20181522 Ver 1_PCN Form Submission_20181105

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
20181522
Is a payment required for this project?*
r No payment required
r Fee received
r Fee needed - send electronic notification
Reviewing Office*
Raleigh Regional Office - [phone]
Information for Initial Review
1a. Name of project:
Rex Healthcare Cancer Center
1a. Who is the Primary Contact?*
David G. Cooper
1b. Primary Contact Email:*
[e-mail]
Date Submitted
11/5/2018
Nearest Body of Water
Richland Creek
Basin
Neuse
Water Classification
QNSW
Version# *
1
What amout is owed?*
r• $240.00
* $570.00
Select Project Reviewer*
Stephanie Goss:eads\szgoss
1c. Primary Contact Phone:*
[phone]
Site Coordinates
Latitude: Longitude:
35.821014 -78.707423
FA. Processing Information U
County (or Counties) where the project is located:
Wake
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?
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
18 - Minor Discharges
r 401 Water Quality Certification - Express
W Riparian Buffer Authorization
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:
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. lathe project located in any of NC's twenty coastal counties?
r Yes r No
1j. Is the project located in a designated trout watershed?
0 Yes r No
B. Applicant Information
1d. Who is applying for the permit?
W Owner r Applicant (other than owner)
1e. Is there an Agent/Consultant for this project?
r Yes r No
2. Owner Information
2a. Name(s) on recorded deed:
Rex Hospital Inc.
2b. Deed book and page no.:
2c. Responsible party:
Mr. William Muck
2d. Address
Street Address
4420 Lake Boone Trail
Address Line 2
CKY
Raleigh
Postal / Zip Code
27607-6599
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
State / Frovinoe / Pagion
NC
Country
USA
2f. Fax Number:
[phone]
r Yes r No
r Yes r No
C. Project Information and Prior Project History v
1. Project Information

1b. Subdivision name:
(if appropriate)
1c. Nearest municipality / town:
Raleigh
F
2. Project Identification
2a. Property Identification Number:
0785637844
2c. Project Address
Street Address
Parcel bounded by Macon Pond, Edwards Mill, and Duraleigh Roads.
Address Line 2
City
Raleigh
Pbstal / Zip Cade
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Richland Creek
3b. Water Resources Classification of nearest receiving water:*
C;NSW
3c. What river basin(s) is your project located in?*
Neuse
3d. Please provide the 12 -digit HUC in which the project is located.
030202010800
4. Project Description and History
2b. Property size:
27
State / Rovince / Fbgim
NC
Country
USA
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 parcel is partially forested and partially developed as part of the UNC Healthcare complex The surrounding vicinity consists of roads, residential, commercial, and institutional
development. A single wetland and stream were identified within the forested portion of the site parcel.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
r Yes r No R Unknown
4d. Attach an 8 1/2X11 excerpt from the most recent version of the USGS topographic map indicating the location of the project site. (for DWR)
USGS.pdf
8.03MB
4e. Attach an 8 1/2X11 excerpt from the most recent version of the published County NRCS Soil Survey map depicting the project site. (for DWR)
SoilSurvey.pdf 2.34MB
4f. List the total estimated acreage of all existing wetlands on the property:
0.022
4g. List the total estimated linear feet of all existing streams on the property:
280
4h. Explain the purpose of the proposed project:*
The project proposes to construct the Rex Cancer Center and its associated infrastructure and stormwater measures.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
The project will include four lots, to be divided by proposed streets; lots 1 and 2 are already mostly developed for parking and existing stormwater measures, while lots 3 and 4 are
currently mostly forested. Lots 1 and 2 will be redeveloped, with the proposed Cancer Center building located on Lot 1. Lot 3 Will include parking and a stormwater pond. Lot 4 will
include a stormwater pond and tree conservation area. Typical earth moving and construction equipment will be used; bulldozer, backhoe, cranes, dump trucks.
4j. Please upload project drawings for the proposed project.
Site Plan_Combined_20181022.pdf 52.25MB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
F 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 IT N/A
Corps AID Number:

