20100725 Ver 1_Application_20100903

ors
BEVERLY PURDUE
GOVERNOR
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
P. O. Box 25201, Raleigh, NC 27611-5202
PHONE: [phone]
August 31, 2010
Mr. Monte Matthews
U. S. Army Corps of Engineers
Raleigh Regulatory Field Office
3331 Heritage Trade Drive, Suite 105
Wake Forest, NC 27587
O D
EUGENECON'
SECRETARY
10 'f ? 5
Subject: Nationwide Permit #14
Replace Bridge #638 on SR 1714 with Pipe
Wilkes County, North Carolina
Project Number: 11B.209711 (DWQ Permit Fee: $240)
Dear Mr. Matthews:
The North Carolina Department of Transportation is scheduled to replace Bridge 4638 with pipe
at the same location. The existing bridge is structurally deficient and is only approximately 15 feet
long. One of the barrels will be isolated to carry stormwater only. No on-site detour is proposed.
Stream impacts are tabulated below.
Stream Impacts:
r .Station
<
Y r Eaistmg i'; Proposed Pipe Temporary SRrprap r ,' "Total Impacts'at,
,
,
Number-; `.; . _Structure S?ze° Dewaterm : Im acts feet {this Station ft: '

2 @ 40'x 73"x
Bridge #638 15' long bride 55" w/ 11W 60 20 120
Perm. Fill/Riprap Impacts =
60 feet Total Project Impacts = 120 feet
The replacement of the existing bridge with the proposed new pipe will require temporary
dewatering. An impervious sandbag dike will be constructed approximately 30 feet upstream of
the existing structure to create a small pool. Clean water will temporarily be pumped around the
construction area and will be discharged downstream. Any dirty water located inside the
construction area will be pumped into a silt bag if necessary: Once the new structure is in place,
the impervious dike will be removed and preconstruction streambed elevations will be restored.
P. 0. Box 250, N. WILKESBORO, NC 28659
PHONE [phone] FAX [phone]
Mr. Monte Matthews
Bridge #638 on SR 1714
Page 2
August 31, 2010
Construction of this project will require impacts to waters of the United States in the Yadkin
River Basin. The existing bridge crosses an unnamed tributary to Hay Meadow Creek (Class: C).
This project was reviewed for the presence of threatened and endangered species in August of
2010. The subject project will have no effect on any federally listed endangered plant or animal
species. Historic compliance work will be scheduled and concurrence with the State Historic
Preservation Office will be obtained if required.
The project impacts are not significant in nature and should not alter the best usage for this
stream. All appropriate BMPs will be used during construction. Attached is a Preconstruction
Notification Form, plan sheets, photographs, a marked county map and a marked topography
map.
By copy of this letter, it is requested that Mr. Ron Linville, Mountain Region Coordinator, with
the North Carolina Wildlife Resources Commission comment directly to you concerning the 404
Nationwide Permit application with a copy sent to me.
By copy of this letter, I am forwarding five (5) copies of this application package to Brian Wrenn,
NCDENR, Division of Water Quality, 401 /Wetlands Unit, for his review. It is requested that any
comments related to the 401 certification be forwarded directly to me with a copy sent to the US
Army Corps of Engineers.
We would like to begin construction as soon as possible. If further information is required, please
let me know. Your early review and consideration will be appreciated.
Sincerely,

Heath Slaugh
Division Environmental Officer
Enclosures
cc: Monte Matthews, US Army Corps of Engineers (1 additional copy)
Ron Linville, Western Piedmont Region Coordinator, NCWRC
Brian Wrenn, Division of Water Quality (5 copies)
Amy Euliss, Division of Water Quality
Mike Pettyjohn, PE, Division Engineer
David Wayne, PE, Division Bridge Maintenance Engineer
Rick Minton, Wilkes County Bridge Supervisor
Heath Slaughter, Division Environmental Officer
Scott Pipes, Roadside Environmental Field Operations Technician

Office Use Only
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Pre-Construction Notification PCN Form
A. Applicant Information
1. Processing
1a. Type(s) of approval sought from the
Corps:
I

