20181241 Ver 1_401 Application_20180910

Action History (UTC -05:00) Eastern Time (US & Canada)
Submit by Anonymous User 9/10/2018 10:45:54 AM (Start Event)
Accept by Montalvo, Sheri A 9/10/2018 2:26:01 PM (Non DOT Initial Review)
The task was assigned to Montalvo, Sheri A. The due date is: September 13, 2018 5:00 PM
9/10/2018 10:47 AM

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:*
New Hanover
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:
Nationwide Permit (NWP) Number:
NWP Number Other:
03 - Maintenance
39 - Commercial/Institutional Developments
List all WV numbers you are applying for not on the drop dow n list.
1c. Type(s) of approval sought from the DWR:*
check all that apply
PF 401 Water Quality Certification - Regular
r Non -404 Jurisdictional General Permit
r Individual Permit
r 401 Water Quality Certification - Express
r Riparian Buffer Authorization

1d. Is this notification solely for the record because written approval is not required?
For the record onlyfor DWR 401 Certification: r Yes r No
For the record only for Corps Permit: r Yes r No
1e. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
It so, attach the acceptance letter from rrhgation bank or in -lieu fee program
r Yes r No
1f. Is the project located in anyof NC's twentycoastal 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://wuwv.saw.usace.army.miI/Missions/Regulatory-Permit-Program/Agency-Coordination/Trout.aspx
B. Applicant Information
1a. Who is the Primary Contact?*
Kim Williams; Land Management Group
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) W Agent/Consultant
(Check all that apply)
2. Owner Information
2a. Name(s) on recorded deed:
Cape Fear Country Club Inc.
2b. Deed book and page no.:
2386 0257
2c. Responsible party:
(for Corporations)
Mary Geiss
2d. Address
Street Address
1518 Country Club Road
Address Line 2
Cay
Wilmington
Postal / Zip Code
28403
2e. Telephone Number:
(xxx)xxx-xxxx
State / Province/ Region
NC
Country
USA

2f. Fax Number:
(X")MX-XXM Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Kim Williams
4b. Business Name:
(if applicable)
Land Management Group
4c. Address
Street Address
3805 Wrightsville Avenue; Suite 15
Address Line 2
city
Wilmington
Fbstal / Zip Code
28403
4d. Telephone Number:
[phone]
(xxx)xxx-xxxx
4e. Fax Number:
[phone]
(xxx)xxx-xxxx
4f. Email Address:*
[e-mail]
Agent Authorization Letter*
Pease provide the Agent Authorization Letter If you are submitting this docurrent.
Cape Fear Country Club Agent Form.pdf
RLETYFE M- ST BE RDF
State / Province / Region
NC
Country
USA
238.63KB
C. Project Information and Prior Project History
1. Project Information
1a. Name of project:*
Cape Fear Country Club Renovation
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality/ town:*
Wilmington
1d. Driving directions*
If it is a new project and can not easily be found in a GFS napping system Rease provide directions.
From USACE office, turn left onto Independence Blvd; turn right onto Oleander Drive; turn left onto Country Club Road; road will take you
directly to country club.

2. Project Identification
2a. Property Identification Number:
(tax RN or parcel ID)
R05415-003-006-000
2b. Property size:
(in acres)
177.9
2c. Project Address
Street Address
1518 Country Club Road
Address Line 2
aty
Wilmington
Fbstal / Zip Code
28403
2d. Site coordinates in decimal degrees
State / F rovince / Fbgion
NC
Country
USA
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:*
34.216596 -77.919853
ex: 34.208504 -77.796371
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Jumping Run Branch
3b. Water Resources Classification of nearest receiving water:*
C; SW
Surface Water Lookup
3c. What river basin(s) is your project located in?*
Cape Fear
River Basin Lookup
4. Project Description
4a. Describe the existing conditions on the site and the general land use in the vicinityof the project at the time of this application:*
Site is an existing country club with golf course. Land use in the vicinity of the project is mostly residential, with
some commercial use along the western property boundary.
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
CFCC Topo.pdf 673.51 KB
File type rrust be pdf

