20121050 Ver 1_Application_20121114

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STATE OF NORTH CAROLINA T�p��40 lore;? �o,�
DEPARTMENT OF TRANSPORTATION X441(411��'r
BEVERLY PURDUE P 0 Box 25201 Raleigh NC 27611 5202 EUGENE CON141414
GOVERNOR PHONE [phone] SECRETARY
November 14 2012
Mr Monte Matthews
U S Army Corps of Engineers
Raleigh Regulatory Field Office
3331 Heritage Trade Drive Suite 105
Wake Forest NC 27587
201210
10
Subject Nationwide Permit#14
50
SR 1128C(Andy Hicks Road)
Watauga County North Carolina
Project Number 11C 095094(DWQ Permit Fee $240)
Dear Mr Matthews
The NC Department of Transportation is scheduled to grade drain base and pave SR 1128C Andy
Hicks Road in Watauga County Total project length is approximately 0 7 miles Due to right of
way refusals the project will begin at station 69+00 The road will be widened from about 15 feet to
18 feet Impervious surface area will increase by about 0 25 acres This project will require the
replacement of five wet pipes but only 2 were deemed jurisdictional streams The other three were
carrying seepage emanating from the ditch line itself Impacts are tabulated below
Stream Impacts
Wk. n � WOK"x et tat
� ts 4
88+00 30 x 24 50 x 36 10 40 70
91+90 30 x 24 50 x 36 10 40 70
Permanent Fill/Riprap Impacts=60 feet Total project Impacts = 140 feet
The replacement of the above noted wet pipes will require temporary dewatering An impervious
sandbag dike will be constructed upstream of the existing pipes to create a small pool Clean water
will temporarily be pumped around the construction areas and will be discharged downstream Any
dirty 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
P 0 Box 250 N WILKESBORO NC 28659
PHONE [phone] FAx [phone]

Mr Monte Matthews
SR 1 I28C(Andy Hicks Road Watauga)
Page 2
The wet pipes in question carry different unnamed tributaries to Laurel Creek(Class C Trout) This
project was reviewed for the presence of threatened and endangered species on September 26 2012
This project will have no effect on any federally listed endangered plant or animal species SHPO
coordination is complete An archaeological study was required and was completed with a finding
of no effect
The project impacts are not significant 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 sizes 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 improved by paving the ABC
travel lanes All appropnate 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 this electronic 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
By copy of this electronic letter 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 in the spring If further information is required please let me
know Your early review and consideration will be appreciated
Sincerely
%If" / /1"
Heath Slaughter
Division Environmental Officer
Enclosures
cc Marla Chambers NCWRC
Amy Chapman Division of Water Quality
Amy Euliss Division of Water Quality
Matt Gantt PE Land quality Section
Mike Pettyjohn PE Division Engineer
Ivan Dishman PE District Engineer
Kevin Whittington County Maintenance Engineer
Heath Slaughter Division Environmental Officer
Neil Trivette Roadside Environmental Field Operations Engineer

Doti WATE9p Office Use Only
Corps action ID no
1 o DWQ project no
Form Version 1 3 Dec 10 2008
Pre Construction Notification (PCN) Form
A Applicant Information
1 Processing
1a Type(s)of approval sought from the
® Section 404 Permit ❑Section 10 Permit
Corps
1b 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
1 e Is this notification solely for the record For the record only for DWQ 401 For the record only for Corps Permit
because written approval is not required? Certification
❑Yes ® No ❑Yes ® No
if Is payment into a mitigation bank or in lieu fee program proposed for mitigation ❑Yes ® No
of impacts? If so attach the acceptance letter from mitigation bank or in lieu
fee program
1g Is the project located in any of NC s twenty coastal counties If yes answer lh ❑Yes ® No
below
lh Is the project located within a NC DCM Area of Environmental Concern (AEC)? ❑Yes ® No
2 Project Information
2a Name of project SR 1128C Andy Hicks Road
2b County Watauga
2c Nearest municipality/town Rominger
2d Subdivision name
2e NCDOT only T I P or state
110 095094
project no
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 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 10
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)
1 b Site coordinates(in decimal degrees) Latitude 36 20487 Longitude 81 83800
(DD DDDDDD) (DD DDDDDD)
1c Property size 4 25 acres
2 Surface Waters
2a Name of nearest body of water(stream river etc)to UTs to Laurel Creek
proposed project
2b Water Quality Classification of nearest receiving water C Trout
2c River basin Watauga
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 existing streams (intermittent and perennial)on the property
100 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 pasty ❑Yes ® No 0 Unknown
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
5 Project History
5a Have permits or certifications been requested or obtained for ❑Yes 0 N ❑ 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
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 ❑Yes ❑ Corps
❑ No ❑ DWQ
W2 ❑ P❑T ❑Yes ❑ Corps
❑ No ❑ DWQ
W3 ❑ P❑T ❑Yes ❑ Corps
0 N ❑ 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
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)
Si ® P®T Piping Riprap& UT#1 to Laurel ® PER ® Corps 2 70
Dewatering Creek ❑ INT ® DWQ
Piping Riprap& UT#2 to Laurel Z PER ® Corps
S2 ® P®T Dewatering Creek ❑ INT ® DWQ 2 70
S3 ❑ P❑T ❑ PER 0 Corps
DINT ❑ 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 140
31 Comments 80 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 Name of waterbody
impact number- (if applicable) Type of impact Waterbody type Area of impact(acres)
Permanent(P)or
Temporary(T)
01 ❑ P❑T
02 0 QT
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 N/A
5h Is a dam high hazard permit required?
El Yes ® No If yes permit ID no
5i 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 ❑Yes
❑ No
B2 ❑ P ❑T ❑Yes
❑ No
B3 ❑ P ❑T El Yes
❑ No
6h Total buffer impacts
6i 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 ❑Yes ®No
impacts to Waters of the U S or Waters of the State?
2b If yes nutigation is required by(check all that apply) ❑ DWQ ❑Corps
❑ Mitigation bank
2c If yes which mitigation option will be used for this
projects ❑ 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 Ocold
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 ❑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 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
la Does the project include or is it adjacent to protected riparian buffers identified ❑Yes ® No
within one of the NC Riparian Buffer Protection Rues?
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?
El Phase II
3b Which of the following locally implemented stormwater management programs H USW
apply(check all that apply) USMP
❑Water Supply Watershed
El Other
3c Has the approved Stormwater Management Plan with proof of approval been El Yes ❑ No
attached?
4 DWQ Stormwater Program Review
❑ Coastal counties
❑ HOW
4a Which of the following state implemented stormwater management programs apply ❑ ORW
(check all that apply) El Session Law 2006 246
El 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 El No
5b Have all of the 401 Unit submittal requirements been met? El Yes El No
Page 8 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(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 El 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
letter) El 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 2B 0200)7
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 El 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 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 El No
habitat?
5b Have you checked with the USFWS concerning Endangered Species Act ❑Yes E] 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 habitat? ❑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?
We coordinated with SHPO
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
J Heath Slaughter 11/14/12
Applicant/Agent s Printed Name Applicant/Agent s Si ture Date
(Agents signature is valid only if an authoriz ion letter from the applicant
is provided) _
Page 10 of 10
PCN Form—Version 1 3 December 10 2008 Version

