20191723 Ver 1_PCN Form Submission (2)_20191216

DWR
mrlslon 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?*
6 Yes
r No
Is this project a public transportation project?*
G Yes r No
Change only if needed.
BIMS # Assigned
20191723
Is a payment required for this project?*
r No payment required
6 Fee received
r Fee needed - send electronic notification
Select Project Reviewer*
Dave Wanucha:eads\djwanucha
Information for Initial Review
1a. Name of project:
Replace bridge #75 on SR 1313 Wth bottomless three sided culvert
1a. Who is the Primary Contact?*
Kevin Hiring
1b. Primary Contact Email:*
[e-mail]
Date Submitted
12/16/2019
Nearest Body of Water
Fish Dam Creek
Basin
Yadkin-PeeDee
Water Classification
WS - IV
Site Coordinates
Latitude:
36.156557
A. Processing Information
County (or Counties) where the project is located:
Wilkes
Is this project a public transportation project?*
IT Yes r No
Is this a NCDOT Project?*
IT Yes r No
(NCDOT only) T.I.P. or state project number:
B-4977
WBS # (?)
39896.1.1
1a. Type (a) of approval sought from the Corps:
Longitude:
-81.245451
Version#*
1
Reviewing Office*
Winston-Salem Regional Office - (336) 776-
9800
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: 14 - Linear transportation
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
B-4977 - Division 11 - STIR - YD 01 (Cool).pdf
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 Yec r• Nn
B. Applicant Information
1d. Who is applying for the permit?
W Owner r 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:
NCDOT
2b. Deed book and page no.:
2c. Responsible party:
2d.Address
Street Address
801 Statesville Road
Address Line 2
city
North Wilkesboro
Fbstal / Zip Code
28659
2e. Telephone Number:
[phone]
2g. Email Address:*
State / Rwince / Fbgion
NC
Country
USA
2f. Fax Number:
70.02KB
r Yes r No
r Yes r No

[e-mail]
C. Project Information and Prior Project History U
1. Project Information
1b. Subdivision name:
ff appropriate)
1c. Nearest municipality/ town:
Millers Creek
2. Project ctct Identification
2a. Property Identification Number:
2b. Property size:
0.5
2c. Project Address
Street Address
Address Line 2
(Sty
State / Province / Region
Postal / Zip Code
Country
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Fish Dam Creek
3b. Water Resources Classification of nearest receiving water:*
WS - IV
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.
030401010302
4. Project Description and History
4a. Describe the existing conditions on the site and the general land use in the vicinityof the project at the time of this application:*
The North Carolina Department of Transportation is scheduled to replace Bridge #75 with a 3-sided bottomless culvert at the same location. The wasting bridge is a 58-year old one -
lane single span bridge with a timber floor on I -beams and reinforced concrete abutments. The bridge has a sufficiency rating of 21 out of a possible 100, and is considered functionally
obsolete according to Federal Highway Administration standards. Rural area.
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)
Maps for B-4977, Bridge #75 replacement, Wilkes County.pdf 411.07KB
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)
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:
250
4h. Explain the purpose of the proposed project:*
Upgrade stream crossing
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
see attached cover letter
4j. Please upload project drawings for the proposed project.
B-4977_Permit Drawings2019-11-22.pdf 2.08MB
B-4977_HYD_EC_12062019.pdf 3.25MB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes r No f 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): Kim Hamlin
Agency/Consultant Company: TGS Engineers
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?
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 r Buffers
r- Open Waters r Pond Construction
3. Stream Impacts
3a. Reason for impact (?)
3b.lmpact type *
3c. Type of impact*
3d. S. name *
3e. Stream Type*
of
3gSwidth *
3h. ImpactM
[3f.Type
urisdiction*
length*
S1
Stream crossing3 sided
-
Permanent
Culvert
Fish Dam Creek
Perennial
Both
10
32
culvert
Average (feet)
(linearfeet)
S2
Stream crossing3 sided
-
Permanent
Bank Stabilization
Fish Dam Creek
Perennial
Both
10
61
culvert
Average (feet)
(linearfeet)
S3
Stream crossing - 3 sided
Temporary
Dewatering
Fish Dam Creek
Perennial
Both
10
24
culvert
Average (feet)
(lirearfeet)
�
Stream crossin drivewa
g y
Permanent
Fill
LIT to Fish Dam Creek
Perennial
Both
2
77
Average (feet)
(linearfeet)
S5
Stream crossing -driveway
Temporary
Dewatering
LIT to Fish Dam Creek
Perennial
Both
2
10
Average (feet)
(linearfeet)
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts: 3i. Total temporary stream impacts:
170 34
3i. Total stream and ditch impacts:
204
3j. Comments:
The driveway pipe that we are replacing (Stream crossing - driveway) is already perched and discharging onto rock. It will remain perched and will
discharge on rip rap with the new design. This will allow it to remain free flowing during high flowevents, when water levels rise in Fish Dam Creek.
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:
replacing ebsting bridge with another bottomless structure
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
see attached cover letter

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?
C Yes r No
2c. If yes, mitigation is required by (check all that apply):
r DWR W Corps
2d. If yes, which mitigation option(s) will be used for this project?
r Mitigation bank 9 Payment to in -lieu fee r 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.
C Yes r No
4b. Stream mitigation requested:
(linear feet)
77 mitigated at 2:1 = 154
4d. Buffer mitigation requested (DWR only):
(square feet)
0
4f. Non -riparian wetland mitigation requested:
(acres)
0
4h. Comments
4c. If using stream mitigation, what is the stream temperature:
cool
4e. Riparian wetland mitigation requested:
(acres)
0
4g. Coastal (tidal) wetland mitigation requested:
(acres)
0
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?
r Yes C No
If no, explain why:
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:
See attached permit drawings
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
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:
CE Type 1A
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification Rules (15ANCAC 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 C No
I 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.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR forth is project?*
r Yes r Nor NIA
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?
FHWA
5e. Is this a DOT project located within Division's 1-8?
r Yes r No
5f. Will you cut any trees 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?
Natural Heritage Program and visual observation
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
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?*
Project was reviewed by NCDOT HEU
7c. Historic or Prehistoric Information Upload
AR16-10-0019nosurvey.pdf 2.55MB
Wilkes75NoSurvey.pdf 1.87MB
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?*
Flood Risk Information System

Miscellaneous
Comments
1) - Cover letter with additional information attached below.
2) - Detour map for project attached.
3) The Catawba Indian Nation, Cherokee Nation, ECBI, and UKBCI tribes were contacted on November 14th to alert them of this project. I requested that they provide any comments by
December 15th. At this time (December 16th), I have only heard from the Cherokee Nation. The tribal notification letters and the response from the Cherokee Nation are provided
below.
4) - Natural Resource Technical Memo
5) - Natural Heritage Program screening
Miscellaneous attachments not previously requested.
Catawba Tribal Notification B-4977, Wilkes County.pdf 456.79KB
Cherokee Nation Tribal Notification B-4977, Wilkes County.pdf 456.84KB
EBCI Tribal Notification B-4977, Wilkes County.pdf 456.96KB
UKBCI Tribal Notification B-4977, Wilkes County.pdf 456.85KB
121019 NCDOT CDR TIP B-4977 Fish Dam Creek.pdf 215.95KB
Final Natural Resources Memo B-4977 20190820.pdf 675.94KB
Bridge #75, Letter.pdf 107.4KB
NHP - project_report_congo_road_bridge_75_replacement.pdf 871.83KB
Signature
® 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:
Kevin Hining
Signature
Yid Ili &Wl
Date
12/16/2019