20210302 Ver 1_ePCN Application_20210610

DWR
Division of Water Resources
Pre-Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
June 1,2021 Ver4.1
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?*
R Yes r No
Change only if needed.
BIMS#Assigned* Version#*
20210302 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
la.Name of project:
Cherokee County-Bridge 170
1a.Who is the Primary Contact?*
Patrick J.Breedlove
1b.Primary Contact Email:* 1c.Primary Contact Phone:*
[e-mail] [phone]
Date Submitted
6/10/2021
Nearest Body of Water
Marble Creek
Basin
Hiwassee
Water Classification
Class C
Site Coordinates
Latitude: Longitude:
35.125991 -83.999481
A. Processing Information
County(or Counties)where the project is located:
Cherokee
Is this a NCDMS Project
✓ Yes 6' 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:

WBS#(?)
17BP.14.R.167
Pre-Filing Meeting Information
Is this a courtesy copy notification?*
✓ Yes G No
ID# Version
20210302 Version 1
Pre-fling Meeting or Request Date
2/11/2021
Attach documentation of Pre-Filing Meeting Request here:
Click the upload button or drag and drop files here to attach docurrent
Cherokee County-B170-Pre-Filing Acknowiedgement.pdf 1.08MB
Pie type mast be FCF
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)
f7 Regional General Permit(RGP)
r Standard(IP)
1c.Has the NWP or GP number been verified by the Corps?
✓ Yes 6 No
Regional General Permit(RGP)Number: 201902350-Work associated with bridge construction,widening,replacement,and
interchanges
RGP Numbers(for multiple RGPS):
ld.Type(s)of approval sought from the DWR:
fJ 401 Water Quality Certification-Regular r 401 Water Quality Certification-Express
r Non-404 Jurisdictional General Permit r Riparian Buffer Authorization
r Individual 401 Water Quality Certification
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 (' No
1g.Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
6 Yes rNo
1g.Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
✓ Yes rNo
1h.Is the project located in any of NC's twenty coastal counties?
✓ Yes (' No
1j.Is the project located in a designated trout watershed?
6. Yes r 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 ( No

2.Owner Information
2a.Name(s)on recorded deed:
NCDOT Division 14
2b.Deed book and page no.:
2c.Contact Person:
2d.Address
Street Address
253 Webster Road
Address Line 2
City State/Aovince/Region
Sylva North Carolina
Postal/Zip Code Country
28779 United States
2e.Telephone Number: 2f.Fax Number:
[phone]
2g.Email Address:*
[e-mail]
C. Project Information and Prior Project History C^U
1. Project Information
1b.Subdivision name:
(if apprgxiate)
1c.Nearest municipality/town:
Murphy
2. Project Identification
2a.Property Identification Number: 2b.Property size:
2c.Project Address
Street Address
Address Line 2
Qly State/Rovince/Region
Postal/Zip Code Country
3.Surface Waters
3a.Name of the nearest body of water to proposed project:*
Marble Creek
3b.Water Resources Classification of nearest receiving water:*
Class C
3c. What river basin(s)is your project located in?*
Hiwassee
3d.Please provide the 12-digit HUC in which the project is located.
060200020404
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 land use is an existing wood floor on steel I-beam bridge on a two lane secondary road.Project site is located is a rural residential area with mowed yards adjacent to the project
site with a metal recycling center nearby.
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
4f.List the total estimated acreage of all existing wetlands on the property:
0.00
4g.List the total estimated linear feet of all existing streams on the property:
300

