20181399 Ver 1_PCN Form Submission_10/12/2018 7:00 AM

DWR
IDIOM n 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
Change only if needed.
BIMS # Assigned
20181399
Is a payment required for this project?*
r No payment required
r Fee received
r Fee needed - send electronic notification
Select Project Reviewer*
Robb Mairs:eads\rlmairs2
Information for Initial Review
1a. Name of project:
DOLLAR GENERAL
1a. Who is the Primary Contact?*
HAYWOOD PITTMAN
1b. Primary Contact Email:*
PITTMANSOIL@YAHOO. COM
Date Submitted
10/12/2018
Nearest Body of Water
LIT TO SIKES BRANCH
Basin
White Oak
Water Classification
SA
Site Coordinates
Version# *
1
Reviewing Office*
Wilmington Regional Office - [phone]
1c. Primary Contact Phone:*
[phone]
Latitude:
Longitude:
34.713246
76.990052
AProcessing Information
County (or Counties) where the project is located:
Carteret
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)
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?
rJ Nationwide Permit (NWP)
F- Regional General Permit (RGP)
F Standard (IP)

1c. Has the NWP or GP number been verified by the Corps?
r Yes r No
Nationwide Permit (NWP) Number:
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
F- 401 Water Quality Certification - Regular
F Non -404 Jurisdictional General Permit
F Individual Permit
39 - Commercial/Institutional Developments
1e. 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:
,r! 401 Water Quality Certification - Express
r Riparian Buffer Authorization
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
1i. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
r- Yes r No r Unknown
1j. Is the project located in a designated trout watershed?
C Yes r No
F. Applicant Information
1d. Who is applying for the permit?
r Owner V 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:
ELBERT LIKENS
2b. Deed book and page no.:
1345-476,1479-361
2c. Responsible party:
r Yes r^ No
r Yes r^ No
2d. Address
Street Address
3315 HWY 70
Address Line 2
Cfty
State / Frovinee / R�gicn
NEW BERN
NC
Postal / Zip Code
Ocuntry,
28546
US
2e. Telephone Number:
2f. Fax Number:
[phone]
2g. Email Address:*
PITTMANSOIL@YAHOO. COM
3. Applicant Information (if different from owner)

3a. Applicant is:
F Agent
r Other
If other pease specify.
3b. Name:
GEORGE BARNES
3c. Business Name:
GLANDON FOREST EQUITY
3d. Address
Street Address
3825 BARRETT AVENUE SUITE 100
Address Lim 2
city
RALEIGH
Postal / Zip Code
27609
3e. Telephone Number:
[phone]
3g. Email Address:*
PITTMANSOIL@YAHOO. COM
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality/ town:
NEWPORT
2• Project Identification
2a. Property Identification Number:
630504649370000,630501366940000
2c. Project Address
Street Address
4252 HWY 24
Address Line 2
aty
NEWPORT
Postal / Zip Code
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
UT TO SIKES BRANCH
3b. Water Resources Classification of nearest receiving water:*
SA
3c. What river basin(s) is your project located in?*
White Oak
3d. Please provide the 12 -digit HUC in which the project is located.
03020302
4. Project Description and History
State / Province/ Region
NC
(buntry
US
3f. Fax Number:
2b. Property size:
1.12, 9.59
State / Province / Fegion
NC
Ox ntry
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:*
RESIDENCE LOCATED ON SITE WITH WOODED AREA SURROUNDING
4b. Have permits or certifications been requested or obtained for this project (including all prior phases) in the past?*
r Yes 6 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)
BOGUE USGS.pdf 784.04KB
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)

ags_bcdd113b2bb24310a68b263d656ef67b.pdf 201.26KB
4f. List the total estimated acreage of all existing wetlands on the property:
.25
4g. List the total estimated linear feet of all existing streams on the property:
500
4h. Explain the purpose of the proposed project:*
CONSTRUCTION OF A DOLLAR GENERAL STORE
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
IMPACT OF MAN MADE DITCH WHICH IS JURISDICTIONAL. THE AREA WILL BE FILLED TO CONSTRUCT DOLLAR GENERAL STORE AND STORM WATER DEVICE.
4j. Please upload project drawings for the proposed project.
Newport -Bogue (2) WETLAND FILL.pdf 143.61 KB
DG BOGUE IMPACT 1.pdf 191.09KB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes r No C Unknown
Comments
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
r Preliminary f Approved r Not Verified r Unknown r WA
Corps AID Number:
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
6. Future Project Plans
6a. 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?
FD. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
V Wetlands r Streams -tributaries
r Buffers
)— Open Waters r Pond Construction
2. Wetland Impacts
2a1 Reason(?) 2b. Impact type * (?) 2c. Type of W.* 2d. W. name * 2e. Forested* 2f. Type of2g. Impact
Jurisdicition*(?) J I
area*
1 COMMERCIAL P Hardwood Flat 1 Yes Corps 0.035
(acres)
2g. Total Temporary Wetland Impact
0.000
2g. Total Wetland Impact
0.035
2h. Comments:
2g. Total Permanent Wetland Impact
0.035

