20201293 Ver 1_401 Application_20201001

I I DWR
Division of Water Resources
Pre-Construction Notification (PCN) Form
September 1,2020 Ver 3.2
Initial Review
Has this project met the requirements for acceptance in to the review process?*
✓ Yes
✓ No
Is this project a public transportation project?*
0 Yes r No
Change only if needed.
BIMS#Assigned* Version#*
20201293 1
Is a payment required for this project?*
✓ No payment required
G Fee received Reviewing Office*
✓ Fee needed-send electronic notification Asheville Regional Office-[phone]
Select Project Reviewer*
Kevin Mitchell:eads\rkmitchell
Information for Initial Review
1a.Name of project:
Bridge 560073,SR 1341 Foster Creek Road,UT to Foster Creek
1a.Who is the Primary Contact?*
Yates Allen
lb.Primary Contact Email:* 1c.Primary Contact Phone:*
[e-mail] [phone]
Date Submitted
10/1/2020
Nearest Body of Water
Foster Creek
Basin
French Broad
Water Classification
Class C;Tr,ORW
Site Coordinates
Latitude: Longitude:
35.933115 -82.595597
A. Processing Information
County(or Counties)where the project is located:
Madison
Is this a NCDMS Project
✓ Yes G No
Is this project a public transportation project?*
6 Yes r No
Is this a NCDOT Project?*
(7 Yes r No
(NCDOT only)T.I.P.or state project number:
B-6012

WBS#(7)
48207.3.1
1a.Type(s)of approval sought from the Corps:
I7 Section 404 Permit(wetlands,streams and waters,Clean Water Act)
r Section 10 Permit(navigable waters,tidal waters,Rivers and Harbors Act)
lb.What type(s)of permit(s)do you wish to seek authorization?
I7 Nationwide Permit(NWP)
r Regional General Permit(RGP)
r Standard(IP)
1c.Has the NWP or GP number been verified by the Corps?
✓ Yes r No
Nationwide Permit(NWP)Number: 18-Minor Discharges
NWP Numbers(for multiple NWPS):
Id.Type(s)of approval sought from the DWR:
17 401 Water Quality Certification-Regular r 401 Water Quality Certification-Express
I—Non-404 Jurisdictional General Permit r Riparian Buffer Authorization
I— Individual Permit
le.Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification: r Yes ( No
For the record only for Corps Permit: r Yes (R No
1f.Is this an after-the-fact permit application?*
a Yes r No
1g.Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
✓ Yes (zNo
1g.Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
✓ Yes rNo
Acceptance Letter Attachment
I h.Is the project located in any of NC's twenty coastal counties?
✓ Yes (z No
1j.Is the project located in a designated trout watershed?
6' Yes r No
B. Applicant Information
Id.Who is applying for the permit?
17 Owner r Applicant(other than owner)
le.Is there an Agent/Consultant for this project?*
✓ Yes ( No
2.Owner Information
2a.Name(s)on recorded deed:
NC Department of Transportation
2b.Deed book and page no.:
2c.Responsible party:
2d.Address
Street Address
55 Orange Street
Address Line 2
DIY State/Bovine/Region
Asheville NC
Postal/Zip Code Country
28801 USA

2e.Telephone Number: 2f.Fax Number:
[phone] [phone]
2g.Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
lb.Subdivision name:
(if appropriate)
1c.Nearest municipality/town:
Mars Hill
2. Project Identification
2a.Property Identification Number: 2b.Property size:
2c.Project Address
Street Address
Address Line 2
CA, State/Bovine/Fbgion
Fbstal/Zip Code Country
3.Surface Waters
3a.Name of the nearest body of water to proposed project:*
Foster Creek
3b.Water Resources Classification of nearest receiving water:*
Class C;Tr,ORW
3c. What river basin(s)is your project located in?*
French Broad
3d.Please provide the 12-digit HUC in which the project is located.
06010105001
4. Project Description and History
4a.Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this application:*
New cored-slab bridge being constructed to replace old timber bridge on paved SR 1341 over Foster Creek.General land use is scattered residential,agriculture,and forests
4b.Have Corps permits or DWR certifications been obtained for this project(including all prior phases)in the past?*
r Yes F 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 73-Madison topo 1-24000.pdf 1.1MB
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
4g.List the total estimated linear feet of all existing streams on the property:
650
4h.Explain the purpose of the proposed project:*
The purpose of the overall project is to replace the old timber bridge on SR 1341 over Foster Creek with a new cored-slab bridge.The purpose of the permitted project was to extend
an existing driveway pipe to provide enough solid ground for guardrail installation to meet safety standards.
4i.Describe the overall project in detail,including indirect impacts and the type of equipment to be used:*
The site was dewatered.The existing 20'by 24"driveway pipe was removed.A 36'by 30"pipe was installed and backfilled.Equipment used included a excavator,a dump truck,and a
skid steer loader.
4j.Please upload project drawings for the proposed project.
bridge 73 plan sheets.pdf 1.4MB
5.Jurisdictional Determinations
5a.Have the wetlands or streams been delineated on the property or proposed impact areas?*
6 Yes r No r Unknown

