20110852 Ver 1_Application_20110916

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STATE OF NORTH CAROLINA
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DEPARTMENT OF TRANSPORTATIOss"A,o~T~~c ~~>/
BEVERLY EAVES PERDUE ~ Eugen~yyyqE5~3q,~i, Jr.
GOVERNOR SECRET'~~
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September 1, 2011
U.S. Army Corps of Engineers
Wilmington Regulatory Field Office ~j
P.O. Box 1890 ~ ~ ~ ~ ~~ ~.~
Wilmington, North Carolina 28402-1890
ATTN: Mr. Ronnie Smith
NCDOT Coordinator
Dear Sir:
Subject: Notification for Nationwide Permit 14 (Minor Road Crossing)
NCDENR 401 WQC 3820
Curve Realignment at SR 1540 & SR 1515 Robeson County
State Project Number: 45264; TIP#: W-5140
The North Carolina Department of Transportation (NCDOT) has scheduled to realign the
intersection of SR 1540 (Sally Road) and SR 1515 (St Anna Road). Total project length is
0.237miles. The project is a Spot Safety project that has been designed to eliminate a hazardous
intersection. The following is a brief statement of the problem, as developed by the NCDOT
Regional Traffic Safety Engineer:
SR 1540 intersects,SR 1515 to forma "Y" shaped intersection. One leg of SR 1515
is currently under stop control. The majority of the traffic follows SR 1515 and must
make a turning movement to stay on the route. Motorist do not expect to turn, miss
it, resulting in a pattern of run of road crashes.
Crossin Roadwa Station Existin Culvert Pro osed Culvert
Permit site #1 Sta. 16 + 75 60 LF 24" RCP 140 LF 48" RCP
New Surface Water Impacts = 80 linear feet
Unnamed Surface Waters Roadway Station Impacts
Permit site #1 ~ Sta. 16+75 - Sta. 21+ 25 0.0516 acres/ 2250 fr2
New Surface Water Impacts = 0.0516 acres
Construction of this project will require impacts to the waters of the United States in the Lumber
River Basin. Permit site #1 conveys surface drainage to an UT of the Lumber River (B; Sw,
HQW). The project is located within the 03040203 Hydrologic Unit, sub basin 03-07-51.
P. O. box I I SQ, Fayetteville, NC 28302-1150 - Telephone [phone]- Far [phone]

Permit Site #1 proposes impacts to jurisdictional surface waters located from Station 16+75 -
Station 21+25. The un-named tributary is a road side channel. NCDOT proposes to shift the
existing channel and re-establish it 35fr North of its current location, resulting in 450LF of
surface water impacts. The channel is approximately 6 foot deep and 5 foot wide with basically
1.5:1 side slopes. An existing 60LF24" RCP conveys drainage under SR 1515, then the UT runs
parallel to SR 1540. A proposed 140LF 48" RCP will replace the existing structure, resulting in
80LF of surface water impacts. Being that the pipe conveys a roadside ditch, burial is not
proposed. The pipe will be laid upon the finished roadside ditch grade. The outfall channel is at
such a low gradient that hydrology is always in the channel. Total impacts of this necessary shift
include 450LF of surface water or 2250 sq ft; 0.0516 acres. The channel shall remain the same
length and will be shifted in order to allow room for the adjustment of the intersection.
RESOURCE STATUS
In general, there will be minor impacts proposed as a result of the replacement of the culvert
across SR-1515 and the relocation of the jurisdictional tributary in Robeson County. A
Nationwide Permit # 14 /NCDENR 401 WQC 3820 is required for the project.
Endangered Species: Plants and animals with Federal classification of Endangered (E) or
Threatened (T) are protected under provisions of Section 7 and Section 9 of the Endangered
Species Act of 1973, as amended. As of September 22, 2010, the U.S. Fish and Wildlife Service
lists three federally protected species for Robeson County.
Federal) Protected S ecies for Robeson Coun
SCIENTIFIC NAME COMMON NAME STATUS
AIligalor mississipprensis American alligator T (S/A)
Picoides borealis Red-cockaded woodpecker E
Rhus michouxii Michaux's sumac E
"E" denotes Endangered (a species that is in danger of extinction throughout
all or a significant portion of its range).
T(S/A)- Threatened due to similarity of appearance, a species that is threatened
Due to similarity of appearance with other rare species and is listed for its
Protection. These species are not biologically endangered or threatened and
Are not subject to Section 7 consultation.
A biological conclusion of "No Effect" was reached for all species during the September 9, 2010
survey for protected species. Protected species were not identified, nor, was the general habitat
for each species identified.
REGULATORY APPROVALS
Application is hereby made for a Department of the Army Nationwide Permit 14 /NCDENR 401
WQC 3820 as required by the above-described activities.
The National Register was reviewed in addition to conducting a field view of the project for
significant historic features.

