20201865 Ver 1_401 Application_20230106

DWR
Division of Water Resources
Initial Review
Pre -Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
April 13, 2022 Ver 4.3
Has this project met the requirements for acceptance in to the review process?*
Yes
No
Is this project a public transportation project?*
Yes No
Change only if needed.
BIMS # Assigned* Version#*
20201865 1
Is a payment required for this project?*
No payment required
Fee received
Fee needed - send electronic notification
Select Project Reviewer*
Erin Davis:eads\ebdavis:[e-mail]
Information for Initial Review
Reviewing Office*
Central Office - [phone]
la. Name of project:
Cornbread Valley Mitigation Project
la. Who is the Primary Contact?*
Lin Xu
1 b. Primary Contact Email: * lc. Primary Contact Phone: *
[e-mail] [phone]
Date Submitted
1/6/2023
Nearest Body of Water
Jones Creek
Basin
Little Tennessee
Water Classification
WS-III, Tr
Pre -Filing Meeting Date Request was submitted on:
11/30/2020
Site Coordinates
Latitude:
35.1036224
A. Processing Information
County (or Counties) where the project is located:
Macon
Is this a NCDMS Project
Yes No
Is this project a public transportation project? *
Yes No
Longitude:
-83.4535805

la. Type(s) of approval sought from the Corps:
Section 404 Permit (wetlands, streams and waters, Clean Water Act)
Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
Has this PCN previously been submitted?*
Yes
No
1 b. What type(s) of permit(s) do you wish to seek authorization?
Nationwide Permit (NWP)
Regional General Permit (RGP)
Standard (IP)
lc. Has the NWP or GP number been verified by the Corps?
Yes No
If yes, please provide a statement concerning compliance with the Coastal Zone Management Act.
Nationwide Permit (NWP) Number: 27 - Restoration
NWP Numbers (for multiple NWPS):
Id. Type(s) of approval sought from the DWR:
401 Water Quality Certification - Regular
Non-404 Jurisdictional General Permit
Individual 401 Water Quality Certification
le. Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification:
For the record only for Corps Permit:
1f. Is this an after -the -fact permit application?*
Yes No
lg. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
Yes No
lg. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
Yes No
lh. 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
ld. Who is applying for the permit?
Owner Applicant (other than owner)
1e. Is there an Agent/Consultant for this project? *
Yes No
2. Owner Information
2a. Name(s) on recorded deed:
WM-Bill Mrs (Rita Byrd)
2b. Deed book and page no.:
DB: 0-10 PG: 91
2c. Contact Person:
401 Water Quality Certification - Express
Riparian Buffer Authorization
Yes No
Yes No

2d. Address
Street Address
1765 North Jones Creek Road
Address Line 2
City State / Province / Region
Franklin North Carolina
Postal / Zip Code Country
28734 United States
2e. Telephone Number:
[phone]
2g. Email Address: *
[e-mail]
2a. Name(s) on recorded deed:
Steve David Byrd
2b. Deed book and page no.:
DB: D-26 PG: 1406
2c. Contact Person:
2f. Fax Number:
2d. Address
Street Address
69 Allison Watts Road
Address Line 2
City State / Province / Region
Franklin North Carolina
Postal / Zip Code Country
28734 United States
2e. Telephone Number:
[phone]
2g. Email Address: *
[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
Lin Xu
3b. Business Name:
NCDEQ - DMS
2f. Fax Number:
3c. Address
Street Address
217 W. Jones St, Suite 3000A
Address Line 2
City State / Province / Region
Raleigh North Carolina
Postal / Zip Code Country
27603 United States
3d. Telephone Number: 3e. Fax Number:
[phone]
3f. Email Address: *
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Ian Eckardt
4b. Business Name:
Wildlands Engineering, Inc.

