20110185 Ver 1_Application_20110224

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STATE OF NORTH CAROLINA
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DEPARTMENT OF TRANSPORTATION '4 44 "?
BEVERLY EAVES PERDUE EUGENEONTI, JR.
GOVERNOR SECRETARY
February 21, 2011
Mr. Brian Wrenn
401 1 '1 0
401/Transportation Permitting Unit
1650 Mail Service Center 185
Raleigh, NC 27699-1650
SUBJECT: Pipe Replacement on SR 1637 (Warlick Road), Cleveland County
Dear Mr. Wrenn:
The North Carolina Department of Transportation requests authorization to replace an existing
pipe on SR 1637 (Warlick Road) in Cleveland County. NCDOT proposes to replace a
deteriorating 37-foot long, 103" x 71" CMPA with a 50-foot long, 96" CMP. There is a
shallow scourhole at the outlet of the existing pipe, the required one-foot burial of the new pipe
outlet is based upon the streambed elevation at the downstream point of the scourhole. Five feet
of riprap will be utilized at the pipe outlet and will be incorporated into an existing root mass for
structure/bank stabilization. Ten feet of riprap will be utilized at the pipe inlet for structure
stabilization. A sidestream/seep enters the main channel immediately upstream of the new pipe;
therefore, the riprap stabilization of the main channel will be extend to the 15 feet of bank
stabilization on the side channel. A temporary cofferdam pumping system will be used to divert
the stream around the construction site as needed. All areas affected by temporary cofferdam
system will be graded and restored back to pre-project conditions., The scope of the work
involves two unnamed tributaries to Little Knob Creek, which is classified as a Class WS-IV
Watershed by the Division of Water Quality.
The project area is not located within '/ mile of any critical watershed area nor is SR 1637 a rural
or urban arterial; therefore, hazardous spill basins are not required. Enclosed is the hazardous
spill basin checklist.
This office has conducted a GIS and field survey for the project for historical sites and
threatened/endangered species sites. No sites listed on the National Register of Historic Places
are located in the vicinity of the project nor did there appear to be any eligible structures. The
federally listed species for Cleveland County (USFWS listed date September 22, 2010) include
the Dwarf-flowered heartleaf (Hexastylis nanri fora). National Heritage Program records
document the nearest Dwarf-flowered heartleaf location approximately 1.1 miles south of the
proposed project area. The heartleaf is usually found on dry to moist ravine slopes (usually
north facing and of the oak-hickory-pine forest type) and in boggy areas near springheads.
There is no suitable habitat within the proposed project area and no species were observed. No
impact on the heartleaf species is anticipated.
Post Office Box 47 Shelby, North Carolina 28151-0047
SR 1637, Warlick Road
Page 2
February 21, 2011
I have enclosed a pre-construction notification for a NW#14 (GO 3820), sketches of planned
activities and location maps relative to the project.
Project information for the 401 Automated Payment Procedure is as follows:
• Work order number: 150464-55120005-121320231 1-3370
• TIP#: NA
• Project Category: $240.00 Fee
If you have any questions or concerns please feel free to contact me at [phone]. Thank you for
your time and consideration on this matter.
Respectfully yours,
M.L. Holder, P.E.
Division Engineer
Twelfth Division
BY: lbu?A
Trish Simon
Division 12 Environmental Supervisor
Enclosures
cc: Polly Lespinasse, Division of Water Quality, Mooresville Regional Office-
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Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
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 Permit (NWP) number: 14 or General Permit (GP) number:
1c. Has the N WP or GP number been verified by the Corps? ? Yes N No
1d. Type(s) of approval sought from the DWQ (check all that apply):
® 401 Water Quality Certification - Regular ? Non-404 Jurisdictional General Permit
? 401 Water Quality Certification - Express ? Riparian Buffer Authorization
le. Is this notification solely for the record
because written approval is not required? For the record only for DWQ 401
Certifcation:
? Yes ® No For the record only for Corps Permit:

