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HomeMy WebLinkAbout20160504 Ver 1_Application_20160518Carpenter, Kristi From: Sent: To: Subject: Attachments: Kristi, This is the NW3 I was referring to. Thanks, Brian Wrenn 919-707-8792 Wrenn, Brian L Wednesday, May 18, 2016 12:09 PM Carpenter,Kristi FW: PCN SR -1522 MONTGOMERY COUNTY SKM BT_36316051807430.pdf From: King, Art C Sent: Wednesday, May 18, 2016 10:38 AM To: 'Andrew.E.Williams2@usace.army.mil' <Andrew.E.Williams2@usace.army.mil> Cc: Wrenn, Brian L <brian.wrenn@ncdenr.gov> Subject: PCN SR -1522 MONTGOMERY COUNTY Andy, Attached is a PCN notification for NWP#3 for a pipe replacement on SR -1522 in Montgomery County. The pipe is in a HQW zone on Drowning Creek. A location map, a dewatering plan, a basic design and sediment control design are also included. Please contact me if you have questions or need additional information. Thanks, Art Art C. King Division Environmental Office NCDOT Highway Division 8 910-944-2344 office 910-690-6581 mobile ackingkncdot.gov 902 N. Sandhills Blvd. Aberdeen, NC 28315 Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed to third parties. Email correspondence to and from this sender is subject to the N.C. Public Records Law and may be disclosed to third parties. o�ot WArF,q q 9 r O Office Use Only: Corps action ID no. DWQ project no. Form Version 1.3 Dec 10 2008 Page 1 of 10 PCN Form — Version 1.3 December 10, 2008 Version Pre -Construction Notification PC Form A. Applicant Information 1. Processing la. Type(s) of approval sought from the Corps: N 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 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 le. Is this notification solely for the record because written approval is not required? For the record only for DWQ 401 Certification: ® Yes ❑ No For the record only for Corps Permit: ❑ Yes ® No 1f. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts? If so, attach the acceptance letter from mitigation bank or in -lieu fee program. ElYes ®No 1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h below. ❑ Yes ® No 1h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ❑ Yes ® No 2. Project Information 2a. Name of project: SR -1522 pipe repair 2b. County: Montgomery County 2c. Nearest municipality / town: Jackson Springs 2d. Subdivision name: NA 2e. NCDOT only, T.I.P. or state project no: 86.206211 3. Owner Information 3a. Name(s) on Recorded Deed: NCDOT Highway Div. 8 3b. Deed Book and Page No. 3c. Responsible Party (for LLC if applicable): 3d. Street address: 902 North Sandhills Blvd 3e. City, state, zip: Aberdeen, NC 28315 3f. Telephone no.: 910-944-2344 3g. Fax no.: 3h. Email address: Page 1 of 10 PCN Form — Version 1.3 December 10, 2008 Version 4. Applicant Information (if different from owner) 4a. Applicant is: ® Agent ❑ Other, specify: 4b. Name: Art C. King 4c. Business name (if applicable): NCDOT Highway hwa Division 8 4d. Street address: 902 North Sandhills Blvd. 4e. City, state, zip: Aberdeen, NC 28315 4f. Telephone no.: 910-944-2344 4g. Fax no.: 910-944-5623 4h. Email address: acking@ncdot.gov S. Agent/Consultant Information (if applicable) 5a. Name: 5b. Business name (if applicable): 5c. Street address: 5d. City, state, zip: 5e. Telephone no.: 5f. Fax no.: 5g. Email address: Page 2 of 10 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 1b. Site coordinates (in decimal degrees): 1c. Property size: Latitude: 35.2345 Longitude: - 79.6685 (DD.DDDDDD) (-DD.DDDDDD) <1 acres 2. Surface Waters 2a. Name of nearest body of water (stream, river, etc.) to proposed project: Drowning Creek 2b. Water Quality Classification of nearest receiving water: WS-11I;Sw,HQW 2c. River basin: Lumber 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: Rural forested 3b. List the total estimated acreage of all existing wetlands on the property: <0.01 3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property: 100 3d. Explain the purpose of the proposed project: To replace a failing steel culvert pipe 3e. Describe the overall project in detail, including the type of equipment to be used: excavate existig pipe,and install a new one using: Track hoe, dump truck, grader, paving equipment. 