Stream and wetland verified on-site, no AID issued to date.
NCDOT Drainage Easement, Allowable
5c. If Sa is yes, who delineated the jurisdictional areas?
Stream A
Name (if known): David G. Cooper
490
Agency/Consultant Company: Ecological Engineering, LLP
Other:
5d1. Jurisdictional determination upload
RexHealthcareCancerCenter_BufferDeterminationLetter_20180731.pdf 3.41 MB
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?
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
W Wetlands r Streams -tributaries W Buffers
r Open Waters r Pond Construction
2. Wetland Impacts
r
Reason M 2b. Impact type * (?) 2c. Type of W. 2d. W. name * 2e. Forested * 2f. Type of 2g. Impact
Jurisdicition*(?) area*
171,
JWetlarmwater Pond P Headwater Forest nd A Yes Corps 0.022
(acres)
2g. Total Temporary Wetland Impact
0.000
2g. Total Wetland Impact
0.022
2h. Comments:
Wetland impact is necessary due to site topography and the need for a stormwater pond.
6. Buffer Impacts (for DWR)
6a. Project is in which protect basin(s)?
Check all that apply.
V Neuse
F Catawba
F Goose Creek
F Other
2g. Total Permanent Wetland Impact
0.022
r Tar -Pamlico
F Randleman
F Jordan Lake
6b. Impact Type 6c. Per or Temp 6d. Stream name 6e. Buffer mitigation required? 6f. Zone 1 impact 6g. Zone 2 impact
NCDOT Drainage Easement, Allowable
P
Stream A
No
490
340
6h. Total buffer impacts:
Zone 1
Total Temporary impacts: 0.00
Zone 1
Total Permanent impacts: 490.00
Zone 1
Total combined buffer impacts: 490.00
Zone 2
0.00
Zone 2
340.00
Zone 2
340.00

61. Comments:
Buffer impacts are within the NCDOT drainage easement. Flow conveyed through buffer within a pipe from a wet detention pond, outlet to dissipator
pad located outside of stream channel. Flow attenuated and Nitrogen reduced by wet pond.
Supporting Documentation
C18068_Site-C1.pdf
804.14KB
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 impacts to the on-site stream are avoided. A dissipator pad originally proposed to outlet within the stream channel was able to be slightly moved
outside of the stream channel and now outlets to a non -stream drainageway adjacent to the stream. The width of buffer impact will be no greater than
the 30' wide sewer easement.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Construction techniques will not be able to avoid or minimize impacts to the wetland. The small wetland Will be impacted in its entirety.
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?
f Yes
r No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
Impacts to WoUS are 0.022 acre, which is below the threshold for mitigation.
F. Stormwater Management and Diffuse Flow Plan (required by DWR) U
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?
F- Level Spreader
F_ Vegetated Conveyance (lower SHWT)
r Wetland Swale (higher SHWT)
P Other SCM that removes minimum 30% nitrogen
r Proposed project will not create concentrated stormwater flow through the buffer
Diffuse Flow Documentation
C18068_SIA - 2018.10.18.pdf
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
19.63MB
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
2d. Which of the following stormwater management program(s) apply:
P Local Government r State
Local Government Stormwater Programs
W Phase II W NSW r USMP r Water Supply
Please identify which local government stormwater program you are using.
City of Raleigh
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?*
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
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.
The project will control runoff and water quality through on-site detention. No future impacts in the vicinity are anticipated. The parcel is expected to be
developed in its entirety; no other undeveloped areas are available within the drainage area for the stream, and no water quality impacts are expected
in the future.
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
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 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
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?
USFWS records of federally protected species documented from Wake County NC were consulted, most recently on Oct. 23, 2018. NC Natural
Heritage Program records dated July 2018 show no records of any naturally occurring federally protected species within 1.0 mile of the site parcel. A
reintroduction site for Michaux's sumac is located within 1.0 mile of the site parcel. On-site evaluation in June 2018 by Ecological Engineering staff
revealed limited habitat for Michaux's sumac, with no specimens observed. No habitat is present for red -cockaded woodpecker or mussel species. No
bald eagles or eagle nests were observed on the site parcel during on-site investigation in June 2018.
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?*
NOAA fisheries EFH mapper.
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?*
No potentially historic structures currently exist within the site parcel. The site soil has been disturbed in the past. NC State Historic Preservation Office
web service shows that surveyed structures (WA -2509, Harrison Family Houses) located adjacent to the site are now gone, likely as a result of the
construction of Macon Pond Road. These structures were not given any historic designation.
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 Floodplain Mapping Program (NCfloodmaps.com). Project is located in Zone X
Miscellaneous
Comments
Miscellaneous attachments not previously requested.
Signature
W 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:
David G. Cooper
Signature
Sign
Date
11/5/2018

