20191744 Ver 1_PCN Form Submission (3)_20191220

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
20191744
Is a payment required for this project?*
r No payment required
6 Fee received
r Fee needed - send electronic notification
Select Project Reviewer*
April Norton:eads\arnorton
Information for Initial Review
1a. Name of project:
Replace Bridge No. 19 over Lynch Creek on SR 1771 (Dave Smith Rd)
1a. Who is the Primary Contact?*
Division Engineer, NCDOT Division 7, Mr. Mike Mills, PE
1b. Primary Contact Email:*
[e-mail]
Date Submitted
12/20/2019
Nearest Body of Water
Lynch Creek
Basin
Roanoke
Water Classification
22-58-1-2; C;03010104
Site Coordinates
Latitude: Longitude:
36.262459-79.22294
A. Processing Information
County (or Counties) where the project is located:
Caswell
Is this project a public transportation project?*
/: Yes r No
Is this a NCDOT Project?*
IT Yes r No
(NCDOT only) T.I.P. or state project number:
WBS # (1)
17BP.7.R.110
1a. Type(s) of approval sought from the Corps:
Version#*
1
Reviewing Office*
Central 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.:
N/A
2c. Responsible party:
2d.Address
Street Address
PO Box14996
Address Line 2
City
Greensboro
Rostal / Zip Code
27415
2e. Telephone Number:
[phone]
2g. Email Address:*
State / Rovince / Rion
NC
Country
USA
2f. Fax Number:
[phone]
r Yes r No
r Yes r No

[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
Division Engineer, NCDOT Division 7, Mr. Mike Mills, PE
3b. Business Name:
3c.Address
Street Address
PO Box14996
Address Line 2
City
Greensboro
Postal / Zip Code
27415
3d. Telephone Number:
[phone]
3f. Email Address:*
[e-mail]
State / Rovince / legion
NC
Country
USA
3e. Fax Number:
[phone]
C. Project Information and Prior Project History O
1. Project Information
1b. Subdivision name:
(ff appropriate)
NIA
1c. Nearest municipality/ town:
Prospect Hill
F-
2. Project Identification
2a. Property Identification Number:
2b. Property size:
N/A
N/A
2c. Project Address
Street Address
Address tine 2
City
State / Rovince / legion
Postal / Zip Code
Country
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Lynch Creek
3b. Water Resources Classification of nearest receiving water:*
22-58-1-2; C;03010104
3c. What river basin(s) is your project located in?*
Roanoke
3d. Please provide the 12-digit HUC in which the project is located.
030101040502
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 project area is a mix of undisturbed, forested areas, the existing bridge and roadway and some single family residences.
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)
Bridge _19_Caswell_USGS.pdf 2.22MB
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)
Bridge _19_Caswell _soil.pdf 1.58MB

4f. List the total estimated acreage of all existing wetlands on the property:
There are approximately 0.558 acres of wetland wihtin the study area; only about .08 are actually
within the project area
4g. List the total estimated linear feet of all existing streams on the property:
Approximately 125 LF of channel within the project area
4h. Explain the purpose of the proposed project:*
The existing bridge is a three span bridge on a timber deck which is structurally deficient and functionally obsolete and must be replaced with a new bridge structure.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
Traffic will be detoured offsite. Erosion and sedimentation control measures will be installed. The proposed structure will be replaced on its existing alignment. This project proposes no
stream impact and only 0.08 acres of wetland impact (0.01 acres fill, 0.01 acres mechanized clearing and 0.06 acres of hand clearing). The existing bridge is a three span bridge on a
timber deck which is structurally deficient and functionally obsolete. The project itself has been designed to have as little environmental impact as necessary including limiting roadway
fill slopes to 2:1 in the wetland areas. There is no direct discharge of stormwater in the receiving waters; the bridge does contain deck drains however, these will discharge onto the
sloping, Class II rip rap abutments. Grated inlets have been utilized to conduct stormwater from the bridge into a discharge pipe which outlets at non -erosive velocities into a wooded
area before flowing into the wetland. There are ditches in all four quadrants which will be retained; these ditches outlet and then sheetflow before entering any resources. Due to the
nature of the low impact bridge design and replacement, there is little change in the pre vs post discharges and the existing ditches do not need to be modified, therefore additional
stormwater measures are not necessary. Equipment to be used includes a track hoe, dump truck, paving equipment and various hand tools, possibly a crane to move construction
material such as reinforced bars of steel and concrete buckets to place concrete.
4j. Please upload project drawings for the proposed project.
160019_Permit Dravrings_20180710 Revised.pdf 1.69MB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes
Comments:
r No
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
r Preliminary t' 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): Robert Lepsic
Agency/Consultant Company: formerly with EPR
Other:
5d1. Jurisdictional determination upload
NCDOT Caswell 19 Revised 7-10-18.pdf
Bridge 19 Division 7 packet.pdf
6. Future Project Plans
6a. Is this a phased project?*
r Yes r No
940.44KB
5.47MB
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
la. Where are the impacts associated with your project? (check all that apply):
W Wetlands r Streams -tributaries r Buffers
r Open Waters r Pond Construction
2. Wetland Impacts
2a1 Reason (?) 2b. Impact type * (?) 2c. Type of W. * 2d. W. name * 2e. Forested * 2f. Type of 2g. Impact
Jurisdicition*(?) area*
1
Fill
P
Bottomland Hardwood Forest _]
WG
Yes
--]
Both
0.010
(acres)
1
Mech Clearing
P
Bottomland Hardwood Forest
WG
Yes
Both
0.010
(acres)

