20160505 Ver 1_Application_20160518

Carpenter, Kristi
From: Hood, Donna
Sent: Wednesday, May 18, 2016 12:17 PM
To: Carpenter,Kristi
Subject: FW: Bridge #71 Replacement, SR 1338 (St. Clair Road), Alexander County
Attachments: Perm it_application_package.pdf; permit_plans.pdf; image2jpg; image3jpg;
image4jpg;image6jpg
Follow Up Flag: Follow up
Flag Status: Completed
I forgot to send this to you—my sincere apologies!
The Monroe Bypass has messed up my mind lately. O
From: Beam, Patricia
Sent: Wednesday, April 13, 2016 10:01 AM
To: Hood, Donna <[e-mail]>; Kichefski, Steven L SAW (Steven. L. [e-mail])
<[e-mail]>
Cc: Henderson, Andrew <[e-mail]>
Subject: Bridge #71 Replacement, SR 1338 (St. Clair Road), Alexander County
This project was originally submitted as a non -notifying NW 3 due to consultant design which did not included riprap
under the bridge; however, the contractor working on the project and the Division 12 Bridge Engineer have requested
that riprap be placed under the bridge and tied into the riprap ditchlines. This will require an additional 50 feet of riprap
impacts, which is above the DWR GC#3883 threshold for non -notifying.
Please note that the project has been let and the contractor is mobilizing equipment to begin work on the project. It
would be appreciated if this application could be expedited.
Thank you
Trish Beam
Division 12 Environmental Office
From: Beam, Patricia
Sent: Tuesday, November 24, 2015 3:55 PM
To: Kichefski, Steven L SAW (Steven. L. [e-mail]) <Steven. L. [e-mail]>; Hood, Donna
<[e-mail]>
Subject: Bridge #71 Replacement, SR 1338 (St. Clair Road), Alexander County
The North Carolina Department of Transportation proposes to replace an existing 40.6 foot long x 20 foot wide timber
deck bridge with a 70 -ft long x 20 ft wide concrete bridge on SR 1338, St. Clair Road in Alexander
County. Approximately 5 feet of riprap slope protection will be used at the end of the new ditchlines in all four
quadrants of the project. Therefore, there will be a total of 20 feet of permanent riprap impacts Grassy Creek, which is
classified as Class C waters by the Division of Water Resources. The project will not impact any federally listed T & E
species (survey conducted 6/25/15, bat habitat assessment form for bridge and surrounding trees completed February
2015; available upon request) or historical structures (NCDOT Cultural Resources Review- Internal Tracking No. 13-08-
0007). No wetlands or high quality waters will be impacted by this project.

Also provided below is a link to google map of the proposed permit site:
https://www.google.com/maps/place/St+Clair+Rd,+Taylorsvil Ie,+NC+28681/@35.9809844,-
81.195897,217m/data=!3m 1! 1e3!4m2!3m 1! 1sOx88511501991b01cd:Oxa86fe580e6be0e05
We intend to utilize a NW 3, with no formal notification for the construction of the project. Please let me know if you
need additional information regarding this project. Attached is a map and plans of proposed activities.
Thank you,
Trish Beam
Division 12 Environmental Office
Email correspondence to and from this sender is subject to the N.C. Public Records Law and may be disclosed to third parties.

