20140639 Ver 1_401 Application_20140614

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4 0 g 3
20 140638
l'
Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.4 January 2009
Page 1 of 10
PCN Form — Version 1.4 January 2009
U14 D
914
Pre - Construction Notification (PCN) Form
A. Applicant Information
1. Processing
1a. Type(s) of approval sought from the Corps:
Section 404 Permit C] Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps?
Yes ❑ No
1d. Type(s) of approval sought from the DWQ (check all that apply):
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 P9 No
For the record only for Corps Permit:
❑ Yes UrNo
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 [2(No
1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1h
below.
`'Yes ❑ No
1h. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes No
2. Project Information
2a. Name of project:
I lr. C:J 1 C� e r lC e1
2b. County:
—
2c. Nearest municipality I town:
N c L _) t t r 0
2d. Subdivision name:
2e. NCDOT only, T.I.P. or state project no:
3. Owner Information 2
3a. Name(s) on Recorded Deed: �� C K R H rw O 2'
3b. Deed Book and Page No.
3c. Responsible Party (for LLC if
applicable):
i
3d. Street address:
n �
3e. City, state, zip:
3f. Telephone no.:
�� 3
3g. Fax no.:
3h. Email address:
Ct �`�ckSC)t ®
' I'1(. > C Z CIn
Page 1 of 10
PCN Form — Version 1.4 January 2009
U14 D
914

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 rfo
4g
Fax no -
4h Email address
5.
Agent/Consultant Information (if applicable)
5a
Name
L �?
5b
Business name
(if applicable)_
5c
Street address
U`ve Loa ,t C,�
5d
City, state, zip
t L, ', V5LIQ
5e
Telephone no
5I i 1r,
5f
Fax no
5g
Email address
Page 2 of 1b

Page 3 of 10
PCN Form -Version 1 4 January' 2009
ts, rroject intormation and Prior Project History
1. Property Identification
la Property identification no (tax PIN or parcel ID) y U -
1b Site, coordinates (in decimal degrees) Latitude N'35'' ^' S'j ,� " Longitude
- '
1c Property size
acres
2. Surface Waters
2a Name of nearest body,of water to proposed project bn , Cctcj -
2b Water Quality Classification of nearest receiving water IC(' CSC`
2c River basin ` 5e -
3. Project Description
3a Describe the existing conditions on the site and the general land use in the vicinity of the projecUat the time of this
apl1plication Mo,oaG`Pd he'r6cccec ,_15 C�,ve „, V,tlmar- ,aY- 6- 41-lefbcAc(?oct �
S
GudP � (4 rlrrlwrur
C1PC1C1la` Ore 5�1vv i blr, � cl y4t 516k'�'Til rtl S 1Y- C)” C,
� , C��VYIi
tal estimated acreage of all existing wetlands on the property e
tal estimated linear feet of all existing streams (intermittent and perennial) on the property
FExplain-the
purpose of the proposed project �'Cn�fi1 e- t-(o1� C�{ 10 "_Vk VIP (;J , oakiv
3e Describe the overall project in deta I, including the type of equipment to be used X15 �(d h (lr) bf 31
� I it
w i j�11 Vl1 eKCd va tt-f-' C t �� Cl 5 t! i 6
JDeterminations
4. Jurisdictional
4a Have jurisdictional wetland orstream determinations by the
Corps or State been requested or obtained for this property 1
�'es ❑ No ❑ Unknown
project (including all prior phases) in the past?
Comments
4b If the Corps made the jurisdictional determination, what type
of determination was made?
❑ Preliminary a)Final
4c If yes, who delineated the jurisdictional areas? Agency /Consultant Company
Name (rt known) Other /v I �N P
4d If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation
"' bj WOscL5i+ Oki ADr, ac)4
5 Project History -
5a Have permits or certifications been,requested or obtained for
this project (including all prior phases) m the past? ❑ Yes o ❑Unknown
5b If yes, explain in detail according to "help file" instructions
6 Future Project Plans
6a Is this,a phased project? ❑ Yes o
6b If yes, explain -
Page 3 of 10
PCN Form -Version 1 4 January' 2009

