20110883 Ver 1_Application_20111003

Dare NC 12 emergency pipe replacement Buxton
Dare NC 12 emergency pipe replacement Buxton
Shook, Ryan L
Sent Monday October 03 20119 07 AM
To Biddlecome William 3 SAW (William 3 Biddlecome @usace army mil)
Cc Ward Garcy Carrillo Sonia
Attachments PCN pdf (4 MB)
I:
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Page 1 of 1
I sent you a PCN on 9/23/11 requesting a NW 3 for a pipe replacement on NC 12 in Buxton Dare County Since then it has
been determined that the waterline located on the east side of the road will need to be relocated It is being proposed to
install the proposed waterline by method of open cut across the stream bed while the project is being dewatered and will be
installed in the dry The PCN has been updated also requesting a NW 12 and the drawings are updated showing the proposed
location and depth of the waterline This pipe was damaged during Hurricane Irene and a steel plate was placed across the
road The hole has continually gotten worse and the project is being proposed to begin on 10/10/11 Will it be possible to
have the permit issued by this time? Let me know if you need any additional information
Sonia
I discussed this project with Garcy and it will not require written authorization from DWQ This PCN is requesting a GC for
a NW 12 and is in addition to the one sent on 9/23/11 requesting a GC for a NW 3 Permit #11 0883 If you have any
questions please contact Garcy
Thanks
Ryan
Ryan Shook �,
Environmental Specialist
NCDOT Division 1
113 Airport Dr Suite 100
Edenton NC 27932
Office 252 482 7977
Fax [phone]
Email correspondence to and from this sender is subject to the N C Public Records Law and may be disclosed to third
parties
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Buz fir
Office Use Only
Corps action ID no
DWQ project no
Form Version 1 3 Dec 10 2008
Page 1 of 11
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 the
Corps
®Section 404 Permit ❑Section 10 Permit
1 b
Specify Nationwide Permit (NWP) number NW 3 & 12 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 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 1h
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
NC 12 pipe replacement 0 006 miles SE of SR 1233 Light Plant
Rd
2b
County
Dare
2c
Nearest municipality / town
Buxton
2d
Subdivision name
2e
NCDOT only T I P or state
project no
State Project no 1 B 102811
3
Owner Information
3a
Name(s) on Recorded Deed
NCDOT
3b
Deed Book and Page No
n/a
3c
Responsible Party (for LLC if
applicable)
NCDOT Division One
3d
Street address
113 Airport Drive Suite 100
3e
City state zip
Edenton NC 27932
3f
Telephone no
252 482 7977
3g
Fax no
252 482 8722
3h
Email address
rlshook @ncdot gov
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
4c Business name
(if applicable)
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 Business name
(if applicable)
5c Street address
5d City state zip
5e Telephone no
5f Fax no
5g Email address
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)
1 b Site coordinates (in decimal degrees)
Latitude 35 26729 Longitude 7553184
(DD DDDDDD) ( DD DDDDDD)
1c Property size
0 01 acres
2 Surface Waters
2a Name of nearest body of water (stream river etc ) to
UT to Cape Creek a tributary to Pamlico Sound
proposed project
2b Water Quality Classification of nearest receiving water
SA HQW
2c River basin
Pasquotank
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
NC 12 is a two lane paved road through the village of Buxton and the general land use is a mix of commercial residential
and vacant lots along NC 12
3b List the total estimated acreage of all existing wetlands on the property
< 1 acre
3c List the total estimated linear feet of all existing streams (intermittent and perennial) on the property
60
3d Explain the purpose of the proposed project
To replace 2 failing pipes on NC 12
3e Describe the overall project in detail including the type of equipment to be used
The existing 2 @ 60 x 68 6 corrugated metal pipes will be replaced with the proposed 1 @ 16 2 x 5 1 x 63
1 aluminum box culvert with aluminum headwalls with riprap on the four corners for slope stabilization on its current
alignment The current pipes will be removed entirely Proper fill will be used to bring road to existing height Heavy
equipment that will be used will be an excavator backhoe and dump trucks The work site will be dewatered during the
project There is a waterline located on the east side of the project that will need to be relocated The existing waterline
will need to be relocated and it is being to complete this while the work area is being dewatered The relocation would
take place by cutting a trench across the stream bed and backfdlmg with material excavated from the trench and
reconnecting to the existing waterline located in the shoulder of the road The waterline will be buried approximately 3
below the stream bed
4 Jurisdictional Determinations
4a Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
❑ Yes ® No ® Unknown
project (including all prior phases) in the past?
Comments
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
4d If yes list the dates of the Corps jurisdictional determinations or State determinations and attach documentation
Page 3 of 11
PCN Form — Version 1 3 December 10 2008 Version

5 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
6b If yes explain
Page 4 of 11
PCN Form —Version 1 3 December 10 7008 Version

