20190331 Ver 2_ePCN Application_20221017

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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:
11/20/2020
BIMS#Assigned" Version#"
20190331 2
Is a payment required for this project?*
No payment required Reviewing Office"
Fee received Winston-Salem Regional Office-(336)776-
Fee needed-send electronic notification 9800
Select Project Reviewer"
Dave Wanucha:eads\djwanucha
Information for Initial Review
1a.Name of project:
Replacement of Bridge No.81 on SR 1926 over Deals Creek
1a.Who is the Primary Contact?"
Amy Euliss
1 b.Primary Contact Email:" 1c.Primary Contact Phone:*
[e-mail] [phone]
Date Submitted
10/17/2022
Nearest Body of Water
Deals Creek
Basin
Yadkin-PeeDee
Water Classification
C
Site Coordinates
Latitude: Longitude:
35.743370 -80.462895
A. Processing Information
County(or Counties)where the project is located:
Rowan
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)
17BP.9.R.76
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
Please provide the date of the previous submission.*
10/11/2019
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 Division 9
2b.Deed book and page no.:
2c.Contact Person:

2d.Address
Street Address
375 Silas Creek Parkway
Address Line 2
city State/Province/Region
Winston Salem NC
Postal/Zip Code Country
27106 USA
2e.Telephone Number: 2f.Fax Number:
[phone]
2g.Email Address:*
[e-mail]
C. Project Information and Prior Project History
1.Project Information
1b.Subdivision name:
(if appropriate)
1c.Nearest municipality I town:
Salisbury
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:
Deals Creek
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.
030401030105
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 include SR 1926(Hannah Ferry Road),undeveloped forest and the disturbed/maintained right-of-way.
4b.Have Corps permits or DWR certifications been obtained for this project(including all prior phases)in the past?
Yes No Unknown
If yes,please give the DWR Certification number or the Corps Action ID(exp.SAW-0000-00000).
USACE Action ID SAW-2019-00473.DWR no.2019-0331
4f.List the total estimated acreage of all existing wetlands on the property:
2.44
4g.List the total estimated linear feet of all existing streams on the property:
329
4h.Explain the purpose of the proposed project:
To remove Bridge#790081 and replace with a new,modern bridge structure.
41.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 after the hand clearing of vegetation is conducted.Bridge replacement construction adjacent to the existing bridge using
heavy equipment from the upland roadway approaches.Deck drains on the bridge do not discharge directly into the stream.Bridge demolition will occur after the bridge and new roadway
approaches are completed.Demolition will include the removal of the bridge deck and removal of the abutments to the ground line to avoid utility impacts.Replacing the bridge on new
alignment to the southeast(downstream)is required to:provide continued access to the end of the road because of the presence of a water main to the northwest(upstream);no detour
route is available;and,this alignment also avoids impacts to the tributary to Deals Creek.

5. Jurisdictional Determinations
5a.Have the wetlands or streams been delineated on the property or proposed impact areas?*
Yes No Unknown
Comments:
5b.If the Corps made a jurisdictional determination,what type of determination was made?*
Preliminary Approved Not Verified Unknown N/A
Corps AID Number:
SAW-2019-00473
5c.If 5a is yes,who delineated the jurisdictional areas?
Name(if known): Brandon Phillips
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
2.Wetland Impacts
2a1 Reason(?) 2b.Impact type*(?) 2c.Type of W.* 2d.W.name 2e.Forested* 2f.Type of Jurisdicition]2g.Impact
area*
W1 roadway fill P Bottomland Hardwood Forest Wetlands C and D Yes Both 0.430
(acres)
W2 excavation P Bottomland Hardwood Forest Wetland C Yes Both 0.030
(acres)
W3 hand clearing T Bottomland Hardwood Forest Wetlands C and D Yes Both 0.180
ac es)
2g.Total Temporary Wetland Impact 2g.Total Permanent Wetland Impact
0.180 0.460
2g.Total Wetland Impact
0.640
2i.Comments:
Permanent impacts are associated with the roadway fill required for the new bridge approaches and the excavation needed for positive drainage and the
requirement to have a zero net fill within the floodplain.Temporary impacts are associated with the hand clearing of vegetation.
3. Stream Impacts
E
3a.Reason for impact(?) 3b.lmpact type* 3c.Type of impact* 3d.S.name* 3e.Stream Type* 3f.Type of 3g.S.width 3h.Impact
(?) Jurisdiction* length*
S7 construction and demo Temporary Dewatering Deals Creek Perennial Both LA.,ag.
(feet) (linear feet)
3i.Total jurisdictional ditch impact in square feet:
0
3i.Total permanent stream impacts: 31.Total temporary stream impacts:
0 126

31.Total stream and ditch impacts:
126
3j.Comments:
Temporary impacts are associated with the construction of the new bridge and the demolition of the existing bridge.No permanent impacts to the stream
are proposed.Temporary impacts in acreage are equal to 0.08 acres.
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:
The proposed bridge span length was extended to avoid impacts to Deals Creek.Riprap protection at the bridge abutments is being placed outside of
the jurisdictional stream boundary to avoid permanent impacts to Deals Creek.
1 b.Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
NCDOT Best Management Practices(BMPs)for Construction and Maintenance Activities will be employed.Demolition and construction methods from
the roadway approaches will be used to minimize 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
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: 4c.If using stream mitigation,what is the stream temperature:
(linear feet)
4e.Riparian wetland mitigation requested:
4d.Buffer mitigation requested(DWR only): (acres)
(square feet) 0.46 acres at a 2:1 ratio
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
If no,explain why:
2. Stormwater Management Plan
2a.Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?"
Yes No
Comments:
Stormwater runoff from the proposed bridge will be routed to deck drains that discharge over the floodplain of Deals Creek.Please see the attached Stormwater Management Plan for
details on the minimization of water quality impacts.
G. Supplementary Information v

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 will require the preparation of a Minimum Criteria Determination Checklist.
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 5g(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
5i.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?
USFWS IPaC and NCNHP data and site specific surveys.See Supplemental Information attached under Miscellaneous for threatened and endangered
species write-ups and biological conclusions.
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?*
NOAA EFH 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?*
See attached"No Archaeological Survey Required Form'and"Historic Architecture and Landscapes No Survey Required Form."
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 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
NCDWQ RPW B-UT to Deals Cr.pdf 72.86KB
R76 DP 1 Wetland data sheet.pdf 411.47KB
R76 DP 2 Wetland data sheet.pdf 398.65KB
R76 upland data sheet.pdf 368.71 KB
R76_Bridge81_Figure3_WatersMap.pdf 3.67MB
17BP.9.R.76 reapplication cover letter.pdf 204.04KB
Bridge 76 MANLAA concurrence tricolored.pdf 255.89KB
R.76_Permit_Plans_2019-03-01.pdf 2.33MB
17-05-0058_NoSurveyReq.pdf 4.73MB
PA 17-05-0058 Rowan(NSR).pdf 7.46MB
Tribal Coordination Br 81 Rowan.pdf 6AMB
Bridge 81 on SR 1926.pdf 1.52MB
SAW-2019-00473(signed NWP).pdf 1.81MB
File must be PDF or KMZ
Comments
Additional Miscellaneous attachments include photographs of the site,a cover letter that includes information regarding the Threatened and Endangered Species that are listed in Rowan
County,and a MANLAA request for the tricolored bat for submittal by the USACE to USFWS.
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:
Amy Euliss
Signature
0�6_9s
Date
10/17/2022