20231322 Ver 1_ePCN Application_20230925

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:
9/25/2023
BIMS # Assigned
20231322
Is a payment required for this project?*
No payment required
Fee received
Fee needed - send electronic notification
Select Project Reviewer*
Andrew Moore:andrew.w.moore
Information for Initial Review
la. Name of project:
COURTESY COPY Owenby Ln Subdivision
1a. Who is the Primary Contact?*
Michael Anderson, PE
1b. Primary Contact Email: *
[e-mail]
Date Submitted
9/25/2023
Nearest Body of Water
Swannanoa River
Basin
French Broad
Water Classification
C
Site Coordinates
Latitude:
35.612533
A. Processing Information
Is this project connected with ARPA funding?
Yes No
County (or Counties) where the project is located:
Buncombe
Is this a NCDMS Project
Yes No
Is this project a public transportation project?*
Yes No
Longitude:
-82.338892
Version#*
1
Reviewing Office*
Asheville Regional Office - (828) 2964500
1c. Primary Contact Phone:*
[phone]
O

Ia. 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
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 for the 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:
Robert Dix and Beth Dix
2b. Deed book and page no.:
3709 211
2c. Contact Person:
Robert Dix
2d. Address
Street Address
125 Owenby Ln
Address Line 2
City Stale / Province / Region
Leicester INC
Postal / Zip Code Country
28748 us
Yes No
Yes No

2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Michael Anderson, PE
4b. Business Name:
Carolinas Engineering and Development, PA
4c.Address
Street Address
11 Duke St
Address Line 2
City
Asheville
Postal / Zip Code
28803
4d. Telephone Number:
[phone]
4f. Email Address:
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(if appropriate)
Owenby Ln Subdivision
1c. Nearest municipality / town:
Black Mountain
2. Project Identification
2a. Property Identification Number:
0609-84-0558
2c. Project Address
Street Address
99999 Owenby Ln
Address Line 2
City
Black Mountain
Postal / Zip Code
28711
3. Surface Waters
3a. Name of the nearest body of water to proposed project:
Swannanoa River
3b. Water Resources Classification of nearest receiving water:"
C
3c. What river basin(s) is your project located in?*
French Broad
3d. Please provide the 12-digit HUC in which the project is located.
060101050602
4. Project Description and History
2f. Fax Number:
State / Province / Region
NC
Country
us
4e. Fax Number:
2b. Property size:
4.35
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:
Mostly wooded, suburban area in Black Mountain, NC. Surrounding uses are single-family and vacant land.
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:
0.0
4g. List the total estimated linear feet of all existing streams on the property:
4501f
4h. Explain the purpose of the proposed project:
Proposed 8" public sewer main crossing below the invert of an unnamed tributary to Swannanoa River to serve 4 single family homes.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:"
8" DIP sewer main will be encased in concrete to protect stream. Sewer installation will be provided via trackhoe, cofer dam, and temporary pump around. Stream invert will be restored
and stream banks stabilzed with temporary matting and permanent seeding.
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:
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?
N/A
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
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:
Only one crossing is proposed. The crossing is below stream invert.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Cofer dam and pump around will prevent sediment from being introduced into the stream. No obstructions will be created with this installation.
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:
N/A
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:
Not adjacent to riparian 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:
Less than 1 acre of disturbance.
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.
No additional development proposed on the property.
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?
US Fish and Wildlife Service Map

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?
NOAA Fisheries map
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
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?
FEMA flood 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
2346 owenby In - full set 2023-09-20 sealed.pdf 13.9MB
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:
Michael Anderson
Signature
,W1OA1rWG'1k"fAV
Date
9/25/2023
L