20210662 Ver 1_ePCN Application_20210331

DWR
Division of Water Resources
Initial Review
Pre -Construction Notification (PCN) Form
October 26, 2020 Ver 3.3
Has this project met the requirements for acceptance in to the review process?*
6 Yes
✓ No
Is this project a public transportation project?*
C Yes ( No
Change only 1 needed.
BIMS # Assigned* Version#*
20210662 1
Is a payment required for this project?*
6 No payment required
✓ Fee received
✓ Fee needed - send electronic notification
Select Project Reviewer*
Robert Tankard:eads\rbtankard
Information for Initial Review
la. Name of project:
COURTESY COPY Jarvis Property
la. Who is the Primary Contact?*
Doug Dorman
lb. Primary Contact Email:*
[e-mail]
Date Submitted
3/31/2021
Nearest Body of Water
Pamlico Sound
Basin
Pasquotank
Water Classification
SA
Site Coordinates
Latitude:
35.257731
Pre -Filing Meeting Information
ID#
Pre -fling Meeting or Request Date*
3/31/2021
Longitude:
-75.547545
Attach documentation of Pre -Filing Meeting Request here:*
Jarvis DWR Pre -Filing Meeting Request Form.pdf
Reviewing Office *
Washington Regional Office - [phone]
lc. Primary Contact Phone:*
[phone]
Version
54.7KB
A. Processing Information
County (or Counties) where the project is located:
Dare

Is this a NCDMS Project
✓ Yes r No
Is this project a public transportation project?*
✓ Yes r No
la. Type(s) of approval sought from the Corps:
[7 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?*
✓ Yes
r No
1b. What type(s) of permit(s) do you wish to seek authorization?
fJ Nationwide Permit (NWP)
r Regional General Permit (RGP)
r Standard (IP)
lc. Has the NWP or GP number been verified by the Corps?
✓ Yes r No
Nationwide Permit (NWP) Number: 14 - Linear transportation
NWP Numbers (for multiple NWPS):
Id. Type(s) of approval sought from the DWR:
17 401 Water Quality Certification - Regular
r Non-404 Jurisdictional General Permit
r Individual Permit
le. Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification:
For the record only for Corps Permit:
If. Is this an after -the -fact permit application?*
✓ Yes (7 No
✓ 401 Water Quality Certification - Express
✓ Riparian Buffer Authorization
lg. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
CYes rNo
lg. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
✓ Yes rNo
Acceptance Letter Attachment
lh. Is the project located in any of NC's twenty coastal counties?
r Yes C No
li. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
✓ Yes
r No r Unknown
1j. Is the project located in a designated trout watershed?
✓ Yes r No
B. Applicant Information
Id. Who is applying for the permit?
7 Owner r Applicant (other than owner)
le. Is there an Agent/Consultant for this project?*
✓ Yes r No
2. Owner Information
2a. Name(s) on recorded deed:
Kathleen & 011ie Jarvis
2b. Deed book and page no.:
2476/0909
2c. Responsible party:
FYes r No
r Yes r No

2d.Address
Street Address
PO Box 963
Address Line 2
Oty State / Province / legion
Buxton NC
Postal / Zip Code Country
27920 USA
2e. Telephone Number: 2f. Fax Number:
[phone]
2g. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Doug Dorman
4b. Business Name:
Atlantic Environmental Consultants, LLC
4c. Address
Street Address
PO Box3266
Address Line 2
City
Kitty Hawk
Postal / Zip Code
27949
4d. Telephone Number:
[phone]
4f. Email Address:*
[e-mail]
Agent Authorization Letter*
Jarvis Sigend Agent Auth.pdf
State / Rovince/ legion
NC
Country
USA
4e. Fax Number:
505.61 KB
C. Project Information and Prior Project History
C^U
1. Project Information
1b. Subdivision name:
(d apprcpriate)
None
lc. Nearest municipality/ town:
Buxton
2. Project Identification
2a. Property Identification Number:
052607784410
2c. Project Address
Street Address
48993 NC 12 Hwy
Address Line 2
C7ry
Buxton
Postal / Zip code
27920
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Pamlico Sound
3b. Water Resources Classification of nearest receiving water:*
SA
2b. Property size:
0.34 acres
State/ Rovince/ legion
NC
Country
USA

