20180317 Ver 1_401 Application_20180318

DWR
Division of water Resources
Pre -Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
January 31, 2018 Ver 2.3
Please note: fields marked with a red asterisk below are required. You will not be able to submit the form until all mandatory questions are answered.
Also, if at any point you wish to print a copy of the E -PCN, all you need to do is right -click on the document and you can print a copy of the form.
Below is a link to the online help file.
https:lledocs.deq.nc.govMaterResources101edocl6247041PCN%20Help%20File%202018-1-30.pdf
A. Processing Information
County (or Counties) where the project is located:*
Mecklenburg
Is this project a public transportation project?*(?)
f Yes f• No
1a. Type(s) of approval sought from the Corps:*
V Section 404 Permit (wetlands, streams and waters, Clean Water Act)
r Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
1b. What type(s) of permit(s) do you wish to seek authorization?*
r% Nationwide Permit (NWP)
r Regional General Permit (RGP)
Nationwide Permit (NWP) Number: 12 - Utility Lines
NWP Number Other:
List all NW numbers you are applying for not on the drop dow n list.
1c. Type(s) of approval sought from the DWR:*
check all that apply
W 401 Water Quality Certification - Regular r 401 Water Quality Certification - Express
F Non -404 Jurisdictional General Permit r Riparian Buffer Authorization
*
1d. Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification:
For the record only for Corps Permit:
C Yes O No
O Yes O No
1e. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
V so, attach the acceptance letter from rr tigation bank or in -lieu fee program
r Yes F No
1f. Is the project located in any of NC's twenty coastal counties?*
r Yes r No

1h. Is the project located in a designated trout watershed?*
f Yes r No
Link to trout information: http://v wv.saw.usace.army.mil/Missions/Regulatory-Permit-Prograni/Agency-Coordination/Trout.aspx
B. Applicant Information
1a. Who is the Primary Contact?*
Tony Martin, PE
1b. Primary Contact Email:*
Anthony. [e-mail]
1c. Primary Contact Phone:*
[phone]
1d. Who is applying for the permit?
F- Owner V Applicant (other than owner) V Agent/Consultant
(Check all that apply)
2. Owner Information
2a. Name(s) on recorded deed:
Please see the Construction Plan Sheets
2b. Deed book and page no.:
2c. Responsible party:
(for Corporations)
Tony Martin, PE Engineering Project Manager
2d. Address
Street Address
Address Line 2
CKY
F bstal / Zip Code
2e. Telephone Number:
(xxx)xxx-xxxx
[phone]
2f. Fax Number:
(XXX)XXX-XXXX
2g. Email Address:*
Anthony. [e-mail]
3. Applicant Information (if different from owner)
3a. Applicant is:
f Agent
r Other Charlotte Water
If other please specify.
3b. Name:
Tony Martin, PE Engineering Project Manager
3c. Business Name:
(if applicable)
Charlotte Water
State/ Rovince / Fbgion
Country

3d. Address
Street Address
5100 Brookshire Blvd.
Address Line 2
City
State/ Province/ Region
Charlotte
NC
Pbstal / Zip ( ode
Country
28216
USA
3e. Telephone Number:
[phone]
()=)xux-xxxx
3f. Fax Number:
(XXX)XXX-XXXX
Email Address:*
Anthony. Marti [e-mail]. nc. us
4. Agent/Consultant (if applicable)
4a. Name:
Aliisa Harjuniemi
4b. Business Name:
(if applicable)
Carolina Wetland Services. Inc.
4c. Address
Street Address
550 E Westinghouse Blvd.
Address Line 2
City
State/ Province/ Region
Charlotte
NC
Postal / Zip Code
Country
28273
USA
4d. Telephone Number:
[phone]
(XXX)XM-XXXX
4e. Fax Number:
4f. Email Address:*
[e-mail]
Agent Authorization Letter*
Pease provide the Agent Authorization Letter if you are subnitting this docurrent.
Agent Certification of Authorization_021518.pdf 18.14KB
PLETYPE MHr BE PDF
C. Project Information and Prior Project History
1. Project Information
1a. Name of project:*
Four Mile Creek Sevuer Outfall Replacment
1b. Subdivision name:

(if appropriate)
1c. Nearest municipality/ town:*
Matthews
1d. Driving directions*
V it is a new project and can not easily be found in a GPS napping system Rease provide directions.
