20190823 Ver 1_PCN Form Submission_20190617

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Pre -Construction Notification (PCN) Form
September 29, 2018 Ver 3
Initial Review
Has this project met the requirements for acceptance into the review process?*
r Yes
r No
Is this project a public transportation project?*
r Yes r No
Change only if needed.
BIMS # Assigned *
Version#*
20190823
1
Is a payment required for this project?*
* No payment required
What amout is owed?*
* Fee received
r $240.00
r Fee needed - send electronic notification
r $570.00
Reviewing Office* Select Project Reviewer*
Raleigh Regional Office - [phone] Stephanie Goss:eads\szgoss
Information for Initial Review
1a. Name of project:
1011 Washington Street
1a. Who is the Primary Contact?*
Eric Kulz
1 b. Primary Contact Email:*
[e-mail]
Date Submitted
6/17/2019
Nearest Body of Water
Lynn Branch
Basin
Neuse
Water Classification
WS -III; NSW
Site Coordinates
Latitude:
35.772525
A. Processing Information
County (or Counties) where the project is located:
Wake
Is this project a public transportation project?*
r Yes r No
Longitude:
-78.776268
1a. Type(s) of approval sought from the Corps:
V Section 404 Permit (wetlands, streams and waters, Clean Water Act)
F Section 10 Permit (navigable venters, tidal waters, Rivers and Harbors Act)
1 b. What type(s) of permit(s) do you wish to seek authorization?
P Nationwide Permit (NWP)
F- Regional General Permit (RGP)
r- Standard (IP)
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:
rJ 401 Water Quality Certification - Regular
F Non -404 Jurisdictional General Permit
F Individual Permit
13 - Bank Stabilization
1e. Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification:
For the record only for Corps Permit:
F 401 Water Quality Certification - Express
fJ 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
1j. Is the project located in a designated trout watershed?
r- Yes r No
B. Applicant Information
1d. Who is applying for the permit?
F- Owner FT 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:
Alexander & Cecile Kohlhofer (project within Town of Cary 20 -foot sanitary sewer easement
2b. Deed book and page no.:
016424 - 00534
2c. Responsible party:
Eric Kulz (Town of Cary)
2d. Address
Street Address
1011 Washington Street
Address Line 2
aY
Cary
Postal / Zip Cade
27511-3919
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
Eric Kulz
State / Rwince / Pagion
NC
Country
USA
2f. Fax Number:
r Yes r No
r Yes r No

3b. Business Name:
Town of Cary
3c. Address
Street Address
P.O. Box 8005
Address Line 2
cfty
Cary
Postal / Zip Code
27512-8005
3d. Telephone Number:
[phone]
3f. Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(if appropriate)
Greenwood Forest
1c. Nearest municipality/ town:
Cary
2. Project Identification
2a. Property Identification Number:
Real ID# 0017778
2c. Project Address
Street Address
1011 Washington Street
Address Line 2
4tY
Cary
Postal / Zip (ode
27511-3919
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Lynn Branch
3b. Water Resources Classification of nearest receiving water:*
WS -III; 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.
030202011001
4. Project Description and History
Slate / Rwince / Region
NC
Country
USA
3e. Fax Number:
2b. Property size:
0.78
State / Rwince / Pagron
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 project site is a single-family residential lot within the Greenwood Forest subdivision, which was constructed in the 1960s. General land use in the vicinity is single-family residential,
with commercial development to the west along Kildaire Farm Road.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
r Yes 6 No r Unknown
4d. Attach an 8 1/2 X11 excerpt from the most recent version of the USGS topographic map indicating the location of the project site. (for DWR)
USGS.pdf 73.09KB
4e. Attach an 8 1/2 X11 excerpt from the most recent version of the published County NRCS Soil Survey map depicting the project site. (for DWR)
Soils.pdf 227.94KB
4f. List the total estimated acreage of all existing wetlands on the property:
0
4g. List the total estimated linear feet of all existing streams on the property:

100
4h. Explain the purpose of the proposed project:*
The purpose of the project is to cover a partially -exposed sewer line (eight -inch vitrified clay pipe; VCP) in the right streambank to protect the pipe from breakage and releasing sewage
to Lynn Branch.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
The project will entail laying back the undercut bank that hangs over the sewer line, establishing a 2:1 slope, and stabilizing the streambank with erosion control fabric and Class B
riprap.
4j. Please upload project drawings for the proposed project.
Washington St Impact Map.pdf 466.76KB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes r No r 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 r N/A
Corps AID Number:
Sc. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
5dl. 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 projector related activity?
No.
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
F Wetlands 17 Streams -tributaries V Buffers
r- Open Waters F Pond Construction
3. Stream Impacts
3a. 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*
i1 streambank stabilizaStabilization nch P::] Both A ] �
12
(linearfeet)
31. Total jurisdictional ditch impact in square feet:
0
31. Total permanent stream impacts: 31. Total temporary stream impacts:
0 12
3i. Total stream and ditch impacts:
12
3j. Comments
6. Buffer Impacts (for DWR)
6a. Project is in which protect basin(s)?

