Pre-Construction Notification (PCN) Form edited 11-18-23.pdf

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mrlsloa of Water l:esnurces
Pre-Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
October 2,2023 Ver 4.3
Please note:fields marked with a red asterisk*below are required. You will not be able to submit the form until all mandatory questions are answered.
Also,if at any point you wish to print a copy of the E-PCN,all you need to do is right-click on the document and you can print a copy of the form.
Below is a link to the online help file.
hftps:Hedocs.deq.nc.g ov/Wate rResou rces/DocView.aspx?d bid=0&id=2196924
A. Processing Information
Pre-Filing Meeting Date Request was submitted on:
11/17/2023
If this is a courtesy copy,please fill in this with the submission date.
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
Is this project connected with ARPA funding?*
Yes No
County(or Counties)where the project is located:
Wake
Is this a NCDMS Project*
O YesO No
Click Yes,only if NCDMS is the applicant or co-applicant.
DO NOT CHECK YES,UNLESS YOU ARE DMS OR CO-APPLICANT.
Is this project a public transportation project?*
Yes No
This is any publicly funded by municipal,state or federal funds road,rail,airport transportation project.
la.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
1 b.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):
List all NW numbers you are applying for not on the drop down list.
1d.Type(s)of approval sought from the DWR:
check all that apply
401 Water Quality Certification-Regular 401 Water Quality Certification-Express
Non-404 Jurisdictional General Permit Riparian Buffer Authorization
Individual 401 Water Quality Certification
1e.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?
If so,attach the acceptance letter from mitigation bank or in-lieu fee program.
Yes No
Acceptance Letter Attachment
Click the upload button or drag and drop files here to attach document
Yardly Buffaloe Village-SOA 10-16-23.pdf 547.75KB
FILE TYPE MUST BE PDF
1 h.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
Link to trout information:http://www.saw.usace.army.mil/Missions/Regulatory-Permit-Program/Agency-Coordination/-rrout.aspx
B. Applicant Information U
1a.Who is the Primary Contact?*
Kevin C Martin
1c.Primary Contact Phone:*
1 b.Primary Contact Email:* (xxx)xxx-xxxx
[e-mail] [phone]
1d.Who is applying for the permit?
Owner Applicant(other than owner)
(Check all that apply)
le.Is there an Agent/Consultant for this project?
Yes No
2.Owner Information
2a.Name(s)on recorded deed:"
Joyce S Miles,Teresa Vogt Hunt,&Stephen Vogt
2b.Deed book and page no.:
2c.Contact Person:
(for Corporations)
Joyce Miles
2d.Address*
Street Address
P.O.Box 513
Address Line 2
City State/Province/Region
Knightdale NC
Postal/Zip Code Country
27545 USA
2e.Telephone Number:*
[phone]
2f.Fax Number:
(xxx)xxx-xxxx
2g.Email Address:
[e-mail]
3.Applicant Information(if different from owner)
3a.Name:*
TM BTR of Carolinas LLC,Attn.Megan Ledbetter

3b.Business Name:
(if applicable)
3c.Address"
Street Address
11405 N Community House Road,Suite 150
Address Line 2
City State/Province/Region
Charlotte NC
Postal/Zip Code Country
28277 USA
3d.Telephone Number:*
[phone] 3e.Fax Number:
(xxx)xxx-xxxx (xxxbxx-xxxx
3f.Email Address:
[e-mail]
4.Agent/Consultant(if applicable)
4a.Name:*
Kevin C Martin
4b.Business Name:
(if applicable)
S&EC,PA
4c.Address
Street Address
8412 Falls of Neuse Rd.,Ste.104
Address Line 2
City State/Province/Region
Raleigh NC
Postal/Zip Code Country
27615 USA
4d.Telephone Number:*
[phone] 4e.Fax Number:
(xxx)xxx-xxxx (rax)xxx-xxxx
4f.Email Address:
[e-mail]
C. Project Information and Prior Project History
1.Project Information
1 a.Name of project:*
Yardly Buffaloe Village
1 b.Subdivision name:
(if appropriate)
1c.Nearest municipality/town:*
Raleigh
2. Project Identification
2a.Property Identification Number: 2b.Property size:
(tax PIN or parcel ID) (in acres)
1746410189&1746308877 37.1
2c.Project Address
Street Address
5221&5225 Forestville Rd.
Address Line 2
City State/Province/Region
Raleigh NC
Postal/Zip Code Country
27603 USA
2d. Site coordinates in decimal degrees
Please collect site coordinates in decimal degrees.Use between 4-6 digits(unless you are using a survey-grade GPS device)after the decimal place as appropriate,based on how the location was
determined. (For example,most mobile phones with GPS provide locational precision in decimal degrees to map coordinates to 5 or 6 digits after the decimal place.)

