20151215 Ver 1_Application_20151123

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Office Use Only;
Corps actio:� ID no.
DWQ project no.
Form Version 1.4 January 2009
Pre-Construction Notification (PCN) Form
A. Applicant Information
1. Processing
1 a. Type(s) of approva� so�ght from the Corps: ❑X 5ection 404 Permit ❑ Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: 34 or General Permit {GP} number:
1 c. Has the NWP or GP number been �erified by the Corps? ❑ Yes []x No
1 d. Type(s) af approval sought from the DWQ (check all that apply):
� 401 Water Quality Certificatian — Regular ❑ Non-404 ,luri5dictional General Permit
❑ 401 Water Quality Certification — Express X� Riparian Buffer Authorization
1 e. Is this notification solely for the record For the record only for DWQ For the record only for Corps Permit:
because written approva� is not required? 401 Certification:
❑ Yes 0 No ❑ Yes 0 No
1f. Is payment into a mitigation bank or in-lieu fee program �roposed for
mitigation af impacts? li so, attach the acceptance letter from mitigation bank XO Yes � No
or in-lieu fee program.
1g. Is the project located in any of NCs iwenty coastal counties. If yes, answer 1 h � Yes X❑ No
below.
1h. ls the project locafed within a NC DCM Area of En�ironmental Concerri (AEG)? ❑ Yes ❑X No
2. Project Information
2a. Name of project: Widen SR 18381SR 2220 from U5 15-501 in Orange Co. to SR 1416 in Durham Ca.
2b. County: Orange and Durham Counties
2c. Nearest municipality / town: Chapel Hilf and Durham
2d. Subdivision name:
2e. NC�OT only, T.I.P. or state projec# no: TIP No.: EB-4707 AIB; WBS Number: 38664.1.1
3. �v►rner Informativn
3a. Name(s) on Recorded Deed: NCDOT
3b. Deed Book and Page No.
3c. Responsible Party (for LLC if Mr. J.R. Hopkins, P.E.
applicable):
3d. Street address: 2612 N. Duke S#reet
3e. City, state, zip: Durham, NC 27704
3f. Telephon� no.: (919} 220-4600
3g. Fax no.: [phone]
3h. Email address: Emai! questians or comments to: Chris Murray at: cmurray@ncdo#.gov
Page 1 of 10
PCN Form — Version 1.4 January 20D9

4. Applicant Information (if difFerent from owner)
4a. Applicant is: ❑ Agent ❑ Other, specity:
4b. Name:
4c. Business name
(if applicable):
4d. Street address:
4e. City, sta#e, zip:
4f. Telephone no.:
4g. Fax na.:
4h. Email address:
5. AgentlConsultant Information (if applicable)
5a. Narr�e:
5b. Business name
(if applicable):
5c. Street address:
5d. City, state, zip:
5e. 7elephone no.:
5f. Fax no.:
5g. Email address:
Page 2 of 10

