HE-0014 ePCN

Pre-Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
October 2, 2023 Ver 4.3
Please note: fields marked with a red asterisk * below are required. You will not be able to submit the form until all mandatory questions are answered.
Also, if at any point you wish to print a copy of the E-PCN, all you need to do is right-click on the document and you can print a copy of the form.
Below is a link to the online help file.
https://edocs.deq.nc.gov/WaterResources/DocView.aspx?dbid=0&id=2196924
Pre-Filing Meeting Date Request was submitted on:*
If this is a courtesy copy, please fill in this with the submission date.
Does this project involve maintenance dredging funded by the Shallow Draft Navigation Channel Dredging and Aquatic Weed Fund or involve the distribution or transmission of energy or
fuel, including natural gas, diesel, petroleum, or electricity?*
Is this project connected with ARPA funding?*
County (or Counties) where the project is located:*
Is this a NCDMS Project *
DO NOT CHECK YES, UNLESS YOU ARE DMS OR CO-APPLICANT.
Is this project a public transportation project?*
Is this a NCDOT Project?*
(NCDOT only) T.I.P. or state project number:
WBS #*
1a. Type(s) of approval sought from the Corps:*
Has this PCN previously been submitted?*
1b. What type(s) of permit(s) do you wish to seek authorization?*
1c. Has the NWP or GP number been verified by the Corps?*
Nationwide Permit (NWP) Number:
A. Processing Information
3/24/2023
Yes No
Yes No
Davidson
Yes No
Click Yes, only if NCDMS is the applicant or co-applicant.
Yes No
This is any publicly funded by municipal,state or federal funds road, rail, airport transportation project.
Yes No
HE-0014
50795
(for NCDOT use only)
Section 404 Permit (wetlands, streams and waters, Clean Water Act)
Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
Yes
No
Nationwide Permit (NWP)
Regional General Permit (RGP)
Standard (IP)
Yes No
14 - Linear transportation
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:*
1e. Is this notification solely for the record because written approval is not required?
*
For the record only for DWR 401 Certification:
For the record only for Corps Permit:
1f. Is this an after-the-fact permit application?*
1g. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
Acceptance Letter Attachment
1h. Is the project located in any of NC's twenty coastal counties?*
1j. Is the project located in a designated trout watershed?*
Link to trout information: http://www.saw.usace.army.mil/Missions/Regulatory-Permit-Program/Agency-Coordination/Trout.aspx
1a. Who is the Primary Contact?*
1b. Primary Contact Email:*
1c. Primary Contact Phone:*
1d. Who is applying for the permit?*
1e. Is there an Agent/Consultant for this project?*
2. Owner Information
List all NW numbers you are applying for not on the drop down list.
check all that apply
401 Water Quality Certification - Regular 401 Water Quality Certification - Express
Non-404 Jurisdictional General Permit Riparian Buffer Authorization
Individual 401 Water Quality Certification
Yes No
Yes No
Yes No
If so, attach the acceptance letter from mitigation bank or in-lieu fee program.
Yes No
Click the upload button or drag and drop files here to attach document
Accept_HE-0014_Div 9.pdf 231.02KB
FILE TYPE MUST BE PDF
Yes No
Yes No
B. Applicant Information
Amy Euliss
[e-mail]
(xxx)xxx-xxxx
[phone]
Owner Applicant (other than owner)
(Check all that apply)
Yes No
2a. Name(s) on recorded deed:*
2b. Deed book and page no.:
2c. Contact Person:
2d. Address *
2e. Telephone Number:*
NC Department of Transportation
(for Corporations)
Amy Euliss
City
Winston-Salem
State / Province / Region
North Carolina
Postal / Zip Code
27127
Country
USA
Street Address
375 Silas Creek Parkway
Address Line 2
(xxx)xxx-xxxx
[phone]
1a. Name of project:*
1b. Subdivision name:
1c. Nearest municipality / town:*
2a. Property Identification Number:2b. Property size:
2c. Project Address
2d. Site coordinates in decimal degrees
Please collect site coordinates in decimal degrees. Use between 4-6 digits (unless you are using a survey-grade GPS device) after the decimal place as appropriate, based on how the location was
determined. (For example, most mobile phones with GPS provide locational precision in decimal degrees to map coordinates to 5 or 6 digits after the decimal place.)
