20100929 Ver 1_Application_20101104

a
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
Y EAVES PERDUE
GOVERNOR
November 1, 2010
'WAS O19A?R ?OJO O
**gry?,,
EUGENE A. CONTI, JR.
SECRETARY
Mr. Brian Wrenn
Division of Water Quality 1i
401/Transportation Permitting Unit Lr
1650 Mail Service Center
Raleigh, NC 27699-1650
SUBJECT: Emergency Pipe Replacement on SR 1901 (Ralph Road), Iredell County
Dear Mr. Wrenn:
The North Carolina Department of Transportation requests authorization to replace collapsed
pipe on SR 1901 (Ralph Road) in Iredell County. Please note that the pipe is on a dead-end road
in a residential area; therefore, construction commenced immediately. A 52-foot long, 30" CMP
was replaced with a 52-foot long, 48" CMP with associated riprap for structure stabilization.
The new pipe would be on -3.5% slope to connect upstream and downstream streambed
elevations; therefore, the inlet was placed at existing streambed elevation and the outlet remains
slightly perched. A short (5 feet) outlet "rock ladder" was constructed to promote stream
connectivity. Temporary cofferdams and bypass pumping was used to manage the streamflow
during construction. The scope of the work resulted in 15 feet of permanent rock impacts to
unnamed tributary to Little Rocky Creek, which is classified as Class C Waters by the Division
of Water Quality.
The project area is not located within '/2 mile of any critical watershed area nor is SR 1901 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. The
federally listed species for Iredell County (USFWS listed date September 22, 2010) include the
Dwarf-flowered heartleaf (Hexasrylis naniJlora) and the Bog Turtle (Glypienimys rrmhlenbergii).
The Natural Heritage Program records document the nearest dwarf-flowered heartleaf location
approximately 22 miles southwest of the proposed project 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 potential habitat within the
proposed project area, and no species were observed. National Heritage Program records
document the nearest bog turtle location approximately 8 miles west of the proposed project area
in Alexander County. Bog turtles are usually found in bogs, marshes, and wet pastures.
Post Office Box 47 Shelby, North Carolina 28151-0047
r
1
i
SR 1901, Ralph Road
Page 2
November 1, 2010
There is no suitable habitat located within the project area. It is anticipated that the proposed
project will no impact on the dwarf-flowered heartleaf (Hexastylis naniflora ) or bog turtle
(Glyptemmys muhlenbergii).
1 have enclosed a pre-construction notification for a NW# 3, 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: 150461-55120005-12.204921-3 1 26
• TIP4: 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 on this matter.
Respectfully yours,
M.L. Holder, P.E.
Division Engineer
Twelfth Division
BY:
Trish Simon
Division 12 Environmental Supervisor
Enclosures
cc Polly Lespinasse, Division of Water Quality, Mooresville Regional Office
O?O? W AT eq?G
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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. 1 Processing
la. Type(s) of approval sought from the
Corps:
? Section 404 Permit El Section 10 Permit
11,. Specify Nationwide Permit (NWP) number: 3 or General Permit (GP) number:
1c I - . Has the N WP or GP number been verified by the Corps? ? Yes ® No
to . 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
1 e . Is this notification solely for the record
I 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 of impacts? If so, attach the acceptance letter from mitigation bank or in-lieu
fee program. ? Yes
1g
' . Is the project located in any of NC's twenty coastal counties. If yes, answer 1h
below. ? Yes ®No
1ri . Is the project located within a NC DCM Area of Environmental Concern (AEC)? ? Yes ® No
2. Project Information
2a i. Name of project: SR 1901 (Ralph Road)
21! . County: Iredell
2c . Nearest municipality / town: Central
2c1 . Subdivision name: NA
2e
1 . NCDOT only, T.I.P. or state
project no: 12 204921
3.1 Owner Information
3a . Name(s) on Recorded Deed: NCDOT Right of Way
3t . Deed Book and Page No.
3c . Responsible Party (for LLC i f
applicable):
3c . Street address:
3e . City, state, zip:
3fl Telephone no.:
3g . Fax no.:
31 ? . 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, state, 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
5b. 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: 35.9363757 Longitude: -
Site coordinates (in decimal degrees):
lb 80.9638048
(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 Little Rocky Creek
proposed project:
2b! Water Quality Classification of nearest receiving water: Class C
2cl River basin: Yadkin
3. I Project Description
3ai Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application:
Existing pipe on unpaved secondary road. Surrounding landuse is designated cropland and pasture.
30 List the total estimated acreage of all existing wetlands on the property:
1 0
3c) List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
1 80
3d1. Explain the purpose of the proposed project:
The purpose of the proposed work is to replace a collapsed pipe for the safety of the travelling public.
3e!. Describe the overall project in detail, including the type of equipment to be used:
Replacement of a collapsed 52-foot long, 30" CMP with a 52-foot long, 48" CMP. Riprap used at the pipe inlet and outlet
for structure stabilization. The new pipe was installed on a 1.2% slope and left slightly perched in an effort to prevent
stream destabilization. (Connection of the upstream and downstream streambed elevation would result in -3.5% slope).
A five foot rock ladder installed to relieve perched condition. Project constructed using typical heavy equipment
(trackhoe, backhoe, etc.).
4.1 Jurisdictional Determinations
4a: Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
? Yes ®No ? Unknown
project (including all prior phases) in the past?
Comments: Jurisdictional evaluation made by Div 12 DEO.
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:
4di If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
5.1 Project History
5a1. Have permits or certifications been requested or obtained for
El Yes ® No ? Unknown
this project (including all prior phases) in the past?
5b1. If yes, explain in detail according to "help file" instructions.
Page 3 of 11
PCN Form - Version 1.3 December 10, 2008 Version
6. Future Project Plans
6a. Is this a phased project? ? Yes ®No
61b. If yes, explain.
Page 4 of 11
PCN Form -Version 1.3 December 10, 2008 Version
C. I Proposed Impacts Inventory
1. ! Impacts Summary
lat. Which sections were completed below for your project (check all that apply):
?) Wetlands ® Streams - tributaries ? Buffers
?I 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.
gal 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 El Yes El Corps
? No ? DWQ
W2 (:1 P El T El Yes [I Corps
? No ? DWQ
W3 El P ? T El Yes El Corps
1 ? No ? DWQ
W4 ? P ? T ? Yes ? Corps
? No ? DWQ
WL ? P ? T ? Yes ? Corps
? No ? DWQ
Wi3 ? P ? T ? Yes ? Corps
? No ? DWQ
2g: Total wetland impacts
2h. Comments:
3.1 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.
39. 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 Rock ladder for UT to Little Rocky ? PER ® Corps 2 5
1 perched condition Creek ® INT ® DWQ
SCI' ®P ? T Inlet rock UT to Little Rocky ? PER ® Corps 2 10
stabilization Creek ® INT ® DWQ
S? P El T El PER ? Corps
? INT ? DWQ
S41 ? P ? T ? PER ? Corps
1 ? INT D DWQ
SI ?P?T ?PER ?Corps
1 ? INT ? DWQ
S I El P ? T ? PER ? Corps
I ? INT ? DWQ
3h.. Total stream and tributary impacts 15
30 Comments:
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) or
Temporary
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 (acres)
number of pond
Flooded Filled Excavated Flooded Filled Excavated Flooded
P1
P2
5f. 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.
? Neuse ?Tor-Pamlico ? Other:
Project is in which protected basin? ? Catawba ? Randleman
6b. 6c. 6d. 6e. 6f. 6g.
Buffer impact
number- Reason Buffer Zone 1 impact Zone 2 impact
Permanent (P) or for Stream name mitigation (square feet) (square feet)
Temporary T impact required?
B1 ?P?T ?Yes
? No
32 ? P ? T ? Yes
? No
B3 ?P?T ?Yes
? No
6h. Total buffer impacts
6i. Comments:
Page 6 of 11
PCN Form -Version 1.3 December 10, 2008 Version
D. I Impact Justification and Mitigation
1. 1 Avoidance and Minimization
1a: Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
Replacement of previous pipe with pipe of lesser or same length. Rock ladder construction to facilitate some aquatic passage.
1 bi Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
tai. 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 mitigat ion option will be used for this
project? El Mitigation bank

