20240316 Ver 1_ePCN Application_20240227

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# *
20240316
1
Is a payment required for this project?*
No payment required
What amount is owed?*
Fee received
$240.00 $570.00
Fee needed - send electronic notification
$323.00 $767.00
Reviewing Office*
Select Project Reviewer*
Central Office - [phone]
Ryan Conchilla:ryan.conchilla
Information for Initial Review
1a. Name of project:
Bethabara Road Culvert Replacement Project
1a. Who is the Primary Contact?*
Jessica Tisdale
1b. Primary Contact Email: * 1c. Primary Contact Phone:*
[e-mail] [phone]
Date Submitted
2/27/2024
Nearest Body of Water
Monarcas Creek
Basin
Yadkin-PeeDee
Water Classification
C
Site Coordinates
Latitude: Longitude:
36.150376-80.150376
A. Processing Information
Is this project connected with ARPA funding?
Yes No
County (or Counties) where the project is located:
Forsyth
Is this a NCDMS Project
Yes No
Is this project a public transportation project?*
Yes No
O

Is this a NCDOT Project?*
Yes No
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
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
14 - Linear transportation
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
'Id. 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:
See attached parcel sheet
2b. Deed book and page no.:
N/A
2c. Contact Person:
Todd Love, P.E.
401 Water Quality Certification - Express
Riparian Buffer Authorization
r
Yes No
Yes No

2d.Address
Street Address
City Hall - Stormwater Division
Address Line 2
101 North Main Street
city
Winston-Salem
Postal / Zip Code
27101-4015
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
Todd Love, P.E.
3b. Business Name:
City of Winston-Salem Stormwater Division
3c.Address
Street Address
101 North Main Street
Address Line 2
city
Winston-Salem
Postal / Zip Code
27101
3d. Telephone Number:
[phone]
3f. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Jessica Tisdale
4b. Business Name:
HDR Engineering, Inc. of the Carolinas
4c.Address
Street Address
555 Fayetteville Street
Address Line 2
Suite 900
city
Raleigh
Postal / Zip Code
27601
4d. Telephone Number:
[phone]
4f. Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality / town
Winston-Salem
State / Province / Region
North Carolina
Country
U.S.
2f. Fax Number:
State / Province / Region
NC
Country
U.S.
3e. Fax Number:
State / Province / Region
NC
Country
U.S.
4e. Fax Number:
a
2. Project Identification

