20240357 Ver 2_ePCN Application_20240507

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# *
20240357 2
Is a payment required for this project?*
No payment required
Fee received
Fee needed - send electronic notification
Reviewing Office*
Central Office - [phone]
Information for Initial Review
la. Name of project:
Smith Project
la. Who is the Primary Contact?*
Adam Carter
1b. Primary Contact Email:*
[e-mail]
Date Submitted
5/7/2024
Nearest Body of Water
Sandy Run
Basin
Lumber
Water Classification
WS-II;HQW
Site Coordinates
Latitude:
35.203689
A. Processing Information
Is this project connected with ARPA funding?
Yes No
County (or Counties) where the project is located:
Moore
Is this a NCDMS Project
Yes No
Longitude:
-79.518403
What amount is owed?*
$240.00
$323.00
Select Project Reviewer*
Sue Homewood:Sue.Homewood
1c. Primary Contact Phone:*
[phone]
$570.00
$767.00
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
Please provide the date of the previous submission.'
2/27/2024
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."
No a coastal county.
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
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
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)
le. Is there an Agent/Consultant for this project?
Yes No
2. Owner Information
2a. Name(s) on recorded deed:
SMITH, LANCE J
2b. Deed book and page no.:
5964/155
2c. Contact Person:
SMITH, LANCE J
401 Water Quality Certification - Express
Riparian Buffer Authorization
Yes No
Yes No

2d. Address
Street Address
4337 JOHNSON AVE
Address Line 2
City
WESTERN SPRINGS,
Postal / Zip Code
60558
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
NA
3b. Business Name:
3c. Address
Street Address
4337 JOHNSON AVE
Address Line 2
city
WESTERN SPRINGS
Postal / Zip Code
60558
3d. Telephone Number:
[phone]
3f. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Samuel Adam Carter
4b. Business Name:
Wetland Solutions, LLC
4c.Address
Street Address
P.O. Box 244
Address Line 2
city
Bunnlevel
Postal / Zip Code
28323
4d. Telephone Number:
[phone]
0. Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(if appropriate)
PINEWILD CC LOT 2294
1c. Nearest municipality / town:
Pinehurst
State / Province / Region
NC
Country
USA
2f. Fax Number:
State / Province / Region
NC
Country
USA
3e. Fax Number:
State / Province / Region
NC
Country
USA
4e. Fax Number:
O
2. Project Identification

2a. Property Identification Number:
854207591376
2b. Property size:
1.34
2c. Project Address
Street Address
20 Barons Drive
Address Line 2
city
Pinehurst
Postal / Zip Code
28374
3. Surface Waters
3a. Name of the nearest body of water to proposed project:"
Sandy Run
3b. Water Resources Classification of nearest receiving water:'
WS-II;HQW
3c. What river basin(s) is your project located in?
Lumber
3d. Please provide the 12-digit HUC in which the project is located.
030402030201
4. Project Description and History
State / Province / Region
NC
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 project area is forested with a monoculture of Long Leaf pine. Abutting the parcel is a golf fairway and utilty power line.
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.
4f. List the total estimated acreage of all existing wetlands on the property:
.16
4g. List the total estimated linear feet of all existing streams on the property:
203 intermittent
4h. Explain the purpose of the proposed project: *
The purpose of this proposed project is to construct a driveway across a jursdictional feature to access the upland part of the lot for home.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used: *
The project will consist of constructing a road crossing and installing the culvert. Excavador, backhoe, and grader will be used to install culvert and construct the road.
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:
SAW-2024-00442 (Pinewild CC Lot 2294 / 20 Barons Drive / Pinehurst NC / Moore County) /
Standard Permit Application.
5c. If 5a is yes, who delineated the jurisdictional areas?

Name (if known): Samuel Adam Carter
Agency/Consultant Company: Wetland Solutions, LLC
Other:
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)
See attached ENG4353 for adjoyning property owners
8. Scheduling of Activity:
Once permits are recieved we will proceed with construction of road crossing.
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
2a1 Reason (?)
2b. Impact type" (?)
2c. Type of W. *
2d. W. name
2e. Forested"
2f. Type of Jurisdicition *
(?)
2g. Impact
area"`
W1
Road Crossing
P
Headwater Forest
W1
Yes
:: ]
Both
J
0.016
(acres)
2g. Total Temporary Wetland Impact
0.000
2g. Total Wetland Impact
0.016
2h.Type(s) of Material Being Discharged and the Amount of Each Type in Cubic Yards:
25
2i. Comments:
3i. Total cubic yard stream impacts:
69
4g. Total cubic yard open water impacts:"
0
E. Impact Justification and Mitigation
1. Avoidance and Minimization
2g. Total Permanent Wetland Impact
0.016
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
They pick the nearest point to cross the weltand to minimize the impact.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
The contractor will minimize the impact by working in the driest times available to minimize sediment transport along with constructing a silt fence
withoutlets and maintenance regimen.
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
2c. If yes, mitigation is required by (check all that apply):
D W R Corps
2d. If yes, which mitigation option(s) will be used for this project?
Mitigation bank Payment to in -lieu fee program Permittee Responsible Mitigation
O

4. Complete if Making a Payment to In -lieu Fee Program
4a. Approval letter from in -lieu fee program is attached.
Yes No
4b. Stream mitigation requested:
(linear feet)
23ft
4d. Buffer mitigation requested (DWR only):
(square feet)
4f. Non -riparian wetland mitigation requested:
(acres)
4h. Comments
4c. If using stream mitigation, what is the stream temperature:
warm
4e. Riparian wetland mitigation requested:
(acres)
.016
49. Coastal (tidal) wetland mitigation requested:
(acres)
6. Buffer mitigation (State Regulated Riparian Buffer Rules) - required by DWR
6a. Will the project result in an impact within a protected riparian buffer that requires buffer mitigation? If yes, you must fill out this entire form - please contact DWR for more information.
Yes No
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
1. Diffuse Flow Plan
la. 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:
No, River Basin has no protected riparian 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
Comments:
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.
No more room abutting lot to develope.
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.
The waste from home will be treated through sewer alocation of Pinehurst. Capsity unknown at this time
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.
Raleigh
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?
USFWS IPAC and Natural hertage explore site to assess sites for SEC7 and 9 of ESA
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's 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?
HPOWEB 2.0
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?
NC Flood Risk Information System
Miscellaneous
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
Barons Drive IP PACKETpdf
8.31 MB
2294, PINEWILD -updated site plan.pdf
1AMB
20 Barons Drive DMS Acceptance.pdf
245.76KB
2294, PINEWILD - SITE PLAN2024 no trees2.pdf
993.54KB
2294, PINEWILD - SITE PLAN2024c.pdf
IAMB
20240403_Itr_RFO ACarter_AltParNo_00991468_20_Barons_Drive _s_.pdf
361.97KB
2294, Pinewild - Site PIan2024C.pdf
1.39MB
Barons Drive _Eng_Form_4345 (1) SIGNED.pdf
131.21KB
SAW-2024-00442_Withdrawal.pdf
178.66KB
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");
O

• 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:
Samuel Adam Carter
Signature
Siswr m'�i/`lnwr C'� trit
Date
5/7/2024