20230586 Ver 1_ePCN Application_20230417

i 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:
1/9/2023
BIMS # Assigned
20230586
Is a payment required for this project?*
No payment required
Fee received
Fee needed - send electronic notification
Reviewing Office*
Winston-Salem Regional Office - (336) 776-
9800
Information for Initial Review
la. Name of project:
Hwy 152 E NC DOT
la. Who is the Primary Contact?*
Holden Sabato
1b. Primary Contact Email: *
[e-mail]
Date Submitted
4/17/2023
Nearest Body of Water
Cold Water Creek
Basin
Yadkin-PeeDee
Water Classification
WS-VI
Site Coordinates
Latitude:
35.571178
A. Processing Information
Is this project connected with ARPA funding?
Yes No
County (or Counties) where the project is located:
Rowan
Is this a NCDMS Project
Yes No
Longitude:
-80.55525
Version#*
1
What amout is owed?*
$240.00
$570.00
Select Project Reviewer*
Dave Wanucha:[e-mail]
1c. Primary Contact Phone: *
[phone]
O

Is this project a public transportation project?*
Yes No
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
1b. 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
Nationwide Permit (NWP) Number: 14 - Linear transportation
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
401 Water Quality Certification - Regular
Non-404 Jurisdictional General Permit
Individual 401 Water Quality Certification
401 Water Quality Certification - Express
Riparian Buffer Authorization
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
1f. 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
1h. 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
1d. 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:
Donald T Moore
2b. Deed book and page no.:
1372 / 865
2c. Contact Person:
Donald T Moore

2d. Address
Street Address
110 Bud Lane
Address Line 2
City
China Grove
Postal / Zip Code
28023
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
2a. Name(s) on recorded deed:
Washam Jeffrey Scott
2b. Deed book and page no.:
1273/37
2c. Contact Person:
Washam Jeffrey Scott
2d.Address
Street Address
965 E NC 152 Highway
Address Line 2
City
China Grove
Postal / Zip Code
28023
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
2a. Name(s) on recorded deed:
Washam Marsha Helen
2b. Deed book and page no.:
739 / 122
2c. Contact Person:
Washam Marsha Helen
2d.Address
Street Address
930NCHWY152E
Address Line 2
City
China Grove
Postal / Zip Code
28023
2e. Telephone Number:
[phone]
2g. Email Address:
[e-mail]
2a. Name(s) on recorded deed:
Martin Randy and Ronnie Isenhour
2b. Deed book and page no.:
9995 / 302
2c. Contact Person:
Martin Randy and Ronnie Isenhour
State / Province / Region
North Carolina
Country
USA
2f. Fax Number:
State / Province / Region
North Carolina
Country
USA
2f. Fax Number:
State / Province / Region
North Carolina
Country
USA
2f. Fax Number:

2d. Address
Street Address
850 E NC 152 Highway
Address Line 2
City
China Grove
Postal / Zip Code
28023
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
2a. Name(s) on recorded deed:
Altec Industries Inc.
2b. Deed book and page no.:
9995/302
2c. Contact Person:
Altec Industries Inc.
2d.Address
Street Address
210 Inverness Center drive
Address Line 2
City
Birmingham
Postal / Zip Code
35242
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
2a. Name(s) on recorded deed:
Hitachi Metal NC LTD
2b. Deed book and page no.:
9995 / 451, 1285 / 636
2c. Contact Person:
Hitachi Metal NC LTD
2d.Address
Street Address
1 Hitachi Metals Drive
Address Line 2
City
China Grove
Postal / Zip Code
28023
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Jennifer Robertson
4b. Business Name:
Atlas Environmental
State / Province / Region
North Carolina
Country
USA
2f. Fax Number:
State / Province / Region
Alabama
Country
USA
2f. Fax Number:
State / Province / Region
North Carolina
Country
USA
2f. Fax Number:

4c. Address
Street Address
338 S. Sharon Amity Road #411
Address Line 2
City
Charlotte
Postal / Zip Code
28211
4d. Telephone Number:
[phone]
4f. Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality I town:
Rowan
2. Project Identification
State / Province / Region
North Carolina
Country
USA
4e. Fax Number:
2a. Property Identification Number:
125 069, 125 082, 117 176, 117 083, 117 157,
2b. Property size:
117 079, 117 174, 117 085
5.6
2c. Project Address
Street Address
565 NC-152
Address Line 2
City
State / Province / Region
China Grove
North Carolina
Postal / Zip Code
Country
28023
USA
3. Surface Waters
3a. Name of the nearest body of water to proposed project:"
Cold Water Creek
3b. Water Resources Classification of nearest receiving water:
WS-VI
3c. What river basin(s) is your project located in?*
Yadkin-PeeDee
3d. Please provide the 12-digit HUC in which the project is located.
030401050202
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 ground surface generally slopes down towards the Western boundary. The topographic relief of the review area is approximately 60 feet with an approximate maximum elevation of
832 feet and minimum elevation of 772 feet. The surrounding area predominantly consists of an industrial development immediately to the North, residential development to the East, and
forested/agricultural land to the South. This project encompasses a section of State Highway 152 East with an added buffer so much of the surrounding area of the project is dedicated to
highway infrastructure. At the time of the site visit, three occupied residences were observed within the review area. None of these structures are proposed for removal regarding this
project.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?
Yes No Unknown
If yes, please give the DWR Certification number or the Corps Action ID (exp. SAW-0000-00000).
SAW-2021-01365
4f. List the total estimated acreage of all existing wetlands on the property:
0.037 acres
4g. List the total estimated linear feet of all existing streams on the property:
3379

