20151309 Ver 1_Application_20151216

7Yansportatlon
US Army Corps of Engineers
Raleigh Regulatory Field Office
Attn: Mr. David Bailey
3331 Heritage Trade Dr., Ste. 105
Wake Forest, NC 27587
PAT McCRORY
Governor
NICHOLAS J. TENNYSON
Secretary
December 15, 2015
NC Division of Water Resources
Winston-Salem Regional Office
Attn: Mr. Dave Wanucha
450 W. Hanes Mill Rd, Ste. 103
Winston-Salem, NC 27105
Subject: Nationwide 14 Permit and Jordan Lake Riparian Buffer Application for the
replacement of Bridge No. 42 on SR 1007 (Mebane Oaks Road} over Rock Creek.
Orange County, North Carolina, WBS ElementNo. 17BP.7.R.63
Dear Mr. Bailey and Mr. Wanucl�a:
The North Carolina Department of Transportation (NCDOT) is proposing to replace a
functionally obsolete 18.5'single span timber bridge with a new 20' x 4.5' bottomless box culvert
with a concrete footing keyed into bedrock. An off-site detour will be used to convey traffic
during construction. The project will also include minor approach work on the existing roadway.
Please find enclosed a PCN application, Stormwater Management Plan, Culvert Survey Report,
permit drawings, buffer drawings, a USGS quad map, SHPO Concurrence Forms, and
photographs.
The North Carolina Natural Heritage Database ��vas checked for records of threatened and
endangered species. The database lists four species for Orange County that have federal stahts.
Bald eagle (Haliaeetus leucocephalus) is protected in every county in North Carolina under the
Bald and Golden Eagle Protection Act. Dwarf wedgemussel (Alasmidonta heterodon),
Michaux's sumac (Rhus michauxii), and smooth coneflower (Echinacea laevigata) are listed as
endangered.
Habitat for bald eagle primarily consists of mature forest in proximity to large bodies of open
water for foraging. Large dominant trees are utilized for nesting sites, typically within 1.0 mile of
open water. A desktop-GIS assessment ofthe project study area, as well as the area within a
113-mile radius (1.0 mile plus 660 feet) ofthe project limits, was performed on August 6, 2015
using 2010 color aerials. No water bodies large enough or sufficiently open to be considered
potential feeding sources were identified. Since there was no foraging habitat within the review
area, a survey of the project study area and the area within 660 feet of the project limits was not
conducted. Additionally, a review of the NCNHP database on August 6, 2015 revealed no known
occuirences of this species within 1.0 mile of the project study area. The closest known
occurrence is approximately 3.0 miles east of the project. Due to the lack of habitat, known
occurrences, and minimal impact anticipated for this project, it has been determined that the
subject project will not affect this species.
�Nothing Compares��
StaleofNortLCarolina � DepanmentofTmnsponation � DivisionofHigUways,Division70EFce
] 584 Yanceyville Sireet, Greensbom, NC 27405� P. O. ➢ox 14996, Greensbom, NC 27475-099G
33G-487-0000

