20191177 Ver 1_PCN Form Submission_20190830

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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#*
20191177
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:
Park Village Ponds Sediment Removal
1a. Who is the Primary Contact?*
Wesley L. Haskins - Foster Lake and Pond Mgt., Inc.
1 b. Primary Contact Email:*
v,[e-mail]
Date Submitted
8/30/2019
Nearest Body of Water
White Oak Creek
Basin
Cape Fear
Water Classification
WS-V;NSW
Site Coordinates
Latitude:
35.774403
A. Processing Information
County (or Counties) where the project is located:
Wake
Is this project a public transportation project?*
r Yes r No
Longitude:
-78.854355
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 waters, 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:
P 401 Water Quality Certification - Regular
F Non -404 Jurisdictional General Permit
F Individual Permit
29 - Residential Developments
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:
F 401 Water Quality Certification - E)press
F 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
19. 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?
Owner W Applicant (other than owner)
le. Is there an Agent/Consultant for this project?
C Yes r No
2. Owner Information
2a. Name(s) on recorded deed:
Park Village Homeowners Assoc.
2b. Deed book and page no.:
007453,00464
2c. Responsible party:
2d. Address
Street Address
106 Castle Hayne Dr.
Address Line 2
City
Cary
Postal / Zip Code
27519
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
Foster Lake and Pond Mgt., Inc.
State / Rwince / Fiejim
N.C.
Country
United States
2f. Fax Number:
r Yes r No
rYes rNo

3b. Business Name:
3c.Address
Street Address
9020 White Oak Rd.
Address Line 2
City
Garner
Postal / Zip Code
27529
3d. Telephone Number:
[phone]
3f. Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(if appropriate)
Park Village
1c. Nearest municipality/ town:
Cary
2. Project Identification
2a. Property Identification Number:
0743361882,0743454549
2c. Project Address
Street Address
106 Castle Hayne Dr.
Address Line 2
4IY
Cary
Postal / Zip (ode
27519
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
White Oak Creek
3b. Water Resources Classification of nearest receiving water:*
WS-V;NSW
3c. What river basin(s) is your project located in?*
Cape Fear
3d. Please provide the 12 -digit HUC in which the project is located.
030300020608
4. Project Description and History
State / Ftovince / fbgion
N.C.
Country
United States
3e. Fax Number:
2b. Property size:
WA
State / Frovince / Pagion
N.C.
Country
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:*
Park Village is a residential subdivision in Cary, N.C. Two ponds are located in the subdivision that serve as stormwater retention ponds (non-regulated) that will have accumulated
sediment removed. The ponds also serve a recreational and aesthetic value to the community. Pond 1 is located at 106 Castle Hayne Dr. (35.774403, -78.854355) and Pond 2 is
located at 214 Bell Arthur Dr. (35.771378, -78.849571). Pond 1 is appro)dmately 1.75 acres and Pond 2 is appropmately 1.25 acres.
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
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 Topo-Wake County IMaps.pdf 697.58KB
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)
NRCS Soil Survey -Wake County IMaps.pdf 312.25KB
4f. List the total estimated acreage of all existing wetlands on the property:
No wetlands associated with ponds.

4g. List the total estimated linear feet of all existing streams on the property:
Unknown. Work is restricted to ponds and not working in streams.
4h. Explain the purpose of the proposed project:*
The purpose of the project is to remove accumulated sediment in each pond. The accumulated sediment has reduced storage capacity and volume. The sediment is also unsightly to
the residents.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
Each pond will be lowered with a siphon to a controlled depth to expose the areas of excavation. The areas will be excavated with a track excavator. Equipment mats will be used as
needed within the pond to limit disturbance and allow for equipment use. The excavated material will be double -handled in order to stack the material to dewater and to move the
material to allowfor loading. All material will be hauled off-site to a legal landfill. Seed and strawwill be applied to all disturbed areas on the pond shoreline following work.
4j. Please upload project drawings for the proposed project.
Park Village Pond 1 Castle Hayne Dr. Drawing.pdf
Park Village Pond 2 Bell Arthur Dr. Dravdng.pdf
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes IT No
Comments:
James Lastinger visited the site 8/20/19. Ponds are potentially jurisdicational and have no
associated wetlands adjacent to the ponds.
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
5c. 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
2.1 MB
2MB
r Unknown
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?
Unknown
D. Proposed Impacts Inventory 1
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
F Wetlands r Streams -tributaries r Buffers
V Open Waters r Pond Construction
4. Open Water Impacts
4e. Wate rbody type 4f. Impact area
4a. Site # 4al. Impact Reason 4b. Impact type 4c. Name of waterbody 4d. Activity type 11
Sediment Removal
T
Castle Hayne Pond
Dredging
Pond
0.08
Sediment Removal
T
Bell Arthur Pond
Dredging
Pond
0.07
49. Total temporary open water Impacts:
0.15
4g. Total open water impacts:
0.15
4h. Comments:
E. Impact Justification and Mitigation
4g. Total permanent open water impacts:
0.00