N Yes ? No
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 N No
1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1h
below. ? Yes ® No
1h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ? Yes ®No
2. Project Information
2a. Name of project: SR 1637 (Warlick Road)
2b. County: Cleveland
2c. Nearest municipality / town: Fallslon
2d. Subdivision name:
2e. NCDOT only, T.I.P. or state
project no: 12b.202321
3. Owner Information
3a. Name(s) on Recorded Deed: NC DOT Right of Way
3b. Deed Book and Page No.
3c. Responsible Party (for LLC i f
applicable):
3d. Street address:
3e. City, state, zip:
3f. Telephone no.:
3g. Fax no.:
3h. Email address:
Page 1 of 11
PCN Form - Version 1.3 December 10, 2008 Version
4. Applicant Information (if different from owner)
4a. Applicant is: ? Agent ? Other, specify:
4b. Name: Mike Holder
4c. Business name
(if applicable):
N.C. Department of Transportation, Division 12
4d. Street address: 1710 East Marion Street
4e. City, slate, zip: Shelby, NC 28151
4 Telephone no. 704-480-9020
4g. Fax no.: 704-480-5401
41h. Email address: [e-mail]
5. Agent/Consultant Information (if applicable)
5a. Name: Trish Simon
Sb. Business name
(if applicable):
N.C. Department of Transportation, Division 12
5c. Street address: 1710 East Marion Street
5d. City, state, zip: Shelby, NC 28151
5e. Telephone no.: 704-480-9044
5f. Fax no.: 704-480-5401
5g. Email address: [e-mail]
Page 2 of 11
PCN Form - Version 1.3 December 10, 2008 Version
B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): NA
Latitude: 35.476660 Longitude: -
1 b. Site coordinates (in decimal degrees): 81.566551
(DD.DDDDDD) (-DD.DDDDDD)
1 c. Property size: <.10 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to UT to Little Knob Creek
proposed project:
2b. Water Quality Classification of nearest receiving water: WS-IV
2c. River basin: Broad
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:
Existing 37-foot long, 103" x 71" CMPA, with headwalls landuse is mostly agriculture/pasture land. Culvert is on paved
secondary road.
3b. List the total estimated acreage of all existing wetlands on the property:
0
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
100 feet
3d. Explain the purpose of the proposed project:
The purpose of the proposed work is to replace the deteriorating culvert for the safety of the travelling public.
3e. Describe the overall project in detail, including the type of equipment to be used
NCDOT proposes to replace a deteriorating 37-foot long, 103" x 71" CMPA with a 50-foot long, 96" CMP with a headwall
at the inlet end. There is a shallow scourhole at the outlet of the existing pipe, the required one-foot burial of the new
pipe is based upon the streambed elevation at the downstream point of the scourhole. Five feet of riprap will be utilized
at the pipe outlet and will be incorporated into an existing root mass for structure/bank stabilization. Ten feet of riprap will
be utilized at the pipe inlet for structure stabilization. A sidestream/seep enters the main channel immediately upstream
of the new pipe; therefore, the riprap stabilization of the main channel will be extend to the 15 feet of bank stabilization on
the side channel. A temporary cofferdam pumping system will be used to divert the stream around the construction site
as needed. Area affected by temporary cofferdam system will be graded and restored back to pre-project conditions. All
Best Management Practice's will be utilized during the course of the project. The Project will be constructed using
typical heavy equipment (trackhoe, backhoe, etc.)
4. Jurisdictional Determinations
4a.! Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past? ? Yes ® No ? Unknown
Comments: Jurisdictional stream determination made by
Division 12 DEO.
4b. If the Corps made the jurisdictional determination, what type
? Preliminary ? Final
of determination was made?
4c. If yes, who delineated the jurisdictional areas? Agency/Consultant Company:
Name (if known): Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
Page 3 of 11
PCN Form - Version 1.3 December 10, 2008 Version
5. Project History
5a. Have permits or certifications been requested or obtained far
this project (including all prior phases) in the past? ? Yes ®No ? Unknown
5b. If yes, explain in detail according to "help file" instructions.
6. Future Project Plans
6a. Is this a phased project? ? Yes ® No
6b. If yes, explain.
Page 4 of 11
PCN Form - Version 1.3 December 10, 2008 Version
C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for 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 jurisdiction
number- Type of impact Type of wetland Forested (Corps - 404, 10 Area of impact
Permanent (P) or (if known) DWQ - non-404, other) (acres)
Temporary T
W1 ? P ? T ? Yes ? Corps
? No ? DWQ
W2 ? P ? T ? Yes ? Corps
? No ? DWQ
W3 ? P ? T ? Yes ? Corps
? No ? DWQ
W4 ? P ? T ? Yes ? Corps
? No ? DWQ
W5 ? P ? T ? Yes ? Corps
? No ? DWQ
W6 ? P ? T ? Yes ? Corps
? No ? DWQ
2-,. Total wetland impacts
2h. Comments:
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a. 3b. 3c. 3d. 3e. 3f. 3g.
Stream impact Type of impact Stream name Perennial Type of jurisdiction Average Impact
number - (PER) or (Corps - 404, 10 stream length
Permanent (P) or intermittent
DWQ -non-404,
width
(linear
Temporary (T) (INT ? other) (feet) feet)
S1 ®P ? T Increase in pipe 1s` Ut to Little ® PER ® Corps

