20190529 Ver 1_PCN Form Submission_20190425

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 *
20190529
Is a payment required for this project?*
f No paymentrequired
� Fee received
f Fee needed - send electronic notification
Select Project Reviewer"
Kevin Barnett:eads\khbarnett
Information for Initial Review
1a. Name of project:
East Vineyard Road Improvement
1a. Who is the PrimaryContact?*
Patrick J. Breedlove
1b. PrimaryContact Email:*
pj breed love@ncd ot.gov
Date Submitted
4/25/2019
Nearest Body of Water
Shooting Creek
Basin
Hiwassee
Water Classification
Class C : Tr.
Site Coordinates
Latitude:
3520621
Longitude:
-83.65772
A. Processing Information
County (or Counties) where the project is located:
Clay
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:
WBS # (�)
80047
1a. Type(s) of approval sought from the Corps:
Ve rsion# *
1
Reviewing Office *
Asheville Regional Office - (S28) 296-4500
1c. PrimaryContact Phone:*
(82S)631-1145
::

�J 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?
C' Yes r No
Nationwide Permit (NWP) Number:
14 - Linear transportation
NWP Numbers (for multiple NWPS):
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
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
East Vineyard - Clay County - Mitigation Acceptance Letter.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 - Division 14
2b. Deed book and page no.:
2c. Responsible party:
2d. Address
Street Address
253 Webster Road
Address Line 2
�Y
Sylva
Fbstal / Zip Code
28779
2e. Telephone Number:
(82S)631-1145
S[ate / FYovince I Region
North Carolina
Cauntry
United States
2f. Fax Number:
(82S)586-4043
637.88KB
x
C' Yes R No
C' Yes G No
�,

2g. Email Address:*
pj b r e e d I o v e@ n cd o t. g o v
C. Project Information and Prior Project History " I
1. Project Information
1b. Subdivision name:
(rf appropriate)
1c. Nearest municipality/town:
Hayseville
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:*
Shooting Creek
3b. Water Resources Classification of nearest receiving water:*
Class C : Tr.
3c. What river basin(s) is your project located in?*
Hiwassee
3d. Please provide the 12-digit HUC in which the project is located.
060200020105
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:*
Existing conditions are a paved secondary road that crosses (4) unnamed tributaries to Shooting Creek. Project area is located within a rural residential community with large agriculture
fields nearby with large forested land tracts in project proximity. The secondary road provides access to local traffiq emergency traffic (volunteer fire department) and commercial traffic
(commercial business).
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
� Yes r No � Unknown
4d. 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)
East Vineyard - Clay County - Topo Project Map.pdf
765.OSKB
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)
East Vineyard - Clay County - NRCS Soil Map.pdf 304.08KB
4f. List the total estimated acreage of all existing wetlands on the property:
1.00
4g. List the total estimated linear feet of all existing streams on the property:
1,400
4h. Explain the purpose of the proposed project:*
The purpose of project is to slightly widen secondary road and reconstruct roadway curve to a lesser skew for traffic. Construction will bring secondary road to current NCDOT
standards, establish roadway shoulders and resolve safety issues for commercial and emergency traffic.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
NCDOT contractor will install erosion and sediment control measures. NCDOT contractor will install diversion and pump around devices at Site 1, Site 5, Site 6, Site 7 and Site 11.
Culverts will be replaced and e#ended and gabion walls at Site 9 and Site 12 will be constructed. Diversion and pump around devices will be removed. Roadway shoulder and base will
be constructed and roadway curve will be constructed on a lesser skew. Once grading allows final paving will be completed. Roadway will be constructed utilizing the following
equipment: excavator, dozer, dump trucks, paving equipment, pumps and various hand tools.
4j. Please upload project drewings for the proposed project.
East Vineyard - Clay Counry - Design Permit Plans (Final).pdf 1.91 MB
5. Jurisdictional Determinations
Sa. Have the wetlands or streams been delineated on the property or proposed impact areas?*

