20230341 Ver 2_More Info Received_20240226

D. Proposed Impacts Inventory
1. Impacts Summary
la. Where are the impacts associated with your project
(check all that apply):
0 Wetlands
❑ Buffers
❑ Pond Construction
❑ Streams - tributaries
❑ 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)*
Site A
Culvert
Permanent
Unknown
Site A-Culvert/Fill
Yes
Corps
0.021
Site B
Culvert
Permanent
Unknown
Site B —
Culvert/Fill/RR
Yes
Corps
0.125
Site B
Other
Permanent
Unknown
Site B — Embedded
RR
Yes
Corps
0.001
Site C
Culvert
Permanent
Unknown
Site C —
Culvert/Fill/RR
Yes
Corps
0.053
Site C
Other
Permanent
Unknown
Site C — Embedded
RR
Yes
Corps
0.000
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
0.000 ac
2g2. Total permanent wetland impacts
0.200 ac
2g3. Total wetland impacts
0.200 ac
2h. Type(s) of material being discharged and the amount of each type in cubic yards:
Culvert with fill over for crossings. Not sure on cubic yardage?
Page 9 of 22 PCN Form Version 4.3- December 4, 2023

2i. Comments:
Note that the "Site C — Embedded Rip Rap" as shown above is 15 sf, so 0.000 acres. Also note that the
embedded rip rap above is broken out as separate because the understanding is that this is an impact, but
mitigation not required for it for a Nationwide 29.
Page 10 of 22 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)
Site B
Access Phase
Permanent
Crossing/
UT to Turkey
Perennial
Corps
8
89
1
Culvert
Creek
Site C
Access Phase
Permanent
Crossing/
UT to Turkey
Perennial
Corps
5
68
11 Section 11
Culvert
Creek
S3
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S4
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S5
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S6
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S7
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S8
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S9
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S10
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S11
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S12
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S13
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S14
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S15
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S16
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S17
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S18
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S19
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
S20
Click to enter
Temp/ Perm
Choose one
Click to enter
Per/Int
Choose one
Click to enter
Click to enter
3i1. Total jurisdictional ditch
impact:
157 linear ft
3i2. Total permanent stream
impacts:
157 linear ft
30. Total temporary stream
impacts:
Click to enter. linear ft
34. Total stream and ditch
impacts:
Click to enter. linear ft
3j. Comments:
These streams are overlapping with wetlands impacts as provided in Section D.2. above. Total square footage
is 0.026 ac. Our understanding is that mitigation is not required for this situation where stream impacts are less
than 0.03 ac.
Page 11 of 22 PCN Form Version 4.3- December 4, 2023

Page 12 of 22 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/ Perm
Click to enter.
Choose one
Choose one
Click to enter.
4g.
Total temporary open water impacts
Click to enter. ac
4g.
Total permanent open water impacts
Click to enter. ac
4g.
Total open water impacts
Click to enter. ac
4h.
Comments:
Click to enter.
5.
Pond or Lake Construction
If pond or lake construction is proposed, complete the table below. (*This does NOT include offline stormwater
management ponds.)
5a.
5b.
5c.
5d.
5e.
Pond ID
Proposed use or
Wetland Impacts
(ac)
Stream
Impacts (ft)
Upland
#
purpose of pond
Impacts (ac)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
P1
Choose one
Click to
Click to
Click to
Click to
Click to
Click to
Click to
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 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 22 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
Site #*
6b.
Impact Type*
6c.
Impact Duration*
6d.
Stream Name*
6e.
Buffer
Mitigation
Required?*
6f.
Zone 1 Impact*
(sq ft)
6g.
Zone 2 Impact*
(sq ft)
131
Choose one
Temp/ Perm
Click to enter.
Y/N
Click to enter.
Click to enter.
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/ Perrr
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/ Perrr
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:
White Oak Basin. These streams only have "vegetated setbacks", and are not considered buffers, per DWR.
Please attach supporting documentation (impact maps, plan sheets, etc.) for the proposed project.
Page 14 of 22 PCN Form Version 4.3- December 4, 2023

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:
Layout specifically designed to minimize the impacts of the stream and/or wetlands while meeting the NCDOT
design requirements, adjacent neighborhood tie ins, and accessibility to rear sections of the property. To access
the large portion of the development tract, it is not feasible to avoid impacts, The crossing location is at the
narrowest location possible. The proposed roadside ditches shall terminate and diffuse flow prior to entering the
vegetated setbacks/wetlands. The only sections of setbacks/wetlands proposed are those needed to construct
the NCDOT typical cross-section/slopes. Headwalls have been designed, as required by NCDOT, to limit
impacts to the streams, wetlands, and vegetated setbacks.
1 b. Specifically describe measures taken to avoid or minimize proposed impacts through construction techniques:
The sedimentation and erosion control plan design has been completed such that the temporary sediment
basins and temporary skimmer sediment basins, as applicable, are installed directly up -slope of the roadside
ditches that discharge up slope of the vegetated setbacks and wetland areas. Silt fence will also be utilized to
surround all disturbed area and straw wattles will be used, where needed, to slow velocities and reduce
suspended solids prior to entering those areas.
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 0 Corps
(check all that apply)
2b. If yes, which mitigation option(s) will be used for this 0 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:
Batchelors Delight Mitigation Bank
3b. Credits purchased/requested:
Type: Non -riparian
Wetland
Quantity 0.04
Type: Riparian Wetland
Quantity 0.36
Type: Choose one
Quantity Click to enter.
Attach receipt and/or approval letter.
3c. Comments:
0.20 total wetlands credits required, not inclusive of embedded rip rap in channel. 2:1 ratio yields quantities
above. Credit reservation letter completed.
4. Complete if Using an In Lieu Fee Program
4a. Attach approval letter from in lieu fee program.
4b. Stream mitigation requested:
Click to enter. linear feet
4c. If using stream mitigation, what is the stream temperature:
Choose one
Page 15 of 22 PCN Form Version 4.3- December 4, 2023