20231613 Ver 1_PCN_FillableForm_v4-3_02142023_Ennis Branch_signed_20231122

STarE
NORTH CAROLINA
Environmental Quality
Water Resources
Office Use Only
Corps Action ID no. [Click to enter.] Date received: [Click to enter.]
DWR project no. [Click enter.] Date received: [Click to enter.]
Site Coordinates:
Latitude (DD.DDDDDD): 34.7445
Longitude (DD.DDDDDD):-78.9062
Form Version 4.3, April 20, 2022
Pre -Construction Notification (PCN) Form
(Ver. 4.2, January 31, 2022))
For Nationwide Permits and Regional General Permits and corresponding Water Quality Certifications
Please note: fields marked with a red asterisk are required. The form is not considered complete until all
mandatory questions are answered.
The PCN help document may be found at this link:
https://edocs. deg. nc.gov/WaterResources/DocView.aspx?dbid=O&id=2196924&cr= 1
Please ensure you have submitted a pre -filing meeting request at least 30 days prior to submitting this
form, as DWR will not be able to accept your application without documentation of this important first step.
The Division has developed a Pre -filing Meeting Request email address 401 PreFile()ncdenr.gov to accept
the federally required pre -filing meeting request and provide confirmation receipt of submittal . This receipt
or similar documentation will satisfy 40 C.F.R. Section 121.4(a) which states "At least 30 days prior to
submitting a certification request, the project proponent shall request a pre -filing meeting with the certifying
agency." In accordance with 40 C.F.R. Section 121.5(b)(7), and (c)(5), all certification requests must
include documentation that a pre -filing meeting request was submitted to the certifying authority at least 30
days prior to submitting the certification request.
Attach documentation of Pre -Filing Meeting Request to this Application.
Date of Pre -filing Meeting Request (MM/DD/YYYY) : 4/28/2022
Page 1 of 24 PCN Form Version 4.3- April 20, 2022

A. Processing Information
County (counties) where project is located:
Wake Additional (if needed).
Is this an ARPA project?
❑ Yes ® No
If yes, ARPA project number:
" The project number can be found on the "Letter of Intent to Fund"
(LOIF) or "Offer and Acceptance Letter". If you are unable to locate
Click or tap here to enter text.
your DWI ARPA Funding Project Number, please contact Corey
Basinger at corev.basinaerencdenr. aov for further assistance.
Is this a NCDMS project?
(Click yes only if NCDMS is the applicant or co-
❑ Yes ❑x No
applicant)
Is this a public transportation project?
(Publicly funded municipal, state, or federal road, rail,
❑ Yes ❑x No
or airport project)
Is this a NCDOT project?
❑ Yes ❑x No
If yes, NCDOT TIP or state project number:
Click to enter.
If yes, NCDOT WBS number:
Click to enter.
❑x Section 404 Permit (wetlands, streams, waters,
Clean Water Act)
la. Type(s) of approval sought from the Corps:
❑ Section 10 Permit (navigable waters, tidal
waters, Rivers and Harbors Act)
Has this PCN previously been submitted?
❑ Yes ❑x No
Please provide the date of the previous submission.
Click tn -ntar a riaf-
❑x Nationwide Permit (NWP)
1 b. What type(s) of permit(s) do you wish to seek
❑ Regional General Permit (RGP)
authorization?
❑ Standard (IP)
This form may be used to initiate the standard/ individual permit
process with the USACE. Please contact your Corps
representative concerning submittals for standard permits. All required items can be included as attachments and
submitted with this form.
1 c. Has the NWP or GP number been verified by the Corps?
❑ Yes ❑x No
NWP number(s) (list all numbers):
29 & 58
RGP number(s) (list all numbers ):
Click to enter
Are you a federal applicant?
❑ Yes ❑x No
If yes, please provide a statement concerning compliance with the Coastal Zone Management Act
Click to enter text.
1 d. Type(s) of approval sought from DWR (check all that apply):
❑x 401 Water Quality Certification — Regular
❑ 401 Water Quality Certification— Express
❑ Non-404 Jurisdictional General Permit
❑ Riparian Buffer Authorization
❑ Individual 401 Water Quality Certification
Is this a courtesy copy notification
❑ Yes ❑x No
Page 2 of 24 PCN Form Version 4.3- April 20, 2022

1 e.
Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification:
❑ Yes
0 No
For the record only for Corps Permit:
❑ Yes
0 No
1 f.
Is this an after -the -fact permit/certification application?
❑ Yes
0 No
1 g.
Is payment into a mitigation bank or in -lieu fee program proposed for
mitigation of impacts?
0 Yes
❑ No
If yes, attach the acceptance letter from mitigation bank or in -lieu fee program.
1 h.
Is the project located in any of NC's twenty coastal counties?
❑ Yes
0 No
1 i.
Is the project located within an NC DCM Area of Environmental
Concern (AEC)?
❑ Yes
0 No ❑ Unknown
1j.
Is the project located in a designated trout watershed?
❑ Yes
0 No
If yes, you must attach a copy of the approval letter from the appropriate Wildlife Resource Commission Office.
Trout information may be found at this link: httr)://www.saw.usace.army.mil/Missions/Regulatory-Permit-
Program/Agency-Coordination/Trout.aspx
Page 3 of 24 PCN Form Version 4.3- April 20, 2022

