20150153 Ver 1_401 Application_20150215

ATLANTIC ENVIRONMENTAL CONSULTANTS, LLC
P.O. Box 3266, Kitty Hawk, NC 27949
(252) 261 -7707 fax [phone]
February 3, 2015
Jennifer A Burdette
NC DWR, 401 Buffer Permitting Unit
1650 Mail Service Center
Raleigh, NC 27699 -1650
RE: EKMS, Inc. — Nationwide #18
Lot 6, Shingle Landing Farm Subdivsion, Currituck County
Dear Ms Burdette,
Enclosed is a Preconstruction Notification Form (PCN) for a Nationwide# 18 permit to
develop lot 6 located at 120 Fox Lane in the Shingle Landing Farm subdivision in
Moyock, Currrtuck County, North Carolina
The proposed impact includes wetland fill in Section 404 wetlands to construct a single
family residence Wetland impacts were limited to a total of 0.10 acre, which is covered
under a USACE Nationwide 18 General Permit
We request that you initiate the application process and if have questions or need
additional information please contact me at 252- 261 -7707
Sincerely,
Doug Dorman
Atlantic Environmental Consultants, LLC
cc Josh Pelletier, USACOE

Transmittal Letter
February 3, 2015
Atlantic Environmental Consultants, LLC
PO Box 3266
Kitty Hawk, NC 27949
252 - 261 -7707
dougdorman @embargmail.com
To.
NCDWR Attention: Jennifer A. Burdette
1650 Mail Service Center
Raliegh, NC 2699 -1650 Re: EKMS, Inc. PCN
Job Number:
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Attached
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❑
Under Separate Cover via*
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Shop Drawings
150003
❑
Prints
0-- Plans
❑ Other.
Y
Copy of Letter
1
❑
Change Order
❑ Samples
Notice of Jurisdictional Determination
❑
Total Quantity
2/3/15
❑
Reproducible
❑ Specification
Sutimittae"
Quantity`-
;'Date �,�t
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,,r �° r� � r;�;> > r = Description- �rraa
1
4
1/5/15
150003
Site Plan
1
4
2/3/15
-��- -- '
PCN Application
1
4
4/25/11
Notice of Jurisdictional Determination
1
1
2/3/15
$240 Check made out to NCDENR
'These areo trans mitted ",'asrchecke&b,
For Approval ❑ Approved as Submitted ❑ Resubmit copies for approval
❑ For Your Use ❑ Approved as Noted ❑ Submit [ #] copies for distribution
• As Requested ❑ Returned for Corrections ❑ Return [ #] corrected prints
• For Review and Comment ❑ Revise and Resubmit /Work May Not Proceed
❑ FOR BIDS DUE* [Type text here] ❑ PRINTS RETURNED AFTER LOAN
'Comm�irits: .,7:
to:
,,Copy
Josh Pelletier, USACOE
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ign�u're -

A nof W9 Ofice�e Only
11 T Corps 4ction ID no v
° 2 0 1 5 0 1 5 3 DWQ protect no
Form Version 1 3 Dec 10 2008
Page 1 of 11
PCN Form — Version 1 3 December 10, 2008 Version
Pre - Construction Notification PC Form
A. Applicant Information
1.
Processing
la
Type(s) of approval sought from the
Corps
®Section 404 Permit El Section 10 Permit
1 b Specify Nationwide Permit (NWP) number 18 or General Permit (GP) number
1 c
Has the NWP or GP number been verified by the Corps? ❑ Yes
® No
1d
Type(s) of approval sought from the DWQ (check all that apply)
® 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 ® No
For the record only for Corps Permit
❑ Yes ® No
1f
Is payment into a mitigation bank or in -lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in -lieu
fee program.
® Yes
❑ No
1g
Is the project located in any of NC's twenty coastal counties If yes, answer 1 h
below
® Yes
❑ No
1h
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes
® No
2.
Project Information
2a
Name of project
EKMS, Inc
2b
County
Curntuck
2c
Nearest municipality / town
Moyock
2d
Subdivision name
Shingle Landing Farm
2e
NCDOT only, T I P or state
project no
N/A
3
Owner Information
3a
Name(s) an Recorded Deed
EKMS, Inc
3b
Deed Book and Page No
975/784
3c
Responsible Party (for LLC if
applicable)
none
205
3d
Street address
PO Box 729 DENR - WgTER RESOURCES
3e
City, state, zip
Moyock, NC 27958
3f
Telephone no
N/A
3g
Fax no
N/A
3h
Email address
N/A
Page 1 of 11
PCN Form — Version 1 3 December 10, 2008 Version

