20110308 Ver 1_401 Application_20110411

201 10308
OF W A T?9
O? p° Office Use Only:
y Corps action ID no.
° DWQ project no.
Form Version 1.4 January 2009
Pre-Construction Notification (PCN) Form
A. Applicant Information
1. Processing
1 a. Type(s) of approval sought from the Corps: ? Section 404 Permit ? Section 10 Permit
1 b. Specify Nationwide Permit (NWP) number: 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 X? 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? If so, attach the acceptance letter from mitigation bank
or in-lieu fee program.
? Yes ? No
1 g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below. ? Yes ?X No
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ? Yes Q No
2. Project Information
2a. Name of project: Hobson Court Lot 4
2b. County: Wake
2c. Nearest municipality / town: Raleigh
2d. Subdivision name: Hobson
2e. NCDOT only, T.I.P. or state project no:
3. Owner Information l LS U V/ I C4
3a. Name(s) on Recorded Deed: u
Gray Line Builders r1% In A
3b. Deed Book and Page No. 14180 pg 0025
3c. Responsible Party (for LLC if
applicable): Alan Hill ?? TBZLIUIM
3d. Street address: 804 Preston Village Way
3e. City, state, zip: Cary, NC 27519
3f. Telephone no.: 919-669-5472
3g. Fax no.:
3h. Email address: [e-mail]
Page 1 of 10
PCN Form - Version 1.4 January 2009
4. Applicant Information (if different from owner)
4a. Applicant is: ?X 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:
5b. Business name
(if applicable):
5c. Street address:
5d. City, state, zip:
5e. Telephone no.:
5f. Fax no.:
5g. Email address:
Page 2 of 10
B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): 0794961658
1b. Site coordinates (in decimal degrees): Latitude: Longitude:
1 c. Property size: 0.21 acres
2. Surface Waters
2a. Name of nearest body of water to proposed project:
2b. Water Quality Classification of nearest receiving water:
2c. River basin:
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:
We have a home under construction. All surrounding homes have been completed. There is one empty lot left to be built on.
3b. List the total estimated acreage of all existing wetlands on the property: 0.0689
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property: 60
3d. Explain the purpose of the proposed project:
To install a small timber retaining wall wall in outer zone to protect the structure
3e. Describe the overall project in detail, including the type of equipment to be used:
No equipment - all hand labor to install small timber retaining wall in the outer zone
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? ? Yes ? No X? Unknown

