20181254 Ver 1_PCN Submission Form_20180912

Action History (UTC -05:00) Eastern Time (US & Canada)
Submit by Anonymous User 9/12/2018 3:10:12 PM (Start Event)
Accept by Montalvo, Sheri A 9/17/2018 10:49:43 AM (Non DOT Initial Review)
The task was assigned to Montalvo, Sheri A. The due date is: September 17, 2018 5:00 PM
9/12/2018 3:12 PM

DWR
Division of water Resources
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 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.govMaterResources/0/edocl6247041PCN%20Help%20File%202018-1-30.pdf
A. Processing Information
County (or Counties) where the project is located:*
Cabarrus
Is this project a public transportation project?*
f Yes f• No
This is any publicly funded by nunicipal,state or federal funds road, rail, airport transportation project.
1a. Type (s) of approval sought from the Corps:*
V Section 404 Permit (wetlands, streams and waters, Clean Water Act)
F Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
1b. What type(s) of permit(s) do you wish to seek authorization?*
IJ Nationwide Permit (NWP)
r Regional General Permit (RGP)
r Standard (IP)
This form may be Corps to initiate the standard/individual permit process. Please contact your Corps representative for submittal of standard permits.
All required items that are not provided in the E -PCN and be added to the miscellaneous upload located at the bottom of this form.
Nationwide Permit (NWP) Number: 03 - Maintenance
NWP Number Other:
List all IWV nurrbers you are applying for not on the drop down list.
1c. Type(s) of approval sought from the DWR:*
check all that apply
IJ 401 Water Quality Certification - Regular r 401 Water Quality Certification - Express
F Non -404 Jurisdictional General Permit r Riparian Buffer Authorization
r Individual Permit
*
1d. Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification:
O Yes O No
For the record only for Corps Permit: O Yes O 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 mitigation bank or in -lieu fee program
f Yes C No
1f. Is the project located in anyof NC's twentycoastal counties?*
r Yes C No
1h. Is the project located in a designated trout watershed?*
f Yes f• No
Link to trout information: http://vmw.saw.usace.army.mil/Missions/Regulatory-Permit-ProgranVAgency-Coordination/Trout.aspx
B. Applicant Information
1a. Who is the Primary Contact?*
Carolina Garcia -Zaragoza Villa
1b. Primary Contact Email:*
[e-mail]
1c. Primary Contact Phone:*
(XXX)XXX-XXXX
[phone]
1d. Who is applying for the permit?
V Owner r Applicant (other than owner) r Agent/Consultant
(Check all that apply)
2. Owner Information
2a. Name(s) on recorded deed:
City of Concord
2b. Deed book and page no.:
19/45
2c. Responsible party:
(for Corporations)
City of Concord
2d. Address
Street Address
35 Cabarrus Ave. W
Address Line 2
aty
Concord
Fbstal / Zip Code
28025
2e. Telephone Number:
(XXX)XXX-XXXX
[phone]
2f. Fax Number:
[phone]
(XXX)XXX-)O=
2g. Email Address:*
[e-mail]
State/ Province/ Region
NC
Country
USA
C. Project Information and Prior Project History

