HomeMy WebLinkAboutPre Construction Notification (Army Corps of Engineering)U.S. Army Corps of Engineers (USACE)
Fort Worth District
Nationwide Permit (NWP) Pre-Construction Notification (PCN) Form
This form integrates requirements of the Nationwide Permit Program within the Fort Worth District, including
General and Regional Conditions. Please consult instructions included at the end prior to completing this form.
n nts
• Description of NWP 29
• Part I: NWP Conditions and Requirements Checklist
o General Conditions Checklist
o NWP 29-Specific Requirements Checklist
o Regional Conditions Checklist
• Part II: Project Information Form
• Part III: Project Impacts and Mitigation Form
• Part IV: Attachments Form
• Instructions
DESCRIPTION OF NWP 29 - RESIDENTIAL DEVELOPMENTS
Residential Developments. Discharges of dredged or fill material into non-tidal waters of the United
States (U.S.) for the construction or expansion of a single residence, a multiple-unit residential
development, or a residential subdivision. This NWP authorizes the construction of building foundations
and building pads and attendant features that are necessary for the use of the residence or residential
development. Attendant features may include but are not limited to roads, parking lots, garages, yards,
utility lines, storm water management facilities, septic fields, and recreation facilities such as
playgrounds, playing fields, and golf courses (provided the golf course is an integral part of the
residential development).
The discharge must not cause the loss of greater than 1/2-acre of non-tidal waters of the U.S.,
including the loss of no more than 300 linear feet of stream bed, unless for intermittent and ephemeral
stream beds this 300 linear foot limit is waived in writing by the district engineer. This NWP does not
authorize discharges into non-tidal wetlands adjacent to tidal waters.
Subdivisions. For residential subdivisions, the aggregate total loss of waters of U.S. authorized by
this NWP cannot exceed 1/2-acre. This includes any loss of waters of the U.S. associated with
development of individual subdivision lots.
Part I: NWP Conditions and Requirements Checklist
To ensure compliance with the General Conditions (GC), in order for an
authorization by a NWP to be valid, please answer the following questions:
1. Navigation (Applies to Section 10 waters [i.e. navigable waters of the U.S.], see
instruction 4 for link to list):
a. Does the project cause more than a minimal adverse effect on navigation?
❑ Yes ❑ No ® N/A
b. Does the project require the installation and maintenance of any safety lights and signals
prescribed by the U.S. Coast Guard on authorized facilities in navigable waters of the U.S.?
❑ Yes ❑ No ® N/A
Page 1 of 18 SWF Recommended Application Form - NWP 29
c. Does the Applicant understand and agree that if future operations by the U.S. require the
removal, relocation, or other alteration of the structure or work herein authorized, or if, in the
opinion of the Secretary of the Army or his authorized representative, said structure or work
shall cause unreasonable obstruction to the free navigation of the navigable waters, the
Applicant will be required, upon due notice from the USACE, to remove, relocate, or alter the
structural work or obstructions caused thereby, without expense to the U.S.; and no claim
shall be made against the U.S. on account of any such removal or alteration?
❑ Yes ❑ No ® N/A
If you answered yes to question a. or b. above, or if you answered no to question c. above,
please explain how the project would be in compliance with this GC or be aware that the project
would require an individual permit application:
Not Applicable
2. Aquatic Life Movements:
a. Does the project substantially disrupt the necessary life cycle movements of those species of
aquatic life indigenous to the waterbody, including those species that normally migrate
through the area? ❑ Yes ® No
b. Is the project's primary purpose to impound water? ❑ Yes ® No
c. Will culverts placed in streams be installed to maintain low flow conditions?
® Yes ❑ No ❑ N/A
If you answered yes to question a. or b. above, or if you answered no to question c. above,
please explain how the project would be in compliance with this GC or be aware that the project
would require an individual permit application:
3. Spawning Areas:
a. Does the project avoid spawning areas during the spawning season to the maximum extent
practicable? ❑ Yes ❑ No ® N/A
b. Does the project result in the physical destruction (e.g., through excavation, fill, or
downstream smothering by substantial turbidity) of an important spawning area?
