20090477 Ver 1_Application_20090428

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STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
BEVERLY EAVES PERDUE
GOVERNOR
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EUGENE A. CON TL JR. 4
SECRETARY
April 23, 2009
®94477
Mr. Steve Lund
USACE, Asheville Field Office
151 Patton Avenue, Room 208
Asheville, NC 28801-5006
SUBJECT: Emergency Pipe Replacement on SR-1527 (Meadowcreek Road), Cleveland County
Dear Mr. Lund:
The North Carolina Department of Transportation requests authorization to replace a failed pipe
on SR 1527 (Meadowcreek Road) in Cleveland County. NCDOT proposes to replace the 60-foot
long, 30" CMP with an 80-foot long, 30" HDPE. The pipe failure caused the bank to slough
off and the road to cave; therefore, the project was considered an emergency project and
construction commenced immediately. The increase in pipe length is necessary to provide an
adequate road shoulder. The skew of the new pipe will require a minor realignment (-10 feet) of
the upstream channel to better align the pipe and the channel. The streambed material will be
salvaged and utilized in the new channel and coir fiber matting will he used on the hanks/bench
for stabilization. The new pipe is on an steep slope (>4%) and the channel steepens sharply
downstream of the roadway: therefore, a 10-foot "rock ladder" will be constructed at the pipe
outlet using shot rock, which will reconnect the pipe outlet to the streambed and will also provide
energy dissipation during storm events. A temporary cofferdam pumping system will he used to
divert the stream around the construction site, as needed. Any areas affected by temporary
cofferdam system will be graded and restored back to pre-project conditions. All Best
Manaeement Practice's will be utilized during the course of the project. Due to the existing site
conditions, NCDOT requests a waiver from the Regional Conditions 2(b) (c) permit depth
specification for the construction of this project.
the total scope of the work will result in 40 feet of permanent impacts to an unnamed tributary to
Wards Creek. which is classified as Class C Waters by the Division of Water Quality.
The project area is not located within '/ mile of any critical watershed area, nor is SR 1527 a
rural or urban arterial; therefore, hazardous spill basins are not required. Enclosed is the
hazardous spill basin checklist. No sites listed on the National Register of Historic Places are
located in the vicinity of the project nor did there appear to be any eligible structures. There will
be no effect on anv for historical structures.
Post Office Box 47 Shelby, North Carolina 28151-0047

SR 1527, Meadowcreek Road
Page 2
April 23, 2009
This office has conducted a GIS and field survey for threatened and endangered species in the
vicinity of the project. The Natural Heritage Program records document the nearest dwarf-
flowered heartleaf location approximately 5.4 miles southeast of the proposed project. The
heartleaf is usually found on dry to moist ravine slopes (usually north facing and of the oak-
hickory-pine forest type) and in boggy areas near springheads. The project area is mostly rural,
forested areas. There is suitable habitat within the proposed project area, but no heartleaf species
were observed. NCDOT is recommending a finding of "no effect" for T&E species.
I have,enclosed.a pre-construction notification for a NW4 14, sketches of planned activities and
locatiowmaps relative to the project.
Project information for the 401 Automated Payment Procedure is as follows:
• Work order number: 150455-55120005-12.202321-3126
• TIP#: NA
• Project Category: $240.00 Fee
If you have any questions or concerns please feel free to contact me at [phone]. Thank you for
your time and consideration on this matter.
Respectfully yours,
M.L. Holder, P.E.
Division Engineer
Twelfth Division Q
BY:
Trish Simon
Division 12 Environmental Supervisor
Enclosures
cc: Brian Wrenn, Division of Water Quality, Transportation Permitting Unit
Polly Lespinasse, Division of Water Quality, Mooresville Regional Office
OF WATFq
Office Use Only:
??\s Corps action ID no.
? DWQ project no.
.
Form Version 1.3 Dec 10 2008
Pre-Construction Notification PCN Form
A. Applicant Information
1. Processing
la. Type(s) of approval sought from the
Corps:
®Section 404 Permit ? Section 10 Permit
11b. Specify Nationwide Permit (NWP) number: 14 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps? ? Yes ® No
1d. Type(s) of approval sought from the DWQ (check all that apply):
® 401 Water Quality Certification - Regular ? Non-404 Jurisdictional General Permit
? 401 Water Quality Certification - Express ? Riparian Buffer Authorization
1e. Is this notification solely for the record
because written approval-is not required? For the record only for DWQ 401
Certification:
? Yes ®No For the record only for Corps Permit:

