Pre-Construction Notification (PCN) Form_Cub Creek Station & Sandy Ridge USACE RFAI Update 7_25_23.pdf

DWR
mrlsloa 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.gov/WaterResources/0/edoc/624704/PCN%20Help%20File%202018-1-30.pdf
A. Processing Information
Pre-Filing Meeting Date Request was submitted on:
4/19/2022
If this is a courtesy copy,please fill in this with the submission date.
Is this project connected with ARPA funding?*
Yes No
County(or Counties)where the project is located:
Durham
Is this a NCDMS Project*
Yes No
Click Yes,only if NCDMS is the applicant or co-applicant.
DO NOT CHECK YES,UNLESS YOU ARE DMS OR CO-APPLICANT.
Is this project a public transportation project?*
Yes 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:*
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
1 b.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: 29-Residential Developments
NWP Numbers(for multiple NWPS):
List all NW numbers you are applying for not on the drop down list.
1d.Type(s)of approval sought from the DWR:
check all that apply
401 Water Quality Certification-Regular 401 Water Quality Certification-Express
Non-404 Jurisdictional General Permit Riparian Buffer Authorization
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: Yes No

For the record only for Corps Permit: Yes No
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?
If so,attach the acceptance letter from mitigation bank or m-lieu fee program.
Yes No
Acceptance Letter Attachment
Click the upload button or drag and drop files here to 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?
Yes No
Link to trout information:http://www.saw.usace.army.mil/Missions/Regulatory-Permit-Program/Agency-Coordination/Trout.aspx
B. Applicant Information
1a.Who is the Primary Contact?*
Deborah Shirley
1c.Primary Contact Phone:
1 b.Primary Contact Email: (xxx)xxx-xxxx
[e-mail] [phone]
1d.Who is applying for the permit?*
Owner Applicant(other than owner)
(Check all that apply)
le.Is there an Agent/Consultant for this project?*
Yes No
2.Owner Information
2a.Name(s)on recorded deed:
The Shaffer Living Trust
2b.Deed book and page no.:
DB:008621,DP:000689
2c.Contact Person:
(for Corporations)
Leonard B.Shaffer
2d.Address*
Street Address
P.O.Box 1599
Address Line 2
City State/Province/Region
Apex NC
Postal/Zip Code Country
27502 USA
2e.Telephone Number:*
(xxx)xxx-xxxx
[phone]
2f.Fax Number:
(xxx)xxx-xxxx
2g.Email Address:
[e-mail]
2a.Name(s)on recorded deed:*
Steven Belvin Living Trust
2b.Deed book and page no.:
DB:008618 DP:000453&DB:009283 DP:000379
2c.Contact Person:
(for Corporations)
Leonard B.Shaffer

2d.Address*
Street Address
3818 Cub Creek Road
Address Line 2
City State/Province/Region
Durham NC
Postal/Zip Code Country
27704 USA
2e.Telephone Number:*
(xxx)xxx-xxxx
[phone]
2f.Fax Number:
(xxx)xxx-xxxx
2g.Email Address:
[e-mail]
2a.Name(s)on recorded deed:
Joven Group Three
2b.Deed book and page no.:
DB:001174,DP:000952
2c.Contact Person:
(for Corporations)
Leonard B.Shaffer
2d.Address*
Street Address
P.O.Box 1599
Address Line 2
City State/Province/Region
Apex NC
Postal/Zip Code Country
27502 USA
2e.Telephone Number:*
(xxx)xxx-xxxx
[phone]
2f.Fax Number:
(xxx)xxx-xxxx
2g.Email Address:
[e-mail]
3.Applicant Information(if different from owner)
3a.Name:*
Leonard Shaffer
3b.Business Name:
(if applicable)
Joven Group
3c.Address*
Street Address
P.O.Box 1599
Address Line 2
City State/Province/Region
Apex NC
Postal/Zip Code Country
27502 USA
3d.Telephone Number:*
[phone] 3e.Fax Number:
(xxx)xxx-xxxx (xxx)xxx-xxxx
3f.Email Address:
[e-mail]
4.Agent/Consultant(if applicable)

