20160571 Ver 2_PCN Form Submission_20180306

Action History (UTC-05:00) Eastern Time (US & Canada)
�brrrit by Anonymous User 3/5/2018 3:24:59 PM (Start Event)
Accept by Carpenter,Kristi 3/6/2018 2:07:33 PM (DOT Initial Review)
* Due to the temporary impacts to w�tlands being greater than 0.10 acre and the presence of Buffer
Impacts, written approual is needed. Written approual always requires a reviewfee; in this case a minor
fee of $240.00.
• The task was assigned to Carpenter,Kristi . The due date is: March 8, 2018 5:00 PM
3/5/2018 3:25 PM

�� �
�ivislan af Water Resour�es
Pre-Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
January 31, 2018 Ver 2.3
*
Please note: fields marked with a red asterisk beloware required. You will not be able to submit the form until all mandatory questions are ans�red.
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/0/edoc/624704/PCN%20Help%20File%202018-1-30.pdf
A. Processing Information
County (or Counties) where the project is located:*
Guilford
Is this project a public transportation project?* (')
C Yes l' No
Is this a NCDOT Project?*
f• Yes r No
(NCDOT only) T.I.P. or state project number:
EL-5104
WBS #
45125.3.1
(fa- f�D�T use only)
1a. Type(s) of approval sought from the Corps:*
I7 Section 404 Permit (wetlands, streams and waters, Clean Water Act)
r% Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
1b. What type(s) of permit(s) do you wish to seek authorization?*
fJ Nationwide Permit (NWP)
fJ Regional General Permit (RGP)
Nationwide Permit (NWP) Number
NWP Number Other:
List all MN nurrbers you are applying for not on the drop dow n list.
Regional General Permit (RGP) Number:
33 - Temporary Construction
Other
RGP Number Other:
3893
List all RGP nurrt�ers you are applying for not on the drop dow n list.
1c. Type(s) of approval sought from the DWR:*

check all that apply
fJ 401 Water Quality Certification - Regular r 401 Water Quality Certification - Express
r Non-404 Jurisdictional General Permit �J Riparian Buffer Authorization
*
1d. Is this notification solelyfor the record because written approval is not required?
For the record only for DWR 401 Certification:
For the record onlyfor Corps Permit:
�' Yes �' No
f' Yes C' No
1e. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
If so, attach the acceptance letter from rritigation bank or in-lieu fee program
C' Yes r No
1f. Is the project located in any of NC's twenty coastal counties? *
f Yes r No
1h. Is the project located in a designated trout watershed?*
C' Yes C No
Link to trout information: http://�wwv.saw.usace.army.mil/Missions/Regulatory-Permit-Program/Agency-Coordination/Trout.aspx
B. Applicant Information
1a. Who is the Primary Contact? *
Terry A. Kuneff, P.E., CFM
1b. PrimaryContact Email:*
[e-mail]
1c. PrimaryContact Phone:*
(xxx)xxx-xxxx
[phone]
1d. Who is applying for the permit?
rJ Owner r P,pplicant (other than owner) r Agent/Consultant
(Check all that apply)
2. Owner Information
2a. Name(s) on recorded deed:
City of High Point
2b. Deed book and page no.:
DB 7267, PG 883, DB 6199, PG 2373
2c. Responsible party:
(for Corporations)
Randy McCaslin, Deputy City Manager
2d. Address
Street Address
211 S. Hamilton Street
Address Line 2
aty
High Point
Fbstal / Zip Code
27260
2e. Telephone Number:
(xxx)xxx-xxxx
[phone]
State / FYovince / F�gion
NC
Caurdry
Guilford

2f. Fax Number:
(xxx)xxx-xxxx
2g. Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1a. Name of project:*
Deep River Greenway (a.k.a. Penny Road Greenway)
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality/town:*
High Point
1d. Driving directions*
IF it is a new project and can not easily be found in a GPS rrapping system Rease provide directions.
Near the intersection of Deep River Road and Hickswood Road to Penny Road near the Environmental Center
2. Project Identification
2a. Propertyldentification Number:
(tax RNor parcel ID)
0218584,0202937
2b. Propertysize:
(in acres)
967.42
2c. Project Address
Street Address
Address Line 2
Qty
Fbstal / Zip Code
State / Rovince / Faegion
Country
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 e�mple, 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:*
36.0006 -79.97185
ex:34.208504 -77.796371
3. SurFace Waters
3a. Name of the nearest body of water to proposed project:*
W. Fork Deep River
3b. Water Resources Classification of nearest receiving water:*
WSIV;CA
Surface Water Lookup