B. Applicant Information
1 a.
Who is the primary contact?
Deborah Shirley
1 b.
Primary Contact Email:
[e-mail]
1 c.
Primary Contact Phone: (###)###-####
[phone]
1 d.
Who is applying for the permit/certification? (check
all that apply)
❑ Owner 0 Applicant (other than owner)
1 e.
Is there an agent/consultant for this project?
® Yes ❑ No
2.
Landowner Information
2a.
Name(s) on Recorded Deed:
Yellowbridge Captial LLC
2b.
Deed Book and Page No.:
DB:013508, DP:01177 & 01181
2c.
Contact Person (for corporations):
Gerald L. Hornick
2d.
Address
Street Address:
113 Mill Point Rd
Address line 2:
Click to enter.
City:
Kitty Hawk
State/ Province/ Region:
NC
Postal/ Zip Code:
27949
Country:
USA
2e.
Telephone Number: * (###)###-####
[phone]
2f.
Fax Number: (###)###-####
Click to enter.
2g.
Email Address:
[e-mail]
3.
Applicant Information (if different from owner)
3a.
Name:
Tucker Ennis
3b.
Business Name (if applicable):
Lennar Corporation — Raleigh Division
3c.
Address:
Street Address:
1100 Perimeter Park Drive
Address line 2:
Suite 112
City:
Morrisville
State/ Province/ Region:
NC
Postal/ Zip Code:
27560
Country
USA
3d.
Telephone Number: * (###)###-####
[phone]
3e
Fax Number: (###)###-####
Click to enter.
3f.
Email Address:
[e-mail]
Page 4 of 24 PCN Form Version 4.3- April 20, 2022

4. Agent/ Consultant (if applicable)
4a. Name:
Deborah Shirley
4b. Business Name:
Soil & Environmental Consultants, PA
4c. Address:
Street Address:
8412 Falls of Neuse Rd
Address line 2:
Suite 104
City:
Raleigh
State/ Province/ Region:
NC
Postal/ Zip Code:
27615
Country:
USA
4d. Telephone Number: (###)###-####
[phone]
4e Fax Number: (###)###-####
[phone]
4f. Email Address:
[e-mail]
Agent Authorization Letter:
Attach a completed/signed agent authorization form or letter. A sample form may be found at this link:
httr)s://www.saw.usace.army. mil/Missions/Reaulatorv-Permit-Program/Permits/2017- Nationwide -Pe rmits/Pre-
construction-Notification/
Page 5 of 24 PCN Form Version 4.3- April 20, 2022

C. Project Information and Prior Project History
1. Project Information
1 a. Name of project:
Ennis Branch (aka Yellowbridge)
1 b. Subdivision name (if appropriate):
Click to enter
1 c. Nearest municipality/town:
Apex
2.
Project Identification
2a.
Property identification number (tax PIN or parcel ID):
0722752304 & 0722743789
2b.
Property size (in acres):
48.24 acres plus offsite sewer easements
2c.
Project Address:
Street Address:
2813 & 2817 US 64 Hwy W
Address line 2:
Click to enter
City:
Apex
State/ Province/ Region:
NC
Postal/ Zip Code:
27949
Country:
USA
2d.
Site coordinates in decimal degrees (using 4-6 digits
after the decimal point):
Latitude (DD.DDDDDD): 34.7445
Longitude (-DD.DDDDDD):--78.9062
3. Surface Waters
3a. Name of nearest body of water to proposed project:
Reedy Branch
3b. Water Resources Classification of nearest receiving
WS-IV;NSW
water:
The Surface Water Classification map may be found at this link:
htti)s:Hncden r. mai)s.arcais.com/apes/webappviewer/index. htmI?id=6e 125ad7628f494694e259c8Odd64265
Cape Fear
3c. In what river basin(s) is your project located? *
Choose additional (if needed)
3d. Please provide the 12-digit HUC in which the project is
030300020609
located:
The Find Your HUC map may be found at this link:
httr)s:Hncdenr.mar)s.arcais.com/apes/Publiclnformation/index.html?appid=ad3a85aOc6d644aOb97cdO69db238ac3
Page 6 of 24 PCN Form Version 4.3- April 20, 2022