length
Knob Creek
? INT
® DWQ 4 13

S2 ® P ? T Structure/Bank
stabilization at 1" Ut to Little ® PER ® Corps
4
15
inlet and outlet Knob Creek ? INT ®DWQ
S3 ® P ? T Bank stabilization 2n° Ut to Little ? PER ® Corps 1 15
Knob Creek ® INT
- ® DWQ
S4 ? P ® T Cofferdam bypass 1s` & 2n° Ut's to 9 PER ® Corps

pumping
Little Knob Creek
® INT
® DWQ 4 50
S5 ? P ? T ? PER ? Corps
? INT ? DWQ
S6 ? P ? T ? PER ? Corps
? INT ? DWQ
3h. Total stream and tributary impacts 43
3i. Comments: Total permanent stream impacts on 1" and 2nd Ut's to Little Knob Creek
Page 5 of 11
PCN Form - Version 1.3 December 10, 2008 Version
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. 4b. 4c. 4d. 4e.
Open water Name of waterbody
impact number- (if applicable) Type of impact Waterbody type Area of impact (acres)
Permanent (P) or
Temporary T
01 ?P?T
02 ?P?T
03 ?P?T
04 ?P?T
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If and or lake construction proposed. then complete the chart below.
5a. 5b. 5c. 5d. 5e.

Pond ID
Proposed use or purpose Wetland Impacts (acres) Stream Impacts (feet) Upland

b (acres)
num
er of pond
Flooded Filled Excavated Flooded Filled Excavated Flooded
P1
P2
St. 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 an impacts require mitigation, then you MUST fill out Section D of this form.
6a.
? Neuse ? Tar-Pamlico ? Other:
Project is in which protected basin? ? Catawba ? Randleman
61b. 6c. 6d. 6e. 6f. 6g.
Buffer impact
number- Reason Buffer Zone 1 impact Zone 2 impact
Permanent (P) or for Stream name mitigation (square feet) (square feet)
Temporary T impact required?
B1 ?P?T ?Yes
? No
82 ?P?T ?Yes
? No
B3 ?P?T ?Yes
? No
6h. Total buffer impacts
6i. Comments:
Page 6 of 11
PCN Form -Version 1.3 December 10, 2008 Version
D. Impact Justification and Mitigation
1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
NCDOT proposes to leave a large root mass intact at the pipe outlet and incorporate the riprap structure stabilization into the
root mass in an effort to minimize bank erosion at the outlet. Pipe burial at the pipe outlet is based upon the normal streambed
elevation past the existing outlet scourhole.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Minimization of impacts by installing appropriate erosion control measures.
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 mitigat ion 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 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: ? warm ? cool ?cold
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 7 of 11
PCN Form - Version 1.3 December 10. 2008 Version
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? ? Yes ®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 8 of 11
PCN Form - Version 1.3 December 10, 2008 Version
E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1a . 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
Comments:
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project? NA %
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, na rrative description of the plan:
Complies with NCDOT's individual NPDES permit NCS000250.
? Certified Local Government
2e. Who will be responsible for the review of the Stormwater Management Plan? ? DWQ Stormwater Program
® DWQ 401 Unit
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this project? NA
? Phase II
3b. Which of the following locally-implemented stormwater management programs ? NSW
? 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

