20210190 Ver 1_ePCN Application_20230901

DWR
Division of Water Resources
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
20210190
Is a payment required for this project?*
No payment required
Fee received
Fee needed - send electronic notification
Select Project Reviewer*
Dave Wanucha:[e-mail]
Information for Initial Review
la. Name of project:
Bridge No. 165 on SR 5469 (Shopton Road) over Coffey Creek
1a. Who is the Primary Contact?*
Joel Howard
1b. Primary Contact Email: *
[e-mail]
Date Submitted
9/1/2023
Nearest Body of Water
Coffey Creek
Basin
Catawba
Water Classification
C
Site Coordinates
Latitude:
Longitude:
35.163200
-80,930500
A. Processing Information
Is this project connected with ARPA funding?
Yes No
County (or Counties) where the project is located:
Mecklenburg
Is this a NCDMS Project
Yes No
Version#*
1
Reviewing Office *
Winston-Salem Regional Office - (336) 776-
9800
1c. Primary Contact Phone: *
[phone]
8
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#M
BP10.R013.1
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
1b. 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
Regional General Permit (RGP) Number:
RGP Numbers (for multiple RGPS):
1d. Type(s) of approval sought from the DWR:
401 Water Quality Certification - Regular
Non-404 Jurisdictional General Permit
Individual 401 Water Quality Certification
201902350 - Work associated with bridge construction, widening, replacement, and
interchanges
le. 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? *
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
1h. 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 AgentlConsultant for this project?
Yes No
2. Owner Information
2a. Name(s) on recorded deed:
NCDOT Division 10
2b. Deed book and page no.:
N/A
2c. Contact Person:
401 Water Quality Certification - Express
Riparian Buffer Authorization
Yes No
Yes No

2d. Address
Street Address
716 W Main Street
Address Line 2
City
Albemarle
Postal / Zip Code
28001
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Proiect Information
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality I town:
Charlotte
2. Project Identification
State / Province / Region
NC
Country
USA
2f. Fax Number:
2a. Property Identification Number:
2b. Property size:
N/A
8.6
2c. Project Address
Street Address
SR 5469 (Shopton Rd) at Coffey Creek
Address Line 2
City
State / Province / Region
Charlotte
NC
Postal / Zip Code
Country
28217
Mecklenburg
3. Surface Waters
3a. Name of the nearest body of water to proposed project:
Coffey Creek
3b. Water Resources Classification of nearest receiving water:
C
3c. What river basins) is your project located in?*
Catawba
3d. Please provide the 12-digit HUC in which the project is located.
030501030103
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 site conditions include SR 5469 (Shopton Rd), residential land, forested land adjacent to Coffey Creek, 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
4f. List the total estimated acreage of all existing wetlands on the property:
.283
4g. List the total estimated linear feet of all existing streams on the property:
684
4h. Explain the purpose of the proposed project: *
The purpose of the project is to replace the structurally deficient SR 5469 (Shopton Rd) bridge over Coffey Creek with a new bridge.

4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used: *
The existing bridge structure was built in 1975 and is approximately 91 feet in length and 30 feet in width consisting of two 11-foot travel lanes and no shoulders. At present, there is a
seven -foot sidewalk on the south side and five-foot bike lanes on both sides of the road. The existing right-of-way along SR 5469 (Shopton Road) is approximately 65 feet. Bridge No. 165
has a posted single vehicle weight of 17 tons and a truck tractor semitrailer weight limit of 23 tons. SR 5469 (Shopton Road) is classified as a collector with a posted speed limit of 45-miles
per hour.
The proposed project would replace the existing, two-lane bridge structure on the same roadway alignment with an approximately 70-foot wide structure with three 11-foot travel lanes,
including a three-foot buffer between the travel lane and bike lane, to tie into the existing three lanes on the approaches. The approach roadway would extend approximately 710 feet to
the west and approximately 816 feet to the east of the proposed bridge. The roadway approaches will include three,11-foot travel lanes with a three-foot buffer between the travel lane and
the five-foot bike lanes. The total length of the project is 0.32 miles. The proposed right-of-way would vary and would extend 185 feet at its widest point. The project would require
approximately 2.05 acres of right of way acquisition and 0.93 acre of easements. Residential and business relocations are not anticipated.
There will be 154 linear feet (LF) of permanent impacts and 166 LF of temporary impacts necessary for installation of bank stabilization along Coffey Creek. There will be 0.098 acre of
permanent fill impact and 0.025 acre of hand clearing impact to Wetland B, 0.005 acre of permanent fill impact to Wetland A, and 0.002 acre of permanent fill impact and 0.021 acre of
mechanized clearing impact to Wetland C for the roadway and associated fill slopes. There will be 7 LF of permanent impacts to Stream B and 7 LF of permanent impacts to Stream C for
installation of bank stabilization at drainage outfalls. There will be 13 LF of temporary impacts to Stream B, 14 LF of temporary impacts to Coffey Creek, and 12 LF of temporary impacts to
Stream C for dewatering and installation of a 12-inch water line. Total project wetland impacts include 0.105 acre permanent wetland fill impact, 0.021 acre mechanized clearing impact,
and 0.025 acre hand clearing impact. Total project stream impacts include 168 LF of permanent bank stabilization impacts and 205 LF of temporary impacts of which 154 LF overlap with
permanent impacts and are excluded from temporary impact totals (Attachment A).
The project will utilize typical heavy equipment such as cranes, excavators, bulldozers, skidsteers, and trucks for the construction.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
Yes No O Unknown
Comments:
See 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?
This is a bridge replacement project.
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
8
2a1 Reason (?)
2b. Impact type* (?)
2c. Type of W.
2d. W. name
2e. Forested*
2f. Type of Jurisdicition *
?)
29• Impact
area *
Fill
P
Bottomland Hardwood Forest
Wetland C
Yes
Both
0.002
(acres)
Mechanized Clearing
P
Ftt,mland Hardwood Forest
Wetland C
Yes
Both
0.021
(acres)
2B
Fill
P
E.dplain Pool
Wetland A
No
Both
0.005
acres)
2C
Fill
P
Fttomland Hardwood Forest
Wetland B
No
Both
0.098
(acres)
2C
Hand Clearing
T
Bottomland Hardwood Forest
Wetland B
No
Both
0.025
(acres)

