20220190 Ver 1_ePCN Application_20220130

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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,f needed.
BIMS # Assigned*
20220190
Is a payment required for this project?
No payment required
Fee received
Fee needed - send electronic notification
Select Project Reviewer*
Colleen Cohn:eads\cmcohn
Information for Initial Review
1a. Name of project:
COURTESY COPY 6032 Waters Edge Drive
la. Who is the Primary Contact?*
John R. Davis, Jr.
1 b. Primary Contact Email:
[e-mail]
Date Submitted
1 /30/2022
Nearest Body of Water
Tar River Reservoir
Basin
Tar -Pamlico
Water Classification
WS-IV NSW
Site Coordinates
Latitude:
35.885128
A. Processing Information
County (or Counties) where the project is located:
Nash
Is this a NCDMS Project
Yes No
Longitude:
-77.892770
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)
Version# *
1
Reviewing Office*
Raleigh Regional Office - [phone]
1c. Primary Contact Phone:*
[phone]
u

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:
Regional General Permit (RGP) Number:
RGP Numbers (for multiple RGPS):
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
197800080 - Bulkheads and Riprap
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:
Donald Mills
2b. Deed book and page no.:
Book 24 Page 166
2c. Contact Person:
2d.Address
Street Address
211 Market Street
Address Line 2
City
Suffolk
Postal / Zip Code
23434
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
401 Water Quality Certification - Express
Riparian Buffer Authorization
State / Province / Region
VA
Country
USA
2f. Fax Number:
Yes No
Yes No

3. Applicant Information (if different from owner)
3a. Name:
3b. Business Name:
3c.Address
Street Address
Address Line 2
City
Postal / Zip Code
3d. Telephone Number:
3f. Email Address: *
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
John R. Davis, Jr.
4b. Business Name:
Soil Horizons LLC
4c.Address
Street Address
285 Dreamcatcher Trail
Address Line 2
City
Youngsville
Postal / Zip Code
27596
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)
Lake Haven
1c. Nearest municipality / town:
Rocky Mount, NC
2. Project Identification
2a. Property Identification Number:
048096
2c. Project Address
Street Address
6032 Waters Edge Drive
Address Line 2
City
Rocky Mount
Postal / Zip Code
27803
3. Surface Waters
3a. Name of the nearest body of water to proposed project:
Tar River Reservoir
State / Province / Region
Country
3e. Fax Number:
State / Province / Region
NC
Country
USA
4e. Fax Number:
2b. Property size:
1.05
State / Province / Region
NC
Country
USA
3b. Water Resources Classification of nearest receiving water:*
WS-IV NSW

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.
030201010606
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:
This property is an existing residential subdivision lot that is mostly mowed grass except for a few scrubby trees along the water line. This is a corner lot at the western intersection Waters
Edge Drive and Bend of the River Road in Nash County.
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:
0
4h. Explain the purpose of the proposed project:
This property is a residential subdivision lot with a proposed single family house. To access the water, a proposed retaining wall, pier and boat house is proposed at the water high water
line of the reservoir. Most of the Tar -Pam riparian buffer is existing ongoing yard with established grass. The water side edge of Zone 1 of the buffer is steep and too difficult to mow and
maintain and has grown up in bushes, saplings and a few scrubby trees.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used: *
This project proposes to install a retaining wall along the landward side of the western property line which is 60.8 feet long. The proposed wall is above the high water line and will be
backfilled up to the approximate elevation of the existing back yard area. No wetlands or waters of the US will be filled on the landward side of the retaining wall. A pier and boat house will
be constructed in the reservoir on the water side of the wall during times when the water level in the reservoir is low. This will be done by driving pilings into the lake bed from a barge to
support the structures. No excavation or filling will be conducted in WOUS with this project.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?
Yes No Unknown
Comments:
Only uplands adjacent to reservoir
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: Project is covered under USACE Regional General Permits
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?
No other permits or impacts are anticipated with this project.
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?
6f. Zone 1 impact
6g. Zone 2 impact
Allowable with Mitigation
P
Tar River
Yes
580
0
6h. Total buffer impacts:
Zone 1
Zone 2
Total Temporary impacts:
0.00
0.00
Zone 1
Zone 2
Total Permanent impacts:
580.00
0.00
Zone 1
Zone 2
Total combined buffer impacts:
580.00
0.00
61. Comments:
The other areas of the buffer are existing and ongoing turf established areas with sheet flow. See Figure 1.
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:
Zone 1 impacts will involve improvement in the slope and reduce erosion potential into reservoir. Grass and smooth slope will encourage sheet flow to
bulkhead.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Construction will be conducted during low water levels. Backfill materials will be stabilized with grass and protected from offsite transport by silt fencing.
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
2c. If yes, mitigation is required by (check all that apply):
DWR Corps
2d. If yes, which mitigation option(s) will be used for this project?
Mitigation bank Payment to in -lieu fee program Permittee Responsible Mitigation
4. Complete if Making a Payment to In -lieu Fee Program
4a. Approval letter from in -lieu fee program is attached
Yes No
4b. Stream mitigation requested:
(linear feet)
0
4d. Buffer mitigation requested (DWR only):
(square feet)
580
4f. Non -riparian wetland mitigation requested
0
4h. Comments
Existing vegetation will interfere with bulkhead construction on landowners property.
4c. If using stream mitigation, what is the stream temperature:
4e. Riparian wetland mitigation requested:
(acres)
0
4g. Coastal (tidal) wetland mitigation requested:
(acres)
0
6. Buffer mitigation (State Regulated Riparian Buffer Rules) - required by DWR
6a. Will the project result in an impact within a protected riparian buffer that requires buffer mitigation? If yes, you must fill out this entire form - please contact DWR for more information.
Yes No
6b. If yes, then identify the square feet of impact.
6c. Reason for impact 6d. Total impact (square Multiplier 6e. Required mitigation
feet) (square feet)

Zone 1 Bulkhead construction 580 2 f,160
Zone 2 0 0 0
6f. Total buffer mitigation required
1160
6g. If buffer mitigation is required, is payment to a mitigation bank or NC Division of Mitigation Services proposed?
Yes No
6j. Comments:
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
2c. Does this project have a stormwater management plan (SMP) reviewed and approved under a state stormwater program or state -approved local government stormwater program?
Yes No
N/A - project disturbs < 1 acre
Comments:
G. Supplementary Information
1. Environmental Documentation
la. Does the project involve an expenditure of public (federallstatellocal) 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.
4. Sewage Disposal (DWR Requirement)
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.
Sewage Disposal will be by on -site septic system installed outside of riparian buffers.

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
What Federal Agency is involved?
USACE
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
Unknown
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?
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?
This item is covered by the Regional General Permit 197800056 and 197800080
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?*
This item is covered by the Regional General Permit 197800056 and 197800080
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:
A flood study will be conducted by Appian Consulting Engineers, PA
8c. What source(s) did you use to make the floodplain determination?*
Survey indicates floodplains. See Figure 1.
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 dreg and drop files here to attach document
6032 Waters Edge Drive DMS Acceptance.pdf 235.98KB
6032 Waters Edge PCN Docs.pdf 9.03MB
File must be PDF or KMZ
Comments
Signature U
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 belielf; 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:
John R. Davis, Jr.
Signature
Date
1 /30/2022