20170897 Ver 1_401 Application_20170721

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Office Use Only -
Corps action ID�o.l 7 0 8 9
DWQ project no.
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:
❑ Section 404 Permit ❑ Section 10 Permit
1 b. Specify Nationwide Permit (NWP) number: t YI♦ or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps?
`5LYes ❑ No
1 d. Type(s) of approval sought from the DWQ (check all that apply):
'401 Water Quality Certification - Regular ElNon-404Jurisdictional General Permit
LVH❑ 401 Water Quality Certification - Express ❑ Riparian Buffer Authorization
1 e. Is this notification solely for the record
because written approval is not required?
For the record only for DWQ
401 Certification:
❑ Yes o
For the record only for Corps Permit:
❑ 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
or in -lieu fee program.
❑ Yes 6Q4No
1 g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below.
❑ Yeso
711
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes o
2. Project Information
2a. Name of project:
PC -c, e- +_ -
2b. County:
v V7 Grp vn b U
2c. Nearest municipality / town:
�'�, »Cfe- r Iv G
2d. Subdivision name:
,v 4
2e. NCDOT only, T.I.P. or state project no:
3. Owner Information
3a. Name(s) on Recorded Deed:
C M J4 }gyp,► y r,., L
3b. Deed Book and Page No.
b rij q 9 L, -2-&4;- 2 1
3c. Responsible Party (for LLC if
applicable):
3d. Street address:
3e. City, state, zip:
-C Z i
3f. Telephone no.:
662_4 6,6- y- "�
3g. Fax no.:
�o 2-1 (0 12- 3 2
3h. Email address:
r-" "-,k- . ; o 5 _-) c e r.�.
Page 1 of 10
PCN Form - Version 1.4 January 2009

4. Applicant Information (if different from owner)
4a. Applicant is:
❑ Agent ❑ 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. Agent/Consultant Information (if applicable)
5a. Name:
5b. Business name
(if applicable):
5c. Street address:
5d. City, state, zip:
5e. Telephone no.:
5f. Fax no.:
5g. Email address:
Page 2 of 10

B.
Project Information and Prior Project History
1.
Property Identification
1a.
Property identification no. (tax PIN or parcel ID):
Ll 3c-, •::�L
1 b.
Site coordinates (in decimal degrees):
Latitude:�5 L1 (p j (pQ( r, Longitude: ea
1 c.
Property size:
acres
2.
Surface Waters
2a.
Name of nearest body of water to proposed project:
2b.
Water Quality Classification of nearest receiving water:
too T
2c.
River basin:
3.
Project Description i ,i plc, l �q �� n c f7 1 e �� d., c �, V n n -rte �;+�► S`'` "�
3a.
Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this ern
L
application: V0#1 �5 � h fe ti,c%,� �•cr 1 Y4s vhG 3cv� v►> , �fn � (�-
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3b.
List the total estimated acreage of all existing wetlands on the property:
3c.
List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
3d.
Explain the purpose of the proposed project:
3e.
Describe the overall project in detail, including the type of equipment to be used:t-
ro I r, -� 6a I I -t )L d I G I 1 ✓- c r Z-f R ,, , h c) i•-, n aa�L, � �'v� fi►� hq-3c'_.
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4.
Jurisdictional Determinations
4a.
Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (includingall prior phases)in the past?
RYes ❑ No ❑ Unknown
c cel" � 1-r
Comments: fff,n ��re "A +,ji 1!5 ,
4b.
If the Corps made the jurisdictional determination, what type
of determination was made?
El Preliminary Final
4c.
If yes, who delineated the jurisdictional areas?
Name (if known): W,- I1,Y, ro e,
Agency/Consultant Company:
Other:
4d.
If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
7 " C7 AA
5.
Project History
5a.
Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past?
❑ Yes E No ❑ Unknown
5b.
If yes, explain in detail according to "help file" instructions.
6.
Future Project Plans
6a.
Is this a phased project?
❑ Yes E340
6b. If yes, explain.
Page 3 of 10
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 VFStreams — 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.
Wetland impact
number
Permanent (P) or
Temporary T
2b.
Type of impact
2c.
Type of wetland
2d.
Forested
2e.
Type of jurisdiction
Corps (404,10) or
DWQ (401, other)
2f.
Area of
impact
(acres)
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:
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.
Stream impact
number
Permanent (P) or
Temporary (T)
3b.
Type of impact
3c.
Stream name
3d.
Perennial (PER) or
intermittent (INT)?
3e.
Type of
jurisdiction
3f.
Average
stream
width
(feet)
3g.
Impact
length
(linear
feet)
S1 -
Choose one
S2 -
Choose one
-
-
S3 -
Choose one
-
-
S4 -
Choose one
-
-
S5 -
Choose one
S6 -
Choose one
-
-
3h. Total stream and tributary impacts
3i. Comments:
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.
Open water
impact number
Permanent (P) or
Temporary T
4b.
Name of waterbody
(if applicable)
4c.
Type of impact
4d.
Waterbody
type
4e.
Area of impact (acres)
01 -
Choose one
Choose
02 -
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.
Pond ID number
5b.
Proposed use or
purpose of pond
5c. 5d. 5e.
Wetland Impacts (acres) Stream Impacts (feet) Upland
(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 mitigation, then you MUST fill out Section D of this form.
6a. Project is in which protected basin?
❑ Neuse ❑ Tar -Pamlico ❑ Catawba ❑ Randleman ❑ Other:
6b.
Buffer Impact
number—
Permanent (P) or
Temporary T
6c.
Reason for impact
6d.
Stream name
6e.
Buffer
mitigation
required?
6f.
Zone 1
impact
(square
feet)
6g.
Zone 2
impact
(square
feet
B1 -
Yes/No
B2 -
Yes/No
B3 -
Yes/No
B4 -
Yes/No
B5 -
Yes/No
B6 -
Yes/No
6h. Total Buffer Impacts:
6i. Comments:
Page 5 of 10