1. Project Information
1a. Name of project:*
2017-026 Chadbourne Ave and Chelwood Dr Culvert Replacements
1b. Subdivision name:
(if appropriate)
Zemosa Acres
1c. Nearest municipality / town:
*
Concord
1d. Driving directions*
If it is a new project and can not easily be found in a GPS napping system Please provide directions.
From 1-85 take exit 55 to Hwy 73 East. Turn right onto Chadbourne Ave NW.
2. Project Identification
2a. Property Identification Number:
(tax PIN or parcel ID)
N/A
2b. Property size:
(in acres)
N/A
2c. Project Address
Street Address
663 Chadbourne Ave NW & 3240 Chelwood Dr NW
Address Line 2
Oty,
State / Province / Region
Concord
NC
Pbstal / Zip Code
Country
28027
USA
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:*
35.422979 -80,632648
ex: 34.208504 -77.796371
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Unnnamed tributary to Irish Buffalo Creek
3b. Water Resources Classification of nearest receiving water:*
C (Irish Buffalo Creek)
Surface Water Lookup
3c. What river basin(s) is your project located in?*
Yadkin-PeeDee
River Basin 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:*
There are two existing stream culverts at Chadbourne Ave NW: a 60" CMP at creek elevation, which conveys the
base flow, and a 48" CMP installed at a higher elevation. The culverts are approximately 62ft long. Culverts are
undersized and in poor condition. Bedrock is very shallow at this location.
There are two existing stream culverts at Chelwood Dr NW: a 72" CMP at creek elevation, which conveys the base
flow, and a 48" CMP installed at a higher elevation. The culverts are approximately 62ft long. Culverts are
undersized and in poor condition. Scour at the downstream end has created over a 1ft deep drop.
The general land use is Residential - Low Density.
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)
Click the upload button or drag and drop files here to attach docurrent
US Topo - Chadbourne_Chelwood.pdf
File type rrust be pdf
26.51 MB
4c. Attach an 8 1/2X1 I excerpt from the most recent version of the published County NRCS Soil Survey map depicting the project site.
(for DWR)
Oick the upload button or drag and drop files here to attach docurrent
Chad bourneChelwood_Soil_Map.pdf 669.94KB
File type mist be pdf
4d. List the total estimated acreage of all existing wetlands on the property:
None
4e. List the total estimated linear feet of all existing streams on the property:
(intermttent and perennial)
325 linear -ft within the constrction area (160ft in Chadbourne &165 ft in
Chelwood
4f. Explain the purpose of the proposed project:*
To replace aging CMP culverts with a new double box precast concrete culverts to address maintenance issues.
4g. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:
For each location, do the following steps. Note that both locations cannot be built at the same time, one must be
finished before the other starts.
1. Install downstream erosion control measures.
2. Temporary dam will be constructed upstream of the project and set up pump around operations using excavator
with hydraulic thumb.
3. Remove existing pavement structure and culvert using excavator.
4. Clear vegetation from stream banks within the construction limits.
5. Replace sewer utility line across the creek under the proposed culvert.
6. Prepare subgrade with excavator and soil compactor.
7. Install double barrel precast culvert boxes (2-7'x6' in Chadbourne; 2-7'x7' in Chelwood), with cranes.
8. Install modular bock wingwalls, with cranes.
9. Backfill behind wingwalls and on top of culvert, using dump truck, excavator and walk behind soil compactor.
10. Construct pavement, curb and gutter and other roadway appurtenances over the culvert.
11. For Chadbourne, add 1 -ft natural stream bed fill inside the west cell using dump truck, excavator, Bob Cat and
walk behind soil compactor. For Chelwood, add 1 -ft natural stream bed fill inside the west cell and 2 -ft fill inside the
east cell.
12. Construct rock sills using excavator with hydraulic thumb to place rocks.
13. Re -construct banks at a 2 Horizontal to 1 Vertical, using dump truck, excavator and walk behind soil
compactor.
14. Fine grade slope of banks with a Bob Cat, install rip rap, erosion control mats, and plant vegetation.
15. Remove dam and discontinue pumping.
16. Remove erosion control measures after site is stabilized.
Once one culvert crossing has been completed, start with the second location and follow the same steps.
4h. Please upload project drawings for the proposed project.
nick the upload button or drag and drop files here to attach docurrent
2017-026 Chadbourne 09-11-18 - signed.pdf
11.34MB
2017-026 Chelwood 09-11-18 - signed.pdf
11.33MB
Chadbourne Surface Water Impacts Exhibit.pdf
354.27KB
Chelwood Surface Water Impacts Exhibit.pdf
394.88KB
File type mast be pdf

5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
f Yes r No r Unknown
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
r Preliminary r Approved r Unknown r N/A
Corps AID Number:
Exarrple: SAW -2017-99999
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
5d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
5dl. Jurisdictional determination upload
Click the upload button or drag and drop files here to attach docurrent
File type mast be PDF
6. Project History
6a. Have permits or certifications been requested or obtained for this project (including all prior phases) in the past?
f Yes r No r Unknown
7. Future Project Plans
7a. Is this a phased project?*
f Yes r 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? This includes other separate and distant crossing for linear projects that require Department of the
Army authorization but don't require pre -construction notification.
No
D. Proposed Impacts Inventory
1. Impacts Summary
la. Where are the impacts associated with your project? (check all that apply):
r- Wetlands V Streams -tributaries r- Buffers
r- Open Waters r- Pond Construction
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. Reason for impact*3b.lmpact 3c. Type of impact*3d. Stream name* 3e. Stream 3f. Type of 3g. Stream 3h. Impact s fei
type* Type* Jurisdiction* width* length*

