20110816 Ver 1_Application_20110831

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Office !Use Only:
Corps 'action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Pi e-Construction Notification (PCIN) Form
A. Applicant Information
1 . Processing '
1a. Type(s) of approval sought from
Corps: non-reporting nationwid the
e permit I
[R Section 404 Permit ? Section 1;0 Permit
I
1b. Specify Nationwide Permit (NW P) number: NWP 3 and NWP 13 or! General Permit (GP) number.
1c. Has the NWP or GP number b n verified by the Corps? ?!Yes
® No
1d. Type(s) of approval sought fro
® 401 Water Quality Certificati
? 401 Water Quality Certificati the DWQ (check all that apply):
on - Regular ? Non-404 Jurisdictional General Permit
on -Express ? Riparian Buffer Authorization
le. Is this notification solely for the
because written approval is not ecord
equired? For the record only for DWQ 401
Certification:
Yes ? No For the record only for Corps Permit:

® Yes ? No
If. Is payment into a mitigation ban
of impacts? If so, attach the acc
fee program. or in-lieu fee program proposed for mitigation
eptance letter from mitigation bank or In-lieu ? Yes ® No
1g . Is the project located in any of
below. C's twenty coastal counties. If yes, answer 1 h ? Yes ® No
1 h . Is the project located within a N DCM Area of Environmental Concern (AEC)? ? Yes ® No
2. Project Information
2a. Name of project: Proposed driveway pipe replacement conveying an' UT to Horse Creek adjacent to
SR 1147 (Holden Road I
2b. County: Franklin
2c. Nearest municipality / town: Louisburg
2d. Subdivision name:
2e. NCDOT only, T.I.P. or state
project no: i
3. Owner Information g;
3a. Name(s) on Recorded Deed: NCDOT Division 5
3b. Deed Book and Page No. G 3 2 99
3c. Responsible Party (for LLC if
applicable):
ERW41gq
3d. Street address: 2612 N. Duke Street
3e. City, state, zip: Durham, NC '27704
3f. Telephone no.: [phone]
3g. Fax no.: [phone]
3h. Email address: wbowman(Dncdot.aov,
!
4. Applicant Information (if differ It from owner) N/A
5. AgentfConsultant Information ( applicable) NIA
Page ) of 9 f
PCN Form , -Version 1.3 December 10, 2008 Version
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B. Project Information and Prio Project History
1. Property identification
1a. Property identification no. (tax IN or parcel ID):
1b. Coordinates (in decimal degree ):
Site: Latitude:36.024585 I Longitude: -78.512916

M (
D .ODDDOD) (-DD. DDDDDD)

Property size:
.
? 0.01 acres
2. Surface Waters
2a. Name of nearest body of water stream, r ver, etc.) to
proposed project: Horse Creek
2b. Water Quality Classification of n earest receiving water: WS-IV NSW
2c. River basin: Neuse I
3. Project Description I
i
3a. Describe the existing conditions on the site and the general land use in the vicinity ofithe project at the time of this
application:
A driveway pipe carrying a jurisdic oval stream is undersized and misali
ned therefore r
lti
i
il
f

slope and shoulder section of SR 1 g
esu
ng
n
a
ure to the adjacent
47. In order to repair this site, the driveway pipe 011 be replaced and better aligned to
direct flow towards the existing cross line.
i
3b. List the total estimated acreage o f all existing wetlands on the property: I
NONE
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
60H
3d. Explain the purpose of the p oposed project: Pipe ends have fallen off. Plan to replace the driveway pipe, which will
facilitate a stable shoulder sectio between the driveway and cross line.
3e. Describe the overall project in d ail, including the type of equipment to be used:
A backhoe and/or excavator will be sed to replace the driveway pipe. Once the driveway pipe is replaced, the ends will be
armored with rip rap underlined with lack fabric. Additionally the slight channel change will be necessary to send water from
the new driveway pipe outlet over to a cross line pipe. Both sides of this channel change will be lined with rip rap armoring
underlined with black fabric, then soil material will rest against the rock at the top of the slopes and will be revegetated using
seed straw, and/or matting as a ro Hate.
4. Jurisdictional Determinations
4a. Have jurisdictional wedand or stre am determinations by the
Corps or State been requested o
project (including all prior phases obtained for this property /
in the past?
? Yes ® No ? Unknown
Comments: N/A
4b. If the Corps made the jurisdiction
of d
t
i
ti 1 determination, what type
? Preliminary ? Final
erm
e
na
on was made?
4c. If yes, who delineated the jurisdi final areas? Agency/Consultant Cojmpany: N/A
Name if known : N/A
( )
Other: N/A
4d. If yes, list the dates of the Corps j risdictional determinations or State determinations and attach documentation