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
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1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
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2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for
impacts to Waters of the U.S. or Waters of the State?
❑ Yes ,"No
2b. If yes, mitigation is required by (check all that apply):
❑ DWQ ❑ Corps
2c. If yes, which mitigation option will be used for this
project?
❑ Mitigation bank
❑ payment to in -lieu fee program
❑ Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter)
Type: Choose one
Type: Choose one
Type: Choose one
Quantity:
Quantity:
Quantity:
3c. Comments:
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:
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
El Yes 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
1 a. Does the project include or is it adjacent to protected riparian buffers identified
❑ Yes O'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 O No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why:
���ry
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2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
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2e. Who will be responsible for the review of the Stormwater Management Plan?
3. Certified Local Government Stormwater Review
3a. In which localgovernment's jurisdiction is thisproject?
%✓Ncvm�i G
❑ Phase II
❑ NSW
3b. Which of the following locally-implemented stormwater management programs
❑ USMP
apply (check all that apply):
❑ Water Supply Watershed
❑ Other:
3c. Has the approved Stormwater Management Plan with proof of approval been
❑ Yes �&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)
1a.
Does the project involve an expenditure of public (federal/state/local) funds or the
❑ Yes Z_/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
❑ Yes ❑ 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,
F] Yes [f(No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b.
Is this an after -the -fact permit application?
]ayes ❑ No
2c.
If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
�, wee t �rMy veeJtJ
3.
Cumulative Impacts (DWQ Requirement)
3a.
Will this project (based on past and reasonably anticipated future impacts) result in
❑ Yes R' o
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.
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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
habitat?
❑ Yes P/No
5b. Have you checked with the USFWS concerning Endangered Species Act
impacts?
❑ Yes KNo
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?
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?
❑ Yes &KNo
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
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
❑ Yes140
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?
❑ Yes [*No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination?
Applicant/Agent's Printed NameAppli
Date
an Agent's Signature
(Agent's signature is valid only if an authorization
letter from the applicant isprovided.)
Page 10 of 10

