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NORTH CAROLINA
Environmental Quality
Water Resources
Office Use Only
Corps Action ID no. [Click to enter.] Date received: [Click to enter.]
DWR project no. Dlick enter.] Date received: [Click to enter.]
Site Coordinates:
Latitude (DD.DDDDDD): 35.679547
Longitude (DD.DDDDDD):-78.941872
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=0&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(a)-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) : 5/11/2023
Page 1 of 23 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 ❑x 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 corey.basinger(cDncdenr.gov 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)
1 a. 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 to enter a date.
❑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 & 18
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 23 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
❑x No
For the record only for Corps Permit: *
❑ Yes
❑x No
1f.
Is this an after -the -fact permit/certification application? *
❑ Yes
❑x No
1g.
Is payment into a mitigation bank or in -lieu fee program proposed for
mitigation of impacts?
® 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
❑x No
1 i.
Is the project located within an NC DCM Area of Environmental
Concern (AEC)? *
❑ Yes
❑x No ❑ Unknown
1j.
Is the project located in a designated trout watershed? *
❑ Yes
❑x 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: http://www.saw.usace.army.mil/Missions/Regulatory-Permit-
Program/Agency-Coordination/Trout.aspx
Page 3 of 23 PCN Form Version 4.3- April 20, 2022
B. Applicant Information
1a.
Who is the primary contact?
Deborah Shirley
1 b.
Primary Contact Email:
dshirley@sandec.com
1 c.
Primary Contact Phone: (###)###-####
(919)846-5900
1 d.
Who is applying for the permit/certification? (check
all that apply)
❑ Owner ❑x Applicant (other than owner)
1e.
Is there an agent/consultant for this project?
® Yes ❑ No
2.
Landowner Information
2a.
Name(s) on Recorded Deed:
Wellons, Helon Joy & Johnson, Ray E / Horton
Myrtle H
2b.
Deed Book and Page No.:
DB:20-E, DP:556 / DB:13-E, DP:2029
2c.
Contact Person (for corporations):
CliCK io eni,
2d.
Address
Street Address:
400 Johnson Farm Rd / PO Box 312
Address line 2:
('lirk to ente
City:
New Hill
State/ Province/ Region:
NC
Postal/ Zip Code:
27562 / 27562
Country:
USA
2e.
Telephone Number: (###)###-####
(919)422-8606
2f.
Fax Number: (###)###-####
(lirk to ant
2g.
Email Address:
rsjohnson@kbhomes.com
3.
Applicant Information (if different from owner)
3a.
Name:
R. Scott Johnson
3b.
Business Name (if applicable):
KB Homes RALEIGH
3c.
Address:
Street Address:
4506 S. Miami Blvd
Address line 2:
Suite 100
City:
Durham
State/ Province/ Region:
NC
Postal/ Zip Code:
27703
Country
USA
3d.
Telephone Number: (###)###-####
(919)422-8606
3e
Fax Number: (###)###-####
Click to enter.
Page 4 of 23 PCN Form Version 4.3- April 20, 2022
3f. Email Address: rsjohnson@kbhomes.com
4.
Agent/ Consultant (if applicable)
4a.
Name: *
Deborah Shirley
4b.
Business Name:
Soil & Environmental Consultants, Inc.
4c.
Address: *
Street Address:
8412 Falls of Neuse Road
Address line 2:
Suite 104
City:
Raleigh
State/ Province/ Region:
NC
Postal/ Zip Code:
27515
Country:
USA
4d.
Telephone Number: (###)###-####
(919)846-5900
4e
Fax Number: (###)###-####
(919)846-9467
4f.
Email Address:
dshirley@sandec.com
Agent Authorization Letter:
Attach a completed/signed agent authorization form or letter. A sample form may be found at this link:
https://www.saw.usace.army.mil/Mission s/Regulatory-Permit-Program/Permits/2017-Nationwide-Permits/Pre-
construction-Notification/
Page 5 of 23 PCN Form Version 4.3- April 20, 2022
C. Project Information and Prior Project History
1. Project Information
la. Name of project: *
Utley Farms
1 b. Subdivision name (if appropriate):
Click to enter.
