20141107 Ver 1_401 Application_20141014

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Corps action ID no.
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
1 a.
Type(s) of approval sought from the Corps:
❑X Section 404 Permit ❑ Section 10 Permit
1 b. Specify Nationwide Permit (NWP) number: or General Permit (GP) number:
1 c.
Has the NWP or GP number been verified by the Corps?
PYes ,�W`No
1 d.
Type(s) of approval sought from the DWQ (check all that apply):
Z 401 Water Quality Certification — Regular ❑ Non -404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
1 e.
Is this notification solely for the record
because written approval is not required?
For the record only for DWQ
401 Certification:
❑ Yes ❑X No
For the record only for Corps Permit:
❑ Yes E9 No
1 f.
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
1 g.
Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below.
❑ Yes ❑X No
1 h.
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes 0 No
2.
Project Information
2a.
Name of project:
Whispering Hills Subdivision
2b.
County:
Nash
2c.
Nearest municipality / town:
Spring Hope
2d.
Subdivision name:
Whispering Hills
2e.
NCDOT only, T.I.P. or state project no:
3.
Owner Information
3a.
Name(s) on Recorded Deed:
Anthony W. Brown Sr., Betty P. Brown
3b.
Deed Book and Page No.
Book 2064 Page 954
3c.
Responsible Party (for LLC if
applicable):
3d.
Street address:
4745 Lancaster Store Rd OCT 2 0 2014
3e.
City, state, zip:
Spring Hope, NC, 27882
RESOURCES
(252) 904 -9080 401 & BUFFER PERMITTING
3f.
Telephone no.:
3g.
Fax no.:
3h.
Email address:
73teebrown @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 Business 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):
286200238372
lb Site coordinates (in decimal degrees).
Latitude 36.005986 Longitude. 78.117139
1'c Property size
14076 acres
2. Surface Waters
2a Name of nearest body of'water to proposed project:
Little Peachtree,,Credk
2b. Water°Quality Classification of nearest receiving,water
C;NSW
2c. River basin:
Tar - Pamlico
3. Project Description
3a Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application,
The -site is a portion of a large 140 76 acre lot, which is currently a wooded area and is,23 26 acres.
3b. List the,total estimated acreage of all existing wetlands on,the,property: 0
3c. List the total,estimated,linear feet of all existing streams (intermittent and perennial) on the property: 0
3d Explain the purpose of th&proposed project
The purpose of the proposed project is,to construct a new subdivision
3e. Describe the overall project in detail, including the type of equipment to be used:
Simple subdivision construction=and land Gearing
4. Jurisdictional Determinations
4a. Have jurisdictional,wetland or stream determinations by the
Corps or State been requested orobtained for this ,,property,/
project includin ,aIC rior phases) in the past?
s o n
C ents
4b If the Corps made the jurisdictional determination, what type
of determination was made?
El Preliminary 0, Final
4c If yes, who delineated the jurisdictional areas?
Name (if known)
Agency/Consultant Company
Other:
4d If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
5. Project History
5a. Have permits orcertifications been requested or obtained for
this project (including, all prior phases) in the past?
❑ Yes OX ,No ❑,Unknown
5b. If'yes, explain in detail according to, "help'file" ",instructions.
6. Future Project Plans
6a. Is this a phased project*
X❑ Yes ❑X No
6b. If yes, explain
We are in'the,beginning of creating the subdivision More phases to be added later
Page 3 of 10
PCN Form — Version 1, 4 January 2009

C. Proposed Impacts Inventory
1. Impacts Summary
la Which sections were completed below for your prolect,(check all that apply)
❑X Wetlands ❑ Streams — tributaries ❑ Buffers ❑ 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 T
2b
Type of'impact
26
Type.ofwetland
2d
Forested
2e
Type of jurisdiction
Corps (404,10) or
DWQ (401,, other)
2f
Area of
impact
(acres)'
W1 P
Culvert
Pine Flat
Yes
DWQ
005
W2 -
Choose one
Choose one
Yes /No
-
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:
005
2h Comments
Impacted area;will be 50 feet long and 50'feet wide Of the 50 feet in width, 40 feet would be comprised of,the drainage pipe�and the remaining 10 feet
in width will be made up of 5 feet,rnp rap on each side of the pipe
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
intermittentr(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

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 individual) list all open water,im acts below.
4a
Open water
impact number
Permanent (P) or
Temporary T
4b
Name of waterbody
(if applicable)
4c.
Type ofimpact
4d
Waterbody '
type
4e
Area ofimpact (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
5fa Total:
'5g Comments:
5h Is,a dam high hazard permit required?
❑ Yes ❑, No If yes, permit1Dlno:
51. Expected pond surface area (acres)*
5j. 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 require miti ation, then you MUST fill out Section D of this form.
6a. Project is in which protected'basin?
❑ Neuse ❑ Tar - Pamlico ❑ Catawba ❑ Randleman []Other.
6b
Buffer Impact
number —
Permanent (P) or
Temporary (T)_
6c.
Reason for impact
6d
Stream name
6e.
Buffer
mitigation
required?
6f.
Zone 1
impact
(square
feet )
6g
Zone 2
impact
(square
feet
61 =
Yes/No
B2 -
Yes /No
B3 -
Yes /No
B4 -
Yes /No
B5 -
Yes /No,
B6 -
Yes/No
6h Total ,Buffer Impacts:
61. Comments:
Page 5 of 10

