HomeMy WebLinkAbout20150717 Ver 2_PCN NWP 18_48 inch cleanup area_7-15-15_20170508P
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PC NF
orm –V ersion1
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4 J
an ua ry2
00 9
Off i c eU
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C
orp s a
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on ID no . __ _ __ _ _ __ _ _ __
D
WQ
pro
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F
orm V
e
rs
i
on 1 .
4 J
an ua r y 2 00 9
A .A ppli
c an
t I
n
f or
ma
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r ocess ing
1a.T
y pe(s )o
f a
pprov
al
s ough
t f
rom
t
he Cor ps:S ec
t i
on 4 04Perm
it
Sec
t i
on
1
0 Perm
it
1b.
S pec
if
y N
at i
onw
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it
( N
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b
er:or G ener
al
Perm
it
( GP )num
b
er :
1
c
.Ha
s
t
he N
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P or GP num
b
er
b
eenv er
if i
e
d b
y
t
he Corp s ?Y es No
1d.T
y pe(s )o
f a
pprov
al
s ough
t
f
rom
t
he D
W Q
( chec k
allt
h
at a
pp
l
y ):
4 0
1 W at
er
Q
u
alit
y Cer
t ifi
c
at i
on –Regu
l a
r Non4 04J ur
i
s
di
c
t i
on
al
G ener
al
Perm
it
4 0
1 W at
er
Q
u
alit
y Cer
t i
f
i
c
at i
on –Ex pr essR
i
p
a
r
ia
n Bu
ff
er Au
t
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i
z
at i
on
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e
.I
s
t
h
i
s no
t i
f
i
c
at i
ons o
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e
l
y
f
or
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itt
en
a
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?
F
or
t
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d
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l
y
f
or D
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4 0
1
Cer
t ifi
c
at i
on:
Y es No
F
or
t
he rec or
d
on
l
y
f
or Cor psPerm
it
:
Y es No
1f .I
s p
a
y men
t i
n
t
o
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it i
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at i
on
ba
nk or
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li
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m propose
d f
or
m
it i
g
at i
ono
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i
mp
a
c
t
s?
If
s o,
atta
ch
t
he
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nc e
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tt
e r
f
romm
it i
g
at i
on
ba
nk
or
i
n
li
eu
f
eeprogr
a
m
.
Y es No
1
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s
t
he pro
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ec
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at
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n
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ny o
f
NC
’
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t i
es
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y es ,
a
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Y es No
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w
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NC DC
M
A re
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E nv
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2 .P
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ectIn
f
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2 a.
N
a
me o
f
pro
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t
:
2 b.
Coun
t
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2
c
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Ne
a
re s
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p
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2 d.
Su
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2
e
.
NCD
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T .I.
P
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or s
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3 .O
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N
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3b.
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4 a.A ppli canti s
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A gentOt her
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:
4 b.Name
:
4 c .B usi nessname
(if appli c able)
:
4 d.St ree t addres s
:
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:
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:
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P
a ge3o
f 10
PC NF
orm–Vers ion
1
.
4 J
an uary2
00 9
B
.P r o
j e
c
t I
n
f
or m
a
t i
o
n and
Pr
i
or P ro
j e
c
t Hi
s
t
or
y
1.P
r oper
ty I
d
e n
t
i
f
ica
t
io n
1a.Propertyidentifi cationno.(t a
x
P INorpar ce lID)
:
1b.Sit e coordi nates(i ndec imaldegr ees)
:L
at it ude
:L
ongitude
:
1c .Propertys i
z
e
:
ac res
2 .S
ur
f
aceWa
t
ers
2 a.Name o
f nearestbody
o
f w at erto propos edproject
:
2 b.W at er Qu al it
y Clas si f ic a t ion o
f near estrec ei
v
i ngwater
:
2 c .Ri
v
erbas in
:
3 .P
r o
j
ec
t D
escr ip
t
io n
3a.Des cr ibet hee
x
is t ing condit ionson t hes iteandt hegenerallandus eint he
v
ic i nityoft heprojectatt hetimeoft hi s
appli c ation
:
3b.
L
i stt hetotalestimatedacreageo
f al le
x
i sti ngwetla ndsont hepropert
y
:
3c .
