20140406 Ver 1_401 Application_20140414

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McGill
A S S O C I A T E S
April 23, 2014
Ms. Sonia G. Carrillo
North Carolina Division of Water Resources
Transportation Permitting Unit
1617 Mail Service Center
Raleigh, North Carolina 27699 -1650
RE: Pre - Construction Notification
46th Avenue Drive NE
Bridge Replacement Project
City of Hickory
Catawba County, North Carolina
Dear Ms. Carrillo:
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ENGINEERING & g
As you requested by e -mail, please find enclosed check number 058669 in the amount of
$330.00 for additional permitting fees related to the above referenced project.
We appreciate your assistance with this project. Please do not hesitate to call if you have
any questions or need additional information during your review.
Sincerely,
McGILL ASSOCIATES, P.A.
1411.--
GRE OFFMAN, PE, CPESC
Project Engineer
cc: Mr. Rick Patton, City of Hickory p 0­t*N%9flY2 "�201 Mr. Shad Walters, McGill Associates
Mr. Andy Lovingood, McGill Associates
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X:\2013 \13.01416 - 46th Ave Crossing Hickory \Letters\DWR SC23aprilI4.docx
55 Broad Street P.O. Box 2259 ph: 828.252.0575
Asheville, North Carolina 28801 Asheville, North Carolina 28802 f: 828.252.2518
www.mcgillengineers.com

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McGill
A S S O C I A T E S
April 15, 2014
Mr. David Brown
Regulatory Specialist
Asheville Regulatory Field Office
US Army Corps of Engineers
151 Patton Avenue, Room 208
Asheville, North Carolina 28801
Dear Mr. Brown:
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RE: Pre - Construction Notification Form
46th Avenue Drive NE
Bridge Replacement Project
City of Hickory
Catawba County, North Carolina
The Hickory, North Carolina area experienced a 1,000 -year storm event on July 27, 2013,
including the drainage area for Snow Creek, part of the Catawba River Basin. Flooding during
the storm event overtopped the bridge over Snow Creek at 46th Avenue Drive NE, resulting in
the complete failure of the bridge structure. The bridge services residents in the Windridge
Subdivision in the City of Hickory. The former bridge was a structural plate culvert with a 24-
foot opening and the City would like to replace the failed bridge with a span structure with a
clear opening of 71.75' between the bridge end bents. Please find enclosed for your review the
Pre - Construction Notification (PCN) submittal package for this project. The submittal package
includes one copy of each of the following items:
1. Fully executed PCN form.
2. Project plans.
3. Project narrative.
4. Check made payable to `NC Division of Water Resources' for $240 application fee
(check sent to NC -DWR Transportation Permitting Unit).
We appreciate your assistance with this project. Please do not hesitate to call if you have
any questions or need additional information during your review. We look forward to receiving
a 404/401 permit for the 46th Avenue Drive NE Bridge Replacement Project.
55 Broad Street P.O. Box 2259 Ph: 828.252.0575 u
Asheville, North Carolina 28801 Asheville, North Carolina 28802 f: 828.252.2518 www.mcgillengineers com hY
FNS:,

Mr. David Brown
April 15, 2014
Page 2 of 2
Sincerely,
McGILL ASSOC ES, .A.
DAVE PASKO
Senior Engineering Technician
Enclosures
cc: NCDENR — DWR Transportation Permitting Unit — Raleigh, w/5 copies of enc
Mr. Alan Johnson, NCDENR — DWR Mooresville Office, w /enc
Mr. Rick Patton, City of Hickory, w /enc
Mr. Shad Walters, McGill Associates, w /enc
Mr. Andy Lovingood, McGill Associates, w /enc
X:\2013 \13.01416 -City of Hickory\Letters \015apr14 - corp permit.docx

