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STATE of NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY LYNDO TIPPETT
GOVERNOR SECRETARY
MEMO TO: John Dorney, DENR/DWQ/401/Wetland Unit
FROM: Trish Simon, Division 12 Environmental Officer 15
DATE: September 12, 2002
SUBJECT: Pre-construction Notification (Courtesy Copy)
Enclosed is a courtesy copy of pre-construction notification permit application for a
bridge project in Cleveland County,
is
Post Office Box 47 Shelby, North Carolina 28151-0047
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STATE of NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY P.O. BOX 25201, RALEIGH, N.C. 27611-52o1 LYNDO TIPPETT
GOVERNOR SECRETARY
P.O. BOX 47, 1710 East Marion Street
Shelby, N. C. 28151-0047
September 12, 2002
Mr. John W. Hendrix - NCDOT Projects
US Army Corp of Engineers, Asheville Regulatory Field Office
151 Patton Avenue, Room 208
Asheville, N. C. 28801-5006
Dear Mr. Hendrix:
The North Carolina Department of Transportation, Division of Highways, proposes the following
project for your issuance of a Section 404 Permit. We believe this project can be accomplished
under Nationwide #3 Permit, Maintenance and Nationwide #33 Permit, Temporary Construction,
Access, and Dewatering.
COUNTY: Cleveland
LOCATION: Bridge #182, SR 1637, southwest ofBelwood
STREAM: Knob Creek, Class WS-IV Waters (From a point 0.3 miles downstream of
Adams Creek to a point 0.6 miles upstream of mouth)
PROJECT DESCRIPTION: The project consists of replacing a 125' long x 20' wide deteriorating
bridge with a 135' long x 30' wide concrete, three span bridge on same location. Temporary
impervious cofferdams will be necessary to install the pier footings on the sides of the streams on
the 100-year floodplain. Class 2 riprap will be placed around the pier footings and along the stream
bank under the bridge for structure protection/stabilization. Upon project completion, the area
impacted by the temporary cofferdams will be restored to pre-construction conditions. Enclosed is
a PCN application, a sketch of planned activities, and location maps relative to the proposed
project.
Mr. John W. Hendrix
Bridge # 182
September 12, 2002 - Page 2
Based upon the "Guidelines for the Location and Design of Hazardous Spill Basins", referenced in
DOT's Best Management Practices for the Protection of Surface Waters, the applicable locations
for the placement of hazardous spill basins are at stream crossings on highways functionally
classified as rural or urban arterials and where the stream crossing is within'/2 mile of the critical
area. The proposed project is located in a WS-IV watershed; however, SR 1637 is not classified as
an arterial road nor is the stream crossing within 'h of the critical watershed. Hazardous spill basins
are not required. Enclosed is the NCDOT hazardous spill basin checklist for this project.
A review of the Natural Heritage information for the threatened species listed for Cleveland
County, the dwarf-flowered heartleaf (Hexastylis naniflora), did not reveal any known sites in the
immediate vicinity. I have conducted a survey for the heartleaf species in the project area on
September 11, 2002. None were observed. It was determined that this species was not in the
proposed project area. No significant effect on this species is anticipated. A review of the available
information from the National Register of Historic Places was also conducted. It is anticipated that
no historic sites will be affected by the proposed project.
Your earliest consideration for this request would be greatly appreciated. Should you have any
questions, please call me at 704480-9020.
Respectfully yours,
M.L. Holder, P.E.
Division Engineer
Twelfth Division
BY:
Trish Simon
Division 12 Environmental Officer
Enclosures
cc: Mr. Michael L. Holder, P.E., Division Engineer
Mr. Dan Holdetman, P.E. , Division Bridge Engineer
Mr. Neil Trivette, Roadside Environmental Field Engineer
Mr. Ron Linville, WRC
Mr. Brian Cole, USF & WS
Mr. John Dorney, DENR,DWQ,401/Wetlands Unit (Courtesy copy)
File
Office Use Only: Form Version October 2001
USACE Action ID No. DWQ No®2 1 5 7 8
If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A" rather than
leaving the space blank-
L Processing
Check all of the approval(s) requested for this project:
® Section 404 Permit
? Section 10 Permit
? 401 Water Quality Certification
? Riparian or Watershed Buffer Rules
2. Nationwide, Regional or General Permit Number(s) Requested: Nationwide Permit #3, #33
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here:
4. If payment into the North Carolina Wetlands Restoration Program (NCWRP) is proposed for
mitigation of impacts (see section VIII - Mitigation), check here: ?
