20180482 Ver 1_PCN Form Submission_20180405

Action History (UTC-05:00) Eastern Time (US & Canada)
�brrrit by Anonymous User 4/4/2018 3:21:02 PM (Start Event)
Accept by Carpenter,Kristi 4/5/2018 4:59:17 PM (DOT Initial Review)
. The task was assigned to Carpenter,Kristi. The due date is: April 9, 2018 5:00 PM 4/4/2018 3:21 PM

�� �
�ivislan af Water Resour�es
Pre-Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
January 31, 2018 Ver 2.3
*
Please note: fields marked with a red asterisk beloware required. You will not be able to submit the form until all mandatory questions are ans�red.
Also, if at any point you wish to print a copy of the E-PCN, all you need to do is right-click on the document and you can print a copy of the form.
Below is a link to the online help file.
https://edocs.deq. nc.gov/WaterResources/0/edoc/624704/PCN%20Help%20File%202018-1-30.pdf
A. Processing Information
County (or Counties) where the project is located:*
Iredell
Is this project a public transportation project?*
C Yes l' No
lhis is any publicly funded by rrunicipal,state or federal funds road, rail, airport transportation project.
Is this a NCDOT Project?*
f• Yes r No
(NCDOT only) T.I.P. or state project number:
12.204911
WBS #
12.204911
(for �ICDOT use only)
1a. Type(s) of approval sought from the Corps:*
fJ 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: 03 - Maintenance
NWP Number Other:
List all MN nurrbers you are applying for not on the drop dow n list.
1c. Type(s) of approval sought from the DWR:*
check all that apply
� 401 Water Quality Certification - Regular r 401 Water Quality Certification - Express
r Non-404 Jurisdictional General Permit r Riparian Buffer Authorization
*
1d. Is this notification solelyfor the record because written approval is not required?

For the record onlyfor DWR 401 Certification:
For the record onlyfor Corps Permit:
r Yes r No
r 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
f Yes �' No
1f. Is the project located in anyof NC's twentycoastal counties?*
l' Yes C•' No
1h. Is the project located in a designated trout watershed?*
f Yes C No
Link to trout information: http://wvwv.saw.usace.army.mil/Missions/Regulatory-Permit-Program/Agency-Coordination/Trout.aspx
B. Applicant Information
1a. Who is the PrimaryContact?*
Trish Beam
1b. PrimaryContact Email:*
[e-mail]
1c. PrimaryContact Phone:*
(xxx)xxx-xxxx
[phone]
1d. Who is applying for the permit?
rJ Owner r Applicant (other than owner) r Agent/Consultant
(Check all that apply)
2. Owner Information
2a. Name(s) on recorded deed:
NCDOT Right of Way
2b. Deed book and page no.:
2c. Responsible party:
(for Corporations)
Mark Stafford
2d. Address
Street Address
1710 East Marion Street
Address Line 2
PO box 47
a�y
Shelby
Fbstal / Zip Code
28151
2e. Telephone Number:
(xxx)xxx-xxxx
[phone]
2f. Fax Number:
[phone]
(xxx)xxx-xxxx
2g. Email Address:*
[e-mail]
State / R ovince / F�gion
NC
Country
USA

C. Project Information and Prior Project History
1. Project Information
1a. Name of project:*
I-77 Stream Stabilization
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality/ town:*
Mooresville
1d. Driving directions*
IF it is a new project and can not easily be found in a GPS rrapping system Rease provide directions.
From Mooresville travel south on MNy 21 to I-77, then north onto the on ramp to I-77 North. Project is located just off ebt 33 on ramp to I-77
north.
2. Project Identification
2a. Propertyldentification Number:
(tax RN or parcel ID)
2b. Propertysize:
(in acres)
2c. Project Address
SYreet Address
Address Line 2
a�y
Fbstal / Zip Code
State / Rovince / F�gion
Country
2d. Site coordinates in decimal degrees
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 how the 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.)
Latitude:* Longitude:*
35.556257 -80.857474
ex:34.208504 -77.796371
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Unnamed tributary to Catawba River
3b. Water Resources Classification of nearest receiving water:*
WS-IV: Class B
Surface Water Lookup
3c. What river basin(s) is your project located in?*
Catawba
River Basin Lookup

4. Project Description
4a. Describe the existing conditions on the site and the general land use in the vicinityof the project at the time of this application:*
Existing failing concrete ditched channel. Land use is small forested area within a mix of commercial/residential
area.
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)
Qick the upload button or drag and drop files here to attach docurrem
topo map.pdf
Fle type rrust be pdF
141.27KB
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)
aick the upload button or drag and drop files here to attach docurrent
Soil_Map.pdf
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)
200
950.09KB
4f. Explain the purpose of the proposed project:*
The purpose of the purposed project is to stabilize the stream for the safety of the travelling public.
4g. Describe the overall project in detail, including indirect imapacts and the type of equipment to be used:*
The North Carolina Department of Transportation (NCDOT) proposes to stabilize a failing concrete ditched stream
along I-77 north bound lane at exit 33 in Iredell County. The concrete ditched stream has failed in multiple
locations and is causing banks to become unstable. NCDOT proposes to remove the failed concrete ditch for
approximately 129 feet and replace it with embedded riprap. There will be no new permanent impacts, however,
approwmately 40 feet of temporary impacts will be needed for dewatering construction site. The temporary impacts
will be to an unnamed tributary to the Catawba River (Lake Norman) which is classified as WS-IV; Class B waters
by the Division of Water Resources. A temporary cofferdam pumping system will be used to divert the stream
around the construction site as needed. Area affected by temporary cofferdam system will be graded and restored
back to pre-project conditions. All Best Management Practice's will be utilized during the course of the project.
4h. Please upload project drawings for the proposed project.
C7ick the upload button or drag and drop files here to attach docurrent
Drawings.pdf 62.52KB
Fle type rrust be pdF
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
f• Yes C' No l" Unknawn
Comme nts:
Division 12 Environmental Office
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
l" Preliminary l" Approved �' Unknown f•' f�llA
Corps AID Number:
6carrple: SAV�2017-99999
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Division 12 Environmental Office
Agency/Consultant Company: NC DOT

