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1471
1523
1278
1486 1471
1896
1278
311
311
68
1.24
1486
35’
3
0
’

STATE STATE PROJECT REFERENCE NO.
F. A. PROJ. NO.DESCRIPTION
NO.
TOTAL
SHEETS
N.C.
SHEET

DIVISION OF HIGHWAYS
STATE OF NORTH CAROLINA

DESIGN DATA PROJECT LENGTH
LETTING DATE:

STATE PROJECT NO.
NORTH CAROLINA DEPARTMENT OF TRANSPORTATION
2012 STANDARD SPECIFICATIONS
1
VICINITY MAP
(NOT TO SCALE)

NCDOT CONTACT:
$
$
$
$
U
S
E
R
N
A
M
E
$
$
$
$
DIVISION 7
OFF-SITE DETOUR

D
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P
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R
T
ME
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OF TRANSPORT
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T
I
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L
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TYPE OF WORK: GRADING, PAVING, DRAINAGE AND STRUCTURE

SIGNATURE:
P.E.
SIGNATURE:
P.E.C
O
N
T
R
A
C
T
:

TIM JORDAN, PE
PROJECT ENGINEER
HYDRAULICS ENGINEER
PROGRAM MANAGER
DIVISION BRIDGE
TIM POWERS, PE
HYDRAULICS ENGINEER
ROADWAY DESIGN ENGINEER
65% PLANS
DO NOT USE FOR CONSTRUCTION
PRELIMINARY PLANS
INCOMPLETE PLANS
DO NOT USE FOR R/W ACQUISITION
V = 35 MPH
ADT 2007 = 9200
Prepared in the Office of Hatch Mott MacDonald for
17BP.7.R.22
T
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.
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2
GUILFORD COUNTY
LOCATION: BRIDGE NO.895 OVER BOULDING BRANCH ON SR 1486 (LEXINGTON AVENUE)
LICENSE NO. F-0669
PLANS PREPARED BY:
PO Box 700
Fuquay-Varina, NC 27526
[phone]
[phone] (Fax)
www.hatchmott.com
DAVID FUH, PE
TOTAL LENGTH TIP PROJECT = 0.047 MILES
LENGTH STRUCTURE TIP PROJECT = 0.005 MILES
LENGTH ROADWAY TIP PROJECT = 0.042 MILES
NC License No: F-0258
Engineering

N
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/ N
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-L-
SR 1486
-L- STA 10+50.00
BEGIN PROJECT 17BP.7.R.22
-L- STA 13+00.00
END PROJECT 17BP.7.R.22
LIMITS
PROJECT
17BP.7.R.22
E. LEXINGTON AVE.
BOULDING BRANCH
-L- Sta. 11+83.52
BEGIN CULVERT
-L- Sta. 12+11.96
END CULVERT
TO NC 68 TO I-74/US 311
N. C. DEPT. OF TRANSPORTATION
DIVISION OF HIGHWAYS
SHEET OF
GUILFORD COUNTY
PROJECT: 17BP.7.R22
SR 1486 (LEXINGTON AVENUE)
BOULDING BRANCH ON
BRIDGE NO. 895 OVER
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2/24/2014DIVISION OF HIGHWAYS BRIDGE #895 ON SR1486
NC

D
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T
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T
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E
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ing
ton
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Montlieu Ave
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E Lexington Ave
N
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oll
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R
iv
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r

R
d
1471
1523
1278
1486 1471
1896
1278
311
311
68
1.24
1486
35’
3
0
’

STATE STATE PROJECT REFERENCE NO.
F. A. PROJ. NO.DESCRIPTION
NO.
TOTAL
SHEETS
N.C.
SHEET

DIVISION OF HIGHWAYS
STATE OF NORTH CAROLINA

DESIGN DATA PROJECT LENGTH
LETTING DATE:

STATE PROJECT NO.
NORTH CAROLINA DEPARTMENT OF TRANSPORTATION
2012 STANDARD SPECIFICATIONS
1
VICINITY MAP
(NOT TO SCALE)

NCDOT CONTACT:
$
$
$
$
U
S
E
R
N
A
M
E
$
$
$
$
DIVISION 7
OFF-SITE DETOUR

D
E
P
A
R
T
ME
N
T
OF TRANSPORT
A
T
I
O
N
S
T
A
T
E OF NORT
H
C
AR
O
L
I
N
A
TYPE OF WORK: GRADING, PAVING, DRAINAGE AND STRUCTURE

SIGNATURE:
P.E.
SIGNATURE:
P.E.C
O
N
T
R
A
C
T
:

TIM JORDAN, PE
PROJECT ENGINEER
HYDRAULICS ENGINEER
PROGRAM MANAGER
DIVISION BRIDGE
TIM POWERS, PE
HYDRAULICS ENGINEER
ROADWAY DESIGN ENGINEER
65% PLANS
DO NOT USE FOR CONSTRUCTION
PRELIMINARY PLANS
INCOMPLETE PLANS
DO NOT USE FOR R/W ACQUISITION
V = 35 MPH
ADT 2007 = 9200
Prepared in the Office of Hatch Mott MacDonald for
17BP.7.R.22
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GUILFORD COUNTY
LOCATION: BRIDGE NO.895 OVER BOULDING BRANCH ON SR 1486 (LEXINGTON AVENUE)
LICENSE NO. F-0669
PLANS PREPARED BY:
PO Box 700
Fuquay-Varina, NC 27526
[phone]
[phone] (Fax)
www.hatchmott.com
DAVID FUH, PE
TOTAL LENGTH TIP PROJECT = 0.047 MILES
LENGTH STRUCTURE TIP PROJECT = 0.005 MILES
LENGTH ROADWAY TIP PROJECT = 0.042 MILES
NC License No: F-0258
Engineering