Located northeast of the Fair Forest Drive and Grayfox Lane intersection in Matthews, North Carolina (Figures 1 and 2, attached).
2. Project Identification
2a. Property Identification Number:
(tax RN or parcel ID)
multiple, please see the construction plan sheets
2b. Property size:
(in acres)
35 acres
2c. Project Address
Street Address
Located northeast of the Fair Forest Drive and Grayfox Lane intersection in Matthews, North Carolina (Figures 1 and 2, attached).
Address Line 2
City
State / Rovince / Pagion
Matthews
NC
Postal / Zip Code
Country
28105
USA
2d. Site coordinates in decimal degrees
Please collect site coordinates in decimal degrees. Use between 4-6 digits (unless you are using a survey -grade GPS device) after the decimal place as
appropriate, based on how the location was determined. (For example, most mobile phones with GPS provide locational precision in decimal degrees to
map coordinates to 5 or 6 digits after the decimal place.)
Latitude:* Longitude:*
35.094069 -80.728781
ex: 34.208504 -77.796371
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Four Mile Creek
3b. Water Resources Classification of nearest receiving water:*
Class C
Surface Water Lookup
3c. What river basin(s) is your project located in?*
Catawba
River Basin Lookup
4. Project Description
4a. 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 project area consists of forested upland areas, maintained and unmaintained open areas, and forested
riparian areas (Figure 3, attached). The vegetation communities present within the project limits consist of
degraded Piedmont Alluvial forest and maintained urban areas. The surrounding areas consist of single family
residential developments.
According to the United States Department of Agriculture - Natural Resources Conservation Service (USDA-NRCS)
Web Soil Survey of Mecklenburg County (Figure 4) and the most recently published NRCS Soil Survey for
Mecklenburg County (Figure 5), current and historic on-site soils consist of Cecil sandy clay loam (8 to 15 percent
slopes, moderately eroded [CeD21), Enon sandy loam (2 to 8 and 8 to 15 percent slopes [EnB and EnD]), Helena
sandy loam (2 to 8 percent slopes [HeB]), Mecklenburg fine sandy loam (8 to 15 percent slopes [MeD]), Monacan
loam (0 to 2 percent slopes, frequently flooded [MO]), and Wilkes loam (15 to 25 percent slopes [WkE]). Of the on-
site soils, Monacan loam is listed on the Web Soil Survey Hydric Soils List as containing hydric inclusions.
A review of the National Wetlands Inventory (NWI) GIS layer depicts one potential wetland feature within the project
limits (Figure 6, attached).
4b. Attach an 8 1/2 X 11 excerpt from the most recent version of the USGS topographic map indicating the location of the project site. (for
DWR)
Click the upload button or drag and drop files here to attach document
Figure2_USGS.pdf
File type crust be pdr
502.26KB
4c. Attach an 8 1/2 X 11 excerpt from the most recent version of the published County NRCS Soil Survey map depicting the project site.
(for DWR)
Click the upload button or drag and drop files here to attach document
Figure4_CurrentSoils.pdf 240.18KB
File type rrust be pdt
4d. List the total estimated acreage of all existing wetlands on the property:
0.877 ac.
4e. List the total estimated linear feet of all existing streams on the property:
(internittent and perennial)
5,156 If perennial, 205 If intermittent
4f. Explain the purpose of the proposed project:*
The purpose of the project is to replace the 30 -year-old deteriorating and undersized Four Mile Creek Sewer. The
existing 8 -inch diameter Four Mile Creek Sewer is over 30 years old. The condition of the existing pipes and
manholes has degraded over time and much of the system needs replacement or rehabilitation. Furthermore, the
sewer does not have sufficient hydraulic capacity to convey the existing and projected flows within the basin that it
serves. Either of these factors could lead to a failure of the sewer, which would result in the overflow of raw
sewage into Four Mile Creek and onto the backyards of adjacent property owners. This situation will be alleviated
by the replacement or rehabilitation of existing manholes and by the replacement of an existing 8 -inch sewer with a
new 16 -inch sewer.
