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HomeMy WebLinkAbout20221502 Ver 1_ePCN Application_20221027DW R mrlsloa of ware. Resources 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?* Yes No Is this project a public transportation project?* Yes No Change only if needed. Pre -Filing Meeting Date Request was submitted on: 4/29/2022 BIMS # Assigned" 20221502 Is a payment required for this project? No payment required Fee received Fee needed - send electronic notification Reviewing Office* Central Office - (919) 707-9000 Information for Initial Review 1a. Name of project: International Drive Extension 1 a. Who is the Primary Contact?* Jason Hartshorn, PWS 1 b. Primary Contact Email: jason.hartshorn@kimley-horn.com Date Submitted 10/27/2022 Nearest Body of Water Crabtree Creek Basin Neuse Water Classification C;NSW Site Coordinates Latitude: Longitude: 35.841986 -78.825076 A. Processing Information County (or Counties) where the project is located: Wake Is this a NCDMS Project Yes No Is this project a public transportation project?* Yes No Is this a NCDOT Project?* Yes No Version# * 1 What amout is owed? $240.00 $570.00 Select Project Reviewer* Rob Ridings:eads\rgridings 1c. Primary Contact Phone:* (919)678-4155 u 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 types) 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: NWP Numbers (for multiple NWPS): 1d. Type(s) of approval sought from the DWR: 401 Water Quality Certification - Regular Non-404 Jurisdictional General Permit Individual 401 Water Quality Certification 14 - Linear transportation 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? Yes No 1g. 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 1j. Is the project located in a designated trout watershed? Yes No B. Applicant Information 401 Water Quality Certification - Express Riparian Buffer Authorization 1d. 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: Town of Morrisville 2b. Deed book and page no.: N/A 2c. Contact Person: Martha Paige, Town Manager 2d.Address Street Address 100 Town Hall Drive Address Line 2 City State/ Province Region Morrisville NC Postal / Zip Code Country 27560 USA Yes No Yes No 2e. Telephone Number: (919)463-6150 2g. Email Address: MPaige@townofmorrisville.org 4. Agent/Consultant (if applicable) 4a. Name: Jason Hartshorn, PWS 4b. Business Name: Kimley-Horn 4c.Address Street Address 421 Fayetteville Street Address Line 2 Suite 600 City Raleigh Postal / Zip Code 27601 4d. Telephone Number: (919)678-4155 4f. Email Address:* jason.hartshorn@kimley-horn.com C. Proiect Information and Prior Proiect History 1. Project Information 1b. Subdivision name: (if appropriate) N/A 1c. Nearest municipality / town: Morrisville 2. Project Identification 2f. Fax Number: State / Province / Region NC Country USA 4e. Fax Number 2a. Property Identification Number: See attached Figure 5: Property Parcels Map 2b. Property size: and Property Parcels Table 1.9 2c. Project Address Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country 3. Surface Waters 3a. Name of the nearest body of water to proposed project: Crabtree Creek 3b. Water Resources Classification of nearest receiving water: QNSW 3c. What river basin(s) is your project located in?* Neuse 3d. Please provide the 12-digit HUC in which the project is located. 030202010801 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: * The International Drive Extension project is located at the northern terminus of the existing International Drive, west of McCrimmon Parkway and east of Airport Boulevard in Morrisville, Wake County, North Carolina. Land use within the project study area consists of the existing International Drive roadway corridor and the associated right-of-way and undeveloped forested area in Morrisville, Wake County, NC. Land use in the vicinity of the project is generally developed for industrial and commercial uses, with pockets of undeveloped forested area, riparian corridors, and pockets of residential development. 4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?* Yes No Unknown 4f. List the total estimated acreage of all existing wetlands on the property: 0 4g. List the total estimated linear feet of all existing streams on the property: 440 4h. Explain the purpose of the proposed project:' The purpose of the International Drive Extension project is to extend the existing International Drive north to connect to Stephen's Park Drive, a planned roadway associated with the adjacent SPARK development (SAW-2021-01709; DWR# 201220773) (permitted by others). The extension of International Drive to connect to Stephen's Park Drive will provide a connection from Aviation Parkway to McCrimmon Parkway as part of the Town of Morrisville's Comprehensive Transportation Plan. The extension of International Drive will facilitate traffic flow and provide a public thoroughfare and connectivity between three major active roadways (Aviation Parkway, Airport Boulevard, and McCrimmon Parkway), contributing to an improved, safer, and more efficient roadway network for the Town of Morrisville. 