20190229 Ver 1_PCN Form Submission_20190222

D1�VR
�irlslan af Water Resources
Initial Review
Pre-Construction Notification (PCN) Form
September 29, 2018 Ver 3
Has this project met the requirements for acceptance in to the review process?*
F Yes
C' No
Is this project a public transportation project?"
� Yes r No
Change only rf needed.
BIMS # Assigned *
20190229
Ve rsion# *
1
Is a payment required for this project?*
f No paymentrequired
� Fee received Reviewing Office *
f Fee needed - send electronic notification Central Office -[phone]
Select Project Reviewer"
April Norton:eads\arnorton
Information for Initial Review
1a. Name of project:
Widening of NC 42 from US 421 to SR 1579 and along SR 1579 from NC 42 to SR 1538 (Central)
1a. Who is the PrimaryContact?*
NCDOT
1b. PrimaryContact Email:*
[e-mail]
Date Submitted
2/22/2019
Nearest Body of Water
Patchet Creek
Basin
Cape Fear
Water Classification
C
Site Coordinates
Latitude:
35.465381
A. Processing Information
County (or Counties) where the project is located:
Lee
Is this project a public transportation project?*
r Yes r No
Is this a NCDOT Project?*
G Yes r No
(NCDOT only) T.I.P. or state project number:
R-3830
WBS # (�)
38887.1.1
1a. Type(s) of approval sought from the Corps:
1c. PrimaryContact Phone:*
[phone]
Longitude:
-79.082738
::

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?
r Nationwide Permit (NWP)
rJ Regional General Permit (RGP)
� Standard (IP)
1c. Has the NWP or GP number been verified bythe Corps?
F Yes r No
Regional General Permit (RGP) Number:
198200031 - NCDOT Bridges, Widening Projects 2015
RGP Numbers (for multiple RGPS):
1d. Type(s) of approval sought from the DWR:
fJ 401 Water Quality Certification - Regular
r' Non-404 Jurisdictional General Permit
r Individual Permit
1e. Is this notification solelyfor the record because written approval is not required?
Forthe record onlyfor DWR401 Certification:
For the record onlyfor Corps Permit:
r 401 Water Quality Certification - E�ress
r Riparian Buffer Authorization
x
C' Yes R No
C' Yes G No
1f. Is this an after-the-fact permit application?*
� Yes r No
1g. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
F Yes r No
1g. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
� Yes r No
Acceptance LetterAttachment
R-3830 Revised - STR - RW - CF 04.pdf
1h. Is the project located in any of NC's twenty coastal counties?
C' Yes r No
1j. Is the project located in a designated trout watershed?
� Yes r No
B. Applicant Information
1d. Who is applying for the permit?
rJ Owner r Applicant (other than owner)
1e. Is there an Agent/Consultant for this project?
� Yes r No
2. Owner Information
2a. Name(s) on recorded deed:
NCDOT
2b. Deed book and page no.:
2c. Responsible party:
2d. Address
Street Address
1000 Birch Ridge Road
Address Line 2
Century Center Building A
ary
Raleigh
Postal / Zip Code
27610
2e. Telephone Number:
[phone]
State / Rovince / Region
NC
Country
USA
2f. Fax Number:
67.S4KB
�,

