20221397 Ver 1_ePCN Application_20221010

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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
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.
Pre-Filing Meeting Date Request was submitted on:
4/29/2022
BIMS#Assigned" Version#*
20221397 1
Is a payment required for this project?*
No payment required
Fee received Reviewing Office*
Fee needed-send electronic notification Mooresville Regional Office-[phone]
Select Project Reviewer*
Amy Chapman:eads\aschapman
Information for Initial Review
1a.Name of project:
Replacement of Bridge#830115 over Stony Run
1a.Who is the Primary Contact?*
Joel Howard-NCDOT Division 10
1 b.Primary Contact Email:* 1c.Primary Contact Phone:*
[e-mail] [phone]
Date Submitted
10/10/2022
Nearest Body of Water
Stony Run
Basin
Yadkin-PeeDee
Water Classification
C
Site Coordinates
Latitude: Longitude:
35.243828 -80.310004
A. Processing Information
County(or Counties)where the project is located:
Stanly
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#(1(
BP10.R018.1
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(N W P)
Regional General Permit(RGP)
Standard(IP)
1c.Has the NWP or GP number been verified by the Corps?
Yes No
Regional General Permit(RGP)Number: 201902350-Work associated with bridge construction,widening,replacement,and
interchanges
RGP Numbers(for multiple RGPS):
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 Division 10
2b.Deed book and page no.:
2c.Contact Person:
Joel Howard

2d.Address
Street Address
716 W Main Street
Address Line 2
City State/Province/Region
Albemarle NO
Postal/Zip Code Country
28001 USA
2e.Telephone Number: 2f.Fax Number:
[phone]
2g.Email Address:*
[e-mail]
4.Agent/Consultant(if applicable)
4a.Name:
Michael A.lagnocco
4b.Business Name:
STV Engineers,Inc.
4c.Address
Street Address
900 West Trade Street
Address Line 2
Suite 715
City State/Province/Region
Charlotte NO
Postal/Zip Code Country
28202-1144 USA
4d.Telephone Number: 4e.Fax Number:
[phone] [phone]
4f.Email Address:
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1 b.Subdivision name:
(if appropriate)
1c.Nearest municipality/town:
Oakboro
2.Project Identification
2a.Property Identification Number: 2b.Property size:
7.8
2c.Project Address
Street Address
SR 1968(St.Martin Road)at Stony Run
Address Line 2
City State/Province/Region
Oakboro NO
Postal/Zip Code Country
28129 USA
3. Surface Waters
3a.Name of the nearest body of water to proposed project:
Stony Run
3b.Water Resources Classification of nearest receiving water:
C
3c. What river basin(s)is your project located in?*
Yadkin-PeeDee

3d.Please provide the 12-digit HUC in which the project is located.
030401050405
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:
Existing conditions along Bridge 115 on SR 1968(St.Martin Road)over Stony Run include undeveloped forest and scrub/shrub vegetation,and agricultural fields.
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:
.009
4g.List the total estimated linear feet of all existing streams on the property:
307
4h.Explain the purpose of the proposed project:"
NCDOT proposes to replace the existing functionally deficient bridge on SR 1968(St.Martin Rd.)over Stony Run with a new bridge.STV Engineers,Inc.is providing planning,design,and
Section 404/401 services on behalf of Division 10;a MCDC and a delineation of waters of the U.S.have been completed.Jurisdictional waters of the U.S.delineated in the study area
include Stony Run as well as one small(.009-acre)potential wetland area.
4i.Describe the overall project in detail,including indirect impacts and the type of equipment to be used:
Erosion and sedimentation control measures will be installed.Bridge demolition will include the removal of the bridge deck and the bridge abutments.Bridge replacement construction will
take place using heavy equipment operating from the upland roadway approaches.Impervious dikes will be placed around the bridge abutments.These areas will be dewatered to ensure
all work is done in dry conditions.Approximately 111 LF of temporary dewatering impacts may result(note:all but 6 LF of the temporary dewatering stream impacts are overlapped by the
proposed permanent stream impacts).Stream bank stabilization around the bridge abutments will result in approximately 125 LF of permanent impact to the stream bank.Within the 125
LF of bank stabilization will be approximately 7 LF of permanent impacts due to installation of a bridge pier.There are roadside ditches that flow towards the bridge on both sides of the
structure which will be maintained in the proposed condition.On the begin side of the bridge,a traffic bearing grated drop inlet with double frame and grates(2GI)was placed on the right
side of the roadway in the shoulder berm gutter to pick up runoff from the bridge.The proposed bridge will be built on the same alignment with a temporary off-site detour.
5. Jurisdictional Determinations
5a.Have the wetlands or streams been delineated on the property or proposed impact areas?*
Yes No Unknown
Comments:
See Cover Letter Attachments(Attachment B-Delineation Materials)
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): Joshua Kotheimer,PWS
Agency/Consultant Company: STV Engineers,Inc.
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* r3e,_Stream Type* 3f.Type of 3g.S.width 3h.Impact Jurisdiction* length*
Bridge Pier Permanent Other �FmyRun Perennial Both 9
Average(feet) Qinear feet)

