20131259 Ver 2_ePCN Application_20220902

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)
April 13, 2022 Ver 4.3
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.
Pre -Filing Meeting Date Request was submitted on:
8/26/2022
BIMS # Assigned* Version#*
20131259 2
Is a payment required for this project?*
No payment required
Fee received
Fee needed - send electronic notification
Select Project Reviewer*
Holley Snider:eads\hasnider
Information for Initial Review
la. Name of project:
COURTESY COPY 804 S Second Street, Carolina Beach
la. Who is the Primary Contact?*
Dana Lutheran
Reviewing Office*
Wilmington Regional Office - [phone]
1 b. Primary Contact Email:* lc. Primary Contact Phone:*
[e-mail] [phone]
Date Submitted
9/2/2022
Nearest Body of Water
Atlantic Ocean
Basin
Cape Fear
Water Classification
SA;HQW
Site Coordinates
Latitude: Longitude:
34.0268 77.8967
A. Processing Information
County (or Counties) where the project is located:
New Hanover
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: 18 - Minor Discharges
NWP Numbers (for multiple NWPS):
ld. 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
1 i. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
Yes No
1j. Is the project located in a designated trout watershed?
Yes No
B. Applicant Information
Id. 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:
Jason Wade
2b. Deed book and page no.:
6194 / 241
2c. Contact Person:
401 Water Quality Certification - Express
Riparian Buffer Authorization
Unknown
Yes No
Yes No

2d. Address
Street Address
701 Carolina Beach Ave S
Address Line 2
City
Carolina Beach
Postal / Zip Code
28428
State / Province / Region
NC
Country
US
2e. Telephone Number: 2f. Fax Number:
[phone]
2g. Email Address: *
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Dana Lutheran
4b. Business Name:
Southern Environmental Group, Inc. (SEGi)
4c. Address
Street Address
5315 South College Road, Suite E
Address Line 2
City
Wilmington
Postal / Zip Code
28412
4d. Telephone Number:
[phone]
4f. Email Address: *
[e-mail]
C. Project Information and Prior Project History
State / Province / Region
NC
Country
US
4e. Fax Number:
1. Project Information
1b. Subdivision name:
(if appropriate)
NA
lc. Nearest municipality / town:
Carolina Beach
2. Project Identification
2a. Property Identification Number:
R09010-027-007-000
2c. Project Address
Street Address
804 S Second Street
Address Line 2
City
Carolina Beach
Postal / Zip Code
28428
3. Surface Waters
3a. Name of the nearest body of water to proposed project: *
Atlantic Ocean
3b. Water Resources Classification of nearest receiving water: *
SA;HQW
3c. What river basin(s) is your project located in?*
2b. Property size:
0.14
State / Province / Region
NC
Country
US
Cape Fear

3d. Please provide the 12-digit HUC in which the project is located.
030300050704
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:*
In 2014, this site received a NWP 18, to fill 0.013-acre of non -riparian wetlands (i.e., non-riverine swamp forest), which was necessary to construct a single family dwelling and associated
driveway. That work, which consisted of removing woody vegetation, from the impact area, and filling with clean earthen soil, in preparation of constructing the dwelling. The 15' wide
driveway, which has an 18" x 15' double walled, corrugated pipe, is also in place. Today, the site is mostly grassy, with shrubby vegetation around the perimeter. Mitigation was not required
for the previously authorized impact.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past? *
Yes No Unknown
If yes, please give the DWR Certification number or the Corps Action ID (exp. SAW-0000-00000).
2/7/14 General Permit and PJD under SAW-2013-01133 (see attached)
4f. List the total estimated acreage of all existing wetlands on the property:
0.04
4g. List the total estimated linear feet of all existing streams on the property:
0
4h. Explain the purpose of the proposed project: *
The purpose of this project is to expand the existing building pad and driveway to serve a duplex, rather than a single family dwelling,
access the proposed structure.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used: *
The project will entail removing woody and herbaceous vegetation from approximately 0.04-acre of wetlands and 25' of the ditch (i.e.,
earthen soil, and the existing 18" x 15' DCP, within the RPW, will be replaced with 42" x 35' RCP, with headwalls will be used on each
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
Yes No
Comments:
The wetland line has not changed since it was originally delineated.
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
Preliminary Approved Not Verified Unknown N/A
Corps AID Number:
SEGi is not seeking a JD with this action
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?*
David Scibetta
SEGi
Yes • No
to ensure there is adequate area to maintain and
RPW). The wetlands will be backfilled with clean
side of the driveway.
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?
On 2/7/14 General Permit AID# SAW-2013-01133 was issued for a single family dwelling. However, the property has since changed hands, and the new owner wants to build a duplex. No
future impacts are anticipated to make the project viable, and the work will not provide access to currently landlocked property, where wetland impacts would be needed, to be developed.
D. Proposed Impacts Inventory
1. Impacts Summary
la. Where are the impacts associated with your project? (check all that apply):
Wetlands Streams -tributaries
Open Waters Pond Construction
2. Wetland Impacts
Buffers
2a. Site #* (?)
2a1 Reason (?)
2b. Impact type* (?)
2c. Type of W.*
2d. W. name
2e. Forested*
2f. Type of Jurisdicition *
(?)
2g. Impact
area*
A
Driveway
P
Non-Riverine Swamp Forest
A
Yes
Corps
0.040
(acres)