4c. Address
Street Address
1430 South Mint Street, Suite 104
Address Line 2
City
Charlotte
Postal / Zip Code
28203
4d. Telephone Number:
[phone]
4f. Email Address: *
[e-mail]
C. Project Information and Prior Project History
State / Province / Region
North Carolina
Country
United States
4e. Fax Number:
1. Project Information
1 b. Subdivision name:
(if appropriate)
lc. Nearest municipality / town:
Town of Franklin
2. Project Identification
2a. Property Identification Number: 2b. Property size:
6562715245, 6562725090 18 acres (proposed conservation easement)
2c. Project Address
Street Address
1765 North Jones Creek Road
Address Line 2
City
Franklin
Postal / Zip Code
28734
3. Surface Waters
3a. Name of the nearest body of water to proposed project: *
Jones Creek
3b. Water Resources Classification of nearest receiving water: *
WS-III, Tr
3c. What river basin(s) is your project located in?*
Little Tennessee
3d. Please provide the 12-digit HUC in which the project is located.
060102020104
4. Project Description and History
State / Province / Region
North Carolina
Country
United States
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 project area is located within a rural watershed in central Macon County, NC. Land use in and immediately adjacent to the project area consists of agriculture, forest, and rural
residential. Livestock currently have access to all project stream and wetlands. Project streams exhibit erosion, incision, aggradation, and low bedform diversity. Ditching and grazing have
altered and degraded project wetlands. Native vegetation within the project area has been highly altered or removed by agriculture.
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:
2.899
4g. List the total estimated linear feet of all existing streams on the property:
9,747
4h. Explain the purpose of the proposed project: *
The purpose of the project is to provide stream and wetland mitigation credits in the Little Tennessee 06010202 service area for the North Carolina Department of Environmental Quality
Division of Mitigation Services. Mitigation practices will include stream restoration, stream enhancement, wetland re-establishment, wetland rehabilitation, wetland enhancement, wetland
creation, and riparian buffer planting.

4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used: *
The project proposes restoration and enhancement of approximately 8,298 linear feet of streams as well as 2.094 acres of wetland re-establishment, rehabilitation, enhancement, and
creation. Stream restoration and enhancement II will be achieved through natural channel design including Priority 1 and Priority 2 approaches. Priority 1 restoration will involve the
excavation of new channels within the existing floodplain and Priority 2 sections of channel will be constructed where needed to transition grade from existing to proposed elevations. Both
approaches will include the installation of in -stream structures including boulder clusters, brush toes, brush pack, constructed riffles, cover Togs, log j-hooks, angled log drops, logs sills, log
vanes, rock drops, and rocks sills. Enhancement II will involve fencing out cattle, buffer planting, bank grading/benching, and limited in -streams structures. Wetland mitigation approaches
include 0.566 acres of re-establishment, 0.629 acres of rehabilitation, 0.206 acres of enhancement, and 0.693 acres of wetland creation. Wetland uplift will involve restoring stream and
floodplain connectivity, floodplain grading, filling existing ditches, fencing out cattle, and removing/treating invasive plants. A best management practice (BMP) is proposed above UT3B to
slow and filter runoff from upland livestock trails. Post -construction the project area will be planted with native riparian and wetland species. The project area will be protected in perpetuity
by a conservation easement.
Excavators will be used for channel and floodplain excavation as well as for bank grading, while articulated trucks, track trucks, and off road trucks will be used for hauling soil. Small
equipment such as mini excavators and skid steers may also be used during grading activities.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
Yes
Comments:
No Unknown
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
Preliminary Approved Not Verified Unknown N/A
Corps AID Number:
SAW-2020-02051
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
Jordan Hessler
Wildlands Engineering, Inc.
5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
The Preliminary Jurisdictional Determination was issued by David Brown of the USACE on October 28, 2021 and is included in Appendix 3 of the Mitigation Plan.
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?
D. Proposed Impacts Inventory
1. Impacts Summary
la. Where are the impacts associated with your project? (check all that apply):
Wetlands Streams -tributaries
Open Waters Pond Construction
2. Wetland Impacts
Buffers
2a. Site #* (?)
2a1 Reason (?)
2b. Impact type* (?)
2c. Type of W.*
2d. W. name*
2e. Forested*
2f. Type of Jurisdicition*
(?)
29. Impact
area*
W1
Floodplain Grading
T
Headwater Forest
A
Yes
Both
0.132
(acres)
W2
Stream Restoration
P
Headwater Forest
A
No
Both
0.023
(acres)
W3
Floodplain Grading
T
Bottomland Hardwood Forest
B
No
Both
0.129
(acres)
W4
Stream Restoration
P
Bottomland Hardwood Forest
B
No
Both
0.008
(acres)
W5
Floodplain Grading
T
Bottomland Hardwood Forest
C
Yes
Both
0.038
(acres)
W6
Stream Restoration
P
Bottomland Hardwood Forest
C
Yes
Both
0.002
(acres)
W7
Floodplain Grading
T
Bottomland Hardwood Forest
D
Yes
Both
0.006
(acres)