B. Project Information and Prior Project History
1. Property Identification
1a. Property identiftcation no. (tax PIN or parcel ID): N/A
1 b. Site coordinates (in deamal degrees): Latitude: 35.944726 Longitude: 78.990309
1 c. Property size: 37.74 acres
2. Surface Waters
2a. Name of nearest body of water io proposed project: New Hope Creek and �JTs to New Hope Creek
2b. Water Quality Class�cation of nearest recei�ing water: WS-1V NSW
2c. Ri�er basin: Cape Fear River Basin-Jordan Watershed
3. Project Descri�tion
3a. Describe the existing conditions on ihe site and the general la�d use in the �ic�nity of the project af �e time of this
appfication:
Land use in the rrianity is generally mixed comprised of woods, residentiaE houses, apartment oomplexes, businesses, etc. The project is an existing
two lane road with curb and gutter and shoulder sections.
3b. List the total estimated acreage of all existing wetiands on the property: 0.5
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) an the property: 623
3d. Explain the purpose of the proposed proje�t:
This praject will widen the roadway to three lanes (two travel lanes and a rivo-way leR hand tum lane) while some segments will remain iwo lane rdwy.
�
3e. Desaibe fhe o�eralf protect in detail, including the type of equipment to be �sed:
Widen SR 183815R 2224 irom US 15-501 in Orange Co. to SR 1916 in Durham Co. Equipment indudes crane, �ackhoe, dump truck, bahcat, etc.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream deterrrrinations by the � Yes ❑ No ❑ Unknown
Corps or State been requested or ob#ained for this property 1
ro�ect includin all rior hases in the ast? Comments: 5ee attached preliminary JD requesf packet
4b. If the Corps made the jurisdictiona! determination, what type
of determination was made? ❑ Preliminary ❑ Final
4c. If yes, who delineated the jurisdictional areas? AgencylGonsu�tant Com�any: Kim�ey Nom and ,4ssoc.
Name (if known}: Beth Reed Other:
4d. If yes, list the dates o#the Corps jurisdictionai determinations or State determinations and atfach documentation.
See attached preliminary JD request padcet.
5. Project HPstory
5a. Ha�e permits or certifications been requested or obtained for �Yes OX Na ❑ Unknown
this project (including all prior phases) iR the past?
5b. If yes, explain in detail according ta "help file" instructions.
6. Future Project Plans
6a. Is this a phased projeci? ❑ Yes ,�]X No
6b. If yes, explain.
Page 3 of 10
PCN Forrn — Version 1.� Jan�ary 2D09

G. Praposed impacts Inventory
1. Impacts Summary
1a. Which sections were completec! below for your project (check all thaf apply);
OX Wetlands ❑X Streams — tributaries OX Buffers OX Open WaterS ❑ Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, ihen complete this question far each wet�and area impacted.
2a. 2b. 2c. 2d. 2e. 2f.
Wetland impact Type of impact Type of wetland Forested Type of jurisdiction Area of
numbar Corps (404,10) or impact
Permanent (P) or DWQ (409 , other) (acres)
Tem ora
W1 P Fill Bottomland Hardwood Forest Yes Corps 0.42
� P Mechanized clearing Bottomland Hardwood Forest Yes Corps 0.03
{N3 - Choose one Choase one No -
{N4 - Choose one Choose one � No -
W5 - Choose one Choose one Yes1No -
1Ng - Choose one Choose ane Yes1Na -
2g. ToEaI Wetland Impacts: Q.05
2h. Comments:
5ee attached wetland delineation form for wetland at Permit 5ite 5 in the Praliminary JD request packet.
3. Stream Impacts
if there are perennial or intermittent stream impacts (induding ternporary impacts) proposed or� the site, then comple#e this
question for all stream sites impacted.
3a. 3b. 3c. 3d. 3e. 3f. 3g.
Stream impact Type of impact S#ream name Perennial (PER) or Type of Average Impact
number intermittent (INT)? jurisdiction stream length
Permanent (P) or width (linear
Temporary (f� (fe�) feet)
51 P Fi�l and 8ank stabilization UF New Hope Ck. INT Corps 5 77
S2 7 Dewatering UT New Hape Ck. INT Corps 5 10
S3 P Fill UT New Hope Ck. INT Corps 5 90
S4 T Dewatering UT New Hope Ck. INT Corps 5 iQ
$� P Fifl and Bank stabilization New Hope Creek PER Corps 10 185
S6 T Dewaterir�g New Hope Creek PER Corps 10 20
3h. Tota! strearr� and tributary impacis 392
3i. Comments:
Note: Stream impacts S1 and S2 are combined impacts at Permit Sile 1. Stream impac�s S3 and 54 are comhined impads at Permit Site 3. Stream
impacts S5 and S6 are combined at Permit Site 4.
Page 4 of 10
PCN Form — Version 9.4 January 2009