Transportation
PAT McCRORY
Govemor
NICHOLAS J. TENNYSON
se�.erary
Dwu•f wedgemussel are small freshwater bivalves found in small streams less than five meters
wide to large rivers more than 100 meters wide. The closest record of dwarf wedgemussel is au
historic occurrence in the Eno River approximately 8.2 miles northwest of the subject bridge.
Therefore, the subject project will have No Effect on this species.
Michaux's sumac grows in sandy or rocky open woods in association with basic soils. Several
populations in North Carolina are on highway rights-of-way, roadsides, or on the edges of
artificially maintained clearings. Surveys conducted in 2012 determined that no plants are
present in the project study area. A review of the NCNIIP database on August 6, 2015 revealed
no known occurrences of this species within 1.0 mile of the project study area. The closest
known occurrence is an historic occurrence approximately 6.0 miles northwest of the project.
Therefore, the subject project will have No Effect on this species.
Smooth coneflower is typically found in open woods, glades, cedar ban�ens, roadsides, clearcuts,
diy limestone bluffs, and power line rights-of-way, usually on magnesium and calcium rich soils.
Smooth coneflower occurs in plant communities that have been described as xeric hardpan
forests, diabase glades or dolomite woodlands. Optimal sites are characterized by abundant
sunlight and little competition in the herbaceous layer. Natural iires, as well as large herbivores,
historically influenced the vegetation in this species' range. Surveys conducted in 2012
determined that no plants are presenY in the project study area. A review of NCNI3P database
revealed no known occurrences of smooth coneflower within 1.0 mile of the study area. The
closest known occurrence is an historic occurrence approximately 14.5 miles from the project.
Therefare, the subject project will have No Effect on this species.
This project was reviewed by NCDOT's Human Environment Unit in 2012 for potential affects to
historical architecture and archaeology. It was determined that no survey was required for
historical architecture. A survey was conducted for archaeology on July 27, 2012, and it was
determined there would be no eligible archaeological resources present within the project study
area.
The project study area is comprised mostly of maintained/residential land with hardwood forest
along the stream banks. There are no additional jurisdictional features associated with Bridge 42
other tlian Rock Cxeek. There is a small wetland on the northwest quadrant of the study area.
The wetland is outside of the construction limits, and therefore will not be impacted by the
proposed project.
NCDOT best management practices (BMPs) will be used to minimize and control sedimentation
and erosion. The construction foreman will review the BMPs daily to ensure erosion and
sedimentation is being effectively controlled. If the foreman dete�mines the devices are not
functioning as intended, they will be replaced immediately with better devices.
�Nothing Compares�.�.
S�ateofNortliCamlina � DepartmentofTranspatlation � DivisionofHighways,Division70�ce
7584 Yanceyville Sveet, Greensboro, NC 27405� P. O. Box 14996, Greensbom, NC 27415-499G
336-487-0000

Transportation
ImPacts to Waters of the United States
PAT McCRORY
Governar
NICHOLASJ.TENNYSON
Seaetary
Rock Creek (DWR Class: WS-V; NSW) is shown on the USGS topographic map as a perennial
stream. The channel is well defined with a substrate primarily composed of sand, silt, and gravel
and is approximately 12-14 feet in width. From the project site, Rock Creek flows approximately
2.0-miles to its confluence with Haw Creek. Haw Creek then flows approximately 8.2-miles to
iYs confluence with tlie Haw River. The Haw River meets the definition of a Traditional
Navigable Water. For tl�ese reasons, we believe Rock Creek is a Relatively Permanent Water and
is under the jurisdiction of the U.S. Army Corps of Engineers. In order to construct the project, it
will be necessary to impact waters of the United States in the Cape Fear River Basin (HIJC
03030002). Specifically, NCDOT is requesting to replace Bridge No. 42 witl� a reinforced
concrete bottomless culvert. The impacts are listed in the table below:
Jurisdictional Impact Summary
Perm. Temp. Perm. Temp.
Existing Existing
Station Structure Size / Type Sw SW Channel Channel
Impacts Impacts
Impacts Impacts
(ac) ( ac) � � _
11+81 to 12+03 — Chamiel realignment for bottomless
LT- culvert, temporaiy pipe, and 0.02 0.01 66 45
11+92 to 12+12 — ]mpervious dikes
RT-
Jordan Lake Buffer Impact Summary
Station Type Zone 1(ft2) Zone 2(ft2)
11+32 to 11+85 —
LT-
12+00 to 12+62 —
LT- Road Fill and Clearing 1,122 598
11+18 to 12+00 —
RT-
12+10 to 12+68 —
RT-
11+89 to 12+11 —
LT- Bridge Fill and Clearing 531 0
11+96 to 12+18 —
RT-
Total 1,653 598
�Nothing Compares�_
Sta[eofNorthCarolina � DepartmentofTransporta�ion � DivisionofHighways,Division70�ce
1584 Yanceyville SUeet, Greensboro, NC 27405� P. O. Hoz 14996, Gmensboro, NC 27415-4996
33fi-487-0000

