HomeMy WebLinkAbout20170450 Ver 1_permit_application_package_20170417STATE OF NORTH CAROLINA
DEPARTIV�NT QF TRANSPORTATION
ROY COOPER
GOVERNOR
April 17, 2017
Mr. Steve Kichefski
Asheville Regulatory Field Office
LTS Army Corp of Engineers
151 Patton Avenue
Asheville, NC 28801-5006
JAMES H. TRQGDON, III
SECRETARY
�UBJECT: Bridge #176 Replacement on SR 1876 (Old Willis School Road}, Gaston County
Dear Mr. Kichefski:
The North Carolina Department of Transportation requests authorization to replace an existing
90-foot long x 25-foot wide concrete and timber bridge with a 3-span, 1.Q0-ft long x 33-ft wide
concrete bridge on SR 1836 (Old Willis School Road) in Gaston County. NCDOT proposes to
place a total of 58 feet of rip rap for bank s�abilization under Bridge #176. There will also be 56
feet of temporary impacts to Hoyle Creek associated with the existing end bent removal. Areas
affected by temporary impacts will be restared to pre-project conditions. The scape of work will
result pernnanent and temparary impacts.to Hoyle Creek, which is classified as a WS-N
watershed by the Division of Water Resources.
The Division 12 Enviror�mental Office conducted a threatened/endangered species survey on
February 12, 2016 for Bridge #176 and surrounding areas. The federally listed species for
Gaston County {L7SFWS Iisted date July 24, 2015) is the dwarf-flowered heartleaf (Hexastylfs
nanaflora), the bog turtle {Glypternys muhlenbe�-gia), Schweinitz's sunflower {Helranthus
schweinitzii) and the Northern Long-Eared Bat (Myotis septentrionalis}. Natural Heritage
Program recards document the nearest dwarf-flowered heartleaf location approxiuiately 6.5 miles
north of the proposed project area. The heartleaf is usually found on dry to moist ravine slopes
(usually north facing and of the oak-hickory-pine %rest type) and in boggy areas near
springheads. There did not appear to be suitable habitat wiihin the proposed project area and no
species were observed. No i.mpact an this species is anticipated. The Nahual Heritage Program
records document tlze nearest bog turtle occurrence approximately 1.7 miles west Bog turtle
habitat consists of open, groundwater supplied {spring fed), wetlands along ripariari corridors or
on seepage slopes.. Species listed as threatened due to similarity of appearance do not require
Section 7 consultatian with the USFWS. However, there is no suitable bog turtle habitat present
within the study area; therefore, there will no impact on this species. The Natural Heritage
Program records document the nearest bog turtle occurrence approximately 3.0 miles southeast.
�chweixiitz's sunflawer is typically found alon.g roadside rights-of-way, maintained power lines
and otber utility rights-of-way, edges of thickets and old pastures, clearings and edges of upland
oak-pine-hickory waods and Piedxnont langleaf pine forests, a�nd other sunny or semi-sunny
habitats where disturbances (e.g., mowing, clearing, grazing, blow downs, storms, frequent fire)
Bridge #176, OId Willis School Road
April 17, 2017
Page 2
he�p create open or partially apen areas tox sunlight. No specimens of Schweinitz's sunflower
were observed witlzin the project area; therefore, no impacts on this species is anticipated. The
Natural Heritage Program recards document the nearest Northern Long Eazed Bat location
appro�rnately 31 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 caoler places, li�e caves and mines. Tree species may be used
based on suitab�lity to retai.n bark or provide cavzties or crevices. It has also been found, rarely,
roosting in structures like barns and sheds. North.ern long-eared bats spend winter hibernating in
humid caves and mines. The closest listed underground mine, per NHP database is the
Froneberger Prospec� Mine, 6.2 miles soutk�west of the project site. There are currently no
lcnown hibernaculum or maternity roost trees in Division 12 counties for NLEB; therefore, the
bridge replacement, pipe replacement and any minor tree clearing assaciated with this DOT
project would be exempted from the incidez�tal take under the 4(d} Rule. I have attached a copy
of the NLEB streamlined consultation forna. Per guidance frorn LTSFWS personnel, concurrence
is granted by citing the following website and a 30 day response periad is waived.
htt :l/www.fws. ov/ashevilleltitmis/ ro�ect 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 nor did there appear to be any eligible structures. The �roject has heen reviewed by
NCDOT's cultural resources staff {NCDOT Cultural Resotu�ces Review — Internal Tracking No.
