20230447 Ver 1_Conrad Rev PCN_20230330

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.govfWaterResources/0/edoc/624704/PCN / 2OHelp/ 20File/ 202018-1-30.pdf
A. Processing Information O
Pre -Filing Meeting Date Request was submitted on:
2/20/2023
If this is a courtesy copy, please fill in this with the submission date.
Is this project connected with ARPA funding?"
O Yes No
County (or Counties) where the project is located:"
Currituck
Is this a NCDMS Project"
O Yes OQ No
Click Yes, only if NCD MS is the applicant or co -applicant.
DO NOT CHECK YES, UNLESS YOU ARE DMS OR CO -APPLICANT
Is this project a public transportation project?"
Q Yes OQ 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:"
0 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?"
Q Yes
OQ No
1 b. What type(s) of permit(s) do you wish to seek authorization?"
Q 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):
List all NW 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
0 401 Water Quality Certification - Regular ❑ 401 Water Quality Certification - Express
❑ Non-404 Jurisdictional General Permit ❑ Riparian Buffer Authorization
❑ 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: OQ Yes 0 No

For the record only for Corps Permit: O Yes QQ No
1f. Is this an after -the -fact permit application?"
Q 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.
QQ Yes Q No
Acceptance Letter Attachment
Click the upload button or drag and drop files hereto attach document
Conrad Mitigation Acceptance Letter.pdf 118.3KB
FILE TYPE MUST BE PDF
1 h. Is the project located in any of NC's twenty coastal counties?"
Yes No
1 i. Is the project located within a NC DCM Area of Environmental Concern (AEC)?"
Yes No Q Unknown
1j. Is the project located in a designated trout watershed?"
Q Yes QQ No
Linkto trout information: http://vvww.saw.usace.army.miI/Missions/Regulatory-Permit-Program/Agency-Coordination/Trout.aspx
B. Applicant Information
la. Who is the Primary Contact?"
Doug Dorman
1c. Primary Contact Phone:"
1 b. Primary Contact Email" (xxx)xxx-xxxx
[e-mail] [phone]
1d. Who is applying for the permit?"
G Owner Applicant (other than owner)
(Check all that apply)
1e. Is there an AgentlConsultant for this project?"
C Yes No
2. Owner Information
2a. Name(s) on recorded deed:"
Chris Conrad & Chrystie Lynch
2b. Deed book and page no.:
1700/233
2c. Contact Person:
(for Corporations)
2d.Address*
Street Address
4745 Ludwell Branch Court
Address Line 2
City State / Province / Region
Raleigh NC
Postal /Zip Code Country
27612 USA
2e. Telephone Number:"
(xxx)xxx-xxxx
[phone]
2f. Fax Number:
2g. Email Address:"
[e-mail]
3. Applicant Information (if different from owner)
3a. Name:"
Doug Dorman
u

3b. Business Name:
(if applicable)
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:
(if applicable)
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
1a. Name of project:"
Conrad - Lynch Residence
1b. Subdivision name:
(if appropriate)
Whalehead Club
1c. Nearest municipality/town:"
Corolla
2. Project Identification
State / Province / Region
NC
Country
USA
3e. Fax Number:
(xxx)xxx-xxxx
State / Province / Region
NC
Country
USA
4e. Fax Number:
(xxx)xxx-xxxx
2a. Property Identification Number:
2b. Property size:
(tax PIN or parcel ID)
(in acres)
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
U
LJ
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: "
36.329089-75.811851
ex: 34.208504-77.796371
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
Surface Water Lookup
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
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 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?"
O Yes OO No O 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:
(intermittent and perennial)
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 impact 1,678 square feet (0.04 acres) of wetlands.
4i. 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 0.04 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 (1,733 sq.
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 O Unknown
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made?"
* Preliminary O Approved O Not Verified O Unknown O N/A
Corps AID Number:
Example: SAW-2017-99999
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:
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

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 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):
IS Wetlands ❑ Streams -tributaries Buffers
r- Open Waters ❑ 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".
V
2a1 Reason"(?)
2b. Impact type" (?)
pe of W.*
r�y
2d. W. name"
2e. Forested"
2f. Type of Jurisdicitio
(?)
2g. Impact
area*
=
Residence I
Small-Basin Wetland
Conrad
No
Corps
0.04
(acres)
2g. Total Temporary Wetland Impact
0.000
2g. Total Permanent Wetland Impact
0.04
2g. Total Wetland Impact
0.04
2i. Comments:
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:"
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 (1,733 sf) will remain as wetlands. The total
wetland impacts for the project are 1,678 sf (0.04 acres).
1 b. 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 remaining wetlands will not be
impacted.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. ,ges the project require Compensatory Mitrat�" for impacts to Waters of the U.S. or Waters of the State?
2c. If yes, mitigation is required by (check all that apply):
❑ DWR M Corps
2d. If yes, which mitigation option(s) will be used forthis 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 0.08 acres
3c. Comments

NC Stream Temperature Classification Maps can be found under the Mitigation Concepts tab on the Wilmington Districts 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 OQ No
For a list of options to meet the diffuse flow requirements, click here.
If no, explain why:
Buffer Rules do not apply to this area.
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?"
OO Yes O 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 (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.
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?"
O Yes n 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 i No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?"
OQ Yes O No
5c. If yes, indicate the USFWS Field Office you have contacted.
Raleigh
5d. Is another Federal agency involved?"
O Yes No Unknown
5e. Is this a DOT project located within Division's 1-8?"
v Yes No
5f. Will you cut any trees in order to conduct the work in waters of the U.S.?"
O Yes OQ No
5g. Does this project involve bridge maintenance or removal?"
0 Yes OQ No
O
v

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)?*"
O Yes OQ 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.?"
O Yes OO 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 OQ 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)
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 whetheryour site would impact historic or archeological resources?"
Environmental reviewwith 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)
Link to the FEMA Floodplain Maps: https:Hmsc.fema.gov/portal/search
8a. Will this project occur in a FEMA-designated 100-yearfloodplain?"
U Yes U No
8b. Ifyes, 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
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
Conrad Revised Site Plan.pdf
6MB
Conrad -Lynch Signed Agent Authorization. pdf
115.57KB
Conrad GIS Map.pdf
1.83MB
Conrad NW 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
Signature 0
0 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.
• 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"),

• understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature, AND
• intend to electronically sign and submit the PCN form.
Full Name:"
Doug Dorman
Signature"
T%BUl� T &141 C,{1i
Date
3/30/2023