20160071 Ver 2_PCN Form Submission_20180515

Action History (UTC-05:00) Eastern Time (US & Canada)
�brrrit by Anonymous User 5/15/2018 4:41:35 PM (Start Event)
Accept by Carpenter,Kristi 5/15/2018 4:51:44 PM (DOT Initial Review)
. The task was assigned to Carpenter,Kristi. The due date is: May 18, 2018 5:00 PM 5/15/2018 4:43 PM

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�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:*
Johnston
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 f• No
1a. Type(s) of approval sought from the Corps:*
r% 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)
r Standard (IP)
This form may be Corps to initiate the standard/individual permit process. Please contact your Corps representative for submittal of standard permits.
All required items that are not provided in the E-PCN and be added to the miscellaneous upload located at the bottom of this form.
Nationwide Permit (NWP) Number: 14 - Linear transportation
NWP Number Other:
List all MN nurrbers you are applying for not on the drop down list.
1c. Type(s) of approval sought from the DWR:*
check all that apply
�7 401 Water Quality Certification - Regular r 401 Water Quality Certification - E�ress
r Non-404 Jurisdictional General Permit r% Riparian Buffer Authorization
r Individual Permit
*
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
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
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?*
David DeYoung, Economic & Community Development Director
1b. PrimaryContact Email:*
ddeyou [e-mail]
1c. PrimaryContact Phone:*
(xxx)xxx-xxxx
[phone]
1d. Who is applying for the permit?
r Owner r% Applicant (other than owner) r% Agent/Consultant
(Checkall that apply)
2. Owner Information
2a. Name(s) on recorded deed:
Town of Clayton
2b. Deed book and page no.:
2c. Responsible party:
(for Corporations)
David DeYoung
2d. Address
Street Address
111 East Second Street
Address Line 2
a�y
Clayton
Rutal / Zip Code
27520
2e. Telephone Number:
(xxx)xxx-xxxx
[phone]
2f. Fax Number:
(xxx)xxx-xxxx
2g. Email Address:*
[e-mail]
State / Rovince / fZegion
NC
Cour�try
USA

3. Applicant Information (if different from owner)
3a. Applicant is:
l•' Agent
C' Other
If other please spec'rfy.
3b. Name:
3c. Business Name:
(if applicable)
3d. Address
Street Address
Address Line 2
a�y
Fbstal / Zip Code
3e. Telephone Number:
(xxx)xxx-xxxx
3f. Fax Number:
(xxx)xxx-xxxx
3g. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
David G. Cooper
4b. Business Name:
(if applicable)
Ecological Engineering, LLP
4c. Address
Street Address
1151 SE Cary Parkway
Address Line 2
a�y
Cary
Fbstal / Zip Code
27518
4d. Telephone Number:
[phone]
(xxx)xxx-xxxx
4e. Fax Number:
(xxx)xxx-xxxx
4f. Email Address:*
[e-mail]
Agent Authorization Letter*
Rease provide the Agent Authorization Letter iF you are subrritting this docurrent.
AgentAuthorization_SamsBranch.pdf
RLE NFE M.JST BE FDF
State / Rovince / I�gion
Cour�try
State / Rovince / F�gion
NC
Country
USA
37.24KB

C. Project Information and Prior Project History
1. Project Information
1a. Name of project:*
Sam's Branch Greenway, O'Neil St. to City Road, Version 2
1b. Subdivision name:
(if appropriate)
wa
1c. Nearest municipality/town:*
Clayton
1d. Driving directions*
If it is a new project and can not easily be found in a GPS rrapping system Rease provide directions.
Project begins west of O'Neil St. across from the existing Sam's Branch Greenway, and follows Sam's Branch west to Legend Park at City
Road in Clayton.
2. Project Identification
2a. Propertyldentification Number:
(tax RN or parcel ID)
Multiple private and town-owned parcels
2b. Propertysize:
(in acres)
Study area 21.5 acres across multiple parcels
2c. Project Address
Street Address
1313 N. O'Neil Street
Address Line 2
aty
Clayton
Rutal / Zip Code
27528
2d. Site coordinates in decimal degrees
State / Rovince / FZegion
NC
Country
USA
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�mple, most mobile phones with GPS provide locational precision in decimal degrees to
map coordinates to 5 or 6 digits after the decimal place.)
Latitude: *
35.665472
ex:34208504
3. Surface Waters
Longitude:*
-78.450852
-77.796371
3a. Name of the nearest body of water to proposed project:'�
Sam's Branch
3b. Water Resources Classification of nearest receiving water:*
WS-IV; NSW
Surface Water Lookup
3c. What river basin(s) is your project located in?*

