20210498 Ver 1_Pre-Filing Meeting Request Attachment_20210303

Pre-Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
October 26, 2020 Ver 3.3
Please note: fields marked with a red asterisk * below are required. You will not be able to submit the form until all mandatory questions are answered.
Also, if at any point you wish to print a copy of the E-PCN, all you need to do is right-click on the document and you can print a copy of the form.
Below is a link to the online help file.
https://edocs.deq.nc.gov/WaterResources/0/edoc/624704/PCN%20Help%20File%202018-1-30.pdf
County (or Countie s) where the proje ct is locate d:*
Is this a NCDM S Proje ct *
Is this project a public transportation project?*
1a. Type (s) of approv al sought from the Corps:*
1b. What type (s) of pe rmit(s) do you wish to se e k authorization?*
This form may be used to initiate the standard/individual permit process with the Corps. Please contact your Corps representative concerning submittals for standard permits. All required items that
are not provided in the E-PCN can be added to the miscellaneous upload area located at the bottom of this form.
1c. Has the NWP or GP numbe r be e n v e rifie d by the Corps?*
1d. Type (s) of approv al sought from the DWR:*
1e . Is this notification sole ly for the re cord be cause writte n approv al is not re quire d?
*
For the re cord only for DWR 401 Ce rtification:
For the re cord only for Corps Pe rmit:
1f. Is this an afte r-the -fact pe rmit application?*
1g. Is payme nt into a mitigation bank or in-lie u fe e program propose d for mitigation of impacts?
Acce ptance Le tte r Attachme nt
1h. Is the proje ct locate d in any of NC's twe nty coastal countie s?*
1j. Is the proje ct locate d in a de signate d trout wate rshe d?*
A. Processing Information
Ashe
Yes No
Click Yes, only if NCDMS is the applicant or co-applicant.
Yes No
This is any publicly funded by municipal,state or federal funds road, rail, airport transportation project.
Section 404 Permit (wetlands, streams and waters, Clean Water Act)
Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
Nationwide Permit (NWP)
Regional General Permit (RGP)
Standard (IP)
Yes No
check all that apply
401 Water Quality Certification - Regular 401 Water Quality Certification - Express
Non-404 Jurisdictional General Permit Riparian Buffer Authorization
Individual Permit
Yes No
Yes No
Yes No
If so, attach the acceptance letter from mitigation bank or in-lieu fee program.
Yes No
Click the upload button or drag and drop files here to attach document
FILE TYPE MUST BE PDF
Yes No
Yes No
You must submit a copy of the appropriate Wildlife Re source Commission Office .
Link to trout information: http://www.saw.usace.army.mil/Missions/Regulatory-Permit-Program/Agency-Coordination/Trout.aspx
1a. Who is the Primary Contact?*
1b. Primary Contact Email:*
1c. Primary Contact Phone :*
1d. Who is applying for the pe rmit?*
1e . Is the re an Age nt/Consultant for this proje ct?*
2. Owner Information
1a. Name of proje ct:*
1b. Subdivision name :
1c. Ne are st municipality / town:*
2a. Prope rty Identification Numbe r:
2b. Prope rty size :
2c. Proje ct Addre ss
B. Applicant Information
Richard Thompson
[e-mail]
(xxx)xxx-xxxx
[phone]
Owner Applicant (other than owner)
(Check all that apply)
Yes No
2a. Name (s) on re corde d de e d:*
2b. De e d book and page no.:
2c. Re sponsible party:
2d. Addre ss *
2e . Te le phone Numbe r:*
2f. Fax Numbe r:
2g. Email Addre ss:*
Richard Thompson Hal Monsees
00501/0730 00502/1229
(for Corporations)
City
West Jefferson
State / Province / Region
North Carolina
Postal / Zip Code
28694
Country
USA
Street Address
188 Blueberry Hill
Address Line 2
(xxx)xxx-xxxx
[phone]
(xxx)xxx-xxxx
[e-mail]
C. Project I nformation and Prior Project History
1. Project Information
Daniel's Daughter Bridge
(if appropriate)
Daniel's Daughter
West Jefferson
2. Project Identification
(tax PIN or parcel ID)
parcel ID 12310028 (in acres)
2d. Site coordinate s in de cimal de gre e s
Please collect site coordinates in decimal degrees. Use between 4-6 digits (unless you are using a survey-grade GPS device) after the decimal place as appropriate, based on how the location was
determined. (For example, most mobile phones with GPS provide locational precision in decimal degrees to map coordinates to 5 or 6 digits after the decimal place.)
