20210833 Ver 1_ePCN Application_20210418

DWR
Division of Water Resources
Initial Review
Pre -Construction Notification (PCN) Form
April 4, 2021 Ver 4
Has this project met the requirements for acceptance in to the review process?*
6 Yes
✓ No
Is this project a public transportation project?*
CYes r No
Change cnly 1 needed.
BIMS # Assigned* Version#*
20210833 1
Is a payment required for this project?*
6 No payment required
✓ Fee received
✓ Fee needed - send electronic notification
Select Project Reviewer*
Stephanie Goss:eads\szgoss
Information for Initial Review
la. Name of project:
Jermaine Blood Run Creek Bridge
la. Who is the Primary Contact?*
Jermaine White
lb. Primary Contact Email:*
[e-mail]
Date Submitted
4/18/2021
Nearest Body of Water
Blood Run Creek
Basin
Cape Fear
Water Classification
Class C
Site Coordinates
Latitude:
35.7204572
A. Processing Information
Reviewing Office *
Raleigh Regional Office - [phone]
lc. Primary Contact Phone:*
[phone]
Longitude:
-79.5000456
County (or Counties) where the project is located:
Chatham
Is this a NCDMS Project
✓ Yes G No
Is this project a public transportation project?*
✓ Yes G No
Pre -Filing Meeting Information
Is this a courtesy copy notification?*
✓ Yes f• No

ID# Version
Pre -fling Meeting or Request Date
3/10/2021
Attach documentation of Pre -Filing Meeting Request here:
Click the upload button or drag and drop files here to attach document
DWR Pre -Filing Meeting Request Form.pdf
Fie type mast be FT
la. Type(s) of approval sought from the Corps:
f7 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
6 No
1b. What type(s) of permit(s) do you wish to seek authorization?
f7 Nationwide Permit (NWP)
I- Regional General Permit (RGP)
r Standard (IP)
lc. Has the NWP or GP number been verified by the Corps?
✓ Yes(-No
Nationwide Permit (NWP) Number:
NWP Numbers (for multiple NWPS):
Id. Type(s) of approval sought from the DWR:
I7 401 Water Quality Certification - Regular
r Non-404 Jurisdictional General Permit
r Individual 401 Water Quality Certification
29 - Residential Developments
le. Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification:
For the record only for Corps Permit:
If. Is this an after -the -fact permit application?*
(7 Yes r No
51.79KB
r' 401 Water Quality Certification - Express
✓ Riparian Buffer Authorization
lg. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
✓ Yes ( No
lg. 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?
✓ Yes r: No
1j. Is the project located in a designated trout watershed?
✓ Yes r No
✓ Yes 6 No
✓ Yes 6 No
B. Applicant Information
Id. Who is applying for the permit?
f7 Owner r Applicant (other than owner)
le. Is there an Agent/Consultant for this project?*
✓ Yes f No
2. Owner Information
2a. Name(s) on recorded deed:
Jermaine & Pamela White
2b. Deed book and page no.:
book 2131 page 1089

2c. Contact Person:
2d. Address
Street Address
1895 Flint Ridge Rd.
Address Line 2
oly
Siler City
Postal / ZLp Code
27344
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
State / Province / legion
NC
Country
USA
2f. Fax Number:
C. Project Information and Prior Project History C"U
1. Project Information
1b. Subdivision name:
(if apprepriate)
lc. Nearest municipality/ town:
Siler City
2. Project Identification
2a. Property Identification Number:
12527
2c. Project Address
Street Address
288 Crestview Rd.
Address Line 2
2b. Property size:
30.6
Cris State / Province / legion
Siler City NC
Postal / ZZp Cade Country
27344 USA
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Blood Run Creek
3b. Water Resources Classification of nearest receiving water:*
Class C
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.
030300030206
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 site is located at the bottom of a field on one side. The other side was forestland It is currently being cleared for a residential property. There are large trees on both sides of the
site. However it is accessible from the one side currently.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
r Yes F 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)
VicinityMapBloodrunBridgeURGS.pdf 4.23MB
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)
VicinityMapBloodrunBridgeNRCS (1).pdf 4.23MB
4f. List the total estimated acreage of all existing wetlands on the property:
5
4g. List the total estimated linear feet of all existing streams on the property:

3,050
4h. Explain the purpose of the proposed project:*
Bridge Will be used for personal access to other side of property. To walk across or atv to have access to the property.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
A 48ft x 8ft semi flatbed trailer will be used as a bridge to cross blood run creek. (8) 2ftx2ftx4ft concrete retaining wall blocks will be used to support the bridge. The creek is about 20ft
wide from top of bank to top of bank. The trailer will be placed with an excavator. The natural elevations of the creek banks are almost perfect for the placement of the trailer. The front
of the trailer will rest on the top of the bank(11ft on the ground) on one side of the creek while the landing gear for the trailer will be positioned mid bank. A block will be placed on both
sides so it can't shift. The rear aides of the trailer will rest on the ground as well with 4 support blocks placed under the frame and 2 to the rear of the trailer. This will provide support as
well as prevent movement since the bridge will be in a floodplain. Approximately 180 sgft of dirt will need to be excavated so the trailer will be level. With the trailer being 6ft higher than
the creek bottom there should be no impact to the creek.
4j. Please upload project drawings for the proposed project.
VicinityMap02.pdf
CrossSectio n Blood Ru n Brid ge. pdf
Jerma in a Plan ViewTrai ler. pdf
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
✓ Yes
Comments:
3.88MB
1.56MB
2.69MB
r No (t Unknown
5b. If the Corps made a jurisdictional determination, what type of determination was made? *
✓ Preliminary (' Approved r Not Verified R Unknown ( 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 ( 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
la. Where are the impacts associated with your project? (check all that apply):
r Wetlands r Streams -tributaries
r Open Waters r Pond Construction
6. Buffer Impacts (for DWR)
6a. Project is in which protect basin(s)?
Check all that apply.
✓ Neuse
✓ Catawba
✓ Goose Creek
7 Other cape fear
✓ Tar -Pamlico
✓ Randleman
✓ Jordan Lake
fJ Buffers
6b. Impact Type
6c. Per or Temp
6d. Stream name 6e. Buffer mitigation required?
6f. Zone 1 impact
6g. Zone 2 impact
excavation
P
Blood run creek
No
180
0
placement of bridge
P
Blood run creek
No
248
0
6h. Total buffer impacts:
Zone 1
Zone 2