? Payment to in-lieu fee program
? Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3al
i . Name of Mitigation Bank:
3bi. Credits Purchased (attach receipt and letter) Type Quantity
3c. Comments:
i
4. 1 Complete if Making a Payment to In-lieu Fee Program
4a Approval letter from in-lieu fee program is attached. ? Yes
4b. 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.1 Non-riparian wetland mitigation requested: acres
4g: Coastal (tidal) wetland mitigation requested: acres
4h. Comments:
5.1 Complete if Using a Permittee Responsible Mitigation Plan
5al 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
61b. 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.I Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. I Diffuse Flow Plan
1al. Does the project include or is it adjacent to protected riparian buffers identified ? Yes ® No
within one of the NC Riparian Buffer Protection Rules?
1 b
. If yes, then is a diffuse flow plan included? If no, explain why.
? Yes ? No
j Comments:
2.1 Stormwater Management Plan
2aI What is the overall percent imperviousness of this project? 0%
2bi. 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. (Implementation, management, and inspection of erosion control devices and control of
discharge sources lie. construction equipment).
I
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
3.1 Certified Local Government Stormwater Review
3ai In which local government's jurisdiction is this project? NA
? Phase II
36 . Which of the following locally-implemented stormwater management programs ? NSW
? USMP
apply (check all that apply): ? Water Supply Watershed
? Other:
3ci Has the approved Stormwater Management Plan with proof of approval been ? Yes ? No
attached?
4.1 DWQ Stormwater Program Review
I
? Coastal counties

