20240280 Ver 1_Ting PCN Submitted 2024-02-15_20240215

STATE
NORTH CAROLINA
Environmental Quality
Water Resources
Office Use Only
Corps Action ID no. [Click to enter.] Date received: [Click to enter.]
DWR project no. ;lick enter.] Date received: [Click to enter.]
Site Coordinates:
Latitude (DD.DDDDDD): 35.670265
Longitude (DD.DDDDDD): 78.836832
Form Version 4.3, 1210412023
Pre -Construction Notification (PCN) Form
(Ver. 4.2, 1210412023)
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.nchttps://edocs.deg.ncgov/WaterResources/DocView.aspx?dbid=0&id=2196924&cr=1WaterResources/DocView.aspx?dbid=0&id=2196924&cr=1
Page 1 of 21 PCN Form Version 4.3- December 4, 2023

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. basinaer(cDncdenr.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)
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 o-nto-r ^ -into-
❑x Nationwide Permit (NWP)
1 b. What type(s) of permit(s) do you wish to seek
El 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.
1c. Has the NWP or GP number been verified by the Corps?
® Yes ❑ No
NWP number(s) (list all numbers ):
39
RGP number(s) (list all numbers ):
lick 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 tex
1d. 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 21 PCN Form Version 4.3- December 4, 2023

1e.
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
1f.
Is this an after -the -fact permit/certification application? *
❑ Yes
0 No
1g.
Is payment into a mitigation bank or in -lieu fee program proposed for
mitigation of impacts?
❑ Yes
0 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: http://www.saw.usace.army.mil/Missions/Regulatory-Permit-
Program/Agency-Coordination/Trout.aspx
Page 3 of 21 PCN Form Version 4.3- December 4, 2023

B. Applicant Information
1a.
Who is the primary contact?
Jennifer Burdette
1 b.
Primary Contact Email:
burdette@_nrconsultnc.com
1c.
Primary Contact Phone: (###)###-####
[phone]
1 d.
Who is applying for the permit/certification? * (check
all that apply)
❑ Owner 0 Applicant (other than owner)
1e.
Is there an agent/consultant for this project?*
0 Yes ❑ No
2.
Landowner Information
2a.
Name(s) on Recorded Deed:
Wake County
2b.
Deed Book and Page No.:
2c.
Contact Person (for corporations):
Mark Edmondson
2d.
Address
Street Address:
P.O. Box 550
Address line 2:
City:
Raleigh
State/ Province/ Region:
NC
Postal/ Zip Code:
27602
Country:
USA
2e.
Telephone Number: * (###)###-####
[phone]
2f.
Fax Number: (###)###-####
Click �,
2g.
Email Address:
[e-mail]
3.
Applicant Information (if different from owner)
3a.
Name:
Frank Baird
3b.
Business Name (if applicable):
Capital Associates
3c.
Address:
Street Address:
1501 Sunrise Avenue
Address line 2:
Suite 100
City:
Raleigh
State/ Province/ Region:
NC
Postal/ Zip Code:
27608
Country
USA
3d.
Telephone Number:
[phone]
3e
Fax Number: (###)###-####
3f.
Email Address:
[e-mail]
Page 4 of 21 PCN Form Version 4.3- December 4, 2023

3.
Applicant Information (if different from owner)
3a.
Name:
Natalie Britt
3b.
Business Name (if applicable):
DHIC
3c.
Address:
Street Address:
113 S. Wilmington Street
Address line 2:
Click to enter.
City:
Raleigh
State/ Province/ Region:
NC
Postal/ Zip Code:
27601
Country
USA
3d.
Telephone Number: * (###)###-####
[phone]
3e
Fax Number: (###)###-####
Click to enter.
3f.
Email Address:
[e-mail]
4. Agent/ Consultant (if applicable)
4a. Name:
Jennifer Burdette
4b. Business Name:
Natural Resource Consultants, LLC (NRC)
4c. Address:
Street Address:
308 W. Millbrook Road
Address line 2:
Suite D #200
City:
Raleigh
State/ Province/ Region:
NC
Postal/ Zip Code:
27609
Country:
USA
4d. Telephone Number: * (###)###-####
[phone]
4e Fax Number: (###)###-####
;lick to enter.
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:
httos://www.saw. usace.army. mil/Missions/Regulatory-Permit-Program/Permits/2017-Nationwide-Permits/Pre-
construction-Notification/
Page 5 of 21 PCN Form Version 4.3- December 4, 2023

