20131190 Ver 1_More Info Received_20140421

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t r > Corps action ID no.
c r ® DWQ project no.
Form Version 1.4 January 2009
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A. Applicant Information
1. Processing
1a. Type(s) of approval sought from the Corps: ® Section 404 Permit ❑ Section 10 Permit
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PCN Form — Version 1.4 January 2009
1 b. Specify Nationwide Permit (NWP) number: 3 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps?
® Yes ❑ No
1d. Type(s) of approval sought from the DWQ (check all that apply):
® 401 Water Quality Certification — Regular ❑ Non404 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 Certification:
❑ Yes Q No
For the record only for Corps Permit:
❑ 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 ® 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:
South Caldwell Ave Culvert Replacement
2b. County:
Catawba
2c. Nearest municipality / town:
Newton
2d. Subdivision name:
N/A
2e. NCDOT only, T.I.P. or state project no:
N/A ! r
3. Owner Information t
3a. Name(s) on Recorded Deed:
N /A�`
3b. Deed Book and Page No.
N/A '0'J r anc
3c. Responsible Party (for LLC if
applicable):
City of Newton
3d. Street address:
401 North Main Avenue
3e. City, state, zip:
Newton, North Carolina 28658
3f. Telephone no.:
828 -695 -4296
3g. Fax no.:
828 -465 -7422
3h. Email address:
dwentz @newtonnc.gov
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PCN Form — Version 1.4 January 2009

4. Applicant Information (if different from owner)
4a. Applicant is:
❑ Agent ❑ Other, specify:
4b. Name:
4c. Business name
(if applicable):
4d. Street address:
4e. City, state, zip:
4f. Telephone no.:
4g. Fax no.:
4h. Email address:
5. Agent/Consultant Information (if applicable)
5a. Name:
Clarence M. Lockamy, P.E.
5b. Business name
(if applicable):
The Wooten Company
5c. Street address:
1430 B Old Lenoir Road, NW
5d. City, state, zip:
Hickory, North Carolina 28601
5e. Telephone no.:
828 - 322 -5533
5f. Fax no.:
828- 322 -5242
5g. Email address:
clockamy @thewootencompany.com
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PCN Form — Version 1.4 January 2009
B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID):
See Attached
1b. Site coordinates (in decimal degrees):
I Latitude: °81.2161 Longitude: 35.6538
1c. Property size:
0.14 acres
2. Surface Waters
2a. Name of nearest body of water to proposed project:
Town Creek
2b. Water Quality Classification of nearest receiving water:
"C"
2c. River basin:
Catawba
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:
The site consists of residential lawns and wooded areas with an existing oval shaped culvert in the stream channel. The existing culvert has a 'rubble'
headwall and measures 7 1/2 feet by 14 feet.
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: 148
3d. Explain the purpose of the proposed project:
Removal of existing culvert and replacement with a new 56 ft long precast double barrel concrete culvert measuring 8 ft by11 ft w/ concrete headwall.
3e. Describe the overall project in detail, including the type of equipment to be used:
Replacement of existing culvert. No channel realignment or change of invert depth is proposed. No 'fresh' concrete is required to install new culvert.
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 nor phases) in the past?
❑ Yes ® No ❑ Unknown
Comments:
4b. If the Corps made the jurisdictional determination, what type
of determination was made?
❑ Preliminary ❑ Final
4c. If yes, who delineated the jurisdictional areas?
Name (if known):
Agency /Consultant Company:
Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
5. Project History
5a. Have permits or certifications been requested or obtained for
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.
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PCN Form — Version 1.4 January 2009

C. Proposed Impacts Inventory
1. Impacts Summary
1a. 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.
Wetland impact
number
Permanent (P) or
Temporary T
2b.
Type of impact
2c.
Type of wetland
2d.
Forested
2e.
Type of jurisdiction
Corps (404,10) or
DWO (401, other)
2f.
Area of
impact
(acres)
W1 -
Choose one
Choose one
Yes /No
-
W2
Choose one
Choose one
Yes /No
W3 -
Choose one
Choose one
Yes /No
W4 -
Choose one
Choose one
Yes /No
-
W5 -
Choose one
Choose one
Yes /No
W6 -
Choose one
Choose one
Yes /No
2g. 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.
Stream impact
number
Permanent (P) or
Temporary (T)
3b.
Type of impact
3c.
Stream name
3d.
Perennial (PER) or
intermittent (INT)?
3e.
Type of
jurisdiction
3f.
Average
stream
width
(feet)
3g.
Impact
length
(linear
feet)
S1 P
Culvert
Town Creek 11 -39 -2
PER
Corps
10
148
S2
Choose one
-
S3
Choose one
-
S4
Choose one
S5
Choose one
-
S6 -
Choose one
3h. Total stream and tributary impacts
148
3i. Comments:
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PCN Form —Version 1.4 January 2009

