20231093 Ver 1_PCN_FillableForm_v4-3_02142023_Golden Trace_signed_20230804

E.ME STATE os'YO
•eer�vroEw•
NORTH CAROLINA
Environmental Quality
Water Resources
Office Use Only
Corps Action ID no. [Click to enter.] Date received: [Click to enter.]
DWR project no. [Click enter.] Date received: [Click to enter.]
Site Coordinates:
Latitude (DD.DDDDDD): 35.655180
Longitude (DD.DDDDDD): 78.587078
Form Version 4.3, April 20, 2022
Pre -Construction Notification (PCN) Form
(Ver. 4.2, January 31, 2022))
For Nationwide Permits and Regional General Permits and corresponding Water Quality Certifications
Please note: fields marked with a red asterisk are required. The form is not considered complete until all
mandatory questions are answered.
The PCN help document may be found at this link:
https://edocs.deg. nc.gov/WaterResources/DocView.aspx?dbid=0&id=2196924&cr=1
Please ensure you have submitted a pre -filing meeting request at least 30 days prior to submitting this
form, as DWR will not be able to accept your application without documentation of this important first step.
The Division has developed a Pre -filing Meeting Request email address 401 Pre File(a)-ncdenr.gov to accept
the federally required pre -filing meeting request and provide confirmation receipt of submittal . This receipt
or similar documentation will satisfy 40 C.F.R. Section 121.4(a) which states "At least 30 days prior to
submitting a certification request, the project proponent shall request a pre -filing meeting with the certifying
agency." In accordance with 40 C.F.R. Section 121.5(b)(7), and (c)(5), all certification requests must
include documentation that a pre -filing meeting request was submitted to the certifying authority at least 30
days prior to submitting the certification request.
Attach documentation of Pre -Filing Meeting Request to this Application.
Date of Pre -filing Meeting Request (MM/DD/YYYY) : 2/15/2023
Page 1 of 21 PCN Form Version 4.3- April 20, 2022

A. Processing Information
County (counties) where project is located:
Wake Additional (if needed).
Is this an ARPA project?
❑ Yes ❑x No
If yes, ARPA project number:
" The project number can be found on the "Letter of Intent to Fund"
(LOIF) or "Offer and Acceptance Letter". If you are unable to locate
Click or tap here to enter text.
your DWI ARPA Funding Project Number, please contact Corey
Basinger at core y.basingeramcdenr.gov for further assistance.
Is this a NCDMS project?
(Click yes only if NCDMS is the applicant or co-
❑ Yes ❑x No
applicant)
Is this a public transportation project?
(Publicly funded municipal, state, or federal road, rail,
❑ Yes ❑x No
or airport project)
Is this a NCDOT project?
❑ Yes ❑x No
If yes, NCDOT TIP or state project number:
Click to enter.
If yes, NCDOT WBS number:
Click to enter.
❑x Section 404 Permit (wetlands, streams, waters,
Clean Water Act)
la. Type(s) of approval sought from the Corps:
❑ Section 10 Permit (navigable waters, tidal
waters, Rivers and Harbors Act)
Has this PCN previously been submitted?
❑ Yes ❑x No
Please provide the date of the previous submission.
Click tn antar a Anti-
❑x Nationwide Permit (NWP)
1 b. What type(s) of permit(s) do you wish to seek
❑ Regional General Permit (RGP)
authorization?
❑ Standard (IP)
This form may be used to initiate the standard/ individual permit
process with the USACE. Please contact your Corps
representative concerning submittals for standard permits. All required items can be included as attachments and
submitted with this form.
1 c. Has the NWP or GP number been verified by the Corps?
® Yes ❑ No
NWP number(s) (list all numbers):
29
RGP number(s) (list all numbers ):
Click to enter
Are you a federal applicant?
❑ Yes ❑x No
If yes, please provide a statement concerning compliance with the Coastal Zone Management Act
Click to enter text
1 d. Type(s) of approval sought from DWR (check all that apply):
❑x 401 Water Quality Certification — Regular
❑ 401 Water Quality Certification— Express
❑ Non-404 Jurisdictional General Permit
❑x Riparian Buffer Authorization
❑ Individual 401 Water Quality Certification
Is this a courtesy copy notification
❑ Yes ❑x No
Page 2 of 21 PCN Form Version 4.3- April 20, 2022

1 e.
Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification:
❑ Yes
❑x No
For the record only for Corps Permit:
❑ Yes
❑x No
1f.
Is this an after -the -fact permit/certification application?
❑ Yes
❑x No
1 g.
Is payment into a mitigation bank or in -lieu fee program proposed for
mitigation of impacts?
❑ Yes
❑x No
If yes, attach the acceptance letter from mitigation bank or in -lieu fee program.
1 h.
Is the project located in any of NC's twenty coastal counties?
❑ Yes
❑x No
1 i.
Is the project located within an NC DCM Area of Environmental
Concern (AEC)?
❑ Yes
❑x No ❑ Unknown
1j.
Is the project located in a designated trout watershed?
❑ Yes
❑x No
If yes, you must attach a copy of the approval letter from the appropriate Wildlife Resource Commission Office.
Trout information may be found at this link: http://www.saw.usace.army.mil/Missions/Regulatory-Permit-
Program/Agency-Coordination/Trout.aspx
Page 3 of 21 PCN Form Version 4.3- April 20, 2022