2g. Total Temporary Wetland Impact
0.000
2g. Total Permanent Wetland Impact
0.040
2g. Total Wetland Impact
0.040
2i. Comments:
4. Open Water Impacts
4a. Site #
4a1. Impact Reason
4b. Impact type
4c. Name of waterbody
4d. Activity type
4e. Waterbody type
4f. Impact area
B
Driveway culvert
P
None
Culverts
Ditch
0.01
4g. Total temporary open water Impacts:
0.00
4g. Total open water impacts:
0.01
4h. Comments:
The proposed RPW impact is 0.0025 acre (see attached site plan)
E. Impact Justification and Mitigation
1. Avoidance and Minimization
4g. Total permanent open water impacts:
0.01
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
The applicant used end walls on the driveway crossing, to minimize impacts to the ditch.
lb. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
The limits of impact will be marked, in the field, prior to undertaking land disturbing activities, and silt fence will be in place prior to beginning work.
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
2c. If yes, mitigation is required by (check all that apply):
DWR Corps
2d. If yes, which mitigation option(s) will be used for this project?
Mitigation bank Payment to in -lieu fee program Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
LCFUMB
3b. Credits Purchased/Requested (attach receipt and letter)
Type:
Non -riparian wetland
Quantity:
0.20
3c. Comments
SEGi has requested a mitigation credit reservation letter, which will cover the previously approved impacts (0.013-acre) and the proposed (0.04-acre),
from the LCFUMB, and will forward upon receipt.
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:
This project is not within one of NC's Riparian Buffer River Basins.
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:
Stormwater will be permitted through the town of Carolina Beach
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
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality?*
Yes No
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
Yes No N/A
4b. Describe, in detail, the treatment methods and dispositions (non -discharge or discharge) of wastewater generated from the proposed project. If the wastewater will be treated at a
treatment plant, list the capacity available at that plant.
Town of CB
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?
This site is located within a densely developed area.
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? *
This site does not include work within a waterbody that would support EFH.
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?*
There are no buildings on the property and the site was previously reviewed when being permitted in 2013/14.
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
Yes No
8b. If yes, explain how project meets FEMA requirements:
While the project is located within a 100 year flood zone, there are no specific rules that prohibit filling (i.e., altering the elevation) within this flood zone.
None the less, SEGi reached out to the Town of CB for their preliminary approval of the proposed project. However, the flood plain administrator was out
of the office sick and was not able to provide a response, prior to SEGi submitting this PCN. The Town's response will be forwarded upon receipt.
8c. What source(s) did you use to make the floodplain determination?*
New Hanover County GIS Flood Map
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
804 S Second Street PCN Attachments.pdf 1.61 MB
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:
Dana A. Lutheran
Signature
a:✓at!rc� �i1�iae�
Date
9/2/2022

804 S. Second Street
Pre -Construction Notification Attachments
Prepared for:
Mr. Jason Wade
701 Carolina Beach Ave S
Carolina Beach, NC 28428
Prepared by:
Southern Environmental Group, Inc.
5315 South College Road, Suite E
Wilmington, NC 28412
910.228.1841
Date:
1 September 2022

