20140454 Ver 1_Application_20140430

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STATE OF NORTH CAROLINA �Aa sgyosr r�44UA11 14
DEPARTMENT OF TRANSPORTATION 4rep:�
PAT MCCRORY ANTHONY J. %A
GOVERNOR SECRETARY
April 29, 2014
Mr. John Thomas
US Army Corps of Engineers
3331 Heritage Trade Dr.
Suite 105
Wake Forest, NC 27615
20140454
SUBJECT: Nationwide Permit # 14
Bridge No. 23 on SR 1,650 (Peoples Creek Road) over Peoples Creek (Class WSIV)
WBS project no.: 17BP.9.R.24 (DWQ permit fee $570)
Davie County, NC
Dear Mr. Thomas,
We are requesting a Nationwide 14 pen-nit for replacement of Bridge No.23 with a triple barrel
box culvert on SR 1650 (Peoples Creek Road) over Peoples Creek (Class WSIV) in Davie
County. I' have attached a pre - construction notification application, a topography map with the
project area circled, a stormwater management plan, No Survey Required forms from NCDOT
Cultural Resources for Historic Architecture and Archeology, and a mitigation acceptance letter
from EEP. Also attached are the construction plans, erosion control plans, and a cross section of
the culvert. The project will permanently impact 181 linear feet and temporarily impact 56 linear
feet of Peoples Creek. Stream flow will be isolated into one barrel, with 2' sills and floodplain
benches constructed at the inlet and outlet of the overflow barrels in order to prevent stream over
widening and facilitate aquatic passage. The low flow barrel will be buried V below the stream
bed to ensure aquatic passage. The overflow barrels will be backfilled with class 1 rip rap, or
native bed material of appropriate size to the sill elevation, and the low flow barrel will be
backfilled with class I rip rap to the stream bed elevation to expedite the establishment of a
natural stream bed. The culvert site will be dewatered during construction in accordance with
NCDOT's Best Management Practices.
By copy of this letter, we also request 401 review and approval from the NC Division of Water
Resources with one copy of the application package provided to Amy Chapman; Transportation
Permitting Unit Supervisor, and Dave Wanucha, DOT Project Coordinator. Please charge the
application fee of $570 to WBS project no. 17BP.9.R.23.
By copy of this letter, we also'request Marla Chambers, NC Wildlife Resources Commission, to
comment directly to the Corps concerning the permit request.
Division of Highways a Division Nine o 375 Silas Creek Parkway, Winston - Salem, NC 27127
Telephone [phone] a Fax [phone] ® Courier Box 13 -12 -04

If you have any questions, comments or need additional information after reviewing this material
please contact me at (336) 747 -7802. Thank you for your cooperation in this matter.
Sincerely,
Am Euliss
Division Environmental Officer, NCDOT Division 9
Attachments: Application Package and plans
CC: Amy Chapman, NCDENR -DWR, Transportation Pennitting Unit Supervisor- e-copy
Dave Wanucha, NCDENR-DWR, Environmental Specialist- e -copy
Matt Jones, P.E., Division Bridge Program Engineer- e -copy
Phil Suggs, Division 9 Roadside Environmental Engineer- e -copy
Marla Chambers, WRC- e -copy

c`�oe warF9oc
Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.4 January 2009
Page 1 of 10
PCN Form — Version 1.4 January 2009
Pre-Construction Notification (PCN) Form
A.
Applicant Information
1.
Processing
1 a.
Type(s) of approval sought from the Corps:
❑X Section 404 Permit ❑ Section 10 Permit
1 b. Specify Nationwide Permit (NWP) number: 14 or General Permit (GP) number:
1 c.
Has the NWP or GP number been verified by the Corps?
M1
❑ Yes © No
1d.
Type(s) of approval sought from the DWQ (check all that apply):
❑x 401 Water Quality - Certification — Regular ❑ Non -404 Jurisdictional General Permit
❑ 401 Water,Quality Certification — Express ❑ Riparian Buffer Authorization
1 e.
Is this notification solely for the record
because, written approval is not required?
For the record only for DWQ
401 Certification:
❑ Yes ❑X 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 mitigation bank
or in -lieu fee program.
❑X Yes ❑ No
1g.
Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below.
❑ Yes ❑x No
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes ❑X No
2.
Project Information
2a.
Name of project:
Replace Bridge No. 23 with a triple barrel box culvert
2b.
County:
Davie
2c.
Nearest municipality 1 town:
Advance
2d. Subdivision name:
NA
2e.
NCDOT only, T.I.P. or state project no:
17BP.9.R.24
3.
Owner Information
3a.
Name(s) on Recorded Deed:
NCDOT Division 9
3b. Deed Book and Page No.
3c.
Responsible Party (for LLC if
applicable):
Pat Ivey, P.E. Division Engineer
3d.
Street address:
3e. City, state, zip:
375 Silas Creek Parkway
3f.
Telephone no.:
336 - 747 -7800
3g.
Fax no.:
336 - 703 -6693
3h.
Email address:
pivey @ncdot.gov
Page 1 of 10
PCN Form — Version 1.4 January 2009

