20191067 Ver 1_PCN Form Submission_20190812

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?*
C Yes r No
Change only if needed.
BIMS # Assigned
20191067
Is a payment required for this project?*
r No payment required
r Fee received
r Fee needed - send electronic notification
Select Project Reviewer*
Donna Fbod:eads\drhood
Information for Initial Review
1a. Name of project:
U-5906
1a. Who is the Primary Contact?*
Joel M. Howard (NCDOT)
1b. Primary Contact Email:*
[e-mail]
Date Submitted
8/12/2019
Nearest Body of Water
OF to Cawtawba River
Basin
Yadkin-PeeDee
Water Classification
Water Supply IV (WS-N)
Version# *
1
Reviewing Office*
Mooresville Regional Office - [phone]
1c. Primary Contact Phone:*
[phone]
Site Coordinates
Latitude: Longitude:
35.483178-80.876569
FA. Processing Information U
County (or Counties) where the project is located:
Mecklenburg
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:
t15906
WBS#M
46451.3.1
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?
t' 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:
NCDOT (Scott Cole) Division 10, Division Engineer
2b. Deed book and page no.:
2c. Responsible party:
2d.Address
Street Address
716 West Main Street
Address Line 2
city
Albemarle
Fbstal / Zip 03de
28001
2e. Telephone Number:
[phone]
2g. Email Address:*
State / Frwinee / R�gion
NC
Country
Albemarle
2f. Fax Number:
[phone]
*
r Yes r No
r Yes r No

[e-mail]
C. Project Information and Prior Project History U
1. Project Information
1b. Subdivision name:
(d appropriate)
1c. Nearest municipality/ town:
Cornelius
2. Project Identification
2a. Property Identification Number:
2c. Project Address
Street Address
Address line 2
Oty
Postal / Zip 03de
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
UT to Cawtawba River
3b. Water Resources Classification of nearest receiving water:*
Water Supply IV (WS-IV)
3c. What river basin(s) is your project located in?*
Yadkin -Pee Dee
3d. Please provide the 12-digit HUC in which the project is located.
03050101
4. Project Description and History
2b. Property size:
State / ftovince / Ibgion
O�untry
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 area in the vicinity of this project is heavily developed with commercial properties and privately owned businesses. Along Knox Road there is a development with single family
homes.
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)
TOPO Map.pdf
884.35KB
4e. Attach an 8 112 X 11 excerpt from the most recent version of the published County NRCS Soil Survey map depicting the project site. (for DWR)
Soil Map.pdf 1.11MB
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:
33'
4h. Explain the purpose of the proposed project:*
NCDOT proposes to improve the intersection at SR 2195 (Torrence Chapel Road) and SR 5544 (Catawba Avenue). NCDOT will also be improving the surrounding area by replacing
existing drainage, pavement, adding retaining walls, new signs and signals.
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 adding and additional 33' of pipe to an eAsting (42") RCP with
headwall. Please see inset A on plan sheet 5 of the permit drawing plans. All stream work 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 silt bag adhering to NCDOT's best management practices for pipe construction/replacement. The equipment that will be used for the addition
of pipe will include, but is not limited to: dewatering pump, trackhoe, dumptrucks, vibratory roller, motor grader and paving equipment.
4j. Please upload project drawings for the proposed project.
Plans (Permit Drawings).pdf 5.61 MB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the propertyor proposed impact areas?*
F Yes r No f Unknown

Comments:
Larry Thompson, Division Environmental Officer delineated the stream on 9/20/2018
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
r Preliminary r Approved r Not Verified r Unknown r NIA
Corps AID Number:
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Joel Howard, Division Environmental Specialist
Agency/Consultant Company: NCDOT
Other:
5d1. Jurisdictional determination upload
NC DWQ Stream Form.pdf 386.23KB
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):
r Wetlands W Streams -tributaries r 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 3h. Impact
(?) urisdiction* length*
S1
Pipe Extension
Permanent
Culvert
l!T to Catawba River
Perennial
Both
3
Average (feet)
33
(linear feet)
S2
Pipe EMension
Tem ora
p rY
Culvert
LIT to Catawba River
Perennial
Both
3
Average (feet)
18
(linear feet)
31. Total jurisdictional ditch impact in square feet:
0
31. Total permanent stream impacts:
33
3i. Total stream and ditch impacts:
51
3j. Comments:
E. Impact Justification and Mitigation
1. Avoidance and Minimization
31. Total temporary stream impacts:
18
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 pipe in jurisdictional waters will be adherred to thorughout the life of the project.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
All erosion control devises will be maintained, monitored and inspected as dictated by the NPDES permit. 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?
C' Yes r No

2b. If this project DOES NOT require Compensatory Mitigation, explain why:
It has not yet been discussed with the USACE what ratio of mitigation if any will be required.
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 particular UT to Catawba River does 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 keep on site and inspected as need by an NCDOT representative.
G. Supplementary Information
1. Environmental Documentation
la. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?*
r Yes r No
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?*
f Yes r No
3b. If you answered "no," provide a short narrative description.
This is a stand alone project. NCDOT does not anticiapate any additional land development within the project limits or future impacts to the
downstream water quality of this UT to Catawba River.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
f Yes r Nor WA
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
5d. Is another Federal agency involved?*
r- Yes r No r- Unknown
Se. Is this a DOT project located within Division's 1-8?
r^ Yes r No
5f. Will you cut anytrees in order to conduct the work in waters of the U.S.?
r Yes r- No
5g. Does this project involve bridge maintenance or removal?
r^ Yes r No
5h. Does this project involve the construction/installation of a wind turbine(s)?*
r- Yes r No
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.?
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 North Carolina Natural Heritage Program (NCNHP) Database.
Consultation Documentation Upload
project _report _sr_2195_torrence_chapel_roa_20513_20513.pdf 1.28MB
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?*
South Atlantic Fishery Management Council.
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's Cultrual Resources Staff.
7c. Historic or Prehistoric Information Upload
A No Survey.pdf
HA No Survey.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 Floodplain Maps website.
Miscellaneous
Comments
Miscellaneous attachments not previously requested.
Aerial Map.pdf
Stormwater Management Plan.pdf
Street Map.pdf
U-5906 NRTM.pdf
Permit Site 1 Picture 1.jpg.pdf
Signature
*
W By checking the box and signing below, I certify that:
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751.27KB
445.84KB
1.22MB
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217.05KB
• 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:
Joel M. Howard
Signature
Jvq,x *
Date
8/12/2019