20170151 Ver 1_Cover letter and PCN signed_20170201

STATE OF NORTH CAROLINA
DEP��Nr or �vsPoxTaTTON
ROY COOPER
GOVERNOR
US Army Coips of Engineers
Raleigh Regulatory Field Office
Office
Attn: Mr. David Bailey
3331 Heritage Trade Dr., Ste. 105
Wake rorest, NC 27587
JnMEs H. TxoGDON, III
SECRETARY
February 1, 2017
NC Division of Water Resources
Winston-Salem Regional
Attn: Mr. Dave Wanucha
450 W. Hanes Mill Rd, Ste. 103
Winston-Salem, NC 27105
Subject: Nationwide 14 Permit and Jordan Lake Riparian Buffer Application for B-
4960, Konica Drive Extension (SR 3224) and the removal of Bridge 214 on Judge Adams
Road (SR 3058) over Little Alamance Creek/Lake Mackintosh, Guilford County, North „
Carolina, WBS ElementNo. 40153.1.1; Federal ProjectNo. BRZ-3058(2)
Dear Mr. Bailey and 1VI�. Wanucha:
The North Carolina Department of Transportation (NCDOT) is proposing to remove a
functionally obsolete bridge on SR 3058 (Judge Adams Road) over Little Alamance
Creek in Guilford County. A new bridge will not be constructed. A service road will be
constructed to provide continued access to the properties north of Bridge No. 214. The
proposed service road will tie into existing SR 3224 (Konica Drive), which runs south of
and parallel to I-40/85, will be extended west to the existing utility easement north of
Bridge No. 214 to tie into the northern limit of Judge Adams Road. The existing portion
of SR 3224 (Konica Drive) will remain open during conshuction of the service road.
Bridge No. 214 along SR 3058 (Judge Adams Road) will also remain open dm•ing
construction of the service road and will be removed after the completion of the service
road.
Please find enclosed a PCN application, USGS and Soil Survey vicinity maps,
Stormwater Management Plan, pernzit drawings, buffer drawings and SHPO Conemrence
Forms.
The North Carolina Natural Heritage Database was cl�ecked for records of threatened and
endangered species. The database lists two species for Guilford County that have federal
status. Bald eagle (Haliaeetus leucocephalus) is protected in every county in North
MailingAddress: Location:
NC DEPARTMENT OF 1RANSPORTATION Telephone: [phone] I584 YANCEVII,LE STRL•ET
DNISIONOPHIGE3WAY5 CustanerSe�vice: 1-877-368-4968 GREENSBORO,NC27415-4996
DNISION 7 OFFtCE -
P.O. BOX 14996
GREENSBORO, NC 27415-4996 We6site.� vnvw.ncdot.gov

Carolina under the Bald and Golden I;agle Protection Act. Small whorled pogonia
(Isot��ia medeoloides) is listed as tlu•eatened.
Habitat for bald eagle primarily consists of mature forest in proximity to large bodies of
open water for foraging. Large dominant hees are utilized for nesting sites, typically
within 1.0 mile of open water. A desktop-GIS assessment of the project study area, as
well as the area within a 113-mile radius (1.0 mile plus 660 feet) of the project limits,
was performed on March 20, 2013 using 2010 color aerials. No water bodies large
enough or sufficiently open to be considered potential feedings sources were identified.
Since there was no foraging habitat within the review area, a siuvey of the project study
area and the area within 660 feet of the project limits was not conducted. Additionally, a
review of the NCNHP database on Apri129, 2013 revealed no known occurrences of this
species within 1.0 mile of the project study area. Due to the lack of habitat, known
occun•ences and minimal impact anticipated far this project, it has been determined that
the subject project will not affect this species.
Small whorled pogonia generally occurs in open, dry, deciduous woods with acid soil,
according to the U.S. Fish and Wildlife Service. However, it is also known to occur in a
variety of habitats in North Carolina, including along streams. Potential habitat for the
small whorled pogonia is located within the open mixed hardwood forest on the eastern
end of the study area. Potential habitat in these areas is limited because of a nelatively
:. closed canopy. A review of NCNHP records (updated July 1, 2013) indicates no known
small whorled pogonia occurences within 1.0 mile of the proj ect. Additionally, a survey
was perfoimed on May 13, 2013 and no pogonia plants were found. Therefore, the
subject project will not affect this species.
