20231442 Ver 1_ePCN Application_20231023

DWR
Dlvislon 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:
7/19/2022
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 *
20231442
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:
Old Stage Gemstone
1a. Who is the Primary Contact?*
Chris Schiavone
1b. Primary Contact Email: *
[e-mail]
Date Submitted
10/23/2023
Nearest Body of Water
Little Black Creek
Basin
Neuse
Water Classification
C; NSW
Site Coordinates
Latitude:
35.531395
A. Processing Information
Is this project connected with ARPA funding?
Yes No
County (or Counties) where the project is located:
Wake
Longitude:
-78.696565
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
a
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: 29 - Residential Developments
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:
Old Stage Road, LLC
2b. Deed book and page no.:
Book: 019043, Page: 051-053
2c. Contact Person:
Chris Schiavone

2d. Address
Street Address
206 Raleigh Street
Address Line 2
City
Fuquay-Varina
Postal / Zip Code
27526
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Adam Aycock
4b. Business Name:
Mitchell Environmental, PA
4c.Address
Street Address
1501 Lakestone Village Lane, Suite 205
Address Line 2
city
Fuquay-Varina
Postal / Zip Code
27526
4d. Telephone Number:
[phone]
4f. Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(if appropriate)
Summerlin Estates
1c. Nearest municipality / town:
Fuquay-Varina
2. Project Identification
2a. Property Identification Number:
0694082930,0694082521,0694081130
2c. Project Address
Street Address
0 Old Stage Road
Address Line 2
city
Willow Spring
Postal / Zip Code
27592
3. Surface Waters
3a. Name of the nearest body of water to proposed project:
Little Black Creek
3b. Water Resources Classification of nearest receiving water:
Q NSW
3c. What river basin(s) is your project located in?
Neuse
State / Province / Region
North Carolina
Country
United States
2f. Fax Number:
State / Province / Region
North Carolina
Country
United States
4e. Fax Number:
2b. Property size:
32.81
State / Province / Region
North Carolina
Country
United States

3d. Please provide the 12-digit HUC in which the project is located.
030202011201
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: *
The existing conditions on the site is agricultural field and forested areas. The general land use in the vicinity is agricultural, forested, and residential.
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:
1.5634
4g. List the total estimated linear feet of all existing streams on the property:
0
4h. Explain the purpose of the proposed project:
The purpose of the project is to develop the property into a residential subdivision including all necessary roadway and utility infrastructure.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used: *
The type of equipment to be used is that typical of roadway and utility infrastructure installation including bull dozers, excavators, dump trucks, etc.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?
Yes No Q 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-2022-01652
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company: Mitchell Environmental, PA
Other:
5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
Corps: December 7, 2022
DWR: August 11, 2022
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?
No
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
Q
u
2a1 Reason (?)
2b. Impact type* (?)
2c. Type of W.*
2d. W. name
2e. Forested*
2f. Type of JurisdicitiI
?)
2g. Impact
area *
Road Crossing
L
Bottomland Hardwood Forest
E
Yes
Both
0.060
(acres)
2g. Total Temporary Wetland Impact 2g. Total Permanent Wetland Impact
0.000 0.060
2g. Total Wetland Impact
0.060

2i. Comments:
E. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
Avoidance of wetlands is not practical in order to access upland portions. During the design process, road was positioned in a way as to cross wetland at
the narrowest section to the maximum extent practical.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Silt fence and tree protection fence will be used to ensure impacts will be contained in permitted areas only.
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:
Mitigation thresholds were not met
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:
DWR Buffer Determination attached, which shows there are no buffers on the property
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
Local Government Stormwater Programs
Phase II NSW USMP Water Supply
Please identify which local government stormwater program you are using.
Wake County
Comments:
Project is low density being under 24 % impervious and less than 2 dwelling units per acre; however, Wake County Stormwater tool determines that stormwater devices are needed for this
project.
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.
Project is not likely to spur cumulative impacts, as this is a single phase project.
O
0
L
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
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
Unknown
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
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?
HPOweb 2.0. There is a marker for a house that is no longer on the site and was removed btween 1990-1999
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?
Wake County iMaps Floodplain layer
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
Supporting Docs.pdf 12.73MB
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");
V

• 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:
Adam Aycock
Signature
Date
10/23/2023