20130498 Ver 1_Application_20130508

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Pre-Construction Notification (PCN) Form
A. Applicant Information
1. Processing
1a. Type(s) of approval sought from the
Corps: Section 404 Permit Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: 23 33 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Co rps? Yes No
1d. Type(s) of approval sought from the DWQ (check all that apply):
401 Water Quality Certification – Regular Non-404 Jurisdictional General Permit
401 Water Quality Certification – Express Riparian Buffer Authorization
1e. Is this notification solely for the record
because written approval is not required?

For the record only for DWQ 401
Certification:
Yes No
For the record only for Corps Permit:

Yes No
1f. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mi tigation bank or in-lieu
fee program.
Yes No

1g. Is the project located in any of NC’s twenty coast al counties. If yes, answer 1h
below.
Yes No

1h. Is the project located within a NC DCM Area of En vironmental Concern (AEC)? Yes No
2. Project Information
2a. Name of project: Replacement of Bridge No. 138 ov er Island Creek on SR 1109.
2b. County: Stanly
2c. Nearest municipality / town: Oakboro
2d. Subdivision name: not applicable
2e. NCDOT only, T.I.P. or state
project no: B-4818
3. Owner Information
3a. Name(s) on Recorded Deed: North Carolina Departm ent of Transportation
3b. Deed Book and Page No. not applicable
3c. Responsible Party (for LLC if
applicable): not applicable
3d. Street address: 1 South Wilmington Street
3e. City, state, zip: Raleigh, NC 27601
3f. Telephone no.: [phone]
3g. Fax no.: [phone]
3h. Email address: [e-mail]
Office Use Only:
Corps action ID no. _____________
DWQ project no. _______________
Form Version 1.3 Dec 10 2008

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4. Applicant Information (if different from owner)
4a. Applicant is: Agent Other, specify:
4b. Name: not applicable
4c. Business name
(if applicable):
4d. Street address:
4e. City, state, zip:
4f. Telephone no.:
4g. Fax no.:
4h. Email address:
5. Agent/Consultant Information (if applicable)
5a. Name: not applicable
5b. Business name
(if applicable):
5c. Street address:
5d. City, state, zip:
5e. Telephone no.:
5f. Fax no.:
5g. Email address:

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B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID ): not applicable
1b. Site coordinates (in decimal degrees): Latitude: 35.204453 Longitude: - 80.381840
(DD.DDDDDD) (-DD.DDDDDD)
1c. Property size: 1 acre
2. Surface Waters
2a. Name of nearest body of water (stream, river, e tc.) to
proposed project: Island Creek
2b. Water Quality Classification of nearest receiving w ater: C
2c. River basin: Yadkin-Pee Dee
3. Project Description
3a. Describe the existing conditions on the site and th e general land use in the vicinity of the project at t he time of this
application:
Mixed use of agricultural, forested & rural low den sity residential.
3b. List the total estimated acreage of all existing wetlands on the property:
0.06
3c. List the total estimated linear feet of all exis ting streams (intermittent and perennial) on the pr operty:
335
3d. Explain the purpose of the proposed project:
To replace a structurally deficient and functionally o bsolete bridge.
3e. Describe the overall project in detail, including the type of equipment to be used:
Replacement of bridge number 138, a two span, 61' st ructure, with a two span 80' structure, over Island Cr eek on SR
1109. Cranes, backhoes, excavators will be used.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinat ions by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past?
Comments:
Yes No Unknown
4b. If the Corps made the jurisdictional determinat ion, what type
of determination was made? Preliminary Final
4c. If yes, who delineated the jurisdictional areas?
Name (if known): Steven W. Lund
Agency/Consultant Company: Mulkey, Inc
Other:
4d. If yes, list the dates of the Corps jurisdiction al determinations or State determinations and attac h documentation.
December 8, 2009.
5. Project History
5a. Have permits or certifications been requested or obtained for
this project (including all prior phases) in the pas t? Yes No Unknown
5b. If yes, explain in detail according to “help file ” instructions.

6. Future Project Plans
6a. Is this a phased project? Yes No
6b. If yes, explain.

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C. Proposed Impacts Inventory
1. Impacts Summary
1a. Which sections were completed below for your proje ct (check all that apply):
Wetlands Streams - tributaries Buffers
Open Waters Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, th en complete this question for each wetland area impact ed.
2a.
Wetland impact
number –
Permanent (P) or
Temporary (T)
2b.

