20190849 Ver 1_PCN Form Submission_20190625

DWR
MOM— of Water Resources
Pre -Construction Notification (PCN) Form
September 29, 2018 Ver 3
21nitial Review
Has this project met the requirements for acceptance in to the review process?*
r Yes
r No
Is this project a public transportation project?*
C Yes r No
Change mly if needed.
BIMS # Assigned
20190849
Is a payment required for this project?*
r No payment required
r Fee received
r Fee needed - send electronic notification
Select Project Reviewer*
Kevin Barnett:eads\khbarnett
Information for Initial Review
1a. Name of project:
Henderson County Bridge 247
1a. Who is the Primary Contact?*
Patrick J. Breedlove
1b. Primary Contact Email:*
[e-mail]
Date Submitted
6/25/2019
Nearest Body of Water
Shoal Creek
Basin
French Broad
Water Classification
Clas C
Version# *
1
Reviewing Office*
Asheville Regional Office - [phone]
1c. Primary Contact Phone:*
[phone]
Site Coordinates
Latitude: Longitude:
35.22102-82.58679
FA. Processing Information u
County (or Counties) where the project is located:
Henderson
Is this project a public transportation project?*
r Yes r' No
Is this a NCDOT Project?*
r Yes r No
(NCDOT only) T.I.P. or state project number:
WBS#M
17BP.14.R.179
1a. Type(s) of approval sought from the Corps:

W Section 404 Permit (wetlands, streams and waters, Clean Water Act)
r Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
1b. What types) of permit(s) do you wish to seek authorization?
W Nationwide Permit (NWP)
r' Regional General Permit (RGP)
r' Standard (IP)
1c. Has the NWP or GP number been verified by the Corps?
t' Yes r No
Nationwide Permit (NWP) Number: 03 - Maintenance
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
fJ 401 Water Quality Certification - Regular
F Non-404 Jurisdictional General Permit
F Individual Permit
le. Is this notification solelyfor the record because written approval is not required?
For the record only for DWR 401 Certification:
For the record only for Corps Permit:
r 401 Water Quality Certification - Express
r Riparian Buffer Authorization
1f. Is this an after -the -fact permit application?*
r Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
r- Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
r Yes r No
Acceptance Letter Attachment
1h. Is the project located in any of NC's twenty coastal counties?
r- Yes r No
1j. Is the project located in a designated trout watershed?
r Yes r No
F. Applicant Information
1d. Who is applying for the permit?
[J Owner r Applicant (other than owner)
le. Is there an Agent/Consultant for this project?
f Yes r- No
2. Owner Information
2a. Name(s) on recorded deed:
NCDOT Division 14
2b. Deed book and page no.:
2c. Responsible party:
2d. Address
Street Address
253 Webster Road
Address Line 2
city
Sylva
Postal / Zip Code
28779
2e. Telephone Number:
[phone]
2g. Email Address:*
State / Frwinre / R�gion
North Carolina
Q�untry
United States
2f. Fax Number:
*
r Yes r No
r Yes r No

[e-mail]
C. Project Information and Prior Project History U
1. Project Information
1b. Subdivision name:
(d appropriate)
1c. Nearest municipality/ town:
Flat Rock
2. Project Identification
2a. Property Identification Number:
2c. Project Address
Street Address
Address line 2
Oty
Fbstal / Zip Oxle
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Shoal Creek
3b. Water Resources Classification of nearest receiving water:*
Clas C
3c. What river basin(s) is your project located in?*
French Broad
3d. Please provide the 12-digit HUC in which the project is located.
060101050205
4. Project Description and History
2b. Property size:
State / ftovince / Fbgion
O�untry
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:*
Existing land use is a 20' W x 18' 6" L timber floor on timber joist structure on an existing two lane secondary road. Project site is located in a rural area sparsely populated with
residential housing.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
r Yes r No r 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)
Henderson County - B247 - USGS Topo Map.pdf 993.85KB
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)
Henderson County - B247 - NRCS Soil Map.pdf 497.91 KB
4f. List the total estimated acreage of all existing wetlands on the property:
0.00
4g. List the total estimated linear feet of all existing streams on the property:
200
4h. Explain the purpose of the proposed project:*
Project is to replace an obsolete and deteriorating wood floor on timber joist structure with a three -sided concrete box culvert.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
NCDOT contractor will install erosion and sedimentation control measures. NCDOT contractor will install diversion/dewatering structure in Shoal Creek. Traffic will remain on existing
bridge until one lane of the new box culvert is constructed. Traffic will then be placed on the new one lane structure while the second phase of the culvert is constructed. NCDOT
contractor will remove the existing structure in two phases. Bank stabilization materials will be installed once final grading allows. The diversion/dewatering structure will be removed and
temporary impacts will be restored. The three sided box culvert will be constructed utilizing the follow equipment: crane, dump trucks, excavator, paving equipment, pumps and hand
tools
4j. Please upload project drawings for the proposed project.
Henderson County - B247 - Permit Plans.pdf 2.05MB
Henderson County - B247 - Hydro Report.pdf 3.67MB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes r No O Unknown

