20211248 Ver 1_ePCN Application_20210816

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#*
20211248 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:
Bridge 222 Madison County
1a.Who is the Primary Contact?*
Yates Allen
1b.Primary Contact Email:* 1c.Primary Contact Phone:*
[e-mail] [phone]
Date Submitted
8/16/2021
Nearest Body of Water
Back Branch
Basin
French Broad
Water Classification
Class C
Site Coordinates
Latitude: Longitude:
35.796784 -82.807131
A. Processing Information L)
County(or Counties)where the project is located:
Madison
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:
B-6012

WBS#I7)
48207.3.1
Pre-Filing Meeting Information
Is this a courtesy copy notification?*
✓ Yes G No
ID# Version
Pre-fling Meeting or Request Date
11/18/2018
Attach documentation of Pre-Filing Meeting Request here:
Click the upload button or drag and drop files here to attach document
560222 Madison Field Scoping Meeting.pdf 163.48KB
Pie type mast 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?
G Yes r 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
✓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 6' No
For the record only for Corps Permit: r Yes 6 No
If.Is this an after-the-fact permit application?*
✓ Yes t: 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
lh.Is the project located in any of NC's twenty coastal counties?
✓ Yes 6 No
1j.Is the project located in a designated trout watershed?
6 Yes r 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
55 Orange Street
Address Line 2
atY State/Rovince/Region
Asheville NC
Fbstal/Zip Cork Country
28801 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:
Big Pine
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:*
Back Branch
3b.Water Resources Classification of nearest receiving water:*
Class 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.
060101051103
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:*
Two lane paved road with a timber bridge over Back Branch.Agriculture,scattered private residences,forestland
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
4g.List the total estimated linear feet of all existing streams on the property:
150
4h.Explain the purpose of the proposed project:*
To replace the substandard timber bridge with a new one

4i.Describe the overall project in detail,including indirect impacts and the type of equipment to be used:*
Replace the existing 22'long by 17'wide single span timber bridge with a new 35'long by 24'10"single span cored slab bridge.The new bridge will be located 32'downstream to avoid
impacts to a property deemed eligible for listing on the National Register of Historic Places.This will result in the relocation of 123 LF of existing stream into a 126 LF long new channel.
No channel loss will occur.
Equipment used includes track hoe,crane,and dump trucks.
5.Jurisdictional Determinations
5a.Have the wetlands or streams been delineated on the property or proposed impact areas?*
s Yes r No C Unknown
Comments:
Delineated by NC DOT personnel
5b.If the Corps made a jurisdictional determination,what type of determination was made?*
r Preliminary r Approved r Not Verified r Unknown P' N/A
Corps AID Number:
5c.If 5a is yes,who delineated the jurisdictional areas?
Name(if known): Yates Allen
Agency/Consultant Company: NC DOT
Other:
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?
LD. Proposed Impacts Inventory
1. Impacts Summary
1a.Where are the impacts associated with your project?(check all that apply):
n Wetlands rJ Streams-tributaries r' Buffers
n 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 Stream relocation Permanent Relocation Back Branch Perennial Both 8 126
Average(feet) (linear feet)
$2 Bank stabilization Permanent Stabilization Back Branch Perennial Both 8 120
Average(feet) (linear feet)
S3 Junction of streams Temporary Relocation Back Branch Perennial Both 8 14
Average(feet) (linear feet)
3i.Total jurisdictional ditch impact in square feet:
0
3i.Total permanent stream impacts: 3i.Total temporary stream impacts:
246 14
3i.Total stream and ditch impacts:
260
3j.Comments:
Bank stabilization will occur along the alignment of the new stream channel
E. Impact Justification and Mitigation
1.Avoidance and Minimization
1a.Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
Project is designed to meet safety standards while avoiding a property eligible for listing on the National Register of Historic Places

lb.Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
The site will be dewatered as needed.Pumped water will be treated before entering any aquatic resources.Erosion control measures will be installed
and maintained.
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 CNo
2c.If yes,mitigation is required by(check all that apply):
17 DWR 17 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.
( Yes r No
4b.Stream mitigation requested:
(linear feet) 4c.If using stream mitigation,what is the stream temperature:
126 cool
4d.Buffer mitigation requested(DWR only): 4e.Riparian wetland mitigation requested:
(squarefeet) (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.
C Yes r No
F. Stormwater Management and Diffuse Flow Plan (required by DWR) L)
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:
2.Stormwater Management Plan
2a.Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
( 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 CNo
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 CNo
Ic.If you answered"yes"to the above,has the document review been finalized by the State Clearing House?*
C Yes ( No
Comments:*
CE is attached

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)?*
✓ Yes 6' No
3. Cumulative Impacts(DWR Requirement)
3a.Will this project result in additional development,which could impact nearby downstream water quality?*
C Yes G No
3b.If you answered"no,"provide a short narrative description.
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?*
6. Yes r No
5b.Have you checked with the USFWS concerning Endangered Species Act impacts?*
✓ Yes f• No
5d.Is another Federal agency involved?*
r• Yes r No r Unknown
What Federal Agency is involved?
FHWA
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.?
R Yes r No
5g.Does this project involve bridge maintenance or removal?
6 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 f No r Unknown
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://ecos.fws.gov/ipac/location/D6F4MPHGQ5B6TKD5M2KW HIHNIA/resources
6. Essential Fish Habitat(Corps Requirement)
6a.Will this project occur in or near an area designated as an Essential Fish Habitat?*
✓ yes (7 No
6b.What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
Current databases
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?*
6 Yes rNo
7b.What data sources did you use to determine whether your site would impact historic or archeological resources?*
Project was processed by NC DOT PDEA Cultural Resources personnel who coordinated with SHPO
8. Flood Zone Designation(Corps Requirement)
8a.Will this project occur in a FEMA-designated 100-year floodplain?*

CYes F No
8c.What source(s)did you use to make the floodplain determination?*
https://fris.nc.gov/fris/Indexaspx?FIPS=115&ST=NC&user=General Public
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.
pick the upload button or drag and drop files here to attach document
560222 proposed relocated channel.pdf 152.81KB
B-6017_Madison_CE_Signed.pdf 2.1MB
Bridge 222 Madison photos.pdf 1.92MB
Bridge 222 Madison topo.pdf 1.01MB
Bridge_222_Madison_cover_letter signed.pdf 269.28KB
18-09-0015_EffectsSigned.pdf 3.85MB
031521 NCDOT COR Bridge 560222 Replacement Cherokee response.pdf 217.5KB
B-6012 Catawba Indian Nation Letter.pdf 928.79KB
B-6012 Cherokee Nation Letter.pdf 929.76KB
B-6012 Eastern Band of Cherokee Letter.pdf 928.67KB
B-6012 Muscogee Creek Nation Letter.pdf 929.27KB
B-6012 United Keetoowah Band of Cherokee Letter.pdf 929.41KB
560222_Surface Water Impacts_2021.07.29.pdf 1.77MB
Fle must be RT or KW
Comments
Signature
*
®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:
Yates Allen
Signature
y4T5
Date
8/16/2021