Type of impact
2c.

Type of wetland
(if known)
2d.

Forested

2e.
Type of jurisdiction
(Corps - 404, 10
DWQ – non-404, other)
2f.

Area of impact
(acres)
W1 P T Yes
No
Corps
DWQ
W2 P T Yes
No
Corps
DWQ
W3 P T Yes
No
Corps
DWQ
W4 P T Yes
No
Corps
DWQ
W5 P T Yes
No
Corps
DWQ
2g . Total wetland impacts
2h. Comments:
3. Stream Impacts
If there are perennial or intermittent stream impact s (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a.
Stream impact
number -
Permanent (P) or
Temporary (T)
3b.
Type of impact
3c.
Stream name
3d.
Perennial
(PER) or
intermittent
(INT)?
3e.
Type of
jurisdiction
(Corps - 404, 10
DWQ – non-404,
other)
3f.
Average
stream
width
(feet)
3g.
Impact length
(linear feet)
S1 P T Fill Northern UT to
Island Creek
PER
INT
Corps
DWQ 4 47
S1 P T
Temporary
Causeway &
Workpad
Island Creek PER
INT
Corps
DWQ 25 <0.01 acre
S2 P T Fill Southern UT to
Island Creek
PER
INT
Corps
DWQ 2 46
S2 P T Temporary
Workpad Island Creek PER
INT
Corps
DWQ 25 <0.01 acre
3h. Total stream and tributary impacts
Permanent: 93
linear feet
Temporary: 0.01
acre
3i. Comments: Explanation of Impacts:
Site 1 - The Northern UT to Island Creek currently em pties into Island Creek under the bridge. To accomodat e the workpad
required for the removal of the current bent and in stallation of the new bent, this UT will be re-rout ed to empty into Island
Creek just upstream of the bridge.
This impact will result in 47 linear feet of pemanent stream impact by way of "drying"/ rerouting the UT.
There will also be 0.005 acre of temporary impact to Island Creek by way of a temporary work pad to construct the 4’ base

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ditch, which will carry the new reach of the Northern UT to Island Creek, as well as temporary causeway im pact to Island
Creek for the removal/ installation of the new bent.

Site 2- the Southern UT to Island Creek, two impacts :
1. The extension of a 30” RCP to accommodate the wider shoulders leading up to the wider bridge.
2. The UT will be re-routed away from the bridge en d bent/ rip rap and emptying downstream of the bridg e.
Both of these impacts total 46 linear feet of perman ent stream impact. There will also be <0.01 acre of temporary impact to
Island Creek by way of a temporary work pad to contruct the 2' base ditch to carry the new reach of the Sout hern UT to Island
Creek.
4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuar ies, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impact s below.
4a.
Open water
impact number –
Permanent (P) or
Temporary (T)
4b.
Name of
waterbody
(if applicable)
4c.

Type of impact
4d.

Waterbody type
4e.

Area of impact (acres)
O1 P T
O2 P T
O3 P T
O4 P T
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If pond or lake construction proposed, then complete th e chart below.
5a.

Pond ID
number
5b.

Proposed use or
purpose of pond

5c.
Wetland Impacts (acres)
5d.
Stream Impacts (feet)
5e.
Upland (acres)
Flooded Filled Excav
ated Flooded Filled
Exc
avat
ed
Flooded
P1

P2

5f. Total

5g. Comments:
5h. Is a dam high hazard permit required?
Yes No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:

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6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, th en complete the chart below. If yes, then individuall y list all buffer impacts
below. If any impacts require mitigation, then you MUST fill out Section D of this form.
6a .
Project is in which protected basin?
Neuse Tar-Pamlico Other:
Catawba Randleman
6b.
Buffer impact
number –
Permanent (P) or
Temporary (T)
6c.

Reason
for
impact
6d.

Stream name
6e.

Buffer
mitigation
required?
6f.

Zone 1 impact (square
feet)
6g.

