20071023 Ver 2_401 Application_20101010

INIIIIIIIIIIIIII " Kimley-Horn
IIIIIIIIIIIIIIIIN and Associates, Inc.
October 29, 2010
Mr. James Shern
U.S. Army Corps of Engineers
Raleigh Regulatory Field Office
6508 Falls of the Neuse Road
Suite 120
Raleigh, NC 27615
Mr. Ian McMillan
NC Division of Water Quality
2321 Crabtree Blvd.
Raleigh, North Carolina 27602
SAINDST ??'KVb
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P.0 Box 33068
Raleigh, North Carolina
27636-3068
Al I
Re: Nationwide Permit #12 Application Re-Submittal
Holly Springs Business Park Pump Station - Stream Crossing Improvements
Wake County, North Carolina
(Town of Holly Springs Proj. No. 04-034)
Dear Mr. Shern and Mr. McMillan:
On behalf of The Town of Holly Springs, Kimley-Horn and Associates, Inc. is
re-submitting the enclosed Preconstruction Notification Application for
authorization to construct the above reference project under Nationwide Permit
Number 12.
The proposed project includes the construction permanent stream crossings for
routine maintenance and emergency access along the Holly Springs Business
Park Pump Station utility corridor. The new pump station project was completed
in November 2009 with installation of the final wetland plantings per the
approved planting plan (SAW-2007-02846, DWQ Pr .# 07-1023).
After project completion, the Town of Holly Springs (Town) determined that
certain crossings within the maintained permanent utility easement required
improvements and that the natural channel bottom was not sufficient for access
of equipment. Therefore, the Town determined that crossings of three
jurisdictional streams need to be improved. These improvements will be limited
to a 14-foot width within the permanent utility easement, and will include either a
low-water ford crossing, or a "drivable grass" (i.e. interlocking concrete pavers
with void space for natural materials) option. Either approach will require
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TEL [phone]
FAX [phone]
? Kimley-Horn
and Associates, Inc.
installation of armoring materials in the channel bottom at the crossings, and both
approaches will maintain the existing stream grade through the crossing.
Total cumulative impact will be 42 linear feet of permanent impact to
jurisdictional tributaries (28 LF impact to intermittent stream channel, and 14 LF
impact to perennial stream channel). The following in included with this
submittal:
• Project Summary Sheet
• Preconstruction Notification Form
• Permit Maps and Figures
• Agent Authorization Form
If there is any additional information you need to assist in the processing of this
application, please do not hesitate to contact nie at (919) 6"77-2121.
Very truly yours,
KIMLEY-HORN AND ASSOCIATES, INC.
Chad Evenhouse
Environmental Scientist
Enclosures
Cc: Ms. Stephanie Sudano, P.E., Director of Engineering
? = F1 Kimley-Horn
M and Associates, Inc.
Project Summary Sheet
Project Name: Holly Springs Business Park Pump Station Project- Stream Crossing Improvements
Applicant Name and Address: Town of Holly Springs
Attn: Carl Dean Town Manager
Post Office Box 8
Holly Springs NC 27540
Telephone Number: [phone]
Type of Request: ® Nationwide PCN (NWP #3, 12) ? Indivic
? Jurisdictional Determination ? Other:
Included Attachments: ® Project Plans ® USGS Map
® Agent Authorization ® Delineation Sketch
? Data Forms (Up & Wet) ? NCDWQ Stream Forms
? NCEEP Confirmation ® Aerial Photo
? Agency Correspondence ? Other:
lual Permit Application
® NRCS Soil Survey
? Delineation Survey
? USACE Stream Forms
? Site Photos
? Other:
Check if applicable: ? CAMA County ? Trout County ? Isolated Waters
? Section 7, ESA ? Section 106, NHPA ? EFH
? Mitigation Proposed (? NC EEP ? On-Site ? Off-Site ? Other)
County: Wake Nearest City/Town: Holly Springs
Waterway: Utley Creek
H.U.C.:03030004
Property Size (acres): +/- 12.5
Site Coordinates (in decimal degrees): 35.6499 °N
River Basin: Cape rear
USGS Quad Name: Apex, NC
Approx. Size of Jurisdiction on Site (acres): +/- 1.0
78.8732 °W
Project Location: The project is generally located in a 8,000 foot corridor, located west of NC-55 Bypass and south of New
Hill Road, in the Holly Springs Business Park, in Ho'lly' Springs, Wake County, North Carolina.
Site Description: The project corridor is located west of downtown Holly Springs, in the Holly Springs Business Park. The
corridor follows Green Oaks Parkway and Utley Creek. The surrounding land is primarily forested
Impact Summary (if applicable): The proposed project includes the construction of permanent stream crossings at three
iurisdictional tributaries within the maintained permanent utilitv easement. The project will result in permanent impacts to 28
linear feet of intermittent stream channel, and 14 linear feet of permanent impact to perennial stream channel. In addition,
two intermittent stream crossings with existing culverts will be improved, replacing the culvert with a low water ford
crossing. Stream impacts at the locations with existing culverts will be limited within the footprint of the existing culvert
O
W
t W
tl
d Stream Channel
NWP
# pen
a
er
(acres) e
an
(acres) Intermittent and/or Unimportant
Aquatic Function Perennial and/or Important
Aquatic Function