1c. Nearest municipality/town: *
New Hill
2.
Project Identification
2a.
Property identification number (tax PIN or parcel ID):
0710713968 & 0710736732
2b.
Property size (in acres):
Approximately 56.59 acres
2c.
Project Address:
Street Address:
3720 Old US 1 Highway & 0 New Hill Olive Chapel
Rd
Address line 2:
Click to ente,
City:
Apex
State/ Province/ Region:
NC
Postal/ Zip Code:
27562
Country:
USA
2d.
Site coordinates in decimal degrees (using 4-6 digits
after the decimal point):
Latitude (DD.DDDDDD): 35.679547
Longitude (-DD.DDDDDD):--78.941872
3. Surface Waters
3a. Name of nearest body of water to proposed project:
Little Beaver Creek
3b. Water Resources Classification of nearest receiving
WS-IV;NSW
water:
The Surface Water Classification map may be found at this link:
https://ncdenr.maps.arcqis.com/apps/webappviewer/index.html?id=6e125ad7628f494694e259c80dd64265
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:
https://ncdenr.maps.arcgis.com/apps/PubIicInformation/index.htmI?appid=ad3a85aOc6d644aOb97cd069db238ac3
Page 6 of 23 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 2 parcels north of Old US 1 Highway. The land is partially wooded with agricultural
fields. There are seven streams (A, B, C, D, E, F & G), ten wetlands (W1 through W10) and two ponds ( Pond 1
& 2) within the property boundaries. These properties are bound by Old US 1 Highway to the south, and New Hill
Olive Chapel Rd to the east. General land use in the vicinity consists of rural residential, wooded and agricultural
land.
4b. Have Corps permits or DWR certifications been obtained for this
❑ Yes ❑x 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
4b2. Is any portion of the work already complete?
❑ Yes ❑x No
If yes, describe the completed work.
UJUK W efltel teX1.
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.
Click to enter te)
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'/2 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 0.875 acres
property:
4g. List the total estimated linear feet of all existing streams (intermittent
Approximately 5,540 linear feet
and perennial) on the property:
4g1. List the total estimated acreage of all existing open waters on the
Approximately 0.82 acres
property:
4h. Explain the purpose of the proposed project:
The purpose of the proposed project is construct a residential development and the 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 residential development and the construction of roadway
infrastructure, utilities, single-family lots, and stormwater control measures (SCM). Specifically, there are stream,
wetland and open water impacts associated with road crossings, utilities and lot fill. 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 ❑x No
If yes, describe the type of dredging, the composition of the dredged material, and the locations of disposal area.
1,11LA Lu enRel Le),
Page 7 of 23 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:
,TICK to enter text
5b.
If the Corps made a jurisdictional determination,
❑ Preliminary ❑ Approved ❑x Emailed concurrence
what type of determination was made?
❑ Not Verified ❑ Unknown ❑ n/a
Corps AID number (ex. SAW-0000-00000):
SAW-2022-00965
Name (if known): Kevin Murphrey
5c.
If 5a is yes, who delineated the jurisdictional
Agency/Consultant Company: Soil and Environmental
areas?
Consultants, Inc.
Other: r;lick to enter
5d.
List the dates of the Corps jurisdictional determination or State determination if a determination was made by
either agency.
USACE: Email verified on June 8, 2022 by Lyle Phillips (SAW-2022-00965);
TOA Buffer Determination: Buffer determination completed on May 12, 2023 by Jimmy McClure and Anthony
Scott (Apex 22-023)
5d1.
Attach jurisdictional determinations.
6. Future Project Plans
6a. Is this a phased project?
® Yes ❑ No
6b. If yes, explain.
This project is phased for construction purposes.
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, Regional 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 municipalities and before
permits expire. The exact date is unknown at this time.
Page 8 of 23 PCN Form Version 4.3- April 20, 2022
D. Proposed Impacts Inventory
Impacts Summary
❑x Wetlands
1a. Where are the impacts associated with your project ❑ Buffers
(check all that apply):
❑ Pond Construction
❑x Streams - tributaries
❑x Open Waters
2. Wetland Impacts
If there are wetland impacts proposed on the site, complete this table for each wetland area impacted.
