20140169 Ver 1_401 Application_20140214

2 0 1 4 0 16 9
Office Use Only:
Corps action ID no. SAW-2014-02i
DWQ project no.
J Form Version 1.4 January 2009
Page 1 of 10
PCN Form - Version 1.4 January 2009
Pre - Construction Notification (PCN) Form
A.
Applicant Information _J
1.
Processing --
1 a.
Type(s) of approval sought from the Corps:
❑X Section 404 Permit ❑ Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: 14 or General Permit (GP) number:
1c.
Has the NWP or GP number been verified by the Corps?
❑X Yes ❑ No
1d.
Type(s) of approval sought from the DWQ (check all that apply):
❑X 401 Water Quality Certification - Regular ❑ Non -404 Jurisdictional General Permit
❑ 401 Water Quality Certification - Express ❑ Riparian Buffer Authorization
1e.
Is this notification solely for the record
because written approval is not required?
For the record only for DWQ
401 Certification:
❑ Yes ❑X No
For the record only for Corps Permit:
❑ Yes ❑X 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
1 g.
Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below.
Yes ❑ No
1 h.
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes ❑X No
2.
2a.
2b.
Project Information
Name of project: Trevor Horne House site
County: Onslow
2c.
Nearest municipality / town:
Richlands
2d.
Subdivision name:
2e.
NCDOT only, T.I.P. or state project no:
3.
Owner Information
3a.
Name(s) on Recorded Deed:
Horne Trevor P. & Greta L.
3b.
Deed Book and Page No.
Book 3928 page 639
3c.
Responsible Party (for LLC if
applicable):
nD f�(645OWl'i-3
Fn),
3d.
Street address:
107 Ramona Ave - - -
i
3e.
City, state, zip:
Jacksonville, NC 28540 FFq 2 1 n i. 1
3f.
Telephone no.:
910.382.5251
3g. Fax no.:
D NR - WATER MALITY
3h. Email address:
hornetrevor @hotmail.com
Page 1 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)
5a Name
5b Business name
(if applicable)
5c Street address
5d City, state, zip
5e Telephone no
5f Fax no
5g Email address
Page 2 of 10

B
Project Information and Prior Project History
1
Property Identification
1a
Property identification no (tax PIN or parcel ID)
PIN # 441000225019
1 b
Site coordinates (in decimal degrees)
Latitude Longitude
1c
Property size
71 58 acres
2
Surface Waters
2a
Name of nearest body of water to proposed project
Back Swamp `
2b
Water Quality Classification of nearest receiving water
C SW
2c
River basin
Cape Fear
3
Project Description
3a Describe the existing conditions on the site and the general land use in the vicinity of the protect at the time of this
application
Currently there has been a drive constructed of crushed stone, general land use is residential and agricultural
3b
List the total estimated acreage of all existing wetlands on the property 45
3c
List the total estimated linear feet of all existing streams (intermittent and perennial) on the property 4,900
3d Explain the purpose of the proposed project
To allow access to homesite This is the only allowable point of entry to homesite Only other easement is for utilities Other then current homesite there
3e Describe the overall project in detail, including the type of equipment to be used
The protect consists of approximately 900 yards of crushed stone to be layed compacted in a drive that will allow safe and unimpeded access to homes
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?
0 Yes ❑ No ❑ Unknown
Comments only the area around the violation were delineated
y
4b
If the Corps made the jurisdictional determination, what type
of determination was made?
0 Preliminary ❑ Final
4c
If yes, who delineated the jurisdictional areas?
Name (if known) Brad Shaver
Agency /Consultant Company USAGE
Other
4d If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation
January 14, 2014
5
Project History
5a
Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past?
❑ Yes ❑X No ❑ Unknown
5b If yes, explain in detail according to "help file" instructions
No permits but a jurisdictional determination was complete for Simpson under AID# SAW- 2007 -01427 that noted the area in question as wetland
6
Future Project Plans
6a
Is this a phased project?
❑ Yes ❑X No
6b
If yes, explain
Page 3 of 10
PCN Form — Version 1 4 January 2009

