20141268 All Versions_Application_20141208

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STATE OF NORTH CAROLINA
DEPAR'TMENT OF 'I'RANSPORTATION
PAT L. MCCRORY
Goveanox
December 8, 2014
Mr. Steve Kichefski
Asheville Regulatory Field Office
US Army Corp of Engineers
151 Patton Avenue
Asheville, NC 28801-5006
SUBJECT: Pipe Replacement on SR 1510 (Beulah Road), Iredell County
Dear Mr. Kichefski:
ANTHONYJ.TATA
SECRETARY
The North Carolina Deparhnent of Transportation requests authorizafion to replace a deteriorating
perched pipe on SR 1510 (Beulah Road) in Iredell County. The North Carolina Department of
Transportafion requests authorization to replace a deteriorating pipe on SR 1510 (Beulah Road) in Iredell
County. NCDOT proposes to replace the existing perched 38-foot x 66" with a 40-foot x 72" CMP with 5
feeT of associated riprap at The inlet and outlet for structure stabilization. To provide some aquatic
passage and to prevent stream destabilizaTion, the new pipe will be placed at streambed elevation. (at the
downstream end, the elevation is based upon Yhe natural streambed elevation past an existing shallow
scourhole). The new pipe slope will be at a 73% slope; therefore, it is approximately 10 feet of riprap
will be embedded into the existing shallow scourhole. Due to the site conditions, NCDOT request a
waiver from the Regional Condifions 2(b)(e) permit depth specificarion for the construction of this
project. A temporary cofferdam pumping system will be used to divert the stream around the
construction site as needed. All areas affected by temporary cofferdam system will be restored to pre-
project conditions. The scope of the work involves UT to Goble Creek, which is classified as Class WS-
1V Watexs by the Division of Water Resources.
The project is not located within 'h mile of any critical watershed area nor is SR 1510 a rural or urban
arterial; therefore, hazardous spill basins are not required. Enclosed is the hazardous spill basin checklist.
This office has conducted a GIS and field survey for the project for historical sites and
threatened/endangered species sites. No sites listed on the National Register of Historic Places are located
in the vicinity of the project nor did there appear to be any eligible structures. This office has conducted a
GIS and field survey for the project threatened/endangered species. The federally listed species for
Iredell County (USFWS listed dated November OA, 2014) include dwarf-flowered heartleaf (Hexastydis
naniflora) and the bog turtle (Glyptemys muhlenbergii}(T/SA- Threatened due to simiiarity of
appearance). National Heritage Program records document the nearest heartleaf location 6.2 miles
southwest of the proposed project area. The heartleaf is usually found on dry to moist ravine slopes
(usually north facing and of the oak-hickory-pine forest type) and in boggy areas near
springheads. There is no suitable habitat in the proposed project area and no heartleaf species SR

1510, Beulah Road
Page 2
December 8, 2014
were observed within the project fooYprint. No impact on this species is anticipated. Natural
Heritage Program records document the nearest bog turtle location 7.5 miles southeast of the proposed
project area. Bog hu-tles are typically found in bogs, marshes, and wet pastures. T/SA species are not
subject to Secrion 7 consultation; however, there is no suitable habitaT located within the project area and
no impact on this species is anticipated.
I have enclosed a pre-construcrion notification for a NW#3, sketches of p]anned activities and location
maps relative to the project.
Project information far the 401 Automated Payxnent Procedure is as follows:
• Work arder number: 150465-55120005-12B.204911-3300
• TIP#: NA
• Project Category: $240.00 Fee
If you have any questions or concerns please feel free to contact me at (704) 480-904�4. Thank you for
your time and consideration on this matter.
Respectfully yours,
Reuben D. Chandler, P.E,
Division Engineer
Twelfth Division
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BY: / °
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Trish Beam
Division 12 Environxnental Supervisor
Enclosures

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Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Pre-Construction Noti�cation PC Form
A. A licant Information
1. Processing
1 a. Type(s) of approval sought from the
Corps: � Section 404 Permit ❑ Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: 3 or General Permit (GP) number:
1 c. Has the NWP or GP number been verified by the Corps? ❑ Yes � No
1 d. 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 CeRification — Express ❑ Riparian Buffer Authorization
1e. 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? Certifcation:
❑ Yes � No ❑ Yes � No
1f. 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.
1 g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h ❑ Yes � No
below.
1 h. Is the project located within a NC DCM Area of Environmental Concem (AEC)? ❑ Yes � No
2. Project Information
2a. Name of project: SR 1510 (Beulah Road)
2b. County: Iredell
2c. Nearest municipality / town: Statesville
2d. Subdivision name:
2e. NCDOT only, T.I.P. or state 12b.204911
project no:
3. Owner Information
3a. Name(s) on Recorded Deed: NC DOT Right of Way
3b. Deed Book and Page No.
3c. Responsible Party (for LLC i f
applicable):
3d. Street address:
3e. City, state, zip:
3f. Telephone no.:
3g. Fax no.:
3h. Email address:
Page 1 of 11
PCN Form — Version 1.3 December 10, 2008 Version