L
is t t hetotalestimatedli nearfeeto
f al le
x
is t ing st rea ms (in t ermittentandper enni al)on t hepropert
y
:
3d.E
x
plai n t hepur poseo
f
t heproposedproject
:
3e.Des cribet heo
v
eral lprojectin det ai l
,
i ncludi ngt het
y peo
f equipmentto be us ed
:
4 .J
ur is
d
ic
t
io na l
D
e
t
er m ina
t
io ns
4 a.Ha
v
e j uri sdi ctionalwetl andorstreamdet ermi nationsby
t he
Cor psorStatebeenr equestedorobtained f or t hisproperty/
project
(i ncludingal lpr iorphases)i nt hepast?
Y es No Unknow n
Comments
:
4 b.If
t heCorpsmadet hej ur isdictionaldeterminat ion
,
w
hat t
y pe
of det ermi nationwasmade?
Prel imi nary Fi nal
4 c .If y es
,
w
ho deli neated t hej uri sdi ctionalareas?
Name (if know n)
:
A gency/ConsultantCompa ny
:
Ot her
:
4 d.If y es
,
l istt hedateso
f
t heCorpsj uri sdict ionaldetermi nationsorStatedet ermina t ionsandattachdocum entation.
5 .P
ro
j
ec
t H
is
t
o r
y
5a.Ha
v
e permitsor cer t if i c ation sbeenrequestedorobtai nedf
or
t hi sproject(in cludingal lpriorphas es)in t hepast?
Y es No Unknow n
5b.If y es
,
e
x
pl ai n i ndetailaccording t o “hel p f i le”ins t ruct ions .
6 .F
u
t
ur e
P
r o
j
ec
t P
la ns
6a.Is t hi saphas edproject?Y es No
6b.If y es
,
e
x
pl ai n.
P IN
8
9790
888
6
8
70
79 .7 176
3 .09
D
a n
Ri
ve r
D
a n
Ri
ve r=C
R
o anoke
R I
ver B as
i
n /H
U
C
030 10 103
T h
e pr o
j
e c
t s it
e
i n
c
l ud
e
s t w
o e me rge
nt a nds
cr
ub /s h
r
ub w
e
t lan ds ,
e
a
c
h
co
nt ainanint
e rm
it t
e
nt st
re
a
m c
han n
e
l
.G
e
n
e r
al lan d us
e
i n th
e pr o
j
e c
t s it
e
in
c
l ud
e
s :
po
w
e r ge
n
e r
at i
o
n f a
c
ilit i
e
s (bu ild in
g
s ,
p
a
r
kin
g
l
o
ts ,
e
t
c
. )
,as h
po
nds an d as h f illa
re
as ,a
r
ai l s
e rv
i
ce
lin
e
,
m
a int ain
e
d
g r
ass
e
d a
re
as ,an d
s h
r
ub an d b
r
us hl an d
.
0 .47
T h
e p
u
r po
s
e o
f t his
pr o
j
e c
t is t
o p rov
id
e
f
o r
t h
e c
l
e
an u
p o
f as h
po
nd an d t h
e
t
e mpo r
a
ry
i
mp o
und
me
nt
o
f st
o r m
w at
e r
at t h
e g ro
ut
e
d 4 8i n
c
h CM P
.
S
ee
at t a
c
h
me
nt A an d t h
e
P lan V i
e
w d
r
aw in
g
f
o rpro
j
e c
t d
e
t ails
.
S
ee
t h
e
S
t
o rm
w at
e rD
i
v e r
s i
o
n d
r
aw in
g
f
o r eq
ui
pm e
nt d
e
t ails(
p
u
m p
an d
p
i
p
i n
g
).
A
me cFo
s t
e r W
h
ee
l
e r
A f i
e
ld
rev
i
e
w
o
f t h
e
w
e
t lan d d
e
lin
e
at i
o
n w ithth
e U
SA CE w as
co
nd u
c
t
e
d
o
n Jun
e 9
, 2 015
.
N
o
t
e
:T h
e U
SA CE iss u
e
d N
W
P SA
W
2 014014 77(
9
/2
9
/14
)
f
o r
t h
e
St
e
a
m
St at i
o
n "36 in
c
h Cul
ve r
t P lu
g
"
pr o
j
e c
t w hi
c
h in
c
lu d
e
d i
m p
a
c
t st
o W OU
S
.
