20210145 Ver 1_ePCN Application_20210503

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#*
20210145 1
Is a payment required for this project?*
✓ No payment required
6 Fee received Reviewing Office*
✓ Fee needed-send electronic notification Mooresville Regional Office-[phone]
Select Project Reviewer*
Donna Hood:eads\drhood
Information for Initial Review
1a.Name of project:
Replace Bridge No.329 on SR 1315 over East Fork of Twelve Mile Creek
1a.Who is the Primary Contact?*
Larry Thompson
lb.Primary Contact Email:* 1c.Primary Contact Phone:*
Thompson©ncdot.gov [phone]
Date Submitted
5/3/2021
Nearest Body of Water
East Fork of Twelve Mile Creek
Basin
Catawba
Water Classification
C
Site Coordinates
Latitude: Longitude:
34.983462 -80.709704
Pre-Filing Meeting Information
ID# Version
20210145 1
Pre-fling Meeting or Request Date*
1/25/2021
Attach documentation of Pre-Filing Meeting Request here:*
DWR Pre-Filing Meeting Request Form.pdf 52.54KB
A. Processing Information C^U
County(or Counties)where the project is located:
Union

Is this a NCDMS Project
C- 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:
17BP.10.PE.141
WBS#(?)
17BP.10.PE.141
1a.Type(s)of approval sought from the Corps:
fJ 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?*
C- Yes
6' 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 (' No
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 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: C' Yes 6 No
For the record only for Corps Permit: C' Yes 6 No
If.Is this an after-the-fact permit application?*
C- Yes f No
1g.Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
(' Yes C No
1g.Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
C- Yes r No
Acceptance Letter Attachment
R.141_ILF_Request-FORM-1.pdf 332.96KB
1h.Is the project located in any of NC's twenty coastal counties?
C- Yes 6 No
1j.Is the project located in a designated trout watershed?
C- Yes r No
B. Applicant Information
Id.Who is applying for the permit?
17 Owner r Applicant(other than owner)
le.Is there an Agent/Consultant for this project?*
✓ Yes 6. No
2.Owner Information
2a.Name(s)on recorded deed:
NCDOT Division 10

2b.Deed book and page no.:
N/A
2c.Responsible party:
2d.Address
Street Address
716 W Main Street
Address Line 2
(Sty State/Province/Region
Albemarle NC
Fbstal/Zip Code Country
28001 USA
2e.Telephone Number: 2f.Fax Number:
[phone]
2g.Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
lb.Subdivision name:
(if appropriate)
1c.Nearest municipality/town:
Waxhaw
2. Project Identification
2a.Property Identification Number: 2b.Property size:
N/A 2.1
2c.Project Address
Street Address
SR 1315 @ East Fork of Twelve Mile Creek
Address Line 2
(Sty State/Bovine/Region
Waxhaw NC
Rbstal/Zip Code Country
28173 USA
3.Surface Waters
3a.Name of the nearest body of water to proposed project:*
East Fork of Twelve Mile Creek
3b.Water Resources Classification of nearest receiving water:*
C
3c. What river basin(s)is your project located in?*
Catawba
3d.Please provide the 12-digit HUC in which the project is located.
030501030202
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:*
Existing conditions include SR 1315(New Town Road),agricultural land,residential land,and the disturbed/maintained right-of-way.
4b.Have Corps permits or DWR certifications been obtained for this project(including all prior phases)in the past?*
C Yes C 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)
R141 Figure 1 USGS map.pdf 2.2MB
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)
17BP10R141_Figure2_SoilsMap.pdf 671.14KB
4f.List the total estimated acreage of all existing wetlands on the property:
.09

