20231198 Ver 1_ePCN Application_20230825

DWR
Division of Water Resources
Pre -Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
April 13, 2022 Ver 4.3
Initial Review
Has this project met the requirements for acceptance in to the review process?
Yes
No
Is this project a public transportation project?*
Yes No
Change only If needed.
Pre -Filing Meeting Date Request was submitted on:
8/25/2023
BIMS # Assigned
20231198
Is a payment required for this project?*
No payment required
Fee received
Fee needed - send electronic notification
Select Project Reviewer*
Rebecca Chandler:[e-mail]
Information for Initial Review
la. Name of project:
COURTESY COPY Peters Creek Townhomes
1a. Who is the Primary Contact?*
Ashley Bentz
1b. Primary Contact Email: *
[e-mail]
Date Submitted
8/25/2023
Nearest Body of Water
UT - Perryman Creek
Basin
Yadkin-PeeDee
Water Classification
C
Site Coordinates
Latitude:
36.02658
A. Processing Information
Is this project connected with ARPA funding?
Yes No
County (or Counties) where the project is located:
Forsyth
Is this a NCDMS Project
Yes No
Longitude:
-80.25719
Version#*
1
Reviewing Office *
Winston-Salem Regional Office - (336) 776-
9800
1c. Primary Contact Phone: *
[phone]
a
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 permits) 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:
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
401 Water Quality Certification - Regular
Non-404 Jurisdictional General Permit
Individual 401 Water Quality Certification
29 - Residential Developments
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
fig. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
Yes No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
Yes No
1h. Is the project located in any of NC's twenty coastal counties?
Yes No
1j. Is the project located in a designated trout watershed?
Yes No
B. Applicant Information
1d. Who is applying for the permit?
Owner Applicant (other than owner)
le. Is there an Agent/Consultant for this project?
Yes No
2. Owner Information
2a. Nani on recorded deed:
Estate of Agnes Fishel
2b. Deed book and page no.:
401 Water Quality Certification - Express
Riparian Buffer Authorization
2c. Contact Person:
Jay Taylor - Agent
2d. Address
Street Address
2969 Burke Mill Road
Address Line 2
City
State / Province / Region
Winston Salem
NC
Postal / Zip Code
Country
27103
us
Yes No
Yes No

2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Ashley Bentz
4b. Business Name:
S&ME, Inc
4c.Address
Street Address
3201 Spring Forest Road
Address Line 2
City
Raleigh
Postal / Zip Code
27616
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:
Winston Salem
2. Project Identification
2a. Property Identification Number:
6823-80-2904
2c. Project Address
Street Address
3425 Peters Creek Parkway
Address Line 2
city
Winston Salem
Postal / Zip Code
27127
3. Surface Waters
3a. Name of the nearest body of water to proposed project:
UT - Perryman Creek
3b. Water Resources Classification of nearest receiving water:
C
3c. What river basin(s) is your project located in?*
Yadkin-PeeDee
3d. Please provide the 12-digit HUC in which the project is located.
030401011307
4. Project Description and History
2f. Fax Number:
State / Province / Region
NC
Country
US
4e. Fax Number:
2b. Property size:
18.26
State / Province / Region
NC
Country
US
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: *
The proposed project site is currently undeveloped and forested. Based on a review of Google Earth historical aerial imagery, the site contained a residence that was demolished between
2006 and 2008. The site appears to have contained agricultural fields as recently as the Iate1990's and then was allowed to regrow with minor clearings for the dilapidated structures and
sewer easements. The site is bounded to the north and south by residential developments and a church, is undeveloped directly to the east, and is commercial (Walmart) on the western
side of Peters Creek Parkway. The general vicinity is dominated by residential developments with some commercial and institutional use.
a

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:
0 ac
4g. List the total estimated linear feet of all existing streams on the property:
730 LF
4h. Explain the purpose of the proposed project:*
The purpose of the proposed project is to construct a residential townhome development and provide additional housing to meet the existing need in Winston Salem.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:"
The project will construct approximately 135 townhomes as well as their associated parking, lighting, utilities, open space, and stormwater control measures. Construction will be
performed by standard commercial construction equipment. No specialized equipment not regularly seen on commercial projects is anticipated.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
Yes No Unknown
Comments:
Delineation performed by S&ME May 2023. PJD request submitted 6/29/2023 to Charlotte
Regulatory.
5b. If the Corps made a jurisdictional determination, what type of determination was made?
Preliminary Approved Not Verified Unknown N/A
Corps AID Number:
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Walter Cole
Agency/Consultant Company: S&ME, Inc
Other:
6. Future Project Plans
6a. Is this a phased project?*
Yes No
Are any other NWP(s), regional general permit(s), or individual permits(s) used, or intended to be used, to authorize any part of the proposed project or related activity?
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
Wetlands Streams -tributaries Buffers
Open Waters Pond Construction
3. Stream Impacts
F
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
Road crossing
Permanent
Culvert
S1
Perennial
Corps
12
73
Average (feet)
(linear feet)
gy
Road crossing
Permanent
Rip Rap Fill
S1
Perennial
Corps
13
Average (feet)
(linear feet)
S3
Road crossing
Temporary
Dewatering
S1
Perennial
Corps
10
29
�_]
Aveage (feet)
(linear feet)
3i. Total jurisdictional ditch impact in square feet:
0
31. Total permanent stream impacts: 31. Total temporary stream impacts:
86 29
3i. Total stream and ditch impacts:
115