N/A .
Page 2 of 9 j
PCN Form -Version 1.3 December 10, 2008 Version
5. Project History
5a. Have permits or certifications b
hi en requested or obtained for ? yes ONO ? Unkno
n
t
s project (including all prior p ases) in the past? w
5b. If yes, explain in detail accordin to "help file" instructions.
N/A
6. Future Project Plans
6a. Is this a phased project? ? Yes ® No
6b. If yes, explain, i
N/A
C. Proposed Impacts Inventor) I
1. Impacts Summary
I a. Which sections were completed below for your project (check all that apply):
? Wetlands ® Stream s- tributaries ® Buffers
? Open Waters ? Pond C onstruction
2. Wetland Impacts I
If there are wetland impacts propos on the site, then complete this question for each wetland area impacted.
2a.
Wetland impact 2b. 2c. 2d. 2e. I
Type of jurisdiction 2f.
number - Type of impa ct Type of wetland Forested (Corps - 404, 10 Area of impact
Permanent (P) or (if known) DWQ -anon-404, other) (acres)
Temporary
W1 ? P ? T N/A N/A ? Yes ? Corps;
N/A
C3 No El DWQ
2g. Total Wetland Impacts: NONE
2h. Comments: N/A
3. Stream Impacts
If there are perennial or intermittent s tream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impact .
3a. 3b. 3c. 3d. 3e. 3f. 3g.
Stream impact Type of impa t Stream name Perennial
Type
ypeofjurisdiction

Average

Impact
number - (PER) or (Corps 1404, 10 stream length
Permanent
() or intermittent DWQ-hon-404 width (linear
Temporary (T) (INT)? ,
ottjer) (feet) feet)
Site 1 ® P ? T UT to ® PER ® Corps I

Stream 1 fill
Horse Creek
? INT
® DWQ I 20 25ft
conwrrent

Site 1 ®P ? T
i UT to ® PER ® Corps !
Stream i p rap armor
r g Horse Creek ? INT ® DWQ ; 2ft 35ft
Site 1 ? P ® T dewatering UT to ® PER ® Corps

Stream 1
Horse Creek
? INT
® DWQ 2ft 140ft
3h. Total stream and tributary Impacts 35ft
3i. Comments: extra temporary dewa Bring beyond 35ft selected for best fit for sandbags =perm impacts only 3511
Imber 10, 2008 Version
4. Open Water Impacts
If there are proposed impacts to lak s, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all ope water impacts below. I
4a. 4b. 4c. 4d. I 4e.
Open water Nameof
impact number - waterbod Type of impact Waterbbdy type Area of impact (acres)
Permanent (P) or (if applicab e)
Tem re
01 ? P ? T N/A N/A N/A N/A
4f. Total open wate? Impacts NONE
4g. Comments: N/A I

5. Pond or Lake Construction
If and or lake construction propose then complete the chart below.
Sa. 5b. 5c. 5d. 1
Pond ID
Proposed use or purpo
a of Wetland Impacts (acres) Stre am Impacts (feet) F
nd

