20230151 Ver 1_ePCN Application_20230131

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Pre -Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
April 13, 2022 Ver 4.3
Initial Review
Has this project met the requirements for acceptance in to the review process?*
Yes
No
Is this project a public transportation project?*
Yes No
Change only if needed.
Pre -Filing Meeting Date Request was submitted on:
6/13/2022
BIMS # Assigned*
20230151
Is a payment required for this project?
No payment required
Fee received
Fee needed - send electronic notification
Select Project Reviewer*
Ryan Conchilla:eads\rjconchilla
Information for Initial Review
1a. Name of project:
Bridge 4141 Replacement Alamance County
1a. Who is the Primary Contact?*
Jerry Parker
1 b. Primary Contact Email:
[e-mail]
Date Submitted
1 /31 /2023
Nearest Body of Water
Wells Creek (Upper Cane Creek)
Basin
Cape Fear
Water Classification
WS-V, NSW 16-28-1
Site Coordinates
Latitude:
Longitude:
35.898593
79.457192
A. Processing Information
County (or Counties) where the project is located:
Alamance
Is this a NCDMS Project
Yes No
Is this project a public transportation project?*
Yes No
Version#*
1
Reviewing Office*
Central Office - [phone]
1c. Primary Contact Phone:*
[phone]
u
Is this a NCDOT Project?*
Yes No

(NCDOT only) T.I.P. or state project number:
WBS # (1(
7B.200111
1a. Type(s) of approval sought from the Corps:
Section 404 Permit (wetlands, streams and waters, Clean Water Act)
Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
Has this PCN previously been submitted?"
Yes
No
1 b. What type(s) of permit(s) do you wish to seek authorization?
Nationwide Permit (NWP)
Regional General Permit (RGP)
Standard (IP)
1c. Has the NWP or GP number been verified by the Corps?
Yes No
Nationwide Permit (NWP) Number: 14 - Linear transportation
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
401 Water Quality Certification - Regular
Non-404 Jurisdictional General Permit
Individual 401 Water Quality Certification
le. Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification:
For the record only for Corps Permit:
1f. Is this an after -the -fact permit application?*
Yes No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
Yes No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
Yes No
1 h. Is the project located in any of NC's twenty coastal counties?
Yes No
1j. Is the project located in a designated trout watershed?
Yes No
B. Applicant Information
1d. Who is applying for the permit?
Owner Applicant (other than owner)
le. Is there an Agent/Consultant for this project?"
Yes No
2. Owner Information
2a. Name(s) on recorded deed:
NCDOT
2b. Deed book and page no.:
2c. Contact Person:
Wright R. Archer III, PE
401 Water Quality Certification - Express
Riparian Buffer Authorization
Yes No
Yes No

2d.Address
Street Address
P.O. Box 14996
Address Line 2
1584 Yanceyville Street
City
Greensboro
Postal / Zip Code
27415-4996
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
NCDOT
3b. Business Name:
3c. Address
Street Address
1584 Yanceyville street
Address Line 2
P.O. Box 14996
City
Greensboro
Postal / Zip Code
27415
3d. Telephone Number:
[phone]
3f. Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1 b. Subdivision name:
(if appropriate)
1c. Nearest municipality / town:
Snow Camp
2. Project Identification
2a. Property Identification Number:
2c. Project Address
Street Address
Address Line 2
City
Postal / Zip Code
3. Surface Waters
3a. Name of the nearest body of water to proposed project:
Wells Creek (Upper Cane Creek)
3b. Water Resources Classification of nearest receiving water:
WS-V, NSW 16-28-1
3c. What river basin(s) is your project located in?*
Cape Fear
State / Province / Region
NC
Country
USA
2f. Fax Number
State / Province / Region
NC
Country
USA
3e. Fax Number
2b. Property size:
State / Province / Region
Country

3d. Please provide the 12-digit HUC in which the project is located.
030300020504
4. Project Description and History
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 existing condition is a bridge that no longer meets state standards. It is located in an area that is mostly agricultural with sparse residences. Streams and buffers exist on the property.
The general land use is primarily agricultural.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?
Yes No Unknown
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:
Approximately 75 linear feet
4h. Explain the purpose of the proposed project:
The purpose of the project is to replace a structurally deficient bridge that no longer meets state standards with a new aluminum box culvert.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used: *
This project involves the replacement of an existing 25.5 foot bridge with a 25'-4" x 9'-5" aluminum box culvert with inlet/outlet sills and headwall and endwall. The existing bridge has a
timber deck and timber vertical abutments with steel I -beams. The proposed culvert sills will be inset into the inlet and outlet approximately 2', and will have low flow notches to mimic the
existing stream width. Upstream and downstream stream banks will be stabilized with Class II rip rap. Grassed shoulders and fill slopes will be provided with final roadway section. Typical
roadway/construction equipment will be used such as dump trucks, dozers, track hoes, tamps and paving equipment.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
Yes No Unknown
Comments
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
Preliminary Approved Not Verified Unknown N/A
Corps AID Number:
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Nathan Howell/Mark Guerard
Agency/Consultant Company: Three Oaks Engineering
Other:
6. Future Project Plans
6a. Is this a phased project?*
Yes 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?
No
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
Wetlands Streams -tributaries Buffers
Open Waters Pond Construction
3. Stream Impacts
11
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
Culvert Construction
Permanent
Culvert
Wells Creek
Perennial
Both
10
45
Average (feet)
Qinear feet)
S2
Bank Stabilization
Permanent
Bank Stabilization J
Wells Creek
Perennial
Both
10
23
Average (feet)
Qinear feeQ
S3
Bank Stabilization
Temporary
Bank Stabilization J
Wells Creek
Perennial
Both
10
Average (feeQ
pinear feeQ

