HomeMy WebLinkAbout20211410 Ver 1_ePCN Application_20211105 DW R
Divi.ha of ware.Resources
Pre-Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
June 1,2021 Ver 4.1
Initial Review
Has this project met the requirements for acceptance in to the review process?*
Yes
No
Is this project a public transportation project?*
Yes No
Change only if needed.
BIMS#Assigned* Version#*
20211410 1
Is a payment required for this project?*
No payment required
Fee received Reviewing Office*
Fee needed-send electronic notification Central Office-(919)707-9000
Select Project Reviewer*
Ryan Conchilla:eads\rjconchilla
Information for Initial Review
1a.Name of project:
South Scales Street Bridge Replacement
la.Who is the Primary Contact?*
Jerry Parker
1 b.Primary Contact Email:* 1c.Primary Contact Phone:*
japarker3@ncdot.gov (336)451-6629
Date Submitted
11/5/2021
Nearest Body of Water
Little Troublesome Creek
Basin
Cape Fear
Water Classification
WS-V;NSW
Site Coordinates
Latitude: Longitude:
36.330710 79.665502
A. Processing Information u
County(or Counties)where the project is located:
Rockingham
Is this a NCDMS Project
Yes No
Is this project a public transportation project?*
Yes No
Is this a NCDOT Project?*
Yes No
(NCDOT only)T.I.P.or state project number:
WBS#(?)
17BP.7.R.141
Pre-Filing Meeting Information
Is this a courtesy copy notification?*
Yes No
ID# Version
20211410 1
Pre-fling Meeting or Request Date
9/23/2021
Attach documentation of Pre-Filing Meeting Request here:
Click the upload button or drag and drop files here to attach document
South Scales St Pre-Filing Request.pdf 57.18KB
File type must be PDF
1a.Type(s)of approval sought from the Corps:
Section 404 Permit(wetlands,streams and waters,Clean Water Act)
Section 10 Permit(navigable waters,tidal waters,Rivers and Harbors Act)
Has this PCN previously been submitted?*
Yes
No
1 b.What type(s)of permit(s)do you wish to seek authorization?
Nationwide Permit(NWP)
Regional General Permit(RGP)
Standard(IP)
1c.Has the NWP or GP number been verified by the Corps?
Yes No
Nationwide Permit(NWP)Number: 14-Linear transportation
NWP Numbers(for multiple NWPS):
1d.Type(s)of approval sought from the DWR:
401 Water Quality Certification-Regular 401 Water Quality Certification-Express
Non-404 Jurisdictional General Permit 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: Yes No
For the record only for Corps Permit: Yes No
1f.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?
Yes No
1g.Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
Yes No
1 h.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?
Owner 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
2b.Deed book and page no.:
2c.Contact Person:
2d.Address
Street Address
P.O.Box 14996
Address Line 2
1584 Yanceyville Street
City State/Province/Region
Greensboro NC
Postal/Zip Code Country
27415-4996 USA
2e.Telephone Number: 2f.Fax Number:
(336)487-0000
2g.Email Address:
warcher@ncdot.gov
C. Project Information and Prior Project History
1.Project Information
1b.Subdivision name:
(if appropriate)
1c.Nearest municipality/town:
Reidsville
2.Project Identification
2a.Property Identification Number: 2b.Property size:
2c.Project Address
Street Address
Address Line 2
City State/Province/Region
Postal/Zip Code Country
3. Surface Waters
3a.Name of the nearest body of water to proposed project:
Little Troublesome Creek
3b.Water Resources Classification of nearest receiving water:*
WS-V;NSW
3c. What river basin(s)is your project located in?*
Cape Fear
3d.Please provide the 12-digit HUC in which the project is located.
030300020205
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:
The project is an existing bridge in need of replacement over Little Troublesome Creek within the city limits of Reidsville.The general land use in the area is single and multi-family
residential with commercial businesses,industrial land and public parks nearby.
4b.Have Corps permits or DWR certifications been obtained for this project(including all prior phases)in the past?
Yes No 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:
188
4h.Explain the purpose of the proposed project:*
The purpose of this project is to replace a poorly functioning bridge with a new culvert that will bring the site up to NCDOT standards.
41.Describe the overall project in detail,including indirect impacts and the type of equipment to be used:*
The proposed project will involve the replacement of the existing bridge with two lines of 13'X 12'X 65'RCBC with headwall.A one foot sill will be placed in the north barrel and a 2 ft sill
will be placed in the south barrel.The proposed culvert will provide more hydraulic opening than the existing bridge.The proposed culvert was sized to accommodate a detour alignment to
maintain traffic during construction of the proposed structure and demolition of the existing bridge.Standard road building equipment will be utilized,such as,dozers,cranes,dump trucks
and tamps.
5. Jurisdictional Determinations
5a.Have the wetlands or streams been delineated on the property or proposed impact areas?*
Yes No Unknown
Comments:
No wetlands were identified within the project area.