T
P
T
P Tem Perm. Temp Perm.
emp. erm. emp. erm. Lf ac if ac if ac if Ac
12 28 0.0013 14 0.0006
3 28 0.0013
Total Permanent Impact to Waters of the U.S. (acres) 0.0019
Kimley-Horn Contact: Chad Evenhouse
Direct Number: 919-677-2121
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P.0 Box 33068 TEL [phone]
Raleigh, North Carolina FAX [phone]
27636-3068
O?0?NNA7-! q'9
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07- 10a3 0,-4-
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 A IF
1. Processing J% A AL JR ELI
1 a. Type(s) of approval sought from the
Corps:
®Section 404 Permit El Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: 12, 3 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps? ® Yes ? No
1d. 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 N No
1f.

1 g. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in-lieu
fee program.
Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below. ? Yes

? Yes ® No

® 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: Holly Springs Business Park Pump Station - Stream Crossing Improvements (TONS
Proj. No. 04-034)1
2b. County: Wake
2c. Nearest municipality / town: Holly Springs
2d. Subdivision name: Holly Springs Business Park
2e. NCDOT only, T.I.P. or state
project no: NA
3. Owner Information
3a. Name(s) on Recorded Deed: Town of Holly Springs
3b. Deed Book and Page No.
3c. Responsible Party (for LLC if
applicable): Carl Dean, Town Manager
3d. Street address: 128 S. Main Street
3e. City, state, zip: Holly Springs, NC 27540
3f. Telephone no.: [phone]
3g. Fax no.: [phone]
3h. Email address: [e-mail]
Page 1 of 12
PCN Form - Version 1.3 December 10, 2008 Version
4. Applicant Information (if different from owner)
4a. Applicant is: ? Agent ? Other, specify:
4b. Name:
4c. Business name
(if applicable):
4d. Street address:
4e. City, state, zip:
4f. Telephone no.:
4g. Fax no.:
4h. Email address:
5. Agent/Consultant Information (if applicable)
5a. Name: Chad Evenhouse
5b. Business name
(if applicable): Kimley-Horn and Associates, Inc.
5c. Street address: 3001 Weston Parkway
5d. City, state, zip: Cary, NC 27513
5e. Telephone no.: 919-677-2121
5f. Fax no. 919-677-2050
5g. Email address: [e-mail]
Page 2 of 12
PCN Form - Version 1.3 December 10, 2008 Version
B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): NA
1 b. Site coordinates (in decimal degrees): Latitude: 35.6467 Longitude: - 78.8703
(DD.DDDDDD) (-DD.DDDDDD)
1 c. Property size: +/-12 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
proposed project: Utley Creek
2b. Water Quality Classification of nearest receiving water: C
2c. River basin: Cape Fear
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 project corridor is located west of downtown Holly Springs, in the Holly Springs Business Park. The corridor follows
Green Oaks Parkway, an unnamed tributary to Utley Creek
and th
i
t
,
e ma
n s
em of Utley Creek. A vicinity map is included
as Figure 1. The surrounding area is currently undergoing residential, commercial, and industrial development
though
,
much of the area in the immediate vicinity of the corridor is wooded with mixed pine-hardwood stands ranging from 20-50
years old. Several small unnamed tributaries to Utley Creek occur withi
th
i
n
e ma
ntained utility easement corridor.
3b. List the total estimated acreage of all existing wetlands on the property:
Less than one acre of wetland within the maintained utility easement corridor
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
Approximately 300 linear feet comprised by multiple stream crossings within the maintained utility easement corridor
