20121107 Ver 1_02_P5206BCDF_PCNv1_4_130318_20130318

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PCN Form – Version 1.4January 2009
Office Use Only:
Corps action ID no. _____________
DWQ project no. _______________
Form Version 1.4January 2009
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
1b. Specify Nationwide Permit (NWP) number: 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
1e. 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:
2b. County:
2c. Nearest municipality / town:
2d. Subdivision name:
2e.NCDOT only, T.I.P. or state project no:
3. Owner Information
3a. Name(s) on Recorded Deed:
3b. Deed Book and Page No.
3c. Responsible Party (for LLC if
applicable):
3d. Street address:
3e. City, state, zip:
3f. Telephone no.:
3g. Fax no.:
3h. Email address:
ReidtoNorthKannapolisRailroadSafetyImprovements
Rowan
Salisbury,ChinaGrove
--
P-5206B,C,D,F
NorthCarolinaRailroadCompany(NCRR)
NCRRexistingright-of-way
2809HighwoodsBoulevard,Suite100
Raleigh,NC27604-1000
919-954-7601
919-954-7099
14,33
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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:
MarcHamel
NorthCarolinaDepartmentofTransportation,RailDivision
1SouthWilmingtonSt.,Room555(delivery)or1553MailServiceCenter(mail)
Raleigh,NC27699-1553
919-707-4705
919-715-6580
[e-mail]
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PCN Form – Version 1.4January 2009
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: Longitude:
1c. Property size: acres
2. Surface Waters
2a. Name of nearest body of water to proposed project:
2b. Water Quality Classification of nearest receiving water:
2c. River basin:
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:
3b. List the total estimated acreage of all existing wetlands on the property:
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
3d. Explain the purpose of the proposed project:
3e. Describe the overall project in detail, including the type of equipment to be used:
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
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.
-80.563918
959.2
GrantsCreek,ColdWaterCreek
C,WS-IV,CA
Yadkin
TheP-5206B,C,andDprojectsectionsconsistsofclearingandgradingforasecondtrack,theextensionandgrade-separatedrailcrossingof
KimballRoadinLandis,andtheclosureofmultipleprivateandpublicat-graderoadcrossings.P-5206Finvolvesinstallationofthesecondtrack.
Pleaseseeattachedletterforadetaileddescriptionofprojectsections.
7.48
Thepurposeofthisprojectistoimprovetrainspeed,reliability,efficiency,andsafety.Pleaseseeattachedletter.
Pleaseseeattachedletter.
Axiom Environmental,Inc.
TheprojectwasvisitedandjurisdictionalareaswereapprovedbyJohnThomasoftheUSACEandAmyEulissoftheNCDWQonSeptember30,2010
andAugust28,2012.
AuthorizationforNationwidePermits14and33hasbeenprovidedforjurisdictionalareaimpactsassociatedwithP-5206A,(thegrade-separationofPe
Pleaseseeattachedletteranddesignplans.
35.576732
5,463
SandySmith,ScottDavis
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PCN Form – Version 1.4January 2009
C. Proposed Impacts Inventory
1. Impacts Summary
1a. Which sections were completed below for your project (check all that apply):
Wetlands Streams – tributariesBuffersOpen 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.
Wetland impact
number
Permanent (P) or
Temporary (T)
2b.
Type of impact
2c.
Type of wetland
2d.
Forested
2e.
Type of jurisdiction
Corps (404,10) or
DWQ (401, other)
2f.
Area of
impact
(acres)
W1
W2
W3
W4
W5
W6
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.
Stream impact
number
Permanent (P) or
Temporary (T)
3b.
Type of impact
3c.
Stream name
3d.
Perennial (PER) or
intermittent (INT)?
3e.
Type of
jurisdiction
3f.
Average
stream
width
(feet)
3g.
Impact
length
(linear
feet)
S1
S2
S3
S4
S5
S6
3h. Total stream and tributary impacts
3i. Comments:
Fill Small-BasinWetland No DWQ 0.04
No DWQ 0.05
No DWQ 0.04
No DWQ 0.02
No Corps 0.05
Yes/No -
0.2
WetlandW1throughW4havebeendeterminedtobeisolated.WetlandW5hasbeendeterminedtobejurisdictional.
CulvertreplacementUTtoGrantsCreek INTCorps342
UTtoColdWaterCreek 311
UTtoColdWaterCreek 3217
UTtoColdWaterCreek 680
UTtoColdWaterCreek 455
405
Table3notespermanentimpactstojurisdictionalstreams.Anadditional19feetoftemporaryimpactsareanticipated.Pleaseseetheattachedletter,
PermitDrawings,andWetlandPermitImpactSummariesforcompletepermanentandtemporaryimpacts.
P
P
P
P
P
-
Fill
Fill
Excavation
Fill
Chooseone
Small-BasinWetland
Small-BasinWetland
Small-BasinWetland
HeadwaterWetland
Chooseone
P
P
P
P
P
-
Fill
Culvertreplacement
Culvertextension
Culvertextension
Chooseone
INT
INT
PER
INT
-
Corps
Corps
Corps
Corps
-
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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.
