20171181 Ver 1_401 Application_20170915

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2 0 1 7 1 1 8 1
Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.4 January 2009
Page 1 of 10
PCN Form — Version 1.4 January 2009
Pre -Construction Notification (PCN) Form
A.
Applicant Information
1.
Processing COURTESY
1 a.
Type(s) of approval sought from the Corps:
® Section 404 Permit ❑ Section 10 PeCOPY
1b.
Specify Nationwide Permit (NWP) number: or General Permit (GP) number: 14
1c.
Has the NWP or GP number been verified by the Corps?
❑ Yes ® No
1 d.
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 N 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:
N Yes ❑ No
For the record only for Corps Permit:
N 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 N No
1 g.
Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below.
❑ Yes N No
1 h.
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes N No
2.
Project Information
2a.
Name of project:
Lot 5 Twin Creeks Subdivision
2b. County:
Franklin County
2c.
Nearest municipality / town:
Pilot
2d.
Subdivision name:
Twin Creeks Subdivision RECEIVED
2e.
NCDOT only, T.I.P. or state
project no:
N/A
3.
3a.
Owner Information
Name(s) on Recorded Deed: Philip Cass STORMWATER PERMITTING
3b.
Deed Book and Page No.
2099/407
3c.
Responsible Party (for LLC if
applicable):
3d. Street address:
3541 Oneonta Ave.
3e.
City, state, zip:
Raleigh, NC, 27604
3f.
Telephone no.:
919-696-8269
3g.
Fax no.:
N/A
3h.
Email address:
philipcass01 @gmail.com
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):
030579
1 b. Site coordinates (in decimal degrees):
Latitude:35.9017 Longitude: - 78.3025
1 c. Property size:
3.01 acres (within project area)
2. Surface Waters
2a. Name of nearest body of water to proposed project:
UT to Moccasin Creek
2b. Water Quality Classification of nearest receiving water:
C, NSW
2c. River basin:
Neuse River Basin
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:
Residential forested lot in a subdivision. Rolling topography
3b. List the total estimated acreage of all existing wetlands on the property: +/- 0.2 acres
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property: +/- 930LF
3d. Explain the purpose of the proposed project:
Build a driveway and install a culvert at creek crossing. To provide access to the lot.
3e. Describe the overall project in detail, including the type of equipment to be used:
The project will involve the construction of a gravel driveway at a creek crossing. The driveway will intersect the creek at
a 90 degree angle. A geotextile fabric will be used at the culvert site, for soil stabilization. A 36 inch by 20 foot HDPE
pipe will be installed, backfilled, and compacted. An additional 12 to 24 inches of rip -rap will be installed on the
upstream/inlet of the pipe. Total disturbance 22 feet. Typical construction equipment will be used, backhoe, compactor,
hand tools.
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?
❑ Yes ® No ❑ Unknown
4b. If the Corps made the jurisdictional determination, what type
of determination was made?
El Preliminary El 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 3 of 10
PCN Form — Version 1.4 January 2009

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) or Area of impact
Permanent (P) or
(if known)
DWQ (401, other) (acres)
Temporary T
-
Choose One
Choose one
Yes/No - 0
2g. Total wetland impacts 0
2h. Comments: No wetland impacts are proposed for this project.
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 stream
Impact
number
(PER) or
width
length
Permanent (P) or
intermitte
(feet)
(linear
Temporary (T)
nt (INT)?
feet)
S1 P
Culvert
UT to Moccasin
PER
DWQ
3
22
Creek
3h. Total stream and tributary impacts
22
3i. Comments: Total impacts will result from the installation of a culvert and riprap within the proposed driveway crossing.
Culvert length will be 20 feet. RipRap length will be 2 feet. Total linear impact 22 feet. See 4t' page of attachments.
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
impact number —
waterbody
Type of impact
Waterbody type
Area of impact (acres)
Permanent (P) or
(if applicable)
Temporary T
01 Choose one
Choose One
Choose
0
4f. Total open water impacts
0
4g. Comments: There are no open waters within the project boundaries.
Page 4 of 10
PCN Form — Version 1.4 January 2009