4g.List the total estimated linear feet of all existing streams on the property:
209
4h.Explain the purpose of the proposed project:*
The purpose of the project is to replace the existing deficient SR 1315 bridge over East Fork of Twelve Mile Creek with a new modern structure.
4i.Describe the overall project in detail,including indirect impacts and the type of equipment to be used:*
The North Carolina Department of Transportation,Division 10,plans to replace Bridge No.329 carrying SR 1315(New Town Road)over East Fork of Twelve Mile Creek in Union
County,North Carolina.The existing bridge has two ninety-foot lanes with two-foot shoulders and is an approximately 26 foot long channel beam structure.The existing right-of-way of
SR 1315(New Town Road)is approximately 60 feet in width and is a two-lane structure constructed in 1968 with no existing sidewalk or bicycle facilities.
The proposed project is state funded.The length of the project is approximately 650 feet and proposes to replace the existing two-lane structure in place.The horizontal alignment of
the roadway will be maintained and an off-site detour will be used to facilitate construction.The replacement structure would be a 54'X25'-5"X 10'-2"aluminum box culvert.A culvert is
proposed to minimize the construction timeframe and the resultant disruption of local school traffic.The proposed right-of-way would be 127 feet at its widest point.
Erosion and sediment control measures will be installed at the outset of construction.An existing 16"water line south of New Town Road will be rerouted and will require open-cutting a
portion of the stream channel.Work to install the 16"water line will be done in the dry utilizing impervious dikes,a pump around system,and a dewatering device.This portion of work
will be completed prior to culvert construction and the stream bed will be restored to natural conditions.
During the culvert installation phase of the project impervious dikes will be installed within the channel north and south of New Town Road.A pump around station will be utilized to divert
water from the northern side of the New Town Road to the southern side while construction is in progress.The existing bridge will be removed by heavy equipment operating from the
upland roadway approaches and replaced with a 54'x 25-5"x 10'-2"aluminum box culvert,this will result in 55 If of permanent impacts to the stream.Following installation of the culvert,
45 If of stream will be excavated to make it even with the 1'sill inside the newly installed culvert.Additionally,side slopes will be reinforced with class-1 riprap and flood benches will have
geotextile fabric installed for approximately 11 If along the stream for bank stabilization.
A lateral'V ditch will be created on the north western side of New Town Road,this will result in a permanent wetland impact of 0.01 acre.On the northeastern side of New Town Road,
0.01 acre of wetlands will be permanently impacted by roadway fill and on the southeastern side of New Town Road 0.02 acre of wetlands will be permanently impacted by roadway fill.
The mechanized equipment to be used for construction will include track hoes,back-hoes,bulldozers and grading equipment.
4j.Please upload project drawings for the proposed project.
R.141_Permit Drawings.pdf 2.93MB
5.Jurisdictional Determinations
5a.Have the wetlands or streams been delineated on the property or proposed impact areas?*
c Yes r No f Unknown
Comments:
Attached is a stream form for Stream A,wetland data forms for Wetlands A,B,and C,photographs
of the site,and a figure depicting the approximate potential waters of the U.S.
5b.If the Corps made a jurisdictional determination,what type of determination was made?*
C' Preliminary C' Approved 6 Not Verified C' Unknown C' N/A
Corps AID Number:
5c.If 5a is yes,who delineated the jurisdictional areas?
Name(if known): Hal Bain
Agency/Consultant Company: Rummel Klepper and Kahl,LLP
Other:
5d1.Jurisdictional determination upload
R141 Figure 3 waters map.pdf 1.82MB
R141 Wetland Determination Data Forms.pdf 828.92KB
R141 trib stream form.pdf 90.42KB
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?
No.
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 r 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*
W1 Excavation P Headwater Forest WC No Both 0.010
(acres)
W2 Fill P Headwater Forest WB No Both 0.010
(acres)
W3 Fill P Headwater Forest WB No Both 0.020
(acres)
2g.Total Temporary Wetland Impact 2g.Total Permanent Wetland Impact
0.000 0.040
2g.Total Wetland Impact
0.040
2h.Comments:
A lateral'V'ditch will be created on the north western side of New Town Road,this will result in a permanent wetland impact of 0.01 acre.On the
northeastern side of New Town Road,0.01 acre of wetlands will be permanently impacted by roadway fill and on the southeastern side of New Town
Road 0.02 acre of wetlands will be permanently impacted by roadway fill.
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*
S1 Bridge Replacement Permanent Culvert East Fork of Twelve Mile Perennial Both 15 55
Creek Average(feet) (linear feet)
S2 Bridge Replacement Permanent Excavation East Fork of Twelve Mile Perennial Both 15 45
Creek Average(feet) (linear feet)
S3 Bridge Replacement Permanent Bank Stabilization East Fork of Twelve Mile Perennial Both 15 11
Creek Average(feet) (linear feet)
Sq Bridge Replacement Temporary Culvert East Fork of Twelve Mile Perennial Both 15 17
Creek Average(feet) (linear feet)
3i.Total jurisdictional ditch impact in square feet:
0
3i.Total permanent stream impacts: 3i.Total temporary stream impacts:
111 17
3i.Total stream and ditch impacts:
128
3j.Comments:
Temporary impacts totaling 17 LF are overlapping and associated with the demolition of the existing bridge and the dewatering of the stream for the
construction of the proposed bridge replacement.Permanent impacts are associated with the bank stabilization of East Fork of Twelve Mile Creek,the
installation of the aluminum box culvert,and excavating accumulated sediment in East Fork of Twelve Mile Creek.
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:
Replacing the bridge with a culvert in-place was incorporated to minimize impacts.The horizontal alignment of the roadway was maintained and the
culvert length was minimized to reduce impacts.Riprap bank stabilization for protection of the bridge abutments is being placed only on the stream
banks and will not disturb the stream bed.Work will be conducted from the upland areas/roadway approaches.
lb.Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
NCDOT Best Management Practices for Construction and Maintenance Activities will be employed.Demolition and construction methods from the
upland roadway approaches will be used to minimize potential temporary demolition related impacts and avoid construction related impacts.
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 r 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 17 Payment to in-lieu fee r 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.
17 Yes r No
4b.Stream mitigation requested:
(linear feet) 4c.If using stream mitigation,what is the stream temperature:
100 warm
4e.Riparian wetland mitigation requested:
4d.Buffer mitigation requested(DWR only): (acres)
(square feet) .04
4f.Non-riparian wetland mitigation requested: 4g.Coastal(tidal)wetland mitigation requested:
(acres) (acres)
4h.Comments
Permanent impacts of 100 LF to the bed and banks of East Fork of Twelve Mile Creek is proposed for the culvert installation and channel excavation.
The stabilization of the proposed flood benches will permanently impact 11 LF of the streambank of East Fork of Twelve Mile Creek;mitigation for this
impact is not proposed.Permanent impacts to wetlands will result from-0.01 acre from excavation and-0.03 acre from fill.
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 ( No
If no,explain why:
Project is located in the Catawba River Basin and is not subject to NC Riparian Buffer Protection Rules because it is not directly connected to the Catawba River.
2.Stormwater Management Plan
2a.Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
r• Yes r No
Comments:
Please see attached Stormwater Management Plan in the Miscellaneous section for details on the minimization of water quality impacts.
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?*
rr Yes C 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(NEPA/SEPA)?*
✓ Yes f No
Comments:*
A Minimum Criteria Determination Checklist was prepared for this bridge replacement project.
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 rz No
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.
Project involves the replacement of an existing bridge and is not anticipated to affect future development.
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 No
5b.Have you checked with the USFWS concerning Endangered Species Act impacts?*
( Yes (' No
5c.If yes,indicate the USFWS Field Office you have contacted.
Asheville
5d.Is another Federal agency involved?*
✓ Yes r No r Unknown
5e.Is this a DOT project located within Division's 1-8?
✓ Yes r No
5f.Will you cut any trees in order to conduct the work in waters of the U.S.?
( Yes C No
5g.Does this project involve bridge maintenance or removal?
✓ Yes r No
5g(1).If yes,have you inspected the bridge for signs of bat use such as staining,guano,bats,etc.?
( Yes C No
If you answered"Yes"to 5g(1),did you discover any signs of bat use?
✓ Yes r No r Unknown
5h.Does this project involve the construction/installation of a wind turbine(s)?*
C Yes (' No
Si.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.?
f Yes r No
5j.What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
USFWS IPaC and NCNHP data and site specific surveys.Mussel surveys were performed by the NCDOT Biological Surveys Group in June 2016 and
October 2018 and no bivalves were found during both surveys.See Supplemental Information attached under Miscellaneous for threatened and
endangered species write-ups and biological conclusions.
Consultation Documentation Upload
NCNHP_Report_08162019.pdf 1.04MB
B-5797 Aquatic Species Survey Report 2019.pdf 10.42MB
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?*
NOAA EFH Mapper
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?*
See attached"No Archaeological Survey Required Form"and"Historic Architecture and Landscapes No Survey Required Form."
7c.Historic or Prehistoric Information Upload
R.141 No Archaeological Survey Required Form.pdf 570.86KB
R.141 No Survey Required Architectural Form.pdf 3.24MB
8. Flood Zone Designation(Corps Requirement)
8a.Will this project occur in a FEMA-designated 100-year floodplain?*
(' Yes ( No
8c.What source(s)did you use to make the floodplain determination?*
FEMA FIRM maps
Miscellaneous (.)
Comments
Additional Miscellaneous attachments include Supplemental Information regarding the Threatened and Endangered Species that are listed in Union County.Field work for this project
was conducted on March 22,2016 by members of Rummel Klepper and Kahl,LLP.
Miscellaneous attachments not previously requested.

(SF-890329)_I-YD_SMPv2.08_(20180814)(Aug 2018).pdf 179.72KB
T&E Supplemental info for R141 ePCN Form.pdf 132.81KB
Signature
FJ 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:
Larry Thompson
Signature
Date
5/3/2021