20220276 Ver 1_ePCN Application_20220216

DWR
Division of Water Resources
Initial Review
Pre -Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
December 6, 2021 Ver 4.2
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#*
20220276 1
Is a payment required for this project?*
No payment required
Fee received
Fee needed - send electronic notification
What amout is owed? *
$240.00
$570.00
Reviewing Office* Select Project Reviewer*
Asheville Regional Office - [phone] Kaylie Yankura:eads\kyankura
Information for Initial Review
la. Name of project:
Obst Property
la. Who is the Primary Contact?*
Mark and Tavia Obst
1 b. Primary Contact Email: * lc. Primary Contact Phone: *
[e-mail] [phone]
Date Submitted
2/16/2022
Nearest Body of Water
Boylston Creek
Basin
French Broad
Water Classification
BIMS Class C
Site Coordinates
Latitude:
35.35517
A. Processing Information
Longitude:
82.58607
County (or Counties) where the project is located:
Henderson
Is this a NCDMS Project
Yes No
Is this project a public transportation project? *
Yes No
la. 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)
lc. Has the NWP or GP number been verified by the Corps?
Yes No
Nationwide Permit (NWP) Number: 03 - Maintenance
NWP Numbers (for multiple NWPS):
Id. Type(s) of approval sought from the DWR:
401 Water Quality Certification - Regular
Non-404 Jurisdictional General Permit
Individual 401 Water Quality Certification
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
lg. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
Yes No
lg. 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
401 Water Quality Certification - Express
Riparian Buffer Authorization
Yes No
Yes No
B. Applicant Information
ld. 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:
Mark and Tavia Obst
2b. Deed book and page no.:
Book 3401 page: 430
2c. Contact Person:
2d. Address
Street Address
109 Baler Drive
Address Line 2
City State / Province / Region
Mills River North Carolina
Postal / Zip Code Country
28759 USA
2e. Telephone Number: 2f. Fax Number:
[phone]
2g. Email Address: *
[e-mail]

C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(if appropriate)
lc. Nearest municipality / town:
Mills River
2. Project Identification
2a. Property Identification Number:
2b. Property size:
+/- 6 acres
2c. Project Address
Street Address
109 Baler Drive
Address Line 2
City State / Province / Region
Mills River North Carolina
Postal / Zip Code Country
28759 USA
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Boylston Creek
3b. Water Resources Classification of nearest receiving water: *
BIMS Class C
3c. What river basin(s) is your project located in?*
French Broad
3d. Please provide the 12-digit HUC in which the project is located.
060101050401
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: *
Property is residential. Grassed and trees leading to the drainage ditch/stream that fronts the property along Baler Drive.
After the August 2021 Storm event in NW North Carolina, debris, fallen trees and surface erosion obstructed flow in the ditch/stream.
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:
0.00826 acres
4g. List the total estimated linear feet of all existing streams on the property:
+/- 350 LF
4h. Explain the purpose of the proposed project: *
Removal of debris, trees limbs and and sediments from the ditch/stream
Repair, rehabilitation of previously serviceable structure and culverted road crossing
Repair side slope damage returning to original slope
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used: *
Utilize a bobcat to facilitate the removal of debris from the ditch/stream
Utilize a bobcat to repair side slope damage
Utilize a bobcat to place an additional 120 LF of 18" culvert pipe to match existing culvert pipe for the road crossing and to minimize future erosion.
Utilize a bobcat to place additional fill (approx. 400 cys) around the 18" culverted road crossing pipe to minimize potential future erosion
Utilize a bobcat to install on the downstream side of the culverted road crossing to prevent future erosion of the ditch/stream by future high flows
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
Yes No
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
Preliminary Approved Not Verified Unknown N/A
Unknown
Corps AID Number:
SAW-2021-02579

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?
No
D. Proposed Impacts Inventory
1. Impacts Summary
la. Where are the impacts associated with your project? (check all that apply):
Wetlands
Open Waters
3. Stream Impacts
Streams -tributaries
Pond Construction
Buffers
3a. Reason for impact (?)
3b.Impact type*
3c. Type of impact*
3d. S. name*
3e. Stream Type*
(?)
3f. Type of
Jurisdiction*
3g. S. width*
3h. Impact
length*
Si
storm debris
Temporary
Bank Stabilization
UT
Perennial
Both
3
Average (feet)
120
(linear feet)
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
0
3i. Total stream and ditch impacts:
120
3j. Comments:
E. Impact Justification and Mitigation
3i. Total temporary stream impacts:
120
1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
Approach was designed to maintain normal downstream flows to the maximum extent possible
Materials were place in a manner that will not result in erosion by expected high flows
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Removal of storm debris and and all rehabilitation activities were performed in the wet so as to not impact normal flow of the ditch/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:
No impacts to the Waters of the U.S. or Waters of the State- therefore no Compensatory Mitigation is required
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
If no, explain why:
According to the Options for Meeting Diffuse Flow Provisions of the Stormwater and Riparian Buffer Protection Programs, drainage ditches, roadside ditches and stormwater outfalls
through riparian buffers are exempt.

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
2b Provide an explanation of the violation(s):
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
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
5e. Is this a DOT project located within Division's 1-8?
Yes No
No Unknown
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
5i. 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?
IPaC US Fish and Wildlife
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
Yes No

Are there submerged aquatic vegetation (SAV) around the project vicinity?*
Yes No
Unknown
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat? *
NOAA 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 status?*
Yes No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
North Carolina Historic Preservation website
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?*
Insurance documents
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:
Mark Obst
Signature
ldlc9/k Q.ds/
Date
2/16/2022