20180201 Ver 1_PCN Form Submission_20180213

Action History (UTC-05:00) Eastern Time (US & Canada)
�brrrit by Anonymous User 2/13/2018 8:48:44 AM (Start Event)
Accept by Carpenter,Kristi 2/13/2018 2:36:05 PM (DOT Initial Review)
• The task was assigned to Carpenter,Kristi . The due date is: February 16, 2018 5:00 PM
2/13/2018 8:49 AM

E-PCN Submittal
���
�lulslaa af Water Resources
Pre-Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
January 31, 2018 Ver 2.3
*
Please note: fields marked with a red asterisk below are required. You will not be ab/e to submit the form until all mandatory questions are ans�red.
Also, if at any point you wish to print a copy of the E-PCN, all you need to do is right-click on the document and you can print a copy of the form.
Below is a link to the online help file.
https://edocs. deq. nc.gov/WaterResources/0/edoc/624704/PCN%20Help%20File%202018-1-30. pdf
A. Processing Information
County(or Counties) where the project is located:*
Buncombe
Is this project a public transportation project? *(')
C�' Yes C' No
Is this a NCDOT Project?*
r Yes C' No
(NCDOT only) T.I.P. or state project number:
Bridge 100026 Buncombe
WBS #
17BP.13.R.138
(for NCDOT use only)
1a. Type(s) of approval sought from the Corps:*
rJ Section 404 Permit (wetlands, streams and waters, Clean Water Act)
r Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
1b. What type(s) of permit(s) do you wish to seek authorization?*
fJ Nationwide Permit (NWP)
r Regional General Permit (RGP)
Nationwide Permit (NWP) Number: 14 - Linear transportation
NWP Number Other:
List all MNnurrbers you are applying for not on the drop down list.
1c. Type(s) of approval sought from the DWR:*

check all that apply
r% 401 Water Quality Certification - Regular r 401 Water Quality Certification - E�ress
r Non-404 Jurisdictional General Permit r Riparian Buffer Authorization
*
1d. Is this notification solelyfor the record because written approval is not required?
For the record only for DWR 401 Certification: �' Yes C•' No
For the record only for Corps Permit: �' Yes C�' No
1e. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
If so, attach the acceptance letter from rritigation bank or in-lieu fee program
C' Yes �' No
1f. Is the project located in anyof NC's twentycoastal counties?*
C' Yes C•' No
1h. Is the project located in a designated trout watershed?*
f Yes C•' No
Link to trout information: http://w�nn�v.saw.usace.army.mil/Missions/Regulatory-Permit-PrograrrUAgency-Coordination/Trout.aspx
B. Applicant Information
1a. Who is the Primary Contact?*
Roger Bryan
1b. Primary Contact Email:*
[e-mail]
1c. PrimaryContact Phone:*
(xxx)xxx-xxxx
[phone]
1d. Who is applying for the permit?
I7 Owner r Applicant (other than owner) r AgenUConsultant
(Check all that apply)
2. Owner I nformation
2a. Name(s) on recorded deed:
NC DOT
2b. Deed book and page no.:
2c. Responsible party:
(for Corporations)
2d.Address
Street Address
Address Line 2
�'
Fbstal / Zip Code
I 2e. Telephone Number:
(xxx)xxx-xxxx
2f. Fax Number:
(xxx)xxx-xxxx
State / Rovince / F�gion
Country

2g. Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1a. Name of project:*
Bridge 100026 Buncombe
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality/town:*
Sandy Mush
1d. Driving directions*
If it is a new project and can not easily be found in a C�S rrapping system Rease provide directions.
Take NC 63 then turn left onto SR 1220 (South Turkey Creek Road) and go several miles and turn right onto SR 1384.
2. Project Identification
2a. Property Identification Number:
(tax RNor parcel ID)
2b. Propertysize:
(in acres)
2c. Project Address
Street Address
Address Line 2
Qty
Fbstal / Zip Code
State / Rovince / F�gion
Country
2d. Site coordinates in decimal degrees
I Please collect site coordinates in decimal degrees. Use between 4-6 digits (unless you are using a survey-grade GPS device) after the decimal place as
appropriate, based on howthe location was determined. (For example, most mobile phones with GPS provide locational precision in decimal degrees to
I map coordinates to 5 or 6 digits after the decimal place.)
Latitude:* Longitude:*
35.62688 -82.76170
ex:34.208504 -77.796371
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
South Turkey Creek
3b. Water Resources Classification of nearest receiving water:*
Class C
Surface Water Lookup

