20100416 Ver 1_Application_20100601

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STATE OF NORTH CAROLINA
BEVERLY EAVES PERDUE
GOVERNOR
May 25, 2010
DEPARTMENT OF TRANSPORTATION ?9
Ms. Liz Hair
US Army Corp of Engineers
Asheville Regulatory Field Office
151 Patton Avenue, Room 208
Asheville, N. C. 28801-5006
EUGENE A. CONTI, JR.
SECRETARY
100416
SUBJECT: Pipe Extension/Rock Ladder Construction, SR 1443 (Smith Grove Church
Road), Alexander County
Dear Ms. Hair:
The North Carolina Department of Transportation proposes to place a 4-foot extension on an
existing 48-ft, 18" RCP on SR 1443 (Smith Grove Church Road) in Alexander County. The
extension will result in the outlet invert being perched and on a steep slope (13%); therefore, it
will be necessary to construct a -5- ft rock ladder to connect the outlet invert to the downstream
bed elevation and to provide energy dissipation during high flows. A 48-ft (.001 acre) linear
wetland is located upslope of the crossing, with the confluence with the main channel at the
existing pipe inlet. The linear wetland will be temporarily impacted by road construction and will
be restored upon project completion, stabilized with coir fiber matting, and seeded with wetland
seed mix. Due to the existing site conditions, NCDOT requests a waiver from the Regional
Condition 2(b)(c) permit depth specification, for the construction of this project. The
stream is an intermittent channel is limited flow; however, temporary cofferdams and bypass
piping will be utilized, if needed, to manage the stream during construction. Upon project
completion, the area disturbed by the temporary cofferdams will be restored and stabilized. The
total scope of the work will result in 10 feet of permanent impacts to an unnamed tributary to
Mill Creak, which is classified as a WS-11 watershed (HQW) by the Division of Water Quality.
The project is not located within '/] mile of any critical watershed area nor is SR 1443 a rural or
urban arterial; therefore, hazardous spill basins are not required. Enclosed is the hazardous spill
basin checklist.
This office has conducted a GIS and field survey for the project for historical sites and
threatened/endangered species sites. No sites listed on the National Register of Historic Places
are located in the vicinity of the project nor did there appear to be any eligible structures.
Post Office Box 47 Shelby, North Carolina 28151-0047
SR 1443, Smith"GroveChurch Road
Page 2
May 25,'2010
1
a:
The federally listed species for Alexander County (USFWS listed date January 31, 2008)
include dwarf flowered heartleaf (Hexastylis nunior(i) and the bog turtle (GIJptemnips
muhlenbergii)-(TISA- Threatened due to similarity of appearance). National Heritage Program
records document the nearest dwarf-flowered heartleaf location -20.5 miles southeast of the
proposed project area in Catawba County. The heartleaf is usually found on dry to moist ravine
slopes (usually north facing and of the oak-hickory-pine forest type) and in boggy areas near
springheads. There is no suitable habitat within the proposed project area and no species were
observed. Natural Heritage Program records document the nearest bog turtle location --2.9
southeast of the proposed project area. "Be(, turtles are typically found in bogs, marshes, and svet
pastures. T/SA species are not subject to Section 7 consultation; however, there is no suitable
habitat located within the project area and no impact on this species is anticipated.
I have enclosed a pre-construction notification for a NW414, sketches of planned activities, and
location maps relative to the project.
Project information for the 401 Automated Payment Procedure is as follows:
• Work order number: 150459-55120005-12C.002008-3126
• TIP #: NA
• Project Category: $240.00 Fee
If you have any questions or concerns, please feel free to contact me at [phone]. Thank
you for your time and consideration to this matter
Respectfully yours,
M.L. Holder, P.E.
Division Engineer
Twelfth Division
BY: I /
Trish Simon
Division 12 Environmental Supervisor
Enclosures

Cc: Brian Wrenn, DWQ, 401/Transportation Permitting Unit
Polly Lespinasse, DWQ. Mooresville Regional Office

Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Pre-Construction Notification PCN Form
A. Applicant Information
1. Processing
1 a. Type(s) of approval sought from the
Corps:
®Section 404 Permit ? Section 10 Permit
1 b. Specify Nationwide Permit (NWP) number: 14 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps? ? Yes ® No
1d. Type(s) of approval sought from the DWQ (check all that apply):
® 401 Water Quality Certification - Regular ? Non-404 Jurisdictional General Permit
? 401 Water Quality Certification - Express ? Riparian Buffer Authorization
le. Is this notification solely for the record
because written approval is not required? For the record only for DWQ 401
Certification:
? Yes ® No For the record only for Corps Permit:

