20170254 Ver 1_More Info Received - Email_20170315 (72)

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Comps _Etion ID 17v.
DWQ projec► no.
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Pre -Construction Notification (PCN) Form
A. Applicant Information
i. Processing
1 a. Type(s) of approval sought from the Corps: F Section 404 Permit ❑ Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: 27 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps?
® Yes ❑ No
1d. Type(s) of approval sought from the DWQ (check all that apply):
® 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 ❑ No ❑ Yes ❑ No
1 f. 1s payment into a mitigation bank or in -lieu fee program proposed for
mitigation of impacts? If so, attach the acceptance letter from mitigation bank ❑ Yes ® No
or in -lieu fee program.
1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1h ® Yes ❑ No
below.
1h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ® Yes ❑ No
2. Project Information
2a. Name of project: Core Sound Wetland Enhancement
2b. County: Calleret
2c. Nearest municipality 1 town: Harker; Island
2d. Subdivision name:
2e. NCDOT only, T.I.P. or state project no:
3. Owner Information
3a. Name(s) on Recorded Deed:
National Park Service, Cape Lookout National Seashore
3b. Deed Book and Page No.
3c. Responsible Party (for LLC if
applicable):
3d. Street address:
131 Charles St.
3e. City, state, zip:
Harkers Island, NC, 28531
3f. Telephone no.:
252.728.2250 ext 3012
3g. Fax no.:
3h. Email address:
jed—[e-mail]
Page I or 1—V
PCM form — version i.4 January zMv

4. Applicant Information (if different from owner)
4a. Applicant is:
❑ Aaent ❑ Other, specify:
4b. Name:
4c. Business name
(if applicable):
4d. Street address:
4e. City, state, zip:
4f. Telephone no.:
4g. Fax no.:
4h. Email address:
5. AgentlConsultant Information (if applicable)
5a. Name: Kris Bass
5b. Business name Kris Bass Engineering
(if applicable):
5c. Street address: 625 S Lakeside Dr
5d. City, state, zip:
Raleigh, NC, 27606
5e. Telephone no.:
919.960.1552
5f. Fax no.:
5g. Email address:
[e-mail]
Page 2 of 10

13. Project Information and Prior Project. History
1. Property Identification
a. Property itlentincation no. ttax PIA or parcel ID):
r 5 acua'u5ou'u'u
1b. Site coordinates (in decimal degrees):
r Latitude: 34.636 Longitude: -15•o13
ic. Property size:
1.7 acres
z. serfa�a Waters
2a. Dame oi nearest Dotty oi water to proposeD project:
Back Sound
A5. vv.t�r Quality Claaaitioation or „earest receiving water:
ort, vRvv
2c. River basin:
White Oak
J. Yrcjar.t Dva�.-Iptlan
3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
ap'lio-tion:
Existing conaalllons Include upland natural areas anti tlistulaeO wetlands. vvetlana= Mr.w Snouted by Inman actl:iti=m --..d a mw-rby ditch ey-tens.
ab. List Me totdl estimate'u acreage oi all existing wetiantts on Lille property: 0.035
ac. t_ist trie totai estimated linear rest or all existing streams (intermiuent antl perennial) on die property: 0
3t]. Expiain Me purpose or Me proposed project:
Project involves wetland resloratioMenRancement and creation Tor'aemonstration an'a educational purposes. Additional motives incluse water quality pi
ae. DescriBe Me overall project in detail, inciutting Me type or equipment to De uses:
Work will Involve the reversal of drainage lm,,owts b, filling av pie7Viny altZa-, miner 50mainy to Irnpre-r. Flan -rid df-ralty, and .. m.jor rapl..nllnn �trer
4. Jurisdictional Determinations
4a. Flava ;ariaaivtional rrod-ria or stream determinations by the
Corps or State peen requestett or oDtaineu For triis property r
project (includingall prior phases)in the past?
® res ❑ Ido ❑ Unitnown
t;oTTerltS:
uD. It Me Corps matte Me jurist]lat-.Qrnzl 3.v.rnni.-_ttom, T..n-t type
of determination was mazier
®Preliminary L1 f=inal
mac. IF yes, wrio Eellneatett trie juristtictional areas?
Ia4.rMv t1T KMo .n): Tom Charles
HgencyrConsultant Company: Kris Sass Engineering
Other:
4d. If yes, list the dates of the Corps Jurisdictional determinations or State determinations and attach documentation.
*. P. ojat t 1'1115tor r
5a. Have permits or certifications been requested or obtained for
As project (innlz;tiing -11 prior pfl.aa.) In tMe pasrr
® Yes ❑ No ❑ Unknown
55. It yea, explain in detail according to "help file" instructions.
Prior permits or roa' construction associate'u witrl ti,e Matlonal Park
6. Future Project Plans
Ea. is As a priases project
❑ res ® ICo
bD. IT yes, c..plalrl.
Page 3 of 10
PCN Form - Version 1.4 January 2009