Comments:
delineated by NC DOT personnel;minnows seen in UT
5b.If the Corps made a jurisdictional determination,what type of determination was made?*
✓ Preliminary r Approved r Not Verified r Unknown F N/A
Corps AID Number:
5c.If 5a is yes,who delineated the jurisdictional areas?
Name(if known): Yates Allen
Agency/Consultant Company: NC DOT
Other:
5d1.Jurisdictional determination upload
6. Future Project Plans
6a.Is this a phased project?*
✓ Yes ( 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 I-J Streams-tributaries r Buffers
r Open Waters r Pond Construction
3.Stream Impacts
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*
51 extend pipe Permanent Fill UT to Foster Creek Perennial Both 1 16
Average(feet) (linear feet)
S2 extend pipe Temporary Dewatering UT to Foster Creek Perennial Both 1 20
Average(feet) (linear feet)
3i.Total jurisdictional ditch impact in square feet:
0
3i.Total permanent stream impacts: 3i.Total temporary stream impacts:
16 20
3i.Total stream and ditch impacts:
36
3j.Comments:
Temporary and permanent impacts located in same footprint
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:
Increase in pipe length was minimized to extent practicable to meet safety standards for guardrail installation
1b.Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
The site was dewatered.Erosion control measures were installed.
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?
✓ Yes 0' No
2b.If this project DOES NOT require Compensatory Mitigation,explain why:

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?
✓ Yes a No
If no,explain why:
2.Stormwater Management Plan
2a.Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
6 Yes r No
Comments:
G. Supplementary Information L)
1. Environmental Documentation
la.Does the project involve an expenditure of public(federal/state/local)funds or the use of public(federal/state)land?*
✓ Yes C No
lb.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(NEPAISEPA)?*
✓ Yes ( No
Comments:*
Falls within threshold of State Minimum Criteria Checklist(MCCL)
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)?*
✓ Yes RNo
2b Provide an explanation of the violation(s):
3. Cumulative Impacts(DWR Requirement)
3a.Will this project result in additional development,which could impact nearby downstream water quality?*
✓ Yes ( No
3b.If you answered"no,"provide a short narrative description.
4.Sewage Disposal(DWR Requirement)
4a.Is sewage disposal required by DWR for this project?*
✓ Yes r No s 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?*
✓ Yes a No
5b.Have you checked with the USFWS concerning Endangered Species Act impacts?*
✓ Yes 6 No
5d.Is another Federal agency involved?*
✓ Yes F No r Unknown
5e.Is this a DOT project located within Division's 1-8?
✓ Yes r No
5f.Will you cut any trees in order to conduct the work in waters of the U.S.?
✓ Yes (- No
5g.Does this project involve bridge maintenance or removal?
✓ Yes r No

5h.Does this project involve the construction/installation of a wind turbine(s)?*
✓ Yes G No
5i.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.?
✓ Yes allo
5j.What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
Field review,current USFWS county list for T/E species
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?*
✓ Yes RNo
6b.What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
current databases
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?*
✓ Yes GNo
7b.What data sources did you use to determine whether your site would impact historic or archeological resources?*
https://nc.maps.arcgis.com/apps/webappviewer/index html?id=79ea671 ebdcc45639f0860257d5f5ed7
7c.Historic or Prehistoric Information Upload
8. Flood Zone Designation(Corps Requirement)
8a.Will this project occur in a FEMA-designated 100-year floodplain?*
✓ Yes GNo
8c.What source(s)did you use to make the floodplain determination?*
https://fris.nc.gov/fris/
Miscellaneous L)
Comments
Miscellaneous attachments not previously requested.
Bridge 73 Madison photos.pdf 1.49MB
Bridge 73 Madison signed cover letter.pdf 261.99KB
DWR Pre-Filing Meeting Request Form.pdf 55.4KB
Signature U
*
I7 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:
Yates Allen
Signature
eaeolif
Date
10/1/2020