20211518 Ver 1_Pre-Construction Notification (PCN) Form_20211019

DWR
Division of Water Resources
Pre -Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
June 1, 2021 Ver 4.1
Please note: fields marked with a red asterisk below are required. You will not be able to submit the form until all mandatory questions are answered.
Also, if at any point you wish to print a copy of the E-PCN, all you need to do is right -click on the document and you can print a copy of the form.
Below is a link to the online help file.
https://edoes. deq. n e.gov/WaterResou rces/0/ed oc/624704/PCN % 20 Help / 20F i le / 202018-1-30. pdf
A. Processing Information
County (or Counties) where the project is located:*
Haywood
Is this a NCDMS Project*
r Yes C No
Click Yes, only if NCDlvS is the applicant a co -applicant.
Is this project a public transportation project?
O Yes F No
This is arry publicly funded by m ricipal,state a federal funds road, rail, airport transpafatm project.
1a. Type(s) of approval sought from the Corps:*
Section 404 Permit (wetlands, streams and waters, Clean Water Act)
❑ Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
Has this PCN previously been submitted?*
O Yes
O No
1 b. What type(s) of permit(s) do you wish to seek authorization?*
IJ Nationwide Permit (NWP)
r Regional General Permit (RGP)
r Standard (IP)
1c. Has the NWP or GP number been verified bythe Corps?*
r Yes F No
Nationwide Permit (NWP) Number:
NWP Numbers (for multiple NWPS):
List all NJVnurbers ycu are applying fa not cn the drop dawn list.
1d. Type(s) of approval sought from the DWR:*
check all that apply
401 Water Quality Certification - Regular r 401 Water Quality Certification - Express
r Non-404 Jurisdictional General Permit r Riparian Buffer Authorization
r Individual 401 Water Quality Certification
Pre -Filing Meeting Information
Before submitting this form please ensure you have submitted the Pre -Filing Meeting Request Form as we will not be able to accept your application without this important first step. The Pre -Filing
Meeting Request Form is used in accordance with 40 C.F.R. Section 121.4(a) "At least 30 days prior to submitting a certification request, the project proponent shall request a pre -filing meeting with the
certifying agency" and in accordance with 40 C.F.R. Section 121.5(b)(7), and (c)(5) all certification requests shall include documentation that a pre -filing meeting request was submitted to the certifying
authority at least 30 days prior to submitting the certification request. Click here to read more information on when this form is needed prior to application submission or here to viewthe form.
Is this a courtesy copy notification?
r Yes E No
ID#
Version
Pre -fling Meeting or Request Date *

8/25/2021
Attach documentation of Pre -Filing Meeting Request here:*
Cickthe upload button a drag and drop files here to attach dccurrent
DWR Pre -Filing Meeting Request Form.pdf 49.47KB
File type crust be FCF
............ ...................................................... ..............................
1e. Is this notification sole lyfor the record because written approval is not required?
*
For the record onlyfor DWR401 Certification: r Yes 6' No
For the record onlyfor Corps Permit: r Yes 6' No
1f. Is this an after -the -fact permit application?*
r Yes (-- No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
If so, attach the acceptance letter from ratigadon bank a in -lieu fee program
Yes O No
Acceptance Letter Attachment
Cickthe upload button a drag and drop files here to attach dccurrent
FiLEiYFE MJST BE FDF
1 h. Is the project located in any of NC's twentycoastal counties?*
r Yes r• No
1j. Is the project located in a designated trout watershed?*
6 Yes r No
You must submit a copy of the appropriate Wildlife Resource Commission Office.
Link to trout information: http://www.saw.usace.army.mil/Missions/Regulatory-Permit-Progra"Agency-Coordination/Trout.aspx
B. Applicant Information
la. Who is the Primary Contact?*
Marek Hevier
1c. Primary Contact Phone:*
1b. Pri mary Contact Email:*
(xxx)xxx-xxxx
[e-mail]
[phone]
1d. Who is applying for the permit?
,W Owner
❑ Applicant (other than owner)
(Check all that apply)
le. Is there an Agent/Consultant for this project?*
r• Yes r No
2. Owner Information
2a. Name(s) on recorded deed:*
Richland Estates LLC A NC LLC
2b. Deed book and page no.:
1011/1169
2c. Contact Person:
(fa Corporations)
Marek Hevier
2d. Address*
Sheet Address
4365 Arnold Avenue
Address Line 2
aty
State / Aovince / Pegicn
Naples
Florida
Postal / Zp Code
Country
34104
United States
2e. Telephone Number:*
(xxx)xxx-xxxx
[phone]
2f. Fax Number:
(xxx)xxx-xxxx