❑ Yes ❑ No ® N/A
If you answered no to question a. above, or if you answered yes to question b. above, please
explain how the project would be in compliance with this GC or be aware that the project would
require an individual permit application:
Not Applicable
4. Migratory Bird Breeding Areas:
a. Does the project avoid waters of the U.S.
the maximum extent practicable? ❑ Yes
that serve as breeding areas for migratory birds to
❑ No ® N/A
If you answered no to question a. above, please explain how the project would be in compliance
with this GC or be aware that the project would require an individual permit application:
Not Applicable
S. Shellfish Beds:
a. Does the project occur in areas of concentrated shellfish populations? ❑ Yes ® No
If you answered yes to question a. above, please explain how the project would be in compliance
with this GC or be aware that the project would require an individual permit application:
Page 2 of 18 SWF Recommended Application Form - NWP 29
Not Applicable
6. Suitable Material:
a. Does the project use unsuitable material (e.g., trash, debris, car bodies, asphalt, etc.)?
❑ Yes ® No
b. Is the material used for construction or discharged in a water of the U.S. free from toxic
pollutants in toxic amounts (see Section 307 of the Clean Water Act)? ® Yes ❑ No
If you answered yes to question a. above, or if you answered no to question b. above, please
explain how the project would be in compliance with this GC or be aware that the project would
require an individual permit application:
7. Water Supply Intakes:
a. Does the project occur in the proximity of a public water supply intake? ❑ Yes ® No
If you answered yes to question a. above, please explain how the project would be in compliance
with this GC or be aware that the project would require an individual permit application:
8. Adverse Effects From Impoundments:
a. Does the project create an impoundment of water? ❑ Yes ® No
b. If you answered yes to question a. above, are the adverse effects (to the aquatic system due
to accelerating the passage of water, and/or restricting its flow) minimized to the maximum
extent practicable? ❑ Yes ❑ No ® N/A
If you answered no to question b. above, please explain how the project would be in compliance
with this GC or be aware that the project would require an individual permit application:
Not Applicable
9. Management of Water Flows:
a. Does the project maintain the pre-construction course, condition, capacity, and location of
open waters to the maximum extent practicable, for each activity, including stream
channelization and storm water management activities? ® Yes ❑ No
b. Will the project be constructed to withstand expected high flows? ® Yes ❑ No
c. Will the project restrict or impede the passage of normal or high flows? ❑ Yes ® No
If you answered no to question a. or b. above, or if you answered yes to question c. above,
please explain how the project would be in compliance with this GC or be aware that the project
would require an individual permit application:
10. Fills Within 100-Year Floodplains:
a. Does the project comply with applicable FEMA-approved state or local floodplain management
requirements? ® Yes ❑ No ❑ N/A
If you answered no to question a. above, please explain how the project would be in compliance
with this GC or be aware that the project would require an individual permit application:
Page 3 of 18 SWF Recommended Application Form - NWP 29
11. Equipment:
a. Will heavy equipment working in wetlands or mudflats be placed on mats, or other measures
be taken to minimize soil disturbance? ❑ Yes ❑ No ® N/A
If you answered no to question a. above, please explain how the project would be in compliance
with this GC or be aware that the project would require an individual permit application:
Not Applicable
12. Soil Erosion and Sediment Controls:
a. Will the project use appropriate soil erosion and sediment controls and maintain them in
effective operating condition throughout construction? ® Yes ❑ No
b. Will all exposed soil and other fills, as well as any work below the ordinary high water mark or
high tide line, be permanently stabilized at the earliest practicable date? ® Yes ❑ No
c. Be aware that if work will be conducted within waters of the U.S., Applicants are encouraged
to perform that work during periods of low-flow or no-flow.
If you answered no to question a. or b. above, please explain how the project would be in
compliance with this GC or be aware that the project would require an individual permit
application:
13. Removal of Temporary Fills:
a. Will temporary fills be removed in their entirety and the affected areas returned to pre-
construction elevations? ❑ Yes ❑ No ® N/A
b. Will the affected areas be revegetated, as appropriate? ❑ Yes ❑ No ® N/A
If you answered no to question a. or b. above, please explain how the project would be in
compliance with this GC or be aware that the project would require an individual permit
application:
Not Applicable
14. Proper Maintenance:
a. Will any authorized structure or fill be properly maintained, including maintenance to ensure
public safety? ® Yes ❑ No
If you answered no to question a. above, please explain how the project would be in compliance
with this GC or be aware that the project would require an individual permit application:
15. Wild and Scenic River:
There are no Wild and Scenic Rivers within the geographic boundaries of the Fort Worth District.
Therefore, this GC does not apply.