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WATAUGA COUNTY SR1128C
ANDY HICKS RD
REVISED 11/14/2012
STATION NEW PIPE SIZE EXISTING PIPE WET PIPE CREEK SIZE
4+45 70 X 18 60 X 18 YES 6-
9+25 50- 8- ADD NO
13+90 10 X18 10 X18 NO
18+00 50-X-18- ADD NO
25+00 50— 30 X 18 YES SEEP
29+30 50-X 30-X-24- YES 1-
34+35 50 X 21 30 X 18 YES 6-
/13+75 10 X 18 ADD NO
54+75 50 X 24 ADD YES 6-
57+55 60 X 36 10 X 24 YES 1-
59+75 10 X 18 ADD NO
62+60 50 X 18 30 X 18 NO
68+90 50 X12 30 X 24 YES 3-
71+90 50 X 24 30 X 18 No wet ditch
74+75 50 X 18 30 X 18 NO
79+75 50 X 24 30 X 18 No wet ditch
81+20 50 X 24 ADD NO
88+00 50 X 36 30 X 24 YES 2
91+90 60 X 36 30 X 24 Yes 2
97+00 50 X 24 30 X 18 NO
105+50 40 X 24 30 X 24 NO
DOES NOT INCLUDE DRY DRIVEWAY PIPE
I
WET DRIVEWAY PIPE
29+00 10 X 18 10 X 15 YES 6
51+45 30 X 15 30 X 15 YES 6-
91+82 20 X 15 ADD No Wet ditch
Gapped Section is strike thru format

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11/14/2012
SHIFTED CENTERLINE SHEET
Andy Hicks Rd
Revised 11 29 06 3/14/200 SR 1128C
SHIFTED SHIFTED SHIFTED
STATION LEFT RIGHT STATION LEFT RIGHT STATION LEFT RIGHT
01+00 45+00 6 89+00
02+00 2 46+00 3 90+00
03+00 47+00 3 91+00 14
04+00 2 48+00 3 92+00 17
05+00 11 49+00 3 93+00 18
06+00 50+00 94+00 18
07+00 51+00 3 95+00
08+00 52+00 2 96+00
09+00 3 53+00 97+00 3
10+00 4 54+00 3 98+00
11+00 9 55+00 6 99+00
12+00 8 56+00 6 100+00
13+00 7 57+00 5 101+00
14+00 9 58+00 6 102+00
15+00 3 59+00 5 103+00
16+00 60+00 5 104+00
17+00 61+00 5 105+00
18+00 62+00 6 106+00
19+00 63+00 5
20+00 64+00 5
21+00 65+00 5
22+00 66+00 7
23+00 67+00
24+00 68+00
25+00 69+00
26+00 70+00
27+00 4 71+00
28+00 3 72+00
29+00 73+00
30+00 74+00
31+00 75+00
32+00 76+00
33+00 77+00
34+00 4 78+00
35+00 2 79+00
36+00 3 80+00
37+00 3 81+00
38+00 82+00 6
39+00 83+00 7
40+00 84+00 6
41+00 85+00 3
42+00 86+00
43+00 5 87+00
44+00 7 88+00

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