20170951 Ver 1_PCN Form Submission_20170802

Action History (UTC-05:00) Eastern Time (US & Canada)
�brrrit by Anonymous User 8/2/2017 4:49:35 PM (Start Event)
Accept by Carpenter,Kristi 8/3/2017 2:26:00 PM (DOT Initial Review)
• The task was assigned to Carpenter,Kristi . The due date is: August 7, 2017 5:00 PM
8/2/2017 4:50 PM

�� �
6fvlslaa of Water Resources
Pre-Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
June 28, 2017 Ver 1.8
*
Please note: fields marked with a red asterisk below are required. You will not be ab/e to submit the form until all mandatory questions are ans�red.
Below is a link to the DRAFT online help file. http://edocs.deq.nc.gov/WaterResources/0/doc/549884/Page1.aspx
A. Processing Information
County (or Counties) where the project is located:*
Onslow
Is this a NCDOT Project?*
C� Yes �' No
(NCDOT only) T.I.P. or state project number:
W-5601A
WBS #
50138.1. F D2
(for f�1CDOT use only)
� 1a. Type(s) of approval sought from the Corps:*
rJ Section 404 Permit (wetlands, streams and waters, Clean Water Act)
r Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
1b. What type(s) of permit(s) do you wish to seek authorization?*
fJ Nationwide Permit (NWP)
r Regional General Permit (RGP)
Nationwide Permit (NWP) Number:
NWP Number Other:
List all MN nurrbers you are applying for not on the drop dow n list.
14 - Linear transportation
1c. Type(s) of approval sought from the DWR:*
check all that apply
� 401 Water Quality Certification - Regular
� Non-404 Jurisdictional General Permit
r 401 Water Quality Certification - Express
r Riparian Buffer Authorization
1d. Is this notification solelyfor the record because written approval is not required?
For the record only for DWR 401 Certification:
I For the record only for Corps Permit:
1e. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
*
l" Yes C•' No
C•' Yes C' No

If so, attach the acceptance letter from rritigation bank or in-lieu fee program
C' Yes C•' No
1f. Is the project located in any of NC's twenty coastal counties?*
C� Yes l" No
1g. Is the project located within a NC DCM Area of Environmental Concern (AEC)?*
C' Yes �' No C' Unknown
B. Applicant Information
1a. Who is the Primary Contact?*
Anneliese Westphal
1b. Primary Contact Email:*
[e-mail]
1c. PrimaryContact Phone:*
(xxx)xxx-xxxx
[phone]
1d. Who is applying for the permit?
r Owner �J Applicant (other than owner) r Agent/Consultant
(Check all that apply)
2. Owner I nformation
2a. Name(s) on recorded deed:
State of North Carolina
2b. Deed book and page no.:
f�UA
2c. Responsible party:
(for Corporations)
Karen Collette, P.E.
� 2d.Address
Street Address
5501 Barbados Blvd.
Address Line 2
��
Castle Hayne
Fbstal / Zip Code
28429
2e. Telephone Number:
(xxx)xxx-xxxx
[phone]
2f. Fax Number:
[phone]
(xxx)xxx-xxxx
2g. Email Address:*
kecol lette@n cdot. g ov
3. Applicant Information (if different from owner)
3a. Applicant is:
State / Rovince / F�gion
NC
Country
USA

C� Agent
C' Other
If other please specify.
3b. Name:
Anneliese Westphal
3c. Business Name:
(if applicable)
NCDOT Division 3
3d.Address
Street Address
5501 Barbados Blvd.
Address Line 2
��
Castle Hayne
Fbstal / Zip Code
28429
3e. Telephone Number:
[phone]
(xxx)xxx-x�cx
3f. Fax Number:
[phone]
(xxx)xxx-xxxx
3g. Email Address:*
[e-mail]
State / Rovince / F�gion
NC
Country
USA
C. Project Information and Prior Project History
1. Project Information
1a. Name of project:*
Rhodestown Road Curve Realignment
1b. Subdivision name:
(if appropriate)
wa
1c. Nearest municipality/town:*
Richlands
1d. Driving directions*
If it is a new project and can not easily be found in a C�5 rrapping system Rease provide directions.
From Wilmington, NC travel north on US 17 to Jacksonville, NC. In Jacksonville, travel west on US 258/NC 24 for appro�amately 7.1 miles and
then turn right onto SR 1329 Rhodestown Fire Department Rd. Travel for 732 feet and then turn right onto SR 1317 Briarneck Rd. Travel for
788 feet and then turn left onto SR 1316 Rhodestown Rd. Travel for 2.2 miles and arrive at the project site.
2. Project Identification
2a. Property Identification Number:
(t�vc RN or parcel ID)
� wa
2b. Propertysize:

