20210934 Ver 2_Preserves at Holland Pre-Construction Notification (PCN) submittal 071222_20230731

DWR
IDIOM— 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://edocs.deq.nc.govfVVaterResources/0/edoc/624704/PCN / 20Help/ 20File/ 202018-1-30.pdf
A. Processing Information O
Pre -Filing Meeting Date Request was submitted on:
5/10/2021
If this is a courtesy copy, please fill in this with the submission date.
County (or Counties) where the project is located:"
Wake
Is this a NCDMS Project"
0Yes ONo
Click Yes, only if NCD MS is the applicant or co -applicant.
Is this project a public transportation project?"
O Yes OO 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:"
❑O 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?"
O Yes
O No
1 b. What type(s) of permit(s) do you wish to seek authorization?"
❑ Nationwide Permit (NWP)
❑ Regional General Permit (RGP)
❑O Standard (IP)
1c. Has the NWP or GP number been verified by the Corps?"
OYes ONo
Are you a federal applicant?"
0Yes ONo
If yes, please provide a statement concerning compliance with the Coastal Zone Management Act."
No selected
1 d. Type(s) of approval sought from the DWR:
check all that apply
❑O 401 Water Quality Certification - Regular
❑ Non-404 Jurisdictional General Permit
O Individual 401 Water Quality Certification
1e. Is this notification solely for the record because written approval is not required?
❑ 401 Water Quality Certification - Express
❑ Riparian Buffer Authorization
For the record only for DWR 401 Certification: O Yes O No
For the record only for Corps Permit: O Yes O No
1f. Is this an after -the -fact permit application?"
Yes C- 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.
O Yes O No
Acceptance Letter Attachment
Click the upload button or drag and drop files hereto 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?"
0Yes ONo
Linkto trout information: http://www.saw.usace.army.miI/Missions/Regulatory-Permit-Program/Agency-Coordination/Trout.aspx
B. Applicant Information
1a. Who is the Primary Contact?"
Josh Swindell
1c. Primary Contact Phone:"
1 b. Primary Contact Email" (xxx)xxx-xxxx
[e-mail] [phone]
1d. Who is applying for the permit?"
Owner O Applicant (other than owner)
(Check all that apply)
1e. Is there an AgentlConsultant for this project?"
OO Yes O No
2. Owner Information
2a. Name(s) on recorded deed:"
Trinity Brownstones, LLC
2b. Deed book and page no.:
Book: 18724, Page: 2489
2c. Contact Person:
(for Corporations)
Josh Swindell
2d.Address*
Street Address
4441 Six Forks Road
Address Line 2
City
State / Province / Region
Raleigh
NC
Postal /Zip Code
Country
27609
United States
2e. Telephone Number:"
[phone]
2f. Fax Number
2g. Email Address:"
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:"
Scott Mitchell
4b. Business Name:
inapplicable)
Mitchell Environmental, PA

4c. Address"
Street Address
1501 Lakestone Village Lane
Address Line 2
Suite 205
City
Fuquay-Varina
Postal /Zip Code
27526
4d. Telephone Number:"
[phone]
4f. Email Address:"
[e-mail]
C. Proiect Information and Prior Proiect History
1. Project Information
1a. Name of project:"
The Preserves at Holland
1b. Subdivision name:
(if appropriate)
State / Province / Region
NC
Country
United States
4e. Fax Number:
(xxx)xxx-xxxx
u
lJ
1c. Nearest municipality/town:"
Fuquay-varina
2. Project Identification
lJ
2a. Property Identification Number:
2b. Property size:
(tax PIN or parcel ID)
(in acres)
0666428418
28.39
2c. Project Address
Street Address
804 Holland Road
Address Line 2
City
State / Province / Region
Fuquay-Varina
NC
Postal /Zip Code
Country
27526
United States
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:"
35.570370-78.781895
ex: 34.208504-77.796371
3. Surface Waters
3a. Name of the nearest body of water to proposed project:"
UT to Kenneth Creek
3b. Water Resources Classification of nearest receiving water:"
C
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."
030300040501
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:"
Existing conditions on the site are primarily agricultural fields with a few structures and barns. The land use in the general vicinity is mostly residential.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?"
0• Yes O No O Unknown
If yes, please give the DWR Certification number or the Corps Action ID (exp. SAW-0000-00000).
Corps: SAW-2021-01104
4b(2). Is Any Portion of the Work Already Complete?"
0Yes 0No
If yes, describe the completed work.
Sewer and water system installation are under construction.
4c. List of Other Certificates or Approvals/Denials received from other Federal, State, or Local Agencies for work described in this application, not related to the 404 or 401.
4f. List the total estimated acreage of all existing wetlands on the property:
1.11
4g. List the total estimated linear feet of all existing streams on the property:
(intermittent and perennial)
0
4h. Explain the purpose of the proposed project:"
The purpose of the project is to develop the land into a residential subdivision including roadway and utility infrastructure.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:"
Equipment to be used is that typical with roadway and utility infrastructure construction, including excavators, bull dozers, dump trucks, etc.
4k. Will this activity involve dredging in wetlands or waters?"
O Yes 0• No
If yes, Describe the type of dredging, the composition of the dredged material and the location of disposal area
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?"
0• Preliminary O Approved O Not Verified O Unknown N/A
Corps AID Number:
Example: SAW-2017-99999
SAW-2021-01104
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company: Mitchell Environmental, PA
Other:
5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR.
June 28, 2021
6. Future Project Plans
6a. Is this a phased project?"
O 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 projector 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.
7. Addresses of Adjoining Property Owners, Lessees, Etc., Whose Property Adjoins the Waterbody (if more than can be entered here, please attach a supplemental list)
8. Scheduling of Activity:
D. Proposed Impacts Inventory
v
1. Impacts Summary

