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Home My WebLink About20110423 Ver 1_401 Application_20110511r City of Greensboro North Carolina Lf ff lf0 01? TPIn-1 ? TO: NC DWQ, 401 WETLANDS UNIT DATE: 2321 CRABTREE BLVD., SUITE 250 PROJECT: RALEIGH, NC 27604 RE: WE ARE SENDING YOU: ® ATTACHED THE FOLLOWING ITEMS: ? SHOP DRAWINGS ? CHANGE ORDER ? UNDER SEPARATE COVER VIA: ? PRINTS ? SPECIFICATIONS ? LETTER ® OTHER 201 10423 Engineering & Inspections APRIL 28, 2011 P04566A BLUFORD PARK TRAIL CONNECTOR 4 COPIES DATE REVISION DESCRIPTION 5 4/27/2011 PRE-CONSTRUCTION NOTIFICATION APPLICATION 2 4/27/2011 EASTWOOD AVE. SIDEWALK CONNECTOR CONSTRUCTION DRAWINGS 2 4/27/2011 EASTWOOD AVE. SIDEWALK CONNECTOR BUFFER IMPACT EXHIBIT THESE ARE TRANSMITTED AS CHECKED BELOW: ® FOR APPROVAL ? APPROVED AS SUBMITTED ? APPROVED AS NOTED ? FOR YOUR USE ? AS REQUESTED ? RETURNED FOR CORRECTIONS ? FOR REVIEW ? RESUBMITTED ? RETURNED AFTER LOAN ? FOR DISTRIBUTION ? OTHER COMMENTS: PRE-CONSTRUCTION NOTIFICATION FOR JORDAN LAKE BUFFER AUTHORIZATION. COPY TO SUE HOMEWOOD. FILE PO Box 3136 Greensboro, NC 27402-3136 > www.greensboro-nc.gov , 336-373-CITY (2489) , TTY # 333-6930 SIGNED GUY INGLE. DESIGN ENGINEER I City of Greensboro I North Carolina April 29, 2011 N.C. Division of Water Quality 401 Wetlands Unit 2321 Crabtree Blvd., Suite 250 Raleigh, NC 27604 Engineering & Inspections Subject: Pre-Construction Notification Jordan Lake Water Supply Watershed Buffer Authorization Eastwood Avenue Sidewalk Connector for the Bluford Park Trail Greensboro, NC The City of Greensboro is submitting the attached Pre-Construction Notification (PCN) form with supplemental and supporting documentation to request the issuance of a Buffer Authorization for encroachment into the riparian buffers of an unnamed tributary of South Buffalo Creek, DWQ Stream Index 16-11-14-2, designated by FEMA as South Buffalo Creek Tributary 6. Due to the nature of this type of project, avoidance of impacts is not entirely possible. Impacts have, however, been minimized as much as practical while adhering to the requirements of the Americans with Disabilities Act and Federal Highways Administration guidance for the accommodation of pedestrians within street right-of-way. This project involves the installation of approximately 490 linear feet of 5 foot wide concrete sidewalk along the existing shoulder of Eastwood Avenue, and connecting to an existing trail in Bluford Park. The purpose of the sidewalk is to provide pedestrian access to the park trail system. The sidewalk was originally requested by the City's Parks and Recreation Department to be constructed as a 10 foot wide trail, which was subsequently reduced to 5 feet in width due to the implementation of the Jordan Lake Water Supply Watershed Protection Rules. The portion of the sidewalk along Eastwood Avenue has been designed to slope toward the street to ensure diffuse flow is maintained within the buffer being impacted parallel to the street. The sidewalk will then gradually transition as it leaves the street to a flat grade as it extends down the hill to connect to the existing Bluford Park Trail. P.O. Box 3136 • Greensboro, NC 27402-3136 • www.greensboro-nc.gov • (336) 373-2302 • (336) 373-CITY (2489) • TTY # 333-6930 E15045 There are no other impacts to jurisdictional streams or wetlands associated with this project. Sedimentation of the stream will be minimized to the maximum extent practicable by strict implementation of, and compliance with, a State approved sediment and erosion control plan. Erosion and sediment control measures will be inspected for compliance weekly and after each significant rain event for function, possible repairs or modification to ensure the device is operating as intended. We appreciate your prompt attention to this matter. Any questions or requests for additional information concerning this project may be directed to the Project Engineer, Bruce Overman, at (336) 373-2100. Sincerely, Guy Ingle, esign Iggine/er Engineering Division 1 1 1 EASTWOOD AVENUE SIDEWALK CONNECTOR FOR THE BLUFORD PARK TRAIL 1 1 PRE-CONSTRUCTION NOTIFICATION ? FOR BUFFER ENCROACHMENT 1 1 1 z? 1 / ?.. 3AV 331 '1S A` Nino 1 0 J a a J ? R ST ST ? HO OF ? as = Q c $ o 7 ' Q Z O W a2! MO-1"11M J a W Q s ao ?o H z? U Q >? b 1S N103I41-1 13113 ?S S?i00H O?y U, y3O NN1/3Ad NOllavo L 3Ad 321omm JO tea. J?? *e J cy 50 O lS,? Ohs ? 'ilk s r yy N ? c N p u tD O?y 4O 00 ?O W Y 7Q 0 a Oj v Print Preview Guilford County, NC Page 1 of 1 Old Parcel Number 000002170000200021 Condo Book Parcel Number 0023439 Condo Page PIN 7873671294 Total Assessed Value $0 Owner Name CITY OF GREENSBORO Total Building Value $0 Mailing Address 1 PO BOX 3136 Total Out Building Value $0 Mailing Address City GREENSBORO Total Land Value $63,200 Mailing Address State NC Total Deferred Value $0 Mailing Address Zip 27402 Building Count Property Address 2300 OPEN BOTHWELL ST Building Number Legal Desc 1 Sot # 8.42 AC BLUFORD PK BOTHWELL Year Built Land Units 8.4200 Heated Area Deed Book Bedrooms Deed Page Bathrooms Plat Book Use Code GOVERNMENT OWNED I Plat Page Appraisal Model Code Disclaimer: While every effort is made to keep information provided over the internet accurate and up-to-date, Guilford County does not certify the authenticity or accuracy of Map Scale such information. 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CONTRACT SHEET OF ~ ~ ~ ~ 1:x,3 ~r'; l7 f~~_1G + 'u ~ t). - ~ ~ _ ~"~r B~ ~ 100 YEAR ~ a ~ '1 ~ FLOODPLAIN ° ° N• C BOUNDARY ~ ~ ~:7. - RT ~ ~ } jl 11 RE'M ON-ENCROACH ~ . 0 I i A N MEN w o N Nq I, it 1 r T q qo °a RFq N B~ O B~ o ~ it l I wr. SOUTH - .r------'`''~ FqL EK TRIBUTq -m.... ° I / 0 CaE RY o ] ~ l 11 . ~ o f . 6 ( ~ STONE OUTLET WITH wo ~ EXCAVATED 2 .x4 TRAP . JN w ~ / EXISTING WOODEN r FE CHMEN T MA NON-EI~ROA q~EA i 1 BRIDGE roe rah--•- Q r ~l t ~ i iJ 1 . -~'INV 710.33 Tae w T CO OL LOG S S S ~ ' ~ ZONE B 1 v~i ~ ~j 11 ~``'"`-roe 00 ~~r o e S S S ~ • B1 55 PROP. SILT FENCE PROP,ISILT FENCE ~ ~o' BUFF~q ZONE B3 ;f PROP.. SILT FENCE f ; ZQNE B3 30 ~ . . r o e-~-._..._._/ Ix 1 ~ ~ SUFFER BEGIN SIDEWALK ° .:;~~°~ti~:~: ~ it 1 STA. ~~°75.65 r 5a°®F F ..~..W;.. . • ~ , ® gel i e ~5 GN ~G~e~® it 1 PZ~ 5 IDEWALK ~P WSFTS ~ ~ _ ~o • NE :BALK 30' BtIFFEA ~~i it ~ a~ ~ - - -D-e - 4 BUFFS ~ ,s-ZONE B1 R 50 ° 6UFFER UFFER ZONE 8i ZONE B2 jl 1 r ~ . , ZONE B - ZO E B3 ~ 1° ti5,.r pEWALK ZONE B4 ~ 5 FT SI ~ ~ ZONE B3 NEW - ® p ~ - app t~ 1 -°-TIE TO EXISTING p a9 s,, ~ 1 SIDEWALK STA. 6+69.34 ® ZONE B4 _ ~ ~ it e ill ,e•, ~o ~ ~ ~ ~ ~ A G,~ i ~~1 / ~ 099 ! 