804 S. Second St. PCN Attachments 9-1-22 SEGi
Appendices
Number
Description
1
Parcel Information and Aerials
2
Previously Issued NWP
3
804 S. Second Street Site Plan
4
Town of Carolina Beach Flood Zone Approval
5
LCFUMB Credit Reservation Letter

804 S. Second St. PCN Attachments 9-1-22
SEGi
Attachment 1
Parcel Information and Aerial
For Detailed Ownership Information CLICK
the Green Dot
PID: R09010-027-007-000
MAPI D: 313014.42.2601.000
MAPIDKEY: 313014.42.2601
Calculated Acreage: 0.14
Click for ETAX Details

7/19/22, 8:19 AM New Hanover County
PARID: R09010-027-007-000
WADE JASON TAMARA 804 SECOND ST S
'Parcel
Alt ID 313014.42.2601.000
Address 804 S SECOND ST
Unit
City CAROLINA BEACH
Zip Code -
Neighborhood A5031
Class RES-Residential
Land Use Code 958-Unused Land
Living Units
Acres
Zoning R-1-WB RESIDENTIAL SF
Legal
Legal Description LOT 3 BLK 52 CAROLINA BEACH REV
Tax District CB
Owners (On Januaryl st)
Owner WADE JASON TAMARA
City CAROLINA BEACH
State NC
Country
Zip 28428
THE DATA IS FROM 2022
https://etax.nhcgov.corn/pt/Datalets/PrintDatalet.aspx?pin=R09010-027-007-000&gsp=PROFILEALL&taxyear=2022&jur=NH&ownseq=0&card=1 &roll=... 1/1

804 S. Second St. PCN Attachments 9-1-22 SEGi
Attachment 2
Previously Issued NWP and JD

Action ID. SAW-2013-01133
U.S. ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
County: New Hanover USGS Quad: Carolina Beach
GENERAL PERMIT (REGIONAL AND NATIONWIDE) VERIFICATION
Property Owner/Applicant: Mr. Richard Winters
Address: 315 Meridian Drive
Garner, North Carolina 27529
Telephone No.: [phone]
Size and location of property (water body, road name/number, town, etc.): Property is lot 3 block 52, Wilmington
Beach, located at 804 S. 2"d Street, New Hanover County, North Carolina. PM R09010-027-007-000 (34.0268 N, -
77.8967 WI
Description of projects area and activity: Authorization to fill 0.013 acres of non -riparian wetlands for the purpose of
constructing a single-family residential home.
Applicable Law: ® Section 404 (Clean Water Act, 33 USC 1344)
❑ Section 10 (Rivers and Harbors Act, 33 USC 403)
Authorization: Regional General Permit Number:
Nationwide Permit Number: 18
Your work is authorized by the above referenced Hermit provided it is accomplished in strict accordance with the attached
conditions and your submitted plans on 12/4/2013 and 1/24/2014. Any violation of the attached conditions or deviation from
your submitted plans may subject the permittee to a stop work order, a restoration order and/or appropriate legal action.
This verification will remain valid until the expiration date identified below unless the nationwide authorization is modified,
suspended or revoked. If, prior to the expiration date identified below, the nationwide permit authorization is reissued and/or
modified, this verification will remain valid until the expiration date identified below, provided it complies with all requirements of
the modified nationwide permit. if the nationwide permit authorization expires or is suspended. revoked, or is modified, such that the
activity would no longer comply with the terms and conditions of the nationwide permit, activities which have commenced (i.e., are
under construction) or are under contract to commence in reliance upon the nationwide permit, will remain authorized provided the
activity is completed within twelve months of the date of the nationwide permit's expiration, modification or revocation, unless
discretionary authority has been exercised on a case -by -case basis to modify, suspend or revoke the authorization.
Activities subject to Section 404 (as indicated above) may also require an individual Section 401 Water Quality Certification. You
should contact the NC Division of Water Quality (telephone [phone]) to determine Section 401 requirements.
For activities occurring within the twenty coastal counties subject to regulation under the Coastal Area Management Act (CAMA).
prior to beginning work you must contact the N.C. Division of Coastal Management .
This Department of the Army verification does not relieve the permittee of the responsibility to obtain any other required Federal.
State or local approvals/permits.
If there are any questions regarding this verification. any of the conditions of the Permit. or the Corps of Engineers regulatory
program, please contact Emily Hushes at [phone].
Corps Regulatory Official HUGHES.EMILY.BURTON.1289073660
Expiration Date of Verification: March 18, 2017
Date: 2/7/2014
The Wilmington District is committed to providing the highest level of support to the public. To help us ensure we continue to do so,
please complete the Customer Satisfaction Survey located at our website at http://regulatorv.usacesurvev.com/ to complete the survey
online.
Copy Furnished:
Dana Lutheran, Southern Environmental Group, Inc. 5315 South College Road, Suite E, Wilmington, NC 28412