This project was reviewed by NCDOT's Human Environment Unit in 2013 for potential
affects to historical architecture and archaeology. It was determined that no survey was
required for historical architectiue or archaeological resources and that no cultural
resources will be affected by this project.
The proj ect study area is comprised of an existing d'ut road/utility easement where Konica
Drive is proposed to be extended to. The existing bridge is a timber construction with
concrete interior and end bents. Judge Adams Road, a gravel lane, accesses the bridge
from the narth and south. Jurisdictional features associated with this project include
Little Alamance Creek (Lake Mackintosh), UT to Little Alamance Creek and small,
ripas'ian wetland areas.
NCDOT best management practices (BMPs) will be used to minimize and control
sedimentation and erosion. The constnxction foreman will review the BMPs daily to
ensure erosion and sed'unentation is being effectively controlled. If the foreman
determines the devices are not functioning as intended, they will be replaced 'unmediately
with better devices. NCDOT will adhere to Design Standards in Sensitive Watersheds
within the project area.

Impacts to Waters of the United States
The UT to Little Alamance Creek (Lake Mackintosh) [DWR Class: WS-IV; NSW; CA;
16-19-3-(4.5)] is shown on the USGS topographic map as a intermittent stream, however
in the field study it is definitively perennial, displaying geomorphological, hydrological
and biological characteristics indicative of perennial siuface waters.. The channel is well
defined with a substrate primarily composed of sand and is approximately 3-5 feet in
width. From the project site, UT to Little Alamance Creek flows into Little Alamance
Creek (Lake Mackintosh). Little Alamance Creek (Lake Mackintosh) outletsto Big
Alamance Creek which flows to its confluence with the IIaw River. The Haw River
meets the definition of a Traditional Navigable Water. For these reasons, we believe UT
to Little Alamance Creek (Lake Mackintosh) is a Relatively Pennanent Water and is
under the jurisdiction of the U.S. Army Corps of Engineers. In order to construct the
project, it will be necessaiy to impact waters oPthe United States in the Cape Fear River
Basin (HUC 03030002). Specifically, NCDOT is requesting to reinove Bridge 214
permanently and extend Konica Drive to provide access to the otherwise landlocked
properties. The impacts are listed in the table below.
Structure P�rmanent
Station Size / Fiil in
Wetlands
Type (ac)
-L-
27+80RT
-L-
27+OORT
-Yl-
15+00 to
16+30
Culvert
Extension
& Basin
Roadway
Fill
Bridge
Removal
Station
-L-27+0/28+50
Jurisdictional Impact Summaiy
Perm. Temp. Perm.
ring SW �w ExiSting
° Impacts Channel
ands Impacts
, � a�) .,r,
Hand
Clea
i
V`�'etl
Impacts
(ac)
0 I 0 I 0.02 I<0.01
<0.01 I 0.04 I 0 � 0
0 0 0 010
Jordan Lake Buffer Impact Summary
Type Zone 1 (ft2)
Roadway Crossing � 9,129
Temp.
Existing
Channel
Impacts
135 25
0 0
0 0
Zone 2 (ftZ)
5,852
Total � 9,129 � 5,852

Permits Requested
NCDOT is hereby requesting autharization under Section 404 of the Clean Water Act to
proceed with the conshuction project outlined above. We are also requesting a 401
Water Quality Certification and 7ordan Lake Riparian Buffer Authorization from the
North Carolina Department of Environment and Natural Resources (DENR), Division of
Water Resources (DWR).
If you have any questions or need additional information, please contact Jerry Parker at
[phone] or jpazker(�ncdot. o�v. Your review and consideration are greatly
appreciated.
Sincerely,
. �rn - `��li��
J. . Mills, PE
ivision Engineer, Division 7
Enclosures
cc: Gary Jordan, USFWS (electronic copy)
Travis Wilson, VJI2CS (electronic copy)
Tim Powers, NCDOT (electronic copy)
Ed Lewis, NCDOT
Chris Smitherman, NCDOT
Kim Whitley, Roadside Environmental Field Operations Engineer, NCDOT
7eremy Wa�ren, NCDOT
Bobby Norris, District 2 Engineer, NCDOT
File Copy

IL 71
i���i
o2�FWATp�QG
°j G
>
O Y
Pre-Construction Noti�cation
Office llse Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2D08
�� Form
A. Applicant Information
1. Processing
1a. Type(s) of approval sought from the
� Section 404 Permit ❑ Section 10 Permit
Corps:
1b. Specify Nationwide Permit (NWP) number: 14 or General Permit (GP) number.
