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Form Version 1 4 January 2009
Page 1 of 10
PCN Form — Version 1.4 January 2009
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Pre - Construction Notification (PCN) Form /A 6
A.
Applicant Information APR 3
i
1.
Processing o E
la
Type(s) of approval sought from the Corps
❑Section 404 Permit ❑ Section R EMIT ry
lb Specify Nationwide Permit (NWP) number or General Permit (GP) number:
1c
Has the NWP or GP number been verified by the Corps?
❑ Yes ❑ No
1 d
Type(s) of approval sought from the DWQ (check all that apply)
❑ 401 Water Quality Certification — Regular ❑ Non -404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑X Riparian Buffer Authorization
le
Is this notification solely for the record
because written approval is not required?
For the record only for DWQ
401 Certification
❑ Yes ❑ No
For the record only for Corps Permit
❑ Yes ❑ 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 ❑ No
1g
Is the project located in any of NC's twenty coastal counties If yes, answer 1h
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.
Village Glen Retaining Wall Replacement
2b.
County.
Wake
2c
Nearest municipality / town.
Raleigh
2d
Subdivision name
Village Glen
2e. NCDOT only, T.I.P. or state project no.
3.
Owner Information
3a
Name(s) on Recorded Deed'
Village Glenn Homeowner's Association, Inc and Laura W Myers Trust
3b
Deed Book and Page No.
3315 page 261 and 11497 page 26
3c
Responsible Party (for LLC if
applicable)
Village Glen Homeowners Association, Inc c/o Elite Management Consultants
3d
Street address
4412 Blue Ridge Road, Suite 100
3e
City, state, zip
Raleigh, NC 27612
3f
Telephone no '
9192337660
3g
Fax no
3h
Email address
karenbayless @elite -mgmt corn
Page 1 of 10
PCN Form — Version 1.4 January 2009
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4.
Applicant Information (if different from owner)
4a
Applicant is
X❑ Agent ❑ Other, specify
4b
Name
Village Glen Homeowners Association, Inc.
4c
Business name
(if applicable)
c/o Elite Management Consultants
4d
Street address.
4412 Blue Ridge Road, Suite 100
4e
City, state, zip
Raleigh, NC 27612
4f
Telephone no.
919- 233 -7660
4g
Fax no
4h
Email address
karenbayless @elite -mgmt com
5.
Agent/Consultant Information (if applicable)
5a
Name
Erwin Williams
5b
Business name
(if applicable)-
TerraTech Engineers, Inc.
5c
Street address.
4905 Professional Court
5d
City, state, zip-
Raleigh, NC 27609
5e
Telephone no
919 - 876 -9799
5f
Fax no
5g
Email address
ewilliams @terratechengmeers com
Page 2 of 10
B.
Project Information and Prior Project History
1.
Property Identification
1 a. Property Identification no (tax PIN or parcel ID)
0795 -35 -1981 and 0795 -35 -1584
1 b
Site coordinates (in decimal degrees)
Latitude 35 8255 Longitude -78 6858
1 c
Property size.
005 acres
2.
Surface Waters
2a
Name of nearest body of water to proposed project
unnamed tributary to Crabtree Creek
2b
Water Quality Classification of nearest receiving water
2c
River basin
Neuse
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-
Area of planned construction is a creek bank adjacent to an existing foundation for a townhome where a timber retaining wall has deflected and risks
damaging the townhome The areas surrounding the subject include single family and multi - family construction A pond is located up- gradient of the
area of concern
3b
List the total estimated acreage of all existing wetlands on the property 0 01
3c
List the total estimated linear feet of all existing streams (Intermittent and perennial) on the property 90
3d Explain the purpose of the proposed project
Installation of a gablon retaining wall to protect the existing stream bank from eroding further and undermining the existing house
3e Describe the overall project in detail, including the type of equipment to be used
Foundation excavation and gablon wall construction to the southwest of the existing timber wall and townhome
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?
❑ Yes ❑X No ❑ Unknown
Comments
4b
If the Corps made the jurisdictional determination, what type
of determination was made?
El Preliminary El Final
4c
If yes, who delineated the jurisdictional areas?
Name (if known):
Agency /Consultant Company
Other:
4d
If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation
5.
Project History
5a
Have permits or certifications been requested or obtained for
this project (including all prior phases) In the past?
