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DWQ project no.
Form Version 1.4 January 2009
Pre-Construction Notification (PCN) Form
A. Applicant Information
1. Processing
1 a. Type(s)of approval sought from the Corps: ❑X Section 404 Permit ❑ Section 10 Permit
1 b. Specify Nationwide Permit(NWP) number: 29 or General Permit(GP) number:
1 c. Has the NWP or GP number been verified by the Corps? ❑Yes ❑X No
1 d. Type(s)of approval sought from the DWQ (check all that apply):
❑X 401 Water Quality Certification— Regular ❑ Non-404 Jurisdictional General Permit
❑ 401 Water Quality Certification— Express ❑ Riparian Buffer Authorization
1 e. Is this notification solely for the record For the record only for DWQ For the record only for Corps Permit:
because written approval is not required? 401 Certification:
❑ Yes ❑X No ❑Yes ❑X No
1f. Is payment into a mitigation bank or in-lieu fee program proposed for
mitigation of impacts? If so, attach the acceptance letter from mitigation bank ❑X Yes ❑ No
or in-lieu fee program.
1 g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h ❑ Yes ❑X No
below.
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ❑Yes ❑X No
2. Project Information
2a. Name of project: Weddington Subdivision
2b. County: Wake
2c. Nearest municipality/town: Apex
2d. Subdivision name: Weddington Subdivision
2e. NCDOT only, T.I.P. or state project no:
3. Owner Information
3a. Name(s)on Recorded Deed: See Attached Owner Information Sheet.
3b. Deed Book and Page No. See Attached Owner Information Sheet.
3c. Responsible Party(for LLC if
applicable):
3d. Street address: See Attached Owner Information Sheet.
3e. City, state, zip: See Attached Owner Information Sheet.
3f. Telephone no.: See Attached Owner Information Sheet.
3g. Fax no.: See Attached Owner Information Sheet.
3h. Email address: See Attached Owner Information Sheet.
Page 1 of 10
PCN Form—Version 1.4 January 2009

4. Applicant Information (if different from owner)
4a. Applicant is: ❑ AgentX❑ Other, specify: Developer
4b. Name: Will Yadusky
4c. Business name Baker Residential of the Carolinas
(if applicable):
4d. Street address: 111 James Jackson Avenue, Suite 211
4e. City, state, zip: Cary, NC, 27513
4f. Telephone no.: 919-602-7622
4g. Fax no.:
4h. Email address: [e-mail]
5. Agent/Consultant Information (if applicable)
5a. Name: Justin M. Milstein
5b. Business name Timmons Group
(if applicable):
5c. Street address: 5410 Trinity Road, Suite 102
5d. City, state, zip: Raleigh, NC, 27607
5e. Telephone no.: O: 919-866-4508, M: 252-933-5764
5f. Fax no.: 919-859-5663
5g. Email address: [e-mail]
Page 2 of 10

B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): See Attached Owner Information Sheet.
1 b. Site coordinates (in decimal degrees): Latitude: 35.7688 Longitude: -78.9199
1 c. Property size: 134.85 acres
2. Surface Waters
2a. Name of nearest body of water to proposed project: White Oak Creek
2b. Water Quality Classification of nearest receiving water: WS-IV; NSW
2c. River basin: Cape Fear
3. Project Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application:
Existing conditions on the site consists of mostly forested vegetation,small areas of cleared abandoned agricultural fields,including a single-family
home site and an existing sewer line and associated easement that runs along the eastern portion of the properties running south from Green Level
West Road.General land use in the vicinity is mostly forest land and residential developments.
3b. List the total estimated acreage of all existing wetlands on the property: 18.425
3c. List the total estimated linear feet of all existing streams (intermittent and perennial)on the property: 4,039
3d. Explain the purpose of the proposed project:
The purpose of the project is to construct the proposed 190 lot subdivision,for single-family dwellings, including roadway and utility infrastructure.
3e. Describe the overall project in detail, including the type of equipment to be used:
Equipment typical for road construction and grading will be used to construct the proposed project such as track hoes,bulldozers,dump trucks,etc.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the ❑X Yes ❑ No ❑ Unknown
Corps or State been requested or obtained for this property/
project(includingall prior phases) in the past? Comments: Stream/Buffer
4b. If the Corps made the jurisdictional determination, what type ❑ Preliminary ❑ Final
of determination was made?
4c. If yes, who delineated the jurisdictional areas? Agency/Consultant Company:Timmons Group
Name (if known):John Kase, LSS Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
Stream/Buffer Determination Letter issued on July 27,2015 by Ricky Temple,Town of Apex(Apex#15-009),see attached.
James Lastinger, USACE visited the site and gave verbal confirmation of wetlands on August 7,2015.
5. Project History
5a. Have permits or certifications been requested or obtained for ❑Yes ❑X No ❑Unknown
this project(including all prior phases) in the past?
5b. If yes, explain in detail according to"help file" instructions.
6. Future Project Plans
6a. Is this a phased project? ❑ Yes ❑X No
6b. If yes, explain.
Page 3 of 10
PCN Form—Version 1.4 January 2009