? Yes ® No
1f. 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.
Yes
El
® No
1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below. ? Yes ®No
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ? Yes ®No
2. Project Information
2a. Name of project: SR 1443, Smith Grove Church Road
2b. County: Alexander
2c. Nearest municipality / town: Taylorsville
2d. Subdivision name: NA
2e. NCDOT only, T.I.P. or state
project no: 12C.002008
3. Owner Information
3a. Name(s) on Recorded Deed: NCDOT Right of Way
31b. Deed Book and Page No.
3c. Responsible Party (for LLC if
applicable):
3d. Street address:
3e. City, state, zip:
3f. Telephone no.:
3g. Fax no.:
3h. Email address:
Page 1 of 11
PCN Form - Version 1.3 December 10, 2008 Version
4. Applicant Information (if different from owner)
4a. Applicant is: ? Agent ? Other, specify:
4b. Name: Mike Holder
4c. Business name
(if applicable):
N.C. Department of Transportation, Division 12
4d. Street address: 1710 East Marion Street
4e. City, stale, zip: Shelby, NC 28151
4f. Telephone no.: 704-480-9020
4g. Fax no.: 704-480-5401
4h. Email address: [e-mail]
5. Agent/Consultant Information (if applicable)
5a. Name: Trish Simon
Sb. Business name
(if applicable):
N.C. Department of Transportation, Division 12
5c. Street address: 1710 East Marion Street
5d. City, state, zip: Shelby, NC 28151
5e. Telephone no.: 704-480-9044
5f. Fax no.: 704-480-5401
5g. Email address: [e-mail]
Page 2 of 11
PCN Form - Version 1.3 December 10, 2008 Version
B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): NA
Latitude: 36.0189539 Longitude: -
1b. Site coordinates (in decimal degrees): 81.0677853
(DD.DDDDDD) (-DD.DDDDDD)
1c. Property size: 10 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to UT to Mill Creek
proposed project:
2b. Water Quality Classification of nearest receiving water: WS-ll. HQW
2c. River basin: Yadking
3. Project Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application:
Unpaved Secondary Road. Landuse is mostly forested
3b. List the total estimated acreage of all existing wetlands on the property:
.001
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
60
3d. Explain the purpose of the proposed project:
The purpose of the proposed work is to extend the existing pipe to create a better roadway shoulder for the safety of the
travelling public.
3e. Describe the overall project in detail, including the type of equipment to be used:
NCDOT proposes to extend an existing 48-foot, 18" RCP 4 ft. The extension will result in the outlet invert being perched
and on an steep slope (13%), therefore, it will be necessary to construct a -5- ft rock ladder to connect the outlet invert to
the downstream bed elevation and to provide energy dissipation during high flows. The stream is in an intermittent
channel with limited aquatic life. A 48-ft (.001 acre) linear wetland is located upslope of the crossing, with the confluence
with the main channel at the existing pipe inlet. The linear wetland will be temporarily impacted by road construction and
will be restored upon project completion and seeded with wetland seed mix. Temporary cofferdam/bypass pumping will
be used to divert the stream flow around the construction sites if needed. The Project will be constructed using typical
heavy equipment (trackhoe, backhoe, etc.).
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past?
ED Yes ? No ? Unknown
Comments: Jurisdictional stream determinations made by
the Division 12 DEC. Division of Water Quality personnel
verification of determination.
4b. If the Corps made the jurisdictional determination, what type
? Preliminary ? Final
of determination was made?
4c. If yes, who delineated the jurisdictional areas? Agency/Consultant Company:
Name (if known): Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
Page 3 of 11
PCN Form - Version 1.3 December 10. 2008 Version
S. Project History
5a. Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past? ? Yes ® No ? Unknown
5b. If yes, explain in detail according to "help file" instructions.
6. Future Project Plans
6a. Is this a phased project? ? Yes ®No
6b. If yes, explain.
Page 4 of 11
PCN Form - Version 1.3 December 10, 2008 Version
C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
? Wetlands ® Streams - tributaries ? Buffers
? Open Waters ? Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a. 2b. 2c. 2d. 2e. 2f.
Wetland impact Type of jurisdiction
number - Type of impact Type of wetland Forested (Corps - 404, 10 Area of impact
Permanent (P) or (if known) DWQ - non-404, other) (acres)
Temporary T