W8
Stream Restoration
P
Bottomland Hardwood Forest
D
Yes
Both
0.000
(acres)
W9
Floodplain Grading
T
Bottomland Hardwood Forest
E
Yes
Both
0.003
(acres)
W10
Floodplain Grading
T
Headwater Forest
F
Yes
Both
0.027
(acres)
W11
Stream Restoration
P
Headwater Forest
F
Yes
Both
0.001
(acres)
W12
Floodplain Grading
T
Headwater Forest
G
Yes
Both
0.030
(acres)
W13
Stream Restoration
P
Headwater Forest
G
Yes
Both
0.003
(acres)
W14
Floodplain Grading
T
Headwater Forest
H
Yes
Both
0.053
(acres)
W15
Stream Restoration
P
Headwater Forest
H
Yes
Both
0.004
(acres)
W16
Floodplain Grading
T
Headwater Forest
I
Yes
Both
0.017
(acres)
W17
Floodplain
Grading/Culvert
Construction
T
Headwater Forest
J
Yes
Both
0.002
(acres)
W18
Wetland/Floodplain
Grading
T
Seep
K
No
Both
0.131
(acres)
W19
Stream Restoration
P
Seep
K
No
Both
0.007
(acres)
W20
Stream Restoration
P
Seep
L
No
Both
0.002
(acres)
W21
Bank
Grading/Construction
Access
T
Bottomland Hardwood Forest
M
No
Both
0.014
(acres)
W22
Stream Restoration
P
Bottomland Hardwood Forest
M
No
Both
0.001
(acres)
W23
Floodplain
Grading/Construction
Access
T
Bottomland Hardwood Forest
N
No
Both
0.194
(acres)
W24
Bank
Repair/Construction
Acess
T
Headwater Forest
0
Yes
Both
0.056
(acres)
W25
Construction Access
T
Headwater Forest
P
Yes
Both
0.012
(acres)
W26
Floodplain Grading
T
Bottomland Hardwood Forest
Q
No
Both
0.012
(acres)
W27
Stream Restoration and
Culvert Installation
P
Bottomland Hardwood Forest
Q
No
Both
0.015
(acres)
W28
Crossing Fill
P
Headwater Forest
R
Yes
Both
0.015
(acres)
W29
Floodplain Grading
T
Bottomland Hardwood Forest
S
No
Both
0.016
(acres)
W30
Construction Access
T
Bottomland Hardwood Forest
T
No
Both
0.014
(acres)
W31
Stream Restoration
P
Bottomland Hardwood Forest
T
No
Both
0.001
(acres)
W32
Floodplain/Wetland
Grading
T
Seep
U
No
Both
0.168
(acres)
W33
Stream Restoration
P
Seep
U
No
Both
0.046
(acres)
W34
Floodplain Grading
T
Bottomland Hardwood Forest
V
No
Both
0.078
(acres)
W35
Floodplain/Wetland
Grading
T
Bottomland Hardwood Forest
X
No
Both
0.257
(acres)
W36
Stream Restoration
P
Bottomland Hardwood Forest
X
No
Both
0.022
(acres)

