20181013 Ver 1_401 Application_20180724

Action History (UTC -05:00) Eastern Time (US & Canada)
Submit by Anonymous User 7/24/2018 11:19:35 AM (Start Event)
Accept by Montalvo, Sheri A 7/24/2018 1:46:08 PM (Non DOT Initial Review)
The task was assigned to Montalvo, Sheri A. The due date is: July 27, 2018 5:00 PM
7/24/2018 11:21 AM

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:*
Johnston
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: 12 - Utility Lines
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
f Yes C No
1f. Is the project located in anyof NC's twentycoastal counties?*
r Yes C No
1h. Is the project located in a designated trout watershed?*
t' Yes f• No
Link to trout information: http://vmw.saw.usace.army.mil/Missions/Regulatory-Permit-ProgranVAgency-Coordination/Trout.aspx
B. Applicant Information
1a. Who is the Primary Contact?*
Tyson Kurtz
1b. Primary Contact Email:*
[e-mail]
1c. Primary Contact Phone:*
(XXX)XXX-XXXX
[phone]
1d. Who is applying for the permit?
❑ Owner r Applicant (other than owner) rJ Agent/Consultant
(Check all that apply)
2. Owner Information
2a. Name(s) on recorded deed:
See attached landowner list
2b. Deed book and page no.:
2c. Responsible party:
(for Corporations)
Rick Hester, Johnston Co District Manager
2d. Address
Street Address
309 E. Market Street
Address Line 2
City
Smithfield
Fbstal / Zip Code
27577
2e. Telephone Number:
(XXX)XXX-XXXX
[phone]
2f. Fax Number:
(XXX)XXX-)O=
2g. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
State/ Province/ Fbgion
NC
Country

Tyson Kurtz
4b. Business Name:
(if applicable)
EEE Consulting, Inc.
4c. Address
Street Address
601 Cascade Pointe Lane
Address Line 2
Suite 101
City
State / Province / Fbgion
Cary
NC
Postal / Zip Code
Country
27513
USA
4d. Telephone Number:
[phone]
(XXX)XXX-XXXX
4e. Fax Number:
(xxx)xxx-xxxx
4f. Email Address:*
[e-mail]
Agent Authorization Letter*
Rease provide the Agent Authorization Letter if you are submtting this docunent.
Agent Auth 2.pdf 40.35KB
RLE TYPE M.15T BE RDF
C. Project Information and Prior Project History
1. Project Information
.................................................................................................................................................................................................
1a. Name of project:*
Project No. 00358-0140; Wilson's Mills WD-WTP Service Line
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality / town:
*
Wilson's Mills
1d. Driving directions*
If it is a new project and can not easily be found in a GPS rrapping system Rease provide directions.
From US 40 take 70 E for ten miles.
2. Project Identification
2a. Property Identification Number:
(tax RN or parcel ID)
See attached landowner list
2b. Property size:
(in acres)
40.5
2c. Project Address

Street Address
Alignment corridor from Wilson's Mills WTP to Wilson's Mills Road
Address Line 2
City State/ Province/ Region
Postal / Zip Code 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:*
35.576741 -78.345320
ex: 34.208504 -77.796371
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Neuse River
3b. Water Resources Classification of nearest receiving water:*
WS-IV: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:*
The project alignment is located primarily along the edge of, and within, previously disturbed NCDOT and local
ROW. The western extent of the alignment will connect to a proposed Booster Pump Station located next to the
Wilson's Mills Elementary school. The alignment will connect the new pump station to the edge of the Wilson's Mills
Water Treatment Plant (WTP) property. The waterline will run along disturbed grass lawns and occasionally cross
through areas of Mixed Pine/Hardwood Forest.
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 document
P2 updated topo.pdf 965.67KB
File type mast 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
project 2 Soils map.pdf 862.92KB
File type mast be pdf
4d. List the total estimated acreage of all existing wetlands on the property:
8.29
4e. List the total estimated linear feet of all existing streams on the property:
(intern ittent and perennial)
488.1
4f. Explain the purpose of the proposed project:*