Open water
impact number
Permanent (P) or
Temporary (T)
4b.
Name of waterbody
(if applicable
4c.
Type of impact
4d.
Waterbody
type
4e.
Area of impact (acres)
O1
O2
O3
O4
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If pond or lake construction proposed, then complete the chart below.
5c.
Wetland Impacts (acres)
5d.
Stream Impacts (feet)
5e.
Upland
(acres)
5a.
Pond ID number
5b.
Proposed use or
purpose of pond
FloodedFilledExcavated FloodedFilledExcavated
P1
P2
5f.Total:
5g. Comments:
5h. Is a dam high hazard permit required? 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.Project is in which protected basin? Neuse Tar-Pamlico Catawba Randleman Other:
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)
B1
B2
B3
B4
B5
B6
6h.Total Buffer Impacts:
6i. Comments:
ChooseoneChoose
Noopenwaterimpactsareanticipated.
Chooseone
Nopondconstructionisproposed.
Yes/No
Theprojectdoesnotliewithinawatershedwithadesignatedriparianbuffer.
-
-
-
-
Chooseone
Chooseone
Chooseone
Choose
Choose
Choose
Chooseone
-
-
-
-
-
-
Yes/No
Yes/No
Yes/No
Yes/No
Yes/No
)
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PCN Form – Version 1.4January 2009
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
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:
3b. Credits Purchased (attach receipt and letter)
Type:
Type:
Type:
Quantity:
Quantity:
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:
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.
Pleaseseeattachedletter.
Pleaseseeattachedletter.
485
warm
0.1
Chooseone
Chooseone
Chooseone
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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:
n/a
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PCN Form – Version 1.4January 2009
E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1a. Does the projectinclude or is it adjacent to protected riparian buffers identified
within one of the NC Riparian Buffer Protection Rules? Yes No
1b. If yes, then is a diffuse flow plan included? If no, explain why.
Yes No
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:
2d.If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:

2e. Who will be responsible for the review of the Stormwater Management Plan?
3. Certified Local Government Stormwater Review
3a. In which local government’s jurisdiction is this project?
3b. Which of the following locally-implemented stormwater management programs
apply (check all that apply):
Phase II
NSW
USMP
Water Supply Watershed
Other:
3c. Has the approved Stormwater Management Plan with proof of approval been
attached? Yes No
4. DWQ Stormwater Program Review
4a. Which of the following state-implemented stormwater management programs apply
(check all that apply):
Coastal counties
HQW
ORW
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
Grassshoulders,slopes,andswaleswillbeusedtotreatstormwaterdischargepriortoenteringsurfacewaters.Pleaseseeattached Stormwater
ManagementPlan.
RowanCo.,Salis.,Ch.Grv.,Landis,Kann.
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PCN Form – Version 1.4January 2009
F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1a. Does the project involve an expenditure of public (federal/state/local) funds or the
use of public (federal/state) land? Yes No
1b. 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
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
Yes No
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.)
Comments:
Yes No
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,
or Riparian Buffer Rules (15A NCAC 2B .0200)?
Yes No
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
additional development, which could impact nearby downstream water quality? Yes No
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.
Theproposedprojectisdesignedtoimprovesafetyalongthisstretchof railbyremoving13at-gradecrossingsandreplacingthemwith2grade-
separatedcrossing(oneinassociationwiththispermitapplicationandonewhichhasbeenpermittedundertheP-5206Aproject).Thegrade-
separatedcrossingisintendedtoeliminatetrain-automobileinteractionsandmaintaincurrenttrafficflow.Nonewpublicfacilitiesoraccessto
developedordevelopableareasareproposed;therefore,theseupgradedcrossingsarenotanticipatedtoencourageanynearbydevelopment.
Nosewagedischargeisanticipatedasaresultof theproposedproject.
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or
habitat?
NI Yes D No
5b, Have you checked with the USFWS concerning Endangered Species Act
impacts?
0 Yes Ell No
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?
USFWS- NC Ecological Services County Listings, and NCNHP Virtual Workroom data (online), Field surveys were conducted for listed species during
the appropriate survey windows. No individuals were identified and the project will have No Effect on listed species,
6 Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?
Yes DI No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
NOAA Fisheries Essential Fish Habitat Mapper v2 0 (online)
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Wilt this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
Yes 0 No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
Consultation with the State Historic Protection Office and NEPA documentation. No impacts will occur in association with jurisdictional areas;
however, the railroad project will impact a property eligible for the National Register of Historic Places, A signed MOA is available,
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?
El Yes El No
8b. If Yes, explain how project meets FEMA requirements:
NCDOT Hydraulics. Unit coordination with FEMA.
8c. What source(s) did you use to make the floodplain determination?
NCFloodmaps.com digital GIS data,
grC,_
Applicant/Agent's Printed Name
Applicant/Agent's Signature
(Agent's signature is valid only if an authorization
letter from the applicant is provided.)
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