20171030 Ver 1_401 Application_20170817

Montalvo, Sheri A
From: Montalvo, Sheri A
Sent: Thursday, August 17, 2017 2:12 PM
To: [e-mail]
Subject: Peoples Stream Repair
Attachments: Agent Authorization Form.pdf
Importance: High
Kris,
We have received the PCN for the above, however page 12 of 12 was signed by you
which will require an agent authorization form to be completed and emailed back to me
in order to take the project off hold and forwarded through the review process. I have
attached one for your use.
Thanks
Sheri Montalvo
Administrative Assistant
401 & Buffer Permitting Branch
Division of Water Resources
North Carolina Department of Environmental Quality
919-807-6303 (office)
919 807-6494 (fax)
sheri.montalvo()ncdenr.gov
Physical: 512 N. Salisbury St., Ste 942-D, Raleigh, NC 27604
Mailing: 1617 Mail Service Center, Raleigh, NC 27699-1617
Email correspondence to and from this address is subject to the
North Carolina Public Records Law and may be disclosed to third parties.

O�O� W A T9
Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
t,
Page 1 of 12
PCN Form — Version 1.3 December 10, 2008 Version
Pre -Construction Notification (PCN) Form
A.
Applicant Information
1.
Processing
1a. Type(s) of approval sought from the
Corps:
® Section 404 Permit El Section 10 Permit
1 b. Specify Nationwide Permit (NWP) number: 27 or General Permit (GP) number:
1 c.
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
because written approval is not required?
For the record only for DWQ 401
Certification:
❑ Yes ® No
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
® No
1 g.
Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below.
❑ Yes
® No
1h.
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes
® No
2.
Project Information
2a.
Name of project:
Peoples Stream Repair
2b.
County:
Wake
2c.
Nearest municipality / town:
Cary
2d.
Subdivision name:
Preston Woods
2e.
NCDOT only, T.I.P. or state
project no:
3.
Owner Information
3a.
Name(s) on Recorded Deed:
Ronnie T. Peoples, Carol L. Peoples
3b.
Deed Book and Page No.
007495, 00952
3c.
3d.
Responsible Party (for LLC if
applicable):
Street address:
100 Links End Dr.
nn rR (a mn
w Pg
nR
3e. City, state, zip:
Cary, NC, 27513
AUG 17
2017
3f.
Telephone no.:
3g.
Fax no.:
MOURCE
401 & BU FER PERMITTING
3h.
Email address:
Page 1 of 12
PCN Form — Version 1.3 December 10, 2008 Version

4. Applicant Information (if different from owner)
4a. Applicant is:
❑ Agent ❑ Other, specify: Neighborhood HOA
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:
Kris Bass
5b. Business name
(if applicable):
Kris Bass Engineering
5c. Street address:
625 S Lakeside Dr.
5d. City, state, zip:
Raleigh, NC, 27606
5e. Telephone no.:
9199601552
5f. Fax no.:
5g. Email address:
[e-mail]
Page 2 of 12

B.
Project Information and Prior Project History
1.
Property Identification
1a.
Property identification no. (tax PIN or parcel ID):
0744779978
1 b.
Site coordinates (in decimal degrees):
Latitude: 35.804985 Longitude: - 78.838466
(DD.DDDDDD) (-DD.DDDDDD)
1 c.
Property size:
0.53 acres
2.
Surface Waters
2a.
Name of nearest body of water (stream, river, etc.) to
Unnamed Tributary
proposed project:
2b.
Water Quality Classification of nearest receiving water:
C, NSW
2c.
River basin: map is available at
Neuse
hftp://h2o.enr.state.nc.us/admin/maps/
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 existing stream is rapidly eroding away the Peoples Residence's back yard. The stream is heavily influenced by an
upstream culvert. This is causing the formation of a sediment bar that is forcing the water into the bank of the Peoples
residence's backyard. The water being forced this way is causing the bank to erode and fall in. The stream is incised
throughout its length and has very steep banks.
3b.
List the total estimated acreage of all existing wetlands on the property:
0%
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
140 Linear Feet
3d.
Explain the purpose of the proposed project:
The goal of this project is to move the stream away from the eroded bank and then to rebuild the bank and stabilize the
stream to prevent future erosion. This project will also provide small floodplains on both sides of the stream.
3e.
Describe the overall project in detail, including the type of equipment to be used:
This project will involve taking the existing incised stream and moving it away from the eroded stream bank. The eroded
stream bank will be rebuilt using stone, geo-lifts, and excess soil. The rebuilt stream bank will be planted with live stakes,
cuttings, and grass. This project will be making a new section of channel that is slightly narrower in certain areas and
adding bankfull benches to provide a floodplain that can be accessed during larger storm events. The bankfull bench
floodplains will be planted with wetland plants. This project also includes digging a new scour pool just downstream of the
existing culverts. The design was completed using natural channel design techniques. The work will be accomplished
using a small excavator as well as some hand tools.
Page 3 of 12
PCN Form — Version 1.3 December 10, 2008 Version

