20210453 Ver 1_ePCN Application_20220627

DWR
Division of Water Resources
Pre-Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
April 13,2022 Ver 4.3
Initial Review
Has this project met the requirements for acceptance in to the review process?*
Yes
No
Is this project a public transportation project?*
Yes No
Change only if needed.
Pre-Filing Meeting Date Request was submitted on:
2/25/2021
BIMS#Assigned* Version#"
20210453 1
Is a payment required for this project?*
No payment required Reviewing Office*
Fee received Winston-Salem Regional Office-(336)776-
Fee needed-send electronic notification 9800
Select Project Reviewer*
Dave Wanucha:eads\djwanucha
Information for Initial Review
la.Name of project:
Proposed Improvements at U.S.311/N.C.65 Railroad Crossing
1a.Who is the Primary Contact?*
Amy Euliss
lb.Primary Contact Email:* 1c.Primary Contact Phone:*
[e-mail] [phone]
Date Submitted
6/27/2022
Nearest Body of Water
Town Fork Creek
Basin
Roanoke
Water Classification
C
Site Coordinates
Latitude: Longitude:
36.289077 -80.141490
A. Processing Information
County(or Counties)where the project is located:
Stokes
Is this a NCDMS Project
Yes No
Is this project a public transportation project?*
Yes No
Is this a NCDOT Project?*
Yes No

(NCDOT only)T.I.P.or state project number:
R-5768
WBS#(7)
44670.1.1
1a.Type(s)of approval sought from the Corps:
Section 404 Permit(wetlands,streams and waters,Clean Water Act)
Section 10 Permit(navigable waters,tidal waters,Rivers and Harbors Act)
Has this PCN previously been submitted?*
Yes
No
lb.What type(s)of permit(s)do you wish to seek authorization?
Nationwide Permit(NWP)
Regional General Permit(RGP)
Standard(IP)
1c.Has the NWP or GP number been verified by the Corps?
Yes No
Regional General Permit(RGP)Number: 201902350-Work associated with bridge construction,widening,replacement,and
interchanges
RGP Numbers(for multiple RGPS):
1d.Type(s)of approval sought from the DWR:
401 Water Quality Certification-Regular 401 Water Quality Certification-Express
Non-404 Jurisdictional General Permit Riparian Buffer Authorization
Individual 401 Water Quality Certification
le.Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification: Yes No
For the record only for Corps Permit: Yes No
lf.Is this an after-the-fact permit application?*
Yes No
1g.Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
Yes No
1g.Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
Yes No
lh.Is the project located in any of NC's twenty coastal counties?
Yes No
1j.Is the project located in a designated trout watershed?
Yes No
B. Applicant Information
ld.Who is applying for the permit?
Owner Applicant(other than owner)
le.Is there an Agent/Consultant for this project?*
Yes No
2.Owner Information
2a.Name(s)on recorded deed:
NCDOT Division 9
2b.Deed book and page no.:
2c.Contact Person:
Amy Euliss

2d.Address
Street Address
375 Silas Creek Parkway
Address Line 2
City State/Province/Region
Winston Salem NC
Postal/Zip Code Country
27127 USA
2e.Telephone Number: 2f.Fax Number:
[phone]
2g.Email Address:*
[e-mail]
4.Agent/Consultant(if applicable)
4a.Name:
Matt Martin
4b.Business Name:
RK&K
4c.Address
Street Address
8601 Six Forks Road
Address Line 2
Forum 1,Suite 700
City State/Province/Region
Raleigh NC
Postal/Zip Code Country
27615 USA
4d.Telephone Number: 4e.Fax Number:
[phone]
4f.Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
lb.Subdivision name:
(if appropriate)
1c.Nearest municipality/town:
Walnut Cove
2.Project Identification
2a.Property Identification Number: 2b.Property size:
2c.Project Address
Street Address
Intersection of US 311(S.Main Street),NC 65,and Stokesburg Road(SR 1928)
Address Line 2
City State/Province/Region
Postal/Zip Code Country
3. Surface Waters
3a.Name of the nearest body of water to proposed project:*
Town Fork Creek
3b.Water Resources Classification of nearest receiving water:*
C
3c. What river basin(s)is your project located in?*
Roanoke

