20211806 Ver 1_ePCN Application_20211210

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Pre -Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
December 6, 2021 Ver 4.2
Initial Review
Has this project met the requirements for acceptance in to the review process?*
Yes
No
Is this project a public transportation project?*
Yes No
Change only if needed.
BIMS # Assigned*
Version#*
20211806
1
Is a payment required for this project?
No payment required
What amout is owed?*
Fee received
$240.00
Fee needed - send electronic notification
$570.00
Reviewing Office*
Select Project Reviewer*
Raleigh Regional Office - [phone]
Colleen Cohn:eads\cmcohn
Information for Initial Review
1a. Name of project:
663 Governors Club
1a. Who is the Primary Contact?*
Kevin Martin
1 b. Primary Contact Email: * 1c. Primary Contact Phone:*
[e-mail] [phone]
Date Submitted
12/10/2021
Nearest Body of Water
UT to Cub Creek
Basin
Cape Fear
Water Classification
WS-IV:NSW
Site Coordinates
Latitude: Longitude:
35.843638-79.055574
A. Processing Information
County (or Counties) where the project is located:
Chatham
Is this a NCDMS Project
Yes No
Is this project a public transportation project?*
Yes No
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?*
Yes
No
1 b. What type(s) of permit(s) do you wish to seek authorization?
Nationwide Permit (NWP)
Regional General Permit (RGP)
Standard (IP)
1c. Has the NWP or GP number been verified by the Corps?
Yes No
Nationwide Permit (NWP) Number:
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
401 Water Quality Certification - Regular
Non-404 Jurisdictional General Permit
Individual 401 Water Quality Certification
29 - Residential 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:
1f. Is this an after -the -fact permit application?*
Yes No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
Yes No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
Yes No
1 h. Is the project located in any of NC's twenty coastal counties?
Yes No
1j. Is the project located in a designated trout watershed?
Yes No
B. Applicant Information
1d. Who is applying for the permit?
Owner Applicant (other than owner)
le. Is there an Agent/Consultant for this project?
Yes No
2. Owner Information
2a. Name(s) on recorded deed:
Bold Construction
2b. Deed book and page no.:
DB: 0789 DP: 0431
2c. Contact Person:
Chris Ehrenfeld
2d.Address
Street Address
845 S Elm Street
Address Line 2
City
Himsdale
Postal / Zip Code
60521
2e. Telephone Number:
[phone]
2g. Email Address:
[e-mail]
401 Water Quality Certification - Express
Riparian Buffer Authorization
State / Province / Region
IL
Country
USA
2f. Fax Number:
Yes No
Yes No
U

4. Agent/Consultant (if applicable)
4a. Name:
Kevin Martin
4b. Business Name:
Soil & Environmental Consultants, PA
4c.Address
Street Address
8412 Falls of Neuse Road, Suite 104
Address Line 2
City
Raleigh
Postal / Zip Code
27615
4d. Telephone Number:
[phone]
4f. Email Address:"
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1 b. Subdivision name:
(if appropriate)
Governors Club
1c. Nearest municipality / town:
Chapel Hill
2. Project Identification
State / Province / Region
NC
Country
USA
4e. Fax Number:
[phone]
2a. Property Identification Number:
2b. Property size:
0070221
+/- 2.59
2c. Project Address
Street Address
End of Cherry Dr.
Address Line 2
City
State / Province / Region
Chapel Hill
NC
Postal / Zip Code
Country
27517
USA
I Surface Waters
3a. Name of the nearest body of water to proposed project:
UT to Cub Creek
3b. Water Resources Classification of nearest receiving water:*
WS-IV;NSW
3c. What river basin(s) is your project located in?*
Cape Fear
3d. Please provide the 12-digit HUC in which the project is located.
030300020607
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: *
We are unaware of any permitting history for the overall Gvernors Club Subdivision which was begun in the 1980's. This lot was recorded August 11th, 1992 and there have been no
wetland, stream or bufer impacts on it to date. The buffer authorization request for the driveway is being submited to Chatham County for their authorization.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?
Yes No Unknown
4f. List the total estimated acreage of all existing wetlands on the property:
0