16. Tribal Rights:
a. Will the project or its operation impair reserved tribal rights, including, but not limited to,
reserved water rights and treaty fishing and hunting rights? ❑ Yes ® No ❑ N/A
If you answered yes to question a. above, please explain how the project would be in compliance
with this GC or be aware that the project would require an individual permit application:
Page 4 of 18 SWF Recommended Application Form - NWP 29
17. Endangered Species (see also Box 8 in Part III):
a. Is the project likely to jeopardize the continued existence of a threatened or endangered
species or a species proposed for such designation, as identified under the Federal
Endangered Species Act (ESA), or will the project destroy or adversely modify the critical
habitat of such species? ❑ Yes ® No
b. Might the project affect any listed species or designated critical habitat? ❑ Yes ® No
c. Is any listed species or designated critical habitat in the vicinity of the project?
❑ Yes ® No
d. If the project "'may affect" a listed species or critical habitat, has Section 7 consultation
addressing the effects of the proposed activity been completed?
❑ Yes ❑ No ® N/A
If you answered yes to question a. or b. or c. above, or if you answered no to question d. above,
please explain how the project would be in compliance with this GC or be aware that the project
would require an individual permit application:
18. Historic Properties (see also Box 9 in Part III):
a. Does the project have the potential to cause effects to any historic properties listed,
determined to be eligible for listing on, or potentially eligible for listing on the National
Register of Historic Places, including previously unidentified properties?
❑ Yes ® No ❑ N/A
If you answered yes to question a. above, please explain how the project would be in compliance
with this GC or be aware that the project would require an individual permit application:
19. Designated Critical Resource Waters:
a. Will the project impact critical resource waters, which include NOAA-designated marine
sanctuaries, National Estuarine Research Reserves, state natural heritage sites, and
outstanding national resource waters or other waters officially designated by a state as having
particular environmental or ecological significance and identified by the district engineer after
notice and opportunity for public comment? ❑ Yes ® No
If you answered yes to question a. above, be aware that discharges of dredged or fill material
into waters of the U.S. are not authorized by NWP 29 for any activity within, or directly affecting,
critical resource waters, including wetlands adjacent to such waters.
20. Mitigation (see also Box 10 in Part III):
a. Will the project include appropriate and practicable mitigation necessary to ensure that
adverse effects on the aquatic environment are minimal? ❑ Yes ® No
If you answered no to question a. above, please include an explanation in Box 10 of why no
mitigation would be necessary in order to be in compliance with this GC or be aware that the
project would require an individual permit application.
21. Water Quality (see also Box 11 in Part III):
a. If in Texas, does the project comply with the conditions of the TCEQ water quality certification
for NWP 29? ® Yes ❑ No ❑ N/A
b. If in "Indian Country," does the project comply with the conditions of the EPA water quality
certification for NWPs? ❑ Yes No ® N/A
Page 5 of 18 SWF Recommended Application Form - NWP 29
c. If in Louisiana, does the project have an individual water quality certification, waiver, or other
approval by the LDEQ? ❑ Yes ❑ No ® N/A
If you answered no to question a., b., or c. above, please be aware that the project would require
an individual permit application.
22. Coastal Zone Management:
The Fort Worth District does not cover any Coastal Zone; therefore, this GC does not apply.
23. Regional and Case-By-Case Conditions:
See the Regional Conditions checklist below to ensure compliance with this GC.
24. Use of Multiple Nationwide Permits:
a. Does the project use more than one NWP for a single and complete project?
❑ Yes ® No
b. If you answered yes to question a. above, be aware that unless the project's acreage loss of
waters of the U.S. authorized by the NWPs is below the acreage limit of the NWP with the
highest specified acreage limit, no NWP can be issued, and the project would require an
individual permit application.
If you answered yes to question a. above, please explain how the project would be in compliance
with this GC and what additional NWP number you intend to use:
25. Transfer of Nationwide Permit Verifications:
a. Does the Applicant agree that if he or she sells the property associated with the nationwide
permit verification, the Applicant may transfer the nationwide permit verification to the new
owner by submitting a letter to the appropriate USACE district office to validate the transfer?
® Yes ❑ No
26. Compliance Certification:
a. Does the Applicant agree that if he or she receives the NWP verification from the USACE, they
must submit a signed certification regarding the completed work and any required mitigation
(the certification form will be sent by the USACE with the NWP verification letter)?
