20180511 Ver 1_401 Application_20180418

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://edocs.deq.nc.govMaterResources/0/edocl6247041PCN%20Help%20File%202018-1-30.pdf
A. Processing Information
County (or Counties) where the project is located:*
Franklin
Is this project a public transportation project?*
f Yes f• No
This is any publicly funded by nunicipal,state or federal funds road, rail, airport transportation project.
1a. Type (s) of approval sought from the Corps:*
V Section 404 Permit (wetlands, streams and waters, Clean Water Act)
F Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
1b. What type(s) of permit(s) do you wish to seek authorization?*
IJ Nationwide Permit (NWP)
r Regional General Permit (RGP)
r Standard (IP)
This form may be Corps to initiate the standard/individual permit process. Please contact your Corps representative for submittal of standard permits.
All required items that are not provided in the E -PCN and be added to the miscellaneous upload located at the bottom of this form.
Nationwide Permit (NWP) Number: 29 - Residential Developments
NWP Number Other:
List all IWV nurrbers you are applying for not on the drop down list.
1c. Type(s) of approval sought from the DWR:*
check all that apply
IJ 401 Water Quality Certification - Regular r 401 Water Quality Certification - Express
F Non -404 Jurisdictional General Permit IJ Riparian Buffer Authorization
r Individual Permit
*
1d. Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification:
O Yes O No
For the record only for Corps Permit: 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
r Yes r No
Acceptance Letter Attachment
Click the upload button or drag and drop files here to attach docurrent
letter from NCDMS for Oak Park.pdf 78.63KB
FILEIYP EMHrBEPDF
1f. Is the project located in any of NC's twenty coastal counties?*
f Yes r No
1h. Is the project located in a designated trout watershed?*
r Yes r No
Link to trout information: http://v wv.saw.usace.army.mil/Missions/Regulatory-Permit-ProgranVAgency-Coordination/Trout.aspx
B. Applicant Information
1a. Who is the Primary Contact?*
Sean Clark
1b. Primary Contact Email:*
[e-mail]
1c. Primary Contact Phone:*
(xxx)xxx-xxxx
[phone]
1d. Who is applying for the permit?
V Owner r Applicant (other than owner) r Agent/Consultant
(Check all that apply)
2. Owner Information
2a. Name(s) on recorded deed:
2 Gen Holdings, LLC
2b. Deed book and page no.:
DB 1882; DP 312 16, DB 016935; DP 00543
2c. Responsible party:
(for Corporations)
Earl Dickinson
2d. Address
Street Address
1207 Roseneath Road
Address Line 2
aty
Richmond
Postal / Zip Code
23230
2e. Telephone Number:
(xxx)xxx-xxxx
[phone]
2f. Fax Number:
(XXX)XXX-XXXX
2g. Email Address:*
[e-mail]
State / Province / Region
VA
Country
Chesterfield

C. Project Information and Prior Project History
1. Project Information
1a. Name of project:*
Oak Park
1b. Subdivision name:
(if appropriate)
Oak Park
1c. Nearest municipality /town:*
Franklinton / Youngsville
1d. Driving directions*
ff it is a new project and can not easily be found in a CPS rrapping system Please provide directions.
Turn east onto Bert Wilson Road off of US 1 Hwy and continue approximately 1.84 miles. Bert Wilson Road becomes Oak Park Blvd east of
it's intersection with Hicks Road. The subject property is east and south of Oak Park Blvd.
2. Project Identification
2a. Property Identification Number:
(tax RN or parcel ID)
1864-13-4291,1864-44-0246
2b. Property size:
(in acres)
+/- 258.11 acres
2c. Project Address
Street Address
Hicks Road and 975 Hicks Road
Address Line 2
City State/ Province/ Region
Franklinton & Youngsville (property is divided) NC
Rbstal / Zip Code Country
27596 Franklin
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:*
35.656724° N 78.839610° W
ex: 34.208504 -77.796371
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Cedar Creej
3b. Water Resources Classification of nearest receiving water:*
C; NSW
Surface Water Lookup