4. Open Water lmpacts
If there are proposed impacfs to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individual! list ail o en water im acts below.
4a. 4b. 4c. 4d. 4e.
�pen water Name of waterbody
impact number (if applicable) Type of impact Waterbody Area of impact (acres)
Permanent (P) or type
iem ora
01 P UT fo New Hope Creek Fill �ond 0.01
02 - Chaose one Choose
03 - Choose one Choose
04 - Choose one Choose
4f. Total open water impacts D.oi
4g. Comments: ese pan impa s are i as ermi i e .
5. Pond or Lake Construction
If ond or lake construction ro osed then com lete the chart below.
5a. 5b. 5c. 5d. �e.
Pond iD number Proposed use or Wetland Impacts (acres} Stream Impa�ts (feet) Upland
purpose of pond (acres)
Flooded Filled �xca�ated Flooded Filled F�cca�ated
P1 Choose one
P2 Choase one
5f. Total:
5g. Comments:
5h. ls a darr� high hazarrf permit required? ❑ Yes � IVo 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 indi�idually lisi all buffer impacts
below. If an im acts re uire miti ation, then ou MUST fill out Section D of this form.
6a. Project is in which protected basin? ❑ iVeuse ❑ Tar-Pamlica ❑ Catawba � Randleman X� Other:C�-,lordan vus
6b. 6c. 6d. 6e. 6f. 6g.
Buffer Impact Reason far impact Stream name Buffer �one 1 Zone 2
number— mitigation impact impact
Permanent (P) or required? (square (square
Tem ora feet feet
B1 P Road crossing UT to New Hepe Creek No 3,978 3,632
B2 P Parallel impact UT to iVew Hope Creek Yes 2,534 394
B3 P Prot. nf exisk. structure UT to New Hope Creek No 328 0
B4 P Road crossing UT to New Hope Creek No 5,88i 1,785
B5 P Road crossing New Hope Creek No 8,785 1,919
B6 P Road crossing UT to New Hope Creek YeslNo 1,765 2,994
6h. Total Buffer Impacts: 2�,7s8 �0,716
6i. Comments: �OT� info for 5ite B7:Reason for impact: Road crassing, Stream: UT to New Hope Creek, No buffer �nitigation required, 497 sf of
BZ 1 impact and D sf of BZ2 impact.
rage 5 ot i v

D. Impact Justification and Mitigation
1. Arroidance and Minimizativ�
9a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
Project impacts have been avoided and minimized throughout the design process. Wetland impacts al Permit Site 5 have been minimized by
removing a skimmer basin at this location and deleting ditching through the wetland. The minimum amount of rip rap has been designed at the outlef
and inlet of pipe structures. Consideration has also been given when determining where to widen symmetrically or to one side of the road based on
locatian of streams, wetlands, pands and riparian butfers.
1b. Specifically describe measures taken to a�oid or minimize the propased impacts through construdion techniques.
5ide slopes havae heen reduced to 2:1 to reduce wetland and stream impacts. The contrac#or will re�iew the site prior to and after pipelroadway fill and
will only use the minimum amount of rip rap lo stabilize dislurbed stream banks.
2. Com ensato Miti ation for Im acts to Waters of the Ll.S. or Waters of the StaEe
2a. Does the project require Compensatory Mitigatien for [JX Yes ❑ No
impacis to Waters of the lf.S. or Waters pf the State?
2b. If yes, mitigation is required by (check ali that apply): ❑X DWQ ❑X Corps
❑ Mitigation bank
2c. If yes, w�ich mitigation option will be used for this �X payment to in-iieu fee program
project?
❑ Permittee Responsible Mitigation
3. Com lete if Usin a Miti ation Bank
3a. Name of Mitigation Bank:
Type: Choose one Quantity:
3b. Credits Purchased {attach receipt and leiter) Type: Choose one Quantity:
7ype: Choose one Quantity:
3c. Gomments:
4. Com lete if Makin a Pa ment to In-lieu Fee Pro ram
4a, Approval lefter from in-lieu fee program is attached. ❑X Yes
4b. 5tream mitigation requested: 95 linear feet
4c. If using stream mitigation, stream temperature: warm
4d. BufFer mitigation requested (DWQ only): 2,928 square feet
4e. Riparian wetland initigation requested: 0.05 acres
4f. Non-riparian wetland mitigation requested: acres
4g, Coastal (tidal} wetland mitigation requested: acres
4h. Comment5:5tream mitigation requesied af a 2:1 ratio and wetland mitigalion requested at at 2:1 reGo
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsibfe mifigation plan, provide a description of the prpposed mitigation plan.
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PCN Form — Version 1.4 January 20D9

6. Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
8a. Will the project result in an impact within a protected riparian buffer that requires
i�ufFer mitigatio�? OX Yes ❑ No
6b. I� yes, then icfentify the square feet of impact to each zone of the riparian bufFer that requires mitigaiion. Calculate the
amount of mitigation required.
6c. fid. 6e.
Zone Reason for impact To#al impact Mu�tiplier Required mitigation
(square feet) (square feet)
Zone 1 Paraue� 2,5� 3(2 for Catawba) 7,so2
Zone 2 Parallel 394 1.5 591
6f. Total bufFer rnitigation required: s,193
6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to pri�ate mitigation bank,
permittee responsible riparian bufFer restoratian, payrnent into an appro�ed in-lieu fee fund).
Payment into in-lieu fee fund. 5ee attached letter.
6h. Comments:
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E. Stormwater Management and Diifuse Flow Plan (required by DW�j
1. Diffuse Flow Plan
1a, Does the project include or is it adjacent to protected riparian bufFers identified 0 Yes ❑ No
within one of the NC Ri arian Buffer Proiection Rules?
1 b. ff yes, then is a diffuse flow plan included? If nn, explain why.
❑X Yes � No
2. Stormwater Mana ement Plan
2a. What is the o�erall percent imperviousness of this project? 20 o�a
2b. Does this ro'ect ne uire a Stormwater Mana ement Plan? ❑X Yes ❑ No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why:
2d. If this prajed QDES require a Stormwater Management Plan, then pro�ide a brief, narratirre description of the plan:
See stormwater management plan altached as part of permit drawing package.
2e. Who will be responsible for the re�iew of the Stormwater Management Plan? NCpENR-DWR
3. Certified L.ocal Gorrernment Stormwater Re�iew
3a. in which local o�ernment's 'urisdiction is this ro'ect?
❑ Phase f I
3b. Which of the following locally-implemented stormwater management programs ❑ NSW
apply (check all that apply): ❑ USMP
� Water Supply Watershed
Q O#her: NCDOT delegaied
3c. Has the approved Stormwater Management Plan with proof of approval been ❑ Yes ❑ EVo
attached?
4. DWQ 5tormwater Pro ram Review
�Coastal cour�ties
❑HQW
4a. Which of the following state-implemented stormwater management programs apply �ORW
(check all that apply):
❑$ession Law 2006-246
❑ Other:
4b. Fias the apAro�ed Stormwater Rllanagement Plan with proof af approrral been �] Yes ❑ No
attached?
5. DW� 407 Unit Stormwdter Re�iew
5a. Does the Sformwater Management Plan meet the appropriate requirements? � Yes � No
5b. Ha�e al! of the 401 Unit sui�mittal requirem�nts been met? � Yes ❑!Vo
�age 8 of 10
PCN Form — Version 1.4 January 2009