14-OS-0016). The praject area is not located within %Z mile of any eritical watershed area. SR
1$3b is not 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 notif cation for a NW#3, plan sheets, and location maps
relative to the proj ect.
Project informatian for the 401 Automated Payment Procedure is as follows:
• Work order number: 150472-55120005-17BP.12.R.60-3372
• TII'#: NA
• project Category: $240.00 Fee
If you have any questions or concerns please feel free to contact me at {704} 480-9044. Thank you for
your time and consideration on this rnatter.
Sincerely,
Mark Stafford, P.E.
Division Engineer
Twelfth Division
BY: ,
Trish Beam
Division 12 Environmental Supervisor
Enclosures
Office Use Only:
Corps action la no.
DWQ project no.
Form Version 1.3 pec 10 2Q08
Pre-Construction Notification PCN) Form
A. A licant Information
1. Processing
1 a. Type(s) of approval sought from the
Corps: � Section 404 Permit ❑ Section 10 Permit
1 b. 5pecify IVationwide Permit (NWP) number: 3 or General Permit (GP} number:
1c. Has the NWP or GP number been verified by the Corps? ❑ Yes � IVo
1 d. Type(s) of approval sougF�t from the DWQ (check all that apply);
� 401 Water Quality Certification — Regular ❑ Non-404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ❑ Riparia� Buffer Authorization
1 e. Is this notification saleiy for the record Far the record only for DWQ 409 For the record only for Corps Permi#:
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. lf yes, answer 1 h ❑ Yes � No
below.
1 h. Is the project located within a NC DCM Area of En�ironrr�ental Concern (AEC)? ❑ Yes � No
2. Project Information
2a. Name of project: Bridge #176, SR 1836 {Old Willis 5chool Road)
2b. County: Gaston
2c. Nearest muni�ipality 1 town: Dallas
2d. Subdivision name:
2e. NCDOT only, T.I.P. or state 17BP.12.R.60
project no:
3. �wner 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 na.:
3g. Fax no.:
3h. Email address:
Page 1 of 11
PCN Form — Version 1.3 December 10, 2008 Version
4. Applicant Information (if different irorrr owner)
4a. Ap�lieant is: ❑ Agent ❑ Other, specify:
4b. Name: Mark 5taffard
4c. Business name
{if a}�plicable): �•C. Departrnent of Transportation, plvision 12
4d. Street address: 1710 East Marion Street
4e. City, staie, zip: Shelby, NC 28951
4f. Telephone no.: 704-480-9020
4g. Fax no.: 7D4-480-5401
4h. Emai� address: mstafford@ncdot.go�
5. AgentlConsultant Information (if appiicable)
5a. Name: Trish Bearr�
5b. Busir�ess name
(if applicable): N.C. Department of Transportatian, Di�ision 12
5c. Stree# address: 1710 East Marion Street
5d. City, state, zip: Shelby, tVC 28151
Se. Te(ephone no.: 704-480-9044
5f. Fax no.: 704-480-5401
5g. �mail address: pdbeam@ncdot.gov
Page 2 of 91
�CN Forrn — Version 1.3 December 10, 2Q08 Version
B. Project Information and Prior Project History
1. Property [dentifrcatian
1a. Property icfentification no. (tax PIN or parcei ID): NA
1 b. Site coardinates {in decimaR degrees): Latitude: 35.33504 Longitude: - 89.13378
(Dd.DDDDDD} (-DD.DDDDdQ)
1 c. Property size: 0.2 acres
2. Surtace Waters
2a. Name of nearest body of waker (stream, river, etc.) to �oyle Creek
propased project:
2b. Water Quality Classification of nearest receiving water: WS-IV
2c. Ri�er basin: Catawba
3. Project Description
3a. Describe the existing conditions on the site and the generaf land use in khe vicinity of the project at the time of this
application:
Existing 90-foot bridge on paved secondary road. Land use around project site is residentiallwooded and open farmland.