® Yes ❑ No
27. Notification:
a. All residential developments and subdivisions as described in NWP 29 must submit a pre-
construction notification to the district engineer prior to commencing the activity.
b. Does the Applicant agree that he or she will not begin the project until either:
1) He or she is notified in writing by the district engineer that the activity may proceed under
the NWP with any special conditions imposed by the district or division engineer; or
2) Forty-five calendar days have passed from the district engineer's receipt of the complete
PCN and the Applicant has not received written notice from the district or division engineer?
However, if the Applicant was required to notify the USACE pursuant to general condition 17
that listed species or critical habitat might be affected or in the vicinity of the project, or to
notify the USACE pursuant to general condition 18 that the activity may have the potential to
cause effects to historic properties, the Applicant cannot begin the activity until receiving
written notification from the USACE that there is "no effect" on listed species or "no potential
to cause effects" on historic properties, or that any consultation required under Section 7 of
the Endangered Species Act and/or Section 106 of the National Historic Preservation Act is
completed. ❑ Yes ❑ No
Page 6 of 18 SWF Recommended Application Form - NWP 29
c. Does the Applicant agree that if the district or division engineer notifies the Applicant in
writing that an individual permit is required within 45 calendar days of receipt of a complete
PCN, the Applicant cannot begin the activity until an individual permit has been obtained?
❑ Yes ❑ No
28. Single and Complete Project:
a. Does the Applicant certify that the project is a "single and complete project" as defined
below?
® Yes ❑ No
Single and complete project: The term "single and complete project" is defined at 33 CFR
330.2(i) as the total project proposed or accomplished by one owner/developer or partnership
or other association of owners/developers. A single and complete project must have
independent utility (see definition).
Independent utility: Defined as a test to determine what constitutes a single and complete
project in the USACE regulatory program. A project is considered to have independent utility if
it would be constructed absent the construction of other projects in the project area. Portions
of a multi-phase project that depend upon other phases of the project do not have
independent utility. Phases of a project that would be constructed even if the other phases
were not built can be considered as separate single and complete projects with independent
utility.
Page 7 of 18 SWF Recommended Application Form - NWP 29
To ensure compliance with the NWP 29-specific requirements please answer the
following questions:
1. Does the project involve the construction or expansion of a single residence, a multiple-unit
residential development, or a residential subdivision? ® Yes ❑ No
If you answered no to question 1. above, be aware that discharges of dredged or fill material into
waters of the U.S. are not authorized by NWP 29 and would require an individual permit
application.
2. Does the project (for residential subdivisions, including the development of individual subdivision
lots) cause the loss of greater than 1/2-acre of non-tidal waters of the U.S ? ❑ Yes ® No
If you answered yes to question 2. above, be aware that discharges of dredged or fill material
into waters of the U.S. are not authorized by NWP 29 and would require an individual permit
application. Note: For residential subdivisions, the aggregate total loss of waters of the U.S.
authorized by this NWP cannot exceed 1/2-acre, including any loss of waters of the U.S.
associated with development of individual subdivision lots.
3. Does the project cause the loss of more than 300 linear feet of perennial stream bed?
❑ Yes ® No
If you answered yes to question 3. above, be aware that discharges of dredged or fill material
into waters of the U.S. are not authorized by NWP 29 and would require an individual permit
application.
4. Does the project cause the loss of more than 300 linear feet of intermittent or ephemeral stream
bed? ❑ Yes ® No
If you answered yes to question 4. above, be aware that the 300 linear foot limit must be waived
in writing by the district engineer in order for the project to be authorized by NWP 29 and
otherwise would require an individual permit application.
5. Does the project cause a discharge into non-tidal wetlands adjacent to tidal waters?
❑ Yes ® No
If you answered yes to question S. above, be aware that discharges of dredged or fill material
into waters of the U.S. are not authorized by NWP 29 and would require an individual permit
application.
Page 8 of 18 SWF Recommended Application Form - NWP 29
REGIONAL CONDITIONS CHECKLIST
To ensure compliance with the Regional Conditions within the Fort Worth District,
in the State of Texas, in order for an authorization by a NWP to be valid, please
answer the following questions (for projects in Texas only):
1. Will the project include required compensatory mitigation at a minimum one-for-one ratio for all
special aquatic sites that exceed 1/10 acre and require pre-construction notification, and for all
losses to streams that exceed 300 linear feet and require pre-construction notification (unless the
appropriate District Engineer determines in writing that some other form of mitigation would be
more environmentally appropriate and provides a project-specific waiver of this requirement)?
