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Home My WebLink About20090876 Ver 2_Application_20111123 1 � �� D � � � '� ,��, � NOV 2 3 2011 STATE OF NORTH CAROLINA DENR wATEROUALITY 1HETLANDS AND STORMWATER BRANCH DEPARTN�NT OF TRANSPORTATION BEVERLY EAVES PERDUE EUGENE A CONTI 1R GOVERNOR SECRETARY November 21 2011 NCDENR DWQ /,� Transportation Permitting Unrt C �lU � 1650 Mail Service Center , � � �� Raleigh NC 27699-1650 �j � Attention Rob Ridings NCDOT Coordinator Sub�ect Maintenance repair activity at a failed hydraulic pipe system and rip rap bed and bank stabilization along Wade Avenue (west of Wade Avenue and I 440 interchange) in Wake County TIP No RSP 1 WBS Element No 42188 The NCDOT submitted a permrt application for maintenance repair activity at a failed hydraulic pipe system along Wade Avenue on August 10 2009 (TIP No R 4436) The NCDENR DWQ issued a 401 Water Quality Certification and Neuse Buffer Authorization for these impacts on August 14 2009 (DWQ Pro�ect No 20090876) However the pro�ect has never been constructed due to funding constraints The site continues to erode and remains very unstable The Department now has determined to proceed with construction of this previously described work (and additional work) at this time (now known as TIP No RSP-1) The impacts previously permitted for the failed hydraulic pipe system (now listed as Site 1) have changed due to a revised design and additional stream degradation The Department now proposes to conduct additional streambank stabilization activities downstream of this failure in an area now listed as Srte 2 A recent evaluation of this area and the ad�acent hydraulic system has identified failures at the outlet of an existmg box culvert The Department proposes to stabilize the streambanks and streambed at the outlet of a box culvert These impacts are noted as Site 3 Specific Construction Activity Site 1 2 An 18 incr �oncr:�e pipe was installed under Wade Avenue and a 36 inch concrete ptpe mstalled parallel to u�� along the fill slope of Wade Avenue in 1969 Some type of significant failure has occurred at this site since the installation Many pipe segments have become detached from the hydraulic system and the stream has now undercut approximately 20 feet below ad�acent natural ground The NCDOT proposes to replace this failed hydraulic system and stabilize the stream The repairs include installation of a stormwater dry detention basin riser pipe structures and rip rap in the flow line and streambed Division F�ve—2612 North Dul.e Street Durham North Carolma 27704 Telephone 919 220 4600 F1� 919 �60 3371 L 2 Site 3 The tail end of concrete rip rap lined flumes are failing along the streambank at the outlet i ' of an existing box culvert at the toe of fill slope along Wade Avenue The Department proposes � to remove the damaged concrete flumes and replace wrth iip rap lined drtches Addrtionally a rip rap lmed plunge pool will be installed in the footprint of a large blow hole at the outlet of the culvert Impacts to Waters of the Un�ted States The repairs at Sites 1 2 will result in impacts to an unnamed tributary to House Creek and the repairs at Srte 3 will result in impacts to House Creek Information concernmg these impacts is presented m Permrt Drawing Sheets 1 5 and on Page 5 of the attached pre construction notification (PCN) Impacts to Riparian Buffer