20091084 Ver 1_Application_20091014

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STATE OF NORTH CAROLINA
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DEPARTMENT OF TRANSPORTATION
BEVERLY EAVES PERDUE
GOVERNOR
October 9, 2009
N.C. Division of Water Quality
Transportation Permitting Unit
2321 Crabtree Blvd./Suite 250
Raleigh, NC 27604-2260
EUGENE A. CONTI, JR.
SECRETARY
09 1'084
Attention: Mr. Rob Riding, NCDOT Project Coordinator
Subject: Bank stabilization along Middle Creek at the crossing of Bridge No. 25 on
SR 1203 (Green Hill Road) in Franklin County. WBS No. 5B.203211.
The North Carolina Department of Transportation (NCDOT) proposes to remove an old
bridge foundation (concrete footer) and beaver dam from the center of the stream that has
been obstructing water flow and causing scour by the eastern headwall of the bridge.
Grouting the void below the headwall is also proposed to help stabilize this area from further
damage. Then the headwall and adjacent stream banks will be armored with rip rap for long
term stabilization, which will involve permanent rip rap of,60 LF along the bank of a
buffered stream. Temporary buffer impacts of 1000 SF (600 SF in Zone 1 and 400 SF in
Zone 2) are necessary to access the creek and this scour area to be repaired.
Application is hereby made for NCDENR-DWQ Section 401 Water Quality Certification
(WQC) No. 3687, WQC No. 3689, and a Tar-Pamlico Riparian Buffer Authorization. An
automated payment procedure has been implemented between the NCDOT and NCDWQ.
This procedure will enable the Division to apply for the 401 WQC without submitting a
check for, this permit application. This procedure will provide payment to the NCDWQ
by charging the permit application fee of $240.00 directly to the appropriate NCDOT
WBS No. 5B.203211. A pre-construction notification, construction plan sketch, project
mapping, and photographs are attached with this request. If you have any questions or
need additional information, please contact Ms. Heather Montague at [phone].
Sincerely,
41 JW. Bowman, P.E.
7 Division Engineer
cc: Mr. Reese Briley, NCDOT DIV 5 Bridge Maintenance Superintendent
Mr. Danny Moss, NCDOT Franklin County Bridge Maintenance Supervisor
Mr. Tim Robbins, NCDOT DIV 5 Roadside Environmental Field Ops
Division Five-2612 North Duke Street, Durham, North Carolina 27704
Telephone: [phone] Fax: [phone]
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78.5009 000° W 178.4839333° W 178.466 666° W1
Name: KITTRELL Location: 036.1719563° N 078.4878973° W
Date: 9/25/2009 Caption: Sour Repair Site - 58.203511 Figure 1
Scale: 1 inch equals 2000 feet SR 1203 (Green Hill Road)
Franklin County
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Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Pre-Construction Notification (PCN Form
A. Applicant Information
1. Processing
la. Type(s) of approval sought from the
Corps: non-reporting
® Section 404 Permit ? Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: NWP 3 and NWP 13 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps? ? Yes ®No
1d. Type(s) of approval sought from the DWQ (check all that apply):
M 401 Water Quality Certification - Regular ? Non-404 Jurisdictional General Permit
? 401 Water Quality Certification - Express ® Riparian Buffer Authorization
le. Is this notification solely for the record
because written approval is not required? For the record only for DWQ 401
Certification:
? Yes ® No For the record only for Corps Permit:

® Yes ? 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 or in-lieu
fee program. ? Yes ® No
1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below. ? Yes ®No
Ih. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ? Yes ® No
2. Project Information
2a. Name of project: Proposed bank stabilization to east bank of Middle Creek on SR 1203 (Green Hill Rd),
at the crossing of Bridge No. 25.
2b. County: Franklin
2c. Nearest municipality / town: Franklinton
2d. Subdivision name: N/A
2e. NCDOT only, T.I.P. or state
project no: WBS No. 5B.203211
3. Owner Information
3a. Name(s) on Recorded Deed: NCDOT Division 5
3b. Deed Book and Page No. N/A
3c. Responsible Party (for LLC if
applicable): N/A
3d. Street address: 2612 N. Duke Street
3e. City, state, zip: Durham, NC 27704
3f. Telephone no.: [phone]
3g. Fax no.: [phone]
31h. Email address: wbowman(a?ncdot.gov
4. Applicant Information (if different from owner) N/A
5. Agent/Consultant Information (if applicable) N/A
Page 1 of 8
PCN Form -Version 1.3 December 10, 2008 Version
B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): N/A
1 b. Coordinates (in decimal degrees):
Site: Latitude:36.1720 Longitude: -78.4876
(DD.DDDDDD) (-DD.DDDDDD)
1 c. Property size: < 0.01 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to

