20140716 Ver 1_401 Application_20140714

of wA rF9 0 1 4 0 7 1 6
o� pG 2 Office Use Only:
r Corps action ID no.
-a
o < DWQ project no.
Form Version 1.4 January 2009
Page 1 of 10
PCN Form — Version 1.4 January 2009
Pre - Construction Notification (PCN) Form
A.
Applicant Information
1.
Processing
1a.
Type(s) of approval sought from the Corps:
❑X Section 404 Permit ❑ Section 10 Permit
1b.
Specify Nationwide Permit (NWP) number: 18 or General Permit (GP) number:
1c.
Has the NWP or GP number been verified by the Corps? _T_Z
Yes ❑ No
1d.
Type(s) of approval sought from the DWQ (check all that apply):
M 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:
❑X Yes ❑ No
For the record only for Corps Permit:
❑ Yes ❑X No
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 ❑X No
1g.
Is the project located in any of NC's twenty coastal counties. If yes, answer 1h
below.
X❑ Yes ❑ No
1 h.
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑X Yes ❑ No
2.
Project Information
2a.
Name of project:
Charboneau utility shed
21b.
County:
Onslow ------ _- .�,.�_
2c.
Nearest municipality /town:
Hubert
0
2d.
Subdivision name:
Highlands of Queens Creek
2e.
NCDOT only, T.I.P. or state project no: T
ff1 1 2014
3.
Owner Information
3a.
Name(s) on Recorded Deed:
Donald and Heather Charboneaua,r,Wu.-
4172/612
3b.
Deed Book and Page No.
3c.
Responsible Party (for LLC if
applicable):
Donald Charboneau
3d.
Street address:
339 Inverness Dr.
3e.
City, state, zip:
Hubert, NC 28539
3f.
Telephone no.:
910 - 708 -1496 or 757 -701 -6390
3g.
Fax no.:
3h.
Email address:
redbar1973 @gmail.com
Page 1 of 10
PCN Form — Version 1.4 January 2009

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 no
4g Fax no
4h Email address
5. Agent/Consultant Information,(if applicable)
5a Name
5b Busmess,name
(if applicable)
5c Street address
5d City„ state, zip
5e Telephone no
5f Fax no
5g Email address
Page 2 of 10

B.
Project Information and Prior'Project History
1.
Property Identification
1a
Property Identification no (tax PIN or parcel ID)
13076 -46
1b
Site coordinates (In decimal, degrees)
I Latitude 34 6943 Longitude -77 1981
1 c
Property size
045 acres
2.
Surface Waters
2a
Name,of nearest body of water to proposed project
Tributary to Parrot Swamp
2b
Water Quality Classification of nearest receiving water
SA Waters
2c
River basin
White Oak
3.
Project Description
3a Describe the,existing conditions on the site and the general land use,in the vicinity ofithe project at the time,ofathis
application
This land (and surrounding) is used as a residency Typical residential lot cleared with scattered trees currently mowed
3b
List the total, estimated acreage of'all existing wetlands orr the property 0 15
3c
List the total estimated linear feet of all existing streams (intermittent and perennial) on the property
3d Explain the purpose of the proposed project
To install a utility shed with power for residential use
3e Describe the overall project in detail, including the type of equipment to be used
A 12'x 16' shed will be installed on four 4 "x4" beams as runners The beams will sit either directly on the ground or on six inch wide leveling blocks Th<
4.
Jurisdictional Determinations
4a
Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past?
0 Yes ❑ No ❑ Unknown
Comments
4b
If,the Corps made the jurisdictional determination, what type
of determination was made?
E] Preliminary ❑X Final
4c
If yes, who delineated the jurisdictional areas?
Name (if known) Pittman Soil Consultants
Agency /Consultant Company
Other
4d If yes, list,the dates of the Corps jurisdictional determinations or State determinations and,attach documentation
Approximately 2008 (Action ID 2007 - 01429)
5.
Project History
.5a
Have permits or certifications been requested or obtained for
this project (including all -prior phases) in,the past?
❑ Yes ❑X No ❑ Unknown
5b
If yes, explain in detail according to "help file" Instructions
6
Future Project Plans
6a
Is this a phased project?
❑ Yes ❑X No
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)
❑X Wetlands ❑ Streams —tributaries ❑ Buffers El' Open Waters ❑ Pond Construction
2 Wetland Impacts
If there are wetland Impacts proposed on the site, then complete this question for each wetland area impacted
2a
Wetland Impact
number
Permanent-(P) or
Temporary Y
2b
Type of Impact
2c
Type of wetland
2d
Forested
2e
Type of jurisdiction
Corps (404,10) or
DWo (401, other)
2f
Area of
Impact
(acres)
W1 P
Fill
Pocosin
No
Corps
0 005
W2 T
Excavation
Pocosin
No
Corps
0 005
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
-
2g Total Wetland Impacts
001
2h Comments
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 14 January 2009

