20120431 Ver 1_Application_20120507

FW SR 2162 Mark Teague Rd Chatham PCN doc Page 1 of 1
FW SR 2162 Mark Teague Rd Chatham PCN doc
Herndon, Mason
Sent Monday May 07 2012 3 54 PM
To Carrillo Sonia
Attachments SR 2162 Mark Teague Rd Cha -1 doc (475 KB)
Sonia sorry to keep bothering you but attached is a revised PCN for SR 2162 in
Chatham County (DWQ Proj #12 -0431) that I received electronically from Art King
on April 30 2012 I hope to issue the WQC this week
If you have any questions please let me know
Thank you again' Hopefully I won t bother you anymore today )
MH
Mason Herndon
Environmental Senior Specialist
NCDENR Division of Water Quality
Surface Water Protection
mason herndon @ncdenr gov
Phone [phone]
E -mail correspondence to and from this address may be subject to the
North Carolina Public Records Law and may be disclosed to third parties
- - - -- Original Message---- -
From King Art C
Sent Monday April 30 2012 5 12 PM
To Herndon Mason Smith Ronnie D SAW
Subject SR 2162 Mark Teague Rd Chatham PCN doc
Ronnie Mason
Attached is the revised PCN for SR -2162 Chatham Sheet 4 has the corrected impact
totals Please insert the correction into the package I sent
Mason please forward the correction to Ms Carrillo
Thanks
Art
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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Corps action ID no
DWQ project no
Form Version 1 3 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
1a
Type(s) of approval sought from the
Corps
Section 404 Permit Section 10 Permit
FE ❑
1 b 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
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
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 2162 Mark Teague Rd
2b
County
Chatham
2c
Nearest municipality / town
Pittsboro
2d
Subdivision name
N/A
2e
NCDOT only T I P or state
project no
8C 019109
3
Owner Information
3a
Name(s) on Recorded Deed
NC Department of Transportation
3b
Deed Book and Page No
3c
Responsible Party (for LLC if
applicable)
3d
Street address
902 North Sandhillblvd
3e
City state zip
Aberdeen NC 28315
3f
Telephone no
910 944 2344
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 Division Engineer
4b
Name
Richard W Hancock PE
4c
Business name
(if applicable)
PO Box 1067
4d
Street address
902 North Sandhi[[ Blvd
4e
City state zip
Aberdeen NC 28315
4f
Telephone no
910 944 2344
4g
Fax no
910 944 5623
4h
Email address
rwhancock @ncdot gov
5
Agent/Consultant Information (if applicable)
5a
Name
Justin Bullock PE
5b
Business name
(if applicable)
NC Dept of Transportation Chatham Co Maintenance
5c
Street address
1404 E Raleigh St
5d
City state zip
Siler City NC 27344
5e
Telephone no
[phone]
5f
Fax no
[phone]
5g
Email address
jebullock @ncdot gov
Page 2 of 10
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)
1b Site coordinates (in decimal degrees)
Latitude 35 7043 Longitude 792957
(DD DDDDDD) ( DD DDDDDD)
1c Property size
2 16 acres
2 Surface Waters
2a Name of nearest body of water (stream river etc ) to
proposed project
Landrum Creek
2b Water Quality Classification of nearest receiving water
C
2c River basin
Cape Fear
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
Rural forested agricultural Natured roadbed being used as an unpaved roadway
3b List the total estimated acreage of all existing wetlands on the property
0 11 AC
3c List the total estimated linear feet of all existing streams (intermittent and perennial) on the property
50 LF
3d Explain the purpose of the proposed project
Grading Drainage Base Pave and Erosion Control on SR 2162 Crossing pipe replacement
3e Describe the overall project in detail including the type of equipment to be used
Clearing grubbing drainage erosion control and paving Dozer grader track hoe dump turck
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 Delineation submitted to the COE
❑ 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) A C King J S Badgett
Agency /Consultant Company NCDOT
Other
4d If yes list the dates of the Corps jurisdictional determinations or State determinations and attach documentation
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 3 of 10
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 ®P ❑ T
fill for roadway
Headwater
® Yes
❑ No
® Corps
® DWQ
0 06 acres
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 impacts
0 06 acres
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
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 [-IT
pipe
LIT of Landrum
Crk
❑ PER
® INT
® Corps r
® DWQ
3 5
24
S2 ❑ P ® T
dewatenng
❑ PER
® INT
® Corps
® DWQ
20
S3 ❑ P ❑ T
❑ 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
44
31 Comments 24 for pipe 20 for dewatering total 44
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 —
(if applicable)
Type of impact
Waterbody type
Area of impact (acres)
Permanent (P) or
Temporary T
01 ❑P ❑T
NA
02 ❑P ❑T
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
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)
51 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 El Tar Pamlico [-I Other NA
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
NA
❑ Yes
❑ No
B2 ❑P ❑T
❑Yes
❑ No
B3 ❑P ❑T
❑Yes
❑ No
6h Total buffer impacts
61 Comments
Page 5 of 10
PCN Form — Version 1 3 December 10 2008 Version

D Impact Justification and Mitigation
1 Avoidance and Minimization
la Specifically describe measures taken to avoid or minimize the proposed impacts in designing project
minimum pipe installation and road width construction to provide a safe roadway
lb Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques
Safety fencing installed along the right way limit to protect the adjacent wetlands Minimum pipe installed to provide safe
crossing
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
❑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
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
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?
33%
2b
Does this project require a Stormwater Management Plan?
❑ Yes ® No
2c
If this project DOES NOT require a Stormwater Management Plan explain why outside of HQW or ORW area
2d
If this project DOES require a Stormwater Management Plan then provide a brief narrative
description of the plan
Rock Silt Check Dams or Wattles in Ditchlines with Type B Sediment Dams at outlets from project
❑ 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
❑ HQW
4a
Which of the following state implemented stormwater management programs apply
❑ 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 8 of 10
PCN Form — Version 1 3 December 10 2008 Version

F
Supplementary Information
1
Environmental Documentation (DWQ Requirement)
1a
Does the project 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 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
❑ 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?
Onsite survey NCDOT SDV natural heritage layer
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?
SDV Natural Heritage layer
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?
NCDOT /SHPO screening review SDV Natural Heritage layer
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 floodplaln determination?
c
Applicant/Agent s Printed Name
i
Date
Applicant/Agent s Signature
(Agent s signature is valid only if an authorization letter from the applicant
is provided
Page 10 of 10
PCN Form — Version 1 3 December 10 2008 Version