Transportation
April 13, 2016
Mr. Steve Kichefski
Asheville Regulatory Field Office
US Army Corp of Engineers
151 Patton Avenue
Asheville, NC 28801-5006
PAT McCRORY
Governor
NICHOLAS J.TENNYSON
Secretary
SUBJECT: Bridge #71 Replacement on SR 1338 (St. Clair Road), Alexander County
Dear Mr. Kichefski:
The North Carolina Department of Transportation requests authorization to replace an existing
40.6 -foot long x 20 -foot wide timber deck bridge with a 70 -ft long x 20 -ft wide concrete bridge on
SR 1338 (St. Clair Road) in Alexander County. NCDOT proposes to place a total of 70 feet of
riprap bank stabilization under Bridge 471. Therefore, there will be a total of 70 -feet of permanent
riprap impacts to Grassy Creek, which is classified as Class C waters by the Division of Water
Resources.
The Division 12 Environmental Office conducted a threatened/endangered species survey on SR
1338 (St. Clair Road) on June 25, 2015. The federally listed species for Alexander County (USFWS
listed dated July 24, 2015) include the dwarf -flowered heartleaf (Hexastylis nanii lora)- Threatened;
the bog turtle (Clemmys muhlenbergii)- Threatened due to similarity of Appearance (T/SA); and
the Northern Long Eared Bat (Myotic septentrionalis)- Threatened. The Natural Heritage Program
records document the nearest dwarf -flowered heartleaf location approximately 11.5 miles southeast
of the proposed project. The heartleaf is usually found on dry to moist ravine slopes (usually north
facing and of the oak -hickory -pine forest type) and in boggy areas near springheads. There is no
potential habitat within the proposed project area and no species were observed. There will be "No
Effect' on the Hexastylis nanii lora species for this project. The Natural Heritage Program records
document the bog turtle location approximately 4 miles southeast of the proposed project. Bog
turtles are typically found in bogs, marshes, and wet pastures. There is no suitable habitat located
within the project footprint. T/SA species are not subject to Section 7 consultation; however, no
habitat existed at the project and no species were observed; no impact on this species is anticipated.
The Natural Heritage Program records document the nearest Northern Long Eared Bat location
approximately 20 miles northwest of the proposed project area. During summer, northern long-
eared bats roost singly or in colonies underneath bark, in cavities, or in crevices of both live and
dead trees. They may also roost in cooler places, like caves and mines. Tree species may be used
based on suitability to retain bark or provide cavities or crevices. It has also been found, rarely,
roosting in structures like barns and sheds. Northern long-eared bats spend winter hibernating in
humid caves and mines. Minimal roadside tree clearing will be done as part of these pipe
replacements project. There are no abandoned structures, barns or shed in close vicinity and the
closest underground mine — Dagenhart mine (per NET database) is 7.2 miles southeast of the
project area.

Bridge #71 Replacement, SR 1338, St. Clair Road
Page 2
April 13, 2016
There are currently no known hibernaculum or maternity roost trees in Division 12 counties for
NLEB; therefore, the minor tree clearing associated with this DOT project would be exempted from
incidental take under the 4d rule. Attached is the U.S. Fish and Wildlife Service (USFWS) NLEB
4(d) Rule streamlined consultation form. Per guidance from USFWS personnel, concurrence is
granted by citing the following website and a 30 day response period is waived.
http:/hvww.fws.gov/asheville/htmis/project review/NLEB_in WNC.html
There are no sites listed on the National Register of Historic Places are located in the vicinity of
the project and the project has been reviewed and cleared by cultural resources staff (NCDOT
Cultural Resources Review — Internal Tracking No. 13-08-0007).
The project area is not located within /2 mile of any critical watershed area nor is SR 1338 a rural
or urban arterial; therefore, hazardous spill basins are not required. Enclosed is the hazardous spill
basin checklist.
I have enclosed a pre -construction notification for a NW#3, sketches of planned activities and
location maps relative to the project.
Project information for the 401 Automated Payment Procedure is as follows:
• Work order number: 150475-55120005-17BP.12.R.103-3372
• TIP#: NA
• Project Category: $240.00 Fee
If you have any questions or concerns please feel free to contact me at [phone]. Thank you for your
time and consideration on this matter.
Respectfully yours,
Mark Stafford, P.E.
Division Engineer
Twelfth Division
BY: I��
Trish Beam
Division 12 Environmental Supervisor
Enclosures