Determination of Jurisdiction:
A. ❑ Based on preliminary information, there appear to be waters of the US including wetlands within the above described project
area. This preliminary determination is not an appealable action under the Regulatory Program Administrative Appeal Process
(Reference 33 CFR Part 331).
B. ❑ There are Navigable Waters of the United States within the above described project area subject to the permit requirements of
Section 10 of the Rivers and Harbors Act and Section 404 of the Clean Water Act. Unless there is a change in the law or our
published regulations, this determination may be relied upon for a period not to exceed five years from the date of thi s
notification.
C. ® There are waters of the US and/or wetlands within the above described project area subject to the permit requirements of
Section 404 of the Clean Water Act (CWA)(33 USC § 1344). Unless there is a change in the law or our published regulations,
this determination may be relied upon for a period not to exceed five years from the date of this notification.
D. El The jurisdictional areas within the above described project area have been identified under a previous action. Please reference
jurisdictional determination issued - . Action ID _
Basis For Determination
The site exhibits wetland criteria as defined in the 1987 Corps Wetland Delineation Manual and appropriate Regional
Supplement and is adjacent to an unnamed tributary to Carolina Lake which drains via Henniker's Ditch to the Cape Fear
River, a Traditional Navigable Water of the L.S. This determination was made by information provided by Southern
Environmental Group, Inc. and a site visit by Emily Hughes on 6/13/2013.
Remarks.
Attention USDA Program Participants
This delineation/determination has been conducted to identify the limits of Corps' Clean Water Act jurisdiction for the particular site
identified in this request. The delineation/determination may not be valid for the wetland conservation provisions of the Food Security
Act of 1985. If you or your tenant are USDA Program participants, or anticipate participation in USDA programs, you should request
a certified wetland determination from the local office of the Natural Resources Conservation Service, prior to starting work.
F. Appeals Information (This information applies only to approved jurisdictional determinations as indicated in B and C
above).
This correspondence constitutes an approved jurisdictional determination for the above described site. If you object to this
determination, you may request an administrative appeal under Corps regulations at 33 CFR Part 331. Enclosed you will find a
Notification of Appeal Process (NAP) fact sheet and request for appeal (RFA) form. If you request to appeal this determination you
must submit a completed RFA form to the following address:
US Army Corps of Engineers
South Atlantic Division
Attn: Jason Steele, Review Officer
60 Forsyth Street SW. Room 10M l5
Atlanta, Georgia 30303-8801
Phone: [phone]
In order For an RFA to be accepted by the Corps, the Corps must determine that it is complete, that it meets the criteria for appeal
under 33 CFR part 331.5. and that it has been received by the Division Office within 60 days of the date of the NAP. Should you
decide to submit an RFA form. it must be received at the above address by 4/7/2014.
**It is not necessary to submit an RFA form to the Division Office if you do not object to the determination in this correspondence.
Corps Regulatory Official:
HUGHE5.EMlLY.BuRToN.1289a7366t3 ^� w �•., '�" x
Date: 2/7/2014 Expiration Date: 2/7/2019

