20231413 Ver 1_ePCN Application_20231017

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Division of Water Resources
Pre -Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
October 2, 2023 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:
7/25/2023
Does this project involve maintenance dredging funded by the Shallow Draft Navigation Channel Dredging and Aquatic Weed Fund or involve the distribution or transmission of energy or
fuel, including natural gas, diesel, petroleum, or electricity?
Yes No
BIMS # Assigned
20231413
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:
DENC Old Milburnie Road Gasline Exposure Reapir
1a. Who is the Primary Contact?*
Joey Lawler, PWS
1b. Primary Contact Email: *
[e-mail]
Date Submitted
10/17/2023
Nearest Body of Water
Unnamed tributary to Hodges Mill Creek (27-26-1-(2))
Basin
Neuse
Water Classification
C; NSW
Site Coordinates
Latitude:
35.854447
A. Processing Information
Is this project connected with ARPA funding?
Yes No
County (or Counties) where the project is located:
Wake
Longitude:
-78.497958
Version#*
1
What amount is owed?*
$240.00
$323.00
Select Project Reviewer*
Zachary Thomas:zachary.thomas
1c. Primary Contact Phone: *
[phone]
$570.00
$767.00
V
Is this a NCDMS Project
Yes No

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: 03 - Maintenance
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
401 Water Quality Certification - Express
Riparian Buffer Authorization
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?
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. Name(s) on recorded deed:
North Carolina Department of Transportation (right-of-way only)
2b. Deed book and page no.:
N/A
2c. Contact Person:
Angel Flores (courtesy Dominion Energy North Carolina)

2d. Address
Street Address
2020 Energy Drive
Address Line 2
City
Apex
Postal / Zip Code
27502
2e. Telephone Number:
[phone]
2g. Email Address:*
Angel. [e-mail]
3. Applicant Information (if different from owner)
3a. Name:
Staci Rogge
3b. Business Name:
Dominion Energy North Carolina
3c.Address
Street Address
2020 Energy Drive
Address Line 2
city
Apex
Postal / Zip Code
28502
3d. Telephone Number:
[phone]
3f. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Joey Lawler, PWS
4b. Business Name:
S&ME, Inc.
4c.Address
Street Address
2016 Ayrsley Town Boulevard
Address Line 2
Suite 2-A
City
Charlotte
Postal / Zip Code
28273
4d. Telephone Number:
[phone]
4f. Email Address:
[e-mail]
C. Proiect Information and Prior Proiect History
1. Project Information
1b. Subdivision name:
(if appropriate)
N/A
1c. Nearest municipality I town:
Raleigh
2. Project Identification
State / Province / Region
North Carolina
Country
USA
2f. Fax Number:
State / Province / Region
North Carolina
Country
USA
3e. Fax Number:
State / Province / Region
North Carolina
Country
USA
4e. Fax Number:

2a. Property Identification Number:
1746952990
2c. Project Address
Street Address
Old Milburnie Road
Address Line 2
city
Raleigh
Postal / Zip Code
27616
3. Surface Waters
3a. Name of the nearest body of water to proposed project:
Unnamed tributary to Hodges Mill Creek (27-26-1-(2))
3b. Water Resources Classification of nearest receiving water:
C;NSW
3c. What river basin(s) is your project located in?"
Neuse
3d. Please provide the 12-digit HUC in which the project is located.
030202010703
4. Project Description and History
2b. Property size:
13.02
State / Province / Region
North Carolina
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: "
See the accompanying information.
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:
0.10
4g. List the total estimated linear feet of all existing streams on the property:
319
4h. Explain the purpose of the proposed project: `
See the accompanying information.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:
See the accompanying information.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?"
Yes No
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): Joey Lawler, PWS
Agency/Consultant Company: S&ME, Inc.
Other:
6. Future Project Plans
Unknown
6a. Is this a phased project?"
Yes No
Are any other NWP(s), regional general Perri or individual Perri used, or intended to be used, to authorize any part of the proposed project or related activity?
No, no other permits will be needed to authorize any project -related work other than the permits being applied for in this pre -construction notification.
D. Proposed Impacts Inventory

1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
Wetlands Streams -tributaries
Open Waters Pond Construction
3. Stream Impacts
- Buffers
❑
S1
3a. Reason for impact (?)
Grade control structure and
fill to cover exposure
3b.lmpact type"
Permanent
3c. Type of impact"
Fill
3d. S. name *
S1
3e. Stream Type* �[3f.
Intermittent
Type of
urisdiction *
Both
3g. S. width
Average (feet)
3h. Impact
length
21
(linear feet)
S2
Temporary disturbance
Temporary
_]
Excavation
S1
Intermittent
Both
Average (feet)
16
(linear feet)
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts: 3i. Total temporary stream impacts:
21 16
3i. Total stream and ditch impacts:
37
3j. Comments:
6. Buffer Impacts (for DWR)
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
Temporary disturbance
T
S2 (Hodges Mill Creek)
No
418
363
6h. Total buffer impacts:
Zone 1 Zone 2
Total Temporary impacts: 418.00 363.00
Zone 1 Zone 2
Total Permanent impacts: 0.00 0.00
Zone 1 Zone 2
Total combined buffer impacts: 418.00 363.00
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:
See the accompanying information.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
See the accompanying information.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
Q

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:
Because the project will not result in permanent stream impacts exceeding mitigation thresholds, compensatory mitigation is not required.
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
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
Comments:
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)
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 entails the restoration, repair, and reinforcement of an existing utility line. It can be assumed that no additional development will result.
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
5c. If yes, indicate the USFWS Field Office you have contacted.
Raleigh
5d. Is another Federal agency involved?*
Yes No
Unknown
0
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?
USFWS IPaC and NCNHP databases. See the accompanying information related to protected species.
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 EFH Mapper.
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?
NCSHPO HPOWEB 2.0 GIS database.
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:
Based on the proposed pipeline alignment, the project will encroach upon the FEMA-designated floodplains/floodway associated with Hodges Mill
Creek. A courtesy notification with no additional permitting requirements will be submitted to the Wake County Floodplain Administrator. The floodplain
impacts will not result in a rise of the base flood elevation.
8c. What source(s) did you use to make the floodplain determination?*
FEMA Flood Map Service Center.
Miscellaneous
r-
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
ACCOMPANYING PCN PACKAGE - OLD MILBURNIE ROAD GASLINE REPAIR.pdf 14.48MB
File must be PDF or KMZ
Comments
Please see the attached permit package documentation for additional information.
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:
Joey Lawler, PWS
Signature
6A1-e%
L
Date
10/17/2023