20190700 Ver 1_PCN Form Submission_20190530

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
20190700
Is a payment required for this project?*
r No payment required
r Fee received
r Fee needed - send electronic notification
Select Project Reviewer*
Joanne Steenhuis:eads\jhsteenhuis
Information for Initial Review
1a. Name of project:
W-5706C - Roundabout at intersection of NC 41 and NC 410
1a. Who is the Primary Contact?*
Jim Rerko
1b. Primary Contact Email:*
[e-mail]
Date Submitted
5/30/2019
Nearest Body of Water
Bear Ford Swamp (Hester Millpond)
Basin
Lumber
Water Classification
Q Sw
Site Coordinates
Version# *
1
Reviewing Office*
Wilmington Regional Office - [phone]
1c. Primary Contact Phone:*
[phone]
Latitude: Longitude:
34.643427-78.735949
FA. Processing Information u
County (or Counties) where the project is located:
Bladen
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:
W-5706C
WBS # (?)
44852.1.3
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: 14 - Linear transportation
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:
r 401 Water Quality Certification - Express
r 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?
[J Owner r 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.:
not applicable
2c. Responsible party:
not applicable
2d. Address
Street Address
Highway Division 6
Address Line 2
500 Transportation Drive
city
State / Ftwince/ fagion
Fayetteville
North Carolina
Rstal / Zip Code
Country
28301
USA
2e. Telephone Number:
2f. Fax Number:
[phone]
*
r Yes r No
r Yes r No

2g. Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(if appropriate)
not applicable
1c. Nearest municipality/town:
Dublin/Elizabethtown
2. Project Identification
2a. Property Identification Number:
2c. Project Address
Street Address
Address Line 2
atY
Postal / Zip Code
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Bear Ford Swamp (Hester Millpond)
3b. Water Resources Classification of nearest receiving water:*
C; SW
3c. What river basin(s) is your project located in?*
Lumber
3d. Please provide the 12-digit HUC in which the project is located.
030402030801
4. Project Description and History
2b. Property size:
10
State / Province / Region
Country
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 existing intersection at NC 41 and NC 410 is a traditional 4-way road crossing with a 4-way stop sign configuration (installed in 2017). Both roads are rural two-lane roads with
speed limits of 55 MPH. NC 41 has 12-foot paved lanes with 4-foot unpaved shoulders. NC 410 has 12-foot paved lanes with grassed shoulders. Existing land use is primarily forested
land, agriculture, rural residential, and small commercial.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
r Yes 6 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)
NC —Dublin _20160608_TM_geo. pdf
NC_Tar _Heel_20160614_TM_geo. pdf
26MB
24.87MB
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:
0.08
4g. List the total estimated linear feet of all existing streams on the property:
4h. Explain the purpose of the proposed project:*
The purpose of this project in to convert the existing 4-way intersection at NC 41 and NC 410 to a roundabout configuration. The goal is to improve safety for local and through traffic
travelling through the NC 41/NC 410 intersection. The intersection was reviewed by NCDOT Division 6 as a highway safety improvement location in March 2015. The review included
evaluation of the Five -Year Crash History Data for the period between 2009-2014, which showed that 28 crashes had occurred,19 involving injuries and 9 resulting in property damage
only. Based on the review, it was recommended that the existing intersection signage be evaluated, and missing signage replaced; and, that the intersection be evaluated for installation
of a roundabout. In July 2016, NCDOT recommended construction of a roundabout as a safety project. Subsequent to funding approval for construction of a roundabout, an All -Way
stop treatment was installed August 2017 as an interim measure.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
The project will convert the existing 4-way intersection at NC 41 and NC 410 to a roundabout. A majority of the construction will occur during the summer months of June -August while
Bladen High School is out of session. The intersection will be closed during construction and an off -site detour will be employed. Eastbound and westbound NC 41 detours would utilize
NC 131 and Center Road (SR 1100) and would involve an additional travel distance of up to 4.9 miles. Northbound and southbound NC 410 would utilize Pleasant Grove Church Road
(SR 1107) and would involve an additional travel distance of up to 4.2 miles. Standard road building equipment, such as dozers, trucks, and other earthmoving vehicles, will be used
during construction.