II. Applicant Information
1. Owner/Applicant Information
Name: Mike Holder NCDOT
Mailing Address: P.O. Box 47
Shelbv NC 28151
Telephone Number: 704-480-9020
E-mail Address:
2. Agent Information (A signed and dated copy of the Agent Authorization letter must be
attached if the Agent has signatory authority for the owner/applicant.)
Name: Trish Simon
Company Affiliation: NCDOT
Mailing Address: P.O. Box 47
Shelby, NC 28151
Telephone Number: 704-480-9044 Fax Number: 704-480-5401
E-mail Address: tsimon _ dot state nc us
Fax Number: 704-480-5401
Page 5 of 12
HL Project Information
Attach a vicinity map clearly showing the location of the property with respect to local
landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property
boundaries and development plans in relation to surrounding properties. Both the vicinity map
and site plan must include a scale and north arrow. The specific footprints of all buildings,
impervious surfaces, or other facilities must be included. If possible, the maps and plans should
include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property
boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion,
so long as the property is clearly defined. For administrative and distribution purposes, the
USACE requires information to be submitted on sheets no larger than 11 by 17-inch format;
however, DWQ may accept paperwork of any size. DWQ prefers full-size construction
drawings rather than a sequential sheet version of the full-size plans. If full-size plans are
reduced to a small scale such that the final version is illegible, the applicant will be informed that
the project has been placed on hold until decipherable maps are provided.
1. Name of project: Bridge #182 Replacement on SR 1637. Cleveland County
2. T.I.P. Project Number or State Project Number (NCDOT Only): 5.8052019
3. Property Identification Number (Tax PIN): _ NCDOT Right of wav
4. Location
County: Cleveland Nearest Town: Lawndale
Subdivision name (include phase/lot number): NA
Directions to site (include road numbers, landmarks, etc.): From Fallston. north on SR 1650.
left on SR 1637. -5 miles to bridge.
5. Site coordinates, if available (UTM or Lat/Long): { 1 } 35°28' 10"N / 81 °33'38"W
(Note - If project is linear, such as a road or utility line, attach a sheet that separately lists the
coordinates for each crossing of a distinct waterbody.)
6. Describe the existing land use or condition of the site at the time of this application:
Bridge on a paved secondary road
7. Property size (acres): 0.10 acres NCDOT right of wav. _ . ,
8. Nearest body of water (stream/river/sound/ocean/lake): Knob Creek. Class WS-IV Waters
(From a point 0.3 miles downstream of Adams Creek to a point 0.6 miles upstream of mouth)
9. River Basin: Broad
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http://h2o.enr.state.nc.us/admin/maps/.)
Page 6 of 12
10. Describe the purpose of the proposed work: The project consists of replacing a 120' long x
20' wide deteriorating and obsolete timber bridge with a 135' long x 30' wide concrete three
span concrete bridge TemporgU impervious cofferdams will be necessary for vier footing
installation.
11. List the type of equipment to be used to construct the project: A trackhoe and crane
will be used during construction.
12. Describe the land use in the vicinity of this project: The surrounding area is wooded.
IV. Prior Project History
if jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Include
the USACE Action ID Number, DWQ Project Number, application date, and date permits and
certifications were issued or withdrawn. Provide photocopies of previously issued permits,
certifications or other useful information. Describe previously approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits issued for prior segments of the same T.I.P. project, along with
construction schedules.
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application:
No future permit requests anticipated.
VL Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. The applicant must also
provide justification for these impacts in Section VII below. All proposed impacts, permanent
and temporary, must be listed herein, and must be clearly identifiable on an accompanying site
plan. All wetlands and waters, and all streams (intermittent and perennial) must be shown on a
delineation map, whether or not impacts are proposed to these systems. Wetland and stream
evaluation and delineation forms should be included as appropriate. Photographs may be
included at the applicant's discretion. If this proposed impact is strictly for wetland or stream
mitigation, list and describe the impact in Section VIII below. If additional space is needed for
listing or description, please attach a separate sheet.