3c. What river basin(s) is your project located in?*
Cape Fear
RiverBasin Lookup
4. Project Description
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:*
Unused, and unmodified land
4b. Attach an 8 1/2 X 11 excerpt from the most recent version of the USGS topographic map indicating the location of the project site. (for
DWR)
C7ick the upload button or drag and drop files here to attach docurrent
Fle type rrust be pdf
4c. Attach an 8 1/2 X 11 excerpt from the most recent version of the published County NRCS Soil Survey map depicting the project site.
(for DWR)
Qick the upload button or drag and drop files here to attach docurrent
Fle type rrust be pdf
4d. List the total estimated acreage of all existing wetlands on the property:
2.766
4e. List the total estimated linear feet of all existing streams on the property:
(interrrittent and perennial)
923
4f. Explain the purpose of the proposed project:*
To connect the existing greenway from Deep River Road to the existing greenway at the Piedmont Environmental
Center on Penny Road.
4g. Describe the overall project in detail, including indirect imapacts and the type of equipment to be used:*
Overall project is an asphalt trail with bridges over E. Fork Deep River and 3 streams, and elevated boardwalk in
wetlands and stream buffers. Equipment will utilize special wetland mats. No grubbing or filling will occur within the
wetlands or stream buffers.
4h. Please upload project drawings for the proposed project.
Qick the upload button or drag and drop files here to attach docurrent
FINAL PLANS.pdf 15.77MB
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5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
C•' Yes C' No C' Unknown
Comme nts:
Sb. If the Corps made a jurisdictional determination, what type of determination was made?*
C Preliminary C' Approved C' Unknown l' f�UA
Corps AID Number:
6carrple: SAW-2017-99999
SAW-2010-01843
5c. If Sa is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Othe r:
Stantec Consulting Services, Inc

5d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
October 19, 2010, and April 30, 2013
Note: A reverification was requested on March 5, 2018
5d1. Jurisdictional determination upload
C7ick the upload button or drag and drop files here to attach docurrent
404 Permit.pdf 116.33K6
Fle type rrust be FDF
6. Project History
6a. Have permits or certifications been requested or obtained for this project (including all prior phases) in the past?*
f• Yes �' No �' Unknown
6b. If yes, please give the DWR Certification number or the Corps Action ID (exp. SAW-0000-00000).
NCDWR Project No. 20160571
SAW-2010-01843
Project History Upload
Qick the upload button or drag and drop files here to attach docurrent
401 Permit.pdf 3.95M6
Fle type rrust be FLF
7. Future Project Plans
7a. Is this a phased project? *
f Yes C•' 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 activit�/? This includes other separate and distant crossing for linear projects that require Department of the
Army authorization but don't require pre-construction notification.
f�UA
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
rJ Wetlands �J Streams-tributaries �J Buffers
r Open Waters r Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a. Site #- Reason for impact* 2b. Impact type * 2c. Type of wetland* 2d. Wetland name *2e. 2f. Type of 2g. Impact
Forested* Jurisdicition* area*
Land Clearing T Bottomland Hardwood W1 Yes Corps 0.710
N�p label (e.g. fd�ad Qossing 1- Qalvert, F�rrranent (P� or ForeSt (404, 10) or �R(401, (acres)
dewatering, etc) Terrporary (� other)
Land Clearing T Bottomland Hardwood W2 Yes Corps 0.020
N�p label (e.g. Fd�ad Qossing 1- Qalvert, F�rrranent (P� or Forest (404, 10) or �R(401, (acres)
dewatering, etc) Terrporary (� other)
2g. Total Temporary Wetland Impact
0.730
2g. Total Permanent Wetland Impact
0.000
2g. Total Wetland Impact
0.730

