20171507 Ver 3_More Information Received_20220621 (2)

DWR
oirlslna of Water Resources
Pre -Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
December 6, 2021 Ver 4.2
Please note: fields marked with a red asterisk * below are required. You will not be able to submit the form until all mandatory questions are answered.
Also, if at any point you wish to print a copy of the E-PCN, all you need to do is right -click on the document and you can print a copy of the form.
Below is a link to the online help file.
https://edocs.deq.nc.gov/WaterResources/0/edoc/624704/PCN % 2OHelp % 20File % 202018-1-30.pdf
A. Processing Information
County (or Counties) where the project is located:"`
Wake
Is this a NCDMS Project*
Yes • No
Click Yes, only if NCDMS is the applicant or co -applicant.
Is this project a public transportation project?*
Yes No
This is any publicly funded by municipal,state or federal funds road, rail, airport transportation project.
1a. 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)
1c. Has the NWP or GP number been verified by the Corps?*
Yes No
Nationwide Permit (NWP) Number: 14 - Linear transportation
NWP Numbers (for multiple NWPS):
List all NW numbers you are applying for not on the drop down list.
1d. Type(s) of approval sought from the DWR:
check all that apply
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
1g. 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 No
401 Water Quality Certification - Express
Riparian Buffer Authorization
Yes No
Yes No

Acceptance Letter Attachment
Click the upload button or drag and drop files here to attach document
Hasse Ave Extension - Stream SOA 03-15-2022.pdf 180.39KB
Hasse Ave Extension - Wetland SOA 03-15-2022.pdf 185.06KB
RES CF02 - SOA Cloud & Banner - Hasse Ave Extension.pdf 165.8KB
FILE TYPE MUST BE PDF
1 h. Is the project located in any of NC's twenty coastal counties?
Yes No
1j. Is the project located in a designated trout watershed?
Yes No
Link to trout information: http://www.saw.usace.army.mil/Missions/Regulatory-Permit-Program/Agency-CoordinationfFrout.aspx
B. Applicant Information
1a. Who is the Primary Contact?*
Camden Brunick
Ic. Primary Contact Phone:
1 b. Primary Contact Email:* (xzx)xxx-xxxx
[e-mail] [phone]
1d. Who is applying for the permit? *
Owner Applicant (other than owner)
(Check all that apply)
1e. Is there an Agent/Consultant for this project?
Yes No
2. Owner Information
2a. Name(s) on recorded deed:"
Judy G. Hackney & Edwin Goodwin
2b. Deed book and page no.:
DB: 13-E DP: 3764, DB: 003195 DP: 00151 & DB: 003195 DP: 00149
2c. Contact Person:
(for Corporations)
2d.Address*
Street Address
2505 Olive Chapel Rd
Address Line 2
City
State / Province / Region
Apex
NC
Postal / Zip Code
Country
27502
USA
2e. Telephone Number:*
(xxx)xxx-xxxx
[phone]
2f. Fax Number:
2g. Email Address: *
[e-mail]
3. Applicant Information (if different from owner)
3a. Name:*
Town of Apex
3b. Business Name:
(if applicable)

3c. Address
Street Address
P.O. Box 250
Address Line 2
City
Apex
Postal / Zip Code
27502
3d. Telephone Number:"`
[phone]
3f. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:*
Camden Brunick
4b. Business Name:
(if applicable)
Soil & Environmental Consultants, PA
4c. Address
Street Address
8412 Falls of Neuse Road, Suite 104
Address Line 2
City
Raleigh
Postal / Zip Code
27615
4d. Telephone Number: *
[phone]
4f. Email Address: *
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1a. Name of project:*
Hasse Avenue Extension
1b. Subdivision name:
(if appropnatc)
1c. Nearest municipality / town:
Apex
2. Project Identification
State / Province / Region
NC
Country
USA
3e. Fax Number:
State / Province / Region
NC
Country
USA
4e. Fax Number:
[phone]
(xxz)xxx-xxxx
2a. Property Identification Number:
(tax PIN or parcel ID)
2b. Property size:
0721491564, 0721492956, 0722411102 &
(in acres)
0722406699
+/- 4.4
2c. Project Address
Street Address
2500 Olive Chapel Road
Address Line 2
City
State / Province / Region
Apex
NC
Postal / Zip Code
Country
27502
USA
2d. Site coordinates in decimal degrees
Please collect site coordinates in decimal degrees. Use between 4-6 digits (unless you are using a survey -grade GPS device) after the decimal place as appropriate, based on how the location was
determined. (For example, most mobile phones with GPS provide locational precision in decimal degrees to map coordinates to 5 or 6 digits after the decimal place.)
u
L^J
L^J

