20191760 Ver 1_PCN Form Submission (3)_20191230

DWR
Dlrlslon 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
20191760
Is a payment required for this project?*
r No payment required
r Fee received
r Fee needed - send electronic notification
Select Project Reviewer*
Donna Hood:eads\drhood
Information for Initial Review
1a. Name of project:
C-5621
1a. Who is the Primary Contact?*
Joel M. Howard
1b. Primary Contact Email:*
[e-mail]
Date Submitted
12/30/2019
Nearest Body of Water
Gambles Creek/MCDovell Creek
Basin
Catawba
Water Classification
WS-N;CA/C
Site Coordinates
Latitude:
35.480836
A. Processing Information
County (or Counties) where the project is located:
Mecklenburg
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:
C-5621
WBS # (?)
50146.3.1
1a. Type (a) of approval sought from the Corps:
Longitude:
-80.872907
Version#*
1
Reviewing Office*
Mooresville Regional Office - [phone]
1c. Primary Contact Phone:*
[phone]
L.1

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
1j. Is the project located in a designated trout watershed?
r 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:
Brett D. Canipe
2b. Deed book and page no.:
2c. Responsible party:
North Carolina Department of Transportation
2d.Address
Street Address
716 West Main Street
Address Line 2
City
State / Rovince / Rion
Albemarle
NC
Rstal / Zip Code
Country
28001
USA
2e. Telephone Number:
2f. Fax Number:
[phone]
[phone]
2g. Email Address:*
r Yes r No
r Yes r No

bdcanipe@ncdotgov
3. Applicant Information (if different from owner)
3a. Name:
Joel M. Howard
3b. Business Name:
North Carolina Department of Transportation
3c.Address
Street Address
716 West Main Street
Address Line 2
city
Albemarle
Postal / Zip Code
28001
3d. Telephone Number:
[phone]
3f. Email Address:*
[e-mail]
State / Rmince / Region
NC
Country
USA
3e. Fax Number:
[phone]
C. Project Information and Prior Project History O
[Project Information
1b. Subdivision name:
(d appropriate)
1c. Nearest municipality/ town:
Cronelius
2. Project Identification
2a. Property Identification Number:
2c. Project Address
Street Address
Address tine 2
City
Postal / Zip Code
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Gambles Creek/McDowell Creek
3b. Water Resources Classification of nearest receiving water:*
WS-N;CA/C
3c. What river basin(s) is your project located in?*
Catawba
3d. Please provide the 12-digit HUC in which the project is located.
03050101
4. Project Description and History
2b. Property size:
State / Province / Region
Country
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 area along US 21 is developed with commercial properties to include eating establishments, hotels, a gas station and several privately owned businesses. The area of South Hill
Street Mich is to the east of US 21 consist of single family homes. The northern section of the project consist of an apartment complex Be)dey at Lake Norman Apartments. The land
within the project limits has been heavily developed and lies within few tenth of 1-77.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
r' Yes r No r 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)
C-5621 Topo Map.pdf 498.58KB
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)

