20120378 Ver 1_401 Application_20120412

4/12/12
North Carolina D"
To Whom It May Concern
Please contact me if you have any questions
Thank you
Randy Hignite
Cell 252 916 5328
201 20378
RECEIVED
APR 16 2012
APR j 72012 �

201 20378
Office Use Only
Corps action ID no
DWQ project no
Form Version 1 3 Dec 10 2008
Page 1 of 11
PCN Form - Version 1 3 December 10 2008 Version
Pre - Construction Notification PCN Form
A Applicant Information
1
Processing
I
i
la
Type(s) of approval sought from the
Corps
®Section 404 Permit ❑Section 10 Permit
lb Specify Nationwide Permit (NWP) number 18 or General Permit (GP) number
1c
Has the NWP or GP number been verified by the Corps?
® Yes
❑ No
1 d
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
le
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 m lieu
fee program
El Yes
No
1g
Is the project located in any of NC s twenty coastal counties If yes answer 1 h
below
N Yes
❑ 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
Wolfe Minor Fill
2b
County
Hyde
2c
Nearest municipality / town
Ocracoke
2d
Subdivision name
Widgeon Woods
2e
NCDOT only T I P or state
project no
qPR
3
Owner Information
16. U 2
3a
Name(s) on Recorded Deed
Jeff Wolfe
3b
Deed Book and Page No
Pook 98 Page 227
BrB,
3c
Responsible Party (for LLC if
applicable)
3d
Street address
52 South Widgeon Road
3e
City state zip
Ocracoke North Carolina 27960
3f
Telephone no
3g
Fax no
3h
Email address
-
-
Page 1 of 11
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
Randy Higrnte
5b
Business name
(if applicable)
5c
Street address
1255 Juniper Bay Road
5d
City state zip
Swan Quarter North Carolina 27885
5e
Telephone no
252 9165328
5f
Fax no
5g
Email address
Page 2 of 11
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)
1 b Site coordinates (in decimal degrees)
Latitude 35 10717 Longitude 75 983753
(DD DDDDDD) ( DD DDDDDD)
1 c Property size
17 acres
2 Surface Waters
2a Name of nearest body of water (stream river etc ) to
Pamlico Sound
proposed project
2b Water Quality Classification of nearest receiving water
2c River basin
Pasquotank HUC 03020105
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 property is located in an existing subdivision with residential properties on adjacent lands There is a man made relic
mosquito ditch at the rear of the property that extends across several adjacent lots
3b List the total estimated acreage of all existing wetlands on the property
900 sq ft (0 02 acres)
3c List the total estimated linear feet of all existing streams (intermittent and perennial) on the property
3d Explain the purpose of the proposed project
The purpose of the project is to fill a man made relic mosquito ditch in order to negate current property erosion as well as
eliminate an avenue for flood waters to impacts residential properties A secondary benefit would be to eliminate an area
used by snakes mosquitos and other animals
3e Describe the overall project in detail including the type of equipment to be used
The project would inivolve clean fill material and appropriate equipment in order to fill an approximate 90 foot x 10 foot
wetland area The area will be filled to the elevation of the adjacent high ground and all material will be confined to the
permit area
4 Jurisdictional Determinations
4a Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
® Yes ❑ No ❑ Unknown
project (including all prior phases) in the past?
Comments
4b If the Corps made the jurisdictional determination what type
®Preliminary [:1 Final
of determination was made
4c If yes who delineated the jurisdictional areas?
Agency /Consultant Company
Name (if known) Josh Pelletier
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
El Yes ®No El Unknown
this project (including all prior phases) in the past
5b If yes explain in derail according to help file instructions
Page 3 of 11
PCN Form — Version 1 3 December 10 2008 Version

6 Future Project Plans
6a Is this a phased project? ❑ Yes ® No
6b If yes explain
Page 4 of 11
PCN Form — Version 1 3 December 10 2008 Version

C Proposed Impacts Inventory
1 Impacts Summary
la 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
Fill
❑ Yes
® Corps
0 02
® 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 Only permitted portion of the man made ditch will be filled
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
(PER) or
(Corps 404 10
stream
length
Permanent (P) or
intermittent
DWQ — non 404
width
(linear
Temporary (T)
(INT)?
other)
(feet)
feet)
S1 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S2 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S3 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S4 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S5 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S6 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
.)h Total stream and tributary impacts
31 Comments
Page 5 r)f 11
PCN Form —Version 1 3 December 10 2008 Version