4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used: The International Drive Extension project is proposing to extend the existing International Drive roadway, which also includes extending curb and gutter, utilities, and sidewalk, north approximately 640 feet to connect to Stephen's Park Drive. The extension of International Drive is proposing to cross two streams; therefore, the project also includes the installation of two culverts as a result of the roadway extension. Headwalls are proposed as part of the design for the inlet and outlet of both culverts to minimize stream impacts to the extent practicable. Typical site development and structural construction equipment will be utilized including dump trucks, graders, bulldozers, asphalt pavers, excavators, and concrete trucks. 5. Jurisdictional Determinations 5a. Have the wetlands or streams been delineated on the property or proposed impact areas?* Yes No Unknown Comments: Kimley-Horn environmental staff delineated the project study area on July 14-15, 2021 and February 24, 2022 and identified two jurisdictional streams (S4 and S5) in or within 50 feet of the project study area. A Town of Morrisville Stream Origin and Buffer Determination (TOM#: DETER-2-0025) was issued by Ben Mills of the Town of Morrisville on September 9, 2021 for the larger SPARK development. Documentation is attached as part of this permit application. Additionally, a Preliminary Jurisdictional Determination Request for the project is included as part of this permit application for review by the USACE. 5b. If the Corps made a jurisdictional determination, what type of determination was made?* Preliminary Approved Not Verified Unknown N/A Corps AID Number: 5c. If 5a is yes, who delineated the jurisdictional areas? Name (if known): Emma Radford, WPIT, CA and Mackenzie Richards, PWS Agency/Consultant Company: Kimley-Horn Other: 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? The proposed project is a single and complete undertaking, and no additional permits are anticipated as part of this roadway extension at this time. 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 3. Stream Impacts U 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 11 (?) Jurisdiction* length* S1 Site 1-Perpendicular Permanent Culvert Stream S4 Perennial Both 10 165 Roadway Crossing Average (feet) (linear feet) S2 Site 1-Perpendicular Permanent Culvert Stream S5 Intermittent Both 73 Roadway Crossing Average (feet) (linear feet) S3 Site 1-Temporary Dewatering Temporary Dewatering Stream S4 Perennial Both 10 40 and Construction Access Average (feet) pinear feet) S4 Site 1-Temporary Dewatering Temporary Dewatering Stream SS Intermittent Both 60 and Construction Access average (feet) (linear feet) 31. Total jurisdictional ditch impact in square feet: 31. Total permanent stream impacts: 238 31. Total stream and ditch impacts: 338 3i. Total temporary stream impacts: 100 3j. Comments: Unavoidable impacts to jurisdictional streams will result from the proposed roadway extension and associated stream crossings. At Impact Site 1, a total of 238 LF (0.045 acres) of permanent impacts to streams S4 and S5 will result from the installation of culverts to carry the streams beneath the proposed International Drive roadway extension corridor. Culverts will be installed as to not impede normal baseflow and will allow for the movement of aquatic species within the streams. Temporary stream impacts will result from construction access and temporary dewatering of the streams via pump around to complete the roadway extension and culvert installation. Temporary impacts will be restored to pre -construction contours. 6. Buffer Impacts (for DWR) 6a. Project is in which protect basin(s)? Check all that apply. Neuse Tar -Pamlico Catawba Randleman Goose Creek Jordan Lake Other 6b. Impact Type 6c. Per or Temp 6d. Stream name 6e. Buffer mitigation required? 