[EXTERNAL] Culvert Placement
Elliott, William A CIV USARMY CESAW (US) <[e-mail]>
Thu 7/6/2077 1:55 PM
r -,:Rogers, Frank<[e-mail]>;
9 1 attachment
NWP14.pdf;
Thank you for notifying me about your intentions to utilize Nationwide Permit 14 (NWP 14), which authorizes activities
in waters of the U.S. (WoUS) associated with (maintenance, stream bank stabilization, minor discharges of fill material,
etc.). The work you described is located at 40 Tree Frog Hollow, Candler, NC. As described, the proposed project
would involve approximately 20 Linear feet of Culvert inpacts.
On March 19, 2017, the regional conditions of NWP 14 pertaining to notification requirements changed. These
changes affect the requirements for submittal of pre -construction notification for work conducted in the western
counties of North Carolina. Based upon details provided for your project, you are not required to submit pre -
construction notification to our office. You may proceed with your work as proposed provided it is accomplished in
accordance with all the conditions of the attached NWP 14.
Your project is located in a North Carolina Wildlife Resources Commission designated trout watershed. Per regional
condition 1.2, no work in streams at this location can be conducted between October 15 and April 15 during the trout
waters moratorium. Also, your project must meet the requirements of regional condition 3.6 for installation of
culverts. These requirements define measures which promote the safe passage of fish and other aquatic organisms
and are to be included in the construction/installation of culverts.
This statement does not preclude the need to obtain other applicable federal, state, or local authorizations for your
project. The changes to NWP XX may not affect the pre -construction notification requirements to receive the
required corresponding Clean Water Act Section 401 Water Quality Certification from North Carolina Division of
Water Resources (DWR). Please contact your DWR County Project Manager, at 828-296-4500, to determine the
required pre -construction notification/permit application submittal process for DWR.
If you have any questions regarding this information, you may contact me at 828-271-7980 x. 4224.
Sincerely,
William Elliott
Regulatory Specialist
US Army Corp of Engineers
Asheville Regulatory Field Office
151 Patton Ave, Room 208
Asheville, NC 28801
Phone: [phone], ext 4224
Fax: [phone]
Remember! Water is the Universal solvent and ... "it runs downhill"
The Wilmington District is committed to providing the highest level of public support. Please vist our website at:
http://www.saw. usace.army.mil/Missions/Regu latoryPerm itProg ra m.aspx

Please assist us in better serving you! Please complete the customer survey by clicking on the following link:
http://pert.nwp.usace.army.mil/survey.htm]

[EXTERNAL] Frog Hollow Drive - Buncombe County
Mitchell, Robert K <[e-mail]>
Thu 7/6/2017 2:47 PM
:Rogers, Frank<Frank.Rogers@Clayton Homes.com>;
c -c Doug Sharp<[e-mail]>; Price, Zan (George) <[e-mail]>; Stanley, Stephanie
<[e-mail]>; bobbycan6@gmaiLcom <bobbycan6@gmaiLcom>;
� 2 attachrnents
PCN-help-complete-2013-03.pdf; PCN1-4-2009interactive-reader-enabled 2013-06.pdf,
Mr. Rogers,
Thanks for speaking with me today. As we discussed on the phone, the installation of the 20 foot culvert on an
unnamed tributary to South Hominy Creek will require written approval from the North Carolina Division of
Water Resources because it is adjacent to a stream classified as Trout. Please fill out the attached Pre
Construction Notification form (PCN) and submit five copies and the fee to our Raleigh office. I have attached a
PCN help document and a link to pertinent information to help guide you through the process. The second link
is the Water Quality Certification 4088 (WQC). You will want to read this and make sure that your project meets
all of the conditions of the WQC 4088.
Please have this submitted by August 7, 2017. Feel free to contact me if you have additional questions and I
would be glad to assist you. Thanks for your time.
Pertinent information - http://deg.nc.gov/about/divisions/water-resources/water-resources-
permits/wastewater-branch/401-wetlands-buffer-permits/401-401-isolated-wetlands-waters-
program#FeesProcedures
WQC 4088 - http://edocs.deg.nc.gov/WaterResources/0/doc/493430/`Pagel.aspx
Kevin Mitchell
Environmental Specialist — Asheville Regional Office
Water Quality Regional Operations Section
NCDEQ— Division of Water Resources
828-296-4650 Office
Email [e-mail]
2090 U.S. Hwy. 70
Swannanoa, N.C. 28778
- 7'� Nothing Compares
Nl�z_
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.