20140574 Ver 5_PCN Form Submission_20190318

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
Oiange only if needed.
BIMS # Assigned
20140574
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:
Sunset Bluffs Subdivision - Phase 17
1a. Who is the Primary Contact?*
Chad Blackmon
1b. Primary Contact Email:*
[e-mail]
Date Submitted
3/18/2019
Nearest Body of Water
UT to Basal Creek
Basin
Neuse
Water Classification
B; NSW
Site Coordinates
Version# *
5
What amout is owed?*
r• $240.00
* $570.00
Select Project Reviewer*
Stephanie Goss:eads\szgoss
1c. Primary Contact Phone:*
[phone]
Latitude: Longitude:
35.623467 -78.806356
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:
W 401 Water Quality Certification - Regular
F Non -404 Jurisdictional General Permit
F Individual Permit
12 - Utility Lines
r 401 Water Quality Certification - Express
r 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:
SSBNC,LLC
2b. Deed book and page no.:
016421 ; 01765
2c. Responsible party:
Chad Blackmon
2d. Address
Street Address
PO Box 36
Address Line 2
CKY
Holly Springs
Postal / Zip Code
27540
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
State / Frovinoe / fbgion
NC
Ceuntry
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:
(d appropriate)
Sunset Bluffs
1c. Nearest municipality/town:
Fuquay-Varina
2. Project Identification
2a. Property Identification Number:
0658728353
2c. Project Address
Street Address
Herbert Akins Road
Address Line 2
Oty
Fuquay-Varina
Postal / Zip Oxde
27526
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
UT to Basal Creek
3b. Water Resources Classification of nearest receiving water:*
B: 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.
030202010901
4. Project Description and History
2b. Property size:
21.97
State / Frovinre / Region
NC
Or ntry
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:*
Site is currently forested, and surrounded by residential subdivisions, and Herbert Akins Elementary School.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?
F Yes r No r Unknown
4c. If yes, please give the DWR Certification number or the Corps Action ID (exp. SAW -0000-00000).
Corps Action ID: SAW -2013-01898
DWR #14-0574 v4
Project History Upload
Sunset Bluffs Sewer Ouffall DWR Permit 071014.pdf
2.15MB
Sunset X DWQ Neuse Buffer Stream Origin Letter 071713.pdf
372.83KB
Sunset Bluffs Sewer Ouffall Corps Permit 071714.pdf
4.67MB
Sunset Bluffs South_DWR_401_Certification.pdf
218.84KB
Sunset Bluffs South-DWR _401 -Certification _082216.pdf
210.12KB
Sunset Bluffs _USACEpermit_022416.pdf
654.36KB
Sunset Bluffs _USACEpermit_081016.pdf
448.98KB
4d. Attach an 81/2 X 11 excerpt from the most recent version of the USGS topographic map indicating the location of the project site. (for DWR)
Sunset Bluffs-USGS Map 031519.pdf 688.64KB
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)
Sunset Bluffs -Soils Map 031519.pdf 1.11 MB
4f. List the total estimated acreage of all existing wetlands on the property:
1.88
4g. List the total estimated linear feet of all existing streams on the property
11,648
4h. Explain the purpose of the proposed project:*
The proposed project will provide gravity sewer service to Herbert Akins Elementary School, allowing for the abandonment of an wasting sewage pump station on school property.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
Project will install 870 linear feet of gravity sewer to allow connection to Herbert Akins Elementary School. Two small temporary impacts to forested wetlands are required for installation.
Equipment used includes tracked excavators, rollers, etc.
4j. Please upload project drawings for the proposed project.

