20140423 Ver 1_Application_20140424

FW: Non - reporting NWP 3 and NWP 13 with corresponding WQC No. 3883 and WQC ... Page 1 of 1
FW: Non - reporting NWP 3 and NWP 13 with corresponding WQC No. 3883
and WQC No. 3885 on SR 1534 (Broad Road) in Person County
Ridings, Rob
Sent: Monday, April 28, 2014 8:36 AM
To: Carrillo, Sonia
Attachments: SR 1534 Broad Road Person —1.pdf (674 KB) ; SR 1534 (Broad Road) Perso —l.pdf (531 KB) ; SR 1534 Broad Road
Person -2.pdf (230 KB)
Here's a Courtesy Copy NW 3 and 13. If you can, please include the email in the file info since they didn't have a
cover letter.
Thanks!
rob
i 40 423
From: Montague, Heather W
Sent: Wednesday, April 23, 2014 2:32 PM
To: Ridings, Rob; Alsmeyer, Eric C SAW ( Eric.C.Alsmeyer @usace.army.mil)
Cc: Pearson, Donald R; Souther, Zachary S
Subject: Non - reporting NWP 3 and NWP 13 with corresponding WQC No. 3883 and WQC No. 3885 on SR 1534
(Broad Road) in Person County
Rob and Eric-
Person County Bridge Maintenance has a cross line in need of replacement on SR 1434 (Broad Road), in
Roxboro. The pipe site involves an existing 50" CMP that is 40ft long. There is a large scour hole to the outlet end.
The 50" CMP that was 40ft long has separated joints and will be replaced with a new 9'11" x 67' corrugated aluminum
structure plate -arch that is 48ft long with aluminum headwalls. Rip rap will be installed underlined with geotextile along
the stream banks for long term stability. Additionally some rip rap in the flow line (not to exceed 20ft) at the outlet of the
new pipe may be necessary to reestablish the channel bed. Note site will be temporarily dewatered to maintain dry work
area, while stream flow will be pumped around the site. The site is within the Roanoke River Basin, so buffer rules do
not apply. Although this crossing is mapped as having hydric soils (Cw), no wetlands exists within the
construction footprint. We propose to work under a non - reporting NWP 3 and NWP 13 with corresponding WQC
No. 3883 and WQC No. 3885.
For maintenance sites such as this one, NCDOT Division 5 has a procedure in place to provide our construction
crews with print outs of the general conditions along with a letter head cover sheet explaining the intent to
operate under a non - reporting permit as long as all applicable conditions are meet. Oversight from both the
Environmental Staff and REU Field Operations Unit will ensure compliance with the permit conditions are met
and that standard BMPs are followed. Attached to this email is a courtesy PCN for your files along with site maps
and a construction plan. This work is scheduled to begin in late May. I will notify you of a start date and then a
completion date once I have that information.
Heather W. Montague
NCDOTDIV5 Environmental Specialist
hwmontague @ncdot.gov
(252)492 -0111 office
(919)691 -1596 cell
Email correspondence to and from this sender is subject to the N.C. Public Records Law and may be disclosed to third parties.
https: / /mail.nc. gov /owa/ ?ae= Item &t = IPM. Note& id= RgAAAADMSzLcd9 W2TJH14 %2bm... 4/29/2014