W1 ? P ®T Ditch
reshaping/erosion Seep into ditchline ? Yes ® Corps
001
control measures (linear wetland) ®No ® DWQ .
W2 ? P ? T ? Yes ? Corps
? No ? DWQ
W3 ? P ? T ? Yes ? Corps
? No ? DWQ
W4 ? P ? T ? Yes ? Corps
? No ? DWQ
W5 ? P ? T ? Yes ? Corps
? No ? DWQ
W6 ? P ? T ? Yes ? Corps
? No ? DWQ
25. Total wetland impacts .001
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. 3b. 3c. 3d. 3e. 3f. 3g.
Stream impact Type of impact Stream name Perennial Type of jurisdiction Average Impact
number - (PER) or (Corps - 404, 10 stream length
Permanent (P) or intermittent DWQ - non-404, width (linear
Temporary (T) (INT)? other) (feet) feet)

S1 ®P ? T Pipe
extension/Rock
UT to Mill Creek
? PER
® Corps
1
10
Ladder ®INT ®DWQ
S2 ? P ® T Cofferdams/Bypass UT to Mill Creek ? PER ® Corps 1 15
Pumping ® INT ® DWQ
S3 ? P ? T ? PER ? Corps
? INT ? DWQ
S4 ? P ? T ? PER ? Corps
? INT ? DWQ
S5 ? P ? T ? PER ? Corps
? INT ? DWQ
S6 ? P ? T ? PER ? Corps
? INT ? DWQ
3h. Total stream and tributary impacts 25
3i. Comments: Temporary Cofferdams/bypass pumping will be used only if necessary. Stream is intermittent with limited flow
Page 5 of 11
PCN Form -Version 1.3 December 10, 2008 Version
4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impacts below.
4a. 4b. 4c. 4d. 4e.
Open water Name of waterbody
impact number - (if applicable) Type of impact Waterbody type Area of impact (acres)
Permanent (P)
01 ?P?T
02 ?P?T
03 ?P?T
04 ?P?T
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
if and or lake construction proposed, then complete the chart below.
5a. 5b. 5c. 5d. 5e.
Wetland Impacts (acres) Stream Impacts (feet) Upland
Pond ID Proposed use or purpose of (acres)
number pond
Flooded Filled Excavated Flooded Filled Excavated Flooded
P1
P2
U. Total
5g. Comments:
5h. Is a dam high hazard permit required?
? Yes ? No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If an impacts require mitigation, then you MUST fill out Section D of this form.
6a.
Project is in which protected basin?
6b. 6c. 6d.
Buffer impact
number - Reason
Permanent (P) for
B1 ?P?T
B2 ?P?T
33 ?P?T
6i. Comments:
? Neuse ? Tar-Pamlico ? Other:
? Catawba ? Randleman
6e. 6f. 6q.
Buffer
Stream name mitigation
required?
? Yes
? No
? Yes
? No
? Yes
? No
6h. Total buffer impacts
Zone 1 impact Zone 2 impact
(square feet) (square feet)
Page 6 of 11
PCN Form - Version 1.3 December 10, 2008 Version
D. Impact Justification and Mitigation
1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
The pipe extension will result in the outlet invert being perched and on an steep slope (13%), therefore, it will be necessary to
construct a -5- It rock ladder to connect the outlet invert to the downstream bed elevation and to provide energy dissipation
during high flows. The linear wetland will be temporarily impacted by road construction and will be restored upon project
completion and seeded with wetland seed mix.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Appropriate erosion control measures will be in place during project 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? ? Yes ® No
2b. If yes, mitigation is required by (check all that apply): ? DWQ ? Corps

2c. If yes, which mitigation option will be used for this project? ? Mitigation bank
? Payment to in-lieu fee program
? Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter) Type Quantity
3c. Comments:
4. Complete if Making a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached. ? Yes
41b. Stream mitigation requested: linear feet
4c. If using stream mitigation, stream temperature: ? warm ? cool ?cold
4d. Buffer mitigation requested (DWQ only): square feet
4e. Riparian wetland mitigation requested: acres
4f. Non-riparian wetland mitigation requested: acres
4g. Coastal (tidal) wetland mitigation requested: acres
41h. Comments:
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
Page 7 of 11
PCN Form -Version 1.3 December 10, 2008 Version
6. Buffer Mitigation (State Regulated Riparian Buffer Rules) - required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation? ? Yes ® No
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.