Page 4 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):
® Wetlands ❑ Streams — tributaries ❑ 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 Tvpe of imn_act Tvpe of wetland Forested Type of jurisdiction Area of
number Corps (404,10) or impact
Permanent (P) or DWQ (401, other) (acres)
W1 T
Excavation Non-Tidal Freshwater Marsh
No
Corps
0.01
W2 �-
Choose one Choose one
Yes/No
-
W3 -
Choose one Choose one
Yes/No
-
W4 l -
Choose one Choose one
Yes/No
-
W5 -
Choose one Choose one
Yes/No
-
W6 -
Choose one Choose one
Yes/No
-
2g. Total Wetland Impacts: 0.01
2h. Comments:
Welland impacts are temporary to accomplish restoration efforts. Additional wetlands will be created around the border of this project to buffer and
protect the restored work.
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. 'Xc. 3d. 3e. 3f. 3g.
Stream impact Type of impact dream name Perennial (PER) or Type of Average Impact
number intermittent (INT)? jurisdiction stream length
Permanent (P) or width (linear
Temporary (T) (feet) feet)
S1 - Choose one - -
S2 - Choose one - -
S3 - Choose one -
S4 - Choose one - -
g5 - Choose one - -
S6 - Choose one - -
3h. Total stream and tributary Impacts
3i. nommenls:
Page 4 of 10
PCN Form — Version 1.4 January 2009

w. Open water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
Iiia U.S. Lite.—. ins:.iaeull limit J1 open :cater irn .i;t'; 6alo�—
zTa.
Open wa►er
imp -El nern6er
Permanent kr) or
Temporary T
ZFs.
Name of waLerbody
(it applicable)
ZFc.
Type of impact
ZFs.
Waterbody
type
ZFe.
Area of impact (acres)
01 T
Dnepr malm6nanee
U5
02 -
Choose ona
Chooua
0 1 -
CRoose one
CRoose
04 -
Choom..om
4T. I ot41 span .4tar Irnr.—at5
zFg. Comments: i--xcavaung in area t orain into ine exisung ana proposea Wetlancis.
5. Po; -.ti or L -,X� Con -traction
IT pona or IaRe construction proposeM, filen complete Me cnaR 17elow.
5a.
Pons 10 number
56.
Proposes use or
purpose of pons
OC. 50. 5e.
vvedand impacts (acres) stream Impacts (Teel) Opians
(acres)
Flooded
Filled
Excavated Flooded
Filled
Excavated
P1
Choasa aria
Pz
Choose one
5f. Total:
5g. Comments:
5f1. Is a spm flito R� rs parmit �yairca r
❑ Yee U Rty It yea, permit 113no:
51. Expected pond surface area (acres):
b). slze OT pons :aIvrsflatl (uur.3):
5k. Method of construction:
6. Buffer Impacts (for OWQ)
IT pra;cat will irnp-at a protected riparian 6atrar, [Fran aomplato Me of! -F[ 6alo.. It yaa, Man inaiNkaaally liei all batter i.p-ats
13eiow. It any impacts require mitigation, tnen you mu* i ml out Section Q oT tfiis Torm.
6a. Project is in which protected basin?
❑ Rai:i.a ❑ I a7 -P. ��Jluo ❑ Cata-,6a ❑ Ranalaman ❑ OtRer:
6b.
6uner Impact
numoer-
Permanent (P) or
I em ora I
6c.
Raaaen Ta- imp -at
6d.
WF06 �, ;-.ama
6e.
BuTrar
mitigation
required?
6f.
4ORW i
impact
(square
TOO
6y.
Lone z
impaUt
(square
Teei
131 -
r es/Ro
B2 -
To51Ra
�3
8�ivo
B4 -
Ye51Ne
05 -
Yes/No
gg -
Tes/No
&l. i opal Qurrer ImpaCI S:
vi. Comments:
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.
The largest portion of the work will be focused on ditch maintenance and upland areas. Existing wetlands and vegetation will be preserved or only
slighltly modified to accomodate Improved hydrology with the restoration.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Construction will be accomplish using minimal equipment. Work will be done using manual labor and hand tools as possible with immediate replanting.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for ❑ 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): ❑ DWG ❑ Corps
8 Mitigation bank
2c. If yes, which mitigation option will be used for this ❑ 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:
4. Complete if Making a Payment to In -lieu Fee Program
4a. Approval letter from in -lieu fee program is attached.
❑ Yes
4b. Stream mitigation requested:
linear feet
4c. If using stream mitigation, stream temperature:
Choose one
4d. Buffer mitigation requested (DWQ only):
square feet
4e. Riparian wetland mitigation requested: acres
4f. Non -riparian wetland mitigation requested: acres
4g. Coastal (tidal) wetland mitigation requested: acres
4h. Comments:
S. 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