1a. Where are the impacts associated with your project? (check all that apply):
Wetlands Streams -tributaries Buffers
Open Waters O Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
"W." will be used in the table below to represent the word "wetland".
2a1 Reason"(?)
2b. Impact type*(?)
2c. Type of W.*
2d. W. name"
2e. Forested"
2f. Type of Jurisdicition"
2g. Impact
area"
Fill
P
Unknown
B
Yes
Corps
0.071
(acres)
2g. Total Temporary Wetland Impact
0.000
2g. Total Permanent Wetland Impact
0.071
2g. Total Wetland Impact
0.071
2h.Type(s) of Material Being Discharged and the Amount of Each Type in Cubic Yards:
2,600 of soil fill
2i. Comments:
3i. Total cubic yard stream impacts:"
0
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 individually list all open
water impacts below.
4a1. Impact Reason
4b. Impact type" (?)
rName of waterbody (?)
4d. Activity type"
4e. Waterbody type"
4f. Impact
area"
Pond Fill
P
Pond
Fill
Pond
L(a:res)__J
4g. Total temporary open water Impacts:
0.00
4g. Total permanent open water impacts:
0.75
4g. Total open water impacts:
0.75
4g. Total cubic yard open water impacts:"
2600
4h. Comments:
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:"
Avoidance of wetland fringe around the pond is not practical due to the close proximity to the proposed fill of open water.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:"
Silt fencing will be provided to contain impacts to the proposed area only.
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?
v Yes No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
Thresholds for mitigation not met.

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 O No
For a list of options to meet the diffuse flow requirements, click here.
If no, explain why:
Cape Fear River Basin
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?"
0Yes ONo
2b. Does this project meet the requirements for low density projects as defined in 15A NCAC 02H .1003(2)?"
0Yes ONo
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?"
OO Yes O No
O N/A - project disturbs < 1 acre
Hint: projects that have vested rights, exemptions, or grandfathenng from state or locally implemented storm —ter programs or projects that satisfy state or locally -implemented stonnwater programs through use of community in -lieu programs should answer
no to this question.
2d. Which of the following stormwater management program(s) apply (check all that apply):"
❑O Local Government ❑ State
If you have a local government approval please include the SMP on their overall impact map.
Local Government Stormwater Programs"
❑O Phase II ❑ NSW
H USMP ❑ Water Supply
Please identify which local government stormwater program you are using."
Fuquay-Varina
Comments:
G. Supplementary Information
1. Environmental Documentation
la. Does the project involve an expenditure of public (federal/state/local) funds orthe 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 (based on past and reasonably anticipated future impacts) result in additional development, which could impact nearby downstream water quality?"
O Yes O No
3b. If you answered "no," provide a short narrative description.
The project only has one phase.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?"
vYes L�)No0N/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?"
O Yes No
5d. Is another Federal agency involved?"
Yes No
5e. Is this a DOT project located within Division's 1-8?"
O Yes OO No
5f. Will you cut any trees in order to conduct the work in waters of the U.S.?"
OO Yes O No
5g. Does this project involve bridge maintenance or removal?"
O Yes OO 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)?*"
O Yes OO No
OO Unknown
5i. Does this project involve (1) blasting, and/or (2) other percussive activities that will be conducted by machines, such as jackhammers, mechanized piledrivers, etc.?"
Yes C) No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?"
USFWS iPaC
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 EFH Mapper
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
Linkto the State Historic Preservation Office Historic Properties Map (does not include archaeological data: http://gis.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)?"
O Yes • No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?"
HPOWEB 2.0
8. Flood Zone Designation (Corps Requirement)
Link to the FEMA Floodplain Maps: https:Hmsc.fema.gov/portal/search
8a. Will this project occur in a FEMA-designated 100-yearfloodplain?"
v Yes No
8c. What source(s) did you use to make the floodplain determination?"
Wake County iMaps Floodplain layer
Miscellaneous
Comments
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
USACE Holland pond fill app 6.20.22.pdf 303.33KB
File must be PDF or KMZ
Signature
❑O 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,
• 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'),
• agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act'),
• understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature, AND
• intend to electronically sign and submit the PCN form.
Full Name:"
Adam Aycock
Signature"
Date
7/12/2022