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
Doug Dorman
5b
Business name
(if applicable)
Atlantic Environmental Consultants, LLC
5c
Street address
PO Box 3266
5d
City, state, zip
Kitty Hawk, NC 27949
5e
Telephone no
252 - 261 -7707
5f
Fax no
252 - 261 -7707
5g
Email address
dougdorman @embargmail com
Page 2 of 11
PCN Form —Version 1 3 December 10, 2008 Version

B. Project Information and Prior Project History
1. Property Identification
1a Property identification no (tax PIN or parcel ID)
009COOONABL0000
1 b Site coordinates (in decimal degrees)
Latitude 36 532548 Longitude - 76 17919
(DD DDDDDD) ( -DD DDDDDD)
1 c Property size
0 92 acres
2. Surface Waters
2a Name of nearest body of water (stream, river, etc ) to
Shingle Landing Creek
proposed project
2b Water Quality Classification of nearest receiving water
SA
2c River basin
Albemarle
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
Undeveloped single family lot Property located in the Shingle Landing Farm subdivision
3b List the total estimated acreage of al! existing wetlands on the property
0 13 acres
3c List the total estimated linear feet of all existing streams (intermittent and perennial) on the property
None
3d Explain the purpose of the proposed project
A home is to be constructed on the vacant lot and some wetlands need to be filled provide setbacks to septic system and
area for the house
3e Describe the overall project in detail, including the type of equipment to be used
Project includes Fill in one (1) area of Section 404 wetlands (0 10 ac ) Equipment utilized for this project to include an
excavator or backhoe, a dump truck will bring in fill material During construction silt fence will be placed at the wetland
interface to prevent intrusion of fill material into wetlands not permitted for fill
4 Jurisdictional Determinations
4a Have Junsdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
® Yes ❑ No ❑ Unknown
project (including all prior phases) in the past?
Comments
4b If the Corps made the jurisdictional determination, what type
❑ Preliminary ® Final
of determination was made?
4c If yes, who delineated the )unsdIctional areas?
Agency /Consultant Company Atlantic Environmental
Consultants, LLC
Name (if known) Doug Dorman
Other
4d If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation
Kyle Barnes - 4/25/11
5 Project History
5a Have permits or certifications been requested or obtained for ❑ Yes ® No ❑ Unknown
this project (including all prior phases) in the past?
5b If yes, explain in detail according to "help file" instructions
Page 3 of 11
PCN Form — Version 1 3 December 10, 2008 Version

6 Future Project Plans
6a Is this a phased project? ❑ Yes ® No
6b If yes, explain
Page 4 of 11
PCN Form —Version 1 3 December 10, 2008 Version

C Proposed Impacts Inventory
1 Impacts Summary
is Which sections were completed below for 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
2a
2b
2c
2d
2e
2f
Wetland impact
Type of jurisdiction
number —
Type of impact
Type of wetland
Forested
(Corps - 404, 10
Area of impact
Permanent (P) or
(if known)
DWQ — non -404, other)
(acres)
Temporary T
W1 ®P ❑ T
404 wetland fill
Forested
❑ Yes
® No
® Corps
® DWQ
010
W2 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W3 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W4 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W5 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W6 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
2g. Total wetland impacts
010
2h Comments
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted
3a
3b
3c
3d
3e
3f
3g
Stream impact
Type of impact
Stream name
Perennial
Type of jurisdiction
Average
Impact
number -
(PER) or
(Corps - 404, 10
stream
length
Permanent (P) or
intermittent
DWQ — non -404,
width
(linear
Temporary (T)
(INT)?
other)
(feet)
feet)
S1 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S2 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S3 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S4 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S5 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S6 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
3h Total stream and tributary impacts
31 Comments
Page 5 of 11
PCN Form —Version 1 3 December 10, 2008 Version

