20220164 Ver 1_ePCN Application_20220202

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Pre-Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
December 6,2021 Ver 4.2
Initial Review
Has this project met the requirements for acceptance in to the review process?*
Yes
No
Is this project a public transportation project?*
Yes No
Change only if needed.
BIMS#Assigned* Version#*
20220164 1
Is a payment required for this project?
No payment required
Fee received Reviewing Office*
Fee needed-send electronic notification Central Office-[phone]
Select Project Reviewer*
Ryan Conchilla:eads\rjconchilla
Information for Initial Review
1a.Name of project:
Widening of NC211 from south of NC73 in West End to north of SR1241(Holly Grove School Rd)R-5726
la.Who is the Primary Contact?*
NCDOT
1 b.Primary Contact Email:* 1c.Primary Contact Phone:*
[e-mail] [phone]
Date Submitted
2/2/2022
Nearest Body of Water
McLendons Creek
Basin
Cape Fear
Water Classification
C
Site Coordinates
Latitude: Longitude:
35.270019 -79.599896
A. Processing Information
County(or Counties)where the project is located:
Moore
Is this a NCDMS Project
Yes No
Is this project a public transportation project?*
Yes No
Is this a NCDOT Project?*
Yes No
(NCDOT only)T.I.P.or state project number:
R-5726

WBS#(')
50218.1.1
1a.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)
Has this PCN previously been submitted?
Yes
No
1 b.What type(s)of permit(s)do you wish to seek authorization?
Nationwide Permit(N W P)
Regional General Permit(RGP)
Standard(IP)
1c.Has the NWP or GP number been verified by the Corps?
Yes No
Regional General Permit(RGP)Number: 201902350-Work associated with bridge construction,widening,replacement,and
interchanges
RGP Numbers(for multiple RGPS):
1d.Type(s)of approval sought from the DWR:
401 Water Quality Certification-Regular 401 Water Quality Certification-Express
Non-404 Jurisdictional General Permit Riparian Buffer Authorization
Individual 401 Water Quality Certification
le.Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification: Yes No
For the record only for Corps Permit: Yes No
1f.Is this an after-the-fact permit application?*
Yes No
1g.Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
Yes No
1g.Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
Yes No
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 No
B. Applicant Information
1d.Who is applying for the permit?
Owner Applicant(other than owner)
le.Is there an Agent/Consultant for this project?
Yes No
2.Owner Information
2a.Name(s)on recorded deed:
Mutiple Properties
2b.Deed book and page no.:
2c.Contact Person:

2d.Address
Street Address
1598 Mail Service Center
Address Line 2
City State/Province/Region
Raleigh NO
Postal/Zip Code Country
27699-1598 USA
2e.Telephone Number: 2f.Fax Number:
[phone]
2g.Email Address:*
[e-mail]
C. Project Information and Prior Project History
1.Project Information
1 b.Subdivision name:
(if appropriate)
1c.Nearest municipality I town:
West End
2.Project Identification
2a.Property Identification Number: 2b.Property size:
2c.Project Address
Street Address
Address Line 2
City State/Province/Region
Postal/Zip Code Country
3. Surface Waters
3a.Name of the nearest body of water to proposed project:
McLendons Creek
3b.Water Resources Classification of nearest receiving water:*
C
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.
030300030301
4. Project Description and History
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:*
NO 211 serves local and regional traffic and is generally two lanes with speed limits varying from 35 miles per hour(mph)to 55 mph.This section of NO 211 through the project study area
is classified as a minor arterial in the NCDOT functional classification system.Land use is predominately agriculture with dispersed commercial and residential areas.
4b.Have Corps permits or DWR certifications been obtained for this project(including all prior phases)in the past?*
Yes No Unknown
4f.List the total estimated acreage of all existing wetlands on the property:
6.51
4g.List the total estimated linear feet of all existing streams on the property:
1,711
4h.Explain the purpose of the proposed project:
The primary purposes of the proposed project include the following:Alleviate existing congestion at the NO 211 and SR 1239(Seven Lakes Drive)intersection,improve mobility and
reduce the number of conflict points along NO 211 from N.C.73 in
West End to SR 1241(Holly Grove School Road),and improve east-west system linkage on NO 211 in Moore County between Pinehurst,the largest town in Moore County,and 1-73/1-
74/US 220 in Montgomery County.