❑ Yes ❑ No ® N/A
If you answered no to question 1. above, be aware that the project would not be authorized by a
NWP 29 and would require an individual permit application.
2. Does the project involve a discharge into habitat types that are wetlands (typically referred to as
pitcher plant bogs) that are characterized by an organic surface soil layer and include vegetation
such as pitcher plants (Sarracenia sp.), sundews (Drosera sp.), and sphagnum moss (Sphagnum
sp.) or wetlands (typically referred to as bald cypress-tupelo swamps) comprised predominantly
of bald cypress trees (Taxodium distichum), and water tupelo (Nyssa aquatica), that are
occasionally or regularly flooded by fresh water with common associates including red maple
(Acer rubrum), swamp privet (Forestiera acuminata), green ash (Fraxinus pennsylvanica), water
elm (Planera aquatica), lizard's tail (Saururus cernuus), water mermaid weed (Proserpinaca spp.),
buttonbush (Cephalanthus occidentalis), and smartweed (Polygonum spp.)? ❑ Yes ® No
If you answered yes to question 2. above, notification of the District Engineer is required in
accordance with NWP GC 27, and the USACE will coordinate with other resource agencies as
specified in NWP GC 27(d).
3. Is the project in the area of Caddo Lake within Texas that is designated as a "Wetland of
International Importance" under the Ramsar Convention? ❑ Yes ® No
If you answered yes to question 3. above, notification of the District Engineer is required in
accordance with NWP GC 27, and the USACE will coordinate with other resource agencies as
specified in NWP GC 27(d)
4. a. Is the project in an area of Dallas, Denton, or Tarrant counties that is within the study area of
the "Final Regional Environmental Impact Statement (EIS), Trinity River and Tributaries" (May
1986)? ❑ Yes ® No
b. If Yes, does the project meet the criteria and follow the guidelines specified in Section III of
the Record of Decision for the Regional EIS, including the hydraulic impact requirements?
❑ Yes ❑ No ® N/A
If you answered no to question 4b. above, be aware that the project would not be authorized by
a NWP 29 and would require an individual permit application.
Page 9 of 18 SWF Recommended Application Form - NWP 29
To ensure compliance with the Regional Conditions within the Fort Worth District,
in the State of Louisiana, in order for an authorization by a NWP to be valid, please
answer the following questions (for projects in Louisiana only):
1. Does the activity cause the permanent loss of greater than 1/2 acre of seasonally inundated
cypress swamp and/or cypress-tupelo swamp? ❑ Yes ® No
If you answered yes to question 1. above, be aware that the project would not be authorized by
a NWP 29 and would require an individual permit application.
2. Does the activity cause the permanent loss of greater than 1/2 acre of pine savanna, pine
flatwoods, and/or pitcher plant bogs? ❑ Yes ® No
If you answered yes to question 2. above, be aware that the project would not be authorized by
a NWP 29 and would require an individual permit application.
3. Has the activity been determined to have an adverse impact upon a federal or state designated
rookery and/or bird sanctuary? ❑ Yes ® No
If you answered yes to question 3. above, be aware that the project would not be authorized by
a NWP 29 and would require an individual permit application.
4. Does the activity fell any existing den or candidate den trees within areas known to be occupied
by the threatened Louisiana black bear? (Candidate den trees are defined as bald cypress and/or
tupelo gum with visible cavities, having a minimum diameter-at-breast-height of 36 inches, and
associated with rivers, lakes, streams, bayous, sloughs, or other waterbodies.) ❑ Yes ® No
If you answered yes to question 4. above, be aware that the project would not be authorized by
a NWP 29 and would require an individual permit application.
5. Does the project involve instream activities in the following waterways: Bayou Boeuf Tributaries
in Rapides Parish: (Brown Creek, Mack Branch, Clear Creek, Little Brushy Creek, Loving Creek,
Little Loving Creek, Long Branch, Bayou Clear, Castor Creek, Valentine Creek, and Little Bayou
Clear), Amite River (LA Highway 37 at Grangeville to Port Vincent), Bogue Falaya River and
Tributaries, Abita River and Tributaries, Bayou Chinchuba (between U.S. 190 and Louisiana
Highway 59), West Pearl River, Bogue Chitto River and Tributaries, and Red River tributaries in
Grant Parish (Black Creek, Swafford Creek, Cypress Creek, Beaver Creek, Cress Creek, Jordon
Creek, Hudson Creek, Gray Creek, Moccosin Branch and James Branch)? ❑ Yes ® No
If you answered yes to question 5. above, notification of the District Engineer is required in
accordance with NWP GC 27 due to the occurrence of threatened or endangered species.
