20201784 Ver 1_ePCN Application_20201221

I I DWR
Division of Water Resources
Pre-Construction Notification (PCN) Form
October 26,2020 Ver 3.3
Initial Review
Has this project met the requirements for acceptance in to the review process?*
6 Yes
✓ No
Is this project a public transportation project?*
0 Yes r No
Change only if needed.
BIMS#Assigned* Version#*
20201784 1
Is a payment required for this project?*
✓ No payment required Reviewing Office*
6 Fee received Winston-Salem Regional Office-(336)776-
✓ Fee needed-send electronic notification 9800
Select Project Reviewer*
Dave Wanucha:eads\djwanucha
Information for Initial Review
1a.Name of project:
New Hope Church Rd Bridge Replacement
1a.Who is the Primary Contact?*
Jerry Parker
lb.Primary Contact Email:* 1c.Primary Contact Phone:*
[e-mail] [phone]
Date Submitted
12/21/2020
Nearest Body of Water
New Hope Creek
Basin
Cape Fear
Water Classification
WS-V NSW
Site Coordinates
Latitude: Longitude:
36.003564 79.0903068
Pre-Filing Meeting Information
ID# Version
20201784 1
Pre-fling Meeting or Request Date*
12/3/2020
Attach documentation of Pre-Filing Meeting Request here:*
New Hope Rd Pre-Filing.pdf 57.05KB
A. Processing Information C^U
County(or Counties)where the project is located:
Orange

Is this a NCDMS Project
✓ Yes r No
Is this project a public transportation project?*
✓ Yes r No
Is this a NCDOT Project?*
✓ Yes r No
(NCDOT only)T.I.P.or state project number:
WBS#(7)
17BP.7.R.111
1a.Type(s)of approval sought from the Corps:
(7 Section 404 Permit(wetlands,streams and waters,Clean Water Act)
r Section 10 Permit(navigable waters,tidal waters,Rivers and Harbors Act)
Has this PCN previously been submitted?*
✓ Yes
r No
lb.What type(s)of permit(s)do you wish to seek authorization?
fJ Nationwide Permit(NWP)
r Regional General Permit(RGP)
r Standard(IP)
1c.Has the NWP or GP number been verified by the Corps?
C Yes rNo
Nationwide Permit(NWP)Number: 14-Linear transportation
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
r Non-404 Jurisdictional General Permit 17 Riparian Buffer Authorization
r 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 r No
For the record only for Corps Permit: r Yes r No
If.Is this an after-the-fact permit application?*
✓ Yes r No
1g.Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
CYes rNo
1g.Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
✓ Yes rNo
Acceptance Letter Attachment
lh.Is the project located in any of NC's twenty coastal counties?
CYes rNo
1j.Is the project located in a designated trout watershed?
✓ Yes r No
B. Applicant Information
Id.Who is applying for the permit?
7 Owner r Applicant(other than owner)
le.Is there an Agent/Consultant for this project?*
✓ Yes r No
2.Owner Information
2a.Name(s)on recorded deed:
NC Department of Transportation