4. Applicant Information (if different from owner)
4a. Applicant is:
❑ Agent ❑X Other, specify: DEO
4b. Name:
Amy Euliss
4c. Business name
(if applicable):
NCDOT Division 9
4d. Street address:
375 Silas Creek Parkway
4e. City, state, zip:
Winston Salem, NC -27127
4f. Telephone no.:
336- 747 -7802
4g. Fax no.:
336 - 703 -6693
4h. Email address:
[e-mail]
5. Agent/Consultant Information (if applicable)
5a. Name
5b. Business name
(if applicable):
5c. Street address:
5d. City, state, zip:
5e. Telephone no.:
5f. Fax no.:
5g. Email address:
Page 2 of 10

B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID):
NA
1 b. Site coordinates (in decimal degrees)':
Latitude: 35.9239 Longitude: 80.38
1 c. Property size:
0.4 acres
2. Surface Waters
2a. Name of nearest body of water to proposed project:
Peoples Creek
2b. Water Quality Classification of nearest receiving water:
Class WSIV
2c. River basin:
Yadkin- Pee Dee
3. Project Description
3a. 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 existing site is a bridge. The surrounding area is sparse residential and rural.
3b. List the total estimated acreage of all existing wetlands on the property: 0
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property: 237
3d. Explain the purpose of the proposed project:
Replace a structurally deficient bridge with a 3 barrel box culvert
3e_ Describe the overall project in detail, including the type of equipment to be used:
replace a bridge with a culvert. Standard road building equipment will be used.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property t
project (including all prior phases) in the past?
❑ Yes ❑X No ❑ Unknown
Comments:
4b. If the Corps made the jurisdictional determination, what type
of determination was made?
❑ Preliminary ❑ Final
4c. If yes, who delineated the jurisdictional areas?
Name (if known):
Agency /Consultant Company:
Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
5. Project History
5a. Have permits or certifications been requested or obtained for ❑ Yes © No ❑ Unknown
this project (including all prior phases) in the past?
5b. If yes, explain in detail according to `help file" instructions.
6. Future Project Plans
6a. Is this a phased project? ❑Yes ❑X No
6b. If yes, explain.
Page 3 of 10
PCN Form — Version 1.4 January 2009

C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
❑ Wetlands ❑X 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
2d.
Forested
2e.
Type of jurisdiction
Corps (404,10) or
DWQ (401, other)
2f.
Area of
impact
(acres)
iN1
Choose one
Choose one
Yes/No
-
W2 -
Choose one
Choose one
Yes /No
-
W3 -
Choose one
Choose one
Yes/No
-
W4 -
Choose one
Choose one
Yes /No
-
W5 -
Choose one
Choose one
Yes /No
-
W6 -
Choose one
Choose one
Yes/No
-
2g. Total Wetland Impacts:
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 (I NT)?
3e.
Type of
jurisdiction
3f.
Average
stream
width
(feet)
3g•
Impact
length
(linear
feet)
S1 P
Culvert
Peoples Creek
PER
Corps
7
181
S2 T
Dewatering
Peoples Creek
PER
Corps
7
56
S3
Choose one
-
-
S4 -
Choose one
-
-
S5 -
Choose one
-
-
S6 -
Choose one
-
-
3h. Total stream and tributary impacts
237
3i. Comments.
Page 4 of 10
PCN Form — Version 1,4 January 2009

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
4b.
Name of waterbody
(if applicable)
4c.
Type of impact
4d.
Waterbody
type
4e.
Area of impact (acres)
01
Choose one
Choose
02
Choose one
Choose
03 _ -
Choose one
Choose
04
Choose one
Choose
4f. Total open water impacts
4g. Comments:
I
5. Pond or Lake Construction'
If pond or lake construction proposed, the 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)
Flooded
Filled
Excavated
Flooded
Filled
Excavated
P1
Choose one
P2
Choose one
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 ❑ Catawba ❑ Randleman ❑ Other:
6b.
Buffer Impact
number—
Permanent (P),or
Temporary
6c.
Reason for impact
6d.
Stream name
6e.
Buffer
mitigation
required?
6f.
Zone 1
impact
(square
feet )
6g.
Zone 2
impact
(square
feet
B1
Yes/No '
B2 _
Yes/No
B3 -
Yes /No
B4 -
Yes /No
B5 _
Yes /No
B6
Yes /No
6h. Total Buffer Impacts:
6i. Comments:
Page 5 of 10

