20190331 Ver 1_PCN Form Submission_20190311

D1�VR
�irlslan af Water Resources
Initial Review
Pre-Construction Notification (PCN) Form
September 29, 2018 Ver 3
Has this project met the requirements for acceptance in to the review process?*
F Yes
C' No
Is this project a public transportation project?"
� Yes r No
Change only rf needed.
BIMS # Assigned *
20190331
Is a payment required for this project?*
f No paymentrequired
� Fee received
f Fee needed - send electronic notification
Select Project Reviewer"
Dave Wanucha:eads\djwanucha
Information for Initial Review
1a. Name of project:
Replacement of Bridge #790051 on SR 1926 over Deals Creek
1a. Who is the PrimaryContact?*
Amy Euliss — NCDOT Div 9 EO
1b. PrimaryContact Email:*
[e-mail]
Date Submitted
3/11 /2019
Nearest Body of Water
Deals Creek
Basin
Yadkin-PeeDee
Water Classification
C
Site Coordinates
Latitude:
35.743370
A. Processing Information
County (or Counties) where the project is located:
Rowan
Is this project a public transportation project?*
r Yes r No
Is this a NCDOT Project?*
G Yes r No
(NCDOT only) T.I.P. or state project number:
Ve rsion# *
1
Reviewing Office *
Winston-Salem Regional Office - (336) 776-
9800
1c. PrimaryContact Phone:*
[phone]
Longitude:
-80.462895
::
WBS # (�)
17BP.9.R.76
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)
r Standard (IP)
1c. Has the NWP or GP number been verified bythe Corps?
C' Yes r No
Nationwide Permit (NWP) Number:
14 - Linear transportation
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
fJ 401 Water Quality Certification - Regular
r' Non-404 Jurisdictional General Permit
r Individual Permit
1e. Is this notification solelyfor the record because written approval is not required?
Forthe record onlyfor DWR401 Certification:
For the record onlyfor Corps Permit:
r 401 Water Quality Certification - E�ress
r Riparian Buffer Authorization
1f. Is this an after-the-fact permit application?*
� Yes r No
1g. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
F Yes r No
1g. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
� Yes r No
Acceptance LetterAttachment
SR 1621 - Bridge 81 - Division 9- RW - YD 103.pdf
1h. Is the project located in any of NC's twenty coastal counties?
C' Yes r No
1j. Is the project located in a designated trout watershed?
� Yes r No
B. Applicant Information
1d. Who is applying for the permit?
rJ Owner r Applicant (other than owner)
1e. Is there an Agent/Consultant for this project?
� Yes r No
2. Owner Information
2a. Name(s) on recorded deed:
NCDOT Division 9
2b. Deed book and page no.:
2c. Responsible party:
2d. Address
Street Address
375 Silas Creek Parkway
Address Line 2
�Y
Winston-Salem
Fbstal / Zip Code
27127
2e. Telephone Number:
[phone]
S[ate / FYovince I Region
NC
Cauntry
USA
2f. Fax Number:
[phone]
69.57KB
x
C' Yes R No
C' Yes G No
�,

