20170323 Ver 2_More Info Received_20170628

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Form Version 1.4 January 2009
Pre-Construction Notification (PCN) Form
A. Applicant Information
1. Processing
1a. Type(s)of approval sought from the Corps: ❑X Section 404 Permit 0 Section 10 Permit
lb.Specify Nationwide Permit(NWP)number: 12 or General Permit(GP)number:
1c. Has the NWP or GP number been verified by the Corps? 0 Yes ❑X No
I d. Type(s)of approval sought from the DWQ(check all that apply):
❑X 401 Water Quality Certification—Regular 0 Non-404 Jurisdictional General Permit
❑ 401 Water Quality Certification—Express ® Riparian Buffer Authorization
le. 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 ❑X Yes ❑ 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 ❑ Yes ❑X No
or in-lieu fee program.
1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h ❑ Yes ❑X No
below.
lh. Is the project located within a NC DCM Area of Environmental Concern(AEC)? ❑Yes ® No
2. Project Information
2a. Name of project: Cleveland Springs Phase 3
2b. County: Johnson and Wake
2c. Nearest municipality/town: Garner
2d. Subdivision name: Cleveland Springs
2e. NCDOT only,T.I.P.or state project no:
3. Owner Information
3a. Name(s)on Recorded Deed: Lighthouse Cleveland Springs LLC
3b. Deed Book and Page No. Johnston County(Book 04039 Page 0733) Wake County(Book 14517 Page 0893)
3c. Responsible Party(for LLC if
applicable):
3d. Street address: 1712 Bay Cir W
3e. City,state,zip: Orange Park, FL 32073-4748
3f. Telephone no.:
3g. Fax no.:
3h. Email address:
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PCN Form—Version 1.4 January 2009

4. Applicant Information(if different from owner)
4a. Applicant is: ❑ Agent ® Other, specify: Owner of Project
4b. Name: Agency Partners
4c. Business name
(if applicable):
4d. Street address:
4e. City,state,zip:
4f. Telephone no.:
4g. Fax no.:
4h. Email address:
5. Agent/Consultant Information(if applicable)
5a. Name: Jim Spangler
5b. Business name Spangler Environmental, Inc.
(if applicable):
5c. Street address: 4338 Bland Road
5d. City, state,zip: Raleigh, NC 27609
5e. Telephone no.: 919-875-4288
5f. Fax no.: 919-875-4287
5g. Email address: [e-mail]
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B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no.(tax PIN or parcel ID): Johnston: 06H06003A Wake: 1628623224
lb. Site coordinates(in decimal degrees): Latitude: 35.608 Longitude: -78.5773
1c. Property size: 37.81 acres
2. Surface Waters
2a. Name of nearest body of water to proposed project: Unnamed Tributary to Swift Creek
2b. Water Quality Classification of nearest receiving water: C; NSW
2c. River basin: Neuse River
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:
The subject property is currently vacant,primarily undeveloped,and wooded.Properties within the vicinity of the subject property are generally
residential or undeveloped.Adjoining the north and west of the subject property are wooded land with a single family residential structure to the west.
Residential subdivisions under development adjoin the subject property to the south and east.A petroleum pipeline adjoins the property to the south.
3b. List the total estimated acreage of all existing wetlands on the property: 0.592
3c. List the total estimated linear feet of all existing streams(intermittent and perennial)on the property: 2,027
3d. Explain the purpose of the proposed project:
The purpose of this project is to construct a gravity sewer line to an existing manhole for a residential subdivision on the subject property.
3e. Describe the overall project in detail, including the type of equipment to be used:
The project is a residential subdivision that will involve grading/earth moving and utility work by using grading and excavating equipment.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the ❑Yes ❑X No ❑ Unknown
Corps or State been requested or obtained for this property/ Comments:
project(including all prior phases)in the past?
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:
Name(if known): Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
5. Project History
5a. Have permits or certifications been requested or obtained for Yes 0 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? 0 Yes ❑X No
6b. If yes,explain.
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PCN Form—Version 1.4 January 2009