Transportation
Permits Requested
PAT McCRORY
Governor
NICHOLAS J. TENNYSON
Secrefary
NCDOT is hereby requesting authorization under Section 404 of the Clean Water Act to proceed
with the construction project outlined above. We are also requesting a 401 Water Quality
Certification and Jordan Lake Riparian Buffer Authorization from the North Carolina Department
of Environment and Natural Resources (DENR), Division of Water Resources (DWR).
If you have any questions or need additionai information, please contact Jerry Parker at (336)
256-2063 or jparker(a�ncdot.eov. Your review and consideration are greatly appreciated.
Sincerely,
�1 �� ��/�
J.M. Mills, PE
Division Engineer, Division 7
Enclosures
cc: Tim Powers, NCDOT
Bury Harrington, Roadside Environmental Field Operations Engineer
Jeremy Wanen, NCDOT
Chuck Edwards, District 1, Dishict Engineer
Travis Wilson, Wildlife Resources Commision (electronic copy)
Gary Jordan, US Fish & Wildlife Service (electronic copy)
File Copy
�Nothing Compares�`
State of North Camline � Department of Transporlation � Division ofHig}��vays, Division 7 0fiice
1584 Yanceyville Sheet, Greensboro, NC 27405� P. O. Hox 1499G, Greensborq NC 27415-4996
33G-487-0000

� � o��FW ATFRpG O�ce Use Only:
�� �� � � Corps action ID no.
>
o -~c DWQ project no.
re-Construction Notification P �'iYj��jQn 1.3 Dec 10 20D8
A. A licant Information
1. Processing
1 a. Type(s) of approval sought from the
Corps: � Section 404 Permit ❑ Section 10 Permit
1 b. Specify Nationwide Permit (NWP) number: 14 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps? � Yes ❑ No
1 d. Type(s) of approval sought from the DWQ (check all that apply):
� 401 Water Quality Certification — Regular ❑ Non-404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express � Riparian Buffer Authorization
1e. Is this notification solely for the record For the record only for DWQ 401 For the record only for Corps Permit:
because written approval is not required? Certification:
❑ Yes � No ❑ Yes � No
1f. Is payment into a mitigation bank oY in-lieu fee program proposed for mitigation � Yes ❑ No
of impacts? If so, attach the acceptance letter from mitigation bank or in-lieu
fee program.
1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h ❑ Yes � No
below.
1 h. Is the project located within a NC DCM Area of Environment�l Concern (AEC)? ❑ Yes � No
2. Project Information
2a. Name of project: Replace Bridge No. 42 on SR 1007 over Rock Creek
2b. County: Orange
2c. Nearest municipality / town: Swepsonville
2d. Subdivision name: N/A
2e. NCDOT only, T.I.P. or state 17BP.7.R.63
project no:
3. Owner Information
3a. Name(s) on Recorded Deed: North Carolina Department of Transportation
3b. Deed Book and Page No. N!A
3c. Responsible Party (for LLC if Division Engineer NC DOT Division 7, Mr. Mike Mills, PE
applicable):
3d. Street address: PO Box 14996
3e. City, state, zip: Greensboro, NC 27415
3f. Telephone no.: [phone]
3g. Fax no.: [phone]
3h. Email address: [e-mail]
Page 1 of 11
PCN Form — Version 1.3 December 10, 2008 Version

4. Applicant Information (if different from owner)
4a. Applicant is: ❑ Agent � Other, specify: NC DOT Highway Division 7
4b. Name: Division Engineer NC DOT Division 7, Mr. Mike Mills, PE
4c. Business name NC DOT
(if applicable):
4d. Street address: PO Box 14996
4e. City, state, zip: Greensboro, NC 27415
4f. Telephone no.: [phone]
4g. Fax no.: [phone]
4h. Emalladdl'ess: [e-mail]*note:pfeasealsocopyM�.JerryParker,HighwayDivislon7Environmental
Supervisor on a!I correspondence — jparker v�cdotgov
5. AgentlConsultant Information (if applicable)
5a. Name: Mr. Jerry Parker
Sb. Business name NC DOT Highway Division 7, Division Environmental Supervisor
(if applicable):
5c. Street address: PO Box 14996
5d. City, state, zip: Greensboro, NC 27415
5e. Telephone no.: [phone]
5f. Fax no.: [phone]
5g. Email address: [e-mail]
Page 2 of 11
PCN Form — Version 1.3 December 10, 2008 Version

