20240469 Ver 1__20240618_RFAI Response_Irwin Creek Stream Restoration (DWR#20240469)_20240618

x STATE
" n
u C
se vuannt°1
NORTH CAROLINA
Environmental Quality
Water Resources
Office Use Only
Corps Action I D no. [Click to enter.]
DWR project no. Click enter.]
Site Coordinates:
Date received: [Click to enter.]
Date received: [Click to enter.]
Latitude (DD.DDDDDD): 35.267911'
Longitude (DD.DDDDDD):-80.830562'
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.deq. nc.qov/WaterResources/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:
Mecklenburg 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"
"Offer
43341045
(LOIF) or and Acceptance Letter". If you are unable to locate
your DWI ARPA Funding Project Number, please contact Corey
Basinger at corey.basingera(),ncdenr. gov 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)
la. 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.
Clink to -nt,-r n rIat,
❑x Nationwide Permit (NWP)
1 b. What type(s) of permit(s) do you wish to seek
El Regional General Permit (RGP)
authorization?
❑ Standard (I P)
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.
1 C. Has the NWP or GP number been verified by the Corps?
® Yes ❑ No
NWP number(s) (list all numbers ):
27
RGP number(s) (list all numbers ):
Click to ent,
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 text
1d. Type(s) of approval sought from DWR (check all that apply):
❑ 401 Water Quality Certification — Regular
❑ 401 Water Quality Certification— Express
❑ Non-404 Jurisdictional General Permit
❑ Riparian Buffer Authorization
❑x 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

1 e.
Is this notification solely for the record because written approval is not required? *
For the record only for DWR 401 Certification: *
❑ Yes
❑x No
For the record only for Corps Permit: *
❑ Yes
❑x No
1f.
Is this an after -the -fact permit/certification application? *
❑ Yes
❑x No
1g.
Is payment into a mitigation bank or in -lieu fee program proposed for
mitigation of impacts?
p Yes
❑x 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
❑x No
1 i.
Is the project located within an NC DCM Area of Environmental
Concern (AEC)? *
❑ Yes
❑x No ❑ Unknown
1j.
Is the project located in a designated trout watershed? *
❑ Yes
❑x 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/Requlatory-Permit-
Program/Agency-Coordination/Trout.aspx
Page 3 of 21 PCN Form Version 4.3- December 4, 2023

B. Applicant Information
1 a.
Who is the primary contact?
Taylor Kiker
1 b.
Primary Contact Email:
[e-mail]
1 c.
Primary Contact Phone: (###)###-####
980-296-0810
1 d.
Who is applying for the permit/certification? (check
all that apply)
❑ Owner ❑x Applicant (other than owner)
1 e.
Is there an agent/consultant for this project?
® Yes ❑ No
2.
Landowner Information
2a.
Name(s) on Recorded Deed:
City of Charlotte
2b.
Deed Book and Page No.:
UICK to enter.
2c.
Contact Person (for corporations):
Click to enter.
2d.
Address
Street Address:
2145 Suttle Avenue
Address line 2:
Click to ente, .
City:
Charlotte
State/ Province/ Region:
North Carolina
Postal/ Zip Code:
28208
Country:
USA
2e.
Telephone Number: (###)###-####
Click to enter.
2f.
Fax Number: (###)###-####
Click to enter.
2g.
Email Address:
Click to enter.
3.
Applicant Information (if different from owner)
3a.
Name:
Stephanie Roberts -Bowman
3b.
Business Name (if applicable):
Charlotte -Mecklenburg Storm Water Services
3c.
Address:
Street Address:
2145 Suttle Avenue
Address line 2:
City:
Charlotte
State/ Province/ Region:
North Carolina
Postal/ Zip Code:
28208
Country
USA
3d.
Telephone Number: (###)###-####
[phone]
3e
Fax Number: (###)###-####
Click to enf,
3f.
Email Address:
Stephanie. [e-mail]
Page 4 of 21 PCN Form Version 4.3- December 4, 2023