Project Narrative
On July 27, 2013, the Hickory, North Carolina area experienced what is described by many as a 1,000 -
year storm event. This included the drainage basin for Snow Creek, which flows out of the urban
Hickory area north to Lake Hickory (Catawba River). The drainage area for Snow Creek is approximately
3,500 acres. The storm event produced flooding that overtopped the 46th Avenue Drive NE bridge over
Snow Creek, resulting in the complete failure of the bridge structure. The downstream wingwall cracked
at the center point and partially fell off its footing. The approximately 24' -wide structural plate culvert
failed and dropped off of its footing into the creek. All of the utilities crossing over the bridge were
severed and there are remains of the decorative safety wall in the creek. Additionally, fill material that
was located over the structural culvert deposited in the creek, approximately 80 I.f. downstream of the
bridge, and raised the bottom of the creek approximately 3', based on the North Carolina Floodplain
Mapping Program & FEMA's model for the pre -storm event conditions. 46th Avenue Drive NE is a City of
Hickory road that services residents in the Windridge Subdivision .
The City of Hickory would like to replace the structural plate structure with a box beam bridge structure
that will include approximately 71.75' clear span between the bridge end bents. Additional work will
include replacing the severed utilities beneath the creek bed and removing accumulated sediment
downstream of the bridge. The construction sequence will include the following:
1. Installation of silt fence at the toe of the existing failed slope, in order to restrain additional
sediment from reaching the stream during demolition activities. It will not be possible to
install by -pass piping in the creek due to the fact that the elevation of the thalweg 80 I.f.
downstream from the bridge is 9' higher than the thalweg at the upstream end of the
bridge. The total disturbed area for the project, including repaving portions of 46th Avenue,
is approximately 0.6 acres.
2. Removal of the existing bridge structure. This work will entail the removal of the existing
wingwalls and structural plate culvert from the creek. Culvert and wall footings will
removed where necessary, but it is hoped that the footings that run parallel to the flow line
of the creek will be left in place as structural support for the footer rocks for the slope
beneath the bridge.
3. Once the existing bridge structure is removed, work can begin on the replacement structure.
Pilings will be installed at the location of the end bents, prior to the installation of the end
bent structures. When the bents are installed the contractor can grade the new slope
beneath the bridge. This will require the re- adjustment of the silt fence in order to
accommodate the finished grade contours for the project. Concurrent to the grading work
beneath the bridge, the contractor will remove the sandbar that was deposited
approximately 80 I.f. downstream of the bridge. The sandbar currently blocks the flow of
the stream at the outlet of the pool at the downstream end of the bridge. The stream
bottom will be lowered to pre -storm event conditions, approximately 3' lower than what
currently exists. Removing the sandbar will allow the contractor to install the footer rocks at
the toe of the embankment beneath the bridge in the dry. The task of removing the

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sandbar and relocating the cobble material will involve in- stream work. The cobble material
that makes up the sandbar will be used beneath the bridge structure to raise the thalweg
elevation approximately 2'.
4. With the structural elements of the bridge in place, the contractor will install the creek
crossings for the utilities, including the 8" d.i.p. waterline, 2.5" pvc sewer force main with 6"
d.i.p. encasement pipe, 3" pvc conduit for cable tv line, replacement gas line, and conduit
for telephone and electrical lines. All of the utilities will be placed a minimum of V beneath
the stream bottom.
5. Work will begin on the bridge deck and finalizing the approach areas to the bridge on 46th
Avenue.
6. Seeding (temporary and permanent) will be in accordance with the requirements of the
NCDENR — Division of Land Quality, with cover placed on finished slopes within 7 days of
completion. Additionally, riparian plants will be placed in the lower bank zone of the
finished slopes in the project area. -
7. Final paving of 46th Avenue.

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Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.4 January 2009
Pre - Construction Notification (PCN) Form
A. Applicant Information
1. Processing
1 a. Type(s) of approval sought from the Corps:
❑X Section 404 Permit ❑ Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: NWP 3 or General Permit (GP) number:
1 c. Has the NWP or GP number been verified by the Corps?
❑ Yes ❑X No
1d. Type(s) of approval sought from the DWQ (check all that apply):
❑X 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 ❑X No
For the record only for Corps Permit:
❑ Yes ❑X 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 ❑X No
1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below.
❑ Yes ❑X No
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes ❑X No
2. Project Information
2a. Name of project:
46th Avenue Drive NE Bridge Replacement
2b. County:
Catawba
2c. Nearest municipality / town:
Hickory
2d. Subdivision name:
Windridge Subdivision
2e. NCDOT only, T.I.P. or state project no:
N/A
3. Owner Information
3a. Name(s) on Recorded Deed:
City of Hickory, NC
3b. Deed Book and Page No.
2568/1031
3c. Responsible Party (for LLC if
applicable):
City of Hickory, NC
3d. Street address:
76 North Center Street
3e. City, state, zip:
Hickory, NC 28601
3f. Telephone no.:
828.323.7416
3g. Fax no.:
3h. Email address:
rpatton @hickorync.gov
Page 1 of 10
PCN Form — Version 1.4 January 2009

4. Applicant Information (if different from owner)
4a. Applicant is:
❑X 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:
Greg Hoffman, PE
5b. Business name
(if applicable):
McGill Associates, P.A.
5c. Street address:
55 Broad Street
5d. City, state, zip:
Asheville, NC 28801
5e. Telephone no.:
828.252.0575
5f. Fax no.:
828.252.2518
5g. Email address:
greg.hoffman @mcgillengineers.com
Page 2 of 10

