20180877 Ver 1_401 Application_20180625

Action History (UTC -05:00) Eastern Time (US & Canada)
Submit by Anonymous User 6/25/2018 10:53:58 AM (Start Event)
Accept by Montalvo, Sheri A 6/25/2018 11:08:52 AM (Non DOT Initial Review)
The task was assigned to Montalvo, Sheri A. The due date is: June 28, 2018 5:00 PM
6/25/2018 10:55 AM

DWR
Division of water Resources
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 below are required. You will not be able to submit the form until all mandatory questions are answered.
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.govMaterResources/0/edocl6247041PCN%20Help%20File%202018-1-30.pdf
A. Processing Information
County (or Counties) where the project is located:*
Wilkes
Is this project a public transportation project?*
f Yes f• No
This is any publicly funded by nunicipal,state or federal funds road, rail, airport transportation project.
1a. Type (s) of approval sought from the Corps:*
V Section 404 Permit (wetlands, streams and waters, Clean Water Act)
F Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
1b. What type(s) of permit(s) do you wish to seek authorization?*
IJ 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: 39 - Commercial/Institutional Developments
NWP Number Other:
List all IWV nurrbers you are applying for not on the drop down list.
1c. Type(s) of approval sought from the DWR:*
check all that apply
IJ 401 Water Quality Certification - Regular r 401 Water Quality Certification - Express
F Non -404 Jurisdictional General Permit r Riparian Buffer Authorization
r Individual Permit
*
1d. Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification:
r Yes C No
For the record only for Corps Permit: C Yes O 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 mitigation bank or in -lieu fee program
f Yes C No
1f. Is the project located in anyof NC's twentycoastal counties?*
r Yes C No
1h. Is the project located in a designated trout watershed?*
f Yes f• No
Link to trout information: http://vmw.saw.usace.army.mil/Missions/Regulatory-Permit-ProgranVAgency-Coordination/Trout.aspx
B. Applicant Information
1a. Who is the Primary Contact?*
Rodney Newton
1b. Primary Contact Email:*
[e-mail]
1c. Primary Contact Phone:*
(xxx)xxx-xxxx
[phone]
1d. Who is applying for the permit?
❑ Owner r Applicant (other than owner) rJ Agent/Consultant
(Check all that apply)
2. Owner Information
2a. Name(s) on recorded deed:
Town of Wilkesboro
2b. Deed book and page no.:
DB: 0799 PG: 0363
2c. Responsible party:
(for Corporations)
Samuel Hinnant
2d. Address
Street Address
P. O. Box 218
Address Line 2
832 Main Stret
City State / Province/ Region
North Wilkesboro North Carolina
Fbstal / Zip Code Country
28569
2e. Telephone Number:
(xxx)xxx-xxxx
[phone]
2f. Fax Number:
(xxx)xxx-xxxx
2g. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)

4a. Name:
Walter Cole
4b. Business Name:
(if applicable)
S&ME, Inc.
4c. Address
Street Address
3201 Spring Forest Road
Address Line 2
city
Raleigh
Pbstal / Zip Code
27616
4d. Telephone Number:
[phone]
(xxx)xxx-xxxx
4e. Fax Number:
(XXX)XXX-XXXX
4f. Email Address:*
[e-mail]
State / Province/ Region
North Carolina
Country
United States
Agent Authorization Letter*
Reese provide the Agent Authorization Letter if you are submitting this document.
SME Agent Authorization. pdf 302.78KB
RLE TYPE M-67 BE RDF
C. Project Information and Prior Project History
1. Project Information
1a. Name of project:*
North Carolina National Gurad Regional Readiness Center Project
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality / town:
*
North Wilkesboro
1d. Driving directions*
ff it is a new project and can not easily be found in a GPS napping system Rease provide directions.
From North Wilkesboro, take Elkin Highway (NC 268) to Woodside Drive, site is located on south side of Woodside Drive before the
intersection with River Liberty Grove Church Road.
2. Project Identification
2a. Property Identification Number:
(tax RN or parcel ID)
3889-13-0527
2b. Property size:
(in acres)
379.5 total 118.92 to be conveyed to NC National Guard
2c. Project Address