B. Applicant Information
1 a.
Who is the primary contact?
Deborah Shirley
1 b.
Primary Contact Email:
[e-mail]
1 c.
Primary Contact Phone: (###)###-####
[phone]
1 d.
Who is applying for the permit/certification? (check
all that apply)
❑ Owner 0 Applicant (other than owner)
1 e.
Is there an agent/consultant for this project?
® Yes ❑ No
2.
Landowner Information
2a.
Name(s) on Recorded Deed:
Bryan, Robert Lewis / Bryan, Timothy S / Slater,
Richard S & Sharon Q / Bryan, William W Jr &
Amanda H
2b.
Deed Book and Page No.:
DB:16880, DP:655 / DB:15205, DP:1098 /
DB:18938, DP:1538 / DBA958, DP:165
2c.
Contact Person (for corporations):
Click to enter.
2d.
Address
Street Address:
1813 New Bethel Ch Rd / 7620 Windaliere Rd /
5801 Spottle Owl Lndg / 1709 new Bethel Ch Rd
Address line 2:
Click to entei.
City:
Garner / Cornelius / North Myrtle Beach / Garner
State/ Province/ Region:
NC / NC /SC / NC
Postal/ Zip Code:
27529 / 28031 / 29582 / 27529
Country:
USA
2e.
Telephone Number: (###)###-####
[phone]
2f.
Fax Number: (###)###-####
Click to enter.
2g.
Email Address: *
[e-mail]
3.
Applicant Information (if different from owner)
3a.
Name:
Tucker Ennis
3b.
Business Name (if applicable):
Lennar Corporation — Raleigh Division
3c.
Address:
Street Address:
1100 Perimeter Park Dr
Address line 2:
Suite 112
City:
Morrisville
State/ Province/ Region:
NC
Postal/ Zip Code:
27560
Country
USA
Page 4 of 21 PCN Form Version 4.3- April 20, 2022

3d. Telephone Number: (###)###-####
[phone]
3e Fax Number: (###)###-####
UiicK 10 enter.
3f. Email Address:
[e-mail]
4. Agent/ Consultant (if applicable)
4a. Name:
Deborah Shirley
4b. Business Name:
[e-mail]
4c. Address:
Street Address:
8412 Falls of Neuse Road
Address line 2:
Suite 104
City:
Raliegh
State/ Province/ Region:
NC
Postal/ Zip Code:
27615
Country:
USA
4d. Telephone Number: (###)###-####
[phone]
4e Fax Number: (###)###-####
[phone]
4f. Email Address:
[e-mail]
Agent Authorization Letter:,
Attach a completed/signed agent authorization form or letter. A sample form may be found at this link:
https://www.saw. usace.army. mil/Missions/Regulatory-Permit-Prog ram/Permits/2017-Nationwide-Permits/Pre-
construction-Notification/
Page 5 of 21 PCN Form Version 4.3- April 20, 2022

C. Project Information and Prior Project History
1. Project Information
1 a. Name of project:
Golden Trace
1 b. Subdivision name (if appropriate):
Click to enter.
1 c. Nearest municipality/town:
Garner
2.
Project Identification
2a.
Property identification number (tax PIN or parcel ID):
1629-23-1622, 1629-23-3112, 1629-23-9795, &
1629-23-7034
2b.
Property size (in acres):
Approximately 47.7 Acres
2c.
Project Address:
Street Address:
1725 New Bethel Church Road
Address line 2:
Click to enter.
City:
Garner
State/ Province/ Region:
NC
Postal/ Zip Code:
27529
Country:
USA
2d.
Site coordinates in decimal degrees (using 4-6 digits
after the decimal point):
Latitude (DD.DDDDDD): 35.655180
Longitude (-DD.DDDDDD):-78.587078
3. Surface Waters
3a. Name of nearest body of water to proposed project:
Swift Creek
3b. Water Resources Classification of nearest receiving
C;NSW
water:
The Surface Water Classification map may be found at this link:
https://ncdenr.maps.arcqis.com/apps/webappviewer/index. html?id=6e125ad7628f494694e259c8Odd64265
Neuse
3c. In what river basin(s) is your project located? *
Choose additional (if needed)
3d. Please provide the 12-digit HUC in which the project is
030202011004
located:
The Find Your HUC map may be found at this link:
https://ncdenr.maps.arcgis.com/apps/Publiclnformation/index.html?appid=ad3a85aOc6d644aOb97cdO69db238ac3
Page 6 of 21 PCN Form Version 4.3- April 20, 2022