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:
Existing conditions consist of two parcels to the south of US 64 Highway West. The land is partially wooded with
agriculutrial fields on the property. There are three streams (A, B & C) and five wetlands (W2, W3, W4, W5 &
LW2) within the property. Onsite also includes the area of two drained ponds that were determined to be non -
jurisdictional by the USACE (i.e. Sackett). The evaluation area of the offsite sewer connection has 2 streams (A
& Z), and five wetlands (W2, W6, W7, W8 & W9). General land use in the vicinity consist of residential and
forested land.
4b. Have Corps permits or DWR certifications been obtained for this
❑ Yes 0 No ❑ Unknown
project (including all prior phases) in the past?
If yes, please give the DWR Certification number and/or Corps
[Click to enter.]
Action ID (ex. SAW-0000-00000):
jClick to enter.]
Attach any pertinent project history documentation
02. Is any portion of the work already complete?
❑ Yes 0 No
If yes, describe the completed work.
Click to enter text.
4c. List of other certifications or approvals/denials received from other federal, state or local agencies for work
described in this application not related to the 404 or 401.
N/A
4d. Attach an 8'h x 11" excerpt from the most recent version of the USGS topographic map indicating the location of
the project site.
4e. Attach an 8'h x 11" excerpt from the most recent version of the published County NRCS Soil Survey map
depicting the project site.
4f. List the total estimated acreage of all existing wetlands on the
Approximately 7.70 acres
property:
4g. List the total estimated linear feet of all existing streams (intermittent
Approximately 2,345 linear feet
and perennial) on the property:
4g1. List the total estimated acreage of all existing open waters on the
0 acres
property:
4h. Explain the purpose of the proposed project:
The purpose of the project is to construct a residential development and its necessary infrastructure.
4i. Describe the overall project in detail, including the type of equipment to be used:
The overall project consists of a single-family and mult-family residential development and the construction of
roadway infrastructure, utilities, single-family lots and Storm Water Control Measures (SCM). Specifically, there
are stream and wetland impacts associated with road crossings and utilities, and wetland impacts associated
with lot fill. Additionally, there is 25,000 SF of commercial building space adjacen to US Hwy 64 W. Equipment
typically used for construction and earthwork such as backhoes, bulldozers, excavators, graders, pavers etc. will
be utilized for this project.
4j. Attach project drawings/site diagrams/depictions of impact areas for the proposed project.
4k. Will this activity involve dredging in wetlands or waters?
❑ Yes 0 No
If yes, describe the type of dredging, the composition of the dredged material, and the locations of disposal area.
Click to enter text
Page 7 of 24 PCN Form Version 4.3- April 20, 2022

5.
Jurisdictional Determinations
5a.
Have the wetlands or streams been delineated on the property or in
® Yes ❑ No ❑ Unknown
proposed impact areas?
Comments:
Click to enter text
5b.
If the Corps made a jurisdictional determination,
❑ Preliminary ❑ Approved 0 Emailed concurrence
what type of determination was made?
❑ Not Verified ❑ Unknown ❑ n/a
Corps AID number (ex. SAW-0000-00000):
SAW-2022-00147
Name (if known): Steven Ball
5c.
If 5a is yes, who delineated the jurisdictional
Agency/Consultant Company: S&EC
areas?
Other: Click to enter
5d.
List the dates of the Corps jurisdictional determination or State determination if a determination was made by
either agency.
USACE- Email concurrence by Lyle Phillip on September 19, 2023 (SAW-2022-00147);
Town of Apex- Stream Buffer determination conducted by James Misciagno on February 1, 2022 (Apex 21-006)
5d1.
Attach jurisdictional determinations.
6. Future Project Plans
6a. Is this a phased project?
® Yes ❑ No
6b. If yes, explain.
Per the project engineer: The project will be phased with the 25,000 SF of future commercial space unknown at
this time.
Are any other NWP(s), regional general permit(s), or individual permit(s) used, or intended to be used, to
authorize any part of the proposed project or related activity? This includes other separate and distant crossings
for linear projects that require Department of the Army authorization but don't require pre -construction
notification.
It is my understanding that there are no intended future phases beyond the property boundaries shown.
Therefore, no additional NWP, Reginal General Permits, or IP are anticipated.
7. Addresses of adjoining property owners, lessees, etc. whose property adjoins the waterbody (if more than can be
entered here, please attach a supplemental list)
Please reference Wake County GIS
8. Scheduling of activity:
Construction timeline will be after permits are issued by agencies, including the local municipalitiy and before
permits expire. The exact date is unknown at this time.
Page 8 of 24 PCN Form Version 4.3- April 20, 2022

D. Proposed Impacts Inventory
1. Impacts Summary
❑x Wetlands ❑x Streams - tributaries
1 a. Where are the impacts associated with your project ❑ Buffers ❑ Open Waters
(check all that apply):
❑ Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, complete this table for each wetland area impacted.
2a.
2a1.
2b.
2c.
2d.
2e.
2f.
2g.
Site #
Impact
Impact
Wetland Type
Wetland Name
Forested
Jurisdiction
Impact Area
Reason/Type
Duration
?
Type*
(ac)
W1
Culvert
Permanent
Bottomland
Impact 1A -
Yes
Both
0.100
Hardwood
Wetland 4
Forest
W2
Fill (Incl.
Permanent
Headwater
Impact 2B —
Yes
Both
0.026
Riprap)
Forest
Wetland 5
W3
Road/
Permanent
Headwater
Impact 2C —
Yes
Both
0.025
Driveway
Forest
Wetland 5
Crossing
W4
Fill (Incl.
Permanent
Headwater
Impact 2D —
Yes
Both
0.046
Riprap)
Forest
Wetland 5
W5
Road/
Permanent
Headwater
Impact 2E —
Yes
Both
0.045
Driveway
Forest
Weltand 5
Crossing
Other
Temporary
Bottomland
Impact 3 — Wetland
Yes
Both
0.002
W6
Hardwood
4
Forest
Other
Permanent
Bottomland
Impact 6 — Wetland
Yes
Both
0.372
W7
Hardwood
2 Permanent No
Forest
Permanent Loss
Other
Permanent
Bottomland
Impact 7 — Wetland
Yes
Both
0.004
W8
Hardwood
9 Permanent No
Forest
Permanent Loss
W9
Choose one
Temp/ Perm
Choose one
.;lick to enter
Y/N
Choose one
Click to enter
W10
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W11
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W12
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W13
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W14
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W15
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
Page 9 of 24 PCN Form Version 4.3- April 20, 2022

