20191317 Ver 1_401 Application_20191001

Below is a link to the online help file.
https•//edocs deq nc gov/WaterResources/0/edoc/624704/PCN%2OHelp%2OFile%202018-1-
30.pdf (https:Hedocs.deq.nc.gov/WaterResources/0/doc/603610/Pa eg l.aspx)
A. Processing Information
County (or Counties) where the project is located:
M
Add additional county
Is this project a public transportation project. *
RECOVEWDEN?"R
OCT 01 2019
Woor Resources
Psrmitting Section
Yes Caro
This is any publicly funded by municipal,state or federal funds road, rail, airport transportation project.
1 a. Type(s) of approval sought from the Corps: *
Section 404 Permit (wetlands, streams and waters, Clean Water Act) 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? *
Nationwide Permit (NWP) Regional General Permit (RGP) Standard (IP)
This form may be used to initiate the standard/individual permit process with the Corps. Please
contact your Corps representative concerning submittals for standard permits. All required
items that are not provided in the E -PCN can be added to the miscellaneous upload area located
at the bottom of this form.
1c. Has the NWP or GP number been verified by the Corps? *
Yes [�No
--GGMGGl�1iA
3

Nationwide Permit (NWP) Number:
Add additional NWP
NWP Numbers (for multiple NWPS):
List all NW numbers you are applying for not on the drop down list.
1 d. Type(s) of approval sought from the DWR: *
check all that apply .
401 Water Quality Certification - Regular Non -404 Jurisdictional General Permit Individual
Permit;
401 Water Quality Certification - Express Riparian Buffer Authorization
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:
1f. Is this an after -the -fact permit application? *
Yes No
Yes G; • Yes P •
P rE LG�G
1g. 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 No
Acceptance Letter Attachment
Click the upload button or drag and drop files here to attach document
4

FILE TYPE MUST BE PDF
1 h. Is the project located in any of NC's twenty coastal counties? *
Yes No
1j. Is the project located in a designated trout watershed? *
Yes GQNo
You must submit a copy of the appropriate Wildlife Resource Commission
Office.
Link to trout information: http://www.saw.usace.army.mil/Missions/Re u�oKy-Permit-
Pro r�Agency-Coordination/Trout.aspx
(http•//www saw usace.army.mil/Missions/Re ug latoKy-Permit-Pro rg am/Agency-
Coordination/Trout. aspx)
Lr G r
N
B. Applicant Information 1a. Who is the Primary Contact? *
1b. Primary Contact Email: *
1d. Who is applying for the permit?
Owner
(Check all that apply)
1c. Primary Contact Phone: *
(xxx)xxx-xxxx
Applicant (other than owner)
Billy Miller
9

bhcreekAgmail.com
[phone]
Illl.o.. C�
1e. Is there an Agent/Consultant for this project? *
Yes PNO
2. Owner Information 2a. Name(s) on recorded deed:
2b. Deed book and page no.:
2c. Responsible party:
(for Corporations)
2d. Address *
Street Address
Address Line 2
City
Postal / Zip Code
2e. Telephone Number: *
(XXX)XXX-XXXX
2f. Fax Number:
(XXX)XXX-XXXX
2g. Email Address:
Add another owner
State / Province / Region
Country
6

0i
Billy and Alia Miller
II..
00452/0577
II..
4241 Big Horse Creek Rd
II.
Lansing
NC
IIII.000.
28643
USA
Illl.00e.
[phone]
.II..
bhcreekkgmail.com
II..

C. Project Information and Prior Project
History
1. Project Information 1a. Name of project:
1 b. Subdivision name:
(if appropriate)
4239 stream stabilization
1c. Nearest municipality/ town: *
2. Project Identification 2a. Property Identification Number:
(tax PIN or parcel ID)
2c. Project Address
Street Address
Address Line 2
City
Postal / Zip Code
2d. Site coordinates in decimal degrees
2b. Property size:
(in acres)
State / Province / Region
Country
a

0 o
08135-081
Ia1]
Illlaaaa
4239 Big Horse Creek Rd
Lansing
NC
Illlaaoo
28643
a
Please collect site coordinates in decimal degrees. Use between 4-6 digits (unless you are using
a survey -grade GPS device) after the decimal place as appropriate, based on how the location
was determined. (For example, most mobile phones with GPS provide locational precision in
decimal degrees to map coordinates to 5 or 6 digits after the decimal place.)
Latitude: * Longitude: *
ex: 34.208504 -77.796371
3. Surface Waters
3a. Name of the nearest body of water to proposed project:
3b. Water Resources Classification of nearest receiving water: *
Surface Water
Lookup (https:Hncdenr maps arcgis com/apps/webappviewer/index.html?id=6e125ad7628f4946
94e259c80dd64265)
9

