20240600 Ver 1_ePCN Application_20240422

DW R
DHlsloo 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# *
20240600
1
Is a payment required for this project?*
No payment required
What amount is owed?*
Fee received
$240.00 $570.00
Fee needed - send electronic notification
$323.00 $767.00
Reviewing Office*
Select Project Reviewer*
Mooresville Regional Office - [phone]
Andrew Pitner:andrew.pitner
Information for Initial Review
1a. Name of project:
Grace Church Road
1a. Who is the Primary Contact?*
Jennifer Robertson
1b. Primary Contact Email:* 1c. Primary Contact Phone:*
[e-mail] [phone]
Date Submitted
4/22/2024
Nearest Body of Water
Grants Creek
Basin
Yadkin-PeeDee
Water Classification
Class: C
Site Coordinates
Latitude: Longitude:
35.616934-80.541623
A. Processing Information -
Is this project connected with ARPA funding?
Yes No
County (or Counties) where the project is located:
Rowan
Is this a NCDMS Project
Yes No
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
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
39 - Commercial/Institutional Developments
le. Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification:
For the record only for Corps Permit:
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
fig. 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)
le. Is there an Agent/Consultant for this project?
Yes No
2. Owner Information
2a. Name(s) on recorded deed:
Edgar Martinez
2b. Deed book and page no.:
1373, 608
2c. Contact Person:
2d. Address
Street Address
8350 SW 37th Street
Address Line 2
City
Miami
Postal / Zip Code
33155
401 Water Quality Certification - Express
Riparian Buffer Authorization
State / Province / Region
Flordia
Country
USA
Yes No
Yes No

2e. Telephone Number: 2f. Fax Number:
[phone]
2g. Email Address:'
[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
Michael Gorman & Vic Cividini
3b. Business Name:
SJP Properties
3c.Address
Street Address
3891nterpace Parkway
Address Line 2
City
State / Province / Region
Parsippany
New Jersey
Postal / Zip Code
Country
07054
USA
3d. Telephone Number: 3e. Fax Number:
[phone]
3f. Email Address:
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Jennifer Robertson
4b. Business Name:
Atlas Environmental, Inc.
4c.Address
Street Address
338 S. Sharon Amity Road
Address Line 2
#411
City
State / Province / Region
Charlotte
North Carolina
Postal / Zip Code
Country
28211
USA
4d. Telephone Number: 4e. Fax Number:
[phone]
4f. Email Address:
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality / town:
Salisbury
2. Project Identification
2a. Property Identification Number: 2b. Property size:
477 079 35 acres
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2c. Project Address
Street Address
555 Grace Church Road
Address Line 2
City
Salisbury
Postal / Zip Code
28147
3. Surface Waters
3a. Name of the nearest body of water to proposed project:
Grants Creek
3b. Water Resources Classification of nearest receiving water:
Class: C
3c. What river basin(s) is your project located in?"
Yadkin-PeeDee
3d. Please provide the 12-digit HUC in which the project is located.
030401030101
4. Project Description and History
State / Province / Region
North Carolina
Country
USA
4a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this application: *
The site consists of wooded land throughout the site with access road traversing the property. The ground surface is generally sloping to the middle/Southeast of the review area towards
drainage features. At the time of the site visit, no structures and no evidence of previously existing structures were observed within the review area.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?
Yes No Unknown
If yes, please give the DWR Certification number or the Corps Action ID (exp. SAW-0000-00000).
SAW-2024-00510
4f. List the total estimated acreage of all existing wetlands on the property:
0.018
4g. List the total estimated linear feet of all existing streams on the property:
1,799 LF
4h. Explain the purpose of the proposed project:
The purpose of this project is for the construction of an industrial development. The general scope of the project will include one industrial building, one SCM, and associated paved
roadways/parking. Entry to a paved parking area will be possible via a road running through the Northern portion of the property which connects to Grace Church Road. Municipal water is
available along Grace Church Road.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:
The development will require one proposed permanent unavoidable impact to Waters of the United States. Impact S1 will consist of 143.7 linear feet (-0.008 acre) of total intermittent
stream impact on CH 100 for a road crossing. The installation of a 114 linear feet culvert is proposed at the crossing.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?"
Yes No Unknown
Comments:
delineation concurrence
5b. If the Corps made a jurisdictional determination, what type of determination was made?
Preliminary Approved Not Verified Unknown N/A
Corps AID Number:
SAW-2024-00510
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Atlas Staff
Agency/Consultant Company: Atlas Environmental
Other:
5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
A delineation concurrence was made on April 8, 2024
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?
No
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
3. Stream Impacts
❑
3a. Reason for impact (?)
3b.lmpact type"
3c. Type of impact"
3e. Stream Type*
(?)
3f. Type of
Jurisdiction
3g. S. width
r3h.mpact
*
h
g1
access road ::Iff:]
Culvert :T�100
Intermittent
Both
Average (feet)
�
144
(linear feet)
31. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
144
3i. Total stream and ditch impacts:
144
3j. Comments:
Permanent stream impacts: 0.008 acres
E. Impact Justification and Mitigation
1. Avoidance and Minimization
3i. Total temporary stream impacts:
0
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
Impacts are limited to one intermittent stream unavoidable due to gaining access to the site. No impacts are proposed to wetlands. Over 80 % of the
stream on -site will be avoided and preserved.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
The civil engineers have designed the road crossing to include headwalls at both the upstream and downstream ends of the culver. The culvert will be
buried 1 ft. below the existing grade.
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:
Surface water impacts are limited to one intermittent stream of less than 0.02 acres. Therefore, USACE mitigation will not be required. DWR does not require mitigation for intermittent
stream impacts.
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
If no, explain why:
The receiving water is a Class C water and does not require buffers.
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?
Yes No
2b. Does this project meet the requirements for low density projects as defined in 15A NCAC 02H .1003(2)?
Yes No
0
8

