20160728 Ver 1_Application_20160727

Carpenter,Kristi
From:Thomson, Nicole J
Sent:Wednesday, July 27, 2016 2:55 PM
To:[e-mail]; Wrenn, Brian L; [e-mail]; Wilson, Travis
W.
Cc:Powers, Tim; Cail, William G; Carpenter,Kristi; Nancy Scott
([e-mail]); Tracy Parrot ([e-mail]);
Parker, Jerry A
Subject:Bridge 132 on SR 1500 (Allison Rd) over UT to South Hyco Creek, Orange Co
Attachments:Cover letter and PCN signed.pdf; Bridge_132_Orange_USGS.pdf
Attached, please find an application and supplemental information for the above proposed bridge replacement. I will
have to break it up into separate emails due to file sizes.

Dave B – your hard copy is in the mail.

Also, I will be on vacation next week so if there are any questions related to the project, I have cc-ed Jerry, Tim Powers
and Galen Cail in the hopes that they can answer them.

Thank you!

Nikki

Nicole J. Thomson
Division Environmental Supervisor Assistant
Division Environmental Office

919-754-7806 Mobile

[e-mail]

PO Box 14996
Greensboro, NC 27415-4996

Email correspondence to and from this address is subject to the

North Carolina Public Records Law and may be disclosed to third parties.

Email correspondence to and from this sender is subject to the N.C. Public Records Law and may be disclosed to third parties.
1

Transportarion
July 27, 2016
US .Aimy Corps of Engineers
Raleigh Regulatory Field Office
Attn: Mr. David Bailey
3331 Heritage Trade Dr., Ste. 105
Wake Forest, NC 27587
PA7' McCRORY
Govemor
NICHOLAS J. TENNYSON
Secretary
NC Division of Water Resources
Winston-Salem Regional Office
Attn: Ivv�. Brian Wrenn
450 W. Hanes Mill Rd, Ste. 103
Winston-Salem, NC 27105
Subject: Nationwide 14 Permit Application for the replacement of Bridge No. 132 on SR 1500
(Allison Road) over UT to South Hyco Creek. Orange County, North Carolina, WBS
Element No. 17BP.7.R.87
Dear Mr. Bailey and Mr. Wrenn:
The North Cairolina Department of Transportation (NCDOT) is proposing to replace a
functionally obsolete 18'Tsingle span timber bridge with a new 2@10'x6' reinforced concrete
box culvert with 1' and 2' sills. 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 Concwrence Forms, and
photographs.
The North Carolina Natura] Heritage Database was checked for records of threatened and
endangered species. The database lists four species for Orange County that have federal status.
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 Zaevigata) are listed as
endangered.
Habitat for bald eagle primarily consists of mature forest in proximity Yo 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 of the 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 Januaiy 19, 2016
using 2013 color aerials. Several impoundments of approximately 2 acres or greater (to the south
and southeast of the subject bridge) were identified as water bodies large enough and sufficiently
open to be considered potential feeding sources. A field scoping meeting on February 19, 2014
determined that the subject project would have no effect on bald eagle. Additionally, a review of
the NCNHP database on Janua�y 12, 2016 revealed no known occurrences of this species within
1.0 mile of the project study area. The closest known occurrence is approximately 14A miles
south of the project. Due to the lack of habitat, known occuirences, and minimal impact
anticipated far this project, it has been determined that the subject project will not affect this
species.
�Nothing Compares��
Sla�eofNorihCarolina I DepartmantofT�ansporlalion � DivisionofHighways,Division70t3ice
1584 Yance�ville Street, Greensborq NC 27405� P. O. Box 14996, Greensboro, NC 27415-499G
336-487-0000