2a.
Site #*
2a1.
Impact
Reason/Type*
2b.
Impact
Duration*
2c.
Wetland Type*
2d.
Wetland Name*
2e.
Forested
?*
2f.
Jurisdiction
Type*
2g.
Impact Area
(ac)*
W1
Road/
Driveway
Crossing
Temporary
Headwater
Forest
Impact 1A — W1
Yes
Both
0.032
W2
Road/
Driveway
Crossing
Permanent
Headwater
Forest
Impact 1A — W1
Yes
Both
0.165
W3
Road/
Driveway
Crossing
Permanent
Headwater
Forest
Impact 1 B- W2
Yes
Both
0.065
W4
Other
Permanent
Headwater
Forest
Impact 1 C- W2
Yes
Both
0.005
W5
Fill (Incl.
Riprap)
Permanent
Headwater
Forest
Impact 1 D-W2
Yes
Both
0.008
W6
Choose one
Temp/ Perm
Choose one
Mick to enter
Y/N
Choose one
Click to enter
W7
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W8
Choose one
-emp/ Perm
Choose onE
Click to enter
Y/1
choose one
Click to enter
W9
Choose one
Temp/ Perm
Choose one
Click 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
Mick 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
Mick to enter
Y/P
Choose one
Click to enter
2g1. Total temporary wetland impacts
0.032 ac
2g2. Total permanent wetland impacts
0.243 ac
2g3. Total wetland impacts
0.275 ac
2h. Type(s) of material being discharged and the amount of each type in cubic yards:
Page 9 of 23 PCN Form Version 4.3- April 20, 2022
Click to enter text.
2i. Comments:
Temporary wetland impacts will be brought back to pre -construction contours and the existing adjacent wetland
source will assist in the restoration of the wetland vegetation.
Page 10 of 23 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 3 -
Permanent
Crossing/
Stream A
Perennial
Both
6
115
Road Crossing
Culvert
S2
Impact 3 —
Permanent
Crossing/
Stream A
Perennial
Both
4
36
Road Crossing
Culvert
Permanent No
Permanent
Loss — Riprap
dissipator pad
S3
Impact 3-Road
Temporary
Other
Stream A
Perennial
Both
7
24
crossing
Temporary
construction
access
S4
Impact 4 —
Permanent
Crossing/
Stream C
Intermittent
Both
1
106
Road Crossing
Culvert
S5
Impact 4 —
Permanent
Crossing/
Stream C
Intermittent
Both
2
18
Road Crossing
Culvert
Permanent No
Permanent
Loss — Riprap
Dissipator Pad
S6
Impact 4 —
Temporary
Other
Stream C
Intermittent
Both
1
16
Road Crossing
Temorary
Construction
Access
S7
Impact 10—
Temporary
Other
Stream A
Perennial
Both
2.5
42
Sanitary
Sewer
S8
Impact 11 —
Temporary
Other
Stream C
Intermittent
Both
3
37
Sanitary
Sewer
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
Page 11 of 23 PCN Form Version 4.3- April 20, 2022
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
impacts:
275 linear ft
M.
Total temporary stream
119 linear ft
impacts:
34.
Total stream and ditch
394 linear ft
impacts:
3j.
Comments:
Total permanent loss stream = 221 LF (0.019 acres); Total permanent -no permanent loss stream = 54 LF (0.004
acres) ; Total temporary stream = 119 LF (0.009 acres); Temporary stream impacts will be brought back to pre -
construction stream bed elevations and the stream banks will be stabilized. Permanent -No permanent loss
stream impacts are locations where riprap will be placed below the stream bed for dissipatin and stabilization.
Page 12 of 23 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
Impact 1A-Road/
Driveway Crossing
Permanent
Pond 2
Fill
Pond
0.017
02
Impact 1A-Road/
Driveway Crossing
Temporary
Pond 2
Other
Pond
0.011
03
Impact 2-Lot fill
Permanent
Pond 1
Fill
Pond
0.214
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
0.011 ac
4g.
