20190446 Ver 1_401 Application_20190408

Staff Review
Does this application have all the attachments needed to accept it into the review process?
r Yes r No
ID#*
20190446
Version* 1
Is this project a public transportation project?* r Yes
r No
Reviewer List:* Andrew Moore:eads\awmoore3
Select Reviewing Office:* Asheville Regional Office - [phone]
Submittal Type:*
401 Application
Does this project require a request for payment to be sent?*
r
Yes
r
No
How much is r $240.00
*
owed? r $570.00

Project Submittal Form
Please note: fields marked with a red asterisk below are required. You will not be able to submit the form until all
mandatory questions are answered.
Project Type: r New Project
f Pre -Application Submittal
r More Information Response
r Other Agency Comments
r For the Record Only (Courtesy Copy)
New Project - Please check the new project type if you are trying to submit a new project that needs an official approval
decision.
Pre -Application Submittal - Please check the pre -application submittal if you just want feedback on your submittal and
do not have the expectation that your submittal will be considered a complete application requiring a formal decision.
More Information Response - Please check this type if you are responding to a request for information from staff and
you have and ID# and version for this response.
Other Agency Comments - Please check this if you are submitting comments on an existing project.
Project Contact Information
Name: Jonathan Hyman
Who is submitting the inforrration?
Email Address: [e-mail]
Project Information
Project Name: Hyman Riverbank Stabilization
Is this a public transportation project?
r Yes
r No
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
r Yes r No r Unknown
County (ies)
Avery
Please upload all files that need to be submited.
Click the upload button or drag and drop files here to attach docurr t
7_Water_Sound_PCN_Form_20190319.pdf 6.86MB
Only pdf or lTrz files are accepted.
Describe the attachments:
Pre -Construction Notification Form and Aerial Map
V By checking the box and signing box below, I certify that:
o I have given true, accurate, and complete information on this form;
o I agree that submission of this form is a "transaction" subject to Chapter 66, Article 40 of the NC General Statutes (the
"Uniform Electronic Transactions Act")
o 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 online form."
Signature:
wPiSDf� ��
Submittal Date: Is filled in autorratically.

A
Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.4 January 2009
V
Page 1 of 10
PCN Form — Version 1.4 January 2009
Pre -Construction Notification (PCN) Form
A.
Applicant Information
1.
Processing
1 a.
Type(s) of approval sought from the Corps:
Section 404 Permit
❑ Section 10 Permit
1 b. Specify Nationwide Permi(NWP) umber: (3 or General Permit (GP) number:
1 c.
Has the NWP or GP number been verified by the Corps?
Yes ❑ No
1 d.
Type(s) of approval sought from the DWQ (check all that apply):
0 401 Water Quality Certification — Regular ❑ Non -404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
1 e.
Is this notification solely for the record
because written approval is not required?
For the record only for DWQ
401 Certification:
❑ Yes 6QNo
For the record only for Corps Permit:
❑ Yes Z? to
1f.
Is payment into a mitigation bank or in -lieu fee program proposed for
mitigation of impacts? If so, attach the acceptance letter from mitigation bank
or in -lieu fee program.
❑ Yes gNo
1g.
Is the project located in any of NC's twenty coastal counties. If yes, answer 1h
below.
❑ Yes QNo
1h.
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes ❑ No
2.
Project Information
2a.
Name of project:
marl 1VerbahIf, ,S}0S11*%
0 pr1
2b.
County:
Fl,V@r
2c.
Nearest municipality/ town:
Elk ark
2d.
Subdivision name:
2e.
NCDOT only, T.I.P. or state project no:
3.
Owner Information
3a.
Name(s) on Recorded Deed:
-S6no i4ivi at%d 1,�Ipa,
�M%We E Asift
3b.
Deed Book and Page No.
P104 avok. HH NAP— 3S
Vt VA
3c.
Responsible Party (for LLC if
applicable):
qL-
E-- Prl01ar4 ---------
"'--3d.
3d.
Street address:
13l6 (, , e Pt,
wn-kr d pr
3e.
City, state, zip:
arIAP -�$ 0`?
Elk Phirk,,NC 58422
3f.
Telephone no.:
04 . H30 _ QS'q
3g.
Fax no.:
3h.
Email address:
V
Page 1 of 10
PCN Form — Version 1.4 January 2009

4. Applicant Information (if different from owner)
4a. Applicant is:
❑ Agent ❑ Other, specify:
4b. Name:
4c. Business name
(if applicable):
4d. Street address:
4e. City, state, zip:
4f. Telephone no.:
4g. Fax no.:
4h. Email address:
5. Agent/Consultant Information (if applicable)
5a. Name:
5b. Business name
(if applicable):
5c. Street address:
5d. City, state, zip:
5e. Telephone no.:
5f. Fax no.:
5g. Email address:
a �•
Page 2 of 10

