20190858 Ver 1_401 Application_20190625

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190820 58
ENGINEERS
June 21, 2019 1984.020 (34)
Department of Environmental Quality \S)
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WBSCP Unit
1650 Mail Service Center T d�6
Raleigh, North Carolina 27699 ��
$ p411
Subject: Town of Mocksville
Contract 9.0—Jericho Church Road Water Line
Pre-Construction Notification (PCN) Form
Gentlemen:
The Town of Mocksville recently installed approximately 720 feet of replacement water line
along Jericho Church Road, a portion of which crosses Bear Creek. The new 6-inch ductile iron
pipe replaces an existing water line that was washed out by a flood. The new water line was
constructed to restore water service to customers on the west side of Town. An after-the-fact
permit is therefore required for the temporary impacts to Bear Creek during construction.
On behalf of the City, we are submitting the following items for your review and approval:
• Four (4) fully executed Pre-Construction Notification Forms
• Four (4) copies of the Construction Drawings
• A check in the amount$240 for the Application Fee
Should you have any questions or need additional information, please feel free to call me at
704.338.4668 or email me at [e-mail]
Yours very truly,
WILLIS ENGINEERS
/41(114/(
Charles A. Willis,Jr., P.E., BCEE
Enclosures
cc w/ Enclosures: Mr. Matt Settlemyer,Town of Mocksville
10700 Sikes Place,Suite 115
Charlotte, North Carolina 28277
704.377.9844/NC License F-0114

e W A T6.9OG
Office Use Only:
9 Corps action ID no.
>
I ills DWQ project no.
Form Version 1.4 January 2009
Pre-Construction Notification (PCN) Form
A. Applicant Information
1. Processing
la. Type(s) of approval sought from the Corps: ❑X Section 404 Permit ❑ Section 10 Permit
1 b. Specify Nationwide Permit (NWP) number: 12 or General Permit(GP) number:
1c. Has the NWP or GP number been verified by the Corps? ❑ Yes ❑X No
1d. Type(s) of approval sought from the DWQ (check all that apply):
❑X 401 Water Quality Certification—Regular ❑ Non-404 Jurisdictional General Permit
❑ 401 Water Quality Certification—Express ❑ Riparian Buffer Authorization
1 e. Is this notification solely for the record For the record only for DWQ For the record only for Corps Permit:
because written approval is not required? 401 Certification:
❑Yes ❑X No ❑Yes ❑X No
1f. Is payment into a mitigation bank or in-lieu fee program proposed for
mitigation of impacts? If so, attach the acceptance letter from mitigation bank ❑ Yes ❑X No
or in-lieu fee program.
1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1h ❑ Yes ❑X No
below.
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ❑ Yes ❑X No
2. Project Information
2a. Name of project: JERICHO CHURCH ROAD WATER LINE
2b. County: DAVIE
2c. Nearest municipality/town: TOWN OF MOCKSVILLE
2d. Subdivision name: N/A
2e. NCDOT only, T.I.P. or state project no: N/A
3. Owner Information
3a. Name(s) on Recorded Deed: SEE ATTACHED
3b. Deed Book and Page No. SEE ATTACHED
3c. Responsible Party (for LLC if
applicable):
3d. Street address:
3e. City, state, zip:
3f. Telephone no.:
3g. Fax no.:
3h. Email address:
Page 1 of 10
PCN Form—Version 1.4 January 2009

4. Applicant Information (if different from owner)
4a. Applicant is: ❑ Agent ❑X Other, specify: TOWN MANAGER
4b. Name: MATT SETTLEMYER
4c. Business name TOWN OF MOCKSVILLE
(if applicable):
4d. Street address: 171 SOUTH CLEMENT STREET
4e. City, state,zip: MOCKSVILLE, NORTH CAROLINA 27028
4f. Telephone no.: 336-753-6701
4g. Fax no.: 336-751-9187
4h. Email address: [e-mail]
5. Agent/Consultant Information (if applicable)
5a. Name: CHARLES A. WILLIS, JR., P.E., BCEE
5b. Business name WILLIS ENGINEERS
(if applicable):
5c. Street address: 10700 SIKES PLACE, SUITE 115
5d. City, state,zip: CHARLOTTE, NC 28277
5e. Telephone no.: 704-338-4668
5f. Fax no.: N/A
5g. Email address: [e-mail]
Page 2 of 10

