20221266 Ver 1_Pre-Construction Notification (PCN) Online Applicaiton Modified 12-19-22_20221219

DWR
IDIOM— of Water 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
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.govfVVaterResources/0/edoc/624704/PCN / 20Help/ 20File/ 202018-1-30.pdf
A. Processing Information O
Pre -Filing Meeting Date Request was submitted on:
7/22/2022
If this is a courtesy copy, please fill in this with the submission date.
County (or Counties) where the project is located:"
Nash
Is this a NCDMS Project"
0Yes ONo
Click Yes, only if NCD MS is the applicant or co -applicant.
Is this project a public transportation project?"
O Yes OO No
This is any publicly funded by municipal,state or federal funds road, rail, airport transportation project.
la. Type(s) of approval sought from the Corps:"
❑O 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?"
O Yes
O No
1 b. What type(s) of permit(s) do you wish to seek authorization?"
❑O 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):
List all NVV numbers you are applying for not on the drop down list.
1 d. Type(s) of approval sought from the DWR:
check all that apply
❑O 401 Water Quality Certification - Regular
❑ Non-404 Jurisdictional General Permit
❑ Individual 401 Water Quality Certification
29 - Residential Developments
le. Is this notification solely for the record because written approval is not required?
❑ 401 Water Quality Certification - Express
❑ Riparian Buffer Authorization
For the record only for DWR 401 Certification: O Yes O No
For the record only for Corps Permit: O Yes O No
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.
O Yes O No
Acceptance Letter Attachment
Click the upload button or drag and drop files hereto attach document
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?"
O Yes V No
Linkto trout information: http://www.saw.usace.army.miI/Missions/Regulatory-Permit-Program/Agency-Coordination/Trout.aspx
B. Applicant Information
1a. Who is the Primary Contact?"
Ethan Averette
1c. Primary Contact Phone:"
1 b. Primary Contact Email:" (xxx)xxx-xxxx
[e-mail] [phone]
1d. Who is applying for the permit?"
❑O Owner ❑ Applicant (other than owner)
(Check all that apply)
1e. Is there an AgentlConsultant for this project?"
Yes � No
2. Owner Information
2a. Name(s) on recorded deed:"
Axiom Development 3, LLC
2b. Deed book and page no.:
BK 3186, PG 499-503
2c. Contact Person:
(for Corporations)
Thomas White
2d.Address*
Street Address
3739 National Drive, Suite 105
Address Line 2
City State / Province / Region
Raleigh NC
Postal /Zip Code Country
27612 US
2e. Telephone Number:"
(xxx)xxx-xxxx
[phone]
2f. Fax Number:
2g. Email Address:"
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:"
Ethan Averette
4b. Business Name:
(if applicable)
Stocks Engineering, PA

4c. Address"
Street Address
801 E. Washington St.
Address Line 2
City
Nashville
Postal /Zip Code
27856
4d. Telephone Number:"
[phone]
4f. Email Address:"
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1a. Name of project:"
Choplin Farms
1b. Subdivision name:
(if appropriate)
Choplin Farms
1c. Nearest municipality/town:"
Middlesex
2. Project Identification
State / Province / Region
NC
Country
US
4e. Fax Number:
(xxx)xxx-xxxx
2a. Property Identification Number:
2b. Property size:
(tax PIN or parcel ID)
(in acres)
273200441805
110.31
2c. Project Address
Street Address
S NC-231
Address Line 2
City
State / Province / Region
Postal /Zip Code
Country
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.)
Latitude:" Longitude:"
35.738051-78.208019
-77.796371
3. Surface Waters
3a. Name of the nearest body of water to proposed project:"
Moccasin Creek
3b. Water Resources Classification of nearest receiving water:"
QNSW
Surface Water Lookup
3c. What river basin(s) is your project located in?"
Neuse
3d. Please provide the 12-digit HUC in which the project is located."
030202030102
River Basin Lookup
4. Project Description and History
U
lJ
lJ

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 site is currently vacant and the surrounding properties are a mix of agricultural and vacant.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?"
O Yes O No O Unknown "The design features of our wetlands and jurisdictional water impacts include a road,
4f. List the total estimated acreage of all existing wetlands on the property: a 72" diameter pipe, a 48" diameter pipe and a 4" diameter water utility line. These
6.30 designed features will be permanent impacts on the wetlands and waters. Temporar
4g. List the total estimated linearfeet of all existing streams on the property: impacts include a dam, sediment trap and stream crossing (Timber Mat)."
(intermittent and perennial)
90
4h. Explain the purpose of the proposed project:"
Develop the existing vacant parcel into a subdivision with 102 Lots with associated driveway, roadways
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be „�_J: *
The site will be cleared, grubbed and graded where needed to install the designed features of the subdivision. Excavators, bulldozers, other work trucks and asphalt paving machines will
be used.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?"
Yes No
Comments:
Wetland delineation performed by Terracon Consultants, Inc.
5b. If the Corps made a jurisdictional determination, what type of determination was made?"
O Preliminary O Approved O Not Verified O Unknown O N/A
Corps AID Number:
Example: SAW-2017-99999
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Jeff Harbour, PWS
Agency/Consultant Company: Terracon Consultants, Inc.
Other:
6. Future Project Plans
6a. Is this a phased project?"
O Yes O No
6b. If yes, explain.
Phase 1 will consist of the 71 lots before the stream crossing. Phase 2 will consist of 31 lots located after the stream crossing.
O Unknown
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 projector 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.
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
Wetlands 2 Streams -tributaries Buffers
Open Waters O 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".
2a1 Reason"(')
2b. Impact type" M
2c. Type of W.*
2d. W. name"
2e. Forested" ��2f.
Type of Jurisdicitio
M
2g. Impact
area"
Culvert Crossing
P
FItomland Hardwood Forest
W1
Yes
Corps
(acres)
::::]
2g. Total Temporary Wetland Impact
0.0007 Acres
2g. Total Permanent Wetland Impact
0.071 Acres
0.071