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SR 1486
-L- STA 10+50.00
BEGIN PROJECT 17BP.7.R.22
-L- STA 13+00.00
END PROJECT 17BP.7.R.22
LIMITS
PROJECT
17BP.7.R.22
E. LEXINGTON AVE.
BOULDING BRANCH
-L- Sta. 11+83.52
BEGIN CULVERT
-L- Sta. 12+11.96
END CULVERT
TO NC 68 TO I-74/US 311
BUFFER IMPACTS PERMIT
N. C. DEPT. OF TRANSPORTATION
DIVISION OF HIGHWAYS
SHEET OF
GUILFORD COUNTY
PROJECT: 17BP.7.R22
SR 1486 (LEXINGTON AVENUE)
BOULDING BRANCH ON
BRIDGE NO. 895 OVER
SHEET __ OF __
PERMIT DRAWING ENGLISH
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DIVISION OF HIGHWAYS 17BP.7.R.22 GUILFORD COUNTY

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BRIDGE #895 ON SR 1486 2/24/2014 Rev. May 2006

Page 5 of 11
C. Proposed Impacts Inventory
1. Impacts Summary
1a. Which sections were completed below for your project (check all that apply):
Wetlands Streams - tributaries Buffers
Open Waters Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
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
2g. Total wetland impacts 0
2h. Comments:
3. Stream Impacts
If there are perennial or intermittent stream impacts (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 14'X10' Box Culvert Boulding Branch PER
INT
Corps
DWQ +/- 15 56
S2 P T Temporary
Construction Boulding Branch PER
INT
Corps
DWQ +/- 15 45
S3 P T
Temporary
Dewatering
(concurrent with
construction)
Boulding Branch PER
INT
Corps
DWQ +/- 15 103
S4 P T Permanent Bank
Stabilization Boulding Branch PER
INT
Corps
DWQ +/- 15 34
S5 P T Water Line Utility
Relocation Boulding Branch PER
INT
Corps
DWQ +/- 15 40
S6 P T Temporary
Construction
UT to Boulding
Branch (SA)
PER
INT
Corps
DWQ +/- 1 5
S7 P T Water Line Utility
Relocation
UT to Boulding
Branch (SA)
PER
INT
Corps
DWQ +/- 1 40
S8 P T
Temporary
Dewatering
(concurrent with
Construction)
UT to Boulding
Branch (SA)
PER
INT
Corps
DWQ +/- 1 40
3h. Total stream and tributary impacts 363
3i. Comments: Of the proposed impacts, only 56 linear feet are permanent and will require mitigation at a 2:1 ratio. The
temporary construction impacts are necessary for installing the box culvert and relocating the water line. An impervious dike
and diversion channel is proposed (see attached Construction Sequencing) to conduct the construction activities in the dry.
The proposed 103 LF of temporary dewatering is concurrent with the proposed box culvert installation. In addition, there is a
UT to Boulding Branch located on the south side of the proposed bridge replacement that will be temporarily impacted with
dewatering in order to install the proposed waterline.

Page 6 of 11
4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impacts 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
4f. Total open water impacts 0
4g. Comments:
5. Pond or Lake Construction
If pond or lake construction proposed, then complete the chart below.
5a.

Pond ID
number
5b.

Proposed use or purpose of
pond

5c.
Wetland Impacts (acres)
5d.
Stream Impacts (feet)
5e.
Upland
(acres)
Floode
d Filled Excavated Flooded Filled Excavated 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:
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually 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: Randleman
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 Road
crossing Boulding Branch Yes
No 3,102 732
B2 P T Utility Line
relocation Boulding Branch Yes
No 2,366 1,066
6h. Total buffer impacts 5,468 1,798
6i. Comments: The impacts associated with the culvert installation and utility line relocation fall under the "potentially
allowable" category per the Randleman Buffer Rules Table of Uses {15A NCAC 02B .0250 (9)}

Page 7 of 11
PCN Form – Version 1.3 December 10, 2008 Version

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
The proposed project is to remove the existing two span structure and replace it with a double, reinforced, concrete box
culvert. Roadway approach work is minimized as much as is practical to reduce the overall project footprint. Impacts to
the associated protected riparian buffers has also been reduced by promoting sheet flow, out-letting drainage pipes
outside the riparian buffer and proposing rip rap aprons to reduce the flow to non-erosive velocities.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Impacts will be minimized by strict enforcement of Best Management Practices for the protection of surface waters,
restrictions against the staging of equipment in or adjacent to waters of the US and coordination (including a pre-
construction meeting) with the Division Environmental Supervisor.
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:
3b. Credits Purchased (attach receipt and letter) Type Quantity
3c. Comments:
4. Complete if Making a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached. Yes
4b. Stream mitigation requested: 112 linear feet (EEP Acceptance letter attached)
4c. If using stream mitigation, stream temperature: warm cool cold
4d. Buffer mitigation requested (DWQ only): square feet
4e. Riparian wetland mitigation requested: acres
4f. Non-riparian wetland mitigation requested: acres
4g. Coastal (tidal) wetland mitigation requested: acres
4h. Comments:
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.