Transportation
PAT McCRORY
Governor
NICHOLAS J. TENNYSON
se�rerary
Dwarf 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 an
historic occurrence in the Eno River approximately 8.0 miles soutl� 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 cleaiings. A field scoping meeting on February 19, 2014 determined that
the subject project would have no effect on Michaux's sumac. A review ofthe NCNHP database
on January 12, 2016 revealed no known occurrences of this species within 1.0 mile of the project
study area. The closest Imown occurrence is an historic occurrence approximately 10.1 miles
south of the project Therefore, the subject project will have no effect on this species.
Smooth coneflower is typically found in open woods, glades, cedu� barrens, roadsides, clearcuts,
dry 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 fires, as well as large herbivores,
historically influenced the vegetation in this species' range. A�ield scoping meeting on February
19, 2014 determined that the subject project would have no effect on smooth coneflower. A
review of NCNIIP database revealed no known occurrences of smooth coneflower within 1.0
mile of the study area. The closest laiown occurrence is approximately 18.9 miles southeast of
the project. Therefore, the subject project will have no effect on this species.
This project was reviewed by NCDOT's Human Environment Unit in 2013 for potential affecYs to
historical architecture and archaeology. It was determined that no survey was required for
historical architecture. A survey was conducted for archaeology on October 17, 2013, 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 roadway, hardwood forest, and
residential land. There are no additional jurisdictional features associated with Bridge 132 other
than UT to South Hyco Creelc
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 determines the devices are not
functioning as intended, they will be replaced immediately wiYh better devices.
Impacts to Waters of the United States
UT to South Hyco Creek (DWR Class: WS-II; HQW) is shown on the USGS topographic map as
a perennial stream. The channel is well defined with a substrate primarily composed of cobble,
pebble, sand, and silt and is approximately 8-12 feet in widYh. From the project site, UT to South
Hyco Creek flows approximately 0.05 mile to its confluence with South Hyco Creek. SouYh
�Nothing Compares���_
StateofNorthCamlina � DepaAmentofTransportation � DivisionofHighways,Division70ffice
IS84 Yanceyvi0e Street, Greensbom, NC 27405� P. O. Aox 14996, GreensUoro, NC 27415-4996
336-487-0000

3 :i
Transportation
PAT McCRORY
covemor
NICHOLAS J. TENNYSON
Secremry
Hyco Creek then flows approximately 5.5 miles to Lake Roxboro. Water flowing through Lake
Roxboro travels approximately 3.5 miles. South Hyco Creek continues 49 miles past Lake
Roxboro and flows into Lake Hyco. Water flowing through Lake Hyco travels approximately
12.2 miles before meeting Hyco River. The Hyco River meets the definition of a Traditional
Navigable Water. For these reasons, we believe UT to South Hyco 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 Roanoke
River Basin (HUC 03010104). Specifically, NCDOT is requesting to replace Bridge No. 132
with a reinfarced concrete box culvert. The impacts are listed in the table below:
Jurisdictional Impact Summary
Perm. Temp.
Perm. Temp. �xisting Existing
Station Structure Size / Type I pacts Impacts Channel Channel
Impacts Impacts
(ac) (ac) � �
13+02 to 13+85 Double 10'x6' Reinforced Concrete Box 0.02 <0.01 146 12
Culvert
Pe�mits Requested
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 additional information, please contact Jeiry Parker at (336)
256-2063 or jparker(hicdot.gov. Your review and consideration are greafly appreciated.
Sincerely,
/�.�� .L� cyl�
� 7.M ills, PE
D' ision Engineer, Division 7
Enclosures
cc: Gary Jordan, USFWS (electronic copy)
Travis Wilson, WRCS (electronic copy)
Tim Powers, NCDOT (electronic copy)
Ba��y Hairington, Roadside Enviromnental Field Operations Engineer
Jeremy Wa�ren, NCDOT
Chuck Edwards, District 1, District Engineer
�Nothing Compares��_.
StateofNoriLCazotina � Deparhnentof7caospoAa�ion � DiviaionofHighways,Diviaion70ffiue
1584 Ya��ceyvitle Sneet, Greensborq NC 27405I P. O. I3ox 14996, Greens6om, NC 27415-4996
33G-487-0000

