20120158 Ver 1_Application_20120215

BEVERLY EAVES PERDUE
GOVERNOR
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
February 7 2012
Mr Tom Steffens
U S Army Corps of Engineers
Washington Regulatory Field Office
Post Office Box 1000
Washington, North Carolina 27889 -1000
(Courtesy Copy)
Mr Rob Ridings
Wetlands /401 Unit
NC DENR Division of Water Quality
1650 Mail Service Center
Raleigh, NC 27609
w
'?01
EUGENE A CONTT, JR
SECRETARY
12"' 0 15 00
Subject NWP 14 request, for the widening of SR 1629 (Julian Allsbrook Highway) from
Virginia Ave to South Street in Hahfax County, NC WBS # 37742
Dear Sus
Please find enclosed the Pre - Construction Notification for the above referenced project
All of SR 1629 except for the above mentioned section is a curb and gutter 2 lane section
with a center turn The proposed project is to add a center turn lane as well as curb and
gutter to the rest of SR 1629 There are unavoidable impacts to an UT to Chockoyotte
Creek associated with this project Chockoyotte Creek is located in the Roanoke River
Basin and is classified by the Division of Water Quality at this crossing as Class C waters
Best Management Practices for the Protection of Surface Waters will be strictly adhered
to during this project
Federally Protected Species and Cultural Resources
The Fish and Wildlife Service (FWS) currently list three federally protected species for
Halifax County (Table 1)
[phone] x 3532 tccoggms @ncdot gov
Post Office Box 3165 Wilson, North Carolina 27895 -3165

Table 1- Federally Protected Species of Halifax County
Common Name
Scientific Name
Federal
Status
Habitat
Present
Biological
Conclusion
Red cockaded
woodpecker
Picoides borealis
E
N
No Effect
Dwarf Wedgemussel
Alasmidonta heterodon
E
N
No Effect
Tar River Spmymussel
Elliptio steinstansana
E
N
No Effect
No element occurrences are listed on the NHP database within one mile of this crosslme During
an on site visit no pine trees suitable for RCW foraging or nesting are near or adjacent to the
crosslme No mussel habitat present for the Tar River Spmymussel and the Dwarf wedge mussel
The base flow of this channel is only a couple of inches and rates as an intermittent stream This
project is not likely to ,jeopardize the continued existence of any of the federally protected
species listed in Halifax County No sites eligible for listing on the National Register occur
within the area of potential effect This project will not affect listed or eligible historic
properties
Minimization Information
Impacts will be minimized by strict enforcement of Best Management Practices for the protection
of surface waters and wetlands restrictions against the staging of equipment in or adjacent to
waters of the US and coordination (including a pre construction meeting) with the Division
Environmental Officer
Regulatory Approvals
USACE Section 404 Permit The project qualifies for Nationwide Permit 14 (Linear
Transportation Project) All permit conditions will be followed
NCDWQ Section 401 Certification The project qualifies for 401 General Certification number
3704 All conditions of the general certification will be followed For our files please provide
written authorization that the activity is authorized
NCDWQ Buffer Rules Project in Roanoke River Basin
Please contact Chad Coggins [phone] or Byron Bateman at [phone] if you have
any questions or need additional information Your time and effort are appreciated
Respectfully �Y�ours
r-
YW nRouse W
Acting Division Engineer — Division 4
[phone] x 3532 tccoggms @ncdot gov
Post Office Box 3165 Wilson North Carolina 27895 3165

O�oF war FgQG
Office Use Only
Corps action ID no
DWQ project no
Form Version 13 Dec 10 2008
Page 1 of 10
PCN Form — Version 1 3 December 10 2008 Version
Pre - Construction Notification (PCN) Form
A
Applicant Information
1
Processing
la
Type(s) of approval sought from ihe_7
Corps
® Sect 40
ion 4 Permit El Section 10 Permit
1b Specify Nationwide Permit (NWP) number 14 or General Permit (GP) number
1c
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
le
Is this notification solely for the record
because written approval is not required?
For the record only for DWQ 401
Certification
❑ Yes ® No
For the record only for Corps Permit
® Yes ❑ No
1f
Is payment into a mitigation bank or in lieu fee program proposed for mitigation
of impacts? If so attach the acceptance letter from mitigation bank or in lieu
fee program
❑ Yes
® No
1g
Is the project located in any of NC s twenty coastal counties If yes answer 1 h
below
❑ Yes
® No
1h
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes
® No
2
Project Information
2a
Name of project
SR 1629 widening from Virginia Ave to South Street
2b
County
Halifax
2c
Nearest municipality / town
Roanoke Rapids
2d
Subdivision name
2e
NCDOT only T I P or state
project no
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 10
PCN Form — Version 1 3 December 10 2008 Version

