20140719 Ver 2_401 Application_20150515

LETTER OF TRANSMITTAL
DATE May 19, 2015
To NCDENR -DWR- Raleigh
Attn Jennifer Burdette
512 N Salisbury St Raleigh, NC 27604
9th Floor, Archdale Bldg, Room 942G -1
FROM Chris Jain (for Hy Nguyen)
PROJECT Van Hanh Temple
DPR PROJECT # 10003
RE Updating PCN form
COPIES
DATE i NO
landscape architecture
=9V planning
evil engineering
WE ARE SENDING YOU THE FOLLOWING ITEMS
VIA UPS
DESCRIPTION
1 varies 11 -shts Van Hanh Temple Construction Documents (C -0 thru C -10)
3 5 -19 -2015 10 -pgs Revised Signed PCN Form
- - -- 5 -19 -2015 1 check Check No 14836 in the amount of $240 00 payable to NCDENR
THESE ARE TRANSMITTED
FORAPPROVAL FOR YOUR USE
FOR REVIEW/ COMMENT OTHER
REMARKS
Chris Jain (for Hy Nguyen)
hnguyen @dprassociates net
COPY TO
SIGNED
RECIEVED BY
DPR Associates, Inc. 1 420 Hawthome Land Chariotte, NC 282011 ph 704 332 1204 I fx 704 332 1210 1 www dprassoaates net

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7 �
P <
Office Use Only
Corps action ID no
DWQ project no
Form Version 1 4 January 2009
Page 1 of 10
PCN Form —Version 1 4 January 2009
Pre - Construction Notification (PCN) Form
A.
Applicant Information
1P
1
Processing
`i?v v
1 a
Type(s) of approval sought from the Corps
❑X Section 404 Permit ❑ Section 10 Permit
1 b Specify Nationwide Permit (NWP) number 12 or General Permit (GP) number
1c
Has the NWP or GP number been verified by the Corps?
❑X Yes
❑ No
1 d
Type(s) of approval sought from the DWQ (check all that apply)
❑X 401 Water Quality Certification — Regular ❑ Non -404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
1 e
Is this notification solely for the record
because written approval is not required?
For the record only for DWQ
401 Certification
❑ Yes ❑X No
For the record
❑ Yes
only for Corps Permit
❑X No
1f
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
❑X No
1 g
Is the project located in any of NC's twenty coastal counties If yes, answer 1 h
below
❑ Yes
❑X No
1h
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes
X❑ No
2
Project Information
2a
Name of project
Van Hanh Temple
2b
County
Wake
2c
Nearest municipality / town
Raleigh
2d
Subdivision name
N/A
µ
2e
NCDOT only, T I P or state project no
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3
Owner Information
3a
Name(s) on Recorded Deed
Van Hanh Temple
IIIAt 1 9 2015
3b
Deed Book and Page No
DB 7975 PG 514 & MB 1974, PG 100
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3c
Responsible Party (for LLC if
applicable)
Van Hanh Temple / North Carolina Buddhist Association
L 401 & 13UFL h �� (
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3d
Street address
4229 Forestville Road
3e
City, state, zip
Raleigh, NC 272616
3f
Telephone no
919 - 426 -4757
3g
Fax no
3h
Email address
dulenc @gmail com
Page 1 of 10
PCN Form —Version 1 4 January 2009

Or
4
Applicant Information (if different from owner)
4a
Applicant is
XD Agent ❑X Other, specify
4b
Name
Same as Above
4c
Business name
(if applicable)
4d
Street address
4e
City, state, zip
4f
Telephone no
4g
Fax no
4h
Email address
5
Agent/Consultant Information (if applicable)
5a
Name
Hy Nguyen, PE
5b
Business name
(if applicable)
DPR Associates, Inc
5c
Street address
420 Hawthorne Lane
5d
City, state, zip
Charlotte, NC 28204
5e
Telephone no
704 - 332 -1204
5f
Fax no
704- 332 -1210
5g
Email address
hnguyen @dprassocaites net
Page 2 of 10

