20120688 Ver 1_Application_20120716

1
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STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
BEVERLY PURDUE P O Box 25201 Raleigh, NC 27611 5202
GOVERNOR PHONE 919 - 733 -2520
July 11, 2012
Mr Monte Matthews
U S Army Corps of Engineers
Raleigh Regulatory Field Office
3331 Heritage Trade Drive, Suite 105
Wake Forest, NC 27587
Mlko
6 D
2012
�NOSANDSit�y� 7Y
EUGENE C69f P R
SECRETARY
12068 031
Subject Nationwide Permit #14
SR 1368 (Powers Hollow Road)
Ashe County, North Carolina
Project Number 11C 005126 (DWQ Permit Fee $570)
Dear Mr Matthews
The NC Department of Transportation is scheduled to grade, dram, base and pave SR 1368,
Powers Hollow Road in Ashe County Total project length is approximately 0 51 miles The
roadway will be widened from 14' to 18' and paved Impervious surface area will increase by
about 0 25 acres This project will require the replacement of four wet pipes as shown below
Stream Impacts
Number
p gisatw e
Pine Size
Iti cts f g
a eri� ft
t th�ss Staho
1 +29
40'x 36"
50'x 42
10
40
60
9 +36
30 x 24
50'x 24"
10
40
70
14+692
20 x 18
110 x 24
10
40
140
16 +47 2
30 x 18
110 x 24
10
40
130
Permanent FdMprap
Impacts = 240 feet
Total project Impacts =
400 feet
1 This pipe carves intermittent pond overflow
2 The excessive replacement pipe length at these two locations is due to extreme pipe skew
P O Box250 N Wn mBORO NC 28659
PHONE [phone] FAX [phone]

Mr Monte Matthews
SR 1368 (Powers Hollow Road, Ashe)
Page 2
• Please note that all wet pipe slopes exceed 6% and need not be buried These pipes may
remain perched after replacement due to excessive slope If so, nprap energy dissipater
pads will be placed in the stream channel at the outlet of these pipes
The replacement of the above noted wet pipes will require temporary dewatenng An impervious
sandbag dike will be constructed upstream of the existing culverts to create a small pool Clean
water will temporarily be pumped around the construction areas and will be discharged
downstream Any duty water located inside of the construction areas will be pumped into a silt
bag if necessary Once the new pipes are in place, the impervious dikes will be removed and
preconstruction streambed elevations will be restored
The wet pipes in question will impact three different unnamed tributaries to Big Horse Creek
(Class C, Trout, ORW) The wet pipes at stations 14 +69 and 16 +47 both carry UT #3 This
project was reviewed for the presence of threatened and endangered species on June 29, 2012
This project will have no effect on any federally listed endangered plant or anneal species
Historic compliance work will be scheduled and concurrence with the State Historic Preservation
Office will be obtained if required
The project impacts are not sigmficant in nature and should not remove or degrade existing water
quality uses Stormwater will be routed through grass or rock lined ditches, depending on the
ditch line slope Pipe saes used will be the minimum necessary to create a safe roadway By
utilizing the erosion control measures outlined in the attachments to this application, downstream
water quality standards will be protected Overall water quality in the area will be unproved by
paving the ABC travel lanes All appropriate BMPs will be used during construction
Attached is a Preconstruction Notification Form, plan sheets with proposed erosion control
measures, a marked county map, a marked topography map and photographs
By copy of tins letter, it is requested that Mrs Marla Chambers with the North Carolina Wildlife
Resources Commission comment directly to you concerning the 404 Nationwide Permit
application with a copy sent to me A trout buffer variance will be needed from 13 +25 — 14 +75
(rt ), 15+00 — 16 +50 (It ) and 16 +75 — 18 +50 (rt ) All of the buffer zone work is actually on the
other side of the road from the creek so we are widening away The creek is dust very close
By copy of this letter, I am forwarding three (3) copies of this application package to David
Wainwright, NCDENR, Division of Water Quality, 401/Wetlands Unit for his review It is
requested that any comments related to the 401 certification be forwarded directly to me with a
copy sent to the US Army Corps of Engineers
We would like to begin construction as soon as possible If further information is required, please
let me know Your early review and consideration will be appreciated

N
:3
Mr Monte Matthews
SR 1368 (Powers Hollow Road, Ashe)
Page 3
Sincerely, Ad
eath Slaughter
VIA
Division Environmental Officer
Enclosures
cc Marla Chambers, NCWRC
David Wainwright, Division of Water Quality (3 copies)
Amy Euhss, Division of Water Quality
Matt Gantt, PE, Land quality Section
Mike Pe"ohn, PE, Division Engineer
Doug Tetzlaff, District Engineer
Randall Miles, County Maintenance Engineer
Heath Slaughter, Division Environmental Officer
Scott Pipes, Roadside Environmental Field Operations Technician

o�ot W ArF9QG
o c
Office Use Only
Corps action ID no
DWQ project no
Form Version 1 3 Dec 10 2008
Page 1 of 10
PCN Form — Version 13 December 10 2008 Version
Pre - Construction Notification CN) Form
A Applicant Information
1
Processing
1 a
Type(s) of approval sought from the
Corps
® Section 404 Permit ❑ Section 10 Permit
1 b Specify Nationwide Permit (NWP) number 14 or General Permit (GP) number
1 c
Has the NWP or GP number been verified by the Corps?
❑ Yes
® No
Id
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 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 1368 Powers Hollow Road
2b
County
Ashe
2c
Nearest municipality / town
Tuckerdale
2d
Subdivision name
2e
NCDOT only T I P or state
project no
11 C 005126
3
Owner Information
3a
Name(s) on Recorded Deed
NCDOT
3b
Deed Book and Page No
3c
Responsible Party (for LLC if
applicable)
3d
Street address
801 Statesville Road
3e
City state zip
North Wilkesboro NC 28659
3f
Telephone no
336 903 -9202
3g
Fax no
336 - 667 -4549
3h
Email address
hslaughter @ncdot gov
Page 1 of 10
PCN Form — Version 13 December 10 2008 Version

