20201196 Ver 1_401 Application_20201028

I I DWR
Division of Water Resources
Pre-Construction Notification (PCN) Form
September 1,2020 Ver 3.2
Initial Review
Has this project met the requirements for acceptance in to the review process?*
6 Yes
✓ No
Is this project a public transportation project?*
0 Yes r No
Change only if needed.
BIMS#Assigned* Version#*
20201196 1
Is a payment required for this project?*
✓ No payment required Reviewing Office*
6 Fee received Winston-Salem Regional Office-(336)776-
✓ Fee needed-send electronic notification 9800
Select Project Reviewer*
Dave Wanucha:eads\djwanucha
Information for Initial Review
1a.Name of project:
R-5737
1a.Who is the Primary Contact?*
Amy Euliss
lb.Primary Contact Email:* 1c.Primary Contact Phone:*
[e-mail] [phone]
Date Submitted
10/28/2020
Nearest Body of Water
Abbotts Creek and Rich Fork
Basin
Yadkin-PeeDee
Water Classification
Abbotts Creek(WSIII;CA),Abbotts Creek(Class C),Rich Fork(Class C)
Site Coordinates
Latitude: Longitude:
35.861146 -80.185583
A. Processing Information
County(or Counties)where the project is located:
Davidson
Is this a NCDMS Project
✓ Yes G No
Is this project a public transportation project?*
6 Yes r No
Is this a NCDOT Project?*
6 Yes r No
(NCDOT only)T.I.P.or state project number:
R-5737

WBS#(?)
50195.1.1
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)
lb.What type(s)of permit(s)do you wish to seek authorization?
I7 Nationwide Permit(NWP)
r Regional General Permit(RGP)
r Standard(IP)
1c.Has the NWP or GP number been verified by the Corps?
✓ Yes r No
Nationwide Permit(NWP)Number: 14-Linear transportation
NWP Numbers(for multiple NWPS):
Id.Type(s)of approval sought from the DWR:
17 401 Water Quality Certification-Regular r 401 Water Quality Certification-Express
✓Non-404 Jurisdictional General Permit r Riparian Buffer Authorization
✓ Individual Permit
le.Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification: r Yes 6 No
For the record only for Corps Permit: r Yes (R No
1f.Is this an after-the-fact permit application?*
✓ Yes ( No
1g.Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
✓ Yes r No
1g.Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
✓ Yes rNo
Acceptance Letter Attachment
R-5737-Division 9-STR-YD 103.pdf 496.79KB
Ih.Is the project located in any of NC's twenty coastal counties?
✓ Yes 6' No
1j.Is the project located in a designated trout watershed?
✓ Yes f No
B. Applicant Information U
1d.Who is applying for the permit?
17 Owner r Applicant(other than owner)
le.Is there an Agent/Consultant for this project?*
✓ Yes G No
2.Owner Information
2a.Name(s)on recorded deed:
NCDOT Division 9
2b.Deed book and page no.:
2c.Responsible party:
2d.Address
Street Address
375 Silas Creek Parkway
Address Line 2
Cris State/Bovine/Region
Winston Salem NC
Postal/Zip Code Country
27127 USA

2e.Telephone Number: 2f.Fax Number:
[phone]
2g.Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
lb.Subdivision name:
(if appropriate)
1c.Nearest municipality/town:
Lexington
2. Project Identification
2a.Property Identification Number: 2b.Property size:
2c.Project Address
Street Address
Address Line 2
CA, State/Rovince/Fbgion
Fbstal/Zip Code Country
3.Surface Waters
3a.Name of the nearest body of water to proposed project:*
Abbotts Creek and Rich Fork
3b.Water Resources Classification of nearest receiving water:*
Abbotts Creek(WSIII;CA),Abbotts Creek(Class C),Rich Fork(Class C)
3c. What river basin(s)is your project located in?*
Yadkin-PeeDee
3d.Please provide the 12-digit HUC in which the project is located.
030401030206 and 030401030203
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 existing conditions at the site include paved roadway flanked on either side by Davidson County Community College,businesses,and undeveloped land.
4b.Have Corps permits or DWR certifications been obtained for this project(including all prior phases)in the past?*
r Yes F 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)
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)
4f.List the total estimated acreage of all existing wetlands on the property:
6.97
4g.List the total estimated linear feet of all existing streams on the property:
4434
4h.Explain the purpose of the proposed project:*
The purpose of the project is to eliminate crossings conflicts,improve operational efficiencies and enhance safety by converting the existing at-grade intersection to an interchange.
The need for the project results from projected traffic volumes to increase 11 to 13 percent by 2040.Existing congestion at the intersection is frequent during the am and pm peak
hours.This congestion has resulted in 9 crashes over a five-year period(8/1/12 to 7/31/17).
4i.Describe the overall project in detail,including indirect impacts and the type of equipment to be used:*
The North Carolina Department of Transportation(NCDOT)proposes to convert the existing at grade intersection of US 29/US 70/Business 85 at SR 1798(Old Greensboro Road)to an
interchange.The interchange will be comprised of a compressed elongated roundabout with three roundabouts.The design consolidates the existing intersections of the Davidson
Community College Road at Caldcleugh Road and Caldcleugh Road at Old Greensboro Road into one roundabout.Old Greensboro Road will go under US 29-70.On/off ramps will be
provided in combination with an elongated roundabout.The intersection of Old Greensboro Road at S.Old Greensboro Road will be converted into a roundabout.
Standard road building equipment will be used.No indirect impacts are anticipated.
4j.Please upload project drawings for the proposed project.
R5737_Permit Drawngs_20201006.pdf 9.64MB