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? Comments: ❑ Yes ® No ❑ Unknown 4b. If the Corps made the jurisdictional determination, what type of determination was made? ❑ Preliminary ❑ Final 4c. If yes, who delineated the jurisdictional areas? Name (if known): Agency/Consultant Company: Other: 4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation. S. Project History 5a. Have permits or certifications been requested or obtained for this project (including all prior phases) in the past? ❑ Yes ® No ❑ Unknown 5b. If yes, explain in detail according to "help file" instructions. 6. Future Project Plans 6a. Is this a phased project? ❑ Yes ® No 6b. If yes, explain. Page 3 of 10 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. 26. 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) Temporary Wl ❑ P ❑ T NA ❑ Yes ❑ Corps ❑ No ❑ DWQ W2 ❑ P ❑ T ❑ Yes ❑ Corps ❑ No ❑ DWQ W3 ❑ P ❑ T ❑ Yes ❑ Corps ❑ No ❑ DWQ W4 ❑P❑T 1-1 Yes El Corps El 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 ail stream sites impacted. 3a. 3b. 3e. 3f. 3g. Stream impact Type of impact Stream name Perennial Type of jurisdiction Average Impact number - Permanent(P)or (PER) or intermittent (Corps - 404, 10 stream length Temporary (T) (INT)? DWQ—non-404, other) width (feet) (linear feet) S1 ®P ❑ T pipe UT of Drowning ® PER ®Corps Creek ❑ INT ® DWQ 5-11ft loft S2 ❑ P ❑ T ❑ PER ❑ Corps ❑ INT ❑ DWQ S3 ❑ P ❑ T ❑ PER ❑ Corps ❑ INT ❑ DWQ S4 ❑ P ❑ T ❑ PER ❑ Corps ❑ INT ❑ DWQ S5 ❑ P ❑ T ❑ PER ❑ Corps ❑ INT ❑ DWQ S6 ❑ P ❑ T ❑ PER ❑ Corps ❑ INT ❑DWQ 3h. Total stream and tributary impacts 10ft 3i. Comments: Pipe lengthen by 10 feet to meet current safety standards for road shoulder width. Page 4 of 10 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. Open water 4b. Name of waterbody 4c. 4d. 4e. impact number- Permanent (P) or (if applicable) Type of impact Waterbody type Area of impact (acres) Temporary T 01 ❑P❑T NA 02 ❑P❑T 03 ❑P❑T 04 ❑P❑T 4f. Total open water impacts 4g. Comments: 5. Pond or Lake Construction If pond or lake construction proposed, then complete the chart below. 5a. 5b. 5c. 5d. 5e. Pond IDWetland Proposed use purpose Impacts (acres) Stream Impacts (feet) Upland number ofpond (acres) Flooded Filled Excavated Flooded Filled Excavated Flooded P1 NA P2 5f. Total 5g. Comments: 5h. Is a dam high hazard permit required? ❑ Yes ❑ No If yes, permit ID no: 5i. Expected pond surface area (acres): 5j. 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 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- Permanent (P) or Reason for Stream name Buffer mitigation Zone 1 impact (square feet) Zone 2 impact Temporary impact required? (square feet) B1 ❑P❑T NA El Yes ❑ No B2 ❑P❑T El Yes ❑ No B3 ❑P❑T El Yes ❑ No 6h. Total buffer impacts 6i. Comments: Page 5 of 10 PCN Form - Version 1.3 December 10, 2008 Version D. Impact Justification and Mitigation 1. Avoidance and Minimization la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project. Pipe replaced in it's original location. Addition pipe length installed to meet current safety standards. 1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques. Dewatering and excavation in the dry will be conducted using current NCDOT BMP's. 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 2b. If yes, mitigation is required by (check all that apply): ❑ DWQ ❑ Corps 2c. If yes, which mitigation option will be used for this project? ❑ Mitigation bank ❑ 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: linear feet 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 6 of 10 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 buffer mitigation? ❑ Yes ®No 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. Zone 6c. Reason for impact 6d. Total impact (square feet) Multiplier 6e. Required mitigation (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 7 of 10 PCN Form — Version 1.3 December 10, 2008 Version E. Stormwater Management and Diffuse Flow Plan (required by DWQ) 1. Diffuse Flow Plan la. 