11 ® I ~ it l i 1 it .l / ~ 11 i 1 i il1 / PP / 1a® 0 i ,l1 v~ r o TEAR FLOODPLq 0 i it ~ xN i il1 a i it i i i ii l d 11 1 - - i ~ll 1 i~ 11 i 1 it r 1 1 11 l 1 1 i il1 I 1 1 ill 1 t 1 ~ ~ f~ TT A T T~ ; O W O O R05ETTA RD o 3 J F ~ BUFFER IMPACT B1 BUFFER IMPACT W TEMPORARY IMPACT TEMPORARY IMP, ER IMPACT B3 'ORARY IMPACT a IN ZONE 1 ONE 2 Eu.ST TN ZONE 2 BO'f4~w 2405 5F TOTAL 2006 SF TOTAL Fy SF TOTAL ~A oA aE BUFFER IMPACT B2 BUFFER IMPACT ,R IMPACT B4 EoMONO ~ PERMANENT IMPACT PERMANENT IMPA ~py.~a IN ZONE 1 IN ZONE 2 ANENT IMPACT aNE ~ 846 SF TOTAL F OTAL PROJECT P-4566A 849 S T 3F TOTAL a Mummy tiN n J M I-AO W /BUS 85 S , I-40 E ! BU5 85 N ,ako~t§ aia8g6r.~~~ A o 4),. .,w~~ ~ iJ~ u f5 w A ti tl ~,,,p 2pp"~ I ~~,Pp s,~f~~'~iP~pBlt~ ^ 1.~. ` ~ o r A --w~wre man= REVISIONS TYPE CONTRACT CONTRACTOR AS-BUILT AUT . DATE S :*D ATE BENCH MARKS JOB NO. P -4566A CffY OF GREENSBORO ROADWAY DESIGNED BY BHO ENGINEERING DMSION SEWER DETAILED BY BS SHEET NO. WATER CHECKED BY OF 2007 SCALE 1" =30' EXISTING BLUFORD PARK TRAIL TO BOTHWELL STREET SIDEWALK 2010-021 1/29/2007 21142 CONTRACT SHEET ti, OF .t ~r ~ It r n GENERAL NOTES ~ !00 YEAR o ` !i 1 FLOODPLAIN o N,C ~ Id 1 60UNDARY ~ ~ cRZO a d di d 1. WALKING TRAIL TO BE CONSTRUCTED BASED DN TYPIGAL ! ~.F~fA Nppi ENCR0AC1•yyE~~, o ' Nq li 1 I AAE Q 6 d i _^___.__~..I wn 3 o d 1 d 2. PROVIDESGROUND COVEREONLEXPOSED SLOPES WITHIN 21 ~ ~A~ ~ ~ ?0~ m I ~ / . ---•-•.r,~ SOUTH @~F~ ~ ~ 0 1 d( d o I ~\LO CREEK TRISUTgAy. /d i CALENDAR GAYS FOLLDWING COMPLETION OF ANY PHASE ~r ~R® 1 OF GRADING AND PERMANENT GRDUND COVER FOR ALL ~q~~ ~ I STONE OUTLET WITH w d d 1 DISTURBED AREAS WITHIN 15 WORKING DAYS OR 30 > • / I EXCAVATED 2' xA' TRAP ' ' ° ~ dd 1 w o I ' i ~ CALENDAR DAYS FOLLOWING COMPLETION OF CONSTRUCTION ~ DR DEVELOPMENT, 0~ N TING WOODEN r F CyMEN T ~ . d i . wr ~ ERIS EMA NON-•ENCROA SEA ~ d II d w SAID&E roe og- ® ~ d di d i" INV 710.33 roe ~ d i 3. THE DISTURBED LIMIT5 ARE LINES PARALLEL TO AND 3° ~ roe - SEDIMENT CO L LOG ~ SS d 9d d OUTSIDE OF THE CUT/FILL LINES ON EACH SIDE OF THE "`'--roe- ~ TRAIL. ~°0 ~ 5 PROP. SILT FENCE roa SS"' SS --~-d~ P ILT FENCE ~ ~ 6 3 BUFF F N lu~d i PRO ,?'S 1 EA PROP. SILT E CE roa~_./' ~ d 4. THE BOARDWALK ANO BRIDGE ARE TO BE CONSTRUCTED BY THE CITY OF GREENSBORO PARKS ANO RECREATION a ~ 30 • _ _ -F - - 'nn,~,~,,- dwd li i BUFF "~'?'V~ LK ~ ER - - -fF F--F_ f~ dd I DEPARTMENT. FUNDING WILL BE PROVIDED BY TH!E CITY ~ BEGIN SIDEWA / ~ ~ ~ i STA. 1+75. fi5 C, 50 ° _ ®s dd d OF GREENSBORO ~ ~ ~ ~ _ 3 sN Q a li 1 5. THE GRADE OF THE TRAIL AT .THE BEGINNING AND END OF Qat,~ C' ; g~¢F - EW 5 FT gIDEW d ~ _ - 4 5°' BUFF N v dd ! THE BOARDWALK AND BRIDGE ARE TO BE COORDINATED WITH THE CITY OF GREENSBORO PARKS ANA RECREATION DEPARTMENT, CONTACT MIKE SIMPSON AT (336) 373-3812. ~'Q{rDiGt r g r-° WALK vo • 1( 1 z5,s FT SIDE _ ,~BUF ACT ~pp i N - ® ~ O EXISTING °m' ~ TIE T ' ® 1 ® os I I EXISTING o ~ d , ® ~ p ~ , i SIDEWALK STA. 6+69 1LK STA. 6+69.34 C6t,/ ®t' 0 ua~ts ® IN 1 ® a ~ d' COG Water c 73-2033 p Id i ® Gy d