4 Applicant Information (d 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 (d 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 10
PCN Form — Version 13 December 10 2008 Version

B Project Information and Prior Project History
1 Property Identification
1 a Property identification no (tax PIN or parcel ID)
lb Site coordinates (in decimal degrees)
Latitude 36 54440 Longitude - 8152359
(DD DDDDDD) ( DD DDDDDD)
1 c Property size
31 acres
2 Surface Waters
2a Name of nearest body of water (stream river etc) to
proposed project
UTs to Big Horse Creek
2b Water Quality Classification of nearest receiving water
C Trout ORW
2c River basin
New
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
Unpaved road in a rural area
3b List the total estimated acreage of all existing wetlands on the property
0 acres
3c List the total estimated linear feet of all e)asbng streams (intermittent and perennial) on the property
320 linear feet
3d Explain the purpose of the proposed project
Upgrade roadway
3e Describe the overall project in detail including the type of equipment to be used
See attached cover letter
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
❑ 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) -
Agency /Consultant Company
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 13 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 junsdicbon
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
❑Yes
El Corps
W1 ❑ P ❑ T
❑ No
❑ DWQ
❑ Yes
❑ Corps
W2 ❑ P ❑ T
❑ No
❑ DWQ
❑ Yes
❑ Corps
W3 ❑ P [—IT
❑ No
❑ DWQ
❑ Yes
❑ Corps
W4 ❑ P ❑ T
❑ No
❑ DWQ
❑ Yes
❑ Corps
W5 ❑ P ❑ T
❑ No
❑ DWQ
❑ Yes
❑ Corps
W6 ❑ P ❑ T
❑ 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 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 M
(INT)?
other)
(feet)
feet)
S1 ®P ®T
Piping Riprap &
UT #1 to Big
® PER
® Corps
1
60
Dewatenng
Horse Creek
❑ INT
® DWQ
S2 ®P ®T
Piping Riprap &
UT #2 to Big
❑ PER
® Corps
1
70
Dewatenng
Horse Creek
® INT
® DWQ
S3 ®P ®T
Piping Riprap &
UT #3 to Big
® PER
® Corps
1
140
Dewatenng
Horse Creek
❑ INT
® DWQ
S4 ®P ®T
Piping Riprap &
UT #3 to Big
® PER
® Corps
1
130
Dewatenng
Horse Creek
❑ INT
® DWQ
S5 ❑ P ❑ T
❑ PER
❑ INT
❑ Corps
❑ DWQ
S6 ❑ P ❑ T
❑ PER
❑ INT
❑ Corps
❑ DWQ
3h. Total stream and tnbutary impacts
400
31 Comments 160 linear feet of the impacts are temporary
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
impact number —
Name of waterbody
(if applicable)
Type of impact
Waterbody type
Area of impact (acres)
Permanent (P) or
Temporary
01 ❑P ❑T
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 the complete the chart below
5a
5b
5c
5d
5e
Wetland Impacts (acres)
Stream Impacts (feet)
Upland
Pond ID
Proposed use or purpose
(acres)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
number
of pond
P1
P2
5f Total
5g Comments N/A
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
impact
required?
❑Yes
B1 ❑P ❑T
❑ No
❑Yes
B2 [-]PDT
❑ No
El Yes
B3 ❑P ❑T
❑ 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
The pipe lengths are the minimum needed to improve roadway
1 b Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques
All appropriate BMPs will be used during construction
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 nut►gation is regmred 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
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 d 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 13 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
❑ Yes ® No
buffer mitigation?
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
6c
6d
6e
Zone
Reason for impact
Total impact
Multiplier
Required mitigation
(square feet)
(square feet)
Zone 1
3 (2 for Catawba)
Zone 2
f 15
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
permrttee 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
1 a
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?
%
2b
Does this project require a Stormwater Management Plan
❑ Yes ® No
2c
If this project DOES NOT require a Stormwater Management Plan explain why Secondary Road Project
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 governments jurisdiction is this project?
❑ Phase II
3b
Which of the following locally implemented stormwater management programs
❑ NSW
El 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
❑ 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 S 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
® Yes
❑ No
use of public (federalfstate) land?
lb
If you answered `yes to the above does the project require preparation of an
State
❑ Yes
® No
environmental document pursuant to the requirements of the National or
(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
❑ 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 violations)
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
N/A _
Page 9of10
PCN Form — Version 13 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?
GIS and visual observation
6 Essential Fish Habitat (Corps Requirement)
6a Will 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?
WRC will comment
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?
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
8c What source(s) did you use to make the floodplain determination? ncfloodmaps
7 Heath Slaughter
7/11/12
Applicant/Agent s Printed Name
Date
Applicant/Agent s Sigo ture
(Agent s signature is valid only d an author¢a on letter from the applicant
is provided
Page 10 of 10
PCN Form — Version 13 December 10 2008 Version

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