20240303 Ver 1_ePCN Application_20240223

DWR
Division of Water Resources
Pre -Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
October 2, 2023 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.
Does this project involve maintenance dredging funded by the Shallow Draft Navigation Channel Dredging and Aquatic Weed Fund or involve the distribution or transmission of energy or
fuel, including natural gas, diesel, petroleum, or electricity?
Yes No
BIMS # Assigned Version# *
20240303 1
Is a payment required for this project?*
No payment required
Fee received
Fee needed - send electronic notification
Select Project Reviewer*
Rob Ridings: rob. ridings
Information for Initial Review
la. Name of project:
Roadway improvments and upgrades NC 115 (Statesville Rd) from US 421 to NC 18
1a. Who is the Primary Contact?*
Kevin Hining NCDOT
1b. Primary Contact Email: *
[e-mail]
Date Submitted
2/23/2024
Nearest Body of Water
Yadkin River and Fishing Creek (both are Class C)
Basin
Yadkin-PeeDee
Water Classification
Class C
Site Coordinates
Latitude: Longitude:
36.155431-81.116546
A. Processing Information
Is this project connected with ARPA funding?
Yes No
County (or Counties) where the project is located:
Wilkes
Is this a NCDMS Project
Yes No
Reviewing Office*
Central Office - [phone]
1c. Primary Contact Phone:*
[phone]
O
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-5759
WBS # (?)
44691.1.1
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
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
Regional General Permit (RGP) Number:
RGP Numbers (for multiple RGPS):
1d. Type(s) of approval sought from the DWR:
401 Water Quality Certification - Regular
Non-404 Jurisdictional General Permit
Individual 401 Water Quality Certification
201902350 - Work associated with bridge construction, widening, replacement, and
interchanges
1e. Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification:
For the record only for Corps Permit:
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:
NCDOT
2b. Deed book and page no.:
2c. Contact Person:
Kevin Hining
401 Water Quality Certification - Express
Riparian Buffer Authorization
Yes No
Yes No

2d. Address
Street Address
801 Statesville Rd
Address Line 2
city
North Wilkesboro
Postal / Zip Code
28659
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(If appropriate)
1c. Nearest municipality I town:
North Wilkesboro
2. Project Identification
2a. Property Identification Number
2c. Project Address
Street Address
Address Line 2
city
Postal / Zip Code
3. Surface Waters
3a. Name of the nearest body of water to proposed project:
Yadkin River and Fishing Creek (both are Class C)
3b. Water Resources Classification of nearest receiving water:
Class C
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.
030401010307 and 030401010401
4. Project Description and History
State / Province / Region
NC
Country
USA
2f. Fax Number:
2b. Property size:
State / Province / Region
Country
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: *
A fairly even mix of commercial (gas stations, restaurants, grocery store, etc.) and residential properties. Largely Urban in nature, but surrounded by larger blocks of woodlands and fields.
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:
0.5 acres
4g. List the total estimated linear feet of all existing streams on the property:
4500
4h. Explain the purpose of the proposed project: *
The North Carolina Department of Transportation (NCDOT) is proposing to upgrade the existing NC 115 (Statesville Road) from US 421 to NC 18 (2nd Street) in North Wilkesboro, Wilkes
County. The project is
approximately 3 miles in length. The project proposes to construct a median -divided roadway, maintaining the two existing lanes of traffic and adding protected left turns lanes, 4-foot bike
lanes, and a 5-foot sidewalk along the south side of the facility within the North Wilkesboro municipal limits.
The project needs are to improve the alignment of intersections, improve sight distances, address traffic queuing at C.C. Wright Elementary School during drop-off and pickup, and provide
shoulders to allow stalled vehicles to safely pull over. Some intersections will be upgraded to roundabouts to improve traffic flow. In some areas, a 16-foot left turn lane will be provided.
The proposed improvements include 4-foot bike lanes. The proposed improvements vary along NC 115, depending on roadway segment.

4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used: *
The project involves upgrading an existing 3-mile section of HWY 115. This work will require some impacts to streams and wetlands, primarily as a result of widening the roadway and
improving turning lanes. Standard road building equipment will be used including trucks, cranes, excavators, bulldozers, and track loaders.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?
Yes No O 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:
SAW-2019-01602
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Nathan Howell
Agency/Consultant Company: Three Oaks Engineering
Other: H.Slaughter and K.Hining NCDOT
5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
USACE - 8/28/2019
NCDWR - 8/14/2019
A review in fall 2021 showed no changes
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
1a. Where are the impacts associated with your project? (check all that apply):
Wetlands Streams -tributaries Buffers
Open Waters Pond Construction
2. Wetland Impacts
2a1 Reason (?)
2b. Impact type* (?)
2c. Type of W.*
2d. W. name
2e. Forested*
2f. Type of Jurisdicition *
(?)
2g. Impact
area
mechanized clearing
P
Bottomland Hardwood Forest
WB
Yes
Both _]
0.010
(acres)
mechanized clearing
P
Bottomland Hardwood Forest
WE
No
Both
0
(acm
(acres)
F77]
roadway fill
P
Ftomland Hardwood Forest
WE
No
Both
0.010
acres)
2g. Total Temporary Wetland Impact
0.000
2g. Total Wetland Impact
0.040
2i. Comments:
3. Stream Impacts
2g. Total Permanent Wetland Impact
0.040
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* i length*

