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Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Pre-Construction Notification (PCN) Form
A. Applicant Information
1. Processing
1 a. Type(s) of approval sought from the
Corps: non-reporting � Section 404 Permit ❑ Section 10 Permit
1 b. Specify Nationwide Permit (NWP) number: non-reporting NWP 14 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps? ❑ Yes � No
1d. 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 Certification — Express � Riparian Buffer Authorization
1 e. 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? Certification:
❑ 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.
1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1h ❑ Yes � No
below.
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ❑ Yes � No
2. Project Information
2a. Name of project: Proposed upgrading and paving SR 2747 (John Adams Road)
2b. County: Wake
2c. Nearest municipality / town: Willow Springs
2d. Subdivision name: N/A
2e. NCDOT only, T.I.P. or state WgS No. 5C.092100
project no:
3. Owner Information
3a. Name(s) on Recorded Deed: NCDOT Division 5
3b. Deed Book and Page No. N/A
3c. Responsible Party (for LLC if N/A
applicable):
3d. Street address: 2612 N. Duke Street
3e. City, state, zip: Durham, NC 27704
3f. Telephone no.: (919)220-4600
3g. Fax no.: (919)560-3371
3h. Email address: Ihopkins(c�ncdot.qov
4. Applicant Information (if different from owner) N/A
5. Agent/Consultant Information (if applicable) N/A
Page 1 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): N/A
1 b. Coordinates (in decimal degrees):
Site 1: Latitude: 35.5745 Longitude: -78.6843
Site 2: Latitude: 35.5719 Longitude: -78.6857
(DD.DDDDDD) (-DD.DDDDDD)
1 c. Property size:
9.45ac (1.3mi long project with 60ft ROW)
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to UTs to Black Creek
proposed project:
2b. Water Quality Classification of nearest receiving water: C NSW
2c. River basin: Neuse
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 existing pipes needs to be replaced to support road improvements. Sites are surrounded by wooded land agricultural
land.
3b. List the total estimated acreage of all existing wetlands on the property:
NONE
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
120ft (60ft at each crossing)
3d. Explain the purpose of the proposed project: The pipe replacements will facilitate road improvements through the
crossings.
3e. Describe the overall project in detail, including the type of equipment to be used:
At Site 1: The existing 48ft long metal pipe will be replaced with a 40ft aluminum pipe with headwalls. The skew here will
be eliminated to minimize the construction footprint, but this will require a slight channel change. At Site 2: The existing
40ft metal pipe will be replaced with a 40ft aluminum pipe with headwalls. The replacement pipe sizes by site will be
based on Hydraulic recommendations and Bridge Maintenance inventory. Rip rap will be installed underlined with
geotextile for long term stability surrounding the mouths of the new pipe ends and some rip rap in the flow line may be
needed to repair any bed scour. The NCDOT will also dewater the work zones as needed during construction.
Equipment ma include an excavator, a backhoe, a bulldozer, and rader.
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: N/A
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: N/A
Name (if known): N/A Other: N/A
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
N/A
Page 2 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.
N/A
6. Future Project Plans
6a. Is this a phased project? ❑ Yes � No
6b. If yes, explain.
N/A
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 of jurisdiction
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 orar T
W 1 ❑ P❑ T N/A N/A ❑ Yes ❑ Corps N/A
❑ No ❑ DWQ
2g. Total Wetland Impacts: NONE
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PCN Form — Version 1.3 December 10, 2008 Version
2h. Comments: Although the soils are mapped as hydric at Site 1, this crossing has been significantly altered from the
conditions that existed when the USACE and NCDWQ met onsite in 2008 thereby eliminating the wetlands adjacent to the
roadway on the pipe outlet an reducing the wetlands to the pipe inlet. Additionally the proposed construction has been
reduced to hold to the existing gravel width and the proposed new pipe length is shorter allowing for this pipe replacement and
road improvements to completely avoid wetland impacts.