2g1.
Total temporary wetland impacts
0.002 ac
2g2.
Total permanent wetland impacts
0.618 ac
2g3.
Total wetland impacts
0.620 ac
2h.
Type(s) of material being discharged and the amount of each type in cubic yards:
N/A
2i.
Comments:
Total permanent loss wetland = 0.242 acres; Total permanent -no permanent loss wetland = 0.376 acres; Total
temporary stream = 0.002 acres
Page 10 of 24 PCN Form Version 4.3- April 20, 2022

3. Stream Impacts
If there are perennial or intermittent stream/ tributary impacts (including temporary impacts) proposed on the site,
complete this table for all stream/ tributary sites impacted.
** All Perennial or Intermittent streams must be verified by DWR or delegated local government
3a
3b.
3c.
3d.
3e.
3f.
3g.
3h.
Site #*
Impact
Impact
Impact Type*
Stream Name*
Stream
Jurisdiction
Stream Width
Impact length
Reason*
Duration*
Type*
Type*
(avg ft) *
(linear ft)
S1
Impact 1A,
Permanent
Crossing/
Stream A
Perennial
Both
13
126
Road Crossing
Culvert
S2
Impact 1A,
Permanent
Other
Stream A
Perennial
Both
11
87
Permanent No
Permanent
Loss Riprap
Dissipator Pad
S3
Impact 2A,
Permanent
Fill (Incl.
Stream C
Intermittent
Both
3
31
Crossing
Riprap)
S4
Impact 4,
Temporary
Other
Stream Z
Perennial
Both
4
39
Utility Crossing
S5
Impact 5,
Temporary
Other
Stream A
Perennial
Both
4
30
Utility Crossing
S6
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S7
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S8
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S9
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S10
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S11
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S12
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S13
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S14
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S15
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S16
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S17
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S18
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S19
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S20
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
3i1. Total jurisdictional ditch
0 linear ft
impact:
3i2. Total permanent stream
244 linear ft
impacts:
36. Total temporary stream
69 linear ft
impacts:
3i4. Total stream and ditch
313 linear ft
impacts:
Page 11 of 24 PCN Form Version 4.3- April 20, 2022

3j. Comments:
Total permanent loss stream = 157 LF (0.039 acres); Total permanent -no permanent loss stream = 87 LF ( 0.021
acres) ; Total temporary stream = 69 LF ( 0.005 acres)
Page 12 of 24 PCN Form Version 4.3- April 20, 2022

4.
Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other
open water of the U.S., individually list all open water impacts in the table below.
4a.
Site #
4a1.
Impact Reason
4b.
Impact
Duration
4c.
Waterbody Name
4d.
Activity Type*
4e.
Waterbody
Type
4f.
Impact area
(ac)
01
Click to enter.
Temp/ Perm
Click to enter.
Choose one
Choose one
Click to enter.
02
Click to enter.
Temp/ Perm
Click to enter.
Choose one
Choose one
Click to enter.
03
Click to enter.
Temp/ Perm
Click to enter.
Choose one
Choose one
Click to enter.
04
Click to enter.
Temp/ Perm
Click to enter.
Choose one
Choose one
Click to enter.
05
Click to enter.
Temp/ Perm
Click to enter.
Choose one
Choose one
Click to enter.
4g.
Total temporary open water impacts
Click to enter. ac
4g.
Total permanent open water impacts
Click to enter. ac
4g.
Total open water impacts
Click to enter. ac
4h.
Comments:
Click to enter.
5.
Pond or Lake Construction
If pond or lake construction is proposed, complete the table
below. (*This
does NOT include
offline stormwater
management ponds.)
5a.
5b.
5c.
5d.
5e.
Pond ID
Proposed use or
Wetland Impacts
(ac)
Stream
Impacts (ft)
Upland
#
purpose of pond
Impacts (ac)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
P1
Ghoose one
Click tc,
Click to
Click to
Click to
Click to
Click to
Click to
enter.
enter.
enter.
enter.
enter.
enter.
enter.
P2
Choose one
Click to
Click to
Click to
Click to
Click to
Click to
Click to
enter.
enter.
enter.
enter.
enter.
enter.
enter.
P3
Choose one
Click to
Click to
Click to
Click to
Click to
Click to
Click to
enter.
enter.
enter.
enter.
enter.
enter.
enter.
5f.
Total
Click to
Click to
Click to
Click to
Click to
Click to
Click to
enter.
enter.
enter.
enter.
enter.
enter.
enter.
5g.
Comments:
Click to enter.
5h.
Is a dam high hazard permit required?
❑ Yes ❑ No
If yes, permit ID no.:
Click to enter.
5i.
Expected pond surface area (acres):
Click to enter.
5j.
Size of pond watershed (acres):
Click to enter.
5k.
Method of construction:
Click to enter
Page 13 of 24 PCN Form Version 4.3- April 20, 2022

