20110666 Ver 1_401 Application_20110711

AECOM
TO: NC DWQ
401/Wetlands Unit
1650 Mail Service Center
Raleigh, NC 27699
WE ARE SENDING YOU
? Attached ? Prints
? Shop Drawings ? Change Order
? Copy of Letter
Letter
241 10666
DATE: 11-Jul-11 PROJECT NO.: 60184291.12.02
ATTENTION: Amy Chapman
RE: Hogan Lane Water and Sewer Extensions
PCN Application
? Under separate cover via the following items:
ID Plans ? Samples ? Specifications
COPIES DATE NO. DESCRIPTION
3 PCN Form
3 Agent Authorization Form
3 Statement of Availability
2 24"X36" Plans - Full Size
3 11 "X17" Plans

I mC.JC Ar rZ 1 rVANOMl 1 1 CU HJ l rIlLU tU tStLUVV:
IZI For approval ? Approved as submitted
? For your use ? Approved as noted
? As requested ? Returned for corrections
? For review and comment ?
? For Bids Due .2011
? Prints Returned After I nan to I Ic
COPY TO: Project File 60184291/500 SIGNED: Beth Steffens
If enclosures are not as noted, kindly notify us at once.
701 Corporate Center Drive, Suite 475, Raleigh, North Carolina 27607-5074
Telephone [phone] Facsimile 919.854.6259
? Resubmit copies for approval
? submit copies for distribution
? Return corrected prints
20110666
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Office Use Only:
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.
?X Yes ? No
1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1h
below. ? Yes ?X No
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ? Yes X? No
2. Project Information
2a. Name of project: Hogan Lane Water and Sewer Extension
2b. County: Wake
2c. Nearest municipality / town: Raleigh
2d. Subdivision name: NA
2e. NCDOT only, T.I.P. or state project no: 3 201,
3. Owner Information NR .
3a. Name(s) on Recorded Deed: City of Raleigh
3b. Deed Book and Page No. MB 1969, Page No. 26; MB 2011, Page 164
3c. Responsible Party (for LLC if
applicable): City of Raleigh - Public Utilities Department
3d. Street address: 1 Exchange Plaza, Suite 620
3e. City, state, zip: Raleigh, NC 27602
3f. Telephone no.: 919-857-4544
3g. Fax no.: 919-857-4545
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: ? 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: Beth Steffens
5b. Business name
(if applicable): AECOM
5c. Street address: 701 Corporate Center Drive, Suite 475
5d. City, state, zip: Raleigh, NC 27607
5e. Telephone no.: 919-256-6311
5f. Fax no.: 919-854-6259
5g. Email address: [e-mail]
Page 2 of 10
B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): 0794-23-5162
1 b. Site coordinates (in decimal degrees): Latitude: 35.7915 Longitude: -78.688
1 c. Property size: 0.33 acres
2. Surface Waters
2a. Name of nearest body of water to proposed project: Rocky Branch
2b. Water Quality Classification of nearest receiving water: C, NSW
2c. River basin: Neuse
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 is located in a residential housing area that is maintained by the homeowners.
3b. List the total estimated acreage of all existing wetlands on the property:
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property: 40
3d. Explain the purpose of the proposed project:
Replacement of existing 18-inch sewer line for maintenance reasons and extension of sewer line at the request of the property owners.
3e. Describe the overall project in detail, including the type of equipment to be used:
The sewer lines will be installed using an open-trench method. Backhoes and trench boxes will be used as applicable.
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? ? 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 X? 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 Choose one 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:
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
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
Tem ora T
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
P1 Choose one
P2 Choose one
5f. Total:
5g. Comments:
5h. Is a dam high hazard permit required? ? Yes F] 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 ou MUST fill out Section D of this form.
6a. Project is in which protected basin? pX 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 T open trench/refill Rocky Branch Yes 100 200
B2 - Yes/No
B3 - Yes/No
B4
Yes/No
B5 - Yes/No
B6 - Yes/No
6h. Total Buffer Impacts: 100 200
6i. Comments: Impact measurement calculated from edge of 30' existing City of Raleigh sanitary sewer to edge of Zone 1 and Zone 2
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.
All impacts will be temporary. All areas of disturbance will be returned to grade and contours and seeded.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Erosion and sedimentation control devices will be installed prior to land disturbing activities and the contractor will be instructed to minimize land
disturbance during construction.
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 X Yes No
buffer mitigation?
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 new sewer/open trench 0 3 (2 for Catawba) 300
Zone 2 1.5
6f. Total buffer mitigation required: 300
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).
Payment to a private mitigation bank is proposed. A statement of availability from EarthMark North Carolina, LLC is attached.
Per the NCDENR Buffer Interpretation/Clarification Memo #2011-001 dated 3/3/2011
6h. Comments: Installing a new non-electric utility line outside of a maintained corridor of an existing utility line easement: In Zone 2 (Allowable), In
Zone 1 (Allowable w/Mitigation). Therefore mitigation is only required for the portion of the line being installed in Zone 1.
Page 7 of 10
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
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 ? No
4. DWQ Stormwater Program Review

