20230854 Ver 1_Pre-Construction Notification (PCN) Form submitted 4-26-23_20230615

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
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:Hedoes.deq.nc.gov/WaterResources/0/edoc/624704/PCN%20Help/20File/202018-1-30.pdf
A. Processing Information
Pre-Filing Meeting Date Request was submitted on:*
4/10/2023
If this is a courtesy copy,please fill in this with the submission date.
Is this project connected with ARPA funding?
Yes No
County(or Counties)where the project is located:*
Chatham
Is this a NCDMS Project*
Yes No
Click Yes,only if NCDMS is the applicant or co-applicant.
DO NOT CHECK YES,UNLESS YOU ARE DMS OR CO-APPLICANT.
Is this project a public transportation project?*
Yes 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:*
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
1 b.What type(s)of permit(s)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: 29-Residential Developments
NWP Numbers(for multiple NWPS):
List all NW numbers you are applying for not on the drop down list.
1d.Type(s)of approval sought from the DWR:
check all that apply
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
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.
Yes No
Acceptance Letter Attachment
Click the upload button or drag and drop files here to attach document
FILE TYPE MUST BE PDF
1 h.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
Link to trout information:http://www.saw.usace.army.mil/Missions/Regulatory-Permit-Program/Agency-Coordination/Trout.aspx
B. Applicant Information
1a.Who is the Primary Contact?*
Rhiannon Graham
1c.Primary Contact Phone:
1 b.Primary Contact Email: (nX)"X-xxxx
[e-mail] [phone]
1d.Who is applying for the permit?*
Owner Applicant(other than owner)
(Check all that apply)
1e.Is there an Agent/Consultant for this project?
Yes No
2.Owner Information
2a.Name(s)on recorded deed:"`
Pea Ridge Developers LLC
2b.Deed book and page no.:
2c.Contact Person:
(for Corporations)
Andrew Ross
2d.Address"
Street Address
PO Box 5548
Address Line 2
City State/Province/Region
Cary NC
Postal/Zip Code Country
27512 USA
2e.Telephone Number:*
[phone]
2f.Fax Number:
("X)xxx-xxxx
2g.Email Address:*
[e-mail]
3.Applicant Information(if different from owner)
3a.Name:*
Andrew Ross
3b.Business Name:
(if applicable)
Pea Ridge Developers,LLC

3c.Address*
Street Address
PO Box 5548
Address Line 2
City State/Province/Region
Cary NC
Postal/Zip Code Country
27512 USA
3d.Telephone Number:*
[phone] 3e.Fax Number:
(xxx)xxx-xxxx (xxx)xxx-xxxx
3f.Email Address:
[e-mail]
4.Agent/Consultant(if applicable)
4a.Name:*
Rhiannon Graham
4b.Business Name:
(if applicable)
Terracon Consultants
4c.Address*
Street Address
2401 Brentwood Road
Address Line 2
Suite 107
City State/Province/Region
Raleigh NC
Postal/Zip Code Country
27604 USA
4d.Telephone Number:*
[phone] 4e.Fax Number:
(xxx)xxx-xxxx (xxx)xxx-xxxx
4f.Email Address:*
[e-mail]
C. Project Information and Prior Project History
1.Project Information LJ
1 a.Name of project:*
Firefly Overlook
1 b.Subdivision name:
(if appropriate)
Firefly Overlook
1c.Nearest municipality/town:
Pittsboro
2.Project Identification U
2a.Property Identification Number: 2b.Property size:
(tax PIN or parcel ID) (in acres)
17531,18070 76
2c.Project Address
Street Address
1623 North Pea Ridge Road
Address Line 2
City State/Province/Region
Pittsboro NC
Postal/Zip Code Country
27312 USA
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:*
35.71978 -79.06740
ex:34.208504 -77.796371
3. Surface Waters
3a.Name of the nearest body of water to proposed project:
Jordan Lake
3b.Water Resources Classification of nearest receiving water:*
WS-IV,B;NSW,CA
Surface Water Lookup
3c. What river basin(s)is your project located in?*
Cape Fear
3d.Please provide the 12-digit HUC in which the project is located.*
030300020610
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 existing conditions on site are composed of undeveloped forested land.There is a small subdivision to the south and west of the property.The rest of the land adjacent to the site is
undeveloped land.
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:
0.55
4g.List the total estimated linear feet of all existing streams on the property:
(intermittent and perennial)
4,001
4h.Explain the purpose of the proposed project:
To construct a road crossing to access a housing development with 32 lots to provide single family housing.
41.Describe the overall project in detail,including indirect impacts and the type of equipment to be used:
32 lots are proposed,a single access road to access the lots.The lots will be served by private septic systems and water wells.Typical grading and construction equipment will be used.
5. Jurisdictional Determinations
5a.Have the wetlands or streams been delineated on the property or proposed impact areas?