d Oq 1 d d GDOT Traf 73-8646 9~p di d COG/Guild 73-2084 COG Nat r 73-5859 ® ® i! 1 I ~ Tanks r ® / d 1i I GDOT St 73-8569 / ® d di d ~ d dd d NPR dd ! / . / .ip0 ~~0 I 1 DPL 80 d Pd 1 / PEAR FL00 q~• di i d d d d Id i S d 1 d 1 r I ~rnnlt d d d 9 d 1( 1 d ( i d If plies li i d d g d dd g ~ dd d t d d d dd ~ 9 dd l 4 d IT I? d r i 1 1 a eras VARIABLE 1' 5 i' 5' 5' 3' CIS DISC ER 1' S' 1 J~ 1 ~G ~ this map shown with a dotted 4 G ~pT T e were not , they were 4X V 4~ 2 c a% z% Fti~ % T-~ 4x ~ ~ ion the Geograpt~c , GT z% 3• ~ F~ va~Iae~E . ti A% F 3 1 3. ~ 1 on Sy~1em ~ ti~'~ T<< 4.' CQNCRETE - ~ F 4" CONCRETE 4" CONCRETE by$pteC~fyofG , 3, 4" CONCRETE TYPICAL SECTION TYf TYPICAL SECTION TYPICAL SECTION STA. 2+60 - 3+00 STA STA, 3+00 - 6+69 STA: 1+76 - 2+60 ~ c i i - c t t ®®,1{{{illftPtjj~~ ~ max yr . ~ SEAL ~ 23032 ' CONTRACT CONTRACTOR AS-BUILT AUTH. DATE REVISIONS rSEWER F TH. DATE BENCH MARKS JOB NO. P -4566A Cff)(OF GREENSBORO DESIGNED BY BHO ENGINEERING I CONST. SURVEY BY BS KASIWOOD AVE. SIDEWALK r SHEET NO. CHECKED BY FOR nM BLUMRD PARK IML ; OF 29/2007 K 2010-027 1/ /29/2007 SCALE: 1" = 40' EXISTING BLUFORD PARK TRAIL TO BOTHWELL STREET 20110.423 t Cc °? warF9Q d p r d 2()114423 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 1a. Type(s) of approval sought from the Corps N/A El Section 404 Permit El Section 10 Permit 1b. Specify Nationwide Permit (NWP) number: N/A or General Permit (GP) number: 1c. Has the NWP or GP number been verified by the Corps? N/A ? Yes ? No 1 d. 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 ? No 1 g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h below. ? Yes ® No 1h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ? Yes ® No 2. Project Information 2a. Name of project: Eastwood Avenue Sidewalk Connector for the Bluford Park Trail 2b. County: Guilford 2c. Nearest municipality / town: Greensboro 2d. Subdivision name: N/A 2e. NCDOT only, T.I.P. or state project no: N/A l" 3. Owner Information r' 4 2f) 11 17,7 3a. Name(s) on Recorded Deed: City of Greensboro 4t 4r- , 3b. Deed Book and Page No. N/A LR 3c. Responsible Party (for LLC if applicable): N/A 3d. Street address: P.O. Box 3136 (300 West Washington St) 3e. City, state, zip: Greensboro, NC 27402 3f. Telephone no.: 336-373-2100 3g. Fax no.: 336-373-2338 3h. Email address: Bruce.Overman@greensboro-nc.gov 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: 4c. Business name (if applicable): 4d. Street address: 4e. City, state, zip: 4f. Telephone no.: 4g. Fax no.: 4h. Email address: 5. Agent/Consultant Information (if applicable) 5a. Name: 5b. Business name (if applicable): 5c. Street address: 5d. City, state, zip: 5e. Telephone no.: 5f. Fax no.: 5g. Email address: E 1 1 0 Page 2 of 11 PCN Form - Version 1.3 December 10, 2008 Version ' 1 1 1 1 u B. Project Information and Prior Project History 1. Property Identification 1a. Property identification no. (tax PIN or parcel ID): 00-00-217-0-0002-00-021 Latitude: 36.049211 Longitude: - 1b. Site coordinates (in decimal degrees): 79.758462 (DD.DDDDDD) (-DD.DDDDDD) 1 c. Property size: 8.42 acres 2. Surface Waters 2a. Name of nearest body of water (stream, river, etc.) to proposed project: Unnamed