20191399 Ver 1_PCN Form Submission_20191008

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
Change mly if needed.
BIMS # Assigned * Version#*
20191399 1
Is a payment required for this project?*
r No payment required
r Fee received Reviewing Office*
r Fee needed - send electronic notification Mooresville Regional Office - [phone]
Select Project Reviewer*
Donna Fbod:eads\drhood
Information for Initial Review
1a. Name of project:
Replacement of Bridge #291 on SR 1348 (Old NC Hwy 90)
1a. Who is the Primary Contact?*
Trish Beam
1b. Primary Contact Email:*
[e-mail]
Date Submitted
10/8/2019
Nearest Body of Water
Duck Creek
Basin
Catawba
Water Classification
Class C, Tr
1c. Primary Contact Phone:*
[phone]
Site Coordinates
Latitude: Longitude:
35.926593-81.308417
FA. Processing Information U
County (or Counties) where the project is located:
Alexander
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 # (?)
17BP.12.R.88
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?*
C Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
C Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
C Yes t No
Acceptance Letter Attachment
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?
C 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?
r Yes C No
2. Owner Information
2a. Name(s) on recorded deed:
NCDOT
2b. Deed book and page no.:
2c. Responsible party:
Mark Stafford
2d.Address
Street Address
1710 East Marion Street
Address Line 2
city
Shelby
Fbstal / Zip Code
28151
2e. Telephone Number:
[phone]
2g. Email Address:*
State / Frovinee / R�gion
NC
0�untry
USA
2f. Fax Number:
[phone]
*
C Yes r No
r Yes C No

[e-mail]
C. Project Information and Prior Project History U
1. Project Information
1b. Subdivision name:
(i appropriate)
1c. Nearest municipality/ town:
Taylorsville
2. Project Identification
2a. Property Identification Number:
2c. Project Address
Street Address
Address line 2
Oty
Fbstal / Zip 03de
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Duck Creek
3b. Water Resources Classification of nearest receiving water:*
Class C, Tr
3c. What river basin(s) is your project located in?*
Catawba
3d. Please provide the 12-digit HUC in which the project is located.
030501010902
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:*
Ebsting bridge on paved secondary road. Landuse in vicinity is cropland and pasture
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)
14-12-0006 Alexander Topo.pdf 853.54KB
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)
Bridge291_Soil _Map.pdf 236.37KB
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:
100
4h. Explain the purpose of the proposed project:*
To replace a deteriorating bridge for the safety of the travelling public
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
To replace an eAsting 3 span 20 foot wide reinforced concrete girder bridge with a 3 span 30 foot wide cored slab bridge. The proposed bridge will incorporate sloped abutments with 4
foot caps. 8" x 4" slot deck drains, left and right will be required. Typical heavy construction equipment (trackhoes, backhoes, cranes) will be utilized for the construction of the bridge.
4j. Please upload project drawings for the proposed project.
SF-010291_Hyd_Permit_Package 05232019.pdf 2.12MB
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 N/A
Corps AID Number:
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company: NCDOT Environmental Office
Other:
5d1. Jurisdictional determination upload
6. Future Project Plans
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 7 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 *
3f. Type of
3g. S. width *
3h. Impact
❑
M
Jurisdiction*
length*
S1
Bank stabilization at ditchline
Permanent
Bank Stabilization
Duck Creek
Perennial
Both
30
7
(L-16+25, 35' LT)
Average (feet)
(linearfeet)
S2
Bank stabilization at ditchline
Tem ora
P ry
Bank Stabilization
Duck Creek
Perennial
Both
30
10
(L-16+25, 35' LT)
Average (feet)
(linear feet)
S3
Bank stabilization at ditchline
Permanent
Bank Stabilization
Duck Creek
Perennial
Both
30
6
(L-16+25, 35' RT)
Average (Feet)
(lir�earfeet)
S4
Bank stabilization at ditchline
Tem ora
P ry
Bank Stabilization
Duck Creek
Perennial
Both
30
10
(L-16+25, 35' RT)
Average (feet)
(linearfeet)
S5
Bank stabilization at ditchline
Permanent
Bank Stabilization
Duck Creek
Perennial
Both
30
6
(L -16+25, 40'LT)
Average (feet)
(lir�earfeet)
S6
Bank stabilization at ditchline
Tem ora
P rY
Bank Stabilization
Duck Creek
Perennial
Both
30
10
(L-16+25, 40' RT)
Average (feet)
(linear feet)
S7
Bridge Replacement (L -
Temporary
Dewatering
Duck Creek
Perennial
Both
30
20
16+15 & 16+35)
Average (feet)
(linearfeet)
31. Total jurisdictional ditch impact in square feet:
0
31. Total permanent stream impacts:
19
3i. Total stream and ditch impacts:
69
3j. Comments:
E. Impact Justification and Mitigation
1. Avoidance and Minimization
3i. Total temporary stream impacts:
50
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
Runoff from the bridge will be captured and discharged onto deck drain dissipater pads.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
L^J

Minimal impact to stream Men removing existing bridge components
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 C No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
Existing bridge being replaced with bridge
CStormwater 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:
The bridge is not located in an area with protected riparian buffers
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
C Yes r No
Comments:
Stormwater management plan attached
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
Comments:*
The project is listed as a type and class of activity which qualifies as a non -major action under the Minimum Criteria ruels; therefore, a minimum criteria
checklist has been completed for the project.
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification Rules (15ANCAC 2H .0500), Isolated Wetland Rules (15ANCAC 2H .1300), or DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15ANCAC 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 a minimum criteria project with little anticipated impacts.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
C Yes C No r N/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?*
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
Se. 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 f 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?
f Yes r No f Unknown
5h. Does this project involve the construction/installation of a wind turbine(s)?*
r Yes r No
r Unknown
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.?
r^ Yes r No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
NC Natural Heritage database and on -site surveys. Division 12 is located in the white nose syndrome area; however, there are no known hibernacula
or roosting trees in Division 12 counties.
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?*
Per Natural Heritage database, there are no salt marshes, oyster reefs or seagrass beds in the vicinity of the project.
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?*
Cultural resources review and approval (tracking no. 14-12-0006)
7c. Historic or Prehistoric Information Upload
14-12-0006NHPARevised2.pdf 4.42MB
PA 14-12-0006 Alexander Update (NSR).pdf 4.31 MB
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year flood plain?*
r Yes
r No
8b. If yes, explain how project meets FEMA requirements:
NCDOT hydraulic unit coordination
8c. What source(s) did you use to make the floodplain determination?*
NCDOT hydraulics unit
Miscellaneous
Comments
Miscellaneous attachments not previously requested.
B4980 PDR Photos.pdf
NLEB_memo.pdf
B-4980 V2 NRTR_Revision 6_25_15.pdf
Vicinity_B-291 _B-4980. pdf
Hazardous Spill Checklist.pdf
cover_letter.pdf
Signature
12.76MB
115.79KB
13.81 MB
653.21 KB
4.38KB
223.38KB
v

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:
Trish Beam
Signature
Date
10/8/2019