20110484 Ver 1_401 Application_20110511

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DWQ project no.
Form Version 1.4 January 2009
Pre-Construction Notification (PCN) Form
A. Applicant Information
fbSpecify rocessing
pe(s) of approval sought from the Corps: ?X Section 404 Permit
? Section 10 Permit
Nationwide Permit (NWP) number: 29 & 33 or General Permit (GP) number:
s the NWP or GP number been verified by the Corps? Yes No
pe(s) of approval sought from the DWQ (check all that apply):
401 Water Quality Certification -Regular
E] Non-404 Jurisdictional General Permit
? 401 Water Quality Certification - Express ? Riparian Buffer Authorization
1 e. Is this notification solely for the record For the record only for DWQ
because written approval is not required? 401 Certification:
? Yes ?X 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.
1 g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below.
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
2. Project Information
2a. Name of project: Lake Rim North Addition
2b. County: Cumberland
2c. Nearest municipality / town: Fayetteville
2d. Subdivision name: Lake Rim North
2e. NCDOT only, T.I.P. or state project no:
3. Owner Information
For the record only for Corps Permit:
? Yes ?X No
? Yes ? No
? Yes ?X No
? Yes No
1 8 2011
8
3a. Name(s) on Recorded Deed: K & G Developers, LLC
3b. Deed Book and Page No. Deed Bk 7068 Pg 868, Bk 6956 Pg 173, Bk 6956 Pg 176
3c. Responsible Party (for LLC if
annlirahla)• Harold Kidd
3d. Street address_ _ 6885 Cliffdale Road
3e. City, state, zip: Fayetteville, NC 28314
3f. Telephone no.: 910-864-9727
3g. Fax no.: 910-868-6796
311. Email address: [e-mail]
Page 1 of 10
PCN Form - Version 1.4 January 2009
Page 2 of 10
B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): 9487-83-6238; 9487-75-7051; 9487-74-7238
1 b. Site coordinates (in decimal degrees): Latitude: 35.05489 Longitude: 79.03954
1 c. Property size: 59.39 acres
2. Surface Waters
2a. Name of nearest body of water to proposed project:
2b. Water Quality Classification of nearest receiving water: Bones Creek
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:
Property is an existing tract of land with rolling hills. The property was timbered around 2002 and is mostly cleared with existing weeds and briars
covering most of these areas. The general land use in the vicinity is residential development.
3b. List the total estimated acreage of all existing wetlands on the property: 4.1
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:
Project is to consist of a residential development to include sanitary sewer, storm sewer, water, streets and sidewalks. An 8" sanitary sewer line is to
be constructed across Bones Creek. This line will be above ground.
3e. Describe the overall project in detail, including the type of equipment to be used:
"
An 8
sanitary sewer line is to be constructed across Bones Creek with piers. Streets are to be constructed with utilities to service residential
development. Contractor to use standard heavy equipment for earth moving, utility constr & asphalt paving
.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
0 Yes ? No ? Unknown
r2ject includin all prior phases) in the past? Comments:
4b. If the Corps made the jurisdictional determination, what type
of determination was made? ? Preliminary Q Final
4c. If yes, who delineated the jurisdictional areas? Agency/Consultant Company:
Name (if known): T.J. Pappas, REM Other: K+ Environmental Services
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation
.
Met Wednesday, April 13, 2011 with Crystal Amschler 8 Jennifer Frye and received verbal determination. Documental determination not yet received.
5. Project History
5a. Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past? ?Yes EE 99 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):
?X 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 impact
Type of wetland
Forested
Type of jurisdiction .
Area of
number
Permanent (P) or Corps (404,10) or impact

Temporary T DWQ (401, other) (acres)
W1 P Road Crossing Scrub Shrub No Corps 0.024
W2 P Road Crossing Scrub Shrub No Corps 0.057
W3 T Sediment Measure Unknown No Corps 01
_ W4 T _ Utility Crossing Vegatative Yes Corps 0.098
W5 Choose one Choose one Yes/No
W6 Choose one Choose one Yes/No
2g. Total Wetland Impacts: 0.279
2h. Comments:
(W3) Bones Creek is above ground sanitary sewer for clearing and grubbing. It is temporary impact and above ground.
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 (PER) or Type of Average Impact
number
Permanent (P) or intermittent (INT)? jurisdiction stream length

Temporary (T) width (linear
(feet) 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
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.
Open water 4b.
Name of waterbody 4c. 4d. 4e.
impact number
Permanent (P) or (if applicable) Type of impact Waterbody Area of impact (acres)

Temporary T type
01 Choose one Choose
02 Choose one Choose
03 Choose one Choose
04 Choose one Choose
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

Pond ID number
Proposed use or
Wetland Impacts (acres)
Stream Impacts (feet) .
Upland
purpose of pond (acres)
Flooded Filled Excavated Flooded Filled Excavated
Pi Stormwater 1.12
P2 Choose one
5f. Total: 12
5g. Comments: Used as a storm water detention basin.
5h. Is a dam high hazard permit required? ? Yes Z No If yes, permit ID no:
5i. Expected pond surface area (acres): 1.12
5j. Size of pond watershed (acres): 66.23
5k. Method of construction: Mechanized
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? E] Neuse [] Tar-Pamlico F1 Catawba E] Randleman ? Other:
6b 6c
.
Buffer Impact .
Reason for impact 6d.
Stream name 6e.
Buffer 6f.
Zone 1 6g.
Zone 2
number -
Permanent (P) or mitigation impact impact