number s)
pond
Flooded Filled Excavated Flooded Filled Excavated Flooded
P1 N/A N/A N/A N/A N/A N/A N/A N/A
P2
5f. 7 tal NONE NONE NONE NONE
NONE NONE
NONE
5g. Comments: N/A
a dam high hazard permit requ ired? red?
? Yes ®No If yes, permi I t ID no: N/A
xpected pond surface area (acr
de es): N/A
i
ize of pond watershed (acres): N/A
ethod of construction: N/A
er Impacts (for DWQ)
ct will Impact a protected ripari an buffer, then complete the chart below. If yes, then; individually list all buffer impacts
low. If an im acts re uire mi ation then ou MUST fill out Section D of this form:
T
? Nauss ? Tar-P amlico ? Other:
t is in which protected basin? ? Catawba ? Randleman
6c. 6d. 6f. 6g.
er impact
mber- Reason for Buffer Z Zone 2 impact
nent (P) or impact Stream name mitigation (
e' (square feet)
re reuired? ;
® P ? T _
-`Rip rap UT t -0-Yes--
? Impact 1 Horse Creek ®No 0 SF

i

6h. Total buffer Impacts 0 SF 0 SF
6i,Comments: Not to exceed 401-F of new buffer impacts associated with rip rap used or Bank stabilization
D
I
Page 4 of 9 r
PCN Form - Version 1.3 December 10, 2008 Version
I 1
ustification and Mitig ation
i
nce and Minimization
cifically describe meas
Ew
site and will require mi
ith filter fabric for long
e used. Additionally i
ithin previously maintai
1 b. Specifically describe measu
Sediment and erosion control Best
construction. res taken to avo id or minimize the ro osed im acts in desi nin
imal disturbance. S to w ll be dewatered and the re laced ,g g project. vv1
rm stabilization. Only the amount of rip rap neces ary for st bil ilation arnd sl ght hanne P
acts within the buffers will be reduced by dewatenng at best location and no Gearing due
led transportation facility and maintained yards.
res taken to avoid or minimize the proposed impacts through construction techniques.
Management Practices for protection of surface waters will be enforced during project
I
2. Compensatory Mitigation for mpacts to Waters of the U.S. or Waters of the State
project require Com
o Waters of the U.S. o
c nsatory Mitigation for
Waters of the State? ? Yes ® No

a
mitigation is required (check all that apply): ? DWQ ? Corpsl

ich mitigation option wi wi
g
=
1
ll be used for this project? ? Mitigation bank I
? Payment to in-lieu fete program
? Permittee Responsible Mitigation
If Using a Mitigation Bank
itigation Bank: N/A
1
. r es urchased (attach receip and letter) Type N/A Quantity N/A
3c. Comments: N/A I
4. Complete If Making a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee p gram is attached. ? Yes
4b. Stream mitigation requested: N/A linear feet
4c. If using stream mitigation, stream emperature: ? warm ? cool ?wid
4d. Buffer mitigation requested (DW only): N/A square feet
4e. Riparian wetland mitigation reque led: N/A acres
I
4f. Non-riparian wetland mitigation uested: N/A acres
4g. Coastal (tidal) wetland mitigation r -Nuested: N/A acres
4h. Comments: N/A
5. Complete If Using a Permittee R esponsible Mitigation Plan
5a. If using a permittee responsib le mitigation plan, provide a description of the proposed mitigation plan. N/A
nber 10, 2008 Version
tigation (State Reg lated Riparian Buffer Rules) -required by DWQ
oject result in an imp
,1 ct within a protected riparian buffer that requires ? Yes ®No
,
igation?
n identify the square eet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
U
mitigation required.
c. 6d. 6e.
Reason for impa Total impact Multiplier Required mitigation
(square feet) (square feet)
N/A N/A 3 (2 for Catawba) N/A
N/A N/A 1.5 N/A
6f. Total buffer mitigation required: NONE
69• If buffer mitigation is required, iscuss what
type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffe restoration, payment into an approved in-lieu fee furid). N/A
6h. Comments: N/A
Page 6 of 9
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 i adjacent to protected riparian buffers identified
I
® Yes ? No
within one of the NC Riparian Buffer Protection Rules?
1b. If yes, then is a diffuse flow pla n included? If no, explain why.
El Yes ? No
Comments: N/A
2. Stormwater Management Pla n
2a. What is the overall percent imp erviousness of this project? N/A
2b. Does this project require a Sto water Management Plan? ? Yes ENO
2c. If this project DOES NOT requi re a Stormwater Management Plan, explain why: NC DOT state Permit No. NCS000250