3 6.4
8
9697
44
8
P
a ge
4
o
f 10
PC NF
orm–Vers ion
1
.
4 J
an uary2
00 9
C
.P ropo
s
e
d
I
mp
a c
t
s
I
nv
e
n
t
or
y
1.I
mp ac
t
s
S
ummar
y
1a.W hic h sec t ionswerecompl etedbelo
w f
or y
our project
(checkallt hatapply)
:
W et lan ds St rea ms –t ri butari es B uffers OpenWaters Pond Construct ion
2 .
We
t
la n
d I
mp ac
t
s
If t herear ewetlandimpactspropos edont hesite
,
t hencompletet hi squestionfor eachwetlan d ar eaimpacted.
2 a.
W et l andimpact
num ber
Permanent
(P )or
T emporar y (T )
2 b.
Ty peo
f impact
2 c .
Ty peo
f w et la nd
2 d.
For ested
2 e.
Ty peo
f j ur isdi ction
Corps (4 04
,
10)or
DW Q(4 01
,
ot her)
2f .
A r eao
f
impact
(acr es)
W 1
W2
W 3
W4
W 5
W 6
2 g.T
o
t
a lWe
t
la n
d
I
m pac
t
s :
2 h.Com ments
:
3 .St
r eam
I
mpac
t
s
If
t herear eperenni alorintermittentstrea m impacts(inc ludi ngtempor aryimpacts)propos edont hes ite
,
t hencompl etet his
question f or allstrea m si t esimpacted.
3a.
St rea m impact
num ber
Permanent(P )or
T empor ary(T )
3b .
Ty peo
f impact
3c .
St rea m name
3d.
Per ennial(P E R)or
in t ermittent(INT )?
3e.
Ty peof
j urisdiction
3f .
A
v
er age
st rea m
w idt h
(f eet)
3g.
Impact
l engt h
(l i near
f eet)
S1
S2
S3
S4
S5
S6
3h.T
o
t
a ls
t
r eama n
d t
r i
b
u
t
ar
y
impa c
t
s
3i .Comm ents
:
F
l
oo
d in
g
S
e e p
N
o
C
o rp
s 0
.
2 85
N
o
C
o rp
s 0
.
122
Y
e
s
/N
o
Y
e
s
/N
o
Y
e
s
/N
o
Y
e
s/N
o
0 .40 7
F
l
oo
d in
g U
T
D
an Ri
v e rI
NT C
o rp
s 2 2 1
9
U
T
D
an Ri
v e r
2
9
7
U
T
D
an Ri
v e r
2 13 2
44 8
D
uk
e
En
e rgy
is
req
u
e
st in
g
a w ai
ve r o
f t h
e
300 f
ee
t
o
f st
re
a
m
i
m p
a
c
t li
m
it f
o r
t h
e pr o po
s
e
d i
m p
a
c
ts t
o
t h
e
s
e
l
o
w
q
ualit
y
st
re
a
m c
hann
e
ls
.
T h
e
NC
St
re
a
m
A ss
e
ss
me
nt M
e
t h
o
d (NC SA M
)
f
o rm
s a
re
att a
c
h
e
d
.
St
re
a
m
i
m p
a
c
t sw illb
e
t
e mpo r
a
ry
d u
e
t
o
st
o rm
w at
e r
i
mp o
und
me
nt (f l
oo
d i n
g
).
Im po
und
e
d
w at
e r
w illb
e re mov e
d w ithin72
o
u
r
s
v
ia
p
u
mp
in
g
.
Pu
mp e
d f l
o
ws w illb
e
d is
c
ha
rge
d t
o
t h
e
S
e rv
i
ce W
at
e r
S
e
tt lin
g
P
o
nd b
y
w a
y o
f
ex
is t i n
g p
i
p
in
g
t
o
a
pr o po
s
e
d n
e
w s t
o rm
w at
e r o
utf all
.
