20210259 Ver 1_ePCN Application_20210205

DWR
mrlslon of Water Resources
Pre -Construction Notification (PCN) Form
October 26, 2020 Ver 3.3
Initial Review
Has this project met the requirements for acceptance in to the review process?*
r Yes
r No
Is this project a public transportation project?*
G Yes r No
Change only if needed.
BIMS # Assigned
20210259
Is a payment required for this project?*
r No payment required
r Fee received
r Fee needed - send electronic notification
Select Project Reviewer*
Holley Snider:eads\hasnider
Information for Initial Review
la. Name of project:
COURTESY COPY Lot 64 Belvedere
1a. Who is the Primary Contact?*
Gene Young, REHS
1b. Primary Contact Email:*
[e-mail]
Date Submitted
2/5/2021
Nearest Body of Water
Intracoastal Waterway
Basin
White Oak
Water Classification
SA; HOW
Site Coordinates
Latitude: Longitude:
34.383031-77.640342
Pre -Filing Meeting Information
ID#
Pre -fling Meeting or Request Date*
2/5/2021
Attach documentation of Pre -Filing Meeting Request here:*
DWR Pre -Filing Meeting Request Form.pdf
Version#*
1
Reviewing Office*
Wilmington Regional Office - [phone]
1c. Primary Contact Phone:*
[phone]
Version
54.66KB
A. Processing Information C^U
County (or Counties) where the project is located:
Pender

Is this a NCDMS Project
r Yes r No
Is this project a public transportation project?*
r Yes r No
la. Type(s) of approval sought from the Corps:
* Section 404 Permit (wetlands, streams and waters, Clean Water Act)
r Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
Has this PCN previously been submitted?*
r Yes
r No
1b. What type(s) of permit(s) do you wish to seek authorization?
W Nationwide Permit (NWP)
r Regional General Permit (RGP)
r Standard (IP)
1c. Has the NWP or GP number been verified by the Corps?
r Yes r No
Nationwide Permit (NWP) Number:
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
W 401 Water Quality Certification - Regular
r Non-404 Jurisdictional General Permit
r Individual Permit
29 - Residential Developments
le. Is this notification solely for the record because written approval is not required?
For the record only for DWR401 Certification:
For the record only for Corps Permit:
r 401 Water Quality Certification - E)press
r Riparian Buffer Authorization
1f. Is this an after -the -fact permit application?*
r Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
r Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
r Yes r No
Acceptance Letter Attachment
1h. Is the project located in any of NC's twenty coastal counties?
r Yes r No
1i. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
r Yes r No r Unknown
1j. Is the project located in a designated trout watershed?
r Yes r No
B. Applicant Information
1d. Who is applying for the permit?
F Owner W Applicant (other than owner)
le. Is there an Agent/Consultant for this project?*
r Yes (- No
2. Owner Information
2a. Name(s) on recorded deed:
Robert Crane
2b. Deed book and page no.:
1154/1
2c. Responsible party:
*
r Yes r No
r Yes r No

2d.Address
Street Address
138 Timberslide CT
Address Line 2
aty
State / Province / Iagion
Springboro
OH
Postal / Zip (ode
Country
45066
USA
2e. Telephone Number: 2f. Fax Number:
[phone]
2g. Email Address:*
[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
Chris Plaford
3b. Business Name:
Capital Asset Topsail Development, LLC
3c.Address
Street Address
1121 Military Cutoff RD, suite c 336
Address Line 2
City
State / Province / legion
Wilmington
NC
Postal / Zip Code
Country
28405
USA
3d. Telephone Number: 3e. Fax Number:
[phone]
3f. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Gene Young, REHS
4b. Business Name:
Applied Resource Management, PC
4c.Address
Street Address
257 Transfer Station RD
Address Line 2
City
State / Province / legion
Hampstead
NC
Postal / Zip (ode
Country
28443
USA
4d. Telephone Number: 4e. Fax Number:
[phone]
4f. Email Address:*
[e-mail]
Agent Authorization Letter*
Scan Feb 4 2021 at 9.06 AM.pdf 1.34MB
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(if appropriate)
Belvedere
1c. Nearest municipality/ town:
Hampstead, NC

