20191549 Ver 1_PCN Form Submission (2)_20191112

DWR
Olrlslon of Water Resources
Pre -Construction Notification (PCN) Form
September 29, 2018 Ver 3
Initial Review
Has this project met the requirements for acceptance in to the review process?*
r Yes
r No
Is this project a public transportation project?*
G Yes r No
Change only if needed.
BIMS # Assigned
20191549
Is a payment required for this project?*
r No payment required
r Fee received
r Fee needed - send electronic notification
Select Project Reviewer*
Joanne Steenhuis:eads\jhsteenhuis
Information for Initial Review
1a. Name of project:
TIP U-5788
1a. Who is the Primary Contact?*
Anneliese Westphal
1b. Primary Contact Email:*
[e-mail]
Date Submitted
11/12/2019
Nearest Body of Water
Shallotte River
Basin
Lumber
Water Classification
SC; HOW
Site Coordinates
Latitude:
33.975346
A. Processing Information
County (or Counties) where the project is located:
Brunswick
Is this project a public transportation project?*
IT Yes r No
Is this a NCDOT Project?*
r Yes r No
(NCDOT only) T.I.P. or state project number:
U-5788
WBS#M
44360.1.1
1a. Type (a) of approval sought from the Corps:
Longitude:
-78.382526
Version#*
1
Reviewing Office*
Wilmington Regional Office - [phone]
1c. Primary Contact Phone:*
[phone]
V

W 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?
W Nationwide Permit (NWP)
r Regional General Permit (RGP)
r Standard (IP)
1c. Has the NWP or GP number been verified by the Corps?
r Yes r No
Nationwide Permit (NWP) Number: 14 - Linear transportation
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
W 401 Water Quality Certification - Regular
r Non-404 Jurisdictional General Permit
r Individual Permit
le. Is this notification solely for the record because written approval is not required?
For the record only for DWR401 Certification:
For the record only for Corps Permit:
r 401 Water Quality Certification - Express
r Riparian Buffer Authorization
1f. Is this an after -the -fact permit application?*
r Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
r Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
r Yes r No
Acceptance Letter Attachment
1h. Is the project located in any of NC's twenty coastal counties?
r Yes r No
11. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
r Yes r No r Unknown
1j. Is the project located in a designated trout watershed?
d Yes r No
B. Applicant Information
1d. Who is applying for the permit?
r Owner W Applicant (other than owner)
le. Is there an Agent/Consultant for this project?*
r Yes r No
2. Owner Information
2a. Name(s) on recorded deed:
N/A
2b. Deed book and page no.:
N/A
2c. Responsible party:
NCDOT Highway Division 3 c/o D. Chad times, P.E.
2d.Address
Street Address
5501 Barbados Blvd.
Address Line 2
City
State / Frovince / Region
Castle Hayne
NC
Postal / Zip Code
Country
28429
USA
r Yes r No
r Yes r No
V

2e. Telephone Number: 2f. Fax Number:
[phone]
2g. Email Address:*
[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
Anneliese Westphal
3b. Business Name:
NCDOT Division 3
3c.Address
Street Address
5501 Barbados Blvd
Address tine 2
City
State / Province / Region
Castle Hayne
NC
Postal / Zip Code
Country
28429
US
3d. Telephone Number: 3e. Fax Number:
[phone]
3f. Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
ff appropriate)
1c. Nearest municipality/ town:
Shallotte
2. Project Identification
2a. Property Identification Number:
Multiple parcels - see attached plans
2c. Project Address
Street Address
Address Line 2
City
Shallotte
Postal / Zip Code
28459
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Shallotte River
3b. Water Resources Classification of nearest receiving water:*
SC, HQW
3c. What river basin(s) is your project located in?*
Lumber
2b. Property size:
10.2
State / Province / Region
North Carolina
Country
United States
3d. Please provide the 12-digit HUC in which the project is located.
030402080202
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:*
The site is located in downtown Shallotte and therefore land use is largely residential and commercial with some marshes and forest.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
F Yes G No F Unknown

