20200347 Ver 1_PCN Form Submission_20200306

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?*
r Yes
r No
Is this project a public transportation project?*
G Yes r No
Change only if needed.
BIMS # Assigned
20200347
Is a payment required for this project?*
r No payment required
r Fee received
r Fee needed - send electronic notification
Select Project Reviewer*
Dave Wanucha:eads\djwanucha
Information for Initial Review
1a. Name of project:
B-5825
1a. Who is the Primary Contact?*
NCDOT
1b. Primary Contact Email:*
[e-mail]
Date Submitted
3/6/2020
Nearest Body of Water
Yadkin River
Basin
Yadkin-PeeDee
Water Classification
WS-IV
Site Coordinates
Latitude:
36.216144
A. Processing Information
County (or Counties) where the project is located:
Yadkin
Forsyth
Is this project a public transportation project?*
r Yes r No
Is this a NCDOT Project?*
r Yes r No
(NCDOT only) T.I.P. or state project number:
B-5825
WBS # (?)
45778.1.1
Longitude:
-80.432081
Version#*
1
Reviewing Office*
Winston-Salem Regional Office - (336) 776-
9800
1c. Primary Contact Phone:*
[phone]
U

1a. Type(s) of approval sought from the Corps:
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?
r Nationwide Permit (NWP)
W Regional General Permit (RGP)
r Standard (IP)
1c. Has the NWP or GP number been verified by the Corps?
r Yes r No
Regional General Permit (RGP) Number:
RGP Numbers (for multiple RGPS):
1d. Type(s) of approval sought from the DWR:
W 401 Water Quality Certification - Regular
r Non-404 Jurisdictional General Permit
r Individual Permit
198200031 - NCDOT Bridges, Widening Projects 2015
le. Is this notification solelyfor the record because written approval is not required?
For the record onlyfor DWR401 Certification:
For the record onlyfor Corps Permit:
F- 401 Water Quality Certification - E)press
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-5825 Mitigation packet.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?
C Yes C No
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
1000 Birch Ridge Drive
Address tine 2
city
Raleigh
Postal / Zip Cade
27610
State / Province / Ifgion
NC
Country
us
574.7KB
r Yes r No
r Yes r No
2e. Telephone Number:
[phone]
2f. Fax Number:

2g. Email Address:*
[e-mail]
C. Project Information and Prior Project History U
1. Project Information
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality/ town:
Donnaha
Project Identification
2a. Property Identification Number: 2b. Property size:
2c. Project Address
Street Address
Address Line 2
(Sty State / Rovince / Region
Postal / Zip Code Country
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Yadkin River
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.
030401011007
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:*
Predominately undeveloped forest, along with agriculture land, some rural residences, and Donnaha Park located on the west side of the Yadkin River.
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)
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:
0.11
4g. List the total estimated linear feet of all existing streams on the property:
4h. Explain the purpose of the proposed project:*
To replace a structurally deficient bridge. Bridge No. 35 has a sufficiency rating of 4 out of 100. The bridge is considered structurally deficient due to a superstructure appraisal of 3 out
of 9 according to Federal Highway standards. This also necessities the need to replace an existing 72-inch Corrugated Metal Pipe (CMP).
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
The North Carolina Department of Transportation (NCDOT) proposes to replace bridge number 980035 on NC 67 (Reynolda Road) over the Yadkin River (STIP B-5825) in Yadkin &
Forsyth Counties. The replacement structure will be a 72-inch girder bridge approximately 1,065-feet long providing a minimum clear roadway width of 32-feet on new alignment to the
north. The bridge will include two 12-foot travel lanes, 4-foot offsets, and bicycle safe rails. The bridge length is based on preliminary design information and is set by hydraulic
requirements. The roadway grade of the newstructure will be raised from 3 feet to 6 feet. The 72" Corrugated Metal Pipe (CMP) on SR 1600 (Donnaha Road) over an unnamed
tributary to the Yadkin River Will be replaced with a single 9' x 10' Reinforced Box Culvert (RCBC). The existing single 9' x 9' RCBC on NC 67 (Reynolda Road) over an unnamed
tributary to the Yadkin River east of Bridge No. 980035 will be retained and extended. Project construction on NC 67 (Reynolda Road) will extend approximately 1,533-feet from the west
end of the new bridge and 1,402-feet from the east end of the new bridge. The approaches will be widened to provide two 12-foot travel lanes with 8-foot shoulders (11-feet with
guardrail) including 4-foot paved.
Project construction on SR 1600 (Donnaha Road) will extend approximately 968-feet north from NC 67. SR 1600 will be realigned and widened to improve the sight distance to the west.
The realignment of SR 1600 to the east will include two 12-foot travel lanes with 8-foot shoulders (11-feet With guardrail). NC 67 has a functional classification of Minor Arterial and will
be designed using Regional Tier Guidelines with a 60 mile per hour design speed.
4j. Please upload project drawings for the proposed project.
B-5825_Permit_Drawings _2020-02-26.pdf 5.11 MB

