20240682 Ver 1_ePCN Application_20240514

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# *
20240682 1
Is a payment required for this project?*
No payment required
Fee received
Fee needed - send electronic notification
Select Project Reviewer*
Mary Plummer:mary.plummer
Information for Initial Review
la. Name of project:
Replacement of Bridge No. 030231 on SR 1637 (Jacks Branch Road) over Cabin Branch
1a. Who is the Primary Contact?*
Joel Howard
1b. Primary Contact Email: *
[e-mail]
Date Submitted
5/14/2024
Nearest Body of Water
Cabin Creek
Basin
Yadkin-PeeDee
Water Classification
C
Site Coordinates
Latitude: Longitude:
35.059559-80.145576
A. Processing Information
Is this project connected with ARPA funding?
Yes No
County (or Counties) where the project is located:
Anson
Is this a NCDMS Project
Yes No
Reviewing Office*
Mooresville Regional 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:
BP10-R033
W BS # (?)
BP10.R033
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
1e. 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)
Ile. Is there an Agent/Consultant for this project?
Yes No
2. Owner Information
2a. Name(s) on recorded deed:
NCDOT, Division 10
2b. Deed book and page no.:
2c. Contact Person:
401 Water Quality Certification - Express
Riparian Buffer Authorization
Yes No
Yes No

2d. Address
Street Address
716 West 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:
Wadesboro
2. Project Identification
2a. Property Identification Number:
Roadway easement
2c. Project Address
Street Address
3759-3755 Jacks Branch Road
Address Line 2
City
Wadesboro
Postal / Zip Code
28170
3. Surface Waters
3a. Name of the nearest body of water to proposed project:
Cabin Creek
3b. Water Resources Classification of nearest receiving water:
C
3c. What river basins) is your project located in?*
Yadkin-PeeDee
3d. Please provide the 12-digit HUC in which the project is located.
030401040105
4. Project Description and History
State / Province / Region
NC
Country
USA
2f. Fax Number:
2b. Property size:
9.7
State / Province / Region
NC
Country
USA
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:
Rural roadway.
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:
1.04
4g. List the total estimated linear feet of all existing streams on the property:
756
4h. Explain the purpose of the proposed project: *
The primary purpose of the proposed project is to improve safety of Bridge No. 231, which was
built in 1951 and has been deemed functionally obsolete.

4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used: *
The project proposes to replace bridge No. 231, which is over Cabin Branch on SR 1637 (Jacks Branch Rd.) in Anson County, approximately 3.5 miles southwest of Ansonville. The
existing structure is approximately 25 feet long and 20 feet wide. SR 1637 has a posted speed limit of 55 miles per hour (mph). The curve of the road at the bridge has a radius of
approximately 450 feet with a designed speed of 35 mph. The replacement structure will be a bridge approximately 55 feet long and 33 feet wide, with approach slabs 11 feet long and 33
feet wide on both ends of the new bridge The roadway on the structure will have 2 lanes 10 feet wide and shoulders 3 feet and 11 inches wide. The bridge length is based on preliminary
design information and is set by hydraulic requirements.
Project construction will extend approximately 140 feet to the south of the approach slab and 105 feet to the north of the approach slab. The approaches will provide two 10-foot lanes and
3-foot shoulders. The roadway is designed as a Rural Local with a 40-mph design speed. Standard road construction and bridge installation equipment such as cranes, excavators, dump
trucks, and similar vehicles would be used for the project. Proper erosion and sedimentation control measures would be employed throughout the project.
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-2023-00478
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Byron Levan and Trevor Hall
Agency/Consultant Company: Three Oaks Engineering
Other:
5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
PJD - April 28, 2023.
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 r' Buffers
Open Waters Pond Construction
2. Wetland Impacts
U
2a1 Reason (?)
2b. Impact type * M
2c. Type of W. *
2d. W. name
2e. Forested *
2f. Type of Jurisdicition *
�29. Impact
(?)
area *
Conversion, construction
access
P
Fttomland Hardwood Forest
WA
Yes
Corps
0.005
(acres)
Fill, roadway
P
mland Hardwood Forest
ff
WA
Yes
Corps
0.010
(acres)
Conversion, construction
access
P
Headwater Forest
WC
Yes
Corps
0.005
(acres)
2g. Total Temporary Wetland Impact
0.000
2g. Total Wetland Impact
0.020
2g. Total Permanent Wetland Impact
0.020
2i. Comments:
There are 0.010 acres of proposed permanent wetlands impacts from roadway fill for the bridge replacement. There are 0.010 acres of proposed
permanent wetland impacts from mechanized clearing for the bridge replacement. Wetland areas cleared of vegetation, will be used for the bridge
replacement, and then maintained for future access.
There are a total of 0.020 acres of proposed permanent wetland impacts.