B.
Project Information and Prior Project History
1
Property Identification
1a
Property identification no (tax PIN or parcel ID)
(ID 009544) PIN 1746 -49 -3709
1b
Site coordinates (in decimal degrees)
Latitude 35 864168 Longitude -78 513184
1c
Property size
4 895 acres
2
Surface Waters
2a
Name of nearest body of water to proposed project
Harris Creek (Peeples Creek) (Wake Crossroad Lake)
2b
Water Quality Classification of nearest receiving water
C, NSW
2c
River basin
NEUSE RIVER
3.
Project Description
3a 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 has an existing building and existing outdoor religious displays and gazeboos
3b
List the total estimated acreage of all existing wetlands on the property 1 03
3c
List the total estimated linear feet of all existing streams (intermittent and perennial) on the property 390
3d Explain the purpose of the proposed project
(3c Centerline of creek is property line per Map book 1974, pg 100, but surveyed boundary is not the same) Proposed new building
parking lot Proposed 8" gravity sewer to serve new building needs to aerial -cross the stream to tie into existing sewers stem
3e
The
Describe the overall project in detail, including the type of equipment to be used
proposed gravity sewer will be aerial crossing with concrete piers
4
Jurisdictional Determinations
4a
Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past?
❑X Yes ❑ No ❑ Unknown
Comments USAGE- Wetlands (Eric Alsmeyer) on 11 -12 -10 &
4b
If the Corps made the jurisdictional determination, what type
of determination was made?
❑ Preliminary ❑X Final
4c
If yes, who delineated the jurisdictional areas?
Name (if known) Eric Alsmeyer, Martin Richmond
Agency /Consultant Company
Other
4d If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation
USACE - Wetlands (Eric Alsmeyer) on 11 -12 -10 & DWQ- Streama (Martin Richmond) on 10 -18 -10
5
Project History
5a
Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past?
❑X Yes ❑ No ❑ Unknown
5b If yes, explain in detail according to "help file" instructions
Previous permit/certification was issued on July 22, 2014, DWR #14 -0719 for boring sewer under the creek Aerial crossing is now required by Raleig
6.
Future Project Plans
6a
Is this a phased project?
❑ Yes ❑X No
6b
If yes, explain
Page 3 of 10
PCN Form — Version 1 4 January 2009
ind

C. Proposed Impacts Inventory
1. Impacts Summary
la Which sections were completed below for your project (check all that apply)
❑X Wetlands ❑X Streams —tributaries ❑X Buffers ❑ 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
2a
2b
2c
2d
2e
2f
Wetland impact
Type of impact
Type of wetland
Forested
Type of jurisdiction
Area of
number
Corps (404,10) or
impact
Permanent (P) or
DWQ (401, other)
(acres)
Temporary T
W1 T
Type In (Other)
Unknown
No
Corps
002847
W2 T
Type In (Other)
Unknown
No
Corps
001653
W3 P
Type In (Cone piers)
Unknown
No
DWQ
000165
W4
Choose one
Choose one
Yes /No
W5
Choose one
Choose one
Yes /No
W6
Choose one
Choose one
Yes /No
2g Total Wetland Impacts
1 0 047
2h Comments
W1 Type of Impact is open cut for Construction (on -site)
W2 Type of Impact is open cut for Construction (off -site)
W3 Type of Impact is for concrete piers Proposed sewer crossing is aerial with concrete piers No stream impact is anticipated besides the rip -rap
The 8" gravity sewer crossing will be inside the 16" steel casing
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
3a
3b
3c
3d
3e
3f
3g
Stream Impact
Type of impact
Stream name
Perennial (PER) or
Type of
Average
Impact
number
intermittent (INT)?
jurisdiction
stream
length
Permanent (P) or
width
(linear
Temporary (T)
(feet)
feet)
S1 P
Choose one
Harris Creek (Peeples)
PER
DWQ
20
S2
Choose one
S3
Choose one
S4
Choose one
S5
Choose one
S6
Choose one
3h Total stream and tributary impacts
20
31 Comments
Proposed sewer crossing is aerial with concrete piers No stream impact is anticipated besides the rip -rap per City of Raleigh requirements The 8"
gravity sewer aerial crossing will be inside the 16" steel casing See plans
Page 4 of 10
PCN Form — Version 1 4 January 2009