2d. If this project DOES require a tormwater Management Plan, then provide a brief, narrative description of the plan: NIA
? 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 tormwater Review
3a. In which local government's juri diction is this project? Franklin County
? Phase II
3b. Which of the following locally-i plemented stomtwater management programs ? NSW
? USMP
apply (check all that apply): ? Water Supply Watershed
? Other:
3c. Has the approved Stormwater anagement Plan with proof of approval been ? Yes ? No
attached? N/A
4. DWOStarmwater Program Re view
? Coastal counties

4a. Which of the following state-imp
lemented stormwater management programs apply ? HOW
? ORW
(check all that apply): N/A
? Session Law 2006-246
? Other:
4b. Has the approved Stormwater M anagement Plan with proof of approval been
attached? NIA ? Yes ? No
5. DWQ 401 Unit Stormwater Rev iew
5a. Does the Stormwater Manage ent Plan meet the appropriate requirements? N/A ? Yes ? No
5b. Have all of the 401 Unit submitt I requirements been met? N/A ? Yes ? No
Page 7 of 9 i
PCN Form - Version 1.3 December 10, 2008 Version
F. Supplementary Information
1. Environmental Documentati on (DWQ Requirement)
la. Does the project involve an ex penditure of public (federallstate/local) funds or the
®Yes ? No
use of public (federal/state) lar d?
1b. If you answered 'yes' to the a ove, does the project require preparation of an
environmental document pursu ant to the requirements of the National or State ?Yes No
(North Carolina) Environmenta Policy Act (NEPA/SEPA)?
1c, If you answered "yes" to the ab ove, has the document review been finalized by the
State Clearing House? (If so, a ttach a copy of the NEPA or SEPA final approval
letter.) ? Yes ? No
Comments: N/A
2. Violations (DWQ Requireme )
2a. Is the site in violation of DWq Welland Rules (15A NCAC 21-1.0500), Isolated
Wetland Rules (15A NCAC 2H 1300), DWQ Surface Water or Wetland Standards, ? Yes ® No
or Riparian Buffer Rules (15A CAC 2B .0200)?
2b. Is this an after-the-fact permit plication? ? Yes ® No
2c. If you answered 'yes' to one or both of the above questions, provide an explanation of the violation(s): N/A
3. Cumulative Impacts (DWQ Re quirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in ?Yes ® No
additional development, which c ould impact nearby downstream water quality?
3b. If you answered 'yes" to the abo ve, 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..
N/A
4. Sewage Disposal (DWQ Requ rement)
4a. Clearly detail the ultimate treatm ent methods and disposition (non-discharge or discharge) of wastewater generated from
the proposed project, or availab a capacity of the subject facility.
N/A
Page 8 of 9 j
PCN Form - Version 1.3 December 10, 2008 Version
cies and De ignated Critical Habitat (Corps Requirement)
projectoccur
ccur in or nea an area with federally protected species or
? Y es N
M o
d with the US S concerning Endangered Species Act
? Y
s
e
® No

5c. If yes, indicate the USFWS Fiel d Office you have contacted. ? Raleigh
? As
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat? Biologists from NCDO O.N.E. has visited this site and rendered a biological conclusion of 'No Effect'
http://www.fws.gov/nc-es/es/coi jntyfr.html and NC Natural Heritage Program Database, Element Occurrences
6. Essential Fish Habitat (Corps Requirement)
63. Will this project occur in or near an area designated as essential fish
? Y
habitat? es ®No
6b. What data sources did you use o determine whether your site would impact Essential Fish Habitat?
http://ocean.floridamarine.org/ef coralfimstviewer.htm ,

7. Historic or Prehistoric Cultur I Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated
tat
N
i having historic or cultural preservation
[I Yes
® No
s
us (e.g.,
at
onal Historic T st designation or properties significant in '
North Carolina history and arch eology)?
7b. What data sources did you use determine whether your site would impact historic or archeological resources?
HPO's historic layer using GIS rcView database and http //ois ncdcr govlhpoweb/
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: N/A
8c. What source(s) did you use to m ke the floodplain determination? httl2:/Avww.ncfloodmgps.com/