2b.Deed book and page no.:
2c.Responsible party:
Wright Archer
2d.Address
Street Address
1584 Yancyville Street
Address Line 2
P.O.Box 14996
atY State/Province/legion
Greensboro NC
Fbstal/Zip Code Country
27415-4996 USA
2e.Telephone Number: 2f.Fax Number:
[phone]
2g.Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b.Subdivision name:
(if appropriate)
1c.Nearest municipality/town:
Chapel Fill
2. Project Identification
2a.Property Identification Number: 2b.Property size:
2c.Project Address
Street Address
Address Line 2
City State/Province/Region
Fbstal/Zlp Code Country
3.Surface Waters
3a.Name of the nearest body of water to proposed project:*
New Hope Creek
3b.Water Resources Classification of nearest receiving water:*
WS-V NSW
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.
030300020601
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 Hope Church Road is classified as a Local Road in the Statewide Functional Classification System and is not a National
Highway System Route.Land use within the vicinity primarily consists of forested land,agriculture,and low density residences.
4b.Have Corps permits or DWR certifications been obtained for this project(including all prior phases)in the past?*
f Yes f No 6' 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#99 Topo Map.pdf 1.8MB
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)
Bridge#99 Soil Survey.pdf 4.11MB
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:
97
4h.Explain the purpose of the proposed project:*
NCDOT is proposing to replace a structurally deficient bridge with a new bridge in the same alignment.An offsite detour will be utilized during construction.
4i.Describe the overall project in detail,including indirect impacts and the type of equipment to be used:*
The North Carolina Department of Transportation(NCDOT)has proposed to replace Orange County Bridge#99 on New Hope Church Road(SR 1732)over New Hope Creek.The
existing structure is a three span bridge(3@35')and is a reinforced concrete deck on I-Beams.The end bents are reinforced concrete caps on timber piles and the interior bents are
reinforced concrete posts and beams.The proposed structure is a single span(1 @105'),39"precast concrete box beam with 4'deep caps.This structure has been designed to have
as little environmental and surface water impacts as possible.Standard road building equipment will be utilized including dozers,backhoes,dump trucks,tamps and cranes.A temporary
causeway will be utilized to remove an interior bent.
4j.Please upload project drawings for the proposed project.
Bridge#99 Permit Drawings.pdf 3.41MB
5.Jurisdictional Determinations
5a.Have the wetlands or streams been delineated on the property or proposed impact areas?*
6 Yes r No f Unknown
Comments:
5b.If the Corps made a jurisdictional determination,what type of determination was made?*
r Preliminary r Approved r Not Verified c Unknown r N/A
Corps AID Number:
5c.If 5a is yes,who delineated the jurisdictional areas?
Name(if known): Robert Lepsic
Agency/Consultant Company: Arcadis
Other:
5d1.Jurisdictional determination upload
6. Future Project Plans
6a.Is this a phased project?*
C 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
1a.Where are the impacts associated with your project?(check all that apply):
r Wetlands 17 Streams-tributaries 17 Buffers
r Open Waters r Pond Construction
3.Stream Impacts
3a.Reason for impact(?) 3b.Impact type* 3c.Type of impact* 3d.S.name* 3e.Stream Type* 3f.Type of 3g.S.width* 3h.Impact
(?) Jurisdiction* length*
S1 Bridge construction Permanent Bank Stabilization New Hope Creek Perennial Both 45 87
Average(feet) (linear feet)
S2 Causeway const. Temporary Fill New Hope Creek Perennial Both 45 22
Average(feet) (linear feet)
3i.Total jurisdictional ditch impact in square feet:
0
3i.Total permanent stream impacts: 3i.Total temporary stream impacts:
87 22
3i.Total stream and ditch impacts:
109
3j.Comments:

6. Buffer Impacts(for DWR)
6a.Project is in which protect basin(s)?
Check all that apply.
r Neuse r-Tar-Pamlico
r-Catawba 1 Randleman
r-Goose Creek IJ Jordan Lake
n Other
6b.Impact Type 6c.Per or Temp 6d.Stream name 6e.Buffer mitigation required? 6f.Zone 1 impact 6g.Zone 2 impact
Bridge P New Hope Creek No 4,260 533
Road Crossing P New Hope Creek No 266 1,636
6h. Total buffer impacts:
Zone 1 Zone 2
Total Temporary impacts: 0.00 0.00
Zone 1 Zone 2
Total Permanent impacts: 4,526.00 2,169.00
Zone 1 Zone 2
Total combined buffer impacts: 4,526.00 2,169.00
61.Comments:
Supporting Documentation
Bridge#99 SW and Buffer Impacts.pdf 163.51KB
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:
This structure has been designed to have as little environmental and surface water impacts as possible.2:1 roadway fill slope will be used to minimize
impacts.To avoid direct discharge of bridge storm water into the receiving water,deck drains will not be required for the proposed bridge.This project
is a bridge to bridge project with an offsite detour
lb.Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Storm water impacts to the stream will be minimized by utilizing grated inlets and pipes to collect bridge storm water and use of rip rap outlet protection
at 15+09 RT to dissipate energy to provide a diffuse flow(nonerosivesheet flow)in a wooded area.This diffused flow will run for a distance of 20'+/-
before entering the buffer.In the southwest quadrant an existing roadside ditch outlets at 13+10 RT.The ditch outlets and becomes non-erosive
sheet flow 200'+/-before entering the buffer.In the northwest quadrant an existing roadside ditch will transition into a Special Lateral'V'Ditch with
Class B Rip Rap and outlets at 13+75 LT and becomes non-erosive sheet flow 160'+/-before entering the buffer.In the northeast quadrant an
existing roadside ditch will transition into a Special Lateral'V'Ditch with Class B Rip Rap and outlets at 17+00 LT and becomes non-erosive sheet flow
13'+/-before entering the
buffer.In the southeast quadrant an existing roadside ditch will transition into a Special Lateral'V'Ditch with Class B Rip Rap and outlets at 16+94 RT
and becomes nonerosive sheet flow45'+/-before entering the buffer.
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?
C Yes 6' No
2b.If this project DOES NOT require Compensatory Mitigation,explain why:
Project does not meet or exceed the thresholds established for required compensatory mitigation
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?
6 Yes C No
What type of SCM are you providing?

n Level Spreader
n Vegetated Conveyance(lower SHWT)
n Wetland Swale(higher SHWT)
n Other SCM that removes minimum 30%nitrogen
fJ Proposed project will not create concentrated stormwater flow through the buffer
Diffuse Flow Documentation
Bridge#99 Diffuse Flow Plan.pdf 161.88KB
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
1. Environmental Documentation
1a.Does the project involve an expenditure of public(federal/state/local)funds or the use of public(federal/state)land?*
6 Yes r 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 R No
Comments:*
Project qualifies as a Categorical Exclusion and therefore does dot require preparation of an environmental document.
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)?*
✓ Yes ( No
3. Cumulative Impacts(DWR Requirement)
3a.Will this project result in additional development,which could impact nearby downstream water quality?*
✓ Yes 6. 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 !' 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?*
✓ Yes f• No
5b.Have you checked with the USFWS concerning Endangered Species Act impacts?*
✓ Yes r No
5c.If yes,indicate the USFWS Field Office you have contacted.
Raleigh
5d.Is another Federal agency involved?*
✓ Yes t No r Unknown
5e.Is this a DOT project located within Division's 1-8?
6 Yes r No
5j.What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
USFWS Website
IPAC USFWS Website
Consultation Documentation Upload
Bridge#99 Concurrence Letter.pdf 167.07KB

6. Essential Fish Habitat(Corps Requirement)
6a.Will this project occur in or near an area designated as an Essential Fish Habitat?*
✓ Yes f 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?*
✓ Yes 6 No
7b.What data sources did you use to determine whether your site would impact historic or archeological resources?*
NCDOT Cultural Resource Personnel
7c.Historic or Prehistoric Information Upload
Bridge#99 No Survey Archaeology.pdf 1.65MB
Bridge#99 No Survey Architecture.pdf 2.1 MB
8. Flood Zone Designation(Corps Requirement)
8a.Will this project occur in a FEMA-designated 100-year floodplain?*
t: 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
Miscellaneous attachments not previously requested.
Signature
*
17 By checking the box and signing below,I certify that:
• The project proponent hereby certifies that all information contained herein is true,accurate,and complete to the best of my knowledge and belief;and
• The project proponent hereby requests that the certifying authority review and take action on this CWA 401 certification request within the applicable reasonable period of time.
• 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:
W.R.Archer III,PE
Signature
Date
12/21/2020