20210305 Ver 1_ePCN Application_20210329

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#*
20210305 1
Is a payment required for this project?*
✓ No payment required
6 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 155 Burke
1a.Who is the Primary Contact?*
Roger Bryan
lb.Primary Contact Email:* 1c.Primary Contact Phone:*
[e-mail] [phone]
Date Submitted
3/29/2021
Nearest Body of Water
Unnamed tributary to Irish Creek
Basin
Catawba
Water Classification
WS-III
Site Coordinates
Latitude: Longitude:
35.803638 -81.762806
Pre-Filing Meeting Information
ID# Version
20210305 1
Pre-fling Meeting or Request Date*
2/12/2021
Attach documentation of Pre-Filing Meeting Request here:*
20210304 Ver 1_PreFiling 30-Day Clock Reached Email_20210313.html 3.23KB
A. Processing Information C^U
County(or Counties)where the project is located:
Burke

Is this a NCDMS Project
✓ Yes f No
Is this project a public transportation project?*
6 Yes r No
Is this a NCDOT Project?*
6 Yes r No
(NCDOT only)T.I.P.or state project number:
WBS#(7)
17BP.13.PE.165
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
✓ No
lb.What type(s)of permit(s)do you wish to seek authorization?
r Nationwide Permit(NWP)
17 Regional General Permit(RGP)
r Standard(IP)
1c.Has the NWP or GP number been verified by the Corps?
6 Yes r No
Regional General Permit(RGP)Number: 201902350-Work associated with bridge construction,widening,replacement,and
interchanges
RGP Numbers(for multiple RGPS):
1d.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 r 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 t: No
If.Is this an after-the-fact permit application?*
✓ Yes f' No
1g.Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
6Yes rNo
1g.Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
✓ Yes rNo
Acceptance Letter Attachment
Bridge 110155 Burke mitigation letter signed.pdf 272.98KB
Ih.Is the project located in any of NC's twenty coastal counties?
C Yes 0' No
1j.Is the project located in a designated trout watershed?
C Yes 6 No
B. Applicant Information
1d.Who is applying for the permit?
I7 Owner r Applicant(other than owner)
le.Is there an Agent/Consultant for this project?*
C Yes G 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
Goodman Lake Road
Address Line 2
coy State/Rovince/Region
Quaker Meadows NC
Postal/Zip Code Country
28655 US
2e.Telephone Number: 2f.Fax Number:
[phone]
2g.Email Address:*
[e-mail]
C. Project Information and Prior Project History L)
1. Project Information
lb.Subdivision name:
(f appropriate)
1c.Nearest municipality/town:
Quaker Meadows
2. Project Identification
2a.Property Identification Number: 2b.Property size:
2c.Project Address
Street Address
Address Line 2
Coy State/Bovine/Region
Postal/Zip Code Country
3.Surface Waters
3a.Name of the nearest body of water to proposed project:*
Unnamed tributary to Irish Creek
3b.Water Resources Classification of nearest receiving water:*
WS-III
3c. What river basin(s)is your project located in?*
Catawba
3d.Please provide the 12-digit HUC in which the project is located.
030501010402
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:*
The project area contains and existing bridge and low density rural residential areas.Some agriculture and horticulture operations present.
4b.Have Corps permits or DWR certifications been obtained for this project(including all prior phases)in the past?*
r Yes G No C 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 110155 Burke Topo Map.pdf 193.22KB
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:
0.0
4g.List the total estimated linear feet of all existing streams on the property:

200
4h.Explain the purpose of the proposed project:*
The project will replace a structurally deficient bridge with a concrete box culvert.
4i.Describe the overall project in detail,including indirect impacts and the type of equipment to be used:*
A two barrel 8'x8'culvert will be constructed using excavator and trucks.Stream will be bypassed with an impervious dike during construction.
4j.Please upload project drawings for the proposed project.
Bridge 110155 Burke Permit Drawings.pdf 1.51MB
5.Jurisdictional Determinations
5a.Have the wetlands or streams been delineated on the property or proposed impact areas?*
✓ Yes r No O Unknown
Comments:
5b.If the Corps made a jurisdictional determination,what type of determination was made?*
✓ Preliminary r Approved c Not Verified r Unknown r N/A
Corps AID Number:
5c.If 5a is yes,who delineated the jurisdictional areas?
Name(if known):
Agency/Consultant Company:
Other:
5d1.Jurisdictional determination upload
6. Future Project Plans
6a.Is this a phased project?*
✓ Yes f• 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 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*
81 Box Culvert Permanent Culvert UT to Irish Creek Perennial Both 16 104
Average(feet) (linear feet)
$2 Bank Stablization Permanent Bank Stabilization UT to Irish Creek Perennial Both 16 30
Average(feet) (linear feet)
S3 Bank Stabilization Permanent Bank Stabilization UT to Irish Creek Perennial Both 16 40
Average(feet) (linear feet)
S4 Dewatering Temporary Dewatering UT to Irish Creek Perennial Both 16 125
Average(feet) (linear feet)
3i.Total jurisdictional ditch impact in square feet:
0
3i.Total permanent stream impacts: 3i.Total temporary stream impacts:
174 125
3i.Total stream and ditch impacts:
299
3j.Comments:

E. Impact Justification and Mitigation
1.Avoidance and Minimization
Ia.Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
The culvert length is the minimum necessary to construct a two lane roadway.The structure was designed to carry the range of stream flows that will
occur.
lb.Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
The stream will be dewatered during construction to minimize the potential impacts from sedimentation and contact with uncured concrete.
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 C No
2c.If yes,mitigation is required by(check all that apply):
r DWR fJ Corps
2d.If yes,which mitigation option(s)will be used for this project?
n Mitigation bank fJ Payment to in-lieu fee I— 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.
6 Yes r No
4b.Stream mitigation requested:
(linear feet) 4c.If using stream mitigation,what is the stream temperature:
104 cool
4d.Buffer mitigation requested(DWR only): 4e.Riparian wetland mitigation requested:
(square feet) (acres)
4f.Non-riparian wetland mitigation requested: 4g.Coastal(tidal)wetland mitigation requested:
(acres) (acres)
4h.Comments
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
1. Diffuse Flow Plan
la.Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection Rules?
✓ Yes (.7 No
If no,explain why:
The area is not regulated by NC Riparian Buffer Protection Rules.
2.Stormwater Management Plan
2a.Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
( Yes r No
Comments:
The SMP is in the Permit Drawings attachment.
G. Supplementary Information
1. Environmental Documentation
Ia.Does the project involve an expenditure of public(federal/state/local)funds or the use of public(federal/state)land?*
(' Yes rNo
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:*
A state MCDC is attached in the additional information section.

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 f•No
3. Cumulative Impacts(DWR Requirement)
3a.Will this project result in additional development,which could impact nearby downstream water quality?*
C Yes tc No
3b.If you answered"no,"provide a short narrative description.
No change in the roadway system or capacity.
4.Sewage Disposal(DWR Requirement)
4a.Is sewage disposal required by DWR for this project?*
✓ Yes f 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 P No
5b.Have you checked with the USFWS concerning Endangered Species Act impacts?*
✓ Yes 6 No
5d.Is another Federal agency involved?*
✓ Yes t No r Unknown
5e.Is this a DOT project located within Division's 1-8?
✓ Yes G No
5f.Will you cut any trees in order to conduct the work in waters of the U.S.?
(7 Yes CNo
5g.Does this project involve bridge maintenance or removal?
6 Yes r No
5g(1).If yes,have you inspected the bridge for signs of bat use such as staining,guano,bats,etc.?
t: Yes r No
If you answered"Yes"to 5g(1),did you discover any signs of bat use?
✓ Yes G No r Unknown
5h.Does this project involve the construction/installation of a wind turbine(s)?*
✓ Yes r 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 G No
5j.What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
Current species listing and field survey of the site.
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 P No
6b.What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
Current mapping
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 f No
7b.What data sources did you use to determine whether your site would impact historic or archeological resources?*
The project was reviewed as part of the NC DOT Programmatic Agreement for Cultural Resources.
7c.Historic or Prehistoric Information Upload
Bridge 110155 Burke No Archaeology Survey Required Form.pdf 548.62KB
Bridge 110155 Burke No Historic Architecture Survey Required.pdf 1.33MB

8. Flood Zone Designation(Corps Requirement)
8a.Will this project occur in a FEMA-designated 100-year floodplain?*
r Yes Na(c
8c.What source(s)did you use to make the floodplain determination?*
Current mapping
Miscellaneous
Comments
Miscellaneous attachments not previously requested.
Bridge 110155 Burke MCDC.pdf 877.37KB
Bridge 110155 Burke Natural Resources Technical Report.pdf 24.76MB
Signature
*
IJ 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:
Roger D.Bryan
Signature
Date
3/29/2021