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 consist of four parcels located north of New Bethel Church Road. The land is partially wooded
with agricultural fields and residential lots along the road. There are four streams (A, C, D & E) and five wetlands
(W1 through W5) within the properties. There are also two existing culverts within streams C and E. General land
use consists of rural residential, new residential devleopments, agricultural and wooded land.
4b. Have Corps permits or DWR certifications been obtained for this
❑ Yes ❑x No ❑ Unknown
project (including all prior phases) in the past?
If yes, please give the DWR Certification number and/or Corps
[Click to enter.]
Action ID (ex. SAW-0000-00000):
jClick to enter.]
Attach any pertinent project history documentation
02. Is any portion of the work already complete?
❑ Yes ❑x No
If yes, describe the completed work.
Click to enter text.
4c. List of other certifications or approvals/denials received from other federal, state or local agencies for work
described in this application not related to the 404 or 401.
Click to enter text.
4d. Attach an 8'h x 11" excerpt from the most recent version of the USGS topographic map indicating the location of
the project site.
4e. Attach an 8'h x 11" excerpt from the most recent version of the published County NRCS Soil Survey map
depicting the project site.
4f. List the total estimated acreage of all existing wetlands on the
Approximately 0.26 acres
property:
4g. List the total estimated linear feet of all existing streams (intermittent
Approximately 4,900 linear feet
and perennial) on the property:
4g1. List the total estimated acreage of all existing open waters on the
Click to enter. acres
property:
4h. Explain the purpose of the proposed project:
The purpose of this project is to construct a residential development and its necessary infrastructure.
4i. Describe the overall project in detail, including the type of equipment to be used:
The overall project consists of a single-family residential development to include but not limited to: construction of
roadway infrasturcure, utilities, single-family lots, greenway trails, amenities and Stormwater Control Measures
(SCM). Specifically there are stream and riparian buffer impacts associated with road crossings, sanitary sewer,
and SCM outfalls. Equipment typically used for construction and earthwork such as backhoes, bulldozers,
excavators, graders, pavers etc. will be utilitized for this project.
4j. Attach project drawings/site diagrams/depictions of impact areas for the proposed project.
4k. Will this activity involve dredging in wetlands or waters?
❑ Yes ❑x No
If yes, describe the type of dredging, the composition of the dredged material, and the locations of disposal area.
Click to enter text
Page 7 of 21 PCN Form Version 4.3- April 20, 2022

5.
Jurisdictional Determinations
5a.
Have the wetlands or streams been delineated on
the property or in
® Yes ❑ No ❑ Unknown
proposed impact areas?
Comments:
GIICK to enter text.
5b.
If the Corps made a jurisdictional determination,
0 Preliminary ❑ Approved ❑ Emailed concurrence
what type of determination was made?
❑ Not Verified ❑ Unknown ❑ n/a
Corps AID number (ex. SAW-0000-00000):
SAW-2021-02602
Name (if known): Steven Ball
5c.
If 5a is yes, who delineated the jurisdictional
Agency/Consultant Company: Soil and Environmental
areas?
Consultants, PA
Other: ';lick to enter
5d.
List the dates of the Corps jurisdictional determination or State determination if a determination was made by
either agency.
USACE issued the PJD on January 28, 2022 ; NBRRO
#21-430 was issued on December 7, 2021 by Chris
Smith.
5d1.
Attach jurisdictional determinations.
6. Future Project Plans
6a. Is this a phased project?
® Yes ❑ No
6b. If yes, explain.
This project will be broken into two phases for local utlitiy acceptance purposes but is planned to be built in one
phase. No additional phases are planned.
Are any other NWP(s), regional general permit(s), or individual permit(s) used, or intended to be used, to
authorize any part of the proposed project or related activity? This includes other separate and distant crossings
for linear projects that require Department of the Army authorization but don't require pre -construction
notification.
It is my understanding that there are no intended future phases beyond the property boundaries shown.
Therefore, no additional NWP, Regional General Permits, or IP are anticipated.
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)
Please reference Wake County GIS
8. Scheduling of activity:
Construction timeline will be after permits are issued by agencies, including the local municipality and before
permits expire. The exact date is unknown at this time.
Page 8 of 21 PCN Form Version 4.3- April 20, 2022

