20120376 Ver 1_401 Application_20120412

2n12�976
DAyIs e MARTIN • POWELL
ENGINEERS & SURVEYORS UMON
April 16 2012
Mr John Thomas
Raleigh Regulatory Field Office
U S Army Corps of Engineers
3331 Heritage Trade Drive Suite 105
Wake Forest North Carolina 27587
Dear Mr Thomas
Re County of Davidson NC
185 /US Hwy 64 Area
Sewer System Improvements
DMP Project 110154 (BF)
On behalf of Davidson County NC please find the attached Pre Construction Notification for the above
referenced project The PCN includes the required form supplemental information figures and
engineering plans The proposed gravity sewer has been designed to meet the conditions of Nationwide
12 as described in the PCN form Submittal of this notification is required due to unavoidable mechanized
clearing in two small headwater wetlands (W1 W4) for the installation of the line A copy of this PCN is also
being submitted to the North Carolina Division of Water Quality as the project design could not comply
with their condition 12 described below
Two (2) stream crossings are proposed for this project as described in the PCN Open cut techniques are
planned due to the presence of an extensive amount of bedrock along the stream channel
The project was designed so that the gravity sewer line is located a minimum of 50 feet from the stream
banks per correspondence with the NC Division of Water Quality Winston Salem Regional Office This
involved significant increase in trench depth and project costs due to steep slopes along the majority of the
corridor There are locations along the corridor where the construction easement encroaches within 50
feet of the stream banks This was considered necessary due to the additional cost of moving the entire
corridor and therefore the sewer line upslope While a 50 foot offset of the sewer line is required by
NCDWQ design criteria there are no riparian buffer rules in effect in this watershed preventing minimal
encroachment within this area The significant increase in construction cost and time due to the deeper
installation trench made it impractical to shift the construction corridor upslope but a maximum offset
allowable has been maintained everywhere possible
Should you have any questions or require additional information please give me a call
Sincerely
DAVIS MARTIN POWELL & ASSOCIATES
al�,
Ben Palmer PE
c Ian McMillan NCDWQ 401 Permitting Unit
Sue Homewood NCDWQ WSRO
Laura Vanhoy Davidson County
File
T 336 886 4821 1 F 336 886 - [4458 1 www dmp me com
t4gt16)b1 pJ 6jd 1qV- p,1Wtf rlVeWA06c
E
APR 1 7 1012

20120376
DAVIDSON COUNTY NC
Interstate 85 / US Hwy 64 Area
Sewer System Improvements
NATIONWIDE PERMIT 12 PRE CONSTRUCTION NOTIFICATION
EXHIBIT LIST
EXHIBIT 2WRED
1 PCN Form
2 Supplemental Information
3 Figures
4 Delineation Information
5 Engineering Plans & Details
Figures (Exhibit 3) IDENR R 1 Vicinity Map 2 USGS Map R Y 7 2012
3 Soils Map
4 Gravity Sewer g
5 Site S1 8►ar►d
6 Sites W1 W4 & S2
3
w

