20240193 Ver 1_ePCN Application_20240130

DWR
Division of Water Resources
Pre -Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
October 2, 2023 Ver 4.3
Initial Review
Has this project met the requirements for acceptance in to the review process?
Yes No
Is this project a public transportation project?*
Yes No
Change only If needed.
Does this project involve maintenance dredging funded by the Shallow Draft Navigation Channel Dredging and Aquatic Weed Fund or involve the distribution or transmission of energy or
fuel, including natural gas, diesel, petroleum, or electricity?
Yes No
BIMS # Assigned Version# *
20240193 1
Is a payment required for this project?*
No payment required
Fee received
Fee needed - send electronic notification
Select Project Reviewer*
Kristina Morales: Kristine. Morales
Information for Initial Review
la. Name of project:
COURTESY COPY Lots 48 & 49 - Chamblee South
1a. Who is the Primary Contact?*
Mike Kahm
1b. Primary Contact Email: *
[e-mail]
Date Submitted
1/30/2024
Nearest Body of Water
Black Creek and Reedy Creek
Basin
Nauss
Water Classification
Black Creek
Site Coordinates
Latitude:
35.4924109
A. Processing Information
Is this project connected with ARPA funding?
Yes No
County (or Counties) where the project is located:
Johnston
Is this a NCDMS Project
Yes No
Longitude:
-78.4917147
Reviewing Office*
Raleigh Regional Office - [phone]
1c. Primary Contact Phone:*
[phone]
Is this project a public transportation project?*
Yes No

1a. Type(s) of approval sought from the Corps:
Section 404 Permit (wetlands, streams and waters, Clean Water Act)
Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
Has this PCN previously been submitted?*
Yes
No
1b. What type(s) of permit(s) do you wish to seek authorization?
Nationwide Permit (NWP)
Regional General Permit (RGP)
Standard (IP)
1c. Has the NWP or GP number been verified by the Corps?
Yes No
Are you a federal applicant?"
Yes No
If yes, please provide a statement concerning compliance with the Coastal Zone Management Act."
N/A
Nationwide Permit (NWP) Number:
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
401 Water Quality Certification - Regular
Non-404 Jurisdictional General Permit
Individual 401 Water Quality Certification
401 Water Quality Certification - Express
Riparian Buffer Authorization
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?
Yes No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
Yes No
1h. Is the project located in any of NC's twenty coastal counties?
Yes No
1j. Is the project located in a designated trout watershed?
Yes No
B. Applicant Information
1d. Who is applying for the permit?
Owner Applicant (other than owner)
1e. Is there an Agent/Consultant for this project?
Yes No
2. Owner Information
2a. Name(s) on recorded deed:
Durham Land Acquisitions LLC
2b. Deed book and page no.:
6543, Pages 530-533
2c. Contact Person:
Vincent Markle

2d. Address
Street Address
4821 N Church Ln SE
Address Line 2
Ste B
city
Atlanta
Postal / Zip Code
30339
2e. Telephone Number:
[phone]
2g. Email Address:"
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(if appropriate)
Chamblee South
1c. Nearest municipality / town:
Four Oaks
2. Project Identification
State / Province / Region
GA
Country
United States
2f. Fax Number:
2a. Property Identification Number:
2b. Property size:
07G08006P-Q
1.15 and 1.56
2c. Project Address
Street Address
106 Bristow Court
Address Line 2
116 Bristow Court
City
State / Province / Region
Four Oaks
NC
Postal / Zip Code
Country
27524
United States
3. Surface Waters
3a. Name of the nearest body of water to proposed project:
Black Creek and Reedy Creek
3b. Water Resources Classification of nearest receiving water:"
Black Creek
3c. What river basin(s) is your project located in?"
Neuse
3d. Please provide the 12-digit HUC in which the project is located.
03020203
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: "
Request to fill 0.029 acres of wetland on Lots 48 and 49 at the Chamblee subdivision in Johnston County to access the septic areas on those lots on the opposite side of the wetlands from
the home site. The attached plan illustrates the proposed crossings, which are 20' wide and include a 15" RCP culvert under each crossing to allow for continuity of flow within the wetland
area. Note that the total proposed fill is 1,285 SF (490 SF + 795 SF) or 0.029 acres.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?
Yes No Unknown
4b(2). Is Any Portion of the Work Already Complete?
Yes No
If yes, describe the completed work.
4c. List of Other Certificates or Approvals/Denials received from other Federal, State, or Local Agencies for Work Described in This Application. not related to the 404 or 401.
USACE has indicated that the Corps does not require anything else. It is your responsibility to contact the North Carolina Division of Water Resources (NCDWR) Raleigh Regional Office to
determine the 401 requirements for this project. Please note that, if an Individual 401 WQC is required from NCDWR, the conditions of the Individual 401 WQC, once issued, are also
conditions of the NWP referenced above. You may not conduct the activity authorized by the above referenced NWP without a valid 401 Water Quality Certification.