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Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Page 1 of 8
PCN Form — Version 1.3 December 10, 2008 Version
Pre - Construction Notification PCN Form
A.
Applicant Information
1.
Processing
1 a.
Type(s) of approval sought from the
Corps: non - reporting
®Section 404 Permit El Section 10 Permit
1 b.
Specify Nationwide Permit (NWP) number: NWP 3 and NWP 13 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
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:
Proposed pipe replacement; SR 1534 (Broad Road)
2b.
County:
Person
2c.
Nearest municipality / town:
Roxboro
2d.
Subdivision name:
2e.
NCDOT only, T.I.P. or state
project no:
3.
Owner Information
3a.
Name(s) on Recorded Deed:
NCDOT Division 5
3b.
Deed Book and Page No.
3c.
Responsible Party (for LLC if
applicable):
3d.
Street address:
2612 N. Duke Street
3e.
City, state, zip:
Durham, NC 27704
3f.
Telephone no.:
(919)220 -4600
3g.
Fax no.:
(919)560 -3371
3h.
Email address:
[e-mail]
4.
Applicant Information (if different from owner) N/A
S.
Agent/Consultant Information (if applicable) N/A
Page 1 of 8
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. Coordinates (in decimal degrees):
Site 1:
Latitude: 36.4070 Longitude: - 78.9616
(DD.DDDDDD) (- DD.DDDDDD)
1 c. Property size:
< 0.01 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
UT Marlowe Creek
proposed project:
2b. Water Quality Classification of nearest receiving water:
C
2c. River basin:
Roanoke
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:
This cross line involves a 50" pipe that is 40ft long. The existing pipe has separated joints and the structure needs to be
replaced completely. Site is surrounded by wooded and agricultural land.
3b. List the total estimated acreage of all existing wetlands on the property:
NONE: Although this crossing is listed as having hydric soils (Cw), no wetlands exists within the construction footprint.
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
80ft
3d. Explain the purpose of the proposed project: The pipe replacement will strengthen the roadway and shoulder sections at
the crossing.
3e. Describe the overall project in detail, including the type of equipment to be used:
There is a large scour hole to the outlet end. The 50" CMP that was 40ft long has separated joints and will be replaced with a
new 9'11" x 67' corrugated aluminum structure plate -arch that is 48ft long with aluminum headwalls. Rip rap will be installed
underlined with geotextile along the stream banks for long term stability. Additionally some rip rap in the flow line at the outlet
of the new pipe may be necessary to reestablish the channel bed. Equipment may include a backhoe, an excavator, and
grader.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
El Yes ®No El Unknown
project (including all prior phases) in the past?
Comments: N/A
4b. If the Corps made the jurisdictional determination, what type
L] Preliminary El Final
of determination was made?
4c. If yes, who delineated the jurisdictional areas?
Agency /Consultant Company: N/A
Name (if known): N/A
Other: N/A
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
N/A
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.
N/A
Page 2 of 8
PCN Form — Version 1.3 December 10, 2008 Version

6. Future Project Plans
6a. Is this a phased project?
❑ Yes ® No
6b. If yes, explain.
N/A
C. Proposed Impacts Inventory
1. Impacts Summary
1 a. 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
N/A
N/A
❑ Yes
❑ Corps
N/A
❑ No
❑ DWQ
2g. Total Wetland Impacts:
NONE
2h. Comments: N/A
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)
Site 1 ® P ❑ T
fill
UT to
® PER
® Corps
8
Stream 1
pipe
Marlowe Creek
❑ INT
® DWQ
5
concurrent
Site 1 ® P ❑ T
rip rap fill
UT to
® PER
® Corps
20
Stream 1
in blow hole
Marlowe Creek
❑ INT
® DWQ
5
concurrent
Site T
tCreek
5
0
Stream 1❑
rip rap
Marlowe
[:1 INT
® DWQ
concurrent
Site 1 ❑ P ® T
dewatering
UT to
® PER
® Corps
5
80
Stream 1
Marlowe Creek
❑ INT
® DWQ
3h. Total stream and tributary impacts
80
3i. Comments: Rip rap in the flow line at the outlet of the new pipe may be necessary to reestablish the channel bed due to
existing blow hole that has scoured out the channel and left the old pipe perched.
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
impact number -
waterbody
Type of impact
Waterbody type
Area of impact (acres)
Permanent (P) or
(if applicable)
Temporary T
01 ❑ P ❑ T
N/A
N/A
N/A
N/A
4f. Total open water impacts
NONE
4g. Comments: N/A
Page 3 of 8
PCN Form -Version 1.3 December 10, 2008 Version

