20110580 Ver 1_Application_20110617

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STATE OF NORTH CAROLINA
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DEPARTMENT OF TRANSPORTATION ~~q~R
BEVERLY EAVES PERDUE
GOVERNOR
June 13, 2011
Ms. Amy Euliss
NC DENR Division of Water Quality
585 Waughtown Street
Winston-Salem, NC 27107
Mr. Andrew Williams
US Army Corps of Engineers
6508 Falls of the Neuse Suite 120
Raleigh, NC 27615814
(Two Copies)
Subject: Guilford County, US 421, 0.2 miles south of Company Mill Road
Project Number # 7B.104111
To Whom I[ May Concern:
H
EUGENE A. CONTI, JR.
3ECREraRY
I1~~~~
The North Carolina Department of Transportation (NCDOT) proposes to remove a broken wingwall, drive
sheetpiles and place Class II riprap in the stream to improve severely perched downstream end of an
existing culvert in Guilford County. The proposed work is necessary in order to stop severe scouring at the
end of the culvert and therefore maintain the structural integrity of the culvert and ultimately improve the
roadway. This activity will result in permanent impacts to an UT of Big Alamance Creek. The NCDOT
anticipates that the activity will be authorized under Nationwide Permit (NWP) 14. This application is
intended as a request for written authorization from the US Army Coppe of Engineers for the Nationwide 14.
This package is also being forwarded to the NC Division of Water Quality for authorization as prescribed
under General Water Quality Certification 3820. Although the project falls within the Jordan Lake
watershed, all work involving buffered area is proposed to be within the existing transportation facility. The
following information is being provided to satisfy conditions of the Nationwide Permit and General Water
Quality Certification.
P.O. Box 14996 Greensboro, NC 27415-4996 Telephone No. [phone] Fax No. [phone]

PROJECT INFORMATION
Road Name Stream Project Length
miles Classification
US 421 South L1T to Bi Alamance Creek N/A Subdivision
River Basin: DWQ
ID Water Quality
Desi lion % Impervious Surface
Cape Fear 16-19- (1) WS-IV; NSW N/A
Buffer Rules ~ Buffer Rule Conditions (where applicable)
Yes Jordan Lake Buffer
Protected Species Presentb Mapped Historic
Pro erties` CAMA
AEC Essential Fishery Habitat
No No No No
° Separate documentation attached as needed: ° See the attached Endangered Species Review Sheet for further information: `When
Appligble -See the attached Historic Review Letter for further information
CULVERT REPAIR
Site Station N/A Stream T Perennial
Existing Stream 5-8 feet Proposed 5~8 feet
Width Stream Width
Constmction Remove broken wingwall, drive sheetpiles to Dewatering N/A
Method replace vuingwall and place Class II riprap in Device'
stream to alleviate scouring from seventy
perohed culvert . No equipment is proposed
to be in the stream.
Burial Depth N/A E/C Plan WA
Date
Construction As soon as practicable Duration One week
Date
Im cts ft. ximatel 10 linear feet of rmanent stream im cts.
Special
Conditions
Restoration Plan Within 75 working days of the project completion any disturbed area adjacent to the stream will be
restored and seeded.
RCP = reinfonred concrete pipe; CMP =Corrugated metal pipe; CMPA = Conugated metal pipe arch; E/C =Erosion control. 'A less inwsive
dewatering device maybe used in lieu of the one proposed.

MINIMIZATION INFORMATION
Impacts will be miahnized by strict enforcement of Beat biaaagemeat Practices for the protection of
surface waters and wetlands, restrletions against the staging of equipment is or adjacent to waters of
the US, end coordiaatioa (iaclndhsg a pre-coastractioa meeting( with the Division Environmental
Officer.
MITIGATION INFORMATION
Stream mitigation is not aaticipatsd, as the impacts to any iadividnal stream do not exceed 130 feet
Wetland mitigation is not aatiMpated, as wetland impacts do not exceed 0.10 acres and do not occur
in a naigne natural wetland.
APPLICATION INFORMATION
Enclosed please fiord the Pre-coastractioa Notification Form and snpportiag docnmoatatioa for the
above referenced project. If yon have any questions or seed any additional information, please
contact Jerry Parker at [phone]. Yonr Limo and effort are appreciated.
Sincerely,
~~,~~~~
J.M. Mills, P.E.
Division Engineer, Division 7
Enclosures
CC: Jeremy Warren, Bridge Maintenance NCDOT
Barry Harrington, NCDOT
Paul Ingram, NCDOT
NC DENR DWQ Wetlands/401 unit (Six copies)