6. To the best of the applicant's knowledge, is any excavated and/or fill material to be placed within
wetlands free of contaminants? ❑ Yes ❑ No ® N/A
If you answered no to question 6. above, be aware that the project would not be authorized by a
NWP 29 and would require an individual permit application.
7. Regional Condition 7 applies to work within the Louisiana Coastal Zone and/or the Outer
Continental Shelf off Louisiana, and therefore does not apply in the USACE Fort Worth District.
Work in these areas may require coordination with the USACE Galveston or New Orleans districts.
Page 10 of 18 SWF Recommended Application Form - NWP 29
S. Does the activity adversely affect greater than 1/10 acre of wetlands, and/or adversely impact a
designated Natural and Scenic River, a state or federal wildlife management area, and/or refuge?
❑ Yes ® No
If you answered yes to question 8. above, notification of the District Engineer is required in
accordance with NWP GC 27.
9. Be aware that NWP 29, via disavowal of water quality certification by the LDEQ, is considered
denied without prejudice. Individual requests for approval under NWP 29 will be considered on a
case-by-case basis only after receipt by the appropriate USACE district of an individual water
quality certification, waiver, or other approval by the LDEQ.
Additional Discussion:
Page 11 of 18 SWF Recommended Application Form - NWP 29
Part II: Project Information
Box 1 Project Name:
Applicant Name
Randall's University Park Re plat of Lot 3R
Ali ]afFer
Applicant Title
Applicant Company, Agency, etc.
Owner
Mailing Address
Applicant's internal tracking number (if any)
5727 Richmond Ave, APT. 202
Dallas TX 75206
Work Phone with area code
Home Phone with area c«ie
Fax #
E-mail Address
979 202-1933
aiiinksa@yahoo.com
Relationship of applicant to property:
® Owner ❑ Purchaser ❑ Lessee ❑ Other:
Application is hereby made for verification that subject regulated activities associated with subject project qualify
for authorization under a USACE nationwide permit or permits as described herein. I certify that I am familiar
with the information contained in this application, and that to the best of my knowledge and belief, such
information is true, complete, and accurate. I further certify that I possess the authority to undertake the
proposed activities. I hereby grant to the agency to which this application is made the right to enter the
above-described location to inspect the proposed, in-progress, or completed work. I agree to start work only
after all necessary permits have been received.
Signature of applicant
Date (mm/dd/yyyy)
Box 2 Authorized Agent/Operator Name and Signature: (If an agent is acting for the applicant
during the permit process)
Rabon Metcalf P.E.
Agent/Operator Title
Agent/Operator Company, Agency, etc.
Owner
RME Consulting Engineers
Mailing Address
P.O. Box 9253 - College Station TX 77842
E-mail Address
rabon@rmengineer.com
Work Phone with area code
Home Phone with area code
1
Fax #
Cell Phone #
979 764-0704
(979) 764-0704
I hereby authorize the above-named agent to act in my behalf as my agent in the processing of this application and to furnish,
upon request, supplemental information in support of this permit application. I understand that I am bound by the actions of
m agent, and I understand that if a federal or state permit is issued I or m agent, must sign the permit.
Signature of apple'
Da a (mm/dd/yyyy)
I ceitil'i that I am familiar with the information contained in this application, and that to the best of my
knowledge and belief, such information is true complete, and accurate.
Signature of authorized agent
Date (mm/dd/yyyy)
Box 3 Name of property owner, if other than applicant:
Multiple Current Owners fWmu/tfpleprmentprvp&-Wowneras, dk ir/weandindudealistasan
Owner Title
Owner Company, Agency, etc.
Page 12 of 18 SWF Recommended Application Form - NWP 29
Mailing Address
Work Phone with area code Home Phone with area code
Box 4 Project location, including street address, city, county, state, and zip code
where proposed activity will occur:
Chimney Hill Drive, College Station, Brazos County, TX - 77840
Nature of Activity (Description of project; include all features; see instructions):
Residential development of five (5) lots which will included the installation of 60 LF of 60"
diameter culvert.
Project Purpose (Description of the reason or purpose of the project; see instructions):
Has a delineation of waters of the U.S., including wetlands, been completed? (see instructions)
❑ Yes, Attached ® No
If a delineation has been completed, has it been verified in writing by the USACE?