2c. Does this project have a stormwater management plan (SMP) reviewed and approved under a state stormwater program or state -approved local government stormwater program?
Yes No
N/A - project disturbs < 1 acre
2d. Which of the following stormwater management program(s) apply:
Local Government State
Local Government Stormwater Programs
Phase II NSW USMP Water Supply
Please identify which local government stormwater program you are using.
Rowan County
Comments:
One SCM is planned to treat all the stormwater within the project area.
G. Supplementary Information
1. Environmental Documentation
la. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?
Yes No
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification Rules (15A NCAC 2H .0500), Isolated Wetland Rules (15A NCAC 2H .1300), or DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15A NCAC 2B .0200)? *
Yes No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality?
Yes No
3b. If you answered "no," provide a short narrative description.
This is a single and complete project. Existing water and septic is accessible along Grace Church Road.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?
Yes No N/A
4b. Describe, in detail, the treatment methods and dispositions (non -discharge or discharge) of wastewater generated from the proposed project. If the wastewater will be treated at a
treatment plant, list the capacity available at that plant.
Existing water and septic is accessible along Grace Church Road.
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or habitat?*
Yes No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?
Yes No
5c. If yes, indicate the USFWS Field Office you have contacted.
Asheville
5d. Is another Federal agency involved?*
Yes No Unknown
5e. Is this a DOT project located within Division's 1-8?
Yes No
5f. Will you cut any trees in order to conduct the work in waters of the U.S.?
Yes No
5g. Does this project involve bridge maintenance or removal?
Yes No
5h. Does this project involve the construction/installation of a wind turbine(s)?*
Yes No
5i. Does this project involve (1) blasting, and/or (2) other percussive activities that will be conducted by machines, such as jackhammers, mechanized pile drivers, etc.?
Yes No

5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
IPAC and NC NHP databases; field surveys and report; FWS coordination; self -certification forms are attached
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?
NOAA Essential Fish Habitat Mapper
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?
NC HPO database search, field surveys, report of findings, SHPO coordination, see enclosed comment letter from SHPO
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?
FEMA NFHL data layer
Miscellaneous
O
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
EPCN documents compressed.pdf 48.44MB
File must be PDF or KMZ
Comments
Signature
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:
Allyson Sinclair
Signature
Date
4/22/2024
L