20141292 Ver 2_PCN Form Submission_20190201

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
20141292
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:
9900 Ray Road
1a. Who is the Primary Contact?*
Deborah E. Shirley
1b. Primary Contact Email:*
[e-mail]
Date Submitted
2/1/2019
Nearest Body of Water
UT to Lower Barton Creek
Basin
Neuse
Water Classification
WS -IV; NSW
Site Coordinates
Latitude: Longitude:
35.9204 -78.7119
FA. Processina Information
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)
Version# *
2
What amout is owed?*
r• $240.00
* $570.00
Select Project Reviewer*
Stephanie Goss:eads\szgoss
1c. Primary Contact Phone:*
[phone]

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:
W 401 Water Quality Certification - Regular
F Non -404 Jurisdictional General Permit
F Individual Permit
29 - Residential Developments
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. 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?
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:
Cleats Properties, LLC
2b. Deed book and page no.:
015807;00598
2c. Responsible party:
Chris Suber
2d. Address
Street Address
PO Box 446
Address Line 2
CKY
Camden
Postal / Zip Cade
27921
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
State / Frovince / Pagion
NC
Country
USA
2f. Fax Number:
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:
2b. Property size:
0789-50-0359
14.35
2c. Project Address
Street Address
9900 Ray Road
Address Line 2
CKY
State / Rovinee / Region
Raleigh
NC
Rostal / Zip Cade
Country
27613
USA
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
UT to Lower Barton Creek
3b. Water Resources Classification of nearest receiving water:*
WS -IV; 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.
030202010602
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 existing conditions onsite are wooded with a stream system bisecting the property. The general land use in the vicinity of the project is residential.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
F Yes F No r" Unknown
4c. If yes, please give the DWR Certification number or the Corps Action ID (exp. SAW -0000-00000).
A PCN application was submitted and authorized for the impacts included on December 16, 2014. A 404 Nationwide Permit Verification was issued on 1/21/15 (SAW -2013-01631); and a
401 Water Quality Certification was issued on January 2, 2015 (DWR #14-1292). The impacts requested within this application have not changed, however the previous authorizations
have expired.
Project History Upload
404 NWP 29_Cleats Properties_01-21-15.pdf
DWR 401 Approval_Cleats Property_01-01-15.pdf
1.05MB
184.85KB
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)
USGS.pdf
1.04MB
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)
ss.pdf 217.9KB
4f. List the total estimated acreage of all existing wetlands on the property:
Approximately 0.397 acres
4g. List the total estimated linear feet of all existing streams on the property:
Approximately 1,784 linear feet
4h. Explain the purpose of the proposed project:*
The purpose of the project is to request a re -authorization to provide access to an upland area and to construct a residential structure.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
The overall project consists of constructing a driveway which will result in one stream crossing, plunge pools and a residential structure. Equipment such as bull dozers, bucket loaders
and other typical equipment used for land disturbance and construction will be utilized for this project.
4j. Please upload project drawings for the proposed project.
DEST2515-signed.pdf 1.21 MB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
F Yes F No f Unknown

Comments:
Driveway -culvert
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
Culvert
r Preliminary r Approved r Not Verified r Unknown r IIA
Perennial
Corps AID Number:
14
Average (feet)
SAW -2013-01631
Corridor
5c. If 5a is yes, who delineated the jurisdictional areas?
omland Hardwood Forest
Name (if known): Steven Ball
Yes
Agency/Consultant Company: Soil & Environmental Consultants, PA
0.003
(acres)
Other:
5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
On May 13, 2013, Mr. Dave Shaeffer of the USACE verified the jurisdictional streams and wetlands on the subject property. A Jurisdictional Determination was issued on February 4,
2013, AID# SAW -2013-01631. On May 2, 2013, Martin Richmond of the NCDWQ conducted a buffer determination for the subject property, see attached letter (NBRRO #13-154).
5d1. Jurisdictional determination upload
Signed JD 020614.pdf 839.91 KB
12060.w2 buffer Itr.pdf 1.23MB
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?
None to my knowledge.
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
W Wetlands W Streams -tributaries W Buffers
r Open Waters r Pond Construction
2. Wetland Impacts
2a1 Reason (?) 2b. Impact type * (?) 2c. Type of W. 2d. W. name * 2e. Forested* 2f. Type of 2g. Impact
Jurisdicition*(?) area*
Impact #1 Driveway -Culvert P �ff-mland Hardwood Forest W1 Yes Both 0.004
(acres)
Impact #1 Driveway -Construction T Bott
2g. Total Temporary Wetland Impact
0.003
2g. Total Wetland Impact
0.007
2h. Comments:
3. Stream Impacts
2g. Total Permanent Wetland Impact
0.004
F1 3h Reason for impact (?) 3b.lmpact type * 3c. Type of impact* 3d. S. name* 3e. Stream Type *]3f.
Type of 3g. S. width * 3h. Impact
(?) Jurisdiction* length*
S1
Driveway -culvert
Permanent
Culvert
A- UT to Barton Creek
Perennial
Both
14
Average (feet)
19
(linearfeet)
Corridor
Driveway -Construction
Corridor
omland Hardwood Forest
W1
Yes
Both
0.003
(acres)
2g. Total Temporary Wetland Impact
0.003
2g. Total Wetland Impact
0.007
2h. Comments:
3. Stream Impacts
2g. Total Permanent Wetland Impact
0.004
F1 3h Reason for impact (?) 3b.lmpact type * 3c. Type of impact* 3d. S. name* 3e. Stream Type *]3f.
Type of 3g. S. width * 3h. Impact
(?) Jurisdiction* length*
S1
Driveway -culvert
Permanent
Culvert
A- UT to Barton Creek
Perennial
Both
14
Average (feet)
19
(linearfeet)
32
Driveway -Construction
Corridor
Temporary
Other
Barton Creek
ffo
Perennial
Both ]�;;;B;;]
3i. Total jurisdictional ditch impact in square feet:
0