Tributary of South Buffalo Creek 2b. Water Quality Classification of nearest receiving water: Class C, NSW 2c. River basin: Cape Fear 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: Site is part of a local city park adjacent to South Buffalo Creek. The area around the sidwalk is a grassy field between the street and an unnamed tributary of South Buffalo Creek 3b. List the total estimated acreage of all existing wetlands on the property: 0.0 3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property: 1890 3d. Explain the purpose of the proposed project Provide connectivity between existing Bluford Park Trail and Bothwell St Sidewalk 3e. Describe the overall project in detail, including the type of equipment to be used: This will be a 5 ft concrete sidewalk mostly beside the existing Eastwood Avenue. Construction equipment to be utilized are backhoe, skidsteer and other heavy equipment. 4. Jurisdictional Determinations 4a. Have jurisdictional wetland or stream determinations by the Corps or State been requested or obtained for this properly / project (including all prior phases) in the past? ? Yes ®No ? Unknown Comments: 4b. If the Corps made the jurisdictional determination, what type ? Preliminary E] Final of determination was made? N/A 4c. If yes, who delineated the jurisdictional areas? Agency/Consultant Company: Name (if known): N/A Other. 4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation. 5. 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. 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 6b. If yes, explain. .Page 4 of 11 PCN Form - Version 1.3 December 10, 2008 Version 1 1 r 1 7 0 1 1 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 N/A 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 W1 ? P ? T ? Yes ? Corps ? 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 2g. Total wetland impacts 0.0 2h. Comments: No wetland impacts associated with this project. 3. Stream Impacts N/A 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 - or (PER) (Corps - 404, 10 stream length Permanent (P) or intermittent DWQ - non-404, width (linear Temporary (T) (INT)? other) (feet) feet) S1 ? P ? T ? PER ? Corps ? INT ? DWQ S2 ? P ? T ? PER ? Corps ? 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 0.0 3i. Comments: No stream impacts associated with this project. Page 5 of 11 PCN Form - Version 1.3 December 10, 2005 Version 4. Open Water Impacts N/A 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. Open water impact number - Permanent (P) or Temporary 4b. Name of waterbody (if applicable) 4c. Type of impact 4d. Waterbody type 4e. Area of impact (acres) 01 ?P?T 02 ?P?T 03 ?P?T 04 ?P?T 4L Total open water impacts 0.0 4g. Comments: No open water impacts associated with this project. 5. Pond or Lake Construction N/A If pond or lake construction proposed, then complete the chart below. 5a. Pond ID 5b. Proposed use or purpose 5c. Wetland Impacts (acres) 5d. Stream Impacts (feet) 5e. Upland (acres) number of pond Flooded Filled Excavated Flooded Filled Excavated Flooded P1 P2 5[ Total. 59. 