EXHIBIT 1
Pre - Construction Notification Form

W A 7F79
20120376
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
1a
Type(s) of approval sought from the
Corps
®Section 404 Permit El Section 10 Permit
1b Specify Nationwide Permit (NWP) number 12 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 1h
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
Davidson County 185 / US Hwy 64 Sewer System Extension
2b
County
Davidson
2c
Nearest municipality / town
Lexington
2d
Subdivision name
N/A
2e
NCDOT only T I P or state
project no
N/A
3
Owner Information
3a
Name(s) on Recorded Deed
Davidson County proposed sewer easement to be recorded
3b
Deed Book and Page No
Multiple properties proposed sewer easement to be recorded
3c
Responsible Party (for LLC if
applicable)
3d
Street address
3e
City state zip
APR
3f
Telephone no
&t+YATER pV
3g Fax no
3h
Email address
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 Proposed owner of sewer easement
4b
Name
Robert Hyatt County Manager
4c
Business name
(if applicable)
Davidson County
4d
Street address
PO Box 1067
4e
City state zip
Lexington North Carolina 27293 1067
4f
Telephone no
336 242 2200
4g
Fax no
336 248 8440
4h
Email address
robert hyatt@davidsoncountync gov
5
Agent/Consultant Information (if applicable)
5a
Name
Ben Palmer
5b
Business name
(if applicable)
Davis Martin Powell & Associates
5c
Street address
6415 Old Plank Road
5d
City state zip
High Point NC 27265
5e
Telephone no
336 886 -4821
5f
Fax no
336 886 -4458
5g
Email address
bpalmer @dmp inc com
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)
See Table appended to this form
1 b Site coordinates (in decimal degrees)
Latitude Table Longitude Table
(DD DDDDDD) ( DD DDDDDD)
1c Property size
2 8 ac (easement) acres
2 Surface Waters
2a Name of nearest body of water (stream river etc ) to
Pounder Fork
proposed project
2b Water Quality Classification of nearest receiving water
WSV B
2c River basin
Yadkin
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
The proposed gravity sewer passes through primarily forest and agricultural areas with some residential and commercial
land
3b List the total estimated acreage of all existing wetlands on the property
<0 1 acre
3c List the total estimated linear feet of all existing streams (intermittent and perennial) on the property
80 linear feet of perennial stream within proposed easements
3d Explain the purpose of the proposed project
The proposed gravity sewer will extend service to the western side of Intersate 85 at the US Hwy 64 interchange This
extension will be start of a future project which will provide service to Davis Townsend Elementary School which currently
operates an on site sewage disposal system Several area businesses have expressed an interest/need in public sewer
due to inadquate on site systems Also the County desires to enhance the 85/64 interchange in an effort to spur local
economic development in this commerical corridor
3e Describe the overall project in detail including the type of equipment to be used
Wastewater collected by this sewer line will be transported to the City of Lexington system for treatment Sewer line
construction will occur within a 40 foot construction corridor and will be accomplished using standard construction
techniques and equipment Clearing and grubbing of existing vegetation will occur along with implementation of the
NCDENR approved sediment and erosion control plan Lines will be installed via open cut trenching methods The
construction area will be re graded to preconstruction contours and seeded /mulched Stream crossings will be
constructed in dry conditions by use of a bypass pipe or coffer dam The crossings locations will be stabilized using
natural material or rip rap over filter fabric below the stream bed elevations Construction will comply with all conditions of
Nationwide Permit 12
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
4b If the Corps made the jurisdictional determination what type
❑ Prelimina ry ❑ Final
of determination was made?
4c If yes who delineated the jurisdictional areas?
Agency /Consultant Company Carolina Ecosystems Inc
Name (if known) Brian Smith
Other Delineated March 2012
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
❑ Yes ® No ❑ Unknown
this project (including all prior phases) in the past?
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
This gravity sewer is the first terminus of a larger project which will be extended further upstream for future connection of
Davis Townsend Elementary School (currently served by on site disposal system date of future project is unknown at
this time)
Page 4 of 11
PCN Form — Version 1 3 December 10 2008 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 [] POT
Clearing
excavation
Headwater Forest
® Yes
El No
® Corps
El DWQ
0 017
backfill
W2 ®P ❑ T
Maintained
clearing
Headwater Forest
® Yes
[:1 No
® Corps
El DWQ
0 020
W3 [I POT
Clearing
excavation
Headwater Forest
® Yes
[:1 No
® Corps
El DWQ
0 015
backfdl
W4 ®P ❑ T
Maintained
clearing
Headwater Forest
® Yes
El No
® Corps
El DWQ
0 016
W5 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W6 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
2g Total wetland impacts
0 068
2h Comments See Figure 6 for details
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 [:I POT
Excavation
Pounder Fork
® PER
® Corps
p
10
18
backfdl
[I INT
❑ DWQ
S2 ❑ P ®T
Excavation
Pounder Fork
® PER
® Corps
10
15
backfdl
❑ INT
❑ DWQ
S3 ❑ P [IT
❑ PER
❑ Corps
❑ INT
❑ DWQ
S4 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S5 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S6 ❑ P ❑ T
❑ PER
❑Corps
❑ INT
❑ DWQ
3h Total stream and tributary impacts
33
31 Comments Temporary open cut stream crossings due to significant bedrock in the stream channels
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
Tem ora T
01 ❑P ❑T
02 ❑P ❑T
03 ❑P ❑T
04 ❑P ❑T
417 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
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 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
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
impact
required?
B1 ❑P ❑T
El Yes
❑ No
B2 ❑P ❑T
El Yes
❑ No
B3 ❑P ❑T
El Yes
❑ No
6h Total buffer impacts
61 Comments
Page 6 of 11
PCN Form — Version 1 3 December 10 2008 Version

