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HomeMy WebLinkAbout20210371 Ver 2_401 Application_20221221 (2)DWR Division 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.gov/WaterResources/0/edoc/624704/PCN % 20Help % 20File % 202018-1-30.pdf A. Processing Information Pre -Filing Meeting Date Request was submitted on: * 9/26/2022 If this is a courtesy copy, please fill in this with the submission date. County (or Counties) where the project is located:* Wake Is this a NCDMS Project* Yes No Click Yes, only if NCDMS is the applicant or co -applicant. Is this project a public transportation project?* Yes 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:* 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: 29 - Residential Developments Nationwide Permit (NWP) Number: 18 - Minor Discharges NWP Numbers (for multiple NWPS): List all NW numbers you are applying for not on the drop down list. Id. Type(s) of approval sought from the DWR: * check all that apply 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? 401 Water Quality Certification - Express Riparian Buffer Authorization For the record only for DWR 401 Certification: Yes No For the record only for Corps Permit: Yes No 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? If so, attach the acceptance letter from mitigation bank or in -lieu fee program. • Yes No Acceptance Letter Attachment Click the upload button or drag and drop files here to attach document Fairway Crossing SD - Buffer SOA 12-14-22.pdf Fairway Crossing Subdivision Wetland SOA 12-14-22.pdf 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?* Yes No 260.44KB 582.05KB Link to trout information: http://www.saw.usace.army.mil/Missions/Regulatory-Permit-Program/Agency-Coordination/Trout.aspx B. Applicant Information la. Who is the Primary Contact?* Sean Clark 1 b. Primary Contact Email:* sclark@sageecological.com Id. Who is applying for the permit?* Owner (Check all that apply) le. Is there an Agent/Consultant for this project? * Yes No 2. Owner Information 2a. Name(s) on recorded deed: * Leoterra Wendell Development, LLC 2b. Deed book and page no.: DB: 19030 / DP: 2370 2c. Contact Person: (for Corporations) Christopher Lyons 2d. Address* Street Address 110 Shields Park Drive Address Line 2 Suite A City Kernersville Postal / Zip Code 27284 2e. Telephone Number: * (xxx)xxx-xxxx (336)682-1414 2f. Fax Number: (xxx)xxx-xxxx 2g. Email Address: * kat.lyons@leoterradevelopment.com 4. Agent/Consultant (if applicable) 4a. Name:* Kim Hamlin 4b. Business Name: (if applicable) Sage Ecological Services, Inc. 1 c. Primary Contact Phone: * (xxx)xxx-xxxx (919)559-1537 Applicant (other than owner) State I Province / Region NC Country USA 4c. Address * Street Address 3707 Swift Drive Address Line 2 City Raleigh Postal / Zip Code 27606 4d. Telephone Number: * (919)622-7888 (xxx)xxx-xxxx 4f. Email Address: * khamlin@sageecological.com C. Project Information and Prior Project History State / Province / Region NC Country USA 4e. Fax Number: (mx)mx-xxxx 1. Project Information 1 a. Name of project: * Jake May Drive Property 1b. Subdivision name: (if appropriate) Fairway Crossing Subdivsion lc. Nearest municipality / town:* Wendell 2. Project Identification 2a. Property Identification Number: 2b. Property size: (tax PIN or parcel ID) (in acres) 1773968771 32.58 2c. Project Address Street Address 0 Jake May Drive Address Line 2 City Wendell Postal / Zip Code 27591 2d. Site coordinates in decimal degrees State / Province / Region NC Country USA 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:* 35.7729 ex: 34.208504 3. Surface Waters 3a. Name of the nearest body of water to proposed project: * Buffalo Creek -78.3936 -77.796371 3b. Water Resources Classification of nearest receiving water: * C;NSW 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.* 030202011502 River Basin Lookup 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 Site consists of a combination of agriculture and undeveloped wooded land. A small homesite is adjacent to Wendell Falls Parkway. No other structures are currently present on the Site. Land use in the vicinity includes rural residences, agriculture, timber land, and undeveloped, forested land 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: 4.835 4g. List the total estimated linear feet of all existing streams on the property: (intermittent and perennial) 1615 4h. Explain the purpose of the proposed project: * The Project includes the construction of a residential subdivision to meet the demand for housing in this area. 4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used: * The proposed project includes the construction of a residential subdivision with associated roads, utilities, and associated attendant features. Access to the site will be provided by a connection to Jake May Drive along the eastern boundary. The Project will tie into existing water and wastewater infrastructure adjacent to the Site. Heavy equipment typically used for utility installation projects (e.g., backhoes, bulldozers, etc.) will be utilized. 