20211006 Ver 1_ePCN Application_20210616

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#*
20211006 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:
US19 Jack and Bore Failed Culvert-Clyde
1a.Who is the Primary Contact?*
Kevin Barnett
lb.Primary Contact Email:* 1c.Primary Contact Phone:*
[e-mail] [phone]
Date Submitted
6/16/2021
Nearest Body of Water
Sally Haynes Branch
Basin
French Broad
Water Classification
C
Site Coordinates
Latitude: Longitude:
35.530324 -82.891100
A. Processing Information L)
County(or Counties)where the project is located:
Haywood
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#(?)
14.104411
Pre-Filing Meeting Information
Is this a courtesy copy notification?*
✓ Yes ( No
ID# Version
Pre-fling Meeting or Request Date
5/4/2021
Attach documentation of Pre-Filing Meeting Request here:
Click the upload button or drag and drop files here to attach document
DWRPreApplicationMeeting.pdf 333.56KB
Pie type nest be FCF
1a.Type(s)of approval sought from the Corps:
I7 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?
fJ Nationwide Permit(NWP)
✓Regional General Permit(RGP)
✓Standard(IP)
1c.Has the NWP or GP number been verified by the Corps?
( Yes r No
Nationwide Permit(NWP)Number: 03-Maintenance
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
✓Non-404 Jurisdictional General Permit r Riparian Buffer Authorization
✓ 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 ( No
For the record only for Corps Permit: r Yes ( No
If.Is this an after-the-fact permit application?*
( Yes rNo
1g.Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
✓ Yes ( No
1g.Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
✓ Yes rNo
lh.Is the project located in any of NC's twenty coastal counties?
✓ Yes ( No
1j.Is the project located in a designated trout watershed?
✓ Yes ( No
B. Applicant Information
1d.Who is applying for the permit?
17 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:
NC Department of Transportation
2b.Deed book and page no.:
2c.Contact Person:
2d.Address
Street Address
253 Webster Rd.
Address Line 2
Cty State/Rovince/Region
Sylva NC
Fbstal/Zip Cork Country
28778 US
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:
Clyde
2. Project Identification
2a.Property Identification Number: 2b.Property size:
2c.Project Address
Street Address
Address Line 2
Oty State/Province/Region
Fbstal/Zip Code Country
3.Surface Waters
3a.Name of the nearest body of water to proposed project:*
Sally Haynes Branch
3b.Water Resources Classification of nearest receiving water:*
C
3c. What river basin(s)is your project located in?*
French Broad
3d.Please provide the 12-digit HUC in which the project is located.
060101060105
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:*
In May of this year,a sinkhole developed in the culvert crossing under US19 in the vicinty of Clyde.In order to repair the road,a new culvert will be jack and bored next to the existing
pipe.
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
4f.List the total estimated acreage of all existing wetlands on the property:
0.0
4g.List the total estimated linear feet of all existing streams on the property:
150
4h.Explain the purpose of the proposed project:*
To return US19 to operational status

4i.Describe the overall project in detail,including indirect impacts and the type of equipment to be used:*
A Jack and Bore machine will install new 30"steel welded pipe next to the existing pipe.
5.Jurisdictional Determinations
5a.Have the wetlands or streams been delineated on the property or proposed impact areas?*
✓ Yes f No r Unknown
Comments:
5b.If the Corps made a jurisdictional determination,what type of determination was made?*
✓ Preliminary r Approved r Not Verified r Unknown O. 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 r: 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?
None at this time
D. Proposed Impacts Inventory
1. Impacts Summary
1a.Where are the impacts associated with your project?(check all that apply):
E Wetlands 17 Streams-tributaries r Buffers
[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*
S1 New Culvert Temporary Culvert Sally Haynes Branch Perennial Both 1 150
Average(feet) (linear feet)
3i.Total jurisdictional ditch impact in square feet:
0
3i.Total permanent stream impacts: 3i.Total temporary stream impacts:
O 150
3i.Total stream and ditch impacts:
150
3j.Comments:
E. Impact Justification and Mitigation L)
1.Avoidance and Minimization
1a.Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
This is the minimum amount of impact necessary to return the road to service.
lb.Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
DOT only plans to replace the existing length of pipe currently in place.
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
2b.If this project DOES NOT require Compensatory Mitigation,explain why:
Less than 300LF of new impact
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 r No
If no,explain why:
There will be no changes to the surrounding landscape
2.Stormwater Management Plan
2a.Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
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?*
6 Yes r 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(NEPAISEPA)?*
f Yes (' No
1c.If you answered"yes"to the above,has the document review been finalized by the State Clearing House?*
✓ Yes 6 No
Comments:*
Financial amount of project below threshold for clearing house.
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)?*
r Yes f No
2b Provide an explanation of the violation(s):
3. Cumulative Impacts(DWR Requirement)
3a.Will this project result in additional development,which could impact nearby downstream water quality?*
✓ Yes 6 No
3b.If you answered"no,"provide a short narrative description.
No changes to surround landscape and no new opportunities for development.
4.Sewage Disposal(DWR Requirement)
4a.Is sewage disposal required by DWR for this project?*
✓ Yes rNor 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?*
f Yes (' No
5c.If yes,indicate the USFWS Field Office you have contacted.
Asheville
5d.Is another Federal agency involved?*

✓ Yes 6 No r Unknown
5e.Is this a DOT project located within Division's 1-8?
✓ Yes G 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 G No
5h.Does this project involve the construction/installation of a wind turbine(s)?*
✓ Yes r 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 rNo
5j.What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
GIS layer
6. Essential Fish Habitat(Corps Requirement)
6a.Will this project occur in or near an area designated as an Essential Fish Habitat?*
✓ Yes 6No
6b.What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
NOAA website
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 RNo
7b.What data sources did you use to determine whether your site would impact historic or archeological resources?*
Checked with ETRACS
8. Flood Zone Designation(Corps Requirement)
8a.Will this project occur in a FEMA-designated 100-year floodplain?*
✓ Yes RNo
8c.What source(s)did you use to make the floodplain determination?*
County Flood Map
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.
Oick the upload button or drag and drop files here to attach document
ArcComments.pdf 340.54KB
Facing north and down towards open stream from road shoulder-channel realignment plan.pdf 1.37MB
Facing south and up towards road from open stream-bore pad in this location.pdf 768.76KB
Facing south and up towards road from open stream-trees to cut.pdf 908.56KB
Facing south towards junction box from edge of road.pdf 607.98KB
US 19 23 Clyde sinkhole_Map and Project Area.pdf 1.26MB
US 19 23 Clyde sinkhole_rough plan x sec.pdf 1.27MB
US 19 23 Clyde sinkhole_SHPO viewer May 3 2021.pdf 218.51 KB
US19.Clyde.Map.pdf 14.12MB
US19.CulvertFailure.NRCS.SoilSurvey.pdf 1.03MB
US19FailedCulvert.USGS.Topo.pdf 1.05MB
USFWSComments.pdf 296.06KB
WRCComments.pdf 321.29KB
Re must be FIT or KbE
Comments
Signature
*
rJ 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:
Kevin H Barnett
Signature
Ida&µfr7
Date
6/16/2021