M
4
B.
Project Information and Prior Project History
1.
Property Identification l qt 3 �!k �tver' Re
1a.
Property identification no. (tax PIN or parcel ID):
Ay coot4 C,l ; 1$ 9005gq$y0
1b.
Site coordinates (in decimal degrees):
Latitude: Zj(p , ((p(Q7Cj 0 Longitude: —�� � . C'11�j r♦is S
1 c.
Property size:
�„ 0. fo ' acres
2.
Surface Waters
2a.
Name of nearest body of water to proposed project:
5(k
2b.
Water Quality Classification of nearest receiving water:
2c.
River basin:
WGA
3.
Project Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application:
R�tiderl�tA1 pbpmJ61 w;44:4 Ok Qui e R41e. E(cvaled e1w levels hayt eroded
riverbank.
3b.
List the total estimated acreage of all existing wetlands on the property:
3c.
List the total estimated linear feet of all existing streams (intermittent and perennial) on the property: 14o,
3d.
Explain the purpose of the proposed project:
Siwlll* 61VI464k and P*V., '-twlHw evosto.l
3e. Describe the overall project in detail, including the type of equipment to be used:
Wil► Plate tb%k aim awe's edgge J0 err��k a rock 4a. WIM i6pe balk a� I -N
Gacon3t M^i {o Mold .l. 041 stea he&A If 401d P14At Vt atwtM to cV9•k room Syb4ew+, �q,,,prK-r►f
4. uris ictional ;terminationsai ,
4a.
Have jurisdictional wetland or stream determinations bg the
Corps or State been requested or obtained for this property /
project (includingall prior phases) in the past?
❑ Yes B --No ❑ Unknown
Comments:
4b.
If the Corps made the jurisdictional determination, what type
of determination was made?
❑ Preliminary ❑ Final
4c.
If yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other.-
ther:4d.
4d.
If yes, list the dates of the Corps jurisdictional determinations or State determinations nd 11tac h documentation.
Nv,x d- � c� 3 C.�&IA.d -e �Lr� v�� � 11
5.
Project History
5a.
Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past?
El Yes rIlUn ❑ Unknown
5b.
If yes, explain in detail according to "help file" instructions.
6.
Future Project Plans
6a.
Is this a phased project?
❑ Yes o
6b.
If yes, explain.
Page 3 of 10
PCN Form — Version 1.4 January 2009
D4

C. Proposed Impacts Inventory
1. Impacts Summary. .. '
1 a. Which tections we(e'compi"eted belbW fot'your project (check all that apply):
❑ Wetlands ❑ Streams — tributaries ❑ Buffers ❑ Open Waters ❑ Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a.
2b.
2c.
2d.
2e. 2f.
Wetland impact
Type of impact
Type of wetland
Forested
Type of jurisdiction Area of
number
Corps (404,10) or impact
Permanent (P) or
DWQ (401, other) (acres)
Temporary
W1 -
Choose one
Choose one
Yes/No
-
W2
Choose one
Choose one
H
Yes/No
`"
` .`Choobe one
' '` CKobs
W4
Choose one
Choose one
Yes/No
W5
Choose one
Choose one
Yes/No
W6 -
Choose one
Choose one
Yes/No
-
2g. Total Wetland Impacts:
2h. Comments:
• �. a .• " • t.. e
3: , $tr"earrf'Irripacts .. � .. - , - � .. . • " f � " . :. • • • • . " : r ,
If there'are perdn'riial br in,tetrfiitt6hestream:impacts(includingntemporary ienpacts� proposed"on,tM site; theh`comptete tl'is "
question for all stream sites impacted. ` "
3a.
3b.ype
3c.
3d.
3e.
3f.
3g.
Stream impact
of impa
Stream name
Perennial (PER) or
Type of
Average
Impact
number
intermittent (INT)?
jurisdiction
stream
length
Permanent (P) or
width
(linear
Temporary (T)
(feet)
feet)
S1
Choose one
i k^__
b
140,
S2 -
Choose one
-
S3
Choose one •
S4 -
Choose one
-
-
S5 -
Choose one
S6 -
Choose one
-
3h. Total stream and tributary impacts
3i. Comments:
Page 4of10
. PCN Form — Version 1.4 January 2009

4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impacts below.
4a.
Open water
impact number
Permanent (P) or
Temporary T
4b.
Name of waterbody
(if applicable)
4c.
Type of impact
4d.
Waterbody
type
4e.
Area of impact (acres)
01
Choose one
Choose
O2 -
Choose one
Choose
03
Choose one
Choose
04
Choose one
Choose
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If pond or lake construction proposed, the complete the chart below.
5a.
Pond ID number
5b.
Proposed use or
purpose of pond
5c.
Wetland Impacts (acres)
5d. 5e.
Stream Impacts (feet) Upland
(acres)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
P1
Choose one
P2
Choose one
5f. Total:
5g. Comments:
5h. Is a dam high hazard permit required?
❑ Yes ❑ No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If any impacts require mitigation, then you MUST fill out Section D of this form.
6a. Project is in which protected basin?
❑ Neuse ❑ Tar -Pamlico ❑ Catawba ❑ Randleman ❑ Other:
6b.
Buffer Impact
number —
Permanent (P) or
Temporary
6c.
Reason for impact
6d.
Stream name
6e.
Buffer
mitigation
required?
6f.
Zone 1
impact
(square
feet)
6g.
Zone 2
impact
(square
feet
61 -
Yes/No
B2 -
Yes/No
B3 -
Yes/No
B4 -
Yes/No
B5 -
Yes/No
B6 -
Yes/No
6h. Total Buffer Impacts:
6i. Comments:
Page 5 of 10