20191223_10251310248_1_Soil _Map.pdf 1.24MB
4f. List the total estimated acreage of all existing wetlands on the property:
0
4g. List the total estimated linear feet of all existing streams on the property:
527
4h. Explain the purpose of the proposed project:*
This is a roadway widening project with dual roundabouts North and South of SR 5544 (Catawba Ave) and US 21 intersection in Cornelius. This project will improve Highway safety an
traffic congestion by improving flow and mobility at the ebsitng intersections.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
Erosion control measures will be installed prior to any ground disturbing activities. There are three permit sites along the project where permanent and temporary surface water impacts
will occur. Site 1 impacts occur at a 42" RCP and headwall. Site 2 impacts
occur at a channel relocation and a rip rap outlet. Site 3 impacts occur at a channel relocation. Dissipater pads are used to reduce water velocities entering streams within the project.
NCDOT will attempt to avoid and minimize impacts to streams to the greatest extent practicable during the construction of the project. All stream work will be conducted in the dry by
dewatering the permitted sites prior to construction. The water will be pumped off site or into an approved silt bag adhering to NCDOT's best management practices for pipe
construction/replacement. The equipment that will be used to construct these Roundabouts and Pipe improvements include but is not limited to: dewatering pump, trackhoe, dump
trucks, vibratory roller, motor grader and paving equipment.
4j. Please upload project drawings for the proposed project.
C-5621_Permit Drawings_20191217.pdf 2.92MB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes r No r Unknown
Comments:
This work has been reviewed by the USACOE (Nicholle.M.Braspennickx) 8/23/2019
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 No.2018-01958
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Joel M. Howard
Agency/Consultant Company: NCDOT
Other:
5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
8/23/2019 was the day that the Corp meet onsite to reviewthe project and 11/19/2019 was the date that NCDOT received the revised PJD.
5d1. Jurisdictional determination upload
Stream ID Forms for C-5621.pdf 1.11 MB
SAW No. 2018-01958 C 5621 PJD.pdf 1.09MB
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):
r- Wetlands W Streams -tributaries r Buffers
r Open Waters r Pond Construction
3. Stream Impacts

S2
S3
Channel Relocation
Rip Rap Outlet
Permanent
Permanent
Relocation
Rip Rap Fill
Site 2A
Site 213
Intermittent
Perennial
Both -]
Both
2
Average (feet)
2
Average (feet)
397
(lin�rfeet)
12
(liriearfeet)
�
Channel Relocation
Permanent
Relocation
Site 3
Intermittent
Both
1
Aver�e(feet)
92
(liriearfeet)
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
527
3i. Total stream and ditch impacts:
527
3j. Comments:
E. Impact Justification and Mitigation
1. Avoidance and Minimization
3i. Total temporary stream impacts:
0
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
NCDOT's best management practice for the installation of pipe in jurisdictional waters will be adhered to throughout the life of the project.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
All erosion control devises will be maintained and monitored and inspected as dictated by the NPDES permit.
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:
It has not yet been determined by the t1SACE or DWR if Mitigtion will be required for this project.
F. Stormwater Management and Diffuse Flow Plan (required by DWR) u
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:
Gambles Creek and McDowell Creek do not fall under any NC Riparian Buffer Protection Rules.
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
r Yes r No
Comments:
NPDES records will be kept on site and inspected as needed by an NCDOT representative.
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?*
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 (NEPA/SEPA)?*
r Yes r No
1c. If you answered "yes" to the above, has the document review been finalized bythe State Clearing House?*
r Yes r No
Comments:*
This project is federally funded and has been reviewed under the Catergorical Exclusion Checklist
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.
This is a stand alone prject. NCDOT does not anticiapate any additional development within the project limits or future impacts to the downstream
water quality or Gambles Creek or McDowell Creek.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
r 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?*
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 r Unknown
5e. Is this a DOT project located within Division's 1-8?
r Yes r No
5f. Will you cut anytrees in order to conduct the work in waters of the U.S.?
r Yes r No
5g. Does this project involve bridge maintenance or removal?
r Yes r No
5h. Does this project involve the construction/installation of a wind turbine(s)?'
r Yes r No
51. 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.?
r Yes r No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
The North Carolina Natural Heritage Program (NCNHP) database.
Consultation Documentation Upload
NCNHP Report.pdf 1.1 MB
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?*
South Atlantic Fishery Management Council
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?*
NCDOT Cultral Resources Staff
7c. Historic or Prehistoric Information Upload
18-07-0024_NoHistoricPropertiesAffected.pdf 15.52MB
US21-SR2697 (Mecklenburg) No Survey form.pdf 504.59KB
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 Floodplain Map website
Miscellaneous
Comments
Miscellaneous attachments not previously requested.
SAW No. 2018-01958 C 5621 PJD.pdf
Signature
17 By checking the box and signing below, I certify that:
1.09MB
. 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:
Joel M. Howard
Signature
*Od
Date
12/30/2019