4h.Explain the purpose of the proposed project:*
Project is to replace an obsolete and deteriorating wood floor on steel I-beam bridge with an aluminum box culvert in the existing bridge footprint.
4i.Describe the overall project in detail,including indirect impacts and the type of equipment to be used:*
NCDOT contractor will install erosion and sediment control measures.NCDOT contractor will install diversion pipe prior to the construction of the aluminum box culvert.The UT will
dewatered and realigned to allow for approach fill slopes.Bank stabilization material will be permanently installed once final grading allows.Diversions will be removed and temporary
impacts will be restored.The proposed project will be constructed utilizing the following equipment:crane,excavator,dump trucks,paving equipment,pumps and hand tools.
5.Jurisdictional Determinations
5a.Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes r No O Unknown
Comments:
5b.If the Corps made a jurisdictional determination,what type of determination was made?*
C Preliminary r Approved r Not Verified c Unknown r N/A
Corps AID Number:
5c.If 5a is yes,who delineated the jurisdictional areas?
Name(if known):
Agency/Consultant Company:
Other:
6. Future Project Plans
6a.Is this a phased project?*
C Yes 0 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.Impact type* 3c.Type of impact* 3d.S.name* 3e.Stream Type* 3f.Type of 3g.S.width* 3h.Impact
(?) Jurisdiction* length*
81 Aluminum Box Culvert Permanent Culvert Marble Creek Perennial Both 10 40
Average(feet) (linear feet)
32 Dewatering Temporary Dewatering Marble Creek Perennial Both 10 70
Average(feet) (linear feet)
S3 Roadway Fill Slope Permanent Relocation UT to Marble Creek Perennial Both 2 50
Average(feet) (linear feet)
34 Dewatering Temporary Dewatering UT to Marble Creek Perennial Both 2 70
Average(feet) (linear feet)
S5 Streambank Stabilization Permanent Bank Stabilization Marble Creek Perennial Both 10 13
Average(feet) (linear feet)
S6 Streambank Stabilization Permanent Bank Stabilization Marble Creek Perennial Both 10 12
Average(feet) (linear feet)
3i.Total jurisdictional ditch impact in square feet:
0
3i.Total permanent stream impacts: 3i.Total temporary stream impacts:
115 140
3i.Total stream and ditch impacts:
255
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 existing bridge is being replaced with a structure that is adequate for the traffic needs with in same disturbed location.The box culvert was
designed for the minimum size criteria to ensure conveyance of traffic on the secondary road.
lb.Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
The on-site stream(Marble Creek&UT to Marble Creek)will be temporary diverted/dewatered while the box culvert is constructed and while the
existing bridge is removed.Erosion and sediment control measures will be installed prior to ground disturbance.Both of these measures will aid in the
prevention of sediment into downstream habitats.
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):
I7 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 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.
6 Yes r No
4b.Stream mitigation requested:
(linear feet) 4c.If using stream mitigation,what is the stream temperature:
40 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
6. Buffer mitigation(State Regulated Riparian Buffer Rules)-required by DWR
6a.Will the project result in an impact within a protected riparian buffer that requires buffer mitigation?If yes,you must fill out this entire form-please contact DWR for more
information.
✓ Yes O No
F. Stormwater Management and Diffuse Flow Plan (required by DWR) U
1. Diffuse Flow Plan
Ia.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 not located within a N.C.Riparian Buffer Protection Area.
2.Stormwater Management Plan
2a.Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
t Yes r No
Comments:
G. Supplementary Information C^U
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(NEPA/SEPA)?*
(r Yes rNo
1c.If you answered"yes"to the above,has the document review been finalized by the State Clearing House?*
✓ Yes ( No
Comments:*
NCDOT MCDC Completed.
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 ( 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.
The project is only to replace the existing subject bridge with an aluminum box culvert and does not increase the capacity of roads in the area.The
proposed project is not a road widening or improvement project.
4.Sewage Disposal(DWR Requirement)
4a.Is sewage disposal required by DWR for this project?*
✓ Yes ( 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 rNo
5b.Have you checked with the USFWS concerning Endangered Species Act impacts?*
( Yes rNo
5c.If yes,indicate the USFWS Field Office you have contacted.
Asheville
5d.Is another Federal agency involved?*
✓ Yes ( No r Unknown
5e.Is this a DOT project located within Division's 1-8?
✓ Yes ( No
5f.Will you cut any trees in order to conduct the work in waters of the U.S.?
( Yes r 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 r No
If you answered"Yes"to 5g(1),did you discover any signs of bat use?
✓ Yes ( No r Unknown
5h.Does this project involve the construction/installation of a wind turbine(s)?"
✓ Yes ( 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 r No
5j.What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
U.S.Fish&Wildlife-ECOS-Online Mapper
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-Essential Fish Habitat

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?*
C Yes f• No
7b.What data sources did you use to determine whether your site would impact historic or archeological resources?*
NCDOT Culture Resource Specialist
8. Flood Zone Designation(Corps Requirement)
8a.Will this project occur in a FEMA-designated 100-year floodplain?*
C Yes f• No
8c.What source(s)did you use to make the floodplain determination?*
N.C.Flood Maps-Flood Risk Information System
Miscellaneous
Please use the space below to attach all required documentation or any additional information you feel is helpful for application review.Documents should be combined into one
file when possible,with a Cover Letter,Table of Contents,and a Cover Sheet for each Section preferred.
Click the upload button or drag and drop files here to attach docunent
Cherokee County-B170-GP 50 Cover Letter(Final).pdf 38.13KB
Cherokee County-B170-USGS Topo Map.pdf 638.97KB
Cherokee County-B170-NRCS Soil Survey.pdf 525.08KB
Cherokee County-B170-Permit Plans.pdf 2.81MB
Cherokee County-B170-Site Photos.pdf 7.02MB
Cherokee County-B170-Historic Archictecture.pdf 826.66KB
Cherokee County-B170-Archaeology.pdf 1.7MB
Cherokee County-B170-Hydro Report.pdf 4.28MB
Cherokee County-B170-JD(Signed).pdf 223.28KB
Cherokee County-B170-Mitigation Acceptance Letter.pdf 457.24KB
Cherokee County-B170-SWP(Final).pdf 2.18MB
Cherokee County-B170-NC Hertiage Program.pdf 1.33MB
Cherokee County-B170-Bat Assessment Form.pdf 36.88KB
Pie mist be FCF or KW
Comments
Signature U
*
I7 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:
Patrick Jeremy Breedlove
Signature
c 7nt c my r r
Date
6/10/2021