� Yes r No r 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:
Sc. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
Sd1. Jurisdictional determination upload
East Vineyard - Clay County - JD (Final).pdf 437.82KB
6. Future Project Plans
6a. Is this a phased project?*
C' 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?
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
fJ Wetlands fJ Streams-tributaries
r Open Waters I� Pond Construction
2. Wetland Impacts
r Buffers
2a. Site #* ('-) 2a7 Reason (7) 2b. Impact type *(') 2c. Type of W. * 2d. W. name * 2e. Forested *�f. Type of 2g. Impact
Jurisdicition*(') area*
Site 2 Roadway Fill P Bottomland Hardwood Forest Unnamed No Both 0.080
(acres)
Site 3 Roadway Fill P Bottomland Hardwood Forest Unnamed No Both 0.010
(acres)
Site 4 Roadway Fill P Bottomland Hard�nrood Forest Unnamed No Both 0.020
(acres)
Site 8 Roadway Fill P Bottomland Hard�nood Forest Unnamed No Both 0.010
(acres)
Slte 10 Roadway Fill P Bottomland Hard�nrood Forest Unnamed No Both 0.010
(acres)
2g. Total Temporary Wetland Impact
0.000
2g. Total Wetland Impact
0.130
2h. Comments:
3. Stream Impacts
� 3a. Reason for impact (?) 3b.lmpact type *
S1 Site 1 Permanent
gp Site 1A Temporary
Type of impact"
2g. Total Permanent Wetland Impact
0.130
S. name *
to Shooting Creek
to Shooting Creek
3e. Stream Type" 3f. Type of
(?) Jurisdiction�`
Perennial , Both
Perennial
S. width* II3h. Impact
.*
�4�
Average(Feet) (�inearfeet)
1 1105
Average(feet) � Qinearfeet)

Site 5 Permanent Culvert UT to Shootin Creek Perennial Both 3 32
S3 9
Average (feet) Qinear feet)
� Site 5A Temporary Dewatering UT to Shooting Creek Perennial Both 3� 80
Average (feet) (linear feet)
Site 6 Permanent Culvert UT to Shootin Creek Perennial Both 1 15
SS 9
Average (feet) (linear feet)
S6 Site 6A Temporary Dewatering UT to Shooting Creek Perennial Both 1 55
Average (feet) (linear feet)
Site 7 Permanent Culvert UT to Shootin Creek Perennial Both 1 15
S7 9
Average (feet) (linear feel)
gg Site 7A Temporary Dewatering UT to Shooting Creek Perennial Both 1 55
Average (feet) (linear feet)
Site 9 Permanent Other UT to Shootin Creek Perennial Both 3 156
S9 9
Average (feet) Qinear feel)
S10 Site 9A Temporary Dewatering UT to Shooting Creek Perennial Both 3 175
Average(feet) Qinearfeet)
Site 11 Permanent Culvert UT to Shootin Creek Perennial Both 1 15
S11 9
Average(feet) Qinearfeet)
S12 Site 11A Temporary Dewatering UT to Shooting Creek Perennial Both 1 55
Average(feet) (linearfeet)
Site 12 Permanent Other UT to Shootin Creek Perennial Both 3 60
S13 9
Average(feet) (linearfeet)
S14 Site12A Temporary Dewatering UT to Shooting Creek Perennial Both 3 75
Average (feet) Qinear feet)
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
337
3i. Total stream and ditch impacts:
937
3j. Comments:
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:
The existing roadway widening is to the minimum extent necessary to allow 14' paved lanes with 3'-4' grassed shoulders and curve skew has been
designed to the minimum ex[ent necessary to provide safe lane width for local, emergency and commercial traffic. All culvert ex[ensions are due to
minor shoulder widening and both gabion walls have been designed to the minimum extent to provide lane and shoulder �nndth in the two impact areas.
1b. Specificallydescribe measures taken to avoid or minimize the proposed impacts through construction techniques:
The onsite UT's to Shooting Creek will be diverted and pumped around wfiile construction is underway for culverts and gabion walls. Erosion and
sedimentation control devices will be installed prior to ground disturbing activities. All measures listed above will aid in the prevention of sediment into
downstream habitats of Shooting Creek.
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 II� Corps
2d. If yes, which mitigation option(s) will be used for this project?
r Mitigation bank �J Payment to in-lieu fee I� 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.
� Yes r No
3i. Total temporary stream impacts:
600
J
4b. Stream mitigation requested:
(iinearfeet) 4c. If using stream mitigation, what is the stream temperature:
121 cold