Zone 2 impact
(square feet)
B1 P T Yes
No
B2 P T Yes
No
B3 P T Yes
No
6h. Total buffer impacts
6i. Comments:

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D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or mi nimize the proposed impacts in designing project.
Bridge deck drains will be used on the eastern most si de of the proposed bridge and will not be allowed t o directly
discharge into the water.
An off-site detour will be used to allow the bridge to be replaced in-place
1b. Specifically describe measures taken to avoid or mi nimize the proposed impacts through construction techni ques.
Best Management Practices (BMPs) and measures used in the project are non-structural and are an attempt to reduce
the storm water impacts to the receiving stream due t o erosion and runoff as well as attenuate and disper se storm water
before entering the receiving waters.
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 yes, mitigation is required by (check all that apply): DWQ Corps
2c. If yes, which mitigation option will be used for this
project?
Mitigation bank
Payment to in-lieu fee program
Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank: not applicable
3b. Credits Purchased (attach receipt and letter) Ty pe Quantity
3c. Comments:
4. Complete if Making a Payment to In-lieu Fee Prog ram
4a. Approval letter from in-lieu fee program is att ached. Yes
4b. Stream mitigation requested: 93 linear feet

4c. If using stream mitigation, stream temperature: warm cool cold
4d. Buffer mitigation requested (DWQ only): n/a squa re feet
4e. Riparian wetland mitigation requested: 0 acres
4f. Non-riparian wetland mitigation requested: 0 acr es
4g. Coastal (tidal) wetland mitigation requested: 0 acres
4h. Comments:
5. Complete if Using a Permittee Responsible Mitiga tion Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation pla n.

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6. Buffer Mitigation (State Regulated Riparian Buff er Rules) – required by DWQ
6a. Will the project result in an impact within a prot ected riparian buffer that requires
buffer mitigation?
Yes No

6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mit igation. Calculate the
amount of mitigation required.
Zone
6c.
Reason for impact
6d.
Total impact
(square feet)

Multiplier
6e.
Required mitigation
(square feet)
Zone 1 3 (2 for Catawba)
Zone 2 1.5
6f. Total buffer mitigation required:
6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to pr ivate mitigation bank,
permittee responsible riparian buffer restoration, p ayment into an approved in-lieu fee fund).

6h. Comments:

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E. Stormwater Management and Diffuse Flow Plan (re quired by DWQ)
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffe rs identified
within one of the NC Riparian Buffer Protection Rule s? Yes No
1b. If yes, then is a diffuse flow plan included? If no, explain why.
Comments:
Yes No
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project? n/a
2b. Does this project require a Stormwater Manageme nt Plan? Yes No
2c. If this project DOES NOT require a Stormwater Ma nagement Plan, explain why:
2d. If this project DOES require a Stormwater Manag ement Plan, then provide a brief, narrative descripti on of the plan:
See attached Stormwater Management Plan.
2e. Who will be responsible for the review of the St ormwater Management Plan?
Certified Local Government
DWQ Stormwater Program
DWQ 401 Unit
3. Certified Local Government Stormwater Review
3a. In which local government’s jurisdiction is this project? not applicable
3b. Which of the following locally-implemented stormw ater management programs
apply (check all that apply):
Phase II
NSW
USMP
Water Supply Watershed
Other:
3c. Has the approved Stormwater Management Plan with proof of approval been
attached?
Yes No
4. DWQ Stormwater Program Review
4a. Which of the following state-implemented stormw ater management programs apply
(check all that apply):
Coastal counties
HQW
ORW
Session Law 2006-246
Other:
4b. Has the approved Stormwater Management Plan wit h proof of approval been
attached? Yes No N/A
5. DWQ 401 Unit Stormwater Review
5a. Does the Stormwater Management Plan meet the ap propriate requirements? Yes No N/A
5b. Have all of the 401 Unit submittal requirements been met? Yes No N/A