(in acres)
wa
2c. Project Address
Street Address
Address Line 2
(7iy
Fbstal / Zip Code
2d. Site coordinates in decimal degrees
State / FYovince / F�gion
Country
i Please collect site coordinates in decimal degrees. Use between 4-6 digits (unless you are using a survey-grade GPS device) after the decimal place as
appropriate, based on howthe location was determined. (For example, most mobile phones with GPS provide locational precision in decimal degrees to
map coordinates to 5 or 6 digits after the decimal place.)
i Latitude:* Longitude:*
34.851197 -77.49343
ex:34208504 -77.796371
3. SurFace Waters
3a. Name of the nearest body of water to proposed project:*
i New River
3b. Water Resources Classification of nearest receiving water:*
C; NSW
Surface Water Lookup
3c. What river basin(s) is your project located in?*
White Oak
RiverBasin Lookup
4. Project Description
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 conditions within the e�asting 60 feet of R/W include a secondary road facility with grassed shoulders ditch
sections. The property to the north of the project is developed as residential property and the property to the
south is both forested and agricultural.
4b. Attach an 8 1/2 X 11 excerpt from the most recent version of the USGS topographic map indicating the location of the project site. (for
DWR)
Gick the upload button or drag and drop files here to attach docurrent
W-5601A Rhodestown Rd_Topo.pdf 289.69KB
Fle type rrust be pdF
4c. Attach an 8 1/2 X 11 excerpt from the most recent version of the published County NRCS Soil Survey map depicting the project site.
(for DWR)
Gick the upload button or drag and drop files here to attach docurrent
W-5601A Rhodestown Rd_Soil.pdf 618.78KB
Fle type rrust be pdF
4d. List the total estimated acreage of all existing wetlands on the property:
0
4e. List the total estimated linear feet of all existing streams on the property:

(interrrittent and perennial)
0
4f. Explain the purpose of the proposed project:
The purpose of this project is to improve safety by reducing runoff road crashes by widening shoulder widths and
improving the curve radius.
4g. Describe the overall project in detail, including the type of equipment to be used:
W-5601A is a curve realignment project in Onslow County. Therefore, part of this project is on new location.
Therefore, road construction activities will include clearing, grading, fill, drainage, and paving. Typical road
building and construction equipment will be used including excavators, dump trucks, motor graders, milling and
paving equipment.
4h. Please upload project drawins for the proposed project.
aick the upload button or drag and drop files here to attach docurrent
W-5601 A_Permit_Drawings_20161031.pdf 1.19M6
Fle type rrust be pdf
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the propertyor proposed impact areas?*
�' Yes C' No c' Unknown
Comments:
The features have been delineated, but a PJD request has not yet been
submitted to the Corps. It will be submitted soon.
5b. If the Corps made a jurisdictional determination, what type of determination was made? *
C' Preliminary C' Approved C•' Unknown
Corps AID Number:
I 6carrple: SAV�2017-99999
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Othe r:
Christopher Dustin
SEPI
5d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
NCDOT will submit a PJD request via email. NCDOT's Corps representative and NCDWR representative met on-site on 1/6/2016.
5d1. Jurisdictional determination upload
C7ick the upload button or drag and drop files here to attach docurrent
Fle type rrust be FDF
6. Project History
6a. Have permits or certifications been requested or obtained for this project (including all prior phases) in the past?*
C' Yes �' No �' Unknown
7. Future Project Plans
7a. Is this a phased project?*
C' Yes C•' 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? This includes other separate and distant crossing for linear projects that require Department of the
Army authorization but don't require pre-construction notification.

D. Proposed I m pacts I nventory
1. Impacts Summary
I 1a. Where are the impacts associated with your project? (check all that apply):
r Wetlands r Streams-tributaries r Buffers
fJ Open Waters r Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
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.
'* All Perennial or Intermittent streams must be verified by DWR or delegated local government.
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. Site # - Reason for
impact
Site 1
N�p label (e.g. Finad Qossing 1)
Site 1
fv�p label (e.g. I�ad Qossing 1)
4b. Impact
type
P
F2rrranent (F) or
Terrporary (�
T
F2rrrenent (Pj or
Terrporary (�
4g. Total temporary open water Impacts:
0.01
4g. Total permanent open water impacts:
0.01
4g. Total open water impacts:
0.02
4h. Comments:
Site 1 Permanent impacts: 425 sq. ft.
Site 1 Temporary impacts: 79 sq. ft.
4c. Name of waterbody
N/A
(if applicable)
N/A
(if applicable)
5. Pond or Lake Construction
If pond or lake construction is proposed, then complete the chart below.
4d. Activity 4e. Waterbody4f. Impact area
type type
Culverts Tributary 0.01
(acres)
Dewatering Tributary 0.01
(acres)
6. Buffer Impacts (for DWR)
If project will impact a protected riparian buffer, then complete the chart below. Individually list all buffer impacts below.
E. Impact Justification and Mitigation

