20191668 Ver 1_PCN Form Submission_20191209

DWR
Dlrlslon of Water Resources
Pre -Construction Notification (PCN) Form
September 29, 2018 Ver 3
Initial 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 only if needed.
BIMS # Assigned
20191668
Is a payment required for this project?*
r No payment required
r Fee received
r Fee needed - send electronic notification
Select Project Reviewer*
Donna Hood:eads\drhood
Information for Initial Review
1a. Name of project:
Replacement of Bridge 292 over Little Meadow Creek
1a. Who is the Primary Contact?*
Larry Thompson
1b. Primary Contact Email:*
[e-mail]
Date Submitted
12/9/2019
Nearest Body of Water
Smiths Lake (Little Meadow Creek)
Basin
Yadkin-PeeDee
Water Classification
C (13-17-14-1)
Site Coordinates
Latitude: Longitude:
35.313811-80.437660
A. Processing Information
County (or Counties) where the project is located:
Cabarrus
Is this project a public transportation project?*
IT Yes r No
Is this a NCDOT Project?*
r Yes r No
(NCDOT only) T.I.P. or state project number:
17BP.10.R.108
WBS # (?)
17BP.10.R.108 (Bridge #120292)
1a. Type (a) of approval sought from the Corps:
Version#*
1
Reviewing Office*
Mooresville Regional Office - [phone]
1c. Primary Contact Phone:*
[phone]
U

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 type(s) 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?
r Yes r No
Nationwide Permit (NWP) Number: 03 - Maintenance
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
W 401 Water Quality Certification - Regular
r Non-404 Jurisdictional General Permit
r Individual Permit
le. Is this notification solely for the record because written approval is not required?
For the record only for DWR401 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
B. Applicant Information
1d. Who is applying for the permit?
r Owner W Applicant (other than owner)
le. Is there an Agent/Consultant for this project?*
r Yes r No
2. Owner Information
2a. Name(s) on recorded deed:
North Carolina Department of Transportation
2b. Deed book and page no.:
not applicable
2c. Responsible party:
not applicable
2d.Address
Street Address
716 W. Main Street
Address Line 2
City
Albemarle
Rostal / Zip Code
28001
2e. Telephone Number:
[phone]
2g. Email Address:*
State / Province / Rion
North Carolina
Country
USA
2f. Fax Number
r Yes r No
r Yes r No

[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
Larry Thompson
3b. Business Name:
3c.Address
Street Address
716 Main Street
Address Line 2
city
Albemarle
Postal / Zip Code
28001
3d. Telephone Number:
[phone]
3f. Email Address:*
[e-mail]
State / Rovince / Region
NC
Country
USA
3e. Fax Number:
C. Project Information and Prior Project History O
1. Project Information
1b. Subdivision name:
(if appropriate)
Not Applicable
1c. Nearest municipality/ town:
Georgeville, NC (Concord, NC)
2. Project Identification
2a. Property Identification Number: 2b. Property size:
not applicable
2c. Project Address
Street Address
not applicable
Address Line 2
City State / Rovince / Region
Postal / Zip Code Country
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Smiths Lake (Little Meadow Creek)
3b. Water Resources Classification of nearest receiving water:*
C (13-17-14-1)
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.
030401050307
4. Project Description and History
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:*
Emsting bridge is a single, 24' span bridge with steel I beams sitting on vertical timber abutments. The travel layout on the bridge and surrounding road is 2 @ 8' wide travel lanes. The
Project area appears to be zoned as "Single Family, Rural/agricultural for land use (Cabarrus county eAsting land use map, 8/2008). The current land cover conditions can be viewed in
figure 4 of the Natural resources Technical Report, attached within the 'miscellaneous' file drop.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
F 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)
NC —Locust _20160713_TM_geo_8.5x11.pdf 3.36MB