4a.
Which of the following state-implemented stormwater management programs apply ? HOW
? ORW
(check all that apply): ? Session Law 2006-246
? Other:
4b. Has the approved Stormwater Management Plan with proof of approval been
attached? ? Yes ? No
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 9 of 11
PCN Form -Version 1.3 December 10, 2008 Version
F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1a. 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)?
1c. 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
letter.) ? Yes ? No
Comments:
2. Violations (DWQ Requirement)
2a. Is the site in violation of DWQ Welland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards, ? Yes ® No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. Is this an after-the-fact permit application? ? 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.
The project is classified as a minimum critieria project which has low potential for cumulative/indirect impacts and will not
result in additional development which could impact water quality.
4. Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility.
No wastewater generated from project
Page 10 of 11
PCN Form - Version 1.3 December 10, 2008 Version
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?
51b. Have you checked with the USFWS concerning Endangered Species Act ? Yes ® No
impacts?
5c. If yes, ind icate the USFWS Field Office you have contacted. El Raleigh
? Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
NC Natural Heritage Program database and on-site survey.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat? ? Yes ®No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
No salt marshes, oyster reefs, or seagrass beds in the vicinity of the project.
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 ®No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
71b. What data sources did you use to determine whether your site would impact historic or archeological resources?
The National Register of Historic Places were reviewed for historic sites in the vicinity of the project; however, the pipe
replacement project occurs within a previously impacted area (NCDOT Right of Way).
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain? ? Yes ®No
81b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination? FEMA FIRM panal number: 3710263300J
M f {v?ale? yyf ?? -Zl?/l
Applicant/Agent's Printed Name Applicant/Agent's Signature Date
(Agent's signature is valid only 6 an authorization letter from the applicant
is rovided.
Page 1 1 of 11
PCN Form - Version 1.3 December 10, 2008 Version
SR 1637, Warlick Road
Cleveland County
Inlet
Downstream
Upstream
Outlet
1% f 1, gin 1'l as nt x 1
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W es' Pipe Replacement .?
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Name: LAWNDALE Location: 035.4802454' N 081.5645674°W
Date: 2118/2011 Caption: Pipe Replacement, SR 1637 (Warlick Road), UT to Big Knob
Scale: 1 inch equals 1333 feet Creek, WS-IV Watershed, Broad River Basin
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NCDOT
HAZARDOUS SPILL BASIN CHECKLIST
Division: 1? County: Cleyplnnd ProjectID: 1213.202311
River Basin: Broad Bridge No: NA
Route: SR 1637 Stream: Ut to Little Knob Creek
Water Quality Criteria:
Yes No
Stream Crossing Blue Line On USGS rv- r-
ORW r W
WSI r w
WS 11,111 OR IV, Crossing Within 0.5mi of W.S. Critical Area r r?
Roadway Criteria:
Route Designation-
Arterial Urban
Arterial Rural
Additional Site Infonnation:
Is a Hazardous Spill Basin Required?
Yes No
F- W
F W
Yes No
r r
Criteria Based Upon NCDOT "Best Management Practices for the
Protection of Surface Waters" (March, 1997).