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: Example: SAW-2017-99999 SAW-2021-00385 5c. If 5a is yes, who delineated the jurisdictional areas? Name (if known): Agency/Consultant Company: Other: 6. Future Project Plans 6a. Is this a phased project?* David Gainey, Kim Hamlin Sage Ecological Services, Inc. (Sage) 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? This includes other separate and distant crossing for linear projects that require Department of the Army authorization but don't require pre -construction notification. no D. Proposed Impacts Inventory 1. Impacts Summary la. Where are the impacts associated with your project? (check all that apply): Wetlands Open Waters Streams -tributaries 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". Buffers u 2a. Site #* (?) 2a1 Reason * (?) 2b. Impact type* (?) 2c. Type of W.* 2d. W. name* 2e. Forested * 2f. Type of Jurisdicition * (?) 2g. Impact area* A Road crossing P Headwater Forest WG-2 Yes Corps 0.002 (acres) A Road crossing P Headwater Forest WH Yes Corps 0.027 (acres) A Greenway P Headwater Forest WH Yes Corps 0.005 (acres) D Roadway P Headwater Forest WA Yes Corps 0.013 (acres) F Road crossing P Headwater Forest WA Yes Corps 0.139 (acres) G SCM P Headwater Forest WA Yes Corps 0.008 (acres) G Roadway P Headwater Forest WA Yes Corps 0.003 (acres) G Roadway P Headwater Forest WA Yes Corps 0.167 (acres) G Roadway P Headwater Forest WE Yes Corps 0.012 (acres) H Road crossing P Headwater Forest WF-1 Yes Corps 0.063 (acres) F Road crossing T Headwater Forest WA Yes Corps 0.006 (acres) 2g. Total Temporary Wetland Impact 0.006 2g. Total Permanent Wetland Impact 0.439 2g. Total Wetland Impact 0.445 2i. Comments: Total proposed permanent wetland impacts = 0.439 acre (19,130 sf) of which, 0.008 ac (350 sf) are proposed under NWP 18 to construct an SCM to provide stormwater treatment for the development. Proposed temporary wetland impacts total 0.006 acre for culvert installation. Proposed impacts are the result of road crossings to access the upland portions of the Site and greenway trails required by the municipality. For the proposed culverts at Crossings A & D, the culvert pipes are not buried but rather placed at natural elevation to prevent a draining effect on the unimpacted wetlands surrounding the crossing. For the proposed culvert at Crossing F, the pipe is placed at elevation because directly upstream is a pond and therefore, aquatic life passage isn't a concem. Also, this will prevent a draining effect on the unimpacted wetlands surrounding the crossing. 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". 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 A - Roadway Crossing Permanent Culvert SG Intermittent Corps 2 Average (feet) 31 (linear feet) S2 F - Roadway Crossing Permanent Culvert SA Perennial Corps 6 Average (feet) 91 (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: 122 3i. Total temporary stream impacts: 0 3i. Total stream and ditch impacts: 122 3j. Comments: Total proposed permanent stream impacts total 122 LF (641 SF / 0.015 ac) for two road crossings to access the upland portions of the Site. 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* A - Road crossing - Allowable Upon Authorization P SG No 3,317 (square feet) 3,293 (square feet) A - Greenway - Allowable Upon Authorization P SG & SH No 3,303 (square feet) 3,918 (square feet) A - Grading - Deemed Allowable P SH No 0 (square feet) 561 (square feet) A - Grading - Deemed Allowable P SG No 0 (square feet) 72 (square feet) B - Greenway - Allowable Upon Authorization P Pond 1 No 0 (square feet) 2,570 (square feet) C - Greenway - Allowable Upon Authorization P Pond 1 No 4,643 (square feet) 7,736 (square feet) E - Greenway - Allowable Upon Authorization P Pond 1 No 6,677 (square feet) 7,292 (square feet) F - Road crossing - Allowable Upon Authorization P SA No 7,504 (square feet) 5,425 (square feet) F - Grading - Deemed Allowable P SA No 0 (square feet) 2,194 (square feet) G - Grading - Deemed Allowable P SE No 0 (square feet) 3,356 (square feet) G - Grading - Deemed Allowable P SE No 0 (square feet) 611 (square feet) G - Roadway fill - Allowable with Mitigation P SE Yes 0 (square feet) 202 (square feet) 6h. Total buffer impacts: Total Temporary impacts: Total Permanent impacts: Total combined buffer impacts: 