1c. Has the NWP or GP number been verified by the Corps7 � Yes
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 Certiflcation — Express � Riparian Buffer Authorization
1 e. Is this notification solely for the record For the record only for DWQ 401
because written approval is not required7 Certification:
❑ Yes � No
1f. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation
of impacts7 If so, attach the acceptance letter from mitigation bank or in-lieu
fee program.
❑ No
For the record only for Corps Permit:
❑Yes �No
� Yes ❑ No
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: Konica Drive Extension; Removal of bridge #214 over Little Alamance Creek
2b. County: Guilford
2c. Nearest municipality / town: Whitsett
2d. Subdivision name: N/A
2e. NCDOT only, T.I.P. or state g�y960; WBS Element No. 40153.1.1; Federal Project No. BRZ-3058(2)
project no:
3. Owner Information
3a. Name(s) on Recorded peed: North Carolina Department of Transportation
3b. Deed Book and Page No. N/A
3c. Responsible Party (for LLC if Division Engineer NC DOT Division 7, Mr. Mike Mills, PE
___ .__��_..
3d. Street address: PO Box 14996
3e. City, state, zip: Greensboro, NC 27415
3f. Telephone no.: [phone]
3g. Fasc no.: [phone]
3h. Email address: [e-mail]
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: NC DOT Highway Division 7
4b. Name: Division Engineer NC DOT Division 7, Mr. Mike Mills, PE
4c. Business name NC DOT
4d. Street address:
4e. City, state, zip:
4f. Telephone no.:
4g. Fax no.:
PO Box14996
Greensboro, NC 27415
[phone]
[phone]
4h. Emailaddress: [e-mail]*note:pleasealsocopyMr.JerryParker,HighwayDivision7Environmenta!
Supervisor on all correspondence- jparkera�7 cdot.gov
5. AgenUConsultant Information (if applicable)
5a. Name: Mr. Jerry Parker
5b. Business name NC DOT Highway Division 7, Division Environmental Supervisor
5c. Street address:
5d. City, state, zip:
5e. Telephone no.:
5f. Fax no.:
5g. Email address:
PO Box 14996
Greensboro, NC 27415
[phone]
[phone]
[e-mail]
Page 2 of 10
PCN Form - Version 1.3 December 10, 2008 Version

B. Project Information and Prior Project History
1. Property Identification
1 a. Property identification no. (tax PIN or parcel ID): N/A
1 b. Site coordinates (in decimal degrees): Latitude 36.057012 Longitude: -79.587589
(DD.DDDDDD) (-DD.DDDDDD)
1c. Property size: N/A acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to Littie Alamance Creek (Lake Mackintosh)
proposed project:
2b. Water Quality Ciassification of nearest receiving water: WS-IV; NSW; CA; 16-193-(4.5)
2c. River basin: Cape Fear (HUC 03030002)
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:
There currently is a dirt roadlutility easement where existing Konica Drive will be extended to. The existing bridge is a
timber construction with concrete interior and end bents. Judge Adams Road, a gravel lane, accesses the bridge from the
north and south.
3b. List the total estimated acreage of all existing wetiands on the property:
0.19 acres
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
� 285 LF of stream within the project boundaries
3d. Explain the purpose of the proposed project:
The purpose of the proposed project is to remove a functionally obsolete bridge and to provide appropriate access to
properties and utilities, located north of Bridge No. 214, by extending SR 3224 (Konica Drive).
3e. Describe the overall project in detail, including the type of equipment to be used:
The project proposes to remove Bridge No. 214 on SR 3058 (Judge Adams Road) over Little Alamance Creek in Guilford County. A
new bridge will not be constructed. A service road will be constructed to provide continued access to the propeRies north of Bridge
No. 214. The proposed service road will tie into existing SR 3224 (Konica Drive), which runs south of and parallel to I-40/85, will be
extended west to the existing utility easement north of Bridge No. 214 to tie into the northern limit of Judge Adams Road. The
existing portion of SR 3224 (Konica Drive) wiil remain open during construction of the service road. Bridge No. 214 along SR 3058
(Judge Adams Road) will aiso remain open during construction of the service road and will be removed after the completion of the
service road. NCDOT will implement sedimentation, erosion control, and storm water drainage BMPs during construction. NCDOT
will adhere to Design Standards in Sensitive Watersheds within the project area. Equipment to be used includes a track hoe, dump
truck, paving equipment, crane, pumps and various hand tools.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property / � Yes ❑ No ❑ Unknown
project (including all prior phases) in the past?