Construction at Site 1 2 and Site 3 involve streams that are sub�ect to the Neuse River Buffer Rules Information concernmg these impacts is presented in Permit Drawing Sheets 6 9 and on Page 7 of the attached PCN Summary Application is hereby made for a modification to the exishng NCDENR DWQ Section 401 Water Qualrty Certification (WQC) 3687 and Neuse River Buffer Authorization The NCDOT proposes to use Department of the Army Section 404 Nationwide Permrt (NWP) 3 and 13 however this permrt does not require submittal of a PCN to the USACE An automated payment procedure has been implemented between the NCDOT and NCDENR DWQ This procedure will enable the Division to apply for the 401 WQC without submitting a check for this permit application This procedure will provide payment to the NCDWQ by chargmg the permrt application fee directly to the appropriate NCDOT WBS Element No 42188 A pre construction notification and permit drawings are attached with this request If you have any questions or need additional mformation please contact Mr Chris Murray at (919) 220-4633 Sincerely G� �-�-�-�� J W Bowman P E Division Engineer c Division 5 file NCDOT Brian Lipscomb NCDOT ti ti � J i" \ { '^—' / .� \ 1 / ( f 1 4J / � /� \- \ C� \ 4 ��' -^ti '� // ,,� �' Y � ,}F--=��,�- �z�, �\`� 4 �� " f � ) �)�4�l �;� � a�� ,,�� , � .�,��, � !V �=� ,� � \ ��.� � � 1 ��--�� --'o � /%-- ."lY, � -� l � � � �.�� r�]�� \ � � '�,�~.��/�11 1�,/ i 1 ��t'✓�- �%��.�,J ��tiT1� � �; ` i ��.`� J�'*'-�.�. 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' ` � � �(��(� A � / ,+. �\^ah�W l '? .�,\ � `,� F � � � 50 I `T-= r��jr -� .a SCALE 1 24000 t /�1 � {"�'. � f 0 1 MILES r � f�\ �,; i�.�,Y-�.�_ � � \ r 0 1000 YARDS p �'� '�I 1�,.,��'��. i�`��; t`�", ~�J5 �'`�� ^ t •r�� k�p 0 1 KILOMETER `•S..r� s w � � �P�� i� ->> � i+ � Copynght(C)1998 Maptech Inc e � � I � I SITE 3 � � � �./ � �, — — —��.� '" ,�'� .� �. ----- .-�' ,— i ------- c _ - — � --------------- � ° i , %° = —� ' .�-- �� / —————— ——————————_—�.� _._. ,�_..� _._.. _��_=N.= —''�� — - - _----- - _________- ---_- _ --- .�_---- ----------�----�-- ------- _ - - �.,.---------- _ _ — _ _ — _ _ _ _ _ _ _ _ _ _ _ _ —J1—______��______________ _`_I__ _ __ __ _ ___ _ _ �_�___�__ _�__ �_�_ / C / \ // � _ ___�______�_______�________��_______�_�__ _____�______�_____—_ �__ —__ __— __ _ _ ______�_� ________—_ _________ _ _ _ _ __ — _ _ _ �^ _ _ _ � —�_�_______________��___�______ �.�c_____�_�_��_�� ---- --------------------------- T/---------- / ----� �_ ---� ` �'==� � -.-�- �� _ _ _ _ � � �`�� m_ / � �- � -------- -��//// � .�/o�� /,/ � �� 5I'll'E 1 SI'�'� 2 �� I�T C D��'g' �F 'I['�f�N��I�'I°A'I'I�N h �I�I�I�N ��' �'[IGIE�h�51'S zoo o zoo aoo �� LJ�T,g,�, scn�E i zoo 1l�I$�J�C�" �0�188 (1$�FD°1) Vl'.�I)E AV�N�J� �Mi ID WITHERS � RAVENEL �C��t'��N ENGINEERS I PLANNERS I SURVEYORS �y�,ULS iOI�� lO�f�� AN� I �i40 D C ry C I 5 I 6 33 faz 9 6 6 �w 1 h I L N C 3 SH�E'g° fl �V' 9 I �� ❑ �� --------�------------------- — � — — — — — — — II WADE AVE EASTBOUND LANES II ————————————— — �� _��.�_�_�II�_ T T l� _ T T T 5 �� BANK �ItIGII�IAL END OF FII�E II STABILIZATION� ,�CC�RDING T� THE 1969 �L.�NS ETF____— ---- ETF .(^' _gCF— ---- —E-- —__ — ------------- � r `'. =k,— fY ;\ —______ f+ ^ � �Y .— .