B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): SEE ATTACHED
1 b. Site coordinates(in decimal degrees): Latitude: 35.874034 Longitude: -80.578191
lc. Property size: acres
2. Surface Waters
2a. Name of nearest body of water to proposed project: BEAR CREEK
2b. Water Quality Classification of nearest receiving water: WS-IV; C
2c. River basin: YADKIN PEE-DEE
3. Project Description
3a. 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 SITE CONSISTS OF MOSTLY UNDEVELOPED PARCELS ALONG JERICHO CHURCH ROAD,WEST OF VIRGINIA COURT.THE NEW
WATER LINE WAS CONSTRUCTED JUST OUTSIDE THE ROAD RIGHT-OF-WAY IN THE APPROXIMATE LOCATION OF THE RECENTLY
FAILED WATER LINE.
3b. List the total estimated acreage of all existing wetlands on the property: 0
3c. List the total estimated linear feet of all existing streams (intermittent and perennial)on the property: 34
3d. Explain the purpose of the proposed project:
TO REPLACE A RECENTLY FAILED WATER LINE WHICH PROVIDES WATER TO CUSTOMERS ON THE WEST SIDE OF TOWN.
3e. Describe the overall project in detail, including the type of equipment to be used:
THE PROJECT INCLUDED INSTALLATION OF APPROXIMATELY 720 FEET OF 6-INCH DIAMETER DUCTILE IRON WATER LINE TO REPLACE A FAILED LINE.THE NEW
WATER LINE WILL CONTINUE TO PROVIDE SERVICE TO CUSTOMERS ON THE WEST SIDE OF TOWN.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the ❑Yes ❑ No ❑X Unknown
Corps or State been requested or obtained for this property/
project(including all prior phases)in the past? Comments.
4b. If the Corps made the jurisdictional determination,what type ❑ Preliminary El Final
of determination was made?
4c. If yes,who delineated the jurisdictional areas? Agency/Consultant Company:
Name(if known): Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
5. Project History
5a. Have permits or certifications been requested or obtained for ['Yes ❑No ❑X Unknown
this project(including all prior phases) in the past?
5b. If yes, explain in detail according to"help file"instructions.
6. Future Project Plans
6a. Is this a phased project? ❑ Yes ❑X No
6b. If yes, explain.
Page 3 of 10
PCN Form—Version 1.4 January 2009

C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project(check all that apply):
❑ Wetlands X❑ Streams—tributaries 0 Buffers 0 Open Waters 0 Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site,then complete this question for each wetland area impacted.
2a. 2b. 2c. 2d. 2e. 2f.
Wetland impact Type of impact Type of wetland Forested Type of jurisdiction Area of
number Corps (404,10)or impact
Permanent(P) or DWQ (401, other) (acres)
Temporary(T)
W1 - Choose one Choose one Yes/No -
W2 - Choose one Choose one Yes/No -
W3 - Choose one Choose one Yes/No -
W4 - Choose one Choose one Yes/No -
W5 - Choose one Choose one Yes/No -
W6 - Choose one Choose one Yes/No -
2g. Total Wetland Impacts:
2h. Comments:
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site,then complete this
question for all stream sites impacted.
3a. 3b. 3c. 3d. 3e. 3f. 3g.
Stream impact Type of impact Stream name Perennial (PER) or Type of Average Impact
number intermittent(INT)? jurisdiction stream length
Permanent(P) or width (linear
Temporary(T) (feet) feet)
S1 T Stabilization BEAR CREEK PER Corps 34 40
S2 - Choose one - -
S3 - Choose one - -
S4 - Choose one - -
S5 - Choose one - -
S6 - Choose one - -
3h. Total stream and tributary impacts 40
3i. Comments:
Page 4 of 10
PCN Form—Version 1.4 January 2009