Section 404 Permit El Section 10 Permit
1 b. Specify Nationwide Permit (NWP) number: 14 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps? ? Yes ®No
1d. Type(s) of approval sought from the DWQ (check all that apply):
® 401 Water Quality Certification - Regular ? Non-404 Jurisdictional General Permit
? 401 Water Quality Certification- Express ? Riparian Buffer Authorization
le. Is this notification solely for the record T
because written approval is not required? W!Z y for DWQ 401
No For the record only for Corps Permit:
? Yes ®No
'If. Is payment into a mitig ation bank or in-lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in-lieu
fee program. ? Yes ® No
1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below. ? Yes ® No
1h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ? Yes N No
2. Project Information
2a. Name of project: Replace Bridge #638 with Pipe
2b. County: Wilkes
2c. Nearest municipality / town: North Wilkesboro
2d. Subdivision name:
2e. NCDOT only, T.I.P. or state
project no: 11 B.209711
3. Owner Information
3a. Name(s) on Recorded Deed: NCDOT
3b. Deed Book and Page No.
3c. Responsible Party (for LLC if
applicable):
3d. Street address: 801 Statesville Road
3e. City, state, zip: North Wilkesboro, NC 28659
3f. Telephone no.: 336-903-9202
3g. Fax no.: 336-6674549
3h. Email address: [e-mail]
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Page 1 of 10
PCN Form - Version 1.3 December 10, 2008 Version
4. Applicant Information (if different from owner)
4a. Applicant is: ? Agent ? Other, specify:
4b. Name:
4c:. Business name
(if applicable):
4d. Street address:
4e. City, state, zip:
4f. Telephone no.:
4g. Fax no.:
4h. Email address:
5.. AgentlConsultant Information (if applicable)
5a. Name:
5b. Business name
(if applicable):
5c. Street address:
5d. City, state, zip:
5e. Telephone no.:
5f. Fax no.:
5g. Email address:
Page 2 of 10
PCN Form - Version 1.3 December 10, 2008 Version
R. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID):
1b. Site coordinates (in decimal degrees): Latitude: 36.27180 Longitude: -81.14172
(DD.DDDDDD) (-DD.DDDDDD)
tc. Property size: 0.1 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
proposed project: UT to Hay Meadow Creek
2b. Water Quality Classification of nearest receiving water: C
2c. River basin: Yadkin
3. Project Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application:
Substandard bridge to be replaced in a rural area
3b. List the total estimated acreage of all existing wetlands on the property:
0 acres
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
50 linear feet
3d. Explain the purpose of the proposed project:
Upgrade substandard stream crossing
3e. Describe the overall project in detail, including the type of equipment to be used:
See attached cover letter.
4. Jurisdictional Determinations
.4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past?
Comments:

? Yes ®No ? Unknown
4b. If the Corps made the jurisdictional determination, what type
of determination was made?
? Preliminary ? Final
4c. If yes, who delineated the jurisdictional areas?
Name (if known): Agency/Consultant Company:
Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
5. Project History
5a. Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past? ? Yes ® No ? Unknown
5b. If yes, explain in detail according to 'help file" instructions.
6. Future Project Plans
,6 aIs ths a phased project? ? Yes ®No
[,
b. If yes, explain.
Page 3 of 10
PCN Form - Version 1.3 December 10, 2008 Version
C. Proposed Impacts Inventory
1. Impacts Summary
1a. Which sections were completed below for your project (check all that apply):
? Wetlands ® Streams - tributaries ? Buffers
? Open Waters ? Pond Construction

2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a. 2b. 2c. 2d. 2e. 2f.
Wetland impact
number-
Type of impact
Type of wetland
Forested Type of jurisdiction
(Corps - 404, 10
Area of impact
Permanent (P) or (if known) DWQ - non-404, other) (acres)
Temporary
? Yes ? Corps
Vt ? P ? T ? No ? DWQ
? Yes ? Corps
VV2 ? P ? T ? No ? DWQ
? Yes ? Corps
VV3 ? P ? T ? No ? DWQ
? Yes ? Corps
W4 ? P ? T ? No ? DWQ
? Yes ? Corps
W5 ? P ? T ? No ? DWQ
? Yes El Corps
W6 ? P F1 T ? No ? DWQ
2:g. Total wetland impacts

