20200445 Ver 1_PCN Form Submission_20200403

DWR
Dlrlslon 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
20200445
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. 24 on NC 22 over Nicks Creek (BR-0035 Central)
1a. Who is the Primary Contact?*
NCDOT
1b. Primary Contact Email:*
[e-mail]
Date Submitted
4/3/2020
Nearest Body of Water
Nicks Creek
Basin
Cape Fear
Water Classification
WS-III
Site Coordinates
Latitude: Longitude:
35.253501-79.412772
A. Processing Information
County (or Counties) where the project is located:
Moore
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:
BR-0035
WBS#M
67035.1.1
1a. Type (a) 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: 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
BR-0035 - RW - CF 04.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
1000 Birch Ridge Drive
Address Line 2
city
Raleigh
Fostal / Zip Code
27610
2e. Telephone Number:
[phone]
2g. Email Address:*
State / Rwince / Fbgion
NC
Country
USA
2f. Fax Number:
64.82KB
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:
Southern Pines
2. ProjectIdentification
2a. Property Identification Number: 2b. Property size:
2c. Project Address
Street Address
Address Line 2
(Sty State / Province / Pegion
Postal / Zip Code Country
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Nicks Creek
3b. Water Resources Classification of nearest receiving water:*
WS-III
3c. What river basin(s) is your project located in?*
Cape Fear
3d. Please provide the 12-digit HUC in which the project is located.
030300040301
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:*
Land use in the project vicinity consists primarily of forested communities, residential development and a community park with greenway.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
r Yes f No f 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:
0.25
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 this project is to replace a structurally deficient bridge.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
This project involves replacing the eAsting single span, 19-foot bridge with a three barrel culvert downstream of the eAsting structure. Traffic will be maintained on the eAsting bridge
during construction. Standard road building equipment, such as trucks, dozers and cranes will be used.
4j. Please upload project drawings for the proposed project.
BR-0035_Hyd_prm_wet _ Package03312020.pdf 10.52MB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
c Yes C No 6 Unknown
Comments:
Field visit with USACE conducted on 10/15/2019. Updated JD request package attached.
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
F Preliminary r Approved f Not Verified r Unknown r N/A

Corps AID Number:
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Jason Dilday
Agency/Consultant Company: NCDOT
Other:
5d1. Jurisdictional determination upload
BR0035_JDpackage.pdf 16.71 MB
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 projector related activity?
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 Open Waters F Pond Construction
2. Wetland Impacts
r Buffers
2a1 Reason (?)
2b. Impact type * M
2c. Type of W.*
2d. W. name *
2e. Forested *
2C Type of
2g. Impact
Jurisdicition*(?)
area
Site 1
Fill
P
Headwater Forest
WA
No
Corps
0.050
(acres)
Site 2
Fill
P
Headwater Forest
WB/WE
Yes
Corps
0.040
(acres)
Site 2
Mach. Clearing
P
Headwater Forest
WE
Corps
0.010
��A
(acres)
2g. Total Temporary Wetland Impact
0.000
2g. Total Wetland Impact
0.100
2h. Comments:
Relocation of utilities will be directionally bored under wetlands resulting in no impact.
Wetland WE was considered a total take, Mich would incur an additional 0.01 acre of impact.
3. Stream Impacts
2g. Total Permanent Wetland Impact
0.100
F
3a. Reason for impact (?)
3b.lmpact type *
3c. Type of impact*
3d. S. name *
3e. Stream Type *
Type of
3g. S. width *
3h. Impact
(?)
�3f.
Jurisdiction*
length*
S1
Site 3-Culvert
Permanent
Culvert
Nicks Creek
Perennial
Both
20
61
Average (feet)
(linearfeet)
S2
Site 3-Bank Stabilization
Permanent
Bank Stabilization
Nicks Creek
Perennial
Both
20
90
Average (feet)
(linearfcet)
S3
Site 3-Bank Stabilization
t7A
Bank Stabilization
Nicks Creek
Perennial:::]
Both
h;;t;;:1_
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
151
31. Total stream and ditch impacts:
196
3i. Total temporary stream impacts:
45

3j. Comments:
Relocation of the water line on the project will be done by open cut at Nicks Creek, however the work will be done within the temporary impact area of
the culvert installation resulting in no additional impact.
E. Impact Justification and Mitigation u
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
The culvert will be designed to not have direct discharge into Nicks Creek. Sheetflowto be promoted to flowthrough grass shoulders. See stormwater
management plan for additional minimization measures. 3:1 fill slopes will be used in wetlands.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Traffic will be maintained on the existing bridge during construction of the replacement structure. Best Management Practices for Construction and
Maintenance Activities will be adhered to during 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):
F 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)
0
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:
4e. Riparian wetland mitigation requested:
(acres)
0.11
4g. Coastal (tidal) wetland mitigation requested:
(acres)
F. Stormwater Management and Diffuse Flow Plan (required by DWR) u
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:
Nicks Creek is not within a protected buffer basin for NCDWR.
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 (NEPAUSEPA)?*

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
Comments:*
The State Minimum Criteria Determination Checklist for this project was not required to be submitted to the State Clearing House.
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 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 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 r Unknown
5e. Is this a DOT project located within Division's 1-8?
r Yes r- No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
N.C. Natural Heritage Program database; USFWS-Raleigh Field Office website; biological surveys for protected species listed for Moore County, which
include Cape Fear shiner, red -cockaded woodpecker, American chaffseed and Michaux's sumac. Biological conclusion for Cape Fear shiner and
American chaffseed were "No Effect", due to no suitable habitat. Habitat for red -cockaded woodpecker and Michau)ts sumac is available in the study
area, however surveys for the species, conducted on August 28, 2018 revealed no occurrences within the vicinity of the study area. The biological
conclusion for these species is "No Effect". The Northern long-eared bat will addressed through the PBO.
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?*
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?*
SEPA documentation
7c. Historic or Prehistoric Information Upload
8. Flood Zone Designation (Corps Requirement)

8a. Will this project occur in a FEMA-designated 100-year floodplain?*
r Yes r No
81b. 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 floodplain maps
Miscellaneous
Comments
Miscellaneous attachments not previously requested.
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:
Mack Christopher Rivenbark, III
Signature
J04 C. RiVwo. , Ill
Date
4/3/2020