20090002 Ver 2_401 Application_20131220

Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.4 January 2009
Pro-Construction Notification (PCN) Form
A. Applicant Information
1. Processing
la. Type(s) of approval sought from the Corps: ❑ Section 404 Permit ❑ Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps?
❑ Yes ❑ No
1d. Type(s) of approval sought from the DWQ (check all that apply):
N 401 Water Quality Certification — Regular ❑ Non-404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
le. Is this notification solely for the record
because written approval is not required?
For the record only for DWQ
401 Certification:
❑ Yes Z No
For the record only for Corps Permit:
❑ Yes ❑ 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
1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1h
below.
Yes ❑ No
1h. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes No
Project Information
-2.
Name of project:
Falls Mist Subdivision
-2a.
-2b. County:
Fender
2c. Nearest municipality / town:
Rocky Point
2d. Subdivision name: Falls Mist
2e. NCDOT only, T.I.P. or state project no:
3. Owner Information
3a. Name(s) on Recorded Deed:
Rocky Point Properties, LLC
3b. Deed Book and Page No.
3c. Responsible Party (for LLC if
applicable):
2716/246
Rocky Point Properties, LLC c/o Brian Kaiser
3d. Street address:
PO Box 1229
3e. City, state, zip:
Wilmington, NC 28402
3f. Telephone no.:
910-251-5030
3g. Fax no.:
3h. Email address:
[e-mail]
Page I of 10
PCN Form — Version 1.4 January 2009

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)
ba. Name:
Paul Masten
5b, Business name
(if applicable):
S&ME. Inc,
5c. Street address:
3006 Hall Waters Drive, Suite 100
5d. City, state, zip:
Wilmington, NC 28405
Telephone no.-.
910-799-9945
—be.
U Fax no.:
910-799-9958
5g. Email address:
[e-mail]
Page 2 of 10

B. Project Information and Prior Project History
1 . Property Identification
la. Property identification no. (tax PIN or parcel ID):
3234-24-6900-0000
1b. Site coordinates (in decimal degrees):
I Latitude: 34.414847 Longitude: 77.893981
1c. Property size: 40.2 acres
2, Surface Waters
2a. Name of nearest body of water to proposed project: Turkey Creek
2b. Water Quality Classification of nearest receiving water: C'Sw
2c. River basin: Cape Fear River
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
The site currently consists of undeveloped woodland. General land use in the vicinity ofthe project includes undeveloped woodland and agriculture to
the north and west and residential development to the south and east. The Fall Brook subdivision is under construction to the south.
3b. List the total estimated acreage of all existing wetlands on the property: 4.21
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property. 0
3d. Explain the purpose of the proposed project:
The purpose of the project is provide single-family residential housing. The proposed impacts will allow for roadway access to the site.
3e. Describe the overall project in detail, including the type of equipment to be used:
The proposed project will consist of a 46-lot residential subdivision- Mechanized land clearing, grading equipment and typical construction equipment%%
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past?
P9 Yes n No El Unknown
Comments:
4b. If the Corps made the jurisdictional determination, what type
of determination was made?
El Preliminary Final
4c. If yes, who delineated the jurisdictional areas?
Name (if known): Troy Beasley
Agency/Consultant Company: Withers & Ravenel
Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
Originally approved in January 2006 by Lillette Grenade (signed plat attached). Re-approved in 2011 by Crystal Amschler as referenced in the
attached 404 permit. The re-approved boundary plat is not available as the odginal consultant (Withers & Ravenel) is unresponsive.
5. Project History
5a. Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past?
N Yes El No El Unknown
5b. If yes, explain in detail according to "help file" instructions.
- NWP 29 issued by USACE (Action ID 200501193) and has been included.
6. Future Project Plans
6a. Is this a phased project? Yes ED No
6b. If yes, explain.
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PCN Form —Version 1.4 January 2OO9

C. Proposed Impacts Inventory
1. Impacts Summary
I a. Which sections were completed below for your project (check all that apply):
0 Wetlands El Streams —tributaries El suffers El Open Waters El Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each welland area impacted.
Wetland impact
number
Permanent (P) or
Temporary (T)
Type of impact
Type of wetland
Forested
Type of jurisdiction
Corps (404,10) or
DWQ (401, other)
Area of
impact
(acres)
W1 P
Fill
Headwater Wetland
Yes
Corps
0.006
W2 P
Fill
Headwater Wetland
Yes
Corps
0.074
W3 P
Fill
Headwater Wetlarid
Yes
Corps
0.062
W4 P
Fill
Headwater Wetland
Yes
Corps
0.016
W5 P
Fill
Headwater Wetland
Yes
Corps
0.017
W6
Choose one
Choose one
Yes/No
2g. Total Wetland Impacts:
0.18
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.
Stream impact
number
Permanent (P) or
Temporary (T)
Type of impact
Stream name
Perennial (PER) or
intermittent (INT)?
Type of
jurisdiction
Average
stream
width
(feet)
Impact
length
(linear
feet)
S1
Choose one
S2 -
Choose one
S3 -
Choose one
S4 -
Choose one
85 -
Choose one
S6 -
Choose one
I
3h. Total stream and tributary impacts
3i. Comments:
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PCN Form — Version 1.4 January 2OOB