4.
Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past?
Comments:
❑ Yes ❑ No ® Unknown
4b.
If the Corps made the jurisdictional determination, what type
of determination was made?
❑ Preliminary ❑ Final
4c.
If yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
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
this project (including all prior phases) in the past?
❑ Yes ® No ❑ Unknown
5b. If yes, explain in detail according to "help file" instructions.
6.
Future Project Plans
6a.
Is this a phased project?
❑ Yes ® No
6b.
If yes, explain.
Page 4 of 12

C. Proposed Impacts Inventory
1. Impacts Summary
1a. 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
Type of jurisdiction
number —
Type of impact
Type of wetland
Forested
(Corps - 404, 10
Area of impact
Permanent (P) or
(if known)
DWQ — non -404, other)
(acres)
Temporary T
W1 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W2 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W3 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W4 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W5 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W6 []PMT
❑ Yes
❑ Corps
❑ No
❑ DWQ
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
Type of jurisdiction
Average
Impact
number -
(PER) or
(Corps - 404, 10
stream
length
Permanent (P) or
intermittent
DWQ — non -404,
width
(linear
Temporary (T)
(INT)?
other)
(feet)
feet)
S1 ❑ P ® T
Restoration
Unnamed Trib
® PER
❑ INT
® Corps
❑ DWQ
5
50
S2 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S3 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S4 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S5 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S6 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
3h. Total stream and tributary Impacts
50
3i. Comments: This project is meant to enhance the current stream as well as save the neighborhood infrastructure around it
from being damaged.
Page 5 of 12

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.
Open water
impact number —
Permanent (P)
or Temporary
4b.
Name of waterbody
(if applicable)
4c.
Type of impact
4d.
Waterbody type
4e.
Area of impact (acres)
01 ❑ PEI T
02 ❑P❑T
03 ❑P❑T
04 ❑P❑T
4f. Total open water Impacts
4g. Comments:
5. Pond or Lake Construction
If pond or lake construction proposed, then com tete the chart below.
5a.
Pond ID
number
5b.
Proposed use or purpose of
pond
5c.
Wetland Impacts (acres)
5d.
Stream Impacts (feet)
5e.
Upland
(acres)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
P2
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:
Page 6 of 12

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.
® Neuse El Tar -Pamlico El Other:
Project is in which protected basin?
❑ Catawba ❑ Randleman
6b.
6c.
6d.
6e.
6f.
6g.
Buffer impact
number —
Reason for
Buffer
Zone 1 impact
Zone 2 impact
Permanent (P)
impact
Stream name
mitigation
(square feet)
(square feet)
or Temporary
required?
61 ❑ P ®T
Restoration
Unnamed Trib
® No
1144
0
B2 ❑P❑T
❑Yes
❑ No
B3 ❑P❑T
El Yes
❑ No
6h. Total buffer Impacts
1144
0
6i. Comments: All buffers will be restored to a forested condition with project completion.
Page 7 of 12

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.
Stream re -alignment is a necessity for this project to complete the restoration work.
b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Construction will be completed in the dry as much as possible and is limited to a minimal footprint. Work will be completed
using small machinery and using recycled stone and woody materials from the project area.
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
El 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
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:
❑ warm ❑ cool ❑cold
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:
Page 8 of 12
PCN Form — Version 1.3 December 10, 2008 Version

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.
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
buffer mitigation? If yes, you will have to fill out this entire form — please
contact the State for more information.
[] Yes ® No
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.
Zone
6c.
Reason for impact
6d.
Total impact
(square feet)
Multiplier
6e.
Required mitigation
(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 9 of 12