2g. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:*
R. Daniel Hyatt
4b. Business Name:
(d applicable)
Wade Trim
4c. Address*
Street Address
53 North Market Street
Address Line 2
Suite 200
atY
Asheville
Postal / Zp Code
28801
4d. Telephone Number:*
[phone]
(xxx)xxx-xxxx
4f. Email Address:*
[e-mail]
State / Aovince / Regim
NC
Country
United States
4e. Fax Number:
(xxx)xxx-xxxx
C. Project Information and Prior Project History C^�
1. Project Information lJ
1a. Name of project:*
Richland Estates Townhomes
1b. Subdivision name:
(d appropriate)
1c. Nearest municipality / town:
*
Waynesville
2. Project Identification
2a. Property Identification Number:
2b. Property size:
(tax RN a parcel ID)
(in acres)
8615-17-6586
1.5034
2c. Project Address
Street Address
Richland Street
Address Line 2
aty
State / Aovince / Regim
Waynesville
NC
Postal / Zp Code
Country
28786
United States
2d. Site coordinates in decimal degrees
Please collect site coordinates in decimal degrees. Use between 4-6 digits (unless you are using a survey -grade GPS device) after the decimal place as appropriate, based on howthe location was
determined. (For example, most mobile phones with GPS provide locational precision in decimal degrees to map coordinates to 5 or 6 digits after the decimal place.)
Latitude:* Longitude:*
35.491112-82.993038
ex: 34.208504-77.796371
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Richland Creek
3b. Water Resources Classification of nearest receiving water:*
B
Surface Water Lookup

3c. What river basin(s) is your project located in?*
French Broad
3d. Please provide the 12-digit HUC in which the project is located.*
060101060202
River Basin Lookup
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:*
Generally rolling lot with emsting vegetation along Richland Street. A small section of wetland (0.15 acres) is present on the site, and three small streams (a total of 325 LF of stream)
run through the lot and empty into Richland Creek through an existing CMP.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?
r Yes E No r Unknown
4f. List the total estimated acreage of all existing wetlands on the property:
0.15
4g. List the total estimated linear feet of all existing streams on the property:
(intermittent and paenrial)
325
4h. Explain the purpose of the proposed project:*
To provide townhouses to accommodate the growing Waynesville, NC population
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
Installation of a culvert to redirect one of the creeks running through the property to allow 14 townhomes to be built and accessed from Richland Street. The installation of sanitary
sewer, water, and stormwater infrastructure to service the townhomes.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
Yes C No O Unknown
Comments
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
6' Preliminary C Approved (- Not Verified r- Unknown r N/A
Corps AID Number:
Exarrple: SAW-2017-99999
SAW-2017-00824
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company: Equinox Environmental
Other:
5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made bythe Corps or DWR.
04/28/2021
6. Future Project Plans
6a. Is this a phased project?*
G Yes r 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? This
includes other separate and distant crossing for linear projects that require Department of the Army authorization but don't require pre -construction notification.
D. Proposed Impacts Inventory
1. Impacts Summary
la. Where are the impacts associated with your project? (check all that apply):
r Wetlands r Streams -tributaries F- Buffers
r Open Waters r Pond Construction
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.