31. Total jurisdictional ditch impact in square feet:
0
31. Total permanent stream impacts: 3i. Total temporary stream impacts:
68 8
31. Total stream and ditch impacts:
76
3j. Comments:
6. Buffer Impacts (for DWR)
6a. Project is in which protect basin(s)?
Check all that apply.
Neuse Tar -Pamlico
Catawba Randleman
Goose Creek Jordan Lake
Other
6b. Impact Type
6c. Per or Temp
6d. Stream name
6e. Buffer mitigation required?
6f. Zone 1 impact
6g. Zone 2 impact
Road Crossing
P
Wells Creek
No
1,658
512
6h. Total buffer impacts:
Zone 1 Zone 2
Total Temporary impacts: 0.00 0.00
Zone 1
Zone 2
Total Permanent impacts: 1,658.00
512.00
Zone 1
Zone 2
Total combined buffer impacts: 1,658.00
512.00
61. Comments:
E. Impact Justification and Mitigation
1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
Roadway approach work was minimized as much as possible to reduce the overall footprint of the project. Future stream impacts will be lessened by
protecting the outlet and inlet ends of the culvert with bank stabilization.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
NCDOT Best Management Practices for Construction and Maintenance Activities and Best Management Practices for the Protection of Surface Waters
will be utilized throughout construction. Erosion and sedimentation devices will be installed prior to commencing work. Dewatering will occur during
construction to prevent impacts to downstream aquatic resources. A pre -construction meeting with the Division Environmental Supervisor or his
assignee will occur prior to commencing work.
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
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
Project does not meet nor exceed the thresholds for requiring mitigation.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
1. Diffuse Flow Plan
la. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection Rules?
Yes No
u

What type of SCM are you providing?
Level Spreader
Vegetated Conveyance (lower SHWT)
Wetland Swale (higher SHWT)
Other SCM that removes minimum 30 % nitrogen
Proposed project will not create concentrated stormwater flow through the buffer
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?
Yes No
Comments:
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?
Yes No
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 (North Carolina)
Environmental Policy Act (NEPA/SEPA)?*
Yes - No
Comments: *
Project does not meet the threshold for requiring a NEPA/SEPA document.
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)? *
Yes No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality?
Yes No
3b. If you answered "no," provide a short narrative description.
The project as proposed is a small scale public transportation project which by definition has a "low potential" for resulting in additional development.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
Yes No N/A
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?*
Yes No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
Yes No
5c. If yes, indicate the USFWS Field Office you have contacted.
Raleigh
5d. Is another Federal agency involved?*
Yes No
5e. Is this a DOT project located within Division's 1-8?
Yes No
Unknown
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
(PACs Website and consultation with USFWS representative
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?
Yes No

6b. What data sources did you use to determine whether your site would impact an 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 status?*
Yes No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
NCDOT Cultural Resource Personnel (see attached documents)
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
Yes No
8b. If yes, explain how project meets FEMA requirements:
Coordination with NCDOT Hydraulics Unit
8c. What source(s) did you use to make the floodplain determination?*
FEMA Flood Maps
Miscellaneous
Please use the space below to attach all required documentation or any additional information you feel is helpful for application review. Documents should be combined into one file when
possible, with a Cover Letter, Table of Contents, and a Cover Sheet for each Section preferred.
Click the upload button or drag and drop files here to attach document
Bridge #141 Cover Letter.pdf
167.14KB
Bridge #141 Buffer Package.pdf
1.12MB
Bridge #141 Wetland & Stream Package.pdf
1.16MB
Bridge #141 Bridge to Culvert Justification.pdf
84.47KB
Bridge #141 Effects Concurrence.pdf
766.24KB
Bridge #141 Tribal Letters.pdf
1.06MB
File must be PDF or KMZ
Comments
Signature
By checking the box and signing below, I certify that:
• The project proponent hereby certifies that all information contained herein is true, accurate, and complete to the best of my knowledge and belief'; and
The project proponent hereby requests that the certifying authority review and take action on this CWA 401 certification request within the applicable reasonable period of time.
• 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:
W. R. Archer III, PE
Signature
�jf/.5C?G'l ohm I,o�/,4
Date
1 /31 /2023
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