20171445 Ver 3_401 Application_20180218

Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.4 January 2009
A.
Pre -Construction Notification (PCN) Form
Applicant Information
1. Processing
1a. Type(s) of approval sought from the Corps: Q Section 404 Permit ❑ Section 10 Permit
1 b. Specify Nationwide Permit (NWP) number: 13 or General Permit (GP) number:
1c.
1 d.
1 e.
Has the NWP or GP number been verified by the Corps? ❑X Yes ❑ No
Type(s) of approval sought from the DWQ (check all that apply):
Q 401 Water Quality Certification — Regular ❑ Non -404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
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 NX No ❑X Yes ❑ No
1f.
1g.
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.
Is the project located in any of NC's twenty coastal counties. If yes, answer 1h N Yes ❑X No
below.
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes ❑X No
2.
Project Information
2a.
Name of project:
Tarboro Stream Bank Restoration
2b.
County:
Edgecombe
Tarboro
2c.
Nearest municipality / town: v
2d.
Subdivision name:
n/a
2e.
NCDOT only, T.I.P. or state project no:
n/a
3.
Owner Information
3a.
Name(s) on Recorded Deed:
Town of Tarboro
3b.
Deed Book and Page No.
1646/0855
3c.
Responsible Party (for LLC if
applicable):
Town of Tarboro
500 N. Main Street
3d.
Street address:
3e.
City, state, zip:
Tarboro, NC 27886
3f.
Telephone no.:
252.641.4250
3g.
Fax no.:
252.641.4254
3h.
Email address:
[e-mail]
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)
Derrick Smith, PE
The Wooten Company
301 W. 14th Street
Greenville, NC 27834
5a. Name:
5b. Business name
(if applicable):
5c. Street address.-
5d. City, state, zip.
5e.
Telephone no..
252.757.1096
-- .
252.757.3221
[e-mail]
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):
4728-93-8822
1 b.
Site coordinates (in decimal degrees):
ILatitude: 35.893702 Longitude: -77.55
1 c.
Property size:
10 acres
2.
Surface Waters
2a.
Name of nearest body of water to proposed project:
Holly Creek
2b.
Water Quality Classification of nearest receiving water:
C; NSW
2c.
River basin: Tar -Pamlico
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:
Site generally consists of unstable stream bank with adjacent grass vegetation.
3b.
List the total estimated acreage of all existing wetlands on the property: 0.5
3c.
List the total estimated linear feet of all existing streams (intermittent and perennial) on the property: 1,200
3d.
Explain the purpose of the proposed project:
A portion of Holly Creek was washed out during hurricane Mathew exposing a sanitary sewer manhole. The project will stabilize the stream bank.
3e.
Describe the overall project in detail, including the type of equipment to be used:
The
project will reestablish 100 feet of stream bank with rip rap. The equipment used will be an excavator and hand tools.
4.
Jurisdictional Determinations
4a.
Have jurisdictional wetland or stream determinations by the
❑ Yes ❑X No ❑ Unknown I
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past?
Comments:
......... .
❑ Preliminary ❑ Final
4b.
....
If the Corps made the jurisdictional determination, what type
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 El Yes ❑X 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?
❑ Yes ❑X No
6b. If yes, explain.
Page 3 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 ❑X Streams — tributaries ❑X 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 impact
Type of wetland
Forested
Type of jurisdiction
Area of
number
Permanent (P) or
Temporary LTA
Corps (404,10) or
DWQ (401, other)
impact
(acres)
Choose one
Yes/No
Yes/No
-
-
W1
Choose one
Choose one
W2
Choose one
--
W3
......
Choose one
Choose one
Yes/No
-
W4
Choose one
Choose one
Choose one
Choose one
Yes/No
Yes/No
W5
_
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)
Corps
(feet)
20
feet)
100
S1 P
-
Stabilization
Holly Creek
PER
S2
Choose one
S3
Choose one
_
S4 -
Choose one
S5
Choose one
_
S6
Choose one
3h. Total stream and tributary impacts
100
3i. Comments:
This project is to stabilize the bank of Holly Creek due to hurricane Mathew
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 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
01
Choose one l
Choose
02
Choose one
Choose
03
Choose one
Choose one
Choose
Choose
04
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. . 5e.
Pond ID number Proposed use or Wetland Impacts (acres) Stream Impacts (feet) Upland
purpose of pond (acres)
FdIF
Flooded Filled Excavatedlooded 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 vou MUST fill out Section D of this form.
6a. Project is in which protected basin? ❑ Neuse ❑X Tar -Pamlico ❑ Catawba ❑ Randleman ❑ 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
bank stabilization
__
Holly Creek
........
No
1,000
500
B2
.............
Yes/No
B3 -
Yes/No
B4 -
Yes/No
B5 -
Yes/No
B6 -
Yes/No
6h. Total Buffer Impacts:
1,000
500
6i. 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 project will stabilize the stream bank that was washed out during hurricane Mathew. Construction will take place during periods of low flow to
reduce the impacts in the creek.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
The project will be completed during periods of low flow to minimize the impacts to the creek. All equipment and materials will be stored outside the
buffers when not in use.
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 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): ❑ DWQ ❑ Corps
❑ Mitigation bank
2c. If yes, which mitigation option will be used for this ❑ Payment to in-lieu fee programproject?
❑ 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. ❑ 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
buffer mitigation?
❑ Yes ❑X 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.