O�pF VIA
o ®1
Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Page 1 of 11
PCN Form — Version 1.3 December 10, 2008 Version
Pre -Construction Notification (PCN) Form
A. Applicant Information
1.
Processing
1 a.
Type(s) of approval sought from the
Corps:
®Section 404 Permit El Section 10 Permit
1b.
Specify Nationwide Permit (NWP) number: 3 or General Permit (GP) number:
1c.
Has the NWP or GP number been verified by the Corps?
❑ Yes
® No
1d.
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
le.
Is this notification solely for the record
because written approval is not required?
For the record only for DWQ 401
Certification:
❑ Yes M No
For the record only for Corps Permit:
M Yes ❑ No
1f.
Is payment into a mitigation bank or in -lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in -lieu
fee program.
❑ Yes
M No
1g.
Is the project located in any of NC's twenty coastal counties. If yes, answer 1h
below.
❑ Yes
M No
1 h.
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes
M No
2.
Project Information
2a.
Name of project:
Bridge #71, SR 1338 (St. Clair Road)
2b.
County:
Alexander
2c.
Nearest municipality/ town:
Taylorsville
2d.
Subdivision name:
2e.
NCDOT only, T.I.P. or state
project no:
17BP.12.R.103
3.
Owner Information
3a.
Name(s) on Recorded Deed:
NC DOT Right of Way
3b.
Deed Book and Page No.
3c.
Responsible Party (for LLC if
applicable):
3d.
Street address:
3e.
City, state, zip:
3f.
Telephone no.:
3g.
Fax no.:
3h.
Email address:
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:
4b.
Name:
Mark Stafford
4c.
Business name
(if applicable):
N.C. Department of Transportation, Division 12
4d.
Street address:
1710 East Marion Street
4e.
City, state, zip:
Shelby, NC 28151
4f.
Telephone no.:
704-480-9020
4g.
Fax no.:
704-480-5401
4h.
Email address:
[e-mail]
5.
Agent/Consultant Information (if applicable)
5a.
Name:
Trish Beam
5b.
Business name
(if applicable):
N.C. Department of Transportation, Division 12
5c.
Street address:
1710 East Marion Street
5d.
City, state, zip:
Shelby, NC 28151
5e.
Telephone no.:
704-480-9044
5f.
Fax no.:
704-480-5401
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):
NA
Latitude: 35.980936 Longitude: -
1b. Site coordinates (in decimal degrees):
81.196119
(DD.DDDDDD) (-DD.DDDDDD)
1c. Property size:
<.01 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
Grassy Creek
proposed project:
21b. Water Quality Classification of nearest receiving water:
C
2c. River basin:
Catawba
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:
Existing 40.6 -foot x 20 -foot timber bridge; Land use around project site is designated mixed forest land and deciduous
forest land; bridge is on paved secondary road.
3b. List the total estimated acreage of all existing wetlands on the property:
0
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
200 feet
3d. Explain the purpose of the proposed project:
The purpose of the proposed work is to replace the deteriorating bridge for the safety of the travelling public.
3e. Describe the overall project in detail, including the type of equipment to be used:
The North Carolina Department of Transportation requests authorization to replace an existing 40.6 -foot long x 20 -foot
wide timber deck bridge with a 70 -ft long x 20 -ft wide concrete bridge on SR 1338 (St. Clair Road) in Alexander County.
NCDOT proposes to place a total of 70 feet of riprap bank stabilization under Bridge #71. All Best Management Practices
will be utilized during the course of the project. The Project will be constructed using typical heavy equipment (trackhoe,
backhoe, etc.)
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past?
❑ Yes ® No ❑ Unknown
Comments: Jurisdictional stream determination made by
Division 12 DEO.
4b. If the Corps made the jurisdictional determination, what type
❑ Preliminary ❑ Final
of determination was made?
4c. If yes, who delineated the jurisdictional areas?
Agency/Consultant Company:
Name (if known):
Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
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.
Page 3 of 11
PCN Form — Version 1.3 December 10, 2008 Version

