20180772 Ver 1_401 Application_20180618

Action History (UTC -05:00) Eastern Time (US & Canada)
Submit by Anonymous User 6/4/2018 4:18:33 PM (Start Event)
Accept by Montalvo, Sheri A 6/6/2018 1:21:20 PM (Non DOT Initial Review)
• The task was assigned to Montalvo, Sheri A. The due date is: June 7, 2018 5:00 PM 6/4/2018 4:19 PM

DWR
Dfutslon 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.gov/WaterResources/0/edoc/624704/PCN%20Help%20File%202018-1-30. pdf
A. Processing Information
County (or Counties) where the project is located:*
Carteret
Is this project a public transportation project?*
r Yes G No
This is any publicly funded by rrunicipal,state or federal funds road, rail, airport transportation project.
1a. Type(s) of approval sought from the Corps:*
PF 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)
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: 12 - Utility Lines
NWP Number Other:
List all WV nun-bers you are applying for not on the drop dow n list.
1c. Type(s) of approval sought from the DWR:*
check all that apply
401 Water Quality Certification - Regular r 401 Water Quality Certification - Express
r Non -404 Jurisdictional General Permit r Riparian Buffer Authorization
r Individual Permit
*
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 b No
O Yes a 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 mitigation bank or in -lieu fee program
r Yes r No
1f. Is the project located in anyof NC's twenty coastal counties?*
r Yes r No
1g. Is the project located within a NC DCM Area of Environmental Concern (AEC)?*
r Yes r No r Unknown
1h. Is the project located in a designated trout watershed?*
r Yes F No
Link to trout information: http://wwv.saw.usace.army.miI/Missions/Regulatory-Permit-Progrann/Agency-Coordination/Trout.aspx
B. Applicant Information
1a. Who is the Primary Contact?*
Andy Munday
1b. Primary Contact Email:*
[e-mail]
1c. Primary Contact Phone:*
(XXX)XXX-XXXX
1d. Who is applying for the permit?
r Owner V Applicant (other than owner) V Agent/Consultant
(Check all that apply)
2. Owner Information
2a. Name(s) on recorded deed:
Salvation Army
2b. Deed book and page no.:
DB 1582 PG 477
2c. Responsible party:
(for Corporations)
Town of Morehead City
2d. Address
Street Address
706 Arendell Street
Address Line 2
City
Morehead City
Fbstal / Zip Code
28557
2e. Telephone Number:
(XXX)XXX-XXXX
2f. Fax Number:
State / Province / Flegion
NC
Country
USA

[phone]
(xxx)xxx-xxxx
2g. Email Address:*
[e-mail]
3. Applicant Information (if different from owner)
3a. Applicant is:
r Agent
r Other
IF other please specify.
3b. Name:
Andy Munday
3c. Business Name:
(if applicable)
Stroud Engineering PA
3d. Address
Street Address
3302-C Bridges Street
Address Line 2
City
State / Province/ Fbgion
Morehead City
NC
Fbstal / Zip Code
Country
28557
USA
3e. Telephone Number:
[phone]
(XXX)XXX-XXXX
Fax Number:
[phone]
(xxx)xxx-xxxx
3g. Email Address:*
[e-mail]
.. ...... ..... ......
4. Agent/Consultant (if applicable)
4a. Name:
4b. Business Name:
(if applicable)
4c. Address
Street Address
Address Line 2
CKY State/ Province/ Region
Fbstal / Zip Code Country
4d. Telephone Number:
(XXX)XXX-XXXX
Fax Number:
(xxx)xxx-xxxx

4f. Email Address:*
[e-mail]
Agent Authorization Letter*
Rease provide the Agent Authorization Letter if you are submtting this docurrent.
Age ntAuthForm. pdf 242.6KB
RLETYPE M- ST BE RDF
..... ...... ...... ..... ...... ...... ..... ..........
C. Project Information and Prior Project History
1. Project Information
1a. Name of project:*
Church Street Drainage Project
1b. Subdivision name:
(if appropriate)
N/A
1c. Nearest municipality / town:
*
Town of Morehead City
1d. Driving directions*
IF it is a new project and can not easily be found in a GPS mapping system Rease provide directions.
At the Northeast corner of Bridges Street and Church Street.
2. Project Identification
2a. Property Identification Number:
(tax RN or parcel ID)
637616836242000
2b. Property size:
(in acres)
3.47
2c. Project Address
Street Address
N/A
Address Line 2
City
Fostal / Zip Code
State / Province / Fbgion
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 howthe 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:*
34.726936 -76.741022
ex: 34.208504 -77.796371
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*

