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STATE OF NORTH CAROLINA
DEPARTMENT OF 'I'RANSPORTATION
ROY COOPER
GOVERNOR
US Army Corps of Engineers
Raleigh Regulatory Field Office
Attn: Mr. David Bailey
3331 Heritage Trade Dr., Ste. 105
Wake Forest, NC 27587
JAMES H. TROGDON, III
SECRETARY
February 14, 2017
NC Division of Water Resources
Winston-Salem Regional O�ce
Attn: Mr. Dave Wanucha
450 W. Hanes Mill Rd., Ste. 103
Winston-Salem, NC 27105
Subject: Nationwide 14 Permit Application for the Replacement of Bridge No, 283 on SR 2686
(Richardson Drive) over Troublesome Creek, Rockingham County, North Carolina, WBS
Element No. 17BP.7. R.104
Dear Mr. Bailey and Mr. Wanucha:
The North Carolina Department of Transportation (NCDOT) is proposing to replace the subject bridge.
The purpose of the project is to replace a functionally obsolete two-span bridge (1 @17'7", 1@23' 11 ")
concrete reinforced deck on I-beams supported by mass concrete abutments with a new, 2@12'X7'
Reinforced Concrete Box Culvert. An off-site detour will be used to convey traffic during construction.
The project will also include some minor approach work on the existing roadway.
Please find enclosed a PCN application, USGS and Soil Survey vicinity maps, Stormwater Management
Plan, permit drawings, buffer drawings and SHPO Concurrence Forms.
The North Carolina Natural Heritage Database was checked for records of threatened and endangered
species. The database lists three species for Rockingham County that have federal status. Bald eagle
(Haliaeetus leucocepllalus) is protected in every county in North Carolina under the Bald and Golden Eagle
Protection Act. James spinymussel (Pleurobema collina) and Smooth coneflower (Echinacea laevigata)
are listed as threatened.
Habitat for bald eagle primarily consists of mature forest in proximity to large bodies of open water for
foraging. Large dominant trees are utilized for nesting sites, typically within 1.0 mile of open water. A
desktop-GIS assessment of the project study area, as well as the area within a 1.13-mile radius (1.0 mile
plus 660 feet) of the project limits, was performed using 2014 color aerials. No suitable feeding/water
source is located within one mile of the project study area to support Bald eagle habitat. A field scoping
meeting on October 15, 2015 determined that the subject project would have no effect on bald eagle.
Additionally, a review of the NCNHP database revealed no known occurrences of this species within 1.0
mile of the project study area.
Robert Lepsic with EPR surveyed the project reach for James spinymussel (Pleurobe»za collina) habitat in
May and June 2016, as well as searching the NC Natural Heritage Program (NHP) database. The database
search indicated that there are no known occurrences of this species within one mile of the project study
area. Further, no species were obse�ved during the site survey; Little Troublesome Creek and the
Mailing Address: Location:
NC DEPARTMENT OF TRANSPORTATION Telep/tone: [phone] 1584 YANCEVILLE STREET
DIVISION OF HIGIIWAYS Customer Se�vice: 1-877-368-4968 GREENSBORO, NC 27415-4996
DNISION 7 OFFICE
P.O. BOX 14996
GREENSBORO, NC 27415-4996 Website: www.ncdot.gov

intermittent UT to Little Troublesome Creek are severely impacted within the study area and are regularly
maintained, providing poor habitat for the James spinymussel. Email correspondence with Mr. Gary Jordan
(USFWS) indicated that he was comfortable with a"No Effect" biological conclusion for the James
spinymussel. Mr. Lepsic also conducted a survey for smooth coneflower 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 Bridge 283 site is No Effect; Habitat Present. Mr. Gary
Jardan (IJSFWS) released the Programmatic Conference Opinion (PCO) for the listed Northern Long Eared
Bat (NLEB). This opinion, states in part, that "... it is the Service's conference opinion thatNCDOT
activities in eastern North Carolina (Divisions 1-8), as proposed, are not likely to jeopardize the continued
existence of the NLEB. "
This project was reviewed by NCDOT's Human Environment Unit in 2015 and 2017 for potential affects to
historical architecture and archaeology. It was determined there would be no eligible architectural or
archaeological resources present within the project study area.
The project study area is comprised mostly of maintained/disturbed land and nearby businesses. While
there are wetlands within the project study area, no impacts to wetlands are proposed for this project. The
only other jurisdictional features within the project boundaries are Little Troublesome Creek (SA) and a UT
to Little Troublesome Creek (SB).
NCDOT best management practices (BMPs) will be used to minimize and control sedimentation and
erosion. The construction fareman 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 'unmediately with better devices.
Impacts to Waters of the United States
Little Troublesome Creek (DWR Class: WS-V; NSW; 16-7-(1); 03-06-01) is shown on the USGS
topographic map as a perennial stream. The channel is severely impacted within the study area and is 8-10
feet in width with 4-6 foot banks showing significant erosion. A UT to Little Troublesome Creek flows
parallel and south of Richardson Drive. It is 1-2 feet in width with 0-2 foot banks, flowing through a
maintained lawn and rip rap ditch before going subsurface prior to entering Little Troublesome Creek. From
the project site, Little Troublesome Creek flows to its confluence with the Haw River. The Haw River
meets the defmition of a Traditional Navigable Water. For these reasons, we believe Little Troublesome
Creek is a Relatively Permanent Water and is under the jurisdiction of the U.S. Army Corps of Engineers.
In order to construct the project, it will be necessary to impact waters of the United States in the Cape Fear
(H[JC 03030002). Specifically, NCDOT is requesting to replace Bridge No. 283 with a new, 2@12'X7'
Reinforced Concrete Box Culvert. (RCBC). The impacts are listed in the table below:
Jurisdictional Impact Summary
Perm. Temp. Perm. Temp.
Existing Existing
Station Structure Size / Type I p ts I pacts Channel Channel
Impacts Impacts
(ac) ( ac) � �I
12-93 to 13+50 —L- Double 12'X7' RCBC 0.02 <0.01 57 23
12+97 to 13+44 —L- Bank Stabilization 0.02 0 70 0

