20120580 Ver 1_Application_20120612

4
A.
U
STATE OF NORTH CAROLINA 1 Z
DEPARTMENT OF TRANSPORTATION
BEVERLY EAVES PERDUE EUGENE TI JR
GOVERNOR SECRETAR
June 4 2012
U S Army Corps of Engineers
Regulatory Field Office
151 Patton Avenue, Room 208
Asheville, NC 28801 -5006
ATTN Ms Sarah Elizabeth Hair
NCDOT Coordinator
T20�E0
Subject Application for Section 404 Nationwide Permit 33 for the proposed
replacement of Bridge No 453 over Norkett Branch on SR 1003 (White Store
Road) in Union County, Federal Aid Project No BRSTP - 1003(40), WBS
Element 38594 1 1, Division 10, TIP No B -4824
Dear Madam
The North Carolina Department of Transportation ( NCDOT) proposes to replace Bridge No
453 over Norkett Branch on SR 1003 with a new 32'x9 x60' crownspan bottomless culvert
on the existing alignment There will be <0 01 acre (8 linear feet) of temporary stream
impacts due to the installation of temporary impervious dikes during culvert installation
Please see enclosed copies of the Pre - Construction Notification (PCN), permit drawings
stormwater management plan and design plans for the above - referenced project The
Programmatic Categorical Exclusion (PCE) was completed in June 2010 and distributed
shortly thereafter Additional copies are available upon request
This project calls for a letting date of March 19, 2013 and a review date of January 29, 2013,
however, the let date may advance as additional funding becomes available
MAILING ADDRESS TELEPHONE [phone] LOCATION
NC DEPARTMENT OF TRANSPORTATION FAX [phone]
PROJECT DEVELOPMENT AND ENVIRONMENTAL ANALYSIS 1020 BIRCH RIDGE DRIVE
1598 MAIL SERVICE CENTER WEBSITE WWW NCDOT ORG RALEIGH NC 27610-0328
RALEIGH NC 27699 1598

A copy of this permit application and its distribution list will be posted on the NCDOT
Website at http / /www ncdot org /doh/preconstruct/pe /neu/perimt html If you have any
questions or need additional information please call Erin Cheely at [phone]
Sincerel
��
Gregory J orpe, Ph D Manager
Project Development and Environmental Analysis Unit
cc
NCDOT Permit Application Standard Distribution List
2

W AT �9QG
��•1' O Y
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
®Section 404 Permit ❑Section 10 Permit
1 b Specify Nationwide Permit (NWP) number 33 or General Permit (GP) number
1c
Has the NWP or GP number been venfied by the Corps?
❑ Yes
® No
1 d
Type(s) of approval sought from the DWQ (check all that apply)
® 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
1h
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes
® No
2
Project Information
2a
Name of project
Replacement of Bridge No 453 over Norkett Branch on SR 1003 (White Store Road)
2b
County
Union
2c Nearest municipality / town
Marshvdle
2d
Subdivision name
not applicable
2e
NCDOT only T I P or state
project no
B 4824
3
Owner Information
3a
Name(s) on Recorded Deed
North Carolina Department of Transportation
3b
Deed Book and Page No
not applicable
3c Responsible Party (for LLC if
applicable)
not applicable
3d
Street address
1598 Mad Service Center
3e
City state zip
Raleigh NC 27699 1598
3f
Telephone no
[phone]
3g
Fax no
[phone]
3h
Email address
ekcheely@ncdot gov

4 Applicant Information (if different from owner)
4a Applicant is
❑ Agent ❑ Other specify
4b Name
not apphcable
4c Business name
(if applicable)
4d Street address
4e City state zip
4f Telephone no
4g Fax no
4h Email address
5 Agent/Consultant Information (if applicable)
5a Name
not appbcable
5b Business name
(if applicable)
5c Street address
5d City state zip
5e Telephone no
5f Fax no
5g Email address