B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): N/A
1 b. Site coordinates (in decimal degrees): Latitude 36.033721 Longitude: -79.259824
(DD.DDDD�D) (-DD.DDDDDD)
1c. Property size: N/A acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to Rock Creek
proposed project:
2b. Water Quality Classification of nearest receiving water: WS-V; NSW; 16-20-2; 03-06-02
2c. River basin: Cape Fear (HUC 03030002)
3. Project Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application:
The project study area is comprised of mostly maintained/residential with hardwood forest along the stream banks. There
are not additional jurisdictional features associated with Bridge 42 other than Rock Creek. There is a small portion of a
wetland on the norfh side of the study area, but it is located outside the construction limits. The wetland will not be
impacted by the proposed project.
3b. List the total estimated acreage of all existing wetlands on the property:
0.02 acres
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
� 85 LF of stream within the project boundaries
3d. Explain the purpose of the proposed project:
To replace a structurally deficient and functionally obsolete timber bridge.
3e. Describe the overall project in detail, including the type of equipment to be used:
Traffic will be detoured off-site. Erosion and sedimentation control measures will be installed. Water will be diverted around the
construction area. The old bridge will be removed. The proposed stucture will be replaced on its existing alignment. The new
culvert structure will be a 20' by 4.5' bottomless box culvert with a concrete footing keyed into bedrock. The channel will be
excavated and realigned for low flow shaping. Water will be pumped around the work area during construction by installed
impervious dikes upstream and downstream of the existing bridge. Water will be directed into special stilling bains. Equipment
to be used includes a track hoe, dump truck, paving equipment, pumps, and various hand tools.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property! � yes � No ❑ Unknown
project (including all prior phases) in the past7
Comments: N!A
4b. If the Corps made the jurisdictional determination, what type
of determination was made? ❑ Preliminary ❑ Final
4c. If yes, who delineated the jurisdictional areas7 Agency/Consultant Company; N/A
Name (if known): N/A Other: N/A
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations a�d attach documentation.
N!A
5. Project History
5a. Have permits or certifications been requested or obtained for � yes � No ❑ Unknown
this project (including all prior phases) in the past?
5b. If yes, explain in detail according to "help file° instructions.
N!A
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PCN Form — Version 1.3 December 10, 2008 Version

6. Future Project Plans
6a. Is this a phased project? ❑ Yes � No
6b. If yes, expiain.
N/A
Page 4 of 11
PCN Form — Version 1.3 December 10. 2008 Version

C. Proposed Impacts Inventory
1. Impacts Summary
1a. Which sections were completed below for your project (check aIl that apply):
❑ Wetlands � Streams - tributaries � Buffers
❑ Open Waters ❑ Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a. 2b. 2c. 2d. 2e. 2f.
Wetland impact Type ofjurisdiction
number- Type of impact Type of wetland Forested (Corps - 404, 10 Area of impact
Permanent (P) or (if known) DWQ - non-404, other) (acres)
Tem orar T
W1 ❑ P❑ T ❑ Yes ❑ Corps �
❑ No ❑ DWQ
2g. Total wetland impacts �
2h. Comments: There is a small (0.02 acre) wetland to the northwest of the bridge that is outside of the construction limits,
and therefore will not be impacted by the proposed bridge replacement.
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a. 3b. 3c. 3d. 3e. 3f. 3g.
Stream impact Type of impact Stream name Perennial Type of jurisdiction Average Impact
number - � (PER) or (Corps - 404, 10 stream length
Permanent (P) or intermittent DWQ - non-404, width (linear
Temporary (T) (INT)? other) (feet) feet)
Channel
realignment for
bottomless culvert, � PER � Corps P: 66
S1 � P� T temporary pipe, Rock Creek � �NT � DWQ 12-14 T: 45
and impervious
dikes
S2 ❑ P � T ❑ PER ❑ Corps
❑ INT ❑ DWQ
3h. Total Permanent Stream and Tributary Impacts 111'
3i. Comments: Of the 11 LF of stream impacts, only 66 LF are associated with permanent impacts to the stream for the
purpose of stream alignment and fioodplain bench creation. The 45 LF of temporary impacts are associated with the
impervious dikes that will be used upstream and downstream of the proposed crossing. The dewatering of the stream will run
concurrently with the construction activities (i.e. the temporary impacts associated with dewatering are within the permanent
stream impact footprint location).
4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impacts below.
4a. 4b. 4c. 4d. 4e.
Open water Name of waterbody
impact number- (if applicable) Type of impact Waterbody type Area of impact (acres)
Permanent(P)
or Tem ora T
01 ❑P�T
4f. Total open water impacts
4g. Comments: No open water impacts
5. Pond or Lake Construction
If ond or lake construction ro osed, then com lete the chart below.
Page 5 of 11
PCN Form - Version 1.3 December 10, 2008 Version