4a.Name:*
Deborah Shirley
4b.Business Name:
(if applicable)
Soil&Environmental Consultants,PA
4c.Address*
Street Address
8412 Falls of Neuse Road,Suite 104
Address Line 2
City State/Province/Region
Raleigh NC
Postal/Zip Code Country
27615 USA
4d.Telephone Number:* 4e.Fax Number:
[phone] [phone]
(xxx)xxx-xxxx (xxx)xxx-xxxx
4f.Email Address:*
[e-mail]
C. Project Information and Prior Project History U
1.Project Information
1a.Name of project:*
Cub Creek Station&Sandy Ridge
1b.Subdivision name:
(if appropriate)
1c.Nearest municipality/town:
Durham
2.Project Identification
2a.Property Identification Number:
(tax PIN or parcel ID)
0833-56-63-0470,0833-47-71-8289,0833-46- 2b.Property size:
02-1563,0833-45-13-8106,0833-44-46-2879, (in acres)
0833-56-15-6756&0833-56-144798 +/-133.88 acres
2c.Project Address
Street Address
937 Old Oxford Road
Address Line 2
City State/Province/Region
Durham NC
Postal/Zip Code Country
27704 USA
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:*
36.048826 -78.880319
ex:34.208504 -77.796371
3. Surface Waters
3a.Name of the nearest body of water to proposed project:
Cub Creek
3b.Water Resources Classification of nearest receiving water:*
WS-IV;NSW
Surface Water Lookup
3c. What river basin(s)is your project located in?
Neuse

3d.Please provide the 12-digit HUC in which the project is located.*
030202010304
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 onsite consists of primarily of forested land with single-family residential structures.Specifically,there are six(6)wetland features(W1-W6),two(2)linear wetlands
(LW1-LW2),five(5)perennial stream features(SB,SG,SH,SN&SO),and three(3)intermittent stream features(SC,SI&SM)located on the property.General land use in the vicinity of
the project consists of forested land with single-family homes and residential developments.East Carver Street bisects the property from east to west.Old Oxford road bounds the
southeastern portion of the property.
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:
Approximately 9.35 acres of wetlands
4g.List the total estimated linear feet of all existing streams on the property:
(intermittent and perennial)
Approximately 7,261 LF of streams
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 indirect impacts and the type of equipment to be used:
The overall project consists of the construction of a 80 single-family units,159 Townhome units,and 582 apartment unit residential development including but not limited to roadway
infrastructure,utilities,SCMs,and amenities.Specifically,there are buffer impacts associated with one bottomless arch span road crossing,stream impacts associated with a road&
sidewalk crossing,and wetland impacts associated with two sanitary sewer crossings.Equipment typically used for construction and earthwork such as backhoes,bulldozers,excavators,
graders,pavers etc.will be utilized for this project.
5. Jurisdictional Determinations
5a.Have the wetlands or streams been delineated on the property or proposed impact areas?
Yes No 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:
Example:SAW-2017-99999
SAW-2018-02203
5c.If 5a is yes,who delineated the jurisdictional areas?
Name(if known): Steven Ball
Agency/Consultant Company: Soil&Environmental Consultants,PA
Other:
5d.List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR.
USACE:SAW-2018-02024-Site visit conducted on 11/28/2018 by Ross Sullivan,and email verified on 3/5/2019.Subsequent confirmation and new AID by April Norton on 10/26/2021
(SAW-2018-02203).
NCDWR:RRO#19-213-the buffer determination site visit on 7/18/19 by Rick Trone,letter issued 07/19/19.
6.Future Project Plans
6a.Is this a phased project?*
Yes No
6b.If yes,explain.
This will be a phased project for construction,but there will be no future phases that are not included in the existing site plan.
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?This includes other
separate and distant crossing 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.
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