D. Proposed Impacts Inventory
Impacts Summary
1 a. Where are the impacts associated with your project
(check all that apply):
❑ Wetlands
❑x Buffers
❑ Pond Construction
❑x Streams - tributaries
❑ Open Waters
2. Wetland Impacts
If there are wetland impacts proposed on the site, complete this table for each wetland area impacted.
2a.
Site #
2a1.
Impact
Reason/Type
2b.
Impact
Duration*
2c.
Wetland Type
2d.
Wetland Name
2e.
Forested
?*
2f.
Jurisdiction
Type*
2g.
Impact Area
(ac)*
W1
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W2
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W3
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W4
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W5
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W6
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W7
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W8
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W9
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W10
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W11
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W12
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
--hoose one
Click to enter
W13
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
--hoose one
Click to enter
W14
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W15
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
2g1. Total temporary wetland impacts
Click to enter. ac
2g2. Total permanent wetland impacts
Click to enter. ac
2g3. Total wetland impacts
Click to enter. ac
2h. Type(s) of material being discharged and the amount of each type in cubic yards:
N/A
2i. Comments:
Click to enter text.
Page 9 of 21 PCN Form Version 4.3- April 20, 2022

3. Stream Impacts
If there are perennial or intermittent stream/ tributary impacts (including temporary impacts) proposed on the site,
complete this table for all stream/ tributary sites impacted.
** All Perennial or Intermittent streams must be verified by DWR or delegated local government
3a
3b.
3c.
3d.
3e.
3f.
3g.
3h.
Site #*
Impact Reason*
Impact
Impact
Stream Name*
Stream
Jurisdiction
Stream
Impact
Duration*
Type*
Type*
Type*
Width (avg
length
ft) *
(linear ft)
S1
Impact Area A -
Temporary
Other
Stream C
Intermittent
Both
2
21
Sanitary Sewer
S2
Impact Area B —
Permanent
Other
Stream E
Intermittent
Both
5
16
Road
Crossing/Retaining
Wall
S3
Impact Area C —
Permanent
Crossing/
Stream C
Intermittent
Both
4
108
Road Crossing
Culvert
S4
Impact Area C —
Temporary
Other
Stream C
Intermittent
Both
4
29
Construction
Access
S5
Impact Area C —
Permanent
Other
Stream C
Intermittent
Both
4
11
Permanent no
permanent loss —
Dissipator pad
S6
Click to enter
Temp/
Choose
Click to enter
Per/Int
Choose
Click to enter
Click to enter
Perm
one
one
S7
Click to enter
Temp/
Choose
Click to enter
Per/Int
Choose
Click to enter
Click to enter
Perm
one
one
S8
Click to enter
Temp/
Choose
Click to enter
Per/Int
Choose
Click to enter
Click to enter
Perm
one
one
S9
Click to enter
Temp/
Choose
Click to enter
Per/Int
Choose
Click to enter
Click to enter
Perm
one
one
S10
Click to enter
Temp/
Choose
Click to enter
Per/Int
Choose
Click to enter
Click to enter
Perm
one
one
S11
Click to enter
Temp/
Choose
Click to enter
Per/Int
Choose
Click to enter
Click to enter
Perm
one
one
S12
Click to enter
Temp/
Choose
Click to enter
Per/Int
Choose
Click to enter
Click to enter
Perm
one
one
S13
Click to enter
Temp/
Choose
Click to enter
Per/Int
Choose
Click to enter
Click to enter
Perm
one
one
S14
Click to enter
Temp/
Choose
Click to enter
Per/Int
Choose
Click to enter
Click to enter
Perm
one
one
S15
Click to enter
Temp/
Choose
Click to enter
Per/Int
Choose
Click to enter
Click to enter
Perm
one
one
S16
Click to enter
Temp/
Choose
Click to enter
Per/Int
Choose
Click to enter
Click to enter
Perm
one
one
S17
Click to enter
Temp/
Choose
Click to enter
Per/Int
Choose
Click to enter
Click to enter
Perm
one
one
Page 10 of 21 PCN Form Version 4.3- April 20, 2022

S18
Click to enter
Temp/
Choose
Click to enter
Per/Int
Choose
Click to enter
Click to enter
Perm
one
one
S19
Click to enter
Temp/
Choose
Click to enter
Per/Int
Choose
Click to enter
Click to enter
Perm
one
one
S20
Click to enter
Temp/
Choose
Click to enter
Per/Int
Choose
Click to enter
Click to enter
Perm
one
one
3i1.
Total jurisdictional ditch
Click to enter. linear ft
impact:
3i2. Total permanent stream
135 linear ft
impacts:
36. Total temporary stream
50 linear ft
impacts:
3i4. Total stream and ditch
185 linear ft
impacts:
3j.
Comments:
Total permanent loss stream =
124 LF ( 0.011 acres); Total permanent -no permanent loss stream = 11 LF
(0.001 acres); Total temporary
= 50 LF (0.004 acres).
Page 11 of 21 PCN Form Version 4.3- April 20, 2022