3c. What river basin(s) is your project located in?*
Pasquotank
3d. Please provide the 12-digit HUC in which the project is located.
0301020515
4. Project Description and History
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:*
The existing property is a 0.34 acre vacant wooded lot with a mix of residential and commercial properties in the vicinity.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
C- Yes G No C- 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)
Jarvis Topo Map.pdf 454.4KB
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)
Jarvis Soils Map.pdf 539.08KB
4f. List the total estimated acreage of all existing wetlands on the property:
0.07 acres
4g. List the total estimated linear feet of all existing streams on the property:
0
4h. Explain the purpose of the proposed project:*
The purpose is to construct a driveway to access the property and available uplands for the construction of a singel family residence.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
1,287 square feet of Section 404 wetlands will be filled to construct the proposed driveway. Clean sand will be used for the wetland fill and gravel will be installed for the base of the
driveway. Dump trucks will be used to delivery material and a backhoe or small front end loader will be used for grading the materials.
4j. Please upload project drawings for the proposed project.
Jarvis Site Plan 2.pdf 83.66KB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
G Yes
Comments:
C- No C Unknown
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
G Preliminary r Approved r Not Verified C- Unknown C- N/A
Corps AID Number:
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
Doug Dorman
Atlantic Environmental Consultants, LLC
5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
The wetland delineation was verified by Billy Standridge on March 9, 2021.
5d1. Jurisdictional determination upload
6. Future Project Plans
6a. Is this a phased project?*
r Yes f• 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
la. Where are the impacts associated with your project? (check all that apply):
rJ Wetlands r Streams -tributaries
I— Open Waters r Pond Construction
r Buffers

2. Wetland Impacts
2a. Site #*(?)
2a1 Reason (?)
Driveway
2b. Impact type * (?)
P
2c. Type of W.*
Bottomland Hardwood Forest
2d. W. name*
Driveway
2e. Forested*
Yes
2f. Type of
Jurisdicition * (?)
Both
2g. lmpact
area*
0.030
(acres)
2g. Total Temporary Wetland Impact
0.000
2g. Total Wetland Impact
0.030
2h. Comments:
Total wetland impacts are 1,287sf
E. Impact Justification and Mitigation
1. Avoidance and Minimization
2g. Total Permanent Wetland Impact
0.030
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
The driveway is designed to meet the minimum width requirement of 12 feet and is located where it will have the least amount of impacts to access the
proposed house.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
The driveway is designed at the minimum 12 foot width and the height of the fill will be limited to allow for minimal side slope into the wetlands.
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 t: No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
We have limited the wetland impacts to 1,287 sf and only for access to the build -able area; therefore, we are requesting no mitigation for this project.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
1. Diffuse Flow Plan
la. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection Rules?
✓ yes ( No
If no, explain why:
There are no NC Riparian Buffer Rules associated with this property.
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
✓ Yes r No
2b. Does this project meet the requirements for low density projects as defined in 15A NCAC 02H .1003(2)?
✓ Yes G 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?
✓ Yes r No
6 N/A - project disturbs < 1 acre
Comments:
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?*
✓ Yes ( 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)?*
✓ Yes (No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality?*
✓ Yes f No
3b. If you answered "no," provide a short narrative description.
The project is one single family residential property with no future development proposed.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
✓ Yes (Nor N/A
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 rNo
5c. If yes, indicate the USFWS Field Office you have contacted.
Raleigh
5d. Is another Federal agency involved?*
✓ Yes
5e. Is this a DOT project located within Division's 1-8?
✓ Yes ( No
( No r Unknown
5f. Will you cut any trees in order to conduct the work in waters of the U.S.?
( Yes r No
5g. Does this project involve bridge maintenance or removal?
✓ Yes ( No
5h. Does this project involve the construction/installation of a wind turbine(s)?*
✓ Yes ( 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.?
✓ Yes ( No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
US Fish and Wildlife Endagered Species List.
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?*
✓ Yes (No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
The existing wetlands would not support 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?*
✓ Yes (No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
An environmental review request was submitted to North Carolina Historical and Cultural Resource Department on March 31, 2012
7c. Historic or Prehistoric Information Upload
Jarvis Environmental Review Request.pdf 79.71KB
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
( Yes rNo

8b. If yes, explain how project meets FEMA requirements:
House construction vdll meet local building elevation requirements during construction.
8c. What source(s) did you use to make the floodplain determination?*
Dare County Flood Plain Maps.
Miscellaneous
Comments
Miscellaneous attachments not previously requested.
Signature
*
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 knovdedge 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:
Doug Dorman
Signature
Owe, Oetoreaw
Date
3/31/2021