5a. 5b. 5c. 5d. 5e.
Wetland Impacts (acres) Stream Impacts (feet) Upland
Pond ID Proposed use or purpose of (acres)
number pond
Flooded Filled Excavated Flooded Filled Excavated Flooded
P1
P2
5f. Total
5g. Comments: There are no ponds created for this project
5h. Is a dam high hazard permit required?
❑ Yes ❑ No If yes, permit ID no:
5i. Expected pond surtace area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If an im acts re uire miti ation, then ou MUST fill out Section D of this form.
6a.
❑ Neuse ❑ TarvPamlico � Other: Jordan Lake
Project is in which protected basin? ❑ Catawba ❑ Randleman
6b. 6c. 6d. 6e. 6f. 6g.
Buffer impact
number— Reason Buffer Zone 1 impact Zone 2 impact
Permanent (P) for Stream name mitigation (square feet) (square feet)
or Tem ora T im act re uired?
Road fill ❑ Yes
B1 � P 0 T and Rock Creek � No 1,122 598
clearing
Bridge ❑ Yes
B2 � P❑ T Fill and Rock Creek � No 531 0
Clearing
6h. Total buffer impacts 1,653 598
6i. Comments: The impacts associated with the roadway crossing and culvert installation fall under the "potentially allowable"
category per the Jordan Water Supply Buffer Rules Table of Uses {15A NCAC 02B .0267 (9)}
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
The proposed project is to remove and replace a structurally deficient bridge and replace it with a bottomless culvert.
Roadway approach work is minimized as much as is practical to reduce the overall project footprint. Impacts to the
associated protected riparian buffers have also been reduced by promoting sheet flow as well as providing grass shoulders to
promote infiltration. An off-site detour will be employed to avoid the need for a temporary parallel structure. Bank stabilization
will be minimized to those areas where deemed necessary.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Erosion and sedimentation BMPs will be installed prior to construction. Water will be diverted around the work area to prevent
sedimentation of downstream aquatic resources. Impacts will be minimized by strict enforcement of Best Management
Practices for the protection of surtace waters, restrictions against the staging of equipment in or adjacent to waters of the US
and coordination (including a pre-construction meeting) with the Division Environmental Supervisor.
Page 6 of 11
PCN Form — Version 1.3 December 10, 2008 Version

2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for � Yes ❑ No
impacts to Waters of the U.S, or Waters of the State?
2b. If yes, mitigation is required by (check all that apply): ❑ DWQ ❑ Corps
❑ Mitigation bank
2c. If yes, which mitigation option wiil be used for this project? � Payment to in-lieu fee program
❑ Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter) Type Quantity
3c. Comments:
4. Complete if Making a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached. � Yes
4b. Stream mitigation requested: 66
4c. If using stream mitigation, stream temperature: � warm ❑ cool ❑cold
4d. Buffer mitigation requested (DWQ only): square feet
4e. Riparian wetland,mitigation requested: acres .
4f. Non-riparian wetland mitigation requested: acres
4g. Coastal (tidal) wetland mitigation requested: acres
4h. Comments: NCDOT proposes to provide 1:1 mitigation for the impacts to the stream with the installation of the bottomless
culvert. NCDOT does not believe a 2:1 mitigation ratio is required as the thalweg of the channel will not be permanently
impacted with structures or fill. The stream banks will be reshaped and floodplain benches will be built with streambank
stabilization to prevent sour/erosion around the footers of the 3-sided culvert.
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation pla�.
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PCN Form — Version 1:3 December 10, 2008 Version

6. Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation? ❑ Yes � No
While there are impacts to the protected Jordan Riparian area, these impacts are
"allowable" per the Table of Uses {15A NCAC 026.0267(9)}
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigatio� required.
6c. 6d. 6e.
Zone Reason for impact Total impact Multiplier Required mitigation
(square feet) (square feet)
Zone 1 3(2 for Catawba)
Zone 2 1.5
6f. Total buffer mitigation required:
6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in-lieu fee fund).
6h. Comments:
Page 8 of 11
PCN Form — Version 1.3 December 10, 2008 Version