? Yes ®No
1f. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in-lieu
fee program. ? Yes ® No
1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1h
below. ? Yes ® No
1h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ? Yes ® No
2. Project Information
2a. Name of project: SR-1527 (Meadow Creek Road)
2b. County: Cleveland
2c. Nearest municipality / town: Polkville
2d. Subdivision name:
2e. NCDOT only, T.I.P. or state
project no: 12 202321
3. Owner Information
3a. Name(s) on Recorded Deed: NC DOT Right of Way
3b. Deed Book and Page No.
3c. Responsible Party (for LLC if
applicable):
3d. Street address:
3e. City, state, zip:
3f. Telephone no.:
3g. Fax no.:
3h. Email address:
Page 1 of 11
PCN Form - Version 1.3 December 10, 2008 Version
4. Applicant Information (if different from owner)
4a. Applicant is: ? Agent ? Other, specify:
4b. Name: Mike Holder
4c. Business name
(if applicable): N.C. Department of Transportation, Division 12
4d. Street address: 1710 East Marion Street
4e. City, state, zip: Shelby, NC 28151
4f. Telephone no. 704-480-9020
4g. Fax no.: 704-480-5401
4h. Email address: [e-mail]
5. Agent/Consultant Information (if applicable)
5a. Name: Trish Simon
5b. Business name
(if applicable): N.C. Department of Transportation, Division 12
5c. Street address: 1710 East Marion Street
5d. City, state, zip: Shelby, NC 28151
5e. Telephone no., 704-480-9044
5f. Fax no.: 704-480-5401
5g. Email address: [e-mail]
Page 2 of 11
PCN Form - Version 1.3 December 10, 2008 Version
B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): NA
Latitude: 35.486758 Longitude: - 81.65102
1b. Site coordinates (in decimal degrees): (DD.DODDDD) (-DD DDDDDD)
1c. Property size: <0.10 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to LIT to Wards Creek (from source to First Broad River)
proposed project:
2b. Water Quality Classification of nearest receiving water: C
2c. River basin: Broad
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:
Existing 60' 30" CMP with a headwall at the outlet, landuse is mostly forested. Pipe is on unpaved secondary road.
3b. List the total estimated acreage of all existing wetlands on the property:
0 _
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
100 feet
3d. Explain the purpose of the proposed project:
The purpose of the proposed work is to replace deteriorating pipes for the safety of the travelling public.
3e. Describe the overall project in detail, including the type of equipment to be used:
NCDOT proposes to replace a deteriorating 50-foot long, 30" CMP with a 80-foot long, 30" HDPE, with a 10-foot rock
ladder constructed at the end of the culvert to reconnect the pipe outlet to the streambed. Minor stream reiocatior. (-10
ft) will be necessary to align the upstream channel and the new pipe inlet. The Project will be constructed using typical
heavy equipment (trackhoe. backhoe. etc.).