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 below
4a
4b
4c
4d
4e
Open water
Name of waterbody
impact number —
(if applicable)
Type of impact
Waterbody type
Area of impact (acres)
Permanent (P) or
Temporary T
01 ❑ PEI T
02 ❑ PEI T
03 ❑P ❑T
04 ❑P ❑T
4f Total open water impacts
4g Comments
5 Pond or Lake Construction
If pond or lake construction proposed then complete the chart below
5a
5b
5c
5d
5e
Wetland Impacts (acres)
Stream Impacts (feet)
Upland
Pond ID
Proposed use or purpose
(acres)
number
of pond
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
P2
5f Total
5g Comments
5h Is a dam high hazard permit required
❑ Yes ❑ No If yes permit ID no
51 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 any impacts require mitigation then you MUST fill out Section D of this form
6a
❑ Neuse ❑ Tar Pamlico ❑ Other
Project is in which protected basin?
❑ Catawba ❑ Randleman
6b
6c
6d
6e
6f
6g
Buffer impact
number —
Reason
Buffer
Zone 1 impact
Zone 2 impact
Permanent (P) or
for
Stream name
mitigation
(square feet)
(square feet)
Temporary T
im act
required?
61 ❑P ❑T
El Yes
❑ No
B2 ❑ P ❑ T
_
❑ Yes
❑ No
—
B3 ❑P ❑T
❑Yes
❑ No
6h Total buffer impacts
61 Comments
Page 6 of 11
PCN Form — Version 1 3 December 10 2008 Version

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
There are numerous previously excavated mosquito ditches located on Ocracoke Island This is a small portion of these
ditches that run through the Widgeon Woods Subdivision The current ditches are slowly silting in and causing erosion on
adjacent properties Only the portion of the mosquito ditch that effects the applicants property will be impacted
1 b Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques
Containment measures will be utilized in order to ensure that the fill material is confined to the permitted area
2
Compensatory Mitigation for Impacts to Waters of the U S or Waters of the State
2a
Does the project require Compensatory Mitigation for ❑ Yes ® No
impacts to Waters of the U S or Waters of the State?
2b If yes mitigation is iequned by (check all that appl)) U JWQ ❑ Corps
2c
If yes which mitigation option will be used for this
project?
❑ Mitigation bank
F-1 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
❑ warm ❑ cool ❑cold
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 7 of 11
PCN Form — Version 1 3 December 10 2008 Version

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
L 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 8 of 11
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 Ripar an 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?
0%
2b
Does this project require a Stormwater Management Plan?
❑ Yes ® No
2c
If this project DOES NOT require a Stormwater Management Plan explain why Wetland area will be filled with clean fill
material that will be seeded with 0% impervious surface
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?
Hyd County
❑ Phase II
3b
Which of the following locally implemented stormwater 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 9 of 11
PCN Form — Version 1 3 December 10 2008 Version

F
Supplementary Information
1
Environmental Documentation (DWQ Requirement)
la
Does the project involve an expenditure of public (federal /state /local) funds or the
❑ Yes
® No
use of public (federal /state) land?
lb
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 nr Wetland Standards
❑ Yes
® No
or Riparian Buffer Rules (15A NCAC 26 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
F1 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
Page 10 of 11
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 protectea species or
habitat?
❑ Yes ® No
5b Have you checked with the USFWS concerning Endangered Species Act
impacts?
® Yes El No
5c If yes indicate the USFWS Field Office you have contacted
® Raleigh
❑ Asheville
5d What data sources did you use to determine whether your sit- would impact Endangered Species or Designated Critical
Habitat?
Agency Website
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?
No open water impacts
7 Historic or Prehistoric Cultural Resources (Corps Requirement)
7a WIII 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 No habitable structures proposed
8c What source(s) did you use to make the floodplain determination? Survey
Applicant/Agent s Printed Name
Date
Applicant /Agent s Signature
(Agents signature is valid only if an authorization letter from the applicant
is provided )
Page l l of 11
PCN Form - Version 1 3 December 10 2008 Version

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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? _ _
® Raleigh
5c
If yes indicate the USFWS Field Office you have contacted
❑ Asheville
5d
What data sources did you use to determine whether your site would impact Endangered Species or Designated
Critical
Habitat?
Agency Website
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?
No open water impacts
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?
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 No habitable structures proposed
8c What source(s) did you use to make the floodplain determination? Survey
qo-,,m &-ey�
dtX
Applicant/Agent s Printed Name
pplicant/A nt s Sigr@ture
Date
(Agents signature is valid only if an authorization letter from the applicant
is provided
Ems-
APR 1 9 2012
Page 11 of 11`" -►� f
PCN Form — Version 1 3 December 10 2008 Version