AUTHORIZATION TO ACT AS REPRESENTATIVE FORM
Property Legal Description:
DEED BOOK: 1602 PAGE NO: 0153
PIN NO.: 052607784410
PROPERTY STREET ADRESS: 148 Pamlico Shore Road, Ocracoke, NC ),960.
Please Print:
Property Owner: Kathy Jarvis
Property Owner: 011ie Jarvis
The undersigned property owners of the above noted property, so hereby authorize
Doug Dorman , of Atlantic Environmental Consultants, LLC to,
(Contractor/Agent) (Name of consulting firm)
1. Act on my behalf and take all actions necessary for the processin , issuance and
acceptance of permits and/or certifications and any all standard ?nd special
conditions attached.
2. Enter the property to obtain site information including inspections with regulatory
agencies (Dare County, North Carolina Department of Environmental Quality,
U.S. Army Corps of Engineers, etc.) for the purpose of obtaining permits and/or
certifica*ions.
Property Owners Address (if different than property above):
PO Box 963, Buxton, NC 27920
Property Owners Telephone Number: 252-305-1621
We hereby certify that the above information submitted in this application is true and
accurate to the best of our knowledge.
Authorized Sigrature and
ail,ab
Date:
!lam' SLI
Authorized Signature and Title
Date:

NC Surface Water Classification
Flatterat:.�
a _ F r� ,�,.,
1114 � a i L
_ .z..4.11CCLir 317--m,,v. 7a",-C6.4t1LOMIr : •
-+- # ` _ -, . SITE _ . _ _+-4.11
-
17—
•
T. ` �it t n
J
-
- � ,
1
1
t
4
t
1
1
3/31/2021, 12:30:03 PM
Surface Water Classifications
River Basins
C PAS
C TAR
4
110i
ILL
0
0
0.17
,.—
1:18,056
0.35
0.7 mi
0 0.28 0.55
Copyright:© 2013 National Geographic Society, i-cubed
1.1 km
NCDENR Div. Water Resources
NCDENR - Division of Water Resources 1 Copyright:© 2013 National Geographic Society, i-cubed

35° 15' 54" N
35° 15'41"N
449010
449070
449130
449190
Soil Map —Dare County, North Carolina
449i250
I I 1 1 I
449010 449070 449130 449190 449250
Map Scale: 1:2,820 if printed on A landscape (11" x 8.5") sheet.
0
40 ao
160
Meters
240
Feet
0 100 200 400 600
Mapprojedion: Web Mercator Conerwordinates: WGS84 Edge tics: UTM Zone 18N WGS84
449310
449310
449370
449370
449430
449I490
jar 0.
449430 449490
449I550
449610
I I
449550 449610
35° 15'54"N
35° 15' 41" N
Uson Natural Resources
dim Conservation Service
Web Soil Survey
National Cooperative Soil Survey
3/31/2021
Page 1 of 3

Soil Map —Dare County, North Carolina
MAP LEGEND
Area of Interest (AOI)
n Area of Interest (AOI)
Soils
El Soil Map Unit Polygons
Soil Map Unit Lines
▪ Soil Map Unit Points
Special Point Features
Blowout
031 Borrow Pit
Clay Spot
Closed Depression
• Gravel Pit
Gravelly Spot
▪ Landfill
A. Lava Flow
46 Marsh or swamp
Mine or Quarry
CO Miscellaneous Water
• Perennial Water
• Rock Outcrop
• Saline Spot
Sandy Spot
Severely Eroded Spot
• Sinkhole
Slide or Slip
o Sodic Spot
Spoil Area
▪ Stony Spot
ei Very Stony Spot
Wet Spot
▪ Other
Special Line Features
Water Features
Streams and Canals
Transportation
Rails
Interstate Highways
US Routes
Major Roads
Local Roads
Background
rika Aerial Photography
MAP INFORMATION
The soil surveys that comprise your AOI were mapped at
1:24,000.
Warning: Soil Map may not be valid at this scale.
Enlargement of maps beyond the scale of mapping can cause
misunderstanding of the detail of mapping and accuracy of soil
line placement. The maps do not show the small areas of
contrasting soils that could have been shown at a more detailed
scale.
Please rely on the bar scale on each map sheet for map
measurements.
Source of Map: Natural Resources Conservation Service
Web Soil Survey URL:
Coordinate System: Web Mercator (EPSG:3857)
Maps from the Web Soil Survey are based on the Web Mercator
projection, which preserves direction and shape but distorts
distance and area. A projection that preserves area, such as the
Albers equal-area conic projection, should be used if more
accurate calculations of distance or area are required.
This product is generated from the USDA-NRCS certified data as
of the version date(s) listed below.
Soil Survey Area: Dare County, North Carolina
Survey Area Data: Version 20, Jun 2, 2020
Soil map units are labeled (as space allows) for map scales
1:50,000 or larger.
Date(s) aerial images were photographed: Dec 31, 2009—Oct
30, 2017
The orthophoto or other base map on which the soil lines were
compiled and digitized probably differs from the background
imagery displayed on these maps. As a result, some minor
shifting of map unit boundaries may be evident.
uson Natural Resources
dim Conservation Service
Web Soil Survey
National Cooperative Soil Survey
3/31/2021
Page 2 of 3

