20180329 Ver 1_401 Application_20180318

DWR
Division of WaaerResources
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://edoes.deq. ne.govlWaterResources/0/edocl6247041PCN%20Help%20File%202018-1-30. pdf
A. Processing Information
County (or Counties) where the project is located:
Johnston
Is this project a public transportation project?*(?)
r Yes r No
1a. Type(s) of approval sought from the Corps:*
Pr 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?*
17 Nationwide Permit (NWP)
r Regional General Permit (RGP)
Nationwide Permit (NWP) Number:
NWP Number Other:
List all MN nunbers you are applying for not on the drop dow n list.
39 - Commercial/Institutional Developments
1c. Type(s) of approval sought from the DWR:*
check all that apply
Pr 401 Water Quality Certification - Regular r 401 Water Quality Certification - Express
r Non -404 Jurisdictional General Permit r Riparian Buffer Authorization
...............................................................................................................
*
1d. Is this notification solelyfor the record because written approval is not required?
For the record only for DWR 401 Certification:
For the record only for Corps Permit:
b Yes r No
O Yes O No
1e. 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
0 Yes r 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?*
r Yes F No
Link to trout information: http://www.saw.usace.army.miI/Missions/Regulatory-Permit-Prograni/Agency-Coordination/Trout.aspx
B. Applicant Information
1a. Who is the Primary Contact?*
Wyatt Brown
1b. Primary Contact Email:*
[e-mail]
1c. Primary Contact Phone:*
(XXX)XXX-XXXX
[phone]
1d. Who is applying for the permit?
rJ Owner r Applicant (other than owner) r- Agent/Consultant
(Check all that apply)
2. Owner Information
2a. Name(s) on recorded deed:
Leslie Collins
2b. Deed book and page no.:
deed 04987 page 0793
2c. Responsible party:
(for Corporations)
2d. Address
Street Address
630 TURNAGE RD
Address Line 2
City
Smithfield
Fbstal / Zip Code
27577
2e. Telephone Number:
(xxx)xxx-xxxx
[phone]
2f. Fax Number:
(xxx)xxx-xxxx
2g. Email Address:*
[e-mail]
State / Province / Fbgion
NC
Country
Johnston
C. Project Information and Prior Project History
1. Project Information

1a. Name of project:*
Collins Property
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality/ town:
Smithfield
1d. Driving directions*
If it is a new project and can not easily be found in a GPS napping system Pease provide directions.
Beside (east side) Collins Boating (4620 US HWY 70 BUS, Smithfield)
2. Project Identification
2a. Property Identification Number:
(tax RN or parcel ID)
261300-73-7906
2b. Property size:
(in acres)
1.9 ac.
2c. Project Address
Street Address
Address Line 2
City
Postal / Zip Code
State / Province / lbgion
Country
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:*
35.48985 -78.26864
ex: 34.208504 -77.796371
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Bawdy Swamp
3b. Water Resources Classification of nearest receiving water:*
C, NSW
Surface Water Lookup
3c. What river basin(s) is your project located in?*
Neuse
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:*
Site is a wooded area located beside Mr. Collins boating sales, in the vicinity is mostly farm land.
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 docurrent
Get Maps _ topoView labeled.pdf 397.58KB
File type rrust be pdf
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)
nick the upload button or drag and drop files hereto attach docurrent
soils aerial.pdf 191.05KB
File type crust be pdf
4d. List the total estimated acreage of all existing wetlands on the property:
0.089
4e. List the total estimated linear feet of all existing streams on the property:
(intermttent and perennial)
0.00
4f. Explain the purpose of the proposed project:*
fill a very small wetland in the middle of the property so the property can be used for commercial purposes
4g. Describe the overall project in detail, including indirect imapacts and the type of equipment to be used:
There is a small wetland located approximately in the center of the wooded 2.052 acre tract Mr. Collins has
purchased to add to his existing boat retail sales yard. The wet area is a small depression that drains to a non
Neuse buffer man made drainage ditch. The filling of this marginal wet area should not have any adverse affect.
Dump trucks and a track hoe should be used to fill this wetland.
4h. Please upload project drawings for the proposed project.
dick the upload button or drag and drop files here to attach docurrent
Collins property PLS map.pdf 389.29KB
aerial labeled.pdf 789.72KB
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:
5b. If the Corps made a jurisdictional determination, what type of determination was made?
r Preliminary r Approved r Unknown r N/A
Corps AID Number:
Exarrple: SAW -2017-99999
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other
Wyatt Brown
Brown's Environmental Group, Inc
5d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.

September 20, 2016, Neuse Buffer determination, Carlos Bagley Johnston County
5d1. Jurisdictional determination upload
Cick the upload button or drag and drop files here to attach docurrent
Neuse Buffer determination. pdf 2.87MB
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?*
f Yes r No r Unknown
7. Future Project Plans
7a. Is this a phased project?*
f 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
1a. Where are the impacts associated with your project? (check all that apply):
rJ Wetlands r 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*
fill wetland P
lvbp label (e.g. Fbad Crossing 1 - Calvert, Fbrrrenent (F) or
dewatering, etc) Temporary (T)
2g. Total Temporary Wetland Impact
0.000
2g. Total Permanent Wetland Impact
0.880
2g. Total Wetland Impact
0.880
2h. Comments:
Seep
E. Impact Justification and Mitigation
1. Avoidance and Minimization
2d. Wetland name *2e. 2f. Type of 2g. Impact
Forested* Jurisdicition* area*
wetland Yes Both 0.880
(404, 10) or DVNR(401, (acres)
other)
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:*
The 0.88 acre wetland is located in the center of the 2.052 acre tract, the central location makes it difficult to
minimize the impact, we will avoid impact to surrounding trees and brush.

1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*
Silt fences will be installed to avoid sedimentation of the tract, the fill area will be seeded according to regulations.
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?
r Yes r No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
Area of impact is 0.88 acres.
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?
r Yes r No
For a list of options to meet the diffuse flow requirements, click here.
If no, explain why:
not located in area of Neuse Buffer waters.
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
f 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 .1003(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 F No
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.
area is a fill of a small wetland, large natural buffer exists between the fill area and down stream jurisdictional
waters, if development of this area is commenced an approved sediment and erosion control plan and storm water
plan will be implemented as required.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?
r Yes 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?*
r Yes r No !' Unknown
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
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?*
Natural Heritage
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?*
http://wm.habitat.noaa.gov/protection/efh/habitatmapper.htmi
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 f• No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
Dept. Cultural Resources, Historic Preservation Office , No apparent buildings or building sites on the tract
7c. Historic or Prehistoric Information Upload
Click the upload button or drag and drop files here to attach docunent
File crust 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?*
r Yes C No
8c. What source(s) did you use to make the floodplain determination?*
FEMA maps link, Zone X
Miscellaneous
Miscellaneous attachments not previously requested.
Click the upload button or drag and drop files here to attach docurrent
File rrust be FDF or IME
Signature
W 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 NC 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:*
Wyatt Brown
Signature
Initial Review
Is this project a public transportation project?*(?)
r Yes r No
Change only if needed.
Has this project met the requirements for acceptance in to the review process?*
r Yes
f No

BIMS # Assigned *
20180329
Version#*
Reviewing Office *
Raleigh Regional Office - [phone]
Select Project Reviewer*
Stephanie Goss:eads\szgoss
Is a payment required for this project?*
r No payment required
r Fee received
r Fee needed - send electronic notification
What amout is owed?
* $240.00
r $570.00