3. Stream Impacts
❑
g1
3a. Reason for impact (?)
Bank stabilization
3b.lmpact type"
Permanent
3c. Type of impact*
Bank Stabilization Jabin
3d. S. name*
Branch
3e. Stream Type*
(?)
Perennial
3f. Type ofwidth
Jurisdiction*
Both
14
Aveage (feet)
3h. Impact
length*
58
(linear feet)
fl
Dewatering, construction
aCCeSS
Temporary
Dewatering
Cabin Branch
Perennial
Both
h;J�l
31. Total jurisdictional ditch impact in square feet
0
3i. Total permanent stream impacts: 3i. Total temporary stream impacts:
58 17
31. Total stream and ditch impacts:
75
3j. Comments:
There are 58 linear feet of proposed permanent stream impacts for the bridge replacement.
There are 17-linear feet of proposed temporary stream impacts for dewatering and construction access for the bridge replacement.
There are a total of 75-linear feet of proposed permanent and temporary stream impacts.
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 wetland and stream impacts have been kept to the minimum possible to allow for the infrastructure installation. The planned limits of
disturbance for construction were reduced following the wetland delineation to reduce potential impacts. The proposed impact amounts would be a
maximum of potential impacts to the features. The actual construction efforts to replace the infrastructure will likely require less than the proposed totals
and will be the minimum necessary to install the infrastructure.
The stream bed in areas of proposed temporary stream impacts will be restored to pre -project elevations and widths using natural stream bed material.
Temporarily impacted stream banks in planned maintained easements will be restored through regrading, seeding, and woven coir fiber mat and then be
maintained for future maintenance access. Temporarily impacted stream banks outside of planned maintained easements will be restored through
regrading, seeding, woven coir fiber mat, and live staking of deep-rooted native species.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
In wetlands and across stream channels, stumps will be grubbed only as needed to install the infrastructure, and remaining stumps will be cut off at
grade level. The general stripping of topsoil within wetlands along the construction corridor will be avoided. Heavy equipment working in wetlands will be
placed on mats to minimize soil disturbance and compaction. Work in wetlands and streams will be limited to only what is necessary to install the
infrastructure.
All work in or adjacent to streams will be conducted so that the flowing stream does not come in contact with the disturbed area. There will be no change
in pre -construction contours of waters of the United States in temporarily impacted areas. Erosion control matting that incorporates plastic mesh and/or
plastic twine will not be used along streambanks or within wetlands. All mechanized equipment operated near surface waters shall be inspected and
maintained regularly to prevent contamination of surface waters from fuels, lubricants, hydraulic fluids, or other toxic materials. Construction shall be
staged in order to minimize the exposure of equipment to surface waters to the maximum extent practicable.
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)
4d. Buffer mitigation requested (DWR only):
(square feet)
4c. If using stream mitigation, what is the stream temperature:
4e. Riparian wetland mitigation requested:
(acres)
Q
V

4f. Non -riparian wetland mitigation requested:
(acres) 4g. Coastal (tidal) wetland mitigation requested:
0.020 (acres)
4h. Comments
Mitigation of 0.020 riparian wetland credits is proposed for 0.020 acres of permanent wetland impacts for fill and mechanized clearing associated with
the bridge replacement. A mitigation acceptance letter for 0.020 riparian wetland credits from the North Carolina Division of Mitigation Services is
attached.
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:
Not in protected buffer watershed.
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?
Yes No
Comments:
A stormwater management plan is attached along with the permit drawings. Project designed to meet BMP standards outlined in NCDOT's Individual NPDES permit NCS000250.
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: *
The proposed project qualifies as a minimum criteria project (checklist attached).
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 not alter travel patterns, reduce travel time or open areas for development or redevelopment. This project will not influence nearby land
uses or stimulate growth.
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
PC
Q

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?
USWFS IPAC and scoping with USFWS Asheville.
6. Essential Fish Habitat (Corps Requirement)
Ga. 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?
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?
A Historic Architecture and Landscapes No Survey Required Form for the proposed project was completed by a NCDOT Architectural Historian on
December 14, 2021 (attached).
A No Archaeological Survey Required Form for the proposed project was completed by a NCDOT Archaeologists on November 29, 2021 (attached).
A tribal coordination letter was distributed on May 10, 2024 to the Catawba Indian Nation (attached). As of the date of this letter a response has not been
received. A response once received will be forwarded.
8. Flood Zone Designation (Corps Requirement)
Be. Will this project occur in a FEMA-designated 100-year floodplain?
Yes No
8b. If yes, explain how project meets FEMA requirements:
Hydraulics Unit coordination with FEMA.
8c. What source(s) did you use to make the floodplain determination?"
FEMA floodplain mapper.
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
BP10.R033 cover letter_5_14_2024 (002).pdf 303.44KB
BP10.R033 attachments _5_14_2024 (002).pdf 13.06MB
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:
Joel M. Howard
Signature
IW M. h ow. #P
Date
5/14/2024