NOTIFICATION OF ADMINISTRATIVE APPEAL OPTIONS AND PROCESS AND
REQUEST FOR APPEAL
Applicant: Richard Winters /804 S. 2nd Street i File Number: SAW-2013-0I133 Date: 2/7/2014
Attached is:
See Section below
•
INITIAL PROFFERED PERMIT (Standard Permit or Letter of permission)
A
❑
PROFFERED PERMIT (Standard Permit or Letter of permission)
B
❑
PERMMIT DENIAL
C
®
APPROVED JURISDICTIONAL DETERMINATION
D
•
PRELIMINARY JURISDICTIONAL DETERMINATION
E
SECTION I - The following identifies your rights and options regarding an administrative appeal of the above decision.
Additional information may be found at http:llwww.usace.army.millinetlfunctions/cw/cecwolreg or
Corps regulations at 33 CFR Part 331.
A: INITIAL PROFFERED PERMIT: You may accept or object to the permit.
• ACCEPT: If you received a Standard Permit, you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all
rights to appeal the permit, including its terms and conditions, and approved jurisdictional determinations associated with the
permit.
• OBJECT: If you object to the permit (Standard or LOP) because of certain terms and conditions therein, you may request
that the permit be modified accordingly. You must complete Section II of this form and return the form to the district
engineer. Your objections must be received by the district engineer within 60 days of the date of this notice, or you will
forfeit your right to appeal the permit in the future. Upon receipt of your letter, the district engineer will evaluate your
objections and may: (a) modify the permit to address all of your concerns, (b) modify the permit to address some of your
objections, or (c) not modify the permit having determined that the permit should be issued as previously written. After
evaluating your objections, the district engineer will send you a proffered permit for your reconsideration, as indicated in
Section B below.
B: PROFFERED PERMIT: You may accept or appeal the permit
• ACCEPT: if you received a Standard Permit. you may sign the permit document and return it to the district engineer for final
authorization. If you received a Letter of Permission (LOP), you may accept the LOP and your work is authorized. Your
signature on the Standard Permit or acceptance of the LOP means that you accept the permit in its entirety, and waive all
rights to appeal the permit, including its terms and conditions, and approved jurisdictional determinations associated with the
permit.
• APPEAL: If you choose to decline the proffered permit (Standard or LOP) because of certain terms and conditions therein,
you may appeal the declined permit under the Corps of Engineers Administrative Appeal Process by completing Section II of
this form and sending the form to the division engineer. This form must be received by the division engineer within 60 days
of the date of this notice.
C: PERMIT DENIAL: You may appeal the denial of a permit under the Corps of Engineers Administrative Appeal Process by
completing Section II of this form and sending the form to the division engineer. This form must be received by the division
engineer within 60 days of the date of this notice.
D: APPROVED JURISDICTIONAL DETERMINATION: You may accept or appeal the approved JD or provide new
information.
• ACCEPT: You do not need to notify the Corps to accept an approved JD. Failure to notify the Corps within 60 days of the
date of this notice, means that you accept the approved JD in its entirety, and waive all rights to appeal the approved JD.
• APPEAL: if you disagree with the approved JD, you may appeal the approved JD under the Corps of Engineers
Administrative Appeal Process by completing Section II of this form and sending the form to the district engineer. This form
must be received by the division engineer within 60 days of the date of this notice.

E: PRELIMINARY JURISDICTIONAL DETERMINATION: You do not need to respond to the Corps regarding the
preliminary JD. The Preliminary JD is not appealable. if you wish, you may request an approved JD (which may be appealed),
by contacting the Corps district for further instruction. Also you may provide new information for further consideration by the
Corps to reevaluate the JD.
SECTION II - REQUEST FOR APPEAL or OBJECTIONS TO AN INITIAL PROFFERED PERMIT
REASONS FOR APPEAL OR OBJECTIONS: (Describe your reasons for appealing the decision or your objections to an initial
proffered permit in clear concise statements. You may attach additional information to this form to clarify where your reasons or
objections are addressed in the administrative record.)
ADDITIONAL INFORMATION: The appeal is limited to a review of the administrative record, the Corps memorandum for the
record of the appeal conference or meeting, and any supplemental information that the review officer has determined is needed to
clarify the administrative record. Neither the appellant nor the Corps may add new information or analyses to the record.
However, you may provide additional information to clarify the location of information that is already in the administrative
record.
POINT OF CONTACT FOR QUESTIONS OR INFORMATION:
If you have questions regarding this decision and/or the
appeal process you may contact:
District Engineer, Wilmington Regulatory Division,
Attn: Emily Hughes, Regulatory Specialist
If you only have questions regarding the appeal process you may
also contact:
Mr. Jason Steele, Administrative Appeal Review Officer
CESAD-PDO
U.S. Army Corps of Engineers, South Atlantic Division
60 Forsyth Street, Room 10ML5
Atlanta, Georgia 30303-8801
Phone: [phone]
Wilmington Regulatory Field Office
69 Darlington Ave.
Wilmington. NC 28403-1343
[phone]
RIGHT OF ENTRY: Your signature below grants the right of entry to Corps of Engineers personnel,
consultants, to conduct investigations of the project site during the course of the appeal process.
notice of any site investigation, and will have the opportunity to participate in all site investi
and any government
You will be provided a 15 day
ations.
Date:
Telephone number:
Signature of appellant or agent.
For appeals on Initial Proffered Permits send this form to:
District Engineer, Wilmington Regulatory Division. Attn: Emily Hughes, 69 Darlington Avenue, Wilmington, North
Carolina 28403
For Permit denials, Proffered Permits and approved Jurisdictional Determinations send this form to:
Division Engineer, Commander, U.S. Army Engineer Division, South Atlantic, Attn: Mr. Jason Steele, Administrative
Appeal Officer, CESAD-PDO, 60 Forsyth Street, Room 10M15, Atlanta, Georgia 30303-8801
Phone: [phone]