C Proposed Impacts Inventory
1 Impacts Summary
la Which sections were completed below for your project (check all that apply)
❑X Wetlands ❑ Streams — tributaries ❑ Buffers ❑ Open Waters ❑ Pond Construction
2 Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted
2a
Wetland impact
number
Permanent (P) or
T
2b
Type of impact
2c
Type of wetland
2d
Forested
2e
Type of jurisdiction
Corps (404,10) or
DWQ (401, other)
2f
Area of
impact
(acres)
—Temporary
W1 P
Fill
Non- Rivenne Swamp Forest
Yes
Corps
002
W2 P
Culvert
Non- Riverine Swamp Forest
No
Corps
Oil
W3
Choose one
Choose one
Yes /No
W4
Choose one
Choose one
Yes /No
W5
Choose one
Choose one
Yes /No
W6
Choose one
Choose one
Yes /No
2g Total Wetland Impacts
0 13
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
3a
Stream impact
number
Permanent (P) or
Temporary (T)
3b
Type of impact
3c
Stream name
3d
Perennial (PER) or
intermittent (INT)?
3e
Type of
jurisdiction
3f
Average
stream
width
(feet)
3g
Impact
length
(linear
feet)
S1
Choose one
S2
Choose one
S3
Choose one
S4
Choose one
S5
Choose one
S6
Choose one
3h Total stream and tributary impacts
31 Comments
Page 4 of 10
PCN Form — Version 1 4 January 2009

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 indivii ually list all open water impacts below
4a
Open water
impact number
Permanent (P) or
T
4b
Name of waterbody
(if applicable)
4c
Type of impact
4d
Waterbody
type
4e
Area of impact (acres)
—Temporary
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 construction proposed, then complete the chart below
5a
Pond ID number
5b
Proposed use or
purpose of pond
5c
Wetland Impacts (acres)
5d
Stream Impacts (feet)
5e
Upland
(acres)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
P1
Choose one
P2
Choose one
5f Total
5g Comments
5h is a dam high hazard permit required?
❑ Yes ❑ No If yes, permit ID no
51 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, then you MUST fill out Section D of this form
6a Project is in which protected basin?
❑ Neuse ❑ Tar - Pamlico ❑ Catawba ❑ Randleman ❑ Other
6b
Buffer Impact
number –
Permanent (P) or
T
6c
Reason for impact
6d
Stream name
6e
Buffer
mitigation
required?
6f
Zone 1
impact
(square
feet )
6g
Zone 2
impact
(square
feet
—Temporary
131
Yes /No
B2
Yes /No
B3
Yes /No
B4
Yes /No
B5
Yes /No
B6
Yes /No
6h Total Buffer Impacts
61 Comments
Page 5 of 10

D Impact Justification and Mitigation
1 Avoidance and Minimization
1a Specifically describe measures taken to avoid or minimize the proposed impacts in designing project
1b Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques
Minimization measures will include removal of fill material to reduce overall width of drive ds indicated on attachment (3) Once width is reduced edges
of drive will have silt retaining fence installed Removal of fill will result in 100 cubic yards of material being removed overall from wetland area This
reduction of width of drive will lessen overall impacted area from 13 acres down to 0938 acres
2 Com ensatory Mitigation for Impacts to Waters of the U S or Waters of the State
2a Does the protect require Compensatory Mitigation for
impacts to Waters of the U S or Waters of the State?
❑X Yes ❑ No
2b If yes, mitigation is required by (check all that apply)
❑ DWQ ❑X Corps
2c If yes, which mitigation option will be used for this
project?
❑ Mitigation bank
❑Payment to in -lieu fee program
❑ Permittee Responsible Mitigation
3 Complete if Using a Mitigation Bank
3a Name of Mitigation Bank
3b Credits Purchased (attach receipt and letter)
Type Choose one
Type Choose one
Type Choose one
Quantity
Quantity
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
acres
4f Non - riparian wetland mitigation requested
acres
4g Coastal (tidal) wetland mitigation requested
acres
4h Comments
r
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
Page 6 of 10
PCN Form — Version 1 4 January 2009