—_ —t= ^ � ` i�? s''`J `�s "` �I - i�"' -�e v r,r E 7 f iK -� ��,re �� .. r� � x'" � � .. r 7 � {1 qi ,�,. -* � -t C � � e �C\ \l� 1 �_i +\} I / � \ � STREAM IMd�t�CT 30 fi,F \ ' / 0 SE CPEE \/ � �i �� #\\ / P� � \� \ f B/✓y 2 0 I N �qB 7p� fk W �RB rh f2 #\ #\ #\ �1��L111/1J DENOTES IMPACTS IN SURFACE WATER �� ST�REAM FEATURE WILL BE COVERED �� BY THE PROPOSED PIPE SYSTEM AND OUTFALL N C DE�"d' O1F 'I°IaANS]��K'TA'Il'I�N � , �DIVISI�N �F �IGff-IWA�S so o so ioo � W,�� C�UN�°�' SCALE I 50 ��JECT 42188 GI$5�-1) 4 {�J Wf��Hi �VIL:N'11i. ll➢1•Ar WITHERS O� RAVENEL BETW]EEN ENGINEER5 I PLANNERS I SLIRVEYORS 7�yg�UIli 1CILLYGLLi lO�tb� AN1U' I�4IqIO M K D ( N h I 2 5 I 9 9 69 33 0 f 9 6 6 8 h I � C 3 SEIEET 2 �� 9 � — — 1 WADE AVE _FOGE OF TRAVEL WAY EASTBOUND LANES —___ EDGE OF 7RAVEL WAY ______.------ --.—__._ EDGE OF 7'RAVELWAY _ EDGE OF PAVEAIENT -� -T T T -T T r� �_ ._ �7�� '� T T T T r- ---- — ETF-------------� __.._—______— f,+ �` M \�� qB \\�� f I � BANK B z '�e� \ ��'�TF �STABILIZATION � _______ � � ,� — � o --c"t�*'"V-�° �� `'-' "" � Q BANK c � � '� _ �STABILIZATION c rr� r � r �_�. � ' F \ s - �, x C=c t�,` ✓ dq,� C +�C ,,, r,r ,. / :, .rh� � ..�;��\ } /� ��rt R EO CE55 RO FFNGE Y r y, �'� f / ` r'� r � '' a .e.. r-�_ ��F-'� � �`�j`" �. E EE S� J �� 0 -_ ! Y � �. �j '� '' ��,� S�' liTTONWSE�EE 3 � }3 ' /1 �� BN 2 ( 3 , S � / k\� �� j �i SITE 2.� \ STREr11►�g IMI�t1CT=231 LF \ SITE 2B STR�AM I1�I�ACT=102 L� }�+ \ \�\_--------� +� +�+ �� DENOTES IMPACTS IN SURFACE WATER N C DE�'d' �F '�'R.�NSd��IdTA'�"I�N fl�IVISI�N �F 1FIIGH�WA�S so E so ioo W,eb�� C�UN�'� SCALE 1 so �IB�JEC'd' 42188 (R5F—ll �J W.�Y�E AVIEN�JE 1�M� WITHERS O� RAVENEL BETWIEEN ENGINEERS I PLANNERS I SURVEYORS 1[➢LUlli 1�I�DG� 1�� AN�D I SI�O M K D C N hC I 5 I 9 33 fzz h 3 SHIEET 3 �1F 9 , � � �� A` � � � \ \ r' � �r ,- --� �1 I , � l � e r SEE NOTE 3 I I� �_ � '/ W II r \ � - ��-"--, N �� ? ' { b ,� { � — — —r— — �' "—»—EU�re.,._ /�\ � — — — _- ��`� ll �'�+�'F/ ��j'y �-—� ` \ \� � _�� ^�� , % � � � � � �`: �� , __-- �\ ��% � � �� \ ��%x`°� ,,��F"� ' � %� ,_—` \ ,,-'� STR�r�M � ' �� -'� IM�ACT=51 Y,F � \ � \ \ � � �J� � � � . �� y � �� // // �� I'''/ ��\ ut __ �_ �� '� \ y y_==—=�"�J ---==—� I'_ ''�i —_______��pGE"-b�'�� WB ENrRANC��,= ''' o _� � ----EDGE OF TRAVEL WAY � --r-- ------------------ _ ��E OF TRAVELWAY _----- --------- i — — — ' — — —�IADE AVE _�EDTE� OF rRAVELWAY=====__ ______ —i— � � NOTES 1 IMPACTS INVOLVES INSTALLATION OF CLASS II RIPRAP ON STREAM BANKS AND WITHIN FLOWLINE OF CHANNEL 2 RIPRAP PLACEMENT WITHIN THE FLOWLINE TO ARMOUR EXISTING SCOUR HOLE 3 RIPRAP DOWNSTREAM FINISH ELEVATION WILL MATCH EXISTING STREAM ELEVATION SEE DETAIL SHEET 2D ��I°l� � �°I�IE�1��I�'II �1�III��C°�� !��!��!4 DENOTES PERMANENT IMPACTS � IN SURFACE WATER N C I��1�'6' �� 'f'I�AN�fi��Id'd'A'd'I�N �iVI�IG�N �b' �33[IG&-IWA�YS so o so ioo �T�q,�� C�DUN�[°`ft' � ��--��— I 4 SCALE I 50 — — - I��TEC'i° 4218� (i85� 1) t W��E At��N�T� ff$1�'�$� WITHERS �~ RAVENEL ��rw��N � E N G I N C E R S i P L A N N E R S I S U R V C Y O R S �y�U� 14I LLY l tl.: 71`rl'f'il 1LY �N lU' d �I�O M A D C�N C I 5 I f I I -0 g�7�{� 7� 1 { �7l1LiL� � �tl' �7 1 I � � � C � �^ Z � � N fn w � O Z � � V � � F � a cn p, � c m� u� a ¢ � �* � c � � E .� zS m � a H in c�o n � � �, W L � � Q w U � ~ �' � 2 p r. � p� � [�. 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SI'Y'E 1 Z�NE 2 � IMF.�CTS=1341 SF ,��, 'C` —��-" � �\ �_, �, \'F � WSE C EE � � \ �V \`1 �\ #\ \ / � � � � P EX B Nr ? 