6f. Zone 1 impact 6g. Zone 2 impact Site 1-Perpendicular Roadway Crossing P Stream S4 and Stream SS Yes 16,361 7,704 6h. Total buffer impacts: Zone 1 Zone 2 Total Temporary impacts: 0.00 0.00 Zone 1 Zone 2 Total Permanent impacts: 16,361.00 7,704.00 Zone 1 Zone 2 Total combined buffer impacts: 16,361.00 7,704.00 6i. Comments: Unavoidable permanent impacts to the Neuse River Basin Buffer Zones 1 and 2 of streams S4 and S5 within the project study area will result from the proposed International Drive roadway extension and associated grading. Due to the proximity of S4 and S5 to one another, the buffers are co -mingled and splitting impacts between S4 and S5 specifically is challenging. Impacts have been summarized together since mitigation is required. According to NCDWR's Neuse River Basin Riparian Buffers Table of Uses, perpendicular roadway crossings impacting greater than one-third of an acre of riparian buffer are "allowable with mitigation upon authorization". Therefore, since the project is proposing 24,065 sq. ft. (0.55 ac.) of permanent riparian buffer impacts as a result of the roadway extension, compensatory buffer mitigation will be required for the proposed impacts. E. Impact Justification and Mitigation 1. Avoidance and Minimization 1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project: Impacts to jurisdictional streams, wetlands, and riparian buffer zones have been avoided and minimized to the extent practical. Crossings of environmental features have been designed to be near perpendicular to reduce impact lengths. Fill slopes within the jurisdictional features have been tightened to 2:1 where practicable and extensive headwalls are proposed as part of the design on the inlet and outlet of both culverts to further reduce impacts. Additionally, the extension of International Drive is utilizing the existing section of International Drive as much as practicable and ties to the roadway network within the adjacent SPARK development (SAW-2021-01709; DWR# 201220773) rather than continuing on new -location to Airport Boulevard or McCrimmon Parkway, greatly reducing additional stream, wetland, and riparian buffer impacts associated with alternative alignments for International Drive. 1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques: Impacts to streams, wetlands, and riparian buffer zones within the project corridor will be minimized to the extent practical throughout the construction process by avoiding these features with equipment, materials, and access corridors where possible. Where feasible, equipment staging and construction access will be located in upland areas throughout the corridor, and silt fencing will be installed around the permitted limits of disturbance to ensure all equipment is only located within areas to be impacted. Additionally, temporary sediment control measures will be used throughout the project corridor reduce construction stormwater impacts to receiving waters and minimize runoff from the construction sites. 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: Town of Morrisville - Morrisville Community Park Stream and Neuse Riparian Buffer Restoration Project 3b. Credits Purchased/Requested (attach receipt and letter) Type: Quantity: Stream 440 stream credits 3c. Comments Kimley-Horn staff conducted NC Stream Assessment Method (NCSAM) evaluations in the field and found stream S4 to have a NCSAM rating of "High" and S5 to have a NCSAM rating of "Medium". Therefore, the project proposes to provide compensatory mitigation stream credits at a 2:1 ratio for the 165 LF of unavoidable permanent stream impacts to stream S4 and at a 1.5:1 ratio for the 73 LF of unavoidable permanent stream impacts to stream S5. To offset these losses, 440 stream credits have been secured through the Town of Morrisville - Morrisville Community Park Stream and Neuse Riparian Buffer Restoration Project. The Stream Credit Ledger for the Morrisville Community Park Stream and Neuse Riparian Buffer Restoration Project has been attached as part of this application. 4. Complete if Making a Payment to In -lieu Fee Program 4a. Approval letter from in -lieu fee program is attached. Yes No 4b. Stream mitigation requested: (linear feet) 4d. Buffer mitigation requested (DWR only): (square feet) 60,639 4f. Non -riparian wetland mitigation requested: (acres) 4c. If using stream mitigation, what is the stream temperature: 4e. Riparian wetland mitigation requested: (acres) 4g. Coastal (tidal) wetland mitigation requested: (acres) 4h. Comments The project proposes to purchase compensatory mitigation buffer credits at a 3:1 ratio for unavoidable impacts to Neuse River Basin Buffer Zone 1 and a 1.5:1 ratio of unavoidable impacts to Neuse River Basin Buffer Zone 2 of streams S4 and S5. To offset these losses, a total of 60,639 riparian buffer credits have been reserved through the NCDMS In -Lieu Free Program. The DIMS Acceptance Letter has been included as part of this application. 