Latitude :*Longitude :*
3. Surface Waters
3a. Name of the ne are st body of wate r to propose d proje ct:*
3b. Wate r Re source s Classification of ne are st re ce iv ing wate r:*
Surface Water Lookup
3c. What riv e r basin(s) is your proje ct locate d in?*
3d. Ple ase prov ide the 12-digit HUC in which the proje ct is locate d.*
River Basin Lookup
4. Project Description and History
4a. De scribe the e xisting conditions on the site and the ge ne ral land use in the v icinity of the proje ct at the time of this application:*
4b. Hav e Corps pe rmits or DWR ce rtifications be e n obtained for this project (including all prior phase s) in the past?*
4d. Attach an 8 1/2 X 11 e xce rpt from the most re ce nt v e rsion of the USGS topographic map indicating the location of the proje ct site . (for DWR)
4e . Attach an 8 1/2 X 11 e xce rpt from the most re ce nt v e rsion of the publishe d County NRCS Soil Surv e y map de picting the proje ct site . (for DWR)
4f. List the total e stimate d acre age of all e xisting we tlands on the prope rty:
4g. List the total e stimate d line ar fe e t of all e xisting stre ams on the prope rty:
4h. Explain the purpose of the propose d proje ct:*
4i. De scribe the ov e rall proje ct in de tail, including indirect impacts and the type of e quipme nt to be use d:*
City
West Jefferson
State / Province / Region
NC
Postal / Zip Code
28694
Country
USA
Street Address
Daniel's Daughter Drive
Address Line 2
36.329243
ex: 34.208504
-81.418773
-77.796371
New River
High Quality
New
050500010206
This wooded area located between the New River and State Rd 163 is the deeded right of way entrance to Daniel's Daughter Subdivision containing 12 homes. The subdivision and the
low water bridge access are approximately 50 years old.
Yes No Unknown
Click the upload button or drag and drop files here to attach document
Capture.pdf 2.2MB
File type must be pdf
Click the upload button or drag and drop files here to attach document
BlueberryHillUSGSMap.pdf 3.99MB
File type must be pdf
0
(intermittent and perennial)
0
To replace our old low water bridge that is in poor condition and will no longer support heavy vehicles like fire trucks with a new high water bridge.
4j. Ple ase upload proje ct drawings for the propose d proje ct.
5. Jurisdictional Determinations
5a. Hav e the we tlands or streams be e n de line ate d on the prope rty or propose d impact are as?*
Comme nts:
5b. If the Corps made a jurisdictional de te rmination, what type of de te rmination was made ?*
Corps AID Numbe r:
5c. If 5a is ye s, who de line ate d the jurisdictional are as?
Name (if known):
Age ncy/Consultant Company:
Othe r:
5d1. Jurisdictional de te rmination upload
6. Future Project Plans
6a. Is this a phase d proje ct?*
Are any othe r NWP(s), re gional ge ne ral pe rmit(s), or indiv idual pe rmits(s) use d, or intende d to be use d, to authorize any part of the propose d project or re lated activ ity? This
include s othe r se parate and distant crossing for line ar proje cts that re quire De partme nt of the Army authorization but don’t re quire pre -construction notification.
1. Impacts Summary
1a. Whe re are the impacts associate d with your proje ct? (che ck all that apply):
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.
"S." will be used in the table below to represent the word "stream".
3a. Reason for impact *(?)3b.Impact type *3c. Type of impact *3d. S. name *3e . Stre am Type *
(?)
3f. Type of
Jurisdiction *
3g. S. width *3h. Impact
le ngth *
The new bridge will be made of prestressed concrete bridge beams with built in guard rails manufactured by the Eastern Vault Company.(See photo A) Eight 70 foot beams will rest on a
single concrete pier located in the middle of the river. The pier will be constructed of steel reinforced high grade concrete that will be anchored to the bedrock. The finished bridge will
be 140 feet long 12 feet wide just a few feet downstream from the old bridge. The height will be above the base flood elevation (100-yr) for this area which is 2782 feet according to the
NC Flood Risk Information System given to us by the Ashe County Planning Department. The river in this location is about 100 feet wide but because of the whirling motion of the water
adjacent to and downstream from the old bridge the banks on both sides have suffered significant erosion. See aerial photo(B ). To correct this we want to restore the banks using large
boulders and riprap to return the river to its natural dimension of 100 feet.. The added length of the bridge beams will allow us to set them on concrete foundation pads beyond the
restored banks. See picture (C) The pier in the middle of the river will be 3 feet wide and 12 feet long, 12 feet high, constructed of steel reinforced high grade concrete. The river bottom
in this location is solid rock several feet thick. The pier will be anchored to the river bottom using inch and a half steel pins driven and grouted into drilled holes in the river bottom. The
work area in the river will be dewatered before construction begins using an inflatable cofferdam and sand bags. After the area is dry concrete forms will be filled with rebar and C40
grade pumped concrete. The ideal time to work in the river is late summer early fall. The spot where the pier will be built on bedrock has only a few inches of water depth that time of
year. The construction time for the pier should take about two weeks. Once the pier is in place and cured we will no longer be working in the river. The bridge beams will be set in place
using large cranes working well above the river banks. By comparison the new pier will displace just 36 sq. ft of the river while the old bridge piers have been displacing a total of 150 sq.