Jordan Lake Buffer Impact Summary
Station Type Zone 1(ftz) Zone 2(ftz)
-L- 12+39 to 14+19 Roadway Crossing 5,219 1,945
Total 5,219 1,945
Permits Requested
NCDOT is hereby requesting authorization under Section 404 of ihe 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 Jerry Parker at [phone] or
jparker(a�ncdot.gov. Your review and consideration are greatly appreciated.
Sincerely,
. '� � `1'��� � �i�
. . Mills, PE
Division Engineer, Division 7
Enclosures
cc: Travis Wilson, Wildlife Resources Commission (electronic copy)
Gary Jordan, US Fish & Wildlife Service (electronic copy)
Tim Powers, NCDOT (electronic copy)
Aaron Harper, Field Operations Engineer, Div 7&8 Roadside Environmental Unit, NCDOT
Jeremy Warren, NCDOT
Jason Julian, District 3 Engineer, NCDOT
File copy

o�oF W ArF9oG Office Use Only:
� � Corps action ID no.
� �� p c DWQ project no.
i���i
Form Version 1.3 Dec 10 2008
Pre-Construction Noti�cation PC Form
A. A licant Information
1. Processing
1 a. Type(s) of approval sought from the
� Section 404 Permit ❑ Section 10 Permit
Corps:
1b. Specify Nationwide Permit (NWP) number: 14 or General Permit (GP) number:
1 c. Has the NWP or GP number been verified by the Corps? � Yes ❑ No
1 d. Type(s) of approval sought from the DWQ (check all that apply):
� 401 Water Quality Certification — Regular ❑ Non-404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express � Riparian Buffer Authorization
1 e. 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.
1 g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h ❑ Yes � No
below.
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ❑ Yes � No
2. Project Information
2a. Name of project: Bridge 283 on SR 2686 (Richardson Drive) over Little Troublesome Creek
2b. County: Rockingham
2c. Nearest municipality / town: Reidsville
2d. Subdivision name: N/A
2e. NCDOT only, T.I.P. or state WgS 176P.7.R.104
project no:
3. Owner Information
3a. Name(s) on Recorded Deed: North Carolina Department of Transportation
3b. Deed Book and Page No. N/A
3c. Responsible Party (for LLC if Division Engineer NC DOT Division 7, Mr. Mike Mills, PE
applicable):
3d. Street address: PO Box 14996
3e. City, state, zip: Greensboro, NC 27415
3f. Telephone no.: [phone]
3g. Fax no.: . [phone]
3h. Email address: [e-mail]
Page 1 of 11
PCN Form — Version 1.3 December 10, 2008 Version

4. Applicant Information (if different from owner)
4a. Applicant is: ❑ Agent � Other, specify: NC DOT Highway Division 7
4b. Name: Division Engineer NC DOT Division 7, Mr. Mike Mills, PE
4c. Business name NC DOT
(if applicable):
4d. Street address: PO Box 14996
4e. City, state, zip: Greensboro, NC 27415
4f. Telephone no.: [phone]
4g. Fax no.: [phone]
4h. Email address: [e-mail] `note: please a/so copy Mr. Jerry Parker, Highway Division 7 Environmental
Supervisor on all correspondence - jparker@�cdof.gov
5. Agent/Consultant Information (if applicable)
5a. Name: Mr. Jerry Parker
5b. Business name NC DOT Highway Division 7, Division Environmental Supervisor
,.� ___�:__��_..
5c. Street address:
5d. City, state, zip:
5e. Telephone no.:
5f. Fax no.:
5g. Email address:
PO Box 14996
Greensboro, NC 27415
[phone]
[phone]
[e-mail]
Page 2 of 11
PCN Form - Version 1.3 December 10, 2008 Version