6 Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a Will the protect result in an impact within a protected riparian buffer that requires
buffer mitigation?
Yes ❑X No
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
1 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?
lb
If yes, then is a diffuse flow plan included? If no, explain why
❑ Yes ❑ No
2
Stormwater Management Plan
2a
What is the overall percent imperviousness of this project?
2
2b
Does this project require a Stormwater Management Plan?
❑ Yes 0 No
2c
If this project DOES NOT require a Stormwater Management Plan, explain why
Not within 1/2 mile of SA waters and it is an individual residential house
2d
If this project DOES require a Stormwater Management Plan, then provide a brief, narrative
description of the plan
2e
Who will be responsible for the review of the Stormwater Management Plan?
3
Certified Local Government Stormwater Review
3a
In which local government's jurisdiction is this project?
❑ Phase II
❑ NSW
3b
Which of the following locally - implemented stormwater management programs
❑ USMP
apply (check all that apply)
❑ Water Supply Watershed
❑ Other
3c
Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ❑ No
attached?
4
DWQ Stormwater Program Review
❑Coastal counties
❑HOW
4a
Which of the following state - implemented stormwater management programs apply
❑ORW
(check all that apply)
❑Session Law 2006 -246
❑Other
4b
Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ❑ No
attached?
5
DWQ 401 Unit Stormwater Review
5a
Does the Stormwater Management Plan meet the appropriate requirements?
❑ Yes ❑ No
5b
Have all of the 401 Unit submittal requirements been met?
❑ Yes ❑ No
Page 8 of 10
PCN Form — Version 1 4 January 2009

F Supplementary Information
1 Environmental Documentation (DWQ Requirement)
la Does the project Involve an expenditure of public (federal /state /local) funds or the
❑ Yes ❑X No
use of public (federal /state) land?
lb 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
❑ Yes ❑ No
(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
❑ Yes ❑ No
letter )
Comments
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,
❑X Yes ❑ No
or Riparian Buffer Rules (15A NCAC 2B 0200)?
2b Is this an after - the -fact permit application?
❑X Yes ❑ No
2c If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s)
Portions of drive was installed unintentionally on wetlands Owner had no indications that I was impacting wetlands or even what qualified as wetlands
There was no indication in county GIS records of their existence and no mention by other regulatory departments within DOT or county Had driveway
connection culvert installed by DOT and septic permits for home site approved and system inspected after construction with no mention of wetlands or
the possibility of their existence Was only first aware of possibility after phone call from Mr Karl Hammers NCDENR This was followed by visit from
Ms Joanne Steenhuis of same and then meeting with Ms Steenhws and Mr Brad Shaver ACE These individuals gaveme a field education of wetland
3 Cumulative Impacts (DWQ Requirement)
3a Will this protect (based on past and reasonably anticipated future Impacts) result In
❑ Yes ❑X No
additional development, which could Impact nearby downstream water quality?
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
4 Sewage Disposal (DWQ 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
"Ncy _
Onslow County #
Conventional septic system installed at home site in wetlands area Permits obtained through improvement permit
EIP2013 -00659 and Construction permit# ECA 2013 -00971 System to support 4 bedroom home
Page 9 of 10
PCN Form — Version 1 4 January 2009

5 Endangered Species and Designated Critical Habitat (Corps Requirement)
5a Will this project occur in or near an area with federally protected species or
❑ Yes ❑X No
habitat?
5b Have you checked with the USFWS concerning Endangered Species Act
❑ Yes ❑X 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?
Natural Heritage database study
6 Essential Fish Habitat (Corps Requirement)
6a Will this project occur in or near an area designated as essential fish habitat?
❑ Yes ❑X No
6b What data sources did you use to determine whether your site would Impact Essential Fish Habitat?
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
❑ Yes ❑X No
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?
No older structures noted during site investigation
8 Flood Zone Designation (Corps Requirement)
8a Will this project occur In a FEMA- designated 100 -year floodplain?
❑ Yes ❑X No
8b If yes, explain how project meets FEMA requirements
8c What source(s) did you use to make the floodplain determination?
Onslow County GIS - violation area in AE zone
Trevor P Horne
2/19/2014
Applicant /Agent's Printed Name
Date
Applicant /Agent's Signature
(Agent's signature is valid only if an authorization
letter from the applicant is provided )
Page 10 of 10

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