Latitude:*Longitude:*
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
3b. Water Resources Classification of nearest receiving water:*
Surface Water Lookup
3c. What river basin(s) is your project located in?*
3d. Please provide the 12-digit HUC in which the project is located.*
River Basin Lookup
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:*
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
4f. List the total estimated acreage of all existing wetlands on the property:
4g. List the total estimated linear feet of all existing streams on the property:
2f. Fax Number:
2g. Email Address:*
(xxx)xxx-xxxx
[e-mail]
C. Project Information and Prior Project History
1. Project Information
Brown Street Relocation
(if appropriate)
n/a
Lexington
2. Project Identification
(tax PIN or parcel ID)(in acres)
City State / Province / Region
Postal / Zip Code Country
Street Address
Address Line 2
35.790776
ex: 34.208504
-80.272646
-77.796371
Rat Spring Branch
C
Yadkin-PeeDee
030401030104
The project is located on the outskirts of Lexington and the general land use is low-density residential with some forest and open fields.
Yes No Unknown
0
(intermittent and perennial)
1,432
4h. Explain the purpose of the proposed project:*
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
Corps AID Number:
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
6. Future Project Plans
6a. Is this a phased project?*
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? This includes other
separate and distant crossing for linear projects that require Department of the Army authorization but don’t require pre-construction notification.
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
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.
"S." will be used in the table below to represent the word "stream".
3a. Reason for impact *(?)3b.Impact type *3c. Type of impact *3d. S. name *3e. Stream Type *
(?)
3f. Type of
Jurisdiction *
3g. S. width *3h. Impact
length *
S1
S2
S3
S4
S5
The purpose of the project is to relocate existing Brown Street.
The need for the project is to maintain and enhance access to existing industrial facilities with the proposed development of the Siemens Rail Car manufacturing facility. The project will
improve traffic operations given the projected increase in traffic with the new manufacturing facility. It will also improve east-west connectivity in the area.
The construction of Siemen’s Rail manufacturing facility will require the relocation of existing Brown Street. NCDOT committed up to $9 million towards proposed road improvements. The
construction of the Siemen’s Rail manufacturing facility has no impacts to Waters of the US.
The typical section will consist of two undivided 12-foot travel lanes with 8-foot paved shoulders. There will be a new stream crossing of an unnamed tributary to Rat Springs Branch on the
new location roadway. Improvements will be made at Henry Link Access Rd and Old Linwood Rd to accommodate necessary turn lanes. The replacement of two existing culverts will also
be required at Old Linwood Rd crossing the UT to Rat Springs Branch and to convey stormwater.
Standard roadbuilding equipment will be used.
Yes No Unknown
No wetlands were found int the study area.
Preliminary Approved Not Verified Unknown N/A
Example: SAW-2017-99999
Ron Johnson & Gordon Cashin
Arcadis
Yes No
D. Proposed Impacts Inventory
Wetlands Streams-tributaries Buffers
Open Waters Pond Construction
Site 1: Bank Stabilization Permanent Bank Stabilization Rat Spring Branch Perennial Both 12
Average (feet)
7
(linear feet)
Site 2: Culvert Installation Permanent Culvert SC-UT to Rat Spring Branch Intermittent Both 2
Average (feet)
120
(linear feet)
Site 2: Culvert Installation Temporary Dewatering SC-UT to Rat Spring Branch Intermittent Both 2
Average (feet)
10
(linear feet)
Site 3: Bank Stabilization Temporary Dewatering SC-UT to Rat Spring Branch Intermittent Both 2
Average (feet)
81
(linear feet)
Site 4: Channel Stabilization Permanent Stabilization SA-UT to Rat Spring Branch Perennial Both 4
Average (feet)
16
(linear feet)
S6
S7
S8
S9
S10
** All Perennial or Intermittent streams must be verified by DWR or delegated local government.
3i. Total jurisdictional ditch impact in square feet:
3i. Total permanent stream impacts:
3i. Total temporary stream impacts:
3i. Total stream and ditch impacts:
3j. Comments:
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:*
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for impacts to Waters of the U.S. or Waters of the State?
2c. If yes, mitigation is required by (check all that apply):
2d. If yes, which mitigation option(s) will be used for this project?
4. Complete if Making a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached.
4b. Stream mitigation requested:
4c. If using stream mitigation, what is the stream temperature:
NC Stream Temperature Classification Maps can be found under the Mitigation Concepts tab on the Wilmington District's RIBITS website.
