20231133 Ver 1_ePCN Application_20230811

DW R
DHlsloo 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:
4/4/2023
BIMS # Assigned
20231133
Is a payment required for this project?*
No payment required
Fee received
Fee needed - send electronic notification
Reviewing Office*
Raleigh Regional Office - [phone]
Information for Initial Review
1a. Name of project:
5106 Overlook Drive
1a. Who is the Primary Contact?*
John R. Davis, Jr.
1b. Primary Contact Email: *
soil [e-mail]
Date Submitted
8/11/2023
Nearest Body of Water
Tar River Reservoir
Basin
Tar -Pamlico
Water Classification
WS IV NSW
Site Coordinates
Latitude:
35.847630
A. Processing Information
Is this project connected with ARPA funding?
Yes No
County (or Counties) where the project is located:
Nash
Is this a NCDMS Project
Yes No
Longitude:
-77.914990
Version#*
1
What amout is owed?*
$240.00
$570.00
Select Project Reviewer*
Joseph Myers:[e-mail]
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
Regional General Permit (RGP) Number:
RGP Numbers (for multiple RGPS):
1d. Type(s) of approval sought from the DWR:
401 Water Quality Certification - Regular
Non-404 Jurisdictional General Permit
Individual 401 Water Quality Certification
197800056 - Piers, Docks, Boathouses
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 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:
Jeffrey Dale Hewlin
2b. Deed book and page no.:
DB 3093 PG 922
2c. Contact Person:
2d.Address
Street Address
5106 Overlook Drive
Address Line 2
city
Elm City
Postal / Zip Code
27822
401 Water Quality Certification - Express
Riparian Buffer Authorization
State / Province / Region
NC
Country
USA
Yes No
Yes No

2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
John R. Davis, Jr.
4b. Business Name:
Soil Horizons, LLC
4c. Address
Street Address
285 Dreamcatcher Trail
Address Line 2
City
Youngsville
Postal / Zip Code
27596
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:
Elm City
2. Project Identification
2a. Property Identification Number:
372600154181
2c. Project Address
Street Address
5106 Overlook Drive
Address Line 2
city
Elm City
Postal / Zip Code
27822
3. Surface Waters
3a. Name of the nearest body of water to proposed project:
Tar River Reservoir
3b. Water Resources Classification of nearest receiving water:
WS IV NSW
3c. What river basin(s) is your project located in?*
Tar -Pamlico
3d. Please provide the 12-digit HUC in which the project is located.
030201010606
4. Project Description and History
2f. Fax Number:
State / Province / Region
NC
Country
USA
4e. Fax Number:
2b. Property size:
1.03
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: *
This property is an existing residential lot in a subdivision on the Tar River Reservoir. There is an existing retaining wall along the shoreline with some trees that will not be disturbed.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?
Yes No Unknown
a

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:
0
4h. Explain the purpose of the proposed project:"
To construct a boat dock and boat house on pilings with pier along an existing shoreline retaining wall.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used: *
This project will involve the sinking of pilings to support a boat house and dock with pier into the waters of the Tar River Reservoir. Work will be done with customary equipment when the
water level is low to minimize impacts to the waters. The main impact to waters will be the shading from the structure. The total square footage of the structure will be 791 square feet. No
trees or grass along the shoreline buffer will be impacted during the construction.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?
Yes No O Unknown
Comments:
NA
5b. If the Corps made a jurisdictional determination, what type of determination was made?
Preliminary Approved Not Verified Unknown N/A
Corps AID Number:
NA
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?
None.
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
4. Open Water Impacts
4a. Site #
4a7. Impact Reason
4b. Impact type
4c. Name of waterbody
4d. Activity type
4e. Waterbody type
4f. Impact area
Boat Dock House
P
Tar River Reservoir
Dock & Pier
_11
Lake
0.02
4g. Total temporary open water Impacts: 4g. Total permanent open water impacts:
0.00 0.02
4g. Total open water impacts:
0.02
4h. Comments:
The total impacts for the boat dock and house will be 791 sf. or 0.018 acres. The boat house will be 393 sf and the boat dock will be 398 sf.
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:
The boat dock and house will be located along the east end of the bulkhead to avoid impacts to the shoreline trees.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Most construction work will be conducted from the shore. Pilings will be set when water levels are low to minimize sediment impacts into the waters.
O

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:
NA
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
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 No
What type of SCM are you providing?
Level Spreader
Vegetated Conveyance (lower SHWT)
Wetland Swale (higher SHWT)
Other SCM that removes minimum 30 % nitrogen
Proposed project will not create concentrated stormwater flow through the 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
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?
Yes No
N/A - project disturbs < 1 acre
Comments:
NA
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 will not have any impact on future development because it is in an existing subdivision and is limited to the individual lot. No additional
structures or impacts to waters are anticipated after this project.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?
Yes No N/A
4b. 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.
Existing septic system permit approved by Nash County.
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
Sc. If yes, indicate the USFWS Field Office you have contacted.
Raleigh
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?
U. S. Fish and Wildlife IPaC website and other project documentation on nearby site on the Tar River Reservoir. This project activity is covered by the
regional general permit 197800056.
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?
US Fish and Wildlife IPaC website. This project activity is covered by the regional general permit 197800056.
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? *
HPOWEB 2.0 website. No site found near this project. The closest site is the Ed Winstead house located about one mile to the northeast. This activity is
covered by regional general permit 197800056.
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain? *
Yes No
8b. If yes, explain how project meets FEMA requirements:
The project is located in an area of reduced flood risk due to a levee. See attached flood map.
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
5106 Overlook Drive Boat Lift Plans.pdf 17.31MB
File must be PDF or KMZ
Comments
The attachments are site plans and other supporting documents for the project.
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.
8

Full Name:
John R. Davis, Jr.
Signature
c7�,.,�.aar�. cT•
Date
8/11/2023