3d.Please provide the 12-digit HUC in which the project is located.
030101030203
4. Project Description and History
4a.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 existing conditions on the site are largely undeveloped lands to the west with some industrial and lower density residential to the east.
4b.Have Corps permits or DWR certifications been obtained for this project(including all prior phases)in the past?*
Yes No Unknown
4f.List the total estimated acreage of all existing wetlands on the property:
0.12
4g.List the total estimated linear feet of all existing streams on the property:
897
4h.Explain the purpose of the proposed project:*
The purpose of this proposed action is to improve traffic safety and operations at the intersections of US 311,NC 65,and Stokesburg Road,and at the NC 65 Rail Crossing by designing
and constructing the following improvements:
-Improving the vertical alignment(flattening the grades)of the approaches to the NC 65 Rail Crossing,
-Improving the sight distances and cueing storage by realigning NC 65 as it approaches its intersection with Stokesburg Road,
-Signalizing the rail crossing to improve traffic cueing and prevent vehicles from stopping on the tracks.
4i.Describe the overall project in detail,including indirect impacts and the type of equipment to be used:*
Approximately 1,500 feet of US 311 will be realigned horizontally and shifted approximately 65 feet to the northwest to flatten the curve and to provide more separation between its
intersection with NC 65 and the Norfolk Southern Railway Crossing.US 311 will also be realigned vertically and raised 8 feet to provide a smoother approach to the rail crossing.
Approximately 2,400 feet of NC 65 will be realigned to make it the through-movement at its intersection with Stokesburg Road,and to convey the primary traffic flow across the rail
crossing to its intersection with US 311.A traffic signal will be installed on the north side of the rail crossing at the intersection of US 311 and NC 65,and a traffic signal will be installed on
the south side of the crossing at the intersection of NC 65 and Stokesburg Road.Traffic signals at these intersections will reduce congestion and improve traffic operations,provide proper
cueing,and prevent vehicles from stopping on the tracks.The rail crossing at US 311 and NC 65 will be closed temporarily(approximately 30 days)during construction of the adjacent
improvements on US 311 and NC 65,and traffic will be detoured to the rail crossing at Plant Street.Traditional highway construction equipment will be used.
5. Jurisdictional Determinations
5a.Have the wetlands or streams been delineated on the property or proposed impact areas?*
Yes No Unknown
Comments:
5b.If the Corps made a jurisdictional determination,what type of determination was made?*
Preliminary Approved Not Verified Unknown N/A
Corps AID Number:
5c.If 5a is yes,who delineated the jurisdictional areas?
Name(if known): Pete Stafford and Hal Bain
Agency/Consultant Company: RK&K
Other:
5d.List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
A PJD package was sent to DWR and USACE on September 27,2017(attached for reference).A stream call letter was received from DWR.An email was received from the USACE on
12/04/2017(attached for reference)but a PJD was not received.
6.Future Project Plans
6a.Is this a phased project?*
Yes No
Are any other NWP(s),regional general permit(s),or individual permits(s)used,or intended to be used,to authorize any part of the proposed project or related activity?
D. Proposed Impacts Inventory
1. Impacts Summary
la.Where are the impacts associated with your project?(check all that apply):
Wetlands Streams-tributaries Buffers
Open Waters Pond Construction
2.Wetland Impacts

2a.Site#*(?) 2a1 Reason(?) 2b.Impact type*(?) 2c.Type of W.* 2d.W.name 2e.Forested* 2f.Type of Jurisdicition* 2g.Impact
(?) area*
1 Mechanized Clearing P Bottomland Hardwood Forest WD Yes Both 0.010
(acres)
2g.Total Temporary Wetland Impact 2g.Total Permanent Wetland Impact
0.000 0.010
2g.Total Wetland Impact
0.010
2i.Comments:
3. Stream Impacts
3a.Reason for impact(?) 3b.lmpact type* 3c.Type of impact* 3d.S.name* 3e.Stream Type* 3f.Type of 3g.S.width 3h.Impact
(?) Jurisdiction* length*
S1 Culvert Permanent Culvert SA Perennial Both 3 14
Average(feet) (linear feet)
S2 Culvert Temporary Culvert SA Perennial Both 3 10
Average(feet) (linear feet)
3i.Total jurisdictional ditch impact in square feet:
0
3i.Total permanent stream impacts: 3i.Total temporary stream impacts:
14 10
3i.Total stream and ditch impacts:
24
3j.Comments:
E. Impact Justification and Mitigation
1.Avoidance and Minimization
1a.Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
1.Steepening of roadway fill slopes within jurisdictional areas.
2.Stormwater was designed to avoid direct discharge into jurisdictional features to maximum extent practicable.
3.A offsite detour is being utilized to minimize any additional wetland and surface water impacts.
lb.Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Best construction practices will be adhered to.
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
2c.If yes,mitigation is required by(check all that apply):
DWR Corps
2d.If yes,which mitigation option(s)will be used for this project?
Mitigation bank Payment to in-lieu fee program Permittee Responsible Mitigation
4. Complete if Making a Payment to In-lieu Fee Program
4a.Approval letter from in-lieu fee program is attached.
Yes No
4b.Stream mitigation requested:
(linear feet) 4c.If using stream mitigation,what is the stream temperature:
34 warm
4d.Buffer mitigation requested(DWR only): 4e.Riparian wetland mitigation requested:
(square feet) (acres)
0 0
4f.Non-riparian wetland mitigation requested: 4g.Coastal(tidal)wetland mitigation requested:
(acres) (acres)
0 0