C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project(check all that apply):
❑X Wetlands ❑X Streams—tributaries ❑X Buffers ❑ Open Waters ❑ Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a. 2b. 2c. 2d. 2e. 2f.
Wetland impact Type of impact Type of wetland Forested Type of jurisdiction Area of
number Corps (404,10)or impact
Permanent(P)or DWQ (401, other) (acres)
Temporary T
W1 Choose one Choose one Yes/No -
W2 Choose one Choose one Yes/No
W3 Choose one Choose one Yes/No
W4 Choose one Choose one Yes/No
W5 Choose one Choose one Yes/No
W6 Choose one Choose one Yes/No
2g. Total Wetland Impacts:
2h. Comments:
See Wetland Impacts Attachment
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a. 3b. 3c. 3d. 3e. 3f. 3g.
Stream impact Type of impact Stream name Perennial (PER)or Type of Average Impact
number intermittent(INT)? jurisdiction stream length
Permanent(P)or width (linear
Temporary(T) (feet) feet)
S1 P Culvert/Rip-Rap Stream E PER Corps 6 120
S2 P Culvert Extension/Rip-Rap Stream H PER Corps 4 28
S3 - Choose one -
S4 - Choose one - -
S5 - Choose one -
S6 - Choose one -
3h. Total stream and tributary impacts 148
3i. Comments:
S1 Stream Impact E(Impact Map Sheet 6)for Green Level West Road widening.
S2 Stream Impact H(Impact Map Sheet 9)for proposed Cloverdale Road crossing.
Page 4 of 10
PCN Form—Version 1.4 January 2009

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. then indivi ually list all open water impacts below.
4a. 4b. 4c. 4d. 4e.
Open water Name of waterbody
impact number (if applicable) Type of impact Waterbody Area of impact(acres)
Permanent(P)or type
Temporary T
01 Choose one Choose
O2 Choose one Choose
03 Choose one Choose
04 - Choose one Choose
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If pond or lake construction proposed, the complete the chart below.
5a. 5b. 5c. 5d. 5e.
Pond ID number Proposed use or Wetland Impacts (acres) Stream Impacts(feet) Upland
purpose of pond (acres)
Flooded Filled Excavated Flooded Filled Excavated
P1 Choose one
P2 Choose one
5f. Total:
5g. Comments:
5h. Is a dam high hazard permit required? ❑ Yes ❑ No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer,then complete the chart below. If yes, then individually list all buffer impacts
below. If any impacts require miticlation, then vou MUST fill out Section D of this form.
6a. Project is in which protected basin? ❑ Neuse ❑ Tar-Pamlico ❑ Catawba ❑ Randleman ❑X Other:Jordan Lake
6b. 6c. 6d. 6e. 6f. 6g.
Buffer Impact Reason for impact Stream name Buffer Zone 1 Zone 2
number— mitigation impact impact
Permanent(P)or required? (square (square
Temporary T feet) feet
B1 A-P Sewer Easement Stream H No 0 455
B2 B-P Road Crossing Stream H No 9,230 5,222
B3 C-P Road Widening Stream E No 258 168
B4 C-T Road Widening Stream E No 735 434
B5 - Yes/No
B6 - Yes/No
6h. Total Buffer Impacts: 10,223 6,279
6i. Comments:B1 refers to Stream Buffer Impact A for Town of Apex sewer easement; B2 refers to Stream Buffer Impact B for Cloverdale Road
crossing; B3 refers to Stream Buffer Impact C and B4 refers to Stream Buffer Impact C for Green Level West Road widening.
Page 5 of 10