Calico Creek
3b. Water Resources Classification of nearest receiving water:*
SC; HQW
Surface Water Lookup
3c. What river basin(s) is your project located in?*
White Oak
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 land itself is vacant; to the North there are individual lots; to the East there are apartments; to the South is
Lowe's Foods and to the West is a church.
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
USGS Map.pdf 283.08KB
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)
Click the upload button or drag and drop files here to attach docurrent
Soils Maps.pdf 527.96KB
File type rust be pdf
4d. List the total estimated acreage of all existing wetlands on the property:
0.46 acres
4e. List the total estimated linear feet of all existing streams on the property:
(intermittent and perennial)
440 If
4f. Explain the purpose of the proposed project:*
Control flooding along Church Street
4g. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:
The project includes installation of stormwater piping and catch basins along Church Street. The stormwater will be
piped along a 20' drainage easement on the Northern boundary of the Salvation Army property.
4h. Please upload project drawings for the proposed project.
Click the upload button or drag and drop files here to attach docurrent
PM1248-6 SM RO.pdf 217.75KB
PM1248-6 SH2 RO. pdf 490.78KB
File type rust be pdf
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
F 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 f N/A
Corps AID Number:

Exarrple: SAW2017-99999
SAW -2017-00331
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Larry Baldwin
Agency/Consultant Company: Land Management Group
Other:
5d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
April 4, 2018
5d1. Jurisdictional determination upload
Click the upload button or drag and drop files here to attach docurrent
PM2422 USACE SH1.pdf 181.56KB
PM2422 USACE SH2.pdf 124.2KB
File type rrust be FCF
6. Project History
6a. Have permits or certifications been requested or obtained for this project (including all prior phases) in the past?*
r Yes G No r Unknown
7. Future Project Plans
7a. Is this a phased project?*
r Yes G 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.
No
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
W Wetlands r- Streams -tributaries r- Buffers
r- 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*
Installation of storm drain T Bog Unknown No Both 0.070
piping Fbrrranent (F) or (404, 10) or DAR (401, (acres)
Wp label (e.g. Road Crossing 1 - CLlvert, Temporary (T) other)
dewatering, etc)
2g. Total Temporary Wetland Impact
0.070
2g. Total Permanent Wetland Impact

0.000
2g. Total Wetland Impact
0.070
2h. Comments:
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:*
Impact is to minimize by running the stormwater piping along the Northern boundary line
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*
Will recommend using smaller equipment for clearing & installation of pipe
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:
Neither blueline or on soils map
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:
Neither blueline or on soils map
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
r Yes F 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).
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?*
F Yes
r No
Fant: projects that have vested rights, exerrptions, or grandfathering from state or locally irrplerrented storrrwater programs or projects that satisfy state or locally-irrplerrented storrrwater programs
through use of comrunity in -lieu prograrrs 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
F- NSW
r- USMP
r- Water Supply
Please identify which local government stormwater program you are using.*
Phase II
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:
Local funds through Town of Morehead City.
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 21-1.1300), 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.
This is a stormwater project to drain areas that flood along Church Street
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
r Yes r No r "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
5c. If yes, indicate the USFWS Field Office you have contacted.
Raleigh
5d. Is another Federal agency involved?*
r Yes r No
5e. Is this a DOT project located within Division's 1-8?*
r Yes r 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
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?
USFWS website
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?*
None
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?*
None
7c. Historic or Prehistoric Information Upload
click the upload button or drag and drop files here to attach docurrent
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?*
r Yes r No

8c. What source(s) did you use to make the floodplain determination?*
Survey; flood elevation is 6.0'; panel 6376; map 37200637600J.
Miscellaneous
Miscellaneous attachments not previously requested.
Click the upload button or drag and drop files here to attach docurrent
File rrust be KF or INR
Signature
Pr 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:*
J. A. Munday
Signature
,T ,4. M,014CICY
Date Submitted:
6/4/2018
Initial Review
Is this project a public transportation project?* (?
r Yes r No
Change only f needed.
Has this project met the requirements for acceptance in to the review process?*
r Yes
r No
BIMS # Assigned*
20180772
Version#*
1
Reviewing Office
Wilmington Regional Office - [phone]
Select Project Reviewer*
Robb Mairs:eads\rlmairs2
Is a payment required for this project?*
r No payment required
r Fee received
r Fee needed - send electronic notification

What amout is owed?
r $240.00
* $570.00