C. Proposed Impacts Inventory
1 Impacts Summary —
1a Which sections'were completed beloW,for your project (check all that apply)
❑ Wetlands ❑ Streams- tributaries ❑ Buffers ❑ Open Waters El Pond Construction
2 Wetland Impacts
If there are wetland
2a
Wetland impact
number
PTe. oral (PTor
-
impacts proposed on the site, then complete this question for each wetland area impacted
2b 2c 2d 2e 2f
Type of impact Type of wetland Forested Type of jurisdiction Area of
Corps (404,10) or impact
DWQ,(401, other) (acres)
W1
Choose one
Choose one Nct.Jl7)Qi'Iai'1-'�'fj�
(_
104
i
W2
Choose one
Choose one
Yes /No
.�(]�y�5
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
2h Comments 2g Total Wetland Impacts:
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

rage 0 OT i U
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 individually list all open water im acts below
4a
Open water
4b
Name of waterbody
4c
4d
4e
impact number
Permanent (P) or
(if applicable)
Type of'impact
Waterbody
Area of impact (acres)
Temporary T
type
'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, the complete the chart below
5a
5b
5c
5d
5e
Pond ID number
Proposed use or
Wetland Impacts (acres)
Stream Impacts,(feet)
'Upland
purpose of pond
(acres)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
P1
'Choosetione
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)
51 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 re uire mitigation, then you MUST fill, out Section D of this form
6a' Project is in which protected basi0
Neuse Tar- Pamlico Catawba 'El Randleman 0 Other
6b
Buffer Impact
6c
Reason for impact
6d
Stream name
6e
Buffer
6f
Zone 1
6g
Zone 2
number —
Permanent (P) or
mitigation
impact
impact
Temporary T
required?
(square
(square
feet )
feet
B 1
Yes /No
Yes /No
Yes /No
t5-
Yes /No
Yes /No
Yes /No
6h Total Buffer Impacts:
rage 0 OT i U

D. Impact' Justification and Mitigation
1. Avoidance and Minimization
to Specifically describe measures taken to avoid or minimize the,proposed impacts in designing project
Y vt -I r1i nri Wcx II f-z to v r, Ir- �M vnY l I'vl i Ze 1,11-i l)cc c-4
1b Specifically describe measures taken to avoid or minimize the proposed impacts through construction, techniques
'5ChC('V:`to\O 41_' =5pco-fie 1 a ,kUCkb( In" Pao
c � � �,►'LSl U'l ,C�1�"1�t�1 i1<'ci 5
hacn I'C'.�0 -Wv) VV(SUS'W,Ie �Fhe vq 2c (ul�t'Y1(� ru�hU�l t
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 0
f
2b If yes, mitigation is required by (check all that apply)
❑ DWQ ❑ 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. Com letesif 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 Pro ram
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
Buffer mitigation requested (DWQ only)
square feet
Riparian wetland mitigation requested
[4f
acres
Non- riparian wetland mitigation requested
acres
4g Coastal (tidal) wetland mitigation requested
acres
4h Comments
,5., .Complete if Using Fa ftrmittee 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
U�

6. Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a Will the project result in an impact within a protected riparian buffer that requires
buffer mitigations
❑Yes Z'fNo
-- - - -�
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
Multiplier
6e
Required mitigation
(square'feet)
(square feet)
Zone 1
3 (2 for Catawba)
Zone 2
15
6f- Total buffer mitigation, required:
6g If buffer mitigation is required, discuss what type of mitigation is proposed (e g , payment to m rivate
p 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
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
1 b 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?
t1 %
� V
2b Does this project require a Stormwater Management Plan?
❑ Yes No
2c 'If,this prole&DOES NOT require a Stormwater Management Plan, explain why
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
❑ Phase II
❑ NSW
❑ USMP
❑ Water Supply Watershed
❑ Other,
3a In which local, government's jurisdiction is this DEo ect?
3b Which of the following,locally- implemented stormwater management programs
apply (check all that apply)
3c Has the approved Stormwater Management Plan with proof of approval been
attached
❑Yes �Vo
4. DWQ Stormwater Program Review
4a Which of the following state - implemented stormwater management programs apply
(check all that apply)
❑Coastal counties
❑HQW
❑SOession Law 2006 -246
[]Other
4b Has the approved Stormwater Management Plan with proof of approval been
attached
E] Yes E] No
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)
1 a Does the project involve an expenditure of public (federal /state /local) funds or the
,use of public (federal /state) land?
❑ Yes ❑ No
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
letter )
❑ Yes ❑ No
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,
❑ Yes ❑ No
or Riparian Buffer Rules (15A NCAC 2B 0200)?
2b Is this an after - the -fact permit application?
El Yes ❑ No
2c If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s)
3. Cumulative Impacts (DWQ Requirement)
3a Will this project (based on,past' and reasonably anticipated future impacts) result in
additional development, which could impact nearby downstream water quality?
El Yes ❑ No
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," a short
provide narrative description
1
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
Page 9 of 10
PCN Form — Version 1 4 January 2009