3c. What river basin(s) is your project located in?*
French Broad
RiverBasin Lookup
4. Project Description
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 bridge is surrounded by farm and pasture lands.
4b. Attach an 8 1/2 X 11 excerpt from the most recent version of the USGS topographic map indicating the location of the project site. (for
DWR)
Gick the upload button or drag and drop files here to attach docurrent
Bridge 100026 Buncombe Topo Map.pdf 760.55KB
Fle type rrust be pdF
4c. Attach an 8 1/2 X 11 excerpt from the most recent version of the published County NRCS Soil Survey map depicting the project site.
(for DWR)
Gick the upload button or drag and drop files here to attach docurrent
Fle type rrust be pdf
4d. List the total estimated acreage of all existing wetlands on the property:
0.0
4e. List the total estimated linear feet of all existing streams on the property:
(interrrittent and perennial)
150
4f. Explain the purpose of the proposed project:*
The project will replace a structural deficient bridge with a spanning structure.
4g. Describe the overall project in detail, including indirect imapacts and the type of equipment to be used:*
The e�asting bridge will be removed and the footing/abutments for the three-sided culvert (conspan) will be
constructed. The precast sections will then be set into place by crane. Excavator, crane, and trucks will be used
during construction. No impacts to the stream channel will occur.
4h. Please upload project drawings for the proposed project.
C7ick the upload button or drag and drop files here to attach docurrent
Bridge 100026 Buncombe Permit Plans.pdf 1.35M6
Bridge 100026 Buncombe SMP.pdf 1.63M6
Fle type rrust be pdF
5. Jurisdictional Determinations
Sa. Have the wetlands or streams been delineated on the propertyor proposed impact areas?*
C' Yes C� No !' Unknown
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
C' Preliminary �' Approved C' Unknown C� WA
Corps AID Number:
Exarrple: SAV�2017-99999
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):

Sc. If 5a is yes, who delineated the jurisdictional areas?
Agency/Consultant Company:
Othe r:
5d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
5d1. Jurisdictional determination upload
aick the upload button or drag and drop files here to attach docurrent
Fle type rrust be F�F
6. Project History
6a. Have permits or certifications been requested or obtained for this project (including all prior phases) in the past?*
C' Yes C•' No C' Unknown
7. Future Project Plans
7a. Is this a phased project?*
C' 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? This includes other separate and distant crossing for linear projects that require Department of the
Army authorization but don't require pre-construction notification.
D. Proposed Impacts Inventory
1. Impacts Summary
� 1a. Where are the impacts associated with your project? (check all that apply):
� Wetlands I7 Streams-tributaries r Buffers
r Open Waters r Pond Construction
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. Site #- Reason for 3b.lmpact
i impact* type*
1 P
N�p label (e.g. Finad Qossing 1) F2rrranent (Pj or
Terrporary (�
1 P
N�p label (e.g. f3�ad Q'ossing 1) F2rrranent (P'j or
Terrporary (�
1 T
N�p label (e.g. F3�ad Qossing 1) f�rrranent (P� or
Terrporary (�
3c. Type of impact* 3d. Stream name *
Fill South Turkey Creek
Bank Stabilization South Turkey Creek
Dewatering South TurkeyCreek
3e. Stream
Type *
Perennial
F2rennial (F�Z) or
interrrittent (If�
Perennial
F�rennial (FH�) or
interrrittent (If�
Perennial
F�rennial (F�2) or
interrrittent (IfVn
*' All Perennial or Intermittent streams must be verified by DWR or delegated local government.
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
3f. Type of
Jurisdiction *
Both
Both
Both
3g. Stream 3h. Impact
width* length*
17 50
Average (feet) Qinear feet)
17 90
Average(feet) (linearfeet)
17 60
Average(feet) (linearfeet)

