20240476 Ver 1_ePCN Application_20240328

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# *
20240476 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:
Bridge No 790235 over UT to Cold Water Creek (Beaver Creek)
1a. Who is the Primary Contact?*
Amy Euliss - NCDOT Div 9 PDEA Engineer
1b. Primary Contact Email: *
[e-mail]
Date Submitted
3/28/2024
Nearest Body of Water
UT to Cold Water Creek (Lake Fisher) Index No 13-17-9-4-(1)
Basin
Yadkin-PeeDee
Water Classification
WS-IV; CA
Site Coordinates
Latitude:
35.525994
A. Processing Information
Is this project connected with ARPA funding?
Yes No
County (or Counties) where the project is located:
Rowan
Is this a NCDMS Project
Yes No
Longitude:
-80.587978
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.R004
WBS # (1)
BP9.R004.1
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
Nationwide Permit (NWP) Number: 13 - Bank Stabilization
Nationwide Permit (NWP) Number: 33 - Temporary Construction
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
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.:
2c. Contact Person:
Amy Euliss
401 Water Quality Certification - Express
Riparian Buffer Authorization
Yes No
Yes No

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]
4. Agent/Consultant (if applicable)
4a. Name:
Phil May
4b. Business Name:
Carolina Ecosystems, Inc.
4c.Address
Street Address
3040 NC Highway 42 West
Address Line 2
city
Clayton
Postal / Zip Code
27520
4d. Telephone Number:
[phone]
4f. Email Address:*
phi I. [e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality / town:
Kannapolis, NC
2. Project Identification
2a. Property Identification Number:
2c. Project Address
Street Address
Ebenezer Road
Address Line 2
City
China Grove
Postal / Zip Code
28023
3. Surface Waters
3a. Name of the nearest body of water to proposed project:
UT to Cold Water Creek (Lake Fisher) Index No 13-17-9-4-(1)
3b. Water Resources Classification of nearest receiving water:
WS-IV: CA
3c. What river basins) is your project located it *
Yadkin-PeeDee
State / Province / Region
NC
Country
USA
2f. Fax Number:
State / Province / Region
NC
Country
USA
4e. Fax Number:
2b. Property size:
5.1
State / Province / Region
NC
Country
USA

3d. Please provide the 12-digit HUC in which the project is located.
030401050202
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:
Bridge No. 235 on SR 1322 (Ebenezer Road) over UT to Cold Water Creek (Beaver Creek) is located in Rowan County. The project study area totals approximately 5.1 acres and is
primarily comprised of forested and residential land uses. Two streams were delineated in the project area, a UT to Cold Water Creek, locally named Beaver Creek (Stream SA), and an
intermittent stream (SB) east of the project area. 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:
390
4h. Explain the purpose of the proposed project:"
The purpose of the project is to replace existing Bridge 235. The NCDOT Bridge Management Unit conducted a bridge inspection in July 2020. The records indicate Bridge No. 790235
has a sufficiency rating of 68.98. The purpose of the project is to address a deteriorating bridge built in 1962.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:
Ebenezer Road (SR 1322) is a two-lane secondary road with 10-foot lanes and grass shoulders on either side of the roadway. The speed limit along this section is 55 miles per hour
(mph). The proposed bridge improvements include replacing the existing structure, a 36'-8" steel plank deck on I -beams, with a one -span 39" box beam bridge 100-feet long and 36-feet
wide and will include two 12-foot lanes and 4-foot, 11-inch paved shoulders on each side. The bridge will be replaced on the existing alignment while detouring traffic offsite.
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?"
Yes No O 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-2018-02201
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Phil May
Agency/Consultant Company: Carolina Ecosystems, Inc.
Other:
5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
PJD 02/14/2019
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?
No
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
01
❑
3a. Reason for impact (?)
3b.lmpact type*
3c. Type of impact* :]��name'
�3e. Stream Type*
(?)
3f. Type of
Jurisdiction*
3g. S. width
3h. Impact
length*
S1
Riprap on Bank
Permanent
Bank Stabilization
SA
Perennial
Both
18
Average (feet)
108
(linear feet)

S2 Construction access Temporary Dewatering SA Perennial Both 18 L.—
Average(feet)
�_]
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts: 3i. Total temporary stream impacts:
108 29
3i. Total stream and ditch impacts:
137
3j. Comments:
Permanent impacts proposed as a result of bank stabilization with no loss of Waters of the US. Temporary stream impact acreage equals 0.045 and
permanent stream impact acreage equals 0.012.
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:
The proposed bridge is a 100-ft one span bridge with no bents constructed within Waters of the US. Deck drains are not necessary on the proposed
bridge. There is one box that will pick up water from the bridge and outlet onto a rip rap pad. There is one ditch that outlets into the stream but it has a
small drainage area and non -erosive velocities. The banks around the existing bridge are stable and any proposed work along the bank will be re -
stabilized with Class II rip rap.
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 2015 BMP manual and the regulations set forth by the NCG-010000 General
Construction Permit.
Erosion control measures will include placement of silt fence 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:
Permanent impacts are a result of bank stabilization with no riprap placed in the bed of the stream. Therefore no loss of Waters of the US is proposed.
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:
No State riparian buffer rules are in effect within the Yadkin -Pee Dee River basin.
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?
Yes No
Comments:
See stormwater management plan attached.
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 Categorical Exclusion was prepared for environmental documentation under NEPA.
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 with no additional travel lanes. No additional development is anticipated as a result of this
project.
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?
IPaC & NCNHP Data Explorer (both updated 03/25/24). Bat memo and USFWS Section 7 Concurrence Request and USFWS Informal Conference on
the tricolored bat.
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 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 resources staff and the Catawba Nation was
contacted for comments (attached).

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?'�
NC Flood Mapping Program
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
BR235_PCN_Attachments.pdf 27.39MB
File must be PDF or KMZ
Comments
Please see the attached cover letter with referenced attachments.
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
(jfal'J I fal"
Date
3/28/2024
6