20120754 Ver 1_401 Application_20120812

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20120754
Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.4 January 2009
Pre - Construction Notification (PCN) Foam
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.
1 c. 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
1e. 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
1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1h
below.
❑ Yes ® No
1h. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes ® No
2. Project Information
2a. Name of project:
Cane Creek Mitigation Tract (Buckhom Property)
2b. County:
Orange
2c. Nearest municipality / town:
Carrsboro
2d. Subdivision name:
N/A
2e. NCDOT only, T.I.P_ or state project no:
3. Owner Information
3a. Name(s) on Recorded Deed:
Orange Water and Sewer Authority (OWASA)
3b. Deed Book and Page No.
370/131 DC
3c. Responsible Party (for LLC if
applicable):
Ed Holland, OWASA Planning Director
p
3d. Street address:
P.O. Box 366 IN
3e. City, state, zip:
Carrboro, North Carolina 27510-0366
3f. Telephone no.:
919 - 537-4215 2012
3g. Fax no.:
919- 9684464 R .
[e-mail] e�
3h. Email address:
Page 1 of 10
PCN Form — Version 1.4 January 2009
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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::
G
4h. Email address:
5. Agent/Consultant Information (if applicable)
5a. Name:
David Halley, Forestry Consultant
5b_ Business name
(if applicable):
True North Forest Management Services
5c. Street address:
4713 Salem Ridge Road
till -City, state,'zip:
Holly Springs, North Carolina 27540
5e. Telephone no.:
919 - 815-3468
5f. Fax no.:
919- 552 -4129
5g. Email address:
[e-mail]
Page 2 of 10

Pre - Construction Notification (PCN) Form — Attachment
Project ,Description:
3e. Describe the overall project in detail, including the type of equipment to be used:
The project is currently being bid out to professional contractors to install a permanent bridge
over a perennial stream and an access road across the riparian buffer adjacent to the stream
(see sketch map). The size of the watershed above the stream crossing is approximately 1,167
acres. We are requiring a bridge crossing instead of a culvert so as to minimize disturbance to
the stream bed. The installation of the bridge will require the installation of footers on both
sides of the creek. At least a 100 foot "not cut" riparian buffer has been designated on both
sides of the stream that we are crossing. The stream is not a named stream, but it does
eventually flow into Turkey Hill Creek. Turkey Creek flows into the Haw River and the Haw
River flows into Jordan Lake. The-only portion of the riparian forest buffer that will be
disturbed is the area required to build a road across the riparian buffer, across the creek and
out the other side. Only those trees necessary to build the road will be removed. The contract
calls for a road that -is at least sixteen feet wide to accommodate tract' or trailer logging trucks
(80,000 pound - gross weight). The road will be designed and constructed to adequately
accommodate storm water runoff to minimize soil erosion and provide a stable, durable long -
lasting road. The contractors design must include a bridge crossing that is installed to minimize
the negative environmental impacts to the site. We expect to,see the approaches to the bridge
crossing geo- textiled or matted and then graveled to provide a stable and durable road. The
road through the buffer will have to be build up to be level with the bridge. In order to
accommodate large stormwater events we will be requiring some 'type of spillway or low place
on the road below the top level of the bridge that will allow excess flood waters to go around
and through the low area rather than over the bridge. All exposed areas within the riparian
buffer will be stabilized with straw, rock and /or seeding and storm fencing will be installed in
areas of high runoff potential to slow down storm water before entering creek. Based on a
twenty foot wide area, with 50 feet in length on both sides ;plus and extra 12 feet of stream
crossing the area being impacted within the Jordan Lake Buffer Rules will be approximately
2,240 square feet or approximately 0.05 acres. The equipment most likely used from this
project will be bulldozer, excavator, -and dump truck. The road to this crossing will be gated and
locked to restrict access. The property is open to the public for recreation and lease hunting
but motorized vehicle and horse riding by the public is prohibited.
We.have determined that the location of this stream crossing is the most practical and will be
the best alternative as far as minimizing disturbance, preserving aquatic life and habitat, and
protecting water quality. This is our best allowable access alternative and we feel there are no
other practical alternatives.