4 Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U S then indivii ually list all open water impacts below
4a
Open water
impact number
Permanent (P) or
Temporary T
4b
Name of waterbody
(if applicable)
4c
Type of impact
4d
Waterbody
type
4e
Area of impact (acres)
01
Choose one
Choose
O2
Choose one
Choose
03
Choose one
Choose
04
Choose one
Choose
4f Total open water impacts
4g Comments
5. Pond or Lake Construction
If pond or lake construction proposed, the complete the chart below
5a
Pond ID number
5b
Proposed use or
purpose of pond
5c
Wetland Impacts (acres)
5d
Stream Impacts (feet)
5e
Upland
(acres)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
P1
Choose one
P2
Choose one
5f Total.
5g Comments N /A
5h Is a dam high hazard permit required?
❑ Yes ❑ No If yes, permit ID no
51 Expected pond surface area (acres)
5j Size of pond watershed (acres)
5k Method of construction
6 Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below If yes, then individually list all buffer impacts
below If any impacts require mitigation, then vou MUST fill out Section D of this form
6a. Project is in which protected basin?
❑X Neuse ❑ Tar - Pamlico ❑ Catawba ❑ Randleman ❑ Other
6b
Buffer Impact
number —
Permanent (P) or
Temporary T
6c
Reason for impact
6d
Stream name
6e
Buffer
mitigation
required?
6f
Zone 1
impact
(square
feet )
6g
Zone 2
impact
(square
feet
B1
Yes /No
B2 P
rip -rap
Harris Creek 0
No
200
B3 P
concrete piers
Harris Creek
No
36
18
B4
Yes /No
B5
Yes /No
B6
Yes /No
6h Total Buffer Impacts-
36
218
61 Comments Only permanent piers and rip -rap permanent impact
Page 5 of 10

D. Impact Justification and Mitigation
1. Avoidance and Minimization
la Specifically describe measures taken to avoid or minimize the proposed impacts in designing project
Original design and permitted was for the 8" gravity sewer crossing to be bored to minimize the impact to stream and wetlands The creek bottom
elevation turns out to be lower than anticipated, therefore, City of Raleigh requires aerial crossing instead There is no other options besides aerial
crossing Only concrete piers and rip -rap (per Raleigh standard) are permanent impact
lb Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques
The 8" gravity sewer crossing will be aerial to minimize the impact to stream and wetlands Construction to be carried out with extra caution and
diligence to stay within the 20' corridor or less
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 ❑X No
2b If yes, mitigation is required by (check all that apply)
❑ DWQ ❑ Corps
2c If yes, which mitigation option 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
3b Credits Purchased (attach receipt and letter)
Type Choose one
Type Choose one
Type Choose one
Quantity
Quantity
Quantity
3c Comments
4 Complete if Making a Payment to In -lieu Fee Program
4a Approval letter from in -lieu fee program is attached
❑ Yes
4b Stream mitigation requested
linear feet
4c If using stream mitigation, stream temperature
Choose one
4d Buffer mitigation requested (DWQ only)
square feet
4e Riparian wetland mitigation requested
acres
4f Non - riparian wetland mitigation requested
acres
4g Coastal (tidal) wetland mitigation requested
acres
4h Comments
5 Complete if Using a Permittee Responsible Mitigation Plan
5a If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan
Page 6 of 10
PCN Form — Version 1 4 January 2009

6 Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation
Yes ❑X No El
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
Zone
6c
Reason for impact
6d
Total impact
(square feet)
Multiplier
6e
Required mitigation
(square feet)
Zone 1
3 (2 for Catawba)
Zone 2
1 5
6f Total buffer mitigation required:
6g If buffer mitigation is required, discuss what type of mitigation is proposed (e g , payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in -lieu fee fund)
6h Comments
Page 7 of 10