4i.Describe the overall project in detail,including indirect impacts and the type of equipment to be used:*
The proposed improvements for this project consist of widening NC 211 from a two-lane roadway to a four-lane divided roadway,utilizing shoulder and curb and gutter.The proposed
typical section near the southern terminus of the project(Segments Al and A2)include a 23-foot raised median transitioning to a 46-foot wide grass median along Segment B near the
southern intersection with SR 1135(Dead Man Curve Road).Segment Al proposes to widen NC 211 to the east from NC 73 in West End to Church Street.This segment does not cross or
impact any streams or wetlands and is approximately 0.6 miles in length.Segment A2 proposes to widen NC 211 to the west from NC 73 in West End to Church Street.This segment does
not cross or impact any streams or wetlands and is approximately 0.6 miles in length.Segment B proposes to widen NC 211 with a best-fit alignment from Church Street to SR 1241(Holly
Grove School Road).This segment crosses three unnamed tributaries to McLendon's Creek and wetlands and is approximately 4.1 miles in length.NC 211 through West End and from SR
1238(Love Grove Church Road)to the southern intersection of SR 1135(Dead Man Curve Road)includes curb and gutter to minimize property impacts.
No control of access is proposed for NC 211 for the length of the project.A median will be constructed as part of the proposed improvements.Standard road building equipment such as
truck,dozers,and cranes will be used.
5. Jurisdictional Determinations
5a.Have the wetlands or streams been delineated on the property or proposed impact areas?*
Yes No Unknown
Comments:
5b.If the Corps made a jurisdictional determination,what type of determination was made?*
Preliminary Approved Not Verified Unknown N/A
Corps AID Number:
5c.If 5a is yes,who delineated the jurisdictional areas?
Name(if known): Sandy Smith
Agency/Consultant Company: Axion
Other: Deanna Riffey/NCDOT
5d.List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
WA,WC,WD,WE,WI and Streams A-D are PJD and WB&WG are AJD.Sites visits were made 7/21/18.
6.Future Project Plans
6a.Is this a phased project?*
Yes No
Are any other NWP(s),regional general permit(s),or individual permits(s)used,or intended to be used,to authorize any part of the proposed project or related activity?
D. Proposed Impacts Inventory
1. Impacts Summary
1a.Where are the impacts associated with your project?(check all that apply):
Wetlands Streams-tributaries Buffers
Open Waters Pond Construction
2.Wetland Impacts
2a1 Reason(?) 2b.Impact type*(?) 2c.Type of W.* 2d.W.name* 2e.Forested* 2f.Type of Jurisdiciti��2g.Impact
area
Fill P Headwater Forest WC Yes Both acm 0(
(acres)
Hand clearing T Headwater Forest WC Yes Both 0.025
(acres)
Fill P Headwater Forest WF Yes Both 0.381
(acres)
Hand clearing T Headwater Forest WF Yes Both 0.073
(acres)
Excavation P Headwater Forest WB Yes DWR 0.002
(acres)
Fill P Headwater Forest WB Yes DWR 0.026
(acres)
Hand clearing T Headwater Forest WB Yes DWR 0.015
(acres)

Fill P Headwater Forest WG Yes DWR 0.034
(acres)
Fill P Headwater Forest WF Yes [Both 0.120
(acres)
F7]
Hand clearing T Headwater Forest �WF Yes Both 0.021
(acres)
2g.Total Temporary Wetland Impact 2g.Total Permanent Wetland Impact
0.134 0.702
2g.Total Wetland Impact
0.836
21.Comments:
Wetlands at Sites 4&5 are Isolated.There will also be 0.02 acre of temporary fill in wetlands in the Hand Clearing areas for Erosion Control measures.
3. Stream Impacts
❑3a.Reason for impact(?) 3b.lmpact type* 3c.Type of impact* 3d.S.name* 3e.Stream Type* 3f.Type of 3g.S.width* 311.Impact
(?) IIJurisdiction* length*
S7 Roadway/Pipe Permanent Fill SA Perennial Both 3 215
Average(feet) pinearfeeq
S2 Roadway/Pipe Permanent Fill SB Intermittent Both 117
Average(feet) pinear feet)
S3
Pipe Tem ore Fill SB Intermittent Both 3 7 P rY
Average(feet) pinear feet)
3i.Total jurisdictional ditch impact in square feet:
0
3i.Total permanent stream impacts: 3i.Total temporary stream impacts:
332 7
31.Total stream and ditch impacts:
339
3j.Comments:
4. Open Water Impacts
4a. Site# 4a1.Impact Reason 4b.Impact type 4c.Name of waterbody 4d.Activity type �114e.Waterbody type 4f.Impact area
Draining pond T Pond A Drainage Pond 0.43
4g.Total temporary open water Impacts: 4g.Total permanent open water impacts:
0.43 0.00
4g.Total open water impacts:
0.43
4h.Comments:
E. Impact Justification and Mitigation
1.Avoidance and Minimization
1a.Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
Culverts in the project area that convey jurisdictional streams have been buried to provide aquatic passage.Drainage has been designed so that outlets
discharging into wetlands have non-erosive velocities to minimize disturbance to the wetland.
1 b.Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Steepened 3:1 fill slopes have been implemented in areas where wetlands and streams have been impacted by the project.Hand clearing will now be
utilized in wetlands vs mechanized clearing as originally planned.
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
2c.If yes,mitigation is required by(check all that apply):
DWR Corps