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 of jurisdiction Average Impact
number - (PER) or (Corps - 404, 10 stream length
Permanent (P) or intermittent DWQ — non-404, width (linear
Temporary (T) (INT)? other) (feet) feet)
Site 1� P❑ T fill UT to � PER � Corps 3 30
Stream 1 (channel change) Black Crk ❑ INT � DWQ concurrent
Site 1� P❑ T rip rap on banks UT to � PER � Corps 25
Stream 1 (if needed) Black Crk ❑ INT � DWQ 3 concurrent
Site 1❑ P� T dewatering UT to � PER � Corps 3 80
Stream 1 Black Crk ❑ INT � DWQ
Site 2� P❑ T rip rap fill bed scour UT to � PER � Corps 6 10
Stream 2 (if needed) Black Crk ❑ INT � DWQ concurrent
Site 2� P❑ T rip rap on banks UT to � PER � Corps 6 30
Stream 2 (if needed) Black Crk ❑ INT � DWQ concurrent
Site 2❑ P� T dewatering UT to � PER � Corps 6 30
Stream 2 Black Crk ❑ INT � DWQ
3h. Total stream and tributary impacts 110
3i. Comments: Site 1: 30ft of surface water fill for slight channel change, rip rap armoring up to 5ft upstream and 20ft
downstream will be placed on banks for stabilization, and temporary dewatering may be required up to 30ft upstream and 50ft
downstream. Site 2: 5ft upstream and 5ft downstream of surface water fill may be necessary for installation of new pipe to
restore any existing bed scour, rip rap armoring up to 15ft upstream and 15ft downstream will be placed on banks for
stabilization, and temporary water will be may necessary up to 15ft upstream and 15ft downstream.
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
impact number — waterbody Type of impact Waterbody type Area of impact (acres)
Permanent (P) or (if applicable)
Tem orar T
01 ❑ P❑ T N/A N/A N/A N/A
4f. Total open water impacts NONE
4g. Comments: N/A
Page 4 of 11
PCN Form — Version 1.3 December 10, 2008 Version
5. Pond or Lake Construction
If ond or lake construction ro osed, then com lete the chart below.
5a. 5b. 5c. 5d. 5e.
Wetland Impacts (acres) Stream Impacts (feet) Upland
Pond ID Proposed use or purpose of (acres)
number pond
Flooded Filled Excavated Flooded Filled Excavated Flooded
P1 N/A N/A N/A N/A N/A N/A N/A N/A
P2
5f. Total NONE NONE NONE NONE NONE NONE NONE
5g. Comments: N/A
5h. Is a dam high hazard permit required?
❑ Yes � No If yes, permit ID no: N/A
5i. Expected pond surface area (acres): N/A
5j. Size of pond watershed (acres): N/A
5k. Method of construction: N/A
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 mitigation, then you 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 for Buffer Zone 1 impact Zone 2 impact
Permanent (P) or impact Stream name mitigation (square feet) (square feet)
Tem orar T re uired?
Pipe
Site 1� P❑ T replacement ❑ Yes
Buffer Impact 1 for road UT to Black Crk � No 2,550 1,200
improvements
Pipe
Site 2� P❑ T replacement ❑ Yes
Buffer Impact 2 for road UT to Black Crk � No 1,800 900
improvements
6h. Total buffer impacts 4,350 2,100
6i. Comments: Necessary buffer impacts will be required for improvements to this roadway for access and bank stabilization
only. No trees will need to be cut to perform the two pipe replacements.
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project
-the proposed cross section has been reduced to 20ft wide paved roadway with +/-2ft shoulders and +/-8ft ditch widths
-roadway will be shifted where possible to avoid parallel stream and buffer impacts as well as avoiding wetland impacts
-to prevent disturbance, ditches will not be relocated but maintained in existing locations where necessary to ensure proper
drainage
-at the two permit sites the existing pipes will be replaced with new pipes with the same or shorter lengths
-rip rap armoring around the pipe ends and tie-in points to the existing stream bank and flow line will be limited only to the
amount necessary to ensure long term stability
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PCN Form — Version 1.3 December 10, 2008 Version
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Sediment and erosion control Best Management Practices for protection of surface waters will be enforced during project
construction.
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?