Soil Map —Dare County, North Carolina
Map Unit Legend
Map Unit Symbol
Map Unit Name
Acres in AOI
Percent of AOI
CeA
Carteret sand, 0 to 2 percent
slopes, frequently flooded
0.5
1.5%
CuA
Currituck mucky peat, 0 to 1
percent slopes, frequently
flooded
6.9
22.4%
FrD
Fripp fine sand, 2 to 30 percent
slopes
17.2
55.7%
OuB
Ousley fine sand, 0 to 5
percent slopes, rarely
flooded
6.3
20.3%
W
Water
0.0
0.1%
Totals for Area of Interest
30.8
100.0%
USDA Natural Resources Web Soil Survey
Conservation Service National Cooperative Soil Survey
3/31/2021
Page 3 of 3

PAMLICU SOUND
NC 12 HIGHWAY (PAVED ROAD) 60' R/W
N/F
PC "C", SLIDE 43C
MELVIN DEAN COVEY
DB 1551, Pg 405
IV N E. CASTILLO
PCS6C DSLIDE 43C CASTILLO
DB. 2154, Pg. 743
PROPOSED
TTENFLED AREA
1,000 SF
�MIF
Pp9,W
SITE mumu
LOCATION SKETCH IS NOT TO SCALE
DB/F FISH gg L
E1056I PIAGE OIL, CO., INC.
TRACT 1
0.95 ACRES
PROPOSED I — —
WETLAND AREA
TO BEFFILLED
28// E. C/ROUSE GRAY, JR.
N/F
HERYL L. JOHNSON and
L FRANK
DB. 1b20 Pg. 179 DB 1648, Pg 233
WETLANDS
WETLANDS r
i 25' M61
J
TRACT 2 I
0.34 AC. S�
ST
NORTH CAROLINA STATE
PL: B, SL• 152
DB. 2258, Pg. 84
PROPOSED CONVENTIONAL BED SYSTEM
4-45' LINES 3FT O.C.
30'
PRELIMINARY SITE PLAN
KATHY JARVIS
BUXTON — DARE COUNTY — NORTH CAROLINA
60' 120' 180'
GRAPHIC SCALE 1"= 60'
,4TLA/VT/C ENV/RO/V4/ENT,4L CONSULTANTS, LLC
P.O. BOX 3266, K/TTY H.4191( N.C. 27949
[phone], e-mail dougdaecOgmai/. com
FILE: JARVIS 2021 DATE: 3/1/21 REVISED:

Gmail - Environmental Review https://mail google.com/mail/u/0?ik=6f76ba1c92&view=pt&search=all&permmsgid=msg-a:r-...
Pisfi Gmail
Environmental Review
Doug Dorman <[e-mail]>
Doug Dorman <[e-mail]> 31 March 2021 at 15:43
To: DCR - Environmental_Review<[e-mail]>
I have a project in Buxton, Dare County, NC that needs an environmental review for a PCN application. This is for a new single family residence and I have
attached a County GIS Aerial photo, topo map and site plan. If you need more information please let me know.
Project Location:
48993 NC 12 Hwy
Buxton, NC 27920
Owner Information:
Kathy Jarvis
PO Box 963
Buxton, NC 27920
Thank you,
Doug Dorman
Atlantic Environmental Consultants, LLC
PO Box 3266
Kitty Hawk, NC 27949
252-261-7707 office
252-599-2603 cell
1 of 1 3/31/2021, 3:50 PM