0 HC Nh'6 7� fy w �RB �H F +\ +\ #\ � � � � � �� ALLOWABLE BUFFER IMPACTS ZONE 1 �� ALLOWABLE BUFFER IMPACTS ZONE 2 N C DE�'�' �1F "I'RANS]��RTA'I'I�N II�IVISI�N �F HIGIEIWA�S so o so ioo W,�� ( ��jUN'1[°�Y t SCALE � so 1�R�JEC P �d2188 (gBSI� 1) I + W�DE AV]ENUE ]BNiF WITHERS � RAVENEL BCTW�EN ENGINEERS I PLANNERS I SLIRVEYORS uyy�Uui IBI�G� 11�� L�Nlll' I 91QO M K D C N hC I 5 I 9 9 69 33 0 f 9 7 I L C 3 SH�E'1° � �� 9 r �, � ----- _ �f WADE AVE ---��DGE OF 7RAVEL WAY _. f EA57'BOUND LANES EDCE OF TRAVEL WAY ______------ ---_._,_ EDGE OF TRAVELWAY _ EDGE OF PAVEMEN7 —.—, —.- —r -,— �— •— — — —�� —r �- T- -,--- �— r— SI'f'E 2 Z�NE 2 _eTF_____________ IMF.�CTS=1903 SF _____ ___________ f,+y. \`�� a �� Nq9 \`�� lN �� f ,\'�?°F �/ SE C EE � \ / � � �p E� �\ \�� , � — \�.—� ir' B� / py `1 �% _� �� !� ( �� i � � �/ ✓ � SITE 2 ZONE 1 \ IMPr�C'g'S=13 488 S }�+ \ \�\--------� +� +�+ �� ALLOWABLE BUFFER IMPACTS ZONE 1 �� ALLOWABLE BUFFER IMPACTS ZONE 2 N C DE�'Il' O� 'TIdANS��i�'i'ATI�N d�gVISI�N �� d�IGIHWA�S so o so �� W��]E C�UN�'Y �«_ i scn�E i so �IB�JEC�° 42188 (I85F—ll F � WAIDE AVIENiIE �N�1� � WITHERS � RAVENEL ��°w��N ' ENGINEERS I PLANNERS I SURVEYORS �[yLUIL'. 14I�G1Li 1p�AYl' fLN� I SI�O M K D CryN hC I 25 I f 9 C S�I]EE'll° � �� 9 � f � � Z�DNE 1 � �P IMFAC'd'S=1994 SF � P / �� \ s� `'�'� \ 2C 2c Z'P� Z'S�� "�� N �� W C�` � W Z Z�NE 1 � � zo i �M�r�CTS=1663 SI' 'v ' m i � ' � C m m _ x x \� A � CONC FLUM� � X ��— —_ \ / �� \ /X/� / -\\ \ X � \\\ �X/ �� \ �T�'\: �� \ �� ME ,� . . � Z�NE 2 %��C�N� F�U,-'cTF � �\ IMd�ACTS='�26 SF ,-' / Z�N� 2 " �\ �� IM�,�CTS=932 SF � �\ > � � �� \� Y ) � � y i i / � � � � �� i� � � � / S� �� t_ � — s —�'�'� --'�� 1- --T- - -I '_ \ .__ �_ T �_ �� _�� L - - � �� — /`--EDGE O��AVEL WAYWB ENTRANCE __,— ------ � � __-- -- , �pGE OF �AV�L�'�---- O — , � ------------------- ---- --`—�--- EDGE OF TRAVEL WTY � � — — � � — — — WADE � � —_fD('zE.�.E.If36V�LYY�Y ------ --------------- ---�r-- -- � ��I°IE � ALLOWABLE BUFFER IMPACTS ZONE 1 m ��ll' �� ALLOWABLE BUFFER IMPACTS ZONE 2 N � �y�� p- ��NS1��Ib"g°A'd'I�N �I�I�I�N �� lE-�IGIHWAI� so o � so ioo �� UN"1��' � scn�e i so ��J�C�° 421R8 (FgS�-1) �J W H��JE A�'V�NLT� &�M,I° W ITH E RS 6� RAV E N E L �ETw��N E G INEERS I PLANNERS I S ll R EYORS 7[pLUlli 1CI��LLi 1p�J11� f1lNLJ' I 440 I, D C 1 hC 1 175 j7 3 5�-I�E"g' 8 ��' 9 � i I� o N Z O � � a} � q m � a= w � r �n� � z Q= zp �, �LL 111 U � �� Q y � rn Z �� W ¢ H F-(n � � U a� Q W t� W > O � �� U a rn Z H W W 2 � Li. Qc U G ? C J G W � Z � W Q � � � � U � d = � � � � N � o LL �- N �n � M W � U "' ^ m o � N } � z / O r V' m N � m l LL W d N � = Q � � ¢ m � � o � � W W ^ N � � t+, � �,�f �.L z V I� cD N � � � r � d a � � � � m Z� O� Q Q Q Q Q p Z z Z z �� O � ,x,� � J W � N a� �+ � � � u� •=�•v O M F- � E ( !t t � J � <E a� 41 � a�a Z ?� � F ` W F � � m a � u�� Q � G T.g Cg � � - a � � � W I F- � 3 Q W� � � � �� \ / �� W � W W UW 0 � # � � � W�S� T � ///yyy''' � / 7 � ' � � �� ~ 1 � / /� '"_ � � i � / ''C � � � i i ��/ i 2 � � �� a F� /� � � 2 a �� ' � a � a � �-- � � I � II � , � I II � � � I II �� i i i , � �. .,. ...�. �.