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

C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all 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 of jurisdiction
number —
Type of impact
Type of wetland
Forested
(Corps - 404, 10
Area of impact
Permanent (P) or
(if known)
DWQ — non -404, other)
(acres)
Temporary T
W1 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W2 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W3 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W4 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W5 ❑ P F-1 T
El Yes
El Corps
❑ No
❑ DWQ
W6 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
2g. Total wetland impacts
2h. Comments:
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)
Riprap bank
S1 ®P El T
stabilization under
Grassy Creek
® PER
® Corps
g
70
bridge/end of
ElINT
® DWQ
ditchlines
S2 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S3 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S4 E] P ❑ T
E] PER
E] Corps
❑ INT
❑ DWQ
S5 E] P F-1 T
E] PER
El Corps
❑ INT
❑ DWQ
S6 F-1 P F] T
El PER
El Corps
❑ INT
❑ DWQ
3h. Total stream and tributary impacts
70
3i. Comments:
Page 5 of 11
PCN Form —Version 1.3 December 10, 2008 Version

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.
41b.
4c.
4d.
4e.
Open water
Name of waterbody
impact number —
(if applicable)
Type of impact
Waterbody type
Area of impact (acres)
Permanent (P) or
Temporary T
01 []PDT
02 ❑P❑T
03 ❑P❑T
04 ❑P❑T
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If pond or lake construction proposed, then complete the chart below.
5a.
5b.
5c.
5d.
5e.
Wetland Impacts (acres)
Stream Impacts (feet)
Upland
Pond ID
Proposed use or purpose
(acres)
number
of pond
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
P2
51% Total
5g. Comments:
5h. Is a dam high hazard permit required?
❑ Yes ❑ No If yes, permit ID no:
5i. Expected pond surface 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 any impacts require mitigation, then you MUST fill out Section D of this form.
6a.
❑ Neuse El Tar -Pamlico El Other:
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) or
for
Stream name
mitigation
(square feet)
(square feet)
Temporary T
impact
required?
B1 ❑P❑T
El Yes
❑ No
B2 ❑P❑T
F1 Yes
❑ No
B3 ❑P❑T
❑Yes
El No
6h. Total buffer impacts
6i. Comments:
Page 6 of 11
PCN Form — Version 1.3 December 10, 2008 Version

D. Impact Justification and Mitigation
1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Minimization of impacts by installing appropriate erosion control measures.
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 yes, mitigation is required by (check all that apply):
❑ DW Q ❑ Corps
2c. If yes, which mitigation option will be used for this
project?
❑ Mitigation bank
E3 Payment to in -lieu fee program
❑ Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
31b. 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
41b. Stream mitigation requested:
linear feet
4c. If using stream mitigation, stream temperature:
❑ warm ❑ cool ❑cold
4d. Buffer mitigation requested (DWQ only):
square feet
4e. Riparian wetland mitigation requested:
acres
4 Non -riparian wetland mitigation requested:
acres
4g. Coastal (tidal) wetland mitigation requested:
acres
4h. Comments:
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
Page 7 of 11
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
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.
Zone
6c.
Reason for impact
6d.
Total impact
(square feet)
Multiplier
6e.
Required mitigation
(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 by DWQ)
1.
Diffuse Flow Plan
1 a.
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 flow plan included? If no, explain why.
❑ Yes ❑ No
Comments:
2.
Stormwater Management Plan
New bridge slightly wider; therfore,
2a.
What is the overall percent imperviousness of this project?
there is an 0.10 acre increase
in built upon area %
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:
See attached documentation
❑ 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 government's jurisdiction is this project?
NA
❑ Phase II
31b.
Which of the following locally -implemented stormwater management programs
❑ NSW
❑ USMP
apply (check all that apply);
❑ Water Supply Watershed
❑ Other:
3c.
Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ❑ No
attached?
4.
DWQ Stormwater Program Review
❑ Coastal counties
❑ HQW
4a.
Which of the following state -implemented stormwater management programs apply
❑ ORW
(check all that apply):
❑ Session Law 2006-246
❑ Other:
4b.
Has the approved Stormwater Management Plan with proof of approval been
attached?
❑ Yes ❑ No
5.
DWQ 401 Unit Stormwater 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)
1a.
Does the project involve an expenditure of public (federal/state/local) 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)?
1c.
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
❑ Yes
❑ No
letter.)
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)?
21b.
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.
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.
Page 10 of 11
PCN Form — Version 1.3 December 10, 2008 Version