B. Project Information and Prior Project History
7. Property Identification
1a. Property identification no. (tax PIN or parcel ID): N/A
1 b. Site coordinates (in decimal degrees): Latitude 36.342939 Longitude: -79.9677468
(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 Little Troublesome Creek and UT to Little Troublesome
proposed project: Creek
2b. Water Quality Classification of nearest receiving water: WS-V; NSW; 16-17-(1); 03-06-01
2c. River basin: Cape Fear (HUC 03030002)
3. Project Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application:
The project study area is comprised of mostly maintained right of way. The immediate surrounding area is mostly single
family residential housing and a business as well as a maintained utilities (i.e. power and sewer).
3b. List the total estimated acreage of all existing wetlands on the property:
There are 4 wetland pockets within the project study area totaling approximately 1 acre, however, this project proposes
no wetland impacts.
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
� 300 LF within the project study area
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:
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' X 7' reinforced concrete box culvert. The channel will be excavated and realigned for low flow
shaping. The constructed benches on the upstream and downstream ends of the high flow barrel proposes class II rip rap on the
flood bench borders with coir fiber matting between (see typical). 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.
E ui ment to be used includes a track hoe, dum truck, avin e ui ment, um s, and various hand tools.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property / � Yes ❑ No ❑ Unknown
project (including all prior phases) in the past?
Comments: N/A
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: Arcadis
Name (if known): Mr. Robert Lepsic Other: N/A
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
The USACE and DWR reviewed the project study area in June 2016; it is anticipated that a JD will be issued with the 404
Authorization.
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
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 wetiand 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) (if known) DWQ — non-404, other) (acres)
or Temporary
T
W1 ❑ P � T ❑ Yes ❑ Corps
❑ No ❑ DWQ
2g. Total wetland impacts
2h. Comments: While there are wetlands within the project boundarie, no wetland impacts are proposed with this project.
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. 39•
Stream impact Type of impact Stream name Perennial Type of jurisdiction Average Impact
number - (PER) or (Corps - 404, 10 stream length
Permanent (P) intermittent DWQ — non-404, width (linear
or Temporary i�NT)� other) (feet) feet)
(T)
2@ 12' X 7' RCBC Little � pER � Corps
S1 � P � T �12+g3 to 13+50 —L-) Troublesome � INT � DWQ $-10 57
Creek
bank stabilization Little � PER � Corps
S1 � P � T �12+97 to 13+44 —L-) Troublesome � �NT � DWQ $-10 70
Creek
Construction/Impervious Little � PER � Corps
S1 ❑ P� T dikes Troublesome � INT � DWQ $-10 23
Creek
3h. Total Permanent Stream and Tributary Impacts 150'
3i. Comments: Of the 150 LF of stream impacts, only 57 LF are associated with permanent impacts to the stream for the
purpose of the culvert installation. The other 70 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 23 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).
Page 4 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. 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 orar 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.
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 ail buffer impacts
below. If an im acts re uire miti ation, then ou MUST fill out Section D of this form.
6a.
❑ Neuse ❑ Tar-Pamiico � Other: Jordan
Project is in which protected basin? ❑ Catawba ❑ Randleman
6b. 6c. 6d. 6e. 6f. 6g.
Buffer impact
number - Reason for Buffer Zone 1 impact Zone 2 impact
Permanent (P) impact Stream name mitigation (square feet) (square feet)
or Temporary required?
T
B1 � P � T in talll t on Little Troublesome Creek � Nos 5,219 1,945
6h. Total buffer impacts 5,219 1,945
6i. Comments: The impacts associated with the roadway crossing and culvert installation fall under the "potentially allowable"
category per the Jordan Lake Water Supply Buffer Rules Table of Uses {15A NCAC 02B .0267 (9)}
D. Impact Justification and Mitigation
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PCN Form - Version 1.3 December 10, 2008 Version