1 WAtland Tmnactc
- wetland Impact - Y +--- ~- y Area of Located within Distance to
Site Number Type of Impact* Impact 100 year Floodplain** Nearest Stream Type of Wetland***
indicate on ma acres es/no (linear feet

List each impact separately and identify temporary impacts. impacts mciuae, out are nor rnmlrxr w, nrcUw ULCU C,UMu1g, vau,ug, ,,,.,
excavation, flooding, ditching/drainage, etc. For dams, separately list impacts due to both structure and flooding.
Page 7 of 12
100-Year floodplains are identified through the Federal Emergency Management Agency's (FEMA) Flood Insurance Rate Maps
(FIRM), or FEMA-approved local floodplain maps. Maps are available through the FEMA Map Service Center at 1-800-358-9616, or
online at http://x%w",.fema'gov.
""• List a wetland type that best describes wetland to be impacted (e.g., freshwater/saltwater marsh, forested wetland, beaver pond,
Carolina Bay, bog, etc.)
List the total acreage (estimated) of existing wetlands on the property: 0
2. Stream Imnacts. including all intermittent and perennial streams
Stream
Impact Site Length of Impact
h Average Width Perennial or
Number Type of Impact* ear feet)
(l n Stream Name** of Stream Intermittent?
(indicate on Before Impact (please specify)
ma
Temporary
1 cofferdams for pier 80 feet Knob Creek 20 feet Perennial
footings installation
Class 2 Riprap at pier
1 footings for stricture 40 feet
protection/
stabilization
List each impact separately and identify temporary impacts. Impacts include, but are not limited to: culverts and associates rip-rap,
dams (separately list impacts due to both structure and flooding), relocation (include linear feet before and after, and net loss/gain),
stabilization activities (cement wall, rip-rap, crib wall, gabions, etc.), excavation, ditching/straightening, etc. If stream relocation is
proposed, plans and profiles showing the linear footprint for both the original and relocated streams must be included
Stream names can be found on USGS topographic maps. If a stream has no name, list as UT (unnamed tributary) to the nearest
downstream named stream into which it flows. USGS maps are available through the USGS at 1-800-358-9616, or online at
wwtiv.use.s.¢ov. Several internet sites also allow direct download and printing of USGS maps (e.g., AnAw.topozone.com,
www.mapguest.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: Temporary cofferdams
impacts = 80 feet' Ril2ran impacts for pier footings protection = 40 feet. The forty feet of
permanent nprap impacts are contained within the 80 feet of temporary cofferdam impacts,
3. Open Water Impacts, including Lakes, Ponds, Estuaries, Sounds, Atlantic Ocean and any
other Water of the U. S. NO OPEN WATER IlyIPACTS
Open Water Impact
Site Number
indicate on ma
Type of Impact* Area of
Impact
acres Name of Waterbody

(? applicable) Type of Waterbody
(lake, pond, estuary, sound,
bay, etc

" List each impact separately and identify temporary impacts. impacts include, but are not limited to: 1111, excavation, areaging,
flooding, drainage, bulkheads, etc.
4. Pond Creation NO POND CREATION
If construction of a pond is proposed, associated wetland and stream impacts should be
included above in the wetland and stream impact sections. Also, the proposed pond should
be described here and illustrated on any maps included with this application.
Pond to be created in (check all that apply): ? uplands ? stream ? wetlands
Describe the method of construction (e.g., dam/embankment, excavation, installation of
draw-down valve or spillway, etc.):
Page 8 of 12
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.):
Size of watershed draining to pond: Expected pond surface area:
VII. Impact Justification (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It may be useful to provide
information related to site constraints such as topography, building ordinances, accessibility, and
financial viability of the project. The applicant may attach drawings of alternative, lower-impact
site layouts, and explain why these design options were not feasible. Also discuss how impacts
were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce impacts.
NCDOT plans to reolace the deteriorating bridge with another spanning structure rather than a
concrete box culvert, therefore avoiding additional permanent impacts to the stream The
existing bridge and substructure will be removed following the best management practices for
bridge removal A minimal amount of Class 2 riprap will be used on the banks under the bridge
protect the structure and roadway embankment.