ft.
Because our old bridge is in such bad shape, seriously eroded at the river bottom we wanted to start this project last summer but were delayed like so many things by the covid virus.
But we used this time to plan and do research on the best and most affordable way to proceed. We had to go outside our area to find high water bridge contractors. The added costs
due to travel and logistics made the whole project unaffordable. In the process we learned that we have many skilled and knowledgeable trades people in our county as well as retired
engineers that have generously volunteered their assistance. Taking advantage of all this knowledge and generosity we can reduce the project down into several steps, concrete work,
excavating and restoring river banks, placement of the beams using large crane crews will allow us to control costs and the quality of the work. We look forward to working with the
Corps of Engineers and completing the project to everyone’s satisfaction.
Click the upload button or drag and drop files here to attach document
Photo A.pdf 2.02MB
Photo B.pdf 817.2KB
Photo C.pdf 820.5KB
File type must be pdf
Yes No Unknown
Preliminary Approved Not Verified Unknown N/A
Example: SAW-2017-99999
Click the upload button or drag and drop files here to attach document
File type must be PDF
Yes No
D. Proposed Impacts Inventory
Wetlands Streams-tributaries Buffers
Open Waters Pond Construction
S1
S2
** All Perennial or Intermittent streams must be verified by DWR or delegated local government.
3i. Total jurisdictional ditch impact in square fe e t:
3i. Total pe rmane nt stre am impacts:
3i. Total te mporary stre am impacts:
3i. Total stre am and ditch impacts:
3j. Comme nts:
1. Avoidance and Minimization
1a. Spe cifically de scribe me asure s take n to av oid or minimize the propose d impacts in de signing the proje ct:*
1b. Spe cifically de scribe me asure s take n to av oid or minimize the propose d impacts through construction te chnique s:*
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Doe s the proje ct re quire Compe nsatory M itigation for impacts to Wate rs of the U.S. or Wate rs of the State ?
2b. If this proje ct DOES NOT re quire Compe nsatory M itigation, e xplain why:
NC Stream Temperature Classification Maps can be found under the Mitigation Concepts tab on the Wilmington District's RIBITS website.
*** Recent changes to the stormwater rules have required updates to this section .***
1. Diffuse Flow Plan
1a. Doe s the proje ct include or is it adjace nt to prote cte d riparian buffers ide ntifie d within one of the NC Riparian Buffe r Prote ction Rule s?
For a list of options to meet the diffuse flow requirements, click here.
If no, e xplain why:
2. Stormw ater Management Plan
2a. Is this a NCDOT proje ct subje ct to compliance with NCDOT’s Indiv idual NPDES pe rmit NCS000250?*
2b. Doe s this proje ct me e t the re quire me nts for low de nsity proje cts as de fine d in 15A NCAC 02H .1003(2)?*
To look up low density requirement click here 15A NCAC 02H .1003(2).
Comme nts:
1. Environmental Documentation
bank stabilization Permanent Bank Stabilization New River Perennial Both 8
Average (feet)
20
(linear feet)
pier construction Temporary Dewatering New River Perennial Both 10
Average (feet)
20
(linear feet)
0
20
20
40
E. Impact Justification and Mitigation
Our plan is to restore the river banks to there original dimensions. The bridge abutment pads will be placed well beyond the restored banks.
The only construction done in the river will be the single pier. The pier will be anchored to the bedrock in a very shallow section of the river. The work
area will be totally dewatered before construction begins. The finished pier will displace only a fraction of the water that the old piers are displacing.
Yes No
Our proposed project is going to majorly lessen the impact of waters that the old bridge is currently effecting.
F. Stormwater M anagement and Diffuse Flow Plan (required by DWR)
Yes No
We have designed this project very carefully, wanting to have very little impact on surrounding vegetation. All trees, wild flowers and grasses will be protected and preserved during
construction.