4g. Describe the overall project in detail, including indirect imapacts and the type of equipment to be used:*

The existing 8 -inch diameter Four Mile Creek Sewer will be replaced with 16 -inch diameter (5,351 If) and 8 -inch
diameter (467 If) sewers. Under Nationwide Permit (NWP) No. 12, unavoidable wetland impacts associated with the
replacement of the Four Mile Creek Sewer include the mechanized clearing of forested wetlands and temporary
disturbance of herbaceous wetlands, totaling 0.243 acre of wetland impacts. Stream impacts for this project
include five stream crossings and bank stabilization, totaling 492 linear feet of temporary stream impacts. The
construction plans depicting the proposed impacts are included as Sheets 3-8 and the Stream Bank Stabilization,
Temporary Stream Crossing, and Erosion Control details are included as Sheets D1 -D6. The proposed impacts
are described in detail below.
Stream Impacts
Of the 492 If of total stream impacts, 189 If of temporary impacts (S1 -S5) will occur due to five stream sewerline
crossings. All stream impacts will be temporary open trench stream crossings. The temporary impacts were
calculated based on the width of the construction corridor and will include the temporary dewatering devices
required in order to construct the sewerline in dry, temporary stream crossing, sewerline installation, and bank
stabilization. Temporary stream crossings will be returned to their original grade and stabilized (Sheet D6). Riprap
will be keyed at the level of existing grade. The number of crossings has been kept to the minimum necessary and
no permanent crossings are required. The utility crossings will not result in any loss of waters of the U.S.
Restoration of Streams
All areas disturbed by the work shall be re -graded to leave the area in a smooth condition, sloped for drainage
and stabilized. Additional bank stabilization will be required in areas where the easement is abutting the creek. The
additional bank stabilization totals 303 linear feet of stream bank (S6 -S8). All impacted stream banks shall be
permanently stabilized with rip rap below the ordinary high water mark and seeding and mulch with woven coir net
above the ordinary high water mark. Stabilized stream banks shall include all bank areas disturbed by construction
activities. Banks shall be restored to their original contours. Riparian seed mix will be placed on stream slope and
top of bank. See Detail Sheet D5 in the construction plan sheets for more information (attached).
Wetland Impacts
Unavoidable impacts to jurisdictional wetlands total approximately 0.243 acre. Impacts are the result of clearing of
forested wetlands to facilitate replacement of the existing sewer line and temporary disturbance of existing
herbaceous wetlands. Permanent impacts to on-site wetlands total 0.008 acre and are the result of a permanent
maintained easement through Wetland CC in which forested wetland will be meachanically cleared and
permanently converted to maintained herbaceous wetland. Approximately 0.013 acre of temporary forested
wetland impacts will be mitigated through reforestation (see restoration of wetlands below). The remaining 0.222
acre of disturbed area consists of wetlands within an existing sewerline easement and are already maintained as
herbaceous wetland. Wetland crossed to access the new easements will be matted with timber mats. All impacted
areas will be returned to their pre -construction grades.
Restoration of Wetlands
All impacted areas will be returned to their pre -impact grades; there will be no permanent fill in jurisdictional areas.
All cleared forested wetlands, with the exception of the permanent maintained easement, will be reforested with
native bare -root trees or live stakes, as appropriate. Trees will be planted in naturalistic drifts at an average
spacing of 10 -foot centers for an overall average density of 450 trees per acre. If containerized plants (1 gallon)
are used, they shall be a minimum of one year old with a height of 12-24 inches tall, with a root collar diameter
(base of stem) of 1/4 - 3/8 inches. Areas to be reforested shall be hand cleared to remove construction debris and
rocks (larger than 6 inches in any dimension). Plants shall be planted in random mixtures of species, which may
include the following species:
Trees
ironwood (Carpinus caroliniana)
box elder (Acer negundo)
willow oak (Quercus phellos)
green ash (Fraxinus pennsylvanica)
Shrubs
Silky dogwood (Cornus amomum)
Elderberry (Sambucus canadensis)
Silky willow (Salix sericea)
Beauty berry (Callicarpa americana)
A minimum of four tree species and two shrub species should be selected to revegetate the appropriate areas.
An excavator will be used for digging trenches and installing sewer pipe and manholes. A backhoe loader will carry
pipe, manholes and bedding materials to the work area and will be used for backfilling trenches and final grading
operations. Pickup trucks will be used to carry tools, equipment and personnel to the work area.