2g. Email Address:*
[e-mail]
C. Project Information and Prior Project History "
1. Project Information
1b. Subdivision name:
(rf appropriate)
1c. Nearest municipality/town:
Salisbury
2. Project Identification
2a. Propertyldentification Number:
N/A
2c. Project Address
Street Address
SR 1926 over Deals Creek
Address Line 2
�Y
Salisbury
Postal I Zip Code
3. SurFace Waters
3a. Name of the nearest body of water to proposed project:*
Deals Creek
3b. Water Resources Classification of nearest receiving water:*
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.
030401030105
4. Project Description and History
2b. Property size:
7.2
State / Rovince I f�gion
NC
Country
USA
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:*
Exsting conditions include SR 1926 (Hannah Ferry Road), undeveloped forest and the disturbed/maintained right-of-way.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
C' Yes �' No G Unknown
4d. 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)
R76_BridgeSl_Figure1_USGSMap.pdf 3A2MB
4e. 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)
R76_BridgeS1_Figure2_SoilsMap.pdf 274MB
4f. List the total estimated acreage of all existing wetlands on the property:
2.44
4g. List the total estimated linear feet of all existing streams on the property:
329
4h. Explain the purpose of the proposed project:"
To remove Bridge #790081 and replace with a new, modern bridge structure.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
Erosion and sedimentation control measures will be installed after the hand dearing of vegetation is conducted. Bridge replacement construction adjacent to the ebsting bridge using
heavy equipment from the upland roadway approaches. Deck drains on the bridge do not discharge directly into the stream. Bridge demolition will occur after the bridge and new
roadway approaches are completed. Demolition will include the removal of the bridge deck and removal of the abutments to the ground line to avoid utility impacts. Replacing the bridge
on new alignment to the southeast (downstream) is required to: provide continued access to the end of the road because of the presence of a water main to the northv�st (upstream);
no detour route is available; and, this alignment also avoids impacts to the hibutary to Deals Creek.
4j. Please upload project drawings for the proposed project.
R76_Permit_Pla ns_2019-03-01. pdf
17BP.9.R.76_HYD SMPv2.07_(Oct2016).ptlf
2.33MB
171.14KB
5. Jurisdictional Determinations

Sa. Have the wetlands or streams been delineated on the property or proposed impact areas?"
� Yes r No
Comments:
Please see attached Jurisdictional Determination forms and mapping.
Sb. If the Corps made a jurisdictional determination, what type of determination was made?*
� Preliminary r Approved � Not Verified � Unknown r WA
Corps AID Number:
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
Sd1. Jurisdictional determination upload
NCDWQ RPW B- UT to Deals Cr.pdf
R76 DP 1 Wetland data sheet.pdf
R76 DP 2 Wetland data sheet.pdf
R76 upland data sheet.pdf
R76_BridgeS 1 _Figure3_WatersMap. pdf
6. Future Project Plans
72.S6KB
411.47KB
398.65KB
368.71 KB
3.67MB
r Unknown
6a. Is this a phased project?*
C' Yes � No
Are any other NWP(s), regional generel permit(s), or individual permits(s) used, or intended to be used, to authorize any part of the proposed project or related activity?
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
,rJ Wetlands fJ Streams-tributaries
r Open Waters I� Pond Construction
2. Wetland Impacts
� Buffers
2a. Site #* (') 2a1 Reason (') 2b. Impact type *(') 2c. Type of W. * 2d. W. name * 2e. Forested * 2f. Type of 2g. Impact
Jurisdicition*('1 area*
W1 roadway fill P Bottomland Hard�nood Forest Wetlands C and D Yes Both 0.430
(acres)
W2 excavation P Bottomland Hardwood Forest Wetland C Yes Both 0.030
(acres)
W3 hand clearing T Bottomland Hard�,tiood Forest Wetlands C and D Yes Both 0.180
(acres)
2g. Total Temporary Wetland Impact 2g. Total Permanent Wetland Impact
0.180 0.460
2g. Total Wetland Impact
0.640
2h. Comments:
Permanent impacts are associated with the roadway fill required for the new bridge approaches and the excavation needed for positive drainage and
the requirement to have a zero net fill within the floodplain. Temporary impacts are associated with the hand clearing of vegetation.
3. Stream Impacts
Brandon Phillips, CHMM
STV Engineers, Inc.