2g. Email Address:*
[e-mail]
C. Project Information and Prior Project History "
1. Project Information
1b. Subdivision name:
(rf appropriate)
1c. Nearest municipality/town:
Sanford
2. Project Identification
2a. Property Identification Number:
2c. Project Address
Street Address
Address Line 2
ary
Postal I Zip Code
2b. Property size:
State / Aovince / Region
Country
3. SurFace Waters
3a. Name of the nearest body of water to proposed project:*
Patchet Creek
3b. Water Resources Classification of nearest receiving water:*
C
3c. What river basin(s) is your project located in?*
Cape Fear
3d. Please provide the 12-digit HUC in which the project is located.
030300040201,030300040202,030300040101,030300040204,030300040105
4. Project Description and History
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:*
NC 42 is a rural, two-lane undivided North Carolina Secondary Route.
46. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
f Yes �' No r Unknown
4d. Attach an 8 1/2 X 77 excerpt from the most recent version of the USGS topogrephic map indicating the location of the project site. (for DWR)
4e. 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)
4f. List the total estimated acreage of all existing wetlands on the property:
4.9 ac.
4g. List the total estimated linear feet of all existing streams on the property:
1,300 linear feet
4h. Explain the purpose of the proposed project:*
To improve the safety and traffic operations along NC 42/SR 1579 (Broadway Road).
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
The project is designed as a four-lane, median divided facility along NC 42, from US 421 to the existing five-lane section at the US421 interchange, and from there to SR 1579, at NC
42. The remainder of the project will be a three-lane facility with a continuous center turn lane. Standard road building equipment, such as trucks, dozers, and cranes will be used.
4j. Please upload project drawings for the proposed project.
R3830_roadway combined.pdf 13.47MB
R-3830_Hyd_Permit_Drawings_2018-10-15.pdf 7.42MB
5. Jurisdictional Determinations
Sa. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes r No C' Unknown
Comments

Sb. If the Corps made a jurisdictional determination, what type of determination was made?*
� Preliminary r Approved � Not Verified � Unknown r WA
Corps AID Number:
SAW-2011-00310
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Anna Reusche
Agency/Consultant Company: Kimley-Fbrn, Inc.
Other:
5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
Preliminary JD dated S/23/2012. Field visit dated 7/24/2012 conducted by Ronnie Smith. NCDWR stream call letter from Mason Herndon dated 9/7/2012.
Sd1. Jurisdictional determination upload
2011-00310 PJDJId.pdf 2.54MB
NCDWQ_Lee R-3830 Stream Call Letter-signed.pdf 150.62KB
6. Future Project Plans
6a. Is this a phased project?"
� 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 activit�/?
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
17 Wetlands 117 Streams-tributaries � Buffers
� Open Waters I� Pond Construction
2. Wetland Impacts
3. Stream Impacts
2g. Total Temporary Wetland Impact 2g. Total Permanent Wetland Impact
0.019 0.170
2g. Total Wetland Impact
0.189
2h. Comments:

❑ 3a. Reason for impact (?) 3b.lmpact type "` 3c. Type of impact* 3d. S. name * 3e. Stream Type * 3f. Type of 3g. S. width * 3h. Impact
(?) Jurisdiction* length*
Site 1- i e extension Permanent Fill SD Perennial Both 4 71
S1 D P
Average(feet) (linearfee[)
S2
Site 1-bank stabilization Permanent Bank Stabilization SD Perennial DWR 4 14
Average(feet) (linearfeet)
Site 1-bank stabilization Tem orar Bank Stabilization SD Perennial DWR 4 20
S3 P Y
Average(feet) (linearfcet)
Site 2A- i e eMension Permanent Fill SC Perennial Both 4 78
S4 p P
Average(feet) pinearfeet)
S5
Site 2A-bank stabilization Permanent Bank Stabilization SC Perennial DWR 4 18
Average(Feet) pinearfeet)
Site 2A-bank stabilization Tem orar Bank Stabilization SC Perennial DWR 4 43
S6 P Y
Average(feet) Qinearfeet)
Site 3A- i e extension Permanent Fill SB Intermittent Both 3 88
S7 p P
Average(feet) (linearfeet)
S8
Site 3A-bank stabilization Permanent Bank Stabilization SB Intermittent DWR 3 16
Average (feet) (linear feet)
Site 3A-bank stabilization Tem orar Bank Stabilization SB Intermittent DWR 3 25
S9 P Y
Average (feet) (linear feet)
S10 Site 5A-pipe extension Permanent Fill Patchet Creek Perennial Both 5 56
Average (feet) (linear feet)
S11 Site 5A-pipe e�ctension Temporary Fill Patchet Creek Perennial Both 5 13
Average (feet) (linear feet)
S12
Site 5A-bank stabilization Permanent Bank Stabilization Patchet Creek Perennial DWR 5 24
Average (feet) (linear feel)
Site 5A-bank stabilization Tem orar Bank Stabilization Patchet Creek Perennial DWR 5 19
S13 P Y
Average (feet) Qinear feel)
S14 Site 5B-pipe extension Permanent Fill SAA Intermittent Both 1 20
Average(feet) Qinearfeet)
S15 Site 5B-pipe extension Temporary Fill SAA Intermittent Both 1 10
Average (feet) Qinear feet)
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
385
3i. Total stream and ditch impacts:
515
3i. Total temporary stream impacts:
130
3j. Comments:
72 linear feet of permanent impact is attributed to bank stabilization at multiple sites and does not require mitigation.
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 Best Management Practices for Construction and Maintenance Activities will be adhered to. See Stormwater Management Plan for additional
measures.
1b. Specificallydescribe measures taken to avoid or minimize the proposed impacts through construction techniques:
Minimizing roadway sideslopes (max. 3:1) in vicinity of jurisdictional features. Variable width base ditches utilized to diffuse stormwater from roadway
ditches into wetlands.
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?
r Yes r No
2c. If yes, mitigation is required by (check all that apply):
rJ DWR �J Corps
2d. If yes, which mitigation option(s) will be used for this project?
r Mitigation bank rJ Payment to in-lieu fee Ir Permittee Responsible
program Mitigation