4h. Please upload project drawings for the proposed project.

aick the upload button or drag and drop files here to attach document
Construction Plan Sheets.pdf 5.48MB
File type rrust be pdf
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes r No r Unknown
Comments:
On August 8-10, and November 10, 2017, Carolina Wetland Services, Inc.
(CWS) scientists Michelle LaForge, Project Scientist, and Dan Zurlo, Staff
Scientist II, delineated on-site jurisdictional waters of the U.S., including
wetlands. NCDEQ Stream Classification Forms representative of
jurisdictional stream channel are attached (SCP1-SCP4). Wetland
Determination Data Forms representative of on-site jurisdictional wetland
areas are attached as DP1-D2 and DP4-DP8. A Wetland Determination
Data Form representative of on-site non -jurisdictional upland areas is
attached as DP3. Locations of collected data points for stream classification
points and the Wetland Determination Data Forms are depicted on Figure 7
(attached). Photographs 1-12 are representative of the on-site jurisdictional
features and current site conditions.
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
r Preliminary r Approved r Unknown C N/A
Corps AID Number:
Exanple: SAM2017-99999
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Michelle LaForge and Dan Zurlo
Agency/Consultant Company:
Other:
Carolina Wetland Services, Inc.
5d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
5d1. Jurisdictional determination upload
Caickthe upload button or drag and drop files here to attach docurrent
File type rrust be FDF
6. Project History
6a. Have permits or certifications been requested or obtained for this project (including all prior phases) in the past?*
r Yes f No f• Unknown
7. Future Project Plans
7a. Is this a phased project?*
r Yes r No
Are any other NWP(s), regional general permit(s), or individual permits(s) used, or intended to be used, to authorize any part of the
proposed project or related activity? This includes other separate and distant crossing for linear projects that require Department of the
Army authorization but don't require pre -construction notification.
D. Proposed Impacts Inventory
1. Impacts Summary

Ia. Where are the impacts associated with your project? (check all that apply):
V Wetlands V Streams -tributaries r Buffers
F Open Waters r Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a. Site # - Reason for impact* 2b. Impact type * 2c. Type of wetland*
W1 - Wetland Sewerline
T
Crossing
Permanent (P) or
lvbp label (e.g. Fbad Crossing 1 - CUK ert,
Terrporary (1)
dewatering, etc)
0.008
W2 - Wetland Sewerline
T
Crossing
Permanent (P) or
Nbp label (e.g. Fbad Crossing 1 - Culvert,
Terrl—ary (1)
dewatering, etc)
W3 - Wetland Sewerline
T
Crossing
Fbrrrenent (P) or
N13p label (e.g. Fbad Crossing 1 - Culvert,
Temporary (1)
dewatering, etc)
W4 - Wetland Sewerline
P
Crossing
Fbrrranent (P) or
W label (e.g. Fbad Crossing 1 - Culvert,
Temporary (T)
dewatering, etc)
W5 - Wetland Sewerline
T
Crossing
Permanent (P) or
Ivbp label (e.g. Fbad Crossing 1 - Culvert,
Terrporary M
dewatering, etc)
W6 - Wetland Sewerline
T
Crossing
Fbrrranent (P) or
lvbp label (e.g. Fbad Crossing 1 - Culvert,
Temporary M
dewatering, etc)
W7 - Construction Access
T
Nbp label (e.g. Fbad Crossing 1 - Culvert,
Permanent (P) or
dewatering, etc)
Temporary M
W8 - Construction Access
T
lvbp label (e.g. Fbad Crossing 1 - Culvert,
Permanent (P) or
dewatering, etc)
Temporary (1)
2g. Total Temporary Wetland Impact
0.235
2g. Total Permanent Wetland Impact
0.008
2g. Total Wetland Impact
0.243
2h. Comments:
Headwater Forest
2d. Wetland name *2e. 2f. Type of 2g. Impact