1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:*
The project will utilize ditches to convey stormwater runoff and the e�sting drainage patterns have been
maintained as closely as possible.
1b. Specificallydescribe measures taken to avoid or minimize the proposed impacts through construction techniques:*
The project will be constructed utilizing approved Best Management Practices for Construction and Maintenance
Activities. All permit plans and conditions will be enforced so that the amount of impacts is limited to what is
enumerated in this application.
I 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?
C' Yes
�' No
2b. If this project DOES NOT require Compensatory M itigation, explain why:
The only impacts are to a non-mitigable tributary.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
1a. Does this project require a Stormwater Management Plan?
C�' Yes
C' No
1b. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
I The project consists of roadway curve realignment to improve traffic safety. The e�asting 2-lane roadway with
ditches will be relocated as a 2-lane roadway facility with improved shoulders in Onslow County. The existing and
proposed typical section will utilize ditches to convey stormwater runoff. E�asting drainage patterns have been
maintained as closely as possible.
1c. What is the overall percent imperviousness of this project?
23
%
1d. Who will be responsible for the review of the Stormwater Management Plan?*
r Certified Local Government
r DWR 401 & Buffer Permitting Branch
2. Diffuse Flow Plan
r DEMLR Stormwater Review
�J DWR Transportation Permitting Branch
2a. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection
Rules?
C' Yes
�' No
If no, explain why:
There are no protected riparian buffers in the White Oak River Basin.
5. DWR 401 Stormwater Review
5a. Is the Stormwater Management Plan (including BMP Supplemental Forms and Operation and Maintenance Agreements) attached?
C� Yes
C' No
Stormwater Management Plan Upload
aick the upload button or drag and drop files here to attach docurrent
file type rrust be pdf
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?*
C� 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 PolicyAct (NEPA/SEPA)?*
C' Yes C•' No
Comments:*
A CE document was completed for this project.
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
i DWR Surface Water or Wetland Standards or Riparian Buffer Rules (15A NCAC 2B .0200)? *
C' Yes C•' No
2b. Is this an after-the-fact permit application?*
f Yes C•' No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
3. Cumulative Impacts (DWR Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in additional development, which could impact
nearby downstream water quality?*
C' Yes �' No
3b. If you answered "no," provide a short narrative description.
This project is one which qualifies as an action "27" categorical exclusion under 23 CFR 771.117. As such, the
project is in a category of projects that add either no or a minor amount of new impervious surface directly,
� indirectly, or cumulatively. Consequently, the project will not result in cumulative impacts that cause or will cause a
violation of downstream water quality standards.
4. Sewage Disposal (DWR Requirement)
4a. Describe, in detail, the treatment methods and dispositions (non-discharge or discharge) of wastewater generated from the
proposed project. If the wastewater will be treated at a treatment plant, list the capacity available at that plant.
f�UA
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? *
C' Yes C•' No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
C' Yes �' No
5c. If yes, indicate the USFWS Field Office you have contacted.
5d. Is this a DOT project located within Division's 1-8?*
C� Yes
C' No
5i. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?*

An evaluation of the natural communities and threatened and endangered species for this project included a GIS-
based review of aerial imagery, a review of the North Carolina Natural Heritage Program (NCNHP) web-based
mapping tool, and a field survey by environmental scientists.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
C' Yes C•' No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
I NOAA Essential Fish Habitat Mapper
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
Link to the State Historic Preservation Office Historic Properties Map (does not include archaeological data: http://gis.ncdcr.gov/hpoweb/
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 historyand archaeology)?*
C' Yes C•' No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources? *
NCDOT PDEA Human Environment Section screening. Please see attached forms.
7c. Historic or Prehistoric Information Upload
qick the upload button or drag and drop files here to attach docurrent
Fle rrust be F�F
8. Flood Zone Designation (Corps Requirement)
Link to the FEMA Floodplain Maps: https://msc.fema.gov/portal/search
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
C' Yes C•' No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination?*
NC Floodplain Mapping Program
Miscellaneous attachments not previously requested.
C7ick the upload button or drag and drop files here to attach docurrent
Vicinity Map.pdf 134.37KB
Fle rrust be Ft7F
Signature
*
fJ By checking the box and signing below, I certify that:
. 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 AcY');
■ I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic
Transactions AcY');
■ 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:*
Anneliese Westphal
Signature
A��eleSe �es��rs�
Date
8/2/2017
Initial Review
Is this project a public transportation project?
r Yes C' No
Only change this if the project has been reassigned.
Has this project met the requirements for acceptance in to the review process?*
�' Yes
C' No
BIMS # Assigned*
20170951
Version#*
Reviewing Office *
Wilmington Regional Office - [phone]
Select Project Reviewer*
Joanne Steenhuis:eads\jhsteenhuis