4. Open Water Impacts
If there are proposed impacts to lakes, ponds,estuaries,tributaries,sounds,the Atlantic Ocean, or any other open water of
the U.S.then individually list all open water impacts below.
4a. 4b. 4c. 4d. 4e.
Open water Name of waterbody
impact number (if applicable) Type of impact Waterbody Area of impact(acres)
Permanent(P) or type
Temporary (T)
01 - Choose one Choose
O2 - Choose one Choose
03 - Choose one Choose
04 - Choose one Choose
4f.Total open water impacts
4g. Comments: N/A
5. Pond or Lake Construction
If pond or lake construction proposed,then complete the chart below.
5a. 5b. 5c. 5d. 5e.
Pond ID number Proposed use or Wetland Impacts(acres) Stream Impacts (feet) Upland
purpose of pond (acres)
Flooded Filled Excavated Flooded Filled Excavated
•
P1 Choose one
P2 Choose one
5f.Total:
5g. Comments:
NIA
5h. Is a dam high hazard permit required? ❑ Yes ❑ No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts(for DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes,then individually list all buffer impacts
below. If any impacts require mitigation,then you MUST fill out Section D of this form.
6a. Project is in which protected basin? ❑Neuse ❑Tar-Pamlico ❑ Catawba ❑ Randleman ❑Other:
6b. 6c. 6d. 6e. 6f. 6g.
Buffer Impact Reason for impact Stream name Buffer Zone 1 Zone 2
number— mitigation impact impact
Permanent(P) or required? (square (square
Temporary(T) feet) feet)
B1 - Yes/No
B2 - Yes/No
B3 - Yes/No
B4 - Yes/No
B5 - Yes/No
B6 - Yes/No
6h.Total Buffer Impacts:
6i. Comments: N/A
Page 5 of 10

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
THE STREAM IMPACTS WERE INTENDED TO ALLOW LAYING OF THE NEW WATER LINE UNDERNEATH BEAR CREEK.THE IMPACTED
STREAM WAS STABILIZED IMMEDIATELY AFTER THAT PORTION OF CONSTRUCTION WAS COMPLETE.STABILIZATION INCLUDED
UTILIZATION OF FILTER FABRIC AND CLASS B RIP RAP ON BOTH SIDES OF THE DISTURBED STREAMBANK.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
EROSION CONTROL MEASURES WERE IMPLEMENTED TO PROTECT JURISDICTIONAL AREAS.EROSION CONTROL DEVICES WERE
INSPECTED DAILY DURING CONSTRUCTION OF THE NEW WATER LINE AND IMMEDIATELY REPAIRED IFNVHEN NECESSARY.
2. Compensatory Mitigation for Impacts to Waters of the U.S.or Waters of the State
2a. Does the project require Compensatory Mitigation for ❑ Yes X❑ No
impacts to Waters of the U.S. or Waters of the State?
•
2b. If yes, mitigation is required by(check all that apply): ❑ DWQ ❑Corps
❑ Mitigation bank
2c. If yes,which mitigation option will be used for this ❑ Payment to in lieu fee program
project? y
❑ Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank: N/A
Type: Choose one Quantity:
3b. Credits Purchased (attach receipt and letter) Type: Choose one Quantity:
Type: Choose one Quantity:
3c. Comments:
4. Complete if Making a Payment to In-lieu Fee Program
4a.Approval letter from in-lieu fee program is attached. ❑ Yes
4b. Stream mitigation requested: linear feet
4c. If using stream mitigation, stream temperature: Choose one
4d. Buffer mitigation requested (DWQ only): square feet
4e. Riparian wetland mitigation requested: acres
4f. Non-riparian wetland mitigation requested: acres
4g. Coastal (tidal)wetland mitigation requested: acres
4h. Comments:
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
Page 6 of 10 •
PCN Form—Version 1.4 January 2009

6. Buffer Mitigation (State Regulated Riparian Buffer Rules)—required by DWQ
6a.Will the project result in an impact within a protected riparian buffer that requiresEl Yes QX No
buffer mitigation?
6b. If yes,then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.
6c. 6d. 6e.
Zone Reason for impact Total impact Multiplier Required mitigation
(square feet) (square feet)
Zone 1 3 (2 for Catawba)
Zone 2 1.5
6f. Total buffer mitigation required:
6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in-lieu fee fund).
N/A
6h. Comments:
•
Page 7 of 10

•
E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers identified ❑ Yes ❑X No
within one of the NC Riparian Buffer Protection Rules?
lb. If yes, then is a diffuse flow plan included? If no, explain why.
❑Yes ❑ No
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project? 0
2b. Does this project require a Stormwater Management Plan? ❑Yes ❑X No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why:
THIS PROJECT IS A MUNICIPAL WATER LINE THAT DOES NOT INVOLVE CREATING IMPERVIOUS SURFACES.
2d. If this project DOES require a Stormwater Management Plan,then provide a brief, narrative description of the plan:
2e. Who will be responsible for the review of the Stormwater Management Plan?
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this project? TOWN OF MOCKSVILLE
❑ Phase II
3b. Which of the following locally-implemented stormwater management programs ▪ NSW
apply(check all that apply): El USMP
❑Water Supply Watershed
❑Other:
3c. Has the approved Stormwater Management Plan with proof of approval been ❑Yes ❑No
attached?
4. DWQ Stormwater Program Review
Coastal counties
❑HQW
4a. Which of the following state-implemented stormwater management programs apply DORW
(check all that apply):
['Session Law 2006-246
['Other:
4b. Has the approved Stormwater Management Plan with proof of approval been ❑Yes ❑ No
attached?
5. DWQ 401 Unit Stormwater Review
5a. Does the Stormwater Management Plan meet the appropriate requirements? ❑Yes ❑No
5b. Have all of the 401 Unit submittal requirements been met? ❑Yes ❑No
Page 8 of 10
PCN Form—Version 1.4 January 2009

