20211344 Ver 1_ePCN Application_20210909

DWR
Dlrlslon of Water Resources
Pre -Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
June 1, 2021 Ver4.1
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?*
r Yes r No
Change only if needed.
BIMS # Assigned
20211344
Is a payment required for this project?*
r No payment required
r Fee received
r Fee needed - send electronic notification
Select Project Reviewer*
Flolley Snider:eads\hasnider
Information for Initial Review
la. Name of project:
COURTESY COPY Lot 3 Hackney Division
1a. Who is the Primary Contact?*
Gene Young, REHS
1b. Primary Contact Email:*
[e-mail]
Date Submitted
9/9/2021
Nearest Body of Water
Intracoastal Waterway
Basin
White Oak
Water Classification
SA/HOW
Site Coordinates
Latitude: Longitude:
34.409363-77.601590
A. Processing Information
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
Pre -Filing Meeting Information
Version#*
1
Reviewing Office*
Wilmington Regional Office - [phone]
1c. Primary Contact Phone:*
[phone]
Is this a courtesy copy notification?*
r Yes r No

ID#
Version
Pre -fling Meeting or Request Date
9/9/2021
Attach documentation of Pre -Filing Meeting Request here:
nick the upload button or drag and drop files here to attach document
DWR pre -filing lot 3.pdf
File type mast be FCF
1a. Type(s) of approval sought from the Corps:
V 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: 18 - Minor Discharges
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
fJ 401 Water Quality Certification - Regular
r Non-404 Jurisdictional General Permit
r Individual 401 Water Quality Certification
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:
37.91 KB
r 401 Water Quality Certification - E>q)ress
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
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 IT 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?
r Owner 9 Applicant (other than owner)
le. Is there an Agent/Consultant for this project?*
r Yes r No
2. Owner Information
2a. Name(s) on recorded deed:
Southeast Partners VII LLC
2b. Deed book and page no.:
4747:1457
r Yes r No
r Yes r No

2c. Contact Person:
Chris Plaford
2d.Address
Street Address
1121 Military Cutoff RD, Suite C336
Address tine 2
City
State / Rmince / Region
Wilmington
NC
Postal / Zip Code
Country
28405
USA
2e. Telephone Number: 2f. Fax Number:
[phone]
2g. Email Address:*
[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
Gene Young, REHS
3b. Business Name:
Applied Resource Management
3c.Address
Street Address
257 Transfer Station RD
Address tine 2
city
State / Rovince / Fegion
Hampstead
NC
Postal / Zip Code
Country
28443
USA
3d. Telephone Number: 3e. Fax Number:
[phone] [phone]
3f. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Gene Young,REHS
4b. Business Name:
Applied Resource Management
4c.Address
Street Address
257 Transfer Station RD
Address Line 2
(Sty
State / Rmince / Region
Hampstead
NC
Postal / Zip Code
Country
28443
USA
4d. Telephone Number:
4e. Fax Number:
[phone]
[phone]
0. Email Address:*
[e-mail]
C. Project Information and Prior Project History U
1. Project Information
1b. Subdivision name:
(d appropriate)
Hackney Division
1c. Nearest municipality/ town:
Hampstead, NC

2. Project Identification
2a. Property Identification Number:
4224-13-7039-0000
2c. Project Address
Street Address
Moores Landing Extension
Address Line 2
City
Hampstead
Fbstal / 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/HQW
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:
0.68
State / Ravine / 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:*
The site is an existing 4 lot division in an eAsting 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
4f. List the total estimated acreage of all existing wetlands on the property:
0.4
4g. List the total estimated linear feet of all existing streams on the property:
4h. Explain the purpose of the proposed project:*
The purpose of this project is to build a residence on lot 3. A small amount of fill is needed to construct the home.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
Typical construction equipment is to be used. A retaining wall is to be build to allow for the construction of the home and limit
fill impacts.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
G Yes r No r Unknown
Comments:
a pre -filing consultative meeting was done with Emily Greer, USACE
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:
unknown
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Gene Young, REHS
Agency/Consultant Company:
Other:
6. Future Project Plans
6a. Is this a phased project?*
r Yes
Applied Resource Managment
G 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 projector 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 Buffers
r Open Waters r Pond Construction
2. Wetland Impacts
.................. ............
2a1 Reason (?) 2b. Impact type* (?) 2c. Type of W. * 2d. W. name* 2e. Forested * 2f. Type of 2g. Impact
Jurisdicition*(?) area _]
1 fill P Estuarine Woody Wetland wetland No Corps area
(acres)
2g. Total Temporary Wetland Impact
0.000
2g. Total Wetland Impact
0.099
21. Comments:
2g. Total Permanent Wetland Impact
0.099
E. Impact Justification and Mitigation v
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
The access easements from the original lot division has been revised to avoid impacts. The area of fill proposed for this property is only for the
proposed home. No other area of fill is proposed.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
a retaining wall is proposed to be constructed to minimize fill impact and eliminate 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:
The fill amount is below the threshold.
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 r No
If no, explain why:
site is 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)?
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:
G. Supplementary Information

1. Environmental Documentation
1a. 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 (15ANCAC 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 property is in an established division where erosion control and sedimentation can be limited to construction area.
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 provided by subsurface wastewater system already permitted.
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
Se. 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 f• No
51. 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
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
r Yes f• No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
wetland is not an aquatic 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?*
r Yes r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
NC HPOweb
8. Flood Zone Designation (Corps Requirement)

8a. Will this project occur in a FEMA-designated 100-year flood plain?*
IT Yes r No
8b. If yes, explain how project meets FEMA requirements:
unknown. all relevant codes will be met
8c. What source(s) did you use to make the floodplain determination?*
Pender County GIS Tax map
Miscellaneous
Please use the space below to attach all required documentation or any additional information you feel is helpful for application review. Documents should be combined into one
file when possible, with a Cover Letter, Table of Contents, and a Cover Sheet for each Section preferred.
dick the upload button or drag and drop files here to attach document
PCN support lot 3.pdf 493.91 KB
Rle rrust be FDF or tM2
Comments
Signature
*
W 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
qe�,e yaa,hg ?as
Date
9/9/2021