5b.If the Corps made a jurisdictional determination,what type of determination was made?*
Preliminary Approved Not Verified Unknown 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?*
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?
D. Proposed Impacts Inventory
1. Impacts Summary
1a.Where are the impacts associated with your project?(check all that apply):
Wetlands Streams-tributaries Buffers
Open Waters Pond Construction
3. Stream Impacts
3a.Reason for impact(?) 3b.lmpact type* 3c.Type of impact* 3d.S.name* ��3e.Stream Type* 3f.Type of 39.S.width* 3h.Impact
(?) Jurisdiction* length*
S1 Bank Stabilization Permanent Bank Stabilization Little Troublesome Creek Perennial Both 12 69
Average(feet) Qinear feet)
gy Culvert Permanent Culvert Little Troublesome Creek Perennial Both 12 65
Average(feet) pinear feet)
S3 Roadway Fill Permanent Fill Tributary to Little Intermittent Both 54
Troublesome Creek Average(feet) (linear feet)
31.Total jurisdictional ditch impact in square feet:
0
3i.Total permanent stream impacts: 3i.Total temporary stream impacts:
188 0
31.Total stream and ditch impacts:
188
3j.Comments:
6. Buffer Impacts (for DWR)
6a.Project is in which protect basin(s)?
Check all that apply.
Nauss Tar-Pamlico
Catawba Randleman
Goose Creek Jordan Lake
Other
6b.Impact Type 6c.Per or Temp 6d.Stream name 6e.Buffer mitigation required? 6f.Zone 1 impact 6g.Zone 2 impact
Road Crossing Site 1 P Little Troublesome Creek No 5,082 2,721
Road Crossing Site 2 P Little Troublesome Creek No 1,094 380
6h. Total buffer impacts:
Zone 1 Zone 2
Total Temporary impacts: 0.00 0.00
Zone 1 Zone 2
Total Permanent impacts: 6,176.00 3,101.00
.... ....... ..... ... .. ....... ....... ......... ......... ......... ......... ......... ......... ......... ......... ..........
Zone 1 Zone 2
Total combined buffer impacts: 6,176.00 3,101.00
61.Comments:
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:
Roadway approach work area was minimized as much as possible to reduce the overall footprint of the project.Future impacts to the stream will be
reduced by protecting the inlet and outlet ends of the culvert with riprap bank stabilization.
1 b.Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
NCDOT Best Management Practices for Construction and Maintenance Activities and Best Management Practices for the Protection of Surface Waters
will be utilized.Erosion and sedimentation devices will be installed prior to commencing construction.Dewatering will occur during construction to
prevent impacts to the stream and downstream aquatic resources.A Pre-construction meeting with the Division Environmental Supervisor or his
assignee will occur prior to beginning work.
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
2c.If yes,mitigation is required by(check all that apply):
DWR Corps
2d.If yes,which mitigation option(s)will be used for this project?
Mitigation bank Payment to in-lieu fee program Permittee Responsible Mitigation
4. Complete if Making a Payment to In-lieu Fee Program
4a.Approval letter from in-lieu fee program is attached.
Yes No
4b.Stream mitigation requested:
(linear feet) 4c.If using stream mitigation,what is the stream temperature:
188 warm
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 No
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
What type of SCM are you providing?
Level Spreader
Vegetated Conveyance(lower SHWT)
Wetland Swale(higher SHWT)
Other SCM that removes minimum 30%nitrogen
Proposed project will not create concentrated stormwater flow through the buffer
2. Stormwater Management Plan
2a.Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
Yes 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 No
1 b.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 No
Comments:"
Project does not meet the threshold for requiring a NEPA/SEPA document.
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.
Due to the minimal transportation impact resulting from the project,stimulated growth and influence in nearby land use is not anticipated.
4. Sewage Disposal (DWR Requirement)
4a.Is sewage disposal required by DWR for this project?*
Yes No 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.
Raleigh
5d.Is another Federal agency involved?*
Yes No Unknown
5e.Is this a DOT project located within Division's 1-8?
Yes No
5j.What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
USFWS website
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?"
NMFS County Index
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 No
7b.What data sources did you use to determine whether your site would impact historic or archeological resources?*
NCDOT Cultural Resource Personnel
8. Flood Zone Designation (Corps Requirement)
Sa.Will this project occur in a FEMA-designated 100-year floodplain?*
Yes No
8b.If yes,explain how project meets FEMA requirements:
NCDOT Hydraulics Unit coordination with FEMA
8c.What source(s)did you use to make the floodplain determination?*
FEMA Flood Maps
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 document
South Scales St_Permit_Drawings.pdf 2.61 MB
South Scales Street Architecture Info.pdf 3.78MB
South Scales Street Archaeological Info.pdf 768.45KB
South Scales Street Topo Map(Bridge#280).pdf 507.53KB
South Scales Street Bridge to Culvert Justifaction.pdf 150.16KB
File must be PDF or KMZ
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:
W.R.Archer III
Signature
Date
11/5/2021