20190592 Ver 1_PCN Form Submission_20190507

DWR
IDIOM n of Water Resources
Pre -Construction Notification (PCN) Form
September 29, 2018 Ver 3
21nitial Review
Has this project met the requirements for acceptance in to the review process?*
r Yes
r No
Is this project a public transportation project?*
G Yes r No
Change only if needed.
BIMS # Assigned * Version#*
20190592 1
Is a payment required for this project?*
r No payment required
r Fee received
Reviewing Office*
r Fee needed - send electronic notification
Central Office - [phone]
Select Project Reviewer*
April Norton:eads\arnorton
Information for Initial Review
1a. Name of project:
Replace Pipe #40 2134 on SR 2835 (McKnight Mill Rd)
1a. Who is the Primary Contact?*
Division Engineer NCDOT Division 7, Mr. Mike Mills, PE
1b. Primary Contact Email:*
1c. Primary Contact Phone:*
[e-mail]
[phone]
Date Submitted
5/7/2019
Nearest Body of Water
UT to North Buffalo Creek
Basin
Cape Fear
Water Classification
WS-V; NSW; 16-11-14-1; HUC 030300020105
Site Coordinates
Latitude:
36.124814
Longitude:
-79.735000
FA. Processing Information U
County (or Counties) where the project is located:
Guilford
Is this project a public transportation project?*
r Yes r No
Is this a NCDOT Project?*
r Yes r No
(NCDOT only) T.I.P. or state project number:
WBS # (?)
17BP.7.C.14
1a. Type(s) of approval sought from the Corps:

W Section 404 Permit (wetlands, streams and waters, Clean Water Act)
r Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
1b. What types) of permit(s) do you wish to seek authorization?
W Nationwide Permit (NWP)
r' Regional General Permit (RGP)
r' Standard (IP)
1c. Has the NWP or GP number been verified by the Corps?
r Yes r No
Nationwide Permit (NWP) Number: 03 - Maintenance
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
fJ 401 Water Quality Certification - Regular
F Non-404 Jurisdictional General Permit
F Individual Permit
le. Is this notification solelyfor the record because written approval is not required?
For the record only for DWR 401 Certification:
For the record only for Corps Permit:
F 401 Water Quality Certification - Express
W Riparian Buffer Authorization
1f. Is this an after -the -fact permit application?*
r Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
r Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
r Yes r No
Acceptance Letter Attachment
1h. Is the project located in any of NC's twenty coastal counties?
r Yes r No
1j. Is the project located in a designated trout watershed?
C Yes r No
FB. Applicant Information
1d. Who is applying for the permit?
r- Owner rJ Applicant (other than owner)
le. Is there an Agent/Consultant for this project?
r Yes r No
2. Owner Information
2a. Name(s) on recorded deed:
North Carolina Department of Transportation
2b. Deed book and page no.:
WA
2c. Responsible party:
Division Engineer NCDOT Division 7, Mr. Mike Mills, PE
2d.Address
Street Address
PO Box14996
Address Line 2
City
State / Frwinre / R�gion
Greensboro
NC
Fbstal / Zip Code
Q�untry
27415
USA
2e. Telephone Number:
2f. Fax Number:
[phone]
[phone]
2g. Email Address:*
*
r Yes r No
r Yes r No

[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
Division Engineer NCDOT Division 7, Mr. Mike Mills, PE
3b. Business Name:
NC DOT
3c.Address
Street Address
PO Box14996
Address Line 2
City
Greensboro
F stal / Zip Code
27415
3d. Telephone Number:
[phone]
3f. Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
State / Province / Pagion
NC
Country
USA
3e. Fax Number:
[phone]
1b. Subdivision name:
(if appropriate)
N/A
1c. Nearest municipality/town:
Greensboro
2. Project Identification
2a. Property Identification Number:
2b. Property size:
N/A
N/A
2c. Project Address
Street Address
Address Line 2
aty
State / Province / Pagion
Postal / Zip Cade
Country
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
UT to North Buffalo Creek
3b. Water Resources Classification of nearest receiving water:*
WS-V; NSW; 16-11-14-1; HUC 030300020105
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.
030300020105
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:
The project area is a mix of undisturbed, forested areas, maintained lawns and residences, and active farm land.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
r Yes r No r 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)
Pipe 40 2134 Guilford USGS Map.pdf 2.64MB
4e. Attach an 81/2 X 11 excerpt from the most recent version of the published County NRCS Soil Survey map depicting the project site. (for DWR)
Pipe 40 2134 Guilford Soil Map.pdf 2.16MB