4.
Agent/ Consultant (if applicable)
4a.
Name:
Taylor Kiker
4b.
Business Name:
Kimley-Horn and Associates, Inc.
4c.
Address:
Street Address:
200 South Tryon Street
Address line 2:
Sutie 200
City:
Charlotte
State/ Province/ Region:
North Carolina
Postal/ Zip Code:
28202
Country:
USA
4d.
Telephone Number: (###)###-####
[phone]
4e
Fax Number: (###)###-####
Click to entC
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:
https://www.saw. usace.army. mil/Missions/Reg ulatory- Perm it- 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
1. Project Information
1a. Name of project: *
Irwin Creek 1-85 to Statesville Avenue Stream
Restoration
1 b. Subdivision name (if appropriate):
Click to enter.
1 c. Nearest municipality/town: *
Charlotte
2.
Project Identification
2a.
Property identification number (tax PIN or parcel ID):
07718101
2b.
Property size (in acres):
155
2c.
Project Address:
Street Address:
3699-3431 Northerly Rd
Address line 2:
N/A
City:
Charlotte
State/ Province/ Region:
NC
Postal/ Zip Code:
28206
Country:
USA
2d.
Site coordinates in decimal degrees (using 4-6 digits
after the decimal point): *
Latitude (DD.DDDDDD): * 35.267911 °
Longitude (-DD.DDDDDD): *-80.830562°
3. Surface Waters
3a. Name of nearest body of water to proposed project: *
Irwin Creek
3b. Water Resources Classification of nearest receiving
C
water: *
The Surface Water Classification map may be found at this link:
httgs://ncdenr.mar)s.arcgis.com/apes/webappviewer/index.html?id=6el 25ad7628f494694e259c80dd64265
Catawba
3c. In what river basin(s) is your project located? *
Choose additional (if needed)
3d. Please provide the 12-digit HUC in which the project is
030501030101
located:
The Find Your HUC map may be found at this link:
httr)s://ncdenr.maps.arcqis.com/apes/Publiclnformation/index.html?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 Irwin Creek 1-85 to Statesville Avenue Stream Restoration Project is a proposed stream restoration project
located east of Northerly Road in Charlotte, Mecklenburg County, NC. The project proposes to conduct stream
rehabilitation activities within an approximately 4,931 linear feet (LF)/3.6-acre portion of Irwin Creek.
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 ❑x No
If yes, describe the completed work.
(;link to PntPr 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'h x 11" excerpt from the most recent version of the USGS topographic map indicating the location of
the project site.
4e. Attach an 8'h 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
0.71
property:
acres
4g. List the total estimated linear feet of all existing streams (intermittent
8,338 linear feet
and perennial) on the property:
4g1. List the total estimated acreage of all existing open waters on the
N/A acres
property:
4h. Explain the purpose of the proposed project:
The project proposes to conduct stream rehabilitation activities through the implementation of natural channel
design techniques that will result in net increases in aquatic resource functions and services within an
approximately 4,931 linear feet (LF)/3.6-acre portion of Irwin Creek. The goal for the stream rehabilitation is to
reduce stream bank erosion, improve water quality, and provide long term stability. This section of Irwin Creek
flows through a non -active landfill; therefore, the rehabilitation seeks to reduce the amount of potential existing
waste and contaminants from entering the stream by stabilizing the stream banks.
4i. Describe the overall project in detail, including the type of equipment to be used:
To meet the goals and objectives of the Irwin Creek 1-85 to Statesville Avenue Stream Restoration Project,
stream enhancement and restoration activities will be conducted, resulting in 5,359 LF of permanent impacts to
non -wetland waters of the United States (WOTUS). However, these stream impacts will result in net increases in
aquatic resource functions and services. General construction equipment includes, but is not limited to,
bulldozers, excavators, front-end loaders, etc. will be used for construction purposes.
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 text
Page 7 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:
The wetlands and streams within the project study area were delineated by Kimley-Horn staff on November 28,
2023, and December 1, 2023. The PJD request is included in this permit application.
5b.
If the Corps made a jurisdictional determination,
❑ Preliminary ❑ Approved ❑ Emailed concurrence
what type of determination was made? *
❑ Not Verified ❑ Unknown ❑x n/a
Corps AID number (ex. SAW-0000-00000):
Click to enter.
Name (if known): Chris Tinklenberg, Doug Fox
5c.
If 5a is yes, who delineated the jurisdictional
Agency/Consultant Company: Kimley-Horn and Associates,
areas?
Inc.
Other: Click to enter.
5d.
List the dates of the Corps jurisdictional determination or State determination if a determination was made by
either agency.
Click to enter.
5d1.
Attach jurisdictional determinations.
6. Future Project Plans
6a. Is this a phased project?
❑ Yes ❑x No
6b. If yes, explain.
Click to 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.
Click to enter.
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:
Click to enter.
Page 8 of 21 PCN Form Version 4.3- December 4, 2023