4. Applicant Information (if different from owner)
4a. Applicant is: ❑ Agent ❑ Other, specify:
4b. Name: Reuben Chandler
4c. Busines s name N.C. Department of Transportation, Division 12
(if applicable):
4d. Street address: 1710 East Marion Street
4e. City, state, zip: Shelby, NC 28151
4f. Telephone no.: 704-480-9020
4g. Fax no.: 704-480-5401
4h. Email address: [e-mail]
5. Agent/Consultant Information (if applicable)
5a. Name: Trish Beam
5b. Business name N.C. Department of Transportation, Division 12
(if applicable):
5c. Street address: 1710 East Marion Street
5d. City, state, zip: Shelby, NC 28151
5e. Telephone no.: 704-480-9044
Sf. Fax no.: 704-480-5401
5g. Email address: [e-mail]
Page 2 of 11
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): NA
1 b. Site coordinates (in decimal degrees): Latitude: 35.775484 Longitude: - 81.01368
(DD.DDDDDD) (-DD.DDDDDD)
1 c. Property size: <.10 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to Ut to Goble Creek
proposed project:
2b. Water Quality Classification of nearest receiving water: WS-IV
2c. River basin: Catawba
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:
Existing 38-foot long 66" CMP with headwalls; landuse is mostly wooded/residential land. Culvert is on paved secondary
road.
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:
100 feet
3d. Explain the purpose of the proposed project:
The purpose of the proposed work is to replace the deteriorating culvert for the safety of the travelling public.
3e. Describe the overall project in detail, including the type of equipment to be used:
The North Carolina Department of Transportation requests authorization to replace a deteriorating pipe on SR 1510
(Beulah Road) in Iredell County. NCDOT proposes to replace the existing perched 38-foot x 66" with a 40-foot x 72"
CMP with 5 feet of associated riprap at the inlet and outlet for structure stabilization. To provide some aquatic passage
and to prevent stream destabilization, the new pipe will be placed at streambed elevation. (at the downstream end, the
elevation is based upon the natural streambed elevation past an existing shallow scourhole). The new pipe slope will be
at a 7.3% slope; therefore, it is approximately 10 feet of riprap will be embedded into the existing shallow scourhole. A
temporary cofferdam pumping system will be used to divert the stream around the construction site as needed. All areas
affected by temporary cofferdam system will be restored to pre-project conditions.
The Project will be constructed using typical heavy equipment (trackhoe, backhoe, etc.)
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: Jurisdictional stream determination made by
Division 12 DEO.
4b. If the Corps made the jurisdictional determination, what type
of determination was made? ❑ Preliminary ❑ Final
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.
Page 3 of 11
PCN Form — Version 1.3 December 10, 2008 Version

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.
6. Future Project Plans
6a. Is this a phased project? ❑ Yes � No
6b. Ifyes, explain.
Page 4 ot 11
PCN Form — Version 1.3 December 10, 2008 Version