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C. Proposed Impacts Inventory
1. Impacts.Summary
1 a. Which sections were completed below for your project(check all that apply):
❑ Wetlands ❑ Streams—tributaries ❑X Buffers 0 Open Waters 0 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)
Wt 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:
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 T Excavation UT Swift Creek PER DWQ 5 30
S2 - Choose one - -
S3 - Choose one - -
S4 - Choose one - -
S5 - Choose one - -
S6 - Choose one - -
3h.Total stream and tributary impacts 30
3i. Comments:
Temporary impact to the unnamed tributary to Swift Creek due to the installation of the sanitary sewer line that services the residential subdivision.
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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 individually 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)
O1 - 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,then 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:
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5h. Is a dam high hazard permit required? 0 Yes 0 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 mitigation,then you MUST fill out Section ID of this form.
6a. Project is in which protected basin? ❑X Neuse ❑Tar-Pamlico ❑ Catawba ❑ Randleman 0 Other:
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 T utility line installation UT Swift Creek No 1,266 1,064
B2 - Yes/No
B3 - Yes/No
B4 - Yes/No
B5 - Yes/No
B6 - Yes/No
6h.Total Buffer Impacts: 1,265 1,065
6i. Comments: Permanent maintenance corridor will be 10 feet or less.
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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 temporary impacts associated with installing the aerial sewer line will intersect the stream perpendicularly.No fill is proposed within the stream
channel below the buffered jurisdictional call point.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
All appropriate BMPs will be deployed including sediment and erosion control devices.
2. Compensatory Mitigation for Impacts to Waters of the U.S.or Waters of the State
2a. Does the project require Compensatory Mitigation for 0 Yes X❑ No
impacts to Waters of the U.S.or Waters of the State?
2b. If yes, mitigation is required by(check all that apply): 0 DWQ 0 Corps
0 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:
3c. Comments:
4. Complete if Making a Payment to In-lieu Fee Program
4a.Approval letter from in-lieu fee program is attached. 0 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:
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.
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PCN Form—Version 1.4 January 2009

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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 EX 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: c
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:
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E. Stormwater Management and Diffuse Flow Plan(required by DWQ)
1. Diffuse Flow Plan
la. 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?
lb. If yes,then is a diffuse flow plan included? If no,explain why.
Copies of the Stormwater Plan approval letter from the Johnston County Department of Public Utilities for
the site are included. 0 Yes ❑X No
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project? 21
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:
The total acreage within this section of Cleveland Springs Subdivision is 33.081 acres.Present land use is vacant. Undisturbed woodland makes up
89.2%of the site while the other 10.8%was previously cleared for stockpile use and is now managed open space.No wetlands are present within the
property boundary. The primary drainageway that bisects the property longitudinally is a Neuse Riparian Buffered Jurisdictional Watercourse,and
drains to Swift Creek.No fill is proposed within the stream channel below the buffered jurisdictional call point.Subdivision site is shown inside the ESA
on Johnston County ESA Map.
2e. Who will be responsible for the review of the Stormwater Management Plan? Johnston county
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this project? Johnston County
❑ Phase II
CI
3b. Which of the following locally-implemented stormwater management programs NSW
apply(check all that apply): ❑ USMP
❑Water Supply Watershed
❑ Other:
3c. Has the approved Stormwater Management Plan with proof of approval been Z Yes ❑No
attached?
4. DWQ Stormwater Program Review •
❑Coastalcounties
El HQW
4a. Which of the following state-implemented stormwater management programs apply DORW
(check all that apply): ❑Session Law 2006-246
❑Other:
4b. Has the approved Stormwater Management Plan with proof of approval been 0 Yes ❑ No
attached?
5. DWQ 401 Unit Stormwater Review
5a. Does the Stormwater Management Plan meet the appropriate requirements? X❑Yes 0 No
5b. Have all of the 401 Unit submittal requirements been met? 0 Yes ❑ No
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PCN Form—Version 1.4 January 2009

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F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
la. Does the project involve an expenditure of public(federal/state/local)funds or the ❑Yes px No
use of public(federal/state)land?
lb. If you answered"yes"to the above, does the project require preparation of an Yes 0 No
environmental document pursuant to the requirements of the National or State
(North Carolina) Environmental Policy Act(NEPA/SEPA)?
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 Yes 0 No
letter.)
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 OX No
or Riparian Buffer Rules(15A NCAC 2B .0200)?
2b. Is this an after-the-fact permit application? ❑Yes OX 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 0 Yes pX 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.
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.
Municipal sanitary sewer will service the subject property.
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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
habitat?
El Yes ❑X No
5b. Have you checked with the USFWS concerning Endangered Species ActID Yes ❑No
impacts?
5c. If yes, indicate the USFWS Field Office you have contacted. Raleigh
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
NC Natural Heritage Program element occurrence data set.
6. Essential Fish Habitat(Corps Requirement)
6a.Will this project occur in or near an area designated as essential fish habitat? ❑ Yes ❑X No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
National Marine Fisheries Service essential fish habitat mapper
7. Historic or Prehistoric Cultural Resources(Corps Requirement)
7a. Will this project occur in or near an area that the state,federal or tribal
governments have designated as having historic or cultural preservation ❑ Yes 0 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 Natural Heritage Program
8. Flood Zone Designation (Corps Requirement)
8a.Will this project occur in a FEMA-designated 100-year floodplain? ❑Yes ❑X No
8b. If yes, explain how project meets FEMA requirements:
8c.What source(s)did you use to make the floodplain determination?
FEMA Flood Map Service Center(3-3-2017)
Spangler Environmental, Inc. 5-23-17
James A. Spangler(President)
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.)
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