4g. List the total estimated linear feet of all existing streams on the property:
382
4h. Explain the purpose of the proposed project:
The purpose of this project is to construct a driveway crossing to provide access to a single-family residence.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:
Equipment typically used for construction and earthwork such as backhoes, bulldozers, excavators, graders, pavers etc. will be utilized for this project. The inlet rip rap was required by the
County as part of the Erosion Control Approval.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
Yes No Unknown
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
Preliminary Approved Not Verified Unknown N/A
Corps AID Number:
N/A
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Kevin Martin
Agency/Consultant Company: Soil & Environmental Consultants, PA
Other:
6. Future Project Plans
6a. Is this a phased project?*
Yes 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?
It is my understanding that there are no intended future impacts for this lot. Therefore, no additional NWP, Regional General Permits, or IP are anticipated.
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
Wetlands Streams -tributaries Buffers
Open Waters Pond Construction
3. Stream Impacts
❑
S1
F
3a. Reason for impact (?)
driveway crossing
3b.lmpact type*
Permanent
3c. Type of impact*
Culvert
3d. S. name*
Creek
fful
3e. Stream Type*
(?)
Intermittent
3f. Type of
Jurisdiction*
Both
3g. S. width*
Average (feet)
�3h. Impact
length*
49
(linear feet)
F]rip
rap
Permanent
Rip Rap Fill
UT of Cub Creek
Intermittent
Both
Average (feet)
37
(linear feeQ
31. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts: 3i. Total temporary stream impacts:
86 0
31. Total stream and ditch impacts:
86
3j. Comments:
E. Impact Justification and Mitigation
1. Avoidance and Minimization
u

1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
S&EC completed a wetland delineation so that natural resources could be identified and impacts minimized to the maximum extent practicable. The
crossing is required in order to provide vehicular access to a single family residence on an existing lot of record. The crossing has been designed
utilizing 2:1 side slopes and a minimum driveway width with headwalls in order to minimize the impact to the stream. The existing terrain on the site is
steep and the driveway slope has been designed at the maximum slope practical to meet NCDOT requirements and industry standards to minimize the
overall height of the crossing.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
The crossing has been designed utilizing 2:1 side slopes and a minimum driveway width with headwalls in order to minimize the impact to the stream
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 this project DOES NOT require Compensatory Mitigation, explain why:
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
What type of SCM are you providing?
Level Spreader
Vegetated Conveyance (lower SHWT)
Wetland Swale (higher SHWT)
Other SCM that removes minimum 30 % nitrogen
Proposed project will not create concentrated stormwater flow through the buffer
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250? *
Yes No
2b. Does this project meet the requirements for low density projects as defined in 15A NCAC 02H .1003(2)?
Yes No
Comments:
G. Supplementary Information
1. Environmental Documentation
la. Does the project involve an expenditure of public (federal/statellocal) funds or the use of public (federallstate) 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)? x
Yes No
I Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality?*
Yes No
3b. If you answered "no," provide a short narrative description.
We have reviewed the "Draft Internal Policy, Cumulative impacts and the 401 Water Quality Certification and Isolated Wetlands Programs" document
prepared by the NC Division of Water Quality on April 10, 2004, version 2.1. The draft states that many private developments are unlikely to cause
cumulative impacts, including projects such as urban in -fill, most residential subdivisions and small commercial developments as well as agricultural and
silvicultural operations. The 663 Governors Club project is a residential development. Additionally, the project is located within Chatham County,
therefore the adjacent properties that have potential for development will have the following regulations to protect downstream waters:l) the Water
Supply, Watershed Protection Program which limits development densities as well as requires protective riparian buffers; 2) The Jordan Lake Riparian
Buffer Rules. We anticipate that the DWR will advise us if any additional information is needed.
4. Sewage Disposal (DWR Requirement)
U

4a. Is sewage disposal required by DWR for this project?*
Yes No 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.
This lot will be served by the Governors Club Private sewer system that is permitted by DWR. The tap is up at Cherry Dr. The line from the home to the
tap, along with all the other utilities, will cross the stream alongside/under the driveway
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
5d. Is another Federal agency involved?*
Yes No Unknown
Se. Is this a DOT project located within Division's 1-8?
Yes No
5f. Will you cut any trees in order to conduct the work in waters of the U.S.?
Yes 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
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.?
Yes No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
The NC Natural Heritage Programs Data Explorer Map was used to search for elemental occurrences of federally protected species listed within and
within 1-mile of the project boundaries. It was determined based on the search that there are no elemental occurrences that are listed as federally
Threatened/Endangered within or within 1-mile of the project boundaries. References: NC Natural Heritage Program. 2021. Geographic Information
System (GIS) data. NCDNCR, Raleigh, NC. Available at http://www.ncnhp.org/. (Accessed: December 8, 2021).
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 NOAA Habitat Conservation/Habitat Protection: National Marine Fish Service; Essential Fish Habitat Mapper website was referenced. No Essential
Fish Habitat was identified near the project.
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?*
The NC State Historic Preservation Office HPOWEB GIS Service interactive map was referenced on December 8, 2021, no historic listings or study list
entries or determined eligible listings were identified within the property boundaries. Additionally, no structures exist within the property boundaries.
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
Yes No
8c. What source(s) did you use to make the floodplain determination?*
NC Flood Risk Information System Floodplain Mapping Program and confirmation from the project engineer.
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 or drag and drop files here to attach document
E1 -Lot 663-Impact Map.pdf 575.73KB
JD REQUEST with attachments lot 663.pdf 4.82MB
C3.0 GRADING.pdf 1.21 MB
File must be PDF or KMZ
Comments

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 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:
Kevin C Martin
Signature
Date
12/10/2021