Comments:
4b. If the Corps made the jurisdictional determination, what type
of determination was made? Prelimina
? Preliminary ? Final
4c. If yes, who delineated the jurisdictional areas?
Name (if known): Agency/Consultant Company:
Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
5. Project History
5a. Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past? ?Yes
? No ? Unknown
5b. If yes, explain in detail according to "help file" instructions.
6. Future Project Plans
6a. Is this a phased project? ? Yes ?X No
6b. If yes, explain.
Page 3 of 10
PCN Form - Version 1.4 January 2009
C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
? Wetlands ? Streams - tributaries ?X 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.
Wetland impact
number
Permanent (P) or
Temporary T 2b.
Type of impact 2c.
Type of wetland 2d.
Forested 2e.
Type of jurisdiction
Corps (404,10) or
DWQ (401, other) 2f.
Area of
impact
(acres)
W1 Choose one Unknown Yes/No -
W2 Choose one Choose one Yes/No
W3 Choose one Choose one Yes/No
W4 Choose one Choose one Yes/No
W5 Choose one Choose one Yes/No
W6 Choose one Choose one Yes/No
2g. Total Wetland Impacts: 0
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.
Stream impact
number
Permanent (P) or
Temporary (T) 3b.
Type of impact 3c.
Stream name 3d.
Perennial (PER) or
intermittent (INT)? 3e.
Type of
jurisdiction 3f.
Average
stream
width
(feet) 3g.
Impact
length
(linear
feet)
S1 Choose one
S2 Choose one
S3 Choose one
S4 Choose one
S5 Choose one
S6 Choose one
3h. Total stream and tributary impacts o
3i. Comments:
Page 4 of 10
PCN Form - Version 1.4 January 2009
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 individual) list all open water impacts below.
4a. 4b. 4c. 4d. 4e.
Open water Name of waterbody
impact number (if applicable) Type of impact Waterbody Area of impact (acres)
Permanent (P) or type
Temporary T
01 Choose one Choose
02 Choose one Choose
03 Choose one Choose
04 Choose one Choose
4f. Total open water impacts 0
4g. Comments:
5. Pond or Lake Construction
If and or lake construction proposed, then complete the chart below.
5a. 5b. 5c. 5d. 5e.
Pond ID number Proposed use or Wetland Impacts (acres) Stream Impacts (feet) Upland
purpose of pond (acres)
Flooded Filled Excavated Flooded Filled Excavated
P1 Choose one
P2 Choose one
5f. Total: 0
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? ?X Neuse ? Tar-Pamlico ? Catawba ? Randleman ? Other:
6b. 6c. 6d. 6e. 6f. 6g.
Buffer Impact Reason for impact Stream name Buffer Zone 1 Zone 2
number- mitigation impact impact
Permanent (P) or required? (square (square
Temporary T feet feet
B1 P Retaining Wall No 0 0.00002
B2 Yes/No
B3
Yes/No
B4
Yes/No
B5
Yes/No
B6 Yes/No
6h. Total Buffer Impacts: 0 0.00002
6i. Comments:
rage 5 of 10
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.
Small wall needs to be installed in outer zone to protect the structure. No other place to put it
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
All labor - no machines involved
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: Choose one
Type: Choose one
Type: Choose one Quantity:
Quantity:
Quantity:
3c. Comments:
4. Complete if Makin 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: Choose one
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 6 of 10
PCN Form - Version 1.4 January 2009
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 ?X 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 7 of 10
E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
I a. Does the project include or is it adjacent to protected riparian buffers identified
within one of the NC Riparian Buffer Protection Rules? ? Yes ?X No
1 b. If yes, then is a diffuse flow plan included? If no, explain why.
? Yes ? No
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project? %
2b. Does this project require a Stormwater Management Plan? ? Yes ? No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why:
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
2e. Who will be responsible for the review of the Stormwater Management Plan?
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this project?

3b.
Which of the following locally-implemented stormwater management programs
apply (check all that apply): ? Phase II
? NSW
? USMP
? Water Supply Watershed
? Other:
3c. Has the approved Stormwater Management Plan with proof of approval been
attached? ?Yes [I No
4. DWQ Stormwater Program Review

4a.

Which of the following state-implemented stormwater management programs apply
(check all that apply): E]Coastal counties
?HQW
?ORW

?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 8 of 10
PCN Form - Version 1.4 January 2009
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
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 ?X No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. Is this an after-the-fact permit application? ?Yes ?X 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 ?X 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.
Page 9 of 10
PCN Form - Version 1.4 January 2009
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? Yes No
?
5b. Have you checked with the USFWS concerning Endangered Species Act
impacts? ? Yes ? No
5c. If yes, indicate the USFWS Field Office you have contacted.
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
6. Essential Fish Habitat (Corps Requirement)
3a. 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?
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 (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
? Yes ? No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain? ? Yes ? No
3b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination?