3j. Comments:
Impacts for this project are the result of a required road crossing of a perennial stream. Permanent impacts due to the installation of the culvert will total
73 LF (838 sq ft). This will result in a permanent loss of these waters. Permanent impacts in the form of rip rap will total 12.7 LF (109 sq fit). The rip rap
will be embedded within the stream and will be a permanent impact but no permanent loss of waters. Temporary impacts will be a result of dewatering
for construction of the retaining wall and culvert installation. These temporary impacts will total 29.3 LF (303 sq ft).
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:
The alignment of the road crossing was designed around crossing the existing creek at as close to a perpendicular angle as possible. This crossing is
necessary for safety and is required by local regulations to provide multiple access and egress points for the development. This is the only crossing
location in the proposed development. A retaining wall was designed to minimize culvert lengths and impacts to the maximum extent practicable.
Appropriate sediment and erosion control practices equaling those outlined in the most recent version of the "North Carolina Sediment and Erosion
Control Planning and Design Manual" will be used to minimize impacts to the stream.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Specific attention will be paid to ensure grading is only performed to the extent needed for the proposed project and all grading not required will be
avoided. Additional impacts to the jurisdictional stream will be avoided through the use of appropriate sediment and erosion control devices.
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:
Permanent impacts resulting in a permanent loss of features will total 73 LF (838 square feet) and are below those usually requiring mitigation.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
1. Diffuse Flow Plan
la. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection Rules?
Yes No
If no, explain why:
Site is not located within a basin with state -regulated riparian buffers.
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
2d. Which of the following stormwater management program(s) apply:
Local Government State
Local Government Stormwater Programs
Phase II NSW USMP Water Supply
Please identify which local government stormwater program you are using.
Winston Salem
Comments:
The stormwater plan is currently being reviewed by the City of Winston Salem.
G. Supplementary Information
1. Environmental Documentation
la. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?'
Yes No
2. Violations (DWR Requirement)
O
O

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.
The project is being constructed to meet an existing need for housing in the project vicinity.
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.
Winston Salem will accept sewage generated by this project.
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or habitat?*
Yes No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?
Yes No
5d. Is another Federal agency involved?*
Yes No 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
5h. Does this project involve the construction/installation of a wind turbine(s)?*
Yes No
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?
The NC Natural Heritage Program online data explorer (https://www.nenhp.org/data) and US Fish and Wildlife Service Information for Planning and
Consultation (IPaC) report. No critical habitat was identified within the site and no element occurrences of protected species have been observed within
the site or within one mile of the site.
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 USFWS IPaC report and the National Marine Fisheries Service Essential Fish Habitat Mapper
(https://www.habitat.noaa.gov/protection/efh/efhmapper/)
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? *
The North Carolina State Historic Preservation Office web mapping tool HPOWEB (https://www.ncdcr.gov/about/historyldivision-historical-resources/gis-
maps-and-data). There are no historic resources located within the immediate vicinity of the site.
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?
Yes No
8c. What source(s) did you use to make the floodplain determination?*
The project engineer and the FEMA firm map 3710682300J dated January 2, 2009. The FEMA firmette is attached.

Miscellaneous
Please use the space below to attach all required documentation or any additional information you feel is helpful for application review. Documents should be combined into one file when
possible, with a Cover Letter, Table of Contents, and a Cover Sheet for each Section preferred.
Click the upload button or drag and drop files here to attach document
20230824_ImpectMaps.pdf 1.77MB
Attachments.pdf 7MB
File must be PDF or KMZ
Comments
Signature
By checking the box and signing below, I certify that:
• The project proponent hereby certifies that all information contained herein is true, accurate, and complete to the best of my knowledge and belief'; and
• The project proponent hereby requests that the certifying authority review and take action on this CWA 401 certification request within the applicable reasonable period of time.
• I have given true, accurate, and complete information on this form;
• I agree that submission of this PCN form is a "transaction" subject to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
• I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
• I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature; AND
• I intend to electronically sign and submit the PCN form.
Full Name:
Ashley Bentz
Signature
C"Ka4l'?, ff. rVz
Date
8/25/2023
8