4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past? ? Yes ® No ? Unknown
Comments: Jurisdictional stream determination made by
Division 12 DEC.
4b. If the Corps made the jurisdictional determination, what type ? preliminary ? Final
of determination was made? _
4c. If yes, who delineated the jurisdictional areas? Agency/Consultant Company.
Name (if known): Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
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.
Page ; of 11
PCN Form - Version 1.3 December 10, 2008 Version
,46
6. Future Project Plans
6a. Is this a phased project? ? Yes ®No
61b. If yes, explain.
Page 4 of 11
PCN Form - Version 1.3 December 10, 2008 Version
C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
? Wetlands ® Streams - tributaries ? Buffers
? Open Waters ? Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a. 2b. 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)
Temporary T
W1 ? P ? T ? Yes ? Corps
? No ? DWQ
W2 ? P ? T ? Yes ? Corps
? No ? DWQ
W3 ? P ? T ? Yes ? Corps
? No ? DWQ
W4 ? P ? T ? Yes ? Corps
? No ? DWQ
W5 ? P ? T ? Yes ? Corps
? No ? DWQ
W6 ? P ? T ? Yes ? Corps
? No ? DWQ
2_. Total wetland impacts
2h. Comments:
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a. 3b. 3c. 3d. 3e. 3f. 3g.
Stream impact Type of impact Stream name Perennial Type of jurisdiction Average impact
number - (PER) or (Corps - 404, 10 stream length
Permanent (P) or intermittent DWQ - non-404, width (linear
Temporary (T) (INT)? other) (feet) feet)
S1 ® P ? T Increase in pipe Ut to Wards Creek ? PER ? Corps 2 20
length ® INT ® DWQ
S2 ® P ? T Rock ladder Ut to Wards Creek ? PER
® INT ? Corps
® DWQ 2 10
S3 ®P ? T Realignment of Ut to Wards Creek ? PER ? Corps 2 10
upstream channel ® INT ® DWQ
S4 ? P ® T Cofferdam bypass Ut to Wards Creek ? PER ? Corps 2 15
pumping ® INT ? DWQ
S5 ? P? T ? PER ? Corps
? INT ? DWQ
S6 ? P ? T ? PER ? Corps
? INT ?DWQ
3h. Total stream and tributary impacts 55
3i. Comments:
Page 5 of 11
PCN Form -Version 1.3 December 10, 2008 Version
4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impacts below.
4a. 41b. 4c. 4d. 4e.
Open water Name of waterbody
impact number - (if applicable) Type of impact Walerbody type Area of impact (acres)
Permanent (P) or
Temporary T
01 ?P?T
02 ?P?T
03 ?P?T
04 ?P?T
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If and or lake construction proposed, then complete the chart below.
5a. 5b., - 5c. 5d. - 5e.
Welland Impacts (acres) Stream Impacts (feet) Upland
Pond ID Proposed use or purpose (acres)
number of pond
Flooded Filled Excavated Flooded Filled Excavated Flooded
P1
P2
5f. Total
5g. Comments:
5h. Is a dam high hazard permit required?
? Yes - ? No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If an impacts require mitigation, then you MUST fill out Section D of this form.
6a.
? Neuse ?Tar-Pamlico ? Other:
Project is in which protected basin? ? Catawba ? Randleman
6b. 6c. 6d. 6e. 6f. 6g.
Buffer impact
number - Reason Buffer Zone 1 impact Zone 2 impact
Permanent (P) or for Stream name mitigation (square feet) (square feet)
Temporary T im act re uired?
B1 ?P?T ?Yes
? No
B2 ?P?T ?Yes
? No
B3 ?P?T ?Yes
? No
6h. Total buffer impacts
6i. Comments:
Page 6 of 11
PCN Form - Version 1.3 December 10, 2008 Version
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Rock ladder construction utilized out the pipe outlet to provide energy dissipation to prevent channel erosion and also to
provide some habitat connectivity between the upstream and downstream channels.--The minor change in stream alignment
on the upstream is to prevent erosion on the upstream embankment. Bed material from the old channel will be salvaged and
reused in the new channel and coir fiber matting will be utilized for bank/bench stabilization.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for
impacts to Waters of the U.S. or Waters of the State? ? Yes ® No
2b. If yes, mitigation is required by (check all that apply): ? DWQ ? Corps

2c. If yes, which mitigation option will be used for this
project? ? Mitigation bank

E] Payment to in-lieu fee program
? Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter) Type Quantity
3c. Comments:
4. Complete if Making a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached. ? Yes
4b. Stream mitigation requested: linear feet
4c. If using stream mitigation, stream temperature: ? warm ? cool ?cold
4d. Buffer mitigation requested (DWQ only): square feet
4e. Riparian wetland mitigation requested: acres
4f. Non-riparian wetland mitigation requested: acres
49. Coastal (tidal) wetland mitigation requested: acres
4h. Comments:
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
Page 7 of 11
PCN Form - Version 1.3 December 10, 2008 Version
6. Buffer Mitigation (State Regulated Riparian Buffer Rules) -required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation? ? Yes ® No
6b. If yes, then identify the square feel of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.