2g. Total Temporary Wetland Impact
0.025
2g. Total Permanent Wetland Impact
0.126
2g. Total Wetland Impact
0.151
2i. Comments:
3. Stream Impacts
❑
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*
liength*
31
S1 (Bridge Replacement)
Permanent
Bank Stabilization J
Coffey Creek
Perennial
Both
15
154
Average (feet)
(linear feet)
S2
S1 (Dewatering)
Temporary
Dewatering
Coffey Creek
Perennial
Both
15
12
Average (feet)
(linear feet)
S3
S3A (Drainage)
Permanent
Bank Stabilization J
Stream B
Intermittent
Both
Averege (feet)
(linear feet)
S4
S313 (Drainage)
Permanent
Bank Stabilization J
Stream C
Perennial
Both
Average (feet)
(linear feet)
S5
S4A (12" Water Line)
Temporary
Dewatering
Stream B
Intermittent
Both
13
Averege (feet)
(linear feet)
S5
S413 (12" Water Line)
Temporary
Dewatering
Coffey Creek
Perennial
Both
15
14
Average (feet)
(linear feet)
S7
S4C (12" Water Line)
Temporary777]
Dewatering
Stream C
Perennial
Both
12
Average (feet)
(linear feet)
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
168
31. Total stream and ditch impacts:
219
3i. Total temporary stream impacts:
51
3j. Comments:
Temporary Stream impacts total 205 linear feet, 154 linear feet are accounted for within the permanent impacts at Site 1 and are not included in the
table.
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:
Riprap bank stabilization for protection of the bridge abutments is being placed only on the stream banks and will not disturb the stream bed. The bridge
replacement will be conducted from the upland areas/roadway approaches. Dewatering strategies, including impervious dikes, will be employed in order
to work in dry conditions.
1b. 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. 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
2c. If yes, mitigation is required by (check all that apply):
D W R 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
O

4b. Stream mitigation requested:
(linear feet)
4c. If using stream mitigation, what is the stream temperature:
4d. Buffer mitigation requested (DWR only):
(square feet)
4f. Non -riparian wetland mitigation requested:
(acres)
4h. Comments
4e. Riparian wetland mitigation requested:
(acres)
0.105
4g. Coastal (tidal) wetland mitigation requested:
(acres)
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
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 Catawba River Basin but is not located on the main stem of the Catawba 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:
Please see attached Stormwater Management Plan for details on the minimization of water quality impacts (See Attachment A); no deck drains will be utilized.
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
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)?*
Yes No
Comments: *
A Minimum Criteria Determination Checklist was prepared for this bridge replacement project (See Attachment C)
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 .020i *
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
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
Unknown
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 Attachment E - T&E Supplemental Information).
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 Attachment F - "No Archaeological Survey Required Form", "Historic Architecture and Landscapes No Survey Required Form" and " The Cherokee
Nation Coordination Response Letter."
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
Be. What source(s) did you use to make the floodplain determination?
FEMA FIRM Maps 3710452100K eff. 9/2/2015 and 3710452200K eff. 9/2/2015.
Miscellaneous
u
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
BP10.Ro13_Permit_CoverLetter_With _Attachments.pdf 12.35MB
File must be PDF or KMZ
Comments
Please see the attached cover letter and attachments for additional supplemental information.
Signature

p 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
J'W A *W #P
Date
9/1/2023