20230996 Ver 1_ePCN Application_20230712

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:
6/13/2023
BIMS # Assigned
20230996
Is a payment required for this project?*
No payment required
Fee received
Fee needed - send electronic notification
Reviewing Office*
Mooresville Regional Office - [phone]
Information for Initial Review
la. Name of project:
Machado Drive
la. Who is the Primary Contact?*
Melody Davis/ Julie and Benjamin Burgess
1b. Primary Contact Email:
[e-mail]
Date Submitted
7/12/2023
Nearest Body of Water
Duck Creek
Basin
Yadkin-PeeDee
Water Classification
C
Site Coordinates
Latitude:
35.187439°
A. Processing Information
Is this project connected with ARPA funding?
Yes No
County (or Counties) where the project is located:
Union
Is this a NCDMS Project
Yes No
Longitude:
-80.5688450
Version#*
1
What amout is owed?*
$240.00
$570.00
Select Project Reviewer*
Andrew Pitner:[e-mail]
1c. Primary Contact Phone: *
[phone]
a
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 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:
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
401 Water Quality Certification - Regular
Non-404 Jurisdictional General Permit
Individual 401 Water Quality Certification
29 - Residential Developments
le. Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification:
For the record only for Corps Permit:
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?
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
401 Water Quality Certification - Express
Riparian Buffer Authorization
1d. Who is applying forthe permit?
Owner Applicant (other than owner)
le. Is there an Agent/Consultant for this project?
Yes No
2. Owner Information
2a. Name(s) on recorded deed:
CONNER ROBERT BANGER HEIRS (ie Melody Davis)
2b. Deed book and page no.:
(CS22, 0065) (CS21, 328)
2c. Contact Person:
Melody Davis
2d.Address
Street Address
3221 Highway 24-27 E
Address Line 2
City State / Province / Region
Indian Trail North Carolina
Postal / Zip Code Country
28107 USA
Yes No
Yes No

2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Jennifer Robertson
4b. Business Name:
Atlas Environmental Inc.
4c. Address
Street Address
338 S. Sharon Amity Road #411
Address Line 2
City
Charlotte
Postal / Zip Code
28211
4d. Telephone Number:
[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:
Indian Trail
2. Project Identification
2a. Property Identification Number:
08246050 and 08246049
2c. Project Address
Street Address
9707 W Machado Drive
Address Line 2
City
Indian Trail
Postal / Zip Code
28079
3. Surface Waters
3a. Name of the nearest body of water to proposed project:
Duck Creek
3b. Water Resources Classification of nearest receiving water:
C
3c. What river basin(s) is your project located in?*
Yadkin-PeeDee
3d. Please provide the 12-digit HUC in which the project is located.
Goose Creek, 030401050701
4. Project Description and History
2f. Fax Number:
State / Province / Region
North Carolina
Country
USA
4e. Fax Number:
2b. Property size:
15.26
State / Province / Region
North Carolina
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: *
There are a total of three intermittent streams on -site and no wetlands. The surrounding area predominantly consists of residential homes and forested land. The review area is almost
entirely forested with a small clearing in the Southern region along the lower Southwest boundary.
a

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
4g. List the total estimated linear feet of all existing streams on the property:
1,367
4h. Explain the purpose of the proposed project:*
The purpose of the project is for the construction of a single residence. Construction will include mechanized land clearing for grading, utilities, and a driveway connecting to Machado
Drive.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:
Unavoidable impacts to potential waters of the United States include one permanent stream impact. Impact S1 is a permanent stream impact to 25 linear feet (0.001 acre) of intermittent
channel CH 100. Impact S1 is a culverted impact and is necessary for a driveway crossing that will allow road access to the site from Machado Drive. Commercial grade equipment will be
used to complete the project.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
Yes No O Unknown
Comments:
Atlas Staff Delineated the project on June 16, 2023
5b. If the Corps made a jurisdictional determination, what type of determination was made?
Preliminary Approved Not Verified Unknown N/A
Corps AID Number:
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Atlas Staff
Agency/Consultant Company: Atlas Environmental
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?
No this is not a phased project.
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
3a. Reason for impact ()
3b.lmpact type*
3c. Type of impact*
3d. S. name"
3e. Stream Type*
?)
3f. Type of
Jurisdiction*
3g. S. width
3h. Impact
length*
S1
Driveway crossing
Permanent
Culvert
CH 100
Intermittent
Both
Averege (feet)
25
(linear feet)
31. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
25
31. Total stream and ditch impacts:
25
3j. Comments:
0.001 acre of intermittent stream impacts
3i. Total temporary stream impacts:
0
E. Impact Justification and Mitigation O

1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
The project has been designed and engineered to avoid and minimize impacts to the greatest extent possible. All three streams within the review area
are intermittent and only one is proposed for impacts. In total less than 2 % of the stream area within the review area will be impacted.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
The culvert proposed for the steam crossing is an HOPE double -sided 24" culvert and will be buried 20 % to allow for the movement of aquatic life.
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:
Mitigation will not be required as the impact is under the required mitigation threshold. No perennial streams or wetlands were observed on -site.
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:
The Project does not occur within or adjacent to a protected NC riparian 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:
One residence to be constructed at the site.
G. Supplementary Information
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
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 is a single and complete project.
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
O
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?
IPaC, NHP, and field survey
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 Essential 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?
NC HPO Buffer Map and field survey
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 National Flood Hazard Layer .kml
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
Machado Drive NWP 29 compressed.pdf 7.48MB
File must be PDF or KMZ
Comments
The owner of the property is CONNER ROBERT BANGER HEIRS whom is Melody Davis. Melody Davis is selling the property. Jamie and Benjamin Burgess will be closing on the property
soon after this submittal of the report (submitted on July 12, 2023).
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:
Allyson Sinclair
Signature
Li�dAY �XNl1�Q!'2
a

Date
7/12/2023