S.
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?
E] 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?
NC Natural Heritage Program database and on-site surveys.
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?
No salt marshes, oyster reefs, or seagrass beds located in vicinity of project.
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?
Cultural Resources review. Tracking number (13-08-0007).
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: NCDOT Hydraulics coordination with FEMA
8c.
What source(s) did you use to make the floodplain determination? FEMA FIRM panal number: 3710385100J
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Applicant/Agent's Printed NameApp��
Iicant/Agelr�ts SkrAture
Date
(Agent's signature is valid only !fan authorization letterfrom the applicant
is provided.
Page 11 of 11
PCN Form — Version 1.3 December 10, 2008 Version

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NCDOT
HAZARDOUS SPILL BASIN CHECKLIST
Division: 1) County: Alexander Project ID: 17BP.12.R.103
River Basin: Catawba Bridge No: 71
Route: SR 1338 Stream: Grassy Creek
Water Quality Criteria:
Yes No
Stream Crossing Blue Line On USGS w r
ORW r r
WSI r wo
WS 11,111 OR N, Crossing Within 0.5mi of W.S. Critical Area r
Roadway Criteria:
Route Designation- Yes No
Additional Site Information:
Arterial Urban &-` tv
Arterial Rural F Wo
Yes No
Is a Hazardous Spill Basin Required? r w
Criteria Based Upon NCDOT "Best Management Practices for the
Protection of Surface Waters" (March, 1997).

Northern Long -Eared Bat 4(d) Rule Streamlined Consultation Form
Federal agencies should use this form for the optional streamlined consultation framework for the northern long-
eared bat (NLEB). This framework allows federal agencies to rely upon the U.S. Fish and Wildlife Service's
(USFWS) January 5, 2016, intra -Service Programmatic Biological Opinion (BO) on the final 4(d) rale forthe
NLEB for section 7(a)(2) compliance by: (1) notifying the USFWS that an action agency will use the streamlined
framework; (2) describing the project with sufficient detail to support the required determination; and (3) enabling
the USFWS to track effects and determine if reinitiation of consultation is required per 50 CFR 402.16.
This form is not necessary if an agency determines that a proposed action will have no effect to the NLEB or if
the USFWS has concurred in writing with an agency's determination that a proposed action may affect, but is not
likely to adversely affect the NLEB (i.e., the standard informal consultation process). Actions that may cause
prohibited incidental take require separate formal consultation. Providing this information does not address
section 7(a)(2) compliance for any other listed species.
Information to Determine 4(d) Rule Compliance:
YES NO
1. Does the project occur wholly outside of the WNS Zone'?
❑
2. Have you contacted the appropriate agency2 to determine if your project is near
0
❑
known hibemacula or maternity roost trees?
3. Could the project disturb hibernating NLEBs in a known hibernaculum?
❑
4. Could the project alter the entrance or interior environment of a known
❑
hibemaculum?
5. Does the project remove any trees within 0.25 miles of a known hibernaculum at
❑
any time of ear?
6. Would the project cut or destroy known occupied maternity roost trees, or any
❑
EJ
other trees within a 150 -foot radius from the maternity roost tree from June 1
through July 31.
You are eligible to use this form if you have answered yes to question #1 or yes to question #2 and no to
questions 3, 4, 5 and 6. The remainder of the form will be used by the USFW S to track our assumptions in the
BO.
Agency and Applicane (Name, Email, Phone No.): NCDOT, Division 12, Trish Beam,
pdbeant a ncdot. Llov, 704-480-9044
Project Name: Bridge #71 Replacement, SR 1338 (St. Clair Road), Alexander County
Project Location (include coordinates if known):
Basic Project Description (provide narrative below or attach additional information): Replacement of a
timber bridge with bridge on same location.
1http://www.fv .gov/midwest/endangered/=mtnaWnleb/pdf/WNSzone.pdf
See http://www.fws.gov/midwest/endangered/mammals/nleb/nhisites.html
If applicable - only needed for federal actions with applicants (e.g., for a permit, etc.) who are party to the consultation