Latitude:* Longitude:"
35.840324 -78.513905
ex:34.208504 -77.796371
3. Surface Waters
3a.Name of the nearest body of water to proposed project:
Neuse River
3b.Water Resources Classification of nearest receiving water:
C-NSW
Surface Water Lookup
3c. What river basin(s)is your project located in?*
Neuse
3d.Please provide the 12-digit HUC in which the project is located.
030202010704
River Basin Lookup
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 site is mostly wooded however there are 2 single family residences and small agricultural fields within the project area.Surrounding area is either undeveloped or 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:
0.1395
4g.List the total estimated linear feet of all existing streams on the property:
(intermittent and perennial)
596
4h.Explain the purpose of the proposed project:
To allow for development of the site for a public roadway along with private roadways internal to the site.6 commercial lots,222 residential units,and associated improvements are
proposed.
41.Describe the overall project in detail,including indirect impacts and the type of equipment to be used:
Grading equipment typically utilized for residential construction in the piedmont of Nc will be utilized.Indirect impacts are not anticipated.
5. Jurisdictional Determinations
5a.Have the wetlands or streams been delineated on the property or proposed impact areas?
Yes No Unknown
Comments:
Northern portion has a confirmed Jd,southern portion JD was submitted in July 2023 and has not
been confirmed yet
5b.If the Corps made a jurisdictional determination,what type of determination was made?
Preliminary Approved Not Verified Unknown N/A
Corps AID Number:
Example:SAW-2017-99999
SAW-2021-02043(northern)&SAW-2023-01446(southern)
5c.If 5a is yes,who delineated the jurisdictional areas?
Name(if known): Kevin C Martin
Agency/Consultant Company: S&EC,PA
Other:
5d.List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR.
Northern Portion:Corps 11/1/2021
DWR 9/16/2019
Southern Portion:DWR 6/2/2022
6.Future Project Plans
6a.Is this a phased project?*
Yes No

6b.If yes,explain.
The initial subdivision plan that will be permitted and have the impacts will include public roadway along with private roadways internal to the site.
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?This includes other
separate and distant crossing for linear projects that require Department of the Army authorization but don't require pre-construction notification.
buildout will include 6 commercial lots,222 residential units,and associated improvements.The phased buildout is not anticipated to have any environmental impacts beyond what is
included with the current Subdivision Plan.
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
If there are wetland impacts proposed on the site,then complete this question for each wetland area impacted.
"W."will be used in the table below to represent the word"wetland".
2a1 Reason*!'i 2b.Impact type"(?) 2c.Type of W.* 2d.W.name" 2e.Forested* 2f.Type of Jurisdicition"�2g.Impact
area*
Lot fill P Headwater Forest W1 and LW3 Yes Both 0.0582
(acres)
2g.Total Temporary Wetland Impact
0.000
2g.Total Permanent Wetland Impact
0.0582
2g.Total Wetland Impact
0.0582
21.Comments:
6. Buffer Impacts (for DWR)
If project will impact a protected riparian buffer,then complete the chart below.Individually list all buffer impacts below.
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*
Road Crossing P S1b No 33 22,245
(square feet) (square feet)
6h. Total buffer impacts:
Zone 1 Zone 2
Total Temporary impacts: 0.00 0.00
Zone 1 Zone 2
Total Permanent impacts: 330.00 2,245.00
Zone 1 Zone 2
Total combined buffer impacts: 330.00 2,245.00