2g. Total Wetland Impact
0.077
2i. 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".
F I
3a. Reason for im pact" (?)
3b.lmpact type"
3c. Type of impact"
3d. S. name"
3e. Stream Type"
(?)
3f. Type of
Jurisdiction"
3g. S. width"
3h. Impact
length"
S1
Road Crossing
Permanent
Culvert
S1
Perennial
Corps
tAve.ge(feet)
(linear feet)
** All Perennial or Intermittent streams must be verified by DWR or delegated local government.
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
-88 93 LF
3i. Total temporary stream impacts:
15 LF
3i. Total stream and ditch impacts:
_48-
3j. Comments:
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 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"
Allowable
P
Tributary of Mocassin Creek
No
�(,quare
(square feet)
6h. Total buffer impacts:
Zone 1
Total Temporary impacts: -"Bo--- 30 Sf
Total Permanent impacts:
Total combined buffer impacts:
6i. Comments:
Zone 1
3 6,448 sf
Zone 1
33680 6,478 sf
E. Impact Justification and Mitigation
1. Avoidance and Minimization
Zone 2
0.00
Zone 2
3,355.00
Zone 2
3,355.00
3,382 3,066
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:"
We are crossing the stream at a 90 degree angle with NCDOT wing walls to minimize our impact on the stream, associated buffers and wetlands.

1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:"
The proposed project will utilize the latest Erosion Control measures to ensure that there are no unnecessary impacts downstream of the stream
crossing. Silt fence will be located at the toe of the fill slope to delineate the limits of disturbance and to keep sediment from crossing the property line
heading downstream.
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?
O Yes No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
NC Stream Temperature Classification Maps can be found under the Mitigation Concepts tab on the Wilmington District's RIBITS website.
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
1a. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection Rules?
• Yes O No
v
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 NC Stormwater Design Manual. Associated supplement forms and other documentation shall be
provided.
What type of SCM are you providing?
❑ Level Spreader
OO Vegetated Conveyance (lower SHWT)
O Wetland Swale (higher SHVVT)
O Other SCM that removes minimum 30% nitrogen
OO 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?"
V Yes OO No
2b. Does this project meet the requirements for low density projects as defined in 15A NCAC 02H .1003(2)?"
-- Yes — No
To look up low density requirement click here 15A NCAC 02H .1003(2).
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 O 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 (based on past and reasonably anticipated future impacts) result in additional development, which could impact nearby downstream water quality?"
Yes No
v
4. Sewage Disposal (DWR Requirement)

4a. Is sewage disposal required by DWR for this project?"
vYes ci-)NovN/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
5d. Is another Federal agency involved?"
O Yes No
5e. Is this a DOT project located within Division's 1-8?"
0Yes ONo
5f. Will you cut any trees in order to conduct the work in waters of the U.S.?"
OYes 0No
5g. Does this project involve bridge maintenance or removal?"
0Yes ONo
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 construction/installation of a wind turbine(s)?*"
0Yes C•-)No
Unknown
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?"
https://ipac. ecosphere.fvvs. gov/location/0 U70OR3DAREN51 NTCO UGQQ N4H M/resources
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?"
Yes O No
Are there submerged aquatic vegetation (SAV) around the project vicinity?"
O Yes
No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?"
https://ipac. ecosphere.fvvs. gov/location/0 U70OR3DAREN51 NTCO UGQQ N4H M/resources
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
Linkto the State Historic Preservation Office Historic Properties Map (does not include archaeological data: http://gis.ncdcr.gov/hpoweb/
Unknown
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)?"
O Yes O No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?"
https://nc. maps. arcg is. com/apps/webappv iewer/index. html?id=79ea671 ebdcc45639fO860257d5f5ed7
8. Flood Zone Designation (Corps Requirement)
Link to the FEMA Floodplain Maps: https:Hmsc.fema.gov/portal/search
8a. Will this project occur in a FEMA-designated 100-yearfloodplain?"
Yes No
8c. What source(s) did you use to make the flood plain determination?"
https://msc.fema.gov/portal/search?AddressQuery=middlesex / 2C / 20nc#searchresultsanchor
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
9-12-22 Choplin Farms.pdf
Choplin Property -Terracon Investigation.pdf
File must be PDF or KMZ
Signature
By checking the box and signing below, I certify that:
23.94MB
7.14MB
• 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.
• have given true, accurate, and complete information on this form;
• 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:"
Ethan Averette
Signature"
Date
9/13/2022
C^U