The Town of Wilson's Mills and Johnston County propose to install an underground waterline to run from a
proposed Booster Pump Station at the town's water tower, to the edge of the Wilson's Mills WTP, in Johnston
County. Installation of the 24" diameter waterline will offer improved hydraulic capacity of flow between the new
Booster Pump and the WTP.
4g. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:
The proposed alignment runs east to west from a proposed Booster Pump Station, west of the Wilson's Mills
Elementary School, to the western edge of the Wilson's Mills WTP. The preferred route of the waterline from the
WTP is to run along previously cleared ROW which parallel local roads. The alignment will follow Wilson's Mils road
SE for approximately one mile until it zig-zags north to run just south of Main Street. The alignment will mark a left
turn to run behind the Johnston Farms subdivision until reaching the WTP.
The project will involve installation of a 24 -inch underground waterline with associated valves and access points.
The project alignment is approximately 2.6 miles long.
Ground disturbing activities will include clearing and grubbing as needed within the 20 -foot wide LOD, although
that will be minimal as most of the area has been cleared for other easements. Installation of the waterline will
require trenching, and backfilling for the pipeline. Proposed trench widths will range from four to six feet, and
average depth will be approximately three feet below existing ground elevation. The alignment will cross under the
railroad tracks via jack and bore with thick steel casing. Jack and bore drilling will be used to cross under the
occasional NCDOT intersections along the alignment.
The alignment will cross tributaries to the Neuse River and Poplar Creek via open cuts. Cofferdams will be used
while the installation occurs; water upstream will be pumped below the work area through a filter bag. Impacted
areas will be restored to original grade and stabilized. All impacted buffers will be vegetated with native vegetation.
No historic properties were identified along or adjacent to the alignment using the NCHPO database search, and
no buildings were found within or adjacent to the project area during field investigations. No impacts to historic
properties are proposed as part of this project.
4h. Please upload project drawings for the proposed project.
Qick the upload button or drag and drop files here to attach docurrent
2018.07.23 -0358 -0140 -WILSON MILLS PROJECT 2.pdf 19.59MB
File type mist be pdf
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes r No f Unknown
Comments:
3e conducted delineations between March 9 -15, 2018 and also June 25,
2018
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
Preliminary determination is pending site visit. PJD request was submitted to
USACE on 4/30/2018 and field verification is scheduled for 7/11/2018
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
Ray Bode, PWS; Jason Steele, PWS; and Tyson
Ku rtz
EEE Consulting, Inc.
5d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
Preliminary determination is pending site visit. PJD request was submitted to USACE on 4/30/2018 and field verification is scheduled for
7/11/2018
5dl. Jurisdictional determination upload

Crick the upload button or drag and drop files here to attach document
File type mast 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 f• No f Unknown
7. Future Project Plans
7a. Is this a phased project?*
f Yes C 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 V Streams -tributaries V 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*
W1 - Land clearing
T
Headwater Forest
WG
No
Corps
0.109
Ivbp label (e.g. Fbad Crossing 1 - Calvert,
Fern -anent (Fj or
(404, 10) or DAR (401,
(acres)
dewatering, etc)
Terrporary (T)
other)
W2 - Land clearing
T
Headwater Forest
WF
No
Corps
0.016
Nbp label (e.g. Road Crossing 1 - Calvert,
Permanent (P) or
(404, 10) or DAR (401,
(acres)
dewatering, etc)
Temporary (T)
other)
W3 - Land clearing
T
Headwater Forest
WF
No
Corps
0.037
Nbp label (e.g. Fbad Crossing 1 - Calvert,
Ferrranent (F) or
(404, 10) or DAR (401,
(acres)
dewatering, etc)
Temporary (T)
other)
W4 - Land clearing
T
Headwater Forest
WE
No
Corps
0.043
Nbp label (e.g. Fbad Crossing 1 - Culvert,
Permanent (F� or
(404, 10) or DAR (401,
(acres)
dewatering, etc)
Terrporary (T)
other)
W5 - Land clearing
T
Headwater Forest
WE
No
Corps
0.224
Nbp label (e.g. Fbad Crossing 1 - Calvert,
Permanent (F') or
(404, 10) or D✓tR(401,
(acres)
dewatering, etc)
Terrporary (T)
other)
W6 - Land clearing
P
Headwater Forest
WE
Yes
Corps
0.030
Nbp label (e.g. Fuad Crossing 1 - Calvert,
Permanent (P) or
(404, 10) or DhR (401,
(acres)
dewatering, etc)
Temporary (1)
other)
W7 - Land clearing
P
Headwater Forest
WE
Yes
Corps
0.033
Ivbp label (e.g. Fbad Crossing 1 - Calvert,
Permanent (P) or
(404, 10) or DAR (401,
(acres)
dewatering, etc)
Temporary (T)
other)
W8 - Land clearing
P
Headwater Forest
WX
Yes
Corps
0.015
Ivbp label (e.g. Fbad Crossing 1 - Calvert,
Fermanent (Fj or
(404, 10) or DAR (401,
(acres)
dewatering, etc)
Temporary (T)
other)
W9 - Land clearing
T
Headwater Forest
WB
No
Corps
0.286
Nbp label (e.g. Fbad Crossing 1 - Culvert,
Ferrranerd (F) or
(404, 10) or DAR (401,
(acres)
dewatering, etc)
Temporary (T)
other)
W10 - Land clearing
T
Headwater Forest
WB
No
Corps
0.002
Nbp label (e.g. Fbad Crossing 1 - Culvert,
Permanent (F) or
(404, 10) or DAR (401,
(acres)
dewatering, etc)
Temporary (1)
other)