2. Project Identification
2a. Property Identification Number:
4213-03-2252-0000
2c. Project Address
Street Address
soundview Drive
Address Line 2
cly
Hampstead
Postal / Zip Code
28443
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Intracoastal Waterway
3b. Water Resources Classification of nearest receiving water:*
SA; HOW
3c. What river basin(s) is your project located in?*
White Oak
3d. Please provide the 12-digit HUC in which the project is located.
030203020403
4. Project Description and History
2b. Property size:
0.91
State / Province / Region
NC
Country
USA
4a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this application:*
site is undeveloped in an existing neighborhood.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
r Yes r No r Unknown
4d. Attach an 8 1/2 X 11 excerpt from the most recent version of the USGS topographic map indicating the location of the project site. (for DWR)
Site Vicinity. pdf 857.37KB
4e. Attach an 8 1/2 X 11 excerpt from the most recent version of the published County NRCS Soil Survey map depicting the project site. (for DWR)
soils map.pdf 565.72KB
4f. List the total estimated acreage of all existing wetlands on the property:
0.6
4g. List the total estimated linear feet of all existing streams on the property:
n/a
4h. Explain the purpose of the proposed project:*
the purpose is to construct a single family residence
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
In order to build the home, a small area of fill will be needed to allowfor construction equipment such as cranes, backhoes, dump trucks, etc. The fill is proposed to be stabilized with a
retaining wall.
4j. Please upload project drawings for the proposed project.
survey.pdf 186.54KB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes r No r Unknown
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
r Preliminary r Approved r Not Verified r Unknown r N/A
Corps AID Number:
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Gene Young, REHS
Agency/Consultant Company: Applied Resource Management, PC

Other:
5d1. Jurisdictional determination upload
6. Future Project Plans
6a. Is this a phased project?*
r Yes r No
Are any other NWP(s), regional general permit(s), or individual permits(s) used, or intended to be used, to authorize any part of the proposed project or related activity?
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
W Wetlands r Streams -tributaries
r Open Waters r Pond Construction
2. Wetland Impacts
F Buffers
a. Site #* (?) 2a1 Reason (?) 2b. Impact type * (?) 2c. Type of W. 2d. W. name * 2e. Forested * 2f. Type of 2g. Impact
Jurisdicition*(?) area�77�
fill P Estuarine Woody Wetland unknown No Corps 0.070
(acres)
2g. Total Temporary Wetland Impact
0.000
2g. Total Wetland Impact
0.070
2h. Comments:
E. Impact Justification and Mitigation
1. Avoidance and Minimization
2g. Total Permanent Wetland Impact
0.070
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
Fill is only proposed in order to provide proper access for construction equipment to the back of the residence.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
The fill material is to be stabilized with use of a retaining wall. This will minimize the total area of impact by eliminating the use of slope and fill
techniques.
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?
r Yes r No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
below the minimum threshold of 0.1 acres.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
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?
r Yes f• No
If no, explain why:
not in these areas.
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
r Yes r No
2b. Does this project meet the requirements for low density projects as defined in 15ANCAC 02H .1003(2)?
U

r Yes r No
2c. Does this project have a stormwater management plan (SMP) reviewed and approved under a state stormwater program or state -approved local government stormwater
program?
r- Yes r- No
r N/A - project disturbs < 1 acre
Comments:
total impervious as shown on survey is approximately 17%.
G. Supplementary Information
1. Environmental Documentation
la. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?*
r- Yes r No
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification Rules (15A NCAC 2H .0500), Isolated Wetland Rules (15A NCAC 2H .1300), or DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15A NCAC 2B .0200)? *
r- Yes r No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality?*
r- Yes r No
3b. If you answered "no," provide a short narrative description.
this is the only impact proposed on this property.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
r Yes r- Nor N/A
4b. Describe, in detail, the treatment methods and dispositions (non -discharge or discharge) of wastewater generated from the proposed project. If the wastewater will be treated
at a treatment plant, list the capacity available at that plant.
wastewater to be disposed of by on -site septic system.
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?*
r- Yes r No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
r- Yes r No
5d. Is another Federal agency involved?*
r- Yes r No r- Unknown
5e. Is this a DOT project located within Division's 1-8?
r- Yes r No
5f. Will you cut any trees in order to conduct the work in waters of the U.S.?
r- Yes r No
5g. Does this project involve bridge maintenance or removal?
r- Yes r No
5h. Does this project involve the construction/installation of a wind turbine(s)?*
r- Yes r No
5i. Does this project involve (1) blasting, and/or (2) other percussive activities that will be conducted by machines, such as jackhammers, mechanized pile drivers, etc.?
r- Yes r No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
NC Natural Heritage website
Consultation Documentation Upload
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*