4d. 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)
U5788_USGS_MAP _082019.pdf 543.66KB
4e. 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)
U5788_NRCS_MAP _082019.pdf 771.6KB
4f. List the total estimated acreage of all existing wetlands on the property:
0.12
4g. List the total estimated linear feet of all existing streams on the property:
0
4h. Explain the purpose of the proposed project:*
The emsting signalized intersection of Wall Street (non -system), Main Street (US 17 Business), and Shallotte Avenue (non -system) is currently offset and runs split side streets for signal
operations. This causes delay due to an additional signal phase. Aligning the intersection will improve timing for the overall intersection. This will improve mobility through the
intersection.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
Realignment of Wall Street and improving from two 10 foot travel lanes With grassed shoulder to two 11 foot travel lanes With curb and gutter. Additional improvements include roadway
grading, paving, and drainage structures. Construction will be accomplished using typical equipment including excavators, backhoes, pans, and dump trucks. Additional equipment may
be used as required.
4j. Please upload project drawings for the proposed project.
2017.07.28.U5788-PreliminaryPlans.pdf 2.98MB
1.1-5788_Permit Drawings_20190805.pdf 1.15MB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes r No O Unknown
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
r Preliminary r Approved r Not Verified r Unknown r N/A
Corps AID Number:
SAW-2016-02255
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company: Carolina Ecosystems Inc.
Other:
Sd. List the dates of the Corp jurisdiction determination or State determination if a determination was made bythe Corps or DWR
Site visit conducted by USACE and DWR on 8/23/18.
5d1. Jurisdictional determination upload
final signed U 5788 PJD with revised email for PCN.pdf 612.72KB
6. Future Project Plans
6a. Is this a phased project?*
r 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?
D. Proposed Impacts Inventory
1. Impacts Summary
la. Where are the impacts associated with your project? (check all that apply):
W Wetlands r Streams -tributaries r Buffers
r Open Waters r Pond Construction
2. Wetland Impacts
2a1 Reason (?) 2b. Impact type * P) 2c. Type of W. * 2d. W. name* 2e. Forested * 2f. Type of Impact
urisdicition*M]2g.
area*

1
Roadway fill
P
Headwater Forest
WA
Yes
Corps
0.037
(acres)
1
Mechanized Clearing
P
Headwater Forest
�WA
Yes
Corps
0.013
(acres)
2g. Total Temporary Wetland Impact
0.000
2g. Total Wetland Impact
0.050
2h. Comments:
E. Impact Justification and Mitigation
1. Avoidance and Minimization
2g. Total Permanent Wetland Impact
0.050
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
Side slopes within the wetland boundary have been reduced to 3:1 in order to minimize impacts to this area.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Sediment and erosion control measures will be implemented according to North Carolina requirements. Jurisdictional areas that are not permitted to
be impacted and are adjacent to construction areas will be clearly marked with protection fencing or other similar method to avoid inadvertent
encroachment. Copies of the issued permits and impact areas will be provided to the prime contractor and all subcontractors working in or near
jurisdictional areas.
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 r No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
Minimal wetland impact is below typical mitigation threshold for NWP.
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?
r Yes r No
If no, explain why:
The Lumber River basin does not have riparian buffer rules.
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
C Yes r No
Comments:
Stormwater management (see attached permit drawings) for the project has been reviewed and approved by NCDOT.
G. Supplementary Information
U
1. Environmental Documentation
1a. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?*
r 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 (NEPPJSEPA)? *
r Yes
r No
Comments:*
A State Minimum Criteria Determination Checklist has been prepared to document the project impacts.
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification Rules (15ANCAC 2H .0500), Isolated Wetland Rules (15A NCAC 2H .1300), or DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15A NCAC 2B .0200)?*
r Yes r No

3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality?*
r Yes r No
3b. If you answered "no," provide a short narrative description.
The project is designed to better accommodate current traffic flows in Shallotte, and is not planned to increase roadway capacity or development in
the area.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
rYes r Nor WA
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?*
r 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?*
r' Yes r No
5e. Is this a DOT project located within Division's 1-87
r Yes r No
f Unknown
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
Minimum Criteria Determination Checklist (attached) dated April 2019. An NRTR was prepared in November 2016, and included on site habitat
surveys for appropriate species.
Consultation Documentation Upload
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
r Yes r No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
Minimum Criteria Determination Checklist (attached) dated April 2019. NOAA Essential Fish Habitat Mapper.
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 status?*
r Yes r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
Minimum Criteria Determination Checklist (attached) dated April 2019.
7c. Historic or Prehistoric Information Upload
U5788_Historic_Cultural.pdf 14.02MB
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
r Yes r No
8c. What source(s) did you use to make the floodplain determination?*
FEMA Flood Map Service Center
Miscellaneous
Comments
Miscellaneous attachments not previously requested.
U-5788_State_Minimum_Criteria FINAL SIGNED.pdf 5.9MB
Signature
*
W 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:
Anneliese Westphal
Signature
Date
11/12/2019