20120185 Ver 1_Application_20120220

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STATE OF NORTH CAROLINA `R4�5' o 20j
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DEPARTMENT OF TRANSPORTATION t
BEVERLY EAVES PERDUE EUGENE A NTI JR
GOVERNOR SECRETARY
February 15 2012
N C Division of Water Quality
Transportation Permitting Unit
2321 Crabtree Blvd /Suite 250 l—
Raleigh NC 27604 2260
Attention Mr Rob Riding NCDOT Project Coordinator
Subject Proposed roadway construction and extension of a structures conveying
unnamed tributaries to Coon Creek on SR 1523 (Landis Road) in
Granville County WBS No 5C 039043
The North Carolina Department of Transportation ( NCDOT) proposes construct
SR 1523 (Landis Road) in Granville County This roadway improvement project will
include grade, drain base pave and erosion control for the project length of 1 404
miles This project will involve permanent stream impacts include surface water fill and
rip rap armoring for bank stabilization and temporary stream impacts for dewatering
This project is within the Tar - Pamlico River Basin and does involve permanent buffer
impacts Application is hereby made for NCDENR DWQ Section 401 Water Quality
Certification (WQC) No 3820 A pre construction notification construction plan
- sketches project mapping, and photographs are attached with this request By copy of
this letter we are notifying the USACE of the intent to work under a non reporting NWP
14 Please note that this project has been in a design and project development phase for
over eight years and therefore should be grandfathered under the existing NWPs If you
have any questions or need additional information, please contact Mrs Heather
Montague at [phone] or hwmontague@ncodot gov
Sincerely
4z'
J W Bowman P E
Division Engineer
cc Mr Eric Alsmeyer, NCDOT Coordinator U S Army Corps of Engineers
Ms Tasha Johnson, NCDOT DIV 5, District 2 Engineer
Mr Jason Lee, NCDOT Granville County Maintenance Engineer
Mrs Dawn Phipps, NCDOT DIV 5 Roadside Environmental Field Operations
Division Five — 2612 North Duke Street Durham North Carolina 27704
Telephone [phone] Fax [phone]

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Inlet — Site 3
Outlet Site 3
SR 1523 (Landis Road)
Granville County - Maintenance
Secondary Roads Program

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Date 2/15/2012 Caption SR 1523 (Landis Road)
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D�O� W A 7FRl y
Office Use Only
Corps action ID no
DWQ project no
Form Version 1 3 Dec 10 2008
Page 1 of 9
PCN Form — Version 1 3 December 10 2008 Version
Pre - Construction Notification PC
Form
A
Applicant Information
1
Processing
1a
Type(s) of approval sought from the
Corps non reporting
®Section 404 Permit El Section 10 Permit
1 b
Specify Nationwide Permit (NWP) number non reporting NWP 14
or General Permit (GP) number
1c
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 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ® Riparian Buffer Authorization
1 e
Is this notification solely for the record
because Cdr "en app o a' s ^o+ req. ed'
For the record only for DWQ 401
Ce•t Pica+ o^
❑ 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
1h
Is the project located within a NC DCM Area of Environmental Concern (AEC)
❑Yes ® No
2
Project Information
2a
Name of project
SR 1523 (Landis Road)
2b
County
Granville
2c
Nearest municipality / town
Oxford
2d
Subdivision name
N/A
2e
NCDOT only T I P or state
project no
FWBS No SC 039043
3
Owner Information
3a
Name(s) on Recorded Deed
NCDOT Division 5
3b
Deed Book and Page No
N/A
3c
Responsible Party (for LLC if
applicable)
N/A
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@ncdot qov
4
Applicant Information (if different from owner) N/A
r5—AgenVConsultant
Information (if applicable) N/A
Page 1 of 9
PCN Form — Version 1 3 December 10 2008 Version

B Project Information and Prior Project History
1 Property Identification
1 a Property identification no (tax PIN or parcel ID)
N/A
lb Coordinates (in decimal degrees)
Site 1
Latitude 36 3351 Longitude 785554
Site 2
Latitude 36 3331 Longitude 785555
Site 3
Latitude 36 3292 Longitude 785563
Site 4
Latitude 36 3261 Longitude 785566
(DD DDDDDD) ( DD DDDDDD)
1c Property size
— 10 21 acres
2 Surface Waters
2a Name of nearest body of water (stream river etc) to
Coon Creek
proposed project
2b Water Quality Classification of nearest receiving water
C NSW
2c River basin
Tar Pamlico
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
Existing roadway is gravel and will be paved Existing cross line structures are too short and will be extended Site is
surrounded by wooded and agricultural lands
3b List the total estimated acreage of all existing wetlands on the property
NONE
3c List the total estimated linear feet of all existing streams (intermittent and perennial) on the property
240 ft
3d Explain the purpose of the proposed project The cross line extensions and proposed roadway improvements will
provide for a safer travel way and adequate shoulder widths This project is part of the secondary road paving program
The existing gravel roadway will be paved with asphalt
3e Describe the overall project in detail including the type of equipment to be used
The NCDOT will extend the existing cross lines and add new rip rap armoring underlain with filter fabric at the pipe ends for
long term stability The NCDOT will also dewater the work zone during construction as necessary Equipment used will
include a backhoe an excavator and grader pan and dump trucks
4 Junsdictional Determinations
4a Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
El Yes ®No ❑ Unknown
project (including all prior phases) in the pasty
Comments N/A
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 N/A
Name (if known) N/A
Other N/A
4d If yes list the dates of the Corps jurisdictional determinations or State determinations and attach documentation
N/A
Page 2 of 9
PCN Form — Version 1 3 December 10 2008 Version