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 individually list all open water impacts below
4a
4b
4c
4d
4e
Open water
Name of waterbody
impact number —
(if applicable)
Type of impact
Waterbody type
Area of impact (acres)
Permanent (P) or
Temporary T
01 ❑P ❑T
02 ❑P ❑T
03 ❑P ❑T
04 ❑P ❑T
4f. Total open water impacts
4g Comments
5 Pond or Lake Construction
If pond or lake construction proposed, then complete the chart below
5a
5b
5c
5d
5e
Wetland Impacts (acres)
Stream Impacts (feet)
Upland
Pond ID
Proposed use or purpose
(acres)
number
of pond
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
P2
5f. Total
5g Comments
5h Is a dam high hazard permit required?
❑ Yes ❑ No If yes, permit ID no
51 Expected pond surface area (acres)
5l 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 mitigation, then you MUST fill out Section D of this form
6a
❑ Neuse El Tar-Pamlico El Other
Project is in which protected basin?
❑ Catawba ❑ Randleman
6b
6c
6d
6e
6f
6g
Buffer impact
number—
Reason
Buffer
Zone 1 impact
Zone 2 impact
Permanent (P) or
for
Stream name
mitigation
(square feet)
(square feet)
Temporary T
impact
required?
F-1 Yes
B1 ❑P ❑T
❑ No
F-1 Yes
B2 ❑P ❑T
❑ No
❑Yes
B3 ❑P ❑T
❑ No
6h Total buffer impacts
6i Comments
Page 6 of 11
PCN Form — Version 1 3 December 10, 2008 Version

D. Impact Justification and Mitigation
1 Avoidance and Minimization
la Specifically describe measures taken to avoid or minimize the proposed impacts in designing project
The septic system has been placed as far away from the wetlands as possible and a bed septic system will be used which
reduces the size of the drainfield by 50% which minimzes the impacts to wetlands
1b Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques
The drainfield construction is a bed system which reduces space and therefore the setbacks to the wetlands The house will
be constructed as close as possible to the drainfield
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
2b If yes, mitigation is required by (check all that apply)
® DWQ ® Corps
2c If yes, which mitigation option will be used for this
project?
® Mitigation bank
❑ payment to in -lieu fee program
❑ Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a Name of Mitigation Bank Great Dismall Swamp Restoration Bank
3b Credits Purchased (attach receipt and letter)
Type Non Riparian
Quantity 0 20 acres
3c Comments
4 Complete if Making a Payment to In -lieu Fee Program
4a Approval letter from in -lieu fee program is attached
❑ Yes
4b Stream mitigation requested
linear feet
4c If using stream mitigation, stream temperature
❑ warm ❑ cool ❑cold
4d Buffer mitigation requested (DWQ only)
square feet
4e Riparian wetland mitigation requested
acres
4f Non - riparian wetland mitigation requested
acres
4g Coastal (tidal) wetland mitigation requested
acres
4h Comments
5. Complete if Using a Permittee Responsible Mitigation Plan
5a If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan
Page 7 of 11
PCN Form — Version 13 December 10, 2008 Version

6 Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation?
❑ Yes ® No
6b if yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation Calculate the
amount of mitigation required
Zone
6c
Reason for impact
6d
Total impact
(square feet)
Multiplier
6e
Required mitigation
(square feet)
Zone 1
3 (2 for Catawba)
Zone 2
1 5
6f Total buffer mitigation required.
6g If buffer mitigation is required, discuss what type of mitigation is proposed (e g , payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in -lieu fee fund)
6h Comments
Page 8 of 11
PCN Form — Version 1 3 December 10, 2008 Version