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. Site #- Reason for 3b.lmpact 3c. Type of impact* 3d. Stream name *
impact * type *
S1 T Culvert
N�p label (e.g. Fd�ad CYossing 1) F2rrranent (P� or
Teriporary (�
S2 T Culvert
N�p label (e.g. f�ad Qossing 1) F�rrranent (P� or
Terrporary (�
S3 T Culvert
fV�p label (e.g. Fd�ad Qossing 1) F�rrrenent (F) or
Terrporary (�
S4 T Culvert
N�p label (e.g. Fd�ad CYossing 1) F�rrranent (P� or
Terrporary (�
S5 T Culvert
N�p label (e.g. f�ad Qossing 1) F�rrranent (P� or
Terrporary (�
Unnamed Tributary
Unnamed Tributary
Unnamed Tributary
Unnamed Tributary
Unnamed Tributary
3e. Stream 3f. Type of
Type* Jurisdiction*
Intermittent Corps
F2rennial (F$2) or
interrrittent (IfV�
Perennial Corps
F2rennial (�) or
interrrittent (IfV�
Perennial Corps
F2rennial (Fff2) or
interrrittent (IfVn
Perennial Corps
F�rennial (F$2) or
interrrittent QfV�
Intermittent Corps
F2rennial (�) or
interrrittent (IfV�
�" All Perennial or Intermittent streams must be verified by DWR or delegated local government.
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
0
3i. Total temporary stream impacts:
100
3i. Total stream and tributary impacts:
100
3j. Comments:
6. Buffer Impacts (for DWR)
If project will impact a protected riparian buffer, then complete the chart below. Individually list all buffer impacts below.
6a. Project is in which protect basin(s)? *
Check all that apply.
r Neuse r Tar-Pamlico
r Catawba �J Randleman
r Goose Creek r Jordan Lake
r Other
6b. Impact Type *
B1, Greenway bridge
Location and Exerrpt, Allowable, allowable w/
rritigation
6c. Per or
Temp*
P
F�-rranent (F) or
Terrporary (�
6d. Stream name *
E. Fork Deep River
6e. Buffer mitigation
required?*
No
3g. Stream 3h. Impact sqfe�
width* length*
7 20 7
Average(feet) (linearfeet) 4
0
7 20 1
Average(feet) (linearfeet) 4
0
10 20 2
Average(feet) (linearfeet) 0
0
5 20 7
Average(feet) (linearfeet) 0
0
5 20 1
Average(feet) Qinearfeet) 0
0
6f. Zone 1
impact *
917
(squarefeet)
6g. Zone 2
impact*
604
(squarefeet)

6b. Impact Type * 6c. Per or 6d. Stream name *
Temp*
B2, GreenwayBridge P Two Unnamed
Locationand6cerrpt,Allowable,allowablew/ F2rrrenent(Fjor TributBrieSinWetland
rritigation Terrporary (�
B3, Boardwalk and bridge P Unnamed Tributary
Location and 6cerrpt, Allowable, allowable w/ F�rrranent (P� or
rritigation Terrporary (�
B4, Greenway bridge P Unnamed Tributary
Location and 6cerrpt, Allowable, allowable w/ F�rrranent (�) or
rritigation Terrporary (�
B5, Greenway bridge P Unnamed Tributary
Location and Exerrpt, Allowable, allowable w/ F�rrranent (P� or
rritigation Terrporary (�
6h. Total buffer impacts:
Zone 1 Zone 2
Temporary impacts: 0.00 0.00
Zone 1 Zone 2
Permanent impacts: 6,596.00 7,031.00
6e. Buffer mitigation 6f. Zone 1 6g. Zone 2
required?* impact* impact*
No 0 0
(squarefeet) (squarefeet)
No 3,397 5,216
(squarefeet) (squarefeet)
No 878 451
(squarefeet) (squarefeet)
No 7,404 760
(squarefeet) (squarefeet)
Zone 1 Zone 2
Total buffer impacts: 6,596.00 7,031.00
6i. Comments:
Trees and vegetation will be cut flush with the ground to construct elevated boardwalk and bridges in buffers. No
grubbing will take place within the stream buffers.
Supporting Documentation - i.e. Impact Maps, Plan Sheet, etc.
C7ick the upload button or drag and drop files here to attach docurrent
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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:*
Bridges or elevated boardwalks are proposed at all stream crossings. All bridges and boardwalks will be supported
by piles. There will be no concrete abutments constructed within the wetlands or stream buffers.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*
Work in wetlands and stream buffers will be scheduled during dry weather. Hand clearing will be conducted within
the buffers and wetlands. Vegetation will be cut flush with the ground and not grubbed. Bridges will be
prefabricated off-site and placed on piles at the site. Piles will not be located within streams. Temporary culverts
will be used for stream crossings during construction. Timber mats will be utilized within the �tlands for
construction equipment.
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?
f Yes r No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
Project impacts involve less than one acre of wetlands and less than 150 linear feet of stream.