4
Applicant Information (if different from owner)
4a
Applicant is
® Agent ❑ Other specify
4b
Name
John W Rouse Acting Div 4 Engineer
4c
Business name
(if applicable)
NCDOT Div of Highways
4d
Street address
PO Box 3165
4e
City state zip
Wilson NC 27895 -3165
4f
Telephone no
252 237 6164x3501
4g
Fax no
252 234 6174
4h
Email address
twrouse(cDncdot gov
5
Agent/Consultant Information (if applicable)
5a
Name
Chad Coggins
5b
Business name
(if applicable)
NCDOT Div 4 Environmental Officer
5c
Street address
same
5d
City state zip
same
5e
Telephone no
252 296 3532
5f
Fax no
252 234 6174
5g
Email address
tccogpins &ncdot gov
Page 2 of 10

B Project Information and Prior Project History
1 Property Identification
1a Property identification no (tax PIN or parcel ID)
1 b Site coordinates (in decimal degrees)
Latitude 36 4431 Longitude 776534
(DD DDDDDD) ( DD DDDDDD)
1 c Property size
acres
2 Surface Waters
2a Name of nearest body of water (stream river etc ) to
proposed project
UT to Chocko otte Creek
Y
2b Water Quality Classification of nearest receiving water
2c River basin
Roanoke
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
Urban setting
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
20
3d Explain the purpose of the proposed project
All of SR 1629 except for this last section is a curb and gutter 2 lane section with a center turn lane The proposed project
is to add another lane and curb and gutter this last 2 lane section
3e Describe the overall project in detail including the type of equipment to be used
Use mechanical highway equipment to widen roadway
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?
Comments stream exhibits OHWM
❑ Yes ® No ❑ Unknown
4b If the Corps made the Jurisdictional determination what type
of determination was made?
❑ preliminary ❑ Final
4c If yes who delineated the Jurisdictional areas?
Name (if known) Chad and Byron
Agency /Consultant Company NCDOT
Other
4d If yes list the dates of the Corps Jurisdictional determinations or State determinations and attach documentation
6 Project History
5a Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past?
❑ Yes ® No ❑ Unknown
5b If yes explain in detail according to help file instructions
6 Future Project Plans
6a Is this a phased project?
❑ Yes ® No
[!b If yes explain
Page 3 of 10
PCN Form — Version 1 3 December 10 2008 Version