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
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?
❑ Yes ❑ No
2b. If yes, mitigation is required by (check all that apply):
❑ DWQ ❑ Corps
2c. If yes, which mitigation option will be used for this
project?
❑ Mitigation bank
❑Payment to in -lieu fee program
❑ Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter)
Type: Choose one
Type: Choose one
Type: Choose one
Quantity:
Quantity:
Quantity:
3c. Comments:
4. Complete if Making a Payment to In -lieu Fee Program
4a. Approval letter from in -lieu fee program is attached.
❑ Yes
4b. Stream mitigation requested:
linear feet
4c. If using stream mitigation, stream temperature:
Choose one
4d. Buffer mitigation requested (DWQ only):
square feet
4e. Riparian wetland mitigation requested:
acres
4f. Non -riparian wetland mitigation requested:
acres
4g. Coastal (tidal) wetland mitigation requested:
acres
4h. Comments:
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
Page 6 of 10
PCN Form — Version 1.4 January 2009

6. Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation?
El Yes E] No
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.
Zone
6c.
Reason for impact
6d.
Total impact
(square feet)
Multiplier
6e.
Required mitigation
(square feet)
Zone 1
3 (2 for Catawba)
Zone 2
1.5
6f. Total buffer mitigation required:
6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in -lieu fee fund).
6h. Comments:
Page 7 of 10

E.
Stormwater Management and Diffuse Flow Plan (required by DWQ)
1.
Diffuse Flow Plan
1 a. Does the project include or is it adjacent to protected riparian buffers identified
❑ Yes ❑ No
within one of the NC Riparian Buffer Protection Rules?
1 b.
If yes, then is a diffuse flow plan included? If no, explain why.
❑ Yes ❑ No
2.
Stormwater Management Plan
2a.
What is the overall percent imperviousness of this project?
2b.
Does this project require a Stormwater Management Plan?
❑ Yes ❑ No
2c.
If this project DOES NOT require a Stormwater Management Plan, explain why:
2d.
If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
2e.
Who will be responsible for the review of the Stormwater Management Plan?
3.
Certified Local Government Stormwater Review
3a.
In which localgovernment's jurisdiction is thisproject?
❑ Phase II
❑ NSW
3b.
Which of the following locally -implemented stormwater management programs
❑ USMP
apply (check all that apply):
❑ Water Supply Watershed
❑ Other:
3c.
Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ❑ No
attached?
4.
DWQ Stormwater Program Review
❑Coastal counties
❑HQW
4a.
Which of the following state -implemented stormwater management programs apply
❑ ORW
(check all that apply):
❑Session Law 2006-246
❑ Other:
4b.
Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ❑ No
attached?
5.
DWQ 401 Unit Stormwater Review
5a.
Does the Stormwater Management Plan meet the appropriate requirements?
❑ Yes ❑ No
5b.
Have all of the 401 Unit submittal requirements been met?
❑ Yes ❑ No
Page 8 of 10
PCN Form — Version 1.4 January 2009

F. Supplementary Information
1.
Environmental Dobumentation (DWQ Requirement)
1 a.
Does the project involve an expenditure of public (federal/state/local) funds or the
❑ Yes
❑ No
use of public (federal/state) land?
1b.
If you answered "yes" to the above, does the project require preparation of an
environmental document pursuant to the requirements of the National or State
❑ Yes
❑ No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1 c.
If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
❑ Yes
❑ No
letter.)
Comments:
2.
Violations (DWQ Requirement)
2a.
Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards,
El Yes
❑ No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b.
Is this an after -the -fact permit application?
El Yes
❑ No
2c.
If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
3.
Cumulative Impacts (DWQ Requirement)
3a.
Will this project (based on past and reasonably anticipated future impacts) result in
❑ Yes
❑ No
additional development, which could impact nearby downstream water quality?
3b.
If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
4.
Sewage Disposal (DWQ Requirement)
4a.
Clearly detail`tlie Otimate treatment methods and disposition (non -discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility.
Page 9 of 10
PCN Form — Version 1.4 January 2009

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or
❑ Yes No
habitat?
CPJ
5b. Have you checked with the USFWS concerning Endangered Species Act
❑ Yes ❑.No
impacts?
vt--
5c. If yes, indicate the USFWS Field Office you have contacted.
-
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?
❑ Yes
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
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
❑ Yes '�
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did yo use to determine whether your site would impact historic or archeological resources?
kLn
0 VA,
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA -designated 100 -year floodplain?
(,Yes ❑ No
8b. If yes, explain how project meets FEMA requirements: �-
IN t I l
8c. What soAft did you use to make the floodplain determination?
7Yon^JhltA liywlart
3119 % 1q
Applicant/Agent's Printed Name
Date
Applicant/Agent's Signa re
(Agent's signature is valid only if an authorization
letter from theapplicant is rovided.
Page 10 of 10

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