SS
SS
S
S
SS
FOWP
WV WVWV
WV
G
G
G
G
G
FO FO
E
FO FO
FO FO
W
W
W
W
W
GIS WL GIS WL
N/F
CNL RETIREMENT PC1 NC, LP
DB 9653, PG. 39
BM 1996, PG. 1509
PIN: 0785-64-9530
EIR
EIP 2"
MH WITH CAPPED CONDUIT
RIM: 427.73'
U
MH WITH
CAPPED
CONDUIT
RIM: 426.27'
N/F
CWS EDWARDS SAF, LLC
EDWARDS MILL RE I, LLC
EDWARDS MILL RE II, LLC
DB 16262, PG. 417
BM 1996, PG. 362
PIN: 0785-54-3827
N/F
REX HOSPITAL, INC.
DB 12794, PG. 637
BM 2012, PG. 642
PIN 0785-63-7844
2923 EDWARDS MILL RD.
N/F
REX HOSPITAL, INC.
DB 12794, PG. 637
BM 2012, PG. 642
PIN 0785-63-7844
2923 EDWARDS MILL RD.
1,185,520 SF / 27.216 AC +/-
WV NO S
URVEY
NO SURVEY25.00'19.98'SA-
1
3

TT
P
IPE SA-12SA-11SA-10SA-09SA-08SA-07
SA-06
SA-05
SA-04
SA-03 SA-02
SA-01 START
WETLAND 'A'
979 SF / 0.022 AC
BLUE RI
D
G
E

R
O
A
D

E
X
T
.EDWARDS
MILL R
OAD
20.00'30.01'BU
F
F
E
R

Z
O
N
E

1
BUF
F
E
R

Z
O
N
E

2
BLUE RIDGE ROAD, RALEIGH, NC
UNC REX HEALTHCARE
MACON POND ROAD
SITE DEVELOPMENT
Project No:C18067
C1
Drawing No:
Ref No:--
Date:10.23.2018Scale:1" = 100'
Drawn By:MTJ
Checked By:RPL
©2018: All documents and calculations including computer files, drawings, and specification prepared by Stewart, Inc. are instruments of
professional service intended for one-time use. They are subject to copyright and other property right laws and shall remain the property of
Stewart, Inc. They are not to be copied, modified, or changed in any manner whatsoever nor assigned to a third party without prior written
permission of Stewart, Inc.
NORTH050100200
SCALE:1" = 100'
FIRM LICENSE #: C-1051
www.stewartinc.com
PROJECT #: C18068
223 S. WEST ST., #1100
RALEIGH, NC 27603
T 919.380.8750
ZONE 1 IMPACT
(490 SF / 0.011 AC)
ZONE 2 IMPACT
(340 SF / 0.008 AC)
WETLAND "A" IMPACT
(979 SF / 0.022 AC)
PROPOSED SCM
MAC
O
N

P
O
N
D

R
O
A
D
BLUE RIDGE ROADDURALEIGH
ROAD
BLUE
RI
D
G
E
R
O
A
D
EDWARDS
MILL
R
OAD
SITE
Legend
Study Area
Prepared By:
1970 Wake County Soil Survey, Map Sheet 48
.
0 1,000500
1" = 500'
Soil Survey
Rex Healthcare Cancer Center
Raleigh, NC
Figure 2
Stream A
Legend
Study Area
Prepared By:
2013 Raleigh West USGS Quadrangle
.
0 4,0002,000
1" = 2,000'
USGS Quadrangle
Rex Healthcare Cancer Center
Raleigh, NC
Figure 1