4j. Please upload project drawings for the proposed project.
W-5706C_Roadway_Plans.pdf 6.49MB
W-5706C Wetland Permit Drawings_Full_Flat.pdf 1.23MB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?"
r Yes r No r Unknown
Comments:
A wetland was identified south of the NC 41/NC 410 intersection, on the east side of NC 410, in April
2019. A previous delineation in 2017 Dred no other features within the project limits.
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 5a is yes, who delineated the jurisdictional areas?
Name (if known): Jim Mason
Agency/Consultant Company: Three Oaks Engineering, Inc.
Other:
5d1. Jurisdictional determination upload
W-5706C PJD Package_Signed_05302019_Flat.pdf 2.64MB
6. Future Project Plans
6a. 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?
Proposed Impacts Inventory
1. Impacts Summary
la. Where are the impacts associated with your project? (check all that apply):
W Wetlands r Streams -tributaries r Buffers
r Open Waters r Pond Construction
2. Wetland Impacts
2a1 Reason (?) 2b. Impact type * (?) 2c. Type of W. * 2d. W. name * 2e. Forested* 21. Type of 2g. Impact
Jurisdicition*(?) area*
Roadway Fill P Headwater Forest WA Yes
Excavation P Headwater Forest WA Yes Both ]0.030
(acres)
Both
0.020 (acres)
2g. Total Temporary Wetland Impact 2g. Total Permanent Wetland Impact
0.000 0.050
2g. Total Wetland Impact
0.050
2h. Comments:
An additional 0.03 acres of hand clearing will also occur in Wetland WA.
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:

An offsite detour Will be employed. The project will be primarily constructed during the summer months of June -August while Bladen High School is out
of session. This Will avoid any traffic and bus conflicts during the school year. Due to the project location and soil types, 3:1 slopes Will be employed.
Several Special Cut Ditches, Special Lateral Ditches, Basic'V' Ditches, and Special Lateral Base Ditches will be constructed to allow for proper
stormwater drainage. Either Class I or Class B rip rap pads Will be placed at all pipe outlets. No pipes or rip rap pads Will be installed in or outlet into
Wetland WA. Due to the proximity of the wetland to the existing roadway and ditch system, it was not possible to avoid constructing the Special Lateral
'V' Ditch on the east side of NC 410 through Wetland WA. However, impacts to the wetland as a result of the ditch were minimized to the greatest
extent practicable. The wetland's natural slope is away from the road, so the placement of the new ditch should not result in any additional drainage
(no more than the existing ditch system, Mich the wetland currently ties into via a cut through the existing roadway berm). Additionally, hand clearing
is also being employed rather than mechanized clearing to further minimize the permanent impact to the wetland.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
NCDOT Best Management Practices for Construction and Maintenance Activities and Best Management Practices for the Protection of Surface Waters
Will be employed.
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:
Due to minimal amount of impact proposed for this project, NCDOT is proposing that no mitigation be required. A large amount of the wetland is being preserved to the east of the
project, with all of the proposed impacts occurring directly adjacent to the existing roadway. Hand clearing is also being employed rather than mechanized clearing to further minimize
the permanent impact to the wetland.
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
If no, explain why:
This project is located within the Lumber River Basin, where regulated riparian buffer rules are not enforced.
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 SMP.
G. Supplementary Information
1. Environmental Documentation
la. Does the project involve an expenditure of public (federallstate/local) funds or the use of public (federal/state) land?*
r Yes
r No
U
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?*
r Yes
r No
NEPA or SEPA Final Approval Letter
W-5706C_Type I and II CE Checklist _03_15_2018_signed.pdf
2. Violations (DWR Requirement)
4.3MB
2a. Is the site in violation of DWR Water Quality Certification Rules (15ANCAC 2H .0500), Isolated Wetland Rules (15ANCAC 2H .1300), or DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15ANCAC 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?*
C Yes
r No
3b. If you answered "no," provide a short narrative description.
Due to the minimal transportation impact resulting from this intersection reconfiguration, this project will neither influence nearby land uses nor
stimulate growth. Therefore, a detailed indirect or cumulative effects study will not be necessary.

4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
f 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
5e. Is this a DOT project located within Division's 1-8?
r Yes r No
r Unknown
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
USFWS County List, NCNHP Data Explorer (Accessed May 21, 2019), USFWS Information, Planning and Consultation system (IPaC), Field
surveys/assessments completed November 15, 2017 and May 31, 2018 (second visit for rough -leaved loosestrife). All species No Effect, except NLEB,
which is covered by the Programmatic Biological Opinion for Divisions 1 through 8.
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?*
NOAA Fisheries online Essential Fish Habitat Mapper
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?*
NCDOT/Consultant assessment; No Archaeological Survey Required Form completed 10/18/2017. Historic Architecture and Landscapes No Survey
Required Form completed 10/11/2017. Attached forms from Type I and II CE Checklist, signed March 2018.
7c. Historic or Prehistoric Information Upload
Arch and Hist Arch Forms.pdf
8. Flood Zone Designation (Corps Requirement)
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?*
FEMA Mapping
Miscellaneous
Comments
2.88MB
Miscellaneous attachments not previously requested.
W5706C_HYD_SMPv2.02_20190523.pdf 48.17KB
Sig tua rn e
*
W 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:
Gregory W. Price
Signature
Date
5/30/2019