4c. Attach an 8 1/2 X11 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
CFCC Soils.pdf 423.19KB
File type rust be pdf
4d. List the total estimated acreage of all existing wetlands on the property:
0.6
4e. List the total estimated linear feet of all existing streams on the property:
(intermittent and perennial)
540
4f. Explain the purpose of the proposed project:*
The purpose of the project is to maintain and improve drainage throughout the site by installing storm drainage
outlets, removing accumulated sediment from existing channels, and reshaping sections of the channel. Proposed
stormwater improvements are part of Golf Course Renovation project.
4g. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:
The applicant proposes to install several storm drains that will connect into jurisdictional non -stream channels
(Sheets W-2, W-3, and W-4); remove accumulated sediment from two jurisdictional non -stream channels (Sheets
W-3 and W-4); and install 3 weirs and additional fill to one non -stream channel (Sheet W-4). One existing outlet
structure will also be replaced, a concrete bridge will be removed, and a piling -supported bridge will be
constructed (Sheet W-4).
4h. Please upload project drawings for the proposed project.
Click the upload button or drag and drop files here to attach docurrent
File type rust be pdf
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
t: Yes r No r Unknown
Comments:
LMG performed the delineation in 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:
Exarple: SAW2017-99999
Action ID# from previous JD is SAW -2005-00056
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
Christian Preziosi
Land Management Group
5d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
Brennan Dooley of the USACE approved the line in the field on 4/26/18. No JD has been issued yet. Action ID# from previous JD is SAW -
2005 -00056.
5dl. Jurisdictional determination upload
Click 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
6b. If yes, please give the DWR Certification number or the Corps Action ID (exp. SAW-0000-00000).
Action ID# 2005-00056
Project History Upload
Click the upload button or drag and drop files here to attach docurent
Cape Fear Country Club Site Plan Drawings NWP appl.pdf 3.31VIB
File type rust be FDF
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 pacts Inventory
.................... .. ...... ......... ........ .........
......... .... ....... ....... . ......... .........
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
r Wetlands r Streams-tributaries r Buffers
W Open Waters r Pond Construction
4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of the U.S. then individually list
all open water impacts below.
4a. Site # - Reason for
4b. Impact type *
4c. Name of waterbody*
4d. Activity type *
4e. Waterbody type
*4f. Impact
impact *
area
Temporary Impact Storm
T
N/A
Excavation
Ditch
0.02
Drainage # 1-11
Fbrrranent (Fj or
(if applicable)
(acres)
Wp label (e.g. Fbad Crossing 1)
Terporary (T)
TIM #1
T
N/A
Excavation
Ditch
0.04
Nbp label (e.g. Fbad Crossing 1)
Fl rrranent (F) or
(if applicable)
(acres)
Terporary (T)
TIM #2
T
N/A
Excavation
Ditch
0.37
Wp label (e.g. Fbad Crossing 1)
Fbrrranent (Fj or
(f applicable)
(acres)
Terporary (T)
TIM #3
T
N/A
Excavation
Ditch
0.12
Nlap label (e.g. R -)ad Crossing 1)
F2rrranent (P) or
(if applicable)
(acres)
Terporary (T)
TIM #4
T
N/A
Excavation
Ditch
0.51
Nbp label (e.g. Fbad Crossing 1)
Fbrrranent (P) or
(if applicable)
(acres)
Terporary (T)
TIM #5
T
N/A
Excavation
Ditch
0.14
Map label (e.g. Fbad Crossing 1)
Fbrrranent (F) or
(if applicable)
(acres)
Terporary (T)
TIM #6
T
N/A
Excavation
Ditch
0.11
Nbp label (e.g. Fbad Crossing 1)
Permanent (P) or
(if applicable)
(acres)
Temporary (T)

PIW #1
P
N/A
Fill Ditch 0.01
Nbp label (e.g. Finad Grossing 1)
Fbrrranent () or
(if applicable)
(acres)
Temporary (T)
PIW #2
P
N/A
Fill Ditch 0.18
Nbp label (e.g. Road Grossing 1)
Permanent (P) or
(if applicable)
(acres)
Temporary (T)
PIW #3
P
N.A
Fill Ditch 0.01
Ivbp label (e.g. Fbad Crossing 1)
F brnanent (Fj or
(if applicable)
(acres)
Temporary (T)
4g. Total temporary open water Impacts:
1.31
4g. Total permanent open water impacts:
0.20
4g. Total open water impacts:
1.51
4h. 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:*
All wetlands and streams within the project area have been avoided. Most of the proposed open water impacts are
for maintenance purposes. Permanent open water impacts are needed to improve site drainage.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*
One piling supported bridge will be constructed over open waters to avoid impacts to this resource. Silt fencing will
be utilized to ensure sediment does not leave 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:
All impacts are to jurisdictional channels (non -stream). Most of these impacts consist of maintenance activities needed to remove
accumulated sediment from the channels.
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 t: No
For a list of options to meet the diffuse flow requirements, click here.
If no, explain why:
Project located within the Cape Fear River Basin
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 F 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.
Project consists of maintenance activities. No utilities or access to adjacent tracts are proposed.
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 C No
5d. Is another Federal agency involved?*
r Yes r No r Unknown
5e. Is this a DOT project located within Division's 1-8?*
r Yes t: No
5f. Will you cut any trees in order to conduct the work in waters of the U.S.?
r Yes t: No

5g. Does this project involve bridge maintenance or removal?
r Yes r No
5g(1). If yes, have you inspected the bridge for signs of bat use such as staining, guano, bats, etc.? Representative photos of signs of
bat use can be found in the NLEB SLOPES, Appendix F, pages 3-7.
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
If you answered "Yes" to 5g(1), did you discover any signs of bat use?*
r Yes r No r Unknown
— If yes, please show the location of the bridge on the permit drawings/project plans.
5h. Does this project involve the construction/installation of a wind turbine(s)?"
r Yes r 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.?
r Yes r No
If yes, please provide details to include type of percussive activity, purpose, duration, and specific location of this activity on the
property.
Click the upload button or drag and drop files here to attach docurrent
Cape Fear Country Club bridge construction. pdf 52.38KB
File rrust be FDF
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
USFWS IPaC review, NC Natural Heritage Program database review, and on-site assessment. The site is mostly an
epsting golf course and does not provide suitable habitat for any federally -protected species known to occur in the
area.
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?*
EFH Mapper
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?*
According to the NC SHPO HPOWES GIS website, no historic properties are known to occur on site.
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?*
NC Flood Risk Information System Website
Miscellaneous
Miscellaneous attachments not previously requested.
Click the upload button or drag and drop files here to attach docurrent
File crust be FDF or IZE
Signature
R 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:*
Kimberlee C Williams
Signature
Date Submitted:
9/10/2018
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
r No
BIMS # Assigned*
20181241
Version#*
1
Reviewing Office
Wilmington Regional Office - [phone]
Select Project Reviewer*
Chad Coburn:eads\cccoburn
Is a payment required for this project?*

r No payment required
r Fee received
r Fee needed - send electronic notification
What amout is owed?
E $240.00
O $570.00