S1
Chadbourne Culvert
T
Dewatering
Unnnamed tributary
Perennial
Both
36
24
Replacement
Permanent (F'or
of Irish Buffalo
Perennial (F$?)or
Average
(linear feet)
[Vbp label (e.g. Fbad Grossing
Temporary (T)
Creek
intermittent (INT)
(feet)
1)
S2
Chadbourne Culvert
P
Bank
Unnnamed tributary
Perennial
Both
13
26
Replacemen
Permanent (P)orStabilization
of Irish Buffalo
Perennial (FE:�or
Average
(linear feet)
lvbp label (e.g. Road Grossing
Terrporary (T)
Creek
intermittent (INT)
(feet)
1)
S3
Chadbourne Culvert
T
Culvert
Unnnamed tributary
Perennial
Both
0
0
Replacement
F1;rrrenent(P)or
of Irish Buffalo
Perennial (PER or
Average
(linear feet)
[Vbp label (e.g. Road Grossing
Terrporary (T)
Creek
intermittent (INT)
(feet)
1)
S4
Chadbourne Culvert
P
Bank
Unnnamed tributary
Perennial
Both
14
24
Replacement
Permanent (F' or
Stabilization
of Irish Buffalo
Ferennial (FER or
Average
(linear feet)
[Vbp label (e.g. Fbad Grossing
Tenwary (T)
Creek
intermittent (INT)
(feet)
1)
S5
Chadbourne Culvert
T
Dewatering
Unnnamed tributary
Perennial
Both
31
24
Replacement
F2rrranent(P)or
of Irish Buffalo
Perennial (FE:�or
Average
(linear feet)
[Vbp label (e.g. Fuad Grossing
Tenwary (T)
Creek
intermittent (INT)
(feet)
1)
S6
Chelwood Culvert
T
Dewatering
Unnnamed tributary
Perennial
Both
27
14
Relocation
Ferranent(P)or
of Irish Buffalo
Perennial (PER or
Average
(linear feet)
[Vbp label (e.g. Fbad Grossing
Tenporary (T)
Creek
interntttent (INT)
(feet)
1)
S7
Chelwood Culvert
P
Bank
Unnnamed tributary
Perennial
Both
18
29
Relocation
Ferranent(P)or
Stabilization
of Irish Buffalo
Perennial (FE�or
Average
(linear feet)
lvbp label (e.g. Fuad Grossing
Tenporary (T)
Creek
interntttent (INT)
(feet)
1)
S8
Chelwood Culvert
T
Culvert
Unnnamed tributary
Perennial
Both
0
0
Relocation
Permanent (Fj or
of Irish Buffalo
Perennial (FES or
Average
(linear feet)
[Vbp label (e.g. Fbad Grossing
Temporary (T)
Creek
intermittent (INT)
(feet)
1)
S9
Chelwood Culvert
P
Bank
Unnnamed tributary
Perennial
Both
20
37
Relocation
Ferrranent(F' or
Stabilization
of Irish Buffalo
Perennial (FEP�or
Average
(linear feet)
[Vbp label (e.g. Fbad Grossing
Temporary (T)
Creek
intermittent (INT)
(feet)
1)
S10
Chelwood Culvert
T
Dewatering
Unnnamed tributary
Perennial
Both
21
23
Relocation
Permanent (F' or
of Irish Buffalo
Perennial (FERor
Average
(linear feet)
lvep label (e.g. Fbad Grossing
Temporary (T)
Creek
intermittent (INT)
(feet)
1)
"" 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:
116
3i. Total temporary stream impacts:
85
31. Total stream and tributary impacts:
201
3j. Comments:
Refer to Surface Water Impacts exhibits for each location.
Proposed culverts length matches existing culverts, impacts have been added as zero.
Bank stabilization is strictly at the culvert vicinity and the minimum required for the new culvert geometry.
E. Impact Justification and Mitigation
1. Avoidance and Minimization