F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
la. Does the project involve an expenditure of public(federal/state/local)funds or the ❑X Yes ❑ No
use of public(federal/state) land?
1 b. 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 ❑Yes ❑X No
(North Carolina) Environmental Policy Act(NEPA/SEPA)?
lc. If you answered"yes"to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
letter.) ❑Yes ❑No
Comments:
2. Violations (DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards, El Yes ❑X No
or Riparian Buffer Rules(15A NCAC 2B .0200)?
2b. Is this an after-the-fact permit application? ❑X Yes 0 No
2c. If you answered"yes"to one or both of the above questions, provide an explanation of the violation(s):
THE NEW WATER LINE WAS AN EMERGENCY REPLACEMENT OF AN EXISTING FAILED WATER LINE THAT SERVICED TOWN CUSTOMERS
IN THE WEST SERVICE AREA.THE WATER LINE WAS CONSTRUCTED TO ALLOW THESE CUSTOMERS TO RETURN TO THE TOWN'S
WATER SERVICE NETWORK AS QUICKLY AS POSSIBLE.
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project(based on past and reasonably anticipated future impacts) result in ❑Yes ❑X No
additional development, which could impact nearby downstream water quality?
3b. If you answered"yes"to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered"no," provide a short narrative description.
4. Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of.wastewater generated from
the proposed project, or available capacity of the subject facility.
THIS PROJECT CONSISTED OF A REPLACEMENT WATER LINE AND THEREFORE WILL NOT PRODUCE WASTEWATER FOR DISPOSAL.
Page 9 of 10
PCN Form—Version 1.4 January 2009

5. Endangered Species and Designated Critical Habitat(Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or Yes ❑X No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act ❑Yes ❑X No
impacts?
5c. If yes, indicate the USFWS Field Office you have contacted. -
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
USFWS THREATENED&ENDANGERED SPECIES ENVIRONMENTAL CONSERVATION ONLINE SYSTEM.
6. Essential Fish Habitat(Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat? ❑ Yes ❑X No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
NATIONAL MARINE FISHERIES SERVICE WEBSITE
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 ❑ Yes ❑X No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
NC STATE HISTORIC PRESERVATION OFFICE WEBSITE.
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain? ❑X Yes ❑ No
8b. If yes, explain how project meets FEMA requirements:
THE NEW WATER LINE WAS CONSTRUCTED WITH RESTAINED JOINT DUCTILE IRON PIPE AND MAINTAINS A MINIMUM 4 FEET OF COVER
FROM SITE GRADE.THE WATER LINE MAINTAINS A MINIMUM OF 2 FEET OF COVER WHERE IT CROSSES UNDERNEATH BEAR CREEK.
8c. What source(s) did you use to make the floodplain determination?
NORTH CAROLINA FLOOD RISK INFORMATION SYSTEM WEBSITE(NC FLOODMAPS)
nil it fl 4.61-
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Applicant/Agent's Printed Name " Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization
letter from the applicant is provided.)
Page 10 of 10

Town of Mocksville Property Owners •
Jericho Church Road Water Line
ID Owner Name Mailing Address Parcel Address Parcel ID Deed Book/Page Total Area Impacted Area
(acres) (acres)
1 Martin Lee Barber&Dreama E.Barber 1360 Jericho Church Road,Mocksville,NC 27028 1360 Jericho Church Road 5737174158 189-467 10.913 0.010
M Town of Mocksville 171 South Clement Street,Mocksville,NC 27028 Jericho Church Road 5737263738 119-680 0.591 0.030
2 Martin Lee Barber&Dreama E.Barber 1360 Jericho Church Road,Mocksville,NC 27028 1360 Jericho Church Road 5737263773 189-572 0.388 0.186
3 John T.Brock Post Office Box 241,Mocksville,NC 27028 Jericho Church Road 5737277280 982-257 9.589 0.291
•
Willis Engineers
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