W11 - Land clearing T Headwater Forest WB No Corps 0.118
K/hp label (e.g. Fbad Crossing 1 - Culvert, Pernenent (F' or (404, 10) or DAR (401, (acres)
dewatering, etc) Terrporary (T) other)
2g. Total Temporary Wetland Impact
0.835
2g. Total Permanent Wetland Impact
0.078
2g. Total Wetland Impact
0.913
2h. Comments:
A wetland impact table with additional details is attached in the supporting documents section.
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 s
type*
Type*
Jurisdiction*
width*
length*
S1 Waterline crossing
P Bank SC
Perennial
Corps
6
15 9
Nbp label (e.g. Fbad Crossing
Pernenert (F) or Stabilization
Perennial (F$� or
Average
(linear feet) 0
1)
Temporary (T)
intermittent (INT)
(feet)
S2 Waterline crossing
T Excavation DC
Jurisdictiona
Corps
4
48 1
Nbp label (e.g. Fbad Crossing
Farnrenent (F' or
I Ditch
Average
(linear feet) 9
1)
Temporary (T)
Perennial (1`13:� or
(feet)
2
intermittent (INT)
'* All Perennial or Intermittent streams must be verified by DWR or delegated local government.
3i. Total jurisdictional ditch impact in square feet:
192
3i. Total permanent stream impacts:
15
3i. Total temporary stream impacts:
48
3i. Total stream and tributary impacts:
63
3j. Comments:
A stream impact table with additional details is attached in the supporting documentation section. S2 is an impact
to a Potential Non -Wetland W.O.U.S.. DC was not classified as a jurisdictional ditch. DC was titled a Potential Non -
wetland W.O.U.S.. Only a PJD was conducted. DC did not qualify as a intermittent or perennial stream or a
wetland, but still could potentially be a waters of the United States. Impacts to DC must still be considered and this
is the most applicable category to shows impacts.
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 appy.
Q Neuse ❑ Tar -Pamlico
❑ Catawba ❑ Randleman
❑ Goose Creek ❑ Jordan Lake
❑ Other

6b. Impact Type *
6c. Per or
6d. Stream name *
6e. Buffer mitigation
6f. Zone 1
6g. Zone 2
Temp*
required?*
impact*
impact*
B1 -Allowable
T
SC
No
0
673
Location and Exenpt, Allowable, allowable w/
Permanent (Pf or
(square feet)
(square feet)
ration
Temporary (T)
B2 -Allowable
T
SC
No
1,299
0
Location and Exempt, Allowable, allowable w/
Permanent (P/ or
(square feet)
(square feet)
mitigation
Temporary (T)
B3 - Allowable
T
SC
No
0
263
Location and Bxempt, Allowable, allowable w/
Permanent (P/ or
(square feet)
(square feet)
nftation
Temporary (T)
6h. Total buffer impacts:
Zone 1 Zone 2
Temporary impacts: 1,299.00 936.00
Zone 1 Zone 2
Permanent impacts: 0.00 0.00
Zone 1 Zone 2
Total buffer impacts: 1,299.00 936.00
6i. Comments:
A buffer impact table with additional details is attached in the supporting documents section.
Supporting Documentation - i.e. Impact Maps, Plan Sheet, etc.
click the upload button or drag and drop files here to attach document
2018.0719_00358-0140_Impact Maps_Sealed.pdf 1.42MB
Revised P2 Wilsons Mills Impacts.pdf 85.89KB
File must be PDF
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:*
Multiple alignments were evaluated based on environmental impacts, availability of public right-of-way or private
easement requirements, and ease of construction. The alignment route selected utilized eAsting Town owned land
and public ROW as much as possible, minimizing the disturbance to forested and residential land. The waterline
will run through the front of several residential front yards to stay within ROW rather than clearing forested land.
Water valves will be located in uplands and situated such that maintenance access will not need to cross
jurisdictional waters.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*