5.Jurisdictional Determinations
5a.Have the wetlands or streams been delineated on the property or proposed impact areas?*
(r Yes C No r Unknown
Comments:
5b.If the Corps made a jurisdictional determination,what type of determination was made?*
6' Preliminary r Approved r Not Verified r Unknown C N/A
Corps AID Number:
SAW-2018001123
5c.If 5a is yes,who delineated the jurisdictional areas?
Name(if known): Troy Shelton
Agency/Consultant Company: Dewberry Engineers,inc
Other:
5d.List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
June 6,2018
5d1.Jurisdictional determination upload
DWR Stream letter R-5737.pdf 1.36MB
R5737 PJD_Revised 2018.7.31(2)(1).pdf 8.14MB
SAW-2018-01123(signed PJD)5737.pdf 510.95KB
6. Future Project Plans
6a.Is this a phased project?*
C Yes ( 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?
None
D. Proposed Impacts Inventory
1. Impacts Summary
1a.Where are the impacts associated with your project?(check all that apply):
17 Wetlands 17 Streams-tributaries r Buffers
r Open Waters r Pond Construction
2.Wetland Impacts
2a.Site#*(?) 2a1 Reason(?) 2b.Impact type*(?) 2c.Type of W.* 2d.W.name* 2e.Forested* 2f.Type of 2g.Impact
Jurisdicition*(?) area*
la Roadway fill P Non-Tidal Freshwater Marsh WD Yes Both 0.010
(acres)
la Mechanized Clearing for P Non-Tidal Freshwater Marsh WD Yes Both 0.020
Roadway fill (acres)
1a Hand Clearing for T Non-Tidal Freshwater Marsh WD Yes Both 0.050
Roadway fill (acres)
1b Mechanized Clearing of P Non-Tidal Freshwater Marsh WD Yes Both 0.010
easement for EC basin (acres)
2 Mechanized Clearing of P Headwater Forest WJ Yes Both 0.020
easement for EC basin (acres)
4 Mechanized Clearing for P Headwater Forest WH Yes Both 0.010
easement for EC basin (acres)
5 42"RCP P Headwater Forest WC Yes Both 0.070
(acres)
5 Mechanized Clearing for P Headwater Forest WC Yes Both 0.010
42"RCP (acres)
2g.Total Temporary Wetland Impact 2g.Total Permanent Wetland Impact
0.050 0.150
2g.Total Wetland Impact

0.200
2h.Comments:
3.Stream Impacts
3a.Reason for impact(?) 3b.Impact type* 3c.Type of impact* 3d.S.name* 3e.Stream Type* 3f.Type of 3g.S.width* 3h.Impact
(?) Jurisdiction* length*
S1 Site 3:Roadway fill,60"RCP, Permanent Fill SD:UT to Rich Fork Perennial Both 3 243
relocated channel Average(feet) (linear feet)
32 Site 3:Bank Stabilization Permanent Bank Stabilization SD:UT to Rich Fork Creek Perennial Both 3 11
Average(feet) (linear feet)
S3 Site 5:42"RCP Permanent Culvert SB:UT to Abbotts Creek Perennial Both 4 111
Average(feet) (linear feet)
s4 Site 5:Bank Stabilization Permanent Bank Stabilization SB:UT to Abbotts Creek Perennial Both 4 12
Average(feet) (linear feet)
3i.Total jurisdictional ditch impact in square feet:
0
3i.Total permanent stream impacts: 3i.Total temporary stream impacts:
377 0
3i.Total stream and ditch impacts:
377
3j.Comments:
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:
At site 5,the inlet of the pipe is to be placed in a wetland.To reduce the risk of head cutting in the wetland,the pipe will be laid at grade.
At site 3,the stream starts at the existing pipe outlet,and is currently perched.There is a very unstable bank along the right side of the stream in the
vicinity of the pipe outlet.The perch will be corrected by utilizing a junction box The area draining to the existing pipe is mostly impervious coming from
Davidson County Community College and existing US29/70,so aquatic passage will not be affected by the junction box The stream bed and banks at
the outlet have been armored for velocity control.
Impacts for erosion control measures have been minimized as much as possible.At permit sites 1A,1 B,and 2,there will be minimal wetland impacts
for mechanized clearing for installation of skimmer basins.Due to the steep topography,we could not eliminate impacts to the wetlands and provide
adequate erosion control measures.
lb.Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
The project has implemented NCDOT's Design Standards in Sensitive Watersheds for the portion of the project that drains to waters defined as the
Critical Area.There are no impacts to streams or wetlands in the Critical Area;however,construction drainage will discharge into the watershed.
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?
( Yes rNo
2c.If yes,mitigation is required by(check all that apply):
r DWR fJ Corps
2d.If yes,which mitigation option(s)will be used for this project?
r Mitigation bank fJ Payment to in-lieu fee 1 Permittee Responsible
program Mitigation
4. Complete if Making a Payment to In-lieu Fee Program
4a.Approval letter from in-lieu fee program is attached.
r Yes r No
4b.Stream mitigation requested:
(linear feet) 4c.If using stream mitigation,what is the stream temperature:
354 warm
4d.Buffer mitigation requested(DWR only): 4e.Riparian wetland mitigation requested:
(square feet) (acres)