F. 5uppiementary fnformation
1. Enrrironmerrtal Documentation (DWQ Requirement)
1 a. Does the project invol�e an expenditure of public {federallstatelloca� funds or the
use of public (federaVstate} land? ❑X Yes ❑ No
1 b. If you answered "yes° to the abor+e, does the project require preparation of an
ernironmental document pursuant to the requirements of the National or State ❑X Yes ❑ iVo
{North Caroiina) Ern►ironmental Policy Act (NEPAISEPA)?
1c. If you answered "yes° to the abo�e, has the document re�iew been finalized by the
State Clearing Ha�se? (If so, attach a copy of the NEPA or SEPA final appro�al
letter.) . ❑ Yes OX No
Comments:
2. �olations (DWQ Requinemerrt)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2Fi .0500), fsolated
Wefland Ruies (15A NCAC 2H .130p), pWQ SurFace Water or We#land Standards, ❑Yes ❑X No
or Riparian Buffer Rules (15A NCAC 2B .02flD)?
2b. Is this an after-the-fact permit application? ❑ Yes ❑X No
2c. If you answered "yes" to one ar both of the abo�e quesfions, provide an explanation of the violation(s):
3. Cumulative Impacts (DWQ Requirement)
3a. Wilf this project (based on past and reasonably anticipated future impacts} nesult in � Yes ❑X No
additionai deveiopment, which co�ld impact nearby downstream water quality?
3b. If you answered "yes" to the abo�e, submit a qualitati�e or quantitati�e cumulative impad analysis in accordance with the
most recent DWQ policy. If you answered "no," pronide a short narrati�e description.
4. Sewage Disposal (DWQ l�equirement)
4a. Clearly detail the ul#imate treatment methods and disposition (non-discharge ar discharge) of wastewater generated fram
the proposed project, or a�ailable capacity of the su�ject facility.
The praject will not generate wastewater.
Page 9 of 10
PCN Form — Version 1.4 January 2009

5. Endangered Species and Designated Critical Hahitat (Corps Requiremerrty
5a. Will fhis project occur in or near an area w9th federalfy protected species or X Yes
habitat? � � NO
5b. Ffave yqu checked with the USFWS co�cerning �ndangered Species Act � Yes ❑ No
impacts?
5c. If yes, indicaie the USFWS Field Office you ha►+e contaded. Raleigh
5d. What data sources did you use to de#ermine whetner your site wauld impact Endangered Species or besignated Crifica!
Habitat?
The USFWS has wncurred with a Biological Conclusian of May Affed; Nat Likely to Adversely Affect far the Northern long�ared bat. All other
species (dwarF wedgemussel, smooEh coneflower, Michaux's sumac and bald eagle) have a biological conclusion of No Effect.
5. Essential Fish Habitat (Corps Requirement]
6a. Wilf this project occur in or near an area designated as essential fish habitat? ❑ Yes ❑X No
6b. What data sources did you use ta determine whether your site would impact Essentiaf Fish Habitat?
NMFWS Databaase
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal ar tribal
go�ernmenis have designated as having historic or cu�tural preser►ration � Yes OX No
status {e.g., National Historic Trust designation ar properties significant in
North Carolina history and archaeology}?
7b. What data sources did you use to determine whether your site would impact historic or archeolpgical resources?
5HP0 database and conversations with NCbOT personnel.
8. Flood Zone Designation (Carps Requiremerrt)
Sa. Will this project occur in a F�MA-desigr�afed 10ayearfleodplain? ❑X Yes ❑ No
8b. If yes, explain how projed meets FEMA requ�rements:
No work is proposed to the bridge and there is only minor appraach work within the 100-yr floodplain. The earthwork was balanoed so that na fill was
placed in the 100-year Aoodplain and therefore no FEMA ca-ordination was required.
Sc. What source(s) did you use to make the floodplain defermination? �
FEIUTA DFIRM Panel 372Q070900J Effeclive February 2, 20D7 was re�iewed and a portion of the project sludy area is located within the 900-year
floodplain. A preliminary DFRIM Panel 3720070904K issued on March 31, 2015 and a portion of the project study area is still located wlin 10D yr FP.
Christopher Murray 11-23-2015
Applicant/Agen#'s Printed Name ApplicanUAgenYs Sig Date
(Agent's signature is �alid only if an authorizat9on
letter from the a licant is rovided.
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