5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes r No
Comments:
No Agency site visit has occurred.
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): Paul Masten
Agency/Consultant Company: AECOM
Other:
5d1. Jurisdictional determination upload
6. Future Project Plans
r Unknown
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?
No.
D. Proposed Impacts Inventory
1. Impacts Summary
la. Where are the impacts associated with your project? (check all that apply):
W Wetlands W Streams -tributaries r Buffers
r Open Waters r Pond Construction
2. Wetland Impacts
2at Reason (?)
2b. Impact type * (?)
2c. Type of W.
2d. W. name *
2e. Forested*
Type of
2g. Impact
[2f.
urisdicition*(?)
area*
2
Fill
P
Headwater Forest —]
Wetland A
Yes
rps
F
0.010
(acres)
2
Mechanized Clearing
P
Headwater Forest
Wetland A
Yes
Corps
0.020
(acres)
3
Mechanized Clearing
P
Bottomland Hardwood Forest
Wetland B
No
Corps
0.080
(acres)
2g. Total Temporary Wetland Impact
0.000
2g. Total Wetland Impact
0.110
2h. Comments:
3. Stream Impacts
2g. Total Permanent Wetland Impact
0.110
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*
81
Site 1: Temp. Work Pads
Temporary
Workpad/Causeway —]
Yadkin River
Perennial
Both
3A
14rfeet)
(f)
S2
Site 1: Bank stabilization
Permanent
Bank Stabilization J
Yadkin River
Perennial
Both
345
134
Average (feet)
(lir�rfeet)
S3
Site 1: Bank stabilization
Tem orar
P Y
Bank Stabilization
Yadkin River
Perennial
Both
345
43
Average (feet)
(lir�rfeet)

S4
Site 2: stream relocation
Permanent
Relocation
SB Lrr to Yadkin
( )
Intermittent
��_]
3
168
Average (feet)
(lin�rfeet)
S5
Site 2: 3' Std. base ditch
Temporary
Other
SB (UT to Yadkin)
Perennial
Both
3
12
Average (feet)
(linearfeet)
S6
Site 4: pipe removal channel
Permanent
Rip Rap Fill
SC (UT to Yadkin)
Perennial
Both
9
34
improvement
Aver�e(feet)
(lir�rfeet)
g7
Site 4: pipe removal channel
Temporary
Rip Rap Fill
SC (lJT to Yadkin)
Perennial
Both
9
26
Improvement
Average (feet)
(linearfeet)
gg
Site 4: 1 @ 9'x 10' RCBC
Permanent
Fill
Yadkin)
ffo
Perennial
Both
9Average
16nea
(feet)
feet)
S9
Site 4: 1 @ 9'x 10' RCBC
Temporary
Other
SC (UT to Yadkin)
Perennial
Both
9Aver�e
3(linea
(feet)
feet)
S10
Site 4: culvert improvement
Permanent
—]
Bank Stabilization
SC (UT to Yadkin)
Perennial
Both
9
31
Average (feet)
(linearfeet)
S11
Site 4: culvert improvement
Temporary
Bank Stabilization Iff
o Yadkin)
Perennial
Both
9
20
Average (feet)
(linearfeet)
�2�Site
4: 1 @ 9'x 9' RC BC
Permanent
Fill
SC (UT to Yadkin)
Perennial
Both
9
99
E)dension
Average (feet)
(linear feet)
S13
Site 4: channel improvement
Permanent
Bank Stabilization Iff
o Yadkin)
Perennial
Both
9
32
Average (feet)
(linearfeet)
S14
Site 4:channel improvement
Temporary
Bank Stabilisation
SC (UT to Yadkin)
Perennial
Both
9
11
Average (feet)
(lin�rfeet)
31. Total jurisdictional ditch impact in square feet:
3i. Total permanent stream impacts:
663
3i. Total stream and ditch impacts:
819
3i. Total temporary stream impacts:
156
3j. Comments:
Of the total of 663 linear feet of permanent stream impact, 197 linear feet are Bank Stabilization impacts (not requiring mitigation). Therefore,
mitigation is required for 466 linear feet of permanent stream impacts. [see Comment in Section 4h]
E. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
Minimizing shoulder section; providing adequate ground cover; stabilizing embankments and drainage ditches; providing adequate energy dissipation;
utilizing natural features and drainage pathways (e)dsting drainage pathways were utilized to the mapmum extent practicable); and minimizing direct
discharges from the bridge.
The emsting bridge has four (4) bents in the Yadkin River; the proposed bridge will only have two (2) bents in the Yadkin River.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
At Site 2, a portion of a 30-inch RCP will be removed and approbmately 100 linear feet of stream will be 'day -lighted'.
At Site 4, a 72-inch CMP will be removed and approbmately 100 linear feet of stream will be 'day -lighted'.
During the use of temporary work pads for the bridge demolition/construction, stream flow blockage will be limited to 50 % (or less) at any one time.
Best Management Practices for Surface Waters will be used during all phases of construction.
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
f No
2c. If yes, mitigation is required by (check all that apply):
W 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) 4c. If using stream mitigation, what is the stream temperature:
466 warm

