20191358 Ver 1_PCN Form Submission_20191006

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?*
G Yes r No
Oange only if needed.
BIMS # Assigned
20191358
Is a payment required for this project?*
r No payment required
r Fee received
r Fee needed - send electronic notification
Select Project Reviewer*
Amy Chapman:eads\aschapman
Information for Initial Review
1a. Name of project:
Muskrat Branch Culvert
1a. Who is the Primary Contact?*
Dave McHenry
1b. Primary Contact Email:*
[e-mail]
Date Submitted
10/6/2019
Nearest Body of Water
Muckrat Branch
Basin
Little Tennessee
Water Classification
C Tr
Site Coordinates
Version# *
1
Reviewing Office*
Asheville Regional Office - [phone]
1c. Primary Contact Phone:*
[phone]
Latitude: Longitude:
35.040921-83.609345
FA. Processing Information U
County (or Counties) where the project is located:
Clay
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:
R-4416
WBS # (?)
38908
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):
13
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
F 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?
r- Owner rJ 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:
Dave McHenry
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
NC
Q�untry
USA
2f. Fax Number:
*
r Yes r No
r Yes r No

[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
NCDOT Division 14
3b. Business Name:
3c.Address
Street Address
253 Webster Road
Address Line 2
City
Sylva
F stal / Zip Cade
28779
3d. Telephone Number:
[phone]
3f. Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality/town:
Haywesville
2. Project Identification
2a. Property Identification Number:
2c. Project Address
Street Address
US 64
Address Line 2
VA
Fbstal / Zip Code
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Muckrat Branch
3b. Water Resources Classification of nearest receiving water:*
C Tr
3c. What river basin(s) is your project located in?*
Little Tennessee
3d. Please provide the 12-digit HUC in which the project is located.
060200020500
4. Project Description and History
State / Frwince / Pagion
NC
Country
USA
3e. Fax Number:
2b. Property size:
1
State / Ftwince / Pagion
Country
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 collapsed culvert in Muskrat Branch under US 64 on USFS property.
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)
Muskrat Branch culvert location topo.pdf 647.41 KB
4e. Attach an 81/2 X 11 excerpt from the most recent version of the published County NRCS Soil Survey map depicting the project site. (for DWR)
Muskrat culvert soils.pdf 356.97KB

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:
150
4h. Explain the purpose of the proposed project:"
The purpose of the project is to replace a collapsed culvert section and restore a stable fill slope for the highway above.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
The collapse section of culvert will be dewatered as needed with diversions in and possibly entirely through the existing 650 feet of culvert. Then a track howwill be used to remove the
collapse culvert and install a new section that will be attached to the old with a concrete collar.
4j. Please upload project drawings for the proposed project.
R-4416 Muskrat Culvert —Permit Drawings.pdf 5.51 MB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the propertyor proposed impact areas?*
r Yes r No r Unknown
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
r Preliminary r Approved f Not Verified r Unknown r N/A
Corps AID Number:
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Dave McHenry
Agency/Consultant Company: NCDOT
Other:
5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
5d1. Jurisdictional determination upload
R-4416 Muskrat Culvert_PJD.pdf
6. Future Project Plans
809.44KB
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?
D. Proposed Impacts Inventory
1. Impacts Summary
la. Where are the impacts associated with your project? (check all that apply):
r Wetlands W Streams -tributaries ❑ Buffers
r Open Waters r Pond Construction
3. Stream Impacts
3a. Reason for impact (?)
3b.lmpact type *
3c. Type of impact *
3d. S. name *
Stream Type *
3f. Type of
3g. S. width *
Impact
❑
�F3e.
(?)
Jurisdiction*
�31r.
length*
S1
SA-1 culvert replace
P
Permanent
Culvert
Muskrat Branch
Perennial
Both
8
66
Average (fee[)
(linear feet)
S2
SA-1A dewater
Tem orar
P Y
Dewaterin g
Muskrat Branch
Perennial
Both
8
650
Ave age (feet)
(linearfee )
S3
SA-1 B dissi ator
P
Permanent
Ri Ra Fill
P P
Muskrat Branch
Perennial
Both
8
Average(f;t;;]
3i. Total jurisdictional ditch impact in square feet:
0

31. Total permanent stream impacts:
76
31. Total temporary stream impacts:
650
31. Total stream and ditch impacts:
726
3j. 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:
The culvert outlet will be perched to extent practical and a dissipater pad constructed to try and prevent rainbowtrout from ascending the culvert to a
know brook trout population. This is desired by resource agencies.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
We will dewater as needed to work in the dry.
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?
f Yes r No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
This is maintenance of eAsting structure.
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:
It is not in a subject 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
u
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
Comments:*
It is categorical excluded.
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)?*
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.
This is maintenance work.

4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
Yes r 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?*
r Yes r No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
r' Yes r No
5d. Is another Federal agency involved?*
r Yes r- No
What Federal Agency is involved?
USFS
5e. Is this a DOT project located within Division's 1-8?
r 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
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.
R-4416 Muskrat Culvert —Nationwide Narrative.pdf 390.67KB
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
Site reviews and NHP data.
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?*
NMFS
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?*
This work falls within exemptions identified in the PA agreement between NCDOT and NC Historic Preservation Office.
7c. Historic or Prehistoric Information Upload
Muskrat Creek culvert_R-4416 PA Screening information.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?*
FEMA
Miscellaneous
Comments
Thanks for any help you all can provide in expediting this approval process.
1.79 MB
Miscellaneous attachments not previously requested.

MuskRat Culvert outlet photos.pdf
626.22KB
Signature u'
m 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 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:
Dave McHenry
Signature
0"110 ���r�
Date
10/6/2019