20231268 Ver 1_ePCN Application_20230911

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:
8/9/2023
BIMS # Assigned
20231268
Is a payment required for this project?*
No payment required
Fee received
Fee needed - send electronic notification
Select Project Reviewer*
Seren Homer:[e-mail]
Information for Initial Review
la. Name of project:
COURTESY COPY Bryan's Summit
1a. Who is the Primary Contact?*
Andrea Agee
1b. Primary Contact Email: *
and rea. agee@brkconsu Iti ng. io
Date Submitted
9/11/2023
Nearest Body of Water
Unnamed Tributary at Camp Herman (Lake Herman)
Basin
Cape Fear
Water Classification
16-11-10-(1)
Site Coordinates
Latitude:
36.16134
A. Processing Information
Is this project connected with ARPA funding?
Yes No
County (or Counties) where the project is located:
Guilford
Is this a NCDMS Project
Yes No
Longitude:
-79.7373
Version#*
1
Reviewing Office *
Winston-Salem Regional Office - (336) 776-
9800
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
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
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
401 Water Quality Certification - Express
Riparian Buffer Authorization
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:
OFerrell LLC
2b. Deed book and page no.:
8714-2987
2c. Contact Person:
Mr. Wiley Sykes
2d.Address
Street Address
3705 West Market Street, Suite A
Address Line 2
City
State / Province / Region
Greensboro
NC
Postal / Zip Code
Country
27403
USA
Yes No
Yes No

2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
Andrea Agee
3b. Business Name:
BRK Consulting, PLLC
3c.Address
Street Address
536 Buxton Grant Drive
Address Line 2
City
Cary
Postal / Zip Code
27519
3d. Telephone Number:
[phone]
3f. Email Address:
a nd rea. ag ee@brkconsu Iti ng. io
4. Agent/Consultant (if applicable)
4a. Name:
Andrea Agee
4b. Business Name:
BRK Consulting, PLLC
4c.Address
Street Address
536 Buxton Grant Drive
Address Line 2
City
Cary
Postal / Zip Code
27519
4d. Telephone Number:
[phone]
4f. Email Address:
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(if appropriate)
Bryan's Summit
1c. Nearest municipality I town:
City of Greensboro
2. Project Identification
2f. Fax Number:
State / Province / Region
NC
Country
USA
3e. Fax Number:
State / Province / Region
NC
Country
USA
4e. Fax Number:
2a. Property Identification Number: 2b. Property size:
7887287508

2c. Project Address
Street Address
5611 Summit Avenue
Address Line 2
City State / Province / Region
Greensboro NC
Postal / Zip Code Country
27403
3. Surface Waters
3a. Name of the nearest body of water to proposed project:
Unnamed Tributary at Camp Herman (Lake Herman)
3b. Water Resources Classification of nearest receiving water:
16-11-10-(1)
3c. What river basin(s) is your project located in?"
Cape Fear
3d. Please provide the 12-digit HUC in which the project is located.
030300020107
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: "
This site has several residences along Summit Avenue that are to be demolished in conjunction with this project, but the majority of the site is undisturbed. There are moderate slopes from
the road bed to the existing stream.
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:
0.75 ac
4g. List the total estimated linear feet of all existing streams on the property:
1625 ft
4h. Explain the purpose of the proposed project:
This project proposes 50 subdivision lots with all necessary infrastructure required to support this development. Two roads will provide access to the lots, and the stormwater will be
captured by one stormwater management facility.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:
The wetland impact is to provide connection from the east to west. Culverts may be used to continue flow and minimize disruption from the south to the north and to minimize impact to the
water flow and existing wildlife.
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:
SAW-2017-02368
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company: Pilot Environmental, Inc
Other:
5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
09/17/2018
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
0
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
2a1 Reason (?)
2b. Impact type � (?)
2c. Type of W."
2d. W. name
2e. Forested"
2f. Type of Jurisdicition *
(?)
2g. Impact
area
Road Crossing
L
Isolated Wetlands=fft
Yes
Both
1,257.000
(acres)
2g. Total Temporary Wetland Impact
0.000
2g. Total Wetland Impact
1,257.000
21. Comments:
E. Impact Justification and Mitigation
1. Avoidance and Minimization
2g. Total Permanent Wetland Impact
1,257.000
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
The road was strategically located to minimize the impact to the existing wetland. Road bed grades shall connect to existing grade as quickly as possible
to minimize this impact. The contractor shall take all necessary precautions to minimize additional impacts to the wetland.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
We are currently exploring opportunities to use an arch rather than a culvert to minimize the permanent impact to the existing wetlands.
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
6. Buffer mitigation (State Regulated Riparian Buffer Rules) - required by DWR
Q
V
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)
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
If no, explain why:
This wetland impact is not adjacent to protected 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.
City of Greensboro
State Stormwater Programs
Phase II Coastal Counties
HWQ or ORW Other
Comments:
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
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?
Yes No N/A
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or habitat?*
Yes No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?
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?
FWS USFWS Critical Habitat for Threatened and Endangered Species arcgis website. There were no features indicating Threatened or endangered
species on 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 NMFS Critical Habitat ArcGIS Online Map Viewer
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?
NC Historic Preservation Office's HPOWEB 2.0
8. Flood Zone Designation (Corps Requirement)
6a. Will this project occur in a FEMA-designated 100-year floodplain?
Yes No
Sc. What source(s) did you use to make the floodplain determination?
FEMA National Flood Hazard Firmette Floodplain Map
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
2022-0001 WETLANDSSUBMITTAL-WETLANDS-COMBINED.pdf 1.04MB
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 ACV');
• 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:
Andrea Agee
Signature
Date
9/11/2023
QD