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:
BUILDING WAS MOVED WEST TO AVOID ANY ADDITIONAL IMPACTS. MINIMUM PARKING SPACES
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
SILT FENCE WILL BE PLACED AROUND ALL WETLANDS TO MINIMIZE SILT AND EROSION INTO 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:
THE IMPACTS ARE 0.035 ACRES WHICH IS LESS THAN THEA ACRE
FF. 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
What type of SCM are you providing?
rJ Level Spreader
F_ Vegetated Conveyance (lower SHWT)
F_ Wetland Swale (higher SHWT)
R Other SCM that removes minimum 30% nitrogen
F- Proposed project will not create concentrated stormwater flow through the buffer
Diffuse Flow Documentation
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
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
3. Stormwater Requirements
3a. Select whether a completed stormwater management plan (SMP) is included for review and approval or if calculations are provided to document the project will not cause
degradation of downstream surface waters.*
r Stormwater Management r Antidegradation
Plan Calculations
3b. Stormwater Management Plan
Newport -Bogue (2).pdf 13.51MB
3c. Antidegradation Calculations:
Comments
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?*
C 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 (15ANCAC 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.
NO FUTURE DEVELOPMENT PROPOSED
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
r Yes r 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.
SEPTIC
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?*
r Yes r No
Se. Is this a DOT project located within Division's 1-8?
r Yes r No
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
5h. Does this project involve the construction/installation of a wind turbine(s)?*
r Yes r No
r Unknown
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?
USFWS CRITICAL HABITAT FOR THREATENED AND ENDANGERED SPECIES VIEWER
Consultation Documentation Upload
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?*
SOUTH ATLANTIC HABITAT AND ECOSYSTEM IMS, NC MARINE FISHERIES
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
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 SHPO
7c. Historic or Prehistoric Information Upload
8. Flood Zone Designation (Corps Requirement)

8a. Will this project occur in a FEMA -designated 100 -year floodplain?*
C Yes (-- No
8c. What source(s) did you use to make the floodplain determination?*
NC FLOOD PLAIN MAPPING FIRM MAP
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:
RONALD H PITTMAN II
Signature
Sign
Date
9/11/2018

Action History (UTC -05:00) Eastern Time (US & Canada)
Submit by Anonymous User 10/12/2018 7:00:16 AM (Start Event)
Accept by Montalvo, Sheri A 10/15/2018 2:09:52 PM (Non DOT Initial Review)
The task was assigned to Montalvo, Sheri A. The due date is: October 17, 2018 5:00 PM
10/12/2018 7:02 AM

AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION: E 3 65u1 Ul fyo�
LOT NO, PLAN NO. PARCEL ID: 7oo13G gYLrw
STREET ADDRESS: �ZzIZ ['}r�( dL`II lVe"1L%�J�
Please print;
Property Owner:
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
IAYw��o Por' of
(Contractor / Agent) (Name of consulting firm)
to act on my behalf and take all actions necessary for the processing, issuance and acceptance of
this permit or certification and any and all standard and special conditions attached.
Property Owner's Address (if different than property above):
azo 5f2 //PtL
p Telephone: a�� raj- ?90C
We hereby certify the above information submitted in this application is true and accurate to the
best of our knowledge.
Au orized igna ure Authorized Signature
Date: Date:

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Pri nt ed Oct o ber 12 , 201 8

Ow ne r:LIKENS ,E LB ER T L JR
Curre nt PIN:630 50136 842 100 0
C a r t e r e t C o u n t y , N .C .
Dee d Dat e:201 006 30
Pri or P IN:
Dee d R ef :
Dee ded Acres:1.1 5 GIS Ac res:1.218
Ye ar Buil t:19 77
Leg al Descrip tio n:
Ro ll Ty pe:R
Ot her Value:$15,02 4
Bldg Val ue :$54,981
Land Val ue:$67 ,44 1
Tow nship:WHI TE OAK
Sal e Pri ce:$13 4,000
NBHD:1500 03
Total V alue :$13 7,4 46
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Mailing A ddre ss:
Tax Par cel Info rma tion:
Noise Leve l:
Bldg Sq Ft:1,300
Bedro om s: Bathroo ms:
13 45 476/
Tax District:
Fi re District:
1015
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