20191729 Ver 1_401 Application_20191217

Pre-Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
September 29, 2018 Ver 3
1a. Name of proje ct:
1a. Who is the Primary Contact?
1b. Primary Contact Email:1c. Primary Contact Phone :
Site Coordinates
Latitude :Longitude :
County (or Countie s) where the proje ct is locate d:
Ne are st Body of Wate r
Is this project a public transportation project?
Is this a NCDOT Proje ct?
(NCDOT only) T.I.P. or state proje ct numbe r:
WBS #(?)
1a. Type (s) of approv al sought from the Corps:
1b. What type (s) of pe rmit(s) do you wish to se e k authorization?
1c. Has the NWP or GP numbe r be e n v e rifie d by the Corps?
Nationwide Pe rmit (NWP) Numbe r:
NWP Numbe rs (for multiple NWPS):
1d. Type (s) of approv al sought from the DWR:
1e . Is this notification sole ly for the re cord be cause writte n approv al is not re quire d?
For the re cord only for DWR 401 Ce rtification:
For the re cord only for Corps Pe rmit:
Replacement of Bridge 105 over Big Bear Creek
Larry Thompson
[e-mail] [phone]
35.451083 -80.340000
A. Processing Information
Cabarrus
Yes No
Yes No
17BP.10.R.110
12-0105
Section 404 Permit (wetlands, streams and waters, Clean Water Act)
Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
Nationwide Permit (NWP)
Regional General Permit (RGP)
Standard (IP)
Yes No
03 - Maintenance
401 Water Quality Certification - Regular 401 Water Quality Certification - Express
Non-404 Jurisdictional General Permit Riparian Buffer Authorization
Individual Permit
Yes No
Yes No
1f. Is this an afte r-the -fact pe rmit application?
1g. Is payme nt into a mitigation bank or in-lie u fe e program propose d for mitigation of impacts?
Acce ptance Le tte r Attachme nt
1h. Is the proje ct locate d in any of NC's twe nty coastal countie s?
1j. Is the proje ct locate d in a de signate d trout wate rshe d?
1d. Who is applying for the pe rmit?
1e . Is the re an Age nt/Consultant for this proje ct?*
2. Owner Information
3. Applicant Information (if different from owner)
Yes No
Yes No
Yes No
Yes No
B. Applicant Information
Owner Applicant (other than
owner)
Yes No
2a. Name (s) on re corde d de e d:
2b. De e d book and page no.:
2c. Re sponsible party:
2d. Addre ss
2e . Te le phone Numbe r:2f. Fax Numbe r:
2g. Email Addre ss:*
North Carolina Department of Transportation
not applicable
not applicable
City
Albemarle
State / Province / Region
NC
Postal / Zip Code
28001
Country
USA
Street Address
716 W. Main Street
Address Line 2
[phone]
[e-mail]
3a. Name :
3b. Business Name :
3c. Addre ss
3d. Te le phone Numbe r:3e . Fax Numbe r:
3f. Email Addre ss:
Larry Thompson
City
Albemarle
State / Province / Region
NC
Postal / Zip Code
28001
Country
USA
Street Address
716 W. Main Street
Address Line 2
[phone]
[e-mail]
C. Project I nformation and Prior Project History
1b. Subdivision name :
1c. Ne are st municipality / town:
2a. Prope rty Identification Numbe r:2b. Prope rty size :
2c. Proje ct Addre ss
3. Surface Waters
3a. Name of the ne are st body of wate r to propose d proje ct:
3b. Wate r Re source s Classification of ne are st re ce iv ing wate r:*
3d. Ple ase prov ide the 12-digit HUC in which the proje ct is locate d.
3c. What riv e r basin(s) is your proje ct locate d in?*
4. Project Description and History
4a. De scribe the e xisting conditions on the site and the ge ne ral land use in the v icinity of the proje ct at the time of this application:*
4b. Hav e Corps pe rmits or DWR ce rtifications be e n obtained for this project (including all prior phase s) in the past?*
4d. Attach an 8 1/2 X 11 e xce rpt from the most re ce nt v e rsion of the USGS topographic map indicating the location of the proje ct site . (for DWR)
4e . Attach an 8 1/2 X 11 e xce rpt from the most re ce nt v e rsion of the publishe d County NRCS Soil Surv e y map de picting the proje ct site . (for DWR)
4f. List the total e stimate d acre age of all e xisting we tlands on the prope rty:
4g. List the total e stimate d line ar fe e t of all e xisting stre ams on the prope rty:
4h. Explain the purpose of the propose d proje ct:*
4i. De scribe the ov e rall proje ct in de tail, including indirect impacts and the type of e quipme nt to be use d:*
4j. Ple ase upload proje ct drawings for the propose d proje ct.