C. Proposed Impacts Inventory
1. Impacts Summary
1a. 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.
Wetland impact
number
Permanent (P) or
Temporary
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
Po ry m
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 then: 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
Area of impact (acres)
Permanent (P) or
type
Temporary
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 pond or lake construction proposed, the 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 ❑ 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 any impacts require mitigation, then you RAUST fill out Section D of this form.
6a. Project is in which protected basin?
❑ Neuse ❑ Tar - Pamlico ❑ Catawba ❑ Randleman ® Other. Jordan Lake
6b.
6c.
6d.
6e.
6f.
69.
Buffer Impact
Reason for impact
Stream name
Buffer
Zone 1
Zone 2
number —
Permanent (P) or
mitigation
impact
impact
Temporary
required?
(square
(square
feet )
feet
B1 P
Provift access
Unnamed perennial creek
No
1,200
800
B2
Yes/No
B3 -
Yes/No
B4
Yes/No
B5 -
Yes/No
B6 -
Yes/No
6h. Total Buffer Impacts:
1,200
800
6i. Comments: Assuming vve will impact a 20 foot wide section of the stream. Stream banks are approximately 12 feet apart.
Page 5 of, 10

1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
Installing a bridge instead of a culvert to avoid stream channel impacts. Graveling entrances on both side of the stream for at least 100 feet on both
sides of the stream. Installing water diversion ditches into vegetated areas and strawing and seeding any disturbed areas around stream crossing.
Using geotextile or matts on either side of bridge to help with road stabilization of loads across the riparian area.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Following Best Management Practices for Forestry Practices. Keeping disturbed area within the riparian forest buffer-to a minimum.- BMP's will be
installed during and after construction to minimize soil movement.
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
[] 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 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:
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 Permitllee 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.
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
1a. Does the project include or is it adjacent to protected riparian buffers identified
within one of the NC Riparian Buffer Protection Rules?
® Yes ❑ No
1 b. If yes, then is a diffuse flow plan included? If no, explain why.
Very small impact area.
❑ 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 stormwater mana management
9 9 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):
OCoastal counties
❑ HQW
❑ORW
[]Session Law 2006 -246
[]Other:
4b. Has the approved Stounwater 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)
la. Does the project involve an expenditure of public (federal/state/local) funds or the
❑ Yes
❑ No
use of public (federal/state) land?
1b. 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
® No
or Riparian Buffer Rules (15A NCAC 213 .0200)?
2b. Is this an after-the-fact permit application?
[3 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
additional development, which could impact nearby downstream water quality?
❑Yes
No
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, oF*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 11 No
5b. Have you checked with the USFWS concerning Endangered Species Ad
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?
OWASA, Ed Hollatad
Applicant/Agent's Printed Name
i
G �Z
Date
Applicant/Agent's Signature
(Agent's signature is valid only if an authorization
letter from the appleant is provided.)
Page 10 of 10

BUCKHORN GAME LAND
Lidar derived stream network and 50ft buffers
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H
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b
Legend
Existing Access
y Proposed New Access Road
H - Locked Gate
J.. - Stream Crossing
0 125 250 500 750 1,000
Meters
Client: OWASA
Drawn by: Thomas Craven
USGS Quad: EFLAND
LAVLON: 36° 1' 20.56 ", -79° 13' 10.33"
./I, e;... y .
- --1 Feet
0 600 1,200 2,400 3,600
Please note: Tax parcel lines are not surveyed lines.
In some instances the property should follow a natural boundary.
The 50 foot buffers were clipped to the tax parcel boundary and
may be under - represented on this map due to digitizing error.
Legend
PARCEL BOUNDARY
MAIN TRAIL
STREAM CHANNELS
50 FOOT BUFFER
Jan 20th, 2010 1