C. Project Information and Prior Project History
I. Project Information
1a. Name of project:
Ting Park Commercial Tract (DHIC Sportsmanship
Way)
1 b. Subdivision name (if appropriate):
ick to enter.
1c. Nearest municipality/town:
Holly Springs
2.
Project Identification
2a.
Property identification number (tax PIN or parcel ID):
0649891181, 0649898125, & 0649884725
2b.
Property size (in acres):
20
2c.
Project Address:
Street Address:
Site is located off Sportsmanship Way and N. Main
Street
Address line 2:
Click to enter.
City:
Holly Springs
State/ Province/ Region:
NC
Postal/ Zip Code:
27540
Country:
USA
2d.
Site coordinates in decimal degrees (using 4-6 digits
after the decimal point):
Latitude (DD.DDDDDD): 35.670265
Longitude (-DD.DDDDDD):-78.836832
3. Surface Waters
3a. Name of nearest body of water to proposed project: *
UT Little Branch
3b. Water Resources Classification of nearest receiving
C
water:
The Surface Water Classification map may be found at this link:
https://ncdenr. maps.arcqis.com/apes/webappviewer/index. htmI?id=6e125ad7628f494694e259c8Odd64265
Cape Fear
3c. In what river basin(s) is your project located?
CpnczP arirfainnal (if needed)
3d. Please provide the 12-digit HUC in which the project is
030300040102
located:
The Find Your HUC map may be found at this link:
https://ncdenr.maps.arcqis.com/apes/Publicinformation/index.htmi?appid=ad3a85aOc6d644aOb97cdO69db238ac3
Page 6 of 21 PCN Form Version 4.3- December 4, 2023

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 proposed project site is bordered by Sportsmanship Way along the southern parcel boundary and North
Main Street along the eastern parcel boundary. NC Highway 55 parallels the western side of the property parcel.
The project site is mostly forested and consists of upland mixed hardwood and pine forest dominated by loblolly
pine, sweetgum, tulip poplar, and red maple. A sanitary sewer and natural gas pipeline easement run east -to -
west along the southern project boundary. General land use within the surrounding area is primarily comprised of
residential and commercial properties, as well as recreational areas like Ting Park and associated greenway
access.
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 ® 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.
Click to enter text.
4d. Attach an 8'/z x 11" excerpt from the most recent version of the USGS topographic map indicating the location of
the project site.
4e. Attach an 8'/z 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
0.017 acres
property:
4g. List the total estimated linear feet of all existing streams (intermittent
1,971 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 proposed project is to establish an information technology training and certification center to
be accessed via Sportsmanship Way and North Main Street in Holly Springs, Wake County, North Carolina.
Page 7 of 21 PCN Form Version 4.3- December 4, 2023

4i. Describe the overall project in detail, including the type of equipment to be used: *
The proposed project involves the construction of a primary driveway located off Sportsmanship Way and a
secondary driveway located off North Main Street to provide site access to the proposed IT training and
certification center facility. The use of two driveways associated with the site supports efficient ingress and
egress as well as emergency access. The proposed primary driveway (Impact Map A, Sheet E2) will cross a
perennial tributary to Little Branch (Class C) and an existing utility corridor. Impacts associated with the driveway
crossing involve the installation of a 72-inch RCP culvert, which will impact approximately 120 LF of perennial
stream (Impact S1). The crossing also involves the installation of a 21 LF dissipator pad (Impact S4) and two
temporary stream impacts on the upstream and downstream side of the proposed culvert for the use of a pump
around system during construction (Impacts S2, S3).
A pedestrian boardwalk that crosses the perennial stream on site to provide access to an existing greenway is
also proposed for the project (Impact Map B, Sheet E3). There are no stream impacts associated with this project
component since the boardwalk structure will span entirely from top -of -bank to top -of -bank and will not encroach
upon the stream's ordinary high-water mark.
The extension of an existing culvert that runs under North Main Street is proposed (Impact Map C, Sheet E4).
The culvert outlet extension will impact approximately 120 LF of perennial stream (Impact S7). The culvert
extension also involves the installation of a 21 LF dissipator pad (Impact S5) and 6 LF of temporary impact on
the downstream side of the culvert outlet for the use of a pump around system during construction (Impact S6).
Additional infrastructure necessary to support the proposed project includes roads, a sanitary sewer connection,
and stormwater control measures. Impact S8 (Impact Map C, Sheet E4) is a temporary intermittent stream
impact associated with accessing the stream buffer to conduct clearing activities during utility
installation/connection within an existing public utility easement. There are no stream impacts for utility
installation. The 1-foot-wide stream channel will be accessed during periods of low or no flow. Any temporary
impacts to the stream channel will be remediated and the stream channel will be returned to its original
morphology upon the completion of construction activities. There are no additional stream or wetland impacts
associated with site infrastructure or building construction.
The project is located within the Cape Fear River Basin. The Town of Holly Springs enforces a 30-foot buffer on
either side of perennial and intermittent streams for the Cape Fear River Basin. Impacts to stream buffers will
require approval from the Town of Holly Springs prior to project construction.
Equipment typical for construction and earth moving will be utilized to construct the proposed project. A pump
around system will be utilized to separate the flowing stream from the construction area.
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.
Click to enter tex
Page 8 of 21 PCN Form Version 4.3- December 4, 2023