3c. What river basin(s) is your project located in?*
Tar -Pamlico
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 Site is currently a mix of pasture land on the majority of the site and forested areas along the drainages
(streams and wetlands). Municipal sewer lines are also present on the Site. The site is surrounded on all sides by
residential development and has an existing road stub at western property line from the existing subdivision. A
high school is located east of the Site.
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
4 - Figurel - USGS - R.pdf
File type mist be pdf
1.51 MB
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 docurrent
5 - Figure2 - Soils - R.pdf 2.53MB
File type rust be pdf
4d. List the total estimated acreage of all existing wetlands on the property:
34.68
4e. List the total estimated linear feet of all existing streams on the property:
(intermittent and perennial)
11.107
4f. Explain the purpose of the proposed project:*
The purpose of the proposed project is to construct a residential subdivision and associated utilities to meet the
demand for housing in this part of Franklin County
4g. Describe the overall project in detail, including indirect imapacts and the type of equipment to be used:
The overall project is a single-family residential subdivision that consists of 599 -detached residential lots.
Residential streets will connect to existing adjacent roads in the area. The proposed impacts will result from road
construction, lot fill, and sewer line construction. Utilities for the proposed project will connect to existing utility lines
adjacent to the proposed project boundaries. Heavy equipment typically used for utility installation projects (e.g.
back hoes, bull -dowers, etc) will be utilized.
4h. Please upload project drawings for the proposed project.
Click the upload button or drag and drop files here to attach docunent
File type mist be pdf
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the propertyor proposed impact areas?*
r Yes f No r Unknown
Comments:
Wetlands and streams were delineate by Sage Ecological Services, Inc. in
2017.
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
A site meeting was held however a PJD has not yet been issued.

5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Sean Clark & David Gainey
Agency/Consultant Company: Sage Ecological Services, Inc.
Other:
5d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
A site meeting was held with Mr. Andy Williams of the USACE on December 5, 2017.
A site meeting was held with NCDWR on October 13, 2017 and a letter (NBRRO# 17-352) issued on October 18, 2017.
5d1. Jurisdictional determination upload
Click the upload button or drag and drop files here to attach docurrent
NCDWR Buffer Determination Letter (NBRRO #17-352) for Oak Park.pdf 4.96MB
File type mist 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 C No r 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
1a. Where are the impacts associated with your project? (check all that apply):
V Wetlands W Streams -tributaries V 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* 2d. Wetland name *2e. 2f. Type of 2g. Impact
Forested* Jurisdicition* area*
Inset C P NON-NCWAM TYPES Wetland WX No Both 0.079
Ivhp label (e.g. Fdnad Crossing 1 - Q lvert, F2rmanent (P) or (404, 10) or DAR (401, (acres)
dewatering, etc) Temporary (T) other)
2g. Total Temporary Wetland Impact
0.000
2g. Total Permanent Wetland Impact
0.079
2g. Total Wetland Impact
0.079
2h. Comments:
Lot fill is required in this area due to steep slopes.
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. Reason for impact*3b.lmpact 3c. Type of impact*3d. Stream name* 3e. Stream 3f. Type of 3g. Stream 3h. Impact
type* Type* Jurisdiction* width* length*
S1 Inset B P Culvert UT to Cedar Creek Intermittent Both 3 108
ivbp label (e.g. Road Grossing Ferrrenent (P) or Perennial (FffP� or Average (linear feet)
1) Tenporary (T) intermittent (INT) (feet)
** All Perennial or Intermittent streams must be verified by DWR or delegated local government
3i. Total jurisdictional ditch impact in square feet:
0
31. Total permanent stream impacts:
108
3i. Total temporary stream impacts:
0
3i. Total stream and tributary impacts:
108
3j. Comments:
6. Buffer Impacts (for DWR)
If project will impact a protected riparian buffer, then complete the chart below. Individually list all buffer impacts below
6a. Project is in which protect basin(s)?*
Check all that apply.
F Neuse rJ Tar -Pamlico
F Catawba Randleman
F' Goose Creek r- Jordan Lake
F Other
6b. Impact Type *
6c. Per or
Temp*
Inset A (Allowable)
P
Location and Bcenpt, Allowable, allowable w/
Fernanent (P) or
rni igation
Tenporary (T)
Inset B -Road (allowable
P
w/mitigation)
Fernanent (P) or
Location and Bcenpt, Mlow able, a lovable w/
Tenporary (T)
mitigation
Inset B -driveway (allowable
P
w/mitigation)
Fern -anent (P) or
Location and Bcenpt, Mlow able, allowable w/
Tenporary (T)
mitigation
6h. Total buffer impacts:
Zone 1
Temporary impacts: 0.00
Zone 1
Permanent impacts: 8,664.00
6d. Stream name * 6e. Buffer mitigation 6f. Zone 1 6g. Zone 2
required?* impact* impact*
UT to Cedar Creek No 1,014 1,305
(square feet) (square feet)
UT to Cedar Creek Yes 7,650 6,696
(square feet) (square feet)
UT to Cedar Creek Yes
Zone 2
0.00
Zone 2
8,404.00
0 403
(square feet) (square feet)

