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HomeMy WebLinkAbout20171491 Ver 1_PCN Form Submission_20171120Action History (UTC-05:00) Eastern Time (US & Canada) �brrrit by Anonymous User 11/20/2017 9:36:15 AM (Start Event) Accept by Carpenter,Kristi 11/20/2017 2:32:04 PM (DOT Initial Review) • The task was assigned to Carpenter,Kristi . The due date is: November 23, 2017 5:00 PM 11 /20/2017 9:37 AM �� � 6fvlslaa of Water Resources Pre-Construction Notification (PCN) Form For Nationwide Permits and Regional General Permits (along with corresponding Water Quality Certifications) November 25, 2017 Ver 2.1 * Please note: fields marked with a red asterisk below are required. You will not be able to submit the form until all mandatory questions are ans�red. Below is a link to the online help file. http://edocs.deq.nc.gov/WaterResources/0/doc/603610/Page1.aspx A. Processing Information County(or Counties) where the project is located:* Gaston Is this project a public transportation project? (?) r Yes C' No Is this a NCDOT Project? C� Yes C' No (NCDOT only) T.I.P. or state project number: W-5212N WBS # (for NCDOT use only) 1a. Type(s) of approval sought from the Corps: I7 Section 404 Permit (wetlands, streams and waters, Clean Water Act) � Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act) 1b. What type(s) of permit(s) do you wish to seek authorization? �J 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 rJ 401 Water Quality Certification - Regular r Non-404 Jurisdictional General Permit r 401 Water Quality Certification - E�ress 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: C' Yes C•' No For the record only for Corps Permit: C' Yes r No 1e. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts? If so, attach the acceptance letter from rritigation bank or in-lieu fee program C' Yes C•' No i 1f. Is the project located in anyof NCs twentycoastal counties?* C' Yes �' No 1h. Is the project located in a designated trout watershed?* C� No C' Yes Link to trout information: http://v�uwv.saw.usace.army.mil/Missions/Regulatory-Permit-Program/Agency-Coordination/Trout.aspx B. Applicant Information 1a. Who is the Primary Contact?* Trish Beam 1b. Primary Contact Email:* pdbeam@ncdot.gov 1c. PrimaryContact Phone:* (xxx)xxx-xxxx (980)552-4218 1d. Who is applying for the permit? � Owner rJ Applicant (other than owner) r AgenUConsultant (Check all that apply) 2. Owner I nformation 2a. Name(s) on recorded deed: 2b. Deed book and page no.: 2c. Responsible party: (for Corporations) 2d.Address Street Address Address Line 2 �� F�stal / Zip Code 2e. Telephone Number: (xxx)xxx-xxxx 2f. Fax Number: (xxx)xxx-xxxx 2g. Email Address:* State / Rovince / Region Country mstafford@ncdot.gov 3. Applicant Information (if different from owner) 3a. Applicant is: C' Agent C� Other �ivision 12 tngineer If other please specify. 3b. Name: Mark Stafford 3c. Business Name: (if applicable) 3d. Address Street Address 1710 East Marion Street Address Line 2 �� Shelby Fbstal / Zip Code 28151 3e. Telephone Number: (xxx)xxx-xxxx 3f. Fax Number: (xxx)xxx-xxxx 3g. Email Address:* mstafford@ncdot.gov State / FYovince / F�gion North Carolina Country United States C. Project Information and Prior Project History 1. Project Information 1a. Name of project:* Hwy 279 Widening/Improvements 1b. Subdivision name: (if appropriate) 1c. Nearest municipality/town:* Between Cherryville and Dallas 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 Cherryville, follow Hwy 279 to first section starting at St Marks Church Road (SR 1438) to just past Whitesides Road (SR 1624); second section begins at Besstown Road (SR 1446) to just past Long Shoals Road (SR 1609); third section begins at Davis Creek Court (SR 1764) to just past Ashbrook Park Road (SR 1602); fourth section begins at White Jenkins Road (SR 1456) to just past Camp Sertoma Road (private road) 2. Project Identification 2a. Property Identification Number: (tax RN or parcel ID) 2b. Propertysize: (in acres) 2c. Project Address Street Address Address Line 2 Qty Fbstal / Zip Code 2d. Site coordinates in decimal degrees State / FYovince / F�gion Country 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 e>cample, 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:* Permit site 1)35.364660; Permit site 2) 35.337627; Permit site 3) 35.336138; Permit site 4) 35.325291 ex:34.208504 3. Surface Waters Longitude:* 1) -81.316432; 2) -81.233548; 3) - 81.232894:4)-81.227103 -77.796371 3a. Name of the nearest body of water to proposed project:* Little Beaverdam Creek; Little Long Creek 3b. Water Resources Classification of nearest receiving water:* Little Beaverdam Creek - WS-IV watershed; Little Long Creek - Class C Surface Water Lookup 3c. What river basin(s) is your project located in?