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
See attached statement.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
All disturbed areas will be bound by silt fence and tree protection fence before construction begins.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for ❑X Yes ❑ No
impacts to Waters of the U.S. or Waters of the State?
2b. If yes, mitigation is required by(check all that apply): ❑ DWQ ❑X Corps
❑ Mitigation bank
2c. If yes, which mitigation option will be used for this ❑X Payment to in-lieu fee program
project?
❑ Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
Type: Choose one Quantity:
3b. Credits Purchased (attach receipt and letter) Type: Choose one Quantity:
Type: Choose one Quantity:
3c. Comments:
4. Complete if Making a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached. ❑X Yes
4b. Stream mitigation requested: 0 linear feet
4c. If using stream mitigation, stream temperature: Choose one
4d. Buffer mitigation requested (DWQ only): 0 square feet
4e. Riparian wetland mitigation requested: 0.28 acres
4f. Non-riparian wetland mitigation requested: 0 acres
4g. Coastal (tidal)wetland mitigation requested: 0 acres
4h. Comments:
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
Page 6 of 10
PCN Form—Version 1.4 January 2009

6. Buffer Mitigation (State Regulated Riparian Buffer Rules)—required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires ❑ Yes ❑X No
buffer mitigation?
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.
6c. 6d. 6e.
Zone Reason for impact Total impact Multiplier Required mitigation
(square feet) (square feet)
Zone 1 3 (2 for Catawba)
Zone 2 1.5
6f. Total buffer mitigation required:
6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in-lieu fee fund).
6h. Comments:
Page 7 of 10

E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers identified ❑X Yes ❑ No
within one of the NC Riparian Buffer Protection Rules?
1b. If yes, then is a diffuse flow plan included? If no, explain why.
All stormwater runoff from impervious surfaces will be stored and treated via two wetpond facilities and a
stormwater wetland facility per BMP manual,hence no level spreader is required.Overflows are ❑ Yes X❑ No
discharged into rip-rap dissipater pads prior to discharging to buffers.
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project? 55%
2b. Does this project require a Stormwater Management Plan? ❑X Yes ❑ No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why:
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
All stormwater is being stored and treated in two wetpond facilities and one stormwater wetland facility.
2e. Who will be responsible for the review of the Stormwater Management Plan? Town of Apex
3. Certified Local Government Stormwater Review
3a. In which localgovernment's jurisdiction is thisproject? Town of Apex
❑ Phase II
3b. Which of the following locally-implemented stormwater management programs X❑ NSW
apply(check all that apply): ❑ USMP
❑X Water Supply Watershed
❑ Other:
3c. Has the approved Stormwater Management Plan with proof of approval been El Yes X❑No
attached?
4. DWQ Stormwater Program Review
❑Coastal counties
❑HQW
4a. Which of the following state-implemented stormwater management programs apply ❑ORW
(check all that apply): ❑Session Law 2006-246
❑Other:
4b. Has the approved Stormwater Management Plan with proof of approval been ❑Yes ❑ No
attached?
5. DWQ 401 Unit Stormwater Review
5a. Does the Stormwater Management Plan meet the appropriate requirements? ❑Yes ❑No
5b. Have all of the 401 Unit submittal requirements been met? ❑Yes ❑No
Page 8 of 10
PCN Form—Version 1.4 January 2009

F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1 a. Does the project involve an expenditure of public(federal/state/local)funds or the ❑Yes X❑ No
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 ❑Yes ❑No
(North Carolina) Environmental 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 NEPA or SEPA final approval
letter.) ❑Yes ❑No
Comments:
2. Violations (DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards, ❑Yes ❑X No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. Is this an after-the-fact permit application? ❑Yes ❑X No
2c. If you answered "yes"to one or both of the above questions, provide an explanation of the violation(s):
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project(based on past and reasonably anticipated future impacts) result in El Yes ❑X No
additional development, which could impact nearby downstream water quality?
3b. If you answered "yes"to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
This single-family resident subdivision is not likely to spur cumulative impacts.
4. Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge)of wastewater generated from
the proposed project, or available capacity of the subject facility.
Wastewater generated from the project will be collected,treated and discharged by the Town of Apex wastewater treatment system.
Page 9 of 10
PCN Form—Version 1.4 January 2009