Applicant/Agent's Printed Name
Applicant/Agent's Signature
(Agent's signature is valid only if an authorization
letter from the applicant is rovided. 3- 3C)
Date
Page 10 of 10
SURVEY FOR
GRAY LINE BUILDERS
w LOT 4, WADE AVENUE PROPERTY
0
w 1113 HOBSON COURT
a
a PIN# 0794.12-96-1658
0 0
04
REF: D.B. 14180 PAGE 25? REF: B.M. 2002 PAGE 201
ti-
m VICINITY MAP
CITY OF RALEIGH
0
WAKE COUNTY, NORTH CAROLINA LEGEND:
JANUARY 17, 2011 EIP - EXISTING IRON PIPE
a EPK - EXISTING PK NAIL
00 I REVISED JANUARY 21, 2011 NIP - NEW IRON PIPE SET
a 30 15 0 30 60 R/W - RIGHT OF WAY
CAN - CABLE TV BOX
I ES - ELECTRIC BOX
TEL - TELEPHONE PEDESTAL
SCALE 1 "=30' PP - POWER POLE
I I OHL - OVERHEAD LINE
LP - LIGHT POLE
I I WM - WATER METER
I WV - WATER VALVE
_ l CO - SEWER CLEAN-OUT
nl: a FLOODWAY BOUNDARY
o, a PER. B.M. 2002, PAGE 201 NOTE
N I I NO LOMC FOUND -ELEVATIONS ARE BASED ON
11az I NAVD 88 VERTICAL DATUM.
a c 3 NIP -SUBJECT PROPERTY IS LOCATED
?ar, rc 5 6 I IN FEMA SHFA. BASE FLOOD
rczmm? SOS3 e I O ELEVATION (BFE) = 314.3'
ao o ? cri 6 / I PER FIS PORFILE 322P (SOUTHEAST
PRONG BEAVERDAM CREEK, BASIN 18,
J STREAM 30)
J
vNi 10. YEAR FLOOD PLAIN
¢ T
°I"° ? N' ? 0 PER. B.M. 2002, PAGE 201
m < W ry? / aP e6?/P`,/ ALSO PER LOMR-F CASE 02-04-3374A V'. A ? ® TOP OF FOUNDATION ??:t-
z n WALL ELEV=316,97'
K BANK 9,192 sq.ft.
z \ /CREE
TOP OF -
vry NIP (FIELD LOCATED) , 0.21 1 A. C ??? / @o ° 32a 46 77. 6(0' 0
EIP [ 1 Af,
h 14S B\ ?ti / o TOP OF FOUNDATION ,y \ ZJ JJ E
/ / / \ OS. 3B \ \ ((( ,hy WALL ELEV=321.29' ? S
\ FOUNDATION v/ 'per.
/ // \ \ \ \?n ro ae• 21.3' i
FIELD LOCATED
LIMIT OF E \ \ \ N 6Sn \T \ _ / c, 1,
/ NEUSE RIVER
/ RIPARIAN BUFFER
/
II LINE TABLE I
20' DRAINAGE \ \
• EASEMENT \
/ ? C. A R O Qe, 41 WTOP OF ALL ELEV=3 On95'
O?:,4?SSioJ,
O
2 ' a
sFAQ i
.`.3g'y5 C:
•: .LO:
i
CURVE TABLE `??.•?-

\
TIE TO THE CENTERTj
dp OF THE SAC
HOBSON COURT
45' PUBLIC R/W

CAWTHORNE MOSS I DECLARE THAT THIS SURVEY COMPLIES WITH THE NORTH
CAROLINA STANDARDS OF PRACTICE FOR SURVEYING,
(SECTION 1) FOR CLASS A SURVEYS AND THAT THE
& PANCIERA, P.C. CALCULATED0RA110 OF PRECISION BEFORE ADJUSTMENTS
IS 1:10,000+. FURTHERMORE, PROPERTY CORNERS SHOWN
Professional Land Surveyors ARE PRIMARY CONTROL MONUMENTATION FOR THE RE-
C-1525 ESTABLISH OF PROPERTY CORNERS IN THE ABSENCE
OF GRI ONU ENTS AND OTHER SUBDIVISION PROPERTY
333 S. White Street COR S. THI SURVEY IS NOT E RECORDED WITH-
Post Office BOX 1253 OU THE N AUTHORI OF THE SURVEYOR.
Wake Forest, N.C. 27588
[phone]
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