4f. List the total estimated acreage of all existing wetlands on the property:
0.029
4g. List the total estimated linear feet of all existing streams on the property:
4h. Explain the purpose of the proposed project: *
To access septic fields on Lots 48 and 49 that are on the opposite side of the wetlands from the house pads.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:
Fill area 20' wide on each lot for access to the septic fields with 1 - 15" culvert placed under each crossing.
4k. Will this activity involve dredging in wetlands or waters?
Yes No
If yes, Describe the type of dredging, the composition of the dredged material and the location of disposal area
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?
Yes No Unknown
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made?
Preliminary Approved Not Verified Unknown N/A
Corps AID Number:
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
1-29-24
6. Future Project Plans
6a. Is this a phased project?*
Yes No
Are any other NWP(s), regional general permit(s), or individual permits(s) used, or intended to be used, to authorize any part of the proposed project or related activity?
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)
8. Scheduling of Activity:
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
Wetlands Streams -tributaries Buffers
Open Waters Pond Construction
2. Wetland Impacts
U
48
2a1 Reason (?)
Access Septic Field
2b. Impact type* M
P
2c. Type of W.
Isolated Wetlands
2d. W. name
Isolated Wetlands
2e. Forested *
No
2f. Type of Jurisdicition *
(?)
—_—]
Both
2g. Impact
area *
0.011
(acres)
E71�c
cess Septic
P
Isolated Wetlands
Isolated Wetlands
No
::]
Both
0.018
(acres)
2g. Total Temporary Wetland Impact 2g. Total Permanent Wetland Impact
0.000 0.029

2g. Total Wetland Impact
0.029
2h.Type(s) of Material Being Discharged and the Amount of Each Type in Cubic Yards:
2i. Comments:
3L Total cubic yard stream impacts:"
0
4g. Total cubic yard open water impacts:
0
E. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
We purchased lots as -is and septic areas are not available on house side of wetlands.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Propose minimal fill to provide for homeowner access to their respective septic systems from their homesite.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for impacts to Waters of the U.S. or Waters of the State?
Yes No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection Rules?
Yes No
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
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?
Yes No
Comments:
G. Supplementary Information
1. Environmental Documentation
1a. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?
Yes No
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification Rules (15A NCAC 2H .0500), Isolated Wetland Rules (15A NCAC 2H .1300), or DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15A NCAC 2B .0200)? *
Yes No
3. Cumulative Impacts (DWR Requirement)
O
3a. Will this project result in additional development, which could impact nearby downstream water quality?
Yes No

3b. If you answered "no," provide a short narrative description.
No additional development planned on the lots, other than home construction and septic system install.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?"
Yes No N/A
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or habitat?"
Yes No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?"
Yes No
5d. Is another Federal agency involved?"
Yes No
5e. Is this a DOT project located within Division's 1-8?
Yes No
Unknown
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
None
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?
None
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal governments have designated as having historic or cultural preservation status?"
Yes No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
None
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?"
Yes No
8c. What source(s) did you use to make the floodplain determination?
Project Survey - see Construction Plans
Miscellaneous
0-
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
CHAM-Construction Drawings -Approved 3-03-2022 (1).pdf 26.33MB
2023-04-18_Chamblee South -Recorded Plat.pdf 685.3KB
Chamblee Proposed Wetland Crossings -LOTS 48 & 49.pdf 361.97KB
File must be PDF or KMZ
Comments
Signature O
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:
G. Michael Kahm
Signature
Date
1/30/2024