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., individually list all open water impacts in the table below.
4a.
Site #
4a1.
Impact Reason
4b.
Impact
Duration
4c.
Waterbody Name
4d.
Activity Type*
4e.
Waterbody
Type
4f.
Impact area
(ac)
01
;lick to enter.
Temp/ Perm
Click to enter.
Choose one
Choose one
Click to enter.
02
Click to enter.
Temp/ Perm
Click to enter.
Choose one
Choose one
Click to enter.
03
dick to enter.
Temp/ Perm
Click to enter.
Choose one
Choose one
Click to enter.
04
Click to enter.
Temp/ Perm
Click to enter.
Choose one
Choose one
Click to enter.
05
Click to enter.
Temp/ Perm
Click to enter.
Choose one
Choose one
Click to enter.
4g.
Total temporary open water impacts
Click to enter. ac
4g.
Total permanent open water impacts
Click to enter. ac
4g.
Total open water impacts
Click to enter. ac
4h.
Comments:
Click to enter.
5.
Pond or Lake Construction
If pond or lake construction is proposed, complete
the table below. (*This
does NOT include
ofFline stormwater
management ponds.)
5a.
5b.
5c.
5d.
5e.
Pond ID
Proposed use or
Wetland Impacts
(ac)
Stream
Impacts (ft)
Upland
#
purpose of pond
Impacts (ac)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
P1
Choose one
Click tc,
Click to
Click to
Click to
Click to
Click to
Click to
enter.
enter.
enter.
enter.
enter.
enter.
enter.
P2
Choose one
Click to
Click to
Click to
Click to
Click to
Click to
Click to
enter.
enter.
enter.
enter.
enter.
enter.
enter.
P3
Choose one
Click to
Click to
Click to
Click to
Click to
Click to
Click to
enter.
enter.
enter.
enter.
enter.
enter.
enter.
5f.
Total
Click to
Click to
Click to
Click to
Click to
Click to
Click to
enter.
enter.
enter.
enter.
enter.
enter.
enter.
5g.
Comments:
Click to enter.
5h.
Is a dam high hazard permit required?
❑ Yes ❑ No
If yes, permit ID no.:
Click to enter.
5i.
Expected pond surface area (acres):
Click to enter.
5j.
Size of pond watershed (acres):
Click to enter.
5k.
Method of construction:
Click to enter
Page12 of 21 PCN Form Version 4.3- April 20, 2022

6. Buffer Impacts (DWR requirement)
If project will impact a protected riparian buffer, then complete the chart below. Individually list all buffer impacts.
6a. Project is in which protected basin(s)?
(Check all that apply.)
❑x Neuse ❑ Tar -Pamlico ❑ Catawba
❑ Jordan ❑ Goose Creek ❑ Randleman
❑ Other: Click to enter.
Site #*
6b.
Impact Type*
6c.
Impact Duration*
6d.
Stream Name*
6e.
Buffer
Mitigation
Required?*
6f.
Zone 1 Impact*
(sq ft)
6g.
Zone 2 Impact*
(sq ft)
B1
Crossing/ Culvert/
Bridge
Permanent
Stream C
No
8,024
4,607
B2
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B3
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B4
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B5
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B6
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B7
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B8
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B9
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B10
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B11
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B12
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B13
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B14
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B15
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B16
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B17
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B18
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B19
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B20
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
6h. Total temporary impacts:
Zone 1: Click to enter. sq ft
Zone 2: Click to enter. sq ft
6h. Total permanent impacts:
Zone 1: 8,024 sq ft
Zone 2: 4,607 sq ft
6h. Total combined buffer impacts:
Zone 1: 8,024 sq ft
Zone 2: 4,607 sq ft
6i. Comments:
Per the Neuse River Buffer rules; Impacts A-1, A-2, the SCM outFalls at A and D are all considered "deemed
allowable" buffer impacts per 15a NCAC 02b .0714(11)(kk)(i), 15a NCAC 02b .0714(11)(II)(i) and 15a NCAC 02b
.0714(9)(a)(i) and were not included within the table above.
Please attach supporting documentation (impact maps, plan sheets, etc.) for the proposed project.
Page 13 of 21 PCN Form Version 4.3- April 20, 2022