5.
Jurisdictional Determinations
5a.
Have the wetlands or streams been delineated on the property or in
® Yes ❑ No ❑ Unknown
proposed impact areas?
Comments:
Please reference comments in 5d. below.
5b.
If the Corps made a jurisdictional determination,
0 Preliminary ❑ Approved 0 Emailed concurrence
what type of determination was made? *
❑ Not Verified ❑ Unknown ❑ n/a
Corps AID number (ex. SAW-0000-00000):
SAW-2021-01687
Name (if known): Kelly Roth, Jennifer Burdette, Alec
5c.
If 5a is yes, who delineated the jurisdictional
Pierzga
areas?
Agency/Consultant Company: McAdams/NRC
Other: ',lick to enter
5d.
List the dates of the Corps jurisdictional determination or State determination if a determination was made by
either agency.
An Approved Jurisdictional Determination request was initially submitted for the project parcel on May 28, 2021.
Lyle Phillips of the USACE conducted a site visit on August 26, 2021, and issued an email of concurrence on
August 31, 2021, under the prior Navigable Waters Protection Rule (NWPR). NRC re-evaluated the project area
on October 30, 2023, and resubmitted a Preliminary Jurisdictional Determination request consistent with the final
2023 Rule on November 9, 2023. Lyle Phillips with the USACE conducted a field verification of the site on
February 7, 2024, and confirmed the features depicted on the attached Figure 4. Stream determinations were
verified by Andy Kiley of NC DWR on June 30, 2021.
5d1. Attach jurisdictional determinations.
6. Future Project Plans
6a. Is this a phased project?
❑ Yes 0 No
6b. If yes, explain.
C, —, a enter.
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.
No.
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)
Click to enter.
8. Scheduling of activity:
Project construction will commence upon the issuance of 404/401 approvals, an approved sediment and erosion
control plan, stormwater management plan, and buffer authorization from the Town of Holly Springs.
Page 9 of 21 PCN Form Version 4.3- December 4, 2023

D. Proposed Impacts Inventory
Impacts Summary
❑ Wetlands ❑x Streams - tributaries
1a. 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.
Site #*
2a1.
Impact
Reason/Type
2b.
Impact
Duration*
2c.
Wetland Type
2d.
Wetland Name*
2e.
Forested
?*
2f.
Jurisdiction
Type*
2g.
Impact Area
(ac)*
W1
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W2
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W3
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W4
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W5
Choose one
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to enter
W6
Choose one
Temp/ Perm
Choose one
Click 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
Temp/ Perm
Choose one
Click to enter
Y/N
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
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
2g1. Total temporary wetland impacts
0 ac
2g2. Total permanent wetland impacts
0 ac
2g3. Total wetland impacts
0 ac
2h. Type(s) of material being discharged and the amount of each type in cubic yards:
Click to enter text.
2i. Comments:
Click to enter text.
Page 10 of 21 PCN Form Version 4.3- December 4, 2023