D. Proposed Impacts Inventory
1. Impacts Summary
1 a. Where are the impacts associated with your project
(check all that apply):
❑ Wetlands
❑ Buffers
❑ Pond Construction
❑x 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)*
W1
Temp/ Perm
Choose one
Click to enter
Y/N
Choose one
Click to ent(
2g1.
Total temporary wetland impacts
Click to enter. ac
2g2.
Total permanent wetland impacts
Click to enter. ac
2g3.
Total wetland impacts
Click to enter. 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 9 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
Impact 1 — S1
Permanent
Restoration/
Stream 1
Perennial
Both
30
4,931
Enhancement
S2
Impact 2 —
Permanent
Fill (Incl.
Stream 2b
Intermittent
Both
5.5
17
S2b
Riprap)
S3
Impact 3 —
Permanent
Fill (Incl.
Stream 3b
Perennial
Both
5
25
S3b
Riprap)
S4
Impact 4 — S4
Permanent
Fill (Incl.
Stream 4
Perennial
Both
4
14
Riprap)
S5
Impact 5 — S5
Permanent
Fill (Incl.
Stream 5
Perennial
Both
8
49
Riprap)
S6
Impact 6 — S6
Permanent
Fill (Incl.
Stream 6
Perennial
Both
3
23
Riprap)
3i1.
Total jurisdictional ditch
Click to enter. linear ft
impact:
3i2.
Total permanent stream
5,059 linear ft
impacts:
M.
Total temporary stream
Click to enter. linear ft
impacts:
34.
Total stream and ditch
5,059 linear ft
impacts:
Page 10 of 21 PCN Form Version 4.3- December 4, 2023