5. Jurisdictional Determinations
5a. Hav e the we tlands or streams be e n de line ate d on the prope rty or propose d impact are as?*
1. Project Information
(if appropriate)
Not Applicable
Gold Hill, NC (Concord NC)
2. Project Identification
Not applicable Not applicable
City
Not applicable
State / Province / Region
Not applicable
Postal / Zip Code
Not applicable
Country
Not applicable
Street Address
Not applicable
Address Line 2
Not applicable
Big Bear Creek
13-17-31-5
030401050404
Yadkin-PeeDee
The existing structure is a single, steel and concrete, 40' span bridge spanning a tributary of Big Bear Creek. The project area is out of frame in the Cabarrus County Land use map.
The majority of surrounding area is zoned as either single family Rural/Agricultural or Single Family Residential. See attached Natural Resources Technical Report for Land cover map.
Yes No Unknown
NC_Richfield_20190727_TM_geo.pdf 101.16MB
Cabarrus_NRCS_110.pdf 162.46KB
0.08
688
The bridge was originally constructed in 1952 and the timber and steel 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.
NCDOT Highway Division 10 proposes to replace Bridge # 120105 on SR 2450 over Big Bear Creek Branch. The existing structure is a single 40' span, steel I-beam bridge, with vertical
concrete abutments. The proposed structure is a single 70' span, concrete cored slab, with 4.0' tall end-bent caps, and riprapped 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 is to riprap pad located outside the
streambanks, at the northeast quadrant. Class II riprap will be utilized along the southern streambank to provide stabilization once the existing vertical concrete abutment is removed.
Riprap toe protection will be used along the southwest fill slope in lieu of ditching to minimize impacts to wetlands in this location.
17BP10R110_Permit Package Wetland_20190620.pdf 1.47MB
Yes No Unknown
Comme nts:
5b. If the Corps made a jurisdictional de te rmination, what type of de te rmination was made ?*
Corps AID Numbe r:
5c. If 5a is ye s, who de line ate d the jurisdictional are as?
Name (if known):
Age ncy/Consultant Company:
Othe r:
5d1. Jurisdictional de te rmination upload
6. Future Project Plans
6a. Is this a phase d proje ct?*
Are any othe r NWP(s), re gional ge ne ral pe rmit(s), or indiv idual pe rmits(s) use d, or intende d to be use d, to authorize any part of the propose d project or re lated activ ity?
1. Impacts Summary
1a. Whe re are the impacts associate d with your proje ct? (che ck all that apply):
2. Wetland Impacts
2a. Site #*(?)2a1 Reason *(?)2b. Impact type *(?)2c. Type of W.*2d. W. name *2e . Fore ste d *2f. Type of
Jurisdicition *(?)
2g. Impact
are a *
2g. Total Te mporary We tland Impact 2g. Total Pe rmane nt We tland Impact
2g. Total We tland Impact
2h. Comme nts:
3. Stream Impacts
3a. Reason for impact *(?)3b.Impact type *3c. Type of impact *3d. S. name *3e . Stre am Type *
(?)
3f. Type of
Jurisdiction *
3g. S. width *3h. Impact
le ngth *
S1
S2
3i. Total jurisdictional ditch impact in square fe e t:
3i. Total pe rmane nt stre am impacts:3i. Total te mporary stre am impacts:
Preliminary Approved Not Verified Unknown N/A
Joseph Sullivan
KCI Associates of NC
Via Natural Resources Technical Report
Yes No
D. Proposed Impacts Inventory
Wetlands Streams-tributaries Buffers
Open Waters Pond Construction
1 Permanent Fill In
Wetlands
P Headwater Forest Big Bear Creek Yes Both 0.020
(acres)
1 Mechanized Clearing in
Wetlands
P Headwater Forest Big Bear Creek Yes Both 0.020
(acres)
1 Hand Clearing In
Wetlands
T Headwater Forest Big Bear Creek Yes Both 0.010
(acres)
0.010 0.040
0.050
Bank Stabilization Permanent Bank Stabilization Big Bear Creek Branch Perennial Both 23
Average (feet)
26
(linear feet)
Ditch Outlet Temporary Stabilization Big Bear Creek Branch Perennial Both 23
Average (feet)
28
(linear feet)
0
26 28
3i. Total stre am and ditch impacts:
3j. Comme nts:
1. Avoidance and Minimization
1a. Spe cifically de scribe me asure s take n to av oid or minimize the propose d impacts in de signing the proje ct:
1b. Spe cifically de scribe me asure s take n to av oid or minimize the propose d impacts through construction te chnique s:
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Doe s the proje ct re quire Compe nsatory M itigation for impacts to Wate rs of the U.S. or Wate rs of the State ?
2b. If this proje ct DOES NOT re quire Compe nsatory M itigation, e xplain why:
1. Diffuse Flow Plan
1a. Doe s the proje ct include or is it adjace nt to prote cte d riparian buffers ide ntifie d within one of the NC Riparian Buffe r Prote ction Rule s?