Forested* Jurisdicition* area*
Wetland FF No Corps 0.002
(404, 10) or DAR(401, (acres)
other)
Bottomland Hardwood Wetland EE
Forest
Bottomland Hardwood Wetland CC
Forest
Bottomland Hardwood Wetland CC
Forest
Bottomland Hardwood Wetland BB
Forest
Bottomland Hardwood Wetland BB
Forest
Bottomland Hardwood Wetland AA
Forest
Bottomland Hardwood Wetland AA
Forest
No Corps 0.145
(404, 10) or DAR(401, (acres)
other)
Yes Corps 0.002
(404, 10) or DAR(401, (acres)
other)
Yes Corps 0.008
(404, 10) or DAR(401, (acres)
other)
No Corps 0.009
(404, 10) or DAR(401, (acres)
other)
Yes Corps 0.003
(404, 10) or DAR(401, (acres)
other)
No Corps
0.066
(404, 10) or DM (401,
(acres)
other)
Yes Corps
0.008
(404, 10) or DWR(401,
(acres)
other)
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. Site # - Reason for 3b.lmpact 3c. Type of impact* 3d. Stream name*
impact* type *
3f. Type of
S1 -Stream T
Other Stream A
Sewerline Crossing Permanent (F�or
Jurisdiction*
Ivbp label (e.g. Fbad Crossing 1) Temporary (_0
S2 - Stream T
Other Stream B
Sewerline Crossing Permanent (P)or
8
Nbp label (e.g. Fbad Crossing 1) Temporary (T)
S3 - Stream T
Other Stream B
Sewerline Crossing Permanent (F'tor
Nbp label (e.g. Road Crossing 1) Temporary M
0
S4 - Stream T
Other Stream B
Sewerline Crossing Permanent (P)or
3
Ivbp label (e.g. Fbad Crossing 1) Temporary (_0
S5 - Stream T
Other Stream D
Sewerline Crossing Permanent(P)or
Nbp label (e.g. Fbad Crossing 1) Temporary (T)
0
S6 - Bank T
Stabilization Stream B
Stabilization Permanent (F)or
4
Nbp label (e.g. Road Crossing 1) Temporary (1)
S7 - Bank T
Stabilization Stream B
Stabilization Permanent (F�or
Ivbp label (e.g. Fbad Crossing 1) Temporary (_0
0
S8 - Bank T
Stabilization Stream B
Stabilization Permanent(P)or
3
Map label (e.g. Fbad Crossing 1) Temporary (T)
3e. Stream
3f. Type of
3g. Stream 3h. Impact
s fe
Type*
Jurisdiction*
width* length*
Perennial
Corps
20 40
8
Perennial (PER) or
Average (feet) (linear feet)
0
intermittent (IND
0
Perennial
Corps
10 36
3
Ferennial (F$1) or
Average (feet) (linear feet)
6
interrrittent (INT)
0
Perennial
Corps
10 40
4
Perennial (FEIF� or
Average (feet) (linear feet)
0
intermittent (INF)
0
Perennial
Corps
10 39
3
Perennial (P8R) or
Average (feet) (linear feet)
9
intermittent (INF)
0
Intermittent
Corps
4 34
1
Perennial (PBR) or
Average (feet) (linear feet)
3
intermittent (INT)
6
Perennial
Corps
10 75
7
Perennial (F!3:� or
Average (feet) (linear feet)
5
intermittent (INF)
0
Perennial
Corps
10 80
8
Perennial (PER) or
Average (feet) (linear feet)
0
interrrittent (INF)
0
Perennial
Corps
10 148
1
Perennial (PBR) or
Average (feet) (linear feet)
intermittent (INT)
Al
0
** All Perennial or Intermittent streams must be verified by DWR or delegated local government
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
0
3i. Total temporarystream impacts:
492
3i. Total stream and tributary impacts:
492
3j. Comments:
Of the 492 If of total stream impacts, 189 If of temporary impacts (S1 -S5) will occur due to five stream sewerline
crossings. 303 If of additional bank stabilization will be required in areas where the easement is abutting the creek
(S6 -S8).
E. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:*

In order to avoid and minimize impacts to jurisdictional waters of the U.S., the Four Mile Creek Sewer Outfall site
was delineated and the alignment was adjusted based on the delineation results. Proper sediment and erosion
control measures will be used to minimize disturbances to downstream waters. Total width of the construction
corridor within wetlands and stream are limited to 40 linear feet. All unavoidable stream crossings will be at a near
perpendicular angle.