3d. Explain the purpose of the proposed project:
The purpose of the proposed work is to improve accessibility for Town utility and emergency vehicles for maintenance
and emergency response within the utility corriddr. ' '
3e. Describe the overall project in detail, including the type of equipment to be used:
The proposed project includes the construction of permanent stream crossings at three jurisdictional tributaries within the
maintained permanent utility easement. The project will result in permanent impacts to 28 linear feet
f i
t
i
o
n
erm
ttent
stream channel, and 14 linear feet of permanent impact to perennial stream channel. Two additional crossings with
existing culverts will be maintained such that the culvert will b
l
e rep
aced with the low water ford crossing as shown in the
attached figures.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past?
Comments: A jurisdictional determination was obtained with ®Yes ? No ? Unknown
the issuance of the 404 permit 3/8/2008 (USACE Proj. ID
SAW 2001-028476; NCDWQ Prj. No. 07-1023).
4b. If the Corps made the jurisdictional determination, what type
of determination was made? ? Preliminary ? Final
4c. If yes, who delineated the jurisdictional areas? Agency/Consultant Company: Kimley-Horn and Assoc
.
Name (if known): Todd Tugwell Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation
.
USACE Proj. ID SAW 2001-028476 approved 3/8/2008
Page 3 of 12
PCN Form - Version 1.3 December 10, 2008 Version
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.
A jurisdictional determination and 404/401 permit was obtained in 2008 (USACE Proj. ID SAW 2001-028476; NCDWQ
Prj. No. 07-1023). The permitted impacts associated with the new pump station was completed in 2009. However, is
was determined after that work was completed that the crossings as constructed would not be adequate for access for
larger equipment if an emergency occurred or maintenance was necessary within portions of the sewer line utility
easement. Therefore, the Town determined that a 14-foot section at specific stream crossings within the maintained
easement needed to be improved to allow access for larger equipment and vehicles. It was determined that a low-water
ford crossing constructed from riprap, or articulating concrete block revetments, would be appropriate (see attached
detail).
6. Future Project Plans
6a. Is this a phased project? ? Yes ® No
6b. If yes, explain.
Page 4 of 12
PCN 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 ? Yes ? Corps
? No ? DWQ
W2 ? P ? T ? Yes ? Corps
? No ? DWQ
W3 ? P ? T ? Yes ? Corps
? No ? DWQ
W4 ? P ? T ? Yes ? Corps
?No ?DWQ
W5 ? P ? T ? Yes ? Corps
? No ? DWQ
W6 ? P ? T ? Yes ? Corps
? No ? DWQ
2g. Total wetland impacts
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 -
Permanent (P) or (PER) or
intermittent (Corps - 404, 10
DWQ - non-404 stream
width length
(linear
Temporary (T) (INT)? ,
other) (feet) feet)
S1 ®P ? T Riprap or concrete Stream "G" UT to ? PER ® Corps

block fill
Utley Creek
® INT
? DWQ 2 14
S2 ®P ? T Riprap or concrete Stream "C" UT to ® PER ® Corps

block fill
Utley Creek
? INT
? DWQ 2 14
S3 ® P ? T Riprap or concrete Stream "B" UT to ? PER ® Corps

block fill
Utley Creek
® INT
? DWQ 2 14

S4 ® P ? T Riprap or concrete
block fill (replace Stream "E" UT to ? PER
® Corps
NA

existing culvert)
Utley Creek
®INT
?DWQ NA

S5 ® P ? T Riprap or concrete
block fill (replace Stream "D" UT to ? PER
® Corps
NA

existing culvert)
Utley Creek
®INT
?DWQ NA
S6 [J P ? T ? PER ? Corps
? INT ? DWQ
T