C Proposed Impacts Inventory
1 Impacts Summary
1a Which sections were completed below for your project (check all that apply)
❑ Wetlands ® Streams tnbutarnes ❑ 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
26
2c
2d
2e
2f
Wetland impact
Type of jurisdiction
number —
Type of impact
Type of wetland
Forested
(Corps 404 10
Area of impact
Permanent (P) or
(if known)
DWQ — non -404 other)
(acres)
Temporary T
W1 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W2 ❑ P [IT
❑ Yes
❑ Corps
❑ No
❑ DWQ
W3 ❑ P [IT
❑ Yes
❑ Corps
[I No
❑DWQ
W4 []POT
❑ Yes
❑ Corps
❑ No
❑ DWQ
W5 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W6 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
2g Total wetland impacts
2h Comments
3 Stream Impacts
If there are perennial or intermittent 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 of jurisdiction
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 SPOT
pipe
UT to Chochoyotte
Creek
❑ PER
® INT
® Corps
❑ DWQ
10
15
S2 []POT
dewatenng
UT to Chochoyotte
Creek
❑ PER
® INT
❑ Corps
❑ DWQ
10
10
S3 ❑ P ❑ T
❑ PER
❑ INT
❑ Corps
❑ DWQ
S4 []POT
❑ PER
❑ Corps
❑ INT
❑ DWQ
S5 ❑ P ❑ T
❑ PER
❑ INT
❑ Corps
❑ DWQ
S6 ❑ P ❑ T
❑ PER
❑ INT
❑ Corps
❑ DWQ
3h Total stream and tributary impacts
15
31 Comments
Page 4 of 10
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 —
Permanent (P) or
(if applicable)
Type of impact
Waterbody type
Area of impact (acres)
Temporary T
01 ❑ PE] T
02 []PDT
03 ❑P ❑T
04 ❑P ❑T
4f Total open water impacts
4g Comments
5 Pond or Lake Construction
If pond or lake construction proposed then complete the chart below
5a
5b
5c
5d
5e
Pond ID
Proposed use or purpose
Wetland Impacts (acres)
Stream Impacts (feet)
Upland
number
of pond
(acres)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
P2
5f Total
5g Comments
5h Is a dam high hazard permit required
❑ Yes ❑ No If yes permit ID no
51 Expected pond surface area (acres)
5j Size of pond watershed (acres)
5k Method of construction
6 Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer then complete the chart below If yes then individually list all buffer impacts
below If any impacts require mitigation then you MUST fill out Section D of this form
6a
❑ Neuse ❑ Tar Pamlico ® Other Roanoke
Project is in which protected basing
❑ Catawba ❑ Randleman
6b
6c
6d
6e
6f
6g
Buffer impact
number —
Reason
Buffer
Zone 1 impact
Zone 2 impact
Permanent (P) or
for
Stream name
mitigation
(square feet)
(square feet)
Temporary T
impact
required?
61 ❑P ❑T
El Yes
❑ No
`62 ❑P
❑Yes
❑ No
B3 ❑P ❑T
El Yes
❑ No
6h Total buffer impacts
61 Comments
Page 5 of 10

D Impact Justification and Mitigation
1 Avoidance and Minimization
1a Specifically describe measures taken to avoid or minimize the proposed impacts in designing project
Stream will be crossed only once and at a perpendicular (90 degree) angle
1b Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques
Strict enforcement of Best Management Practices for sediment and erosion control the protection of wetlands and
surface waters will be enforced
2 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 mitigation option will be used for this
projects
❑ Mitigation bank
F1 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) --7Type
Quantity
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
Page 6 of 10
PCN Form — Version 1 3 December 10 2008 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 mitigation
(square feet)
Zone 1
3 (2 for Catawba)
Zone 2
1 5
6f Total buffer mitigation required
6g If buffer mitigation is required discuss what type of mitigation is proposed (e g payment to private mitigation bank
permittee responsible riparian buffer restoration payment into an approved in lieu fee fund)
6h Comments
Page 7 of 10

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
1b If yes then is a diffuse flow plan included? If no explain why
Comments
Yes ❑ No
2 Stormwater Management Plan
2a What is the overall percent imperviousness of this prolect7
0%
2b Does this project require a Stormwater Management Plan?
❑ Yes ® No
2c If this project DOES NOT require a Stormwater Management Plan explain why Within Roanoke Basin with a C
Classification
2d If this project DOES require a Stormwater Management Plan then provide a brief narrative description of the plan
❑ Certified Local Government
2e Who will be responsible for the review of the Stormwater Management Plan?
❑ DWQ Stormwater Program
❑ DWQ 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 Program Review
❑ Coastal counties
❑ HOW
4a Which of the following state implemented stormwater management programs apply
❑ ORW
(check all that apply)
❑ Session Law 2006 246
® Other NPDES
4b Has the approved Stormwater Management Plan with proof of approval been
Yes ❑ No
attached?
5 DWQ 401 Unit Stormwater Review
5a Does the Stormwater Management Plan meet the appropriate requirements?
❑ Yes ❑ No
5b Have all of the 401 Unit submittal requirements been met?
❑ Yes ❑ No
Page 8 of 10
PCN Form — Version 1 3 December 10 2008 Version