gy Bank Stabilization Permanent Bank Stabilization Stony Run Perennial Both 30 118
F
Average(feet) (linear(eet)
S3 Dewatering Temporary Dewatering Stony Run Perennial Both 30 6
Average(feet) (linear feet)
3i.Total jurisdictional ditch impact in square feet:
0
3i.Total permanent stream impacts: 3i.Total temporary stream impacts:
125 6
31.Total stream and ditch impacts:
131
3j.Comments:
Temporary impacts to approximately 111 LF feet of Stony Run will result from dewatering,however all but 6 LF of this impact will be overlapped by the
proposed permanent stream impacts.Permanent impacts to Stony Run total 125 LF of which approximately 7 LF feet of impact is associated with
construction of the proposed 110'cored slab bridge with the remaining 118 LF of permanent impact associated with bank stabilization.
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:
Replace bridge in-place was incorporated to minimize impacts;in addition,the proposed bridge is longer than the existing bridge.Riprap protection of
the bridge abutments is being placed/keyed into the stream banks above the surveyed water surface elevation and no impacts to the perennial stream
bed would occur.Class-II riprap abutment protection on both banks of the stream is also proposed to prevent future erosion and stream migration.
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 will be employed,including the use of impervious dikes to facilitate
work in dry conditions.Demolition and construction methods from the upland roadway approaches will be used to minimize potential temporary
demolition related impacts and avoid construction related impacts.
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 this project DOES NOT require Compensatory Mitigation,explain why:
Mitigation is not being offered for the 118 LF of bank stabilization as a loss of waters will not result;mitigation is also not being offered for the minimal 7 LF of permanent stream impact
associated with installation of a bridge pier.
F. Stormwater Management and Diffuse Flow Plan (required by DWR) u
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?
Yes No
If no,explain why:
Project is located in the Yadkin-Pee Dee River Basin and is not subject to NC Riparian Buffer Protection Rules.
2. Stormwater Management Plan
2a.Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
Yes No
Comments:
Overall drainage patterns will be maintained.There are roadside ditches that flow towards the bridge on both sides of the structure which will be maintained in the proposed condition.On
the begin side of the bridge,a traffic bearing grated drop inlet with double frame and grates(2GI)was placed on the right side of the roadway in the shoulder berm gutter to pick up runoff
from the bridge.No bridge deck drains are required.Please see attached Stormwater Management Plan for details on minimization of water quality impacts.
G. Supplementary Information
1. Environmental Documentation
1a.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:*
Bridge replacement project that required the preparation of a Minimum Criteria Determination Checklist;please see signed MCDC included in
Attachment E.
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.
Project involves the replacement of an existing bridge and is not anticipated to affect future development.
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.
Asheville
5d.Is another Federal agency involved?*
Yes No Unknown
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.?
Yes No
5g.Does this project involve bridge maintenance or removal?
Yes No
5g(1).If yes,have you inspected the bridge for signs of bat use such as staining,guano,bats,etc.?
Yes No
If you answered"Yes"to fig(1),did you discover any signs of bat use?
Yes No Unknown
5h.Does this project involve the construction/installation of a wind turbine(s)?*
Yes No
51.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 No
5j.What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
NCNHP database,USFWS IPAC website and site-specific surveys.Biological conclusions are provided as part of the Supplemental Information included
in Attachment D.
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?
Essential Fish Habitat Mapper
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?*
Please see Attachment F for:Historic Architecture and Landscapes No Survey Required Form,dated September 28,2021;No Archaeological Survey
Required Form,dated November 10,2021;Catawba Indian Nation correspondence dated September 29,2021.
8. Flood Zone Designation (Corps Requirement)
8a.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 FIRM mapping
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
RGP50_CoverLetterWithAttachmentS_Br115_R018.pdf 18.77MB
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:
Joel M.Howard
Signature
Date
10/10/2022