proposed project: Middle Creek
2b. Water Quality Classification of nearest receiving water: C NSW
2c. River basin: Tar-Pamlico
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:
There is a huge scour beneath the bridge against the east abutment. Site is surrounded by wooded/agricultural lands.
3b. List the total estimated acreage of all existing wetlands on the property: '
NONE
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
NONE
3d. Explain the purpose of the proposed project: Bank stabilization to repair scour and to armor bridge headwall to
minimized risk of headwall from being further undermined and possibly collapsing.
3e. Describe the overall project in detail, including the type of equipment to be used:
Remove old concrete bridge foundation and beaver dam from center of the stream which is obstructing water flow
causing scour at headwall of bridge. Then armor headwall and adjacent stream banks with rip rap for long term bank
stabilization. Grouting the void below the headwall is also proposed to help stabilize this area from further damage.
Equipment may include a backhoe, an excavator, a bull dozer, and grader.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past? ? Yes ®No ? Unknown
Comments: N/A
4b. If the Corps made the jurisdictional determination, what type
? Preliminary ? Final
of determination was made?
4c. If yes, who delineated the jurisdictional areas? Agency/Consultant Company: N/A
Name (if known): N/A Other: N/A
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
N/A
5. Project History
5a. Have permits or certifications been requested or obtained for ? Yes ®No ? Unknown
this project (including all prior phases) in the past?
5b. If yes, explain in detail according to "help file" instructions.
N/A
Page 2 of 8
PCN Form -Version 1.3 December 1 0, 2008 Version
6. Future Project Plans
6a. Is this a phased project? ? Yes ® No
6b. If yes, explain.
N/A
C. Proposed Impacts Inventory
1. Impacts Summary
1a. Which sections were completed below for your project (check all that apply):
? Wetlands ® Streams - tributaries ® Buffers
? Open Waters ? 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 jurisdiction
number - Type of impact Type of wetland Forested (Corps - 404, 10 Area of impact
Permanent (P) or (if known) DWQ - non-404, other) (acres)
Temporary T
W1 ? P ? T N/A N/A ? Yes ? Corps N/A
? No ? DWQ
2g..Total Wetland Impacts: NONE
2h. Comments: N/A
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 Type of jurisdiction Average Impact
number - (PER) or (Corps - 404, 10 stream length
Permanent (P) or intermittent
DWQ -non-404,
width
(linear
Temporary (T) (INT)? other) (feet) feet)
Site 1 ? P ? T ® PER ® Corps
Stream 1 rip rap Middle Creek
? INT
®DWQ 30 60
3h. Total stream and tributary impacts 60
3i. Comments: restoring bank by armoring slope only, no surface water loss proposed
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 impact Name of waterbody
number- (if applicable) Type of impact Waterbody type Area of impact (acres)
Permanent (P) or
Temporary T
01 ? P ? T N/A N/A N/A N/A
4f. Total open water impacts NONE
4g. Comments: N/A

Page 3 of 8
PCN Form - Version 1.3 December 10, 2008 Version
5. Pond or Lake Construction
If and or lake construction proposed, then complete the chart below.
5a. 5b. 5c. 5d.

Pond ID
Proposed use or purpose of Wetland Impacts (acres) Stream Impacts (feet) pland
J

number cres
(a
)
pond
Flooded Filled Excavated Flooded Filled Excavated Flooded
P1 N/A N/A N/A N/A N/A N/A N/A N/A
P2
5f. Total NONE NONE NONE NONE NONE NONE NONE
5g. Comments: N/A
5h. Is a dam high hazard permit required?
? Yes ®No If yes, permit ID no: N/A
5i. Expected pond surface area (acres): N/A
5j. Size of pond watershed (acres): N/A
5k. Method of construction: N/A
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 an impacts require mitigation, then you MUST fill out Section D of this form.
6a.
? Neuse ® Tar-Pamlico ? Other:
Project is in which protected basin? ? Catawba ? Randleman
61b. 6c. 6d. 6e. 6f. 6g.
Buffer impact
number- Reason for Buffer Zone 1 impact Zone 2 impact
Permanent (P) or impact Stream name mitigation (square feet) (square feet)
Tern ora T required?
Site ®P ? T bank s

Buffer Impact 1
stabilization Middle Creek -1 No 720 SF NONE
Site ? P ®T temp s

Buffer Impact 1
access path Middle Creek ® No 600 SF 400 SF

6h. Total buffer impacts NONE 600 SF
6i. Comments: N/A
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 impacts to riparian buffers will be limited to those necessary to access the stream to remove the old concrete footer and
to reach the headwall and adjacent banks for armoring. Most of the access will utilize the space within the existing
transportation facility down the fill slope. This repair cannot be performed without access through the riparian buffer.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Sediment and erosion control Best Management Practices for protection of surface waters and riparian buffers will be
enforced during project construction.
Page 4 of 8
. PCN Form - Version 1.3 December 10, 2008 Version
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? ? Yes Z No
2b. If yes, mitigation is required by (check all that apply): ? DWQ ? Corps

2c. If yes, which mitigation option will be used for this project? ? Mitigation bank
? Payment to in-lieu fee program
? Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank: N/A
3b. Credits Purchased (attach receipt and letter) Type N/A Quantity N/A
3c. Comments: N/A
4. Complete if Making a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached. ? Yes
41b. Stream mitigation requested: N/A linear feet
4c. If using stream mitigation, stream temperature: ? warm ? cool ?cold
4d. Buffer mitigation requested (DWQ only): N/A square feet
4e. Riparian wetland mitigation requested: N/A acres
4f. Non-riparian wetland mitigation requested: N/A acres
4g. Coastal (tidal) wetland mitigation requested: N/A acres
41h. Comments: N/A
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.
N/A
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 requires
buffer mitigation? ? Yes ® No
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.