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 bet w.
4a.
4b. 4c.
4d.
4e.
Open water
Name of waterbody
impact number
(if applicable) Type of impact
Waterbody
Area of impact (acres)
Permanent (P) or
type
Temporary (T)
01
Choose one
Choose
02
Choose one
Choose
03
Choose one
Choose
04
Choose one
Choose
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If pond or lake con truction proposed, the complete the chart below.
5a,
5b.
5c.
5d.
5e.
Pond ID number
Proposed use or
Wetland Impacts (acres)
Stream Impacts (feet)
Upland
purpose of pond
(acres)
Flooded
Filled
Excavated
Flooded
Filled Excavated
P11
Choose one
P2
Choose one
5f. Total:
5g. Comments:
5h. Is a dam high hazard permit required?
F] Yes E] 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, t en you MUST fill out Section D of this form.
6a. Project is in which protected basin?
E] Neuse Tar-Pamlico Catawba E] Randleman F] Other:
6b.
6c.
6d.
6e.
6f.
6g.
Buffer Impact
Reason for impact
Stream name
Buffer
Zone 1
Zone 2
number —
mitigation
impact
impact
Permanent (P) or
required?
(square
(square
Temporary (T)
feet)
feet)
B1 -
Yes/No
B2 -
YoslNo
B3 -
Yes/No
B4 -
YeslNo
B5 -
Yes/No
B6 -
Yes/No
6h. Total Buffer Impacts:
6i. Comments:
Page 5 of 10

D. Impact Justification and Mitigation
Avoidance and Minimization
—1.
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
Approximately 4.03 acres of wetland have been avoided. The main entrance is proposing to cross a wetland at an area that contains an upland pass
to minimize impacts. Additional impacts in lot 33 and 38 have been avoided by use of an elevated pedestrian walkway that can be used to access the
rear portions of those lots which have been separated bywetland from the rest of the lot. Roadway crossings have been designed to be done at, or
close to9O-degree angles. Proposed impacts are only for roadway access. No impacts for lot fill or stormwater management have been proposed.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Silt fence and other sedimentation and erosion control measures shall be employed to minimize unintended impacts resulting from erosion following
rain events. Vegetated swales will be used for stormwater treatment and conveyance. Recorded restrictive covenants have been proposed to
maintain the wetland conservation areas. A copy of the restrictive covenant has been included.
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):
Ll DWQ 0 corps
2c. If yes, which mitigation option will be used for this
project?
El Mitigation bank
0 Payment to in-lieu fee program
El Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
Type: Choose one Quantity:
3b. Credits Purchased (attach receipt and letter) Type: Choose one Quantity:
Type: Choose one 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:
Choose one
4d. Buffer mitigation requested (DWQ only):
square feet
4e. Riparian wetland mitigation requested:
0.25 acres
4f. Non-riparian wetland mitigation requested:
acres
4g. Coastal (tidal) wetland mitigation requested:
acres
4h. Comments: See attached USACE NWP 29 Verification
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.
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PCN Form —Version 1/4 January 2OOS

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 Yes No
buffer mitigation? I
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
1.5
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 7 of 10

E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
I a. Does the project include or is it adjacent to protected riparian buffers identified
Yes No
within one of the NC Riparian Buffer Protection Rules?
1b. If yes, then is a diffuse flow plan included? If no, explain why.
Yes E] No
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project?
24%
2b, Does this project require a Stormwater Management Plan?
0 yes El 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:
It is our understanding that the project will be cJassified as low-density with stormwater treatment and conveyance being provided via vegetated
swales. The stormwater application Is being prepared by Tripp Engineering (2009-0002)
2e. Who will be responsible for the review of the Stormwater Management Plan?
NCDENR
3. Certified Local Government Stormwater Review
3a, In which local government's jurisdiction is this project?
El Phase 11
El NSW
3b. Which of the following locally-implemented stormwater management programs
0 USMP
apply (check all that apply):
F] Water Supply Watershed
3c. Has the approved Stormwater Management Plan with proof of approval been
El Yes F1 No
4. DWO Stormwater Program Review
Coastal counties
4a. Which of the following state-implemented stormwater management programs apply [_]ORW
(check all that apply): nSession Law 2006-246
4b. Has the approved Stormwater Management Plan with proof of approval been Yes R No
DWQ401 Unit Stormwater Review
-5.
5a. Does the Stormwater Management Plan meet the appropriate requirements?
E] Yes No
5b. Have all of the 401 Unit submittal requirements been met?
[] Yes No
Page 8of1O
PCN Form -Version 1.4 January 2O0B

F. SupplementM Information
1. Environmental Documentation (DWO Requirement)
la. Does the project involve an expenditure of public (federal/state4ocal) funds or the
El Yes
MX No
use of public (federal/state) land?
1L 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
E]Yes
ONo
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1c. 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
El Yes
No
letter.)
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,
E]Yes
FX1 No
or Riparian Buffer Rules (15A NCAG 2B.0200)?
2b. Is this an after-the-fact permit application?
El Yes
MX 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
[I Yes
ZNo
additional development, which could impact nearby downstream water qu ality?
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.
The proposed project is not anticipated to result in additional development and there are no future antidpated impacts associated
with the proposed
4. Sewage Disposal (DWO 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.
Treatment and disposal of wastewater will be performed via use of individual septic systems.
Page 9nf1O
PCN Form — Version 1.4 January 2UUA

6. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project or-cur in or near an area with federally protected species or
Yes El No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act
0 Yes nX No
impacts?
5c. If yes, indicate the USFWS Field Office you have contacted.
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
NC Natural Heritage Program website and USFWS website
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?
NC Division of Marine Fisheries website.
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
L] Yes ZNo
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
NC State Historic Preservation OffiGe website
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?
El Yes nX No
W If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination?
NC Floodplain Mapping Program website
Paul Masten
eX
m-,- tA_
12-20-2013
Applicant/Agent's Printed Name
� Applicant/Agent's Signature
Date
(Agenrs signature is valid only if an authorization
letter from the applicant is provided.)
Page 10 of 10