20220908 Ver 1_ePCN Application_20220705

Pre -Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
April 13, 2022 Ver 4.3
Initial Review
Has this project met the requirements for acceptance in to the review process?*
OO Yes
O No
Is this project a public transportation project?*
OYes 0No
Change only if needed.
Pre -Filing Meeting Date Request was submitted on:
6/29/2022
BIMS # Assigned* Version#*
20220908 1
Is a payment required for this project?*
O No payment required
O Fee received
O Fee needed - send electronic notification
Select Project Reviewer*
Chad Turlington:eads\ccturlington
Information for Initial Review
Reviewing Office*
Fayetteville Regional Office - [phone]
la. Name of project:
COURTESY COPY Fetla - 328 Old Garner Place Road
la. Who is the Primary Contact?*
Ed Fetla
lb. Primary Contact Email:*
lc. Primary Contact Phone:*
[e-mail] [phone]
Date Submitted
7/5/2022
Nearest Body of Water
UT to Big Juniper Creek
Basin
Cape Fear
Water Classification
C
Site Coordinates
Latitude:
35.2938N
A. Processing Information
Longitude:
-79.4995W
County (or Counties) where the project is located:
Moore
Is this a NCDMS Project
0Yes ONo
Is this project a public transportation project?*
0Yes ONo

la. Type(s) of approval sought from the Corps:
EI Section 404 Permit (wetlands, streams and waters, Clean Water Act)
O Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
Has this PCN previously been submitted?*
0 Yes
O No
1b. What type(s) of permit(s) do you wish to seek authorization?
O Nationwide Permit (NWP)
0 Regional General Permit (RGP)
0 Standard (IP)
lc. Has the NWP or GP number been verified by the Corps?
0Yes ®No
Nationwide Permit (NWP) Number:
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
EO 401 Water Quality Certification - Regular
0 Non-404 Jurisdictional General Permit
0 Individual 401 Water Quality Certification
29 - Residential Developments
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:
If. Is this an after -the -fact permit application?*
O Yes O No
O 401 Water Quality Certification - Express
0 Riparian Buffer Authorization
lg. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
O Yes O No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
O Yes O No
lh. Is the project located in any of NC's twenty coastal counties?
O Yes O No
1j. Is the project located in a designated trout watershed?
OYes 0No
B. Applicant Information
OYes 0No
OYes 0No
Id. Who is applying for the permit?
O Owner O Applicant (other than owner)
le. Is there an Agent/Consultant for this project?*
OYes 0No
2. Owner Information
2a. Name(s) on recorded deed:
Ed Fetla
2b. Deed book and page no.:
5324 page295
2c. Contact Person:
Ed Fetla
2d. Address
Street Address
5554 Seven Lakes West
Address Line 2
City
West End
Postal / Zip Code
27376
State / Province / Region
NC
Country
USA

2e. Telephone Number:
[phone]
2f. Fax Number:
2g. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
William Mullin
4b. Business Name:
Dr. JH Carter III & Associates Inc Environmental Consultants
4c. Address
Street Address
515F Midland Road
Address Line 2
City
Southern Pines
Postal / Zip Code
28387
4d. Telephone Number:
[phone]
4f. Email Address:*
[e-mail]
C. Project Information and Prior Project History
State / Province / Region
NC
Country
USA
4e. Fax Number:
1. Project Information
1 b. Subdivision name:
(if appropriate)
lc. Nearest municipality / town:
West End
2. Project Identification
2a. Property Identification Number:
20020574
2c. Project Address
Street Address
328 Old Gamer Place Road
Address Line 2
City
West End
Postal / Zip Code
27376
3. Surface Waters
3a. Name of the nearest body of water to proposed project: *
UT to Big Juniper Creek
3b. Water Resources Classification of nearest receiving water: *
C
3c. What river basin(s) is your project located in?*
Cape Fear
3d. Please provide the 12-digit HUC in which the project is located.
030300030301
4. Project Description and History
2b. Property size:
14ac
State / Province / Region
NC
Country
USA
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 is an undeveloped wooded parcel surrounded by a mix of residential and agricultural uses. The parcel is in a rural area of Moore County North Carolina near the Town of West End.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
O Yes O No 0 Unknown