❑ Yes, Date of approved or preliminary jurisdictional determination (mm/dd/yyyy): USACE project:
❑ No
Are color photographs of the existing conditions available? ❑ Yes, Attached ® No
Are aerial photographs available? ® Yes, Attached ❑ No
❑ Multiple Waters of the U.S. (if mumple waters of t*e us, check here and compleis fhe table in
Attachment D
Waterbody(ies) (if known; otherwise enter "an unnamed tributary to'J: Unnamed Tributary
Tributa ies to what known, downstream waterbod ies : Burton Creek
Latitude & longitude (Decimal Degrees):
N 30.63514 W 96.33216
USGS Quad map name(s):
Watershed(s) and other location descriptions, if known:
Burton Creek which discharges into Carters Creek
Directions to the project location:
From SH 6 go west on FM 60 (University Drive), take a right onto Spring Loop, take a left on
Chimney Hill Drive. The project is on the right (north side) at the cul-de-sac of Chimney Hill
Drive.
Part III: Project Impacts and Mitigation
Box 5 Reason(s) for Discharge into waters of the U.S.:
Construction of 60 LF of 60" diamater culvert
Type(s) of material being discharged and the amount of each type in cubic yards:
Common Fill -300 CY
Total surface area (in acres) of wetlands or other waters of the U.S. to be filled:
0 acres
Page 13 of 18 SWF Recommended Application Form - NWP 29
Indicate the proposed impacts to waters of the U.S. in ACRES (for wetlands and impoundments) and LINEAR
FEET (for rivers and streams), and identify the impact(s) as permanent and/or temporary for each waterbody
type listed below. The table below is intended as a tool to summarize impacts by resource type for planning
compensatory mitigation and does not replace the table of waters of the U.S. in Attachment D for those projects
with impacts to multiple waters of the U.S.
Perm
anent
Tern rary
Waterbod Type
Acres
Linear feet
Acres
Linear feet
Non-forested wetland
Forested wetland
Perennial stream
Intermittent stream
Ephemeral stream
Impoundment
Other:
Total:
Potential indirect and/or cumulative impacts of proposed discharge (if any):
Required drawings (see instructions):
Vicinity map: ® Attached
To-scale plan view drawing(s): ® Attached
To-scale elevation and/or cross section drawing(s): ® Attached
Is any portion of the work already complete? ❑ Yes ® No
If yes, describe the work:
Box 6 Authority: (see instructions)
Is Section 10 of the Rivers and Harbors Act for projects affecting navigable waters applicable?
❑ Yes ® No (see Fort worm Dis&ictNavigable waters list)
Is Section 404 of the Clean Water Act applicable? ❑ Yes ❑ No
Box 7 Larger Plan of Development:
Is the discharge of fill or dredged material for which Section 10/404 authorization is sought
intended for a residential development project which is part of a larger plan of development?
❑ Yes ® No (If yes, please provide lfie information in the remainder of Box 7)
Does the residential development project have independent utility in addition to the larger plan
of development? ❑ Yes ❑ No
If yes, explain:
If discharge of fill or dredged material is part of development, name and proposed schedule
for that larger development (start-up, duration, and completion dates):
Page 14 of 18 SWF Recommended Application Form - NWP 29
Location of larger development (If discharge of fill or dredged material is part of a plan of
development, a map of suitable quality and detail for the entire project site should be
included):
Total area in acres of entire project area (including larger plan of development, where applicable):
Box 8 Federally Threatened or Endangered Species (see instructions)
Please list any federally-listed (or proposed) threatened or endangered species or critical habitat
potentially affected by the project (use scientific names (i.e., genus species), if known):
Not Applicable
Have surveys, using U.S. Fish and Wildlife Service (USFWS) protocols, been conducted?
❑ Yes, Report attached ❑ No (explain):
If a federally-listed species would potentially be affected, please provide a description and a
biological evaluation.
❑ Yes, Report attached ❑ Not attached
Has Section 7 consultation been initiated by another federal agency?
❑ Yes, Initiation letter attached ❑ No
Has Section 10 consultation been initiated for the proposed project?
❑ Yes, Initiation letter attached ❑ No
Has the USFWS issued a Biological Opinion?
❑ Yes, Report attached ❑ No
If es, list date Opinion was issued mm/dd/
Box 9 Historic properties and cultural resources
Please list any historic properties listed (or eligible to be listed) on the National Register of Historic
Places which the project has the potential to affect:
Not Applicable
Has an archaeological records search been conducted?