General Project Information
YES NO
Does the project occur within 0.25 miles of a known hibernaculum?
❑
Does the project occur within 150 feet of a known maternity roost tree?
❑
Does the proj ect include forest conversion'? (if yes, report acreage below)
❑ 0
Estimated total acres of forest conversion
If known, estimated acres' of forest conversion from April l to October 31
If known, estimated acres of forest conversion from June 1 to Jul 316
Does the project include timber harvest? (if yes, report acreage below)
❑
Estimated total acres of timber harvest
If known, estimated acres of timber harvest from April 1 to October 31
If known, estimated acres of timber harvest from June 1 to July 31
Does the project include prescribed fire? (if yes, report acreage below)
❑
Estimated total acres of prescribed fire
If known, estimated acres of prescribed fire from April I to October 31
If known, estimated acres of prescribed fire from June 1 to July 31
Does the project install new wind turbines? (if yes, report capacity in MW below)
❑
Estimated wind capacity
Ageney Determination:
By signing this form, the action agency determines that this project may affect the NLEB, but that any
-resulting incidental take of the NLEB is not prohibited by the final 4(d) rule,
If the USFWS does not respond within 30 days from submittal of this form, the action agency may
presume that its determination is informed by the best available information and that its project
responsibilities under 7(a)(2) with respect to the NLEB are fulfilled through the USFWS January 5,
2016, Programmatic BO. The action agency will update this determination annually for multi-year
activities,
The action agency understands that the USFWS presumes that all activities are implemented as
described herein. The action agency will promptly report any departures from the described activities to
the appropriate USFWS Field Office. The action agency will provide the appropriate USFWS Field
Office with the results of any surveys conducted for the NLEB. Involved parties will promptly notify the
appropriate USFWS Field Office upon finding a dead, injured, or sick NLEB.
i
Signature: �QJ�
Date Submitted:
4 Any activity that temporarily or permanently removes suitable forested habitat, including, but not limited to, tree removal
from development, energy production and transmission, mining, agriculture, etc, (see page 48 of the BO).
s If the project removes less than 10 trees and the acreage is unknown, report the acreage as less than 0.1 acre.
6 I the activity includes tree clearing in June and July, also include those acreage in April to October,

