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Pre-Construction Notification (PCN) Form
A. A licant Information
1. Processing
1a. Type(s) of approval sought from the
Corps: � Section 404 Permit ❑ Section 10 Permit
1b. 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
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
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 or 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 1h ❑ Yes � No
below.
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ❑ Yes � No
2. Project Information
2a. Name of project: Replace Bridge No. 209 on SR 1366 (Atkins Rd) over Frank Creek
2b. County: Orange
2c. Nearest municipality / town: Mebane
2d. Subdivision name: N/A
2e. NCDOT only, T.I.P. or state 176P.7.R.99
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]
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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: p/ease a/so copy Mr. Jerry Parker, Highway Division 7 Environmental
Supervisor on all correspondence — jparker@pcdot gov
5. Agent/Consultant 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]
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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 36.210968 Longitude: -79.246668
(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 Frank Creek
proposed project:
2b. Water Quality Classification of nearest receiving water: WS-II; HQW, NSW; 16-18-2-1; 03-06-02
2c. River basin: Cape Fear River (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 roadway, hardwood forest, and a nearby agricultural area.
There are not additional jurisdictional features associated with Bridge 209 other than Frank 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:
— 105 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 2@12'x7' reinforced concrete box culvert. The channel will be excavated and realigned for low flow
shaping. Water will be directed around the work area during construction by installed impervious dikes upstream and
downstream of the existing bridge. Water will be directed into a 24" temporary pipe. 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 fo�r this property / � Yes ❑ No ❑ Unknown
project (including all prior phases) in the past.
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: EPR
Name (if known): Robert Lepsic Other: The USACE and NC DWR visited the site in July
2016 to confirm the delineation
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
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6. Future Project Plans
6a. Is this a phased project? ❑ Yes � No
6b. If yes, explain.
N/A
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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 ora T
W1 ❑ P❑ T ❑ Yes ❑ Corps �
❑ No ❑ DWQ
2g. Total wetland impacts 0
2h. Comments: N/A
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)
S1 P Culvert Frank Creek PER Corps 12-15 40
S1 P Bank Stabilization Frank Creek PER Corps 12-15 60
S1 T Construction/ Frank Creek PER Corps 12-15 20
Dewatering
3h. Total stream and tributary impacts 120
3i. Comments: Of the 120LF of stream impacts, only 40 LF are associated with permanent impacts to the stream due to the
installation of a 12'X7' double barrel culvert. The other 60 LF of impact is associated with streambank protection (i.e. the rip
rap is restricted to the banks of the channel and will not encroach within the thalweg). The 20 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.
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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 impacts 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)
or Tem ora T im act re uired?
Road fill ❑ Yes
B1 � P❑ T and Rocky Run � No 4,553 893
clearing
6h. Total buffer impacts 4,553 893
6i. Comments: The impacts associated with the roadway crossing and culvert installation fall under the "potentially allowable"
category per the Jordan Lake Buffer Rules Table of Uses {15A NCAC 02B .0267 (6)}
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. 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 reinforced concrete box
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. Please see the attached Bridge to Culvert justification letter from
NCDOT Division 7 Bridge Program Manager.
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 surface 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.
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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
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: 100 LF at a 1:1 ratio
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: Typically, USACE requires 2:1 mitigation for permanent stream impacts due to culvert installation, however,
they do not require compensatory mitigation for streambank stabilization. Conversely, NC DWR does require 1:1 mitigation
for rip rap bank stabilization. Therefore, NCDOT is proposing to mitigate for the entire 100 LF of stream impact at a 1:1 ratio
which will satisfy both the USACE 2:1 ratio for the culvert (40 LF X 2= 80) and the additional 60 LF of bank stabilization at a
1:1 ratio per DWR requirements.
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.
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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 Lake Buffer area, these impacts are
"allowable" per the Table of Uses {15A NCAC 02B.0267 (6)}
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:
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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.
Comments: The proposed structure will be a 2@12'x7' reinforced concrete box
culvert. There is a slight increase in impervious surface but treatment is not ❑ Yes � No
required. It is also important to note that each quadrant of the bridge currently has
roadside ditches that drain directly 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 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
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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)?
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
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 Frank Creek which is Class WS-II; High Quality Waters (HQW), Nutrient Sensitive Waters (NSW) (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.
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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
habitat7 ❑ Yes � No
5b. Have you checked with the USFWS concerning Endangered Species Act � yes
impacts? ❑ No
� 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? Robert Lepsic with EPR surveyed the project reach for Dwart wedgemussel (A/asmidonta heterodon) habitat in
February 2016, as well as searching the NC Natural Heritage Program (NHP) database. The database search indicated
that there are no known occurrences of the mussel within one mile of the project study area. Further, no species were
observed during the site survey. Email correspondence with Mr. Gary Jordan (USFWS) indicated that he was comfortable
with a"No EffecY' biological conclusion for the Dwart wedgemussel.
Mr. Lepsic also conducted a survey for Michaux sumac (Rhus michauxir) and Smooth coneflower (Echinacea laevigata)
at the subject site on June 28, 2016. Marginal roadside habitat exists on all four quadrants of the bridge but no specimens
were found. The biological conclusion for smooth coneflower at the 8ridge 209 site is No Effect; Habitat Present.
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., Natio�al 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 reviewed by NCDOT's Human Environment Unit in 2015 and 2016 for potential affects to historical
architecture and archaeology. It was determined that no survey was required for historical architecture or archaeological
resources.
8. Plood 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: MOA
8c. What source(s) did you use to make the floodplain determination? North Carolina Floodplain Mapping Program
Mr. Mike Mills, PE /f � �n� /�
ApplicanUAgenfs Printed Name �/ ��v/ /a � z7. ��.,
ApplicanUAgent's Sign u Date
(Agenfs signature is valid only if an authorizalion letter from the
applicant is provided.
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