Latitude: * Longitude:*
35.729195-78.916459
ex: 34.208504-77.796371
3. Surface Waters
3a. Name of the nearest body of water to proposed project:
Reedy Branch
3b. Water Resources Classification of nearest receiving water:
WS-IV;NSW
Surface Water Lookup
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.
030300020609
River Basin Lookup
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: *
Existing conditions onsite consists primarily of forested land and field areas as well as some rural single-family homes. Specifically, there are eight (8) wetland features (W1-W8), two (2)
ponds (Pond 1 & 2), two (2) intermittent streams (SB & SC), and one (1) perennial stream (SA) located on property. General land use in the vicinity of the project consists of forested land
with residential neighborhoods. Olive Chapel Road bounds the property to the south.
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).
USACE: 404 issued by James Lastinger on December 15, 2017 (SAW-2017-02473).
4f. List the total estimated acreage of all existing wetlands on the property:
Approximately 0.29 acres
4g. List the total estimated linear feet of all existing streams on the property:
(intermittent and perennial)
Approximately 300 LF
4h. Explain the purpose of the proposed project:
The purpose of the project is extend the existing Hasse Ave Road from the Sweetwater subdivision south to Olive Chapel Road.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used: *
The overall project consists of the construction of a roadway extension of Hasse Ave to Olive Chapel Road. Specifically, there are two (2) road crossings that impact wetlands, streams,
and buffers. Equipment typically used for construction and earthwork such as backhoes, bulldozers, excavators, graders, pavers etc. will be utilized for this project.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?
Yes No Unknown
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made?
Preliminary Approved Not Verified Unknown N/A
Corps AID Number:
Example: SAW-2017-99999
SAW-2020-01905
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Steven Ball
Agency/Consultant Company: Soil & Environmental Consultants, PA
Other:
5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR.
USACE: Site visit and jurisdictional determination issued by Samantha Dailey on December 14, 2020.
Town of Apex: Site visit and determination issued on November 9, 2020 by Jessica Bolin (Apex 20-004).
6. Future Project Plans

6a. Is this a phased project?*
Yes No
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? This includes other
separate and distant crossing for linear projects that require Department of the Army authorization but don't require pre -construction notification.
It is my understanding that there are no intended future phases beyond the property boundaries shown. Therefore, no additional NWP, Regional General Permits, or IP are anticipated.
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
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.
"W." will be used in the table below to represent the word "wetland".
u
2a1 Reason * (?)
2b. Impact type*(?)
2c. Type of W.*
2d. W. name*
2e. Forested*
2f. Type of Jurisdicition*
2g.impact
area
ff::]
Road Crossing
P
Headwater Forest
Wetland 8
Yes
Both
]
0.293
(acres)
2g. Total Temporary Wetland Impact
0.000
2g. Total Permanent Wetland Impact
0.293
2g. Total Wetland Impact
0.293
21. 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.
"S." will be used in the table below to represent the word "stream".
3a. Reason for impact* (?)
3b.lmpact type*
3c. Type of impact*
3d. S. name* ��3e.
Stream Type*
3f. Type of
3g. S. width*
3h. Impact
❑
(?)
Jurisdiction*
length*
g1
Impact 1 - Road Crossing -
Permanent
Culvert
Stream B1
Intermittent
Both
5
106
Culvert
Average (feet)
(linear feet)
S2
Impact 1 - Road Crossing -
Permanent
Other
Stream 131
Intermittent
Both
5
24
Rip Rap (Permanent -No
Average (feet)
(linear feet)
Permanent Loss)
S3
Impact 1 - Road Crossing -
Temporary
Other
Stream 131
Intermittent
Both
4
15
Temporary Construction
Average (feet)
(linear feet)
Access/Dewatering Measures
** All Perennial or Intermittent streams must be verified by DWR or delegated local government.
31. Total jurisdictional ditch impact in square feet:
0
31. Total permanent stream impacts:
130
31. Total temporary stream impacts:
15
31. Total stream and ditch impacts:
145
3j. Comments:
Total permanent stream impacts = 106 LF (567 SF/ 0.013 acres), total permanent -no permanent impacts = 24 LF (116 SF/0.002 acres), total temporary
stream = 15 LF (64 SF/0.001 acres)
6. Buffer Impacts (for DWR)
If project will impact a protected riparian buffer, then complete the chart below. Individually list all buffer impacts below.