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 ofjurisdiction
number — Type of impact Type of wetland Forested (Corps - 404, 10 Area of impact
Permanent (P) or (if known) DWQ — non-404, other) (acres)
Tem ora T
W1 ❑ P❑ T ❑ Yes ❑ Corps
❑ No ❑ DWQ
WZ � P� T ❑ Yes ❑ Corps
❑ No ❑ DWQ
W3 ❑ P❑ T ❑ Yes ❑ Corps
❑ No ❑ 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 ofjurisdiction Average Impact
number - (PER) or (Corps - 404, 10 stream length
Permanent (P) or intermittent DWQ — non-404, width (linear
Temporary (� (INT)? other) (feet) feet)
S1 � P❑ T Additional pipe Ut to Goble Creek � PER � Corps Z 3 2
length ❑ INT ❑ DWQ
S2 � P❑ T Embedded rip rap Ut to Goble Creek � PER � Corps 2_3 10
at the outlet ❑ INT ❑ DWQ
S3 � P❑ T Riprap bank Ut to Goble Creek � PER � Corps 2_3 5
stabilization ❑ INT ❑ DWQ
Temporary � pER � Corps
S4 ❑ P� T cofferdam bypass Ut to Goble Creek 23 25
pumping ❑ INT ❑ DWQ
SS ❑ P❑ T ❑ PER ❑ Corps
❑ INT ❑ DWQ
S6 ❑ P❑ T ❑ PER ❑ Corps
❑ INT ❑ DWQ
3h. Total stream and tributary impacts 17`
3i. Comments: *Permanent Impacts
Page 5 of 11
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
Tem orar T
01 ❑P❑T
02 ❑P❑T
03 ❑P❑T
04 ❑P❑T
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If ond or lake construction ro osed, then com lete the chart below.
5a. 5b. Sc. Sd. Se.
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
Sf. Total
5g. Comments:
5h. Is a dam high hazard permit required?
❑ Yes ❑ No If yes, permit ID no:
Si. Expected pond surtace area (acres):
Sj. 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 an im acts re uire miti ation, then ou 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)
Tem ora T im act re uired?
B1 ❑P❑T ❑Yes
❑ No
62 ❑P❑T ❑Yes
❑ No
B3 ❑P❑T ❑Yes
❑ No
6h. Total buffer impacts
6i. Comments:
Page 6 of 11
PCN Form — Version 1.3 December 10, 2008 Version

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifcally describe measures taken to avoid or minimize the proposed impacts in designing project.
The proposal to placed at existing streambed elevation is a measure to minimize stream destabilization.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Minimization of impacts by installing appropriate erosion control measures.
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?
26. Ifyes, mitigation is �equired by (check all that apply): ❑ DWQ ❑ COfpS
❑ Mitigation bank
2c. If yes, which mitigat ion option will be used for this
project? ❑ 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: linearfeet
4c. If using stream mitigation, stream temperature: ❑ warm ❑ cool ❑cold
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 7 of 11
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 8 of 11
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?
1 b. If yes, then is a diffuse flow plan included? If no, explain why.
Comments: ❑ Yes ❑ No
2. Stormwater Mana ement Plan
2a. What is the overall percent imperviousness of this project? 0°/a
2b. Does this project require a Stormwater Management Plan? ❑ Yes � No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why: Complies with NCDOT's individual
NPDES permit NCS000250.
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 Manageme�t Plan? ❑ DWQ Stormwater Program
� DWQ 401 Unit
3. Certified Local Government Stormwater Review
3a. In which local governmenYs jurisdiction is this project? NA
❑ Phase II
3b. Which of the following locally-implemented stormwater management programs ❑ NSW
❑ 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?
4. DWQ Stormwater Pro ram Review
❑ Coastal counties
❑ HQW
4a. Which of the following state-implemented stormwater management programs apply � ORW
(check all that apply): ❑ 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
Sa. Does the Stormwater Management Plan meet the appropriate requirements? ❑ yes ❑ No
Sb. Have all of the 401 Unit submittal requirements been met? ❑ Yes ❑ No
Page 9 of 11
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)?
1c. If you answered "yes" to the above, has the document review been fnalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
letter.) ❑ 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)?
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 � 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.
The project is a minimum criteria project which has low potential for cumulative/indirect impacts and will not result in
additional development which could impact water quality.
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 wastewater generated from project.
Page 10 of 11
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 � No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act � yes � 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?
NC Natural Heritage Program database.
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?
No salt marshes, oyster reefs, or seagrass beds located in vicinity of project.
7. Historic or Prehistoric CWturai 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?
The State Historic Preservation office resources and the National Register of Historic Places were reviewed for historic
sites in the vicinity of the project; however, the pipe replacement project occurs within a previously impacted area
(NCDOT Right of Way).
8. Flood Zone Designation (Corps Requirement)
Sa. 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? FEMA FIRM panal number: 3710470400J
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is rovided.)
Page 11 of 11
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NCDOT
HAZARDOUS SPILL BASIN CHECKLIST
Division: 1�� County: Trer1P11 Project ID: 12b.204911
River Basin: _ Catawba Bridge No: NA
Route: SR 1510
Water Quality Criteria:
Stream: Ut to Goble Creek
Yes No
Stream Crossing Blue Line On USGS
ORW
WSI
WS II,III OR IV, Crossing Within O.Smi of W.S. Critical Area
Roadway Criteria:
Route Designation-
Arterial Urban
Arterial Rural
Additional Site Information:
Is a Hazardous Spill Basin Required?
Yes No
�" �
t-" �
Yes No
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Criteria Based Upon NCDOT `Best Management Practices for the
Protection of Surface Waters" (March, 1997).