5 Project History
5a Have permits or certifications been requested or obtained for
❑ Yes
® No ❑ Unknown
this project (including all prior phases) in the past?
5b If yes explain in detail according to help file instructions
N/A
6 Future Project Plans
6a Is this a phased project?
❑ Yes
® No
6b If yes explain
N/A
C Proposed Impacts inventory
1 Impacts Summary
la 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 lunsaiction
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
N/A
N/A
❑ Yes
❑ No
❑ Corps
❑ DWQ
N/A
2g Total Wetland Impacts
NONE
Page 3 of 9
PCN Form — Version 1 3 December 10 2008 Version

2h Comments N/A
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
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)
Site 1 ® P ❑ T
® PER
® Corps
Stream 1
fill
Coon Creek
❑ INT
® DWQ
4
20
Site 1 ® P ❑ T
® PER
® Corps
16
Stream 1
rip rap
Coon Creek
❑ INT
®DWQ
4
banks only
Site 1 ❑ P ®T
® PER
® Corps
36
Stream 1
dewatenng
Coon Creek
❑ INT
® DWQ
4
(concurrent)
Site 2 ® P ❑ T
® PER
® Corps
Stream 1
fill
Coon Creek
❑ INT
® DWQ
4
16
Site 2 ® P ❑ T
rip rap
Coon Creek
® PER
® Corps
4
16
Stream 1
❑ INT
®DWQ
banks only
Site 2 ❑ P ®T
dewatenng
Coon Creek
® PER
® Corps
4
32
Stream 1
❑ INT
® DWQ
(concurrent)
Site 3 ® P ❑ T
❑ PER
® Corps
Stream 1
fill
Coon Creek
® INT
® DWQ
3
16
Site 3 ®P ❑ T
❑ PER
® Corps
16
Stream 1
rip rap
Coon Creek
® INT
®DWQ
3
banks only
Site 3 ❑ PET
El PER
® Corps
32
Stream 1
dewatenng
Coon Creek
® INT
® DWQ
3
(concurrent)
Site 4 ® P ❑ T
fill
Coon Creek
❑ PER
® Corps
3
38
Stream 1
® INT
® DWQ
Site 4 ®P ❑ T
❑ PER
® Corps
16
Stream 1
rip rap
Coon Creek
® INT
®DWQ
3
8 in bed
@ outlet
Site 4 ❑ P ®T
❑ PER
® Corps
38
Stream 1
dewatenng
Coon Creek
® INT
®DWQ
3
I
(concurrent)
3h Total stream and tributary impacts
138
31 Comments Rip rap will be placed within flow line only at Site 4 outlet due to topography
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
Name of waterbody
number —
(if applicable)
Type of impact
Waterbody type
Area of impact (acres)
Permanent (P) or
Temporary
01 ❑ P ❑ T
N/A
N/A
N/A
N/A
4f Total open water impacts
NONE
4g Comments N/A
6 Pond or Lake Construction
If pond or lake construction proposed then complete the chart below
Page 4 of 9
PCN Form — Version 1 3 December 10 2008 Version

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
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
P2
5f Total
NONE
NONE
NONE
NONE
NONE
NONE
NONE
5g Comments N/A
5h Is a dam high hazard permit required
❑ Yes ®No If yes permit ID no N/A
51 Expected pond surface area (acres)
N/A
5j Size of pond watershed (acres)
N/A
5k Method of construction
N/A
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 anv impacts require mitigation then you MUST fill out Section D of this form
6a
❑ Neuse ®Tar Pamlico El Other
Project is in 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) or
impact
Stream name
mitigation
(square feet)
(square feet)
Temporary
required?
Site 1 ® P ❑ T
❑ Yes
NONE
NONE
Buffer Impact 1
❑ No
Site 2 ® P ❑ T
❑ Yes
NONE
NONE
Buffer Impact 1
❑ No
Site 3 ® P ❑ T
❑ Yes
NONE
NONE
Buffer Impact 1
❑ No
Site 4 ® P ❑ T
❑ Yes
NONE
NONE
Buffer Impact 1
❑ No
6h Total buffer impacts
NONE
NONE
61 Comments Necessary improvements of expanding this roadway from 40ft maintenance limits to 60ft ROW will involve
impacts to buffers
D Impact Justification and Mitigation — upgrade to the cross line pipe is necessary to construct this roadway
1 Avoidance and Minimization
la Specifically describe measures taken to avoid or minimize the proposed impacts in designing project
The permanent and temporary impacts to streams are necessary to met safety standards for construction
1 b Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques
Sediment and erosion control Best Management Practices for protection of surface waters will be enforced during project
construction
Page 5 of 9
PCN Form — Version 1 3 December 10 2008 Version