3j. Comments:
The overall project proposes the rehabilitation of Irwin Creek to improve the hydraulic and geomorphic function
of the stream. The proposed rehabilitation will create a foundation for potential improvements in water quality
and aquatic habitat within Irwin Creek, including the protection and enhancement of riparian buffers. The
proposed restoration will result in impacts to Irwin Creek and on -site tributaries. Impacts to the streams are
proposed at six (6) permanent impact sites:
•Permanent Impact 1 — 4,931 LF/3.6 acres to Stream 1 (Irwin Creek) results from the rehabilitation of the
channel. The channel rehabilitation will result in a net loss of 100 LF/0.08 acre of Stream 1. However, the
implementation of natural channel design techniques will result in net increases in aquatic resource functions
and services.
•Permanent Impact 2 — 17 LF/0.007-ac to Stream 2b results from the installation of constructed riffle.
•Permanent Impact 3 — 25 LF/0.002-ac to Stream 3b from the installation of constructed riffle.
•Permanent Impact 4 — 14 LF/0.001-ac to Stream 4 from the installation of constructed riffle around existing step -
pool structures.
•Permanent Impact 5 — 49 LF/0.013-ac to Stream 5 from the installation of constructed riffle.
•Permanent Impact 6 — 23 LF/0.002-ac to Stream 5 from the installation of constructed riffle.
To meet the goals and objectives of the Irwin Creek 1-85 to Statesville Avenue Stream Restoration Project,
stream enhancement and restoration activities will be conducted, resulting in 5,059 LF of permanent impacts to
non -wetland waters of the United States (WOTUS). However, these stream impacts will result in net increases in
aquatic resource functions and services.
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.
4a1.
4b.
4c.
4d.
4e.
4f.
Site #*
Impact Reason
Impact
Waterbody Name*
Activity Type*
Waterbody
Impact area
Duration*
Type*
(ac)*
01
Click to enter.
Temp/ Perm
Click to enter.
Choose one
Choose one
Click to ente
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
;lick 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.
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 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.
❑ Neuse ❑ Tar -Pamlico
❑ Catawba
6a.
Project is in which protected basin(s)?
❑ Jordan ❑ Goose Creek
❑ Randleman
(Check all that apply.)
❑ Other: ick to entE
6b.
6c.
6d.
6e.
6f.
6g.
Site #*
Impact Type*
Impact Duration*
Stream Name*
Buffer
Zone 1 Impact*
Zone 2 Impact*
Mitigation
(sq ft)
(sq ft)
Required?*
B1
Choose one
Temp/ Pern,
_:lick to enter.
Y/N
Click to enter.
Click to ente
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 ente sq ft
Zone 2: dick to enter. sq ft
6h.
Total combined buffer impacts:
Zone 1: Click to ente sq ft
Zone 2: dick to enter. sq ft
6i.
Comments:
Click 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:
Avoidance and minimization efforts were implemented during development planning and design to the greatest
extent practicable to reduce the overall impacts on the aquatic environment while staying within nationwide
permit thresholds. The final plan demonstrates maximum avoidance and minimization efforts. The rationale to
support avoidance and minimization efforts includes the following:
-The existing buffers in the project area will be improved or restored, if impacted, through the addition of a native
mix of trees, shrubs, and herbaceous species. The design will designate large trees along the banks to be saved
during construction. The sanitary sewer easement, to the extent possible, will be used as a construction haul
road to minimize the tree impact.
-In order to prevent sedimentation of downstream portions of Irwin Creek, construction will be conducted in the
dry through the use of coffer dams and pumped diversions.
-Further impacts to the streams have been avoided by incorporating temporary timber stream crossings. These
crossings will not result in any impacts and will be removed upon completion of the construction of the project.
-Temporary haul road crossings will be integrated into the stream restoration activities and will be removed upon
completion of the construction project.
-Temporary erosion and sediment control measures placed in waters will be removed and the original grade
restored upon completion of the project. Banks temporarily affected by maintenance work will be matted, re-
seeded, and restored to stable bank conditions.
1 b. Specifically describe measures taken to avoid or minimize proposed impacts through construction techniques:
Stormwater and erosion control measures will be utilized to avoid sedimentation impacts to downstream waters
and control runoff from the construction site.
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:
Click to enter.
3b. Credits purchased/requested:
Type: Choose one
Quantity Click to enter.
Type: Choose one
Quantity Click to enter.
Type: Choose one
Quantity Click to enter
Attach receipt and/or approval letter.
3c. Comments:
UJUK 1U efliel.
Page 14 of 21 PCN Form Version 4.3- December 4, 2023

