20190269 Ver 1_PCN Form Submission_20190304

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 *
20190269
Is a payment required for this project?*
f No paymentrequired
� Fee received
f Fee needed - send electronic notification
Select Project Reviewer"
Donna Hood:eads\drhood
Information for Initial Review
1a. Name of project:
SR-244S (Old Mine Road)
1a. Who is the PrimaryContact?*
Joel Howard
1b. PrimaryContact Email:*
[e-mail]
Date Submitted
3/4/2019
Nearest Body of Water
Little Buffalo Creek
Basin
Yadkin-PeeDee
Water Classification
Class C
Site Coordinates
Latitude:
35.487054
A. Processing Information
County (or Counties) where the project is located:
Cabarrus
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:
Ve rsion# *
1
Reviewing Office *
Mooresville Regional Office - [phone]
1c. PrimaryContact Phone:*
[phone]
Longitude:
80.373201
::
WBS # (�)
10C.013066
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)
r Standard (IP)
1c. Has the NWP or GP number been verified bythe Corps?
F Yes r No
Nationwide Permit (NWP) Number:
NWP Numbers (for multiple NWPS):
Nationwide 14
1d. Type(s) of approval sought from the DWR:
fJ 401 Water Quality Certification - Regular
r' Non-404 Jurisdictional General Permit
r Individual Permit
14 - Linear transportation
1e. Is this notification solelyfor the record because written approval is not required?
Forthe record onlyfor DWR401 Certification:
For the record onlyfor Corps Permit:
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?
C' 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
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?
r Owner fJ Applicant (other than owner)
1e. Is there an Agent/Consultant for this project?
f Yes r No
2. Owner Information
2a. Name(s) on recorded deed:
Scott Cole, PE Division Engineer, Divison 10 (NCDOT)
2b. Deed book and page no.:
2c. Responsible party:
NCDOT, Division 10
2d. Address
Street Address
716 West Main Street
Address Line 2
�Y
Albemarle
Fbstal / Zip Code
28001
2e. Telephone Number:
[phone]
2g. Email Address:*
r 401 Water Quality Certification - E�ress
r Riparian Buffer Authorization
State / Aovince I F�gion
NC
Country
USA
2f. Fax Number:
[phone]
x
C' Yes R No
G Yes C' No

[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
Joel Howard, Environmental Specialist I
3b. Business Name:
NCDOT
3c.Address
Street Address
716 West Main Street
Address Line 2
ary
Albemarle
Postal / Zip Code
28338
3d. Telephone Number:
[phone]
3f. Email Address:"
jhoward@ncdotgov
S[ate / Awince I Region
NC
Country
USA
3e. Fax Number:
[phone]
C. Project Information and Prior Project History �
1. Project Information �
1b. Subdivision name:
(rf appropriate)
1 c. Nearest municipality l town:
Mt. PleasanL. NC
2. Project Identification
2a. Propertyldentification Number:
2c. Project Address
Street Address
SR-2448 (Old Mine Road)
Address Line 2
�Y
Fbstal I Zip Code
3. SurFace Waters
3a. Name of the nearest body of water to proposed project:*
Little Buffalo Creek
3b. Water Resources Classification of nearest receiving water:*
Class C
3c. What river basin(s) is your project located in?*
Yadkin-PeeDee
3d. Please provide the 12-digit HUC in which the project is located.
030401050303
4. Project Description and History
2b. Property size:
S[ate / Awince / Region
Country
Cabarrus
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:*
SR-2448 (Old Mine Road) is an unpaved secondary road in Cabarrus County. It has single family homes along the roadway mnth pasture lands that are fenced on both sides of the
road. Some Parcels have Steams within the Pastures that have Conservation Easements for Stream protection/mitigation. This area of the County is heavily used for agriculture/cattle
farming.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
C' Yes r No C' Unknown
4d. 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)
Topo Map.pdf 1.25MB