B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID):
372517204840
1 b. Site coordinates (in decimal degrees):
Latitude: 35.79169 Longitude: 81.28426
1 c. Property size:
6.74 acres
2. Surface Waters
2a. Name of nearest body of water to proposed project:
Snow Creek
2b. Water Quality Classification of nearest receiving water:
C.
2c. River basin:
Catawba River
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:
The City of Hickory bridge over Snow Creek on 46th Avenue NE that serves the Windridge Subdivision failed during an extreme storm event in July
2013. The bridge was overtopped and the downstream wingwall was destroyed along with the structural plate culvert and utilities. Fill material that
was over the culvert deposited in the stream channel just downstream of the bridge and currently restricts flow.
3b. List the total estimated acreage of all existing wetlands on the property: 0
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property: 1,100
3d. Explain the purpose of the proposed project:
To replace the 46th Avenue Bridge so that residents may use the road to access their property.
3e. Describe the overall project in detail, including the type of equipment to be used:
See project narrative on attached sheet.
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 ❑x 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): N/A
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 ❑X Unknown
5b. If yes, explain in detail according to "help file" instructions.
6. Future Project Plans
6a. Is this a phased project?
❑ Yes ❑X No
6b. If yes, explain.
Page 3 of 10
PCN Form — Version 1.4 January 2009

C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
❑ Wetlands 0 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 impact Type of wetland Forested Type of jurisdiction Area of
Corps (404,10) or impact
number
DWQ (401, other) (acres)
Permanent (P) or
T
—Temporary
W1
Choose one
Choose one
Yes /No
-
W2
Choose one,
Choose one
Yes /No
-
W3
Choose one
Choose one
Yes /No
-
W4
Choose one
Choose one
Yes /No
-
W5
Choose one
Choose one
Yes /No
-
W6
Choose one
Choose one
Yes /No
-
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 (PER) or Type of Average Impact
length
number intermittent (I NT)? jurisdiction stream
width (linear
Permanent ( P ) or
(feet) feet)
Temporary (T)
S1 P-
bridge replacement
Snow Creek
PER
Corps
24
200
S2
Choose one
DWQ
24
200
S3
Choose one
S4
Choose one
S5
Choose one
S6
Choose one
3h. Total stream and tributary impacts
3i. Comments:
Page 4 of 10
PCN Form — Version 1.4 January 2009

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
Area of impact (acres)
Permanent (P) or
type
Temporary T
01
Choose one
Choose
02 -
Choose one
Choose
03 -
Choose one
Choose
04
Choose one
Choose
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.
Pond ID number
Proposed use or
Wetland Impacts (acres)
Stream Impacts (feet)
Upland
purpose of pond
(acres)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
P1
Choose one
P2
Choose one
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 miti ation, then vou MUST fill out Section D of this form.
6a. Project is in which protected basin?
❑ Neuse E] Tar-Pamlico E] Catawba Randleman E] Other:
6b.
6c.
6d.
6e.
6f.
6g.
Buffer Impact
Reason for impact
Stream name
Buffer
Zone 1
Zone 2
number–
mitigation
impact
impact
Permanent (P) or
required?
(square
(square
T
feet
feet
—Temporary
BI
Yes /No
B2
Yes /No
B3
Yes /No
B4
Yes /No
B5
Yes /No
B6
Yes /No
6h. Total Buffer Impacts:
6i. Comments:
Page 5 of 1U

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
In -stream work will be confined to 100 I.f downstream and 60 IS. upstream of the bridge repair project.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
The contractor will properly maintain silt fence to avoid adding sedimentation to the stream. The contractor will lower the sandbar that was desposited
during the storm event, approximately 80 I.f. downstream of the bridge This will allow the contractor to install the toe stabilization required for the
project and construct coffer dams for the installation of the utilities. By -pass piping of the stream is not possible because the stream bottom is 9' higher
80 I.f. downstream of the bridge.
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 ❑X 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: Choose one
Type: Choose one
Type: Choose one
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:
Choose one
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 1.4 January 2009

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.
Zone
6c.
Reason for impact
6d.
Total impact
Multiplier
6e.
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

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
within one of the NC Riparian Buffer Protection Rules?
❑ Yes ❑X No
1 b.
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 ❑X No
2c.
If this project DOES NOT require a Stormwater Management Plan, explain why:
The project will replace the failed bridge structure with the same impervious surface as pre- existing conditions.
2d.
If this project DOES require a Stormwater Management Plan, then provide a brief, narrative
description of the plan:
N/A
2e.
Who will be responsible for the review of the Stormwater Management Plan?
N/A
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
apply (check all that apply):
❑ NSW
❑ USMP
❑ 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
(check all that apply):
❑ORW
❑Session Law 2006 -246
❑ Other:
4b.
Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ❑ 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 8 of 10
PCN Form — Version 1.4 January 2009

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
❑X 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
❑ Yes
ZNo
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,
E] Yes
0 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):
3.
Cumulative Impacts (DWQ Requirement)
3a.
Will this project (based on past and reasonably anticipated future impacts) result in
❑ Yes
Z 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.
No additional wastewater will be generated as a result of this project.
Page 9 of 10
PCN Form — Version 1.4 January 2009