Comments: N/A
4b. If the Corps made the jurisdictional determination, what type � preliminary 0 Final
of determination was made?
4c. If yes, who delineated the jurisdictional areas? Agency/Consultant Company: NC DOT
Name (if known): B. Barrett, J. Mason, J. Nemphill Other: N!A
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
Anticipated to be secured with the issuance of the 404 Authorization
Page 3 of 10
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 Pians
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. Wetiand 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
Riparian/Non � yes � Corps
S2 � P❑ T Fill Tidal Freshwater � No ❑ DWQ �� ��
Marsh
Riparian/ Non � Yes � Corps
S2 ❑ P� T Hand Clearing Tidal Freshwater � No ❑ DWQ 0.04
Marsh
2g. Total wetland impacts 0.05
2h. Comments:
3. Stream Impac4s
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. 3 b. 3c. 3d. 3e. 3f. 39
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 (T) ��NT)? other) (feet) feet)
S1 � P� T Culvert Extension UT to Little � PER � Corps P: 135
and Basin Alamance Creek 15-20
❑ INT � DWQ T: 25
3h. Total Permanent Stream and Tributary Impacts 135'
3i. Comments:
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 ail 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 Temporary
T
Little Alamance
01 ❑ P� T Creek/Lake Bridge Bent Removal Lake 0.10
Mackintosh
4f. Total open water impacts 0.10
4g. Comments: The proposed impacts are temporary in nature and only to remove the existing bridge structure.
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 Fiiled Excavated Flooded
P1
P2
5f. Total
5g. Comments: There.are no ponds created for this project
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 an impacts require miti ation, then ou MUST fill out Section D of this form.
6a. ❑ Neuse ❑ Tar-Pamlico � Other: Jordan
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) impact Stream name mitigation (square feet) (square feet)
or Temporary required?
T
Roadway � Yes
B1 � P❑ T Fill & UT to Little Alamance Creek � No 9,129 5,852
Culvert
6h. Total buffer impacts 9,129 5,852
6i. Comments: Please note that within the riparian buffer area is also a small, non-tidal, non-forested, riparian wetland. A
small amount of wetland within the buffer will be impacted (123 sq. ft, in Zone 1 and 675 sq. ft. in Zone 2). This is only for
reporting purposes as wetland mitigation is not triggered by this proposed project; however, riparian buffer compensatory
mitigation will be required as the proposed impacts are greater than 1/3 acre.
D. Impac4 Justification and Mitigation
Page 5 of 10
PCN Form - Version 1.3 December 10, 2008 Version

1. Avoidance and Minimization
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
The proposed project includes the removal of Bridge No. 214 in Guilford County and constructing a service road to provide access to
properties and utilities who currenily have access via SR 3058 (Judge Adams Road) north of Bridge No. 214. The proposed service
road will be an 18-foot aggregate base road and will be constructed starting at the existing SR 3224 (Konica Drive) west
approximately 2,925 feet to tie into the northern limit of Judge Adams Road. The proposed typical section of the service road will be
two nine-foot wide lanes. The embankment will be graded for two 12-foot lanes with 6-foot shoulders per NCDOT standard practice
The elevation of the eutended new road with its associated fill slopes over the existing stream elevation account for the proposed
impacts for this project. Due to a projected traffic volume of 100 vehides per day (vpd) on Konica Drive, NCDOT will be constructing
a two-lane roadway typical section for the eutension of Konica Drive, but will be placing an 18-foot wide stone surface at this time.
Two cul-de-sacs will be constructed on either side of the Bridge No. 214 location, one at the westernmost terminus of the proposed
service road extending from existing SR 3224 (Konica Drive) and one south of Bridge No. 214 along SR 3058 (Judge Adams Road).