T
T
F
l
oo
d in
g
C h
oo
s
e o
n
e
C h
oo
s
e o
n
e
C h
oo
s
e o
n
e
C h
oo
s
e o
n
e
S
ee p
Ch
oo
s
e o
n
e
Ch
oo
s
e o
n
e
Ch
oo
s
e o
n
e
Ch
oo
s
e o
n
e
T
T
T
F
l
oo
d in
g
F
l
oo
d in
g
Ch
oo
s
e o
n
e
C h
oo
s
e o
n
e
C h
oo
s
e o
n
e
I
NT
I
NT
C
o rp
s
C
o rp
s
P
a ge5o
f 10
4 .O
pe nWa
t
er
I
mpac
t
s
If t herear eproposedimpactstol akes
,
ponds
,
estuari es
,
t ri butar ies
,
sounds
,
t he Atlanti cOc ean
,
or anyot heropenwaterof
t heU.S.t henindi
v
idual lyli s t al lopenwaterimpactsbelo
w .
4 a.
Openwater
impactnum ber
Permanent(P )or
T emporar y (T )
4 b.
Name of w at erbody
(if appl ic able
4 c.
Ty peo
f impact
4 d.
W at erbody
ty pe
4 e.
A r eao
f impact
(ac res)
O1
O2
O3
O4
4f .T
o
t
a l op e nwa
t
erimp ac
t
s
4 g.Com ments
:
5 .P
o n
d
o rLake
C
o ns
t
ruc
t
io n
If pond or l akeconstruct ion propose d
,
t hencompletet hechartbelow.
5c .
W et l andImpacts(acres )
5d.
St r eamImpacts(f eet)
5e.
Upland
(ac res)
5a.
Pond IDnum ber
5b.
Propose d us eor
purp os eo
f pond
Flooded Fi l ledE
x
c a
v
at ed Flooded Fi l ledE
x
c a
v
at ed
P1
P2
5f .T
o
t
a l:
5g.Com ments
:
5h.Is a dam hi ghha
z
ardpermitrequir ed?Y es No If y es
,
permitIDno
:
5i .E
x
pectedpond surf acear ea(ac res)
:
5j .Si
z
e of pond w at ershed (ac res)
:
5k.Met hodofconstruction
:
6 .B
u
f f
er
I
mp ac
t
s (
f
or
D
W Q)
If project
w il l impactaprotected r ipari anbuffer
,
t hencompletet hechartbelo
w .If y es
,
t heni ndi
v
idual lyl istallbufferimpacts
below.If anyimpactsrequi remitigation
,
t henyouM US Tfil l out Section D of t hi sform.
6a .Proj ecti si nwhichprotected bas in?
Neuse T arPaml i coCatawbaRandle man Ot her
:
6b.
B ufferImpact
num ber–
Permanent(P )or
T empor ary(T )
6c .
Reason f or impact
6d .
St r eamname
6e.
B uffer
mit iga t ion
r equir ed?
6f .
Z one1
impact
(square
f eet)
6g.
Z one2
impact
(squar e
f eet)
B1
B2
B3
B4
B5
B6
6h.T
o
t
a l
B
u
f f
er
I
mp ac
t
s :
6i .Comm ents
:
Ch
o o
s
e o
n
e
Ch
oo
s
e
Ch
oo
s
e o
n
e
Y
e
s
/N
o
Ch
oo
s
e o
n
e
Ch
oo
s
e o
n
e
Ch
oo
s
e o
n
e
Ch
oo
s
e
Ch
oo
s
e
Ch
oo
s
e
Ch
oo
s
e o
n
e
Y
e
s
/N
o
Y
e
s/N
o
Y
e
s/N
o
Y
e
s
/N
o
Y
e
s
/N
o
)
P
a ge6o
f 10
PC NF
orm–Vers ion
1
.
4 J
an uary2
00 9
D
.
I
mp
ac
t J u
s
t i
f
i
ca
t i
o
n and M
it i
ga
t i
o
n
1.Av
o i
d
a ncea n
d M
in im iza
t
io n
1a.Specific al lydes cr ibemeasurestakentoa
v
oid or mini mi
z
e t hepropos edimpactsi ndes i gni ngproject.
1b.Specific al lydes cr ibemeasurestakentoa
v
oid or mini mi
z
e t heproposedimpactst hroughconstructiontechniques .