� 2°� WarE90 Office Use Only:
�,. ,� q � Corps action ID no.
>
o -~c DW4 proJect no.
re-Construction Notiiication P 7i'��jQn 7.3 Dec 10 2008
A. A licant Information
1. Processing
1a. Type(s) of approval sought from the
� Section 404 Permit ❑ Sectian 10 Permit
Corps:
1 b. Specify Nationwide Permit (NWP) number: 14 or General Permit (GP) number:
1 c. Has the NWP or GP number been verified by the Corps7 � 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
1 e. Is ihis 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
1 f. Is payment into a mitigation bank or in-Iieu fee program proposed for mitigation � yes ❑ No
of impacts? If so, attach the acceptance letter from mitigation bank or in-lieu
fee program.
1 g. Is the project located in any of NC's twenty coasfal counties. If yes, answer 1 h ❑ Yes � No
below.
1h. Is the project located within a NC DCM Area of Environmental Concem (AEC)? ❑ Yes � No
2. Project Information
2a: Name of project: Replace Bridge No. 132 on $R 1500 over UT to South Hyco Creek
2b. County: Orange
2c. Nearest municipality 1 town: Prospect Hill
2d. Subdivision name: N/A
2e. NCDOT only, T.I.P. or state 17BP.7.R.87
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
PCPI 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. Email address: [e-mail] *note: please also copyMr. JerryParker, Highway Division 7 Environmental
Supervisor on all correspondence— [e-mail]
5. Agent/Consuitant information (if applicable)
5a. Name: Mr. Jerry Parker
5b. 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 36.239406 Longitude: -79.174137
(DD.DDDDDD) (-DD.DDDDDD)
1 c. Property size: N/A acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to UT to South Hyco Creek [22-58-4-(0.5)]
proposed project:
2b. Water Quality Classification of nearest receiving water: WS-II; HQW
2c. River basin: Roanoke River (HUC 03010104)
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 roadway, hardwood forest, and residential areas. There are not
additional jurisdictional features associated with Bridge 132 other than UT to South Hyco Creek.
3b. List the total estimated acreage of all existing wetlands on the property:
N/A
3c, List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
— 158 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 overail project in detail, including the type of equipment to be used:
Tra�c will be detoured off-site. Erosion and sedimentation control measures will be installed. Water wili be diverted around the
construction area. The old bridge will be removed. The proposed stucture will be repiaced on its existing alignment. The new
culvert structure wili be a double 10'x6' reinforced concrete box culvert. The channel will be excavated and realigned for low
flow shaping. Water will be pumped around the work area d�ring construction by installed impervious dikes upstream and
downstream of the existing bridge. Water will be directed into special stiiling 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 /
project (including all prior phases) in the past? ❑ Yes � No ❑ Unknown
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 areas? 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 and 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
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.
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 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)
Tem orar T
❑ Yes ❑ Corps
W1 ❑ P � T ❑ No ❑ DWQ �
2g. Total wetland impacts 0
2h. Comments: There are no wetlands within the project boundaries
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 box UT to South Hyco � PER � Corps P: 146
S1 � P� T culvert, temporary Creek ❑ INT ❑ DWQ $-�Z T: 12
pipe, and
impervious dikes
S2 ❑ P❑ T ❑ PER ❑ Corps
❑ INT ❑ DWQ
3h. Total Permanent Stream and Tributary Impacts 146'
3i. Comments: Of the 158 LF of stream impacts, only 146 LF are associated with permanent impacts to the stream for the
purpose of stream alignment and stabilization with respect to the culvert installation. The 12 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 ail 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 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 an im acts require miti ation, then ou MUST fill out Section D of this form.
6a.
❑ Neuse ❑ Tar-Pamlico ❑ 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) for Stream name mitigation (square feet) (square feet)
orTem ora T im act re uired?
Road fill ❑ Yes
B1 ❑ P � T and � No
clearing
Bridge ❑ Yes
B2 ❑ P❑ T Fill and ❑ No
Clearing
6h. Total buffer impacts
6i. Comments: N/A
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 double barrel, 10X6 box
culvert. Roadway approach work is minimized as much as is practical to reduce the overall project footprint. An off-site
detour will be employed to avoid the need for a temporary parallel structure.
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 protectio� of surface waters, restrictions against the staging of equipment in or adjacent to waters of the US
and coordination (inciuding 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 will 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
3a 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: 146 LF @ a 2:1 ratio
4c. If using stream mitigation, stream temperature: � warm ❑ cool ❑cold
4d. Buffer mitigation requested (DWQ only): square feet
4e. Riparian wetiand mitigation requested: acres
4f. 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.
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 by 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?
1b. If yes, then is a diffuse flow plan included? If no, explain why.
Comments: N/A ❑ Yes ❑ No
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project? N/A °/o
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 government's jurisdiction is this project?
❑ 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 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)
1 a. 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)?
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 appiication? ❑ Yes � No
2c. If you answered "yes" to one or both of the above questions, provide an expianation 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 UT to South Hyco Creek which is Class WS-II; High Quality Waters (HQW) (i.e. not
ORW 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.
Page 10 of 11
PCN Form — Version 1.3 December 10, 2008 Version

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 Offce 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 resources7
This project was reviewed by NCDOT's Human Environment Unit in 2013 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 October 17, 2013, and it was determined there would be no eligible archaeological resources present
within the project study area.
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: N/A
8c. What source(s) did you use to make the floodplain determination? North Carolina Floodplain Mapping Program
Mr. Mike Mills, PE � � �c��%G�' / �' /%
Applicant/AgenYs Printed Name � v �'
ApplicanUAgenPs Signature Date
(Agent's signature is valid only if an authorization letter from the
a licant is rovided.
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PCN Form — Version 1.3 December 10, 2008 Version