20231037 Ver 1_ePCN Application_20230724

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:
7/24/2023
BIMS # Assigned
20231037
Is a payment required for this project?*
No payment required
Fee received
Fee needed - send electronic notification
Select Project Reviewer*
Joey Winston:[e-mail]
Information for Initial Review
la. Name of project:
COURTESY COPY PINE TREE COVE CREEK
1a. Who is the Primary Contact?*
KEVIN NORRIS
1b. Primary Contact Email: *
[e-mail]
Date Submitted
7/24/2023
Nearest Body of Water
PINE TREE COVE CREEK
Basin
French Broad
Water Classification
PINE TREE COVE CREEK
Site Coordinates
Latitude:
35.511
A. Processing Information
Is this project connected with ARPA funding?
Yes No
County (or Counties) where the project is located:
Haywood
Is this a NCDMS Project
Yes No
Longitude:
-83.074
Version#*
1
Reviewing Office*
Asheville Regional Office - [phone]
1c. Primary Contact Phone: *
[phone]
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: 19 - Minor Dredging
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
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
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. Name(s) on recorded deed:
CALVARY ROAD BAPTIST CHURCH
2b. Deed book and page no.:
401 Water Quality Certification - Express
Riparian Buffer Authorization
2c. Contact Person:
JOHN SWANGER
2d. Address
Street Address
2701 SOCO ROAD
Address Line 2
City
State / Province / Region
MAGGIE VALLEY
NC
Postal/Zip Code
Country
28751
USA
Yes No
Yes No

2e. Telephone Number:
[phone]
2g. Email Address:*
INFO@ MYCALVARYROAD. CO M
3. Applicant Information (if different from owner)
3a. Name:
KEVIN NORRIS
3b. Business Name:
MOUNTAIN SITEWORK INC
3c.Address
Street Address
2582 OLD RIVER ROAD
Address Line 2
City
CANTON
Postal / Zip Code
28716
3d. Telephone Number:
[phone]
3f. Email Address:
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
KEVIN NORRIS
4b. Business Name:
MOUNTAIN SITEWORK INC
4c.Address
Street Address
2582 OLD RIVER ROAD
Address Line 2
City
CANTON
Postal / Zip Code
28716
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:
MAGGIE VALLEY
2. Project Identification
2a. Property Identification Number:
2f. Fax Number:
State / Province / Region
NC
Country
USA
3e. Fax Number:
State / Province / Region
NC
Country
usa
4e. Fax Number:
2b. Property size:

2c. Project Address
Street Address
2701 SOCO ROAD
Address Line 2
City
MAGGIE VALLEY
Postal / Zip Code
28751
3. Surface Waters
3a. Name of the nearest body of water to proposed project:
PINE TREE COVE CREEK
3b. Water Resources Classification of nearest receiving water:
PINE TREE COVE CREEK
3c. What river basin(s) is your project located in?*
French Broad
3d. Please provide the 12-digit HUC in which the project is located.
060101060203
4. Project Description and History
State / Province / Region
NC
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: "
CREEK BED HAS FILLED IN OVER TIME AND HAS FILLED IN LARGE CULVERT UNDER MAIN ENTRANCE TO CHURCH
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:
4h. Explain the purpose of the proposed project: *
TO LOWER CREEK BED IN ORDER TO CLEAN OUT CULVERT AND REBUILD HEADWALL TO PREVENT ENTIRE ENTRANCE FROM WASHING OUT IN STORM
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:
TO REMOVE MATERIAL FROM BOTH ENDS OF EXISTING CULVERT.
PUMP EXISTING STREAM AROUND DISTURBED AREA.
LOWER STREAM BED AND CLEAN OUT FILLED IN CULVERT AND REBUILD HEADWALL ON INLET END OF EXISTING CULVERT.
EQUIPMENT TO BE USED WILL BE A LONG REACH EXCAVATOR IN ORDER TO KEEP THE MACHINE OUT OF THE EXISTING STREAM.
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
Corps AID Number:
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
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
E. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
TO DAM UP AND PUMP STREAM AROUND DISTURBED AREA.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
TO DAM UP AND PUMP STREAM AROUND DISTURBED AREA
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:
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
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:
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.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?
Yes No N/A
O
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
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
Unknown
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?
NO DATA SOURCES WERE USED.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?
Yes No
Are there submerged aquatic vegetation (SAV) around the project vicinity?*
Yes No Unknown
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?
NO DATA SOURCES WERE USED.
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?
NO DATA SOURCES WERE USED
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?
NO DATA SOURCES WERE USED
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
Calvary Road Baptist Church.pdf 1.03MB
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.
a

Full Name:
KEVIN NORRIS
Signature
Date
7/24/2023