-
.
3h. Total stream and tributary impacts

42
3i. Comments: Attached in the figures, a key sheet shows all areas that will require some maintenance and improvement
within the permanent utility easement to accommodate the emergency and maintenance equipment. Based on the 2008
delineation and 404/401 permit for the pump station project, the crossings that include impacts to jurisdictional areas are
Page 5 of 12
PCN Form - Version 1.3 December 10, 2008 Version
Crossings 2, 7, and 9 (see sheet 2 in the attached Permanent Stream Crossing Permit Plans). The other crossings are across
non-jurisdictional features. There are two crossings with existing culverts that need to be maintained, and will be replaced
with a low water ford crossing (Crossings 5 and 6). Typical details of the proposed crossing are included in the attached
permit plans drawings.
Impact 1 - (Crossing 2) Construction of the 14-ft permanent stream crossing (Stream G) within the utility permanent easement
will include regrading the stream bed and banks to install a riprap or concrete block revetment for construction of a low-water
ford crossing. The crossing will be installed such that the pre-existing stream grade will be maintained. The total impact to the
stream will be 14 linear feet. This impact is depicted on Sheet 3 of the attached permit drawings.
Impact 2 - (Crossing 7) Construction of the 14-ft permanent stream crossing (Stream C) within the utility permanent easement
will include regrading the stream bed and banks to install a riprap or concrete block revetment for construction of a low-water
ford crossing. The crossing will be installed such that the pre-existing stream grade will be maintained. The total impact to the
stream will be 14 linear feet. This impact is depicted on Sheet 4 of the attached permit drawings. Note that the drawings
show that there was a pre-existing culvert which was removed during construction of the Holly Springs Business Park Pump
Station Project. Therefore, impact 2 is slightly upstream from the previous structure.
Impact 3 - (Crossing 9) Construction of the 14-ft permanent stream crossing (Stream B) within the utility permanent easement
will include regrading the stream bed and banks to install a riprap or concrete block revetment for construction of a low-water
ford crossing. The crossing will be installed such that the pre-existing stream grade will be maintained. The total impact to the
stream will be 14 linear feet. This impact is depicted on Sheet 5 of the attached permit drawings.
Impact 4 - (Crossing 5) Construction of the 14-ft permanent stream crossing (Stream E) within the utility permanent easement
to replace the existing culvert with a riprap or concrete block revetment for construction of a low-water ford crossing. The
crossing will be installed such that the pre-existing stream grade will be maintained. The total impact to the stream will be 14
linear feet. This impact is depicted on Sheet 6 of the attached permit drawings.
Impact 5 - (Crossing 6) Construction of the 14-ft permanent stream crossing (Stream D) within the utility permanent easement
to replace the existing culvert with a riprap or concrete block revetment for construction of a low-water ford crossing. The
crossing will be installed such that the pre-existing stream grade will be maintained. The total impact to the stream will be 14
linear feet. This impact is depicted on Sheet 7 of the attached permit drawings.
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 belgw.-
4a.
Open water 4b.
Name of waterbody 4c. 4d. 4e.
impact number -
Permanent (P) or (if applicable) Type of impact Waterbody type Area of impact (acres)
Temporary T
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.
Page 6 of 12
PCN Form - Version 1.3 December 10, 2008 Version
5a. 15b.
Pond ID Proposed use or purpose
number of pond
5c. 5d.
Wetland Impacts (acres)
Stream Impacts (feet)
Flooded I Filled I Excavated I Flooded I Filled I Excavated
5e.
Upland
(acres)
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.
Project is in which protected basin?
6b. 6c. 6d.
Buffer impact
number - Reason
Permanent (P) or for
Temporarv M impact
B1 ?P?T
B2 ?P?T
B3 ?P?T
? Neuse ? Tar-Pamlico ? Other:
? Catawba ? Randleman
6e. 6f. 6g.
Buffer
Stream name mitigation
required?
? Yes
? No
? Yes
? No
? Yes
? No
6h. Total buffer impacts
Zone 1 impact Zone 2 impact
(square feet) (square feet)
6i. Comments:
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.
The utility corridor includes a 40-foot permanently maintained easement. At each crossing, the permanent fill in the stream
channel is limited to 14 feet within the maintained easement, the minimum width necessary for utility vehicles. The two
locations with existing culverts to be maintained will utilize the same low water ford crossing rather than a culvert and fill.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
At the crossing location within the utility easement, the stream bed will be excavated to a depth to accommodate the riprap or
concrete block for the low water ford crossing such that the elevation of the channel bed will be constructed to pre-
construction elevation and the grade above and below the permanent crossing will be maintained.
Page 7 of 12
PCN Form - Version 1.3 December 10, 2008 Version
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