W37
Floodplain Grading
T
Seep
Y
No
Both
0.004
(acres)
W38
Floodplain Grading
T
Seep
Z
Yes
Both
0.005
(acres)
W39
Bank Grading/Soil
Stockpiling
P
Seep
Z
Yes
Both
0.002
(acres)
W40
Floodplain Grading
T
Headwater Forest
AA
No
Both
0.025
(acres)
W41
Stream Restoration
P
Headwater Forest
AA
No
Both
0.008
(acres)
W42
Floodplain
Grading/Construction
Access
T
Headwater Forest
BB
Yes
Both
0.006
(acres)
W43
Stream Restoration
P
Headwater Forest
BB
Yes
Both
0.001
(acres)
W44
Floodplain Grading
T
Seep
CC
No
Both
0.009
(acres)
W45
Floodplain Grading
T
Seep
DD
Yes
Both
0.010
(acres)
2g. Total Temporary Wetland Impact
1.448
2g. Total Wetland Impact
1.609
2g. Total Permanent Wetland Impact
0.161
2i. Comments:
Impacts to wetlands are needed to conduct mitigation activities and will increase resource function.
3. Stream Impacts
3a. Reason for impact (?)
3b.Impact type*
3c. Type of impact*
3d. S. name*
3e. Stream Type*
(?)
3f. Type of
Jurisdiction*
3g. S. width*
3h. Impact
length*
S1
Stream Restoration
Permanent
Relocation
Jones Creek
Perennial
Both
33
Average (feet)
1,817
(linear feet)
S2
Ford Installation
Permanent
Relocation
Jones Creek
Perennial
Both
33
Average (feet)
16
(linear feet)
S3
Bank Grading/Tie In
Grading/Construction Access
Temporary
Stabilization
Jones Creek
Perennial
Both
33
Average (feet)
646
(linear feet)
S4
Ford Installation
Permanent
Relocation
Jones Creek
Perennial
Both
33
Average (feet)
16
(linear feet)
S5
Stream Restoration
Permanent
Relocation
UT1
Perennial
Both
7
Average (feet)
1,056
(linear feet)
S6
Culvert Installation
Permanent
Culvert
UT1
Perennial
Both
7
Average (feet)
30
(linear feet)
S7
Stream Restoration
Permanent
Relocation
UT1A
Perennial
Both
1
Average (feet)
173
(linear feet)
S8
Stream Restoration
Permanent
Fill
UT1C
Intermittent
Both
1
Average (feet)
88
(linear feet)
S9
Stream Restoration
Permanent
Fill
UT1B
Intermittent
Both
1
Average (feet)
55
(linear feet)
S10
Stream Restoration
Permanent
Relocation
UT2
Perennial
Both
5
Average (feet)
946
(linear feet)
S11
Culvert Installation
Permanent
Culvert
UT2
Perennial
Both
5
Average (feet)
25
(linear feet)
S12
Stream Restoration
Permanent
Relocation
UT2A
Perennial
Both
5
Average (feet)
500
(linear feet)
S13
Stream Restoration
Permanent
Relocation
UT3
Perennial
Both
7
Average (feet)
1,251
(linear feet)
S14
Culvert Installation
Permanent
Culvert
UT3
Perennial
Both
7
Average (feet)
20
(linear feet)
S15
Culvert Installation
Permanent
Culvert
UT3
Perennial
Both
7
Average (feet)
20
(linear feet)

S16
Culvert Installation
Permanent
Culvert
UT3
Perennial
Both
7
Average (feet)
20
(linear feet)
S17
Bank Grading
Temporary
Bank Stabilization
UT3
Perennial
Both
7
Average (feet)
200
(linear feet)
S18
Stream Restoration
Permanent
Relocation
UT3A
Intermittent
Both
5
Average (feet)
75
(linear feet)
S19
Stream Restoration
Permanent
Relocation
UT3A
Perennial
Both
5
Average (feet)
480
(linear feet)
S20
Bank Grading
Temporary
Bank Stabilization
UT3B
Intermittent
Both
5
Average (feet)
18
(linear feet)
S21
Stream Restoration
Permanent
Relocation
UT3B
Perennial
Both
5
Average (feet)
348
(linear feet)
S22
Bank Grading
Temporary
Bank Stabilization
UT3B
Perennial
Both
5
Average (feet)
55
(linear feet)
S23
Bank Grading
Temporary
Bank Stabilization
UT3B1
Perennial
Both
2
Average (feet)
77
(linear feet)
S24
Stream Restoration
Permanent
Relocation
UT3C
Perennial
Both
5
Average (feet)
561
(linear feet)
S25
Culvert Installation
Permanent
Culvert
UT3C
Perennial
Both
5
Average (feet)
20
(linear feet)
S26
Stream Restoration
Permanent
Fill
UT3D
Intermittent
Both
1
Average (feet)
47
(linear feet)
S27
Bank Grading
Temporary
Bank Stabilization
UT3E
Intermittent
Both
1
Average (feet)
36
(linear feet)
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
7,564
3i. Total stream and ditch impacts:
4475
3i. Total temporary stream impacts:
1,032
3j. Comments:
In addition to impacts for restoration and enhancement, two fords and six culvert crossings are proposed for agricultural access. See Section 3.5 of the
approved mitigation plan for additional crossing information.
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:
Proposed mitigation approaches will impact on -site resources; however, these activities are designed to have an overall long-term positive impacts.
Natural channel design techniques will be used to restore and enhance stream function and habitat and re-establish flood storage and connectivity.
Stream restoration is proposed for the most degraded sections of stream while less degraded sections are proposed for enhancement II which typically
involve Tess intrusive approaches. Project design incorporated the location of existing wetlands and avoided them as much as possible. Unavoidable
wetland impacts are primarily due to conversion of wetland to stream and floodplain grading necessary for restoration and enhancement activities.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Construction activities will follow the guidelines outlined in the NC Erosion and Sediment Control Planning and Design Manual. Disturbance will be
limited to the immediate project area. Sedimentation to aquatic resources will be minimized through offline construction of new channels and
implementation of pump around techniques when working in live streams. Silt fence will be installed to intercept storm sheet flow. Haul roads and staging
areas will be located on uplands and temporary crossings will be minimized and placed perpendicular to streams. Timber mats will be used as much as
possible for temporary crossings. Safety fence will be installed to demarcate sensitive areas to avoid unnecessary impacts. Newly constructed channel
banks will be stabilized using biodegradable coir fiber matting, seeding, and planted with native riparian species. See plans for additional information on
avoidance and minimize measures taken during construction.
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 this project DOES NOT require Compensatory Mitigation, explain why:
Compensatory mitigation is not required for aquatic habitat restoration related activities authorized under the
Nationwide 27 since these activities must result in a net increase in aquatic resource functions and services.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
1. Diffuse Flow Plan

la. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection Rules?
Yes No
If no, explain why:
The project is located in the Little Tennessee River Basin with no associated NC Riparian Buffer Protection Rules.
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250? *
Yes No
2b. Does this project meet the requirements for low density projects as defined in 15A NCAC 02H .1003(2)?
Yes No
Comments:
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
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
1c. If you answered "yes" to the above, has the document review been finalized by the State Clearing House?*
Yes No
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification Rules (15A NCAC 2H .0500), Isolated Wetland Rules (15A NCAC 2H .1300), or DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15A NCAC 2B .0200)?*
Yes No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality?*
Yes No
3b. If you answered "no," provide a short narrative description.
This stream and wetland mitigation project seeks to improve water quality. The project area will
be protected in perpetuity from future development through a conservation easement.
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.
Asheville
5d. Is another Federal agency involved?*
Yes
5e. Is this a DOT project located within Division's 1-8?
Yes No
No Unknown
5f. Will you cut any trees in order to conduct the work in waters of the U.S.?
Yes No
5g. Does this project involve bridge maintenance or removal?
Yes No
5h. Does this project involve the construction/installation of a wind turbine(s)?*
Yes No

5i. Does this project involve (1) blasting, and/or (2) other percussive activities that will be conducted by machines, such as jackhammers, mechanized pile drivers, etc.?
Yes No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
See the approved Categorical Exclusion (CE) Document in the Mitigation Plan for additional information. Approximately 5.88 acres of tree clearing is
proposed during the inactive season for bats and will be completed in winter 2022-2023 before April 1st. In addition, no artificial lighting will be added to
the action area and no night work will occur.
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? *
See the approved Categorical Exclusion (CE) Document in the Mitigation Plan for additional information. No in -stream work will occur during the trout
moratorium between October 15 and April 15th.
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?*
See the approved Categorical Exclusion (CE) Document in the Mitigation Plan for additional information.
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?*
North Carolina Floodplain Mapping Program Flood Insurance Rate Map (FIRM) Panel 6562 with an effective date of May 4, 2009.
Miscellaneous
Please use the space below to attach all required documentation or any additional information you feel is helpful for application review. Documents should be combined into one file when
possible, with a Cover Letter, Table of Contents, and a Cover Sheet for each Section preferred.
Click the upload button or drag and drop files here to attach document
Cornbread_Valley_Mitigation_Site_ePCN_Memo_&_Supporting_Documentation.pdf 9.64MB
Cornbread Valley_100175_MP_2022.pdf 247.28MB
Approval Letter_NCDMS Cornbread Valley_SAW-2020-02051.pdf 194.77KB
CornbreadValley401 FeeMemo.pdf 225.93KB
File must be PDF or KMZ
Comments
Cover letter and supporting documentation is uploaded with this submittal.
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:
lan Eckardt
Signature
Full Name (DMS Signature)
Lin Xu
DSM Signature

Date
1/6/2023