E. Impact Justification and Mitigation
1. Avoidance and Minimization
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts through project design:
S&EC completed a stream and wetland delineation and Neuse River Buffer evaluation for the entire property in order to
identify natural resources so that impacts could be avoided and minimized to the maximum extent practicable. Proposed
impacts include two (2) road crossings, one (1) utility crossing and riparian buffer impacts associated with crossings and
SCM's outfalls. Additionally, a pedestrian bridge is proposed avoiding stream impacts. Impact areasA-1 &A-2 are proposed
utility impacts necessary to connect to existing sanitary sewer offsite. Proposed impacts include temporary stream impacts
for an aerial sewer installation. Stream and riparian buffer impacts have been minimized by crossing the stream at a near
perpendicular angle, limiting the construction corridor to 30' wide as well utilizing an existing culvert location at the temporary
stream crossing. Impact area B is a proposed road crossing. Proposed impacts include permanent stream impacts. This
impact is necessary for internal road infrastructure and lot access. Impacts have been minimized by utilizing a retaining wall.
Impact area C is a proposed road crossing. Proposed impacts include permanent (i.e culvert), permanent — no permanent
loss (i.e riprap dissipator), temporary (i.e construction access) stream impacts and associated riparian buffer impacts. This
road crossing is necessary to provide access to the northern portion of the property, as well as provide two points of ingress
and egress for the proposed development. Stream and riparian buffer impacts have been minimized by designing the
crossing at a near perpendicular angle and utilizing headwalls and retaining walls. Per the Neuse River Buffer rules; Impacts
A-1, A-2, the SCM outfalls at A and D are all considered "deemed allowable" buffer impacts per 15a NCAC 02b
.0714(11)(kk)(i), 15a NCAC 02b .0714(11)(II)(i) and 15a NCAC 02b .0714(9)(a)(i) and were not included within the table
above.
1 b. Specifically describe measures taken to avoid or minimize proposed impacts through construction techniques:
Per the project engineer- This project will utilize standard erosion and sediment control techniques such as silt
fences, diversion ditches, temporary sediment traps, sediment basins, baffles and skimmers. There will also be
temporary stream diversions for stream crossing installation.
2. Compensatory Mitigation for Impacts to Waters of the U.S., Waters of the State, or Riparian Buffers
2a. If compensatory mitigation is required, by whom is it required? ❑ DWR ❑ Corps
(check all that apply)
2b. If yes, which mitigation option(s) will be used for this ❑ Mitigation Bank
project? (check all that apply) ❑ In Lieu Fee Program
❑ Permittee Responsible Mitigation
3. Complete if using a Mitigation Bank
(Must satisfy NC General Statute143-214.11 (d1).)
3a. Name of mitigation bank:
ClicK Lu enter.
3b. Credits purchased/requested:
Type: Choose one
Quantity Click to enter.
Type: Choose one
Quantity Click to enter.
Type: Choose one
Quantity Click to enter.
Attach receipt and/or approval letter.
3c. Comments:
Click to enter.
4. Complete if Using an In Lieu Fee Program
4a. Attach approval letter from in lieu fee program.
4b. Stream mitigation requested: Click to enter. linear feet
Page 14 of 21 PCN Form Version 4.3- April 20, 2022

4c.
If using stream mitigation, what is the stream temperature:
Choose one
NC Stream Temperature Classification Maps can be found under the Mitigation Concepts tab on the Wilmington
District's RIBITS website: (Please use the filter and select Wilmington district)
https://ribits.usace.army.mil/ribits apex/f?p=107:27:2734709611497::NO: RP:P27 BUTTON KEY:O
4d.
Buffer mitigation requested (DWR only):
Click to enter. square feet
4e.
Riparian wetland mitigation requested:
Click to enter. acres
4f.
Non -riparian wetland mitigation requested:
Click to enter. acres
4g.
Coastal (tidal) wetland mitigation requested:
Click to enter. acres
4h.
Comments:
Click to enter.
5. Complete if Providing a Permittee Responsible Mitigation Plan
5a. If proposing a permittee responsible mitigation plan, provide a description of the proposed mitigation plan,
including mitigation credits generated.
Click to enter.
5b. Attach mitigation plan/documentation.
6.
Buffer Mitigation (State Regulated Riparian Buffer Rules) — DWR requirement
6a.
Will the project result in an impact within a protected riparian buffer
❑ Yes ❑x No
that requires buffer mitigation?
If yes, please complete this entire section — please contact DWR for more information.
6b.
If yes, identify the square feet of impact to each zone of the riparian buffer that requires
mitigation. Calculate the
amount of mitigation required in the table below.
6c.
6d.
6e.
Zone
Reason for impact
Total impact
Multiplier
Required mitigation
(square feet)
(square feet)
Zone 1
Click to enter.
Click to enter.
Choose one
Click to enter.
Zone 2
:,lick to enter.
Click to enter.
Choose one
Click to enter.
6f. Total buffer mitigation required
Click to enter.
6g.
If buffer mitigation is required, is payment to a mitigation bank or
❑ Yes ❑ No
NC Division of Mitigation Services proposed?
6h.
If yes, attach the acceptance letter from the mitigation bank or NC Division of Mitigation Services.
6i.
Comments:
Click to enter.
Page 15 of 21 PCN Form Version 4.3- April 20, 2022