Temporary T required? (square (square
feet feet)
B1 -
Yes/No
B2
Yes/No
B3
Yes/No
B4
Yes/No
B5
Yes/No
B6
Yes/No
6h. Total Buffer Impacts:
61. Comments: Project is not in a protected buffer area.
Page 5 of 10
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
Temporary impact location W3 at Bones Creek for sanitary sewer is only feasible location to tie into existing system based on gravity flow.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Sediment erosion control features maintained throughout construction. Hand clearing and construction utilized instead of mechanized construction
when prudent. Skid plates placed in and near wetland areas to avoid direct contact.
2. Com ensato 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:
riva eer an arra arms in a area are no currently accepting applications.
3c. Comments:
4. Complete if Makin a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached. ?X Yes
4b. Stream mitigation requested: 0 linear feet
4c. If using stream mitigation, stream temperature: Choose one
4d. Buffer mitigation requested (DWQ only): 0 square feet
4e. Riparian wetland mitigation requested: 0 acres
4f. Non-riparian wetland mitigation requested: -0.1 acres
4g. Coastal (tidal) wetland mitigation requested: 0 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 ? 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.
6c. 6d. 6e.
Zone Reason for impact Total impact Multiplier Required mitigation
(square feet) (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: Site is not within a protected riparian buffer area
Page 7 of 10
E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
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? Yes QX 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? 42%
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:
All storm water run off will be piped to a proposed permanent detention pond located near the southeast corner of project. See Section Pond.
We will provide a copy of the Phase 2 SW Permit and Approved SMP when it is approved.
2e. Who will be responsible for the review of the Stormwater Management Plan? DWQ - Stormwater Unit
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this ro'ect? Fayetteville, NC

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

4a. Which of the following state-implemented stormwater management programs apply

(check all that apply): nCoastal counties

HQW
?O
RW
nX Session Law 2006-246
?Other:
4b. Has the approved Stormwater Management Plan with proof of approval been
attached?
? Yes Q 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? E] 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 ?X 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 ?X 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
d
i ?Yes ?X No
a
d
tional 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.
Sewage to be treated by City of Fayetteville, PWC
Page 9of10
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 ? Yes ?X 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
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
USFW5 Species Reports, Environmental Data Research
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?
USFWS
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?
National Heritage Foundation
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain? ? Yes ?X No
8b. If yes, explain how project meets FEMA requirements:
All improvements will be above the 100 year flood elevation
8c. What source(s) did you use to make the floodplain determination?
FEMA FIRM PANEL 3710949700J
Harold Kidd
C?=?O 5 LQ-Z.O v `
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 10 of 10
NCDWQ Stream Classification Form
Project Name: t,9tcC It 141 014eiver13 as in: e9/'? County: GvAsC 4t-9-)o Evaluator:
DWQ P?/,? Number: Nearest Named Stream: Latitude: 7,f -I///- Signature: = ??y
Date: 4 .) .x010 USGS QUAD: I a Longitude: ?J , pj-140 Location/Directions: /?i.h e a,4,6
*PLEA NOTE: If evaluator and landowner agree that the feature is a man-trade ditch, then use of this form is not necessary.
Also, if in the best professional Judgement of the evaluator, the feature is a than-made ditch and not a modified natural stream-this
rating system should not be used*
Primary Field Indicators: (Circle One Number Per Line)•
I. Geomoriphology Absent Weak Moderate Strong
1) Is There A Riffle-Pool SeQuence? 0 . 60' 2 3
21 is The I IMA Terhtre In ChramhPA
9) Is a Continuous Bed & Bank Present? 0 1 3
('NOTE- UBed & Bank Caused BvDitchowAnd WITHOUTSitmontvThen Score=O')
10) Is a 2n' Order Or Greater Channel (As Indicated
PRIMARY GEOMORPHOL OG Y INDICA
II, Hydrology Absent Weak Moderate Strong
1) Is There A Groundwater
Flow/Discharge Present? L0; 1 2 3
PRIMARYHYDROLOGYINDICATOR POINTS.--O
Secondary Field Indicators: (Circle One Number Per Line)
2Z Is There A Grade Control Point In Channel? 6) 5 1 1.5
3) Does Topography Indicate A
Natural Drainage Way? 0 1 1.5
SECONDARY GEOMORPHOLOGYINDICATOR POINTS.
Il. Hydrology Absent Weak Moderate Strong
1) Is This Year's (Or Last Year's) Leaflitter
Present In Streambed? 1 1 .5 a
2) Is Sediment On Plants (Or Debris) Presents 0 5 1 f.5
S) 1S Mere An Active (Ur Kelic)
PRIMARYBIOLOGYINDICATOR POINTS: ?_

4) Is Water In Channel And >48 Hrs. Since 0 1 1.5
Last Known Rain? N TE: I Ditch Indicated In #9 Above Ski This Ste And #S Below*)
5) Is There Water In Channel During Dry 0 .5 1 1.5
Conditions Or In Growi Seison ?
6) Are Hydric Soils Present In Sides Of Channel (Or In Headcut)? es=1 S/ No=0
SECONDARYHYDROLOGYINDICA TOR POINTS:
III. Biolo Absent Weak Moderate Stron
1) Are Fish Present? .5 1 1.5
8) Are Wetland Plants In Streambed? SAV Mostly OBL Mostly FACW Mostly FAC Mostly FACU
Mostly UPL O
NOTE. YTotal Absence OjAll Plants In Streambed 2 1 75 .5 0 0
As Noted Above Ski 77tis Step UNLESS SAV Present*).
SECONDARYBIOLOGYINDICATOR POINTS:
TOTAL POINTS (Primary + Secondary) = l?" (If Greater Than Or Equal To 19 Points The
Stream Is At Least Intermittent)
Notes:
2
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