El Yes ❑X No ❑ Unknown
5b
If yes, explain in detail according to "help file" Instructions
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
C. Proposed Impacts Inventory
1. Impacts Summary
la Which sections were completed below for your project (check all that apply)
❑ Wetlands ❑ Streams — tributaries ❑ 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
Wetland impact
number
Permanent (P) or
—Temporary
2b
Type of impact
2c.
Type of wetland
2d
Forested
2e
Type of jurisdiction
Corps (404,10) or
DWQ (401, other)
2f
Area of
impact
(acres)
W1 P
retaining wall (Other)
Unknown
Yes
-
001
W2
Choose one
Choose one
Yes /No
W3
Choose one
Choose one
Yes /No
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:
001
2h Comments -
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
Stream impact
number
Permanent (P) or
Temporary (T)
3b.
Type of impact
3c
Stream name
3d
Perennial (PER) or
Intermittent (INT)*?
3e
Type of
jurisdiction
3f
Average
stream
width
(feet)
3g
Impact
length
(linear
feet)
S1 P
retaining wall (Other)
unnamed
PER
60
S2
Choose one
S3
Choose one
S4
Choose one
S5
Choose one
S6
Choose one
3h Total stream and tributary impacts
60
31 Comments
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
4b
Name of waterbody
(if applicable)
4c.
Type of impact
4d
Waterbody
type
4e
Area of impact (acres)
01
Choose one
Choose
02
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, then 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
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 you 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
6c
Reason for impact
6d
Stream name
6e.
Buffer
mitigation
required?
6f
Zone 1
impact
(square
feet )
6g
Zone 2
impact
(square
feet
61 P
protect structures
unnamed
No
800
B2
Yes /No
B3
Yes /No
B4
Yes /No
85
Ye /No
B6
Yes /No
6h Total Buffer Impacts:
61 Comments:
Page 5 of 10
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project
Since the existing construction is in the stream buffer area and must be protected from the stream, there are no available avoidance methods
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques
By using a gabion basket wall, we are reducing the amount of excavation needed when compared to other retaining wall methods such as cast -in-
place concrete and providing a long -term solution with a suitable appearance that enhances erosion protection
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 Q 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
Yes ❑X No
buffer mitigation?
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
6c.
6d
6e
Zone
Reason for impact
Total impact
Multiplier
Required mitigation
(square feet)
(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
within one of the NC Riparian Buffer Protection Rules?
❑ Yes ❑ No
1 b
If yes, then is a diffuse flow plan included? If no, explain why.
❑ Yes ❑ No
2.
Stormwater Management Plan
2a
What is the overall percent imperviousness of this project?
0
2b
Does this project require a Stormwater Management Plan?
❑ 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
2e
Who will be responsible for the review of the Stormwater Management Plan?
3.
Certified Local Government Stormwater Review
3a
In which local government's jurisdiction is this project?
City of Raleigh
3b
Which of the following locally - implemented stormwater management programs
apply (check all that apply).
❑ Phase II
❑ NSW
❑ USMP
❑ Water Supply Watershed
❑ Other
3c
Has the approved Stormwater Management Plan with proof of approval been
attached?
El Yes ❑ No
4.
DWQ Stormwater Program Review
4a
Which of the following state - implemented stormwater management programs apply
(check all that apply)
❑Coastal counties
❑HQW
❑ORW
❑Session Law 2006 -246
❑Other
4b
Has the approved Stormwater Management Plan with proof of approval been
attached9
❑ Yes ❑ No
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 project 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
letter.)
❑ Yes ❑ No
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,
❑ Yes ❑ No
or Riparian Buffer Rules (15A NCAC 2B 0200)?
2b
Is this an after - the -fact permit application?
El Yes ❑ 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
❑ 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
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
i
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
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
-
5d What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
6. Essential Fish Habitat (Corps Requirement)
6a Will this project occur in or near an area designated as essential fish habitat?
❑Ye ❑ No
6b What data sources did you use to determine whether your site would impact 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 (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?
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
8c What source(s) did you use to make the floodplain determination?
Erwin Williams
Applicant/Agent's Printed Name
Date l
Applicant/Agent's Signature
(Agent's signature is valid only if an authorization
letter from the applicant is provided
Page 10 of 10
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SITE
Not to Scale Figure 1. Site Location Plan
Base Map from Wake County GIS
TerraTech Engineers, Inc. (C -1356)
4905 Professional Court Project: 1545 Village Glen
Raleigh, NC 27609 Raleigh, North Carolina
919- 876 -9799 Our Project Number 121 -14 -71993
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