F. Stormwater Management and Diffuse Flow Plan (DWR requirement)
1. Diffuse Flow Plan
1 a. Does the project include or is it adjacent to protected riparian buffers
® Yes ❑ No
identified within one of the NC Riparian Buffer Protection Rules?
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/dispersed flow will be maintained.
All Stormwater Control Measures (SCM) must be designed in accordance with the NC Stormwater Design
Manual (https://deg.nc.gov/about/divisions/energv-mineral-land-resources/energv-mineral-land-permit-
guidance/stormwater-bmp-manual).
Associated supplement forms and other documentation must be provided.
❑ Level Spreader
What Type of SCM are you
❑ Vegetated Conveyance (lower seasonal high water table- SHWT)
providing?
❑ Wetland Swale (higher SHWT)
(Check all that apply)
❑x Other SCM that removes minimum 30% nitrogen
❑ Proposed project will not create concentrated stormwater flow through the
buffer
For a list of options to meet the diffuse flow requirements, click here.
Attach diffuse flow documentation.
2.
Stormwater Management Plan
2a.
Is this an NCDOT project subject to compliance with NCDOT's
Individual NPDES permit NCS000250?
El Yes ❑x No
2b.
Does this project meet the requirements for low density projects as
defined in 15A NCAC 02H .1003(2)?
❑ Yes ❑x No
To look up low density requirements, click here:
http://reports.oah.state.nc.us/ncac/title%2015a%20-%20environ mental%20guality/chapter%2002%20-
%20environmental%20management/subchapter%20h/15a%20ncac%2002h%20.1003.pdf
2c.
Does this project have a stormwater management plan (SMP)
❑x Yes ElNo
reviewed and approved under a state stormwater program or state -
approved local government stormwater program?
❑ n/a — project disturbs < 1 acre
Note: 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.
2d.
Which of the following stormwater management program(s) apply?
❑x Local Government
(Check all that apply.)
❑ State
If you have local government approval, please include the SMP on their overall impact map.
❑x Phase II ❑ USMP
Local Government Stormwater Programs
❑x NSW ❑ Water Supply
Page 16 of 21 PCN Form Version 4.3- April 20, 2022

Please identify which local government stormwater program you are using.
Town of Garner
State Stormwater Programs ❑ Phase II ❑ HQW or ORW
❑ Coastal Counties ❑ Other
Comments:
There are two proposed SCM's that are both wet detention basins.
Page 17 of 21 PCN Form Version 4.3- April 20, 2022

G. Supplementary Information
1. Environmental Documentation
1 a. Does the project involve an expenditure of public (federal/state/local)
❑ Yes ❑x No
funds or the use of public (federal/state) land?
1 b. If you answered "yes" to the above, does the project require
preparation of an environmental document pursuant to the
requirements of the National or State (North Carolina) Environmental
El Yes El No
Policy Act (NEPA/SEPA)?
1 c. If you answered "yes" to the above, has the document review been
finalized by the State Clearing House? (If so, attach a copy of the
❑ Yes ❑ No
NEPA or SEPA final approval letter.)
Comments:
Click to enter.
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),
Federally Non -Jurisdictional Wetlands /Classified Surface Waters
❑ Yes ❑x No
(15A NCAC 2H. 1400) DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. If you answered "yes" to the above question, provide an explanation of the violation(s):
DICK to enter.
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
❑ Yes ❑x No
downstream water quality?
3b. If you answered "no", provide a short narrative description:
We have reviewed the "Draft Internal Policy, Cumulative impacts and the 401 Water Quality Certification and
Isolated Wetlands Programs" document prepared by the NC Division of Water Quality on April 10, 2004, version
2.1. The draft states that many private developments are unlikely to cause cumulative impacts, including
projects such as urban in -fill, most residential subdivisions and small commercial developments as well as
agricultural and silvicultural operations. The Golden Trace project is a residential development. Additionally, the
project is located within the Town of Garner jurisdiction, therefore the adjacent properties that have potential for
development will have the following regulations to protect downstream waters: 1) the Neuse River Basin Riparian
Buffer Protection regulations, these regulations require limited development within the riparian buffer area, in
addition Best Management Practices may be required that control nitrogen if diffuse flow cannot be achieved; 2)
the Phase II NPDES Stormwater Permit Program, this program includes permitting requirements for Municipal
Separate Storm Sewer Systems (MS4s) in addition to post -construction stormwater management requirements.
We anticipate that the DWR will advise us if any additional information is needed.
3c. If yes, provide a qualitative or quantitative cumulative impact analysis in accordance with the most recent DWR
policy. (Attach .pdo
Page 18 of 21 PCN Form Version 4.3- April 20, 2022