Zone 6c.
Reason for impact 6d.
Total impact
(square feet)
Multiplier 6e.
Required mitigation
(square feet)
Zone 1 3 (2 for Catawba)
Zone 2 1.5
6f. Total buffer mitigation required:
6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in-lieu fee fund).
6h. Comments:
Page 8 of 11
PCN Form - Version 1.3 December 10, 2008 Version
E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
la . Does the project include or is it adjacent to protected riparian buffers identified ? Yes ® No
within one of the NC Riparian Buffer Protection Rules?
1b . If yes, then is a diffuse flow plan included? If no, explain why.
? Yes ? No
Comments:
2. Stormwater Management Plan
2a . What is the overall percent imperviousness of this project? NA %
2b . Does this project require a Stormwater Management Plan? ® Yes ? No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why: Com plies with NCDOT's individual
NPDES permit NCS000250.
2d . If this project DOES require a Stormwater Management Plan, then provide a brief, na rrative description of the plan:
? Certified Local Government
2e . Who will be responsible for the review of the Stormwater Management Plan? ? DWQ Stormwater Program
® DWQ 401 Unit
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this project? NA
? Phase 11
3b. Which of the following locally-implemented stormwater management programs ? NSW
? USMP
apply (check all that apply): ? Water Supply Watershed
? Other:
3c. Has the approved Stormwater Management Plan with proof of approval been ? Yes ? No
attached?
4. DWQ Stormwater Program Review
? Coastal counties
® HQW
4a. Which of the following state-implemented stormwater management programs apply ? ORW
(check all that apply): ? Session Law 2006-246
? Other:
4b. Has the approved Stormwater Management Plan with proof of approval been
attached? ? Yes ? No
5. DWQ 401 Unit Stormwater Review
5a. Does the Stormwater Management Plan meet the appropriate requirements? ? Yes ? No
5b. Have all of the 401 Unit submittal requirements been met? ? Yes ? No
Page 9 of 11
PCN Form - Version 1.3 December 10, 2008 Version
F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
la. Does the project involve an expenditure of public (federal/state/local) funds or the ® Yes ? No
use of public (federal/state) land?
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 ? Yes ® No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1c. If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
letter.) ? Yes ? No
Comments:
2. Violations (DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards, ? Yes ® No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
21b. Is this an after-the-fact permit application? ? Yes ® No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in ? Yes ® No
additional development, which could impact nearby downstream water quality?
3b. If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
The project is classified as a minimum critieria project which has low potential for cumulative/indirect impacts and will not
result in additional development which could impact water quality.
4. Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility.
Page 10 of 11
PCN Form - Version 1.3 December 10, 2008 Version
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or ? Yes ® No
habitat?
51b. Have you checked with the USFWS concerning Endangered Species Act ? Yes ® No
impacts?
E] Raleigh
Sc. If yes, indicate the USFWS Field Office you have contacted.
? Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
NC Natural Heritage Program database.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat? ? Yes ® No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
No salt marshes, oyster reefs, or seagrass beds in the vicinity of the project.
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 ? Yes ® No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
The State Historic Preservation Office resources and the National Register of Historic Places werer reviewed for historic
sites in the vicinity of the project, however, the pipe replacement projects occur within a previously impacted area (NC
DOT Right of Way).
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain? ? Yes ®No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination? FEMA FIRM panal number: 3710388200K
M.C. 14oUei IN V 0 -5-25-?o
Applicant/Agent's Printed Name Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant
is provided.)
Page 1 I of 11
PCN Form - Version 1.3 December 10, 2008 Version
C? "I
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Date: 5/25/2010 Caption: Pipe Extension, SR 1443, Smith Grove Church Road, UT to Mill
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NCDOT
HAZARDOUS SPILL BASIN CHECKLIST
Division: 12 County: Alexnnder Project ID: 12C.002008
River Basin: Catawba Bridge No: NA
Route: Pipe Replacement on SR 1443 (Smith Grove Church Road)
Stream: UT to Mill Creek (WS- II, HQW)
Water Quality Criteria:
Yes No
Stream Crossing Blue Line On USGS r-
ORW r W,
WSI r w,
WS 11,111 OR IV, Crossing Within 0.5mi of W.S. Critical Area r r
Roadway Criteria:
Route Designation-
Arterial Urban
Arterial Rural
Additional Site Information:
Yes No
r 1?
r rv
V,., TAT_
Is a Hazardous Spill Basin Required?
F r
Criteria Based Upon NCDOT "Best Management Practices for the
Protection of Surface Waters" (March, 1997).