31. Total permanent stream impacts:
19
31. Total stream and ditch impacts:
31
3j. Comments:
6. Buffer Impacts (for DWR)
6a. Project is in which protect basin(s)?
Check all that apply.
R Neuse
F Catawba
F Goose Creek
F Other
31. Total temporary stream impacts:
12
F Tar -Pamlico
r Randleman
r Jordan Lake
ib. Impact Type 6c. Per or Temp 6d. Stream name 6e. Buffer mitigation required? 6f. Zone 7 impact Bg. Zone 2 impact
)riveway/Road Impact P LIT to Barton Creek No 2,189 1,714
6h. Total buffer impacts:
Zone 1
Total Temporary impacts: 0.00
Zone 1
Total Permanent impacts: 2,189.00
Zone 1
Total combined buffer impacts: 2,189.00
61. Comments:
Zone 2
0.00
Zone 2
1.714.00
Zone 2
1,714.00
Supporting Documentation
IMPACT EXHIBIT.pdf 589.42KB
EEJ:mpact Justification and Mitigation u
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
S&EC completed a wetland delineation and Neuse Buffer evaluation on the property in order to identify jurisdictional streams/wetlands and riparian
buffers. Access to the property requires crossing a perennial stream and wetland system. The project engineer has proposed is a 12' wide drive and
has designed the stream crossing with a box culvert and adjacent 42" CMP for high flows and hydrologic connectivity. The proposed impacts will result
in 0.004 acres of permanent wetland impacts for the culvert and FII, 0.003 acres of temporary wetland impacts for construction activities; 19 linear feet
of permanent stream impact for the culvert and 12 linear feet of temporary stream impacts for construction activities. All temporary wetland and stream
impacts will be brought back to pre -construction contours and original stream elevations, and stabilized post construction. Additionally, the proposed
road crossing will result in Zones 1 & 2 permanent riparian buffer impacts.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Sediment fencing will be utilized to protect water quality during construction activities.
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:
Proposed permanent impacts are below 0.10 acre of wetlands and 150 linear feet of stream, therefore the applicant is not proposing compensatory mitigation in the form of mitigation
payment. However, the applicant has worked with his engineer to avoid and minimize impacts onsite, which is a form of mitigation.
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

What type of SCM are you providing?
F- Level Spreader
F- Vegetated Conveyance (lower SHWT)
F- Wetland Swale (higher SHWT)
F Other SCM that removes minimum 30% nitrogen
V 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
Comments:
Per the project engineer, stormwater management is not required since the increase in post development flow will be less than 10% over the pre -development condition.
G. Supplementary Information (A
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.
We have reviewed the "Draft Internal Policy, Cumulative impacts and the 401 Water Quality Certification and Isolated Wetlands Programs' document
prepared by the NC Division of Water Quality on April 10, 2004, version 2.1. The draft states that many private developments are unlikely to cause
cumulative impacts, including projects such as urban in -fill, most residential subdivisions and small commercial developments as well as agricultural
and silvicultural operations. This project is a single family residence that would not result in additional development or impact downstream water
quality. We anticipate that the DWR will advise us if any additional information is needed.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
r Yes r No r' 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 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 f• No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
North Carolina Natural Heritage Program Data Explorer Search [February 1, 20191. Department of Environment and Natural Resources, Office of Land
and Water Stewardship, Raleigh, NC. http://www.ncnhp.org/
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?*
The NOAA Fisheries Habitat Conservation Essential Fish Habitat Mapper website was referenced. No Essential Fish Habitat was identified near the
project.
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?*
The INC State Historic Preservation Office HPPOWEB GIS Service Interactive Map was referenced on February 1, 2019; no historic listings, stud list
entries, or determined eligible listings were identified within the property boundaries.
7c. Historic or Prehistoric Information Upload
8. Flood Zone Designation (Corps Requirement)
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?*
NC Floodplain Mapping Program.
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:
Deborah E. Shirley
Signature
9e6ol, E_-1111dl
Date
2/1/2019
u