3b. �ist the total estimated acreage of ali existing wetlands on the property:
0
3c. List ihe tota! estimated linear feet of all existir�g 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 safery of the tra�elling public.
3e. bescribe the o�erall prvject in detail, including the type of equipment to be used:
The North Carolina bepartment of Transportation requests authorization to replace an existing 90-foot long X 25-foot
wide concretet and timber bridge with a 3-span, 100-ft long x 33-ft wide concrete bridge on 5R 1836 (Old Willis School
Road) in Gaston County. NCbOT proposes to place a total of 58 feei of rip rap for bank stabilization under Bridge #176.
There will also be 56 feet of temporary impacts #o Hoyle Creek associated with the existing end bent removal. Areas
affected by temporary impacts will be resiored to preproject conditions. All Best Management Practices will be utilized
during the course of the project. The Project will be constructed usir�g typical heavy equipment (trackhoe, backhoe,
etc.)
4. .iurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property 1
project (including a!I 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
of determination was made? ❑ Preliminary ❑ Final
4c. If yes, who delineated the jurisdictional areas? AgencylConsultant Company:
Name (if known): Other:
4d. If yes, list the dates of the Corps jurisdictional determinatians or State determinations and attach documentation.
Page 3 of 11
PCN Form — Version 1.3 December ��, 2008 Version
5. Project Hisiory
5a. Ha�e permits or certiflcations been requested or obtained for
this praject (including all prior phases) in the past? � Y�S ��� ❑ Unknown
5b. If yes, expiain in detail according to "heip file" instructions.
6. Future Project Plans
6a. Is this a phased praject?
6b. If yes, explain.
❑ Yes � No
Page 4 of 1 �
PCN Form — Version 1.3 December 10, 2008 Version
C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below far your project (check all that apply):
❑ Wetlands � Streams - tributaries ❑ Buffers
❑ Open Waters ❑ Pond Cons#ruction
2. Wetland Impacks
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 ofjurisdiction
number — Type of impact Type of wetiand Forested (Corps - 404, 10 Area of impact
Permanent {P) ar {if known) DWQ — non�04, other} (acres)
Tem ora T
W1 ❑P❑T ❑Yes ❑Corps
❑ No ❑ DWQ
W2 � P 0 T ❑ Yes ❑ Corps
❑ No ❑ DW Q
W3 ❑ P 0 T ❑ Yes ❑ Corps
❑ Mo ❑ DWQ
W4 ❑ P❑ T ❑ Yes ❑ Corps
❑ No ❑ DWQ
W5 ❑ P❑ T ❑ Yes ❑ Corps
❑ No ❑ DWQ
W6 ❑POT ❑Yes ❑Corps
❑ No ❑ DWQ
2g. Total wetland impacts
2h. Comments:
3. Stream Impacts
!f there are perennial or intermittent stream impacts (including temporary im�acts) proposed on the site, then complete this
question for all stream sites impacted.
3a. 3b. 3c. 3d. 3e. 3f. 3g.
Stream impact Type of irr�pact Stream name Perennial Type of jurisdiction Arrerage Impact
number - (PER) or (Corps - 404, 10 stream length
Permanent (P) or intermittent DWQ — nor�-404, width (linear
�femporary (T) (INT}? other) (feat) feei)
S1 � P❑ T Rip rap bank �oyle Creek � PER � Corps �8
stabilization ❑ fNT � DWQ
Exisiing End 8ent � P�R � Corps '
52 ❑ P� T Removal HoY�e Creek �g
❑ INT � pWQ
S3 ❑ P❑ T ❑ PER ❑ Corps
❑ IIV7 ❑ DWQ
S4 ❑ P❑ T ❑ PER ❑ Corps
❑ INT ❑ DWQ
S5 ❑ P � T ❑ PER ❑ CorpS
❑ INT ❑ bWQ
56 ❑ P❑ T ❑ PER ❑ Corps i
❑ INT ❑ DWQ �
3h. TotaE stream and tributary impacts *�g
3i. Comments: *Total Permanent Impa�ts = 58 fi. Total temporary impacts = 56 feet {in same �icinity of permanen# impacts).