1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
Only the areas needing sediment removal will be excavated to return ponds to original depth.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
The ponds will be lowered to allow for work in the dry. Equipment mats will be used to limit disturbance to the pond bottom.
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:
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?
G- Yes r No
What type of SCM are you providing?
r Level Spreader
r Vegetated Conveyance (lower SHWT)
r Wetland Swale (higher SHWT)
r Other SCM that removes minimum 30% nitrogen
W Proposed project will not create concentrated stormwater flowthrough 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
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:
Comments:
The project does not require a stormwater management plan. Question 3a. required a choice to be made.
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 is sediment removal to two ponds and is considered to provide long term maintenance for the ponds. No development will occur in relation
to this work.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
r Yes r' Nor IIA
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
5h. Does this project involve the construction/installation of a wind turbine(s)?*
r Yes r No
51. 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 IPAC website
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?*
No EFH present in Wake Co.
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?*
SHPO website.
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?*
Wake County IMaps
Miscellaneous
Comments
Miscellaneous attachments not previously requested.

Signature'
m 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:
Wesley L. Haskins
Signature
IIN-0e 491"&W
Date
8/30/2019

Jurisdictional Determination Request
D. PROPERTY ACCESS CERTIFICATION',4
By signing below, I authorize representatives of the Wilmington District, U.S. Army Corps of
Engineers (Corps) to enter upon the property herein described for the purpose of conducting on-
site investigations, if necessary, and issuing a jurisdictional determination pursuant to Section
404 of the Clean Water Act and/or Section 10 of the Rivers and Harbors Act of 1899. I, the
undersigned, am either a duly authorized owner of record of the property identified herein, or
acting as the duly authorized agent of the owner of record of the property.
Print Name
Capacity: ❑Owner Authorized Agents
E. REASON FOR JD REQUEST: (Check as many as applicable)
❑ I intend to construct/develop a project or perform activities on this parcel which would be
designed to avoid all aquatic resources.
❑ I intend to construct/develop a project or perform activities on this parcel which would be
designed to avoid all jurisdictional aquatic resources under Corps authority.
❑ I intend to construct/develop a projector perform activities on this parcel which may
require authorization from the Corps, and the JD would be used to avoid and minimize
impacts to jurisdictional aquatic resources and as an initial step in a future permitting
process.
V I intend to construct/develop a projector perform activities on this parcel which may
require authorization from the Corps; this request is accompanied by my permit application
and the JD is to be used in the permitting process.
❑ I intend to construct/develop a projector perform activities in a navigable water of the
U.S. which is included on the district Section 10 list and/or is subject to the ebb and flow of
the tide.
H
A Corps JD is required in order obtain my local/state authorization.
I intend to contest jurisdiction over a particular aquatic resource and request the Corps
confirm that jurisdiction does/does not exist over the aquatic resource on the parcel.
❑ I believe that the site may be comprised entirely of dry land.
❑✓ Other:
For NCDOT requests following the current NCDOT/USACE protocols, skip to Part E.
If there are multiple parcels owned by different parties, please provide the following for each additional parcel on a
continuation sheet.
5 Must provide agent authorization form/letter signed by owner(s).
Version: May 2017 Page 3

AGENT AUTHORIZATION FORM
PROPERTY LEGAL DESCRIPTION:
LOT NO. PLAN NO. PARCEL ID: 0743454549 & 0743361882
STREETADDRESS: Castle Hayne Dr. & Bell Arthur Dr., Cary, N.C.
Please print:
Property Owner: Park Village Homeowners Association, Inc.
We, the undersigned registered property owners of the above noted property, do hereby authorize
Wesley Haskins, Foster Lake and Pond Mgt., Inc. to act on our behalf and take all actions necessaryforthe
processing, issuance, and acceptance of this permit or certification and any and all standard and special
conditions attached.
Property Owner's Address (if different than property above):
Telephone: [phone]
We hereby certify the above information submitted in this application is true and accurate to the best of
our knowledge.
Authorized S
Date: -;L -3> 19
Authorized Signature
Date:

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0 215 430 860 ft Maps makes every effort to produce and publish
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NDisclaimer
0 215 430 860 ft Maps makes every effort to produce and publish
i i i I i i I the most current and accurate information possible.
However, the maps are produced for information purposes,
1 inch = 400 feet and are NOT surveys. No warranties, expressed or implied
,are provided for the data therein, its use,orits interpretation.

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