Proper erosion and sedimentation control measures will be implemented as proposed and approved by the NC
Division of Energy, Mineral, and Land Resources (NCDEMLR). Proposed measures include super silt fence along
stream banks and wetland perimeters, stone relief outlets, and compost socks adjacent to wetlands and/or
streams.
Streams will be crossed via open cut. Impacts at open cut crossing locations will be minimized by use of
appropriate erosion control and flow diversion measures during construction. Direct impacts from construction of
the waterline to these features will be temporary, and any impacted areas will be restored to original grade and
stabilized following construction. Prior to excavating in jurisdictional streams, coffer dams will be installed upstream
and downstream of the excavation area to isolate the disturbed area and contain sediment. Stream flow on the
upstream side of the excavation will be pooled above the coffer dam and pumped around the excavation area. The
pumped water will be discharged on the downstream side of the excavation below the lower coffer dam through
sediment bags to filter the discharge water of sediment before allowing the water to be returned to the stream
channel. Impacted stream banks will be stabilized with ripirap as required to provide proper stabilization and
protection against erosion. Riplrap will be keyed into the stream banks such that the original crossisection of the
stream is maintained.
Wetland areas that must be excavated for installation of the pipe will be returned to their original (prelconstruction)
contours and revegetated. Installation will be by low pressure rubber tired excavation equipment where possible. In
all forested wetlands, clearing will be done by hand and grubbing will only occur as needed to excavate trenching
for installation.
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 C No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
Permanent impacts to streams and wetlands are below the thresholds requiring mitigation under the NWP 12. All impacts to protected
buffers are considered allowable and do no require 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?
r- Level Spreader
R Vegetated Conveyance (lower SFM/T)
F' Wetland Swale (higher SHWT)
W 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
File type mist be RDF
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?
ryes F No

2b. Does this project meet the requirements for low density projects as defined in 15A NCAC 02H .1003(2)?*
f• Yes
f 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
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)?*
f• Yes r No
1c. If you answered "yes" to the above, has the document review been finalized by the State Clearing House? (if so, attach a copy of the
NEPA or SEPA final approval letter.)*
r Yes r No
NEPA or SEPA Final Approval Letter
dick the upload button or drag and drop files here to attach docurrent
2017.08.01_NCDEQ-DWI_Ltr of Intent to Fund—Wilsons Mills Proj2.pdf 208.09KB
FILE TYPE M- ST BE FDF
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?*
t' 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.
The proposed project will upgrade the current water transmission lines for the Town of Wilson's Mills, NC. This
project will not facilitate additional development that will effect downstream water quality.
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
5c. If yes, indicate the USFWS Field Office you have contacted.

Raleigh
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.pctf
5h. Does this project involve the construction/installation of a wind turbine(s)?*
f 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.?
f Yes r No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
USFWS IPAC Project Review (March 30 2018). USFWS Official Species List was updated (June 19, 2018) and
contained no changes since the original submission so project review was not re -submitted. NCNHP Project
Review (June 20, 2018).
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
f Yes r No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
NOAA Essential Fish Habitat Mapper (used: April 12, 2018)
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)?*
f Yes r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
NC DNCR SHPO Letter Date: May 4, 2018
7c. Historic or Prehistoric Information Upload
nick the upload button or drag and drop files here to attach docurrent
SHPO Response Letter ER 18-0685.pdf 98.41 KB
File mist 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
8c. What source(s) did you use to make the floodplain determination?*
FEMA FIRM Panels: 3720168600J (eff. 12/2/2005) & 372016900J (eff. 12/2/2005)

Miscellaneous
Miscellaneous attachments not previously requested.
Click the upload button or drag and drop files here to attach docurrent
USFWS Online Project Review Project No 00358-0140 Wilson's Mills WD_WTP Service
1.16MB
Line.pdf
Updated Official Species List Project 2.pdf
235.99KB
Updated NHP project report project_ 2_wilsons_mills_and_l 1232_11232.pdf
825.36KB
Landowners.pdf
75.07KB
140-138 DWR Buffer determination. pdf
579.22KB
File mist be FDF or KNE
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:*
Tyson Jeffrey Kurtz
Signature
Date Submitted:
7/24/2018
Initial Review
Is this project a public transportation project?*(?
a Yes F No
Change only 9 needed.
Has this project met the requirements for acceptance in to the review process?*
f• Yes
f No
BIMS # Assigned *
20181013
Version#*
1
Reviewing Office*
Central Office - [phone]
Select Project Reviewer*
Paul Wojoski:EADS\pawojoski
Is a payment required for this project?*
f No payment required
f Fee received
F Fee needed - send electronic notification

What amout is owed?*
* $240.00
f $570.00