61.Comments:
E. Impact Justification and Mitigation u
1.Avoidance and Minimization
la.Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
Retaining walls have been utilized to avoid stream impacts and to minimize wetland and buffer impacts.
1b.Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:"
Silt fence,tree protection fencing,sediment basins,inlet protection,concrete washouts,construction entrances will be employed during project
construction
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 J 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:
3b.Credits Purchased/Requested(attach receipt and letter)
Type: Quantity:
3c.Comments
NC Stream Temperature Classification Maps can be found under the Mitigation Concepts tab on the Wilmington District's RIBITS website.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
Recent changes to the stormwater rules have required updates to this section.***
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
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 flow will be maintained.
All Stormwater Control Measures(SCM)s must be designed in accordance with the NC Stormwater Design Manual. Associated supplement forms and other documentation shall be
provided.
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
(check all that apply)
For a list of options to meet the diffuse flow requirements,click here.
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
To look up low density requirement click here 15A NCAC 02H.1003(2).

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
Hint: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(check all that apply):"
Local Government _ State
If you have a local government approval please include the SMP on their overall impact map.
Local Government Stormwater Programs`
Phase II NSW
USMP Water Supply
Please identify which local government stormwater program you are using.
City of Raleigh
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(based on past and reasonably anticipated future impacts)result in additional development,which could impact nearby downstream water quality?*
Yes No
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 Yardly Buffaloe Village project is a residential development.Additionally,the
project is located within the City of Raleigh jurisdiction,therefore the adjacent properties that have potential for
development will have the following regulations to protect downstream waters:the Neuse River Basin Riparian
Buffer Protection regulations,these regulations require limited development within the riparian buffer area,in
addition Best Management Practices may be required that control nitrogen if diffuse flow cannot be achieved;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.
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.
All sanitary sewer discharge will be sent to City of Raleigh treatment plant.A sewer analysis was prepared for the project and submitted to City of
Raleigh to confirm capacity.
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
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
Link to the NLEB SLOPES document: http://saw-reg.usace.army.mil/NLEB/1-30-17-signed_NLEB-SLOPES&apps.pdf
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?
S&EC,PA reviewed the referenced project using the USFWS North Carolina Field Office's online project review process and have followed all guidance
and instructions in completing the review.We completed our review September 27,2023 and submitted our project review package on 10/6/23 in
accordance with the instructions for further review(see attached S&EC T&E report)
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 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: http_//gis.ncdcr.gov/hpoweb/
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(e.g.,National Historic Trust
designation or properties significant in North Carolina history and archaeology)?
Yes No
7b.What data sources 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 September 15th,2023,no historic listings or study
list entries or determined eligible listings were identified within the property boundaries.See attached project report
8. Flood Zone Designation (Corps Requirement)
Link to the FEMA Floodplain Maps: https://msc.fema.gov/portal/search
8a.Will this project occur in a FEMA-designated 100-yearfloodplain?*
Yes No
8c.What source(s)did you use to make the floodplain determination?*
Wake County GIS and FEMA FIRM panel
Miscellaneous
Comments
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
DWR prefiling notice reciept conf.pdf 606.68KB
DWR prefiling request Yardley Bufaloe.pdf 656.72KB
SHPO project_report_foresville_buffalo_48168_48168.pdf 1.08MB
Yardly Buffaloe Village_Environmental Impacts—Full Buildout.pdf 1.49MB
S&EC Yardly Buffaloe T&E Report Signed.pdf 5.34MB
5221 5225 Forestville Rd.JD Request.pdf 10.83MB
signed 5225 Forestville rd Agent Authorization_1746410189.pdf 259.02KB
signed 5221 Forestville rd Agent Authorization_1746308877.pdf 257.85KB
Wetland survey KV94.800_Miles Property_Wetlands_signed 6-15-23.pdf 1.84MB
DWR buffer Letter 5221&5225 Forestville Rd.pdf 2.85MB
Corps email confirmation of delineation.pdf 50.43KB
AJD Map_Updated.pdf 7.9MB
Buffaloe—Forestville SE DWR Ietter.pdf 19.31MB
File must be PDF or KMZ

Signature
p 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:*
Kevin C Martin
Signature*
Date
10/16/2023