4.
Complete if Using an In Lieu Fee Program
4a.
Attach approval letter from in lieu fee program.
4b.
Stream mitigation requested:
Click to ente 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.miI/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
❑ Yes ❑ No
that requires buffer mitigation?
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.
6c.
6d.
6e.
Zone
Reason for impact
Total impact
Multiplier
Required mitigation
(square feet)
(square feet)
Zone 1
Click to enter.
Click to enter.
Choose one
Click to enter.
Zone 2
slick 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
❑Yes El No
NC Division of Mitigation Services proposed?
6h.
If yes, attach the acceptance letter from the mitigation bank or NC Division of Mitigation Services.
6i.
Comments:
DICK 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
1 a. 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.,qov/about/divisions/energv-mineral-land-resources/energv-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?
❑ Yes ❑x No
2b.
Does this project meet the requirements for low density projects as
defined in 15A NCAC 02H .1003(2)?
❑x Yes El No
To look up low density requirements, click here:
http://reports.oah.state. nc.us/ncac/title%2015a%20-%20environmental%20guaIity/chapter%2002%20-
%20environmental%20man age ment/subchapter%20h/15a%20ncac%2002h%20.1003.pdf
2c.
Does this project have a stormwater management plan (SMP)
❑ Yes ❑ No
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?
❑ Local Government
(Check all that apply.)
❑ State
If you have local government approval, please include the SMP on their overall impact map.
❑ Phase II ❑ USMP
Local Government Stormwater Programs
❑ 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.
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
1 a. Does the project involve an expenditure of public (federal/state/local)
® Yes ❑ 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
❑ Yes ❑x 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 ❑x No
NEPA or SEPA final approval letter.)
Comments:
This project utilizes local funds, and does not use federal or state land.
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):
UJUK 1U efliel.
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:
The project is conducting stream restoration activities, all of which will improve the aquatic environment. The proposed
activities will not result in any additional development which might impact nearby downstream waters.
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 ❑x 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.
Click to enter.
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
® Yes ❑ No
species or habitat? (IPAC weblink: https://www.fws.gov/ipac/ ffws.govl)
5b. Have you checked with the USFWS concerning Endangered Species
® Yes ❑ No
Act impacts? *
5c. If yes, indicate the USFWS Field Office you have contacted.
Asheville
5d. Is another federal agency involved? *
❑ Yes ❑x No ❑ Unknown
If yes, which federal agency?
Click to enter.
5e. Is this a DOT project located within Divisions 1-8? *
❑ Yes ❑x 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 ❑x 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: http://saw-reg.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)? *
❑ Yes ❑x No
If yes, please show the location of the wind turbine(s) on the permit drawings/ project plans (attach .pdf)
5i. Does this project involve blasting and /or other percussive activities
that will be conducted by machines, such as jackhammers,
❑ Yes ❑x 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? *
A review of the North Carolina Natural Heritage Program (NCNHP) database on January 16, 2024, indicated no known
occurrences of threatened or endangered species occurring within one mile of the project boundary. Kimley-Horn
conducted pedestrian surveys for threatened and endangered species within the project boundary on October 30,
2023. A concurrence request letter was submitted to the USFWS on February 27, 2024. A copy of the NCNHP Report
and IPaC is included, and a copy of USFWS's response will be provided upon receipt.
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? *
❑ Yes ❑x No
Page 19 of 21 PCN Form Version 4.3- December 4, 2023

Is there submerged aquatic vegetation (SAV) around
the project vicinity?
El Yes ❑x No El Unknown
Will this project affect submerged aquatic vegetation?
❑ Yes ❑x No ❑ Unknown
Explain: Click to enter.
6b. What data source(s) did you use to determine whether your site would impact Essential Fish Habitat?
NCNHP element occurrence database did not indicate the presence of EFH within the project boundary
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
Link to the State Historic Preservation Office Historic Properties Map (does not include archaeological data):
http://gis.ncdcr.gov/hpoweb/
7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural
❑ Yes ❑x No
preservation status (e.g., National Historic Trust designation or
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?
Kimley-Horn consulted the North Carolina State Historic Preservation Office (SHPO) HPOWEB GIS service on
February 22, 2024. No documented architectural, cultural, or historic sites of significance within the project
boundary were identified. A request letter was submitted to SHPO to determine the presence of architectural,
cultural, or historic resources on February 27, 2024. At the time of this application, a response from NCSHPO
has not been received. The SHPO response will be provided upon receipt.
7c. Attach historic or prehistoric documentation.
8. Flood Zone Designation (Corps Requirement)
Link to the FEMA Floodplain Maps: https://msc.fema.,qov/portal/search
8a. Will this project occur in a FEMA-designated 100-year floodplain? *
® Yes ❑ No
8b. If yes, explain how the project meets FEMA requirements.
The proposed project will meet FEMA requirements through a No -Rise Certification.
8c. What source(s) did you use to make the floodplain determination?
FIRM Panel: 4555
H. Miscellaneous
Comments:
Click to enter.
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: * Taylor Kiker
Signature: * J Ik
Date: * 06/18/24
Page 21 of 21 PCN Form Version 4.3- December 4, 2023

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