E
Stormwater Management and Diffuse Flow Plan (required by DWQ)
1.
Diffuse Flow Plan
la
Does the project include or is it adjacent to protected riparian buffers identified
❑ Yes ® No
within one of the NC Riparian Buffer Protection Rules?
lb
If yes, then is a diffuse flow plan included If no, explain why
❑ Yes ❑ No
Comments
2
Stormwater Management Plan
2a
What is the overall percent imperviousness of this project?
15%
2b
Does this project require a Stormwater Management Plan?
❑ Yes ® No
2c
If this project DOES NOT require a Stormwater Management Plan, explain why Exisitng
residential lot in a subdivsion
that already obtained stormwater permit
2d
If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan
❑ Certified Local Government
2e
Who will be responsible for the review of the Stormwater Management Plans
❑ DWQ Stormwater Program
❑ DWQ 401 Unit
3
Certified Local Government Stormwater Review
3a
In which local government's jurisdiction is this project?
Dare County
❑ Phase II
3b
Which of the following locally - implemented stormwater management programs
❑ NSW
❑ USMP
apply (check all that apply)
❑ Water Supply Watershed
® Other County Standards
3c Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ® No
attached?
4.
DWQ Stormwater Program Review
® Coastal counties
❑ HOW
4a
Which of the following state - implemented stormwater management programs apply
❑ ORW
(check all that apply)
❑ Session Law 2006 -246
❑ Other
4b
Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ® No
attached?
5
DWQ 401 Unit Stormwater Review
5a
Does the Stormwater Management Plan meet the appropriate requirements?
® Yes ❑ No
5b Have all of the 401 Unit submittal requirements been met?
® Yes ❑ No
Page 9 of 11
PCN Form —Version 1 3 December 10, 2008 Version

F
Supplementary Information
1
Environmental Documentation (DWQ Requirement)
la
Does the project involve an expenditure of public (federal /state /local) funds or the
❑ Yes
® No
use of public (federal /state) land?
lb
If you answered "yes" to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State
❑ Yes
® No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1c
If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
❑ 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
® No
or Riparian Buffer Rules (15A NCAC 2B 0200)?
2b
Is this an after - the -fact permit application?
❑ Yes
® No
2c
If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s)
3
Cumulative Impacts (DWQ Requirement)
3a
Will this project (based on past and reasonably anticipated future impacts) result in
❑ Yes
® No
additional development, which could impact nearby downstream water quality?
3b
If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy If you answered "no," provide a short narrative description
4
Sewage Disposal (DWQ Requirement)
4a
Clearly detail the ultimate treatment methods and disposition (non - discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility
Bed wastewater system
Page 10 of 11
PCN Form — Version 1 3 December 10, 2008 Version

5
Endangered Species and Designated Critical Habitat (Corps Requirement)
5a
Will this project occur in or near an area with federally protected species or
❑ Yes ® No
habitat?
5b
Have you checked with the USFWS concerning Endangered Species Act
® Yes ❑ No
impacts?
® Raleigh
5c
if yes, indicate the USFWS Field Office you have contacted
❑ Asheville
5d
What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
Contacted a Biologist with the USFWS Field office
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?
The wetland area would not support 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
❑ Yes ® No
status (e g, National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b
What data sources did you use to determine whether your site would impact historic or archeological resources?
Contacted Lee Abbott, Assistant State Archeologist for a determation
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 Construction be elevated above designated flood plain
requirements for this location and approved by local municapalities prior to construction
8c What source(s) did you use to make the floodplain determination? Currituck County flooplain maps
Doug Dorman
2/2/15
Applicant/Agent's Printed Name
Date
pp icant/Agent's Signature
at
(Agent's signure is vand only if an authorization letter from the applicant
c nrn«ul�i l
Page 11 of 11
PCN Form —Version 1 3 December 10, 2008 Version