� � �F W A TF9 o�, pG Office Use Only � �� Corps action ID no i ,�, � o � DWQ pro�ect no Form Version 1 3 Dec 10 2008 Pre-�onstruetaon 1�lotafieation PCl� �'orm A A licant Information 1 Processing 1a Type(s) of approval sought from the Corps � Section 404 Permit ❑ Section 10 Permit 1b Specify Nationwide Permit(NWP) number NWP 3 and 13 or General Permit(GP) number � 1 c Has the NWP or GP number been verified by the Corps� � Yes ❑ No 1d Type(s) of approval sought from the DWQ (check all that apply) �401 Water Quality Certification—Regular ❑ Non 404 Junsdictional General Permit ❑ 401 Water Quality Certification—Express � Riparian Buffer Authonzation 1 e Is this notification solely for the record For the record only for DWQ 401 For the record only for Corps Permit because written approval is not required� Certification ❑Yes � No �Yes ❑ No 1f Is payment into a mitigation bank or in lieu fee program proposed for mitigation � Yes � No of impacts� If so attach the acceptance letter from mitigation bank or in lieu fee program 1 g Is the pro�ect located in any of NC s twenty coastal counties If yes answer 1 h ❑ Yes � No below 1h Is the pro�ect located within a NC DCM Area of Environmental Concern (AEC)� ❑Yes ❑ No 2 Pro�ect Information Maintenance repair activity at a failed hydraulic pipe system (Site 1) and streambank 2a Name of pro�ect stabilization (Sites 2 and 3) on Wade Avenue in Wake County A stormwater Dry Detention Basin wdl be installed at Site 1 2b County Wake 2c Nearest murncipality/town Raleigh 2d Subdivision name N/A 2e NCDOT only T 1 P or state RSP 1 (formerly known as R 4436) WBS Number 42188 pro�ect no 3 Owner Information 3a Name(s)on Recorded Deed NCDOT(J W Bowman P E ) 3b Deed Book and Page No N/A 3c Responsible Party (for LLC if N/A applicable) 3d Street address Division 5 Office 2612 N Duke Street 3e City state zip Durham NC 27704 � — — 3f Te� `�one ,� (919)220 4600 3g Fax �� (919) 560 3371 � 3h Email address wbowman@ncdot org � 1 � Page 1 of 11 � PCN Form —Version 1 3 December 10 2008 Version t ! 4 Applicant Information (if different from owner) 4a Appiicant is ❑ Agent ❑ Other specify 4b Name 4c Business name (if apphcable) 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 Busmess name (if applicable) 5c Street address 5d City state zip 5e Telephone no 5f Fax no 5g Email address I 1 r � Page 2 of 11 ' PCN Form —Version 1 3 December 10 2008 Version � t c � B Pro�ect Information and Prior Pro�ect History 1 Property Identif�cation 1a Property identification no (tax PIN or parcel ID) N/A Latitude Site 1 2 35 80317 Site 3 35 80417 1b Site coordinates (in decimal degrees) Longitude Site 1 2 78 70073 Site 3 78 69836 (DD DDDDDD) ( DD DDDDDD) 1 c Property size 0 3 ac acres 2 Surface Waters 2a Name of nearest body of water(stream river etc)to UT to House Creek (Site 1 2) and House Creek (Site 3) proposed pro�ect 2b Water Quality Classification of nearest receiving water C NSW for UT to House Creek and House Creek 2c River basin Neuse River Basin 3 Pro�ect Description 3a Descnbe the existing conditions on the site and the general land use in the vicinity of the pro�ect at the time of this application Wooded land 3b List the total estimated acreage of all existing wetlands on the property OOac 3c List the total estimated linear feet of all existing streams (intermittent and perennial) on the property 30 linear feet at Site 1 231 linear feet at Site 2A 102 linear feet at Site 2B and 51 linear feet at Site 3 3d Explain the purpose of the proposed pro�ect Maintenance repair activities at a faded hydraulic pipe system and streambank stabilization on Wade Avenue in Wake County 3e Describe the overall pro�ect in detail includmg the