1. Avoidance and Minimization
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
Channel improvements were made for the proposed RCBC design. Excavation was kept to a minimum to produce as little
impact as possible. Where excavation is necessary, geo-textile and rip-rap were utilized for bank stabilization in an attempt to
reduce stream bank erosion. Floodpiain benches with coir fiber matting will be installed at upstream and downstream of the
culvert. A low flow barrel on the east side of the culvert was designed to match the stream width to maintain the normal flow
width, depth and velocity of the stream. This will maintain sediment transport to provide a stable stream during bankfuli
discharge. The barrel invert will be a minimum of 1' below the stream bed to consider fish passage. 1' high sills will be
installed at upstream and downstream face of the low flow barrel. A high flow barrel on the west side of the culvert will provide
flood conveyance during high flow storm events. This will reduce shear stress on the stream bottom. 2' high sills will be
installed at upstream and downstream face of the high flow barrel. The NE quadrant has an existing roadside ditch lined with
rip rap that outlets to the stream. This ditch will be replaced with a special cut'V' ditch lined with class B rip rap. The new ditch
has outlet to bank stabilization with class II rip rap to dissipate energy to provide a non-erosive outlet velocity to the stream.
The SW quadrant has an existing roadside ditch that has outlet to rip rap embankment to dissipate energy to provide a non-
erosive outlet velocity to the stream. This ditch will be retained. At NW and SE quadrant, the roadway is fill section. This will
promote sheet flow of pavement runoff through grassed fill slope to remove pollutants via infiltration and settling. The existing
road has two paved lanes (total 24' wide). The proposed road has two paved lanes (total 24' wide) with 6' paved shoulder on
each side. The total project length is only 150 feet. The increases in impervious areas and stormwater discharges (post vs
precondition) are insignificant and the existing ditches do not need to be modified. Therefore, additional stormwater measures
are not required. 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 Brid e Pro ram Mana er.
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 Divison Environmental Supervisor.
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
Page6of11
PCN Form — Version 1.3 December 10, 2008 Version

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: 57 LF @ 2:1 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:
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.
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 Water Supply Riparian area,
these impacts are °allowable" per the Table of Uses {15A NCAC 02B.0267 (9)}
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of 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 7 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?
1 b. If yes, then is a diffuse flow plan included? If no, explain why.
Comments: The proposed structure will be 2@ 12' X 7' RCBC. There is a slight
increase in impervious surface but treatment is not required. It is also important to ❑ Yes � No
note that the Northeast and Southwest quadrants of the bridge currently have
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 Locai 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 appiy � 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 8 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 Wetiand 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. Wiil 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 Aprii 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 businesses and residences 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 Little Troublesome Creek, which is Class WS-V; Nutrient Sensitive Waters
(NSW). 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 9 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 Office you have contacted.
❑ Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
North Carolina Natural Heritage Database and onsite investigation. A desktop-GIS assessment of the project study area, as
well as the area within a 1.13-mile radius (1.0 mile plus 660 feet) of the project limits, was performed using 2014 color aerials.
No suitable feeding/water source is located within one mile of the project study area to support Bald eagle habitat. A field
scoping meeting on October 15, 2015 determined that the subject project would have no effect on bald eagle. Additionally, a
review of the NCNHP database revealed no known occurrences of this species within 1.0 mile of the project study area.
Robert Lepsic with EPR surveyed the project reach for James spinymussel (Pleurobema collina) habitat in May and June
2016, as well as searching the NC Natural Heritage Program (NHP) database. The database search indicated that there are
no known occurrences of this species within one mile of the project study area. Further, no species were observed during the
site survey; Little Troublesome Creek and the intermittent UT to Little Troublesome Creek are severely impacted within the
study area and are regularly maintained, providing poor habitat for the James spinymussel. Email correspondence with Mr.
Gary Jordan (USFWS) indicated that he was comfortable with a"No Effect" biological conclusion for the James spinymussel.
Mr. Lepsic also conducted a survey for smooth coneflower 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 Bridge 283 site is No Effect; Habitat Present.
Mr. Gary Jordan (USFWS) released the Programmatic Conference Opinion (PCO) for the listed Northern Long Eared Bat
(NLEB). This opinion, states in part, that "...it is the Service's conference opinion that NCDOT activities in eastern North
Carolina (Divisions 1-8), as proposed, are not likely to jeopardize the continued existence of the NLEB."
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 project takes place in Rockingham County which is not near any coastal or tidal habitat that would support EFH (i.e.
salt marshes, oyster reefs, etc.).
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal
governments have designated as having historic or cultural preservation � Yes � No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
This project was submitted to the North Carolina Department of Transportation's Human Environment Unit for review in
2015 and 2017. It was determined there would be no eligible architectural or archaeological resources present within the
project study area (see attached letters).
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PCN Form — Version 1.3 December 10, 2008 Version

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: MOA
8c. What source(s) did you use to make the floodplain determination? North Carolina Floodplain Mapping Program
Mr. Milce Mills, PE �y-, ^ ��rL�'V`,Y/ ��� 2/14l2017
Applicant/Agent's Printed Name 0 y �
Applicant/Agent's Signature Date
(AgenYs 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