The project impacts are minor in nature and should not remove or degrade existing water quality
uses. Pipe sizes proposed are the minimum necessary to create a safe highway while
accommodating the 25-year design storm. There is no record within the NCDOT District 1
Office (Robeson County) that the road experiences flood overtopping. By utilizing the erosion
control measures, downstream water quality standards will be protected. All appropriate BMP's
will be utilized during construction.
Attached is a Preconstruction Notification Form, plan sheets, marked county road map, quad
location map and photographs.
If you should have any questions, or need additional information please contact James J. Rerko,
PWS at [phone].
'ncerely,
i7u~ S
~r ~
James .Rerko, PWS
Division 6 Environmental Officer
ATTACHMENTS
Cc: Brian Wren, Division of Water Quality (7 copies)
Mason Hendron, Division of Water Quality (1 copy)
Greg Bums, P.E., Division Engineer

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Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Pre-Construction Notification PC Form
A. A licant Information
1. Processing
1 a. Type(s) of approval sought from the
Corps:
®Section 404 Permit ^ Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: 14 or General Permit (GP) number: 3820
1 c. Has the NWP or GP number been verified by the Corps? ®Yes ^ No
1 d. Type(s) of approval sought from the DWO (check all that apply):
® 401 Water Quality Certification -Regular ^ Non-404 Jurisdictional General Permit
^ 401 Water Quality Certification -Express ^ Riparian Buffer Authorization
1e. Is this notifcation 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
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ^Yes ®No
2. Project Information
2a. Name of project: SR 1515 & SR 1540
2b. Ccunty: Robeson
2c. Nearest municipality /town: Pembroke
2d. Subdivision name: NA
2e. NCDOT only, T.I.P. or state
project no: 45264; TIP# W-5140
3. Owner Information
3a. Name(s) on Recorded Deed: NA
3b. Deed Book and Page No. NA
3c. Responsible Party (for LLC if
applicable): NA
3d. Street address: NA
3e. City, state, zip: NA
3f. Telephone no.: NA
3g. Fax no.: NA
3h. Email address: NA
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: Greg Burns, P.E./ NCDOT/Division 6 Engineer
4c. Business name
(if applicable): NCDOT
4d. Street address: PO BOX 1150
4e. City, state, zip: Fayetteville, NC 28302
4f. Telephone no.: [phone]
4g. Fax no.: [phone]
4h. Email address: [e-mail]
5. AgenUConsultant Information (if applicable)
5a. Name: James J Rerko, PWS
5b. Business name
(if applicable): NCDOT/ Division 6 Environmental Officer
Sc. Street address: PO Box 1150
Sd. City, state, zip: Fayetteville, NC 28302
5e. Telephone no.: [phone] x 26
Sf. Fax no.: [phone]
Sg. 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: Longitude: -
1b. Site coordinates (in decimal degrees): PS#1 34.6953 -79.2142
(DD.DDDDDD) (-DD.DDDDDD)
tc. Property size: 2.8 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to Lumber River
proposed project:
2b. Water Quality Classification of nearest receiving water: B; Sw; HOW
2c. River basin: Lumber
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:
'Y' shaped intersection involving SR 1515 and SR 1540. Surrounding land use is residential & agricultural farm fields.
3b. List the total estimated acreage of all existing wetlands on the property:
0 acres
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
0 LF
3d. Explain the purpose of the proposed project:
Motorists traveling on SR 1515 come to the'Y' shaped intersection and do not anticipate a turning motion, resulting in a
high number of run-off-road crashes. A study was conducted and it was determined that a re-alignment of the
intersection would eliminate the hazard. Therefore, a shifting of SR 1515 is necessary so that motorists have a
continuous movement through the interchange.
3e. Describe the overall project in detail, including the type of equipment to be used:
Impacts will be minimized as much as possible. Existing pavement on SR 1515 between Station 14+10 -Station 19 +85
will be removed. The channel will be shifted, retaining the orginial length,.in order to allow room for the new intersection.
Front end loaders will place fill material. Eventually a motor grader will finish grade the project prior to paving.