4d. Buffer mitigation requested (DWR only):
(square feet)
4f. Non-riparian wetland mitigation requested:
(acres)
0.13
4h. Comments
4e. Riparian wetland mitigation requested:
(acres)
4g. Coastal (tidal) wetland mitigation requested:
(acres)
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.
c" Yes r 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?
C' Yes r No
If no, explain why:
Project is not located within a N.C. Riparian Buffer Protection Area.
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
G Yes r No
Comments:
G. Supplementary Information
1. Environmental Documentation
1a. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federallstate) land?*
r 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 PolicyAct (NEPA/SEPA)?"
� Yes r No
1c. If you answered "yes" to the above, has the document review been finalized by the State Clearing House?*
� Yes r No
Comments:
x
NCDOT MCDC Completed & Attached.
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification Rules (15A NCAC 2H .0500), Isolated Wetland Rules (15ANCAC 2H .1300), or DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15ANCAC 2B .0200)? *
C' 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.
The project is only to only widen the existing two lane secondary road to meet NCDOT standards and to change curve alignment to facilitate current
commercial traffic.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
� Yes r No � 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?*
� Yes r No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
r Yes r No
Sc. If yes, indicate the USFWS Field Office you have contacted.
Asheville
5d. Is another Federal agency involved?*
C' Yes r No
Se. Is this a DOT project located within Division's 1-8?
f Yes r No
Sf. Will you cut anytrees in order to conduct the work in waters of the U.S.?
r Yes r No
Sg. Does this project involve bridge maintenance or removal?
f Yes r No
Sh. Does this project involve the construction/installation of a wind turbine(s)?*
C' Yes r No
r Unknown
Si. 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.?
f Yes r No
Sj. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
U.S. Fish & Wildlife - ECOS - Online Mapper
Consultation Documentation Upload
East Vineyard - Clay County - NWP 14 Cover Letter.pdf
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?"
NOAA - Essential Fish Habitat
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
514.29KB
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?*
NCDOT Culture Resources Specialist
7c. Historic or Prehistoric Information Upload
East Vineyard - Clay County - Archaeological Screening.pdf
East Vineyard - Clay County - Historic Archictecture.pdf
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
r Yes �' No
Sb. If yes, explain how project meets FEMA requirements:
NCDOT programmatic agreement with N.C. Floodplain Mapping.
8c. What source(s) did you use to make the floodplain determination?*
NC Flood Maps.
Miscellaneous
Comments
2.51 MB
426MB
Miscellaneous attachments not previouslyrequested.

East Vineyard - Clay County - MCDC (Signed).pdf
East Vineyard - qay Counry - NCDNCR.pdf
East Vineyard - Clay Counry - Project Photos.pdf
East Vineyard - Clay County - Vicinity Map.pdf
East Vineyard - Clay County - Topo Project Map.pdf
East Vineyard - NCSAM Sheet - Site 1.pdf
East Vineyard - NCSAM Sheet - Site S.pdf
East Vineyard - NCSAM Sheet - Site 6.pdf
East Vineyard - NCSAM Sheet - Site 7.pdf
East Vineyard - Clay County - NWP 14 Cover Letter.pdf
East Vineyard - NCSAM Sheet - Site 11.pdf
Signature
*
,rJ By checking the box and signing below, I certify that:
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. 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:
Patrick Jeremy Breedlove
Signature
.'�jhii.�� r �%;,..,�.r5',..�.'� r
^ �
Date
4/25/2019