20230608 Ver 1_ePCN Application_20230426

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:
3/21/2023
BIMS # Assigned
20230608
Is a payment required for this project?*
No payment required
Fee received
Fee needed - send electronic notification
Select Project Reviewer*
Zachary Thomas:[e-mail]
Information for Initial Review
la. Name of project:
COURTESY COPY Chavis Street Soccer Fields
1a. Who is the Primary Contact?*
Kevin Martin
1b. Primary Contact Email: *
[e-mail]
Date Submitted
4/26/2023
Nearest Body of Water
Franklinton Branch
Basin
Tar -Pamlico
Water Classification
C;NSW
Site Coordinates
Latitude:
36.099849
A. Processing Information
Is this project connected with ARPA funding?
Yes No
County (or Counties) where the project is located:
Franklin
Is this a NCDMS Project
Yes No
Longitude:
-78.446784
Version#*
1
Reviewing Office`
Raleigh Regional Office - [phone]
1c. Primary Contact Phone: *
[phone]
O
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: 42 - Recreation Facility
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
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: Yes No
For the record only for Corps Permit: Yes No
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
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. Nani on recorded deed:
Town of Franklinton
2b. Deed book and page no.:
Book:2297 Page:1655
2c. Contact Person:
G. Bethea
2d. Address
Street Address
101 N Main St
Address Line 2
City State / Province / Region
Franklinton NC
Postal / Zip Code Country
27525 USA

2e. Telephone Number: 2f. Fax Number:
[phone]
2g. Email Address:'
[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
Franklin -Wake Soccer Club, attn. Brain Gackstetter
3b. Business Name:
3c. Address
Street Address
2179 Hicks Road
Address Line 2
City
State / Province / Region
Youngsville
NC
Postal / Zip Code
Country
27596
USA
3d. Telephone Number: 3e. Fax Number:
[phone]
3f. Email Address:
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Kevin Martin
4b. Business Name:
Soil & Environmental Consultants, PA
4c.Address
Street Address
8412 Falls of Neuse Road
Address Line 2
Suite 104
City
State / Province / Region
Raleigh
NC
Postal / Zip Code
Country
27615
USA
4d. Telephone Number: 4e. Fax Number:
[phone] [phone]
4f. Email Address:
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality / town:
Franklinton
2. Project Identification
2a. Property Identification Number: 2b. Property size:
1865-35-5715 17.52
0

2c. Project Address
Street Address
0 Chavis St.
Address Line 2
City
Franklinton
Postal / Zip Code
27525
3. Surface Waters
3a. Name of the nearest body of water to proposed project:
Franklinton Branch
3b. Water Resources Classification of nearest receiving water:
C;NSW
3c. What river basin(s) is your project located in?*
Tar -Pamlico
3d. Please provide the 12-digit HUC in which the project is located.
030201010401
4. Project Description and History
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 project site is currently vacant, forested land. The project is surrounded on all sides by residential properties with a cemetery outside of the northwest corner.
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:
4g. List the total estimated linear feet of all existing streams on the property:
4h. Explain the purpose of the proposed project:*
The project purpose is to construct a recreational soccer facility.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:
Typical grading equipment will be used. The project is for construction of a recreational soccer field and asociate infrastructure.
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 Approved Not Verified Unknown N/A
Corps AID Number:
SAW-2021-02536
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Kevin Martin
Agency/Consultant Company: Soil & Environmental Consultants, PA
Other:
5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
Corps JD email SAW-2021-02536 1-6-2022
DWR buffer letter PBRRO # 21- 395, 12-29-2021
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?
All impacts will be performed during the first phase. Initially the wetland will be impacted for a stormwater basin but once that basin can be removed it will be filled for a soccer field.
D. Proposed Impacts Inventory O

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
W3
2a1 Reason (?)
Fill for soccer field
2b. Impact type" (?)
P
2c. Type of W. *
Headwater Forest
2d. W. name
W3
2e. Forested"
Yes
2f. Type of Jurisdicition *
(?)
Both
2g. Impact
area
0.033
(acres)
W4
Fill for soccer field 1p
Headwater Forest 7]W4
Yes
Both
0.035
(acres)
2g. Total Temporary Wetland Impact
0.000
2g. Total Wetland Impact
0.068
2i. Comments:
E. Impact Justification and Mitigation
1. Avoidance and Minimization
2g. Total Permanent Wetland Impact
0.068
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
All impacts to jurisdictional streams and buffers onsite have been avoided and impacts to wetlands have been limited to the least amount necessary.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Fills slopes were shortened on the southern end of the project to avoid the majority of wetland areas onsite. Fill slopes have been shortened at the north
east corner to avoid the stream and buffer even though grading and revegetation of Zone 2 of the buffer would have been deemed allowable as long as
Zone 2 was revegetated
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:
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
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
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:
See attached stormwater calculations and plans that were developed to meet the low density requirements.
O
G. Supplementary Information O

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
1b. If you answered "yes" to the above, does the project require preparation of an environmental document pursuant to the requirements of the National or State (North Carolina)
Environmental Policy Act (NEPA/SEPA)?*
Yes No
Comments: *
Impacts are below thresholds that would require a SEPA or NEPA
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 213.0201
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.
This project will not result in additional development.
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.
Onsite septic system(s) will be utilized.
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
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?
FWS iPAC & NHP databases, see attached
6. Essential Fish Habitat (Corps Requirement)
Ga. 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 EFH Mapper - Project is located in the Piedmont region of NC far from any EFH areas.
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?"
SHPO 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?"
FEMA DFIRM
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
DWR prefile request conf email.pdf
707.66KB
Agent auth signed 2023.pdf
68.78KB
DWR buffer letter Chavis St. Soccer Fields.pdf
2.61 MB
Corps email conf of JD.pdf
51.2KB
PJD Sketch revised - Chavis St Soccer Fields - 12-29-2021.pdf
609.48KB
C3.0 SITE PLAN.pdf
2.63MB
2023-04-06 - Chavis Street Soccer Fields - STORMWATER MANAGEMENT REPORTpdf
1.93MB
C1.0 EXISTING CONDITIONS.pdf
690.42KB
IPaC_ Explore Location resources15018.pdf
633.61 KB
project _report _chavis_st_soccer _fiields_43844_43844.pdf
829.22KB
Property Report - no mention of structure.pdf
45.48KB
Impact Maps and swale locations C4.0 GRADING PLAN.pdf
1.45MB
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:
Kevin C. Martin
Signature
r/�r eQ/1221aw
Date
4/26/2023
L