4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past? ®Yes ^ No ^ Unknown
Comments: Brad Shaver & Ronnie Smith (COE) and Mason
Hendron (NCDWO) determined that the channel was a
jurisdictional tributary.
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: NA
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
5. Project History
Sa. 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 detail according to "help file" instructions.
NA
Page 3 of 11
PCN Form -Version 1.3 December 10, 2008 Version

6 Future Project Plans
6a Is this a phased projects ^ Yes ®No
6b. If yes, explain.
NA
Page 4 of 11
PCN Form -Version 1.3 December 10, 2008 Version

C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
^ Wetlands ^ Streams -tributaries ^ Buffers
® Open Waters ^ Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a. 2b. 2c. 2d. 2e. 2f.
Wetland impact Type of jurisdiction
number - Type of impact Type of wetland Forested (Corps - 404, 10 Area of impact
Permanent (P) or (if known) DWO -non-404, other) (acres)
Tem ora T
^ Yes ^ Corps
W1 ^ P ^ T NA NA ^ No ^ DWO
^ Yes ^ Corps
W2 ^ P ^ T ^ No ^ DWO
^ Yes ^ Corps
W3 ^ P ^ T ^ No ^ DWO
^ Yes ^ Corps
W4 ^ P ^ T ^ No ^ DWO
^ Yes ^ Corps
WS ^ P ^ T ^ No ^ DWO
^ Yes ^ Corps
W6 ^ P ^ T ^ No ^ DWO
2g. Total wetland impacts
2h. Comments:
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a. 3 b. 3c. 3d. 3e. 3f. 3 g.
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 DWO -non-404, width (linear
Temporary (T) (INT)? other) (feet) feet)
^ PER ^ Corps
S1 ^ P ^ T NA NA ^ INT ^ DWO
^ PER ^ Corps
S2 ^ P ^ T ^ INT ^ DWO
^ PER ^ Corps
S3 ^ P ^ T ^ INT ^ DWO
^ PER ^ Corps
S4 ^ P ^ T ^ INT ^ DWO
^ PER ^ Corps
SS ^ P ^ T ^ INT ^ DWQ
^ PER ^ Corps
S6 ^ P ^ T ^ INT ^ DWO
3h. Total stream and tributary impacts
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
impact number - Name of waterbody
(if applicable)
Type of impact
Waterbody type
Area of impact (acres)
Permanent (P) or
Tem ora T
01 ®P ^ T UT of Lumber River Culvert Roadside Ditch 0.009 acres (80LF)
02 ®P ^ T . UT to Lumber River Channel Relocation Roadside Ditch 0.0516 acre (450LF)
03 ^P^T
04 ^P^T
0.061 acres (530 LF)
4f. Total open water impacts
4g. Comments:. Jurisdictional surface waters flow through upstream road side ditch, under SR 1515 then, run parallel to SR
1540 dawn road side ditch. Surface water channel shall be shifted 35ft North from current location. Proposed culvert is
skewed.

5. Pond or Lake Construction
If and or lake construction ro osed, then com lete the chart below.
5a. Sb. Sc. 5d. 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 NA
P2
SC Total

Sg. Comments:
5h. Is a dam high hazard permit required?
^ Yes ®No If yes, permit ID no:
5i. Expected pond surface area (acres): NA
Sj. Size of pond watershed (acres): NA

Sk. Method of construction: NA
Page 6 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 an im acts re uire mitt anon, then ou 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)
Tem ora T im act re wired?
^Yes
61 ^P^T NA ^ Na
^Yes
62 ^P^T ^ No
^Yes
63 ^ P ^ T ^ No
6h. Total buffer impacts
6i. Comments: NA
D. Impact Justification and Mitigation
1. Avoidance and Minimization
i
1a: Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
NCDOT proposes to make this intersection safer by eliminating the existing turning motion and replacing it with a continuous
motion.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
All construction BMP's shall be utilized.
2. Compensatory Mitigation far 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?
26. [f yes, mitigation is required by (check all that apply): ^ DWQ ^ Cofps
^ 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: NA
3b. Credits Purchased (attach receipt and letter) Type Quantity
Page 7 of 11
PCN Form -Version 1.3 December 10, 2008 Version