EKMS, Inc.
Eldon Miller
PO Box 729
Moyock, NC 27958
I, authorize Doug Dorman of Atlantic Environmental Consultants, LLC (AEC)
to act on my behalf as my agent in the processing of applications and to
furnish, upon request, supplemental information in support of the permit
application.
AUTHORIZATION
DATE

fl
CP
S/TE PLAN FOR WETLAND F /LL PERM I T
FOR
ElWf INC,
MO POCK TOWNSHIP
CURRI TUCK COUNTY, NORTH CAROLINA
BEING THE LOT RESERVED BY OWNER (NOT A BUILDABLE LOT) IN
SHINGLE LANDING FARM AS RECORDED IN P C. M, SLD 178 -179
JANUARY 5, 2015
GRAPHIC SCALE
50 0 25 50 100
DING DR
ITE
( IN FEET) 9 2
1 Inch = 50 I'L }
4� SHINGLE
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i
NOW OR FORMERLY
CTX, INC
P C. L, SLD 51
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WETLANDS TO
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VICINITY MAP
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Q CORNER MARKER
PROPERTY LINE I
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- - RIGHT OF WAY
— — — — — FEMA FLOOD ZONE LINE
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— — — — — — 20' WATER LINE EASEMENT
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NOTES
1 ) ALL DISTANCES SHOWN ARE HORIZONTAL GROUND
DISTANCES
2) AREA BY COORDINATE METHOD
3) THE PROPERTY IS LOCATED IN FLOOD ZONE "AS SHOWN
HEREON" AND AS SHOWN ON MAP PANEL y3721BO2200J,
DATED DECEMBER 16. 2005
4) REFER TO THE CURRITUCK COUNTY UDO FOR BUILDING
SETBACK REQUIREMENTS
I, NICHOLAS M RACKLEY PLS -5062, CERTIFY, rc r, M. N MAN u' vac M.
C THAT THIS PLAT IS OF AN EXISTING PARCEL OF LAND �.`N",,,
THIS /S A SITE PLAN ONLY
(NOT A SURREY) BASED _ O
O �
ON RECORDED / 2 9 w
INFORMATION AND DESIGN - ;< SOLUTIONS FROM THE GROUND UP
PLANS PROVIDED BY
/ 'ten .'� SUR� 150 US Hwy 158 E' - PO Box 339
CONTRACTOR OWNER �,� �.
�'%.� <gS1M�RPG`� Camden, NC 27921 License C -0598
(252) 338 -2913 - (252) 338 -5552 fax
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1
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/
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/
I
- - LEGEND - - I-
-; WETLANDS TO BE FILLED
Q CORNER MARKER
PROPERTY LINE I
PROPERTY EXTENSION
- - RIGHT OF WAY
— — — — — FEMA FLOOD ZONE LINE
15' DOMINION POWER EASEMENT
- - - - - - - - WETLAND LINE
— — — — — — 20' WATER LINE EASEMENT
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NOTES
1 ) ALL DISTANCES SHOWN ARE HORIZONTAL GROUND
DISTANCES
2) AREA BY COORDINATE METHOD
3) THE PROPERTY IS LOCATED IN FLOOD ZONE "AS SHOWN
HEREON" AND AS SHOWN ON MAP PANEL y3721BO2200J,
DATED DECEMBER 16. 2005
4) REFER TO THE CURRITUCK COUNTY UDO FOR BUILDING
SETBACK REQUIREMENTS
I, NICHOLAS M RACKLEY PLS -5062, CERTIFY, rc r, M. N MAN u' vac M.
C THAT THIS PLAT IS OF AN EXISTING PARCEL OF LAND �.`N",,,
THIS /S A SITE PLAN ONLY
(NOT A SURREY) BASED _ O
O �
ON RECORDED / 2 9 w
INFORMATION AND DESIGN - ;< SOLUTIONS FROM THE GROUND UP
PLANS PROVIDED BY
/ 'ten .'� SUR� 150 US Hwy 158 E' - PO Box 339
CONTRACTOR OWNER �,� �.
�'%.� <gS1M�RPG`� Camden, NC 27921 License C -0598
(252) 338 -2913 - (252) 338 -5552 fax