* Catawba 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:* Paved NC highway; General land use in the vicinity of the permit sites are cropland and pasture 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 topo_area4_8.pdf 136.07KB topo_area9_13.pdf 89.17KB topo_area14_16.pdf 78.13K6 topo_area 17_22. pdf 126.17KB 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) C7ick the upload button or drag and drop files here to attach docurrent Little_Beaverdam_Crk_soilmap.pdf Little_Long_Crk_soilmap. pdf Unnamed_tributary_soilmap.pdf Fle lype rrust be pdF 4d. List the total estimated acreage of all existing wetlands on the property: 0.07 4e. List the total estimated linear feet of all existing streams on the property: (interrrdtent and perennial) 250 4f. Explain the purpose of the proposed project: Roadway widening in four areas along Hwy 279 by the addition of a third travel lane 584.55KB 884.17KB 381.7KB 4g. Describe the overall project in detail, including the type of equipment to be used: 4h. Please upload project drawings for the proposed project. Gick the upload button or drag and drop files here to attach docurrent W5212N 25% Roadway Plansheets.pdf W-5212N hyd_Permit_Drawings_2017-06-20.pdf W-5212N Erosion Control Culvert Construction.pdf Fle type rrust be pdf 5. Jurisdictional Determinations 5.75M6 4.85M6 3.03M6 5a. Have the wetlands or streams been delineated on the propertyor proposed impact areas?* r Yes C' No �' Unknown Comments: 5b. If the Corps made a jurisdictional determination, what type of determination was made? * C� Preliminary l" Approved C' Unknown Corps AID Number: Exarrple: SAV�2017-99999 5c. If 5a is yes, who delineated the jurisdictional areas? Name (if known): Agency/Consultant Company: Othe r: Carolina Ecosystems l" N/A 5d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation. 5d1. Jurisdictional determination upload aick the upload button or drag and drop files here to attach docurrent W5212N_JD_draft_signed.pdf Fle type rrust be FDF 6. Project History 32.74MB 6a. Have permits or certifications been requested or obtained for this project (including all prior phases) in the past?* r Yes r No r 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 1a. Where are the impacts associated with your project? (check all that apply): r7 Wetlands r% Streams-tributaries r Buffers r 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. 2a. Site # - Reason for impact * 3) 18" RCP Fill N�p label (e.g. F�ad Qassing 1) 3) 18" RCP Mechanized clearing N�p label (e.g. 13�ad CXossing 1) 3) 15" CSP Mechanized clearing fv�p label (e.g. Id�ad Q�ossing 1) 4) 30" RCP N�p label (e.g. Fd�ad Q-ossing 1) 4) 30" RCP Mechanized clearing N�p label (e.g. 13�ad CXossing 1) 2b. Impact type * 2c. Type of wetland * P Bottomland Hardwood F�rrranent (Pj or Teriporary Forest �� P Bottomland Hardwood F2rrranent (F) or Terrporary Fol'est �� P Bottomland Hardwood F2rrranent (P� or Terrporary FOPeSt �� P Headwater Forest F2rrranent (P� or Terrporary �� P Headwater Forest F2rrrenent (P� or Terrporary �� 2g. Total Temporary Wetland Impact 0.000 2g. Total Permanent Wetland Impact 0.070 2g. Total Wetland Impact 0.070 2h. Comments: 2d. Wetland name * Ze. 2f. 2g. Impact Forested* Jurisdiction area* type * WA No Both 0.010 (404, 10) or d�NR (acres) (401, other) WA No Both 0.030 (404, 10) or CNVR (acres) (401, other) WA WC WC No Both 0.010 (404, 10) or DJVR (acres) (401, other) Yes Both 0.010 (404, 10) or d�NR (acres) (401, other) Yes Both 0.010 (404, 10) or CTJVR (acres) (401, other) 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. Site #- Reason 3b.lmpact 3c. Type of 3d. Stream name * for impact* type* impact* 1) Upstream P Bank Little Beaverdam Creek floodplain F�rrranent(P� Stabilizati bench/Riprap (�Terrporary on bank stabilization fv�p label (e.g. Finad Qossing 1) 1) Triple RCBC P Culvert Little Beaverdam Creek F�ctension F�rrranent(P� fv�p label (e.g. Fd�ad or Terrporary Qossing 1) �T� 1) Upstream P Bank Little Beaverdam Creek Floodplain F�rrranent(Fj Stabilizati Bench/Riprap (�Terrporary on bank stabilization N�p label (e.g. F�ad CYossing 1) 1) Temporary T Dewaterin Little Beaverdam Creek Dewatering for F2rrranent(Pj g Culvert orTerrporary extension/floodpla �� in bench construction fv�p label (e.g. 13�ad trossing 1) 1) Riprap Bank P Bank UTto Little Beaverdam Stabilization F�rrranent(� Stabilizati Creek N�p label (e.g. Road (�Terrporary On Qossing 1) 1) Temporary T Dewaterin UTto Little Beaverdam Dewatering for F�rrranent(P� g Creek Riprap bank aTerrporary stabilization �� N�p label (e.g. Finad Qossing 1) 2) Downstream P Rip Rap Little Long Creek Floodplain bench �rrranent(�j