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 project'
❑ Mitigation bank
❑ Payment to in lieu fee program
❑ Permittee Responsible Mitigation
3
Complete if Using a Mitigation Bank
3a
Name of Mitigation Bank N/A
3b Credits Purchased (attach receipt and letter)
Type N/A
Quantity N/A
3c Comments N/A
4
Complete of Makirg a °ay —e ^t *o Ir he.i Fee orog arr
4a Approval letter from in lieu fee program is attached
❑ Yes
4b
Stream mitigation requested
N/A linear feet
4c
If using stream mitigation stream temperature
❑ warm ❑ cool ❑cold
4d
Buffer mitigation requested (DWQ only)
N/A square feet
4e
Riparian wetland mitigation requested
N/A acres
4f
Non riparian wetland mitigation requested
N/A acres
4g
Coastal (tidal) wetland mitigation requested
N/A acres
4h
Comments N/A
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
N/A
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
N/A
N/A
3 (2 for Catawba)
N/A
Zone 2
N/A
N/A
1 5
N/A
6f Total buffer mitigation required
NONE
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) 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 it adjacent to protected riparian buffers identified
® Yes ❑ No
within one of the NC Riparian Buffer Protection Rules?
lb
If yes then is a diffuse flow plan included? If no explain why
Comments these pipe extensions will not alter storm water runoff at this site no
❑ Yes ® No
new ditches will be cut through the buffers
2
Stormwater Management Plan
2a
What is the overall percent imperviousness of this project?
20%
2b
Does this project require a Stormwater Management Plan?
❑ Yes ® No
2c
If this project DOES NOT require a Stormwater Management Plan explain why NCDOT state Permit No NCS000250
2d
If this Droiect DOES require a Stormwater Management Plan then provide a brief narrative description of the plan N/A
❑ 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?
Granville County
❑ Phase II
❑ NSW
3b
Which of the following locally implemented stormwater management programs
❑ 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? N/A
4
DWQ Stormwater Program Review
❑ Coastal counties
❑ HQW
4a
Which of the following state implemented stormwater management programs apply
❑ ORW
(check all that apply) N/A
❑ Session Law 2006 246
❑ Other
4b
Has the approved Stormwater Management Plan with proof of approval been
F-1 Yes F1 No
attached N/A
5
DWQ 401 Unit Stormwater Review
5a
Does the Stormwater Management Plan meet the appropriate requirements? N/A
❑ Yes ❑ No
5b
Have all of the 401 Unit submittal requirements been met? N/A
❑ Yes ❑ No
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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
® Yes
❑ No
use of public (federal /state) land?
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
❑ Yes
El No
letter)
Comments N/A
2
Violations (DWQ Requirement)
2a
Is the site in violation of DWQ Wetland Rules (15A NCAC 2H 0500) Isolated
Wetland Rules (15A NCAC 2H 1300) DWQ Surface Water or Wetland Standards
❑ Yes
® No
or Riparian Buffer Rules (15A NCAC 2B 0200)?
2b
Is this an after the fact permit application?
❑ Yes
® No
2c
If you answered yes to one or both of the above questions provide an explanation of the violation(s)
N/A
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
N/A
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
N/A
Page 8 of 9
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? These streams are small stream with no habitat for DWM
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
Critical Habitat?
http / /www fws gov /nc es /es /countyfr html and NC Natural Heritage Program Database Element Occurrences
6 Essential Fish Habitat (Corps Requirement)
6a Will this project occur in or near an area designated as essential fish
❑ Yes ® No
habitat?
6b What data sources did you use to determine whether your site would impact Essential Fish Habitat?
http / /ocean flondamarine org /efh coral /ims /viewer htm
7 Historic or Prehistoric Cultural Resources (Corps Requirement)
7a Will this project occur in or near an area that the state federal or tribal
El Yes ®No
governments have designated as having historic or cultural preservation
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?
HPO s historic layer using GIS ArcView database NCDOT HEU /SHPO review and determination of no effect by letter
dated 04/02/04 which remains valid — SHPO s webpage http / /gis ncdcr gov/hpowe
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 make the doodplain determination? http / /www ncfloodmaps com/
J W Bowman, P E
41.-
a UV, / 01--
02/15/12
Applicant/Agent s Signatuplicant/Agent
(Agents signature Is valid only if an authorization let er from "'. applicant
s Printed Name
Date
Is provided }
Page 9 of 9
PCN Form — Version 1 3 December 10 2008 Version