4a.

Which of the following state-implemented stormwater management programs apply
(check all that apply): []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)
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?
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
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination?
I,I:1AFiFTq 4rl; Fi'NS CF. S!#? 7/1/0//
Applicant/Agent's Printed Name Applicant/Agent's Signature
(Agent's signature is valid only if an authorization
letter from the applicant is provided. Date
Page 10 of 10
SAMPLE AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO,
na
PLAN NO. na PARCEL ID: 0794-23-5162
STREET ADDRESS: 603 Royal Street Raleigh, NC 27607
Please print: City of Raleigh - Sewer Easement
Property Owner:
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
Beth Steffens AECOM
of
(Contractor / Agent) (Name of consulting firm)
to act on my behalf and take all actions necessary for the processing, issuance and acceptance of
this permit or certification and any and all standard and special conditions attached.
Property Owner's Address (if different than property above):
Z Exchange Plaza, Suite 620, Raleigh, NC 27602
Telephone: [phone]
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Authorized Signature Authorized Signature
Date:
Q/ Date:
??l?c !J/Y???r?s b•???
Forrest Creek Riparian Buffer Mitigation Bank
Statement of Availability-June 10, 2011
NC Division of Water Quality U.S. Army Corps of Engineers
Ms. Lia Myott Gilleski Mr. Monti Matthews
401 Oversight/Express Permitting Unit CESAW-RG-R
1650 Mail Service Center Raleigh Regulatory Field Office
Raleigh, NC 27699-1650 3331 Heritage Trade Center, Suite 105
Wake Forest, NC 27587
Re Project: Hogan Lane Water and Sewer Extension
This document confirms that City of RalieghlApplicant) for the Hogan Lane Water and Sewer
Extension has expressed an interest to reserve 100 Square feet of Riparian Buffer Mitigation
Credits/Units from the Forrest Creek Riparian Buffer Mitigation Bank. The Forrest Creek
Riparian Buffer Mitigation Bank (Banker) attests to the fact that 100 Square Feet of Mitigation
is currently available for immediate transfer from its Official Bank Credit Ledger to Applicant as
of this date.
Banker will notify applicant if the 100 credits/units become considered "At Risk" of not being
available upon permit issuance. Credits are not considered secured until payment in full is
received from the Applicant resulting in the issuance of a Bill of Sale and Affidavit of Sale by the
bank acknowledging that the applicant has fully secured credits from the bank and the Banker
has accepted full responsibility for the mitigation obligation requiring the credits/units.
The Banker will issue the Affidavit of Sale within ten (10) days of receipt of the balance of the
Purchase Price. Banker shall provide to Applicant with a copy of the Affidavit of Sale and a
documented copy of the debit of credits from the Bank Official Credit Ledger showing the
permit number and the resource type secured by the applicant. A copy of the Affidavit of Sale,
with an updated Official Credit Ledger will also be sent to regulatory agencies showing the
proper documentation.
If any questions need to be answered, please contact me at 239-872-1678
Best Regards
/&44 k;k_
Matthew R. Fisher
EarthMark North Carolina, LLC
An Affiliate of EBX
909 Capability Drive Suite 3100
Raleigh, NC 27606