Fill construction/cons orTerrporary tructed �� glide/Riprap bank stabilization N�p label (e.g. I�ad Qossing 1) 2) Double RCBC P Culvert Little Long Creek Extension F2rrranent(F'� fv�p label (e.g. Id�ad or Terrporary Qossing 1) �� 2) Upstream P Rip Rap Little Long Creek Floodplain bench F�rrrenent(P� Fill construction/cons orTerrporary tructed �� glide/Riprap bank stabilization N�p label (e.g. Fd�ad CYossing 1) 3e. Stream Type * 3f. 3g. Stream 3h. Impact Jurisdictior�idth* length* type * Perennial Both 11 24 F�rennial (FS2) or interrrittent Average (feet) (linear feet) (IfM Perennial Both F2rennial (� or interrrittent (IfVT) Perennial Both F2rennial (Fff�) or interrrittent (If� Perennial Both F2rennial (Fff2) or interrrittent (If� Perennial Both F�rennial (F�2) or interrrittent (If� Perennial Both F2rennial (F$2) or interrrittent (If� Perennial Both F2rennial (FS2) or interrrittent (IfM Perennial Both F2rennial (F8� or interrrittent QfVf) Perennial Both F�rennial (FS2) or interrrittent (If� 11 26 Average (feet) (linear feet) 11 22 Average (feet) (linear feet) 11 45 Average (feet) (linear feet) 3 15 Average (feet) (linear feet) 3 22 Average (feet) (linear feet) 5 21 Average (feet) (linear feet) 5 24 Average (feet) (linear feet) 5 30 Average (feet) (linear feet) 3a. Site #- Reason 3b.lmpact 3c. Type of 3d. Stream name * for impact* type* impact* 2) Temporary T Dewaterin Little Long Creek Dewatering for F2rrranent(P� g Culvel't orTerrporary extension/floodpla �� in bench construction N�p label (e.g. Road Qossing 1) 4) 30" RCP P Culvert UTto Little Long Creek extension F�rrranent(P� N�p label (e.g. F�ad or Terrporary Qossing 1) �T� 4) Bank P Bank UTto Little Long Creek Stabilization F2rrranent(Fj Stabilizati N�p label (e.g. Id�ad (�Terrporary On Qossing 1) 3e. Stream Type * 3f. 3g. Stream 3h. Impact Jurisdictior�idth* length* type * Perennial Both 5 29 F2rennial (F8� or interrrittent Average (feet) (linear feet) (IfV� Intermittent Both �rennial (�) or interrrittent (If� Intermittent Both F2rennial (Fff�) or interrrittent (If� 4) Temporary T Dewaterin UTto Little Long Creek Intermittent Both Dewatering F2rrranent (F) g F�rennial (� or interrrittent N�p label (e.g. F�ad or Terrporary (IfV� Qossing 1) �� *� All Perennial or Intermittent streams must be verified by DWR or delegated local government. 3i. Total jurisdictional ditch impact in square feet: 0 3i. Total permanent stream impacts: 194 3i. Total temporary stream impacts: 107 3i. Total stream and tributary impacts: 301 3j. Comments: 2) The Floodplain bench construction, constructed glide, and Riprap bank stabilization are within the same stream length impact area 1 22 Average (feet) (linear feet) 1 10 Average (feet) (linear feet) 1 11 Average (feet) (linear feet) 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. 5. Pond or Lake Construction If pond or lake construction is proposed, then complete the chart below. 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:* 1.5:1 (rock plated) fill slopes were used throughout the project to limit impacts to jurisdictional streams and wetlands. Preformed scourholes were used where practical at pipe outlets to dissipate energy and promote diffuse flow. At jurisdictional stream crossings, bank stabilization was used and pipe slopes minimized to reduce flow velocities. A constructed glide will be installed at the double 7' x 8' RCBC extension to remedy the perched inverts of the culvert. 1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:* The proposed RCBC extension will be constructed utiliang impervious dikes and a pump and pipe operation. 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 C•' No 2b. If this project DOES NOT require Compensatory Mitigation, explain why: F. Stormwater Management and Diffuse Flow Plan (required by DWR) 1a. Does this project require a Stormwater Management Plan? �' Yes c' No 1b. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan: See stormwater management plan in attached HYD permit package 1c. What is the overall percent imperviousness of this project? % 1d. Who will be responsible for the review of the Stormwater Management Plan?* r Certified Local Government fJ DWR 401 & Buffer Permitting Branch 2. Diffuse Flow Plan r DEMLR Stormwater Review r 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 If no, explain why: �' No 5. DWR 401 Stormwater Review Sa. 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 W-5212N_hyd_Permit_Drawi ngs_2017-06-20. pdf file type rrust be pdf G. Supplementary Information 1. Environmental Documentation 4.85M6 1a. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?