20200233 Ver 1_PCN Form Submission_20200212

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
20200233
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:
Stokes Bridge 15 17BP.9.R.98
1a. Who is the Primary Contact?*
Amy Euliss
1b. Primary Contact Email:*
[e-mail]
Date Submitted
2/12/2020
Nearest Body of Water
Vade Mecum Creek
Basin
Roanoke
Water Classification
B
Site Coordinates
Latitude:
36.397735
A. Processing Information
County (or Counties) where the project is located:
Stokes
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:
WBS # (?)
17BP.9.R.98
1a. Type (a) of approval sought from the Corps:
Longitude:
-80.331086
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
Bridge 15 - Division 9 - STIR - RO 03.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?
GYes GNo
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:
Pat Ivey- NCDOT Division Engineer
2b. Deed book and page no.:
2c. Responsible party:
2d.Address
Street Address
375 Silas Creek Pkwy.
Address Line 2
City
Winston-Salem
Postal / Zip Code
27127
2e. Telephone Number:
[phone]
2g. Email Address:*
State / Rovince / Region
NC
Country
USA
2f. Fax Number:
67.62KB
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:
Danbury
Project Identification
2a. Property Identification Number:
2c. Project Address
Street Address
Address Line 2
City
Postal / Zip Code
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Vade Mecum Creek
3b. Water Resources Classification of nearest receiving water:*
B
3c. What river basin(s) is your project located in?*
Roanoke
3d. Please provide the 12-digit HUC in which the project is located.
030101030108
4. Project Description and History
2b. Property size:
State / Province / Region
Country
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 is located in a rural area. The immediate area consists of agriculture and forested areas. There are two stream channels within the project area and one man-made pond.
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)
Fig1_USGS Vicinity Map_Stokes 15.pdf 468.28KB
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)
Fig2_Soils Map Stokes 15.pdf 791.27KB
4f. List the total estimated acreage of all existing wetlands on the property:
N/A
4g. List the total estimated linear feet of all existing streams on the property:
300
4h. Explain the purpose of the proposed project:*
The purpose of the project is to replace a 1 @18'-6" reinforced concrete Luten Arch with a new culvert consisting of 2@10'X0' RCBCs. The project will also upgrade an wasting pipe to a
30" RCP-N.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
The project will remove the emsting luten arch and replace it with a double barrel RCBC. It will widen the roadway from 18' with 4' unpaved shoulders to 22' with 7' of shoulder and
include a guardrail. Cranes, dump trucks, bulldozers and typical construction equipment will be used. There will be an off -site detour.
4j. Please upload project drawings for the proposed project.
840015_Permit Drawings_(20190828).pdf 1.68MB
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:
Two streams and one small man-made pond were located in the study area.

