20220668 Ver 1_Mecklenburg Rd PCN_20220516

5/2/22, 6:07 PM DOT Initial Review
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Pre-Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
April 13, 2022 Ver 4.3
Has this project met the requirements for acceptance in to the review process?*
Is this project a public transportation project?*
Pre-Filing Meeting Date Request was submitted on:
1a. Name of project:
1a. Who is the Primary Contact?*
1b. Primary Contact Email:*1c. Primary Contact Phone:*
Date Submitted
Initial Review
Yes
No
Yes No
Change only if needed.
Information for Initial Review
Mecklenburg Rd Bridge Replacement
Jerry Parker
[e-mail] [phone]
4/19/2022
5/2/22, 6:07 PM DOT Initial Review
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Nearest Body of Water
Basin
Water Classification
Site Coordinates
Latitude:Longitude:
County (or Counties) where the project is located:
Add another county
Is this a NCDMS Project
Is this project a public transportation project?*
Is this a NCDOT Project?*
(NCDOT only) T.I.P. or state project number:
WBS #(?)
Reddicks Creek
Cape Fear
WS-IV Class C
A. Processing Information
Guilford
Yes No
Yes No
Yes No
17BP.7.R.137
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1a. Type(s) of approval sought from the Corps:
Has this PCN previously been submitted?*
1b. What type(s) of permit(s) do you wish to seek authorization?
1c. Has the NWP or GP number been verified by the Corps?
Regional General Permit (RGP)
Number:
Add additional RGP
RGP Numbers (for multiple RGPS):
1d. Type(s) of approval sought from the DWR:
1e. Is this notification solely for the record because written approval is
not required?
*
For the record only for DWR 401 Certification:
For the record only for Corps Permit:
1f. Is this an after-the-fact permit application?*
Section 404 Permit (wetlands, streams and waters, Clean Water Act)
Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
Yes
No
Nationwide Permit (NWP)
Regional General Permit (RGP)
Standard (IP)
Yes No
201902350 - Work associated with bridge constru
401 Water Quality Certification - Regular 401 Water Quality Certification - Express
Non-404 Jurisdictional General Permit Riparian Buffer Authorization
Individual 401 Water Quality Certification
Yes No
Yes No
Yes No
5/2/22, 6:07 PM DOT Initial Review
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1g. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
1g. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
1h. Is the project located in any of NC's twenty coastal counties?
1j. Is the project located in a designated trout watershed?
1d. Who is applying for the permit?
1e. Is there an Agent/Consultant for this project?*
2. Owner Information
Yes No
Yes No
Yes No
Yes No
B. Applicant Information
Owner Applicant (other than owner)
Yes No
2a. Name(s) on recorded deed:
2b. Deed book and page no.:
2c. Contact Person:
NCDOT
5/2/22, 6:07 PM DOT Initial Review
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Add another owner
1b. Subdivision name:
1c. Nearest municipality / town:
2a. Property Identification Number:2b. Property size:
2d. Address
2e. Telephone Number:2f. Fax Number:
2g. Email Address:*
City
Greensboro
State / Province / Region
NC
Postal / Zip Code
27415-4996
Country
USA
Street Address
1584 Yanceyville Street
Address Line 2
P.O. Box 14996
[phone]
[e-mail]
C. Project Information and Prior Project History
1. Project Information
(if appropriate)
Sedgefield
Greensboro
2. Project Identification
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2c. Project Address
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
3b. Water Resources Classification of nearest receiving water:*
3c. What river basin(s) is your project located in?*
Add another river basin
3d. Please provide the 12-digit HUC in which the project is located.
4. Project Description and History
City State / Province / Region
Postal / Zip Code Country
Street Address
Address Line 2
Reddicks Creek
WS-IV Class C
Cape Fear
030300030105
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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:*
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the
past?*
4f. List the total estimated acreage of all existing wetlands on the property:
4g. List the total estimated linear feet of all existing streams on the property:
4h. Explain the purpose of the proposed project:*
Site is within a residential subdivision and on a golf course.
Yes No Unknown
0
103 ft
The purpose of the project is to replace a structurally deficient bridge with a Reinforced
Concrete Box Culvert
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4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
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?*
Project involves replacing a timber deck bridge over Reddicks Creek with a 12' X 8' RCBC
buried one foot with one foot sills on the inlet and outlet ends. There will be impacts from the
placement of the RCBC in the stream, as well as, impacts from bank stabilization that will be
necessary at the inlet and outlet ends of the culvert to prevent slope failure. Standard road
building equipment will be utilized such as Dump trucks, dozers, cranes and tamps.