Zone 6c.
Reason for impact 6d.
Total impact
(square feet)
Multiplier 6e.
Required mitigation
(square feet)
Zone 1 N/A N/A 3 (2 for Catawba) N/A
Zone 2 N/A N/A 1.5 N/A
6f. Total buffer mitigation required: NONE
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: N/A
Page 5 of 8
PCN Form - Version 1.3 December 10, 2008 Version
E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1 a . Does the project include or is it adjacent to protected riparian buffers identified

within one of the NC Riparian Buffer Protection Rules? ® Yes ? No
1 b . If yes, then is a diffuse flow plan included? If no
explain why
,
.
Comments: this repair will not alter storm water runoff at this site
? Yes ®No
2. Stormwater Management Plan
2a . What is the overall percent imperviousness of this project? 20%
2b . Does this project require a Stormwater Management Plan? ? Yes ® No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why: NCDOT state Permit No. NCS000250
OES require a Stormwater Management Plan, then provide a brief, na rrative description of the plan: N/A
ff ? Certified Local Government
Whowill
onsible for the review o f the Stormwater Management Plan? ? DWQ Stormwater Program
? DWQ 401 Unit
3. Certified Local Government Stormwater Review -
3a. In which local government's jurisdiction is this project? Franklin County
? Phase 11
3b. Which of the following locally-implemented stormwater management programs ? NSW
apply (check all that apply): ? USMP
? Water Supply Watershed
? Other:
3c. Has the approved Stormwater Management Plan with proof of approval been ? Yes ? No
attached? N/A
4. DWQ Stormwater Program Review
? Coastal counties
4a. Which of the following state-implemented stormwater management programs apply E] HOW
? ORW
(check all that apply): N/A ? Session Law 2006-246
? Other:
41b. Has the approved Stormwater Management Plan with proof of approval been
attached? N/A ? Yes ? No
5. DWQ 401 Unit Stormwater Review
5a. Does the Stormwater Management Plan meet the appropriate requirements? N/A ? Yes ? No
51b. Have all of the 401 Unit submittal requirements been met? N/A ? Yes ? No
Page 6 of 8
PCN Form - Version 1.3 December 10, 2008 Version
F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1a . Does the project involve an expenditure of public if
funds or the
f

® Yes
No
El
use o
public (federal/state) land?
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 ? Yes ® No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1c. 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: N/A
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, ? Yes ® No
or Riparian Buffer Rules (15A NCAC 26.0200)?
2b. Is this an after-the-fact permit application? ? Yes ® No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s): N/A
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in
i ? Yes ®No
add
tional 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.
N/A
4. Sewage Disposal (DWQ Requirement) l
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.
N/A
Page 7 of 8
PCN Form - Version 1.3 December,10, 2008 Version
5-En
dangered Species and Designated Critical Habitat (Corps Requirement)
ll this project occur in or near an area with federally protected species or
f
bitat? ® Yes No
v
y
e
ou checked with the USFW S concerning Endangered Species Act
c
p
a
ts?
NCDOT biologist's survey on 08/20/09 revealed poor habitat for ? Yes ® No
DW M and TSM and no endangered mussel specimens were observed.
5c. If yes, indicate the USFWS Field Office you have contacted. ? Raleigh
? Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
hftp://www.fws,c;ov/nc-es/es/countvfr.html and NC Natural Heritage Program Database, Element Occurrences
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat? ? Yes No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
http://ocean.floridamarine.org/efh coral/ims/viewer.htm
-
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 (e.g., National Historic Trust designation or properties significant in ?Yes ®No
North Carolina history and archaeology)?
71b. What data sources did you use to determine whether your site would impact historic or archeological resources?
HPO's historic layer using GIS ArcView database
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain? ? Yes ® No
81b. If yes, explain how project meets FEMA requirements: N/A
8c. What source(s) did you use to make the floodplain determination? http://www.ncfloodmaDs.com/
J. W. Bowman, P.E. (? !/?" ?%7/09
Applicant/Agent's Printed Name Applicant/Agent's Signature
A Date
(
ge s signature is valid only if an authorization letter from the applicant
is provided.
Page 8 of 8
PCN Form - Version 1.3 December 10, 2008 Version

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AMW.

Remove
concrete footer
and sandbar

Photograph 1. View of sour by headwall and concrete footer and accumulated sediments
to be removed.
Temporary
access
through
_ buffer
.a
y
It-A
Photograph 2. Closer view of concrete footer and sketch of temporary access. Notice
beaver dam to be removed.
Bridge Maintenance - Bank Stabilization
SR 1203 (Green Hill Road)
Franklin County