2 .C
o mpe nsa
t
or
y M
i
t
iga
t
io n
f
or
I
mp ac
t
s
t
o Wa
t
erso
f
t h
e
U.S .
or Wa
t
erso
f
t h
e
St
a
t
e
2 a.Doest heprojectr equir eCompensatoryMit iga t ion f
or
impactstoW at ersof t heU.S.or W at er soft heState?
Y es No
2 b.If y es
,
mit iga t ion is re qui redby(checkal lt hatapply)
:
DW QCorps
2 c .If y es
,
w hi chmiti gationoption w il l be us edfort his
project?
Mit iga t ion bank
Pay mentto in li e u f eeprogram
PermitteeRespons ibl eMiti gation
3 .C
o mp le
t
e i
f U
s inga
M
i
t
iga
t
io n
B
a nk
3a.Name o
f Mit i gationBank
:
3b.Cre dit s Pu rc hased (attachr ecei ptandletter)
Ty pe
:
Ty pe
:
Ty pe
:
Q uantity
:
Q uantit
y
:
Q uantity
:
3c .Comm ents
:
4 .C
o mp le
t
e i
f M
ak inga
P
a
y
me n
t t
o
I
n lieu
F
ee
P
r ogr a m
4 a. A ppro
v
all etterfromi nl ieufeeprogram is attached.Y es
4 b.St rea m mit i gationrequested
:
li nearfeet
4 c .If us ingstreammiti gation
,
st r eamtemper ature
:
4 d.B uffermitiga t ion re quested (DW Qonly)
:
squar efeet
4 e.Ri parianwetl andmitigationrequested
:
acr es
4f .Non r ipar ianwetlandmitigationr equested
:
ac res
4 g.Coastal (t idal)w et l andmiti gationrequested
:
ac res
4 h.Com ments
:
5 .C
o mp le
t
e i
f U
s inga
P
er m i
tt
eeRespo nsi
b
le
M
i
t
iga
t
io n
P
la n
5a.If us ingapermitteeres pons iblemitigationpl an
,
pro
v
ide a des cr iptionoft heproposedmiti gationpl an.
T h
e pr o
j
e c
t has b
ee
n d
e
s i
g
n
e
d t
o
a
vo
id
pe rm
an
e
nt i
mp
a
c
ts t
o
w
e
t lan ds an d st
re
a
m
s
.
I mpo
und
e
d w at
e r
w illb
e re mov e
d w ithin72h
o
u
r
s
v
ia
p
u
m p
i n
g
t
o
a s
e
t tli n
g po
nd
.
T h
e pr o po
s
e
d a
c
t i
o
n at t his l
o c
at i
o
n w illb
e m
in
o r
t
e mpo r
a
ry
i
m p
a
c
t st
o
int
e r m
it t
e
nt s u
r
f a
ce
w at
e r
s
.
Im p
a
c
t st
o
w
e
t la ndsands t
re
a
m
s w illb
e
a
vo
id
e
d d u
r
in
g p
u
mp
in
g
a
c
t i
v
it i
e
s
.
A
c ce
ss w illb
e
t h
ro
u
g
h u
p
la nds ,
v
iaadja
ce
nt
ro
adw a
y
s
.B
e
st
Man a
ge me
nt P
r
a
c
t i
ce
s w illb
e
us
e
d d u
r
in
g p
u
mp
in
g
a
c
t i
v
it i
e
s
.
44
8
wa r
m
D
uk
e
En
e rgy
is
req
u
e
st in
g
1:1 s t
re
a
m m
it i
g
at i
o
n s in
ce
t h
e pr o po
s
e
d s t
re
a
m
i
m p
a
c
t sw illb
e
t
o
l
o
w
q
ualit
y
,int
e r m
itt
e
nt
c
hann
e
ls
.
C
h
o os eon e
C
h
o os eon e
C
h
oo seon e
0 .40 7
P
a ge7o
f 10
6 .B
u
ff
er
M
i
t
iga
t
io n (
St
a
t
e Regu la
t
e
d
Ripar ia n
B
u
ff
erRu les)–re qu ire
d by D
W Q
6a.W il l t heprojectr esulti nanimpactwit hinaprotectedr ipari anbuffert hatr equir es
buffermit iga t ion?