E.
Stormwater Management and Diffuse Flow Plan (required by DWQ)
1.
Diffuse Flow Plan
1 a
Does the project include or is it adjacent to protected riparian buffers identified
Yes ❑ No
within one of the NC Riparian Buffer Protection Rules?
lb
If yes, then is a diffuse flow plan included? If no, explain why
Stormwater and erosion control are proposed as part of overall plans submitted and approved by City of
Yes No
Raleigh
Stormwater Department Total TN buydown was approved by City of Raleigh, purchased with a
❑ ❑X
private mitigation bank Copy attached
2
Stormwater Management Plan
2a
What is the overall percent imperviousness of this project?
2b
Does this project require a Stormwater Management Plan?
❑X Yes ❑ No
2c
If this project DOES NOT require a Stormwater Management Plan, explain why
2d
If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan
Stormwater and erosion control are proposed as part of overall plans submitted and approved by City of Raleigh Stormwater Department Total TN
buydown was approved by City of Raleigh, purchased with a private mitigation bank Copy attached
2e
Who will be responsible for the review of the Stormwater Management Plant
Certified Local Government
3
Certified Local Government Stormwater Review
3a
In which local government's jurisdiction is this project?
Raleigh
❑X Phase II
❑ NSW
3b
Which of the following locally - implemented stormwater management programs
❑ USMP
apply (check all that apply)
❑ Water Supply Watershed
❑ Other
3c
Has the approved Stormwater Management Plan with proof of approval been
❑X Yes ❑ No
attached?
4
DWQ Stormwater Program Review
❑Coastal counties
❑HQW
4a
Which of the following state - implemented stormwater management programs apply
❑ORW
(check all that apply)
❑Session Law 2006 -246
❑X Other N /A
4b
Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ❑ No
attached?
5.
DWQ 401 Unit Stormwater Review
5a
Does the Stormwater Management Plan meet the appropriate requirements?
❑ Yes ❑ No
5b
Have all of the 401 Unit submittal requirements been met?
❑ Yes ❑ No
Page 8 of 10
PCN Form — Version 1 4 January 2009

F.
Supplementary Information
1
Environmental Documentation (DWQ Requirement)
la
Does the protect involve an expenditure of public (federal /state /local) funds or the
❑ Yes
❑X No
use of public (federal /state) land?
lb
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
❑ Yes
❑ No
(North Carolina) Environmental Policy Act (NEPA /SEPA)?
1c
If you answered "yes' to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
❑ Yes
❑ No
letter )
Comments
2
Violations (DWQ Requirement)
2a
Is the site in violation of DWQ Wetland Rules (15A NCAC 2H 0500), Isolated
Wetland Rules (15A NCAC 2H 1300), DWQ Surface Water or Wetland Standards,
E] Yes
❑X No
or Riparian Buffer Rules (15A NCAC 2B 0200)?
2b
Is this an after - the -fact permit application?
El Yes
❑X No
2c
If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s)
3.
Cumulative Impacts (DWQ Requirement)
3a
Will this project (based on past and reasonably anticipated future impacts) result in
El Yes
❑X No
additional development, which could impact nearby downstream water quality?
3b
If you answered "yes' to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy If you answered "no," provide a short narrative description
The proposed development for this site includes a new building and parking lot All applicable permits are being obtained with local authority, City of
Raleigh
Total TN buydown was approved by City of Raleigh, purchased with a private mitigation bank Copy attached
4
Sewage Disposal (DWQ Requirement)
4a Clearly detail the ultimate treatment methods and disposition (non - discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility
future +/- 1,359 GPD
Wastewater
discharges to the proposing 8" gravity sewer, discharge
Page 9 of 10
PCN Form —Version 1 4 January 2009

5 Endangered Species and Designated Critical Habitat (Corps Requirement)
5a Will this project occur in or near an area with federally protected species or
❑ Yes ❑X No
habitat?
5b Have you checked with the USFWS concerning Endangered Species Act
❑ Yes ❑X No
impacts'?
5c If yes, indicate the USFWS Field Office you have contacted
-
5d What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat9
Contacted Corps Office (Eric Alsmeyer)
6. Essential Fish Habitat (Corps Requirement)
6a Will this project occur in or near an area designated as essential fish habitat?
❑ Yes ❑X No
6b What data sources did you use to determine whether your site would impact Essential Fish Habitat'?
N/A -not in coastal region
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
❑ Yes ❑X No
status (e g , National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b What data sources did you use to determine whether your site would impact historic or archeological resources?
Contacted Corps Office (Eric Alsmeyer)
8 Flood Zone Designation (Corps Requirement)
8a Will this project occur in a FEMA - designated 100 -year floodplain?
X❑ Yes ❑ No
8b If yes, explain how project meets FEMA requirements
The proposed development is outside of the FEMA floodline The proposed sewer aerial crossing height and design were dictated by City of Raleigh
Engineering The sewer +/- 5 7' sewer vertical clearance with the bottom creek and its relationship to 25 -yr storm were directed by Raleigh
Engineering
8c What source(s) did you use to make the floodplain determination?
I have contacted the FEMA Region IV office (Mohammad Waliullah, 770 - 220 -5493)
Du Le
5 -19 -15
for NC Buddhist Association
Applicant/Agent's Printed Name
Date
Applicant/Agent's Signature
(Agent's signature is valid only if an authorization
letter from the applicant is provided
Page 10 of 10