6. Buffer Impacts (DWR requirement)
If project will impact a protected riparian buffer, then complete the chart below. Individually list all buffer impacts.
6a. Project is in which protected basin(s)?
(Check all that apply.)
❑ Neuse ❑ Tar -Pamlico ❑ Catawba
❑ Jordan ❑ Goose Creek ❑ Randleman
❑ Other: Cape Fear
Site #*
6b.
Impact Type*
6c.
Impact Duration*
6d.
Stream Name*
6e.
Buffer
Mitigation
Required?*
6f.
Zone 1 Impact*
(sq ft)
6g.
Zone 2 Impact*
(sq ft)
131
Choose one
Temp/ Perm
Click to enter
Y/N
Click to enter.
Click to enter
132
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
133
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
134
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
135
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
136
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
137
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
138
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
139
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B10
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
1311
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B12
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B13
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B14
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B15
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B16
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B17
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B18
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B19
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
B20
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
6h. Total temporary impacts:
Zone 1: Click to enter sq ft
Zone 2: Click to enter. sq ft
6h. Total permanent impacts:
Zone 1: Click to enter sq ft
Zone 2: Click to enter. sq ft
6h. Total combined buffer impacts:
Zone 1: Click to enter sq ft
Zone 2: Click to enter. sq ft
6i. Comments:
A Jordan Watershed NPA will be submitted to the Town of Apex for review and anticipated approval
Please attach supporting documentation (impact maps, plan sheets, etc.) for the proposed project.
Page 14 of 24 PCN Form Version 4.3- April 20, 2022

E. Impact Justification and Mitigation
Avoidance and Minimization
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts through project design:
S&EC completed a wetland and stream delineation, and Jordan Lake Watershed Buffer evaluation for
the entire property, including offsite area, in order to identify natural resources so that impacts could be
avoided & minimized to the maximum extent practicable. Impact 1A is proposed road crossing.
Proposed impacts include permanent loss (i.e. culvert & headwalls), permanent -no permanent loss
(i.e. riprap dissipator pads) and temporary (i.e. construction access) stream impacts, and permanent
loss (i.e. culvert, retaining wall & fill slopes) wetland impacts. This road crossing is necessary to
provide access to the property from US 64 Hwy W. Stream and wetland impacts have been minimized
by utilizing an existing culvert location to the east of the proposed culvert, and by utilizing headwalls
and retaining walls. Stream and wetland mitigation is proposed at a 2:1 ratio to compensate for these
proposed permanent loss impacts. Impact 2A is proposed fill necessary for the installation of a storm
pipe from Ennis Branch Way discharging into SCM 1. Proposed impacts include permanent loss
stream impacts. Stream impacts have been minimized by pulling the fill to the south to the maximum
extent practicable. Stream mitigation is proposed at a 2:1 ratio to compensate for these proposed
permanent loss impacts. Impacts 2B is proposed fill necessary for retaining wall and lot fill. Proposed
impacts include permanent wetland loss impacts. Wetland impacts have been minimized by utilizing a
retaining wall. Wetland mitigation is proposed at a 2:1 ratio to compensate for these proposed
permanent loss impacts. Impact 2C and 2E is proposed road fill. Proposed impacts include
permanent wetland loss impacts. These impacts are necessary to provide access to lots, in addition
to utilities. Wetland mitigation is proposed at a 2:1 ratio to compensate for these proposed permanent
loss impacts. Impacts 2D is proposed lot fill. Proposed impacts include permanent wetland loss
impacts. Wetland mitigation is proposed at a 2:1 ratio to compensate for these proposed permanent
loss impacts. Impacts 3 is proposed impacts necessary for the construction of a retaining wall.
Proposed impacts include temporary wetland impacts. Permanent wetland impacts have been
avoided by utilizing a retaining wall in this location. Temporary wetland impacts will be brought back to
pre -construction contours and allowed to revegetate with the adjacent wetland seed source. Impacts 4
& 5 are proposed impacts for sanitary sewer crossings. Proposed impacts include temporary stream
impacts. These impacts are necessary to provide sanitary sewer to the proposed development.
Stream impacts have been minimized by crossing the streams at a near perpendicular angles.
Temporary stream impacts will be brought back to pre -construction stream bed elevations and the
stream banks will be stabilized. Impacts 6 & 7 are proposed impacts for sanitary sewer installation.
Proposed impacts include permanent — no permanent loss wetland impacts. These impacts are
necessary to provide sanitary sewer to the proposed development. Wetland mitigation is proposed at a
1:1 ratio to compensate for the change of function of these wetlands. Impacts 8 — 10 are proposed
Jordan Watershed riparian buffer impacts that will be submitted to the Town of Apex for review and
anticipated approvals.
1 b. Specifically describe measures taken to avoid or minimize proposed impacts through construction techniques:
Per the project engineer: The project will comply with Town of Apex's erocision control and stormwater design
standards as with various Unified Development Ordinance (UDO) and adopted erosion control specifications.
Said specifications include silt fence, silt fence outlets, temporary sediment basins, stone check dams,
temporary and permanent seeding standards, and a full construction and erosion control sequencing plan.
2. Compensatory Mitigation for Impacts to Waters of the U.S., Waters of the State, or Riparian Buffers
2a. If compensatory mitigation is required, by whom is it required?
(check all that apply)
0 DWR 0 Corps
Page 15 of 24 PCN Form Version 4.3- April 20, 2022