Yes No Unknown
Preliminary Approved Not Verified Unknown N/A
Heather Smith
VHB
Yes No
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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?
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
3. Stream Impacts
3a. Reason for
impact (?)
3b.Impact
type *
3c. Type of
impact *
3d. S. name *3e. Stream
Type *(?)
3f. Type of
Jurisdiction *
3g. S.
width
3h.
Impact
length *
S1
S2
Add another impact
3i. Total jurisdictional ditch impact in square feet:
3i. Total permanent stream impacts:3i. Total temporary stream impacts:
D. Proposed Impacts Inventory
Wetlands Streams-tributaries Buffers
Open Waters Pond Construction
Road Crossing Perma Culvert Reddicks Cree Perenn Both 6
Average
(feet)
47
(linear
feet)
×
Dewatering Tempo Dewatering Reddicks Cree Perenn Both 6
Average
(feet)
56
(linear
feet)
×
0
47 56
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3i. Total stream and ditch impacts:
3j. Comments:
6. Buffer Impacts (for DWR)
6a. Project is in which protect basin(s)?
6b. Impact Type 6c. Per or
Temp
6d. Stream name 6e. Buffer mitigation
required?
6f. Zone 1
impact
6g. Zone 2
impact
Add another impact
6h. Total buffer impacts:
Zone 1 Zone 2
Total Temporary impacts:
Zone 1 Zone 2
103
Check all that apply.
Neuse Tar-Pamlico
Catawba Randleman
Goose Creek Jordan Lake
Other
Site 1 Allowable P Reddicks Creek No 785 440 ×
Site 1 Allowable P Reddicks Creek No 461 118 ×
Site 2 Allowable P Reddicks Creek No 886 372 ×
Site 2 Allowable P Reddicks Creek No 1,049 625 ×
0.00 0.00
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Total Permanent impacts:
Zone 1 Zone 2
Total combined buffer
impacts:
6i. Comments:
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction
techniques:
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?
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
3,181.00 1,555.00
3,181.00 1,555.00
E. Impact Justification and Mitigation
Roadway approach work was minimized as much as possible to reduce
the overall footprint of the project. An offsite detour will be used during
construction in order to avoid a temporary crossing. Future stream impacts
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
Yes No
Bank stabilization does not require mitigation and the impacts for stream and Randleman
Buffer are below the required threshold.
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1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC
Riparian Buffer Protection Rules?
What type of SCM are you providing?
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT’s Individual NPDES permit NCS000250?*
Comments:
1. Environmental Documentation
F. Stormwater Management and Diffuse Flow Plan (required
by DWR)
Yes No
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
Yes No
G. Supplementary Information
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1a. Does the project involve an expenditure of public (federal/state/local) funds or the use of public
(federal/state) land?*
1b. 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)?
*
Comments:*
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)?*
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality?*
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?*
5. Endangered Species and Designated Critical Habitat (CorpsRequirement)
Yes No
Yes No
Project does not meet the threshold for requiring preparation of a
NEPA/SEPA document.
Yes No
Yes No
Due to the minimal transportation impact resulting from the proposed project,
stimulated growth and influence to nearby land use is not anticipated.
Yes No N/A
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5a. Will this project occur in or near an area with federally protected species or habitat?*
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
5c. If yes, indicate the USFWS Field Office you have contacted.
5d. Is another Federal agency involved?*
5e. Is this a DOT project located within Division's 1-8?
5j. What data sources did you use to determine whether your site would impact Endangered Species or
Designated Critical Habitat?
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
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?*
7b. What data sources did you use to determine whether your site would impact historic or archeological
resources?*
Yes No
Yes No
Raleigh
Yes No Unknown
Yes No
USFWS IPaC Website and survey from environmental consultants.
Yes No
NMFS County Index
Yes No
NCDOT Cultural Resource Personnel
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8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
8b. If yes, explain how project meets FEMA requirements:
8c. What source(s) did you use to make the floodplain determination?*
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.
Comments
Yes No
NCDOT Hydraulics Unit coordination with FEMA
FEMA flood maps
Miscellaneous
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Mecklenburg Rd Permit Drawings.pdf 2.08MB
Mecklenburg Rd Buffer Permit Drawing.pdf 803.96KB
Mecklenburg Rd Signed Architecture Effects Form.pdf 819.99KB
Mecklenburg Rd Wetland Forms.pdf 2.71MB
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*
· 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:
Signature
Date
Comments
Accept Reject
Signature
By checking the box and signing below, I certify that:
W. R. Archer III
4/19/2022