Y es No
6b.If y es
,
t henidentify
t hesquarefeeto
f impacttoeach
z
oneo
f
t heripar ian buffert hatrequir esmitiga t ion.Calcula t e t he
amount of mit i gationrequir ed.
Z one
6c.
Reasonfor impact
6d.
T ot alimpact
(squarefeet)
Multi pli er
6e.
Required mit ig ation
(squarefeet)
Z one1 3 (2 f or Cat aw ba)
Z one2 1.5
6f .T
o
t
a l
b
u
ff
erm i
t
iga
t
io n r equire
d
:
6g.If buffermit iga t ion i srequi red
,
di scus sw
hat t
y peo
f mit i gationispropos ed(e.g.
,
paymentto pri
v
at e mit iga t ion bank
,
permitteeres ponsibler ipar ia nbufferr estoration
,
paymenti ntoanappro
v
ed i nl i eufeefund).
6h.Com ments
:
P
a ge8o
f 10
PC NF
orm–Vers ion
1
.
4 J
an uary2
00 9
E
.S
t
or m
w a
t e
r
Mana g
e
m
e
n
t
and
Di
ff
u
s
e Fl
o
w
P
l
an (
r
equi
r
e
d by
DW Q)
1.D
i
f f
us e
F
low
P
la n
1a.Doest heprojecti nc ludeori sitadjacentt o protected ri par ian buffer sidentifi ed
w it hinoneo
f
t heNCRipari an B ufferProte ctionRul es?
Y es No
1b.If y es
,
t heni sadiffus eflo
w plan i ncluded?If no
,
e
x
pl ainw
h
y .
Y es No
2 .St
o rmwa
t
er
M
a nage me n
t P
la n
2 a.W hat is t heo
v
erallperc entimper
v
iousnes soft hisproject?%
2 b.Doest hisprojectrequi reaStormwat erManagementPlan?Y es No
2 c .If t hisprojectDOE SNOTrequi reaStormwat erManagementPlan
,
e
x
pl ai nwhy
:
2 d.If
t hi sprojectDOE Sreq uireaStormwaterManagementPlan
,
t henpro
v
ide a bri ef
,
narr ati
v
e desc ri ptiono
f
t hepl an
:
2 e.W ho w il l be res ponsibl efort here
v
ie w of t heStormwaterManagementPlan?
3 .C
er
t
i
f
ie
d
Loca lGo
v
er nme n
t St
o rmwa
t
erRe
v
iew
3a.In w
hic h local go
v
er nment’s j uri sdict ion i st hi sproje ct?
3b.W hic h of t hefol lowingloc allyimpl ementedstormw at ermanagementprograms
apply(checkal lt hatapply)
:
Phas eII
NS W
US MP
W at erS upplyWate rshed
Ot her
:
3c .Hast hea ppro
v
ed St ormw at erMana gementPl anwit hproofofappro
v
albeen
attached?
Y es No
4 .D
W Q
St
or mwa
t
er
P
r ogr amRe
v
iew
4 a.W hic h o
f
t hef
ol lo
w i ngstateimplemented st ormw at ermanagementprograms apply
(checkallt hatapply)
:
Coastal count ies
HQ W
ORW
Sess ion
L
aw 2 0 06246
Ot her
:
4 b.Hast heappro
v
ed St ormw at erMana gementPl anwit hproo
f
o
f appro
v
albeen
attached?
Y es No
5 .D
W Q
40 1 U
n i
t St
or mwa
t
erRe
v
iew
5a.Doest heStormwaterManagementPlanmeett heappropri aterequi rements?Y es No
5b.Ha
v
e allof t he 401Unitsubmittalrequi rementsbeen met ?Y es No
1
T h
e pr o
j
e c
t s it
e me e
ts t h
e
l
o
w d
e
ns it
y c r
it
e r
ia as s
pe c
if i
e
d und
e rDW
R
W
at
e rQ
ualit
y
C
e r
t if i
c
at i
o
n (
W Q
C
)
N
o
.
38
9
0
;
i
.
e
.
, th
e pr o
j
e c
t bu ilt u
po
n a
re
a is
l
e
ss t han 1%
.B
M Psha
v e
b
ee
n d
e
s i
g
n
e
d t
o mee
t t h
e W Q
C N
o
.