Street Address
Woodside Drive
Address Line 2
Oty
State/ Province/ legion
North Wilkesboro
North Carolina
Postal / Zip Code
Country
28569
United States
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:*
36.18949 -81.10048
ex: 34.208504 -77.796371
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Yadkin River
3b. Water Resources Classification of nearest receiving water:*
C
Surface Water Lookup
3c. What river basin(s) is your project located in?*
Yadkin-PeeDee
River Basin 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 site currently consists of mostly undeveloped forested land. Surrounding land use consists of agricultural and
residential development.
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)
Click the upload button or drag and drop files here to attach docurrent
File type mist 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)
Click the upload button or drag and drop files here to attach docurrent
File type mist be pdf
4d. List the total estimated acreage of all existing wetlands on the property:
0.314
4e. List the total estimated linear feet of all existing streams on the property:
(intermttent and perennial)
5,780
4f. Explain the purpose of the proposed project:*
The proposed North Carolina National Guard Regional Readiness Center project is part of the North Carolina
National Guard's Readiness Center Transformation Master Plan which was founded to realign traditional armories
to Readiness Centers that reflect the changing needs of the state based on population and aligns forces to
regional facilities for a more efficient and effective response during natural disasters or other emergencies.
4g. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*

The North Carolina National Guard Regional Readiness Center project has a project scope of mass grading to
facilitate a pad ready site for future construction. In the future, the site will potentially include a helipad, JRSOI, and
building with all associated parking and utilities for construction, but shall not be included as part of the current
project scope. Mass grading will be completed by the National Guard using typical earth moving equipment such
as compaction equipment, bulldozers, graders, etc.
4h. Please upload project drawings for the proposed project.
click the upload button or drag and drop files here to attach docurrent
16-139 Stream Impact Map.pdf 95.5KB
16-139 Stream Impact Overall.pdf 2.72MB
File type mast be pdf
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the propertyor proposed impact areas?*
r Yes f No r Unknown
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
r Preliminary r Approved C Unknown f N/A
Corps AID Number:
Example: SokW-2017-99999
SAW -2017-01818
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
KCI Technologies
5d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
November 7, 2017
5d1. Jurisdictional determination upload
click the upload button or drag and drop files here to attach document
NCNG_Wilkesboro_Jurisdictional_Determination.pdf 342.77KB
File type must be FDF
6. Project History
6a. Have permits or certifications been requested or obtained for this project (including all prior phases) in the past?*
f Yes r No r Unknown
7. Future Project Plans
7a. Is this a phased project?*
r Yes r 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.
No
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):

❑ Wetlands V Streams -tributaries ❑ Buffers
❑ 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 s
type* Type* Jurisdiction* width* length*
S1 Building Pad, Road P Fill UT to Yadkin River Intermittent Both 3 105 3
Ivbp label (e.g. Road Grossing Permanent (F� or Perennial (PEP� or Average (linear feet) 1
1) Tenporary (T) internment (INT) (feet) s
** 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:
105
3i. Total temporary stream impacts:
0
3i. Total stream and tributary impacts:
105
3j. Comments:
E. Impact Justification and Mitigation
1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:*
The location of the building pad grading area was chosen to avoid any wetland impacts and limit the stream
impacts to 105 linear feet out of the 5,780 linear feet total on-site. Appropriate sediment and erosion control
practices equaling those outlined in the most recent version of the "North Carolina Sediment and Erosion Control
Planning and Design Manual' will be used to minimize impacts to the stream.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*
Specific attention will be paid to ensure grading is only performed to the extent needed for the proposed project
and all grading not required will be avoided. Additional impacts to the jurisdictional stream will be avoided through
the use of appropriate sediment and erosion control devices at the toe of the slope of the graded areas.
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
1dff V7
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
Stream impacts are limited to 105 linear feet which is belowthe mitigation threshold of 150 linear feet.
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 r No
For a list of options to meet the diffuse flow requirements, click here.
If no, explain why:
This project is located in the Yadkin-PeeDee River Basin which is not a buffered basin
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?
r Yes f• No
2b. Does this project meet the requirements for low density projects as defined in 15A NCAC 02H .1003(2)?*
r Yes
r 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? *
f• 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 Policy Act (NEPA/SEPA)?*
r Yes r 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
NEPA or SEPA final approval letter.)*
r Yes r No
Comments: *
The project involves public funding and will require NEPA documentation. The National Guard plans to contract out
services to complete the NEPA documentation.
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)? *
r Yes r 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?*
r Yes r No
3b. If you answered "no," provide a short narrative description.
All future development will take place in upland areas.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*