B Project Information and Prior Project History
1 Property Identification
1a Property identification no (tax PIN or parcel ID)
not applicable
1 b Site coordinates (in decimal degrees)
Latitude 34 90200 Longitude 80 35637
(DD DDDDDD) ( DD DDDDDD)
1 c Property size
1 2 acres
2 Surface Waters
2a Name of nearest body of water (stream river etc) to
Norkett Branch
proposed project
2b Water Quality Classification of nearest receiving water
WS V
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 land use within the vicinity of the project consists of about 30% forest land (including mixed hardwood forests) 60%
cultivated land (pastures and agricultural fields) and 10% developed or disturbed land (roadsides and residential areas)
3b List the total estimated acreage of all existing wetlands on the property
0 (No wetlands)
3c List the total estimated linear feet of all existing streams (intermittent and perennial) on the property
180 linear feet
3d Explain the purpose of the proposed project
The purpose of this project is to replace a structurally deficient bridge (sufficiency rating 30 5 out of 100)
3e Describe the overall project in detail including the type of equipment to be used
The project involves replacing a 46 foot bridge with a 60 long 32 wide and 9 high crownspan bottomless culvert on the
existing alignment with an off site detour Standard road building equipment (trucks dozers cranes etc) will be used
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 Rapanos and JD request package sent 1/30/08
NCDOT is requesting a final JD with this permit
4b If the Corps made the jurisdictional determination what type
❑Preliminary [--] Finai
of determination was made
4c If yes who delineated the jurisdictional areas?
Agency /Consultant Company NCDOT
Name (if known) Erin Cheely
Other No JD issued due to only perennial streams
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 ❑ 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 ® No
6b If yes explain

C Proposed Impacts Inventory
1 Impacts Summary
la 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
Site 1 ❑ P ❑ T
❑ Yes
❑ No
❑ Corps
❑ DWQ
Site 2 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
Site 3 ❑ P ❑ T
❑ Yes
❑ No
❑ Corps
❑ DWQ
Site 4 ❑ P ❑ T
❑ Yes
❑ No
❑ Corps
I ❑ DWQ
Site 5 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
Site 6 ❑ P ❑ T
❑ Yes
❑ No
❑ Corps
❑ DWQ
2g Total wetland impacts
0 Permanent
0 Temporary
2h Comments No wetlands within the project limits
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
Average
Impact length
number
(PER) or
jurisdiction
stream
(linear feet)
Permanent (P) or
intermittent
(Corps 404 10
width
Temporary (T)
(INT)?
DWQ — non -404
(feet)
other)
Site 1 ❑ POT
Impervious
Dike
Norkett Branch
® PER
❑ INT
® Corps
❑ DWQ
10
8 ( <0 01ac)
Site 2 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
Site 3 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
Site 4 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
Site 5 ❑ POT
❑ PER
❑ Corps
❑ INT
❑ DWQ
Site 6 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
3h Total stream and tributary impacts
0 Perm
8 Temp
31 Comments <0 01 ac (810 of temporary impact from installation of impervious dikes Once dikes are in place a 32 x9 x60
crownspan culvert will be installed No permanent impacts No impacts from bridge demolition or utility relocation

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 indiv ually list all open water impacts below
4a
4b
4c
4d
4e
Open water
Name of
impact number —
waterbody
Type of impact
Waterbody type
Area of impact (acres)
Permanent (P) or
(if applicable)
Tem ora T
01 ❑P ❑T
02 ❑ PE] T
03 ❑P ❑T
04 ❑P ❑T
4f Total open water impacts
0 Permanent
0 Temporary
4g Comments No open waters within project limits
5 Pond or Lake Construction
If pond or lake construction proposed then complete the chart below
5a
5b
5c
5d
5e
Wetland Impacts (acres)
Stream Impacts (feet)
Upland
Pond ID
Proposed use or
(acres)
number
purpose of pond
Flooded
Filled
Excavat
Flooded
Filled
Excavated
Flooded
ed
P1
P2
5f Total
5g Comments
5h Is a dam high hazard permit required
❑ Yes ❑ No If yes permit ID no
51 Expected pond surface area (acres)
5) 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
❑ Neuse El Tar Pamlico El Other
Project is in which protected basin?
❑ Catawba ❑ Randleman
6b
6c
6d
6e
6f
6g
Buffer impact
number—
Reason for impact
Buffer
Zone 1 impact
Zone 2 impact
Permanent (P) or
Stream name
mitigation
(square feet)
(square feet)
Temporary
required?
B1 ❑P ❑T
❑Yes
❑ No
B2 ❑ P ❑ T
❑ Yes
❑ No
B3 ❑P ❑T
El Yes
❑ No
6h Total buffer impacts
61 Comments Project is not in a protected buffer area

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 new crownspan bottomless culvert will be located on the same alignment as the existing bridge There is a reduction
of impervious area for this project due to the elimination of the paved shoulder at the existing bridge deck location
Water will not discharge directly from the roadway into the creek The roadway runoff will receive treatment from the
open grass shoulders and fill slopes The walls of the proposed final crownspan structure will be set back from the
existing top of stream bank at least 1 foot
lb Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques
By using a bottomless culvert the natural streambed will be preserved and fish passage will not be impeded The use of
impervious dikes during culvert construction will avoid any permanent impacts to the stream and minimize the temporary
impacts as well
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 ® No
If no explain Only temporary impacts, no permanent
2b If yes mitigation is required by (check all that apply)
❑ DWQ ❑ Corps
2c If yes which mitigat ion 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 not applicable
3b Credits Purchased (attach receipt and letter)
Type
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
❑ warm ❑ cool ❑cold
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 The NCDOT does not propose mitigation for the <0 01 ac of temporary impacts from impervious dike
installation This impact does not require permanent fill in the stream bed and therefore under Section 404 of the Clean
Water Act does not constitute Loss of Waters of the U S and is not subject to compensatory mitigation
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