2b. If yes, mitigation is required by (check all that apply): ❑ DWQ ❑ Corps
❑ Mitigation bank
2c. If yes, which mitigation 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: N/A
3b. Credits Purchased (attach receipt and letter) Type N/A Quantity N/A
3c. Comments: N/A
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: N/A linear feet
4c. If using stream mitigation, stream temperature: ❑ warm ❑ cool ❑cold
4d. Buffer mitigation requested (DWQ only): N/A square feet
4e. Riparian wetland mitigation requested: N/A acres
4f. Non-riparian wetland mitigation requested: N/A acres
4g. Coastal (tidal) wetland mitigation requested: N/A acres
4h. Comments: N/A
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.
N/A
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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 N/A N/A 3(2 for Catawba) N/A
Zone 2 N/A N/A 1.5 N/A
6f. Total buffer mitigation required: NONE
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). N/A
6h. Comments: N/A
Page 7 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: this pipe replacement will not alter storm water runoff at this site, no new ❑ Yes � No
ditches will be cut through the buffers
2. Stormwater Mana ement Plan
2a. What is the overall percent imperviousness of this project? <20 %
2b. Does this project require a Stormwater Management Plan? ❑ Yes � No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why: no new ditches will be cut through buffers
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan: N/A
❑ Certified Local Government
2e. Who will be responsible for the review of the Stormwater Management Plan? ❑ DWQ Stormwater Program
❑ DWQ 401 Unit
3. Certified Local Government Stormwater Review
3a. In which local governmenYs jurisdiction is this project? N/A
❑ 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? N/A
4. DWQ Stormwater Program Review
❑ Coastal counties
❑ HQW
4a. Which of the following state-implemented stormwater management programs apply � ORW
(check all that apply): N/A
❑ Session Law 2006-246
❑ Other:
4b. Has the approved Stormwater Management Plan with proof of approval been
attached? N/A ❑ Yes ❑ No
5. DWQ 401 Unit Stormwater Review
5a. Does the Stormwater Management Plan meet the appropriate requirements? N/A � Yes ❑ No
5b. Have all of the 401 Unit submittal requirements been met? N/A ❑ Yes ❑ No
Page 8 of 11
PCN Form — Version 1.3 December 10, 2008 Version
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 � No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1 c. 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
letter.) ❑ Yes ❑ No
Comments: N/A
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): N/A
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.
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.
N/A
Page 9 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
habitat?
The US Fish and Wildlife Service has developed a programmatic biological
opinion (PBO) in conjunction with the Federal Highway Administration
(FHWA), the US Army Corps of Engineers (USACE), and NCDOT for the
Northern Long-eared Bat (NLEB) in eastern North Carolina. The PBO
covers the entire NCDOT program in Divisions 1-8, including all NCDOT
projects and activities. The programmatic determination for NLEB for the
NCDOT program in Divisions 1-8 is "May Affect, Likely to Adversely � Yes ❑ No
Affect." The PBO will provide incidental take coverage for NLEB and will
ensure compliance with Section 7 of the Endangered Species Act for five
years for all NCDOT projects with a federal nexus in Divisions 1-8, which
includes Wake County, where the project is located. Project requirement
for PBO compliance: the contract administrator for construction must
submit to the NCDOT Natural Environment Section (Biological Surveys
Group) the actual amount of tree clearing that occurred for the project.
That information must be sent before the project is completed and should
be reported in tenths of acres.
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?
http://www.fws.gov/nc-es/es/countvfr.html and NC Natural Heritage Program Database, Element Occurrences;
NEU Biological Surveys Group biological conclusion for Dwarf-wedge mussel
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish � Yes � No
habitat?
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
http://ocean.floridamarine.org/efh coral/ims/viewer.htm
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 ❑ 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?
HPO's historic layer using GIS ArcView database, SHPO's webpage http://gis.ncdcr.gov/hpoweb/, and PDEA HEU review
Page 10 of 11
PCN Form — Version 1.3 December 10, 2008 Version
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain? � Yes ❑ No
8b. If yes, explain how project meets FEMA requirements: N/A
8c. What source(s) did you use to make the floodplain determination? http://www.ncfloodmaps.com/
for J. R. Hopkins, P.E. � ��pk, 12/31/15
L
ApplicanUAgent`s Signafur � Date
Applicant/Agent's Printed Name (Agenes signature is �alid only if an authorizatlon let er from the applicant
is provided.) ,
Page 11 of 11
PCN Form — Version 1.3 December 10, 2008 Version