6a. Project is in which protect basirl
Check all that apply.
Neuse Tar -Pamlico
Catawba Randleman
Goose Creek Jordan Lake
Other
6b. Impact Type* (?)
6c. Per or Temp* (?)
, Stream name*
6e. Buffer mitigation required7*
6f. Zone 1 impact*
6g. Zone 2 impact*
Impact 1 - Road Crossing
P
Stream B1
No
7,202
(square fe:_]4,431
(square feet)
6h. Total buffer impacts:
..... ..... ....... ...........
Zone 1 Zone 2
Total Temporary impacts: 0.00 0.00
Zone 1
Zone 2
Total Permanent impacts: 7,202.00
4,431.00
Zone 1
Zone 2
Total combined buffer impacts: 7,202.00
4,431.00
61. Comments:
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: *
S&EC completed a wetland delineation and stream buffer evaluation for the entire property so that natural resources could be identified, and impacts
minimized to the maximum extent practicable. Impact 1 is proposed permanent, permanent -no permanent, temporary stream impacts and permanent
buffer impacts for a road crossing. A riprap dissipator that will be utilized to reduce flow velocities and minimize stream degradation. A temporary
diversion pump, coffer dams, dewatering pump, and discharge hose will be utilized during construction to divert stream flows and minimize the release of
sediments during construction activities. This crossing will occur at a perpendicular angle with the stream and connect to the existing road crossing.
Headwalls and retaining walls will be utilized to minimize impacts to the maximum extent practicable. Compensatory mitigation at a 2:1 ratio has been
proposed to offset permanent stream losses. Impact 2 is proposed permanent wetland impacts for a road crossing. This impact is necessary to connect
Hasse Ave with Olive Chapel Road. The road crossing has been strategically placed to cross the wetland at the thinnest portion of the wetland as well
as avoiding most of the wetland that is located north of the crossing. Compensatory mitigation at a 2:1 ratio has been proposed to offset permanent
wetland impacts.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques: *
Dewatering, pump -around and /or diversion channel will be used at the stream crossing. Retaining Wall added on west side to minimize wetland
impacts. Erosion Control Plan will be developed for approval by Town of Apex.
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:
Environmental Bank & Exchange, LLC (Wetlands), Cane Creek Umbrella Mitigation Bank (Wetlands),
Cane Creek Umbrella Mitigation Banking Instrument (Stream)
3b. Credits Purchased/Requested (attach receipt and letter)
Type: Quantity:
Stream 214 LF
Riparian wetland 0.62 acres
u