Yes No 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:
Example:SAW-2017-99999
SAW-2022-01620
5c.If 5a is yes,who delineated the jurisdictional areas?
Name(if known): Rhiannon Graham
Agency/Consultant Company: Terracon Consultants
Other:
5d.List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR.
3/30/23 by James Lastinger
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 project or 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):
Wetlands Streams-tributaries Buffers
Open Waters Pond Construction
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.
"S."will be used in the table below to represent the word"stream".
F-1
3a.Reason for impact(?) 3b.lmpact type* 3c.Type of impact* 3d.S.name 3e.Stream Type* 3f.Type of 3g.S.width* 3h.Impact
(?) Jurisdiction"` length*
N
Road Crossing Temporary Workpad/Causeway T3 UT to New Hope River Intermittent Both 7 15
Arm of B.Everett Jordan Average(feet) (linear feet)
Lake
n
Road Crossing Permanent Culvert T3 UT to New Hope River Intermittent Both 7 101
Arm of B.Everett Jordan Average(feet) (linear feet)
Lake
N
Road Crossing Permanent Rip Rap Fill T3 UT to New Hope River Intermittent Both 7 40
Arm of B.Everett Jordan Average(feet) (linear feet)
Lake
**All Perennial or Intermittent streams must be verified by DWR or delegated local government.
3i.Total jurisdictional ditch impact in square feet:
0
3i.Total permanent stream impacts:
141
31.Total temporary stream impacts:
15
31.Total stream and ditch impacts:
156
3j.Comments:
The third impact is for embedded riprap in the stream channel(permanent-no loss).For S2 impact the loss is 768 SF.
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:*
Impacts to the stream are for one proposed road crossing.The site has been designed to reduce impacts as much as practicable.There will be no
impacts to the wetlands on site.
1 b.Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
The selected contractor would implement best management practices(BMPs),including,but not limited too,the use of straw bale barriers,silt fences,
and/or sediment traps to control storm water runoff.All stream work would occur in the dry.The"permanent-no loss"category refers to embedded riprap
in the streambed.
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:
Impacts from culvert placement are less than 0.02 ac of stream channel.
NC Stream Temperature Classification Maps can be found under the Mitigation Concepts tab on the Wilmington District's 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 No
1 b.All buffer impacts and high ground impacts require diffuse flow or other form of stormwater treatment. If the project is subject to a state implemented riparian buffer protection program,
include a plan that fully documents how diffuse flow will be maintained.
All Stormwater Control Measures(SCM)s must be designed in accordance with the NC Stormwater Design Manual. Associated supplement forms and other documentation shall be
provided.
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
(check all that apply)
For a list of options to meet the diffuse flow requirements,click here.
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
To look up low density requirement click here 15A NCAC 02H.1003(2).
2c.Does this project have a Stormwater management plan(SMP)reviewed and approved under a state stormwater program or state-approved local government Stormwater program?*
Yes No
N/A-project disturbs<1 acre
Hint:projects that have vested rights,exemptions,or grandfathering from state or locally implemented stormwater programs or projects that satisfy state or locally-implemented stormwater programs through use of community in-lieu programs should answer
no to this question.
3. Stormwater Requirements
3a.Select whether a completed stormwater management plan(SMP)is included for review and approval or if calculations are provided to document the project will not cause degradation of
downstream surface waters.*
Stormwater Management Plan Antidegradation Calculations
Comments:
stormwater management plan will be designed to Chatham County's standards which requires to diffuse concentrated flow before it enters a buffer at any point.We will also be providing
Stormwater management devices to regulate the flow to the pre-development condition flow rates for the 2,10,and 25-year rates.
G. Supplementary Information
1. Environmental Documentation
1a.Does the project involve an expenditure of public(federallstatellocal)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(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.
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
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)?**
Yes No
51.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?*
IPAC.com and on site evaluations by Terracon biologists.
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?
hftps://www.habitat.noaa.gov/apps/efhmapper/
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
Link to the State Historic Preservation Office Historic Properties Map(does not include archaeological data: http:dgis.ncdcr.gov/h/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 whether your site would impact historic or archeological resources?*
SHPO and OSA search by Terracon Archaeologists
8. Flood Zone Designation (Corps Requirement)
Link to the FEMA Floodplain Maps: https://msc.fema.gov/portal/search
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?*
hftps:Hmsc.fema.gov/portal/search#searchresultsanchor
Miscellaneous
Comments
The"permanent-no loss"category refers to embedded riprap in the stream bed.
Jordan Lake Buffer Impacts will be reviewed by Chatham County(Drew Blake).
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
PCN attachments_Optimized.pdf 8.55MB
File must be PDF or KMZ
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:*
Rhiannon Graham
Signature*
11 WWrW e�pia- W
Date
4/26/2023