* r Yes r 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 �' No Comments:* The project is a Type I Categorical Exclusion project which does not involve significant environmental impacts. The Type I actions are those actions which: do not induce significant impacts to planned growth or land use for the area, do not require the relocation of significant numbers of people; do not have a significant impact on any natural, cultural, recreational, historic or other resource; do not involve significant air, noise, or water quality impacts; do not have significant impacts on travel patterns; and do not otherwise, either individually or cumulatively, have any significant environmental impacts. 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)? * C' Yes C•' No 2b. Is this an after-the-fact permit application?* C' 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 (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?* f Yes C•' No 3b. If you answered "no," provide a short narrative description. The project is a Type I Categorical Exclusion project which do not involve significant environmental impacts. They are actions which: do not induce significant impacts to planned growth or land use for the area, do not require the relocation of significant numbers of people; do not have a significant impact on any natural, cultural, recreational, historic or other resource; do not involve significant air, noise, or water quality impacts; do not have significant impacts on travel patterns; and do not otherwise, either individually or cumulatively, have any significant environmental impacts. 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. No wastewater is generated from the project. 5. Endangered Species and Designated Critical Habitat (Corps Requirement) Sa. 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?* �' Yes c' No 5c. If yes, indicate the USFWS Field Office you have contacted. Asheville 5d. Is another Federal agency involved?* C' Yes �' No �' Unknown 5e. Is this a DOT project located within Division's 1-8?* C' Yes C•' No 5f. Will you cut anytrees in order to conduct the work in waters of the U.S.?* �' Yes C' No 5g. Does this project involve bridge maintenance or removal?* C' Yes C•' No I Link to the NLEB SLOPES document: http://sav�reg.usace.army.mil/NLEB/1-30-17-signed_NLEB-SLOPES&apps.pdf 5h. Does this project involve the construction/installation of a wind turbine(s)?** C' Yes G No 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.?* C' Yes r No 5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?* NC Natural Heritage Database. Division 12 is located in the white nose syndrome area for Northern Long Eared Bat; however, there are no known hibernacula or roosting trees in Division 12 counties. 6. Essential Fish Habitat (Corps Requirement) 6a. Will this project occur in or near an area designated as an Essential Fish Habitat?* C' Yes �' No 6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?* There are no salt marshes, oyster reefs or seagrass beds in the Division 12 counties: Cleveland, Lincoln, Gaston, Ale�nder, Iredell, or Catawba. 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 �' No 7b. What data sources did you use to determine whether your site would impact historic or archeological resources? * Cultural resources reviewand assessment of effects (Project Tracking No. 16-04-0024) 7c. Historic or Prehistoric Information Upload C7ick the upload button or drag and drop files here to attach docurrent 16-04-0024EFFECTS.pdf 6.71 MB W-5212N Gaston No NRHP Archaeological Sites Present Form.pdf 28.1 MB Fle rrust be FDF 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?* r Yes l" No 8b. If yes, explain how project meets FEMA requirements: Hydraulic unit coordination with FEMA 8c. What source(s) did you use to make the floodplain determination?* Flood map website, http://fris.nc.gov/fris Miscellaneous attachments not previously requested. Gick the upload button or drag and drop files here to attach docurrent waiver_request_double.pdf waiver_request_triple.pdf Floodmap_site1.pdf Floodmap_site2.pdf Floodmap_site4.pdf ha�ardous_spill_basin.pdf signed_NLEB_ConsultationForm.pdf W-5212N NRTR_final.pdf Fle rrust be FDF Signature * rJ By checking the box and signing below, I certify that: 4.27M6 4.05M6 312.18KB 393.87KB 383.06KB 4.67KB 97.49KB 74.74MB ■ 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:* Trish Beam Signature r -a _ tr�� ��Fr�� i Date: current_date Initial Review Is this project a public transportation project? *(?) C� Yes C' No Change only if needed. Has this project met the requirements for acceptance in to the review process?* C� Yes C' No BIMS # Assigned* 20171491 Version#* 1 Reviewing Office * Mooresville Regional Office - (704) 663-1699 Select Project Reviewer* Donna Hood:eads\drhood