3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
0
3i. Total stream and ditch impacts:
126
3i. Total temporary stream impacts:
126
3j. Comments:
Temporary impacts are associated with the construction of the new bridge and the demolition of the ewsting bridge. No permanent impacts to the
stream are proposed.
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 proposed bridge span length was extended to avoid impacts to Deals Creek. Riprap protection at the bridge abutments is being placed outside of
the jurisdictional stream boundary to avoid permanent impacts to Deals Creek.
1b. Specificallydescribe measures taken to avoid or minimize the proposed impacts through construction techniques:
NCDOT Best Management Practices (BMPs) for Construction and Maintenance Activities will be employed. Demolition and construction methods from
the roadway approaches will be used to minimize impacts.
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?
r Yes r No
2c. If yes, mitigation is required by (check all that apply):
,r! DWR 117 Corps
2d. If yes, which mitigation option(s) will be used for this project?
r Mitigation bank �J Payment to in-lieu fee � Permittee Responsible
program Mitigation
4. Complete if Making a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached.
G Yes r No
4b. Stream mitigation requested:
Qinear feet)
4d. Buffer mitigation requested (DWR only):
(square feet)
4f. Non-riparian wetland mitigation requested:
(acres)
4h. Comments
4c. If using stream mitigation, what is the stream temperature:
4e. Riparian wetland mitigation requested:
(acres)
0.46 at 2:1 ratio
4g. Coastal (tidal) wetland mitigation requested:
�acres)
6. Buffer mitigation (State Regulated Riparian Buffer Rules) - required by DWR
6a. Will the project result in an impact within a protected riparian buffer that requires buffer mitigation? If yes, you must fill out this entire form - please contact DWR for more
information.
r Yes r No
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 r No
If no, explain why:
Project is located in the Yadkin-Pee Dee River Basin.
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
r Yes r No

Comments:
Stormwater runoff from the proposed bridge will be routed to deck drains that discharge over the floodplain of Deals Creek. Please see the attached Stormwater Management Plan for
details on the minimization of water quality impacts.
G. Supplementary Information
1. Environmental Documentation
1a. Does the project involve an expenditure of public (federallstate/local) funds or the use of public (federallstate) land?*
� 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 (NEPAISEPl�?"
� Yes r No
Comments:"
Bridge replacement project that will require the preparation of a Minimum Criteria Determination Checklist.
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 (15ANCAC 2B .0200)? *
C' Yes r No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality?"
� Yes r No
3b. If you answered "no," provide a short narrative description.
Project involves the replacement of an existing bridge and is not anticipated to affect future development.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
C' Yes r No r fWA
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? *
F Yes r No
Sb. Have you checked with the USFWS concerning Endangered Species Act impacts?"
� Yes r No
5c. If yes, indicate the USFWS Field Office you have contacted.
Asheville
Sd. Is another Federal agency involved?"
� Yes r No
Se. Is this a DOT project located within Division's 1-8?
C' Yes r No
Sf. Will you cut anytrees in order to conduct the work in waters of the U.S.?
� Yes r No
Sg. Does this project involve bridge maintenance or removal?
G Yes r No
Sg(1). If yes, have you inspected the bridge for signs of bat use such as staining, guano, bats, etc.?
� Yes r No
If you answered "Yes" to 5g(1), did you discover any signs of bat use?
C' Yes r No C' Unknown
Sh. Does this project involve the construction/installation of a wind turbine(s)?*
� Yes r No
� Unknown
Si. Does this project involve (7) blasting, and/or (2) other percussive activities that will be conducted by machines, such as jackhammers, mechanized pile drivers, etc.?
C' Yes r No
Sj. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
USFWS IPaC and NCNHP data and site specific surveys. See Supplemental Information attached under Miscellaneous for threatened and endangered
species write-ups and biological conclusions.

Consultation Documentation Upload
NCNHP_Division9_Bridge81 _Report_02142019.pdf
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?"
� Yes r No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?"
NOAA EFH mapper.
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
1.15MB
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?*
C' Yes r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
See attached "No Archaeological Survey Required Form" and "Historic Architecture and Landscapes No Survey Required Form."
7c. Historic or Prehistoric Information Upload
17-OS-0058_NoSu rveyReq. pdf 4.73 MB
PA 17-05-0058 Rowan (NSR).pdf 7.46MB
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain? *
r Yes f No
Sb. If yes, explain how project meets FEMA requirements:
NCDOT Hydraulics Unit Coordination with FEMA.
Sc. What source(s) did you use to make the floodplain determination?*
FEMA FIRM maps
Miscellaneous
Comments
Additional Miscellaneous attachments include photographs of the site and a cover letter that includes information regarding the Threatened and Endangered Species that are listed in
Rowan County.
Miscellaneous attachments not previouslyrequested.
R.76 Photopages.pdf
Brg OS1 Permit Cover Letter.pdf
Signature
*
,rJ By checking the box and signing below, I certify that:
14.75MB
231.09KB
. 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 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
Sign
Date
3/11 /2019
�
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