Clearing T Bottomland Hardwood Forest WE, WF, WG Yes Both 0.060
(acres)
2g. Total Temporary Wetland Impact
0.060
2g. Total Wetland Impact
0.080
2h. Comments:
E. Impact Justification and Mitigation
1. Avoidance and Minimization
2g. Total Permanent Wetland Impact
0.020
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
The existing bridge is a three span bridge on a timber deck which is structurally deficient and functionally obsolete and must be replaced with a new
bridge structure. The proposed structure will be replaced on its existing alignment. This project proposes no stream impact and only 0.08 acres of
wetland impact (0.01 acres fill, 0.01 acres mechanized clearing and 0.06 acres of hand clearing). The existing bridge is a three span bridge on a
timber deck which is structurally deficient and functionally obsolete. The project itself has been designed to have as little environmental impact as
necessary including limiting roadway fill slopes to 2:1 in the wetland areas. There is no direct discharge of stormwater in the receiving waters; the
bridge does contain deck drains however, these will discharge onto the sloping, Class II rip rap abutments. Grated inlets have been utilized to conduct
stormwater from the bridge into a discharge pipe which outlets at non -erosive velocities into a wooded area before flowing into the wetland. There are
ditches in all four quadrants which will be retained; these ditches outlet and then sheetflow before entering any resources. Due to the nature of the low
impact bridge design and replacement, there is little change in the pre vs post discharges and the existing ditches do not need to be modified,
therefore additional stormwater measures are not necessary.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Traffic will be detoured offsite. Erosion and sedimentation control measures will be installed prior to construction. This project proposes no stream
impacts and minimal wetland impacts. These impacts will be minimized by strict enforcement of Best Management Practices for the protection of
surface waters, restrictions against staging of equipment in or adjacent to waters of the US and coordination (including a pre -construction meeting)
with the Division Environmental Supervisor prior to construction commencing.
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:
The project proposes no stream impacts and minimal wetland impacts, none of which require mitigation.
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
r No
If no, explain why:
This project is in the Roanoke River Basin which does not have any state regulated riparian buffer rules in place.
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:*
While this project involves the expenditure of public funds, it does not exceed the thresholds that require NEPA/SEPA documentation
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.
Per the NC DWQ April 10, 2004 Version 2.1 Cumulative Impacts Policy, small scale public transportation projects - such as widening projects, bridge
replacements and intersection improvements - have a "low potential for cumulative impact since little (if any) new impervious surface is added and the
projects are usually in already developed locales." This proposed project is within a somewhat developed landscape (i.e. eAsting road, eAsting
residences in the vicinity), this is not a road on a new location (i.e. there is an eAsting road and bridge structure and thus, the area already contains
impervious surfaces) and the project drains to Lynch Creek which is Class C waters. We anticipate the NC DWR will advise us if a qualitative or
quantitative analysis is needed.
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.
Raleigh
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
r Unknown
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
https://ecos.fws.gov/ipac/
In April 2019, biologists from NCDOT Biological Assessment Unit surveyed Lynch Creek for the presence of Pleurobema collina (James spinymussel),
Fusconaia masoni (Atlantic Pigtoe) and Percina rex (Roanoke Logperch). For the spinymussel, no specimens were found, however, the appropriate
habitat is present. Therefore the biological opinion is No effect, Habitat present. For the Pigtoe and Logperch, the project is outside their habitat range
and therefore the biological opinion is No effect.
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?*
This project takes place in Caswell County which is not near any coastal or tidal habitat that would support EFH (i.e. salt marshes, oyster reefs, etc.)
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?*
See attached letters from NCDOT Architectural Historian and NCDOT Archaeologist dated 2016 and 2017 respectively
7c. Historic or Prehistoric Information Upload
17BP.7.R.110_16-12-0010 No Archaeological Survey Required Form Br No 0019 on SR 1771 Dave Smith Road
1.02MB
Caswell.pdf
17BP.7.R.110_No Historical Architecture Survey Required Form 160019.pdf 2.43MB
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 FEMAre quirements:
FEMA/NCDOT MOA
8c. What source(s) did you use to make the floodplain determination?*
hftps://flood.nc.gov/naflood/riskToolsFull.htmi
Miscellaneous
Comments
Miscellaneous attachments not previously requested.
App_A.pdf
App_B.pdf
Bridge 19 Division 7 packet.pdf
NCDOT Caswell 19 Revised 7-10-18.pdf
NCDWR Stream Determination —Bridge 19_Caswell_Revised.pdf
Signature
® By checking the box and signing below, I certify that:
3.13MB
3.8MB
5.47MB
940.44KB
1.17MB
• 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:
P. D. Wilson, PE
Signature
A A l)rlsarq
Date
12120/2019
U
6