5. Pond or Lake Construction
If pond or lake construction proposed, then complete the chart below.
5a.
5b.
5c.
5d.
5e.
Wetland Impacts (acres)
Stream Impacts (feet)
Upland
Pond ID
Proposed use or
(acres)
number
purpose of pond
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
Choose One
P2
Choose One
5f. Total
0
0
0
0
0
0
0
5g. Comments: This project does not propose Pond or Lake construction
5h. Is a dam high hazard permit required?
❑ Yes ®No If yes, permit ID no:
5i. Expected pond surface area (acres):
N/A
5j. Size of pond watershed (acres):
N/A
5k. Method of construction:
N/A
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.
6c.
6d.
6e.
6f.
6g.
Buffer impact
number —
Reason
Buffer mitigation required?
Zone 1 impact
Zone 2 impact
Permanent (P) or
for
Stream name
(square feet)
(square feet)
Temporary T
im act
P
Road
UT to Moccasin
No
1500
1000
X-ing
Creek
6h. Total buffer impacts
1500
1000
6i. Comments: Impacts are due to a proposed driveway crossing. Project lies in the Neuse River Basin. Total buffer impact will
not exceed 2500 square feet. See 3rd page of attachments.
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.
Installing geotextile fabric for increased bank stabilization. Installing a rip -rap apron to prevent erosion.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Lot grading will be minimized to maintain the existing terrain and vegetation as much as possible. Silt fence will be
installed where applicable. Re -seed after construction.
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: N/A
3b. Credits Purchased (attach receipt and letter)
Type: Choose one
Quantity N/A
Type: Choose one
Quantity N/A
Type: Choose one
Quantity N/A
3c. Comments: N/A
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:
0 linear feet
4c. If using stream mitigation, stream temperature:
Choose one
4d. Buffer mitigation requested (DWQ only):
0 square feet
4e. Riparian wetland mitigation requested:
0 acres
4f. Non -riparian wetland mitigation requested:
0 acres
4g. Coastal (tidal) wetland mitigation requested:
0 acres
4h. Comments: N/A
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.
No mitigation is proposed because impacts have been minimized to impact only 22 LF of stream channel.
Page 6 of 10

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 ® 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).
N/A
6h. Comments: No buffer mitigation is proposed because impacts are within the "allowable" limits within the table of uses.
Page 7 of 10

E.
Stormwater Management and Diffuse Flow Plan (required by DWQ)
1.
Diffuse Flow Plan
1a.
Does the project include or is it adjacent to protected riparian buffers identified
❑ Yes ® 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
Comments:
2.
Stormwater Management Plan
2a.
What is the overall percent imperviousness of this project?
1 %
2b.
Does this project require a Stormwater Management Plan?
❑ Yes ® No
2c.
If this project DOES NOT require a Stormwater Management Plan, explain why: The proposed impervious surface area is
less than that requiring an approved stormwater plan.
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
3a.
In which local government's jurisdiction is this project?
Franklin County
❑ 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 1.3 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 2B .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.
Only building 1 driveway.
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.
The single-family residential home will utilize a septic system.
Page 9 of 10
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
® Yes ❑ No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act
❑ Yes ® No
impacts?
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? http://ncnhde.natureserve.org/content/map Occurrence Element Tier 1 Layer. No Michaux Sumac or mussels
listed (Dwarf Wedge, Tar River Spiny) in 1 mile search radius. 08/25/17. Field reconnaissance 08/26/17, No species
found.
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?
www.habitat.noaa.gov/protection/efh/efhmapper/index.html
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 ® 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?
http://gis.ncdcr.gov/hpoweb/ *Records check at the State Historic Preservation Office or the Office of State Archeology
were not performed. No structures were noted during a field reconnaissance of the project location. Utilizing the
HPOWEB GIS mapping service, a 1 -mile radius search of the project center yielded two properties, the H.J.Gay Farm,
HPO Site ID: FK0666. And "House", HPO Site ID: FK1015.The H.J. Gay Farm and "House" are classified by SHPO as a
'Surveyed Only' Structure.
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? www.fris.nc.gov panel 2708
)DO ' -p r C,aSs
qZl��17
Applicant/Agent's Si nature
9
Applicant/Agent's Printed Name
(Agent's signature is valid only if an authorization letter from the applicant
Date
is provided.)
Page 10 of 10

Franklin County, NC
Parcel ID
030579
Owner Name
CASS PHILIP
Owner Mailing Address
3541 ONEONTA AVE
RALEIGH, NC 27604
General Information
Approximate Acres
Land Value
Zoning
LAST SALE
Date
6/9/2017
k owce� MGP
Detailed Parcel Report
Friday, September 1, 2017
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3.01 Map Reference
$35,000.00 Building Value $0.00
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Price Book Page
$29,000.00 2099 407
WARNING: THIS IS NOT A SURVEY.
I,F�a A i n Franklin County This map is prepared for the inventory of real property found within this jurisdiction, and is
Tax/GIS compiled from recorded deeds, plats, and other public records and data. Users of this map
Ounty 215 E. Nash Street are hereby notified that the aforementioned public primary information sources should be
Louisburg, NC 27549 consulted for verification of the information contained on this map. The County and mapping
A RtsearcbTriangieRrgion Community company assume no legal responsibility for the information contained on this map.

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