The number of crossings is dictated by the ebsting sewer infrastructure, easements, and topography.
Charlotte Water requests a waiver for the WGC #4133 Activity Specific Condition 2 as the easement is less than
10 feet from the stream bank in five places within this sewer replacement project. The reasons for these
adjustments are described below.
Sheet 3 between manholes EXMH-244477 and SSMH-1
The eAsting 16 -inch sewer will be lined using cured -in-place pipe lining. This is a trenchless process that is
accomplished through the e)asting upstream and downstream manhole. There will be no disturbance of the
adjoining streambank. Also, as this pipe is eAsting, there is no opportunity to relocate it further from the
streambank.
Sheet 3 between SSMH-2 and SSMH-3, Sheet 4 between SSMH-4 and SSMH-5 and Sheet 6 between SSMH-13
and SSMK14
The eAsting 8 -inch sewer will be replaced with a new 16 -inch sewer on the same alignment within 1-3 feet of
eAsting depth and at approbmately the same slope. In this way the project can make use of the original trenches
(of which a significant amount was excavated in rock), mabmize the utility of the ebsting easements, lessen the
impact on the adjoining property owners, and avoid additional wetlands.
Sheet 6, between SSMH-14 and SSMH-15:
The eAsting 8 -inch sewer pipe will be replaced with a new 16 -inch sewer pipe on a modified alignment. The
proposed location of SSM -15 was selected to provide additional separation between the temporary construction
easement and the adjoining wetland (on the South side). The temporary construction easement on the North side
was made to coincide with the top of stream bank while providing a minimum separation of 10 feet between the
edge of the pipe trench and stream bank.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*
Proper sediment and erosion control measures will be used to minimize disturbances to downstream waters. Anti -
seep collars will be installed at a ma)dmum of 150 -foot intervals for sewerline constructed within wetland areas.
Timber mats will be placed on the wetland within the access easement to protect wetlands from the construction
equipment. All work will be constructed in the dry and all temporary fill will be removed following the work.
Al of the sewer pipeline stream crossings on this project have been designed to be installed by open cut method
rather than jack and bore. As this project is primarily a removal and replacement of ebsting pipe in the same
trench, it does not lend itself to employing directional boring methods. The project is allowing the replacement of
the existing 8 -inch sewer by pipe bursting as an alternate to open cut construction between SSMH-1 and SSMH-2.
The pipe bursting method is feasible in this reach of sewer as the inverts of the ebsting 8 -inch pipe and new 16 -
inch pipe will be the same. However, as the eAsting pipe is being increased by twice the original diameter at a
(relatively) shallow depth, pipe bursting may create bulging of the ground surface along the length of the sewer.
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?
f Yes r No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
Permanent impacts are limited to 0.008 acre of wetland impacts. No permanent stream impacts are proposed. Therefore, mitigation is not
proposed at this time.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
*** Recent changes to the stormwater rules have required updates to this section .***
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection
Rules?
f Yes C No

For a list of options to meet the diffuse flow requirements, click here.
If no, explain why:
The project does not include or is adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection Rules.
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?
r Yes r No
2b. Does this project meet the requirements for low density projects as defined in 15A NCAC 02H .1003(2)?*
r Yes
r No
To look up low density requirement click here 15A NCAC 02H.1 003(2)
G. Supplementary Information
1. Environmental Documentation
1a. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?
r Yes r No
1b. 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 (North Carolina) Environmental Policy Act (NEPA/SEPA)?*
r Yes r No
Comments:*
The project does not require preparation of an environmental document pursuant to the requirements of the
National or State (North Carolina) Environmental Policy Act (NEPA/SEPA).
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification Rules (15A NCAC 2H .0500), Isolated Wetland Rules (15A NCAC 2H .1300), or
DWR Surface Water or Wetland Standards or Riparian Buffer Rules (15A NCAC 2B.0200)?
r Yes r No
2b. Is this an after -the -fact permit application?*
r Yes r No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in additional development, which could impact
nearby downstream water quality?*
r Yes r No
3b. If you answered "no," provide a short narrative description.