Neuse
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 proposed multi-use trail, located in the Town of Clayton, consists of 1.25 miles of asphalt and boardwalk
greenway trail. The trail will connect to an existing trail section at O'Neil Street, and will progress west to Legend
Park at City Road. Ebsting conditions in the project vicinity include forested floodplain, agricultural fields, athletic
fields, community parks, sewer easements, and a pond dam. Surrounding land use is primarily agriculture, forest,
and single family residential. The Town of Clayton is in the process of acquiring land and easements the length of
the corridor. Land acquisitions and easements will be finalized prior to construction.
4b. Attach an 8 7/2 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 docurrent
USGS_Revised_LetterSizePortrait.pdf 2.87MB
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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)
Qick the upload button or drag and drop files here to attach docurrent
SoilSurvey_Revised_LetterSizePortrait.pdf 1.55MB
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4d. List the total estimated acreage of all existing wetlands on the property:
2.0
4e. List the total estimated linear feet of all existing streams on the property:
(interrrittent and perennial)
1,495
4f. Explain the purpose of the proposed project:*
The greenway will add to the e�sting Town of Clayton trail network. This trail section will serve as a connection
between an ewsting trail section and Legend Park. The completion of this greenway project will support bicycle
and pedestrian travel between residential and recreational centers creating a well-rounded integrated
transportation system through the Town of Clayton.
4g. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:'�
Version 2 of this application includes a revision to the proposed trail route that decreases buffer impacts and adds
10LF of stream impact for stabili�ation. The Town of Clayton, Johnston County, proposes to construct the Sam's
Branch Greenway, consisting of 1.25 miles of asphalt and boardwalk greenway trail from O'Neil Street west to City
Road. The greenway will begin at O'Neil Street as a 10-foot wide asphalt trail, and will progress west within Town
property, right-of-way, and easements, crossing three tributaries with boardwalk and Sam's Branch with a bridge.
Three wetlands will be crossed at their narrowest points with boardwalk.
The location of the proposed trail avoids and minimizes impacts to jurisdictional resources to the mabmum extent
practicable. Where feasible, boardwalk will be used to further avoid and minimize impacts to jurisdictional
resources. The contractor selected for the project will determine the equipment used on the project. Trail
contractors generally use small paving machines and earth moving equipment which results in smaller impacts to
the project area than traditional highway construction equipment. Nationwide Permit 14 General Conditions will be
included in the construction documents to direct contractor operations in and around wetlands.
4h. Please upload project drawings for the proposed project.
C7ick the upload button or drag and drop files here to attach docurrent
H14009_half_size_set.pdf 2.95MB
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5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
f' Yes C' No �' Unknown
Comme nts:

5b. If the Corps made a jurisdictional determination, what type of determination was made?*
f•' Preliminary C' Approved C' Unknown C' f�UA
Corps AID Number:
6carrple: SAV�2017-99999
SAW-2016-00301
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Othe r:
Lane Sauls, Ed Hajnos, David Cooper
Ecological Engineering, LLP
5d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
USACE: David Shaeffer, April 2, 2015
NCDWR: James Graham, April 6, 2015
5d1. Jurisdictional determination upload
Click the upload button or drag and drop files here to attach docurrent
NWP14Verification_SamsBranchGreenway_20160212.pdf 4.47MB
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6. Project History
6a. Have permits or certifications been requested or obtained for this project (including all prior phases) in the past? *
C•' Yes f' No l" Unknown
6b. If yes, please give the DWR Certification number or the Corps Action ID (exp. SAW-0000-00000).
USACE: SAW-2016-00301
NCDWR project number: 20160071
Project History Upload
C7ick the upload button or drag and drop files here to attach document
NCDWR_BufferApproval_Received20160223.pdf 270.78KB
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7. Future Project Plans
7a. Is this a phased project?*
f• Yes l" No
7b. If yes, explain.
The proposed greenway between O'Neil Street and Legend Park at City Road is Phase 2 of the Sam's Branch
Greenway project. Phase 1 of the greenway is complete between the Neuse River and O'Neil Street. Future plans
for this greenway include an e�ension west to Clemmons Educational State Forest.
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 Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
rJ 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* 2b. Impact type * 2c. Type of wetland *
4. Hand Clearing, Temp. Fill T
Nbp label (e.g. Id�ad CYossing 1- Qilvert, F2rrranent (P) or
dewatering, etc) Terrporary (�
5. Hand Clearing, Temp. Fill T
N�p label (e.g. Fd�ad Qossing 1- Qalvert, F2rrranent (� or
dewatering, etc) Terrporary (�
7. Hand Clearing, Temp. Fill T
fv�p label (e.g. Finad Qossing 1- Qalvert, �rrranent (� or
dewatering, etc) Terrporary (�
8. Hand Clearing, Temp. Fill T
N�p label (e.g. f3�ad Qossing 1- Qalvert, F2rrrenent (P� or
dewatering, etc) Terrporary (�
10.Hand Clearing, Temp. Fill T
N�p label (e.g. f3�ad Qossing 1- Qalvert, F�rrranent (Fj or
dewatering, etc) Terrporary (�
Bottomland Hardwood
Forest
Bottomland Hardwood
Forest
Bottomland Hardwood
Forest
Bottomland Hardwood
Forest
Bottomland Hardwood
Forest
2d. Wetland name *Ze. 2f. Type of
Forested* Jurisdicition*
Wetland E Yes Both
(404, 10) or D✓VR (401
other)
Wetland H Yes Both
(404, 10) or D✓VR(401
other)
Wetland G Yes Both
(404, 10) or C!✓VR (401
other)
Wetland G Yes Both
(404, 10) or D✓�ft(401
other)
Wetland A Yes Both
(404, 10) or [7✓�R(401
other)
2g. Total Temporary Wetland Impact
0.040
2g. Total Permanent Wetland Impact
0.000
2g. Total Wetland Impact
0.040
2h. Comments:
Trail construction will be limited to upland areas to the extent practicable. Impacts to tributaries and wetlands will
be avoided and minimized by the construction of elevated boardwalk segments. A small area of hand clearing of
wetlands will be required in order to construct these boardwalks. 0.04 acres of impacts to jurisdictional wetlands
will occur within the project corridor.
2g.lmpact
area *
0.004
(acres)
0.000
(acres)
0.006
(acres)
0.020
(acres)
0.010
(acres)
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 *
S1 1. Boardwalk 7, Eros. P Stabilization Stream F Intermittent Both 2 70 2
Ctrl. F2rrranent (Fj or F2rennial (� or Average (linear feet) 0
fv�p label (e.g. f3�ad C7ossing Terrporary (� interrrittent (IfVn (feet)
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:
10
3i. Total temporary stream impacts:
0
3i. Total stream and tributary impacts:
10
3j. Comments:

6. Buffer Impacts (for DWR)
ff project will impact a protected riparian buffer, then complete the chart below. Individually list all buffer impacts below.
6a. Project is in which protect basin(s)? *
Check all that apply.
�7 Neuse r Tar-Pamlico
r Catawba r Randleman
r Goose Creek r Jordan Lake
r Other
6b. Impact Type * 6c. Per or
Temp*
Site 1, Allowable P
Location and Exerrpt, Allowable, allowable w/ F2rrranem (Fj or
rritigation Terrporary (�
Site 2, Allowable P
Location and 6cerrpt, Allowable, allowable w/ F2rrranent (Fj or
rritigation Terrporary (lj
Site 3, Allowable P
Location and 6cerrpt, Allowable, allowable w/ F�rrranent (� or
rritigation Terrporary (lj
Site 6, Allowable P
Location and 6cerrpt, Allowable, allowable w/ F2rrranent (P) or
rritigation Terrporary (�
Site 9, Allowable P
Location and 6cerrpt, Allowable, allowable w/ F2rrranent (F9 or
rritigation Terrporary (�
Site 71, Allowable P
Location and Exerrpt, Allowable, allowable w/ F2rrranent (Fj or
rritigation Terrporary (�
Site 72, Allowable P
Location and Exerrpt, Allowable, allowable w/ F�rrranent (Fj or
rritigation Terrporary (�
6h. Total buffer impacts:
Zone 1
Temporary impacts: 0.00
Zone 1
Permanent impacts: 19,308.00
6d. Stream name *
Stream F
Sam's Branch
Sam's Branch
Stream E
Sam's Branch
Stream C
Stream B
Zone 2
0.00
Zone 2
12,863.00
6e. Buffer mitigation
required?*
No
No
No
No
No
No
No
Zone 1 Zone 2
Total buffer impacts: 19,308.00 12,863.00
6i. Comments:
Version 2 reduces buffer impacts from Version 1 of this application. Greenway trails are an allowable use within
buffer zones. The trail and culverts are designed to only allowfor flowwhich is naturally conveyed through the
existing landscape.
Supporting Documentation - i.e. Impact Maps, Plan Sheet, etc.
C7ick the upload button or drag and drop files here to attach docurrent
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E. Impact Justification and Mitigation
6f. Zone 1
impact *
4,245
(square feet)
3,557
(square feet)
0
(square feet)
3,222
(squarefeet)
7,144
(squarefeet)
3,466
(square feet)
3,674
(square feet)
6g. Zone 2
impact *
2,282
(square feet)
3,318
(squarefeet)
153
(square feet)
1,416
(squarefeet)
2,909
(squarefeet)
7,332
(squarefeet)
7,453
(squarefeet)

1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:*
The construction of the Sam's Branch greenway trail will result in minimal stream impacts. Wetland impacts are
0.04 acres for the project. The following measures have been taken to avoid and minimize impacts to jurisdictional
waters:
Corridor Alignment — The horizontal corridor alignment was designed to avoid and minimize impacts to wetlands,
streams, and buffers to the extent practicable.
Trail Design — Sections of trail which cross wetlands and tributaries will be constructed using elevated boardwalk to
avoid impacts to these waters. The single stream crossing of Sam's Branch will be a 60-foot long bridge spanning
the entire channel.
Minimize Stream Crossings - A detailed analysis was performed at all proposed stream crossings to identify the
best crossing location. This analysis included locating narrow crossing locations and, where feasible, crossing
perpendicular to the stream. Boardwalks and a bridge will be used to cross streams.
Minimize Grading — The trail has been designed, to the extent possible, to match epsting grade in order to
minimize the amount of fill, reducing the overall project footprint, and thus the impacts to jurisdictional resources.
Minimize Clearing — Where feasible, the trail has been located within cleared sewer easements and parklands,
minimizing tree clearing in regulated buffer areas and jurisdictional waters.
Stormwater Treatment — All ditches have been designed to outlet as diffuse flow.
Erosion Control — Silt fence will be installed along fill slopes and upstream of all wetlands and streams. Tree
protection fence will be utilized to demarcate buffer zones in order to maximize protection of riparian areas during
construction.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*
The contractor shall be responsible for minimizing impacts through construction techniques. The bid specifications
will call for, where possible, hand clearing, the use of construction mats and low impact machines in sensitive
areas, and small paving machines. Multiple construction entrances have been provided to minimize heavy
equipment trip distances. Nationwide 14 General Conditions will be included in the construction specifications.
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 C No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
Buffer impacts are allowable for greenway projects. Stream and wetland impacts are below mitigation thresholds, and all practicable
avoidance and minimization methods have been employed.
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?
f• Yes �' No
1b. All buffer impacts and high ground impacts require diffuse flow or other form of stormwater treatment. If the project is subject to a
state implemented riparian buffer protection program, include a plan that fully documents how diffuse flow will be maintained.
All Stormwater Control Measures (SCM)s must be designed in accordance with the NC Stormwater Design Manual. Associated
supplement forms and other documentation shall be provided.
What type of SCM are you providing?

