20121089 Ver 1_401 Application_20121212

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Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Pre - Construction Notification PC Form
A. Applicant Information ,�
1. Processing
I ;
1 a Type(s) of approval sought from the
Corps:
®Section 404 Permit F-1 Section 10 Permit
1 b. Specify Nationwide Permit (NWP) number 29 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
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 N 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
1 g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
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:
Holoman Residence Drainage Pipe
2b. County.
Mecklenburg
2c. Nearest municipality / town:
Charlotte
2d. Subdivision name:
Cotswold
2e. NCDOT only, T.I.P. or state
project no:
3. Owner Information
3a. Name(s) on Recorded Deed:
Mark and Jenifer Holoman
3b Deed Book and Page No.
24141-859
0
fl
3c. Responsible Party (for LLC if
applicable):
N/A
LFU
3d. Street address*
864 Linda Lane
3e. City, state, zip:
Charlotte NC 28211
3f. Telephone no.:
704 - 607 -3820 (mark's mobile)
WeVande &
ftMatv Branch I
3g. Fax no.:
n/a
3h Email address:
mholoman @yahoo.com
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:
5b. Business name
(if applicable):
5c Street address:
5d City, state, zip:
5e Telephone no.:
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):
15718242
Latitude: 35.180661 Longitude: -
1 b. Site coordinates (in decimal degrees):
80.794162
(DD DDDDDD) ( -DD DDDDDD)
1 c. Property size:
0.88 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
McMullen Creek
proposed project
2b. Water Quality Classification of nearest receiving water:
Class C
2c. River basin:
Santee (Catawba) (CU 03050103)
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 site currently contains a single - family residence that was constructed by the current owners in 2008. The drainage
ditch that runs through the property begins underneath the street -level drain on Linda Lane, and extends rear -ward
towards, and then underneath, Sharon Amity Road. All other land in this vicinity is used for single - family residential
purposes.
3b. List the total estimated acreage of all existing wetlands on the property:
N/A
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
390 feet
3d. Explain the purpose of the proposed project.
The project proposes to pipe in a portion of stream channel that runs through the front yard of the property The City of
Charlotte Storm Water Services project that proposes up and downstream storm drainage improvements would increase
the channel's cross section dimensions, resulting in loss of trees and usable property. The purpose and need for the pipe
is three -fold and includes addressing safety concerns, preserving trees, and preventing excessive loss of usable property.
The ditch in the front portion of the property is over 6 feet deep in places, and has become a serious safety hazard for the
homeowner's three young children. In addition, the proposed disturbance corridor is less than that of a channel
enhancement design and will help to preserve existing mature trees. Finally, the proposed pipe is needed to prevent
further channel erosion and is preferred over channel enhancements that would move the top of bank closer to the
already adjacent home foundation.
3e. Describe the overall project in detail, including the type of equipment to be used:
The project proposes to install a pipe in the front section of the property only, which will allow water to flow from the Linda
Lane catch - basins, through an existing pipe underneath the driveway, then through to the rear portion of the home,
thereafter exiting the pipe into an existing open drainage ditch that the current homeowners installed. In conjunction with
the City of Charlotte storm -water services team, a properly sized pipe will be selected and installed using typical
equipment such as excavators. The pipe will accommodate existing drainage pipes and runoff from neighbouring homes.
Page 3 of 11
PCN Form — Version 1.3 December 10, 2008 Version

4.
Jurisdictional Determinations
4a.
Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
®Yes ❑ No El Unknown
project (including all prior phases) in the past?
Comments:
4b.
If the Corps made the jurisdictional determination, what type
❑Preliminary ❑Final
of determination was made?
4c.
If yes, who delineated the jurisdictional areas?
Agency /Consultant Company: NC DNR
Name (if known): Alan Johnson
Other:
4d.
If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
9/27/12
5.
Project History
5a
Have permits or certifications been requested or obtained for
❑ Yes ® No ❑ Unknown
this project (including all prior phases) in the past?
5b.
If yes, explain in detail according to "help file" instructions.
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
1 a. 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
❑ Yes
❑ Corps
❑ 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:
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
Pipe and rip rap
UT to McMullen
❑ PER
® Corps
3
145
apron
Creek
® 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
3h. Total stream and tributary impacts
145
3i. Comments:
Page 5of11
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 ❑P ❑T
02 ❑P ❑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
K 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 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
impact
required?
B1 ❑P ❑T
El Yes
❑ No
B2 ❑P ❑T
El Yes
❑ No
B3 ❑P ❑T
El Yes
❑ No
6h. Total buffer impacts
6i. Comments: A PCCO buffer is located along the channel but this project is exempt from PCCO buffer requirements.
Page 6 of 11
PCN Form — Version 1.3 December 10, 2008 Version

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project
The length of pipe has been minimized to the maximum extent practicable while still meeting the project's goals. The pipe
extends around the side and near the back of the house, thereby alleviating erosion and potential flood concerns. A
substantial length of channel that extends through the back yard will not be impacted by this project
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
During construction, the contractor shall take precautions to "work in the dry" to prevent downstream sedimentation.
Measures shall include pumping any baseflow around the work area and installing temporary rock check dams below the end
of the proposed pipe. Temporary check dams shall be removed following construction and any denuded areas shall be
stabilized with seed and straw.
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
E) 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
15
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
1a. Does the project include or is it adjacent to protected riparian buffers identified
❑ Yes ® No
within one of the NC Riparian Buffer Protection Rules?
1 b. If yes, then is a diffuse flow plan included? If no, explain why.
❑ Yes El 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:
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?
City of Charlotte
® 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
S. 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)
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
® No
or Riparian Buffer Rules (15A NCAC 2B .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
❑ 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 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.
El Raleigh
❑ Asheville
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 P<No
8b. If yes, explain how project meets FEMA requirements.
8c What source(s) did you use to make the floodplain determination?
M ht� w
Applicant/Agent's Printed Name
// -/S
Date
Applicant/Agent's Signature
(Agent's signature is valid only if an authorization letter from the applicant
is provided.)
Page 11 of 11
PCN Form — Version 1.3 December 10, 2008 Version

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