E. Stormwater Management and Diffuse Flow Plan (required hy DWQ)
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers identified � yes ❑ No
within one of the NC Riparian Buffer Protection Rules?
1 b. If yes, then is a diffuse fiow plan included? If no, explain why.
Comments: The proposed structure will be a 20' by 4.5' bottomless culvert. There is
a slight increase in impervious surface and any additional stormwater generated will ❑ Yes � No
be minimal. Additionally, existing grass lined ditches will be utilized in the same
manner as they are now for conveying stormwater to the stream.
2. Stormwater Mana ement Plan
2a. What is the overall percent imperviousness of this project? N/A %
2b. Does this project require a Stormwater Management Plan? � Yes ❑ No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why:
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
Plan is attached.
❑ Certified Local Government
2e. Who will be responsible for the review of the Stormwater Management Plan? ❑ DWQ Stormwater Program
� DWQ 401 Unit
3. Certified Local Government Stormwater Review
3a. In which local governmenYs jurisdiction is this project7
❑ Phase II
3b. Which of the following locally-implemented stormwater management programs ❑ NSW
apply (check all that apply): ❑ USMP
❑ Water Supply Watershed
❑ Other:
3c. Has the approved Stormwater Management Plan with proof of approval been ❑ Yes ❑ No
attached?
4. DWQ Stormwater Pro ram Review
❑ Coastal counties
❑ HQW
4a. Which of the following state-implemented stormwater management programs apply � ORW
(check all that appiy): ❑ Session Law 2006-246
❑ Other:
4b. Has the approved Stormwater Management Plan with proof of approval been
attached? ❑ Yes ❑ No
5. DWQ 401 Unit Sformwater Review
5a. Does the Stormwater Management Plan meet the appropriate requirements? ❑ yes ❑ No
5b. Have all of the 401 Unit submittal requirements been met? ❑ Yes ❑ No
Page 9 of 11
PCN Form — Version 1.3 December 10, 2008 Version

F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1 a. Does the project involve an expenditure of public (federal/statellocal) funds or the � Yes ❑ No
use of public (federal/state) land?
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 ❑ Yes � No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1 c. If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
letter.) ❑ Yes ❑ No
Comments:
2. Violations (DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ SurFace Water or Wetland Standards, ❑ Yes � No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. Is this an after-the-fact permit application? ❑ Yes � No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in � Yes � No
additional development, which could impact nearby downstream water quality?
3b. If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
Per the NC DWQ April 10, 2004 Version 2.1 Cumulative Impacts policy, small scale public transportation projects — such
as widening projects, bridge replacements and intersection improvements — have a"low potential for cumulative impact
since little (if any) new impervious surface is added and the projects are usually in already developed locales." This
proposed project is within a somewhat developed landscape (i.e. existing residential homes in the vicinity), this is not a
road on a new location (i.e. there is an existing road and bridge structure and thus, the area already contains impervious
surfaces) and the project drains to Rock Creek which is Class WS-V; Nutrient Sensitive Waters (NSW) (i.e. not ORW,
HQW, or 303(d) listed waters). We anticipate the NC DWR will advise us if a qualitative or quantitative analysis is
needed.
4. Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility.
It is not anticipated that this project will generate any wastewater as it is a roadway project.
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5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or � yes � No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act � yes ❑ No
impacts?
� Raleigh
5c. If yes, indicate the USFWS Field Office you have contacted.
❑ Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
North Carolina Natural Heritage Database and onsite investigation.
6. Essential Fish Habitat (Corps Requirement�
6a. Will this project occur in or near an area designated as essential fish habitat? ❑ Yes � No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
This bridge replacement project takes place in Orange County which is not near any coastal or tidal habitat that would
support EFH (i.e. salt marshes; oyster reefs, 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 � yes � No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
This project was submitted to the North Carolina Department of Transportation's Human Environment Unit for review in
2012. It was determined that no survey was required for historical architecture, and a field survey on June 27, 2012
supported that no archaeological resources will be affected by this project.
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 requireme�ts:
8c. What source(s) did you use to make the floodplain determination? North Carolina Floodplain Mapping Program
Mr. Mike Mills, PE � /��
ApplicanUAgenYs Printed Name
I'1�• %��
A plicant/AgenYs Signat� Date
(AgenPs signature is valid only if an authorization letter from the
a licant is rovided.
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