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 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
fill
coastal fringe
❑ Yes
® No
® Corps
® DWQ
00002
W2 ❑P ❑T
El Yes
El Corps
❑ No
❑ DWQ
W3 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
❑ Yes
❑ Corps
W4 ❑ P ❑ T
❑ No
❑ DWQ
W5 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W6 []PMT
❑ Yes
❑ Corps
❑No
El DWQ
2g Total wetland impacts
00002
2h Comments There will be 10 sq ft of coastal fringe wetland at the toe of the slope on the southeast corner impacted from
the installation of the headwall
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)
S1 ❑ P ® T
trenching for
waterline
UT to Cape Creek
® PER
❑ INT
® Corps
® DWQ
40
4
S2 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S3 ❑ P ❑ T
❑ PER
❑ INT
❑ Corps
❑ DWQ
S4 ❑ P ❑ T
❑ PER
❑ INT
❑ Corps
❑ DWQ
S5 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S6 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
3h Total stream and tributary impacts
0
acres
31 Comments The trench for the waterline will be cut perpendicular across stream bed and will be 4 wide and 40 long
resulting in 160 sq ft of temporary stream impact from installation of waterline
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
Name of waterbody
impact number —
(if applicable)
Type of impact
Waterbody type
Area of impact (acres)
Permanent (P) or
Temporary T
01 ®P ❑ T
UT to Cape Creek
fill (riprap)
canal
0 001
02 ❑P ❑T
03 ❑P ❑T
04 ❑P ❑T
4f Total open water impacts
0 001
4g Comments There will be 45 sq ft of open water impact resulting from nprap being placed on the northwest corner for
slope stabilization between the headwall and an existing bulkhead
5 Pond or Lake Construction
If pond or lake construction proposed then complete the chart below
5a
5b
5c
5d
5e
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
P2
5f 1 otal
5g Comments
5h Is a dam high hazard permit required
❑ Yes ❑ No If yes permit ID no
5 Expected pond surface area (acres)
51 Size of pond watershed (acres)
5k Method of construction
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 any impacts require mitigation then you 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)
Temporary T
im act
required?
B1 ❑P ❑T
❑Yes
❑ No
B2 ❑ P ❑ T
❑ Yes
❑ No
B3 ❑P ❑T
El Yes
❑ No
6h Total buffer impacts
61 Comments
D Impact Justification and Mitigation
1 Avoidance and Minimization
1a Specifically describe measures taken to avoid or minimize the proposed impacts in designing project
Pipe replacement is going to stay on the existing alignment and the road will be closed during construction This will reduce
temporary impacts to wetlands and the stream by not using an on site detour and keeping the road open
1 b Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques
Methods of construction will be concurrent with NCDOT Best Management Practices for replacement of pipes and for sod and
erosion control
2 Compensatory Mitigation for 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?
2b It yes mitigation is required by (check all that apply)
❑ DWQ ❑ Corps
❑ Mitigation bank
2c if yes which mitigation option will be used for this
El Payment to in lieu fee program
projects
❑ Permittee Responsible Mitigation
3 Complete if Using a Mitigation Bank
3a Name of Mitigation Bank
i
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 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 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
❑ 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
❑ Yes ❑ No
Comments
2
Stormwater Management Plan
2a
What is the overall percent imperviousness of this project?
n/a %
2b
Does this project require a Stormwater Management Plan?
® Yes ❑ No
2c
If this project DOES NOT require a Stormwater Management Plan explain why
2d
If this project DOES require a Stormwater Management Plan then provide a brief narrative
description of the plan
NCDOT state stormwater permit for highway system is applicable' NCDOT will follow
guidelines for Erosion and
Sediment Control
❑ 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?
n/a
❑ 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?
4
DWQ Stormwater Program Review
❑ Coastal counties
❑ HQW
4a
Which of the following state implemented stormwater management programs apply
❑ ORW
❑ Session Law 2006 246
(check all that apply)
® Other NCDOT stormwater
permit No NCS000250
4b Has the approved Stormwater Management Plan with proof of approval been
❑Yes El 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 9 of 11
PCN Form — Version 1 3 December 10 2008 Version

F
Supplementary Information
1
Environmental Documentation (DWQ Requirement)
1a
Does the protect 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 protect 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 Clearing House? (If so attach a copy of the NEPA or SEPA final approval
❑Yes
❑ No
letter )
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 213 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
No wastewater will be created from this project
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?
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?
Natural Heritage database
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?
Marine Fisheries Essintial Fish Habitat List
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?
North Carolina Natural Heritage List
8 Flood Zone Designation (Corps Requirement)
8a Will this project occur in a FEMA designated 100 year floodplain?
® Yes ❑ No
8b If yes explain how project meets FEMA requirements Based on project scope project was not reviewed for FEMA
requirements
8c What source(s) did you use to make the floodplain determination? NC Flood Mapping Information System
Ryan Shook
10/3/11
Applicant/Agent s Printed Name
Date
Applicant/Agent s Signature
(Agents si nature is valid only if an authorization letter from the applicant
is provided
Page 1 l of 11
PCN Form — Version 1 3 December 10 2008 Version

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