Page 5 of 11
PCN Form — Version 1.3 December 1 Q, 2008 Version
4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlanfic Ocean, ar any other open water of
the U.S. then indi�idually list all open water impacks below.
4a. 4b. 4c. 4d. 4e.
Open water Narr3e of waterbody
impact number— (if applicable) Type of impact Waterbody type Area of impact (acres)
Permanent (P) or
iem ora T
01 ❑P❑T
02 ❑P❑T
03 ❑P�T
04 ❑�OT
4f. Total open water impgcts
4g. Comments:
5. Por�d or Lake Construction
If ond or lake construction ro osed, then com lete the chart below.
5a. 5b. 5c. 5d- 5e.
Pond ID Wetland Impacts (acres) Stream Impacts {feet} Upland
Proposed use or purpose (acres}
number of pond
Flooded Filled Exca�ated Flooded Filled Exca�ated Flooded
P1
P2
5f. Total
5g. Comme�ts:
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 waters�ed (acres):
5k. Mathod of cvnstructian:
6. Buffer impacts (for bWQ)
If project will impact a pro#ected riparian b�ffer, then complete the chart below. If yes, then indi�idually list a!I buffer impacts
below. If an impacts require rniti ation, then ou MUST fill out Section D of this form.
sa.
❑ Neuse ❑ Tar-Pamlico ❑ Other:
Project is in which protected basin? ❑ Catawba ❑ Randleman
6b. 6c. 6d. 6e. 6f. 69,
BufFer impact
number— Reason BufFer Zone 1 impact Zone 2 impact
Perrr�aner�t (P) or for 5tream name mi#igation (square feet) (square feet)
Tem ora T im aet re uired?
B1 ❑P❑T ❑Yes
❑ No
B2 ❑P❑T ❑Yes
❑ No
B3 ❑P❑T ❑Yes
❑ No
6h. Total buffer impacts
6i. Comments:
Page 6 of 11
PCN �orm — Version 1.3 December 90, 2008 Version
D. Impact Justification and Mitigation
1. Avoidsnce and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposecE impacts in designing project.
Bridge being re�laced with bridge, no bridge suppor�s in water. No d�rect discharge to stream from bridge. Proposed alignment
same as existing alignment. StorrrEwater runoff directed to riprap energy dissipation prior to entering stream. Riprap bank
stabilization under new bridge to reduce bank erosion.
1 b. Specifically describe measures taken to avoid or minimize khe proposed impacts through construction techniques.
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 5tate?
2b. If yes, mikigation is required by {check alI tl�at a�ply): ❑ DWQ ❑ CorpS
❑ Mitigation banlc
2c. If yes, � hich mitigation option will be used for this � payment to in-lieu fee program
project.
❑ Permittee Responsible Mitigation
3. Cornplete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased {at#ach receipt and letter) Type Quan#ity
3c. Comments:
4. Complete if Making a Payment to ln-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached. ❑ Yes
4b. 5tream mitigation requested: linear feet
4c. If using stream mitigation, stream temperature: ❑ warm ❑ caol ❑cold
4d. BufFer rnitigation requested (DWQ anly): square feet
4e. Riparian wetland mitigation requested: acres
4f. Non-riparian wetland mitigat�on requested: acres
4g. Coastal (tidaf) 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 Fflrm — Version 1.3 Qecem6er 10, 2008 Versian
6. Buffer Mitigation (State Regulated Riparian Buffer Rules} — rec�uired by DWQ
6a. Will the project result in an impact withi� a protected riparian bufFer that requires I❑ Yes � No
buffer mitigation? �
8b. If yes, ther� identify the sq�are fee# of �mpact to each zone of the riparian buffer that requires mi#igation. Calculate the
amount of mitigation required.
Zone
Zone 1
Zone 2
6c. 6�.
Reason for impact To#al impac# Multiplier
(square feet) �
3 (2 for Catawba)
9.5
6f. Total bufFer mitigatian required:
6e.
Required mitigation
(square feet)
6g. ff 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 appro�ed in-lieu fee fund).
