20230219 Ver 2_ePCN Application_20230630

DWR
Division of Water Resources
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:
6/29/2023
BIMS # Assigned
20230219
Is a payment required for this project?*
No payment required
Fee received
Fee needed - send electronic notification
Select Project Reviewer*
Dave Wanucha:[e-mail]
Information for Initial Review
la. Name of project:
NCDOT TIP BP9.R009
1a. Who is the Primary Contact?*
Amy Euliss
1b. Primary Contact Email: *
[e-mail]
Date Submitted
6/30/2023
Nearest Body of Water
South Fork Muddy Creek
Basin
Yadkin-PeeDee
Water Classification
Class C
Site Coordinates
Latitude:
36.010947
A. Processing Information
Is this project connected with ARPA funding?
Yes No
County (or Counties) where the project is located:
Forsyth
Is this a NCDMS Project
Yes No
Longitude:
-80.270469
Version#*
2
Reviewing Office *
Winston-Salem Regional Office - (336) 776-
9800
1c. Primary Contact Phone: *
[phone]
8
Is this project a public transportation project?*
Yes No

Is this a NCDOT Project?*
Yes No
(NCDOT only) T.I.P. or state project number:
BP9.R009
WBS # (1)
BP9.R009.1
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
1b. 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: 13 - Bank Stabilization
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
1h. 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 Project
2b. Deed book and page no.:
2c. Contact Person:
Amy Euliss
401 Water Quality Certification - Express
Riparian Buffer Authorization
Yes No
Yes No

2d. Address
Street Address
375 Silas Creek Parkway
Address Line 2
city
Winston-Salem
Postal / Zip Code
27127
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(If appropriate)
1c. Nearest municipality I town:
Winston-Salem
2. Project Identification
State / Province / Region
NC
Country
USA
2f. Fax Number:
2a. Property Identification Number: 2b. Property size:
NCDOT Project 2.65
2c. Project Address
Street Address
Multiple
Address Line 2
City State / Province / Region
Postal / Zip Code Country
3. Surface Waters
3a. Name of the nearest body of water to proposed project:
South Fork Muddy Creek
3b. Water Resources Classification of nearest receiving water:
Class C
3c. What river basin(s) is your project located in?
Yadkin-PeeDee
3d. Please provide the 12-digit HUC in which the project is located.
030401011307
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:
Land use in the project area consists primarily of residential and utility infrastructure interspersed with forested areas.
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:
136'
4h. Explain the purpose of the proposed project: *
The NCDOT is proposing to replace the existing Bridge No. 241 on SR 3011 (Old Salisbury Rd) over South Fork Muddy Creek in Winston-Salem, NC with a modern two-lane bridge.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used: *
The existing bridge was deemed functionally obsolete by NCDOT and will be replaced with one that includes 2 11-foot lanes and 5 foot paved shoulders on both sides of the bridge. The
roadway approaches will have 6-foot shoulders, 4 feet of which will be paved. Typical roadway construction equipment such as bulldozer, excavator, semi -truck, grader, asphalt mixer, and
road roller are expected to be used.
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:
SAW-2022-00274
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Nathan Howell
Agency/Consultant Company: Three Oaks Engineering
Other:
5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
February 28, 2022
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
r1
-
F
S1
3a. Reason for impact (?)
Bank stabilization
3b.lmpact type*
Permanent
3c. Type of impact*
Bank Stabilization J
3d. S. name*
South Fork Muddy Creek
3e. Stream Type*
(?)
Perennial
3f. Type of
Jurisdiction*
Both
3g. S. width
65
Average (feet)
3h. Impact
length*
208
(linear feet)
g2
Bank stabilization
Temporary
Bank Stabilization J
South Fork Muddy Creek
Perennial
Both
65
Average (feet)
15
(linear feet)
3i. Total jurisdictional ditch impact in square feet:
0
31. Total permanent stream impacts: 3i. Total temporary stream impacts:
208 15
31. Total stream and ditch impacts:
263
3j. Comments:
The water line impacts shown on the permit plans were completed by the City of Winston Salem under a non -reporting NW 58 and thus not included in
the stream impacts above.
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:
Avoidance and minimization of impacts to protected and valued resources were incorporated throughout the design process. A detailed delineation of
wetland and streams was initially performed to determine the boundaries of natural resources. As a result, proposed disturbance limits were shifted to
avoid impacts where possible.
Q
V