VIIL Mitigation
DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC
Division of Water Quality for projects involving greater than or equal to one acre of impacts to
freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial
streams.
USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on March 9, 2000, mitigation will be required when
necessary to ensure that adverse effects to the aquatic environment are minimal. Factors
including size and type of proposed impact and function and relative value of the impacted
aquatic resource will be considered in determining acceptability of appropriate and practicable
mitigation as proposed. Examples of mitigation that may be appropriate and practicable include,
but are not limited to: reducing the size of the project; establishing and maintaining wetland
and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of
aquatic resource functions and values by creating, restoring, enhancing, or preserving similar
functions and values, preferable in the same watershed.
If mitigation is required for this project, a copy of the mitigation plan must be attached in order
for USACE or DWQ to consider the application complete for processing. Any application
lacking a required mitigation plan or NCWRP concurrence shall be placed on hold as
incomplete. An applicant may also choose to review the current guidelines for stream restoration
in DWQ's Draft Technical Guide for Stream Work in North Carolina, available at
http://h2o.enr.state.nc.us/ncwetlands/strmgide.html.
Page 9 of 12
Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
RAPACTS < 150 FEET: MITIGATION NOT ANTICIPATED
2. Mitigation may also be made by payment into the North Carolina Wetlands Restoration
Program (NCWRP) with the NCWRP's written agreement. Check the box indicating that
you would like to pay into the NCWRP. Please note that payment into the NCWRP must be
reviewed and approved before it can be used to satisfy mitigation requirements. Applicants
will be notified early in the review process by the 401/Wetlands Unit if payment into the
NCWRP is available as an option. For additional information regarding the application
process for the NCWRP, check the NCWRP website at http:Uli2o.enr.state.nc.us/wro/index.htm. If
use of the NCWRP is proposed, please check the appropriate box on page three and provide
the following information:
Amount of stream mitigation requested (linear feet):
Amount of buffer mitigation requested (square feet):
Amount of Riparian wetland mitigation requested (acres):
Amount of Non-riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres).
IX. Environmental Documentation (DWQ Only)
Does the project involve an expenditure of public funds or the use of public (federal/state/local)
land?
Yes ® No ?
If yes, does the project require preparation of an environmental document pursuant to the
requirements of the National or North Carolina Environmental Policy Act (NEPA/SEPA)?
Note: If you are not sure whether a NEPA/SEPA document is required, call the SEPA
coordinator at [phone] to review current thresholds for environmental documentation.
Yes ? No
If yes, has the document review been finalized by the State Clearinghouse? If so, please attach a
copy of the NEPA or SEPA final approval letter.
Yes ? No ?
X. Proposed Impacts on Riparian and Watershed Buffers (DWQ Only)
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
required state and local buffers associated with the project. The applicant must also provide
justification for these impacts in Section VII above. All proposed impacts must be listed herein,
and must be clearly identifiable on the accompanying site plan. All buffers must be shown on a
Page 10 of 12
map, whether or not
Regional Office may
applicant's discretion.
XL
XII.
impacts are proposed to the buffers. Correspondence from the DWQ
be included as appropriate. Photographs may also be included at the
Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify )?
Yes ? No ® If you answered "yes", provide the following information:
Identify the square feet and acreage of impact to each zone of the riparian buffers. If buffer
mitigation is required calculate the required amount of mitigation by applying the buffer
multipliers.
Zone* Impact
(square feet Multiplier Required
Mitigation
1 3
2 1.5
I Total
* Zone 1 extends out 30 feet perpendicular from near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.
If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation
of Property, Conservation Easement, Riparian Buffer Restoration / Enhancement, Preservation or
Payment into the Riparian Buffer Restoration Fund). Please attach all appropriate information as
identified within 15A NCAC 2B .0242 or. 0260.
NA
Stormwater (DWQ Only)
Describe impervious acreage (both existing and proposed) versus total acreage on the site.
Discuss stormwater controls proposed in order to protect surface waters and wetlands
downstream from the property.
No additional impervious surface is proposed in this project
Sewage Disposal (DWQ Only)
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.
NA
XM. Violations (DWQ Only)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H.0500) or any Buffer Rules?
Yes ? No
Is this an after-the-fact permit application?
