20210404 Ver 1_ePCN Application_20210326

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#*
20210404 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:
Deep River Road Bridge Replacement
1a.Who is the Primary Contact?*
Della Moore
lb.Primary Contact Email:* 1c.Primary Contact Phone:*
[e-mail] [phone]
Date Submitted
3/26/2021
Nearest Body of Water
West Fork Deep River
Basin
Cape Fear
Water Classification
Randleman Lake
Site Coordinates
Latitude: Longitude:
36.000734 -79.973495
Pre-Filing Meeting Information
ID# Version
20210404 1
Pre-fling Meeting or Request Date*
2/19/2021
Attach documentation of Pre-Filing Meeting Request here:*
DWR Pre-Filing Meeting Request Form(1).pdf 52.67KB
A. Processing Information C^U
County(or Counties)where the project is located:
Guilford

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:
TIP:400067 and Project#:B-5714
WBS#(?)
17BP.7.R.127
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:
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 (7 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:
North Carolina Department of Transportation

2b.Deed book and page no.:
2c.Responsible party:
2d.Address
Street Address
P.O.Box 14996
Address Line 2
1584 Yanceyville Street
aty State/Bovine/legion
Greensboro NC
Postal/Zip Code Country
27415 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:
Jamestown
2. Project Identification
2a.Property Identification Number: 2b.Property size:
2c.Project Address
Street Address
Address Line 2
City State/Province/legion
Postal/Zlp Code Country
3.Surface Waters
3a.Name of the nearest body of water to proposed project:*
West Fork Deep River
3b.Water Resources Classification of nearest receiving water:*
Randleman Lake
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.
030300030104
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:*
This project is over West Fork Deep River,DWR Stream ID 17-3-(1.5),Water Supply(WS)-IV and is in the Cape Fear Basin within waters designated as Critical Supply Watershed and
therefore Randleman Lake Water Supply Watershed Buffer rules apply.NCDOT proposes to replace a structurally deficient bridge with a new bridge that maintains the same alignment.
The surrounding area consists of woodlands adjacent to low residential housing nearby.SR 1523 and SR 1538 both consist of two paved lands with unpaved shoulders.Generally,this
bridge has been designed as a spanning structure.Spanning structures usually do not require work within the stream and do not require stream channel realignment.The horizontal
and vertical clearances allot for human and wildlife passage beneath the structure,does not block fish passage,and does not block navigation by canoeists and boaters.Our
preference will be to completely remove the old structure and the approach fills down to the natural ground elevation from the 100-year floodplain.The new structure will be constructed
within the existing footprint reducing flood hazards to minimal.The area should be stabilized with grass and planted with native tree species.An offsite detour will be utilized during
construction and Best Management Practices will be implemented during all phases of construction.
4b.Have Corps permits or DWR certifications been obtained for this project(including all prior phases)in the past?*
r Yes r 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)
Deep River Rd Topo Map.pdf 1.9MB
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)