4h. Explain the purpose of the proposed project:*
The project is for road improvements along NC Highway 152 related to the adjacent industrial development. A NC DOT project area was established for the road improvements and an
approved jurisdictional determination was requested for that area on March 16, 2023.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:
Unavoidable impacts related to the NC DOT road improvements to Hwy 152 E. include both permanent and temporary stream impacts and permanent wetland impacts. Permanent stream
impacts total 572 linear feet (0.027 acre) and temporary stream impacts total 35 linear feet (0.003 Ac). Permanent wetland impacts total 0.008 acre. Permanent impacts have been
identified as S1 through S7 and W1. Temporary stream impacts have been identified as S8 through S10. The project has been designed and engineered to avoid and minimize impacts to
the greatest extent possible. The NC DOT approved design by Stantec includes the relocation of 424 linear feet of channel as impact S1. The length of the channel after the relocation is
379 linear feet. This open relocation of this channel is occurring to minimize the severity of impacts when compared to culverting the channel. Impacts S4 and S5 are related to bank and
channel stabilization for long term stability avoiding potential future erosion issues. The project will require mechanized land clearing.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
Yes No O Unknown
Comments:
Yes Atlas Staff
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): Atlas Staff
Agency/Consultant Company: Atlas Environmental
Other:
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?
The SAW-2021-01365 Preliminary Jurisdictional Determination was used to define the waters affected by the NC DOT project to 152 Highway East.
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
Wetlands Streams -tributaries L i Buffers
Open Waters Pond Construction
2. Wetland Impacts
O
2a1 Reason (?)
2b. Impact type* (?)
2c. Type of W.*
2d. W. name
2e. Forested"
2f. Type of Jurisdicition *
?)
2g• Impact
area *
ff
-7]
fill
P
__]
Seep
Wetland 1700
L
Both
0.008
(acres)
2g. Total Temporary Wetland Impact
0.000
2g. Total Wetland Impact
0.008
2i. Comments:
3. Stream Impacts
2g. Total Permanent Wetland Impact
0.008
F
3a. Reason for impact (?)
3b.lmpact type*
3c. Type of impact*
3d. S. name*
�3e. Stream Type*
?)
3f. Type of
Jurisdiction*
3g. S. width
3h. Impact
length*
S1
S1
Permanent
Relocation
CH 100
Perennial
Both
�424
Average (feet)
(linear feet)

S2
S2
Permanent
Fill
CH 100
Perennial
Both
2
54
Average (feet)
(linear feet)
S3
S3
Permanent
Fill
Ch 100
Intermittent
Both
19
Averege (feet)
(linear feet)
S4
S4
Permanent
Bank Stabilization
CH 100
Intermittent
Both
2
6
Averege (feet)
(linear feet)
SS
S5
Permanent
Bank Stabilization J
CH 100
Intermittent
Both
2
21
Average (feet)
(linear feet)
S6
S6
Permanent
Fill
CH 100
Intermittent
Both
26
Averege (feet)
(linear feet)
S7
S7
Permanent
Fill
CH 100
Intermittent
Both
2
22
Average (feet)
(linear feet)
S8
S8
Temporary
Relocation
CH 100
Perennial
Both
15
Average (feet)
(linear feet)
S9
S9
Tem ora
P rY
Bank Stabilization
CH 100
Intermittent
Both
2
10
Averege (feet)
(linear feet)
S10
S10
Tem ora
P ry
Bank Stabilization
CH 100
Intermittent
Both
2
10
Average (feet)
(linear feet)
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
572
3i. Total stream and ditch impacts:
607
3j. Comments:
E. Impact Justification and Mitigation
1. Avoidance and Minimization
3i. Total temporary stream impacts:
35
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
The project has been designed and engineered to avoid and minimize impacts to the greatest extent possible. The NC DOT approved design by Stantec
includes the relocation of 424 linear feet of channel as impact St.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
The open relocation of the channel is occurring to minimize the severity of impacts when compared to culverting the channel. Impacts S4 and S5 are
related to bank and channel stabilization for long term stability avoiding potential future erosion issues.
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):
D W R Corps
2d. If yes, which mitigation options) 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)
572
4d. Buffer mitigation requested (DWR only):
(square feet)
4f. Non -riparian wetland mitigation requested
4h. Comments
572 LF 1:1 letter was received March 23, 2023
4c. If using stream mitigation, what is the stream temperature:
warm
4e. Riparian wetland mitigation requested:
(acres)
4g. Coastal (tidal) wetland mitigation requested:
(acres)
0
V

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
1a. 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:
Not located in State Protected Riparian Buffers
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?
Yes No
Comments:
Please see attachment
G. Supplementary Information
1. Environmental Documentation
1a. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?
Yes No
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.
This is not a Phased Project
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
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?
IPAC and NHP and field assessment
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?
NOAA Essential Fish Habitat Mapper
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?
NC HPO buffer map and field assessment
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?
FEMA NFHL and Google Earth Kml
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
HWY 152 E DOT Project NWP 14 compressed.pdf 6.72MB
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:
Allyson Sinclair
Signature
Date
4/17/2023