2b. If yes, which mitigation option(s) will be used for this ® Mitigation Bank
project? (check all that apply) ❑ In Lieu Fee Program
❑ Permittee Responsible Mitigation
3. Complete if using a Mitigation Bank (Must satisfy NC General Statute143-214.11 (d1).)
Cape Fear 02 Umbrella :Flat Rock (wetlands)
3a. Name of mitigation bank:
EBX sponsored RES Cape Fear 02 Umbrella: Dairyland
Site (stream)
3b. Credits purchased/requested:
Type: Riparian Wetland
Quantity 0.86
Type: Stream
Quantity 314
Type: Choose one
Quantity Click to enter.
Attach receipt and/or approval letter.
3c. Comments:
Permanent loss stream impact =
157; 157 @ 2:1 mitigation ratio = 314
Permanent Wetland loss impact
= 0.241 acres; 0.241 @ 2:1 mitigation ratio = 0.483 acres
Permanent, No Permanent loss impact = 0.375 acres; 0.375 @ 1:1 mitigation ratio = 0.375 acres
4.
Complete if Using an In Lieu Fee Program
4a.
Attach approval letter from in lieu fee program.
4b.
Stream mitigation requested:
Click to enter. linear feet
4c.
If using stream mitigation, what is the stream temperature:
Choose one
NC Stream Temperature Classification Maps can be found under the Mitigation Concepts tab on the Wilmington
District's RIBITS website: (Please use the filter and select Wilmington district)
htti)s://ribits.usace.armv.mil/ribits apex/f?p=107:27:2734709611497::NO: RP:P27 BUTTON KEY:O
4d.
Buffer mitigation requested (DWR only):
Click to enter. square feet
4e.
Riparian wetland mitigation requested:
Click to enter. acres
4f.
Non -riparian wetland mitigation requested:
Click to enter. acres
4g.
Coastal (tidal) wetland mitigation requested:
Click to enter. acres
4h.
Comments:
Click to enter.
5. Complete if Providing a Permittee Responsible Mitigation Plan
5a. If proposing a permittee responsible mitigation plan, provide a description of the proposed mitigation plan,
including mitigation credits generated.
Click to enter.
5b. Attach mitigation plan/documentation.
6. Buffer Mitigation (State Regulated Riparian Buffer Rules) — DWR requirement
Page 16 of 24 PCN Form Version 4.3- April 20, 2022

6a. Will the project result in an impact within a protected riparian buffer
❑ Yes ❑x No
that requires buffer mitigation?
If yes, please complete this entire section — please contact DWR for more information.
6b. If yes, identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required in the table below.
6c.
6d.
6e.
Zone
Reason for impact
Total impact
Multiplier
Required mitigation
(square feet)
(square feet)
Zone 1
Uiiur, LU MILM.
Click LU MILM.
%-.I1UUZ't; one
Click LU MILM.
Zone 2
Click to enter.
Click to enter.
Choose one
Click to enter.
6f. Total buffer mitigation required
'lick to enter.
6g. If buffer mitigation is required, is payment to a mitigation bank or
-F
❑Yes ❑ No
NC Division of Mitigation Services proposed?
6h. If yes, attach the acceptance letter from the mitigation bank or NC Division of Mitigation Services.
6i. Comments:
Click to enter.
Page 17 of 24 PCN Form Version 4.3- April 20, 2022

