20231505 Ver 1_ePCN Application_20231103

DW R
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:
9/29/2023
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 *
20231505
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:
Hannah's Farm (South) Driveway Crossing
1a. Who is the Primary Contact?*
Ann Moss Joyner
1b. Primary Contact Email: *
[e-mail]
Date Submitted
11/3/2023
Nearest Body of Water
un-named creek which flows into Back Creek
Basin
Cape Fear
Water Classification
WS-II;HQW,NSW
Site Coordinates
Latitude:
36.140863
A. Processing Information
Is this project connected with ARPA funding?
Yes No
County (or Counties) where the project is located:
Orange
Longitude:
-79.248976
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
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: 18 - Minor Discharges
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:
Ann Moss Joyner
2b. Deed book and page no.:
126/23
2c. Contact Person:

2d. Address
Street Address
6919 Lee St.
Address Line 2
City
Mebane
Postal / Zip Code
27302
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(if appropriate)
Hannah's Farm (South)
1c. Nearest municipality / town:
Mebane
2. Project Identification
2a. Property Identification Number:
9826599771
2c. Project Address
Street Address
Lyla's Lane
Address Line 2
City
Mebane
Postal / Zip Code
27302
3. Surface Waters
3a. Name of the nearest body of water to proposed project:
un-named creek which flows into Back Creek
3b. Water Resources Classification of nearest receiving water:
WS-II;HQW,NSW
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.
030300020405
4. Project Description and History
State / Province / Region
NC
Country
US
2f. Fax Number:
2b. Property size:
11.4
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 land use until recently was agricultural/residential. The new lands will be residential under Orange County's AR zoning regulations.
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
4g. List the total estimated linear feet of all existing streams on the property:
3,264
4h. Explain the purpose of the proposed project: *
Hannah's Farm consists of 18 lots on 110 acres. This project is for a shared driveway on an easement on Lot 3, Hannah's Farm (South) as seen on Plat 126/23. The two lots being served
by this driveway are each 11.4 acres. There will be a 20-long culvert with riprap on the down -stream side.

4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used: *
The culvert area will be excavated to the needed grade, including room for 4" of crushed stone for bedding material. Note that the stream is relatively flat here, so this will include minimal
disturbance. The 20' long correlated dual -wall HDPE culvert pipe will be set by hand. Then it will be backfilled along the length of the pipe, using crushed stone. The backfill will be knifed
under the edge of the pipe to ensure full coverage. Finally, the top will be back -filled using at least 12" of native material (soil) topped by at least 4" of crusher run for the 10'-width of the
driveway. This will all be accomplished with a front-end wheel loader /andor a skid steer, as appropriate.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
Yes No
Comments:
USAC JD review site visit 10/25/23
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-2023-02062
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Julia Tillery
Agency/Consultant Company: USACE Wilmington / Raleigh Field Office
Other:
O Unknown
5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
10/25/2023
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
0
3a. Reason for impact (?)
3b.lmpact type*
3c. Type of impact*
3d. S. name*
3e. Stream Type*Fl
M
3f. Type of
Jurisdiction*
3g. S. width
3h. Impact
length*
S1
driveway crossing
Permanent
Culvert
Back Creek tributary
Perennial
Both
Average (feet)
24
(linear feet)
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts: 3i. Total temporary stream impacts:
24 0
3i. Total stream and ditch impacts:
24
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 Cape Fear

6b. Impact Type
6c. Per or Temp
6d. Stream name
6e. Buffer mitigation required?
6f. Zone 1 impact
6g. Zone 2 impact
Culvert
P
UT to Back Creek
No
1,440
960
6h. Total buffer impacts:
Zone 1 Zone 2
Total Temporary impacts: 0.00 0.00
Zone 1 Zone 2
Total Permanent impacts: 1,440.00 960.00
Zone 1 Zone 2
Total combined buffer impacts: 1,440.00 960.00
6i. 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:
Driveway alignment and approach to the stream was designed to cross at a perpendicular angle at a straight section of stream with no wetlands. Lots
were designed to avoid all other impacts to stream/buffers except this one crossing.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Clearing limits of disturbance will be marked and silt fence or other BMPs will be used. A temporary coffer dam and pump will be installed. Appropriate
stream bank protection will be used in the channel during construction and excess material will be immediately removed from the crossing area and
stockpiled in upland locations. Upon completion of culvert installation the temporary sandbag coffer dams will be removed and flow will be diverted
through the culvert. Following installation of the culvert, areas of temporary stream impact will be restored to similar pre -construction grade. Stream
banks will be matted with biodegradable materials and seeded/live-staked with native species.
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:
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
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:
This project is for a shared driveway for two 11.4 acre lots (22.8 acres, total, for two homes).
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)
Q
u

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.
This is for a shared driveway for two 11.4 acres lots (22.8 total acres).
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
What Federal Agency is involved?
US Army Corps of Engineers (visited site and awarded permit)
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?
https://fws. ma ps.a rcgis. com/home/webma p/vi ewer. htm I?web map=9d 8de5e265ad4fe09893cf75 b8d bfb77
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?
https://www.habitat.noaa.gov/apps/efhmapper/?page=page 8
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?
https://historicsites.nc.gov, http://gis.ncdcr.gov/hpoweb/, hftps://nc.maps.arcgis.com/apps/webappviewer/index.htmi?
id=e5684374f26b496eb2202bcb1c1c2c02
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 https://msc.fema.gov/portal/search, and Orange County NC GIS website, which shows FEMA floodplains
Miscellaneous

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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:
Ann Moss Joyner
Signature
Q7�itr Q.1.v�a%grrt
Date
11/3/2023