El Payment to in-lieu fee program
? Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter) Type Quantity
3c. Comments:
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:
4d. Buffer mitigation requested (DWQ only): ? warm ? cool ?cold
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.
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).
Page 8 of 12
PCN Form - Version 1.3 December 10, 2008 Version
6h. Comments:
Page 9 of 12
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:
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project? NA %
2b. Does this project require a Stormwater Management Plan? ? Yes ® No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why: Due to the nature of the project, it is not
anticipated that this project will generate any additional stormwater.
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?
? Phase II
3b. Which of the following locally-implemented stormwa?ter 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
4a. Which of the following state-implemented stormwater management programs apply ? HQW
? 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 Stormwater 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 10 of 12
PCN Form - Version 1.3 December 10, 2008 Version
F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1a . 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
letter.) ? Yes ? No
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):
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.
This project is not anticipated to generate any additional wastewater.
Page 11 of 12
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?

5c. If yes, indicate the USFWS Field Office you have contacted. ?
Raleigh
? Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
The project is located within the previously permitted utility corridor (SAW 2001-028476; NCDWQ Prj. No. 07-1023), and
construction is limited to within the Town of Holly Springs maintenance easement.
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?
The project is located within the previously permitted utility corridor (SAW 2001-028476; NCDWQ Prj. No. 07-1023), and
construction is limited to within the Town of Holly Springs maintenance easement.
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?
The project is located within the previously permitted utility corridor (SAW 2001-028476; NCDWQ Prj. No. 07-1023), and
construction is limited to within the Town of Holly Springs maintenance easement.
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?
T ? Yes ® No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination? reviewed DFIRM on www.ncfloodmaps.com

Cluj JAtr--- 10. 11,10
Applicant/Agent's Printed Name Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant
is provided.
Page 12 of 12
PCN Form - Version 1.3 December 10, 2008 Version
Appendix A - Figures

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Title Vicinity Map
Prepared For:
Project Holly Springs
Wale County, North Carolina

'" Date Project Number Figure
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Appendix C - Agent Authorization
Letter of Authorization
The Town of Holly Springs authorizes Kimley-Horn and Associates, Inc. to act
as our limited agent to prepare and coordinate in the application to the U.S. Army
Corps of Engineers for 404/401 permits and jurisdictional determinations
associated with the Holly Springs Business Park Pump Station - Stream Crossing
Improvements project in Wake County, North Carolina. Authorization will
terminate on either final agency action or upon written notification from either
parties involved.
Client Address:
Town of Holly Springs
Attn: Ms. Stephanie Sudano, P.E., Director of Engineering
P.O. Box 8
Holly Springs, NC 27540
(Signs ure li nt)
VD? ?+ K)
Date