O20FyW~jAT~F9OG
>_ 1 L-!wv~
O ~ T
Office Use Only:
Corps action ID no.
DWO project no.
Fonn Version 1.3 Dec 10 2008
Pre-Construction Notification PCN Form
A. A licant Information
1. Processing
1 a. Type(s) of approval sough from the
Corps:
®Section 404 Permit ^ Section 10 Permit
1 b. Specify Nafiomvide Permit (NWP) number: 14 or General Permit (GP) number:
1 c. Has the NWP or GP number been verified by the Corps? ^ 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
1 e. Is this notification solely for the record
because written approval is not required? For the record only for DWO 401
Certification:
^ Yes ®No For ttie record only for Corps PermR:

^ Yes ®No
1 f. Is payment into a mfigation 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
1 h. Is the project located within a NC DCM Area of Envrconmental Concern (AEC)? ^ Yes ®No
2. Project Information
2a. Name of project: US 421 (0.2 miles south of Company Mill Road)
2b. County: Guilford
2c. Nearest municipality /town: Greensboro
2d. Subdivision name: N/A
2e. NCDOT only, T.I.P. or state
project no: WBS # 78.104111
3. Owner Information
3a. Name(s) on Recorded Deed:
3b. 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: J. M. Mills
4c. Business name
(if applicable): Division Engineer NCDOT Division Seven
4d. Street address: P.O. Box 14996
4e. City, state, zip: Greensboro, NC 27415
4f. Telephone no.: 336 334-3297
4g. Fax no.:
4h. Email address:
5. AgeM/Consultant Irdortnation (if applicable)
5a. Name: Jerry Parker
5b. Business name
(if applicable): Division Environmerrtal Supervisor
Sc. Street address: P.O. Box 14996
Sd. City, state, zip: Greensboro, NC 27415
5e. Telephone no.: 336 256-2063
Sf. Fax no.:
5g. Email address:
Page 2 of 11
PCN Form -Version 1.3 December 10, 2008 Version