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a Will this protect occur in or near an area with federally protected species or,
habitat?
A Yes ❑ No
5b 'Have you checked with the USFWS concerning Endangered Species Act
impacts?
❑ Yes No
5c If yes, indicate the USFWS Field Office you have contacted
5d What'data sources did you use to detari-1— whether your site would impact Endangered Species or Designated Critical
H rjt il.:t ?,
6 Essential Fish Habitat (Corps Requirement)
6a Will this protect occur in or near an area designated as essential fish habitat? No
6b What data sources did you use to determine Whether your site would impact Essential Fish Habitat? T
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a Will this protect,occur in or near an, area that the state, federal or tribal
governments have designated as having historic or cultural preservation
status (e g , National Historic Trust designation or properties significant in ❑Yes jn,�o
North Carolina history and archaeology)?
7b What data sources did you use to determine whether your site would impact historic or archeological resources?
8. Flood Zone Designation (Corps Requirement)
8a Will this protect occur in ,a FEMA - designated 100 -year floodplain? I –0 Yes ❑ No
8b If yes, explain how protect meets FEMA requirements
�esQd j �cf vvi'1 °I b1 �r resn,ACf uxx: r - lCL,)
UJ �l� CCtu� �I� �I►nc� on c td\(LePry4 iip►-�pe( -N-s.
8c What source(s) did you use to make the floodplain determination?
�T C ✓►�V K 1N*) A PE, COD L" I-e V�-hi Dn
L. i vw S-� L. a so-)
ApplicanUAgent;s Printed Name
r'
Applicant/Agent's Signature
(Agent's signatureYis'valid only if an, authorization
letter fromJtie applicant is provided )
Page 10 of 10
5.�9 -1y
Date

