20240265 Ver 1_ePCN Application_20240214

i DWR
Division of Water Resources
Pre -Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
October 2, 2023 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.
Does this project involve maintenance dredging funded by the Shallow Draft Navigation Channel Dredging and Aquatic Weed Fund or involve the distribution or transmission of energy or
fuel, including natural gas, diesel, petroleum, or electricity?
Yes No
BIMS # Assigned Version# *
20240265 1
Is a payment required for this project?*
No payment required
Fee received
Fee needed - send electronic notification
Select Project Reviewer*
Ryan Conchilla:ryan.conchilla
Information for Initial Review
la. Name of project:
Replace Bridge #246 on SR 2351 (Flat Swamp Rd) over Lick Creek
1a. Who is the Primary Contact?*
Amy Euliss - NCDOT Div 9 PDEA Engineer
1b. Primary Contact Email: *
[e-mail]
Date Submitted
2/14/2024
Nearest Body of Water
Lick Creek
Basin
Yadkin-PeeDee
Water Classification
WS-IV
Site Coordinates
Latitude:
Longitude:
35.637061
-80.15088
A. Processing Information
Is this project connected with ARPA funding?
Yes No
County (or Counties) where the project is located:
Davidson
Is this a NCDMS Project
Yes No
Reviewing Office*
Central Office - [phone]
1c. Primary Contact Phone:*
[phone]
O
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:
BP9.R006
WBS # (1)
BP9.R006.01
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.
2/2/2024
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
Nationwide Permit (NWP) Number:
Nationwide Permit (NWP) Number:
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
401 Water Quality Certification - Regular
Non-404 Jurisdictional General Permit
Individual 401 Water Quality Certification
13 - Bank Stabilization
33 - Temporary Construction
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 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.:
401 Water Quality Certification - Express
Riparian Buffer Authorization
Yes No
Yes No

2c. Contact Person:
Amy Euliss
2d.Address
Street Address
375 Silas Creek Parkway
Address Line 2
city
Winston-Salem
Postal / Zip Code
27127
2e. Telephone 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 / town:
Denton, NC
2. Project Identification
2a. Property Identification Number:
2c. Project Address
Street Address
Flat Swamp Road
Address Line 2
City
Denton
Postal / Zip Code
27239
3. Surface Waters
3a. Name of the nearest body of water to proposed project:
Lick Creek
3b. Water Resources Classification of nearest receiving water:
WS-IV
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.
030401030601
4. Project Description and History
State / Province / Region
NC
Country
us
2f. Fax Number:
[phone]
2b. Property size:
2.8
State / Province / Region
NC
Country
US
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: *
Bridge No. 246 on SR 2351 (Flat Swamp Road) over Lick Creek is located in Davidson County and involves the widening and replacement of Bridge No. 246 over Lick Creek on Flat
Swamp Rd. The project study area totals approximately 2.8 acres with a majority of the project located in forested open space. A small portion of an agricultural field exists towards the
western end of the project study area. Land use surrounding the project area includes residential development, agricultural fields, and undeveloped forest. One stream was delineated in
the project corridor, namely Lick Creek (Stream SA). No wetlands are located in the project study area.
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:
0
4g. List the total estimated linear feet of all existing streams on the property:
217
4h. Explain the purpose of the proposed project:
The purpose of the project is to replace existing Bridge No. 246. Though not considered structural deficient or functionally obsolete, the bridge condition is beginning to deteriorate with the
2022 Structure Safety Report for the bridge indicating delay and section loss on the existing abutments and the substructure having a rating of five out of nine.
O