Total permanent open water impacts
0.231 ac
4g.
Total open water impacts
0.242 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
Choose one
Click to
Click to
Click to
Click to
Click to
Click to
Click t(,
enter.
enter.
enter.
enter.
enter.
enter.
ente
P2
Choose one
Click to
Click to
Click to
Click to
Click to
Click to
Click
enter.
enter.
enter.
enter.
enter.
enter.
ente.
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.
entr
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 23 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: Click to ente
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)
B1
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter
B2
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter
B3
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter
B4
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter
B5
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter
Click to enter.
B6
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter
Click to enter.
B7
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter
Click to enter.
B8
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter
Click to enter.
B9
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:
UICK to enter.
Please attach supporting documentation (impact maps, plan sheets, etc.) for the proposed project.
Page 14 of 23 PCN Form Version 4.3- April 20, 2022
E. Impact Justification and Mitigation
1. Avoidance and Minimization
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts through project design:
S&EC completed a wetland delineation and Jordan Lake Watershed Buffer evaluation for the entire property in
order to identify natural resources so that impacts could be avoided & minimized to the maximum extent
practicable. Proposed impacts include three (3) road crossings, two (2) utility crossings, and two (2) impacts
associated with lot fill. Jordan Lake Watershed buffer impacts will be submitted to the Town of Apex for a No
Practical Alternatives review. Impact #1 (1 A, 1 B) Impact Areas 1 A and 1 B are for a proposed road crossing.
Proposed impacts include permanent wetlands and open waters (i.e. culvert & headwalls), and temporary
wetlands and open waters (i.e. construction access). This road crossing is necessary to provide access to the
southern portion of the property, in addition to providing two points of ingress & egress. Wetland and open water
impacts have been minimized by utilizing head walls, retaining walls and designing with 2:1 slopes at the
crossing. Wetland mitigation is being proposed at a 2:1 ratio to compensate for these proposed permanent
losses. Impact 1C is for proposed SCM fill. Proposed impacts include permanent wetland loss. Wetland impacts
have been minimized by shifting grading to the NW. Wetland mitigation is being proposed at a 2:1 ratio to
compensate for these proposed permanent losses. Impact 1 D is for proposed road and lot fill. Proposed impacts
include permanent wetland loss. Wetland mitigation is being proposed at a 2:1 ratio to compensate for these
proposed permanent losses. Impact # 2 is proposed fill. Proposed impacts include permanent open water
impact to an (existing) pond; the pond has been drained. This impact is necessary for the grading of the internal
residential streets, the grading for sidewalk along Old US 1 Highway, and to allow for buildable lots. Impact # 3 is
a 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. The impact
is necessary to provide access to the eastern and western portions of the property. Stream impacts have been
minimized by utilizing headwalls and retaining walls, by crossing at a near perpendicular angle and by designing
with 2:1 slopes at the crossing. Impact #4 is a 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. The impact is necessary to provide access to the eastern portion of the
property. Stream impacts have been minimized by utilizing headwalls and retaining walls, by crossing at a near
perpendicular angle and by designing with 2:1 slopes at the crossing. Impacts #10 and #11 are proposed utility
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 angle. Temporary wetland impacts will be brought back to pre -construction contours and the
existing adjacent wetland source will assist in the restoration of the wetland vegetation. Temporary stream
impacts will be brought back to pre -construction stream bed elevations and the stream banks will be stabilized.
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 erosion 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? ❑x DWR ❑x Corps
(check all that apply)
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).)
Page 15 of 23 PCN Form Version 4.3- April 20, 2022
3a. Name of mitigation bank:
Cape Fear 02 Umbrella Mitigation Bank: Flat Rock
Mitigation Site
3b. Credits purchased/requested:
Type: Riparian Wetland
Quantity 0.49 acres
Type:
Quantity Click tU c, Ler.
Type: Choose one
Quantity Click to enter.
Attach receipt and/or approval letter.