F. Stormwater Management and Diffuse Flow Plan (DWR requirement)
1. Diffuse Flow Plan
1 a. Does the project include or is it adjacent to protected riparian buffers
0 Yes ❑ No
identified within one of the NC Riparian Buffer Protection Rules?
1 b. All buffer impacts and high ground impacts require diffuse flow or other form of stormwater treatment. If the
project is subject to a state implemented riparian buffer protection program, include a plan that fully documents
how diffuse/dispersed flow will be maintained.
All Stormwater Control Measures (SCM) must be designed in accordance with the NC Stormwater Design
Manual (https:Hdeq.nc.gov/about/divisions/energv-mineral-land-resources/energv-mineral-land-permit-
quidance/stormwater-bmp-manual).
Associated supplement forms and other documentation must be provided.
❑ Level Spreader
What Type of SCM are you
❑ Vegetated Conveyance (lower seasonal high water table- SHWT)
providing?
❑ Wetland Swale (higher SHWT)
(Check all that apply)
0 Other SCM that removes minimum 30% nitrogen
❑ Proposed project will not create concentrated stormwater flow through the
buffer
For a list of options to meet the diffuse flow requirements, click here.
Attach diffuse flow documentation.
2.
Stormwater Management Plan
2a.
Is this an NCDOT project subject to compliance with NCDOT's
Individual NPDES permit NCS000250?
❑ Yes 0 No
2b.
Does this project meet the requirements for low density projects as
defined in 15A NCAC 02H .1003(2)?
❑ Yes 0 No
To look up low density requirements, click here:
httr):Hrer)orts.oah.state.nc.us/ncac/title%2015a%20-%20environmental%20guality/chapter%2002%20-
%20environmental%20management/subchapter%20h/15a%20ncac%2002h%20.1003.pdf
2c.
Does this project have a stormwater management plan (SMP)
0 Yes ❑ No
reviewed and approved under a state stormwater program or state -
approved local government stormwater program?
❑ n/a — project disturbs < 1 acre
Note: Projects that have vested rights, exemptions, or grandfathering from state or locally implemented
stormwater programs or projects that satisfy state or locally -implemented stormwater programs through use of
community in -lieu programs should answer "no" to this question.
2d.
Which of the following stormwater management program(s) apply?
0 Local Government
(Check all that apply.)
❑ State
If you have local government approval, please include the SMP on their overall impact map.
0 Phase II ❑ USMP
Local Government Stormwater Programs
0 NSW 0 Water Supply
Page 18 of 24 PCN Form Version 4.3- April 20, 2022

Please identify which local government stormwater program you are using.
Town of Apex
State Stormwater Programs ❑ Phase II ❑ HQW or ORW
❑ Coastal Counties ❑ Other
Comments:
Click to enter.
Page 19 of 24 PCN Form Version 4.3- April 20, 2022

G. Supplementary Information
1. Environmental Documentation
1 a. Does the project involve an expenditure of public (federal/state/local)
❑ Yes ❑x No
funds or the use of public (federal/state) land?
1 b. If you answered "yes" to the above, does the project require
preparation of an environmental document pursuant to the
requirements of the National or State (North Carolina) Environmental
❑ Yes ❑ No
Policy Act (NEPA/SEPA)?
1 c. If you answered "yes" to the above, has the document review been
finalized by the State Clearing House? (If so, attach a copy of the
❑ Yes ❑ No
NEPA or SEPA final approval letter.)
Comments:
Click to enter.
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),
Federally Non -Jurisdictional Wetlands /Classified Surface Waters
❑ Yes ❑x No
(15A NCAC 2H. 1400) DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. If you answered "yes" to the above question, provide an explanation of the violation(s):
UlICK to enter.
3. Cumulative Impacts (DWR Requirement)
3a. Will this project (based on past and reasonably anticipated future
impacts) result in additional development, which could impact nearby
❑ Yes ❑x No
downstream water quality?
Page 20 of 24 PCN Form Version 4.3- April 20, 2022

3b. If you answered "no", provide a short narrative description:
We have reviewed the "Draft Internal Policy, Cumulative impacts and the 401 Water Quality
Certification and Isolated Wetlands Programs" document prepared by the NC Division of Water Quality
on April 10, 2004, version 2.1. The draft states that many private developments are unlikely to cause
cumulative impacts, including projects such as urban in -fill, most residential subdivisions and small
commercial developments as well as agricultural and silvicultural operations. The Ennis Branch (aka
Yellowbridge) project is a residential development. Additionally, the project is located within the Town
of Apex jurisdiction, therefore the adjacent properties that have potential for development will have the
following regulations to protect downstream waters: 1) the Jordan Watershed Riparian Buffer
Protection regulations, these regulations require limited development within the riparian buffer area in
addition to "diffuse flow" requirements and may require Best Management Practices that control
nitrogen if diffuse flow cannot be achieved 2) the Phase II NPDES Stormwater Permit Program, this
program includes permitting requirements for Municipal Separate Storm Sewer Systems (MS4s) in
addition to post -construction stormwater management requirements; 3) the Water Supply, Watershed
Protection Program which limits development densities as well as requires protective riparian buffers;
We anticipate that the DWR will advise us if any additional information is needed.
3c. If yes, provide a qualitative or quantitative cumulative impact analysis in accordance with the most recent DWR
policy. (Attach .pdf)
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project? 1 ® Yes ❑ No ❑ N/A
4b. If yes, 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.
Per the project engineer: The project is a non -discharge site with a future water and sewer permit required from
the Town of Apex. Connections being made to existing gravity sewer mains located within general proximity to
the site. Treatment Plant: Western Wake Regional Water Reclamation Facility-18 MGD capacity.
5.
Endangered Species and Designated Critical Habitat (Corps Requirement)
5a.
Will this project occur in or near an area with federally protected
® Yes
❑ No
species or habitat? (IPAC weblink: https://www.fws.gov/ipac/ ffws.govl)
5b.
Have you checked with the USFWS concerning Endangered Species
® Yes
❑ No
Act impacts?
5c.
If yes, indicate the USFWS Field Office you have contacted.
Raleigh
5d.
Is another federal agency involved?
❑ Yes
❑ No ❑x Unknown
If yes, which federal agency?
Click to enter.
5e.
Is this a DOT project located within Divisions 1-8?
❑ Yes
❑x No
5f.
Will you cut any trees in order to conduct the work in waters of the
U.S.?
M Yes
❑ No
5g.
Does this project involve bridge maintenance or removal?
❑ Yes
❑x No
Page 21 of 24 PCN Form Version 4.3- April 20, 2022