6i. Comments: Zone 1 000 Zone 1 25,444.00 Zone 1 Zone 2 0.00 Zone 2 37,230.00 Zone 2 25,444.00 37,230.00 Proposed permanent Zone 1 buffer impacts due to perpendicular road crossings total 10,821 SF (0.25 ac.). Proposed permanent Zone 2 buffer impacts due to perpendicular road crossings total 8,718 SF (0.2 ac.). All perpendicular road crossings propose to impact less than 1/3-acre per crossing. Nonperpendicular, permanent impacts due to road fill total 202 SF and will require mitigation. Proposed permanent Zone 1 buffer impacts due to greenway construction totals 14,623 SF (0.34 ac.). Proposed permanent Zone 2 buffer impacts due to greenway construction totals 21,516 SF (0.49 ac.). Proposed greenway trails will be 10-feet wide with a mulch surface. A boardwalk is proposed to span wetland WG-1 and will utilize top -down construction. Proposed permanent Zone 2 buffer impacts due to grading for lot fill total 6,794 SF (0.16 ac.). 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: * A wetland, stream, and riparian buffer delineation was performed to identify sensitive areas prior to site design. Proposed road crossings are aligned to cross the channel as perpendicularly as possible and to minimize impacts to wetlands, streams, and riparian buffers. Streams are not crossed multiple times by roads. Lots were positioned to avoid fill in wetlands, streams and buffers. Stormwater outfalls were designed to minimize impacts to riparian areas. Construction fencing will be used to define the construction corridor and prevent any accidental additional impacts. Silt fencing will be installed to provide additional protection from stormwater runoff. 1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques: * General techniques include the use of construction fencing to define the construction corridor and prevent any accidental additional impacts. Equipment will be parked and cleaned in uplands away from jurisdictional areas. Work within jurisdictional areas will be conducted during periods when dry weather is predicted, and large bare areas of soil will be reseeded and protected as soon as practicable. Silt fencing and sediment basins will also be used to prevent sediment runoff into the stream and wetland areas. 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: Falling Creek Umbrella Mitigation Bank 3b. Credits Purchased/Requested (attach receipt and letter) Type: Riparian wetland Quantity: 0.88 3c. Comments Permanent wetland impacts total 0.439 acre and non -perpendicular, permanent riparian buffer impacts due to road fill total 202 SF which will require compensatory mitigation. The purchase of 0.88 acre of wetland credits and 303 SF of riparian buffer credits from the Falling Creek Umbrella Mitigation Bank and other Wildlands banks is proposed. The Statements of Availability are attached with this application. NC Stream Temperature Classification Maps can be found under the Mitigation Concepts tab on the Wilmington District's RIBITS website. 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 to each zone of the riparian buffer that requires mitigation calculate the amount of mitigation required in the table below. Zone 1 6c. Reason for impact 6d. Total impact (square feet) 0 Multiplier 6e. Required mitigation (square feet) 0 Zone 2 Non -perpendicular road fill 6f. Total buffer mitigation required 303 202 1.5 6g. If buffer mitigation is required, is payment to a mitigation bank or NC Division of Mitigation Services proposed? Yes No 303 6j. Comments: The purchase of 303 SF of riparian buffer credits from the Falling Creek Umbrella Mitigation Bank and other Wildlands banks is proposed. The Statement of Availability is attached with this application. 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 No 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 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 (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? * Yes 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). 2c. Does this project have a stormwater management plan (SMP) reviewed and approved under a state stormwater program or state -approved local government stormwater program? * Yes No N/A - project disturbs < 1 acre Hint: projects that have vested rights, exemptions, or grandfathering from state or locally implemented stormwater programs or projects that satisfy state or locally -implemented stormwater programs through use of community in -lieu programs should answer no to this question. 2d. Which of the following stormwater management program(s) apply (check all that apply): * Local Government State If you have a local government approval please include the SMP on their overall impact map. Local Government Stormwater Programs* Phase II NSW USMP Water Supply Please identify which local government stormwater program you are using.