3c. Comments: NA
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: NA linear feet
4c. If using stream mitigation, stream temperature: ^ warm ^ cool ^cold
4d. Buffer mitigation requested (DWQ only): NA square feet
4e. Riparian wetland mitigation requested: NA acres
4f. Non-riparian wetland mitigation requested: NA acres
4g. Coastal (tidal) wetland mitigation requested: NA acres
4h. Comments: NA
5. Complete if Using a Permittee Responsible Mitigation Plan
Sa. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
NA
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 NA 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).
NA
6h. Comments: NA
Page 8 of 11
PCN Form -Version 1.3 December 10, 2008 Version

E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan

1a. Does the project include or is it adjacent to protected riparian buffers identified
within one of the NC Riparian Buffer Protection Rules? ^Yes ®No
1 b. If yes, then is a diffuse flow plan included? If no, explain why.
^ Yes ®No
Comments:
2. Stormwater Mana ement Plan

2a. What is the overall percent imperviousness of this project? 33
2b. Does this project require a Stormwater Management Plan? ^Yes ®No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why: In agreement with NCDWO and NCDLR;
NCDOT has it's own individual NPDES Permit. This project does not propose any additional impervious surface.
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, na rrative description of the plan:
NA
^ Certified Local Government
2e. Who will be responsible for the review of the Stormwater Management Plan? ^ DWO Stormwater Program
^ DWO 401 Unit
3. Certified Local Government Stormwater Review

3a. In which local government's jurisdiction is this project?
^ 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 Pro ram Review
^ Coastal counties

4a.
Which of the following state-implemented Stormwater management programs apply
(check all that apply): ^ HOW
^ ORW
^ Session Law 2006-246
^ Other:
4b. Has the approved Stormwater Management Plan with proof of approval been
attached?
^Yes ^ No
5. DWQ 401 Unit Stormwater Review

5a. Does the Stormwater Management Plan meet the appropriate requirements? ®Yes ^ No
5b. Have all of the 401 Unit submittal requirements been met? ®Yes ^ No
Page 9 of 11
PCN Form -Version 1.3 December 10, 2008 Version

F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1 a. Does the project involve an expenditure of public (federal/state/local) funds or the ®Yes ^ No
use of public (federal/state) land?
1 b. If you answered "yes' to the above, does the project require preparation of an
nvironmental document pursuant to the requirements of the National or State
^Yes
®No
e
(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: NA
2. Violations (DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
d
d
^Yes
®No
s,
ar
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Stan
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): NA
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 a ccordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
NA
4. Sewage Disposal (DWQ Requirement)
4a . Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of wastewa ter generated from
the proposed project, or available capacity of the subject facility.
Portable toilets will be on site for construction members to utilize.
Page 10 of 11
PCN Form -Version 1.3 December 10, 2008 Version

5. Endangered Species and Designated Critical Habitat (Corps Requirement) (

5a. Will this project occur in or near an area with federally protected species or ^ Yes ®No
habitat?
Sb. Have you checked with the USFWS concerning Endangered Species Act ^ Yes ®No
impacts?
^ Raleigh
Sc. If yes, indicate the USFWS Field Office you have contacted. ,-: .
- ^ Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
USFWS Endangered Species website, Natural Heritage GIS data layer (updated constantly), Preliminary Ground Survey
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 website- http:/lwww/iws.gov/nc-es/fsh~sh.html
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?
In accordance with Programmatic Agreement an Internal NCDOT State Historic Preservation review was conducted.
S. Flood Zone Designation (Corps Requirement)
Sa. Will this project occur in aFEMA-designated 100-year floodplain? ^ Yes ®No
Sb. If yes, explain how project meets FEMA requirements: NA
Sc. What source(s) did you use to make the floodplain determination? NC Floodplain Mapping website- (Tile # 9334)

Greg Bums, P.E. ,~
;
Sept 1, 2011
w
Applicant/Agent's Printed Name ~ pplicanU g is Signa4uie Date
(Agent's signature i$ valid only if an authorization letter from the applicant
i rovided.

Page 11 of 11
PCN Form -Version 1.3 December 10, 2008 Version

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