Total Temporary impacts:
Total Permanent impacts:
Total combined buffer impacts:
0.00 0.00
Zone 1 Zone 2
428.00 0.00
Zone 1 Zone 2
428.00 0.00
6i. Comments:
The front of the bridge will be placed 11ft landward from top of bank. It's 8ft wide. The other side of the bridge, 8ft wide, 22ft long, and lft deep of
excavation is required for level placement of bridge in the buffer. The bridge will sit in the channel excavated on one side.
Supporting Documentation
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:
The site was chosen based on the an area which would require the least amount of impact. The creek cuts the property in half. The site is roughly the
center of the property and will allow the best location for personal access. No trees will have to be cut and the natural topography is suitable to access
without altering the landscape.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
The use of a bridge will allow access without impacting the stream at all. The small affected buffer area will be reseeded. No clearing will be necessary.
Placing the bridge with an excavator means there will no temporary impacts to the creek as well.
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 this project DOES NOT require Compensatory Mitigation, explain why:
The project will not impact the stream. So the conditions of compensatory mitigation will not be met.
F. Stormwater Management and Diffuse Flow Plan (required by DWR) u
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 site location is southwest of Siler City. There are no major watersheds near the site. The water supply doesn't come from any of the major watersheds.
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)?
6' Yes r No
Comments:
G. Supplementary Information
1. Environmental Documentation
la. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land? *
✓ Yes ( No
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification Rules (15A NCAC 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 r No

2b Provide an explanation of the violation(s):
The bridge has already been placed and some small excavation was done in the buffer. Applying for the proper permits after the fact right now in
order to get back in compliance.
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality?*
✓ Yes No
3b. If you answered "no," provide a short narrative description.
This project is solely for personal access to the property by the owner. There are no additional developments planned for the future.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
✓ Yes r No 6 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 f No
5d. Is another Federal agency involved?*
✓ Yes
5e. Is this a DOT project located within Division's 1-8?
✓ Yes G No
G No r Unknown
5f. Will you cut any trees in order to conduct the work in waters of the U.S.?
✓ Yes G No
5g. Does this project involve bridge maintenance or removal?
✓ Yes G No
5h. Does this project involve the construction/installation of a wind turbine(s)?*
✓ Yes G 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?
https://ww .saw.usace.army.mil/Missions/Regulatory-Permit-Program/Agency-Coordination/ESA/
The USACE links for endangered and threatened species map. Also looked through the Geospatial GIS data with the federally listed aquatic species
and the critical habitats for the listed species.
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 f No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
http://www.habitat.noaa.gov/protection/efh/efhmapper/ to make this determination.
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?*
http://www.hpo.dcr.state.nc.us/
7c. Historic or Prehistoric Information Upload
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
6 Yes rNo
8b. If yes, explain how project meets FEMArequirements:

The bridge is level with the top of the bank. If it floods the water will simply go over or around it. There are many areas perforated and not water tight.
The excavated area under the rear a>des will allowa channel for more water to flow under the bride in the event of a flood. The bridge will be located in
an area where the flood plain is roughly 340ft wide, the bridge just not a big enough structure to restrict or displace enough water to raise the flood
height by any substantial amount. Thus not reaching the FEMAflood height increase limit of 1ft.
Sc. What source(s) did you use to make the floodplain determination?*
https://vwvwarcgis.corrdapps/webappviewer/indexhtml?id=65367d5f69774726828390a90e5cde1 c
the chatham county tax gis map was used to make the determination.
Miscellaneous
Comments
Miscellaneous attachments not previously requested.
Signature
*
A 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:
Jermaine White
Signature
Date
4/18/2021

75_ r
Vicin
Bloodr
iJermai
LAT: 35.7204572
LONG: -79.5000456
30"
•
1
2!

13105
•
LAT: 35.7204572
LONG: -79.5000456
7!

Vicinity Map
Bloodrun Bridge
Jermaine White
• LAT: 35.7204572
LONG: -79.5000456
288
•
ti
13105
17

Cross Section
Blood Run Bridge
Jermaine White
Bridge Floor
Bridge Frame
Foundation Blocks
▪ Creek
▪ Creek bank
• Tires
1.1
Os
0 20ft

Plan View
Blood Run Bridge
Jermaine White
Bridge
Blocks
Creek
Creek Bank
7
0 20ft