t^ Yes r No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
not in an aquatic environment
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?*
r Yes r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
NCHPOWEB 2.0
7c. Historic or Prehistoric Information Upload
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
r Yes r No
8b. If yes, explain how project meets FEMA requirements:
unknown. House will be built to meet all requirements.
8c. What source(s) did you use to make the floodplain determination?*
Pander County GIS Tax map
Miscellaneous
Comments
Miscellaneous attachments not previously requested.
Signature
*
V By checking the box and signing below, I certify that:
• The project proponent hereby certifies that all information contained herein is true, accurate, and complete to the best of my knowledge and belief; and
• The project proponent hereby requests that the certifying authority review and take action on this CWA 401 certification request within the applicable reasonable period of time.
• I have given true, accurate, and complete information on this form;
• I agree that submission of this PCN form is a "transaction" subject to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
• I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act');
• I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature; AND
• I intend to electronically sign and submit the PCN form.
Full Name:
Gene Young, REHS
Signature
qej ,G �00,hg, vgs
Date
2/5/2021

Jurisdictional Determination Request
D. PROPERTY OWNER CERTIFICATION'
1, the undersigned, a duly authorized owner of record of the property/properties identified herein,
do authorize representatives of the Wilmington District, U.S. Army Corps of Engineers (Corps)
to enter upon the property herein described for the purpose of conducting on -site investigations
and issuing a detennination associated with Waters of the U.S. subject to Federal jurisdiction
under Sect' 404 f t e Clean Wa er Act and/ Section10 of the River and Harbors Act of
1899 ��;� /I�tQfld' C
� r
maf e 9-A
Property Own lease prim, A � Date
Property Owner Signature
E. JURISDICTIONAL DETERMINATION TYPE
Select One:
I am requesting that the Corps provide a preliminary JD for the property identified herein.
This request does include a delineation.
❑ I am requesting that the Corps provide a preliminary JD for the property identified herein.
This request does NOT include a delineation.
I am requesting that the Corps investigate the property/project area for the presence or
absence of WOUSs and provide an approved JD for the property identified herein. This
request does NOT include a request for a verified delineation.
❑ I am requesting that the Corps delineate the boundaries of all WoUS on a property/project
area and provide an improved JD (this may or may not include a survey plat).
❑✓ I am requesting that the Corps evaluate and approve a delineation of WoUS (conducted
by others) on a property/project area and provide an approved JD (may or may not
include a survey plat).
4 For NCDOT requests following the current NCDOT/USACE protocols, skip to Part E.
5 Waters of the United States
Version: December 2013 Page 4

Date:
To Whom It May Concern:
RE: Agent and Access Authorization Letter
I authorize Gene Young or any employee of Applied Resource Management, PC to act
as an agent on my behalf in all matters dealing with wetland Jurisdictional
Determinations, reviews or permitting.
I furthermore authorize the US Army Corps of Engineers and/or the North Carolina
Division of Water Resources representative(s) to access my property as part of this
process.
Sincery,
�r
Printed Name.
Property Address: �� 6q 5011141/ e�
�k&p Al c
lbrAj,

r-
S 1 L t ra L 1.f a to L
a terra
Psail
lour
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Topsail acb
Map adapted from USGS Topsail, NC 2019
TITLE: Lot 64 Belvedere FIGURE:
Applied Rcoource Site Vicinity
Management, i? C. JOB: SCALE: DATE: DRAWN BY:
1 = 1000 Hampstead, NC 28443 20515 2/5/21 GY

110 PaA 5051 506 )Bo
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r
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PIN: 4213-03-2252-0000
Sale Price:
Acres:0
Pender County
Owner: CRANE, ROBERT M
Sale Date: LAST —SALE —DATE
Land Value: $316,672
138 TIMBERSLIDE CT
Plat: 00160020
Building Value: $0
SPRINGBORO, OH 45066
Account No: 47796
Total value: $316,672
1:3,290
0 0.0225 0.045 0.09 mi
Township: TOPSAIL
Deferred Value: $0
Deed Ref: 1154/1
Subdivision: BELVEDERE PLANTATION
Exempt Amount: 0
0 0.0375 0.075 0.15 km
Tax Codes: G01 F22 R40
PCL Class: R
1 inch = 274 feet N
Property
Address:
Heated Sq Feet:
W / E
Description: LT 64 PB 16/20 BELVEDERE PLANTATION
February 5, 2021
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