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
Culvert
Permanent
Crossing/
S-B (UT Little
Perennial
Both
6
120
Culvert
Branch)
S2
Pump Around
Temporary
Dewatering
S-B (UT Little
Perennial
Both
7
8
Branch)
S3
Pump Around
Temporary
Dewatering
S-B (UT Little
Perennial
Both
7
20
Branch)
S4
Riprap
Permanent
Fill (Incl.
S-B (UT Little
Perennial
Both
7
21
Dissipator Pad
Riprap)
Branch)
S5
Riprap
Permanent
Fill (Incl.
S-B (UT Little
Perennial
Both
8
21
Dissipator Pad
Riprap)
Branch)
S6
Pump Around
Temporary
Dewatering
S-B (UT Little
Perennial
Both
6
6
Branch)
S7
Culvert
Permanent
Crossing/
S-B (UT Little
Perennial
Both
2
12
Culvert
Branch)
S8
Access
Temporary
Other
S-G (UT Little
Intermittent
Both
1
8
Branch)
3i1.
Total jurisdictional ditch
0 linear ft
impact:
3i2.
Total permanent stream
174 linear ft
impacts:
36.
Total temporary stream
42 linear ft
impacts:
3i4.
Total stream and ditch
216 linear ft
impacts:
3j.
Comments:
Permanent stream loss associated with the project totals 132 LF (0.0156 AC/683 SF).
Page 11 of 21 PCN Form Version 4.3- December 4, 2023

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/ Perr^
Click to enter.
Choose one
I 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
Click t,
Click to
Click to
Click to
Click to
Click to
Click to
P1
Choose one
enter.
enter.
enter.
enter.
enter.
enter.
enter.
Click to
Click to
Click to
Click to
Click to
Click to
Click to
P2
Choose one
enter.
enter.
enter.
enter.
enter.
enter.
enter.
Click to
Click to
Click to
Click to
Click to
Click to
Click to
P3
Choose one
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 -
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:
Page 12 of 21 PCN Form Version 4.3- December 4, 2023

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: enter.
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.
B11
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---r
-emp/ Perm
Click to enter.
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:
UiicK to enter.
Please attach supporting documentation (impact maps, plan sheets, etc.) for the proposed project.
Page 13 of 21 PCN Form Version 4.3- December 4, 2023

E. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts through project design:
The applicant obtained a delineation of surface waters and wetlands of the study area before planning the
project to avoid and minimize impacts to aquatic resources to the maximum extent practicable.
Permanent impacts to wetlands on the site have been avoided. The stream along the southern boundary
separates the site from Sportsmanship Way making the stream impacts shown in Impact A Map unavoidable.
Retaining walls were utilized to minimize the impact. The stream impacts shown in Impact C Map to provide a
turn lane in the second entrance are unavoidable due to the existing crossing of N Main Street.
1 b. Specifically describe measures taken to avoid or minimize proposed impacts through construction techniques:
A sediment and Erosion Control Plan for the project will be planned and approved by the Town of Holly Springs
prior to site construction and the project will comply with the supplementary NPDES Construction Stormwater
Permit (NCG010000). The project will adhere to the approved Sediment and Erosion Control Plan and the use
of Best Management Practices to ensure that there are no impacts to downstream water quality as a result of the
project.
Culverts associated with Impact S1 and Impact S7 are designed to be buried 1-foot and centered on the stream
channel to provide aquatic life passage and to maintain the natural dimension, pattern, and profile of the stream.
A pump around system will be utilized to separate the construction area from the flowing stream. Construction
impacts will be minimized by limiting in -channel work to low -flow conditions and working from high-
ground/streambanks.
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? ❑ DWR ❑ 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).)
3a. Name of mitigation bank:
_.._._ ._ enter.
3b. Credits purchased/requested:
Type: Choose one
Quantity lick to enter.
Type: Choose one
Quantity Click to enter.
Type: Choose one
Quantity Click to enter.
Attach receipt and/or approval letter.
3c. Comments:
Click to enter.
4. Complete if Using an In Lieu Fee Program
Page 14 of 21 PCN Form Version 4.3- December 4, 2023

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)
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:
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
6a.
Will the project result in an impact within a protected riparian buffer
that requires buffer mitigation?
❑ Yes 0 No
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.
Zone
6c.
Reason for impact
6d.
Total impact
(square feet)
Multiplier
6e.
Required mitigation
(square feet)
Zone 1
Click to enter.
Click to enter.
Choose one
Click to enter.
Zone 2
Click to enter.
Click to enter
Choose one
Click to enter.
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?
❑ Yes ❑ No
6h.
If yes, attach the acceptance letter from the mitigation bank or NC Division of Mitigation Services.
6i.
Comments:
to enter.
Page 15 of 21 PCN Form Version 4.3- December 4, 2023

