20220076 Ver 1_ePCN Application_20220113

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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#*
20220076
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:
Hurba Waterfront
1a. Who is the Primary Contact?*
Shaun Liggett
1 b. Primary Contact Email: * 1c. Primary Contact Phone:*
[e-mail] [phone]
Date Submitted
1/13/2022
Nearest Body of Water
lake royale
Basin
Tar -Pamlico
Water Classification
28-31-1
Site Coordinates
Latitude:
Longitude:
35.9868067
-78.2090265
A. Processing Information
County (or Counties) where the project is located:
Franklin
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 (N W P)
Regional General Permit (RGP)
Standard (IP)
1c. Has the NWP or GP number been verified by the Corps?
Yes No
Regional General Permit (RGP) Number:
RGP Numbers (for multiple RGPS):
197800080
1d. Type(s) of approval sought from the DWR:
401 Water Quality Certification - Regular
Non-404 Jurisdictional General Permit
Individual 401 Water Quality Certification
197800056 - Piers, Docks, Boathouses
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:
Evelyn and Gary Hurba
2b. Deed book and page no.:
2225/1231
2c. Contact Person:
Evelyn Hurba
2d.Address
Street Address
905 Southwick Avenue
Address Line 2
City
Clayton
Postal / Zip Code
27527
2e. Telephone Number:
[phone]
2g. Email Address:
[e-mail]
401 Water Quality Certification - Express
Riparian Buffer Authorization
State / Province / Region
NC
Country
us
2f. Fax Number:
Yes No
Yes No
U

3. Applicant Information (if different from owner)
3a. Name:
Shaun Liggett
3b. Business Name:
Concept Contracting and Design LLC
3c.Address
Street Address
301 E. Nash Street
Address Line 2
City
Louisburg
Postal / Zip Code
27549
3d. Telephone Number:
[phone]
3f. Email Address:"
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Shaun liggett
4b. Business Name:
Concept contracting and Design LLC
4c.Address
Street Address
301 E. Nash Street
Address Line 2
City
Louisburg
Postal / Zip Code
27549
4d. Telephone Number:
[phone]
4f. Email Address:
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(if appropriate)
Lake Royale
1c. Nearest municipality I town:
Bunn, NC
2. Project Identification
State / Province / Region
NC
Country
us
3e. Fax Number
State / Province / Region
NC
Country
us
4e. Fax Number
2a. Property Identification Number:
2b. Property size:
2831-45-0062
.4564
2c. Project Address
Street Address
213 Sagamore Drive
Address Line 2
City
State / Province / Region
Louisburg
NC
Postal / Zip Code
Country
27549
us
3. Surface Waters
3a. Name of the nearest body of water to proposed project:'r
lake royale

3b. Water Resources Classification of nearest receiving water:*
28-31-1
3c. What river basin(s) is your project located in?*
Tar -Pamlico
3d. Please provide the 12-digit HUC in which the project is located.
0302010106
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:"`
wooded lot
residential lots adjacent
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
4g. List the total estimated linear feet of all existing streams on the property:
4h. Explain the purpose of the proposed project: *
develop waterfront, shoreline stabilization, dock, boathouse, rip rap
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:
excavator and skid steer including boom lift if necessary impacting a temporary path to water front work
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:
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?*
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 project or related activity?
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
6. Buffer Impacts (for DWR)
6a. Project is in which protect basin(s)?
Check all that apply.
Neuse Tar -Pamlico
Catawba Randleman
Goose Creek Jordan Lake
Other

6b. Impact Type
6c. Per or Temp
6d. Stream name
6e. Buffer mitigation required?
6C Zone 1 impact
6g. Zone 2 impact
allowable
P
cypress creek
No
400
400
allowable
T
cypress creek
No
300
300
6h. Total buffer impacts:
Zone 1 Zone 2
Total Temporary impacts: 300.00 300.00
Zone 1 Zone 2
Total Permanent impacts: 400.00 400.00
Zone 1 Zone 2
Total combined buffer impacts: 700.00 700.00
6i. 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:
limited to access to waterfront work and bulkhead
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
silt fence and watershed waddles and temporary hold back ponds
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:
closed body of water
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/state/local) funds or the use of public (federal/state) 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)? *
Yes No
3. 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.
limited to the waterfront buffer zone
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
Yes No N/A
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
5e. 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?
ncdnr website
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?
ncdnr 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 status?*
Yes No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
ncdnr website
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
Yes No
8b. If yes, explain how project meets FEMA requirements:
meets all requirements by following all rules within the buffer zone impacts
8c. What source(s) did you use to make the floodplain determination?*
ncdnr website

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
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:
shaun patrick liggett
Signature
Date
1/13/2022