5. Endangered Species and Designated Critical Habitat(Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or Z Yes ❑ No
habitat?
5b Have you checked with the USFWS concerning Endangered Species Act ❑Yes 0 No
impacts?
5c. If yes, indicate the USFWS Field Office you have contacted
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
The Northern long-eared bat was listed as Threatened in Wake County on 4/2/15.This project involves the removal of trees(see site plan for details).
6. Essential Fish Habitat(Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat? ❑ Yes No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
Essential Fish Habitat(EFH)Mapper www habitat.noaa.gov/protection/efh/ehfmapper
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 ❑ Yes Z No
status(e g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
NC State Historic Preservation Mapper
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain? ❑Yes No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s)did you use to make the floodplain determination?
Wake County iMAPS FEMA Flood Layer
Justin M. Milstein t 10/18/2016
Applicant/Agent's Printed Name Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization
letter from the applicant is provided.)
Page 10 of 10

OWNER INFORMATION
Name(s) on Recorded Deed: ROBERTS, REBECCA TRUSTEE FBO BRANDON ROBERTS
Street Address: 2628 DOCKERY LN
City, State, Zip: RALEIGH NC 27606-9089
Site Address: 4105 GREEN LEVEL WEST RD
PIN: 0723357829
Deed Acres: 50.00
Deed Book and Page No.: N/A
Name(s) on Recorded Deed: SMITH, STALEY C HOFFLER, HALEY S
Street Address: PO BOX 457
City, State, Zip: APEX NC 27502-0457
Site Address: 631 WIMBERLY RD
PIN: 0723242741
Deed Acres: 4.12
Deed Book and Page No.: 014511, 01760
Name(s) on Recorded Deed: SMITH, STALEY C HOFFLER, HALEY S
Street Address: PO BOX 457
City, State, Zip: APEX NC 27502-0457
Site Address: 0 WIMBERLY RD
PIN: 0723249442
Deed Acres: 1.58
Deed Book and Page No.: 014511, 01760

Name(s) on Recorded Deed: SMITH, MARTHA M BACON, MARLOU S
Street Address: PO BOX 343
City, State, Zip: APEX NC 27502-0343
Site Address: 809 WIMBERLY RD
PIN: 0723336374
Deed Acres: 12.71
Deed Book and Page No.: 013314, 00150
Name(s) on Recorded Deed: BACON, MARLOU S SMITH, STALEY C
Street Address: PO BOX 457
City, State, Zip: APEX NC 27502-0457
Site Address: 0 WIMBERLY RD
PIN: 0723430915
Deed Acres: 36.45
Deed Book and Page No.: 016215, 00449
Name(s) on Recorded Deed: SMITH, STALEY C HOFFLER, HALEY S
Street Address: PO BOX 457
City, State, Zip: APEX NC 27502-0457
Site Address: 0 WIMBERLY RD
PIN: 0723444401
Deed Acres: 36.14
Deed Book and Page No.: 014511, 01760

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D. Impact Justification and Mitigation
Proposed impacts to wetlands in impact area D are required in order to provide usable building pads for
the two affected lots. Without your approval of this impact, the owner will be unable to utilize a
substantial amount of upland in this location. The shape and location of this wetland on the site makes
it impractical to avoid. The stream crossing proposed in impact area E is required to gain access to the
upland area in the southwest corner of the site, and to provide a looping waterline utility connection to
Wimberly Road, as required to ensure adequate fire flow throughout the proposed neighborhood.
There is no other access to this upland area that is wide enough for the construction of a paved road;
hence this impact is unavoidable. Proposed impacts to wetlands in impact areas F and G will be limited
to small, narrow wetland fingers that protrude into uplands on the site. These wetland fingers are
impractical to avoid due to their locations on the site. Proposed stream impacts in impact location H are
required for road widening per the Town of Apex. All of these impacts have been minimized to the
maximum extent practicable, by crossing the stream as near to perpendicular as possible, and by
impacting wetlands only in areas that extend well into upland areas of the site. On a percentage basis,
proposed permanent wetland impacts will result in the loss of only 0.76%of 404/401 wetlands on the
site. These proposed wetland losses will be offset through the purchase of mitigation credits from NC
DMS, at a minimum 2:1 ratio, resulting in a net gain of wetlands to the watershed as a direct result of
this project.