Yes No
Yes No
G. Supplementary Information
1a. Doe s the proje ct inv olv e an e xpe nditure of public (fe de ral/state /local) funds or the use of public (fe de ral/state ) land?*
2. Violations (DWR Requirement)
2a. Is the site in v iolation of DWR Wate r Quality Ce rtification Rule s (15A NCAC 2H .0500), Isolate d We tland Rule s (15A NCAC 2H .1300), or DWR Surface Wate r or We tland Standards or
Riparian Buffe r Rule s (15A NCAC 2B .0200)?*
3. Cumulative Impacts (DWR Requirement)
3a. Will this proje ct (base d on past and re asonably anticipate d future impacts) re sult in additional de v e lopme nt, which could impact ne arby downstre am wate r quality?*
3b. If you answe re d “no,” prov ide a short narrativ e de scription.
4. Sewage Disposal (DWR Requirement)
4a. Is se wage disposal re quire d by DWR for this proje ct?*
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this proje ct occur in or ne ar an are a with fe de rally prote cte d spe cie s or habitat?*
5b. Hav e you che cke d with the USFWS conce rning Endange re d Spe cie s Act impacts?*
5d. Is anothe r Fe de ral age ncy inv olv e d?*
5e . Is this a DOT proje ct locate d within Div ision's 1-8?*
5f. Will you cut any tre e s in orde r to conduct the work in wate rs of the U.S.?*
5g. Doe s this proje ct inv olv e bridge mainte nance or re mov al?*
5g(1). If ye s, hav e you inspe cte d the bridge for signs of bat use such as staining, guano, bats, e tc.? Re pre se ntativ e photos of signs of bat use can be found in the NLEB SLOPES,
Appe ndix F, page s 3-7.
Link to the NLEB SLOPES document: http://saw-reg.usace.army.mil/NLEB/1-30-17-signed_NLEB-SLOPES&apps.pdf
If you answe re d "Ye s" to 5g(1), did you discov e r any signs of bat use ?*
*** If ye s, ple ase show the location of the bridge on the pe rmit drawings/proje ct plans.
5h. Doe s this proje ct inv olv e the construction/installation of a wind turbine (s)?**
5i. Doe s this proje ct inv olv e (1) blasting, and/or (2) othe r pe rcussiv e activitie s that will be conducte d by machine s, such as jackhamme rs, me chanize d pile driv e rs, e tc.?*
5j. What data source s did you use to de te rmine whe the r your site would impact Endange re d Spe cie s or De signate d Critical Habitat?*
Consultation Docume ntation Upload
6. Essential Fish Habitat (Corps Requirement)
6a. Will this proje ct occur in or ne ar an are a de signate d as an Esse ntial Fish Habitat?*
6b. What data source s did you use to de te rmine whe the r your site would impact an Esse ntial Fish Habitat?*
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
Yes No
Yes No
Yes No
This bridge will serve as the only access to a fifty year old development that has most of its buildable sites owned and protected by current residents.
Yes No N/A
Yes No
Yes No
Yes No Unknown
Yes No
Yes No
Yes No
Yes No
Yes No Unknown
Yes No
Yes No
USFWS website
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File type must be PDF
Yes No
NOAA website
Link to the State Historic Preservation Office Historic Properties Map (does not include archaeological data: http://gis.ncdcr.gov/hpoweb/
7a. Will this proje ct occur in or ne ar an are a that the state , fe de ral or tribal gov e rnme nts hav e de signate d as hav ing historic or cultural pre se rv ation status (e .g., National Historic
Trust de signation or prope rtie s significant in North Carolina history and archae ology)?*
7b. What data source s did you use to de te rmine whe the r your site would impact historic or arche ological re source s?*
7c. Historic or Pre historic Information Upload
8. Flood Zone Designation (Corps Requirement)
Link to the FEM A Floodplain M aps: https://msc.fema.gov/portal/search
8a. Will this proje ct occur in a FEM A-designate d 100-ye ar floodplain?*
8b. If ye s, e xplain how proje ct me e ts FEM A require me nts:
8c. What source (s) did you use to make the floodplain de te rmination?*
Comme nts
M isce llane ous attachme nts not pre v iously re que ste d.
*
· 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 :*
Signature *
Date
Yes No
National Historic Trust website
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File must be PDF
Yes No
The height will be above the base flood elevation (100-yr) for this area which is 2782 feet according to the NC Flood Risk Information System given to
us by the Ashe County Planning Department
Ashe County Planning Department
M iscellaneous
Click the upload button or drag and drop files here to attach document
File must be PDF or KMZ
Signature
By checking the box and signing below, I certify that:
Richard Glenn Thompson
2/27/2021