4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used: x
BP9.R006 (previously 17BP.9.R.92) proposes to replace Bridge No. 246 on Flat Swamp Road (SR 2351) over Lick Creek in Davidson County. The existing bridge is a 2 @ 45-foot, 3.5-
inch span precast prestressed concrete cored slabs. The replacement bridge is proposed to be a two span bridge with one 70-foot, 24-inch cored slab and one 35-foot, 24-inch cored slab
structure with 11-foot travel lanes and paved shoulders ranging between four to five feet in width.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?"
Yes No O Unknown
Comments:
A Preliminary Jurisdictional Determination was issued for the original 2.8-acre project study area on
February 11, 2020.
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-2020-00258
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Amanda Johnson, PWS and Caleb Sullivan, WRIT
Agency/Consultant Company: WSP USA
Other:
5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
2/11/2020
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
U
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
F1S1
Jurisdiction *
length
S1-Riprap on embankment
Permanent
Bank Stabilization J
Stream SA (Lick Creek)
Perennial
Both
13
51
Average (feet)
(linear feet)
32
S1-Pier Removal
Temporary
Dewatering
Stream SA (Lick Creek)
Perennial
Both
13
20
Average (faaQ
(linear feet)
S3
S1-Dewatering for Riprap on
Temporary
Dewatering
Stream SA (Lick Creek)
Perennial
Both
13
42
embankment
Aveage (feet)
(linear feet)
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
51
31. Total stream and ditch impacts:
113
3i. Total temporary stream impacts:
62
3j. Comments:
Total proposed permanent stream impacts include 51 linear feet (0.01 ac.) of stream bank stabilization. Total proposed temporary stream impacts include
42 linear feet (0.01) of dewatering for stream bank stabilization and 20 linear feet of temporary dewatering for pier removal. Please note that the
temporary dewatering for the pier removal is within the linear feet for permanent bank stabilization.
All of the permanent impacts are the result of bank stabilization. These impacts do not result in the loss of waters of the U.S. and therefore no mitigation
is proposed for these impacts.
E. Impact Justification and Mitigation 8

1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
The following minimization measures were taken as part of project design:
This project is a bridge replacement with riprap on embankment to stabilize the fill slopes. The proposed bridge has two spans of 24-inch cored slab with
one at 70-foot and one at 35-foot. The bridge has 4-foot end bent caps with class I I riprap spill thru slopes. The drainage is comprised of a traffic bearing
flat grate with a 15-inch pipes that outlets into a riprap pad. The drainage is comprised of a traffic bearing flat grate with a 15-inch pipes that outlets into a
riprap pad. The proposed bridge replacement will be span the entirety of the stream and no bridge bents/supports will be placed below the ordinary high
water mark.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
All construction activities will be performed in accordance to the applicable requirements of the 2024 NCDOT Standard Specifications for Roads and
Structures. The erosion and sediment control plans will comply with the regulations set forth by the NCG-010000 General Construction Permit.
Erosion control measures will include placement of silt fences around the construction zone. Construction activities will be completed from upland areas.
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:
The only permanent impacts to Waters of the U.S. are bank stabilizations. Bank stabilization does not result in a loss of waters.
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:
The project area does not include any listed mainstem lakes.
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?
Yes No
Comments:
The project is in compliance with NPDES permit NC S000250.
G. Supplementary Information
1. Environmental Documentation
la. 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 Categorical Exclusion was prepared. It is attached for reference.
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.
The project is a replacement of a structurally deficient bridge in a rural area. No additional development is anticipated as a result of this project.
O
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
What Federal Agency is involved?
FHWA
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?
I PAC and Natural Heritage data explorer
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?'�
National Oceanic and Atmospheric Administration 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?"
The project was reviewed in accordance with the Section 106 Programmatic agreement by NCDOT cultural resource staff and that the Catawba Nation
was consulted for impacts to tribal resources.
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:
The project is located within a FEMA-designated 100-year floodplain. The impact sites are located within the FEMA-designated 100-year floodplain.
Hydraulic modeling found that there is a decrease in the 100-year surface elevation outside the NCDOT ROW and the project for a State Floodplain
Compliance Type B.
8c. What source(s) did you use to make the floodplain determination?"
FEMA Floodplain Maps
Miscellaneous
a

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
BP9.R006 Cover Letter w_Attachments_021324.pdf 8.41 MB
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:
Amy Euliss
Signature
Gf��< i 5:1111"
Date
2/14/2024
M