite.
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? ® Yes ? No
2b. If yes, mitigation is required by (check all that apply): ? DWQ Corps
2c. If yes, which mitigation option will be used for this
project? ® Mitigation bank
? Payment to in-lieu fee program
? Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank: Great Dismal[ Swamp Mitigation Bank
3b. Credits Purchased (attach receipt and letter) Type Quantity
3c. Comments: Type and quantity to be determined by conditions of the permit.
4. Complete if Making a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached. ? Yes
4b. Stream mitigation requested: linear feet
4c. If using stream mitigation, stream temperature: ? warm ?I: cool ?cold
4d. Buffer mitigation requested (DWQ only): square feet
4e. Riparian wetland mitigation requested: acres
4f. Non-riparian wetland mitigation requested: acres
4g. Coastal (tidal) wetland mitigation requested: acres
4h. Comments:
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
Page 7 of 11
PCN Form - Version 1.3 December 10, 2008 Version
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 8 of 11
PCN Form - Version 1.3 December 10, 2008 Version
E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1 a. Does the project include or is it adjacent to protected riparian buffers identified ? Yes ® No
within one of the NC Riparian Buffer Protection Rules?
1 b. If yes, then is a diffuse flow plan included? If no, explain why.
? Yes ? No
Comments: Outside the buffer area
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project? 17.7%
2b. Does this project require a Stormwater Management Plan? ?' Yes ® No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why: Impervious area less than 24%
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
? Certified Local Government
2e. Who will be responsible for the review of the Stormwater Management Plan? ?DWQ Stormwater Program
® DWQ 401 Unit
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this project? Dare County
? Phase II
3b. Which of the following locally-implemented stormwater management programs ? NSW
?' USMP
apply (check all that apply): ?' Water Supply Watershed
® Other:
3c. Has the approved Stormwater Management Plan with proof of approval been ?, Yes ® No
attached?
4. DWQ Stormwater Program Review
Coastal counties
HOW
4a. Which of the following state-implemented stormwater management programs apply ? ORW
(check all that apply):
? Session Law 2006-246
? Other:
4b. Has the approved Stormwater Management Plan with proof of approval been
attached? ? Yes ® No
5. DWQ 401 Unit Stonmwater Review
5a. Does the Stormwater Management Plan meet the appropriate requirements? ® Yes ? No
5b. Have all of the 401 Unit submittal requirements been met? ® Yes ? No
Page 9 of 11
PCN Form - Version 1.3 December 10, 2008 Version
F. Supplementary information
1. Environmental Documentation (DWQ Requirement)
1 a. Does the project involve an expenditure of public (federal/state/local) funds or the Yes ® No
use of public (federal/state) land?
1 b. 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)?
1 c. 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 213 .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):
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in El, 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.
Onsite conventional septic system for 3 bedroom single family residence.
Page 10 of 11
PCN Form - Version 1.3 December 10, 2008 Version
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?
®
Raleigh
5c. If yes, indicate the USFWS Field Office you have contacted.
? Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
Contacted Dale Suiter a Biologist with the USFWS Field office.
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?
This project not located in or near any open waters.
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?
Contacted Lee Abbott, Assistant State Archeologist for a determation.
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain? ® Yes ? No
Sb. If yes, explain how project meets FEMA requirements: Residence construction be elevated above designated flood plain
requirements for this location.
8c. What source(s) did you use to make the floodplain determination? Dare county flooplain maps
000-5 oeve"wx? ea
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? :1
Applicant/Agent's Printed Name _
.0
cant/Agent's Signature Date
(Agent's signature is valid only it an authorization letter from the applicant
is provided.)
Page 11 of 11
PCN Form - Version 1.3 December 10, 2008 Version
Thomas Midgett
PO Box 250
Hatteras, NC 27943
1, Thomas Midgett authorize Doug Dorman of Atlantic Environmental
Consultants, LLC (AEC) to act on my behalf as my agent in the processing of
applications and to furnish, upon request, supplemental information in
support of the permit application.
AUTHORIZATION
DATE
3.
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? ? LOT 42 - -
LOT 41
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LOT 40 `
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WETLAND LINE DATA
From To Bearing Distance
A 2 N 80°08'27" E 19.75'
2 3 N 85°42'12" E 28.58'
3 4 S 89°57'43" E 9.30'
4 5 N 78°34'58" E 11.09'
5 6 N 51 °26'04" E 10.97'
6 C N 62°04'08" E 12.24'
7 8 S 77°46'44" E 23.96'
8 9 N 86°23'32" E 13.44'
9 10 N 75°12'44" E 19.02'
10 11 N 87°03'07" E 13.40'
11 12 N 89°02'50" E 12.24'
12 D N 69°07'35" E 9.64'
LEGEND
O EXISTING IRON STAKE
® FIRE HYDRANT
W WATER METER
® UTILITY POLE
PP 10 X 20' PARKING PAD
FILL PLAN FOR:
THOMAS MIDGETT
KRISTEN T. JACKSON
LOT 22
HATTERAS PINES
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312.63 sq ft
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WETLAND
4,186.53 sq ft
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8 9
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HIGHLAND 2
22,529.64 sq ft
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LOT 23
47449 LOST TREE TRAIL, BUXTON, NC 27920
County Date Scale
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27,028.81 sq ft
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LOT 21