Ch�k all that apply.
V Neuse
F Catawba
F Goose Creek
F Other
F Tar -Pamlico
F Randleman
r Jordan Lake
b. Impact Type 6c. Per or Temp 6d. Stream name 6e. Buffer mitigation required? 6f. Zone 1 impact 6g. ZoneZone 2 impact
'treambank stabilization (riprap) P Lynn Branch No 144 Eo -
6h.
6h. Total buffer impacts:
61. Comments:
See Impact Map uploaded for Section 4.4.1 above.
Supporting Documentation
E. Impact Justification and Mitigation J
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
Stabilization is limited to the length of stream where the pipe is exposed (12 LF).
Ib. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Construction will occur during a period of low flow. Disturbed areas will be either stabilized with filter fabric and riprap or will be seeded and strewed.
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:
Streambank stabilization does not require either stream or buffer 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
fJ Proposed project will not create concentrated stormwater flowthrough the buffer
Diffuse Flow Documentation
Stormwater.pdf 6.99KB
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
Zone 1
Zone 2
Total Temporary impacts:
0.00
0.00
Zone 1
Zone 2
Total Permanent impacts:
144.00
0.00
Zone 1
Zone 2
Total combined buffer impacts:
144.00
0.00
61. Comments:
See Impact Map uploaded for Section 4.4.1 above.
Supporting Documentation
E. Impact Justification and Mitigation J
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
Stabilization is limited to the length of stream where the pipe is exposed (12 LF).
Ib. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Construction will occur during a period of low flow. Disturbed areas will be either stabilized with filter fabric and riprap or will be seeded and strewed.
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:
Streambank stabilization does not require either stream or buffer 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
fJ Proposed project will not create concentrated stormwater flowthrough the buffer
Diffuse Flow Documentation
Stormwater.pdf 6.99KB
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
3c. Antidegradation Calculations:
Stormwater.pdf 6.99KB
Comments:
This project involves restoring cover over an exposed sanitary sewer line and stabilizing the streambank. No concentrated stormwater flow will result from this project. Original contours
will be restored and seeded upon completion of the work.
No impervious surface will be added beyond the riprap used to stabilize the stream banks.
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
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 (North Carolina)
Environmental Policy Act (NEPA/SEPA)? *
r Yes r No
Comments:
Local funds only. In addition, 15A NCAC 01C .0407 states that standard maintenance/repair activities do not require filing of environmental
documents. (3) specifies eAsting utilities.
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 213.0200)? *
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 site vicinity and areas downstream are completely built out.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
r Yes r Nor WA
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.
5d. Is another Federal agency involved?*
C 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?
NCNHP website (6/12/19) and USFWS iPac website (6/12/19).
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?*
Project site not located within the 20 coastal counties.
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 Historic Protection Office HPOWEB Service (accessed 6/12/19). No elements on or near the project site.
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?*
Map No. 3720076400K Firm Panel: 0764. date: 5/2/06.
Miscellaneous
Comments
Miscellaneous attachments not previously requested.
Aerial Zoom.pdf
Signature
P By checking the box and signing below, I certify that:
247.16KB
• 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:
Eric Kulz
Signature
Date
6/17/2019

Upstream Section
0 5 10 15 20 25 300-5-10
Section A - Existing
0 5 10 15 20 25 300-5-10
Section A - Proposed
0 5 10 15 20 25 300-5-10
LOCATION: 1011 WASHINGTON ST
LOCATION: 1002 WARREN AVE
SHEET NO.
RAC
RAC
6/17/19
As ShownScale Hor:
Proj. No.
Design By:
Drawn By:
Date:
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Revisions Plan & Profile1011 Washington StreetSignature
Scale Ver:As Shown1871CARY, NORTH CAROLINATOWNCARYfONORTH CAROLINAP 1.0Storm Drainage Improvements316 North Academy StreetCary, N.C. 27513Tel: [phone] Fax: [phone]www.townofcary.orgVICINITY MAP
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Stormwater Issues

This project involves restoring cover over an exposed sanitary sewer line and stabilizing the
streambank. No concentrated stormwater flow will result from this project. Original contours
will be restored and seeded upon completion of the work.
No impervious surface will be added beyond the riprap used to stabilize the stream banks.

Stormwater Issues

This project involves restoring cover over an exposed sanitary sewer line and stabilizing the
streambank. No concentrated stormwater flow will result from this project. Original contours
will be restored and seeded upon completion of the work.
No impervious surface will be added beyond the riprap used to stabilize the stream banks.
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