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 ❑ No
within one of the NC Riparian Buffer Protection Rules?
1b. If yes, then is a diffuse flow plan included? If no, explain why.
❑Yes No
❑
Comments:
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project?
0%
2b. Does this project require a Stormwater Management Plan?
❑ Yes ® No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why: This project is not adding any impervious
to the project site. This project is a stream restoration project that involves moving the stream away from existing
structures.
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
❑ Certified Local Government
2e. Who will be responsible for the review of the Stormwater Management Plan?
❑ DWQ Stormwater Program
❑ DWQ 401 Unit
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this project?
❑ Phase II
3b. Which of the following locally -implemented stormwater management programs
❑ NSW
❑ 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
attached?
❑ Yes ❑ No
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 10 of 12
PCN Form — Version 1.3 December 10, 2008 Version

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 ® 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,
❑ Yes ® No
or Riparian Buffer Rules (15A NCAC 213 .0200)?
2b.
Is this an after -the -fact permit application?
❑ 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 Requirement)
3a.
Will this project (based on past and reasonably anticipated future impacts) result in
❑ Yes ® 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.
Page 11 of 12
PCN Form — Version 1.3 December 10, 2008 Version

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 ® No
5b. Have you checked with the USFWS concerning Endangered Species Act
impacts?
❑ Yes ® No
5c. If yes, indicate the USFWS Field Office you have contacted.
El Raleigh
❑ Asheville
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
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
❑ Yes ® No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
North Carolina State Historic Preservation Office
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? FEMA Flood Map Service Center, ncfloodmaps.com
Applicant/Agent's Printed Name
Date
A icant/Agent's Signature
(Agent's signature is valid only if an authorization letter from the applicant
isprovided.)
Page 12 of 12

AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. PLAN NO. PARCEL ID: 0744779978
STREET ADDRESS: 100 Links End Dr, Cary, NC 27513
Please print:
Property Owner: Nathan Wagner
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
Kris Bass of Kris Bass Engineering
(Contractor / Agent) (Name of consulting firm)
to act on my behalf and take all actions necessary for the processing, issuance and acceptance of
this permit or certification and any and all standard and special conditions attached.
Property Owner's Address (if different than property above):
Telephone:
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Authorized Signature ized Signature
Date: �� Date:

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Title Job Class ,1G

0
Existing _
stream
centerline
Proposed
scour pool
10 20
Feet
1
XJ vL
029434
Grade up to
existing ground
Proposed
Vegetated Geolift
Proposed Stone
around and under
geolifts
i— Proposed Stream
Vegetated Bench
Existing Culverts
a
3
Second Terrace
Grass to be
planted on slope
2.25
Proposed Stream
Center Line
Existing Tree
Existing
Top of
Bank
Second Terrace
VEGETATED GEOLIFIF STRUCTURE NOTES:
1. Construct as directed by the Project Engineer.
2. A 2 foot thick base layer of stone is to be used when constructing
the geolifts. Stone already found on site to be used.
3. Lay out coir erosion control fabric then place approximately 1 foot of
soil on fabric and fold the remaining fabric on top of the soil lift.
Repeat process for any addition geolifts.
4. Vegetated geolifts to be planted with willow live stakes between each
geolift as well as wetland plants on top of each geolift. They should
also be seeded and fertilized.
5. Any and all proposed changes shall be approved by the Project
Engineer.
Planting Plan
Zone Species
Common Name
Spacing
Type
Quantity
Bankfull Bench Juncus effusus
Juncus
2'
bare root
15
Bankfull Bench Panicum virgatum
Switchgrass
2'
bare root
15
Bankfull Bench Carex crinita
Fringed Sedge
2'
bare root
15
Geo -lifts Juncus effusus
Juncus
2'
bare root
10
Geo -lifts Carex crinita
Fringed Sedge
2'
bare root
10
Geo -lifts Cornus amomum
Silky Dogwood
5'
live stake
3
Geo -lifts Salix nigra
Black Willow
5'
live stake
3
Geo -lifts Platanus occidentalis
American Sycamore
5'
live stake
3
Upper Slopes
Grass mix
4-J
seed mix
400 sq. ft.
Materials Required:
1. Coir erosion control matting: 3 10'x130' rolls
2. Wooden Stakes: 30 18" stakes
3. Metal Staples: 200 staples
Typical Cross Section
N.T.S
Stone
Channel
Wetland
plants to
be planted
on bench
area
Wetland plants and
live tree cuts to
be planted on
geolifts
Bankfull Bench to be
planted with grass
Grade up
to existing
ground
Coir Matting
on slope
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