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: 1 1 n 1 r 1 Page 6 of 11 PCN Form - Version 1.3 December 10, 2008 Version ' 7 1 1 u u 1 1 1 1 1 1 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 any impacts require mitigation, then you MUST fill out Section D of this form. 6a. ? Neuse ?Tar-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? grading 131 ? P ®T & Tributary #6 of South Buffalo ? Yes 2405 erosion Creek ?X No control B2 ®P ? T sidewalk Tributary #6 of South Buffalo ? Yes 846 Creek ® No ?P?T ?Yes ? No 6h. Total buffer impacts 3251 6i. Comments: Project has been designed to minimize impact as much as practically possible D. Impact Justification and Mitigation 1. Avoidance and Minimization 1 a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project. Sidewalk width was minimized to 5 ft and put next to the street with a small, 3 ft grass strip in order to stay as far away from the stream as possible. The portion direclty connecting to the existing trail was also kept as far from the stream as feasible. 1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques. Erosion Control measures as specified will be in place and rigoursly maintained. 2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State 2a. Does the project require Compensatory Mitigation for ? Yes ® No impacts to Waters of the U.S. or Waters of the State? 2b. If yes, mitigation is required by (check all that apply): ? DWQ ? Corps ? Mitigation bank 2c. If yes, which mitigation option will be used for this ? Payment to in-lieu fee program project? ? Permittee Responsible Mitigation 3. Complete if Using a Mitigation Bank 3a. Name of Mitigation Bank: 3b. Credits Purchased (attach receipt and letter) T Type Quantity PAGE 7A OF 11 PCN Form - Version 1.3 December 10, 2008 Version 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 any impacts require mitigation, then you MUST fill out Section D of this form. 6a. ? Neuse ? Tar-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. grading B3 ? P ®T & Tributary #6 of South Buffalo ? Yes 2006 erosion Creek ® No control B4 ®P ? T sidewalk Tributary #6 of South Buffalo ? Yes 849 Creek ® No ?P?T ?Yes ? No 6h. Total buffer impacts 2855 6i. Comments: D. Impact Justification and Mitigation 1. Avoidance and Minimization 1 a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project. Sidewalk width was minimized to 5 ft and put next to the street with a small, 3 ft grass strip in order to stay as far away from the stream as possible. The portion direcity connecting to the existing trail was also kept as far from the stream as feasible. 1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques. Erosion Control measures as specified will be in place and rigoursly maintained. 2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State 2a. Does the project require Compensatory Mitigation for ? Yes ® No impacts to Waters of the U.S. or Waters of the State? 2b. If yes, mitigation is required by (check all that apply): ? DWQ ? Corps ? Mitigation bank 2c. If yes, which mitigation option will be used for this ? payment to in-lieu fee program project? ? Permittee Responsible Mitigation 3. Complete if Using a Mitigation Bank 3a. Name of Mitigation Bank: 3b. Credits Purchased (attach receipt and letter) Type Quantity PAGE 7B OF 11 J J 1 1 1 1 1 1 PCN Form - Version 1.3 December 10, 2008 Version 1 u 1 1 J J 1 I i 1 1 u 1 3c. Comments: 4. 