20181124 Ver 1_401 Application_20180813

Action History (UTC -05:00) Eastern Time (US & Canada)
Submit by Anonymous User 8/13/2018 12:46:58 PM (Start Event)
Accept by Montalvo, Sheri A 8/14/2018 10:01:49 AM (Non DOT Initial Review)
The task was assigned to Montalvo, Sheri A. The due date is: August 16, 2018 5:00 PM
8/13/2018 12:48 PM

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:*
Wake
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: 27 - Restoration
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?*
Greg Jennings
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:
The Greens at Tryon LLC
2b. Deed book and page no.:
16787, pg 803-815
2c. Responsible party:
(for Corporations)
Brian Stai
2d. Address
Street Address
5425 Wisconsin Avenue, Suite 202
Address Line 2
city
Chevy Chase
Fbstal / Zip Code
20815
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
MD
Country
USA

Greg Jennings
4b. Business Name:
(if applicable)
Jennings Environmental LLC
4c. Address
Street Address
7 Samuel Ashe Drive
Address Line 2
aty
Asheville
Postal / Zip Code
28805
4d. Telephone Number:
[phone]
(XXX)XXX-)D=
4e. Fax Number:
(XXX)XXX-)O=
4f. Email Address:*
[e-mail]
State/ Province/ Flegion
NC
Country
USA
Agent Authorization Letter*
Reese provide the Agent Authorization Letter if you are submitting this docurrent.
Agent Authorization Form Greens at Tryon.pdf 178.46KB
RLE TYFE MJST BE FDF
C. Project Information and Prior Project History
1. Project Information
1a. Name of project:*
Greens at Tryon Pond Spillway Stabilization
1b. Subdivision name:
(if appropriate)
Greens at Tryon
1c. Nearest municipality / town:
*
Raleigh
1d. Driving directions*
If it is a new project and can not easily be found in a GPS crapping system Pease provide directions.
Turn into clubhouse parking lot at 2805 Par Drive in Raleigh. Drive to far end of parking lot along pond and park at dam.
2. Project Identification
2a. Property Identification Number:
(tax PN or parcel ID)
1702054055
2b. Property size:
(in acres)
28.21
2c. Project Address

Street Address
2805 Par Drive
Address Line 2
City
State/ Province/ Region
Raleigh
NC
Postal / Zip Code
Country
27603
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 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:*
35.741392 -78.660245
ex: 34.208504 -77.796371
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Walnut Creek
3b. Water Resources Classification of nearest receiving water:*
C;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:*
Stream channel is severely incised due to headcutting in the pond outfall channel downstream of the dam. Land
use is stable golf course and residential community.
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)
(]ick the upload button or drag and drop files here to attach docurrent
UT_ Walnut_Creek_USGS_Map.pdf 16.78MB
File type mist 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)
Qick the upload button or drag and drop files here to attach docurrent
UT_Walnut_Creek_NRCS_Map.pdf 2.33MB
File type mist be pdf
4d. List the total estimated acreage of all existing wetlands on the property:
2
4e. List the total estimated linear feet of all existing streams on the property:
(intermittent and perennial)
2000
4f. Explain the purpose of the proposed project:*
Stabilize eroding and incised stream channel and restore natural vegetated buffer.
4g. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*

Install rock step -pool stream system to prevent future erosion and headcutting while carrying pond outflow down
valley to Walnut Creek. Equipment will include a hydraulic excavator and loader to grade new channel form and
install rock structures. Existing vegetation will be removed and replaced with native riparian buffer.
4h. Please upload project drawings for the proposed project.
C]ick the upload button or drag and drop files here to attach document
GREENS_AT_TRYON_PRELIMINARY_PLAN_07302018.pdf 1.97MB
File type must be pdF
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes f• No r Unknown
Comments:
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:
Example: SAW -2017-99999
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
5d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
5d1. Jurisdictional determination upload
C]ick the upload button or drag and drop files here to attach document
File type must be F OF
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 r Unknown
7. Future Project Plans
7a. Is this a phased project? *
f 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):
F Wetlands V Streams -tributaries V Buffers
F Open Waters F Pond Construction
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 Stream Restoration P Stabilization UT Walnut Creek Perennial Both 20 180
Nbp label (e.g. Finad Crossing Pernanent (F9 or Perennial (FEP� or Average (linear feet) ,
1) Tenporary (T) intermittent (INT) (feet)
0
** All Perennial or Intermittent streams must be verified by DWR or delegated local government.
31. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
180
3i. Total temporary stream impacts:
0
3i. Total stream and tributary impacts:
180
3j. Comments:
Impacts are required to restore natural stability to the stream system.
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.
IJ Neuse r- Tar -Pamlico
F Catawba r- Randleman
r Goose Creek r Jordan Lake
r Other
6b. Impact Type *
6c. Per or
6d. Stream name *
6e. Buffer mitigation 6f. Zone 1
6g. Zone 2
Temp*
required?* impact*
impact*
Allowable
P
UT Walnut Creek
No 4,000
4,000
Location and 5cerrpt, Allowable, allowable w/ Perrranent (P) or
(square feet)
(square feet)
rritiga ion
Temporary (T)
6h. Total buffer impacts:
Zone 1
Zone 2
Temporary impacts:
0.00
0.00
Zone 1 Zone 2
Permanent impacts: 4,000.00 4,000.00
Zone 1 Zone 2
Total buffer impacts: 4,000.00 49000.00
6i. Comments:

Buffer impacts are positive in replacing invasive plants with native healthy riparian buffer with stable streambanks.
Supporting Documentation - i.e. Impact Maps, Plan Sheet, etc.
nick the upload button or drag and drop files here to attach document
GREENS_AT_TRYON_PRELIMINARY_PLAN_07302018.pdf 1.97MB
File mist 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:*
Project will only disturb soil and vegetation necessary to restore natural stability and riparian buffer.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*
Equipment will operate in dry conditions while water is diverted around the construction site.
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:
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 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
Click the upload button or drag and drop files here to attach document
GREENS_AT_TRYON_PRELIMINARY_PLAN _07302018.pdf 1.97MB
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?*
f 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?*
f 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?*
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.
Site is fully built out.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
f 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?
f Yes r No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
f 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?*
f 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?
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 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?
https://www.fws.gov/endangered/
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?*
https://www.fisheries. noaa.gov/national/habitat-conservation/essential-fish-habitat
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/hpov,eb/
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?*
http://gis.ncdcr.gov/hpov,feb/
7c. Historic or Prehistoric Information Upload
Click the upload button or drag and drop files here to attach docurrent
File rust 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?*
https://msc.fema.gov/portal/search#searchresultsanchor
Miscellaneous
Miscellaneous attachments not previously requested.
(lick the upload button or drag and drop files here to attach docurent
UT_Walnut_Creek_DFIRMette.pdf 1.91VIB
UT_Walnut_Creek_Endangered_Species_Habitat.pdf 1.13MB
UT_Walnut_Creek_StreamStats.pdf 196KB
File must be FDF or [I&
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:*
Greg Jennings
Signature
Date Submitted:
8/13/2018
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?
r Yes
f No
BIMS # Assigned *
20181124
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