38
9
0
req
ui
re me
nts f
o r
l
o
w d
e
ns it
y
d
eve
l
o pme
nt
.
T h
e pr o po
s
e
d a
c
t i
o
n w il ln
o
t add
i
m pe r
i
o
us s u
r
f a
ce
s t
o
t h
e pr o
j
e c
t
.
As s
pe c
if i
e
d b
y W Q
C N
o
.
l 38
9
0, t w
o co p
i
e
s
o
f t h
e DW
R L
o
w
De
ns it
y
Su
pp
l
me
nt al
Fo r m
a
re
att a
c
h
e
d t
o
t his P CN
.
P
a ge
9
o
f 10
PC NF
orm–Vers ion
1
.
4 J
an uary2
00 9
F
.S
u
pp
le
m
e
n
t
a
r
y
I
n
f
orm
a
t i
o
n
1.E
n
v
ir o nme n
t
a l
D
o cume n
t
a
t
io n (
D
WQ Req uir eme n
t
)
1a.Doest heprojecti n
v
ol
v
e ane
x
penditure o
f publi c (f ederal/st at e/loc al)f unds or t he
us eofpubl i c(f eder al/st at e)l and?
Y es No
1b.If y ou answer ed“y es”t o t heabo
v
e
,
doest heprojectrequi reprepar ationofan
en
v
ir onmentaldocumentpurs uantto t herequi rementso
f
t heNationalorState
(Nort hCaroli na )En
v
i ronmentalPol i cyA ct(NE PA/S E PA)?
Y es No
1c .If y
ou answer ed“
y es”t o t heabo
v
e
,
hast hedocumentre
v
i ewbeenfina l i
z
ed by
t he
St at e Clear ingHouse ?(If so
,
attacha copy of t heNE PAorSE P A f in alappro
v
al
l etter.)
Com ments
:
Y es No
2 .V
io la
t
io ns(
D
W QReq uir eme n
t
)
2 a.Is t hesitein
v
iol ationofDW Q Wetl andRul es(15A NC A C 2 H.0500)
,
Isol ated
W et lan d Ru l es(15A NC A C 2 H.1300)
,
DW QS urfac eWaterorWetl andStandards
,
or Ri pari anBufferRul es(15A N CAC 2 B.02 00)?
Y es No
2 b.Is t hisanaftert hefactpermitappli cation?Y es No
2 c .If y
ou answered “
y es”t o oneor bot ho
f
t heabo
v
e questions
,
pro
v
ide ane
x
p lanationo
f
t he
v
iola t ion(s)
:
3 .C
umu la
t
i
v
e
I
mpac
t
s (
D
WQ Requ ir eme n
t
)
3a.W il l t hi sproje ct(bas edonpastandreas onably antic ipa t ed f ut ure impac t s)res ult i n
additionalde
v
elopment
,
w
hic h could impa ctnearbydo
w nstrea m w at erqual i t
y
?
Y es No
3b.If y ou answer ed“y es”t o t heabo
v
e
,
submitaqual itati
v
e or quantitat i
v
e cumulati
v
e impac t analys isinac cordancewit h t he
most r ecentDW Qpol i cy.If y ou answer ed“no
,
”pro
v
ide a short narrati
v
e des cr iption.
4 .S
ewage
D
ispo sa l (
D
WQ Requ ir eme n
t
)
4 a.Cl earlydetai lt heultimatetreatmentmet hodsanddi sposition(non dis c harge or di scharge)o
f w a stewatergener atedfrom
t hepropos edproject
,
or a
v
ail a ble c apacityoft hesubjectfaci li ty .
T his
pr o
j
e c
t w il ln
o
t
ge
n
e r
at
e
w as t
e
w at
e r
.
P
a ge
10
o
f 10
5 .E
n
d
a nger e
d S
pec iesa n
d D
es ig na
t
e
d C
r i
t
ica l
H
a
b
i
t
a
t
(
C
or ps Req uir eme n
t
)
5a.W il l t hi sproje ctoccuri nornearanar eawit h
f ederal lyprotected spec ie sor
habit at ?
Y es No
5b.Ha
v
e y ou che ckedwit h t heUSFW Sconc er ningEndanger edSpec ies A ct
impacts?