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Whi
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(check all that apply): ? Session Law 2006-246
? Other:
4b1. Has the approved Stormwater Management Plan with proof of approval been
I attached? ? Yes ? No
5.1 DWQ 401 Unit Stormwater Review
5a I . Does the Stormwater Management Plan meet the appropriate requirements? ® Yes ? No
5G. 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: NA
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): Pipe collapsed as
a result of high streamflow event. Pipe is located on a residential dead-end road, therefore, the pipe replacement
commenced immediately to restore accessibility.
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 a minimum criteria 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. I Endangered Species and Designated Critical Habitat (Corps Requirement)
5ai Will this project occur in or near an area with federally protected species or ? Yes No
habitat?
5b! Have you checked with the USFWS concerning Endangered Species Act ? Yes ®No
impacts?

5c?
If yes, ind icate the USFWS Field Office you have contacted. ? Raleigh

? 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. 1 Essential Fish Habitat (Corps Requirement)
6a ! Will this project occur in or near an area designated as essential fish habitat?
I ? Yes ®No
I
6b ? What data sources did you use to determine whether your site would impact Essential Fish Habitat?
I No salt marshes, oyster reefs, or seagrass beds in the vicinity of the project.
7.1 Historic or Prehistoric Cultural Resources (Corps Requirement)
7ai. 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)?
I
7bi 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 were reviewed for historic
sites in the vicinity of the project, however, the pipe replacement project occurs within a previously impacted area
(NCDOT Right of Way).
8.IFlood Zone Designation (Corps Requirement)
8ai. Will this project occur in a FEMA-designated 100-year floodplain?
I ? Yes ® No
8L. If yes, explain how project meets FEMA requirements:
I
8ci. What source(s) did you use to make the floodplain determination? FEMA FIRM panal number: 3710480000K
I
M. L- 14o (d?-- o / "'Vw,
Applicant/Agent's Printed Name Applicant/Agent's Signature Date
(Agent's signature is valid only 6 an authorization letter from the applicant
is provided.)
Page 11 of 11
PCN Form - Version 1.3 December 10, 2008 Version
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Name: CENTRAL Location: 035.9363757° N 080.9638048° W
Date: 11/1/2010 Caption: Emergency Pipe Replacement, SR 1901 (Ralph Road), UT to
Scale: 1 inch equals 1000 feet Little Rocky Creek, Class C Waters, Yadkin River Basin
NC Department of Transportation SUBJECT - AL7PO fZnA D PROJECT /olZB
Division of Highways
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Emergency Pipe
SR 1901, Ralph
Iredell County
Replacement
Road
Inlet
Downstream
NCDOT
HAZARDOUS SPILL BASIN CHECKLIST
Division: I County: trPr1P11 Project ID: 12.204921
River Basin: Yadkin Bridge No: NA
Route: SR 1901 Stream: Ut to Little Rocky Creek
Water Quality Criteria:
Yes No
Stream Crossing Blue Line On USGS r r
ORW F W
WSI r r
WS 11,111 OR IV, Crossing Within 0.5mi of W.S. Critical Area r r
Roadway Criteria:
Route Designation-
Yes No
Arterial Urban r rr
Arterial Rural r r
Additional Site Information:
Yes No
Is a Hazardous Spill Basin Required? F
Criteria Based Upon NCDOT "Best Management Practices for the
Protection of Surface Waters" (March, 1997).