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 stream will be isolated to one barrel during low flow through installation of floodplain benches and sills This will facilitate aquatic passage and
prevent the stream channel from overwidening. The overflow pipes will be back filled with Gass I or native bed material of a suitable size. The culvert
slope is 0.231 %, so native stream bed material should be retained in the culvert. Further justification is provided in the stormwater management plan
1b. Specifically describe measures'taken to avoid or minimize the proposed impacts through construction techniques.
Construction runoff has been minimized by designing the erosion control plan according to NCDOT's BMP manual.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. D"oes 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):
❑X DWQ ® Corps
2c. If yes, which mitigation option will be used for this
project?
❑ Mitigation bank
❑X Payment to in -lieu fee program
❑ Permittee Responsible Mitigation
3. Com lete if Using a Mitigation Bank
3a. Name of Mitigation Bank:'
3b. Credits Purchased (attach receipt and letter)
Type: Stream
Type: Choose one
Type: Choose one
Quantity: 362'
Quantity:
Quantity:
Credits were requested at a ratio.
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:
362 linear feet
4c. If using stream mitigation, stream temperature:
warm
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: 102 linear feet at a 2:1 ratio
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.
Page 6 of 10
PCN Form — Version 1.4 January 2009

6. Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a. Will the project result in an impact - within a protected 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 mitigation. 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 private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in -lieu fee fund).
6h. Comments:
Page 7 of 10

E.
Stormwater Management and Diffuse Flow Plan (required by DWQ)
1.
Diffuse Flow Plan
1 a.
Does the project include or is it adjacent,to protected riparian buffers identified
within one of the NC Riparian Buffer Protection Rules?
❑ Yes X❑ No
1 b.
If yes, then is a diffuse flow plan included? If no,.explain why.
t
❑ Yes ❑ No
2.
Stormwater Management Plan
2a.
What is the overall percent imperviousness of this project?
38%
2b.
Does this project require a Stormwater Management Plan ?
0X. Yes ❑ No
2c.
If this project DOES NOT require a Stormwater Management Plan, explain why:
2d.
If this project DOES require a Stormwater Management Plan, then provide a brief, narrative
description of the plan:
Stormwater management plan is attached.
2e., Who will be responsible for the review of the Stormwater Management -Plan?
DWR-TPU
3.
Certified Local Government Stormwater Review
3a.
In which local 'overnment's jurisdiction is this project?
❑ Phase II
3b.
Which of the following locally - implemented stormwater management programs
apply (check all that apply):
❑ NSW
❑ USMP
❑ Water Supply Watershed
❑ Other:
3c.
Has the approved Stormwater Management Plan with proof of approval been
❑Yes ❑ No
attached?
4.
DWQ Stormwater Program Review
❑Coastal counties
❑HQW
4a.
Which of the following state - implemented stormwater management programs apply
(check all that apply):
❑ORW
❑Session Law 2006 -246
❑Other:
4b.
Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ❑ No
attached?
5.
DWQ 401 Unit Stormwater Review
5a.
Does the Stormwater Management Plan meet the appropriate requirements?
Q Yes ❑ No
5b.
Have all of the 401 Unit submittal requirements been met?
Q Yes ❑ No
Page 8 of 10
P.CN Form — Version 1.4 January 2009

F. Supplementary Information
1.
Environmental Documentation (DWQ Requirement)
1 a.
Does the project involve an expenditure of public (federal /state /local) funds or the
0 Yes
❑ No
use of public (federal /state) land?
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
❑ Yes
❑X No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1 c.
If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
❑ Yes
QX No
letter ) minimum criteria available upon request
Comments:
2.
Violations (DWQ Requirement)
2a.
Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards,
❑Yes
Q No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b.
Is this an after - the -fact permit application?
❑ Yes
0 No
2c.
If you answered "yes" to one or both of the above 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
❑ Yes
Q No
additional development, which could impact nearby downstream water quality?
3b.
If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
4.
Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods and disposition (non - discharge or discharge) of wastewater
generated from
the proposed project, or available capacity of the subject facility.
NA
Page 9 of 10
PCN Form — Version 1.4 January 2009

5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or
(� Yes 0 No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act
[j Yes pX No
impacts?
5c. If yes, indicate the USFWS Field Office you have contacted.
"
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
NC Natural Heritage Program GIS file, field surveys for Michaux's sumac
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?
❑ Yes ® No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
NA
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
Yes Zx No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
See attached letters of "No Survey Required" from NCDOT cultural resources for'both Archeology and Historic Architecture
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEIVIA- designated 100 -year floodplain? 0 Yes ❑ No
8b. If yes, explain how project meets FEMA requirements:
Mets MOA requirements set forth by NC Floodplain Mapping
8c What source(s) did you use to make the floodplain determination?
NC Floodplain Mapping Digital Maps
04 -29 -2014
Applicant/Agent's Printed Name
Date
A Ii nt/Agent's Si�authonzation
(Agent's sign ure is valid only if
letter from the a licant is provided.)
Page 10 of 10

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