Y es No
5c .If y es
,
i ndic a t e t heUS FW SFieldOffi c eyouha
v
e cont acted.
5d.W hat dat a sour cesdidy
ou us etodetermi new
het hery
our s itew
ould impactEndanger edSpec iesorDesi gnatedCri t i cal
Habit at ?
6 .E
sse n
t
ia l
F
is
h H
a
b
i
t
a
t
(
C
or ps Requ ir e me n
t
)
6a.W il l t hi sprojectoc curinornearanarea des ignatedases senti alfi shhabitat?Y es No
6b.W hat dat a sourc esdidy
ou use t o det ermi new
het hery
our si t e w
ould impactEss ential Fi shHabitat?
7 .H
is
t
or icor
P
r e
h
is
t
or ic
C
u l
t
ur a lResourc es(
C
o rpsRequireme n
t
)
7a.W il l t hi sproje ctoccuri nornearanareat hatt hestate
,
f eder alortribal
go
v
ernmentsha
v
e desi gnatedasha
v
i nghi stor icorculturalpres er
v
at ion
st at us (e.g.
,
Nat ionalHistori cTrust desi gnationor properti ess i gnifi cantin
Nort hCaroli na hi storyandar chaeology)?
Y es No
7b.W hat dat a sour cesdidyouus etodetermi newhet heryours itewouldimpacthi stor icorarcheologi calresources?
8 .F
loo
d Z
o ne
D
es ig na
t
io n (
C
o rpsRequireme n
t
)
8a.W il l t hi sprojectoc curinaFE MA desi gnated100yearfloodpl ai n?Y es No
8b.If y es
,
e
x
plai n how projectmeetsF EMArequi rements
:
8c .W hat sour ce(s)did y ou use t o make t hefloodpl ai n det er mina t ion?
A
p p
l
ican
t /A
g en
t'
s
P
ri n
t
e
d N
ame _______________________________
A
p p
l
ican
t/A
g en
t'
s Signa
t
u re
(A ge nt '
s s i
g nat ure
is v
al
i
d o nl
y i
f an aut hor
iz
at
i
o n
lett e r f ro mt heappl
ic
ant
is
pro
v i
ded .)
D
a
t
e
R
a
l
e
i
g
h
U
S
FW
S
I
nf
o r m
at i
o
n,Pl annin
g
,an d C
o
ns
e rv
at i
o
n
S
y
st
e m
(
I
PaC
)
int
e r
a
c
t i
v e
w
e
bs it
e
an d t h
e
NC Nat u
r
al H
e r
it a
ge
P
rog r
a
m
(NCN HP
)
Nat u
r
al H
e r
it a
ge
D
at abas
e
S
e
a
r c
h i nt
e r
a
c
t i
ve
w
e
bs it
e
.
A
me cFo
st
e r W
h
ee
l
e r
d id n
o
t id
e
nt if
y
an
y
f
e
d
e r
all
y
list
e
d s
pe c
i
e
s d u
r
in
g
t h
e
s it
e ev
aluat i
o
ns i n A
pr
il 2 015
.
N
O
AA Nat i
o
na l Ma
r
i n
e F
is h
e r
i
e
s
S
e rv
i
ce o
nlin
e
in t
e r
a
c
t i
ve
s
o
f tw a
re
"Es s
e
nt ial
F
is h Habit atMa
pp e r v
3
.
0"
.
NC
De p
t
o
f Cul t u
r
al R
e
s
o
u
rc e
s ,St at
e
Hist
o r
i
c
P
re
s
e rv
at i
o
n
O
ff i
ce
(SHP
O
)
int
e r
a
c
t i
ve
w
e
bs it
e
(HP
OW
E
B ).
A
g r
a
p
hi
c ex
hibit
o
f t h
e
100
ye
a
r
f l
oo
d
p
lain f
o r
t h
e pr o
j
e c
t
v
i
c
init
y
is att a
c
h
e
d
.
S
o
u
r ce
:
F
E MA
/
F I
RM
m
a
p
nu
m
b
e r
s 371 07
9
8
9
0 0J ,371 07
999
00 J ,an d
371 070
9
000 J ,d at
e
d J ul
y
3, 2 007
.