f Yes C Nor N/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?
r Yes r No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
r Yes r No
5d. Is another Federal agency involved?*
f Yes f No r Unknown
5e. Is this a DOT project located within Division's 1-8?*
r Yes r No
5f. Will you cut any trees in order to conduct the work in waters of the U.S.?
r Yes r No
5g. Does this project involve bridge maintenance or removal?
r Yes f No
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)?*
r Yes r 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.?
r Yes r No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
An official species list for any species which is listed or proposed to be listed which may be present in the area of
the proposed action was requested from the USFWS via their Information for Planning and Consultation (IPaC)
system. This species list did not identify any protected species which might be present within the area of the
proposed action. A search of the NC Natural Heritage Program (NCNHP) elemental occurrence database did not
identify any state or federally protected species within one mile of the project area. See attached IPaC report.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
r Yes r No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat? *
The USFWS website http:www.fws.gov/Raleigh including IPaC, NC Natural Heritage Program's online database,
GIS data of Elemental Occurrences and Significant Natural Heritage Areas (January 2017) for the project area
downloaded from the North Carolina Center for Geographic Information and Analysis website, NCOneMap.com,
and the Essential Fish Habitat Mapper on the NOAA Habitat Conservation Website.
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)? *
r Yes r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources? *
Review of the historic properties on the North Carolina State Historic Preservation Office Geographic Information
Systems (GIS) Virtual Workroom (Http://gis.ncdcr.gov/hpoweb/) did not reveal any historic properties within the or
its immediate vicinity. See the attached historic resources information for additional information on historic
resources identified within a one -mile search radius of the site. See attached SHPO write up
7c. Historic or Prehistoric Information Upload

Click the upload button or drag and drop files here to attach docurent
SHPO write up.pdf 2.67MB
File rust 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 r No
8c. What source(s) did you use to make the floodplain determination?*
Project Engineer and attached FEMA mapping. Site not in 100 or 500 year floodplain (in Zone X) according to Firm
Maps 3710388900J and 3170387900J. See attached FEMA mapping.
Miscellaneous
Miscellaneous attachments not previously requested.
Click the upload button or drag and drop files here to attach docurrent
FEMA Firmette.pdf 354.91 KB
IPaC Report.pdf 298.38KB
NCNHP Report.pdf 1006.79KB
File rust be FDF or KNE
Signature
rJ 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 Act');
■ 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:*
Walter Cole
Signature
Date Submitted:
6/25/2018
Initial Review
Is this project a public transportation project?* M
f Yes r No
Change only if needed.
Has this project met the requirements for acceptance in to the review process?
r Yes
f No
BIMS # Assigned*
20180877

Version#*
Reviewing Office*
Winston-Salem Regional Office - [phone]
Select Project Reviewer*
Sue Homewood:eads\slhomewood
Is a payment required for this project?*
f• No payment required
f Fee received
f Fee needed - send electronic notification