20181337 Ver 1_PCN Form Submission_10/3/2018 4:09 PM

Action History (UTC -05:00) Eastern Time (US & Canada)
Submit by Anonymous User 10/3/2018 4:09:40 PM (Start Event)
Accept by Montalvo, Sheri A 10/5/2018 12:02:37 PM (Non DOT Initial Review)
The task was assigned to Montalvo, Sheri A. The due date is: October 8, 2018 5:00 PM
10/3/2018 4:11 PM

DWR
MOM— of Water Resources
Pre -Construction Notification (PCN) Form
September 29, 2018 Ver 3
tial Review
Has this project met the requirements for acceptance in to the review process?*
r Yes
r No
Is this project a public transportation project?*
G Yes r No
Qiange only if needed.
BIMS # Assigned
20181337
Is a payment required for this project?*
r No payment required
r Fee received
r Fee needed - send electronic notification
Select Project Reviewer*
Chad Turlington:eads\octurlington
Information for Initial Review
1a. Name of project:
Ravensbrook Subdivision
1a. Who is the Primary Contact?*
Mike Eaker, Southeastern Soil & Environmental
1b. Primary Contact Email:*
[e-mail]
Date Submitted
10/3/2018
3a. Name of the nearest body of water to proposed project:*
Juniper Branch
Site Coordinates
Latitude: Longitude:
35.2360 -79.4100
A. Processing Information
County (or Counties) where the project is located:
Moore
Is this project a public transportation project?*
r Yes r No
1a. Type(s) of approval sought from the Corps:
* 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?
W Nationwide Permit (NWP)
F Regional General Permit (RGP)
F Standard (IP)
1c. Has the NWP or GP number been verified bythe Corps?
r Yes r No
Version# *
1
Reviewing Office*
Fayetteville Regional Office - [phone]
1c. Primary Contact Phone:*
[phone]

Nationwide Permit (NWP) Number:
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
V 401 Water Quality Certification - Regular
F Non -404 Jurisdictional General Permit
F Individual Permit
29 - Residential Developments
F 401 Water Quality Certification - Express
F Riparian Buffer Authorization
1e. Is this notification solelyfor the record because written approval is not required?
For the record only for DWR 401 Certification: r Yes r No
For the record onlyfor Corps Permit: r Yes r No
1f. Is this an after -the -fact permit application?*
r Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
r^ Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
r Yes r No
Acceptance Letter Attachment
1h. Is the project located in any of NC's twenty coastal counties?
r Yes r No
1j. Is the project located in a designated trout watershed?
r Yes r No
B. Applicant Information
1d. Who is applying for the permit?
F- Owner W Applicant (other than owner)
Is there an Agent/Consultant for this project?
r^ Yes r- No
2. Owner Information
2a. Name(s) on recorded deed:
J E Ross
2b. Deed book and page no.:
Book 294 Page 74
2c. Responsible party:
2d. Address
Street Address
45 Sandpiper Drive
Address Line 2
City
Whispering Pines
Postal / Zip Cade
28327
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
2a. Name(s) on recorded deed:
J E Ross
2b. Deed book and page no.:
Book 241 Page 222
2c. Responsible party
2d. Address
State / Rovince / Fbgicn
NC
Country
USA
2f. Fax Number

Street Address
45 Sandpiper Drive
Address Line 2
CKY
Whispering Pines
Postal / Zip Cade
28327
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
2a. Name(s) on recorded deed:
J E Ross
2b. Deed book and page no.:
Book Vol 66B Page 208
2c. Responsible party
2d. Address
Street Address
45 Sandpiper Drive
Address Line 2
CKY
Whispering Pines
Postal / Zip Code
28327
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
2a. Name(s) on recorded deed:
Adriane Chandler Dehghan
2b. Deed book and page no.:
Book 4500 Page 337
2c. Responsible party
2d. Address
Street Address
2901 Isabella Drive
Address Line 2
City
Raleigh
Rstal / Zip Code
27603
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
2a. Name(s) on recorded deed:
Adriane Chandler Dehghan
2b. Deed book and page no.:
Book 4500 Page 337
2c. Responsible party
2d. Address
Street Address
2901 Isabella Drive
Address Line 2
CKY
Raleigh
Postal / Zip Code
27306
State / Province / Region
NC
Country
USA
2f. Fax Number:
State / Province / Pegion
NC
O�ntry
USA
2f. Fax Number:
State / Province / legion
NC
Country
USA
2f. Fax Number:
State / Province / Region
NC
Country
USA

2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
2a. Name(s) on recorded deed:
J E Ross
2b. Deed book and page no.:
Book Vo166B Page 208
2c. Responsible party:
2d. Address
Street Address
C/O Jimmie Ross
Address Line 2
45 Sandpiper Dr
City
Whispering Pines
Postal / Zip Code
28327
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
2a. Name(s) on recorded deed:
Treater C & Harry L Chambers
2b. Deed book and page no.:
Book 99E Page 38
2c. Responsible party:
2d. Address
Street Address
122 Forrest Drive
Address Line 2
CKY
Abredeen
Postal / Zip Cade
28315
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
2a. Name(s) on recorded deed:
Brenda McLaughlin
2b. Deed book and page no.:
Book 1316 Page 182
2c. Responsible party:
2d. Address
Street Address
396 Waynor Road
Address Line 2
City
Carthage
Postal / Zip Axle
28327
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
2f. Fax Number:
State / F rmince / "agim
NC
Cbuntry
USA
2f. Fax Number:
State / F }ovine / Fiegion
NC
Country
USA
2f. Fax Number:
State / F rmince / Fegion
NC
O�ntry
USA
2f. Fax Number:

3. Applicant Information (if different from owner)
3a. Applicant is:
2b. Property size:
r Agent
95
r Other
If other please specify.
3b. Name:
Mike Eaker
3c. Business Name:
State / Provin e / fagion
Southeastern Soil & Environmental Associates
NC
3d. Address
Country
Street Address
USA
PO Box 9321
Address Line 2
City
State / Province/ Pegion
Fayetteville
NC
Rstal / Zip Code
Country
28311
USA
3e. Telephone Number: 3f. Fax Number:
[phone]
3g. Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(if appropriate)
Ravensbrook
1c. Nearest municipality/town:
Whispering Pines
2. Project Identification
2a. Property Identification Number
857404800800,857404712368,
857404719666,857400910233,
857404708356,857404815642,
2b. Property size:
857404817461
95
2c. Project Address
Street Address
Waynor Road
Address Line 2
City
State / Provin e / fagion
Carthage
NC
Postal / Zip Cade
Country
28327
USA
3. Surface Waters
3b. Water Resources Classification of nearest receiving water:*
WS -III
3d. Please provide the 12 -digit HUC in which the project is located.
030300040301
3c. What river basin(s) is your project located in?*
Cape Fear
4. Project Description and History
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 site is mostly wooded, with some open fields (grass). Land use in the vicinity is residential.
4b. Have permits or certifications been requested or obtained for this project (including all prior phases) in the past?*
r Yes r No r Unknown

4d. 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)
Ravensbrook-USGS Topo.pdf 368.66KB
4e. 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)
Ravensbrook_ NRCS Soil.pdf 883.43KB
4f. List the total estimated acreage of all existing wetlands on the property:
20
4g. List the total estimated linear feet of all existing streams on the property:
2500
4h. Explain the purpose of the proposed project:*
To construct a single family residential subdivision connected by a network of roads and utilities (95 Lots).
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
At the proposed road crossing (impact W1) a 58ft long, 36" RCP @ 1 % slope will be installed under the roadway. An 24" deep, 7ft long dissipater pad will be added at the outlet. Water
line will be concurrently installed in the road right-of-way. The area will be back filled, the roadway paved, and side slopes graded at 4:1. Typical construction equipment such as
excavators, loaders, dump trucks, and graders will be utilized.
4j. Please upload project drawings for the proposed project.
ravensbrook construction drawings.pdf 6.94MB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
R Yes r No O Unknown
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
r Preliminary r Approved R Not Verified r Unknown r N/A
Corps AID Number:
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company: Southeastern Soil & Environmental
Other:
5d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
PJD Request for "Rossborn Lane" marked received by James Lastinger, USACE, 2017 May 12
5d1. Jurisdictional determination upload
Rossborn- PJD Form.pdf 130.51 KB
Rossborn Lane JD.pdf 12.08MB
6. Future Project Plans
6a. Is this a phased project?*
R Yes r No
7b. If yes, explain.
There are 4 proposed phases for the subdivision. Phase 1 (27 Lots), Phase 2 (31 Lots), Phase 3 (26 Lots), Phase 4 (11 Lots). The proposed impact is in Phase 2 and is necessary for
installation of the water line and a road crossing.
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?
No. Directional bore will be used to install sanitary sewer line at two locations where it crosses jurisdictional features, and no maintenance corridor is proposed.
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
W Wetlands )- Streams -tributaries ❑ Buffers
r Open Waters r Pond Construction
2. Wetland Impacts
2a. Site #' M 2a1 Reason (?) 2b. Impact type"(?) 2c. Type of W. 2d. W. name" 2e. Forested' 2f. Type of 2g. Impact
Jurisdicition*(?) area*

W1 Road crossing and P Headwater Forest ��A Yes Both 0.098
water line (acres)
29. Total Temporary Wetland Impact
0.000
2g. Total Wetland Impact
0.098
2h. Comments:
E. Impact Justification and Mitigation
1. Avoidance and Minimization
2g. Total Permanent Wetland Impact
0.098
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
Lots were configured to ensure they could be developed without wetland impacts. The road was sited to cross the wetland perpendicular to minimize
impacts. The sewer line path was adjusted to minimize length through the wetlands and will be installed using directional bore to avoid impacts (no
maintenance corridor).
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Sediment and erosion control measures will be used, such as silt fencing, to protect water quality. Construction limits will be clearly marked through
wetlands.
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:
Total impacts are less than 1/10 acre.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
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
If no, explain why:
Cape Fear Basin (03030004) not subject to NC RBPR.
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
Comments:
v
G. Supplementary Information v
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
3. Cumulative Impacts (DWR Requirement)
3a. Will this project 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 residential development is relatively small and will not likely affect regional growth patterns
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
r Yes r No r 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.
Moore County Public Sewer
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?*
r Yes r No r Unknown
5f. Will you cut anytrees 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
Sh. 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?
US FWS iPaC (https://ecos.fws.gov/ipac/) and NC Natural Heritage Program
Consultation Documentation Upload
Woodpecker SOPI Lot Survey Letter draft 5-5-17 pdf.pdf
Ravensbrook_NCNHP rare species report_NCNHDE-7150.pdf
Species List_ Raleigh Ecological Services Field Office.pdf
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?*
NOAA Habitat Conservation National Marine Fisheries Service
https://vmw.habitat.noaa.gov/protection/efh/efhmpper/
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
32.29KB
1.61 MB
185.1 KB
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?*
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 Office (http://gis.ncdcr.gov/hpoweb/)
7c. Historic or Prehistoric Information Upload
8. Flood Zone Designation (Corps Requirement)
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 (https://fris.nc.gov/fris/Fbme.aspx.?ST=NC)
Miscellaneous
Comments
Miscellaneous attachments not previously requested.

Signature
m 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:
Mike Eaker
Signature
Sign
Date
10/3/2018