S. Samar Mitigation (state Regulated Riparian Buffer Rules) — required by DWQ
S.. vvill tfii� p%ect resect in an impact within a protected riparian buffer that requires
Euuer mitigation.
U Yes ❑ No
06. It yes, ellen inentiry Me square reef or impact to eacli zone or in. rip—riarr 6errpr tFiat Caivelat= ilia
amount of mitigation required.
Zone
6c. fid.
ReF3vn rot !Mp—et i otal irRF-Vt
(square reet)
Multiplier
fie.
Required mitigation
tsquare reet)
Zone 1
a (e nor Catawfia)
cone z
1.5
Si. i otal patter rnitination raquiro8: .
6g. If buffer mitigadon is requireti, uiscuss wnat type or mitigation is proposes te.g., payment to private mitigation Banit,
permittee responsible riparian buffer restoration, payment into an approved in-lieu fee fund).
15M. Commawa:
Paye 7 of 10

E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
J. Diffuse clow 21an
1a. Does the project include or is it adjacent to protected riparian buffers identified ❑ Yes 0 No
within one of the NC Riparian Buffer Protection Rules?
1 b. If yes, then is a diffuse flow plan included? If no, explain why.
❑ Yes ❑ No
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project? %
2b. Does this project require a Stormwater Management Plan? ❑ 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:
2e. Who will be responsible for the review of the Stormwater Management Plan?
3. Certified Local Government Stormwater Review
3b. Which of the following locally -implemented stormwater management programs
apply (check all that apply):
3c. Has the approved Stormwater Management Plan with proof of approval been
attached?
❑ Phase II
❑ NSW
®USMP
Water Supply Watershed
[] Other:
❑ Yes ❑ No
4. DWO Stormwater Program Review
❑Coastal counties
❑HQW
4a. Which of the following state -implemented stormwater management programs applyHSession
ORW
(check all that apply): 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 (federallstatellocal) funds or the
use or pulsllc (terieralrstate) IanO r
1b. 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 Policy Act (NEPAISEPA)?
1c. 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
I letter.)
Comments:
iz. violations kLmU4 Requlrementt
2a. Is the site in violation of DWQ WedanO Rules pan MmC zR .0-00'01, Isoiate0
wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards,
or Riparian nutter Rules ti 5H ACAC zb MzUU) r
40. Is iI1is an aver-Me-raci permit application?
® Yes ❑ No
❑Yes ® No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® 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 Reyuiremen.)
3a. Will this project (based on past and reasonably anticipated future impac►b) result in Oyes ® No
aa0itional development, :Rion coals impact ma.My atywnstroarn 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.
4. Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods and disposition (non -discharge or discharge) of wastewater generated from
the propose0 project, or amila0ip �_puo'.ty or tno 3c6;zvt tovility.
Page a of i 0
PCM Form —version i.z .january culla

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?
5b. Have you checked with the USFWS concerning Endangered Species Act
impacts?
5c. If yes, indicate the USFWS Field Office you have contacted.
❑ Yes ❑ No
❑ Yes ® No
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
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?
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 ❑ ves ❑ plo
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?
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA -designated 100 -year floodplain?
8b. If yes, explain how project meets FEMA requirements:
Project does not involve any fill.
8c. What source(s) did you use to make the floodplain determination?
ncfloodmaps:com
t
Awlicant/Agent's Printed Name ppuca s -jlgn
(AqenCV signatur As valid only if an
Page 10 of 10
J® Yes ❑ No
'3'---a-I�)-'Q� r
Date