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*
Impact 3 Sanitary Sewer P Bottomland Hardwood Forest W2 Yes Both 0.129
Crossing:Permanent-No (acres)
Permanent Loss
Impact 4 Sanitary Sewer P Headwater Forest LW1 Yes Both 0.002
Crossing:Permanent-No (acres)
Permanent Loss
2g.Total Temporary Wetland Impact
0.000
2g.Total Permanent Wetland Impact
0.131
2g.Total Wetland Impact
0.131
21.Comments:
3. Stream Impacts
If there are perennial or intermittent stream impacts(including temporary impacts)proposed on the site,then complete this question for all stream sites impacted.
"S."will be used in the table below to represent the word"stream".
3a.Reason for impact(?) 3b.lmpact type* 3c.Type of impact 3d.S.name 3e.Stream Type" 3f.Type of 3g.S.width* 3h.Impact
(?) Jurisdiction* length*
S1 Impact 2:Road&Sidewalk Permanent Culvert Stream I Intermittent Both 23 54
Crossing Average(feet) (linear feet)
S2 Impact 2:Road&Sidewalk Permanent Other Stream I Intermittent Both 15 74
Crossing-RipRap Dissipator Average(feet) near feet)
(Permanent-No Permanent
Loss)
S3 Impact 2:Road Crossing- Temporary Other Stream I Both 5 12
Temporary Construction Average(feet) (linear feet)
Access
**All Perennial or Intermittent streams must be verified by DWR or delegated local government.
3i.Total jurisdictional ditch impact in square feet:
0
3i.Total permanent stream impacts:
128
31.Total temporary stream impacts:
12
31.Total stream and ditch impacts:
140
3j.Comments:
Total permanent loss stream=54 LF(0.028 acres);Total permanent-no permanent loss stream=74 LF(0.026 acres);Total temporary stream=12 LF
(0.001 acres);Temporary stream impacts will be brought back to pre-construction stream bed elevations and the stream banks will be stabilized.
6. Buffer Impacts (for DWR)
If project will impact a protected riparian buffer,then complete the chart below.Individually list all buffer impacts below.
6a.Project is in which protect basin(s)?
Check all that apply.
Neuse Tar-Pamlico
Catawba Randleman
Goose Creek Jordan Lake
Other

6b.Impact Type*(?) 6c.Per or Temp*(?) 6d.Stream name* 6e.Buffer mitigation required?* 6f.Zone 1 impact* 6g.Zone 2 impact*
Impact 1:Road Crossing/Bottomless Arch Span P Stream G No 6,978 4,440
(square feet) (square feet)
-A
6h. Total buffer impacts:
Zone 1 Zone 2
Total Temporary impacts: 0.00 0.00
Zone 1 Zone 2
Total Permanent impacts: 6,978.00 4,440.00
Zone 1 Zone 2
Total combined buffer impacts: 6,978.00 4,440.00
6i.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:
A wetland and stream delineation and Neuse River Buffer evaluation for the entire property was completed in order to identify natural resources so that
impacts could be avoided&minimized to the maximum extent practicable.Impact 1 is a proposed road crossing utilizing a bottomless arch span.
Proposed impacts include permanent riparian buffer impacts,stream impacts will be avoided during construction activities.Retaining walls are being
utilized to minimize the impacts to the riparian buffers.This road crossing is necessary to provide access to the northeastern portion of the property.
Impact 2 is a proposed road&sidewalk crossing.Proposed impacts include permanent(i.e.culvert),permanent-no permanent loss(i.e.riprap
dissipator),temporary(i.e.construction access)stream impacts.This road crossing is necessary to provide access to the northern portion of the
property.This impact starts at the downstream end of the East Carver Street existing culvert.Stream impacts have been minimized by shifting the
sidewalk east and closer to the proposed road crossing,and by utilizing retaining walls.Although this is a short section of permanent loss stream impact,
the OHWM of the stream in this location is wide and therefore stream mitigation is needed.Stream mitigation is proposed at a 2:1 ratio to compensate
for the permanent stream loss.Temporary stream impacts will be brought back to pre-construction stream bed elevations and the stream banks will be
stabilized.Impact 3 is a proposed Sanitary Sewer connection to an existing sanitary sewer ouffall.Proposed impacts include"permanent-no permanent"
loss wetland impacts.The easement is limited to 30'wide and will be revegetated with the existing seed source from the adjacent wetlands.Wetland
mitigation is proposed at a 1:1 ratio for the change in function of the wetlands post construction.Impact 4 is a proposed Sanitary Sewer crossing.
Proposed impacts include"permanent-no permanent"loss wetland impacts.The easement is limited to 30'wide and will be revegetated with the existing
seed source from the adjacent wetlands.Wetland mitigation is proposed at a 1:1 ratio for the change in function of the wetlands post construction.
1 b.Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Bottomless arch span,temporary bridges will be utilized during construction to avoid stream impacts,retaining walls,coir baffles,skimmers,and silt
fence.
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
2c.If yes,mitigation is required by(check all that apply):
DWR Corps
2d.If yes,which mitigation option(s)will be used for this project?
Mitigation bank Payment to in-lieu fee program Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a.Name of Mitigation Bank:
EBX-Neuse sponsored Neu-Con Wetland&Stream Umbrella Mitigation Banks
3b.Credits Purchased/Requested(attach receipt and letter)
Type: Quantity:
Stream 108
Riparian wetland 0.13
3c.Comments
Intermittent-Permanent loss stream impact=54;54 @ 2:1 mitigation ratio=108
Permanent,No Permanent loss impact=0.13 acres;0.13 @ 1:1 mitigation ratio=0.13 acres
NC Stream Temperature Classification Maps can be found under the Mitigation Concepts tab on the Wilmington District's RIBITS website.