4d. Buffer mitigation requested (DWR only):
(square feet)
4e. Riparian wetland mitigation requested:
(acres)
0.11
4f. Non -riparian wetland mitigation requested: 4g. Coastal (tidal) wetland mitigation requested
(acres) (acres)
4h. Comments
NCDOT does not propose mitigation for the 197 linear feet of bank stabilization impacts, as bank stabilization does not require fill in the stream bed
and therefore, under Section 404 of the Clean Water Act, does not constitute Loss of Waters of the U.S. and is not subject to compensatory
mitigation.
Wetland mitigation has been obtained from DMS.
Stream mitigation has been obtained from Brushy Mountain Mitigation Bank.
6. Buffer mitigation (State Regulated Riparian Buffer Rules) - required by DWR
6a. Will the project result in an impact within a protected riparian buffer that requires buffer mitigation? If yes, you must fill out this entire form - please contact DWR for more
information.
r Yes r No
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:
it is not located Within a Buffer Basin.
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:
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
1c. If you answered "yes" to the above, has the document review been finalized bythe State Clearing House?*
r Yes r No
NEPAor SEPA Final Approval Letter
B-5825 MCDC 10Jull9.pdf
2. Violations (DWR Requirement)
4.99MB
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.
Due to the minimal transportation impact resulting from this bridge replacement, this project will neither influence nearby land uses nor stimulate
growth. Therefore, a detailed indirect or cumulative effects study will not be necessary.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*

r' Yes C No r' WA
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 f• 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
If yes, please provide details to include type of percussive activity, purpose, duration, and specific location of this activity on the property.
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
USFWS vdebsite, NCNHP website, and on -site pedestrian surveys.
Consultation Documentation Upload
B-5825 2020-02-24 NLEB Slopes.pdf 265.58KB
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?*
NMFS County Index
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?*
WSEPA Documentation
7c. Historic or Prehistoric Information Upload
B-5825 Historic_ Prehistoric.pdf
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-yearfloodplain?*
r Yes r No
8b. If yes, explain how project meets FEMA requirements:
NCDOT Hydraulics Unit coordination with FEMA
8c. What source(s) did you use to make the floodplain determination?*
FEMA Maps
Miscellaneous
Comments
846.33KB

[from the MCDC]: Donnaha Park is owned by the State of North Carolina and is not a Section 6(f) resource. The land was donated to the State of North Carolina by the United States of
America as a recreational use for the traveling public and as a source for roadway materials in connection with the maintenance and operation of a public highway. Donnaha Park will be
impacted with the proposed project due to the relocation of Donnaha Road.
To address Donnaha Park closure and to address potential river users during bridge demolition/construction, Division 11 personnel will be meeting on -site with the NCWRC, scheduled
for March 4, 2020, for discussion of logistics.
Miscellaneous attachments not previously requested.
B-5825 App Cov Ltr.pdf
Signature
® By checking the box and signing below, I certify that:
375.64KB
• 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:
Michael Anthony Turchy
Signature
Ili r
Date
3/6/2020