F. Stormwater Management and Diffuse Flow Plan (DWR requirement)
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers
❑ Yes ❑x 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.gov/about/divisions/energy-mineral-land-resources/energy-mineral-land-Permit-
guidance/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)
❑ 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?
El Yes 0 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:
httio://reports.oah.state. nc. us/ncac/title%2015a°/o20-°/`2Oenvironmental°/`20guality/chapter%2002%20-
%20environmental%20management/subchapter°/o20h/15a°/o20ncac%2002h%20.1003.pdf
2c.
Does this project have a stormwater management plan (SMP)
0 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?
0 Local Government
(Check all that apply.)
❑ State
If you have local government approval, please include the SMP on their overall impact map.
Local Government Stormwater Programs
0 Phase II ❑ USMP
❑ NSW ❑ Water Supply
Page 16 of 21 PCN Form Version 4.3- December 4, 2023

Please identify which local government stormwater program you are using.
Town of Holly Springs - Stormwater Management Program
State Stormwater Programs ❑ Phase II ❑ HQW or ORW
❑ Coastal Counties ❑ Other
Comments:
Click to enter.
Page 17 of 21 PCN Form Version 4.3- December 4, 2023

G. Supplementary Information
1. Environmental Documentation
1a. 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
El Yes El 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:
NPDES Phase II Stormwater rules will be implemented for the project. It is not anticipated that the proposed
project will result in additional development that could impact nearby downstream water quality.
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? I ® 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.
Wastewater generated from the project will be discharged to the existing sanitary sewer system.
Page 18 of 21 PCN Form Version 4.3- December 4, 2023

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected
0 Yes ❑ No
species or habitat? (IPAC weblink: httbs://www.fws.gov/ipac/ ffws.govl)
5b. Have you checked with the USFWS concerning Endangered Species
0 Yes ❑ No
Act impacts?
5c. If yes, indicate the USFWS Field Office you have contacted.
Raleigh
5d. Is another federal agency involved?
❑ Yes 0 No ❑ Unknown
If yes, which federal agency?
Click to enter.
5e. Is this a DOT project located within Divisions 1-8?
❑ Yes 0 No
5f. Will you cut any trees in order to conduct the work in waters of the
U.S.?
®Yes El No
5g. Does this project involve bridge maintenance or removal? *
❑ Yes 0 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: httr)://saw-reci.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)?
El Yes 0 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 0 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)
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated
Critical Habitat?
On November 8, 2023, a protected species assessment was submitted to the Raleigh Office of the USFWS
including an official species list generated by the USFWS IPaC website and a NCNHP report for the project area.
A self -certification letter, species conclusion table, and email submittal are attached. No further communication
has been received at the time of this application.
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?
El Yes 0 No
Is there submerged aquatic vegetation (SAV) around
the project vicinity? *
El Yes 0 No El Unknown
Page 19 of 21 PCN Form Version 4.3- December 4, 2023

Will this project affect submerged aquatic vegetation? * I ❑ 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 Essential Fish Habitat (EFH) Mapper (http://habitat.noaa.gov/protection/efh/efhmapper/) was
accessed on February 8, 2023.
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
Link to the State Historic Preservation Office Historic Properties Map (does not include archaeological data):
httio://Qis.ncdcr.gov/hipoweb/
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
El Yes 0 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?
Please refer to the attached letter submitted to the State Historic Preservation Office on October 31, 2023. No
further communication has been received at the time of this application.
7c. Attach historic or prehistoric documentation.
8. Flood Zone Designation (Corps Requirement)
Link to the FEMA Floodplain Maps: httos://msc.fema.gov/portal/search
8a. Will this project occur in a FEMA-designated 100-year floodplain? *
❑ Yes 0 No
8b. If yes, explain how the project meets FEMA requirements.
lick to
8c. What source(s) did you use to make the floodplain determination?
FEMA Map Service Center; FIRM map number 3720064900K, panel 0649, effective 7/19/2022.
H. Miscellaneous
Comments:
Permanent stream loss associated with the project totals 216 LF (0.00156 AC/683 SF), which is below the
threshold (0.02 AC/871 SF) required for mitigation.
The project is located within the Cape Fear River Basin. The Town of Holly Springs enforces a 30-foot buffer on
either side of perennial and intermittent streams for the Cape Fear River Basin. Impacts to stream buffers will
require approval from the Town of Holly Springs prior to project construction.
Attach pertinent documentation or attachments not previously requested
Page 20 of 21 PCN Form Version 4.3- December 4, 2023

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: Jennifer Burdette
Signature:
Date: 2/15/2024
Page 21 of 21 PCN Form Version 4.3- December 4, 2023