6. Buffer mitigation (State Regulated Riparian Buffer Rules) -required by DWR
6a.Will the project result in an impact within a protected riparian buffer that requires buffer mitigation?If yes,you must fill out this entire form-please contact DWR for more information.
Yes No
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
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
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 flow will be maintained.
All Stormwater Control Measures(SCM)s must be designed in accordance with the NC Stormwater Design Manual. Associated supplement forms and other documentation shall be
provided.
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
(check all that apply)
For a list of options to meet the diffuse flow requirements,click here.
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
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?
Yes No
N/A-project disturbs<1 acre
Hint: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(check all that apply):"
Local Government i_ State
If you have a local government approval please include the SMP on their overall impact map.
Local Government Stormwater Programs*
Phase II NSW
USMP Water Supply
Please identify which local government Stormwater program you are using.
City of Durham
Comments:
Five wet detention basins,two wetlands,and one level spreader.
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(based on past and reasonably anticipated future impacts)result in additional development,which could impact nearby downstream water quality?*
Yes No
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 Cub Creek Station&Sandy Ridge project is a residential development.Additionally,the project is located within the City of
Durham ETJ,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;3)the Water Supply,Watershed Protection Program which limits development densities as well as requires
protective riparian buffers.We anticipate that the DWR will advise us if any additional information is needed.
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.
Non-discharge,City of Durham has approved capacity for treatement.
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
5c.If yes,indicate the USFWS Field Office you have contacted.
Raleigh
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
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 constructionlinstallation of a wind turbine(s)?**
Yes No
51.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?
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
March 28,2022 and provided an update regarding the botanical surveys on June 7,2022.FWS provided concurrence for all determinations on June 8,
2022.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 concurrence email from USFWS.
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?
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: http1//gis.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 preservation status(e.g.,National Historic Trust
designation or properties significant in North Carolina history and archaeology)?*
Yes No
7b.What data sources did you use to determine whether your site would impact historic or archeological resources?
The NC State Historic Preservation Office HPOWEB GIS Service interactive map was referenced on February 4,2022,no historic listings or study list
entries or determined eligible listings were identified within the property boundaries.Additionally,no structures exist within the property boundaries.
SHPO provided a letter on April 11,2022 stating they have no comments on the project as proposed.
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 No
8b.If yes,explain how project meets FEMA requirements:
A greenway,sanitary sewer easement,and 2 storm outlets will occur within the FEMA designated 100-year floodplain.Only the sanitary sewer
connection is located within wetlands within the FEMA 100-yr floodplain,the greenway and storm outlets are within uplands.
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.
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
PCN Attachments—Cub Creek Station and Sandy Ridge.pdf 23.64MB
File must be PDF or KMZ
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:*
Deborah E.Shirley
Signature*
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Date
6/9/2023