20231562 Ver 1_ePCN Application_20231114

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:
9/14/2023
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 *
20231562
Is a payment required for this project?*
No payment required
Fee received
Fee needed - send electronic notification
Reviewing Office*
Wilmington Regional Office - [phone]
Information for Initial Review
1a. Name of project:
204 West Pelican
1a. Who is the Primary Contact?*
Dana A. Lutheran
1b. Primary Contact Email: *
[e-mail]
Date Submitted
11/14/2023
Nearest Body of Water
Atlantic ICWW
Basin
Cape Fear
Water Classification
SA;HOW
Site Coordinates
Latitude:
33.916080
A. Processing Information
Is this project connected with ARPA funding?
Yes No
County (or Counties) where the project is located:
Brunswick
Longitude:
78.164010
Version#*
1
What amount is owed?*
$240.00
$323.00
Select Project Reviewer*
Holley Snider:Holley.Snider
1c. Primary Contact Phone: *
[phone]
$570.00
$767.00
0
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
1i. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
Yes No Unknown
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)
1e. Is there an Agent/Consultant for this project?
Yes No
2. Owner Information
2a. Name(s) on recorded deed:
Kim and David Anderson
2b. Deed book and page no.:
5079/1311
2c. Contact Person:
Kim Anderson
O

2d. Address
Street Address
812 Elizabeth Dr.
Address Line 2
City
Oak Island
Postal / Zip Code
28465
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Dana Lutheran
4b. Business Name:
Southern Environmental Group, Inc. (SEGi)
4c.Address
Street Address
5315 South College Road
Address Line 2
Suite E
city
Wilmington
Postal / Zip Code
28412
4d. Telephone Number:
[phone]
4f. Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(if appropriate)
NA
1c. Nearest municipality I town:
Oak Island
2. Project Identification
2a. Property Identification Number:
234MA00502
2c. Project Address
Street Address
204 West Pelican
Address Line 2
city
Oak
Postal / Zip Code
28465
3. Surface Waters
3a. Name of the nearest body of water to proposed project:
Atlantic ICWW
3b. Water Resources Classification of nearest receiving water:
SA;HQW
State / Province / Region
NC
Country
us
2f. Fax Number:
State / Province / Region
NC
Country
us
4e. Fax Number:
2b. Property size:
0.28
State / Province / Region
Island
Country
a
3c. What river basins) is your project located in?*
Cape Fear

3d. Please provide the 12-digit HUG in which the project is located.
030402080107
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 project site is located to the west of the State Road 906 bridge, which is the access to the western end of Oak Island, a densely residential, beach community. An area of coastal
marsh that is periodically inundated with saltwater and coming from Davis Canal, located to the west, and the Atlantic ICWW, which is located north of the subject property, extends into the
northern portion of the property. Section 404 wetlands bisect the lot from west to east. Please see SEGi Wetland Boundary Map attached.
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:
0.12
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 this project is to build a single family dwelling, which will be the Applicant's primary residence, in Oak Island, the area in which they live and work currently.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used: *
The project will entail removing woody vegetation, replacing unsuitable soils with clean earthen fill sand or dirt, and grading the land to the desired contour. A retaining wall will be used to
contain the fill in the back yard. In total, 3790 SF (0.087 AC) of Section 404 wetlands will be filled as part of the project. An excavator, front end loader and dump truck will be used to
complete the work. Please see the attached site plan for details.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
Yes No O Unknown
Comments:
SEGi's wetland line was verified by the USAGE on 10/25/23 but a JD has not been issued
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): Noah Dean
Agency/Consultant Company: SEGi
Other:
6. Future Project Plans
6a. Is this a phased project?*
Yes OO 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?
The project will not provide access to currently land locked property. Furthermore, access to the property, as well as sewer and water connection, is available of of West Pelican.
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
O
2a1 Reason (?)
2b. Impact type* (?)
2c. Type of W. *
2d. W. name
2e. Forested *
2f. Type of Jurisdicition *
?)
2g• Impact
area *
House Footprint
L
Non -Tidal Freshwater Marsh
A
Yes
Both
0.087
(acres)
2g. Total Temporary Wetland Impact 2g. Total Permanent Wetland Impact
0.000 0.087

2g. Total Wetland Impact
0.087
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:
The Applicant first had the wetlands and other natural resources, such as coastal wetlands, delineated prior to laying the house footprint on the plan.
Once it was determined avoiding impacting the wetlands was not possible, the Applicant took advantage of the Town of Oak Island's building setback
encroachment allowance, to avoid impacting natural areas such as wetlands, which allowed them to encroaching 6.25' into the front setback, thereby
avoiding approximately 312 SF of wetland impact. Lastly, the Applicant is using a retaining wall to contain the fill dirt, which should ensure runoff, during
sever storm events, does not cause erosion of the slope and carry sediment into the remaining wetlands.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Silt fence will be installed along the proposed wetland impact boundary line prior to placing fill dirt on the property. The measure will be checked regularly
to ensure it is not in need of repairs.
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
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
LCFUMB
3b. Credits Purchased/Requested (attach receipt and letter)
Type: Quantity:
Riparian wetland 0.20
3c. Comments
6. Buffer mitigation (State Regulated Riparian Buffer Rules) - required by DWR
O
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 project is not within one of NC's protected river basins.
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:
The Town of Oak Island will administer stormwater approval with review of the building permit application.

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.
The project will not provide access to currently land locked property. Furthermore, access to the property, as well as sewer and water connection, is
available of of West Pelican. Lastly, implementation of stormwater best management practices should ensure sediment is not discharged outside the
project limits.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?
Yes No N/A
4b. Describe, in detail, the treatment methods and dispositions (non -discharge or discharge) of wastewater generated from the proposed project. If the wastewater will be treated at a
treatment plant, list the capacity available at that plant.
Town of Oak Island
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
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 turf ine(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?
IPaC Official Species List and NLEB Consistency Letter- See attached.
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 proposed project does not consist of work within an area designated as EFH.
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?
SHPO HPOWEB2.0 (see attached)
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:
The project will entail flood plain approval, which takes part during the building permit process and prior to commencing with land disturbance.
8c. What source(s) did you use to make the floodplain determination?"
Brunswick Co. GIS Flood Map (see attached)
Miscellaneous
n
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
204 W Pelican PCN Attachments.pdf 3.21MB
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:
Dana A. Lutheran
Signature
.Ow"'? - -Y A1"-,firtAV
Date
11/14/2023
N