r Level Spreader
r Vegetated Conveyance (lower SHWT)
r Wetland Swale (higher SMNT)
r Other SCM that removes minimum 30% nitrogen
(check all that apply)
For a list of options to meet the diffuse flow requirements, click here.
Diffus Flow Documentation
Qick the upload button or drag and drop files here to attach docurrent
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2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250? *
f Yes C No
2b. Does this project meet the requirements for low density projects as defined in 15A NCAC 02H .1003(2)?*
f• Yes
f No
To look up low density requirement click here 15A NCAC 02H .1003(2).
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?*
G Yes C' 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 (NEPAISEPA)?*
f• Yes �' No
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
NEPAor SEPAfinal approval letter.)*
l" Yes l•' No
Comme nts: *
Comments: The Town of Clayton has coordinated with NCDOT and FHWA regarding environmental
documentation. A Programmatic Categorical Exclusion (PCE) was submitted to NCDOT/FHWA in December, 2015.
The approved, signed PCE dated 5/16/2016 is attached.
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 (15A NCAC 2B .0200)?*
f Yes C•' No
2b. Is this an after-the-fact permit application?*
f Yes �' 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 qualit�/?*
f Yes C•' No
3b. If you answered "no," provide a short narrative description.
This greenway connector segment is not expected to catalyze additional surrounding development.

4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
l' Yes C No C' rUA
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?*
f Yes r No
5d. Is another Federal agency involved?*
C' Yes C•' No
5e. Is this a DOT project located within Division's 1-8?*
f Yes C No
5f. Will you cut any trees in order to conduct the work in waters of the U.S.?
l•' Yes C' No
5g. Does this project involve bridge maintenance or removal?
f Yes C No
C' Unknown
Link to the NLEB SLOPES document: http://saw-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)?*
f Yes f• 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 C•' No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
Ecological Engineering reviewed the USFWS list of federally protected species documented from Johnston County
and the NC Natural Heritage Program database, conducted habitat evaluations, and surveyed for federally
protected species for which potentially suitable habitat was found within the study area. Additionally, Ecological
Engineering staff coordinated with and performed a mussel screening survey with a qualified biologist (Logan
Williams). No protected species were observed within the study area and no evidence of mussels was observed.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
f Yes �' No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat? *
NOAA Fisheries Service Essential Fish Habitat Mapper website/database
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)?*
C' Yes C•' No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources? *
Stewart Engineering coordinated with the State Historic Preservation Office (SHPO). On 2/20/2015, the SHPO
issued a letter stating that no documented historic resources would be affected by the project, and offered no
comment on the project as proposed. The project was assigned SHPO identification number ER 15-0109.
7c. Historic or Prehistoric Information Upload

aick the upload button or drag and drop files here to attach docurrent
ER 15-0109_SHPOLetter.pdf 100.55KB
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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 C' No
8b. If yes, explain how project meets FEMA requirements:
The project has been coordinated through the Local Floodplain administrator and the NC Floodplain Mapping
Program. A No-rise Certification was submitted on 08/04/2015, and subsequently approved, for a proposed
greenway crossing within a FEMA detailed study area.
8c. What source(s) did you use to make the floodplain determination?*
NC Floodplain Mapping Program
Miscellaneous
Miscellaneous attachments not previously requested.
Qick the upload button or drag and drop files here to attach docurrent
115530LB_PCE Sams Branch Greenway Approved_Signed_Sealed.pdf 6.25MB
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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 Act°);
■ 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:*
David G. Cooper
Signature
��.lr�'�C_�. L. •�04��
Initial Review
Is this project a public transportation project?* (')
C•' Yes f" No
C�ange only 'rf needed.
Has this project met the requirements for acceptance in to the review process? *
C•' Yes
l' No
BIMS # Assigned *
20160071
Version#*

Reviewing Office *
Central Office - [phone]
Select Project Reviewer*
Rob Ridings:eads\rgridings
Is a payment required for this project?*
f No payment required
C' Fee received
r Fee needed - send electronic notification
What amout is owed?*
f• $240.00
f $570.00