Comments
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
r Preliminary r Approved r Not Verified r Unknown r NIA
Corps AID Number:
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
5d1. Jurisdictional determination upload
Henderson County - B247 - PJD (Final).pdf
6. Future Project Plans
233.25KB
6a. Is this a phased project?*
r Yes r 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?
[Proposed Impacts Inventory
1. Impacts Summary
la. Where are the impacts associated with your project? (check all that apply):
r Wetlands W Streams -tributaries
r Open Waters r Pond Construction
3. Stream Impacts
r Buffers
3a. Reason for impact (?)
3b.lmpact type *
3c. Type of impact*
3d. S. name*
3e. Stream Type *
of
3g. S. width *
3h. Impact
❑
M
�X­rype
Jurisdiction*
length*
S1
Site 1
Tem ora
p rY
Dewaterin g
Shoal Creek
Perennial
Both
8
135
Average (feet)
(linear feet)
S2
Site 2
Permanent
Bank Stabilization JSh.al
Creek
Perennial
Both
8
33
Average (feet)
(linear feet)
S3
Site 3
Permanent
Bank Stabilization J
Shoal Creek
Perennial
Both
8
33
Average (feet)
(linear feet)
31. Total jurisdictional ditch impact in square feet:
0
31. Total permanent stream impacts:
66
31. Total stream and ditch impacts:
201
3j. Comments:
E. Impact Justification and Mitigation
1. Avoidance and Minimization
31. Total temporary stream impacts:
135
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
The existing bridge structure is being replaced with a structure that is adequate for traffic needs in the existing bridge location. The three sided box
culvert was design for the minimum size criteria to ensure safe conveyance of traffic on the secondary road.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
The on -site stream (Shoal Creek) will be diverted while the new three sided box culvert is constructed, the unclassified excavation occurs and the bank
stabilization materials are installed. Erosion and sedimentation control measures will be installed prior to ground disturbance. Both of these measures
will aid in the prevention of sediment into downstream habitats.
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
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
Proposed impacts do not require 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?
r Yes r No
If no, explain why:
Project is not located within a N.C. Riparian Buffer Protection Area.
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:
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?*
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 Policy Act (NEPA/SEPA)? *
r Yes r No
1c. If you answered `yes" to the above, has the document review been finalized by the State Clearing House?*
r Yes r No
Comments:*
NCDOT MCDC 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 21-1.1300), or DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15A NCAC 2B .0200)? *
r Yes r No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality?*
r Yes r No
3b. If you answered "no," provide a short narrative description.
The project is only to replace the wasting subject bridge due to deterioration and does not increase the capacity of the roads in the area. The
purposed project is not a road widening or improvement project.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
r Yes r Nor 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?*
r Yes r No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
r Yes r No
5c. If yes, indicate the USFWS Field Office you have contacted.
Asheville
5d. Is another Federal agency involved?*

r Yes r No
5e. Is this a DOT project located within Division's 1-8?
f Yes r No
5f. Will you cut anytrees in order to conduct the work in waters of the U.S.?
r Yes r No
5g. Does this project involve bridge maintenance or removal?
r Yes r No
5g(1). If yes, have you inspected the bridge for signs of bat use such as staining, guano, bats, etc.?
r Yes r No
If you answered "Yes" to 5g(1), did you discover any signs of bat use?
r^ Yes r No r^ Unknown
5h. Does this project involve the construction/installation of a wind turbine(s)?*
r- Yes r No
r 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.?
r Yes r No
If yes, please provide details to include type of percussive activity, purpose, duration, and specific location of this activity on the property.
Henderson County - B247 - NWP 3 Cover Letter.pdf 632.35KB
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
U.S. Fish &Wildlife - ECOS - Online Mapper
Consultation Documentation Upload
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
r^ Yes r No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
NOAA- Essential Fish Habitat v3.0
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?*
r- Yes r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
NCDOT Culture Resource Specialist
7c. Historic or Prehistoric Information Upload
Henderson County - B247 - Archaeological Clearance.pdf
Henderson County - B247 - Archictecture Clearance.pdf
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
r Yes r No
8c. What source(s) did you use to make the floodplain determination?*
N.C. Flood Maps - Flood Risk Information System
Miscellaneous
Comments
Miscellaneous attachments not previously requested.
Henderson County - B247 - NC Hertiage Program.pdf
Henderson County - B247 - SMP.pdf
Henderson County - B247 - Bat Habitat Assessment.pdf
Henderson County - B247 - Site Photos.pdf
Signature
*
fJ By checking the box and signing below, I certify that:
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u
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 vritten signature; AND
• I intend to electronically sign and submit the PCN form.
Full Name:
Patrick Jeremy Breedlove
Signature
c9;�,-rw-o 044— aY
Date
6/25/2019