Page 4 of 8
PCN Form —Version 1.3 December 10, 2008 Version
5. Pond or Lake Construction
If pond or lake construction proposed, the complete the chart below.
5a.
Pond ID
number
5b.
Proposed use or purpose of
pond
5c.
Wetland Impacts (acres)
5d.
Stream Impacts (feet)
5e.
Upland
(acres)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
P2
5f. Total
NONE
NONE
NONE
NONE
NONE
NONE
NONE
5g. Comments: N/A
5h. Is a dam high hazard permit required?
❑ Yes No If yes, permit ID no: N/A
5i. Expected pond surface area (acres):
N/A
5j. Size of pond watershed (acres):
N/A
5k. Method of construction:
N/A
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.
Project is in which protected basin?
❑ Neuse ❑Tar- Pamlico ❑Other:
❑ Catawba ❑ Randleman
6b.
Buffer impact
number —
Permanent (P) or
Temporary T
6c.
Reason for
impact
6d.
Stream name
6e.
Buffer
mitigation
required?
6f.
Zone 1 impact
(square feet)
6g.
Zone 2 impact
(square feet)
Site 1 ❑ P ❑ T
Buffer Impact 1
N/A
N/A
N/A
N/A
N/A
6h. Total buffer impacts
NONE
NONE
6i. Comments: N/A
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.
The pipe will be replaced in the same alignment by the new pipe. Rip rap armoring along the stream banks as well as rip rap
within the channel at the outlet will be limited only to the amount necessary to ensure long term stability.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Sediment and erosion control Best Management Practices for protection of surface waters will be enforced during project
construction.
Page 4 of 8
PCN Form —Version 1.3 December 10, 2008 Version

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 project?
❑ Mitigation bank
❑ Payment to in -lieu fee program
❑ Permittee Responsible Mitigation
3.
Complete if Using a Mitigation Bank
3a.
Name of Mitigation Bank: N/A
3b.
Credits Purchased (attach receipt and letter)
Type N/A
Quantity N/A
3c.
Comments: N/A
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:
N/A linear feet
4c.
If using stream mitigation, stream temperature:
❑ warm ❑ cool ❑cold
4d.
Buffer mitigation requested (DWQ only):
N/A square feet
4e.
Riparian wetland mitigation requested:
N/A acres
4f.
Non - riparian wetland mitigation requested:
N/A acres
4g.
Coastal (tidal) wetland mitigation requested:
N/A acres
4h.
Comments: N/A
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.
N/A
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
N/A
N/A
3 (2 for Catawba)
N/A
Zone 2
N/A
N/A
1.5
N/A
6f. Total buffer mitigation required:
NONE
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). N/A
6h.
Comments: N/A
Page 5 of 8
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?
1b.
If yes, then is a diffuse flow plan included? If no, explain why.
❑ Yes 0 N
Comments: this pipe replacement will not alter storm water runoff at this site
2.
Stormwater Management Plan
2a.
What is the overall percent imperviousness of this project?
<20 %
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: N/A
❑ 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
❑ 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? N/A
4.
DWQ Stormwater Program Review
❑ Coastal counties
❑ HQW
4a.
Which of the following state - implemented stormwater management programs apply
❑ ORW
(check all that apply): N/A
❑ Session Law 2006 -246
❑ Other:
4b.
Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ❑ No
attached? N/A
5.
DWQ 401 Unit Stormwater Review
5a.
Does the Stormwater Management Plan meet the appropriate requirements? N/A
❑ Yes ❑ No
5b.
Have all of the 401 Unit submittal requirements been met? N/A
❑ Yes ❑ No
Page 6of8
PCN Form — Version 1.3 December 10, 2008 Version

F.
Supplementary Information
1.
Environmental Documentation (DWQ Requirement)
1 a.
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
❑ Yes
❑ No
letter.)
Comments: N/A
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):
N/A
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.
N/A
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 7 of 8
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
❑ Yes ® No
or habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act
❑ Yes ® No
impacts?
El 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?
http: / /www.fws.gov /nc -es /es /countvfr.html and NC Natural Heritage Program Database, Element Occurrences
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish
❑ Yes ® No
habitat?
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
http : / /ocean.floridamarine.org /efh coral /ims /viewer.htm
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?
HPO's historic layer using GIS ArcView database http: / /gis.ncdcr.gov /hpoweb/
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: N/A
8c. What source(s) did you use to make the floodplain determination? http: / /www.ncfloodmaps.com/
fo, J. W. Bowman, P.E.
Q ��^-
04 -23 -14
ApplicanUAgent's Signatur !
(Agent's signature is valid only If an authorization let er from the applicant
Applicant/Agent's Printed Name
Date
Is provided.)
Page 8 of 8
PCN Form — Version 1.3 December 10, 2008 Version

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