4f. List the total estimated acreage of all existing wetlands on the property:
2.0ac
4g. List the total estimated linear feet of all existing streams on the property:
900 ft
4h. Explain the purpose of the proposed project: *
To cross a stream/wetland complex in order to facilitate the construction of a single family residence
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used: *
The project will involve the construction of a driveway crossing through a stream and wetland complex. A home will be built on the adjacent upland area using conventional construction
materials and equipment.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r) Yes
Comments:
No
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
0 Preliminary 0 Approved '•) Not Verified ( Unknown 0 N/A
Corps AID Number:
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
6. Future Project Plans
Dr JH Carter III
Dr. JH Carter III & Associates Inc...
6a. Is this a phased project?*
C Yes ) No
0 Unknown
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?
D. Proposed Impacts Inventory
1. Impacts Summary
la. Where are the impacts associated with your project? (check all that apply):
2i Wetlands i) Streams -tributaries
C1 Open Waters 0 Pond Construction
2. Wetland Impacts
0 Buffers
2a. Site #* (?)
2a1 Reason (?)
2b. impact type* (?)
2c. Type of W.*
2d. W. name
2e. Forested*
2f. Type of Jurisdicition*
(?)
2g. Impact
area*
1
culvert road crossing
P
Headwater Forest
W1
Yes
Both
0.023
(acres)
2g. Total Temporary Wetland Impact
0.000
2g. Total Wetland Impact
0.023
2g. Total Permanent Wetland Impact
0.023
2i. Comments:
fill slopes will be significant as the top of the roadway will only be approximately 12 feet wide and the bottom of the fill area will be 15 feet wide over the
67.25 feet. The attached diagram illustrates the fill profile as interpreted by the owner.
3. Stream Impacts
3a. Reason for impact (?)
3b.lmpact type*
3c. Type of impact*
3d. S. name*
3e. Stream Type*
(?)
3f. Type of
Jurisdiction*
3g. S. width
3h. Impact
length*
S1
culvert pipe
Permanent
Culvert
S1
Intermittent
Both
4
Average (feet)
15
(linear feet)

3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts: 3i. Total temporary stream impacts:
15 0
3i. Total stream and ditch impacts:
15
3j. Comments:
culvert pipes will be 15 feet long
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:
The path of the driveway was chosen because an old farm road had been previously located in this location.
lb. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Silt fences and erosion control fabrics will be used in and near the wetland/stream complex. Heavy equipment will be kept in upland areas and work will
be completed from the dry.
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 O No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
the project is 0.023 ac of impact, under the tenth of an acre that typically triggers mitigation.
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?
0 Yes O No
If no, explain why:
not in one of the buffered systems, this project is in Moore County.
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
OYes ONo
2b. Does this project meet the requirements for low density projects as defined in 15A NCAC 02H .1003(2)?
OYes 0No
Comments:
it is a single family home on a 14 acre lot.
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 J 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?*
O Yes O No
3b. If you answered "no," provide a short narrative description.
this is a single family home and is not anticipated to have any additional impacts beyond initial construction.

4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
0Yes®• No 0 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?*
0 Yes • No
5d. Is another Federal agency involved?*
0 Yes
5e. Is this a DOT project located within Division's 1-8?
0Yes ®No
0 No Unknown
5f. Will you cut any trees in order to conduct the work in waters of the U.S.?
OYes 0No
5g. Does this project involve bridge maintenance or removal?
0Yes ®No
5h. Does this project involve the construction/installation of a wind turbine(s)?*
0 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.?
0Yes ®No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
NCNHP GIS data and on site observations by Dr. JH Carter III.
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?*
NCNHP GIS data
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?*
on line data base search
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?*
Moore County GIS FEMA mapping layer
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
Fetla site data maps etc.pdf 13.87MB
JD Request with signature.pdf 155.9KB
SAW _JD_ Request _12-2013_fillable_form.pdf 290.93KB
Wetland impact diagram combined.pdf 1.64MB
Final JD Form.pdf 118.47KB
File must be PDF or KMZ
Comments
Signature

[si 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:
William Mullin for Ed Fetla
Signature
Date
7/5/2022