B. Project Information and Prior Project History
1. Property Went cation
1 a. Property identification no. (tax PIN or parcel ID): N/A
Latitude: 35.9606736 N Longitude: -
1b. Site coordinates (in decimal degrees): 79.6666997805W
(DD.DDDDDD} (-DD.DDDDDD)
1 c. Property size: N!A acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to UT to Big Alamance Creek
proposed project:
2b. Water Quality Classification of nearest receiving water: WS-IV; 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:
Rural residential
3b. List the total estimated acreage of all existing wetlands on the property:
0
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
N/A
3d. Explain the purpose of the proposed project:
Remove broken wingwall on the downstream side of culvert and replace with sheetpiles and place Class II riprap in
stream to act as a dissipation pad for severely perched culvert. Backfill behind proposed sheet piles.
3e. Describe the overall project in detail, including the type of equipment to be used:
The site will be de-watered, broken wingwall will be removed, sheetpiles will be installed in location of broken wingwall
and then riprap will be added to stream bed in existing blowhole. Backhoe, trackhoe and excavator will be utilized during
the project. No equipment is proposed to be in the stream.
4. 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: '
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.
5. Project History
5a. Have permits or certifications been requested or obtained for ~ yes ®No ^ Unknown
this project (including all prior phases) in the past?
5b. If yes, explain in detal according to "help file" instructions.
Page 3 of 11
PCN Fonn -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 Fotm -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
Permanerrt (P) or (if known) DWQ -non-404, other) (acres)
Tem ora
Wi ^ P ^ T ^ Yes ^ Corps
^ No ^ DWO
W2 ^ P ^ T ^ Yes ^ Corps.
^ No ^ DWO
W3 ^ P ^ T ^ Yes ^ Corps
^ No ^DWQ
W4 ^ P ^ T ^ Yes ^ Corps
^ No ^ DWO
WS ^ P ^ T ^ Yes ^ Corps
^ No ^ DWO
W6 ^ P ^ T ^ Yes ^ Corps
® No ^ DWO
2g. Total wetland impacts
2h. Comments:
3. Strream Impacts
If there are perennial or irrtermittent stream impacts (including temporary impacts) proposed on the sde, 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 ofjurisdiction Average Impact
number - (PER) or (Corps - 404, 10 stream length
Permanent (P) or intermittent DWO - non~04, width (linear
Temporary (T) (INT)? other) (feet) feet)
St ®P ^ T Riprap in stream UT to Big
Alamance Creek ®PER
^INT ®Corps
®DWQ g_10 ftft 10 feet
S2 ^ P ^ T ^PER ^ Corps
^ INT ^ DWO
S3 ^ P ^ T ^PER ^ Corps
^ INT ^DWQ
S4 ^ P ^ T ^PER ^ Corps
^ INT ^DWQ
SS ^ P ^ T ^PER ^ Corps
^ INT ^ DWO
S6 ^ P ^ T ^PER ^ Corps
^ INT ^ DWO
3h Total stream and tributary impacts 10 feet
3i. 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- ('rf applicable) Type of impact Waterbody type Area of impact (acres)
Permanent (P) or
Tem ora
Ot ^P^T
02 ^P^T
03 ^P^T
04 ^P^T
4f. Total open water impacts
4g. CommeMs:
5. Pond or Lake Construction
If and or lake construction ra osed, then com lete the chart below.
Sa. 5b. 5c. Sd. Se.
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
Sf. Total
5g. Commerris:
Sh. Is a dam high hazard permit required?
^ Yes ^ No If yes, permit ID no:
5i. Expected pond surface area (acres):
Sj. Size of pond watershed (acres):
Sk. Method of construction:
6. Buffer Impacts (for DWG)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individualy list all buffer impacts
below. If an im acts re uire miff ation, then ou MUST fill out Section D of this form.
6a.
^ Neuse ^Tar-Pamlico ®Other: Jordan
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)
Tem ora T im act re wired?
B1 ^P®T ^Yes
^ No
62 ^P^T ^Yes
^ No
B3 ^P^T ^Yes
^ No
6h Total buffer impacts
6i. Comments:
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PCN Forth -Version 1.3 December 10, 2008 Version

D. Impact Justification and Mitigation
t. Avoidance and Minimization
1 a. Specifically describe measures taken to avoid or minimze the proposed impacts in designing project.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Z. 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 mfigation 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. Compkyte 'd 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 mfigation, 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 "rf Using a Permittee Responsible Mitigation Plan
Sa. 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, 20013 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 mtigaton
(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 Fonn -Version 1.3 December 10, 2008 Version

E. Stormwater Management and Diffuse Fbw Plan (required by DWQ)
1. Diffuse Fbw Plan
1 a. 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 inducted? If no, explain why.
Comments: Impacts in the buffer will be temporary and quaky for an exemption as ^ Yes ®No
described in 15 NCAC 028.0267 (g)
2. Stormwater Mana emeM Plan
2a. What is the overall percent imperviousness of this project? N/A
2b. Does this project require a Stormwater Management Plan? ^ Yes ®Nc
2c. If this project DOES NOT require a Stormwater Management Plan, explain why: No i ncreased permanent impervious
coverage is anticipated. Therefore, Stormwater flow will not increase.
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 fhe review of the Stormwater Management Plan? ®DWQ Stormwater Program
^ DWQ 401 Unit
3. Certified Local Govemmerrt Stormwater Review
3a. In which local governments jurisdiction is this project? N/A
^ 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 P ram Review
^ Coastal counties
^ HOW
4a. Which of the following state-implemented Stormwater management programs apply ^ ORW
(check all that apply): ^ Session !mow 2006-246
^ Other:
4b. Has the approved Stornwater 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
Page 9 of 11
PCN Forn -Version 1.3 December 10, 2008 Version

