20230057 Ver 1_ePCN Application_20230109

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.
Pre -Filing Meeting Date Request was submitted on:
6/6/2022
BIMS # Assigned* Version#*
20230057 1
Is a payment required for this project?*
No payment required
Fee received
Fee needed - send electronic notification
Select Project Reviewer*
Chad Turlington:eads\ccturlington:[e-mail]
Information for Initial Review
la. Name of project:
COURTESY COPY Utility Crossing 2927 Rockfish Rd
la. Who is the Primary Contact?*
Adam Carter
Reviewing Office*
Fayetteville Regional Office - [phone]
1 b. Primary Contact Email:* lc. Primary Contact Phone:*
[e-mail] [phone]
Date Submitted
1/9/2023
Nearest Body of Water
Black Branch
Basin
Cape Fear
Water Classification
C
Site Coordinates
Latitude: Longitude:
34.992030 -79.142571
A. Processing Information
County (or Counties) where the project is located:
Hoke
Is this a NCDMS Project
Yes No
Is this project a public transportation project? *
Yes No

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
Nationwide Permit (NWP) Number: 58 - Utility Line Activities for Water and Other Substances (frequently used)
NWP Numbers (for multiple NWPS):
ld. 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:
lf. 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
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
ld. 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:
Raeford Development Company
2b. Deed book and page no.:
1375/478 & 1336/761
2c. Contact Person:
Mubarak shahbain
2d. Address
Street Address
P.O. Box 2048
Address Line 2
City
Reaford
Postal /Zip Code
28376
401 Water Quality Certification - Express
Riparian Buffer Authorization
State / Province / Region
NC
Country
USA
Yes No
Yes No

2e. Telephone Number:
[phone]
2f. Fax Number:
2g. Email Address: *
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Adam Carter
4b. Business Name:
Wetland Solutions, LLC
4c. Address
Street Address
P.O. Box 244
Address Line 2
City State / Province / Region
Bunnlevel NC
Postal / Zip Code Country
28323 USA
4d. Telephone Number: 4e. Fax Number:
[phone]
4f. Email Address: *
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(if appropriate)
lc. Nearest municipality / town:
Reaford
2. Project Identification
2a. Property Identification Number:
494550001062
2c. Project Address
Street Address
2927 Rockfish Road
Address Line 2
City
Reaford
Postal / Zip Code
28323
3. Surface Waters
3a. Name of the nearest body of water to proposed project: *
Black Branch
3b. Water Resources Classification of nearest receiving water: *
C
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.
030300040606
4. Project Description and History
2b. Property size:
22.26
State / Province / Region
NC
Country
USA
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 utility easement has been cleared and grubbed. Outside of this project area to East and West are forested headwater wetlands. Early successional Pinus taeda monoculture to the
North. Southside residential homes.

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:
2ac
4g. List the total estimated linear feet of all existing streams on the property:
80ft
4h. Explain the purpose of the proposed project:*
The purpose for the is to provide sewer to residence in the area.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used: *
A track hoe has been used to install 24 10 inch I beams to support the elevated sewer line across the wetlands. The wetland area in the utility easement was grubbed, but has been
stabilized utilizing matting, winter rye and BMP maintenance regiment.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
Yes
Comments:
Project area was developed through wetland and stream delineation.
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:
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
6. Future Project Plans
Adam Carter
Wetland Solutions, LLC
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
Open Waters
2. Wetland Impacts
Streams -tributaries
Pond Construction
Buffers
2a. Site #* (?)
2a1 Reason (9)
2b. Impact type* (?)
2c. Type of W.*
2d. W. name
2e. Forested *
2f. Type of Jurisdicition *
(9)
2g. Impact
area*
W1
Sewer
P
Headwater Forest
W1
Yes
Both
0.046
(acres)
2g. Total Temporary Wetland Impact
0.000
2g. Total Wetland Impact
0.046
2i. Comments:
E. Impact Justification and Mitigation
1. Avoidance and Minimization
2g. Total Permanent Wetland Impact
0.046

la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
They did not open cut the wetland/stream system
lb. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
They elevated the sewer line.
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:
It is less than 10.ac of impact to wetlands and less than 150ft of stream impact. No applied buffer.
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:
No applied buffer in HUC. Mid Cape Fear
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
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
2b Provide an explanation of the violation(s):
Notification through PCN for NW58 was not obtained prior to installation of utility line.
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 sedimentation transport from initial impact has been defused and is being monitored.
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
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
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?
USFWS IPAC website
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? *
NOAA's Essential Fish Habitat Mapper
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?*
NCHPO HPOWEB
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?*
NC Flood Risk Information System
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
2927 Rockfish Road Fig 1 - Location.pdf 1.46MB
2927 Rockfish Road Fig 2b - Wetland -Utility Line.pdf 1.73MB
2927 Rockfish Road Fig 2c - Wetland Plume.pdf 1.86MB
2927 Rockfish Road Fig 3 - Topo.pdf 1.09MB
2927 Rockfish Road Fig 4 - Soil.pdf 1.45MB
2927 Rockfish Road Fig 5 - NWI.pdf 2.05MB
2927 Rockfish Road Fig 6 - Flood.pdf 887.13KB
2927 Rockfish Road PJD_20220517.pdf 132.98KB
2927 Rockfish Road Soil Map.pdf 798.59KB
2927 Rockfish Road Soil Report.pdf 1 MB
2927 Rockfish Road_IPAC report.pdf 782.52KB
2927 Rockfish Road_Parcel details.pdf 32.98KB
2927 Rockfish Road_SHPO map.pdf 270.97KB
2927 Rockfish_Wetland_Datasheets_Atlantic_and_Gulf_Coastal_Plain_Fillable.pdf 472.89KB
Agent Authorization Signed.pdf 112.97KB
2927 Rockfish _Upland _Datasheets_Atlantic _and _ Gulf_ Coastal_ Plain_Fillable.pdf 454.62KB
2927 Rockfish Road Fig 2a - Wetland.pdf 1.64MB
File must be PDF or KMZ
Comments
After the fact permit submission. 0.046ac of Headwater wetland impact

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:
Samuel Adam Carter
Signature
Sign
Date
1/9/2023