4f.Non-riparian wetland mitigation requested: 4g.Coastal(tidal)wetland mitigation requested:
(acres) (acres)
4h.Comments
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?
✓ Yes 6 No
If no,explain why:
The watershed that the project is not covered under current Riparian Buffer Protection Rules.
2.Stormwater Management Plan
2a.Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
✓ Yes r No
Comments:
Stormwater Management Plan is included in the permit drawings.
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?*
✓ Yes r No
lb.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)?*
✓ Yes 6 No
Comments:*
The project is state funded.A Minimum Criteria Checklist was created for documentation.
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)?*
✓ Yes ( No
3. Cumulative Impacts(DWR Requirement)
3a.Will this project result in additional development,which could impact nearby downstream water quality?*
✓ Yes f No
3b.If you answered"no,"provide a short narrative description.
The project may alter property access or travel patterns.Due to the potential transportation impact-causing activities,this project may influence
nearby land uses or stimulate growth.Therefore,an indirect and cumulative effects screening is provided in the CCR,previously prepared for this
project.Given that the project is an interchange conversion of an existing intersection,and given current growth trends in the area,this project is not
expected to result in induced growth or a change in land use that would not otherwise occur.The screening tool resulted in a total score of 7 points
out of a total of 46 points.Based on the information gathered from local land use and transportation plans,mapping,and field visits and the output of
the screening tool,a Land Use Scenario Assessment is Not Warranted.
4.Sewage Disposal(DWR Requirement)
4a.Is sewage disposal required by DWR for this project?*
CYes rNo6' 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?*
6 Yes rNo
5b.Have you checked with the USFWS concerning Endangered Species Act impacts?*
✓ Yes R No
5d.Is another Federal agency involved?*
✓ Yes G No r Unknown

5e.Is this a DOT project located within Division's 1-8?
✓ Yes G No
5f.Will you cut any trees in order to conduct the work in waters of the U.S.?
6 Yes C No
5g.Does this project involve bridge maintenance or removal?
✓ Yes r:- No
5h.Does this project involve the construction/installation of a wind turbine(s)?*
C Yes G 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.?
✓ Yes C No
If yes,please provide details to include type of percussive activity,purpose,duration,and specific location of this activity on the property.
5j.What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
NCNHP database and field surveys for Schweintz's sunflower.
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?*
C Yes f No
6b.What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
Not applicable
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?*
F Yes C No
7b.What data sources did you use to determine whether your site would impact historic or archeological resources?*
The project was reviewed by NCDOT cultural resource staff.The Catawba Indian Nation was also consulted,and they had no concerns.
Documentation is attached.
7c.Historic or Prehistoric Information Upload
No Historic Properties present of affected 7.2.18.pdf 3.85MB
AR17-12-0007NoSitesPresent.pdf 10.48MB
R-5737 Tribal Coordination.pdf 514.44KB
2020-193-177 Catawba Indian Nation Response.pdf 253.56KB
8. Flood Zone Designation(Corps Requirement)
8a.Will this project occur in a FEMA-designated 100-yearfloodplain?*
CYes (' No
8c.What source(s)did you use to make the floodplain determination?*
FEMA maps
M iscel Ianeous C^)
Comments
Miscellaneous attachments not previously requested.
DWR Pre-Filing Meeting Request Form.pdf 50.68KB
R-5737 Cover letter.pdf 198.14KB
R-5737 JD Determination and preapplication Meeting Minutes 06.20.pdf 52.37KB
Signature U
*
17 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:

Amy Euliss
Signature
�yry�sJO�
Date
10/28/2020