20180918 Ver 1_401 Application_20180718

Action History (UTC -05:00) Eastern Time (US & Canada)
Submit by Anonymous User 7/2/2018 1:01:57 PM (Start Event)
Accept by Montalvo, Sheri A 7/3/2018 1:03:47 PM (Non DOT Initial Review)
• The task was assigned to Montalvo, Sheri A. The due date is: July 5, 2018 5:00 PM 7/2/2018 1:05 PM

DWR
Dfutston 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:*
Wake
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: 29 - Residential Developments
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
1h. Is the project located in a designated trout watershed?*
r Yes r No
Link to trout information: http://wuwv.saw.usace.army.miI/Missions/Regulatory-Permit-Program/Agency-Coordination/Trout.aspx
B. Applicant Information
1a. Who is the Primary Contact?*
Chris Carter - Meritage Homes
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:
Adcock Trust Agreement
2b. Deed book and page no.:
2c. Responsible party:
(for Corporations)
Ball & Minor. CPA - David W. Ball
2d. Address
Street Address
1001 Procure Street, Ste 101
Address Line 2
City
Fuquay-Varina
Postal / Zip Code
27526
2e. Telephone Number:
(XXX)XXX-XXXX
2f. Fax Number:
(xxx)xxx-xxxx
2g. Email Address:*
State / Province / Pegion
North Carolina
Country
USA

[e-mail]
3. Applicant Information (if different from owner)
3a. Applicant is:
r Agent
r Other Developer
V other please specify.
3b. Name:
Chris Carter
3c. Business Name:
(if applicable)
Meritage Homes
3d. Address
Street Address
3005 Carrington Mill Blvd., Suite 100
Address Line 2
City
State / Province/ Fbgion
Morrisville
North Carolina
Fbstal / Zip Code
Country
27560
USA
3e. Telephone Number:
[phone]
(XXX)XXX-XXXX
Fax Number:
(XXX)xxx-xxxx
3g. Email Address:*
[e-mail]
.................................
4. Agent/Consultant (if applicable)
4a. Name:
Justin Milstein, Scott Mitchell
4b. Business Name:
(if applicable)
Mitchell Environmental, PA
4c. Address
Street Address
1501 Lakestone Village Lane, Suite 205
Address Line 2
City
State/ Province / Flegion
Fuquay-Varina
North Carolina
Rbstal/Zip Code
Country
27526
USA
4d. Telephone Number:
[phone]
(XXX)XXX-XXXX
Fax Number:
(XM)XM-

4f. Email Address:*
[e-mail]
Agent Authorization Letter*
Please provide the Agent Authorization Letter if you are sutxrit ing this docurrent.
Agent Authorization Form.pdf 603.94KB
FILE TYPE NUST BE FDF
C. Project Information and Prior Project History
1. Project Information
1a. Name of project:*
Lakeview Subdivision (Formerly 1339 Old Honeycutt Road Assemblage)
1b. Subdivision name:
(if appropriate)
Lakeview Subdivision
1c. Nearest municipality/ town:
Fuquay-Varina
1d. Driving directions*
If it is a new project and can not easily be found in a GPS napping system Please provide directions.
n/a
2. Project Identification
2a. Property Identification Number:
(tax PIN or parcel ID)
0676474253
2b. Property size:
(in acres)
36.18
2c. Project Address
Street Address
1339 Old Honeycutt Road
Address Line 2
C7ty
State / Province / Pegion
Fuquay-Varina
North Carolina
Fbstal/Zip Code
Country
27526
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:*
35.583196 -78.749108
ex: 34.208504 -77.796371
3. Surface Waters