F
Supplementary Information
1
Environmental Documentation (DWQ Requirement)
la
Does the project involve an expenditure of public (federal /state /local) funds or the
use of public (federal /state) lands
® Yes No
❑
lb
If you answered yes to the above does the project require preparation of an
environmental document pursuant to the requirements of the National or State
❑ Yes ® No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1 c
If you answered yes to the above has the document review been finalized by the
State Clearing House? (If so attach a copy of the NEPA or SEPA final approval
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 project (based on past and reasonably anticipated future impacts) result in
❑ Yes ® No
additional development which could impact nearby downstream water quality?
3b
If you answered yes to the above submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy If you answered no provide a short narrative description
4
Sewage Disposal (DWQ Requirement)
4a
Clearly detail the ultimate treatment methods and disposition (non discharge or discharge)
of wastewater generated from
the proposed project or available capacity of the subject facility
Page 9 of 10
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
habitat?
❑ Yes ® No
5b Have you checked with the USFWS concerning Endangered Species Act
impacts?
❑ Yes No
5c 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?
NHP GIS data layer and the fact that the base flow is only 3 4 inches deep and rates as an Intermittent stream
6 Essential Fish Habitat (Corps Requirement)
6a WIII this project occur in or near an area designated as essential fish habitats
❑ Yes ® No
6b What data sources did you use to determine whether your site would Impact Essential Fish Habitat?
base flow is only 3 4 inches deep with numerous obstructions within downstream reach
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?
NCHPO GIS Web service was consulted with no Historic sites within project study area
8 Flood Zone Designation (Corps Requirement)
8a WIII this project occur in a FEMA designated 100 year floodplain?
❑ Yes ® No
8b If yes explain how project meets FEMA requirements
8c What source(s) did you use to make the floodplain determination? NC flood Map
o//2-
Applicant/Agent s Printed Name
Date
Applicant/Agent s Sig ture
(Agent s si ature is valid only if an authorization letter from the applicant
is provided
Page 10 of 10

NC Division of Water Quality — Methodology for Identification of Intermittent and
Perennial Streams and Their Origins v 4 11
NC DWO Stream Identification Form Version 4 1 t
Date 73�.. 2O �e tZ
Protect/Site Alis6
Latitude
Evaluator U 1 fFin �j�{ �, M a- e\
County � IloanctiL �
ongitude
/
Total Points
Stream is at least intermittent
if L> 19 or perennial if >_ 30 Z -7
Stream Determination (circle one)
Ephemeral Intermittent Perennial
Other
e g Quad Name
A Geomorphology (Subtotal = ) �) )
Absent
Weak
Moderate
Strong
1a Continuity of channel bed and bank
0
1
2
1)
2 Sinuosity of channel along thalweg
0
1
05
3
3 In channel structure ex riffle pool step pool
ripple sequence
0
1
2
3
4 Particle size of stream substrate
0
1
2
3
5 Active /relict floodplain
M
1
2
3
6 Depositional bars or benches
0
1
1
3
7 Recent alluvial deposits
0
2
3
8 Headcuts
0
1
perennial streams may also be identified using other methods Seep 35 of manual
3
9 Grade control
0
05
1
15
10 Natural valley
0
UV
1
1 5
11 Second or greater order channel
No= 0
Yes = 3
° artificial ditches are not rated see discussions in manual
B Hydrology (Subtotal = ' )
12 Presence of Baseflow
0
1
2
0
13 Iron oxidizing bacteria
1
2
3
14 Leaf litter
71-T
1
05
0
15 Sediment on plants or debris
0
1
1
1 5
16 Organic debris lines or piles
0
05
1
15
17 Soil based evidence of high water table?
No = 0
es = 3
C Biology (Subtotal = 25 )
18 Fibrous roots in streambed
3
2
1
0
19 Rooted upland plants in streambed
2
1
0
20 Macrobenthos (note diversity and abundance)
0
1
2
3
21 Aquatic Mollusks
1
2
3
22 Fish
0
05
1
1 5
23 Crayfish
0
1
15
24 Amphibians
KID
05
1
1 5
25 Algae
0
1
15
26 Wetland plants in streambed
FACW = 0 75 OBL = 1 5 Other = 0
perennial streams may also be identified using other methods Seep 35 of manual
Notes 0
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