Zone 1 Zone 2
Total buffer impacts: 8,664.00 8,404.00
6i. Comments:
Supporting Documentation - i.e. Impact Maps, Plan Sheet, etc.
nick the upload button or drag and drop files here to attach docurrent
472-03 Oak Park Impact Maps.pdf 1.59MB
File mast be FDF
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:*
The proposed sewer crossing has been designed to be an aerial crossing which will completely avoid stream
impacts.
Proposed subdivision roads were aligned and eliminated so as to avoid impacts to streams and wetlands as much
as possible while avoiding ebsting utilities and property line buffers. Two road crossings were eliminated from the
original site plan so that only one road crossing is required on the 258.11 -acre site.
The proposed road crossing in Inset B was placed so as to avoid a large wetland and stream area downstream.
Although the road crossing proposed is not perpendicular, the crossing was designed to curve slightly to reduce
the stream impacts. Headwalls at the road crossing were also used to reduce the stream impact.
Lot fill has been reduced to a single location (Inset C) and is required due to steep slopes.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*
General techniques include the use of construction fencing to define the construction corridor and prevent any
accidental additional impacts. Silt fencing and temporary basins will also be used to prevent sediment runoff into
the streams and wetlands.
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:
Stream impacts have been minimized to only 108 LF resulting from a single road crossing and wetland impacts have been minimized to
0.079 acre.
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 r No
1b. All buffer impacts and high ground impacts require diffuse flow or other form of stormwater treatment. If the project is subject to a
state implemented riparian buffer protection program, include a plan that fully documents how diffuse flow will be maintained.
All Stormwater Control Measures (SCM)s must be designed in accordance with the NC Stormwater Design Manual. Associated
supplement forms and other documentation shall be provided.
What type of SCM are you providing?

r Level Spreader
r- Vegetated Conveyance (lower SHWT)
r- Wetland Swale (higher SHWT)
rJ Other SCM that removes minimum 30% nitrogen
(check all that apply)
For a list of options to meet the diffuse flow requirements, click here
Diff us Flow Documentation
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File type crust be FDF
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)?*
f Yes
r No
To look up low density requirement click here 15A NCAC 02H.1 003(2)
2c. Does this project have a stormwater management plan (SMP) reviewed and approved under a state stormwater program or state -
approved local government stormwater program?*
r Yes
f No
Fant: projects that have vested rights, exemptions, or grandfathering from state or locally implerrented stormwater programs or projects that satisfy state or locally-inplerrented storrrwater programs
through use of com7unity in -lieu programs should answer no to this question.
2d. Which of the following stormwater management program(s) apply (check all that apply):*
rJ Local Government
r State
Local Government Stormwater Programs*
rJ Phase II
r- NSW
r- USMP
r- Water Supply
Please identifywhich local government stormwater programyou are using.*
Franklin County
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
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)?
f Yes r No
2b. Is this an after -the -fact permit application?*
f 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?*
f Yes r No
3b. If you answered "no," provide a short narrative description.
No additional infrastructure is being added to the site that will facility additional growth in the area. Sewer utilities
are already present through the property and adjacent to the property.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
C Yes r Nor N/A
4b. Describe, in detail, the treatment methods and dispositions (non -discharge or discharge) of wastewater generated from the
proposed project. If the wastewater will be treated at a treatment plant, list the capacity available at that plant.
The project will tie into epsting sewer lines located on the subject property.
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 C 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 f• No r Unknown
5e. Is this a DOT project located within Division's 1-8?*
r Yes C No
5f. Will you cut any trees 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.anny.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?
The NC Natural Heritage Data Base (2018) was referenced and a report (dated March 23, 2018) was received
from NCNHP which identified Cedar Creek as a NHP Natural Area. Cedar Creek runs along the northeastern
property line.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
r Yes C No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
https://wvwv.fishe ries. noaa.gov/resource/map/essential-fish-habitat-mapper
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/hpoveb/

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?*
http://gis.ncdcr.gov/hpov,/eb/
7c. Historic or Prehistoric Information Upload
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File must 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 r No
8b. If yes, explain how project meets FEMA requirements:
No construction is planned in the areas within the floodplain along Cedar Creek.
8c. What source(s) did you use to make the floodplain determination?*
(https://msc.fema.gov/portal/search) FEMA DFIRM Panel # 3720186400K, effective April 16, 2013.
Miscellaneous
Miscellaneous attachments not previously requested.
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Site Photos.pdf 1.84MB
3 - Oak Park Agent Authorization Letter signed.pdf 318.09KB
NCNHP Report for Oak Park Residntial Subdivision (03-23-18).pdf 770.57KB
1 -Oak Park PCN Cover Letter.pdf 91.29KB
File must be FDF or ME
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 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:*
Sean Clark
Signature
Initial Review
Is this project a public transportation project?*(?)
f 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*
20180511
Version#*
Reviewing Office*
Raleigh Regional Office - [phone]
Select Project Reviewer*
Stephanie Goss:eads\szgoss
Is a payment required for this project?*
f No payment required
f Fee received
r Fee needed - send electronic notification
What amout is owed?*
r $240.00
r $570.00