2a. Property Identification Number: 2b. Property size:
See attached figures (3) and 65 % plan sheets
2c. Project Address
Street Address
Address Line 2
City
Postal / Zip Code
3. Surface Waters
3a. Name of the nearest body of water to proposed project:
Monarcas 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.
030401011301
4. Project Description and History
State / Province / Region
Country
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: x
Land use within the vicinity is residential, forested, existing transportation facilities and commercial/businesses along Silas Creek Parkway, University Parkway, and surrounding Wake
Forest University.
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:
184
4h. Explain the purpose of the proposed project:"
The purpose of this project is to replace the Bethabara Road culvert that has resulted in the closure of a section of Bethabara Road in Winston-Salem. Monarcas Creek is conveyed
through the Bethabara Road culvert, northwest of Silas Creek Parkway in the northwestern part of the Winston-Salem (Figures 1, 2). The culvert crossing is located approximately 100 feet
east of the intersection of Hickory Knoll Drive with Bethabara Road and roughly 450 feet west of the intersection of Hickory Glen Road with Bethabara Road. The existing three -sided
culvert is 60' long, 15' wide and 10' tall. The culvert is exhibiting degradation to many of its structural features, which could result in individual feature or collective system failure of the
culvert, impacting the function of the roadway in providing safe travel.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used: x
The project consists of replacing a failing three -sided arch culvert, widening the roadway pavement width 2' to 4' across the project area, widening the sidewalk from 4' to 5' wide, and
adding a 3' 6" wide planting strip between the curb and sidewalk. The existing three -sided culvert is 60' long, 15' wide and 10' tall and will be replaced with a 70' long, 10' 4" tall and 16' 1"
wide aluminum structural plate arch with aluminum headwalls. Headwalls will be installed on both the upstream side and downstream side of the arch. The existing 12' sewer line
paralleling Monarcas Creek will not be exposed during construction. The existing 12" and 24" waterlines will be supported with steel beams during culvert installation and no blasting is
anticipated to install the steel beams. A bypass pumping operation will be utilized during the culvert replacement to continue the natural flow of Monarcas Creek, and a dewatering bag will
be installed south of the existing culvert.
Additionally, the project will not require the addition of right-of-way. Standard road and culvert equipment, such as trucks, backhoes, pile driving equipment (for waterline support during
construction), and cranes will be used.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?
Yes No O Unknown
Comments:
Monarcas Creek is a perennial stream with no adjacent wetlands in the study area (See Figure 4).
Unnamed Tributary (UT) to Monarcas Creek, also a perennial stream, forms a confluence with
Monarcas Creek south of Bethabara Road.
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): Jessica Tisdale
Agency/Consultant Company: HDR Engineering, Inc. of the Carolinas (HDR)
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
la. Where are the impacts associated with your project? (check all that apply):
Wetlands Streams -tributaries O Buffers
Open Waters Pond Construction
3. Stream Impacts
U
F
3a. Reason for impact (?)
3b.lmpact type "
3c. Type of impact*
3d. S. name *
3e. Stream Type*
3f. Type of
3g. S. width
F. Impact
(?)
Jurisdiction*
length*
31
Culvert installation
Temporary
Dewatering
Monarcas Creek
Perennial
Both
15
137
Average (feet)
(linear feet)
gy
Bottomed culvert
Permanent
Culvert
Monarcas Creek
Perennial
Both
15
72
Average (feet)
(linear feet)
S3
Bank stabilization
Permanent
Bank Stabilization
onarcas Creek (up and
[do
Perennial
Both
15
54
wn Stream of Culvert)
Aveage (feet)
(linear feet)
gq
Riprap collar
Permanent
Rip Rap Fill
Monarcas Creek
Perennial
Both
15
69
(up/downstream)
Ave age (feet)
(linear feet)
31. Total jurisdictional ditch impact in square feet
0
3i. Total permanent stream impacts: 31. Total temporary stream impacts:
195 137
31. Total stream and ditch impacts:
332
3j. Comments:
Permanent, non-mitigable, bank stabilization impacts are 54 ((30 LF (upstream) and 24 LF (downstream)) Upstream bank stabilization overlaps with the
rip -rap placement in the streambed. Total, mitigable, permanent stream impacts are 141 linear feet (72 LF (culvert) + 69 (rip -rap collars).
E. Impact Justification and Mitigation O
1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
Tops of bank on jurisdictional Monarcas Creek and Unnamed Tributary (UT) to Monarcas Creek have been surveyed. Using these surveyed features,
designs were adjusted to avoid and/or minimize impacts to Monarcas Creek and the adjoining UT to Monarcas Creek City stream restoration project.
HDR Feld biologists reviewed the project on October 16, 2023 and confirmed there were no wetlands alongside Monarcas Creek in the project area.
Best Management Practices for Protection of Surface Waters will be used. Other avoidance and minimization efforts include utilizing 1.5:1 slopes at the
stream crossing to minimize the length of the culvert and disturbance area around Monarcas Creek. Using 1.5:1 slopes additionally avoids any stream
impacts to the UT to Monarcas Creek City stream restoration project. Retrofitting the aluminum arch culvert with baffles will capture natural stream
sediment in the culvert to support aquatic life.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Erosion and sediment control Best Management Practices (BMPs) will be installed prior to construction and inspected and maintained throughout the
duration of the project. Water will be diverted around work areas to prevent sedimentation of downstream aquatic resources through the use of a pump
around system during culvert installation and a dewatering bag will be installed south of the existing culvert to reduce sedimentation in the stream. A pre -
construction meeting will occur with City staff and permitting agencies (USACE and DWR) will be invited.
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:
(linear feet)
141
4d. Buffer mitigation requested (DWR only):
(square feet)
0
4f. Non -riparian wetland mitigation requested:
(acres)
0
4h. Comments
4c. If using stream mitigation, what is the stream temperature:
warm
4e. Riparian wetland mitigation requested:
(acres)
0
4g. Coastal (tidal) wetland mitigation requested:
(acres)
0
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
2b. Does this project meet the requirements for low density projects as defined in 15A NCAC 02H .1003(2)?
Yes No
Comments:
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:*
This is a culvert replacement project to replace a failing culvert and re -open Bethabara Road for public use. City generated funds will be used for the
project.
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 will replace a failing culvert crossing over Monarcas Creek on Bethabara Road, increase pavement widths 2' to 4' across the project area
and increase sidewalks from 4' to 5' width for pedestrian traffic (blind population nearby). Due to its minimal transportation impact -causing activities, this
project will neither influence nearby land uses nor stimulate growth. Therefore, a detailed indirect and cumulative effects study will not be necessary.
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
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?
HDR completed habitat surveys for all federally listed species. Habitat was not identified for bog turtle or Monarch butterfly (candidate species) and a
"No Effect" biological conclusion was reach for both species. Surveys for Schweinitz's sunflower and tricolored bat were performed October 16, 2023. A
"No Effect" biological conclusion was reached for Schweintz's sunflower and an "Unknown" was concluded for tricolored bat (Proposed Endangered).
There was no evidence of bats using the culvert, furthermore the tricolored bat is not an officially listed species and an "Unknown" biological conclusion
was reached for this species. Tree clearing adjacent to Monarcas Creek (<0.25 acre) would try to be avoided during the tricolored bat pup season from
May 15 to July 31, if possible, for the proposed listed species. The City is working with a contractor to mobilize and remove trees ahead of the May 15
date. A self -certification package was submitted to the USFWS Asheville Field Office on December 21,2023, to document these findings and is attached
to the permit submittal.
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 (EFH) Mapper - This project is in Forsyth County which is not near any coastal or tidal habitat that would support EFH (i.e. salt
marshes, oyster reef, etc.).
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? *
HDR reviewed the NCSHPO GIS website to obtain information regarding historic resources present on the site or in the nearby properties. This review
did not identify any listed properties or sites eligible for listing.
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:
Coordination is being carried out with the local floodplain administrator to ensure compliance within the FEMA guidelines.
8c. What source(s) did you use to make the floodplain determination?
FEMA map numbers 3710681700J (eff. 1/2/2009).

Miscellaneous
0
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
Bethabarand_ePCN_Attachments_20240227.pdf 48.93MB
File must be PDF or KMZ
Comments
Attachment List:
-Figures (1-5)
-Stream Impact Plan Sheet
-Prefiling requests
-Signed ePCN Agent Authorization
-DMS Statement of Credit Availability
-USFWS Coordination (IPaC/NHP Reports)
-Photographs
-65% Plan Sheets
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:
Jessica Tisdale
Signature
Date
2/27/2024
a