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 Q No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act
❑ Yes Q No
impacts?
5c. If yes, indicate the USFWS Field Office you have contacted.
-
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?
❑ Yes ❑X No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
This reach of stream is an area of an existing bridge structure.
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 ❑X 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?
The area is the repair of an existing bridge structure.
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA- designated 100 -year floodplain?
❑X Yes ❑ No
8b. If yes, explain how project meets FEMA requirements:
The installation of the span bridge structure will lower the 100 -year base flood elevation in the immediate vicinity of the project, but will not impact the
floodway. The necessary LOMR information will be provided to FEMA at the completion of the project. A no -rise certification will be submitted to the
City of Hickory and a floodplain development permit will be obtained.
8c. What source(s) did you use to make the floodplain determination?
Models provided by the NC Flood Maps web site, and HecRas analysis.
Gregory R. Hoffman
04 -15 -2014
Applicant/Agent's Printed Name
Date
ppl cant/Agent's Signature
U,n
signature is valid only if an authorization
letter from the applicant is provided.)
Page 10 of 10

AGENT AUTHORIZATION FORM
PROJECT DESCRIPTION: 46th Avenue Drive NE — Bridge Replacement Proiect
Property Owner: City of Hickory
Property Owner:
The undersigned, registered property owners of the above noted property, do hereby authorize
McGill Associates P.A.
(Name of Consulting Firm)
To act on my behalf and take all actions necessary for the processing, issuance and acceptance of this
permit or certification and any and all standard and special conditions attached.
Property Owner's Address (if different than property above)
Post Office Box 398 Hickory North Carolina 28603
Telephone: [phone]
we hereby certify that the above information submitted in this application is true and accurate to the
best of our knowledge.
611orizeeSignatu4� Aut'rj2!!q Signature
Date: g9 Date: y 1 s ! Z,0 �`�

NCDENR - Frequently Asked Questions
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oQ�
Page 3 of 4
What is an Isolated and Other Non -404 Jurisdictional Wetlands
and Waters Permit?
An Isolated and Other Non -404 Jurisdictional Wetlands and Waters Permit is a permit for impacts to
isolated wetlands or surface waters or any other non -404 jurisdictional wetlands or surface waters.
When do I need an Isolated and Other Non -404 Jurisdictional
Wetlands and Waters Permit?
An Isolated and Other Non -404 Jurisdictional Wetlands and Waters Permit is required when a proposed
project involves impacts to wetlands or waters that the USACE determines are not jurisdictional under
Section 404 of the CWA. For a list of activities that may require a permit, click here
(http: / /.portaL ncdenr. org /web /wq /swp /ws /401 /"certsandpermits /fagsHWhen_401) .
How do I apply for a 401 WQC or Isolated and Other Non -404
Jurisdictional Wetlands and Waters Permit?
Use the pre- construction notification (PCN
(http: / /www saw. usace. army. md/ Mnsions/ RegulatoryPermitPrograrrVPermits/ NationwidePamits/ PrecorstructionNotification.aspx)
. . ...- - ---- -. ..
form to apply for general 401 WQCs and Isolated and Other Non -404 Jurisdictional Wetlands and Waters
Permit. A different form (http.//www.saw usace.amy. mil / Missions/ ReguiatoryPermitProgran /Permits.aspx) is required for
individual permits.
In addition to the completed PCN
(http: / /www. saw. usace.army. mil / Missions /Regula.toryPermitProgranit Permits/ NationwidePermits/ PrecoretructionNotification. aspx)
Form, at a minimum you should include the following items with your application:
• A cover letter explaining your project.
• A vicinity map.
• A site plan, drawn to scale, depicting all proposed impact areas (temporary and permanent
impacts). Please note: DWR can accept full size plan sheets.
• Any supporting documentation available, such as correspondence received from the USACE or
photographs.
• All additional information requested within the PCN Form.
• The appropriate application fee (http // portal. ncdenr. org / web /wq /swp /ws/40t /certsand permits /apply /fees) .
......-
Where do I send my application packet?
If you have a transportation project please send the application for DWR to:
NC DWR, Transportation Permitting Unit
1650 Mail Service Center
Raleigh, NC 27699 -1650
NC DWR, Transportation Permitting Unit
512 North Salisbury Street
Raleigh, NC 27604
For all other projects, please send the application for DWR to:
Mailing Address (if sending by first class mail via the US Postal Service):
NC DWR, 401 li Buffer Permitting Unit
1650 Mail Service Center
Raleigh, NC 27699 -1650
http: / /portal.ncdenr.org/ web /wq /swp /ws /401 /certsandpennits /faqs 4/15/2014

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