Yes ? No
Page 11 of 12
XIV. Other Circumstances (Optional):
It is the applicant's responsibility to submit the application sufficiently in advance of desired
construction dates to allow processing time for these permits. However, an applicant may
choose to list constraints associated with construction or sequencing that may impose limits on
work schedules (e.g., draw-down schedules for lakes, dates associated with Endangered and
Threatened Species, accessibility problems, or other issues outside of the applicant's control).
N1 & 9-1"2 - 0;:
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 12 of 12
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CLEVELAND CO. NC SOIL SURVEY
FIELD SHEET 140. 173-53D
N SCALE = 1:24,000
SCS 124 S. POST RD.
?.. ,?-•..`. ='? t SHELBY, NC 28150
14
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INTERMITTENT CHANNEL
EVALUATION FORIM
b
ACTION Ill APPLIC-VN1'.NA,rIE C) '?:? - (?
DATE Z
PROPOSED CHANNEL WORK(i.c., culvc.t, relocation, ve..) / )C)^/ ?P l ( Ike- h! CP 1?11 r? ?5z 163 1
WATERBODY/RIFER BASEN 11.1 b /?O I\ C COUNTY/CITY IP'
RycF..N-r WEATHER CONDITIONS /j /-I
P SP NP I Obsc^,ation
F.DNSIII'l(tIiIL'CaL1IJL'::an1 Present
Beothic llac,ro fn?e^ebr:nes
?A:nphibi-n, P:esenCBreedinc
Algae Andr0r Fun,-,us iwater quality luncuun)
Wildlife Channel Use (i.e. tracks, Ieces, shells, others)
Fcdemlly Protected SPCC:es Present (Discontinue)
Riftlc,?Poni S(ruc:ure
Stable Suewnbanx,
/ I I I C flannel Substrate
(i.:. ,u1cl. cobble. rock. coarse sand)
R:ourian Canopy P-,-sent !SP =,> 50!,,, closure)
I I I U:tde.cut 5a:ikSil:lst:-"m Habitat Structure
/
_ /
JJ I I
I Fl/J lv 111 (..1::.uiel
I
I I ?1 ?? c:iands .-kJjace:lt'ro/Co.ntt . with t_.:tannel
I !Di;cone^uei
/?
t I I P_ sistcnt PaolsrSatu.-ated Bottom
(June th:ouc^ Scot.
'?
Y I I I Sr_pv Grr.::adwate: Discharge (June tilrough Sept.I
( I Adl<l lent : ;t`UIID Ia I:t ?:: SCn[
r /

V I i W:a1:.? M.It C:lal l11 D,111'1
t.IneS
r I H droeh ::c '•legeatmn in-ud acent to channel
Comments Or De,c-lotion
Jmpormnt To Domestic Water Supply'.'
Does Channel .appear On A Quad Or Soils,flap:' Y N Approx. Drninalte.- rea:
Determination
Pr.iai Channel
mirent Channel
mcrai Chan^e!
hrough "Diand
(stool Important Channel LF PROJECT `(GR. Initials
proceed) Lnimoo'ant Char.ncl: LF
mold) (attach ;nap indicaunc location of importanuun-Portant channel)
(no )d)
Evaluator's Sien:tture.
f nthe::han C.O. E. project :nanatte. )
P=Prescnt SP-Sion;ly Prescnt NP =Not Present 114/98

NCDOT
HAZARDOUS SPILL BASIN CHECKLIST
Division: /Z County: CAE?CC,4 v ? Project ID: 5-Yw5-Z019
River Basin: ?1zo e1,1c5_ Bridge No:
Route: 52 1&3 7 Stream: /?,?o g ci2c,=c-?L
Yes No
Stream Crossing Blue Line On USGS r-7' I
ORW r r??
wsi rr, r?
WS II,IlI OR IV, Crossing Within 0.5mi of W. S. Critical Area r r?
Water Quality Criteria:
Roadway Criteria:
Route Designation-
Arterial Urban f r/'
Arterial Rural r r`,"
Additional Site Information:
Is a Hazardous Spill Basin Required?
Yes No
Yes No
r r?'
Criteria Based Upon NCDOT "Best Management Practices for the
Protection of Surface Waters" (March, 1997).