D., Impact, Justification and Mitigation
1. Avoidance and Minimization
1a Specifically Aescribe measuresAaken to,avoid or minimize the proposediimpacts,in designing pro_ ject.
N/A
1 b. Specifically-describe measures taken to avoid or minimize the proposed impacts through,construction techniques.
N/A
F
I
21 Compens4tory Miti "ation,for,lm acts�to.Waters of the,U.S,. or,Waters,of the State
2a,, Does,thenproject require ^Compensatory Mitigation -for
impacts °to Waters of the US or WatersW the State?
❑ Yes ® No
2b. If yes, mitigation is,required' by (check all that,apply):
❑ DWQ ❑ Corps
2c If yes, which,rhitigation option willobe used for this
project?
❑ Mitigation bank
❑ Payment to in- lieu.fee program
❑' PermitteesResponsible Mitigation
3., Complete if Usin f�a,Mitigation Bank
,3a_ Narnne 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. Com 'leteif Makin 2a Pa -ment to in -lieu Fee Pro -ram
4a. Approval,. letter,* — m'm- lieu,fee,program�is attached.
❑ Yes
4b.'Stream mitigation requested:
lmear,feet;
4c 'If using stream mitigation, stream temperature-
Choose,one
4d;, Buffer mitigation.requested (DWQilonly).
,square feet
4e "Riparian ^wetiarid`mitigation requested:
acres
4f , Non - riparian wetland mitigationsequested:
acres
4g, Coastal (tidal) wetland mitigation requested:
acres
4h Comments:
5. Complete,if Usiiig a Permittee Responsible Mitigation;Plan
5a If using a permittee responsible mitigation plan,,ptovide a, description ,ofthe.proposed,mitigation plan
Page�&of 10
PCR Form — Version 1.4 January 2009,

6. Buffer Mitigation (State Regulated Riparian BufferRules) — =required by DWQ
6a Will the project resuit'in,an impact'vothin a protected riparian buffer that requires
E] Yes No
buffer mitigation?
'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.
6c.
6d.
6e.
Zone
Reason for impact
Total impact
Multiplier
Required mitigation
(square feet)
(square feet)
Zone 1
3 (2 for Catawba)
Zone 2
1`.5
6f. Total buffer mitigation requited:
g q
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
1 a. Does the project include or is it adjacent,to protected riparian buffers identified
❑ Yes ❑X No
within one of the NCRiparian Buffer 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?
5.55%
2b.
Does this project re uire,a'Stormwater Management Plan?
❑ Yes ® No
'2c
If this project DOES NOT require a Stormwater Management Plan, explain why-
2d.
If this proiect'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.
Certifiedtocal Government Stormwater Review
3a
In which local government's jurisdiction is this project?
❑ Phase II
0 NSW
3b
Which of the following locally - implemented stormwater management programs
❑ USMP
apply (check all that apply)
❑ Water Supply Watershed,
❑ Other
3c
Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ❑ No
attached?
4. DWQ Stormwater Program Review _
❑Coastal counties
❑HQW
4a.
Which,.of the following state - implemented stormwater management programs apply,
❑ORW
all that.apply);
Session Law 2006 -246
[:]'Session
❑Other
4b.
Has the approved Stormwater Management Plan with proof of'approval.been
❑ Yes ❑ No
attached?
Z.
DWQ 401 UnitStormwatet'Review
5a
Does'the Stormwater Management'iPlan 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 14 January 2009

F. Supplementary Information
1.
Environmental Documentation (DWQ Requirement)
la
Does the project involve an expenditure of public (federal /stateflocal) funds or the
❑ Yes ❑X No
use of public (federal /state) land?
1 b. If, you answered "yes" to the=above, does the projectsequire preparation of an
environmental document pursuant to the requirements of the,National or State
❑ Yes ❑ No
(North Carolina) Environmental Policy Act (NEPA/SEPA)'?
1'c
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 orSEPA final,approval
❑ Yes ❑ No
letter)
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):
I
3.
Cumulative Impacts (DWQ Requirement)
3a
Will this project (based on past and reasonably anticipated future impacts) result'in
❑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,detad the ultimate treatment methods and disposition (non- discharge or discharge) of wastewater generated from
the propose&project, or available capacity of the subject,facility
Septic systems wdl'be constructed for the lots in this subdivision project
Page 9 of 10'
PCN Form — Version A.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
habitat?
❑`Yes XD No
5b. Have you checked with the USFWS concerning Endangered Species Act
impacts?
El Yes pX No
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 Speciesor Designated Critical
Habitat?
6. Essential Fish Habitat (Corps Requirement)
6a Will this;project occur in or near an,area designated as essential fish habitat?
❑'Yes ® No
6b What,data sources did'you use to determine ,whether your site;would impact Essential Fish Habitat?
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 (e g., National Historic Trust designation or properties significant,in
North Carolina history and archaeology)?
Yes ❑X No
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 project occur in a FEMA - designated 100 -year floodplain?
❑ Yes X❑ No
8b. if yes, explain how�project meets FEMA requirements.
8c What source(s) did you use to make the floodplain determination?
Anthony Brown
Applicant/Agent's Printed Name
10-02 -2014
Date
Ap c nt%Ag ne,, ignature
(Agent's ^signature is v donly if an,authonzation
letter from theapplicant is provided
Page 10 of 10

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