4d. Buffer mitigation requested (DWR only):4e. Riparian wetland mitigation requested:
4f. Non-riparian wetland mitigation requested:4g. Coastal (tidal) wetland mitigation requested:
4h. Comments
*** Recent changes to the stormwater rules have required updates to this section .***
Site 4: Channel Stabilization Temporary Dewatering SA-UT to Rat Spring Branch Perennial Both 4
Average (feet)
10
(linear feet)
Site 4: Channel
Improvements
Permanent Other SA-UT to Rat Springs Branch Perennial Both 4
Average (feet)
15
(linear feet)
Site 4: Culvert Installation Permanent Culvert SA-UT to Rat Springs Branch Perennial Both 4
Average (feet)
11
(linear feet)
Site 4: Channel
Improvements
Permanent Other SA-UT to Rat Spring Branch Perennial Both 4
Average (feet)
15
(linear feet)
Site 4: Bank Stabilization Permanent Bank Stabilization SA-UT to Rat Spring Branch Perennial Both 4
Average (feet)
10
(linear feet)
0
194
101
295
Stream acreage is provided on the impact summary sheet.
E. Impact Justification and Mitigation
The new roadway minimizes impacts to the floodplain and makes a near perpendicular crossing of the tributary. A private driveway is being relocated
that eliminates a stream crossing and avoids a new stream crossing.
Best Management Practices will be used during construction to minimize further impacts.
Yes No
DWR Corps
Mitigation bank Payment to in-lieu fee program Permittee Responsible Mitigation
Yes No
(linear feet)
131 warm
(square feet)(acres)
(acres)(acres)
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
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?
For a list of options to meet the diffuse flow requirements, click here.
If no, explain why:
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT’s Individual NPDES permit NCS000250?*
Comments:
1. Environmental Documentation
1a. Does the project involve an expenditure of public (federal/state/local) funds or the 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 (North Carolina)
Environmental Policy Act (NEPA/SEPA)?*
Comments:*
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification Rules (15A 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)?*
3. Cumulative Impacts (DWR Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in additional development, which could impact nearby downstream water quality?*
3b. If you answered “no,” provide a short narrative description.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
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?*
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
5c. If yes, indicate the USFWS Field Office you have contacted.
5d. Is another Federal agency involved?*
What Federal Agency is involved?
5e. Is this a DOT project located within Division's 1-8?*
5f. Will you cut any trees in order to conduct the work in waters of the U.S.?*
Yes No
Riparian Buffer rules do not apply to the Yadkin-Pee Dee River Basin.
Yes No
A stormwater management plan is included in the permit drawing package.
G. Supplementary Information
Yes No
Yes No
A State Minimum Criteria Checklist is being completed for this project.
Yes No
Yes No
The relocation of Brown Street is not anticipated to significantly increase traffic compared to the usage of the existing road, which is becoming an access
road to the Sieman's manufacturing facility. The new Brown Street will convey the existing local traffic.
Yes No N/A
Yes No
Yes No
Asheville
Yes No Unknown
The U.S. Army Corps of Engineers
Yes No
Yes No
5g. Does this project involve bridge maintenance or removal?*
Link to the NLEB SLOPES document: http://saw-reg.usace.army.mil/NLEB/1-30-17-signed_NLEB-SLOPES&apps.pdf
5h. Does this project involve the construction/installation of a wind turbine(s)?**
5i. Does this project involve (1) blasting, and/or (2) other percussive activities that will be conducted by machines, such as jackhammers, mechanized pile drivers, etc.?*
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?*
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
Link to the State Historic Preservation Office Historic Properties Map (does not include archaeological data: http://gis.ncdcr.gov/hpoweb/
7a. Will this project occur in or near an area that the state, federal or tribal governments have designated as having historic or cultural preservation status (e.g., National Historic Trust
designation or properties significant in North Carolina history and archaeology)?*
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
8. Flood Zone Designation (Corps Requirement)
Link to the FEMA Floodplain Maps: https://msc.fema.gov/portal/search
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination?*
Comments
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.
*
· 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.
Yes No
Yes No
Yes No
The Us Fish and Wildlife Service's IPaC system.
Yes No
NMFWS Essential Fish mapper.
Yes No
The North Carolina Department of Transportation (NCDOT) Archaeology Team has reviewed the subject project and determined there are no National
Register listed ARCHAEOLOGICAL SITES within the project’s area of potential effects (form dated 10/5/23). NCDOT architectural historian determined
no historic building survey was required (form dated 4/21/23). The Catawba Indian Nation was consulted and they have no concerns (letter dated
5/3/23).
Yes No
Replacement culverts are sized to not exceed existing Base Flood Elevation (BFE). NCDOT will coordinate with NC Floodplain Mapping to meet FEMA
requirements.
NC Flood Mapping Program, FIRM 6724.
Miscellaneous
Click the upload button or drag and drop files here to attach document
HE-0014 PCN Final Combined (2).pdf 15.44MB
File must be PDF or KMZ
Signature
By checking the box and signing below, I certify that:
Full Name:*
Signature *
Date
Amy Euliss
11/9/2023