4h.Comments
A approval letter from DMS is attached
6. Buffer mitigation (State Regulated Riparian Buffer Rules)- required by DWR
6a.Will the project result in an impact within a protected riparian buffer that requires buffer mitigation?If yes,you must fill out this entire form-please contact DWR for more information.
Yes No
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
1. Diffuse Flow Plan
la.Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection Rules?
Yes No
If no,explain why:
This project is not in a watershed subject to the NC Riparian Buffer Protection Rules.
2. Stormwater Management Plan
2a.Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
Yes No
Comments:
A stormwater management plan is attached.
G. Supplementary Information
1. Environmental Documentation
la.Does the project involve an expenditure of public(federal/state/local)funds or the use of public(federal/state)land?*
Yes No
lb.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
Comments:*
This project included a Type III Categorical Exclusion(CE).A copy is available upon request.
2.Violations (DWR Requirement)
2a.Is the site in violation of DWR Water Quality Certification Rules(15A NCAC 2H.0500),Isolated Wetland Rules(15A NCAC 2H.1300),or DWR Surface Water or Wetland Standards or
Riparian Buffer Rules(15A NCAC 2B.0200)?*
Yes No
3. Cumulative Impacts (DWR Requirement)
3a.Will this project result in additional development,which could impact nearby downstream water quality?*
Yes • No
3b.If you answered"no,"provide a short narrative description.
Due to the minimal transportation impact causing activities resulting from this project,this project will neither influence nearby land uses nor stimulate
growth.
4. Sewage Disposal (DWR Requirement)
4a.Is sewage disposal required by DWR for this project?*
Yes No N/A
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?*
Yes No
5b.Have you checked with the USFWS concerning Endangered Species Act impacts?*
Yes No
5c.If yes,indicate the USFWS Field Office you have contacted.
Asheville

5d.Is another Federal agency involved?*
Yes No Unknown
What Federal Agency is involved?
FHWA
5e.Is this a DOT project located within Division's 1-8?
Yes No
5f.Will you cut any trees in order to conduct the work in waters of the U.S.?
Yes No
5g.Does this project involve bridge maintenance or removal?
Yes No
5h.Does this project involve the construction/installation of a wind turbine(s)?*
Yes No
5i.Does this project involve(1)blasting,and/or(2)other percussive activities that will be conducted by machines,such as jackhammers,mechanized pile drivers,etc.?
Yes No
5j.What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
NRTR Memo,iPAC,field surveys
6. Essential Fish Habitat(Corps Requirement)
6a.Will this project occur in or near an area designated as an Essential Fish Habitat?*
Yes No
6b.What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
https://www.habitat.noaa.gov/apps/efhmapper/
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 status?*
Yes No
7b.What data sources did you use to determine whether your site would impact historic or archeological resources?*
NCDOT Cultural Resource staff reviewed the project for historic architecture and archeology per the Section 106 Programmatic Agreement.The
Catawba Indian Nation was coordinated with and did not raise concerns.
8. Flood Zone Designation (Corps Requirement)
8a.Will this project occur in a FEMA-designated 100-year floodplain?*
Yes No
8c.What source(s)did you use to make the floodplain determination?*
https://msc.fema.gov/portal/search
Miscellaneous
Please use the space below to attach all required documentation or any additional information you feel is helpful for application review.Documents should be combined into one file when
possible,with a Cover Letter,Table of Contents,and a Cover Sheet for each Section preferred.
Click the upload button or drag and drop files here to attach document
2_R-5768_Hyd_permit.pdf 3.87MB
3_DMS_Accept_R-5768 Revised.pdf 277.97KB
4_PJD_Pack_R5768_final.pdf 8.32MB
5_USACE comments 12042017.com.pdf 53.74KB
6_DWR's stream call letter R-5768.pdf 1.09MB
7_R-5768 Tribal Response.pdf 468.51 KB
8_22-224_Revised Informal_Improvements US311 US65 Stokesburg Rd_R-5768.pdf 213.55KB
9_16-11-0005UpdateNoSurvey.pdf 5.05MB
10_PA 16-11-0005 No Archaeological Survey Req Form R-5768 US 311 NC 65 Walnut Cove Stokes.pdf 1.6MB
R-5768 Permit Application cover letter.pdf 190.92KB
File must be PDF or KMZ
Comments
Signature
By checking the box and signing below,I certify that:
• The project proponent hereby certifies that all information contained herein is true,accurate,and complete to the best of my knowledge and belief';and
• The project proponent hereby requests that the certifying authority review and take action on this CWA 401 certification request within the applicable reasonable period of time.
• I have given true,accurate,and complete information on this form;

• I agree that submission of this PCN form is a"transaction"subject to Chapter 66,Article 40 of the NC General Statutes(the"Uniform Electronic Transactions Act");
• I agree to conduct this transaction by electronic means pursuant to Chapter 66,Article 40 of the NC General Statutes(the"Uniform Electronic Transactions Act");
• I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature;AND
• I intend to electronically sign and submit the PCN form.
Full Name:
Amy Euliss
Signature
Date
6/27/2022