4. Complete if Making a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached.
F Yes r No
4b. Stream mitigation requested:
Qinear feet)
313
4d. Buffer mitigation requested (DWR only):
(square feet)
4f. Non-riparian wetland mitigation requested:
�acres)
4c. If using stream mitigation, what is the stream temperature:
warm
4e. Riparian wetland mitigation requested:
(acres)
0.17
4g. Coastal (tidal) wetland mitigation requested:
�acres)
4h. Comments
72 linear feet of permanent impac[ is attributed to bank stabilization and does not require mitigation.
6. Buffer mitigation (State Regulated Riparian Buffer Rules) - required by DWR
6a. Will the project result in an impact within a protected riparian buffer that requires buffer mitigation? If yes, you must fill out this entire form - please contact DWR for more
information.
� Yes (� No
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
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?
� Yes r No
If no, explain why:
This project is not within the protected riparian buffers of the Cape Fear River basin.
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
r Yes r No
Comments:
See attached permit drawings.
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?*
� Yes r No
n
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)
Environme ntal Policy Act (NEPA/SEPA)? *
F Yes r No
1c. If you answered "yes" to the above, has the document review been finalized by the State Clearing House?*
F Yes r No
NEPAor SEPAFinal Approval Letter
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)? *
f Yes r No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality?*
C' Yes r No
3b. If you answered "no," provide a short narrative description.

Implementation of the proposed Build Alternative would not contribute, in conjunction with past, present, or future projects, to substantial adverse
cumulative effects on resources in the study areas.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
f Yes r No � fWA
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?*
� Yes r No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
� Yes r No
Sc. If yes, indicate the USFWS Field Office you have contacted.
Raleigh
Sd. Is another Federal agency involved?*
C' Yes r No
Se. Is this a DOT project located within Division's 1-8?
� Yes r No
C' Unknown
S. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
N.C. Natural Heritage Program database; USFWS-Raleigh Field Office website;biological surveys for protected species listed for Lee County, which
include red-cockaded woodpecker (RCW), Cape Fear shiner and harperella. All species received biological conclusions of "No EffecY', due to no
habitat being present. There was no habitat for the bald eagle within 1.13 miles of the study area. Northern long-eared bat is covered under the PBO
developed between USFWS and NCDOT.
Consultation Documentation Upload
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
� Yes r No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
NMFS County Index
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 status?*
C' Yes r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
NEPA Documentation
7c. Historic or Prehistoric Information Upload
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
r Yes r No
Sb. If yes, explain how project meets FEMA requirements:
NCDOT Hydraulics Unit coordination with FEMA
Sc. What source(s) did you use to make the floodplain determination?*
FEMA Maps
Miscellaneous �
Comments
Miscellaneous attachments not previouslyrequested.
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 hansaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions AcP');
• 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:
Mack Christopher Rivenbark, III
Signature
Hack C. Ri,+�r,b�. l!1
Date
2/22/2019