D Impact Justification and Mitigation
1 Avoidance and Minimization
1 a Specifically describe measures taken to avoid or minimize the proposed impacts in designing project
Efforts have been made to minimize impacts but balanced with the need to limit property dissection and extreme installation
depths Due to Pounder Fork classification as Class B waters a minimum 50 foot separation is required b/w top of bank and
sewer line Based on NCDWQ Winston Salem Regional Office correspondence the sewer line is located at least 50 feet from
the stream banks even though steep slopes along the entire corridor require deeper trench depths The two stream crossings
are required as a result of this 50 foot setback requirement residential structures to the north prevent routing along the north
side Pounder Fork and the Interstate 85 right of way north of US 64 prevents corridor routing on the south side of Pounder
Fork for the potential future project The stream crossings will be made a near perpendicular angles to minimize impacts
1 b Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques
Construction impacts will be minimized by using a maximum 40 foot construction corridor and limiting maintenance corridor
mowing to 15 feet Erosion control measures will be implemented and maintained throughout construction to avoid
sedimentation to surface waters Wetland areas temporarily disturbed during construction will be re graded to pre
construction contours and seeded with a wetland seed mix (no fescue) and allowed to naturally regenerate into forested
wetlands Stream crossings will be stabilized with natural stream bed materials (if appropriate) or rip rap over geotextile fabric
Directional drilling or boring was evaluated for this project but the presence of significant amounts of bedrock along the
channels make this impractical If drilling were proposed and bedrock encountered the construction would have to stop and
disturbed areas remain open while new equipment is mobilized and updated approvals sought Drilling through rock would
require specialized eguupment and extended time needed to construct the stream crossings (resulting in added costs) This
would increase the amout of time areas are disturbed and increase the possibility of environmental impacts occunng due to
large rain events etc The most practical method for accomplishing these crossings will be to quickly and efficiently use open
cut techniques and stabilize the construction corridor
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 If yes mitigation is required by (check all that apply)
❑ DWQ ❑ Corps
❑ Mitigation bank
2c If yes which mitigation option will be used for this
Payment to in lieu fee program
projects
❑ Permittee Responsible Mitigation
3 Complete if Using a Mitigation Bank
3a Name of Mitigation Bank
3b Credits Purchased (attach receipt and letter)
Type
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
Page 7 of 11
PCN Form — Version 1 3 December 10 2008 Version

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?
lb
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?
<1 %
2b
Does this project require a Stormwater Management Plan?
❑ Yes ® No
2c
If this project DOES NOT require a Stormwater Management Plan explain why Extremely low impervious surface
percentage The only proposed impervious surfaces are the top of sewer manholes
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
4a
Which of the following state implemented stormwater management programs apply
❑ HQW
❑ ORW
(check all that apply)
❑ 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)
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)?
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 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)
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
While the proposed sewer line does extend sewer service to a small portion of Davidson County the size (8 inch) and
length (3200 feet) of the gravity sewer are below SEPA criteria for an EA and therefore not likely to cause significant
environmental impacts Due to the current rural development of the area and the allowable land usage due to zoning
restnctiions the most likely future growth would probably be limited to small commercial development along US Hwy 64
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
The sewer line will be connected to the City of Lexington system and wastewater will be treated at the City of Lexington s
WWTP within its existing discharge capacity
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?
E:1 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?
Review of NC Natural Heritage Program database
6 Essential Fish Habitat (Corps Requirement)
6a WIII 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?
NOAA Interactive Mapper Essential Fish Habitat
7 Historic or Prehistoric Cultural Resources (Corps Requirement)
7a WIII 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?
National Register of Historic Places
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? FEMA GIS mapping (Map 3710674500J 3/16/2009)
Robert C Hyatt County Manager
Applicant/Agerffs Signature
)ature
Applicant/Agent s Printed Name
Date
(Agents sig is valid only if an authorization letter from the applicant
is provided
Page 11 of 11
PCN Form — Version 1 3 December 10 2008 Version

1 =n4kW
Supplemental Information

Impact Site Locations
I -85 /US Hwy 64 Area — Sewer System Improvements
Site
Latitude
Longitude
S1
3580915
8019341
S2
3581016
8018567
W1 /W2
3580966
8018623
W3 /W4
3580993
8018571
Property Information
Tract
Property Owner
PIN #
Purpose
1A
Barry Len Berner
6745 04 518993
Gravity Sewer
1
Barry D & Linda S Burkhart
6745 04 612748
Gravity Sewer
2
1 Billy H Bowers
6745 04 614541
Gravity Sewer
3
Amy B Bowers
6745 04 618479
Gravity Sewer
4
Roy D & Jeanette G Swing
6745 04 715443
Gravity Sewer
5
Robert C Laws
6745 04 71 6698
Gravity Sewer
6
Benny W Swing
6745 04 81 1690
Gravity Sewer
7
- ommy G & Angela Ballas
6745 04 813846
Gravity Sewer
8
Wang Sheh Hung
6745 04 92 0772
Gravity Sewer

EXHIBIT 3
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EXHIBIT 4
Delineation Information