HomeMy WebLinkAbout20230928 Ver 1_ePCN Application_20230626DWR
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:
5/4/2023
BIMS # Assigned
20230928
Is a payment required for this project?*
No payment required
Fee received
Fee needed - send electronic notification
Reviewing Office*
Fayetteville Regional Office - (910) 433-3300
Information for Initial Review
1a. Name of project:
468 Moss Pink
la. Who is the Primary Contact?
Matt Van Epps
1b. Primary Contact Email: *
matthewvaneppsl@gmaii.com
Date Submitted
6/26/2023
Nearest Body of Water
Crane Creek
Basin
Cape Fear
Water Classification
WSIII
Site Coordinates
Latitude:
Longitude:
2.61694444
87.38361111
A. Processing Information
Is this project connected with ARPA funding?
Yes No
County (or Counties) where the project is located:
Moore
Is this a NCDMS Project
Yes No
Is this project a public transportation project?*
Yes No
Version#*
1
What amout is owed?*
$240.00
$570.00
Select Project Reviewer*
Chad Turlington:chad.turlington@ncdenr.gov
1c. Primary Contact Phone: *
(910)722-6874
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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: 18 - Minor Discharges
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:
M & L Custom Homes LLC
2b. Deed book and page no.:
5758 page 424
2c. Contact Person:
Matt Van Epps
2d. Address
Street Address
394 Mountain Run
Address Line 2
City State / Province / Region
West End NC
Postal / Zip Code Country
27376 us
2e. Telephone Number:
(910)722-6874
2g. Email Address:*
mafthewvaneppsl@gmaii.com
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(if appropriate)
Woodlake
1c. Nearest municipality / town:
Vass
2. Project Identification
2a. Property Identification Number:
parcel ID 00043421
2c. Project Address
Street Address
468 Moss Pink dr
Address Line 2
City
Vass
Postal / Zip Code
28394
3. Surface Waters
3a. Name of the nearest body of water to proposed project:
Crane Creek
3b. Water Resources Classification of nearest receiving water:
WSIII
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.
030300040307
4. Project Description and History
2f. Fax Number:
2b. Property size:
.16
State / Province / Region
NC
Country
Us
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:
Project is in residential neighborhood. Current site is undeveloped.
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:
0
4h. Explain the purpose of the proposed project:
Single family home development.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:
Develop single family home and add less than 25 cyds of fill around 10' the home. A small bobcat will only be used on the site. No material or equipment will be stored on the site.
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
O
Corps AID Number:
SAW-2023-00864
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Matt Martin
Agency/Consultant Company: USACE
Other:
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?
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
2. Wetland Impacts
01
2a1 Reason (?)
2b. Impact type*(?)
2c. Type of W.*
2d. W. name
2e. Forested*
2f. Type of Jurisdicition *
?)
2g. Impact
area
ff
home
P
Unknown
wetlands
No
Corps
0.013
(acres)
2g. Total Temporary Wetland Impact
0.000
2g. Total Wetland Impact
0.013
2i. Comments:
E. Impact Justification and Mitigation
1. Avoidance and Minimization
2g. Total Permanent Wetland Impact
0.013
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
Impact reduced to areas required for structural needs of the home.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Silt fence is used to minimize impacts to offsite resources. Construction equipment is staged on dry land. All material stored onsite will be stored on high
ground.
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:
The project is under the threshold in the nation wide permit.
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
If no, explain why:
This area is not in the riparian buffer.
0
`I
2. Stormwater Management Plan
2a. Is this a NC DOT 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:
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 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 is single and complete and will result in no additional development.
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
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?
USFWSIPAC
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?
NOAA fish habitat mapper
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 web viewer
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 flood maps
Miscellaneous
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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
468 plot plan.pdf 961.79KB
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:
Matthew Van Epps
Signature
w <Y Aw
Date
6/26/2023