3c. What river basin(s) is your project located in? *
m
Add another river basin
3d. Please provide the 12 -digit HUC in which the project is located. *
River Basin
Lookup (h_ ttp://ncdenr.maps.arcgis.com/apps/Publiclnformation/index html?appid=ad3
a85aOc6d644aOb97cd069db238ac3)
4. Project Description and History
-81.53
USA
36.58
Illloe°a
Big Horse Creek
e
050500010105
II..
OOa
0
050500010105
II..
ea
Lansing
10

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 stream has eroded the shoreline until the stream bed is approximately
twice its normal width. On one side of the stream is a residence with a
drive lane leading to the house and a lawn and garden area. The other side
of the stream is lower lying area with trees and natural vegetation and
briers.
4b. Have Corps permits or DWR certifications been obtained for this project
(including all prior phases) in the past? *
Yes CO,4o Wnknown
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)
Click the upload button or drag and drop files here to attach document
File type must be pdf
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)
Upload
Click the upload button or drag and drop files here to attach document
Ashe county Soil Map of 4239 BHCr.pdf (/Forms/handlers/downloadattachment.as... File type
must be pdf
4f. List the total estimated acreage of all existing wetlands on the property:
4g. List the total estimated linear feet of all existing streams on the property:
(intermittent and perennial)
4h. Explain the purpose of the proposed project: *
11

97.67KB
X
Upload
0
a
Bull
To stabilize the shoreline and help prevent future erosion.
4i. Describe the overall project in detail, including indirect impacts and the type
of equipment to be used: *
4j. Please upload project drawings for the proposed project.
Click the upload button or drag and drop files here to attach document
Drawing of property and work area r.pdf (/Forms/handlers/downloadattachment.as... File type
must be pdf
X
Upload
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed
impact areas? *
12

Yes No Unknown
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination
was made? *
Preliminary [Approved ['Tot Verified [Unknown ['�1/A
Corps AID Number:
Example: SAW -2017-99999
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Agency/Consultant Company: Other:
5d1. Jurisdictional determination upload
Click the upload button or drag and drop files here to attach document
File type must be PDF
6. Future Project Plans 6a. Is this a phased project?
Yes No
Are any other NWP(s), regional general permit(s), or individual peitor related,
or intended to be used, to authorize any part of the proposed project
activity? This includes other separate and distant crossing for linear projects
that require Department of the Army authorization but don't require pre -
construction notification.
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The project will include removing some lar
into the stream restricting flow. Also reinforce ge boulders that have washed
the shoreline using large
boulders that are on adjacent property nearby. This will stabilize the
shoreline and help prevent future erosion. The equipment will consist of a
dump truck and large track hoe. There will .
to be in the stream and disruption be no need for any equipment
p will be minimal.
D. PropOSed Impacts Inventory
I. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply);
Wetlands Streams -tributaries Open Waters Pond Construction
3. Stream Impacts
Buffers
If there are perennial or intermittent stream
temporary impacts) proposed on the site the pacts (including
for all stream sites impacted. n complete this question
"S." will be used in the table below to represent ent the word "stream"
k res.
Add another impact
** All Perennial or Intermittent streams must be verified b D
government. Y WR or delegated local
31. Total jurisdictional ditch impact in square feet:
0
31. Total permanent stream impacts:
0
14

3i. Total temporary stream impacts:
100
31. Total stream and ditch impacts:
100
3j. Comments:
Average (feet)
(linear feet)
0'0 0
3a. Reason for impact * M
3b.lmpact type *
3c. Type of impact *
3d. S. name *
3e. Stream Type * M
3f. Type of Jurisdiction *
3g. S. width *
3h. Impact
length *
15

