20230447 Ver 1_ePCN Application_20230323

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
Initial Review
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:
2/20/2023
BIMS # Assigned
20230447
Is a payment required for this project?*
No payment required
Fee received
Fee needed - send electronic notification
Select Project Reviewer*
Robert Tankard:[e-mail]
Information for Initial Review
la. Name of project:
COURTESY COPY Conrad - Lynch Residence
1a. Who is the Primary Contact?*
Doug Dorman
1b. Primary Contact Email: *
[e-mail]
Date Submitted
3/23/2023
Nearest Body of Water
Atlantic Ocean
Basin
Pasquotank
Water Classification
SA
Site Coordinates
Latitude:
36.329089
A. Processing Information
Is this project connected with ARPA funding?
Yes No
County (or Counties) where the project is located:
Currituck
Is this a NCDMS Project
Yes No
Longitude:
-75.811851
Version#*
1
Reviewing Office*
Washington Regional Office - [phone]
1c. Primary Contact Phone: *
[phone]
a
Is this project a public transportation project?*
Yes No

1a.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
1b. What type(s) of permits) do you wish to seek authorization?
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: 18 - Minor Discharges
NWP Numbers (for multiple NWPS):
1d. 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:
401 Water Quality Certification - Express
Riparian Buffer Authorization
1f. Is this an after -the -fact permit application? *
Yes No
fig. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
Yes No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
Yes No
1h. Is the project located in any of NC's twenty coastal counties?
Yes No
1i. Is the project located within a INC DCM Area of Environmental Concern (AEC)?
Yes No Unknown
1j. Is the project located in a designated trout watershed?
Yes No
B. Applicant Information
1d. 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. Nari on recorded deed:
Chris Conrad & Chrystie Lynch
2b. Deed book and page no.:
1700/233
2c. Contact Person:
2d. Address
Street Address
4745 Ludwell Branch Court
Address Line 2
City
Raleigh
Postal / Zip Code
27612
State / Province / Region
NC
Country
USA
Yes No
Yes No

2e. Telephone Number:
[phone]
2g. Email Address:"
[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
Doug Dorman
3b. Business Name:
Atlantic Environmental Consultants, LLC
3c.Address
Street Address
PO Box 3266
Address Line 2
City
Kitty Hawk
Postal / Zip Code
27949
3d. Telephone Number:
[phone]
3f. Email Address:
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Doug Dorman
4b. Business Name:
Atlantic Environmental Consultants, LLC
4c.Address
Street Address
PO Box 3266
Address Line 2
city
Kitty Hawk
Postal / Zip Code
27949
4d. Telephone Number:
[phone]
4f. Email Address:"
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(if appropriate)
Whalehead Club
1c. Nearest municipality / town:
Corolla
2. Project Identification
2f. Fax Number:
State / Province / Region
NC
Country
USA
3e. Fax Number:
State / Province / Region
NC
Country
USA
4e. Fax Number:
2a. Property Identification Number: 2b. Property size:
115A00000160014 0.46

2c. Project Address
Street Address
806 Lighthouse Drive
Address Line 2
City
State / Province / Region
Corolla
NC
Postal / Zip Code
Country
27927
USA
3. Surface Waters
3a. Name of the nearest body of water to proposed project:
Atlantic Ocean
3b. Water Resources Classification of nearest receiving water:
SA
3c. What river basin(s) is your project located in?*
Pasquotank
3d. Please provide the 12-digit HUC in which the project is located.
030102051305
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 property is an undeveloped residential lot in the Whalehead Club subdivision. Properties in the vicinity are residential.
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:
0.075 acres
4g. List the total estimated linear feet of all existing streams on the property:
0
4h. Explain the purpose of the proposed project:"
The purpose of the project is to develop the property with a single family residence. The proposed development of the property will impacts 3,411 square feet (0.075 acres) of wetlands.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used: *
The property will be developed with a single family residence that will impact 0.075 acres of wetlands. The smaller wetland area in the center will be completely filled. The lager wetland
area in the back will be used as a stormwater retention area with a perimeter berm that will remain as a permanent impact but the inside of the basin will remain as wetlands. For the
purposed of this application we are showing the entire 0.075 ares of wetlands as impacted. Equipment used for the project to include a backhoe, small tractor and dump truck.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
Yes No
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made?
Preliminary Approved Not Verified Unknown N/A
Corps AID Number:
No Action ID number issued yet.
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Doug Dorman
Agency/Consultant Company: Atlantic Environmental Consultants, LLC
Other:
O Unknown
5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
Delineated on March 16, 2023 but has not been verified by the Corps yet.
6. Future Project Plans
Ga. 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
0
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
Wetlands Streams -tributaries Buffers
Open Waters Pond Construction
2. Wetland Impacts
2a1 Reason (?)
2b. Impact type* (?)
2c. Type of W.*
2d. W. name
2e. Forested"
2f. Type of Jurisdicition*
?)
2g. Impact
area
Residence
P
Small -Basin Wetland
Conrad
No
Corps
0.075
(acres)
2g. Total Temporary Wetland Impact
0.000
2g. Total Wetland Impact
0.075
21. Comments:
E. Impact Justification and Mitigation
1. Avoidance and Minimization
2g. Total Permanent Wetland Impact
0.075
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
The development of the property has been designed with the house, parking and septic system as close to the front of the property as possible to try and
avoid and minimize wetland impacts. The stormwater retention area required by Currituck County is designed with a perimeter berm and unfilled area in
the center. The wetland area will be impacted by the creation of the retention area but a majority of the area will remain as wetlands.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
The stormwater retention area in the back of the property will be constructed with a perimeter berm and swales along the north and south sides of the
property will be directed to the retention basin. The construction of the berms and basin will impact the wetlands but the basin should revert back to its
natural state and remain as a wetland area.
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):
D W R 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:
Hidden Lake Mitigation Bank
3b. Credits Purchased/Requested (attach receipt and letter)
Type: Quantity:
Non -riparian wetland 0.15 acres
3c. Comments
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
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
Q
V
If no, explain why:
Buffer Rules do not apply to this area.

2. Stormwater Management Plan
2a. Is this a NC DOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250? *
Yes No
Comments:
G. Supplementary Information
1. Environmental Documentation
1a. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federallstate) 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 result in additional development, which could impact nearby downstream water quality?
Yes No
3b. If you answered "no," provide a short narrative description.
All storwater runoff to be kept on site and directed to stormwater retention areas on the property.
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 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
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?
US Fish & Wildlife Service. IPaC ( Information for Planning and Consultation).
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?
Wetland areas on the property do 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 status?"
Yes No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources? *
Environmental review with NC State Historical Preservation Office pending. Submitted environmental review on 03/23/23 and response will be forwarded
when received.
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:
All construction will be built to meet current FEMA elevation requirements.
8c. What source(s) did you use to make the floodplain determination?"
Recent survey information and Currituck County flood maps.
Miscellaneous U
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
Conrad Site Plan.pdf
6MB
Conrad -Lynch Signed Agent Authorization.pdf
115.57KB
Conrad GIS Map.pdf
1.83MB
Conrad NWI Map.pdf
2.09MB
Conrad PJD Request Form.pdf
224.23KB
Conrad Soils Map.pdf
2.03MB
Conrad Topo Map.pdf
1.56MB
Conrad Wetland Survey.pdf
508.91KB
Conrad - Lynch Data Sheet Up.pdf
143.77KB
Conrad - Lynch Data Sheet Wet.pdf
144.31 KB
File must be PDF or KMZ
Comments
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:
Doug Dorman
Signature
061�0Ot,wmw
Date
3/23/2023
O