140
3i. Total temporarystream impacts:
60
3i. Total stream and tributary impacts:
200
3j. Comments:
The Fill impact will be for the footings/abutments that will be between stream edge and ordinary high water mark.
Bank Stabilization will occur 30 feet upstream and 60 feet downstream of the three-sided structure. Dewatering will
occur during construction of footings/abutments.
E. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:*
The bridge will be replaced with a spanning structure thereby avoiding impact to the stream channel.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*
Dewatering and installation of erosion control measures will limit the potential for sedimentation during project
construction.
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?
C' Yes C•' No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
The project is a spanning structure that does not impact the stream channel.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
""` Recent changes to the stormwater rules have required updates to this section .*'*
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?
C' Yes �' No
For a list of options to meet the diffuse flow requirements, click here.
If no, explain why:
French Broad Basin does not have buffer protection rules.
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
G Yes C' No
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?*

r Yes r 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 PolicyAct (NEPA/SEPA)?*
C' Yes �' No
Comments:*
The project is covered by the Minimum Criteria Rules under Category 9(19A NCAC 02F.0102).
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)? *
I C' Yes �' No
2b. Is this an after-the-fact permit application?*
C' Yes �' No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in additional development, which could impact
nearby downstream water quality?*
C' Yes �' No
3b. If you answered "no," provide a short narrative description.
Replacement of bridge with similar structure. No increase in roadway width or capacity.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project? *
C' Yes C' No r f�/A
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
Sa. Will this project occur in or near an area with federally protected species or habitat? *
C' Yes C•' No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
C' Yes C•' No
5d. Is another Federal agency involved?*
C' Yes C' No
5e. Is this a DOT project located within Division's 1-8?*
C' Yes C� No
5f. Will you cut anytrees in order to conduct the work in waters of the U.S.?*
f Yes C•' No
5g. Does this project involve bridge maintenance or removal?*
�' Yes C' No
�' Unknown
5g(1). If yes, have you inspected the bridge for signs of bat use such as staining, guano, bats, etc.? Representative photos of signs of
bat use can be found in the NLEB SLOPES, Appendix F, pages 3-7.
C' Yes C' No
Link to the NLEB SLOPES document: http://sav�reg.usace.army.mil/NLEB/1-30-17-signed_NLEB-SLOPES&apps.pdF
If you answered "Yes" to 5g(1), did you discover any signs of bat use?*

C' Yes �' No C' Unknown
*""' If yes, please show the location of the bridge on the permit drawings/project plans.
5h. Does this project involve the construction/installation of a wind turbine(s)?"*
C' Yes C' No
Si. 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.?*
C' Yes C� No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?*
Current distribution maps
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
C' Yes C•' No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
Current maps
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
Link to the State Historic Preservation Office Historic Properties Map (does not include archaeological data: http://gis.ncdcr.gov/hpoweb/
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 North Carolina history and archaeology)? *
C' Yes r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources? *
The project was evaluated by NC DOT personnel for cultural resources under a Programmatic Agreement.
7c. Historic or Prehistoric Information Upload
Gick the upload button or drag and drop files here to attach docurrent
Bridge 100026 Buncombe Archaeology Form.pdf 861.75KB
Bridge 100026 Buncombe Historic Architecture Form.pdf 3.98M6
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8. Flood Zone Designation (Corps Requirement)
Link to the FEMA Floodplain Maps: https://msc.fema.gov/portal/search
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
C' Yes �' No
8c. What source(s) did you use to make the floodplain determination?*
Current mapping
Miscellaneous
Miscellaneous attachments not previously requested.
aick the upload button or drag and drop files here to attach docurrent
Bridge 100026 Buncombe Corps Cover Sheet.pdf 3.89KB
Bridge 100026 Buncombe Cover Letter.pdf 643.52KB
Bridge 100026 Buncombe photos.pdf 1.19MB
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Signature
r7 By checking the box and signing below, I certify that:
■ 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 AcY');
■ I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic
Transactions AcY');
■ 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:*
Roger D. Bryan
Signature
��� �. ��y�

Initial Review
Is this project a public transportation project? *(?)
C� Yes C' No
Change only if needed.
Has this project met the requirements for acceptance in to the review process?*
C� Yes
C' No
BIMS # Assigned*
20180201
Version#*
Reviewing Office *
Asheville Regional Office - [phone]
Select Project Reviewer*
Kevin Barnett:eads\khbarnett
Is a payment required for this project?*
C' No payment required
�' Fee received
C' Fee needed - send electronic notification