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)
20190107_10203310625_26_Soil_Map.pdf 437.97KB
4f. List the total estimated acreage of all existing wetlands on the property:
0'
4g. List the total estimated linear feet of all existing streams on the property:
60'
4h. Explain the purpose of the proposed project:*
SR -2445 (Old Mine Road) is an unpaved secondary road in Cabarrus County that the NCDOT plans to widen and pave. By widening and paving Old Mine Road the safety and
serviceability of the road will be improved for the traveling publia To obtain the necessary roadway width, NCDOT proposes to e#ended an exsting (60"x40')CMP with a new
(60"x60')CMP.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
Erosion control measures will be installed prior to any ground disturbing activities. As part of this project NCDOT
will be replacing an ewsting (60"x40') CMP and replacing it with a new (60"x60') CMP. By adding the additional 20' of pipe at permit site 1 the Department will get the necessary road
width and road shoulder to construct t�no 10' travel lanes. This vVnrk will be conducted in the dry by dewatering the permitted site prior to construction. The water will be pumped off site
or into an approved sitt bad adhering to NCDOT's best management practices for pipe construction/replacement The equipment that is required to construct this project includes, but is
not limited to: dewatering pump, trackhoe, dumptrucks, vibratory roller, motor grader and paving equipment.
One of the Conservation Easements that was mentioned earlier in this application is adjacent to the Roadway at Permit Site I. However the Stream within the Conservation Easement will
not be impacted due to our �,wrk at Permit Site 1. The only impact that we will have on the Conservation Easement is the moving of the Conservation Fence to It's proper place at the
edge of NCDOT's right-a-way. This will only take place along the roadway. (There is only about a 5' difference from wfiere it is now to wfiere it will be placed. The stream will not be
impacted inside the ebsting Conservation Easement due to our proposed work.
4j. Please upload project drawings for the proposed project.
Permit Site 1 Pipe Profile.pdf
Permit site 1.pdf
Vicinity Map.pdf
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
� Yes r No
Comments:
The USACE and NCDEQ reviewed this site with NCDOT personnel on the 3rd of January 2019
Sb. If the Corps made a jurisdictional determination, what type of determination was made?*
C' Preliminary r Approved C' Not Verified C' Unknown r WA
Corps AID Number:
Sc. If Sa is yes, who delineated the jurisdictional areas7
Name (if known): Nicholle Brasspennickx
Agency/Consultant Company:
Other:
Sd1. Jurisdictional determination upload
6. Future Project Plans
6a. Is this a phased project?*
C' Yes
USACE
r No
r Unknown
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):
� Wetlands �J Streams-tributaries
r Open Waters Ir Pond Construction
3. Stream Impacts
203.19K6
553.31 KB
303.03KB
� Buffers
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*

S1
20' of additonal CMP Permanent Culvert UT to Little Buffalo Creek Perennial Both 4 20
.4verage (feet) pinear feet)
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
20
3i. Total stream and ditch impacts:
20
3j. Comments:
No impacts will occur within the aforementioned conservation areas.
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's best management practices for the installation of culverts in jurisdictional waters will be adhered to throughout the life of the project. We are
adjusting the placement of our pipe to avoid impacting the adjacent Conservation Easement at Permit Site 1.
1b. Specificallydescribe measures taken to avoid or minimize the proposed impacts through construction techniques:
During the project all erosion control measures will be maintained. Permit site 1 will be dewatered prior to the
beginning of construction and all work will be completed in the dry.
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 r No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
The additional 20' of Impacts does not meet the threshold for Compensatory Mitigation.
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:
Little Buffalo Creek and ifs Unnamed Tributaries do not fall under any NC Riparian Buffer Protection Rules.
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:
NPDES records will be kept on site during the duration of this project. This project will have compliance inspections periodically that will be conducted by the Division 10 Environmental
office and NCDOT's area Roadside Environmental Office.
G. Supplementary Information
1. Environmental Documentation
1a. Does the project involve an expenditure of public (federallstate/local) funds or the use of public (federallstate) land?*
F 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 (NEPAISEPA)? *
r Yes r No
1c. If you answered "yes" to the above, has the document review been finalized by the State Clearing House?*
C' Yes r No
Comments:
*
The project is State Funded and falls under the Minimum Criteria Checklist.
3i. Total temporary stream impacts:
0
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
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality? *
� Yes r No
3b. If you answered "no," provide a short narrative description.
This is a stand alone project. NCDOT does not anticipate any future impacts to the downstream water quality or any additional land development.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
r Yes r No C' fWA
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
Sa. Will this project occur in or near an area with federally protected species or habitat? *
f Yes r No
Sb. Have you checked with the USFWS concerning Endangered Species Act impacts?*
f Yes r No
Sd. Is another Federal agency involved?"
� Yes r No
Se. Is this a DOT project located within Division's 1-8?
C' Yes r No
Sf. Will you cut anytrees in order to conduct the work in waters of the U.S.?
� Yes r No
Sg. Does this project involve bridge maintenance or removal?
C' Yes r No
Sh. Does this project involve the construction/installation of a wind turbine(s)?*
� Yes r No
� Unknown
Si. Does this project involve (7) blasting, and/or (2) other percussive activities that will be conducted by machines, such as jackhammers, mechanized pile drivers, etc.?
C' Yes r No
Sj. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
The North Carolina Natural Heritage Program (NCNHP) Database
Consultation Documentation Upload
project_report_sr_2448_old_mine_road_17264_17264. pdf
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat? *
C' Yes r No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat? *
South AUantic Fishery Management Council
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
1.28 MB
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?"
� Yes r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
NCDOT's Cultural Resources Staff
7c. Historic or Prehistoric Information Upload
17-12-0003_NoSu rvey. pdf
AR17-12-0003 NoSu rvey. pdf
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
C' Yes r No
2.84MB
10.2MB
Sc. What source(s) did you use to make the floodplain determination?*

FEMA Floodplain Maps website.
Miscellaneous
Comments
Miscellaneous attachments not previouslyrequested.
Old Min e Rd_PlanSheetSet_2019. pdf
2.86MB
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 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 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:
Joel M. Howard
Signature
c7�r��`fP ��lk�rrt
Date
3/4/2019