F. Supplementary Information
t. Environmental DocumerMation (DWQ Requirement)
1 a. Does the project involve an expenditure of public (federaUstate/IocaQ funds or the ®Yes ^ No
use of public (federaUstate) land?
1 b. If you answered 'yes" to the above, does the project require preparation of an
environmerdal document pursuant to the requiremerds 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:
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 narative description.
4. Sewage Disposal (DWQ Requirement)
4a . Clearly detail the ultimate treatment methods and disposfion (non-discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility.
NA
Page 10 of 11
PCN Fortn -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?
5b. Have you checked with the USFWS concerning Endangered Species Act ^ Yes ®No
impacts?

Sc. If yes, indicate 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?
US Fish and Wildlife Web Site
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?
N/A
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 Historic Register Web Site
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain? ^ Yes ®No
Hb. If yes, e~lain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination? NC Floodplain Mapping Information System
J.M. Mills /~~~/~~~,t~j~dr~ 6-13-11
ApplicanUAgerrt's Printed Name V ApplicanUAgent's Signature Date
(Agenrs signature s valid onty 'rf an authorization letter from the appliprrt
S ravided.
Page 11 of 11
PCN Forth -Version 1.3 December 10, 2008 Version

N.C. D.O.T.
BRIDGE MAINT. DEPT.
EROSION CONTROL SEQUENCE
COUNTY Guilford
PIPE NO. 2044
S.R. No. US421 South
LOCATION: 0.2mi South of SrpS394~omoenv MIII Rd. LA7. 36a7J7.0 LONG.79~17fi8
Br. No. NA
PROJECT No. 76.104111
DESCRIPTION: Remove broken wingwall on the downstream end of culvert.Drive sheet piles to replace the
wingwall.Place Claesll rip rap to improve the perohed downstream end of the culvert.
Note:
All Erosion Control devices 8 proper installation plus maintenance of erosion control will be performed
by using - NCDOT Best Management Practices for Construction and Maintenance Activates Manual
1 Using filter fabric and sandbags place a cofferdam across downstream end of creek.
2 Pump water from affected area into a slk bag
3 Remove the broken wingwall using the excavator.
4 Drive approximately 18' of sheet piling to replace the wingwall on the culvert.
5 Backfill the erosion hole behind sheet piles with ABC and dirt.
8 Place Class B rip rap behind sheet piles as needed.
7 Place Clasail rip rap in the perched area downstream from the culvert.
8 Remove sand bags from stream.
9 Seed and mulch as naeded.Place silt fence ae needed.
APPROXIMATE PROJECT START DATE NA
PREPARED BY _ Alan Levens TSIII
APPROVAL
TRANSPORTATION SUPERVISOR III
DATE 4/28/2011
DATE
DIV. BRIDGE ENG. DATE

couNr~r Guilford
S.R. No. US 421 south
BRIDGE No NA
SEQUENCEI
1 Using filter fabric and sandbags place a cofferdam across downstream end of creek.
2 Pump water from affected area Into a slk bag
3 Remove the broken wingwaN using the excavator.
4 Drive approximately 16' of sheet piling to replace the wingwall on the culvert.
5 Backfill the erosion hole behind sheet piles with ABC and dirt.
6 Place Class B rip rap behind sheet piles as needed.
sift bag
LEGENDS
,,
Rubble ' 'y trees ~ .,

couNrr Guilford
S.R. No. US 421
BRIDGE No NA
SEQUENCE2
Place Clasall rip rap In the perched area downstream from the culvert.

LEGENDS
,trees

SEQUENCE 3
couNTV cuiHord
PIPE NO. 2044
S.R. No. US421
SEQUENCES
8 Remove sand bags from stream.
9 Seed and mulch as needed.Place slit fence as needed.

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US 421 (0.2 miles south of Company Mill Road) Outlet end with broken wingwall