Ia. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:*
Double barrel precast concrete box culverts will replace existing aging double CMP. For each location, the total
culvert length matches the existing conditions. Headwalls have been designed to avoid extending the culvert
footprint. The proposed low flow barrel width is comparable to the width of the stream channel.
In Chelwood, the new culvert low flow barrel will be buried 1ft by using natural stream bed material, which will
restore the stream bed to a more natural state. The overflow barrel will be buried 2 ft and will receive flows
exceeding base flow.
In Chadbourne, very shallow bedrock has been found. Following the recommendations in the Water Quality
Certification No. 4132, culvert burial will not be provided in the low -flow box in order to avoid rock excavation,
resulting in less impact to the aquatic environment.
Bank transitions will be provided immediately upstream and downstream of the overflow culvert. Wingwalls have
been designed to minimize grading. 6" step grade control rock sills will be used in the culvert approaches.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*
Precast concrete culvert and modular bock wingwalls and headwalls will be used, minimizing concrete placement in
the creek and providing a faster construction. Headwalls will minimize culvert length. Appropriate erosion control
and installation measures will be also used. A temporary stream diversion will be utilized to route flow around the
construction area during construction.
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?
r Yes C No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
The purpose of this project is replacing aging structures. The overall impact has been minimized as much as possible. Combined permanent
impacts to the stream bed is less than 150 linear feet. In addition, replacing the existing CMPs for double concrete barrel culverts buried at
two different elevations will more closely recreate the original stream and will reduce stream impact.
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?
f Yes C No
For a list of options to meet the diffuse flow requirements, click here.
If no, explain why:
The project is in the Yadkin PeeDee Basin and it is not located in or adjacent in any of the Riparian Protection Buffer Program areas.
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?
r Yes G 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?*
f• Yes r 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 Policy Act (NEPA/SEPA)?*
r Yes r No
Comments: *
This is a project funded 100% by the City of Concord.
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)?
f Yes r No
2b. Is this an after -the -fact permit application?*
f 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?*
f Yes r No
3b. If you answered "no," provide a short narrative description.
These are culvert replacement projects in a well established neighborhood.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
f Yes r Nor 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?*
f Yes r No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
r Yes r No
5d. Is another Federal agency involved?*
f Yes r No r Unknown
5e. Is this a DOT project located within Division's 1-8?*
r Yes r No
5f. Will you cut any trees in order to conduct the work in waters of the U.S.?
r Yes f No
5g. Does this project involve bridge maintenance or removal?
r Yes r No
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)?*
f Yes r No
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.?
f Yes r No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?

The U.S. Fish and Wildfire Service - ECOS Environmental Conservation Online System and the Red HUC maps by
the Asheville Ecological Services Field 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?*
The Essential Fish Habitat Map by NOAA Fisheries.
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/hpoveb/
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)?*
r Yes r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
NC State Historic Preservation Office GIS information. This is a maintenance project in a well established
neighborhood.
7c. Historic or Prehistoric Information Upload
Click the upload button or drag and drop files here to attach docurrent
File mist be FDF
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?*
r Yes r No
8b. If yes, explain how project meets FEMA requirements:
The 100 -yr floodplain is delineated just downstream of the Chelwood culvert. Newfill will be needed to replace the
eroded soil due to downstream scour. The amount of new fill within the floodplain will be minimal.
8c. What source(s) did you use to make the floodplain determination?*
FEMA map 3710561100J, dated 11/5/2008.
Miscellaneous
Miscellaneous attachments not previously requested.
Click the upload button or drag and drop files here to attach docurrent
Waiver Request.pdf 2.09MB
File m st be FDF or KW
Signature
rJ 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 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:*
Carolina Garcia Zaragoza Villa
Signature
earalma Cmc 'ago -Fa Vk
Date Submitted:
9/12/2018
Initial Review
Is this project a public transportation project?* (?
f Yes r No
Change ony ff needed.
Has this project met the requirements for acceptance in to the review process?
r Yes
f No
BIMS # Assigned*
20181254
Version#*
Reviewing Office*
Mooresville Regional Office - [phone]
Select Project Reviewer*
Alan Johnson:eads\adjohnson1
Is a payment required for this project?*
f No payment required
f Fee received
G Fee needed - send electronic notification
What amout is owed?*
f $240.00
G $570.00