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 indiv ually list all open water impacts below
4a
Open water
impact number
Permanent'(P) or
Temporary T
4b
Name of waterbody
(if applicable)
4c
Type,of impact
4d
Waterbody
type
4e
Area of impact (acres)
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
Pond ID number
5b
Proposed use or
Purpose of pond
5c
Wetland Impacts (acres)
5d
Stream Impacts (feet)
5e
Upland
(acres)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
P1
Choose,one
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 im acts „re uire mitigation, then, ou;MUST fill out Section D of this form
6a Project is in which protected basin?
❑ Neuse ❑ Tar - Pamlico Catawba [:f Randleman ❑ Other
6b
Buffer Impact
number —
Permanent (P) or
Temporary
6c
Reason for impact
6d
Stream name
6e
Buffer
mitigation
required? q
6f
Zone 1
impact
(square
feet
6g
Zone 2
impact
(square
feet
B1
Yes /No
B2 -
Yes /No
B3 -
Yes /No
B4 -
Yes /No
B5 -
Yes /No
B6
Yes /No
6h Total Buffer Impacts,
61 Comments
Page 5of10

D Impact Justification and Mitigation
1 Avoidance and Minimization
1a Specifically describe measures taken toFavdid or minimize the proposed Impacts In designing project
The shed cannot be placed on ground outside of wetlands because it will negatively impact personal comfort It,will be too,close todhe home for
aesthetic purposes
1b Specifically describe measures taken to avoid or minimize the proposed Impacts through construction techniques
I will ensure that the shed is on 4 "x4" runners and not on a concrete pad No fill dirt will be used This will allow for water flow to continue under the
shed I will dig the trench for the electrical cable by hand so no large machines will need to be used on the wetlands Trench dirt will be replaced when
electrical cable is buried back to original grade
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 ❑X No
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?
El bank
El Payment to in -lieu fee program
❑ Permittee Responsible Mitigation
3 Complete if 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 Program
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
4d Buffer mitigation requested (DWQ only)
square feet
4e Riparian wetland mitigation requested
acres
4f- Non - riparian wetland mitigation requested
acres
4g ,Coastal'(tidal) wetland mitigation'requested
acres_
4h Comments
5 Complete if Using a Permittee 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

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 mitigation?
❑ Yes ❑X No
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
(square feet)
Multiplier
6e
Required,mitigation
(square feet)
Zone 1
3 (2 for Catawba)
Zone,2
1 5
6f Total buffer mitigation required
6g If buffer mitigation is required, discuss what type of mitigation is proposed (e g , payment ^to private 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
1a
Does the project Include or is it °adjacent to protected riparian buffers Identified
`Buffer
❑ Yes ❑X No
within one of the NC RI arian Protection Rules?
lb
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?
0'%
2b
Does this project require a Stormwater Management Plan?
V ❑ Yes ❑X No
2c
If this project DOES NOT require a Stormwater Management Plan, explain why
Residential lot within an approved subdivision stormwater management plan that has been previously approved
12d
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?
Developer
3.
Certified Local Government Stormwater Review
3a
In which local government's jurisdiction Is this project?
Onslow County
❑ Phase II
3b
Which of the following locally - Implemented stormwater management programs
❑ NSW
❑ USMP
apply (check all that apply)
❑ Water Supply Watershed
❑ Other
3c
Has the approved Stormwater Management Plan with proof of approval been
❑Yes ❑X No
attached?
4
DWQ Stormwater Program Review
[ECoastal counties
❑HQW
4a
Which of the following state - Implemented stormwater management programs apply
❑ORW
(check all that apply)
❑Session Law 2006 -246
❑ Other
4b
Has the approved Stormwater Management Plan with proof of approval been
E] Yes ❑X No
attached?
5 DWQ 401 Unit Stormwater Review
5a
Does the Stormwater Management Plan meet the appropriate requirements?
❑X Yes ❑ No
5b
Have all of the 401 Unit submittal requirements been met?
❑X Yes ❑ No
Page 8of10
PCN Form — Version 1 4 January 2009

F
Supplementary Information
1
Environmental Documentation (DWQ Requirement)
1a
Does the project involve an expenditure of public (federal /state /local) funds or the
❑ Yes ❑X No
use of public (federal /state) land?
1,b
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 ❑X No
or Riparian Buffer Rules (15A NCAC 2B 0200)?
2b
is this an after - the -fact permit application?
❑Yes ❑X 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
E] Yes ❑X No
additional development, which could impact nearby downstream water quality?
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," provide a short narrative description
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
Previously approved off -site septic Approved through, developer
Page 9 of 10
PCN Fo -rm — Version 1 4 January 2009

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a Will this project occur in or near an area with federally protected species or
❑ Yes ❑X No
habitat?
5b Have you checked with the USFWS concerning Endangered Species Act
❑Yes ❑X No
impacts?
5c If yes, indicate the USFWS Field Office�you have contacted
-
5d What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
None
6 Essential Fish Habitat (Corps Requirement)
6a Will this project occur in or near an area designated as essential fish habitat?
❑ Yes ❑X No
6b What data sources did you use to determine whether your site would impact Essential Fish Habitat?
None
i
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
❑ Yes ❑X No
status (e g , National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b What data sources did you use to determine whether your site would impact historic or archeological resources?
None
8 Flood Zone Designation (Corps Requirement)
8a Will this project occur in a FEMA- designated 100 -year floodplain? J
❑ Yes ❑X No
8b If yes, explain how project meets FEMA requirements
8c What source(s) did you use to make the floodplain determination?
None
Donald E Charboneau
07 -09 -2014
Applicant/Agent's Printed Name
Date
Applicant/Agent's Sig na ure
(Agent's signature is valid only,if an authorization
'
letter from thea licanfis provided
Page 10 of 10

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