1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
This design alternative was selected after considering many factors, including avoidance and minimization of wetland and stream impacts. Specifically,
the following were considered:
Minimization of impacts to Friedberg Marsh Mitigation site.
- Steepness of slopes were considered and fill slopes increased to the degree practicable to minimize impacts. In some areas, slopes of 2:1 and flatter
were necessary due to safety and design constraints.
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:
There are no'loss of water' impacts that require compensatory mitigation.
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?
Yes No
If no, explain why:
The project is not located in a river basin subject to statewide riparian buffer rules.
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?
Yes No
Comments:
Stormwater management plan is included with the project permit drawings.
G. Supplementary Information
1. Environmental Documentation
1a. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?
Yes No
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 (North Carolina)
Environmental Policy Act (NEPA/SEPA)?*
Yes No
Comments: *
A CE was completed for environmental documentation.
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 proposes to improve transportation infrastructure to alleviate congestion in the future.
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
8

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.
Asheville
5d. Is another Federal agency involved?
Yes No
What Federal Agency is involved?
FHWA
5e. Is this a DOT project located within Division's 1-8?
Yes No
5f. Will you cut any trees in order to conduct the work in waters of the U.S.?
Yes No
5g. Does this project involve bridge maintenance or removal?
Yes No
5g(1). If yes, have you inspected the bridge for signs of bat use such as staining, guano, bats, etc.?
Yes No
If you answered "Yes" to 5g(1), did you discover any signs of bat use?
Yes No Unknown
5h. Does this project involve the construction/installation of a wind turbine(s)?*
Yes No
Unknown
5i. 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.?
Yes No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
The U.S. Fish and Wildlife Service (USFWS) IPaC list for the study area, dated June 14, 2023, lists Schweinitz's sunflower as endangered and the
Tricolored Bat as proposed endangered. It also lists the Bog Turtle as threatened due to similarity of appearance, and the Monarch Butterfly is listed as a
candidate species.
No suitable habitat for the Bog Turtle occurs within the study area. A biological conclusion is not required for the bog turtle.
Suitable habitat for Schweinitz's Sunflower is present in the study area. Plant -by -plant surveys for this species were conducted on September 24, 2021.
No specimens of Schweinitz's sunflower were observed. A NCNHP data explorer report dated July 2021, revealed no known occurrences of this species
within 1.0 mile of the study area. The biological conclusion for this species is No Effect.
The Tricolored Bat was proposed to be listed in September 2022. NCDT initiated consultation with USFWS for a NLAA (not likely to adversely affect)
since it will likely be listed prior to completion of the project. A copy of the concurrence request is included in the permit application. A culvert survey was
conducted on August 10, 2022, of both structures within the study area with a minimum height of 3-feet and minimum length of 60-feet. Both culverts
were surveyed using a 1,000- lumen spotlight to inspect crevices for bats and search for evidence of bat use in the form of guano, staining, and urine.
No specimens of bats or evidence of bats was observed. The Bat Structure Survey Memo is provided in the appendix. A NCNHP data explorer report
dated August 24, 2022, revealed no known occurrences of either of these species within 1.0 mile of the study area. At this time, no biological conclusion
is required for these species.
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?
NOAA Fisheries EFH Mapper
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?"
There were no archeological resources present or affected. Historic architecture and landscape surveys resulted in a'No Historic Properties Present or
Affected' determination. Tribal coordination with the Catawba is provided in the attachments. Documentation is included for all three resources.
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:
This project involves construction activities on or adjacent to FEMA-regulated streams. Therefore, the Division will submit sealed as -built construction
plans to the NCDOT Hydraulics Unit upon completion of project construction, certifying that the drainage structures and roadway embankment that are
located within the 100-year floodplain were built as shown in the construction plans, both horizontally and vertically.
Additionally, the Hydraulics Unit will coordinate with the NC Floodplain Mapping Program (FMP), the delegated state agency for administering FEMA's
National Flood Insurance Program, to determine the status of the project with regard to applicability of NCDOT'S Memorandum of Agreement, or
approval of a Conditional Letter of Map Revision (CLOMR) and subsequent final Letter of Map Revision (LOMR).
8c. What source(s) did you use to make the floodplain determination?
DFIRM panel 3710682200J (panel 6822 revised 01/02/2009)
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
ePCN Supporting Documentation.pdf 35.75MB
File must be PDF or KMZ
Comments
Please refer to the attached supporting documentation for additional information.
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:
Amy Euliss
Signature
Date
6/30/2023
a