J. W. Bowman, P.E. Q / 08/30/11
Applicant/Agent's Printed Name APPlicaM/Agent's Signatur Date
(Agents signature Is valld only If an authorlration le fnxn the applicant
Is MOVIded
3 December 10, 2008 Version
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Name: GRISSOM •
Date: 6/14/2011 Location: 036.0245%, • N 078.-517,914,, ' W
Caption: SR 1147 (Holden Road)
Scale: 1 Inch equals 2000 feet Franklin County
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Ridings, Rob
From: Ridings, Rob
Sent: Wednesday, August 31, 2011 9:01 AM
To: Montague, Heather W
Subject: RE: Non-reporting NWP3 and NWP 13/WQC 3687 and WQC 3689 on SR 1147 (Holden
Road) in Franklin County
Sounds good. You're good to go then.
-----Original Message-----
From: Montague, Heather W
Sent: Wednesday, August 31, 2011 8:32 AM
To: Ridings, Rob
Subject: RE: Non-reporting NWP3 and NWP 13/WQC
Franklin County
Rob-
3687 and WQC 3689 on SR 1147 (Holden Road) in
Yes as you've said, this project will not involve any clearing. My estimate of SF was merely
the area surrounding the channel work, but as the pictures depict is only the scoured out
side slopes to the channel which is deep being routed through the driveway pipe, through a
roadside ditch, then continues under the highway. The rip rap will stay entirely on the banks
and no woody vegetation will be affected by this driveway pipe replacement and bank
stabilization work. Thanks.
-Heather
-----Original Message-----
From: Ridings, Rob
Sent: Wednesday, August 31, 2011 8:17 AM
To: Montague, Heather W
Subject: RE: Non-reporting NWP3 and NWP 13/WQC 3687 and WQC 3689 on SR 1147 (Holden Road) in
Franklin County
Heather,
It seems you checked off that there is 2400 sq ft of zone 1 buffer impact. Unfortunately,
stabilization is allowable but not exempt which would require me to write a certification for
the entire project.
However ...from the pictures it looks like almost the entire streambank area is either non-
vegetated, or just covered with herbaceous grass & weeds.
If the riprap is staying entirely on the banks and none of the woody vegetation is going to
be touched, then we can consider this no buffer impact and keep the entire thing No Written
Cert needed.
Can this be the case?
-Rob
-----Original Message-----
From: Montague, Heather W
Sent: Tuesday, August 30, 2011 4:41 PM
To: Alsmeyer, Eric C SAW; Ridings, Rob
Cc: Phipps, Dawn
Subject: Non-reporting NWP3 and NWP 13/WQC 3687 and WQC 3689 on SR 1147 (Holden Road) in
Franklin County
Rob and Eric-
Please note that this is a pre-existing maintenance issue and is NOT associated with
Hurricane Irene.
Franklin County Maintenance has undersized and misaligned driveway pipe adjacent to SR 1147
(Holden Road) west of Youngsville. There is currently a collapsed shoulder section between
this driveway pipe and the cross line under SR 1147, which is a safety concern. The driveway
pipe will be upsized, realigned (which which require a slight channel change), then the
associated fill slope and shoulder section will be repaired. This maintenance work should
meet the conditions for working under a non-reporting NWP 3 and NWP 13/WQC No. 3687 and WQC
No. 3689.
For maintenance sites such.as this one, NCDOT Division 5 has a procedure in place to provide
our construction crews with print outs of the general conditions along with a letter head
cover sheet explaining the intent to operate under a non-reporting permit as long as all
applicable conditions are meet. Oversight from both the Environmental Staff and REU Field
Operations Unit will ensure compliance with the permit conditions are met and that standard
BMPs are followed. Attached to this email is a courtesy PCN for your files along with site
maps and a construction plan. This work was scheduled to begin within the next few weeks.
-Heather Montague
DIV 5 Env Specialist
[phone] office
[phone] cell
Email correspondence to and from this sender is subject to the N.C. Public Records Law and
may be disclosed to third parties.
z
driveway pipe

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SR 1 147 (Holden Road) Franklin Coanty
Maintenance '-,ltc
driveway pipe
Photograph ?. View looking West.