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 6b. If yes, then identify the square feet of impact. 6c. Reason for impact 6d. Total impact (square feet) Multiplier 6e. Required mitigation (square feet) Zone 1 Perpendicular Road Crossing 16,361 3 11 49,083 Zone 2 Perpendicular Road Crossing 7,704 1.5 11,556 6f. Total buffer mitigation required 60639 6g. If buffer mitigation is required, is payment to a mitigation bank or NC Division of Mitigation Services proposed? Yes No 6j. Comments: According to NCDWR's Neuse River Basin Riparian Buffers Table of Uses, perpendicular roadway crossings impacting greater than one-third of an acre of riparian buffer are "allowable with mitigation upon authorization". Therefore, since the project is proposing 24,065 sq. ft. (0.55 ac.) of permanent riparian buffer impacts as a result of the roadway extension, compensatory buffer mitigation will be required for the proposed impacts. The project proposes to purchase compensatory mitigation buffer credits at a 3:1 ratio for unavoidable impacts to Neuse River Basin Buffer Zone 1 and a 1.5:1 ratio of unavoidable impacts to Neuse River Basin Buffer Zone 2 of streams S4 and S5. To offset these losses, a total of 60,639 of riparian buffer credits have been reserved through the NCDMS In -Lieu Free Program. The DMS Acceptance Letter has been included as part of this application. F. Stormwater Management and Diffuse Flow Plan (required by DWR) 1. Diffuse Flow Plan 1a. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection Rules? Yes No 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 2. Stormwater Management Plan 2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?* Yes No Local Government Stormwater Programs Phase II NSW USMP Water Supply Please identify which local government stormwater program you are using. Town of Morrisville Comments: The project includes the addition of curb and gutter along the proposed roadway. Stormwater captured from the proposed roadway will be routed into and treated by SCMs along the roadside. The proposed SCMs have been sized to treat the stormwater generated from the proposed project prior to being discharged into downstream waters and will comply with the Town of Morrisville's stormwater program. G. Supplementary Information 1. Environmental Documentation 1a. Does the project involve an expenditure of public (federallstatellocal) funds or the use of public (federal/state) land? Yes No 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 (North Carolina) Environmental Policy Act (NEPA/SEPA)?* Yes No Comments: * The proposed project does not require preparation of an environmental document. 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 3b. If you answered "no," provide a short narrative description. The proposed roadway extension is a single and complete undertaking intended to serve the current and projected growth in this area of Wake County and is consistent with the Town of Morrisville's Comprehensive Transportation Plan. No cumulative impacts or additional development is anticipated as a result of the proposed project. 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 u 5d. Is another Federal agency involved?* Yes No Unknown 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 5h. Does this project involve the construction/installation of a wind turbine(s)?* Yes No 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? As of October 24, 2022, the US Fish and Wildlife Service (USFWS) Information for Planning and Consulting (IPaC) tool lists six protected species with potential to occur within the project vicinity. The bald eagle (Haliaeetus leucocephalus) also has potential to occur in the project vicinity and is protected under the Bald and Golden Eagle Protection Act (BGPA). Kimley-Horn reviewed the NC Natural Heritage Program (NCNHP) element occurrence database (updated July 2022) to determine if there are any known occurrences of federally protected species in the project study area or its vicinity. The NCNHP database records indicate that there are no known occurrences of any federally threatened or endangered species in or within 1.0 mile of the project study area. Suitable habitat for the red -cockaded woodpecker (RCW) is not present within the project study area. Forested areas within the study area, mostly comprised of immature pines with dense understories, are disturbed and have been previously harvested throughout the project study area. In addition, a review of the NCNHP database records (updated July 2022) indicates there are no known occurrences of RCW in or within 1.0 mile of the project study area. Due to lack of suitable habitat and