In determining the preferred alternative, NCDOT examined replacing the existing bridge in place as well as the proposed Konica
Drive extension. From a cost perspective, Konica Drive Extension alternative (KDE) is estimated at $1,643,303 compared to the
Judge Adams Bridge alternative (JAB) estimated at $1,523,903. NCDOT analyzed both alternatives with the same typical sections,
matching KDE's 2, 12 foot lanes with 6 foot shoulders to JAB's 2, 9 foot lanes with 4 foot shoulders (a 36 foot width to a 26 foot
width) and vice versa. When bringing up JAB's typical section to KDE's typical section for comparison purposes, NCDOT would
have to construct a 10 foot wider bridge and roadway on Judge Adams Road that would transition down to and tie into the existing 2,
�9-foot lanes with 4 foot shoulders. This would result in the cost of JAB increasing beyond what is presented above as well as
incurring additional jurisdictional impacts. Further, Judge Adams Road has an 11 °/o grade along the roadway down to the bridge; if
NCDOT were to improve JA up to the KDE design parameters, that 11% grade on Judge Adams Road would need to be improved
which would result in a higher and longer bridge, a higher and wider roadway, potential hydraulic backwater issues, and substantial
increase in costs and environmental impacts higher than the KDE. As the purpose of the proposed project is to maintain access to
properties and prevent them from becoming landlocked, the extension of Konica Drive was determined to be the preferred alternative
based upon the above discussed concerns and circumstances related to cost, design, structures and proposed environmental
impacts. The proposed 2, 12-foot lanes with 6-foot shoulders roadway typical is proposed as it matches the typical section of Konica
Drive which is NCDOT policy. The wst estimates�.above reflect this proposed typical section for KDE, and the 2, 9-foot lanes with 4-
foot shoulders typical section proposed for JAB which matches the existing typicai section for Judge Adams Road.
During construction of the� service road, the existing portion of SR 3224 (Konica Drive) will remain open. Bridge No. 214 along
SR 3058 (Judge Adams Road) will remain open during construction of the service road to provide access to properties and utilities
located north of the bridge. The bridge will be removed after the completion of the service road.
Runoff from the roadway runs across grass shoulders, and is collected in ditches, most of which are grass lined. Runoff that finds its
way to storm sewer inlets is first conveyed through grass lined ditches. This promotes infiltration and filtration. The steepness of the
project terrain is the main factor that precludes using filter strips, and preciudes ditches from meeting water quality swale criteria.
The storm sewer near buffers and wetlands is discharged to a preformed scour hole. Storm sewer was minimized on the project in
favor of ditches. Cross pipes outlet to riprap pads to prevent erosion. Several measures such as a drop junction box, oversized
culvert extension pipe, and riprap dissipator basin are used to reduce energy of the large culvert extension.
NCDOT will implement sedimentation, erosion control, and storm water drainage BMPs during construction. NCDOT will adhere to
Design Standards in Sensitive Watersheds within the project area.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Erosion and sedimentation BMPs will be installed prior to construction. Water will be diverted around the work area to prevent
sedimentation of downstream aquatic resources. Impacts will be minimized by strict enforcement of Best Management
Practices for the protection of surface waters, restrictions against the staging of equipment in or adjacent to waters of the US
and coordination (including a pre-construction meeting) with the Division Environmental Supervisor.
Page 6 of 10
PCN Form — Version 1.3 December 10, 2008 Version

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?
2b. If yes, mitigation is required by (check all that apply):
� Yes ❑ No
� 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:
3b. Credits Purchased (attach receipt and letter)
3c. Comments:
4. Complete if Making a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached.
4b. Stream mitigation requested:
4c. If using stream mitigation, stream temperature:
4d. Buffer mitigation requested (DWQ only):
4e. Riparian wetland mitigation requested:
4f. Non-riparian wetland mitigation requested:
4g. Coastal (tidal) wetland mitigation requested:
Type � Quantity
� Yes
135 LF @ 2:1 ratio
� warm ❑ cool ❑cold
square feet
acres
acres
acres
4h. Comments:
5. Complete if Using a Permittee Responsihle Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
6. Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a. Wili 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.
Zone
Zone 1
Zone 2
6c.
Reason for impact
Roadway fill and Culvert
Roadway fill and Culvert
Totalimpact
(square feet)
9,129
5,852
Multiplier
3 (2 for Catawba)
1.5
6f. Total buffer mitigation required:
6e.
Required mitigation
(square feet)
27,387
8,778
36,165
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).
