20211440 Ver 1_ePCN Application_20210930

DWR
mrlslon 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
20211440
Is a payment required for this project?*
r No payment required
r Fee received
r Fee needed - send electronic notification
Reviewing Office*
Asheville Regional Office - [phone]
Information for Initial Review
la. Name of project:
Paulik - NOV
la. Who is the Primary Contact?*
Ronnie Dilbeck
1b. Primary Contact Email:*
[e-mail]
Date Submitted
9/30/2021
Nearest Body of Water
Meadow Branch
Basin
Little Tennessee
Water Classification
C
Site Coordinates
Latitude: Longitude:
35.444-83.921
A. Processing Information
County (or Counties) where the project is located:
Graham
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
What amout is owed?*
IT $240.00
r $570.00
Select Project Reviewer*
Andrew Moore:eads\awmoore3
1c. Primary Contact Phone:*
[phone]
Is this a courtesy copy notification?*
r Yes r No

ID#
NOV-2021-CV-0021
Pre -fling Meeting or Request Date
8/31/2021
Attach documentation of Pre -Filing Meeting Request here:
nick the upload button or drag and drop files here to attach document
DWR Pre -Filing Meeting Request Form (2).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:
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
Version
39 - Commercial/Institutional Developments
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:
49.43KB
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
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 fJ 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:
Istvan G. Paulik
2b. Deed book and page no.:
00939/0020
2c.Contact Person:
r Yes r No
r Yes r No

2d.Address
Street Address
854 Meadow Branch Road
Address tine 2
City
Robbinsville
Postal / Zip Code
28771
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
Ronnie Dilbeck
3b. Business Name:
CreekStone, PLLC
3c.Address
Street Address
132 Blueberry Lane
Address Line 2
City
Franklin
Postal / Zip Code
28734
3d. Telephone Number:
[phone]
3f. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Ronnie Dilbeck
4b. Business Name:
CreekStone, PLLC
4c.Address
Street Address
132 Blueberry Lane
Address Line 2
City
Franklin
Postal / Zip (ode
28734
4d. Telephone Number:
[phone]
4f. Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality/ town:
Robbinsville
2. Project Identification
Slate / ermine / Region
NC
Country
USA
2f. Fax Number:
State / Rminoe / legion
NC
Country
USA
3e. Fax Number:
Slate / Ftminoe / Region
NC
Country
USA
4e. Fax Number:

2a. Property Identification Number:
2b. Property size:
5635-00-00-0001,5635-00-00-0022-131
4.34
2c. Project Address
Street Address
854 Meadow Branch Road
Address tine 2
aty
State / Province / legion
Robbinsville
NC
Postal / Zip Code
Country
28771
USA
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Meadow Branch
3b. Water Resources Classification of nearest receiving water:*
C
3c. What river basin(s) is your project located in?*
Little Tennessee
3d. Please provide the 12-digit HUC in which the project is located.
06010204
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:*
Primary residence of property owner. Surrounding properties are residential.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
f Yes r No r Unknown
4f. List the total estimated acreage of all existing wetlands on the property:
0.46
4g. List the total estimated linear feet of all existing streams on the property:
1071
4h. Explain the purpose of the proposed project:*
Mixed NOV resolution. Corrective action plan for impacts to Meadow Branch and associated riparian wetland. After -the -fact PCN application for wetland fill impacts and culvert
placement.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:
The CAP portion of the project A small trackhoe (12,000 Ib) and skidsteer will be utilized to complete the stream and wetland work. Streambank grading will be undertaken along with two
log vane installations. The log vanes are to be installed for grade control and assistance maintaining desired groundwater levels for wetland function. The two ebsting ditches from
previous work will be plugged and filled to re-establish wetland hydrology.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes r No
Comments:
See Water Resource Inventory Map
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:
SAW-2021-01557
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
6. Future Project Plans
6a. Is this a phased project?*
r Yes r No
O Unknown
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 W Streams -tributaries
r Open Waters r Pond Construction
2. Wetland Impacts
r Buffers
2a1 Reason(?) 2b. Impact type * (') 2c. Type of W.* 2d. W. name * 2e. Forested * 2f. Type of ]2g.mITpat
Jurisdicition*(?) aa
ff�7]
Commercial Pad P Headwater Forest tlik Corps 0.330
(acres)
2g. Total Temporary Wetland Impact
0.000
2g. Total Wetland Impact
0.330
21. Comments:
3. Stream Impacts
2g. Total Permanent Wetland Impact
0.330
u
F
3a. Reason for impact (?) 3b.lmpact type * 3c. Type of impact* 3d. S. name * 3e. Stream Type * 3f. Type of 3g. S. width * 3h. Impact
(?) Jurisdiction* length*
Access Road Permanent Culvert :T�0_
Branch s Perennial Cor erage(feet) (li40S1P
Avnearfcet)
:1
31. Total jurisdictional ditch impact in square feet:
0
31. Total permanent stream impacts:
40
31. Total stream and ditch impacts:
40
3j. Comments:
36" HDPE Culvert
E. Impact Justification and Mitigation
1. Avoidance and Minimization
3i. Total temporary stream impacts:
0
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
This is an after -the -permit where fill impacts have been previously undertaken. Efforts are being taken to restore the devmtered wetland to better
conditions than prior to the most recent construction activities.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Designated haul routes will be utilized when working within the wetland area. A confined stockpile area will be used for spoils associated with
streambank grading. A pump around system will be utilized during log vane installation.
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
2c. If yes, mitigation is required by (check all that apply):
r DWR W Corps
2d. If yes, which mitigation option(s) will be used for this project?
r Mitigation bank W Payment to in -lieu fee r Permittee Responsible
program Mitigation
4. Complete if Making a Payment to In -lieu Fee Program
4a. Approval letter from in -lieu fee program is attached.
r Yes r No

4b. Stream mitigation requested:
(linear feet)
4c. If using stream mitigation, what is the stream temperature:
4d. Buffer mitigation requested (DWR only):
(square feet)
4f. Non -riparian wetland mitigation requested:
(acres)
4h. Comments
4e. Riparian wetland mitigation requested:
(acres)
0.33
4g. Coastal (tidal) wetland mitigation requested:
(acres)
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?
r Yes r No
If no, explain why:
Not within designated watershed
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 NA - 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 (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)?*
r Yes r- No
2b Provide an explanation of the violation(s):
NOV-2021-CV-0021; Failure to secure 401 and Removal of Best Usage.
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.
No further impacts are anticipated for the future.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
r Yes r Nor NIA
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
5e. 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 r No
r Unknown
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.?
r Yes r No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
www.fws.gov
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
r Yes r No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
www.fisheries.noaa.gov and vmw.fws.gov
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?
North Carolina State Historic Preservation National Register
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
r Yes r No
8c. What source(s) did you use to make the floodplain determination?*
www.fema.gov
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.
Click the upload button a drag and drop files here to attach docurn3d
PAULIKcap1.1.pdf 4.55MB
AFcreekstone.pdf 498.2KB
File crust be FOF a IW2
Comments
Signature
*
rJ 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:
Ronald Thomas Dilbeck, PG
Signature

Date
9/30/2021