20180798 Ver 1_401 Application_20180608

Action History (UTC -05:00) Eastern Time (US & Canada)
Submit by Anonymous User 6/8/2018 12:10:08 PM (Start Event)
Accept by Montalvo, Sheri A 6/12/2018 12:04:44 PM (Non DOT Initial Review)
The task was assigned to Montalvo, Sheri A. The due date is: June 13, 2018 5:00 PM
6/8/2018 12:11 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:*
Hyde
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: 18 - Minor Discharges
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
r 401 Water Quality Certification - Regular r 401 Water Quality Certification - Express
rJ 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 r No
Link to trout information: http://wwv.saw.usace.army.miI/Missions/Regulatory-Permit-Progran-VAgency-Coordination/Trout.aspx
B. Applicant Information
1a. Who is the Primary Contact?*
Robin Mann
1b. Primary Contact Email:*
[e-mail]
1c. Primary Contact Phone:*
(XXX)XXX-XXXX
1d. Who is applying for the permit?
W Owner r- Applicant (other than owner) r- Agent/Consultant
(Check all that apply)
2. Owner Information
2a. Name(s) on recorded deed:
Paul H. and Robin A. Mann
2b. Deed book and page no.:
Book 276, Page 887 (2) Hyde County
2c. Responsible party:
(for Corporations)
2d. Address
Street Address
6049 US Highway 64
Address Line 2
City
Manns Harbor
Fbstal / Zip Code
27953
2e. Telephone Number:
(XXX)XXX-XXXX
2f. Fax Number:
(XXX)XXX-XXXX
State / Rovince / Plegion
NC
Country
USA

2g. Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1a. Name of project:*
Mann Residence
1b. Subdivision name:
(if appropriate)
Wahab Village
1c. Nearest municipality/ town:
Ocracoke
1d. Driving directions*
If it is a new project and can not easily be found in a GPS mapping system Please provide directions.
From Irvin S Garrish Highway Turn onto Ocean View Road, property is on the corner of Ocean View Road and Old Beach Road.
2. Project Identification
2a. Property Identification Number:
(tax PIN or parcel ID)
Portion of Pin # 9500-48-3834
2b. Property size:
(in acres)
.23 acres (10,000 sq. feet)
2c. Project Address
Street Address
Lots 3 & 4,131ock C, Wahab Village
Address Line 2
Corner of Old Beach Road and Ocean View Road
City State / Province / Region
Ocracoke NC
Postal / Zip Code Country
27960 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 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:*
35.110097 -75.975622
ex: 34.208504 -77.796371
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Silver Lake

3b. Water Resources Classification of nearest receiving water:*
Tar Pamlico
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:*
Heavily wooded. Land use is Residential, home business, a few restaurants close by.
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)
(lick the upload button or drag and drop files here to attach docurrent
Hyde County Aireal lots.pdf 526.67KB
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
water quality map.pdf 264.96KB
File type rust be pdf
4d. List the total estimated acreage of all existing wetlands on the property:
0.0343
4e. List the total estimated linear feet of all existing streams on the property:
(intermittent and perennial)
none
4f. Explain the purpose of the proposed project:*
To construct a residential home.
4g. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:
House to be 1624 sq. ft with 577 sq. ft of deck/stairs totaling 2201 sq. ft. the lot coverage total to be 22.1 %.
Proposed driveway will cross wetland area in the amount of 24 feet, with 55' of the driveway intruding into the
wetland area.
4h. Please upload project drawings for the proposed project.
Click the upload button or drag and drop files here to attach docurrent
A8064 -SITE PLAN-REVISED-2018-6-8-SIGNED.pdf 119.03KB
File type rrust be pdf
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the propertyor proposed impact areas?*
t: Yes r No r Unknown
Comments:
Army Corp representative flagged area
5b. If the Corps made a jurisdictional determination, what type of determination was made?
t: Preliminary r Approved r Unknown r N/A
Corps AID Number:
Example: SAM2017-99999
SAW -2018-1143

5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Billy W. Standridge, Regularory Specilist
Agency/Consultant Company: U.S. Army Corps of Engineers
Other:
5d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
April 4, 2018 wetland areas were flagged on the lot. The Corp determined that this is considered to be a non -riparian wetland and they
would not be requiring mitigation for this project.
5d1. Jurisdictional determination upload
nick the upload button or drag and drop files here to attach docurrent
File type rust 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 r 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.
none
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
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*
House Construction and P Headwater Forest
driveway F2rrranent (P) or
Vbp label (e.g. Rbad Grossing 1 - Qalvert, Terporary (T)
dewatering, etc)
2g. Total Temporary Wetland Impact
0.000
2g. Total Permanent Wetland Impact
0.011
2g. Total Wetland Impact
0.011
2d. Wetland name *2e. 2f. Type of 2g. Impact
Forested* Jurisdicition* area*
Palustrine Yes Corps 0.011
Forested (PFO) (404, 10)orDJVR(401, (acres)
other)

2h. Comments:
The black silk fencing will be put up prior to construction. During and after construction we will do all necessary to
minimize impact to the area.
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:*
We purchased 2 adjoining lots in order to parallel the house with the wetlands which will minimize the impact of the
wetlands.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*
Black filter cloth will be erected to the site during construction.
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:
The lots do not adjoin any water shed.
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 G No
For a list of options to meet the diffuse flow requirements, click here.
If no, explain why:
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 .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 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)?*
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 t: No
3b. If you answered "no," provide a short narrative description.
There will be no additional developments, the lots meet County requirements for single family dwelling.
4. Sewage Disposal (DWR Requirement)
4a. is sewage disposal required by DWR for this project?*
O 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.
Septic Permit No. 42418-2 from Hyde County Environmental Health Department. Wastewater system type: III -C,
gravity fill.
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?*
f 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?*
O Yes r No r Unknown
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.?
f Yes r No
5g. Does this project involve bridge maintenance or removal?
f 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 t: No
51. 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.?
b Yes C No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
there are no endangered species on the island.

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?*
site plan and County area plat
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/hpovveb/
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?*
site plan and County area plats and local history.
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
8b. If yes, explain how project meets FEMA requirements:
Residential house will be elevated above the flood plan.
8c. What source(s) did you use to make the floodplain determination?*
Survey states the plat appears to be located within a FEMA identified special flood hazard area according to
F.I.R.M. for Hyde County Map number 372095000J, community ID NO. 370133, panel 9500 dated effective May
15, 2003. The property lies within zone "AE (elev. 6.0')" area subject to inundation by the 1 % annual chance flood
as defined therein.
Miscellaneous
Miscellaneous attachments not previously requested.
Click the upload button or drag and drop files here to attach docurrent
surface water classification. pdf 292.12KB
File rrust be FDF or IQVQ
Signature
V 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:*
Paul H. and Robin A. Mann
Signature
Date Submitted:
6/8/2018
Initial Review
Is this project a public transportation project?*(?)
a Yes r No
Change only if needed.
Has this project met the requirements for acceptance in to the review process?*
G Yes
O No
BIMS # Assigned *
20180798
Version#*
Reviewing Office *
Washington Regional Office - [phone]
Select Project Reviewer*
Robert Tankard:eads\rbtankard
Is a payment required for this project?*
F No payment required
r Fee received
r Fee needed - send electronic notification