* Town of Wendell Comments: The stormwater management plan will be reviewed and approved by the locally delegated authority. The applicant requests the 401 Certification approval be conditioned to require the stormwater management plan be approved before any impacts may be conducted. 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 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 3b. If you answered "no," provide a short narrative description. Per the NC DWQ April 2004 Version 2.1 Cumulative Impacts policy, small scale residential development projects have a "low potential for cumulative impact" since the project already in a developed landscape (i.e., existing residences and development in the vicinity) and the area already contains the necessary infrastructure (i.e., sewer, water, electricity, etc.). The project drains to Buffalo Creek, which is Class C; Nutrient Sensitive Waters (NSW), (i.e., not HQW or ORW). We anticipate the NCDWR will advise us if a qualitative or quantitative analysis is needed. 4. Sewage Disposal (DWR Requirement) 4a. Is sewage disposal required by DWR for this project?* Yes No N/A 4b. Describe, in detail, the treatment methods and dispositions (non -discharge or discharge) of wastewater generated from the proposed project. If the wastewater will be treated at a treatment plant, list the capacity available at that plant. 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?* 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 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)?* * 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? * No federally threatened or endangered species are listed to occur on the Site according to the NC Natural Heritage Program (NCNHP) Database. (see attached report dated November 18, 2022). Habitat for red -cockaded woodpecker is not present on the Site; the understory is too dense for foraging and potential cavity trees are not present. Project waters flow through multiple farm ponds/dams before reaching Buffalo Creek (including the on -site pond) creating an impediment for Carolina madtom, Atlantic pigtoe, dwarf wedgemussel, Tar River spinymussel, and yellow lance. Project waters do not provide suitable habitat for Neuse River waterdog as they are small first order streams with slow velocity and substrates dominated by silt and sand. Soils on the site range from slightly acidic to very strongly acidic which are not preferred by Michaux's sumac. 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 Essential Fish Habitat Mapper The proposed Project is located in Wake County which does not include any Essential Fish Habitat. 7. Historic or Prehistoric Cultural Resources (Corps Requirement) Link to the State Historic Preservation Office Historic Properties Map (does not include archaeological data: http://gis.ncdcr.gov/hpoweb/ 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)? * Yes No 7b. What data sources did you use to determine whether your site would impact historic or archeological resources? * The Site is not listed as a historic property or within a historic district. Twenty-two properties and one historic district are listed within 1.0 mile of the Site based on a query of the GIS files from NCSHPO. Eighteen properties and one Blockface area of houses are designated "Surveyed Only (SO)" and two properties are designated as "SO -Gone." One "Study List (SL) property (J. R. Nowell House: WA2160) is approximately 1.0-mile northeast of the Site along Wendell Falls Parkway. The J.R. Nowell House is within a Study List Historic Boundary. 8. Flood Zone Designation (Corps Requirement) Link to the FEMA Floodplain Maps: https://msc.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 floodplain determination? * 3720178300L effective on 07/19/2022 3720177300K effective on 07/19/2022 Miscellaneous Comments Attachments: Agent Authorization Form Figure 1 — USGS Site Vicinity Map Figure 2 — Soil Survey Site Vicinity Map Figure 3 — PJD Sketch Map Figure 4 — NCSHPO Map NCNHP Database Report USFWS IPaC Resource List USACE SAW-2021-00385 Concurrence email NCDWR Buffer Determination Letter (NBRRO #21-050) Impact Maps Fairway Crossing Wetland Credit SOA — Wildlands Fairway Crossing Riparian Buffer Credit SOA - Wildlands Notice of Intent to File Permit Application email 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 SAW-2021-00801 - NWP 29 -NWP 18 Permit Application - Jake May Drive Property 12-21-2022.pdf 5.12MB File must be PDF or KMZ 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: * Kimberly Hamlin Signature* Date 12/21/2022