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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.
Open water
impact number
Permanent (P) or
Temporary( T
4b.
Name of waterbody
(if applicable)
4c.
Type of impact
4d.
Waterbody
type
4e.
Area of impact (acres)
01
Choose one
Choose
02
Choose one
Choose
03
Choose one
Choose
04
Choose one
Choose
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If pond or lake construction proposed, then complete the chart below.
5a.
Pond ID number
5b.
Proposed use or
purpose of pond
5c.
Wetland Impacts (acres)
5d.
Stream Impacts (feet)
5e.
Upland
(acres)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
P1
Choose one
P2
Choose one
5f. Total:
5g. Comments:
5h. Is a dam high hazard permit required?
❑ Yes ❑ No If yes, permit ID no:
51. 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 any impacts require mitigation. then vou MUST fill out Section D of this form.
6a. Project is in which protected basin?
❑ Neuse ❑ Tar - Pamlico ❑ Catawba ❑ Randleman ❑ Other:
6b.
Buffer Impact
number —
Permanent (P) or
Temporary T
6c.
Reason for impact
6d.
Stream name
6e.
Buffer
mitigation
required?
6f.
Zone 1
impact
(square
feet
6g.
Zone 2
impact
(square
feet
131 -
Yes /No
B2 -
Yes /No
B3 -
Yes /No
B4 -
Yes /No
B5 -
Yes /No
B6 -
Yes /No
6h. Total Buffer Impacts:
6i. Comments:
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D. impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
The original design planned for 183 feet of total stream disturbance. The design was reviewed and reduced potential stream impact to 148 feet. A
precast concrete culvert was used instead of a fresh mixed concrete culvert construction. The existing culvert consists of a 'rubble' headwall consisting
of large concrete and asphalt fragments. The new culvert will have a concrete headwall and the deleterious materials (ie. asphaltic) of the existing
headwall will be removed preventing man -made materials being transported downstream during flood events.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Removal and replacement construction operations will be performed during a predefined number of days in the construction schedule, thus limiting
impacts to stream. Erosion control measures including BMP's for erosion control will be employed as needed. Site work will not be conducted during
rain to minimize surface disturbance. Vegetative stabilization of side slopes will reduce potential erosion of exposed side slope soils. The elevation of
the new culvert will be a minimum of 1 ft below stream bed.The designed headwall will also be competent to restrain surface sloughing into the stream.
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 mitigation option will be used for this
project?
❑ Mitigation bank
El 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: Choose one
Type: Choose one
Type: Choose one
Quantity:
Quantity:
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:
Choose one
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.
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PCN Form — Version 1.4 January 2009

6. Suffer Mitigation (State Regulated Riparian Huffer Rules) ® required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation?
Yes X 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:
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Page 8 of 10
PCN Form — Version 1.4 January 2009
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
within one of the NC Riparian Buffer Protection Rules?
® Yes ® No
1b. If yes, then is a diffuse flow plan included? If no, explain why.
® Yes ® No
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project?
ado
2b. Does this project require a Stormwater Management Plan?
® Yes ® No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why:
Project consists of removal and replacement of existing culvert at a street crossing.
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
2e. Who will be responsible for the review of the Stormwater Management Plan?
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this project?
City of Newton
3b. Which of the following locally - implemented stormwater management programs
apply (check all that apply):
® Phase II
❑ NSW
❑ USMP
Water Supply Watershed
® Other:
3c. Has the approved Stormwater Management Plan with proof of approval been
attached?
[]Yes ® No
4. DWQ Stormwater Program Review
4a. Which of the following state - implemented stormwater management programs apply
(check all that apply):
®Coastal counties
❑HQW
®ORW
®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
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PCN Form — Version 1.4 January 2009

F.
Supplementary Information
1.
Environmental Documentation (DWQ Requirement)
1 a.
Does the project involve an expenditure of public (federal /state /local) funds or the
® Yes ® No
use of public (federal /state) land?
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
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 Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards,
El 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 I ® Yes QX No I
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 consists of removal and replacement of a culvert, no additional development is anticipated.
14. 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.
The project does not propose treatment or discharge of wastewater.
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PCN Form — Version 1.4 January 2009

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?
5b. Have you checked with the USFWS concerning Endangered Species Act
® Yes ❑ No
impacts?
5c. If yes, indicate the USFWS Field Office you have contacted.
Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
US Fish & Wildlife Service web page- http: /Avww.fws.gov /raleigh /species /cntylisVcatawba.html
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?
NCDENR website- project site is non - coastal and not located along MFC designated Nursery Areas
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)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
http: / /gis.ncdcr.gov /hpoweb/ Although project site is located near significant historical structures, they are not expected to impact these as they are
located more than 2000 ft from project site.
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA- designated 100 -year floodplain?
F _0 Yes ❑ No
8b. If yes, explain how project meets FEMA requirements:
Replacement of existing culvert in the 100 -year floodplain at a street crossing.
8c. What source(s) did you use to make the floodplain determination?
North Carolina F000dplain Maps web site: http: / /floodmaps.nc.gov /fmis/
Applicant/Agent's Printed Name
Date
Applicant/Agent's Signature
(Agent's signature is valid only if an authorization
letter from the applicant is provided.)
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