3c. Comments:
See attached Statement of Availability 1-16-2024
4.
Complete if Using an In Lieu Fee Program
4a.
Attach approval letter from in lieu fee program.
4b.
Stream mitigation requested:
Click to ente, 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)
https://ribits.usace.army.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:
dick 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
6a. Will the project result in an impact within a protected riparian buffer
❑ Yes ❑ 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
CHLA lU CI IICI .
1. 11 :K lU CI IICI .
(-i IUUJC one
1.11UK lU CI IICI .
Page 16 of 23 PCN Form Version 4.3- April 20, 2022
Zone 2
Click to enter.
Click to enter.
Choose one
Click to ent, .
6f. Total buffer mitigation required
Click to enter.
6g. If buffer mitigation is required, is payment to a mitigation bank or
NC Division of Mitigation Services proposed?
Fpyes El No
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 23 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
® 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://deg.nc.,qov/about/divisions/energv-mineral-land-resources/energv-mineral-land-permit-
qu idance/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)
❑x 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 ❑x No
2b.
Does this project meet the requirements for low density projects as
defined in 15A NCAC 02H .1003(2)?
❑ Yes ❑x No
To look up low density requirements, click here:
http://reports.oah.state. nc.us/ncac/title%2015a%20-%20environmental%20guaIity/chapter%2002%20-
%20environmental%20management/subchapter%20h/15a%20ncac%2002h%20.1003.pdf
2c.
Does this project have a stormwater management plan (SMP)
❑x Yes ElNo
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?
❑x Local Government
(Check all that apply.)
❑ State
If you have local government approval, please include the SMP on their overall impact map.
❑x Phase II ❑ USMP
Local Government Stormwater Programs
❑x NSW ❑x Water Supply
Page 18 of 23 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 23 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):
Click 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? *
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 Utley Farm 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 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; 2) the Water Supply,
Watershed Protection Program which limits development densities as well as requires protective riparian buffers;
and 3) 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. We anticipate that the DWR will
advise us if any additional information is needed.
Page 20 of 23 PCN Form Version 4.3- April 20, 2022
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: Yes, Non -discharge permit to Town of Apex public sewer system via existing and
proposed gravity sewer lines. Wastewater will be treated at the Western Wake Reginal Water Reclamation
Facility — 18 MGD
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.ciov/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.? *
® Yes ❑ No
5g.
Does this project involve bridge maintenance or removal? *
❑ Yes ❑x No
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: http://saw-reg.usace.army.mil/NLEB/1-30-17-signed
NLEB-SLOPES&apps.pdf
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 .pdf)
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 .pdf)
Page 21 of 23 PCN Form Version 4.3- April 20, 2022
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 March 23, 2022. The USFWS
provided concurrence on May 19, 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 concurrence email 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 ente
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):
http://,qis.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
® Yes ❑ No
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?
Froehling & Robertson completed a review of Historical Resources and submitted a request to the State Historic
Preservation Office (SHPO) for review. SHPO provided a letter dated August 20,2021 indicating that portions of
the New Hill Historic District (WA1101) and the Horton Farm (WA1098) are within the project area, both listed in
the National Register of Historic Places, and requested an archaeological survey. An archaeological Survey was
submitted to SHPO for review and a follow up letter was provided dated June 9, 2022. See attached letters ER-
1742
7c. Attach historic or prehistoric documentation.
8. Flood Zone Designation (Corps Requirement)
Link to the FEMA Floodplain Maps: https://msc.fema.,qov/portal/search
8a. Will this project occur in a FEMA-designated 100-year floodplain? ❑ Yes ❑x No
Page 22 of 23 PCN Form Version 4.3- April 20, 2022
8b. If yes, explain how the project meets FEMA requirements.
Mick 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.
H. Miscellaneous
Comments:
Click to ent.
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.
Full Name: Deborah Shirley
y Digitally signed by Deborah ' Shirley
Signature: Debo�mtEr-Shirle
Date:2024.01.18 16:41:21-0500'
Date: 1 /18/2024
Page 23 of 23 PCN Form Version 4.3- April 20, 2022