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
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)
6h Comments

E
Stormwater Management and Diffuse Flow Plan (required by DWQ)
1
Diffuse Flow Plan
la
Does the project include or is it adjacent to protected riparian buffers identified
❑ Yes ® No
within one of the NC Riparian Buffer Protection Rules?
1 b
If yes then is a diffuse flow plan included? If not explain why
❑ Yes ❑ No
Comments
2
Stormwater Management Plan
2a
What is the overall percent imperviousness of this project?
N/A
2b
Does this project require a Stormwater Management Plan?
® Yes ❑ No
2c
If this project DOES NOT require a Stormwater Management Plan explain why
2d
If this project DOES require a Stormwater Management Plan then provide a brief narrative
description of the plan
See attached permit drawings
❑ Certified Local Government
2e
Who will be responsible for the review of 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?
not applicable
❑ Phase II
❑ NSW
3b
Which of the following locally implemented stormwater management programs
❑ USMP
apply (check all that apply)
❑ 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
4a
Which of the following state implemented stormwater management programs apply
❑ HQW
(check all that apply)
❑ ORW
❑ 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 N/A
5b Have all of the 401 Unit submittal requirements been met?
❑ Yes ❑ No N/A

F Supplementary Information
1 Environmental Documentation (DWQ Requirement)
la Does the project involve an expenditure of public (federal /state /local) funds or the
® Yes ❑ No
use of public (federal /state) land?
lb 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
®Yes El No
letter)
Comments PCE signed June 2010
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 2B 0200)?
2b Is this an after the fact permit applications
❑ Yes ® No
2c If you answered yes to one or both of the above questions provide an explanation of the violation(s)
3 Cumulative Impacts (DWQ Requirement)
3a Will this project (based on past and reasonably anticipated future impacts) result in
❑ Yes
additional development which could impact nearby downstream water quality?
® No
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
Due to the minimal transportation impact resulting from this bridge replacement 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 (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
not applicable
10

5 Endangered Species and Designated Critical Habitat (Corps Requirement)
5a WIII this project occur in or near an area with federally protected species or
® Yes ❑ No
habitat?
5b Have you checked with the USFWS concerning Endangered Species Act
❑ Yes ® No
impacts?
E:1 Raleigh
5c If yes Ind Icate the USFWS Field Office you have contacted
❑ Asheville
5d What data sources did you use to determine whether your site would Impact Endangered Species or Designated Critical
Habitat?
While habitat exists within the project area for Michaux s sumac and Schweinitz s sunflower no individuals of these
species are found within the project limits (project area was surveyed by NCDOT biologists in 2007 2009 and 2011) The
project has also been surveyed for Carolina heelsplitter by NCDOT biologists and no mussels of any species were found
with the nearest heelsplitter occurance being over 15 miles (straight line distance) away Thy protect will have no effect
on any Federally Threatened or Endangered species listed for Union County
6 Essential Fish Habitat (Corps Requirement)
6a WIII this project occur in or near an area designated as essential fish habitats
❑ Yes ® No
6b What data sources did you use to determine whether your site would impact Essential Fish Habitat?
NMFS County Index
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 ® 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?
NEPA Documentation
8 Flood Zone Designation (Corps Requirement)
8a WIII this project occur in a FEMA designated 100 year floodplain?
❑ Yes ® No
8b If yes explain how project meets FEMA requirements NCDOT Hydraulics Unit coordination with FEMA
8c What source(s) did you use to make the floodplain determination? FEMA Maps
6"1'12,
Dr Gregory J Thorpe, PhD
Date
Applicant/Agents Printed Name
AplVcilnt ent s Signature
Par
(Agent s signature is valid only, authorization letter from the applicant
is provided
11

PROPERTY OWNERS
NAMES AND ADDRESSES
PARCEL NO NAMES
ADDRESSES
ALL IMPACTS EXIST WITHIN NCDOT ROW
J
Permit Drawing
Sheet a of
DIVISION OF HIGHWAYS
UNION COUNTY
PROJECT 3859411 (B-4824)
BRIDGE NO 453 ON
SR 1003 (WHITE STORE RD)
OVER NORKETT CREEK
SHEET OF 4/17/12

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