VICINITY MAP
(ROT TO SCALEI
v�
Ew • EXISTING IRON PI4
SIP = SET IRON P91
PAUL = MINIMUM OUILDNI) LINE
© = POWER TRANSFORMER
M + TELEPHONE PEDESTAL
© + TV PEDESTAL
• NON•UOfRAIEHTEO POINT
DUE DRAINAGE 6 UTILITY EASEMENT
'Thb cvtI1Ie lhot this COPY Of this plof occurotely Ntopicts the boundary of the larledlotlen of
Sea Ilan 104 Of the Clean ''Rotor Act In the oreos kgooted by lne presanr Droposeu oe H•Ity.os
dot•rminod by the undareigned On this dote. UF4835 there le chance in the law or our puDNShee
regL!atlone. thts delermtnot,*n of Section 401 lureaktlon say bo relleU upon for a peribd not to
exceed flue ycors from this dote. Thla deterninctlon wo5 made uIIGZIng the appropriate Regional
Supplement to the 1907 Corps of Enolnaers WOtiono Delln"tlon 1.1 —OL'
Regulatory Offlrinl
title
Dote
USACE Action
$rues L�_
J H3876 2 C (f el
Nd5 SS'
I �
I Z � CS IINt:.
Loz 50 f7 _ Sf �' 404 Welland I S�LtM HutfW
Portion of
I.ot 51 la wv AoT I
•1c ALF •AOI ULF •A0 f ! g
If\�u_ •'� 41137 SF-' ALF -.1"
404 WETLAND Lo[ TABLE
LRIE
BEAIMND
DISTANCE
WLF •AOI - NLF •A02
SK113'051E
2931'
WLF •AO2 - ALF •AO3
54411'07
353]•
WLF •A03 • ALF •ADS
S291"PW
64.11'
WLF •AOS - ALF 'A06
S61Y9'OT'W
20.02'
WLF eAO6 - WLF -AD?
tM•52'12'W
5028'
ALF •A01 - WLF •AOB
NT4.26'21'E
12.03'
wLF 'A0H - tLF •A09
060.53'06'E
25.11'
WLf Z-1 - WLF •A0
N0'OY291
23.90'
WLF •A0 . ALF •At
N52'45RTE
IRS'27.21'E
xLF •AI- OLT •A01
S60'19'49'E
13.97'
404 WETLAND Llli TABLE
LNrt
,OEAIU116
DISTANCE
TIE - WLF -0
S4I.41'26'W
6.41'
WILF •01 WUf roe
s41.4T'z6•W
s9.t6•
F •02 - ALF ro3
S25•21.2rw
32.5s'
T •03 - ALF '04
SO4'OI99'W
40.02'
ALF •04 - WLF 'OS
516'56,
N.21•
IIA11011AL WETLAOO EXIEIt50N LEIE TABLE
LINE
BEARM
OSTANCE
ALF •03 - tttE •a4
"65'53'50•"
-NLOO-
S E •04 - WLE •O3
W07.434]'E
S4.T1'
E •07 -RLE •02
IRS'27.21'E
]2.53'
KE •02 - FILE •01
N4T'41.26 -E
52.26'
CURVE TABLE
CUFIVE
RAM
LENGTH
BEARIIW
CI!
CH
E -2
25.00'
069'
S E
it r�'— _ ALF
LF -ACS
jI Elf •A01
11404 Welland
' /� ■LF "02 f
S 'a' I1 51A 11
53,317 SF
F (1.22 AC -) i ik
I l
7
I
w
u•
S�Ws
I1
b .8
I'
ALF •05
Ir
tRe hand I O
I•
I�
Io
t10�.. IRE •b1 MLE •02 o'bg I
Ut •04 4.356 SF l e ! .'A,t .l(M Welland
(010 A6.) 1 — wLf •q f
1 Wtf LWIf •02 f
a.:2' 12A r
Fwi '
f++A
FrN'ti�siA iglm f
S +A, 1rH
/ C -2
SO.00' BO.tO' INN' '45• �5+ /
00'
s [.ate 6LHT• /.�'
tpU0L[� (S X931
li n vs
60' .� p
60' 0' 60' 120'
a,Aw jS\\ I-AR0j1
a 2'Y i
r '•.` L -3733
tttit111l1Sf4
CEHSE 110. L-3733
NOTES:
THIS PROPERTY 15 LOCATED IN A
FLOOD HAZARD AREA PER FIRM NAP
3720546000J. DATED JULY 2. 2004,
THE RATIO OF PRECISION AS
CALCULATED 15 4!0.000.
THE AREA WAS OBTAINED ST
COORDINATE MEIH00.
FOR REFERENCE SEE 00 3239 PG
ALSO SEE PLAT CABINET N SLIDE 1440,
CRAVEN COUNTY REGISTRY.
Tax 0 Non 7 -103 -14000
I �l
near f - J
f!
wrnA r IA
RreseN4
2+f r+ v! 343s��y�4
ti
Ji
SCALE: V: 60'
T rtuy &wIiGBLL%Pr rTs
PO 1112 15454
nmw DRRN, NC 2A561
rJA23124JA6
PROPOSED
l LAN l''OR
PATRICK HORNEY
ATLIIJ FLUE
KATE HORNEY
402 LILLrLIJ DRIVE
LOT SIA DIVISION FOR NARK S. E AMY K. STROUD
TOWNSHIP NO. 7 CRAVEN CO. IIC
Apr11 22. 2011
J�
2 3 C01¢