Zone 6c.
Reason for impact 6d.
Total impact
(square feet)
Multiplier 6e.
Required mitigation .
(square feet)
Zone 1 3 (2 for Catawba)
Zone 2 1.5
6f. Total buffer mitigation required:
6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in-lieu fee fund).
6h. Comments:
Page 8 of 11
PCN Form - Version 1.3 December 10, 2008 Version
E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
la . Does the project include or is it adjacent to protected riparian buffers identified
i ? Yes ® No
w
thin one of the NC Riparian Buffer Protection Rules?
1b . If yes, then is a diffuse flow plan included? If no, explain why.
Comments: ? Yes ? No
2. Stormwater Management Plan
2a . What is the overall percent imperviousness of this project? 0%
2b . Does this project require.a Stormwater Management Plan? ? Yes ® No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why: Com plies with NCDOT's individual
NPDES permit NCS000250.
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
? Certified Local Government
2e. Who will be responsible for the review of the Stormwater Management Plan? ? DWQ Stormwater Program
? DWQ 401 Unit
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this project? NA
? Phase II
3b. Which of the following locally-implemented stormwater management programs ? NSW
? USMP
apply (check all that apply): ? Water Supply Watershed
? Other:
3c. Has the approved Stormwater Management Plan with proof of approval been ? Yes ? No
attached?
4. DWQ Stormwater Program Review
? Coastal counties

4a.
Which of the following state-implemented stormwater management programs apply ? HQW
? ORW
(check all that apply):
? Session Law 2006-246
? Other:
4b. Has the approved Stormwater Management Plan with proof of approval been
attached? ? Yes ? No
5. DWQ 401 Unit Stormwater Review
5a. Does the Stormwater Management Plan meet the appropriate requirements? ® Yes ? No
5b. Have all of the 401 Unit submittal requirements been met? ® Yes ? No
Page 9 of 11
PCN Form - Version 1.3 December 10, 2008 Version
Fmentary Information
(DWQ Requirement)
u
oof public (federal/state/loca l) funds or the
Eannexpencliture ®Yes No
l/?
1b. If you answered "yes" to the above, does the project require preparation of an
® No
Y
environmental document pursuant to the requirements of the National or State es
?
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1c. If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval ? yes ? No
letter.)
Comments:
2. Violations (DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
d
d
l
d St
? Yes ® No
an
ar
s,
an
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wet
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. Is this an after-the-fact permit application? ® Yes ? No
2c. If you answered "yes° to one or both of the above questions, provide an explanation of the violation(s): Pipe/road failure
was considered an emergency project which required immediate repair. The DWQ regional office and USACE regulatory field
office were contacted and verbal approval for pipe repair was given.
3. Cumulative Impacts (DWQ Requirement)
3a. Will 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.
The project is a minimum criteria project which has low potential for cumulative/indirect impacts and will not result in
additional development which could impact water quality.
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.
No wastewater generated from project.
Page 10 of 11
PCN Form - Version 1.3 December 10, 2008 Version
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or ? Yes ® No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act ? Yes ® No
impacts?
Sc. If yes, indicate the USFWS Field Office you have contacted. C3 Raleigh
? Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
NC Natural Heritage Program database.
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?
No salt marshes, oyster reefs, or seagrass beds located in vicinity of project.
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation ? Yes
status
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?
The State Historic Preservation office resources and the National Register of Historic Places were reviewed for historic
sites in the vicinity of the project, however, the pipe replacement project occurs within a previously impacted area
(NCDOT Right of Way).
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain? ? Yes ® No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination? FEMA FIRM panal number: 3710261400J
I I . L.
, r d April 23, 2009
Applicant/Agent's Printed Name Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant
is provided.)
Page 11 of 11
PCN Form - Version 1.3 December 10, 2008 Version
SR 1527, Meadowcreek Road
Emergency pipe replacement
Outlet
Downstream
Upstream
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PROJECT AREA
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CLEVELAND COUNTY
SR 1527 1524 p
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MEADOW CREEK ROAD
PIPE REPLACEMENT

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Name: POLKVILLE Location: 035.4854440° N 081.6509445°W
Date: 4/17/2009 Caption: Emergency pipe replacement, SR 1527 (Meadow Creek Rd), LIT
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NCDOT
HAZARDOUS SPILL BASIN CHECKLIST
Division: 1? County: f leveInnd Project ID: 12.202321
River Basin: Broad Bridge No: NA
Route: SR 1527
Water Quality Criteria:
Stream: Ut to Wards Creek
Yes No
Stream Crossing Blue Line On USGS
ORW
WSI
WS 11,111 OR IV, Crossing Within 0.5mi of W.S. Critical Area
Roadway Criteria:
Route Designation-
Additional Site Information:
Yes No
Arterial Urban r r
Arterial Rural F r
Is a Hazardous Spill Basin Required?
Yes No
F W
F 1?
r r
r r
r P
Criteria Based Upon NCDOT "Best Management Practices for the
Protection of Surface Waters" (March, 1997).