3c. Comments
S&EC reached out to four (4) banks for wetland and stream credits within our project HUC, Cape Fear 03030002. Only two (2) banks had the necessary
credits needed. It should be noted that wetland mitigation credits from Wildlands Holdings IV, LLC is anticipating have 0.471 acres by the end of April
2022. These anticipated credits as well as the wetland credits from RES will fulfill the wetland mitigation credits needed. An updated SOA will be
provided from Wildlands once the credits are released in April.
NC Stream Temperature Classification Maps can be found under the Mitigation Concepts tab on the Wilmington District's RIBITS website.
6. Buffer mitigation (State Regulated Riparian Buffer Rules) - required by DWR
6a. Will the project result in an impact within a protected riparian buffer that requires buffer mitigation? If yes, you must fill out this entire form - please contact DWR for more information.
Yes No
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
*** Recent changes to the stormwater rules have required updates to this section .***
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. All buffer impacts and high ground impacts require diffuse flow or other form of stormwater treatment. If the project is subject to a state implemented riparian buffer protection program,
include a plan that fully documents how diffuse flow will be maintained.
All Stormwater Control Measures (SCM)s must be designed in accordance with the INC Stormwater Design Manual. Associated supplement forms and other documentation shall be
provided.
What type of SCM are you providing?
Level Spreader
Vegetated Conveyance (lower SHWT)
Wetland Swale (higher SHWT)
Other SCM that removes minimum 30 % nitrogen
Proposed project will not create concentrated stormwater flow through the buffer
(check all that apply)
For a list of options to meet the diffuse flow requirements, click here
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
To lookup low density requirement click here 15A NCAC 02H .1003(2).
2c. Does this project have a stormwater management plan (SMP) reviewed and approved under a state stormwater program or state -approved local government stormwater program?
Yes No
N/A - project disturbs < 1 acre
Hint: projects that have vested rights, exemptions, or grandfathedng from state or locally implemented stormwater programs or projects that satisfy state or locally -implemented stormwater programs through use of community in -lieu programs should answer
no to this question.
2d. Which of the following stormwater management program(s) apply (check all that apply):"
Local Government State
If you have a local government approval please include the SMP on their overall impact map.
Local Government Stormwater Programs*
Phase II NSW
USMP Water Supply
Please identify which local government Stormwater program you are using.
Apex
Comments:
Stormwater for the roadway will be routed offsite to BMPs (Wet Ponds and/or Stormwater Wetlands) for the adjacent project.
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
U
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 (based on past and reasonably anticipated future impacts) result in additional development, which could impact nearby downstream water quality?*
Yes No
3b. If you answered "no," provide a short narrative description.
We have reviewed the "Draft Internal Policy, Cumulative impacts and the 401 Water Quality Certification and Isolated Wetlands Programs" document
prepared by the NC Division of Water Quality on April 10, 2004, version 2.1. The draft states that many private developments are unlikely to cause
cumulative impacts, including projects such as urban in -fill, most residential subdivisions and small commercial developments as well as agricultural and
silvicultural operations. The Hasse Ave Extension project is a road extension. Additionally, the project is located within the town of Apex ETJ, therefore
the adjacent properties that have potential for development will have the following regulations to protect downstream waters: 1) the Neuse River Basin
Riparian Buffer Protection regulations, these regulations require limited development within the riparian buffer area, in addition Best Management
Practices may be required that control nitrogen if diffuse flow cannot be achieved; 2) the Jordan Watershed Riparian Buffer Protection regulations, these
regulations require limited development within the riparian buffer area in addition to "diffuse flow" requirements and could require Best Management
Practices that control nitrogen if diffuse flow cannot be achieved; 3) the Phase II NPDES Stormwater Permit Program, this program includes permitting
requirements for Municipal Separate Storm Sewer Systems (MS4s) in addition to post -construction stormwater management requirements. We
anticipate that the DWR will advise us if any additional information is needed.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
Yes No 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? *
Yes No
5c. If yes, indicate the USFWS Field Office you have contacted.
Raleigh
5d. Is another Federal agency involved?*
Yes No
5e. Is this a DOT project located within Division's 1-8?*
Yes No
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
Link to the NLEB SLOPES document: http://saw-reg.usace.army.mil/NLEB/1-30-17-signed_NLEB-SLOPES&apps.pdf
5h. Does this project involve the constructionlinstallation of a wind turbine(s)?* *
Yes No
Unknown
51. 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? *
S&EC completed a Threatened & Endangered Species Report, to include a Self -Certification letter through the US Fish & Wildlife Service (USFWS), a
query through the NC Natural Heritage Program database, and an official Species List through the iPac. A formal request was sent to the USFWS on
March 08, 2022. The USFWS has 30 days to respond from the date of the sent request. S&EC has not received a response from USFWS with
determinations made by S&EC that the proposed actions is not likely to adversely affect any federally -listed endangered or threatened species, their
formally designated critical habitat, or species currently proposed for listing under the Endangered Species Act (ESA). Please see attached S&EC
Threatened & Endangered Species report. S&EC will provide the determination from USFWS once received.
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? *
The NOAA Habitat Conservation/Habitat Protection: National Marine Fish Service; Essential Fish Habitat Mapper website was referenced. No Essential
Fish Habitat was identified near the project.
7. Historic or Prehistoric Cultural Resources (Corps Requirement)

Link to the State Historic Preservation Office Historic Properties Map (does not include archaeological data: http_//gis.ncdcr.gov/hpoweb/
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 No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources? *
Froehling & Robertson completed a field visit and State Historic Preservation Office environmental review request that was submitted to NC SHPO on
September 1, 2020. They received response from SHPO on October 8, 2020 determining that no historic resources would be affected by the project.
Please see attached response.
8. Flood Zone Designation (Corps Requirement)
Link to the FEMA Floodplain Maps: https://msc.fema.gov/portal/search
8a. Will this project occur in a FEMA-designated 100-year floodplain? *
Yes No
8b. If yes, explain how project meets FEMA requirements:
The stream crossing will be designed to minimize backwater effects.
8c. What source(s) did you use to make the floodplain determination?
NC Flood Risk Information System Floodplain Mapping Program and confirmation from the project engineer.
Miscellaneous
Comments
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
Hasse Ave Extension PCN Attachments.pdf 17.76MB
File must be PDF or KMZ
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:*
Camden M. Brunick
Signature *
Date
3/16/2022