2d.If yes,which mitigation option(s)will be used for this project?
Mitigation bank Payment to in-lieu fee program Permittee Responsible Mitigation
4. Complete if Making a Payment to In-lieu Fee Program
4a.Approval letter from in-lieu fee program is attached.
Yes No
4b.Stream mitigation requested:
(linear feet) 4c.If using stream mitigation,what is the stream temperature:
332 warm
4e.Riparian wetland mitigation requested:
4d.Buffer mitigation requested(DWR only): (acres)
(square feet) 0.702
4f.Non-riparian wetland mitigation requested: 4g.Coastal(tidal)wetland mitigation requested:
(acres) (acres)
4h.Comments
There is 0.642 acre of mitigation for 404 Wetland mitigation and additional 0.06 acre(1:1 ratio)for 401 Isolated Wetlands mitigation.
6. Buffer mitigation (State Regulated Riparian Buffer Rules)- required by DWR
6a.Will the project result in an impact within a protected riparian buffer that requires buffer mitigation?If yes,you must fill out this entire form-please contact DWR for more information.
Yes No
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
1. Diffuse Flow Plan
la.Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection Rules?
Yes No
If no,explain why:
The project is in the Cape Fear River basin.
2. Stormwater Management Plan
2a.Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?
Yes No
Comments:
G. Supplementary Information
1. Environmental Documentation
la.Does the project involve an expenditure of public(federal/state/local)funds or the use of public(federal/state)land?"
Yes No
1 b.If you answered"yes"to the above,does the project require preparation of an environmental document pursuant to the requirements of the National or State(North Carolina)
Environmental Policy Act(NEPAISEPA)?*
Yes No
1c.If you answered"yes"to the above,has the document review been finalized by the State Clearing House?
Yes No
2.Violations (DWR Requirement)
2a.Is the site in violation of DWR Water Quality Certification Rules(1 SA 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 result in additional development,which could impact nearby downstream water quality?
Yes No

3b.If you answered"no,"provide a short narrative description.
The CIA report from Sept.2017 indicates no effect.The project will not alter travel patterns,reduce travel time,affect access to properties in the area,or
open areas for development or redevelopment.Due to its minimal transportation impact-causing activities(TICAs),this project will neither influence
nearby land uses nor stimulate growth.
4. Sewage Disposal (DWR Requirement)
4a.Is sewage disposal required by DWR for this project?*
Yes No N/A
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?
Yes No
5b.Have you checked with the USFWS concerning Endangered Species Act impacts?*
Yes No
5c.If yes,indicate the USFWS Field Office you have contacted.
Raleigh
5d.Is another Federal agency involved?*
Yes No Unknown
5e.Is this a DOT project located within Division's 1-8?
Yes No
5j.What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
USFWS IPaC and field surveys.Species received biological conclusions of No Effect due to no habitat or habitat with no observation of species during
surveys.Cape Fear shiner:No Habitat;Bald Eagle,RCW,Michaux Sumac:Habitat&No field observation.The NLEB(May Affect,Likely to Adversely
Affect)falls under the PBO.
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?
EFH Mapper
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?*
Yes No
7b.What data sources did you use to determine whether your site would impact historic or archeological resources?*
State Environmental Assessment/Finding of No Significant Impact(SEA/FONSI)
8. Flood Zone Designation (Corps Requirement)
8a.Will this project occur in a FEMA-designated 100-year floodplain?*
Yes No
8c.What source(s)did you use to make the floodplain determination?*
FEMA Mapping and SEA/FONSI
Miscellaneous U
Please use the space below to attach all required documentation or any additional information you feel is helpful for application review.Documents should be combined into one file when
possible,with a Cover Letter,Table of Contents,and a Cover Sheet for each Section preferred.
Click the upload button or drag and drop files here to attach document
R5726_Permit Drawings_20220127.pdf 7.98MB
File must be PDF or KMZ
Comments
Signature U
*
By checking the box and signing below,I certify that:
• The project proponent hereby certifies that all information contained herein is true,accurate,and complete to the best of my knowledge and belief';and
The project proponent hereby requests that the certifying authority review and take action on this CWA 401 certification request within the applicable reasonable period of time.
• 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:
Mack Christopher Rivenbark,III
Signature
JN4 t Ru�tba,�¢,111
Date
2/2/2022