I
Proposed Dwelling 804 S. 2nd Si.
B04 S. 2nd St. Impact Area
802.804 5. 2nd Wetlands
0 5 10
20
30
1 inch = 27 tees
40
Feet
Wetland Impact Map
804 South Second Street
Carolina Beach, New Hanover Co., N.C.
1/24/2014 Project#: 013-025.01

Action ID Number: SAW-2013-01133
Permittee: Richard Winters/804 S. 2"d Street
Date Verification Issued: 2/7/2014
Project Manager: Emily Hughes
County: New Hanover
Upon completion of the activity authorized by this permit and any mitigation required by the permit,
sign this certification and return it to the following address:
US ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
WILMINGTON REGULATORY FIELD OFFICE
69 DARLINGTON AVE.
WILMINGTON, NORTH CAROLINA 28403-1343
Please note that your permitted activity is subject to a compliance inspection by a U. 5. Army Corps of
Engineers representative. If you fail to comply with this permit you are subject to permit suspension,
modification, or revocation.
I hereby certify that the work authorized by the above referenced permit has been completed in
accordance with the terms and condition of the said permit, and required mitigation was completed in
accordance with the permit conditions.
Signature of Permittee Date

804 S. Second St. PCN Attachments 9-1-22 SEGi
Attachment 3
804 S. Second Street Wetland Impact Plan

Proposed
Impact Area A
1545 SF/0.04 AC Wetland
reviously Authorized RPW Impacts = 7 SF / 0.0017 AC
Previously Authorized Wetland Impacts = 491 SF / 0.0113 AC
Total Previously Authorized Section 4'4 Impacts = 566 SF 0.013 AC
Proposed RPW Impact = 110 SF / 0.025 AC
Proposed Wetland Impact = 1545 Sr / 0.04 AC
Cumulative Wetland Impacts = 0.0"3 AC
Cumulative RPW Impacts = 0.004' AC
Cumulative Section 404 Impacts 0.0572 AC
Proposed Dwelling 804 S. 2nd St.
804 S. 2nd St. Impact Area
804 S. 2nd St. Wetlands
Impact Ar-a B
110 SF/0.002" AC RPW
Existng 18" x 15' DWPP to
be r-placed with 42" x 35' RCP
wit headwalls
,
80' South Second Stro-t ROW
Edge of Pavement
0 5 10
20
30
1 inch = 27 feet
40
Feet
Wetland Impact Map
804 South Second Street
Carolina Beach, New Hanover Co., N.C.
9/1/22

804 S. Second St. PCN Attachments 9-1-22 SEGi
Attachment 4
Town of CB Floodplain Approval

From: Gloria Abbotts
To: dlutheran@ segi.us
Subject: Automatic reply: 804 S. Second Street Floodplain Approval
Date: Friday, September 2, 2022 11:26:59 AM
Hello,
I am currently out sick and hope to return Tues, Sept. 6th.
If you need immediate assistance please contact
Haley Moccia, Planner: [e-mail]
Thanks,
Gloria Abbotts

804 S. Second St. PCN Attachments 9-1-22 SEGi
Attachment 5
LCFUMB Credit Reservation Letter
(to be submitted upon receipt)