20201604 Ver 2_ePCN Signature Page_20220221

Ba. Will this project occur in a FEMA-designated 100-year flood plain?"
v Yes No
Bb. Ifyes, explain how project meets FEMA requirements:
According to FEMA FIRM panel 3720179500J (effective 05/02/2006), the central portion of the site along the main stream is located within Zone AE with
base flood elevations between approximately 237- and 249-feet above mean sea level. A FEMA-designated floodway is located along the stream.
The proposed utility crossing and road widening will result in minimal impacts to areas within the 100-year floodplain, with the proposed utility line
impacts consisting only of temporary disturbance for installation.
A CLMOR flood study and coordination with FEMA is currently in progress to determine impacts to the floodway and flood zones following completion of
the proposed road widening. Copies of the approved 404 and 401 permits are required to complete FEMA coordination.
Bc. What source(s) did you use to make the floodplain determination?"
FEMA's National Flood Hazard Layer— FIRM panel 3720179500J (effective 05/02/2006)
Miscellaneous
Comments
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
Jasper Place Road Widening - PCN Deliverables Package.pdf 36.05MB
File must be PDF or KMZ
Signature
X 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.
• have given true, accurate, and complete information on this form;
• 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:" Sydni L. Law
Signature" ;
Date
2/21 /2022