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
I 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
1a.
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?
1 b.
If yes. then is a diffuse flow plan included? If no, explain why.
Project will stabilize the stream bank that washed out during hurricane Mathew. The disturbance will be
temporary.
❑ Yes ❑X No
2.
Stormwater Management Plan
2a.
What is the overall percent imperviousness of this project?
0
2b.
Does this pr9ject require a Stormwater Management Plan?El
Yes ❑X No
2c.
If this project DOES NOT require a Stormwater Management Plan, explain why:
Project will only stabilize an eroded stream bank along Holly Creek
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?
1
3.
Certified Local Government Stormwater Review
3a.
In which local overnme it's 'urisdiction is this �ct?
❑ Phase II
3b.
Which of the following locally -implemented stormwater management programs
❑ NSW
apply (check all that apply):
❑ USMP
❑ Water Supply Watershed
❑ Other:
I
3c.
Has the approved Stormwater Management Plan with proof of approval been
❑Yes ❑ No
attached?
----------------
4. DWQ Stormwater Program Review
❑Coastal
4a.
Which of the following state -implemented stormwater management programs apply
counties
❑HQW
❑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 ❑x 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 El Yes ❑X 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
letter.) ❑ Yes ❑ No
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, E] Yes ❑X No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. Is this an after -the -fact permit application?
❑X Yes
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
The erosion was endangering a public utility that conveys raw sewage and required immediate repair.
3. Cumulative Impacts (DWQ Requirement)
❑ No
3a. Will this project (based on past and reasonably anticipated future impacts) result in ❑ Yes ❑X 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 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 El Yes
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act ❑ Yes
impacts?
5c. If yes, indicate the USFWS Field Office you have contacted.
❑X No
❑X No
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
US Fish and Wildlife Service website
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat? 1 ❑ Yes
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
Natural Heritage Program website
❑X No
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 X❑ 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?
State Historic Preservation Office website
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA -designated 100 -year floodplain? ❑X Yes ❑ No
8b. If yes, explain how project meets FEMA requirements:
Project will stabilize the stream bank of Holly Creek that was washed out during hurricane Mathew
8c. What source(s) did you use to make the floodplain determination?
North Carolina Flood Risk Information System website
Derrick Smith, PE
Applicant/Agent's Printed Name
Applicant/Agent's Signature
(Agent's signature is valid only if an authorization
letter from the applicant is provided.)
Page 10 of 10
Date

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WILSON STREET - HOLLY CREEK
STREAM RESTORATION
AS NOTED
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Dial 811 or 1-800-632-4949, or visit www.nc8ll.org
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NOTES:
1. FOR AREAS OF EARTH BACKFILL, POSTS SHALL BE SET AT DEPTHS OF 4'-0" MIN.
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2. PROVIDE ADEQUATE EXCAVATION AHEAD OF SILT FENCE TO ACT AS A
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3. CONTRACTOR SHALL MAINTAIN AND REMOVE BUILT UP SEDIMENT ON
FENCE AT PERIODIC INTERVALS OR AS DIRECTED BY INSPECTOR.
4. CONTRACTOR MAY USE ALTERNATE MATERIAL OR METHOD
UPON APPROVAL FROM ENGINEER.
4 SILT FENCE
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40
35
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SEEDING SCHEDULE
SEED: THE MIXTURE OF SEED IN ALL DISTURBED AREAS INCLUDING NCDOT
RIGHTS-OF-WAY SHALL BE THE FOLLOWING:
1. SEPT 1 -APRIL 1 NCDOT ONLY
75 POUNDS/ACRE KENTUCKY 31 FESCUE
50 POUNDS/ACRE BAHIAGRASS (WILMINGTON, IF AVAILABLE,
PENSACOLA OTHERWISE)
2. APRIL 1 - SEPT 1 NCDOT ONLY
75 POUNDS/ACRE BAHIAGRASS (WILMINGTON, IF AVAILABLE,
PENSACOLA OTHERWISE)
50 POUNDS/ACRE KENTUCKY 31 FESCUE
35 POUNDS/ACRE BROWNTOP MILLET OR SORGHUM SUDAN HYBRIDS
3. WHERE A "TURF° TYPE GRASSED AREA IS REQUIRED THE FOLLOWING
MIXTURE SHALL BE USED:
20 POUNDSIACRE COMMON BERMUDAGRASS (UNHULLED)
70 POUNDS/ACRE KENTUCKY 31 FESCUE
A. IF SEEDING OCCURS BETWEEN THE MONTHS OF NOVEMBER
AND FEBRUARY, RYE GRAIN SHALL BE PROVIDED IN ADDITION
TO THE ABOVE AT A RATE OF 25 POUNDS/ACRE.
ALL SEEDED AREAS SHALL BE CULTIPACKED TO FIRM SEED BED AND
COVER SEED. SHOULD THE PERMANENT SEED NOT GERMINATE AND PRODUCE
A STAND OF GRASS, THE AREAS SO EFFECTED SHALL BE RESEEDED UNTIL
A PERMANENT STAND IS ESTABLISHED.
3 SEEDING SCHEDULE
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DESIGNED BY:
DCS
DRAWN BY:
DRS
CHECKED BY:
DCS
PROJECT NO.:
2204 - DY
DATE:
OCTOBER 2017
SCALE:
HORZ.:1'= 19
VERT.: 1" =1'
SHEET