If no, e xplain why:
2. Stormw ater Management Plan
2a. Is this a NCDOT proje ct subje ct to compliance with NCDOT’s Indiv idual NPDES pe rmit NCS000250?*
Comme nts:
1. Environmental Documentation
1a. Doe s the proje ct inv olv e an e xpe nditure of public (fe de ral/state /local) funds or the use of public (fe de ral/state ) land?*
1b. If you answe re d “ye s” to the abov e , doe s the proje ct re quire pre paration of an e nv ironme ntal docume nt pursuant to the re quireme nts of the National or State (North Carolina)
Env ironme ntal Policy Act (NEPA/SEPA)?*
Comme nts:*
2. Violations (DWR Requirement)
2a. Is the site in v iolation of DWR Wate r Quality Ce rtification Rule s (15A NCAC 2H .0500), Isolate d We tland Rule s (15A NCAC 2H .1300), or DWR Surface Wate r or We tland Standards or
Riparian Buffe r Rule s (15A NCAC 2B .0200)?*
3. Cumulative Impacts (DWR Requirement)
3a. Will this proje ct re sult in additional de v e lopme nt, which could impact ne arby downstre am wate r quality?*
3b. If you answe re d “no,” prov ide a short narrativ e de scription.
54
E. Impact Justification and Mitigation
Permanent fill into wetlands is minimized. Mechanized and hand clearing in wetland areas is minimized.
Impervious dikes used to dewater construction area and control sediment deposition in Jurisdictional Stream. Erosion control BMP's utilized to minimize
sediment deposition in the stream and wetlands.
Yes No
Project is not in a watershed that requires Riparian Buffer protection.
F. Stormwater M anagement and Diffuse Flow Plan (required by DWR)
Yes No
Yes No
G. Supplementary Information
Yes No
Yes No
A minimum criteria determination checklist was prepared
Yes No
Yes No
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 se wage disposal re quire d by DWR for this proje ct?*
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this proje ct occur in or ne ar an are a with fe de rally prote cte d spe cie s or habitat?*
5b. Hav e you che cke d with the USFWS conce rning Endange re d Spe cie s Act impacts?*
5d. Is anothe r Fe de ral age ncy inv olv e d?*
5e . Is this a DOT proje ct locate d within Div ision's 1-8?
5f. Will you cut any tre e s in orde r to conduct the work in wate rs of the U.S.?
5g. Doe s this proje ct inv olv e bridge mainte nance or re mov al?
5h. Doe s this proje ct inv olv e the construction/installation of a wind turbine (s)?*
5i. Doe s this proje ct inv olv e (1) blasting, and/or (2) othe r pe rcussiv e activitie s that will be conducte d by machine s, such as jackhamme rs, me chanize d pile driv e rs, e tc.?
5j. What data source s did you use to de te rmine whe the r your site would impact Endange re d Spe cie s or De signate d Critical Habitat?*
Consultation Docume ntation Upload
6. Essential Fish Habitat (Corps Requirement)
6a. Will this proje ct occur in or ne ar an are a de signate d as an Esse ntial Fish Habitat?*
6b. What data source s did you use to de te rmine whe the r your site would impact an Esse ntial Fish Habitat?*
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this proje ct occur in or ne ar an are a that the state , fe de ral or tribal gov e rnme nts hav e de signate d as hav ing historic or cultural pre se rv ation status?*
7b. What data source s did you use to de te rmine whe the r your site would impact historic or arche ological re source s?*
7c. Historic or Pre historic Information Upload
8. Flood Zone Designation (Corps Requirement)
8a. Will this proje ct occur in a FEM A-designate d 100-ye ar floodplain?*
8c. What source (s) did you use to make the floodplain de te rmination?*
Comme nts
M isce llane ous attachme nts not pre v iously re que ste d.
Yes No N/A
Yes No
Yes No
Yes No Unknown
Yes No
Yes No
Yes No
Yes No
Yes No
Natural Resources Technical Report (see miscellaneous)
(Northern long-eared bat conclusion: may affect, not likely to adversely affect)
Cabarrus105_NRTR_Draft_Submittal_20180921 (1).pdf 2.07MB
Yes No
NCDOT Natural Resources Technical Report (see miscellaneous).
Yes No
No National Register of Historic Places Eligible or Listed Archaeological Sites Present Form (AR18-10-0002)
AR18-10-0002NoSitesPresent.pdf 10.68MB
Yes No
Bridge survey report, NC Flood risk information system Lookup
M iscellaneous
NRTR included for reference.
Minimum Criteria Determination checklist attached for reference.
*
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 :*
Signature
Date
Cabarrus105_NRTR_Draft_Submittal_20180921.pdf 2.07MB
17BP.10.R.110_MCDC__Bridge_105_Cabarrus_FINAL (signed).pdf 1.29MB
Signature
By checking the box and signing below, I certify that:
Larry Thompson
12/17/2019