the lack of known occurrences, it has been determined that the proposed project would have "No Effect" on RCW. Suitable habitat for the dwarf wedgemussel, Atlantic pigtoe, Carolina madtom, and Neuse River waterdog is not present within the project study area due to the lack of well -oxygenated streams with stable banks. Streams in the project corridor have been impacted by sediment discharge and the banks are incised with frequent failures and sloughing along the evaluated reaches. A review of the NCNHP database records (updated July 2022) indicates there are no known occurrences of these aquatic species in or within 1.0 mile of the project study area. Due to the lack of suitable habitat and the lack of known occurrences, it has been determined that the proposed project will have "No Effect" on these aquatic species. Suitable habitat for Michaux's sumac is not present within the project area. Roadsides and forest edges within the project area were found to be too frequently maintained through mowing and herbicide application to provide suitable habitat for Michaux's sumac. In addition, a review of the NCNHP database records (updated July 2022) indicates there are no known occurrences of Michaux's sumac in or within 1.0 mile of the project corridor. Due to the lack of suitable habitat and the lack of known occurrences, it has been determined that the proposed project will have "No Effect" on Michaux's sumac. The bald eagle is protected under the BGPA, enforced by the USFWS. Habitat for the bald eagle primarily consists of mature forest in proximity to large bodies of open water for foraging. Large dominant trees are utilized for nesting sites, typically within 1.0 mile of open water. A desktop -Geographic Information Systems (GIS) assessment of the project area, as well as the area within a 1.13-mile radius (1.0 mile plus 660 feet) of the project study area, was performed using 2021 color aerials. One water body (Lake Crabtree) large enough or sufficiently open to be considered a potential feeding source was identified. Additionally, a review of the NCNHP database records (updated July 2022) indicates there are no known occurrences of bald eagle in or within 1.0 mile of the project study area. The project study area and the area with 660 feet have primarily been developed and cleared and are discontinuous with the forest surrounding Lake Crabtree. The majority of trees within the project study area are immature pines and therefore unsuitable for nesting habitat. Due to the lack of suitable nesting habitat, the lack of known occurrences, and the minimal impact anticipated from the proposed project, it has been determined that the proposed project will have "No Effect" on the bald eagle. 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 Essential Fish Habitat Mapper was reviewed on October 24, 2022. No essential fish habitat was identified within the project site or within the vicinity of the project. 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?* A review of the State Historic Preservation Office (NCSHPO) HPOWEB GIS Service database performed on October 24, 2022 identified no National Register, Study List, or Determined Eligible sites or districts in or within 1.0 mile of the project study area. Due to the lack of known historic and cultural resources in or within 1.0 of the project study area, as indicated by the NCSHPO HPOWEB, it is anticipated that the proposed project will not impact any known cultural or historical resources. 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?* The FEMA Digital Flood Insurance Rate Map (DFIRM) panels 3720075600J (effective 5/2/2006) indicates the project study area is not located within a FEMA-regulated floodway or flood hazard area. 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 dreg and drop files here to attach document 01_InternationalDrive_PCN_14_Cover _Letter.pdf 534.86KB 03_TOM_InternationalDrive_Agent_Authorization.pdf 49.13KB 04_IntnlDrive_Figures.pdf 3.73MB 05_Fig5.0_McCrimmonParkway_PermitDrawings.pdf 664.29KB 06_InternationalDrive_Mitigation.pdf 291.28KB 07_Spark _TOM_Stream Determination Letter.pdf 9.28MB 08_InternationalDrive_PJD_Request.pdf 3.48MB 09_International Drive Plan and Profile.pdf File must be PDF or KMZ 428.02KB Comments Please see attachments to aid in the review of this permit application. 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 INC General Statutes (the "Uniform Electronic Transactions Act"); I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the INC 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: Jason Hartshorn, PWS Signature �T.rge• �u<c�ct.r, o��:S 5� Date 10/27/2022