2h. Comments:
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a. 3b. 3c. 3d. 3e. 3f. 39
Stream impact Type of impact Stream name Perennial Type of jurisdiction Average Impact
length
t
ream
number - (PER) or (Corps - 404, 10 s
width (linear

intermittent DWQ - non-404,
Permanent (P) or
feet)
Temporary M (INT)? other) (feet)
:i1 ® P ® T Piping, Riprap &
Dewatering UT to Hay
Meadow Creek ® PER
? INT ® Corps
® DWQ 5 120
? PER ? Corps
S2 ? P ? T ? INT ? DWQ
? PER ? Corps
:i3 ? P ? T ? INT ? DWQ
? PER ? Corps
S4 ?P?T ?INT ?DWQ
? PER ? Corps
S5 ? P ? T ? INT ? DWQ
? PER ? Corps
S6 ? P ? T ? INT ? DWQ
3h. Total stream and tributary impacts 120
nmments- so linear feet of the impacts are temporary
Page 4 of 10
PCN Form -Version 1.3 December 10, 2008 Version
4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impacts below.
4a. 4b. 4c. 4d. 4e.
Open water Name of waterbody
impact number - (if applicable) Type of impact Waterbody type Area of impact (acres)
Permanent (P) or
Temporary T
-
01 ?P?T
02 ?P?T
03 ?P?T
04 ?P?T
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If and or lake construction proposed, then complete the chart below.
5a. 5b. 5c. 5d. 5e.
Wetland Impacts (acres) Stream Impacts (feet) Upland
Fond ID Proposed use or purpose (acres)
number of pond
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
P2
5f. Total
5g. Comments: NIA
5h. Is a dam high hazard permit required?
? Yes No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If an impacts require mitigation, then you MUST fill out Section D of this form.
6a. ? Neuse ? Tar-Pamlico ? Other:
Project is in which protected basin? ? Catawba ? Randleman
6b. 6c. 6d. 6e. 6f. 6g.
Buffer impact
number-
Reason
Buffer
Zone 1 impact
Zone 2 impact
Permanent (P) or for Stream name mitigation (square feet) (square feet)
Temporary impact required?
?Yes
B1 ?P?T ? No
?Yes
B2 ?P?T ? No
?Yes
133 ?P?T ? No
6h. Total buffer impacts
61. Comments:
Page 5 of 10
PCN Form -Version 1.3 December 10, 2008 Version
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
The pipe length is the minimum needed to improve safety at this location. Utilization does not warrant a bridge.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
All appropriate BMPs will be used 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? ® Yes ? No
2b. If yes, mitigation is required by (check all that apply): ? DWQ ® Corps

2c. If yes, which mitigation option will be used for this
project? ? Mitigation bank
® Payment to in-lieu fee program

? Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank: EEP
3b. Credits Purchased (attach receipt and letter) Type Quantity
3c. Comments:
4. Complete if Making a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached. ? Yes
4b. Stream mitigation requested: 40 linear feet
4c. If using stream mitigation, stream temperature: ? warm ® cool ?cold
4d. Buffer mitigation requested (DWQ only): square feet
4e. Riparian wetland mitigation requested: acres
4f. Non-riparian wetland mitigation requested: acres
4g. Coastal (tidal) wetland mitigation requested: acres
4h. Comments:
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
Page 6 of 10
PCN Form -Version 1.3 December 10, 2008 Version
6. Buffer Mitigation (State Regulated Riparian Buffer Rules) - required by DWQ
Ea. Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation? ? Yes ®No
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.