4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project? I ® Yes ❑ No ❑ N/A
4b. If yes, describe in detail the treatment methods and dispositions (non -discharge or discharge) of wastewater
generated from the proposed project. If the wastewater will be treated at a treatment plant, list the capacity
available at that plant.
Non -discharge. The proposed sewer will tie into the existing main. Wastewater will be treated at an offsite plant
that is part of City of Raleigh's larger sewer network.
5.
Endangered Species and Designated Critical Habitat (Corps Requirement)
5a.
Will this project occur in or near an area with federally protected
® Yes ❑ No
species or habitat? (IPAC weblink: https://www.fws.gov/ipac/ Ifws.govl)
5b.
Have you checked with the USFWS concerning Endangered Species
® Yes ❑ No
Act impacts?
5c.
If yes, indicate the USFWS Field Office you have contacted.
Raleigh
5d.
Is another federal agency involved?
❑ Yes ❑ No ❑x Unknown
If yes, which federal agency?
,lick to enter.
5e.
Is this a DOT project located within Divisions 1-8?
❑ Yes ❑x No
5f.
Will you cut any trees in order to conduct the work in waters of the
U.S.?
®Yes El No
5g.
Does this project involve bridge maintenance or removal?
❑ Yes ❑x No
5g1.
If yes, have you inspected the bridge for signs of bat use such as
staining, guano, bats, etc.? Representative photos of signs of bat use
❑ Yes ❑ No
can be found in the NLEB SLOPES, Appendix F, pages 3-7.
Representative photos of signs of bat use can be found in the NLEB SLOPES, Appendix F, pages 3-7. Link to
NLEB SLOPES document: http://saw-reg.usace. army. mil/NLEB/1-30-17-signed
NLEB-SLOPES&apps.pdf
If you answered yes to 5g1, did you discover any signs of bat use?
❑ Yes ❑ No ❑ Unknown
If yes, please show the location of the bridge on the permit drawings/ project plans
5h.
Does this project involve the construction/ installation of a wind
turbine(s)?
❑ Yes ❑x No
If yes, please show the location of the wind turbine(s) on the permit drawings/ project plans (attach .pdo
5i.
Does this project involve blasting and /or other percussive activities
that will be conducted by machines, such as jackhammers,
® Yes ❑ No
mechanized pile drivers, etc.?
If yes, please provide details to include type of percussive activity, purpose,
duration, and specific location of this
activity on the property (attach .pdo
Page 19 of 21 PCN Form Version 4.3- April 20, 2022

5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated
Critical Habitat?
S&EC completed a Threatened & Endangered Species Report, to include a Self -Certification letter through the
US Fish & Wildlife Service (USFWS), a query through the NC Natural Heritage Program database, and an official
Species List through the iPac. A formal request was sent to the USFWS on November 23, 2021. FWS provided
an email response on February 15, 2023 confirming the service agrees with S&EC's determinations. The S&EC
determinations were that the proposed project is not likely to adversely affect any federally -listed endangered or
threatened species, their formally designated critical habitat, or species currently proposed for listing under the
Endangered Species Act (ESA). Please see attached S&EC Threatened & Endangered Species report and FWS
comments.
Attach consultation documentation.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as
an Essential Fish Habitat?
❑ Yes ❑x No
Is there submerged aquatic vegetation (SAV) around
the project vicinity?
El Yes ❑x No El Unknown
Will this project affect submerged aquatic vegetation?
❑ Yes ❑x No ❑ Unknown
Explain: Click to enter.
6b. What data source(s) did you use to determine whether your site would impact Essential Fish Habitat?
The NOAA Habitat Conservation/Habitat Protection: National Marine Fish Service; Essential Fish Habitat
Mapper website was referenced. No Essential Fish Habitat was identified near the project.
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
Link to the State Historic Preservation Office Historic Properties Map (does not include archaeological data):
hftp://qis.ncdcr.gov/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
❑ Yes ❑x No
preservation status (e.g., National Historic Trust designation or
properties significant in North Carolina history and archaeology)?
7b. What data source(s) did you use to determine whether your site would impact historic or archeological
resources?
On November 19, 2021, S&EC submitted an Environmental Review Request to the NC State Historic
Preservation Office (SHPO). SHPO provided a response letter on January 11, 2022 confirming they had no
comment on the project as proposed.
7c. Attach historic or prehistoric documentation.
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 ❑x No
8b. If yes, explain how the project meets FEMA requirements.
Click to enter.
Page 20 of 21 PCN Form Version 4.3- April 20, 2022

8c. What source(s) did you use to make the floodplain determination?
NC Flood Risk Information System Floodplain Mapping Program and confirmation from the project engineer.
H. Miscellaneous
Comments:
( lirrlr 4n anfar
Attach pertinent documentation or attachments not previously requested
I. Signature *
❑x By checking the box and signing below, I, as the project proponent, certify to the following:
• The project proponent hereby certifies that all information contained herein is true, accurate, and complete, to
the best of my knowledge and belief;
• 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;
• The project proponent hereby agrees 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");
• The project proponent hereby agrees to conduct this transaction by electronic means pursuant to Chapter 66,
Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
• The project proponent hereby understands that an electronic signature has the same legal effect and can be
enforced in the same way as a written signature; AND
• As the project proponent, I intend to electronically sign and submit the PCN/online form.
Full Name: Deborah Shirley
* Deborah E. Shirley Digitally signed by Deborah ' Shirley
Signature: ����� �� cinci.
Date: 2023.08.04 16:25:16-04'00'
Date: 8/4/2023
Page 21 of 21 PCN Form Version 4.3- April 20, 2022