4f. List the total estimated acreage of all existing wetlands on the property:
-0.00
4g. List the total estimated linear feet of all existing streams on the property:
-150 LF of channel within the project area.
4h. Explain the purpose of the proposed project:*
The proposed project is to replace failing, existing 73-inch x 55-inch corrugated metal arch pipe (CMAP) culvert with a 1 @117-inch X79-inch corrugated aluminum alloy pipe arch
(CAAPA) with headwall. The larger culvert will reduce the outlet velocity.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
Traffic will be detoured off -site. Erosion and sedimentation control measures will be installed. The proposed structure will be replaced on its existing alignment; the existing 73-inch x 55-
inch CMAP Will be replaced by a proposed 117-inch X 79-inch CAAPA with headwall & endwall. The project proposes 43 linear feet (0.01 acres) of permanent stream impact (2 LF of
culvert extension, 16 LF of outlet protection and 41 LF of stream bank stabilization - note the 16LF of outlet protection is within the streambank stabilization footprint and not in addition
to it) and 43 linear feet (0.02 acres) of temporary stream impacts associated with the impervious dikes to dewater the channel so that construction activities take place in the dry (to run
concurrently with the permanent impacts). The pipe inlet and outlet will consist of Class I rip rap embankment at the stream to prevent erosion. Due to a conflicting water line, the culvert
cannot be buried, however, the inlet will be placed at the existing stream bed elevation and no sills Will be installed. In order to protect the outlet stream channel, NCDOT is proposing to
place Class I rip rap in the channel to insure long term stability at the outlet but also to insure adequate cover over the existing water line. Equipment to be used includes a track hoe,
dump truck, paving equipment, various hand tools, and crane to move construction material, including the existing and proposed pipes.
4j. Please upload project drawings for the proposed project.
17BP.7.C.14_Permit Drawings 20190418.pdf 2.42MB
17bp.7.C.14_HYD_SMP_10022018.pdf 118.17KB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the propertyor proposed impact areas?*
r• Yes
r No
Comments:
HDR/ICA conducted field reconnaissance for the subject site in 2016.
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
r Preliminary r Approved r Not Verified r Unknown r N/A
Corps AID Number:
5c. If Sa is yes, who delineated the jurisdictional areas?
Name (if known): Ben Furr
Agency/Consultant Company: HDR/ICA
Other:
5d1. Jurisdictional determination upload
6. Future Project Plans
6a. Is this a phased project?*
r Yes 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 projector related activity?
D. Proposed Impacts Inventory
1. Impacts Summary
la. Where are the impacts associated with your project? (check all that apply):
r Wetlands W Streams -tributaries W Buffers
r Open Waters r Pond Construction
3. Stream Impacts
3a. Reason for impact (?)
3b.lmpact type *
3c. Type of impact*
3d. S. name*
3e. Stream Type *
3f. Type of
3g. S. width *
31h. Impact
❑
(?)
Jurisdiction*
length*
12+92 to 13+03
Permanent
Culvert
UT to North Buffalo Creek
Perennial
BothFIL-Average
(feet)
(linear feet)
12+83 to 13+10
Permanent
Bank Stabilization
UT to North Buffalo Creek
Perennial
Both�]_L-Avenge(fee[)
(linear feet)
H12+g2
-L-p
to 13+02
Tem ora ry
Dewaterin g
Ui to North Buffalo Creek
Perennial
Both
t;;;T�]

31. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
43
3i. Total stream and ditch impacts:
86
3i. Total temporary stream impacts:
43
3j. Comments:
Of the 86 linear feet of stream impact, only 43 linear feet are permanent which will occur mostly in the form of stream bank stabilization.
6. Buffer Impacts (for DWR)
6a. Project is in which protect basin(s)?
Check all that apply.
r- Neuse r Tar -Pamlico
r Catawba r Randleman
r Goose Creek P Jordan Lake
r- Other
6b. Impact Type
6c. Per or Temp
6d. Stream name
6e. Buffer mitigation required?
6f. Zone f impact
6g. Zone 2 impact
Allowable
P
UT to North Buffalo Creek
No
3,395
0
6h. Total buffer impacts:
Zone 1 Zone 2
Total Temporary impacts: 0.00 0.00
Zone 1
Zone 2
Total Permanent impacts: 3,395.00
0.00
Zone 1
Zone 2
Total combined buffer impacts: 3,395.00
0.00
6i. Comments:
The impacts associated with the pipe replacement fall under the "allowable" category per the Jordan Water Supply Buffer Rules Table of Uses f 15A
NCAC 026 .0267 (9)).
Supporting Documentation
17BP.7.C.14_Permit Drawings 20190418.pdf 2.42MB
17bp.7.C.14_HYD_SMP_10022018.pdf 118.17KB
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 proposed project is to remove and replace a failing, eAsting 73-inch x 55-inch CMAP culvert with a 117-inch X 79-inch CAAPA with headwall and
endwall. Roadway approach work was minimized as much as possible to reduce the overall project footprint and to minimize impacts. The new culvert
is larger than the eAsting culvert to reduce the outlet velocity. Impacts to associated riparian buffers have also been reduced by promoting sheet flow
where possible and stabilizing eAsting banks. An off -site detour will be employed to avoid the need for a temporary, parallel structure.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Erosion and sedimentation BMPs will be installed prior to construction. Water will be diverted around the work area to prevent sedimentation of
downstream aquatic resources. Impacts will be minimized by strict enforcement of BMPs for the protection of surface waters, restrictions against
staging of equipment in or adjacent to waters of the US and coordination (including a pre -construction meeting) with the Division Environmental
Supervisor.
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
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
The impacts associated with the pipe replacement fall under the "allowable" category per the Jordan Water Supply Buffer Rules Table of Uses 115A NCAC 02B .0267 (9)) and therefore,
do not require 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?
r Yes r No
What type of SCM are you providing?
F- Level Spreader
F- Vegetated Conveyance (lower SHWf)
F- Wetland Swale (higher SHWT)
r Other SCM that removes minimum 30 % nitrogen
R Proposed project will not create concentrated stormwater flow through the buffer
Diffuse Flow Documentation
17bp.7.C.14_HYD_SMP_10022018.pdf 118.17KB
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:
This project does not add any new impervious surface, therefore, there is no need to provide stormwater treatment.
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?*
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 Policy Act (NEPA/SEPA)? *
r Yes r No
Comments:*
While this project involves an expenditure of public funds, it does not exceed the thresholds that require NEPA/SEPA documentation preparation.
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?*
r Yes r No
3b. If you answered "no," provide a short narrative description.
Per the NC DWQ April 2004 Version 2.1 Cumulative Impacts policy, small scale public transportation projects — such as widening projects, bridge
replacements and intersection improvements — have a "low potential for cumulative impact since little (if any) new impervious surface is added and the
projects are usually already in developed locales." This proposed project is within a somewhat developed landscape (i.e. existing residences in the
vicinity), this is not a road on a new location (i.e. there is an existing road and culvert structure and thus, the area already contains impervious
surfaces), and the project drains to an Uf to North Buffalo Creek, which is Class WS-V; Nutrient Sensitive Water (NSW). We anticipate the NCDWR will
advise us if a qualitative or quantitative analysis is needed.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
r Yes r 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
5c. If yes, indicate the USFWS Field Office you have contacted.
Raleigh
5d. Is another Federal agency involved?*

r Yes r No
r Unknown
5e. Is this a DOT project located within Division's 1-8?
r Yes r No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
The United States Fish and Wildlife Servie (USFWS) lists Isotria medeoloides (Small whorled pogonia) as threatened, Helianthus schweinitai
(Schweinitts sunflower) and Myotis septentrionalis (Northern long-eared bat, NLEB) as endangered in Guilford County. HDRJICA conducted field
investigations on 8/29/16. The project site does not provide habitat for small whorled pagonia due to dense understory and herbaceous layers within
the forested areas. The roadside and powerline ROW do provide habitat for SchweiniKs sunflower, however, no species were observed. The
biological conclusion for small whorled pagonia is no effect and no effect; habitat present for Schweinitts sunflower. Effects of NCDOT projects on
NLEB in Guilford County have been addressed through a Programmatic Biological Opinion which took effect on May 4, 2015.
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?*
r Yes
r No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
This project takes place in Guilford County which is not near any coastal or tidal habitat that would support EFH (i.e. salt marshes, oyster reefs, etc.).
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?*
r Yes
r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
Letters provided by NCDOT Architectural Historian (dated 10/27/2017) and NCDOT Archaeologist (dated 11/15/17); see attached
7c. Historic or Prehistoric Information Upload
C14_HA_17-10-0018NoSurveyReq.pdf
C14_SR 2835 Pipe 402134 Guilford No Archaeological Survey Required Form.pdf
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain? *
f Yes
r No
8c. What source(s) did you use to make the floodplain determination?*
NC Flood Risk Information System
Miscellaneous
Comments
Miscellaneous attachments not previously requested.
Signature
W By checking the box and signing below, I certify that:
3.93MB
1.35MB
• 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:
P. D. Wilson, PE
Signature
P _�. 4),1/S4d1
Date
5/7/2019
U