F. Stormwater Management and Diffuse Flow Plan (required by DWR)
"' Recent changes to the stormwater rules have required updates to this section ."'
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?
r Yes r No
1b. All buffer impacts and high ground impacts require diffuse flow or other form of stormwater treatment. If the project is subject to a
state implemented riparian buffer protection program, include a plan that fully documents how diffuse flow will be maintained.
All Stormwater Control Measures (SCM)s must be designed in accordance with the NC Stormwater Design Manual. Associated
supplement forms and other documentation shall be provided.
What type of SCM are you providing?
r Level Spreader
r Vegetated Conveyance (lower SMNT)
r Wetland Swale (higher SMNT)
r Other SCM that removes minimum 30% nitrogen
(check all that apply)
For a list of options to meet the diffuse flow requirements, click here.
Diffus Flow Documentation
C7ickthe upload button or drag and drop files here to attach dxurrent
Fle type rrust be FC�
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250? *
f Yes r No
2b. Does this project meet the requirements for low density projects as defined in 15A NCAC 02H .1003(2)?*
f• Yes
f No
To look up low density requirement click here 15A NCAC 02H .1003(2).
G. Supplementary Information
1. Environmental Documentation
1a. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?*
C•' Yes C' No
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 PolicyAct (NEPAISEPA)?*
C' Yes r No
Comme nts: *
The signed NCDOT Programamatic Categorical Exclusion (PCE) is attached.
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification Rules (15A NCAC 2H .0500), Isolated Wetland Rules (75A NCAC 2H .7300), or
DWR Surface Water or Wetland Standards or Riparian Buffer Rules (15A NCAC 2B .0200)?*
C' Yes r No
2b. Is this an after-the-fact permit application?*

r Yes r No
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?*
C' Yes C•' No
3b. If you answered "no," provide a short narrative description.
This project is an elevated timber boardwalk greenway system through wetlands and has no side access points to
the boardwalk.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
f Yes C•' No f' f�UA
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? *
f Yes r No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
C•' Yes C' No
Sc. If yes, indicate the USFWS Field Office you have contacted.
Raleigh
5d. Is another Federal agency involved?*
f Yes C No
5e. Is this a DOT project located within Division's 1-8?*
f• Yes r No
C' Unknown
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat? *
North Carolina Department of Cultural Resources, State Historic Preservation Office
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
f Yes r No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat? *
United States Department of the Interior Fish and Wildlife Service
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)? *
C' Yes �' No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources? *
North Carolina Department of Cultural Resources, State Historic Preservation Office
7c. Historic or Prehistoric Information Upload
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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?*
C Yes �' No
8b. If yes, explain how project meets FEMArequirements:
All proposed bridges will span the FEMA designated 100-year floodway, and the low chord of the bridges will be
elevated one (1) foot above the effective BFE. There will be no fill material placed within the 100-year floodway.
8c. What source(s) did you use to make the floodplain determination?*
fris.nc.gov, and Flood Insurance Study, Guilford County, Revised March 16, 2009
Miscellaneous
Miscellaneous attachments not previously requested.
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Signature
�J By checking the box and signing below, I certify that:
■ 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 AcY');
■ 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:*
Randy E. McCaslin
Signature
, �CrP�i'lt� �, �i��ri� 2.cIlr. ir.
Initial Review
Is this project a public transportation project?* (?)
f• Yes r No
Change only if needed.
Has this project met the requirements for acceptance in to the review process? *
f• Yes
f No
BIMS # Assigned *
20160571
Version#*
2
Reviewing Office *
Central Office - [phone]
Select Project Reviewer*
April Norton:eads\arnorton

Is a payment required for this project?*
f No payment required
f Fee received
C Fee needed - send electronic notification
What amout is owed? *
G $240.00
C' $570.00