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F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1a. Does the project involve an expenditure of publi c (federal/state/local) funds or the
use of public (federal/state) land? Yes No
1b. If you answered “yes” to the above, does the pr oject require preparation of an
environmental document pursuant to the requirements of the National or State
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
Yes No
1c. If you answered “yes” to the above, has the docu ment review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
letter.)
Comments: PCE Signed July 2012.
Yes No
2. Violations (DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Rules (1 5A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards,
or Riparian Buffer Rules (15A NCAC 2B .0200)?
Yes No
2b. Is this an after-the-fact permit application? Yes No
2c. If you answered “yes” to one or both of the abo ve questions, provide an explanation of the violation (s):
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in
additional development, which could impact nearby dow nstream water quality? Yes No
3b. If you answered “yes” to the above, submit a qua litative or quantitative cumulative impact analysis i n accordance with the
most recent DWQ policy. If you answered “no,” provide a short narrative description.
Due to the minimal transportation impact resulting f rom this bridge replacement, this project will neithe r influence nearby
land uses nor stimulate growth. Therefore, a detai led indirect or cumulative effects study will not be n ecessary.
4. Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods a nd disposition (non-discharge or discharge) of waste water generated from
the proposed project, or available capacity of the sub ject facility.
not applicable
Norih Carolina Department of Environment and Natural Resources
Division of Water Quality
Coleen H. Sullins
Director
Beverly Eaves Perdue
Governor
l\4s. Cindy Carr
N4ulkey Engineers & Consuitants
P.o. Box 33127
Raleigh, NC 27636
Dee Freeman
Secretary
April 1, 2009
sUBJECT: On-Site Determination for Applicability to the Mitigation Rules [15A NCAC 2H .0506(h)],
84818, Bridge No. 138 Replacement over lsland Creek, SR 1'109, Stanly county
Dear Ms. Carr:
polly Lespinasse of the Division of Water Quality (DWQ) visited the site on March 31 , 2009, in order to provide verification
of p;tential jurisdictional streams previousiy identiiied by your consulting firm for the above-{eferenced. project. These
streams weie evaluated for applicability to the mitigation rules set forth in [15A NCAC 2H .0506(h)]. -The maps containing
the pro.ject corridor were provided in the jurisdictional verificaiion package received by this office on February 1 1, 2009
The jurisdictional features (streams and wetlands) are approximated on these maps.
Based on ihe field veriflcation of the streams located within the project boundaries, a change was made to one (1)
determination and is outlined below:
. Stream Sl (Unnamed tribuiary io lsland Creek): This stream was originally classified as ephemeral for the entire
reach within ihe project boundaries (DWQ Stream ldeniification Form score of 16.5). Based on the site visit, this
stream will be clissifled as intermitient from the origin to Flag S17- DWQ staff re-evaluated the reach using the
DWe Stream ldentification Form and the siream received a score of 20.5 (additional points received from hydrology .
and biology). piease note that isopods and amphipods were identified throughout the reach and crayflsh were
observedln'the stream from Flag St6 downstTeam. Additionally, the stream will be classifled as perennial from Flag
517 to the tributary's confluencJwith lsland Creek. Perennial stream characteristics were observed in addition to ihe
presence of biology (salamanders and crayfish).
Based on the siie reviews of the jurisdictional determinations made by your consuliing firm, DWQ will consider the stream
sites ideniified in the jurisdictionil verification package, qnd revisions identified above, as accurate. Please note that
the DWQ staff did not conduct a verification of wetland boundaries on ihis project'
This letter only addresses the applicability to the mitigatign rules and does not approve any activiiy within buffers, Waters
of the United States, or Waters oi tne Stjte. Any imfact! to wetlands, streams and buffers must comply wiih 404/401
regulations, water supply regulations (15A NCAC 28 .0216), applicable buffer rules, and any other required federal, state
an-d local regulations. Pjeas! be awaie thqt even if no direct impacts are Proposed to any protected buffers, sheet flow of
all new stormwater runoff as per 15A NCAC 28 .0250 is required.
Landowners or affected pariies that dispute a determlnation made by the DWQ or Delegated Local Authority thai a
surface water exists and that it is subject to the mitigation rules may rcquest a determination by the Director' A request
for a determination by the Director shill be referred to the Director in writing c/o Brian Wrenn' DWQ 401 Transportation
Permitting Unit, .1650 lviail Service Center, Raleigh, NC 27699-1650,
lvloorcsvjlle Regional Oflice
Location: 610 East Center Ave., Suite 301 N4ooresville, NC 281 15
Phonq (704) 663J699\Fax: (704)663{040 \ Customer Service: 1-877623'6748
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IfyouhaveanyaddiiionalquestionSorrequjreadditionalinformationpleasecontactPollyLespinasseat(704)663-1699.
Steve Lund, USACE Asheville Field OfRce
il"i" el"itty, owQ Transportation Permitting Unii
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