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 Management Plan 2a. What is the overall percent imperviousness of this project? <33 % 2b. Does this project require a Stormwater Management Plan? ® Yes ❑ No 2c. If this project DOES NOT require a Stormwater Management Plan, explain why: In an HQW zone 2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan: Will utilize BMP's and erosion controls designed for projects in HQW areas. ❑ 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 government's jurisdiction is this project? ❑ Phase II 3b. Which of the following locally -implemented stormwater management programs ❑ NSW apply (check all that apply): ❑ USMP ❑ Water Supply Watershed ❑ Other: 3c. Has the approved Stormwater Management Plan with proof of approval been ❑ Yes ❑ No attached? 4. DWQ Stormwater Program Review ❑ Coastal counties 4a. Which of the following state -implemented stormwater management programs apply ® HQW ❑ 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 5a. Does the Stormwater Management Plan meet the appropriate requirements? ❑ Yes ❑ No 5b. Have all of the 401 Unit submittal requirements been met? ❑ Yes ❑ No Page 8 of 10 PCN Form — Version 1.3 December 10, 2008 Version F. Supplementary Information 1. Environmental Documentation (DWQ Requirement) la. Does the project involve an expenditure of public (federal/state/local) funds or the ®Yes ❑ No use of public (federal/state) land? 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 ❑ Yes ®No (North Carolina) Environmental Policy Act (NEPA/SEPA)? 1c. 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: 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 El 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. 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. Page 9 of 10 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? ® 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. ❑ Raleigh ❑ Asheville 5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat? USF&W maps, NCDOT staff site survey. 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? 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 (e.g., National Historic Trust designation or properties significant in North Carolina history and archaeology)? El Yes El No 7b. What data sources did you use to determine whether your site would impact historic or archeological resources? 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: 8c. What source(s) did you use to make the floodplain determination? Applicant/Agent's Printed Name Date Applicant/Agerit's Sign lure (Agent's signature is valid only if an authorization letter from the applicant is rovided. Page 10 of 10 PCN Form — Version 1.3 December 10, 2008 Version I T Y lz. NOTE : MAP INCLUDES ONLY STATE MAINTAINED ROADS OR IMPORTANT NON -SYSTEM ROADS. ROADS SHOWN AS OF OCTOBER 18. 2004. I MONTGOMERY COL N W E S ■ "R" RAILROAD COMPANY STRUCTURE cmuMR NATIONAL FOREST BOUNDARY F ■"S"OVERHFAD SIGN STATE FOREST BOUNDARY T 160`0 FEDEftAt GAMELAND SOUNDARY 14A '6 1601 \1 �"i"TUNNEL STATE GAMEIAND BOUNDARY ., 20 ■ "Ll" PEDESTRIAN, CATTLE UNDERPASS — _ — MILITARY RESERVATION BOUNDAI NTYLINE / am Gig " ■ "y" VEHICLE UNDERPASS LESS THAN 2V — - - — STATE UNE (aI 1 e , - ■ "V1r NCDOT AND PRIVATE PEDESTRIAN BRIDGES r -- 4 =T INCORPORATEDCm ORVIl1AGC (GENERALIZED) 1k�oe ,1 G4Y. ■"Y" SINGLE POLE SIGN STRUCTURE FREEORTOLLF£RRY CANAL 61 NARROW STREAM WDESITLEAM 1, Pq.^n'gMa. DAMWRHLOCR �\\ i RESENVOIR,POND,OR LAID: IiAyINR1' I� - O COAWUNm ANOTOWNCENTER ® COUNTYSEAT ' 1514 3 i SCHOOL COLIEGEORUNNERSIW . -JD INT�/6 1 v =o s f 98 CHURCH CHURCH WTH CEMETERY CEMETERY 1606 i. * PATROL STATION ® CORREGDONAL OR PENAL WSTN 0 ® HIGHWAY GARAGE OR SAINT. YA 1625 1003 ® HIGHWAY pV.OROIST.OFFICE 9`1590 Q ✓ WBGHTSTATON 163] J e 521 av G Q MONUMENT�SMAl1HIBTONCAL; Z Y LiGHT110USE F'^MY 22 a 571 2 MWNiAiN t+ENC /IU 100 f 1.2 A TRIANGULATION STATION / COASTGUARDSTADON I / b•B u 529 162 .4 yj MILITARY MIUMED 1521 {>} COMMIRCIALORMUNIVI'M-FIEL `.' V e HMIGARONFIEID I ie 20 a 't IANDING STRIP 1524 +� 1832 \ .%a. rte^ � QJ MARIffD AU%ILVIRY FIELD I T Y lz. NOTE : MAP INCLUDES ONLY STATE MAINTAINED ROADS OR IMPORTANT NON -SYSTEM ROADS. ROADS SHOWN AS OF OCTOBER 18. 2004. 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