type of equipment to be used Equipment will include backhoe crane excavator etc 4 Jurisdictional Determ�nations 4a Have�urisdictional wetland or stream determinations by the Corps or State been requested or obtained for this property/ pro�ect(including all prior phases) in the past� ❑ Yes � No ❑ Unknown Comments 4b If the Corps made the�urisdictional determination what type � Preliminary ❑ Final of determination was made� 4c If yes who delineated the�unsdictional areas� AgencylConsultant Company Name (if known) Other 4d if yes list the dates of the Corps�unsdictional determinations or State determinations and attach documentation 5 Pro�ect History t 5a Have permits or certifications been requested or obtained for � Yes ❑ No ❑ Unknown this pro�ect (includmg all prior phases) in the past� 5b If yes explain in defi3�l accoruing to help file instructions Permit application for�his pro�ect(then known as R 4436) on 8/10/09 Impacts only for failed hydraulic pipa system (Site , 1) on Wade Avenue m the permit application DWQ issued WQC and buffer authonzation on 8/14/09 (DW� Pro�ect No 4r 20090876) { � Page 3 of 11 PCN Form—Version 1 3 December 10 2008 Version 6 Future Pro�ect Plans 6a Is this a phased pro�ect� ❑Yes � No 6b If yes explain � Page 4 of 11 PCN Form—Version 1 3 December 10 2008 Version C Proposed Impacts Inventoy 1 Impacts Summary 1 a Which sections were completed below for your pro�ect(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�unsdiction number— Type of impact Type of wetland Forested (Corps 404 10 Area of impact Permanent(P) or (if known) DWQ—non 404 other) (acres) Tem ora T W1 ❑ P 0 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 �mpacts 0 0 acre 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 3b 3c 3d 3e 3f 39 Stream impact Type of impact Stream name Perennial Type of�urisdiction Average impact number (PER) or (Corps 404 10 stream length Permanent(P) or intermittent DWQ—non 404 width (linear Temporary(T) (INT)� other) (feet) feet) S1 � P �T Fill and rip rap m fiow UT to House � PER � Corps 10 ft 30 ft line/bank of stream Creek ❑ INT � DWQ 231 ft at S2 � P ❑ T Rip rap on bank UT to House � PER � Corps 10 ft Site 1 B Creek ❑ INT � DWQ 102 ft at Site 2B S3 � P 0 T Fill and rip rap in flow House Creek � PER � Corps 10 ft 51 ft line/bank of stream ❑ INT � DWQ S4 ❑ P ❑T ❑ PER ❑ Corps ❑ INT ❑ DWQ S5 ❑ P 0 T ❑ PER ❑ Corps ❑ INT ❑ DWQ S6 ❑ P � T ~ ❑ PER ❑ Corps � ❑ INT ❑ DWQ k 3h Total stream and tr�butary�mpacts 414 ft ! f 3i Comments � I 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 estuanes tr�butaries sounds tne Atlantic Ocean or any other open water or the U S then individually list all open water impacts below 4a 4b 4c 4d 4e Open water Name of waterbody impact number (if applicable) Type of impact Waterbody type Area of impact(acres) —Permanent (P) or Tem ora T 01 ❑ P ❑T 02 ❑ P ❑T 03 ❑ P ❑ T 04 ❑ P �T 4f Total open water impacts 0 0 ac 4g Comments 5 Pond or Lake Construction If ond or lake construction ro osed then com lete the chart below 5a 5b 5c 5d 5e Wetland Impacts (acres) Stream Impacts (feet) Upland Pond ID Proposed use or purpose of (acres) number pond Flooded Filled Excavated Flooded Filled Excavated Flooded P1 P2 Sf Total 5g Comments 5h Is a dam high hazard permit required� ❑ Yes ❑ No If yes permit ID no 5i Expected pond surface area (acres) 5� Size of pond watershed (acres) 