❑ Yes, Report attached ❑ No (explain):
Are any cultural resources of any type known to exist on-site?
❑ Yes ❑ No
Has an archaeological pedestrian survey been conducted for the site?
❑ Yes, Report attached ❑ No (explain):
Has Section 106 or SHPO consultation been initiated by another federal or state agency?
❑ Yes, Initiation letter attached ❑ No
Has a Section 106 MOA been signed by another federal agency and the SHPO?
❑ Yes, Attached ❑ No
If es, list date MOA was signed mm/dd/
Box 10 Proposed Conceptual Mitigation Plan Summa (see instructions)
Measures taken to avoid and minimize impacts to waters of the U.S. (if any):
Impacts are below the limits established b NWP 29.
Applicant proposes combination of one or more of the following mitigation types:
❑ Mitigation Bank ❑ On-site ❑ Off-site Number of sites: ❑ None
Page 15 of 18 SWF Recommended Application Form - NWP 29
Applicant proposes to purchase mitigation bank credits: ❑ Yes ❑ No
Mitigation Bank Name:
Number of Credits:
Indicate in ACRES (for wetlands and impoundments) and LINEAR FEET (for rivers and streams) the total quantity
of waters of the U.S. proposed to be created, restored, enhanced, and/or preserved for purposes of providing
compensatory mitigation. Indicate mitigation site type (on- or off-site) and number. Indicate waterbody type
(non-forested wetland, forested wetland, perennial stream, intermittent stream, ephemeral stream,
impoundment, other) or non-jurisdictional (uplands').
Mitigation
Site Type and
Number
Waterbody Type
Created
Restored
Enhanced
Preserved
e.g., On site 1
Non-forested wetland
0.5 acre
eg., Off-site 1
Intermittent stream
500 LF
1000 LF
Totals:
For uplands, lease indicate if designed as an upland buffer.
Summary of Mitigation Work Plan (Describe the mitigation activities listed in the table above):
If no mitigation is proposed, provide a detailed explanation of why no mitigation would be
necessary to ensure that adverse effects on the aquatic environment are minimal:
Impacts are below the limits established by NWP 29.
Has a conceptual mitigation plan been prepared in accordance with the USACE regulations and
LJ Yes, Attached LJ No (explain):
Mitigation site(s) latitude & longitude (Decimal USGS Quad map name(s):
Degrees):
Other location descriptions, if known:
Directions to the mitigation location(s):
Box 11 Water Quality Certification (see instructions):
For Texas:
Does the project meet the conditions of the Texas Commission on Environmental Quality
(TCEQ) Clean Water Act Section 401 certification for NWP 29? ® Yes ❑ No
Does the project include soil erosion control and sediment control Best Management Practices
(BMPs)? ® Yes ❑ No
Does the project include BMPs for post-construction total suspended solids control?
® Yes ❑ No
Page 16 of 18 SWF Recommended Application Form - NWP 29
For Louisiana:
Individual water quality certification issued by LDEQ? ❑ Yes, Attached ❑ No
Water quality certification waiver or other approval by LDEQ? ❑ Yes, Attached ❑ No
Explain:
For Tribal Lands ("Indian Country':
Does the project meet the conditions of the EPA water quality certification for NWPs?
® Yes ❑ No
Box 12 List of other certifications or approvals/denials received from other
federal, state, or local agencies for work described in this application:
Would include but is not restricted to zoning, building, and flood lain
Z
permits
Agency
Approval
T 2
Identification
No.
Date Applied
Date
Approved
Date Denied
City of College
Station
Development
Permit
Randall's
University Park
12/1/10
2/16/11
TCE
SWP3
3/8/11
3/8/11
Page 17 of 18 SWF Recommended Application Form - NWP 29
Part IV: Attachments
Included
A.
List of Property Owners
❑
B.
Delineation of Waters of the U.S., Including Wetlands
❑
C.
Color Photographs
❑
D.
Table of Waters of the U.S. Impacted by the Proposed Project
❑
E.
Required Drawings/Figures
F.
Threatened or Endangered Species Reports and/or Letters
❑
G.
Historic Properties and Cultural Resources Reports and/or Letters
❑
H.
Conceptual Mitigation Plan
❑
I.
Other:
❑
End of Form
Page 18 of 18 SWF Recommended Application Form - NWP 29
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