Deep River Rd Soil Map.pdf 1.87MB
4f.List the total estimated acreage of all existing wetlands on the property:
less than 0.01
4g.List the total estimated linear feet of all existing streams on the property:
200
4h.Explain the purpose of the proposed project:*
NCDOT proposes to replace a structurally deficient bridge with a new bridge in the same alignment due to numerous repairs and maintenance issues over the life span of the existing
structure.The final recommendation is to replace the structure in it's entirety for safety and structural integrity.Therefore,total replacement within the existing alignment has been
proposed with an offsite detour being utilized as well as Best Management Practices followed all phases of 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 Guilford County Bridge#67 on Deep River Road(SR 1523/1538)over Deep River.The existing
structure is a four span bridge(1@30',1@45',and 2@30')and is a precast,prestressed concrete cored slab.The proposed structure is a 3 span(1@35',1@70',and 1@45'),24"
Cored Slab with 4'Deep Caps.This structure has been designed to have as little environmental,wetland,and surface water impacts as possible.Permanent drainage easement(PDE)
will be set to have as little wetland impact as possible.Class I rip rap and geotextile were utilized for bank stabilization to reduce stream bank erosion at the outlet of the ditch into Deep
River.To avoid direct discharge of bridge storm water into the receiving water,deck drains are not required for the proposed bridge.Storm water impacts to the river have been
minimized by utilizing a grated inlet and pipe to collect bridge storm water and use rip rap outlet protection at Sta.16+35 to dissipate energy and provide a non-erosive flow into the
river.In the SE,SW,and NW quadrants,there are no roadside ditches being retained.Those roadway sections are in fill and the runoff
discharges as sheet flow off the pavement through grassed shoulder to remove pollutants via infiltration and settling before entering into the buffer zones.In the NE quadrant,there is a
special cut ditch along the roadway leading to an existing 24"RCP that is being retained and extended while discharges on the NW quadrant into a rip rap lined ditch and down the
embankment to the river at a non erosive velocity.Due to the nature of low impact bridge replacement,the increase in storm water discharges(pre vs.post conditions)are insignificant.
Therefore,additional storm water measures are not required.Construction equipment utilized will consist of but not limited to cranes,excavators,dump trucks,backhoes,hand tools,
compactors,and erosion control&safety materials for pre-construction implementation.
4j.Please upload project drawings for the proposed project.
Deep River Rd Permit Drawings.pdf 3.49MB
5.Jurisdictional Determinations
5a.Have the wetlands or streams been delineated on the property or proposed impact areas?*
6 Yes r No C Unknown
Comments:
West Fork Deep River(Stream Index Number 17-3-(1.5))is classified as WS-IV from the dam at Oak
Hollow Reservoir to Boulding Branch.This section of stream is also located in a designated Critical
Supply Watershed.No other stream features were identified in the study area.
5b.If the Corps made a jurisdictional determination,what type of determination was made?*
r Preliminary r Approved r Not Verified 6 Unknown r N/A
Corps AID Number:
5c.If 5a is yes,who delineated the jurisdictional areas?
Name(if known): Elizabeth Lusk and Anne Burroughs
Agency/Consultant Company: NCDOT
Other: Dewberry Engineers
5d1.Jurisdictional determination upload
Deep River Rd NRTR.pdf 6.55MB
6. Future Project Plans
6a.Is this a phased project?*
C Yes 6. 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):
17 Wetlands 17 Streams-tributaries fJ Buffers
r Open Waters r Pond Construction
2.Wetland Impacts
2a.Site#*(?) 2a1 Reason(?) 2b.Impact type*(?) 2c.Type of W.* 2d.W.name* 2e.Forested* 2f.Type of 2g.Impact
Jurisdicition*(?) area*

L-16+90 to Fill slope P Isolated Wetlands WA Yes Both 0.010
17+17-LT (acres)
2g.Total Temporary Wetland Impact 2g.Total Permanent Wetland Impact
0.000 0.010
2g.Total Wetland Impact
0.010
2h.Comments:
One wetland,Wetland WA,<0.01 acre in size,was identified in the northwest quadrant of the study area(see T&E Survey)within the floodplain of the
West Fork Deep River.Wetland WA is a linear wetland originating at a culvert that then drains to the river.Primary hydrology for this wetland is a
roadside ditch that carries storm water runoff from an adjacent subdivision on the eastside of Deep River Road,as well as occasional back flow and
overbank events of the West Fork Deep River.
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 L-1533 to 15+39-RT Temporary Other WS-IV;CA Perennial Both 11 36
Average(feet) (linear feet)
32 L-16+77 to 16+95-LT Permanent Bank Stabilization WS-IV;CA Perennial Both 11 14
Average(feet) (linear feet)
3i.Total jurisdictional ditch impact in square feet:
0
3i.Total permanent stream impacts: 3i.Total temporary stream impacts:
14 36
3i.Total stream and ditch impacts:
50
3j.Comments:
6. Buffer Impacts(for DWR)
6a.Project is in which protect basin(s)?
Check all that apply.
✓Neuse r Tar-Pamlico
✓Catawba 17 Randleman
✓Goose Creek r Jordan Lake
r Other
6b.Impact Type 6c.Per or Temp 6d.Stream name 6e.Buffer mitigation required? 6f.Zone 1 impact 6g.Zone 2 impact
Riparian Buffer Impacts(Bridge) P DEEP RIVER(Randleman Lake) Yes 2,693 1,361
Riparian Buffer Impacts(Bridge) P DEEP RIVER(Randleman Lake) Yes 3,934 1,824
Riparian Buffer Impacts(Road Crossings) P DEEP RIVER(Randleman Lake) Yes 0 135
Riparian Buffer Impacts(Road Crossings& P DEEP RIVER(Randleman Lake) Yes 6,207 6,783
Parallel Impact)
Wetlands in Buffer @ sta-L-16+90 to 17+17-LT P DEEP RIVER(Randleman Lake) Yes 116 6
6h. Total buffer impacts:
Zone 1 Zone 2
Total Temporary impacts: 0.00 0.00
Zone 1 Zone 2
Total Permanent impacts: 12,950.00 10,109.00
Zone 1 Zone 2
Total combined buffer impacts: 12,950.00 10,109.00
6i.Comments:

Supporting Documentation
Deep River Rd Permit Drawings.pdf 3.49MB
E. Impact Justification and Mitigation
1.Avoidance and Minimization
la.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,wetland,and surface water impacts as possible.Permanent drainage easement
(PDE)will be set to have as little wetland impact as possible.Class I rip rap and geotextile were utilized for bank stabilization to reduce stream bank
erosion at the outlet of the ditch into Deep River.To avoid direct discharge of bridge storm water into the receiving water,deck drains are not required
for the proposed bridge.Storm water impacts to the river have been minimized by utilizing a grated inlet and pipe to collect bridge storm water and use
rip rap outlet protection at Ste.16+35 to dissipate energy and provide a non-erosive flow into the river.In the SE,SW,and NW quadrants,there are
no roadside ditches being retained.Those roadway sections are in fill and the runoff discharges as sheet flow off the pavement through grassed
shoulder to remove pollutants via infiltration and settling before entering into the buffer zones.In the NE quadrant,there is a special cut ditch along
the roadway leading to an existing 24"RCP that is being retained and extended and discharges on the NW quadrant into a rip rap lined ditch and
down the embankment to the river at a non erosive velocity.Due to the nature of low impact bridge replacement,the increase in storm water
discharges(pre vs.post conditions)are insignificant.Therefore,additional storm water measures are not required.
lb.Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Due to the project's location within the Randleman River Watershed,Design Standards in Sensitive Watersheds will be employed;NCDOT Best
Management Practices will be follow to minimize erosion and control runoff within the drainage areas.Riprap(Class I and geotextile filter fabric),will be
utilized in form of bank stabilization with re-vegetation requirements established for erodible/disturbed areas as construction proceeds.Drainage
ditches or erosion control measures will also be utilized in fill slope areas to manage drainage until the project is complete.A preliminary construction
sequence has been established for the removal of the existing bridge that minimizes impacts to the stream prior to starting this project.Erosion control
and safety measures will be installed and maintained as needed until completion.
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 rNo
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 rNo
What type of SCM are you providing?
n Level Spreader
n Vegetated Conveyance(lower SI-IWT)
n Wetland Swale(higher SHWT)
I7 Other SCM that removes minimum 30%nitrogen
I7 Proposed project will not create concentrated stormwater flow through the buffer
Diffuse Flow Documentation
Deep River Rd Stormwater Plans.pdf 51.51KB
2.Stormwater Management Plan
2a.Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
✓ Yes r No
2b.Does this project meet the requirements for low density projects as defined in 15A NCAC 02H.1003(2)?
( Yes r No
Comments:
G. Supplementary Information L)
1. Environmental Documentation
1a.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(NEPA/SEPA)?*
✓ Yes r No

Comments:*
The project funds are State funds for 17BP.7.R.127.
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?*
✓ Yes (cNo
3b.If you answered"no,"provide a short narrative description.
Proper erosion control measures and best management practices are required before the project is initiated.Those measures will have to be
maintained,monitored,and measured throughout the duration of the construction.There should be no work in the stream and buffer rules will remain
in effect and are accommodated within the project's design.
4.Sewage Disposal(DWR Requirement)
4a.Is sewage disposal required by DWR for this project?*
✓ Yes r No 6. WA
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 r No
5b.Have you checked with the USFWS concerning Endangered Species Act impacts?*
( Yes C No
5c.If yes,indicate the USFWS Field Office you have contacted.
Raleigh
5d.Is another Federal agency involved?*
✓ Yes r No r Unknown
5e.Is this a DOT project located within Division's 1-8?
a 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,Aquatic Survey Performed
Consultation Documentation Upload
Deep River Rd T&E Survey.pdf 1.54MB
6. Essential Fish Habitat(Corps Requirement)
6a.Will this project occur in or near an area designated as an Essential Fish Habitat?*
✓ Yes ( 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 r No
7b.What data sources did you use to determine whether your site would impact historic or archeological resources?*
SHPO
7c.Historic or Prehistoric Information Upload
Deep River Rd Architecture No Survey.pdf 4.16MB
Deep River Rd Archaeology No Survey.pdf 1.71MB
8. Flood Zone Designation(Corps Requirement)
8a.Will this project occur in a FEMA-designated 100-yearfloodplain?*
✓ Yes r No
8b.If yes,explain how project meets FEMArequirements:

FEMA Re-delineated study with floodway established,drainage area is 32.8 square miles
(Stream stats),100-year flood overtops the road and is approximate at elevation 776.6.
8c.What source(s)did you use to make the floodplain determination?*
Floodplain investigation study conducted by Mott MacDonald-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 Ill,PE
Signature
Date
3/26/2021