5k Method of construction i ti � � Page 6 of 11 PCN Form —Version 1 3 December 10 2008 Version � � f�� 6 Buffer Impacts (for DWQ) If pro�ect will impact a p otected riparian buffer then complete the chart below If yes then individually list all buffer impacts below If an im acts re uire miti ation then ou MUST fdl out Section D of this form 6a � Neuse ❑ Tar Pamlico ❑ Other Pro�ect is m which protected basin� ❑ Catawba ❑ Randleman 6b 6c 6d 6e 6f 6g Buffer impact number— Reason for BufFer Zone 1 impact Zone 2 impact Permanent(P) impact Stream name mitigation (square feet) (square feet) or Temporary required� T B1 � P ❑T mai nenance UT to House Creek � NoS 4 142 sf 1 496 sf 62 � P ❑T Stab lization UT to House Creek � NoS 13 488 sf 1 903 sf B3 � P�T Stab lization House Creek � NoS 3 437 sf 1 658 sf 6h Total buffer�mpacts 21 067 sf 5 057 sf 6i Comments D Impact Justification and Mitigation 1 Avoidance and Minim�zation 1 a Specifically describe measures taken to avoid or minimize the proposed impacts in designing pro�ect Rip rap has been reduced to minimum amount necessary to provide long term stability 1 b Specifically descnbe measures taken to avoid or minimize the proposed impacts through construction techrnques Construction equipment will not be allowed outside of permitted stream and buffer impact Further minimization will occur on site dunng construction 2 Compensatory Mitigation for Impacts to Waters of the U S or Waters of the State 2a Does the pro�ect require Compensatory Mitigation for ❑ Yes � No impacts to Waters of the U S or Waters of the State� 2b If yes mrtigation is required by(check all that apply) ❑ DWQ ❑ Corps ❑ Mitigation bank 2c If yes which mitigation option wdl be used for this pro�ect� ❑ 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 Page 7 of 11 PCN Form—Version 1 3 December 10 2008 Version � 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 Wi�l the pro�ect result in an impact within a protected riparian buffer that requires ❑ Yes � No buffer mitigation� 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 6c 6d 6e Zone Reason for impact Total impact Multiplier Required mitigation (square feet) (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 npanan buffer restoration payment into an approved in lieu fee fund) 6h Comments Discussed stream and npanan buffer permitting with Rob Ridings on 9/19/2011 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 1 a Does the pro�ect include or is it ad�acent to protected nparian 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 Permit application only involves maintenance repair at a failed site and stabilization of streambanks No new impervious surface is being added to the ❑ Yes � No pro�ect in con�uction with this activity Additionally a stormwater dry detention basin is to be constructed at Site 1 2 Stormwater Mana ement Plan 2a What is the overall percent imperviousness of this pro�ect� N/A% 2b Does this pro�ect require a Stormwater Management Plan� ❑ Yes � No 2c If this pro�ect DOES NOT require a Stormwater Management Plan explain why Permit application only involves maintenance repair at a failed site and stabilization of streambanks No new impervious surface is being added to the pro�ect in con�uction with this activity Additionally a stormwater dry detention basin is to be constructed at Site 1 2d if this pro�ect DOES require a