SSB-PH17-EROSIONPLAN-20190111.pdf
1.54MB
SSB-PH17-OVERALL-201901 1 1.pdf
2.49MB
SSB-PH17-PLANPROFILEl-201901 1 1.pdf
710.03KB
SSB-PH17-SITEPLAN-20190111.pdf
971.73KB
ssbs11+CD-201901151MPACT-PH17-1.pdf
322.39KB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes r No
0.010
(acres)
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:
SAW -2013-01898
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Scott Mitchell
Agency/Consultant Company: Mitchell Environmental, PA
Other:
O Unknown
5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
Corps Preliminary JD: February 24, 2016
DWQ Surface Water Determination Letter: July 17, 2013
5d1. Jurisdictional determination upload
Sunset X DWQ Neuse Buffer Stream Origin Letter 071713.pdf 372.83KB
Sunset Bluffs_USACE_PJD_JamesLastinger_022416.pdf 570.6KB
6. Future Project Plans
6a. Is this a phased project?*
C Yes r No
7b. If yes, explain.
Project has 17 phases. The proposed sewer line impacts are part of Phase 17.
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.
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
2a1 Reason (?) 2b. Impact type * (?) 2c. Type of W. * 2d. W. name * 2e. Forested* 2f. Type of 2g. Impact
Jurisdicition*(?) area*
Im act 1 Sewer installation T Headwater Forest Wetland AN Yes Both 0.004
P
(acres)
Im act 2 Sewer installation T Headwater Forest Wetland AO [es�Botlh
2g. Total Temporary Wetland Impact
0.014
2g. Total Wetland Impact
0.014
2h. Comments:
6. Buffer Impacts (for DWR)
2g. Total Permanent Wetland Impact
0.000
P
0.010
(acres)
2g. Total Temporary Wetland Impact
0.014
2g. Total Wetland Impact
0.014
2h. Comments:
6. Buffer Impacts (for DWR)
2g. Total Permanent Wetland Impact
0.000

6a. Project is in which protect basin(s)?
Check all that apply.
V Neuse r Tar -Pamlico
r- Catawba r Randleman
r- Goose Creek r Jordan Lake
r- Other
ib. Impact Type 6c. Per or Temp 6d. Stream name 6e. Buffer mitigation required? 6f. Zone 1 impact 6g. Zone 2 impact
;ewer installation and easement P UT to Basal Creek No 0 800
6h. Total buffer impacts:
Zone 1 Zone 2
Total Temporary impacts: 0.00 0.00
Zone 1 Zone 2
Total Permanent impacts: 0.00 800.00
Zone 1 Zone 2
Total combined buffer impacts: 0.00 800.00
61. Comments:
Impacted buffer area will returned to pre -development grades, and re -vegetated with herbaceous vegetation. Proposed impacts are limited to Zone 2
only.
Supporting Documentation
ssbsl 1+CD-20190115 IMPACT-PH17-1.pdf 322.39KB
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:
Proposed impacts are unavoidable due to the location of the existing sewer manholes that will be connected by this new sewer main. Additionally,
impacts are designed as perpendicular to wetlands as possible.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Silt fencing will protect areas outside of the construction corridor.
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:
No loss of wetlands and tree removal in impact areas is very minimal.
F. Stormwater Management and Diffuse Flow Plan (required by DWR) v
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?
r Level Spreader
r Vegetated Conveyance (lower SHWT)
r Wetland Swale (higher SHWT)
9 Other SCM that removes minimum 30% nitrogen
r 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)?
f 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
2d. Which of the following stormwater management program(s) apply:
,R Local Government r State
Local Government Stormwater Programs
P Phase II V NSW f USMP F Water Supply
Please identify which local government stormwater program you are using.
Fuquay-Varina
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.
Project is a small gravity sewer line intended to allow the abandonment of an existing sewage pump station on Herbert Akins Elementary School
property.
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?*
f 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
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 Endangered species, threatened species, federal species of concern, and candidate species list for Wake County, NC.

Consultation Documentation Upload
USFWS Wake County Endangered Species 031519.pdf 1.36MB
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 Essential Fish Habitat 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?*
State Historic Preservation Office Historic Properties Map.
7c. Historic or Prehistoric Information Upload
Sunset Bluffs Historic Preservation Map.pdf
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?*
Wake County iMaps.
Miscellaneous
Comments
Miscellaneous attachments not previously requested.
Signature
*
V By checking the box and signing below, I certify that:
666.75KB
• 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:
Scott Mitchell
Signature
S�OTT,y[i7-Gh�LL
Date
3/18/2019