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)
Cabarrus_NRCS.pdf 162.44KB
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:
239
4h. Explain the purpose of the proposed project:*
The bridge was originally constructed in 1963 and the timber joists within the bridge are reaching the end or their useful life. Taking no action would eventually lead to bridge condition
deteriorating rendering it no longer usable. Rehabilitation of bridge features is ultimately equivalent to bridge replacement.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
NCDOT Highway Division 10 proposed to replace Bridge # 120292 on SR 2625 (Mauney Rd) over Little Meadow Creek. The existing structure is a single 24' span, steel I-beam bridge,
with vertical timber abutments. The proposed structure is a single 55' span, 21" concrete cored slab, with 2'-6" tall end -bent caps, and rip -rapped sloping abutments. The current bridge
does not have gutter at the railing and discharges deck/roadway runoff directly to the stream. The proposed bridge will collect deck/roadway runoff and discharge to proposed v-
ditches, at the northwest and southwest quadrants. Class II rip -rap will be utilized along the eastern and western stream bank to provide stabilization once the existing vertical timber
abutment is removed.
4j. Please upload project drawings for the proposed project.
292_Redline Drainage Plans_100pct_20190424.pdf
17BP10R108_PermitPackage Wetland_20190611.pdf
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes r No
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): Joseph Sullivan
Agency/Consultant Company:
Other:
5d1. Jurisdictional determination upload
6. Future Project Plans
6a. Is this a phased project?*
r Yes
KCI Associates of NC
per Natural Resources Technical Report
r No
1.55MB
1.26MB
O Unknown
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
1a. 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
U
3a. Reason for impact (?) 3b.lmpact type * 3c. Type of impact* �3�name* F1 ��eStream Type * 3f. Type of 3g. S. width * 3h. Impact?) Jurisdiction* length*
S1
Bank Stabilization
Permanent
Bank Stabilization J
Little Meadow Creek
Perennial
Both
15
Average (feet)
74
(liriearfeet)
S2
Bank Stabilization
Tem orar
P Y
Bank Stabilization
—]
Little Meadow Creek
Perennial
Both
15
Average (feet)
30
(lirx�rfeet)
3i. Total jurisdictional ditch impact in square feet:

31. Total permanent stream impacts:
74
31. Total stream and ditch impacts:
104
3j. Comments:
E. Impact Justification and Mitigation
1. Avoidance and Minimization
31. Total temporary stream impacts:
30
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
No permanent fill in stream, no dewatering measures proposed
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Erosion control BMP's utilized during construction to minimize sediment introduced into stream
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:
�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?
r Yes r No
If no, explain why:
Project is not within a watershed that requires Riparian Buffer protection.
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
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 Policy Act (NEPA/SEPA)? *
r Yes
r No
Comments:*
A minimum criteria determination checklist was prepared.
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.

According to "Cumulative impacts and the 401 Water Quality Certification and Isolated Wetland Permit Programs - Divison of Water Quality Internal
Policy NC Division of Water Quality" Policy I., Section A. "Generic description of water quality impacts, bridge replacement projects typically don't add
much impervious area to the watershed.
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 C 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
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
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
51. 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?
NCDOT Natural Resources Technical Report (see miscellaneous)
(Northern long-eared bat conclusion: may affect - not likely to adversely affect)
Consultation Documentation Upload
Cabarrus292_NRTR_Draft_Submittal_20180921.pdf 2.04MB
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?*
NCDOT National Resources Technical Report (see miscellaneous)
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?*
No National Register of Historic Places Eligible or Listed Archaeological Sites Present or Affected Form for project (Project Tracking No. 18-10-0003)
7c. Historic or Prehistoric Information Upload
AR18-10-0003NoSitesPresent.pdf 12.51 MB
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
r Yes r No
8b. If yes, explain how project meets FEMA requirements:
Project takes place over Smiths Lake (Little Meadow Creek), a FEMA Limited Detailed Study Area. A HEC-RAS model and subsequently, a Bridge
Survey Report has been completed verifying new structure will not adversely affect Base Flood Elevations.
8c. What source(s) did you use to make the floodplain determination?*

Map of DFIRM panel 5577 Cabarrus/Stanly Counties, City of Locust.
Miscellaneous
Comments
Natural Resources Technical Report attached for reference.
Minimum Criteria Determination checklist attached for reference.
Miscellaneous attachments not previously requested.
Cabarrus292_NRTR_Draft _Submittal _20180921.pdf 2.04MB
17BP.10.R.110_MCDC_Bridge_105_Cabarrus_FINAL (signed).pdf 1.29MB
Signature U
® 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:
Larry Thompson
Signature
Date
12/9/2019