Bridge #71 Replacement
St. Clair Road (SR 1338)
Alexander County
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Bridge #71
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GRASSY CREEK STREAM IMPACTS
DETAIL C
Length
Type
Description
Permanent
20 ft
Class II Rip Rap
on Geotextile
Streambank Stabilization
(At four ditch outlets)
Temporary
0 ft
None
No temporary impacts.
20
JOHN MORGAN & AMBER L. BROWN
BEGIN PROJECT F—PUE PUE PUE
DB12 - 010071
-L- STA. 10 + 70.00 a
SEE DETAIL A ,
F
_TINE _ _._ .
EXISTING R/W
JOYCE LOWE ST.CLAIR
NOTES:
1. GRASSY CREEK IS IN THE
CATAWBA RIVER BASIN.
2. DO NOT INSTALL DECK DRAINS.
3. CLEARING SHALL BE PERFORMED PER
NCDOT METHOD II PLUS 5' BEYOND
TOE OF FILL SLOPES.
GRAPHIC SCALE
157.5 0 15 30
ill_Ullllliwm.—�
S-010071 PormitDmwlnenshdR 11,20/20153:04:55PMTGS
EXISTING BRIDGE DIMENSIONS - 40'-6"X20' (SINGLE -SPAN), 90 DEG. SKEW
PROPOSED BRIDGE DIMENSIONS - 70'X30' (SINGLE -SPAN), 75 DEG. SKEW
TOTAL PROJECT LENGTH - 410'
PUE PUE
SEE DETAIL D
BM -1 -
SEE DETAIL A �
---- -
--- REM6\E
----------------------
SR 1338 ST.CLAIR RD -L-
17' BST
__.REMOVE_-_ �,—
m
F �
PUE —
/Qe CLASS II RIP RAP
SEE DETAIL A J
SEE DETAIL D
7
WOODS
Ncr rc 5<cle,
N.1-1
Ground $.� Slope
D
Min, D- 1 11.
b= 2 FL
FROM -L- STA. 11+00 TO STA. 11+80 LT
FROM -L- STA. 12+25 TO STA. 12+61 LT
FROM -L- STA. 12+00 TO STA. 12+74 RT
STREAM IMPACTS
CLASS II
DETAIL B
LATERAL 'V' DITCH
I Nor ro 5mle) '.
m°.ei �� Fill
Ground -) D PSFr_ slop°
d
Min, D= 1 Ft.
Min. d= 05 R.
6= 2 Ft.
Type of Liner= PSRM
ROM -L- STA. 13+23 TO STA. 13+83 R
WOODS
a
PUE UE
�ti tib`.
SEE DETAIL 6X '
SEE DETAIL C'%
��
r 'CLASS B RIP RAP\,
CLASS II
RIP RAP
L\
PROJECT REFERENCE NO.
178P.12R.103 !SF -01001
PERMIT DRAWING TGSs ;os «saaaouc„
SUITE 200
FOR BRIDGE #010071 rr PHEs1"73-sae?
ALEXANDER COUNTY
WOODS
/ P�E4T
E BERTICE LEE & EDITH I, POWELL
m
NC GN@ 2011
NNO 83
moa i �t
C END PROJECT
\\ DB12 - 010071
WOODS F -L- STA. 14+80.00 0
��L \ o
18'RCP _'J4�-S'\�'� F
-RCiJ�il�f_ �_� \
15.,
W/ELBOWS
TE 21 GASKETS
Re
24„
1 � I
11 m it
CLASS B RIP RAP
ON GEOTEXTILE
SEE DETAIL D
SEE DETAIL B
DETAIL D
RIP RAP AT EMBANKMENT
I Nor ro Smlel Width P-11°1 to
x°. -s x.
5'm
Dimh 1.ami z.o
Grade
GEOTE#LLE
Type of Liner=Clo:. II Rip -R, on Geotedile Fabric
-Ir STA. 12+56 LT
-L- STA. 12+66 RT
-L- STA. 13+07 LT
-L- STA. 13+29 RT
PERMIT DRAWING SHEET 1 OF 3
DETAIL C
STANDARD 'V' DITCH
I rv°no seelel
23
Nmuml
Ground 1.y 1� Ground
D
WAYNE C.& GLENDA B. LOWE
Min. D= 2 H.
FROM -L- STA. 13+08 LT
0.5% SLOPE TO DAYLIGHT
DETAIL D
RIP RAP AT EMBANKMENT
I Nor ro Smlel Width P-11°1 to
x°. -s x.
5'm
Dimh 1.ami z.o
Grade
GEOTE#LLE
Type of Liner=Clo:. II Rip -R, on Geotedile Fabric
-Ir STA. 12+56 LT
-L- STA. 12+66 RT
-L- STA. 13+07 LT
-L- STA. 13+29 RT
PERMIT DRAWING SHEET 1 OF 3

10+00
11+00 12+00 13+00 14+00 15+00
STRUCTURE HYDRAULIC DATA
DESIGN DISCHARGE =
1600
CFS
DESIGN FREQUENCY =
25
YRS
DESIGN HW ELEVATION =
1167.9
FT
BASE DISCHARGE =
2300
CFS
BASE FREQUENCY =
l00
YRS
BASE HW ELEVATION =
1168.97
FT
OVERTOPPING DISCHARGE =
2300
CFS
OVERTOPPING FREQUENCY=
100+
YRS
OVERTOPPING ELEVATION =
1172.4==
FT
—OVERTOPPING ELEVATION
REPRESENTS LOWEST
HIGH POINT ON DECK/ROADWAY,WHICH
OCCURS AT
RIGHT EDGE OF PAVEMENT
@ -L- STA.
13+40
SF-010071_Pennit D�wingylldgn 1120/2015231 Al PM TGS
PERMIT DRAWING
FOR BRIDGE #010071
ALEXANDER COUNTY
PERMIT DRAWING SHEET 3 OF 3