Payment into NC Division Mitigation Services (DMS); please see attached acceptance letter
Page 7 of 10
PCN Form — Version 1.3 December 10, 2008 Version

6h. Comments:
E. Stormwater Management and Diffuse Flow Plan (repuired by DWQ)
Diffuse Flow Plan
1 a. Does the project include or is it adjacent to protected riparian buffers identified
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: See the attached plan; existing drainage patterns through grassed
swales will be maintained.
2. Stormwater Management Pian
2a. What is the overall percent imperviousness of this project?
2b. Does this project require a Stormwater Management Pian?
2c. If this project DOES NOT require a Stormwater Management Plan, explain why:
� Yes ❑ No
� Yes ❑ No
N/A %
�/ ■ .
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
Plan is attached.
❑ Certified Local Government
2e. Who will be responsible for the review of the Stormwater Management Plan? ❑ DWQ Stormwater Program
� DWQ 401 Unit
Local Government Stormwater
3a. In which local governmenYs jurisdiction is this project?
3b. Which of the following locally-implemented stormwater management programs
apply (check all that apply):
3c. Nas the approved Stormwater Management Plan with proof of approval been
attached?
Review
4a. Which of the following state-implemented stormwater management programs appiy
(check all that apply):
4b. Has the approved Stormwater Management Plan with proof of approval been
attached?
5. DWQ 401 Unit
5a. Does the Stormwater Management Plan meet the appropriate requirements?
5b. Have all of the 401 Unit submittal requirements been met?
❑ Phase II
❑ NSW
❑ USMP
❑ Water Supply Watershed
❑ Other:
❑ Yes ❑ No
❑ Coastal counties
❑ HQW
❑ ORW
❑ Session Law 2006-246
❑ Other:
� Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
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F. Supplementary Information
1. Environmentai Documentation (DWQ Requirement)
1 a. Does the project involve an expenditure of public (federal/state/local) funds or the � Yes ❑ No
use of public (federallstate) 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 (NEPAlSEPA)?
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: A programmatic categorical exclusion has been prepared and
submitted for this project.
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 26 .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. Wiil 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.
Per the NC DWQ April 10, 2004 Version 2.1 Cumulative Impacts policy, small scale public transportation projects — such
as widening projects, bridge replacements and intersection improvements — have a"low potential for cumulative impact
since little (if any) new impervious surtace is added and the projects are usuaily in already developed locales." This
proposed project is within a somewhat developed landscape (i.e. project site is adjacent to I-40 corridor, existing
businesses and industrial buildings in the vicinity), this is not a road on a new location (i.e. there is an existing road and
there used to be a bridge structure and thus, the area already contains impervious surFaces) and the project drains to
Little Alamance Creek, which is Class WS-IV; NSW; CA (i.e. not HWQ or ORW). We anticipate the NC DWR will advise
us if a qualitative or quantitative analysis is needed.
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.
It is not anticipated that this project will generate any wastewater as it is a roadway project.
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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
Sd. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat? An onsite investigation for lsotria medeoloides was conducted in 2013 and included in the project NRTR. No
habitat or species were found within the project area. A review of the NCNHP records indicated no k�own occurrences
within 1.0 mile of the study area. Therefore, this project wili have "no effect" on the small whorled pogonia. Additionally,
previous communication with Mr. Gary Jordan (USFWS) determined that a resurvey for the small whorled pogonia was
not needed. Also, Mr. Gary Jordan (USFWS) recently released the Programmatic Conference Opinion (PCO) for the
recently listed Northern Long Eared Bat (NLEB). This opinion, states in part, that "...it is the Seivice's conference opinion
that NCDOT activities in easfern North Carolina (Divisions 1-8), as proposed, are not likely to jeopardize the continued
existence of the NLEB."
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?
This project takes place in Guilford County which is not near any coastal or tidal habitat that would support EFH (i.e. salt
marshes, oyster reefs, etc.).
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal
governinents 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?
North Carolina State Historic Preservation HPOWEB GIS Service was reviewed to determine that the project did not take
place in or near an area designated as having a historic or cultural preservation status. Also, a review was conducted in
2013; see attached letters.
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: MOA
8c. What source(s) did you use to make the floodplain determination? North Carolina Floodplain Mapping Program
Mr. Mike Mills, PE �,; � p �f� �,
ApplicanUAgenfs Printed Name . �U V�(,�t Ci �, ���__
ApplicanUAgent's Signature Date
(Ag s signature is valid only if an authorization letter from the
a licant is provided.)
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