The project will not result in additional development.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
rYes r Nor N/A
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?
r Yes r No

5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
r Yes r No
5d. Is another Federal agency involved?*
f Yes r No
5e. Is this a DOT project located within Division's 1-8?*
r Yes r No
5f. Will you cut anytrees in order to conduct the work in waters of the U.S.?*
r Yes r No
5g. Does this project involve bridge maintenance or removal?*
r Yes r No
r Unknown
Link to the NLEB SLOPES document: http://saw-reg.usace.army.mil/NLEB/1-30-17-signed_NLEB-SLOPES&apps.pdf
5h. Does this project involve the construction/installation of a wind turbine(s)?**
r Yes r No
5i. Does this project involve (1) blasting, and/or (2) other percussive activities that will be conducted by machines, such as jackhammers,
mechanized pile drivers, etc.?*
r Yes r No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?*
To determine which protected species are listed as occurring or potentially occurring within the project vicinity and
prior to conducting the on-site field investigation, CWS consulted the United States Fish and Wildlife Service's
(USFWS) Endangered and Threatened Species and Species of Concern by County for North Carolina online
database for Mecklenburg County. In addition, CWS performed a data review using the North Carolina Natural
Heritage Program (NCNHP) Data E)plorer on February 21, 2018 to determine if any record occurrences of
federally -listed, candidate endangered, threatened species, or critical habitat are located within the project limits.
Based on the NCNHP review, there are no records of federally -protected species within the project limits or within a
mile of the project area. A copy of the NCNHP report is attached. During pedestrian survey on February 20, 2016,
CWS found no potential habitat for federally endangered species other than Northern long-eared bat (Myotis
septentrionalis).
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
r Yes r No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
hftps:llwAw.habitat.noaa.gov/protection/efh/efhmapper/
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
Link to the State Historic Preservation Office Historic Properties Map (does not include archaeological data: http://gis.ncdcr.gov/hpoweb/
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)?*
r Yes r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
A letter was forwarded to the North Carolina State Historic Preservation Office (SHPO) on January 16, 2017 to
determine the presence of any areas of architectural, historic, or archaeological significance that would be
affected by the project. CWS also consulted the SHPO online GIS service and found no historical structures,
buildings, sites, or districts within the project limits. In their response letter dated January 31, 2017, the SHPO
states that they "are aware of no historic resources which would be affected by the project". A copy of the SHPO
response letter is attached.
7c. Historic or Prehistoric Information Upload

Click the upload button or drag and drop files here to attach docurrent
SHPO Response.pdf 106.4KB
File rrust be FDF
8. Flood Zone Designation (Corps Requirement)
Link to the FEMA Floodplain Maps: https://msc.fema.gov/portal/search
8a. Will this project occur in a FEMA -designated 100 -year floodplain?*
f Yes C No
8c. What source(s) did you use to make the floodplain determination?*
FEMA Pane No. 3710448900K
Miscellaneous
Miscellaneous attachments not previously requested.
Clickthe upload button or drag and drop files here to attach document
Figures 1-7.pdf
2.69MB
NCDEQ Stream Classification Forms (SCP1-SCP4).pdf
50.75KB
NCNHP_report.pdf
982.65KB
ORM Form.pdf
132.98KB
Photopage_FourMileCreek.pdf
2.39MB
USACE Wetland Determination Data Forms (DP1-DP8).pdf
150.15KB
File mut be FDF
Signature
rJ By checking the box and signing below, I certify that:
■ I have given true, accurate, and complete information on this form;
■ I agree that submission of this PCN form is a "transaction" subject to Chapter 66, Article 40 of the INC General Statutes (the "Uniform Electronic
Transactions Act');
■ I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic
Transactions Act");
■ I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature; AND
■ I intend to electronically sign and submit the PCN form.
Full Name:*
Aliisa Harjuniemi
Signature
Initial Review
Is this project a public transportation project?* M
r Yes O No
Change only if needed.
Has this project met the requirements for acceptance in to the review process?*
t= Yes
f No
BIMS # Assigned *
20180317

Version#*
Reviewing Office*
Mooresville Regional Office - [phone]
Select Project Reviewer*
Alan Johnson:eads\adjohnson1
Is a payment required for this project?*
f No payment required
f Fee received
C Fee needed - send electronic notification
What amout is owed?*
f $240.00
G $570.00