Zone 6c.
Reason for impact 6d.
Total impact
(square feet)
Multiplier 6e.
Required mitigation
(square feet)
Zone 1 3 (2 for Catawba)
Zone 2 1.5
6f. Total buffer mitigation required:
6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
pennittee responsible riparian buffer restoration, payment into an approved in-lieu fee fund).
6h. Comments:
Page 7 of 10
PCN Form - Version 1.3 December 10, 2008 Version
E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan

Ia. Does the project include or is it adjacent to protected riparian buffers identified ? Yes ® No
within one of the NC Riparian Buffer Protection Rules? ,
1b. If yes, then is a diffuse flow plan included? If no, explain why.
? Yes ? No
Comments:
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project? %
2b. Does this project require a Stormwater Management Plan? ? Yes ® No
2.c. If this project DOES NOT require a Stormwater Management Plan, explain why:
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
? Certified Local Government
2e. Who will be responsible for the review of the Stormwater Management Plan? ? DWQ Stonmwater Program
? DWQ 401 Unit
3. Certified Local Government Stormwater Review

3a. In which local government's jurisdiction is this project?
? Phase II
? NSW
3b . Which of the following locally-implemented stormwater management programs ? USMP
apply (check all that apply): ? Water Supply Watershed
? Other:
3c. Has the approved Stormwater Management Plan with proof of approval been ? Yes ? No
attached?
4. DWQ Stormwater Program Review
? Coastal counties
? HQW
4a . Which of the following state-implemented stormwater management programs apply ? ORW
(check all that apply): ? Session Law 2006-246
? Other:
4b . Has the approved Stormwater Management Plan with proof of approval been
? Yes ? No
attached?
5. DWQ 401 Unit Stormwater Review
5a . Does the Stormwater Management Plan meet the appropriate requirements? ? Yes ? No

51b
. Have all of the 401 Unit submittal requirements been met? I
? Yes ? No
Page 8 of 10
PCN Form -Version 1.3 December 10, 2008 Version
F. Supplementary Information
'I. Environmental Documentation (DWQ Requirement)
la. Does the project involve an expenditure of public (federaUstate/local) funds or the ® Yes ? No
use of public (federal/state) land?
1b. If you answered "yes" to the above, does the project require preparation of an
S
? Yes
® No
tate
environmental document pursuant to the requirements of the National or
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1c. If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval El Yes ? No
letter.)
Comments:
2. Violations (DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards,
? Yes
® No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. Is this an after-the-fact permit application? ? Yes ® No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in ? Yes No
additional development, which could impact nearby downstream water quality?
3b . If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no; provide a short narrative description.
4. Sewage Disposal (DWQ Requirement)
4a . Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility.
N/A
Page 9 of 10
PCN Form -Version 1.3 December 10, 2008 Version
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or ? Yes ® No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act ? Yes ®No
impacts?
El Raleigh
5c. If yes; indicate the USFWS Field Office you have contacted.
? Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
GIS and visual observation
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat? ? Yes ® No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
WRC will comment
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 ? Yes ®No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
8.. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain? ? Yes ®No
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination? ncfloodmaps
J. Heath Slaughter 8/31/10
Applicant/Agent's Printed Name Applicant/Agent's Sig ure Date
(Agent's s ature is valid only if an authorization letter from the applicant
is provided.)
Page 10 of 10
PCN Form - Version 1.3 December 10, 2008 Version

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PROJECT.
ROAD: I1 SR R 1714 1714 BRIDGE # 638 EXISTING BRIDGE DIMENSIONS
IS'LONG X 18'WIDE
COUNTY: WILKES
TYPE: BRIDGE REPLACEMENT
DATE. 82610
PROPOSED PIPE DIMENSIONS
FLOODPLAIN SILL FOR PIPE
I " 2 2 LINES OF 40'
ON X 73" X 55" CMP WITH HEADWALL
INLET AND OUTLET
+
PROPOSED CONCRETE HEADWALL 0
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iY ?1Y`? 1 I
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?

F TO SR 1715 I
44

I cL, (L ?
i

TO SR 1804 -

SILT BAG 2-

I
fTl

REA TO BE LEFT AT BANK FULL ELEVATION
?<rrrrtrrl
(PIPE ° 2) I
Y ?? I
A I
Y`syl 1
o Y II
IMPERVIOUS DIKE

1 1 1 1

l

2% SLOPE

+ R - H H +
NOTE: TEMPORARY EROSION CONTROL DEVICES NOT SHOWN. SURVEY DATE: 82610
STREAM NAME: NO NAMED TRIG. TO HAYMEADOW CREEK CONDUCTED BY: DW
STREAM CLASSIFICATION. C
DRAWN BY. DW
AVERAGE STREAM WIDTH. S'WIDE