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:
Other:
Heather Smith
VHB (formerly Ecological Engineering)
5d1. Jurisdictional determination upload
WetStreamdata Stokes 15 revised 20190801.pdf
6. Future Project Plans
1.38MB
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
17 Open Waters F Pond Construction
3. Stream Impacts
r Buffers
U
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
❑
(?)
Jurisdiction*
length*
S1
1 Culvert Re lacement
P
Permanent
Culvert
Vade Mecum Creek
Perennial
Both
10
57
Average (feet)
(lir�rfeet)
g2
1 Culvert Replacement
Temporary
Dewatering
Vade Mecum Creek
Perennial
Both
10
23
Avenge(feet)
(linearfeet)
S3
1 Culvert Re lacement
P
Permanent
Bank Stabilization
Vade Mecum Creek
Perennial
Both
10
51
Average (feet)
(lir�rfeet)
S4
2a Pipe Re lacement
P P
Permanent
Culvert JSA
Intermittent
Both
2
42
Average (feet)
(linearfeet)
S5
2a Pipe Replacment
Temporary
Dewatering
�SA
Intermittent
Both
2Average(feet)
13arfeet)
S6
21b Pipe Re lacement
P P
Permanent
Bank StabilizationJSA
Intermittent
Both
2
11
Aver�e(feet)
(lir�rfeet)
37
2b Pipe Replacement
Permanent
Culvert JSA
Intermittent
Both
2Aver�e(feet)
18nearfee)
gg
21b Pipe Replacement
Temporary
Dewatering
�SA
Intermittent
Both
2
27
Average (feet)
(lir�rfeet)
31. Total jurisdictional ditch impact in square feet:
0
31. Total permanent stream impacts: 3i. Total temporary stream impacts:
179 63
3i. Total stream and ditch impacts:
242
3j. Comments:
Mitigation is being proposed for the 117 If of permanent stream impacts. This is the permanent stream impacts minus the 62 If of bank stabilization.
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:
The culvert is being replaced in the current alignment to reduce impacts to Vade Mecum Creek, Stream A and the pond. The culvert was designed to
use the shortest length possible and still provide adequate room for the road shoulder and guardrail. Minimal bank stabilization was used where
needed to prevent future sedimentation.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
The culvert will be replaced in the current alignment and construction areas will be limited to areas outside of jurisdictional resources.
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
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 W 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.
r Yes r No
4b. Stream mitigation requested:
(linear feet)
117' at a 2:1 ratio
4d. Buffer mitigation requested (DWR only):
(square feet)
4f. Non -riparian wetland mitigation requested:
(acres)
4h. Comments
4c. If using stream mitigation, what is the stream temperature:
warm
4e. Riparian wetland mitigation requested:
(acres)
4g. Coastal (tidal) wetland mitigation requested:
(acres)
F. Stormwater 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:
This project is located in the Roanoke River Basin and is not subject to state regulated riparian buffer rules.
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
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:
An environmental document is not required. A State Minimum Criteria Checklist was prepared and is attached in the miscellaneous documents section.
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?*
(- Yes r No
3b. If you answered "no," provide a short narrative description.
This is a culvert and pipe replacement in a rural area. The replacement will maintain the current level of service and no further development is
e)pected due to this project.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
r- Yes r No r- 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
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 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
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
51. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
The study area was surveyed by VHB staff (formerly Ecological Engineering) on 4/30/2018 for small-anthered bittercress (Cardamine micranthera)
and 8/28/2018 for Schwinit2s sunflower (Helianthus schweinitai). No specimens were found within the study area. Additionally, NCNHP data, dated July
2018, revealed no known occurrences of small-anthered bittercress within 1.0 mile of the study area. There is a low accuracy record of Shweinit2s
sunflower within 1.0 mile of the study area. James spinymussel (Parvaspina collina), green floater (Lasmigona subviridis) and Roanoke logperch
(Percina rex) were surveyed for by RK&K on April 16, 2019. No proposed or federally listed species were found during the aquatic survey and RK&K
concluded the project would have No Effect on all federally listed aquatic species.
Consultation Documentation Upload
17BP.9.R.98_Final.pdf
3.97MB
Stokesl 5_SchweinitzsSunflowerSurvey_20180828.pdf
226.7KB
Stokes 15 Small anthered bittercress Survey 20180503.pdf
243.84KB
20-136_ConcurrenceBridgeNo.115_NC66VadeMecumCreek_StokesCo.pdf
177.56KB
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 Essential Fish Habitat Mapper
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?*
Coordination with SHPO, see attached correspondence letters.
7c. Historic or Prehistoric Information Upload

PA 17-05-0062 No Archaeological Survey Req Form Br No 15 on NC 66 Stokes.pdf 1.06MB
17-05-0062NoSurvey.pdf 1.91MB
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-yearfloodplain?*
r Yes r No
8c. What source(s) did you use to make the floodplain determination?*
DFIRM 3710690600J
Miscellaneous
Comments
Miscellaneous attachments not previously requested.
MCDC Br 15 Stokes.pdf 2.19MB
Bridge 15 Cover Leter.pdf 156.53KB
Signature U
*
W 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:
Amy Euliss
Signature
Date
2/12/2020