se -as 0
�J-1-_�
stabilization
S1
Bank Stabilization
Big Horse Cree
Perennial
Both
25
100
I I I I I I I..........
X
E. Impact Justification and Mitigation
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1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed
impacts in designing the 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 this project DOES NOT require Compensatory Mitigation, explain why:
NC Stream Temperature Classification Maps can be found under the Mitigation Concepts tab
on the Wilmington District's RIBITS
(https:Hribits.usace.anny.mil/ribits apex/f?p=107.27.2734709611497::NO:RP:P27 BUTTON
KEY:O) website.
F. Stormwater Management and Diffuse
Flow Plan (required by DWR)
* * * Recent changes to the stormwater rules have required updates to this section .* * *
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?
Yes No
For a list of options to meet the diffuse flow requirements, click here
(https:Hfiles nc gov/ncdeq/Water%20Quality/Surface%20Water%20Protection/401/Buffer%20
Clarification%20Memos/Options%20for%20Meeting%2
If no, explain why:
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2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual
NPDES permit NCS000250? *
Yes �No
2b. Does this project meet the requirements for low density projects as defined
in 15A NCAC 02H .1003(2)? *
Yes CTINo
To look up low density requirement click here 15A NCAC 02H .1003(2)
(http:Hreports.oah. state. nc.us/ncac/title%2015a%20-
%20environmental%20quality/chapter%2002%20-
%20environmental%20management/subchapter%20h/ 15 a%20ncac%2002h%20.1003.pd f).
All equipment will be used from the shore and the work is planned while
the water level is extremely low.
Flow of water will remain away from work area.
RLE01
This project is to help manage storm waters and prevent further erosion.
ME
Comments:
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G. Supplementary Information
1. Environmental Documentation funds
1a. Does the project involve an expenditure of public (federal/state/local )
or the use of public (federal/state) land? *
Yes No
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification
es (1 5A 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)?.
Yes No
3.
Cumulative Impacts (DWR Requirement)
3a. Will this project (based on past and reasonably anticipatedfuture
impactswas r
result in additional development, which could impact nearby downstream
quality?
Yes No
3b. If you answered "no," provide a short narrative description.
4. Sewage Disposal (DWR Requirement) 4a. Is sewage
*
disposal required by DWR for this project?
Yes qNo EPNIA
5. Endangered Species and Designated Critical
g p
Habitat (Corps Requirement) 5a. Will this project occur in or
near an area with federally protected species or habitat? *
Yes No
5b. Have you checked with the USFWS concerning Endangered Species Act
impacts?
19

Yes No
This is a rural single family residence.
5d. Is another Federal agency involved?
Yes No
5e. Is this a DOT project located within Division's 1-8?
Yes C�No
5f. Will you cut any trees in order to conduct the work in waters of the U.S.? *
Yes Q10
5g. Does this project involve bridge maintenance or remo
val7 .
Yes QN0
Link to the NLEB SLOPES document: ht ://saw -re .usace.ann .mil/NLEB/1-
SLOPES&a s. df (httN://saw- reg -usace army. MUM EB/1 30-17-sirni XTT rD L
30-17-si
5h. Does this project involve the construction/installation of a wind turbines)?*
Yes FPINo
5i. Does this project involve (1) blasting, and/or (2) othere
that will be conducted by machines, such as jackhammers r echa a activities
drivers, etc.? * ,mechanized pile
Yes qNo
5J. What data sources did you use to determine whether
Endangered Species or Designated Critical Habitat? * your site would impact
Consultation Documentation Upload
Click the upload button or drag and drop files here to attach document
20

File type must be PDF
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish
Habitat? *
Yes No
6b. What data sources did you use to determine whether your site would impact
an Essential Fish Habitat? *
7. Historic or Prehistoric Cultural Resources
(Corps Requirement)
Link to the State Historic Preservation Office Historic Properties Map (does not include
archaeological data: http://gis.ncdcr.gov/hpoweb/ (http://gis.ncdcr.gov/hpoweb/)
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
(e.g., National Historic Trust designation or properties significant in North
Carolina history and archaeology)? *
Yes No
Unknown
555P4IP14q
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7b. What data sources did you use to determine whether your site would impact
historic or archeological resources? *
21

7c. Historic or Prehistoric Information Upload
Click the upload button or drag and drop files here to attach document
File must be PDF
8. Flood Zone Designation (Corps Requirement)
Link to the FEMA Floodplain Maps: https://msc.fema.gov/portal/search
(https://msc.fema.gov/portal/search)
Upload
8a. Will this project occur in a FEMA -designated 100 -year floodplain? *
Yes No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination? *
Miscellaneous Comments
LM
Ashe County flood mapping area 3711205300
Photos of work area.
Miscellaneous attachments not previously requested.
Click the upload button or drag and drop files here to attach document
22

IMG_1 pdf.pdf (/Forms/handlers/downloadattachment.ashx?req=DownLoad&aid=2...
IMG—2 looking up stream of work area.pdf (/Forms/handlers/downloadattachment....
IMG—3 end of 100 feet work area.pdf (/Forms/handlers/downloadattachment.ashx?...
IMG _4 outside of work area.pdf (/Forms/handlers/downloadattachment.ashx?req=... File must be
PDF or KMZ
Signature
By checking the box and signing below, I certify that:
I have given true, accurate, and complete information on this form;
5.08MB 186.07KB 195.62KB 196.46KB
X X X X
Upload
agree that submission of this PCN form is a "transaction" subject to Chapter 66, Article 40 of
ie NC General Statutes (the "Uniform Electronic Transactions Act");
agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the
IC General Statutes (the "Uniform Electronic Transactions Act");
understand that an electronic signature has the same legal effect and can be enforced in the
ime way as a written signature; AND I intend to electronically sign and submit the PCN form.
sea
ull Name: * Signature
Date
illy J Miller
23

I..
9/27/2019
x
Submit
Save as Draft
Submitting...
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