3a. Name of the nearest body of water to proposed project:*
Black Creek
3b. Water Resources Classification of nearest receiving water:*
B; 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:*
E)asting conditions on the site is mostly forest cover and cleared agricultural land. The general land use in the
vicinity of the project consists of mostly residential and commercial developments.
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)
nick the upload button or drag and drop files here to attach docurrent
USGS_Final.pdf 339.95KB
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
Soil Survey_Final.pdf 1.09MB
File type rrust be pdf
4d. List the total estimated acreage of all existing wetlands on the property:
3.40
4e. List the total estimated linear feet of all existing streams on the property:
(intermttent and perennial)
790
4f. Explain the purpose of the proposed project:*
The purpose of the project is to construct the proposed residential development and associated infrastructure for
the development.
4g. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:
Equipment typical for residential building and grading will be used to construct the development such as track
hoes, bulldozers, dump trucks, etc.
4h. Please upload project drawings for the proposed project.
aick the upload button or drag and drop files here to attach docurrent
2018-06-20 Lakeview CD's TOFV 1st Submittal.pdf 58.72MB
File type rrust be pdf
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
C Yes f No r Unknown
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made?
C Preliminary r Approved r Unknown r N/A

Corps AID Number:
Example: SAW2017-99999
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company: Mitchell Environmental, PA
Other: James Lastinger, USACE
5d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
James Lastinger (USAGE) met onsite and confirmed the wetland delineation with MEPA 03/29/18.
DWR Determination Letter 01/29/18.
5dl. Jurisdictional determination upload
Click the upload button or drag and drop files here to attach docurrent
3—Old Honeycutt Road Assemblage-DWR Buffer Letter 012918.pdf 2.46MB
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 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.
No.
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
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*
Wetland Impact 1 P
IVbp label (e.g. Road Grossing 1 - Culvert, F2rrranent (F) or
dewatering, etc) Tenporary (T)
2g. Total Temporary Wetland Impact
0.000
2g. Total Permanent Wetland Impact
Headwater Forest Wetland 1 Yes Corps 0.036
(404, 10) or D✓UR(401, (acres)
other)

0.036
2g. Total Wetland Impact
0.036
2h. Comments:
W1 - Impact for roadway construction and grading.
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:*
Impacts have been minimized as much as is practical, jurisdictional areas have been practically avoided to the
maximum extent possible.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*
All disturbed areas will be bound by silt fence and tree protection fence before construction begins to prevent
impacts to features in non -permitted areas.
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:
Proposed wetland impact of 0.036 Acres is below the threshold for mitigation.
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
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?
F- 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.
Diffus Flow Documentation
Click the upload button or drag and drop files here to attach docurrent
2018-06-20 Lakeview CD's TO FV 1st Submitta1.pdf 58.72MB
File type rust be FDF
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).
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
r No
Fant: projects that have vested rights, exemptions, or grandfathering from state or locally irrplerrented storrrwater programs or projects that satisfy state or locally-inplerrented storrrwater prograrrE
through use of conrrunity in -lieu programs should answer no to this question.
2d. Which of the following stormwater management program(s) apply (check all that apply):*
Pr Local Government
F State
Local Government Stormwater Programs*
F- Phase II
PF NSW
r- USMP
r- Water Supply
Please identify which local government stormwater program you are using.*
Town of Fuquay-Varina
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 r No
3b. If you answered "no," provide a short narrative description.
This application includes the full extent of the proposed project; therefore, future impacts are not anticipated from
this small residential development.
4. Sewage Disposal (DWR Requirement)

4a. Is sewage disposal required by DWR for this project?
rYesr 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.
Wastewater generated from the project will be collected, treated and discharged by the Town of Fuquay-Varina
wastewater treatment system.
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 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.?
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?
The Northern long-eared bat was listed as Threatend in Wake County on 4/5/15. This project involves the removal
of trees ( see site plan for details).
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://wmw.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/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 r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
NC State Historic Preservation Mapper

7c. Historic or Prehistoric Information Upload
Click the upload button or drag and drop files here to attach docurrent
SHPO_Final.pdf 353.76KB
File rrust be Ft7F
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?*
Wake County iMAPS FEMA Flood Layer
Miscellaneous
Miscellaneous attachments not previously requested.
Click the upload button or drag and drop files here to attach docurrent
0_PCN_Cover_Letter_LakeviewSD.pdf 92.9KB
2_LakeviewSubdivision Supporting Documents.pdf 12.35MB
File rrust be FDF or INR
Signature
17 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:*
Justin Marcus Milstein
Signature
02 1� r r �,
Date Submitted:
7/2/2018
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?
G Yes
O No

BIMS # Assigned*
20180918
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