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. Non-riparian wetland mitigation requested: acres 4g. Coastal (tidal) wetland mitigation requested: acres 4h. 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. 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 1 E. Stormwater Management and Diffuse Flow Plan (required by DWQ) 1. Diffuse Flow Plan 1a. 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. Comments: Sidewalk is designed to shed water away from the stream (and toward ? Yes ® No the street's curb) to the maximum extent possible. 2. Stormwater Management Plan 2a. What is the overall percent imperviousness of this project? 0.5% 2b. Does this project require a Stormwater Management Plan? ? Yes ® No 2c. If this project DOES NOT require a Stormwater Management Plan, explain why: No new channelized flow 2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan: ® Certified Local Government 2e. Who will be responsible for the review of the Stormwater Management Plan? ? DWQ Stormwater Program ? DWQ 441 Unit 3. Certified Local Government Stormwater Review 3a. In which local government's jurisdiction is this project? City of Greensboro, NC ® Phase II 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 ? Yes ® No attached? 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 E 1 1 r Page 9 of 11 PCN Form - Version 1.3 December 10, 2008 Version ' 1 r] 1 1 l J 1 1 1 1 1 1 F. Supplementary Information 1. Environmental Documentation (DWQ Requirement) la. Does the project involve an expenditure of public (federallstate/local) funds or the ® Yes ? No use of public (federallstate) 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)? 1 c. 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 ? Yes ® No letter.) Comments: N/A - Project too small 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)? 2b. 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. NIA 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. N/A Page 10 of 11 PCN Form - Version 1.3 December 10, 2008 Version 5. Endangered Species and Designated Critical Habitat "Corps Requiremert) 5a. Will this project occur in or near an area with federally protected species or ? Yes ® No habitat? 5b. Have you checked with the USFWS conceming Endangered Species Act ? Yes ® No impacts? 5c. If yes, indicate the USFWS Feld Office you have contacted. N/A Raleigh ? ? Asheville 5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat? USFWS online 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? USFWS online database 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? National Registry of Historic Places 8. Flout 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: No appreciable change in existing ground elevation 8c. What source(s) did you use to make the floodplain 'determiriation? Flood Insurance Rate Map NC Panel 7873 Bruce H. Overman Jr. , l 7?8G' Applicant[Ageffs Printed Name ApplicantfAgenfs Signat fe Date (Agent's signature is valid only if an authorization letter from the applicant is provided. 1 E 1 1 1 1 u 1 1 1 1 Page 11 of 11 1 PCN Form -Version 1.3 December 10, 2008 Version