Stormwater Management Plan then provide a brief narrative description of the plan ❑ Certified Local Government 2e Who wdl be responsible for the review of the Stormwater Management Plan� ❑ DWQ Stormwater Program ❑ DWQ 401 Urnt 3 Certified Local Government Stormwater Review 3a In which local government s�urisdiction is this pro�ect� ❑ Phase il 3b Which of the following locally implemented stormwater management programs ❑ NSW apply(check all that apply) ❑ USMP ❑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 ❑ HQW 4a Which of the following state implemented stormwater management programs apply � ORW (check all that apply) ❑ Session Law 2006 246 ❑ Other ab Has the approved Stormwater Management Plan with proof of appraval beer� attached� ❑ Yes � ❑ No 5 DWQ 401 Unit Stormwater Review 5a Does the Stormwater Management Plan meet the appropriate requirements� � Yes ❑ No Page 9 of 11 PCN Form—Version 1 3 December 10 2008 Version 5b Have all of the 401 Unit submittal requirements been met� ❑ Yes ❑ No F Supplementary Information 1 Environmental Documentation (DWQ Requirement) 1 a Does the pro�ect 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 pro�ect require preparation of an environmental document pursuant to the requirements of the National or State ❑ Yes � No (North Carolina) Environmental Policy Act(NEPA/SEPA)� 1c If you answered yes to the above has the document review been finalized by the State Cleanng House� (If so attach a copy of the NEPA or SEPA final approval letter) ❑ Yes � No 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 26 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 pro�ect(based on past and reasonably anticipated future impacts) result m � 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 4 Sewage Disposal (DWQ Requirement) 4a Clearly detail the ultimate treatrnent methods and disposition (non discharge or discharge) of wastewater generated from the proposed pro�ect or available capacity of the sub�ect facility N/A 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 pro�ect 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� ❑ Raleigh 5c 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 Cntical Habitat� On site evaluation 6 Essential Fish Habitat(Corps Requirement) 6a Will this pro�ect 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� Available mapping 7 Historic or Prehistoric Cultural Resources (Corps Requirement) 7a Wdl this pro�ect occur in or near an area that the state federal or tnbal governments have designated as having histonc or cultural preservation �Yes � No status (e g National Historic Trust designation or properties significant m North Carolina history and archaeology)� 7b What data sources did you use to determine whether your site would impact historic or archeological resources� Consultation with the State Historic Preservation Office 8 Flood Zone Designat�on (Corps Requirement) 8a Will this pro�ect occur in a FEMA designated 100 year floodplain� ❑Yes � No 8b If yes explain how pro�ect meets FEMA requirements 8c What source(s) did you use to make the fioodplain determination� Consultation w/NCDOT hydraulics unit C � c%�/�GL �� <<lZ�/�� `�S � I I ApplicanUAgents Printed Name Applicant/Agents Signature Date (Agent s signature is valid only if an authorization letter from the applicant is rovided Page 11 of 11 PCN Form—Version 1 3 December 10 2008 Version