Othe r:
5d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
5d7. Jurisdictional determination upload
aick 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 r No �' Unknown
7. Future Project Plans
7a. Is this a phased project? *
f Yes �' 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 activit�/? 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 Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
r Wetlands �J Streams-tributaries r Buffers
r Open Waters r Pond Construction
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. Reason for impact*3b.lmpact 3c. Type of impact*3d. Stream name * 3e. Stream 3f. Type of 3g. Stream 3h. Impact sqfe�
type * Type * Jurisdiction * width * length *
g� Bypass pumping T Dewatering Ut to Catawba River Intermittent Both 3 40 1
N�p label (e.g. F3�ad Qossing F2rrranent (Fj or F2rennial (F$Z) or Average (linear feet) Z
1) Terrporary (lj intermittent (If� (feet) 0
*� 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:
0
3i. Total temporary stream impacts:
40
3i. Total stream and tributary impacts:
40
3j. Comments:
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:*
NCDOT plans to embed riprap into stream to help dissipate energy.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*
Minimization of impacts by installing appropriate erosion control measures.
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?
f Yes �' No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
Failing concrete ditch replacement with embedded riprap.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
�** Recent changes to the stormwater rules have required updates to this section .`��
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection
Rules?
C' Yes r No
For a list of options to meet the diffuse flow requirements, click here.
If no, explain why:
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250? *
l•' Yes C' No
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 l" 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
Comme nts: *
The project is listed as a type and class of activity which qualifies as a Non-major action under the Minimum
Criteria rules; therefore, a minimum criteria checklist as been completed for the stream stabilization project.
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification Rules (15A NCAC 2H .0500), Isolated Wetland Rules (75A NCAC 2H .7300), or
DWR Surface Water or Wetland Standards or Riparian Buffer Rules (75A NCAC 2B .0200)?*
f Yes l•' No
2b. Is this an after-the-fact permit application?*

r Yes r No
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 C•' No
3b. If you answered "no," provide a short narrative description.
The project is a Minimum Criteria Project with little anticipated future impacts.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
f Yes r No �' f�/A
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? *
f• Yes �' No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
G' Yes C' No
5c. If yes, indicate the USFWS Field Office you have contacted.
Asheville
5d. Is another Federal agency involved?*
C' Yes G' No
5e. Is this a DOT project located within Division's 1-8?*
f Yes C No
5f. Will you cut anytrees in order to conduct the work in waters of the U.S.?*
C Yes r No
5g. Does this project involve bridge maintenance or removal?*
C' Yes C No
C' Unknown
Link to the NLEB SLOPES document: http://saw-reg.usace.arrny.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.?*
f 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 Program database and on-site surveys. Division 12 is located in the wtiite nose syndrome
area; however, there are no known hibernacula or roosting trees in the Division 12 counties; therefore, a NLEB
consultation form was completed (See attached).
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? *
Per Natural Heritage database no salt marshes, oyster reefs, or sea-grass beds located in vicinity of the project.

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 history and archaeology)?*
f Yes �' No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources? *
Project occurs within previously disturbed NC DOT Right of Way.
7c. Historic or Prehistoric Information Upload
C]ick 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?*
f Yes �' No
8c. What source(s) did you use to make the floodplain determination?*
FEMA
Miscellaneous
Miscellaneous attachments not previously requested.
aick the upload button or drag and drop files here to attach docurrent
Area to be reconstructed.pdf
Area to be reconstructed2.pdf
Area to be stabilized_retaining wall.pdf
Condition of banks.pdf
Cover Letter.pdf
DS of area to be be reconstructed.pdf
DS of area to be reconstructed.pdf
DS of area to be stabilized_retaining wall.pdf
Existing concrete debris.pdf
Flood.pdf
Insized channel.pdf
10B in stream.pdf
JD Form.pdf
Looking US at end of construction.pdf
retaining wall.pdf
StreamForm.pdf
StreamlinedConsultationForm.pdf
TE_memo.pdf
Fle rrust be FDF or KNQ
Signature
�7 By checking the box and signing below, I certify that:
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■ 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:*
Jeffrey L Wyatt
Signature
�� �
Initial Review
Is this project a public transportation project?* (�)
l•' Yes f No
Change only 'rf needed.
Has this project met the requirements for acceptance in to the review process? *
C•' Yes
C' No
BIMS # Assigned *
20180482
Version#*
1
Reviewing Office *
Mooresville Regional Office - [phone]
Select Project Reviewer*
Donna Hood:eads\drhood
Is a payment required for this project?*
r No payment required
f Fee received
f Fee needed - send electronic notification