"S." will be used in the table below to represent the word "stream".
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*
31
RelocatingStream Permanent Culvert S-3 Perennial l � Both 1 171
Avaage (feet) (linear feet)
**All Perennial or Intermittent streams must be verified by DWR or delegated local government
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
171
3i. Total temporary stream impacts:
0
3i. Total stream and ditch impacts:
171
3j. Comments:
E. Impact Justification and Mitigation
1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:*
Avoid to an extent disturbing existing stream while setting infrastructure for culvert under Richland Street. When it's time to redirect the stream to
construct the remainder of the culvert infrastructure, create a bypass system to protect the stream.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*
Installations will take place in dry conditions utilizing bypass to maintain streamflow down stream. Installations will take place as quickly as possible to
minimize impacts.
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 E No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
Project below threshold to trigger mitigation.
NC Stream Temperature Classification Maps can be found under the Mitigation Concepts tab on the Wilmington District's RIBITS website
F. Stormwater Management and Diffuse Flow Plan (required by DWR) �1
*** Recent changes to the stormwater rules have required updates to this section .***
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?
O Yes F No
For a list of options to meet the diffuse flow requirements, click here.
If no, explain why:
Low impact development
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
r Yes F No
2b. Does this project meet the requirements for low density projects as defined in 15A NCAC 02H .1003(2)? *
F Yes f No
To look up lowdensity requirement click here 15A NCAC 02H .1003(2).
Comments:
G. Supplementary Information V

1. Environmental Documentation
1a. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?*
C 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)? *
r Yes � No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in additional development, which could impact nearby downstream water quality?*
r Yes c No
3b. If you answered "no," provide a short narrative description.
Utilizing 15A NCAC 02H.1003(2) the development will have minimal effects on downstream water quality.
4. Sewage Disposal (DWR Requirement)
4a.Issewage disposal required byDWRforthis project?*
6 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.
Waste water will be tied into the local system for treatment. The Town of Waynesville wastewater treatment plan treats 6 million gallons per day.
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?
6 Yes C No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
C Yes (-- No
5d. Is another Federal agency involved?*
r Yes C No
5e. Is this a DOT project located within Division's 1-8?*
f Yes r No
5f. Will you cut anytrees 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 C No
Link to the NLEB SLOPES document: http://saw-reg.usace.army.mil/NLEB/1-1,0-17-signed_NLEB-SLOPESRapps.pdf
5h. Does this project involve the construction/installation of a wind turbine(s)?'*
C Yes C No
O 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.?*
6 Yes O No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?*
h ttp s: //wvAv. f vds . g o v/ i p a c/
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
C Yes E No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
https://www.fisheries. n oaa.g ov/resource/map/esse ntia I-fish-habitat-mappe r
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
Link to the State Historic Preservation Office Historic Properties Map (does not include archaeological data: http://gis.neder.gov/hpoweb/
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 historyand archaeology)?*
r' Yes r- 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)
Link to the FEMAFIoodplain Maps: https://rrse.fema.gov/portal/search
8a. Will this project occur in a FEMA-designated 100-year floodplain?
(-- Yes C No
8b. If yes, explain how project meets FEMA requirements:
No structure will be built inside the flood plain area.
8c. What source(s) did you use to make the floodplain determination?*
https://rrse.ferna.gov/portal/search
Miscellaneous
Comments
Please use the space belowto attach all required documentation or anyadditional 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.
Oickthe upload button a drag and drop files here to attach docurrent
Supporting Document Package.pdf 36.85MB
SAW-2017-00824 Richland Estates Chruch Street Site PJD.pdf 784.83KB
File must be FLF a IQvI7
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 knowledge and belief'; and
• The project proponent hereby requests that the certifying authority review and take action on this CWA401 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:*
R. Daniel Hyatt
Signature *
[/1. • adaieG
Date
9/14/2021
V