5g1.
If yes, have you inspected the bridge for signs of bat use such as
staining, guano, bats, etc.? Representative photos of signs of bat use
❑ Yes ❑ No
can be found in the NLEB SLOPES, Appendix F, pages 3-7.
Representative photos of signs of bat use can be found in the NLEB SLOPES, Appendix F, pages 3-7. Link to
NLEB SLOPES document: httr):Hsaw-reg.usace.army.miI/NLEB/1-30-17-signed NLEB-SLOPES&aggs.gdf
If you answered yes to 5g1, did you discover any signs of bat use? *
❑ Yes ❑ No ❑ Unknown
If yes, please show the location of the bridge on the permit drawings/ project plans
5h.
Does this project involve the construction/ installation of a wind
turbine(s)?
❑ Yes ❑x No
If yes, please show the location of the wind turbine(s) on the permit drawings/ project plans (attach .pdo
5i.
Does this project involve blasting and /or other percussive activities
that will be conducted by machines, such as jackhammers,
❑ Yes ❑x No
mechanized pile drivers, etc.?
If yes, please provide details to include type of percussive activity, purpose, duration, and specific location of this
activity on the property (attach .pdo
5j.
What data sources did you use to determine whether your site would impact Endangered Species or Designated
Critical Habitat?
S&EC completed a Threatened & Endangered Species Report, to include a Self -Certification letter through the
US Fish & Wildlife Service (USFWS), a query through the NC Natural Heritage Program database, and an official
Species List through the iPac. A formal request was sent to the USFWS on February 1, 2022. S&EC completed
the follow up Michaux's sumac survey on May 10, 2022. FWS concurred with S&EC's determinations on May 11,
2022. The S&EC determinations were that the proposed project is not likely to adversely affect any federally -
listed endangered or threatened species, their formally designated critical habitat, or species currently proposed
for listing under the Endangered Species Act (ESA). Please see attached S&EC Threatened & Endangered
Species report and email concurrence from USFWS.
Attach consultation documentation.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as
an Essential Fish Habitat?
❑ Yes ❑x No
Is there submerged aquatic vegetation (SAV) around
the project vicinity?
El Yes ❑x No El Unknown
Will this project affect submerged aquatic vegetation? *
❑ Yes ❑x No ❑ Unknown
Explain: Click to enter.
6b. What data source(s) did you use to determine whether your site would impact Essential Fish Habitat?
The NOAA Habitat Conservation/Habitat Protection: National Marine Fish Service; Essential Fish Habitat
Mapper website was referenced. No Essential Fish Habitat was identified near the project.
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
Link to the State Historic Preservation Office Historic Properties Map (does not include archaeological data):
httr):Hgis.ncdcr.gov/hr)oweb/
Page 22 of 24 PCN Form Version 4.3- April 20, 2022

7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural ❑ Yes ❑x No
preservation status (e.g., National Historic Trust designation or
properties significant in North Carolina history and archaeology)?
7b. What data source(s) did you use to determine whether your site would impact historic or archeological
resources?
The NC State Historic Preservation Office HPOWEB GIS Service interactive map was referenced on December
15, 2021, no historic listings or study list entries or determined eligible listings were identified within the property
boundaries. S&EC submitted an Environmental Review request on January 3, 2022. SHPO provided a response
letter (ER-22-0102) on February 7, 2022 confirming there is no concern.
7c. Attach historic or prehistoric documentation.
8. Flood Zone Designation (Corps Requirement)
Link to the FEMA Floodplain Maps: httr)s:Hmsc.fema.aov/portal/search
8a. Will this project occur in a FEMA-designated 100-year floodplain? *
❑ Yes ❑x No
8b. If yes, explain how the project meets FEMA requirements.
Click to enter.
8c. What source(s) did you use to make the floodplain determination?
NC Flood Risk Information System Floodplain Mapping Program and confirmation from the project engineer.
Note that offsite utilities are within the FEMA 100-yr floodplain.
H. Miscellaneous
Comments:
':lick to enter
Attach pertinent documentation or attachments not previously requested
I. Signature *
❑x By checking the box and signing below, I, as the project proponent, certify to the following:
• The project proponent hereby certifies that all information contained herein is true, accurate, and complete, to
the best of my knowledge and belief;
• 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;
• The project proponent hereby agrees 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");
• The project proponent hereby agrees to conduct this transaction by electronic means pursuant to Chapter 66,
Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
• The project proponent hereby understands that an electronic signature has the same legal effect and can be
enforced in the same way as a written signature; AND
• As the project proponent, I intend to electronically sign and submit the PCN/online form.
I Full Name: Deborah Shirley I
Page 23 of 24 PCN Form Version 4.3- April 20, 2022

Debor
Signature: * DZbo�' IE, Shirley Date: 023.1 signed by :24:55 05' Shirley
Date: 2023.11.22 13:24:55-OS'00'
Date: * 11/22/2023
Page 24 of 24 PCN Form Version 4.3- April 20, 2022