S1
bank stabilization
Permanent
Bank Stabilization JSB
Perennial
Both
18
77
Average (feet)
(linear feet)
S2
bank stabilization
Temporary
Dewatering
SB
Perennial
Both
18
40
Averege (feet)
(linear feet)
S3
pipe replacement
Permanent
Culvert
SB
Perennial
Both
18
44
Averege (feet)
(linear feet)
S4
channel change
Permanent
Relocation
SA
Perennial
Both
6
92
Average (feet)
(linear feet)
S5
channel change
Temporary
Dewatering
SA
Perennial
Both
11
Averege (feet)
(linear feet)
S6
pipe replacement
Permanent
Culvert
SA
Perennial
Both
44
Average (feet)
(linear feet)
S7
scour protection
Permanent
Rip Rap Fill
SA
Perennial
Both
15
Average (feet)
(linear feet)
gg
pipe replacement
Temporary
Dewatering
SA
Perennial
Both
Averege (feet)
(linear feet)
S9
pipe replacement
Permanent
Culvert
SH
Perennial
Both
35
Average (feet)
(linear feet)
�01
pipe replacement
Temporary
Dewatering
SH
Perennial
Both
16
Average (feet)
(linear feet)
I
pipe replacement
Permanent
Culvert
SG
Perennial
Both
12
157
Averege (feet)
(linear feet)
�2�pipe
replacement
Temporary
Dewatering
SG
Perennial
Both
12
66
Average (feet)
(linear feet)
S13
channel change
Permanent
—]
Relocation
SG
Perennial
Both
12
114
Averege (feet)
(linear feet)
S14
scour protection
Permanent
Rip Rap Fill
SG
Perennial
Both
12
21
Average (feet)
(linear feet)
Sf5
channelchange
Temporary
Dewatering
SG
Perennial
Both
12
13
Average (feel)
(linear feet)
S15
pipe replacement
Temporary
Dewatering
SG
Perennial
Both
12
29
Averege (feet)
(linear feet)
Sf7
pipe replacement
Permanent
Culvert
SG
Perennial
Both
12
5
Average (feet)
(linear feet)
F8]�bank
stabilization
Permanent
Bank Stabilization J
SG
Perennial
Both
12
11
Averege (feet)
(linear feet)
S19
pipe replacement
Temporary
Dewatering
SG
Perennial
Both
12
26
Average (feet)
(linear feet)
�01
scour protection
Permanent
Rip Rap Fill
SF
Perennial
Both
10
Average (feet)
(linear feet)
fftt:
Temporary::]
Dewatering
SF
Perennial
Both
�
10
Averege (feet)
(linear feet)
31. Total jurisdictional ditch impact in square feet:
31. Total permanent stream impacts:
625
3i. Total stream and ditch impacts:
845
3j. Comments:
E. Impact Justification and Mitigation
1. Avoidance and Minimization
3i. Total temporary stream impacts:
220
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
All pipe extensions, channel changes, and proposed scour protection have been designed to have as little surface water impacts as possible. All work
will be done in the dry, and no direct discharge of sediment into jurisdictional resources.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
All Best Management Practices will be adhered to.
0
u

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)
4d. Buffer mitigation requested (DWR only):
(square feet)
4f. Non -riparian wetland mitigation requested:
(acres)
4c. If using stream mitigation, what is the stream temperature:
cool
4e. Riparian wetland mitigation requested:
(acres)
4g. Coastal (tidal) wetland mitigation requested:
(acres)
N/A
4h. Comments
A mitigation acceptance letter will be obtained from NCDMS prior to permitting. I delayed getting the letter to ensure the correct amount of mitigation was
obtained (determined by USACE). I provided an initial estimate of mitigation needs in the PCN summary letter
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:
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?
Yes No
Comments:
NPDES inspections and reports will be conducted weekly and within 24 hours of any 1" rain event. Reports will be housed on site for review.
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
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
Comments: *
A MCDC is attached, but a Environmental document (EIS/EA) was not required
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
a
(A-)
3b. If you answered "no," provide a short narrative description.

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
5d. Is another Federal agency involved?*
Yes No
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
Unknown
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
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
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 Resources Team
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?"
FRIS
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 dreg and drop files here to attach document
R-5759 PCN Support package.pdf 57.63MB
File must be PDF or KMZ
Comments
PCN Support package attached, which includes the following:
Summary Letter
Permit drawings
Sec 106 reviews
Tribal Coordination
MCDC
NRTR
Bat Memo
Signed PJD

Signature
0
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:
Kevin Hiring
Signature
�tr �.rur9
Date
2/23/2024