6h. Cornments:
PageSof1�
PCN Form — Version 1,3 December 10, 2008 Version
E. Stormwater Managemen# and Di#Fuse Flow Plan (required by DWQ)
T. Diffuse Flaw PEan
� 1a. Does the praject include or is it adjacent to protected riparian buffers identified � Yes � No
within one of the NC Riparian Buffer Pro#ection Rules?
1 b. If yes, then is a diffuse flow plan included? If no, explain why.
❑ Yes ❑ Na
i Comments:
! 2. Stormwater Mana ement Plan
Existing bridge is 25 ft wide New
bridge will be 33 ft wide;
2a. What is the o�erali percent imperviousness of this project? therefore increase in
impervious surface width is 32
%
2b. Does this project require a 5tormwater Management Plan? � Yes ❑ No
2c. If this project DOES NOT require a Stormwater Management Plan, exp�ain why:
2d. If tt�is project DOES require a Stormwater Management Plan, then provide a b�ief, narrative description of the plan:
5ee attached SMP spreadsheek documentation
❑ Certified Local Go�ernment
2e. Who will be responsible for the review of the Stormwater Management Plan? ❑ DWQ Stormwater Program
� DWQ 401 Unit
3. Certified Local Government Storrnwater Review
3a. In which lo�al go�ernment's jurisdiction is this project? NA
❑ Phase II
3b. Which of the folfowing Iocally-implemented stormwater management programs ��SW
apply (check aEl that apply): ❑ USMP
❑ Water Supply Watershed
❑ Other:
3c. Has the approved Stormwater Management Plan with praof of approval been ❑ Yes ❑ No
attached?
4. DWQ Stormwater Pro ram Re�iew
❑ Coastal counties
❑ HQW
4a. Which of the fallowing state-impEemented stormwater management programs apply � ORW
(check all that apply):
❑ Session Law 2Qfl6-24B
❑ Dther:
4b. Has the approved Stormwater Manageme�t Pian with proof of approval been
attached? ❑ Yes ❑ No
5. DWQ 401 Unit Stormwater Re�iew
5a. Does the Stormwater Management Plan meet the appropriate requirements? � Yes ❑ No
5b. Ha�e 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
7. Environmentai Documeniation (DWQ Requirement)
1 a. Does the project invol�e an expenditure of public {federallstatellocal) funds or the
use of public {federallstate) land?
1 b. If you answered "yes" to the above, does the project require preparation of an
environrnental document pursuant to the requirements of the National or State
(North Carolina) En�ironmentai Policy Act {NEPAIS�PA)?
� Yes ❑ No
❑ Yes � No
1 c. If you answered "yes" to the above, has the document re�iew been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final appro�al
letter.) ❑ Yes
Comments:
2. Violations (DWQ Requirerr�ent)
2a. Is the site in vialaiion of DWQ Wetland Rules (15A NCAC 2�1 .0500), Isolated
Wetla�d Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland S#andards, ❑ Yes
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. Is this an after-the-fact permit application?
❑ IVo
►� .
❑ Yes � Na
2c. If you answered "yes" to one or both of the af�ove questions, provide an expiana#ion of the violation(s}:
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project {based on pas# and reaso�ably anticipated future impacts) resuft in
additional de�elopment, which could impact nearby downs#ream water quality? ❑ Yes ��o
3b. I� you answered "yes° to the above, submit a qualitative or quantitati►re cumulati�e impact analysis in accordance with the
most recent DWQ policy. If yau answerecf "no," provide a short narrati�e description.
The project is a rninimum criteria project which has low potentiai for cumufativelindirect impacts and will nok result in
additional derrelopment which cauld impact water qua�ity.
4. 5ewage Disposal (DWQ Requirement)
4a. Clearly detai! the ultimate treatrnent methods and disposition (non-discharge vr discharge) of wastewater generated from
the proposed project, or available capacity of the subjec# facility.
No wastewa#er generated form �roejct.
Page 10 of 11
PCN Form — Version 1.3 December 10, 2U08 Version
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Wfll this praject accur in or near an area with federally protected species or
habitat?
5b. Have you checked with the USFWS concerning �ndangered Species Act
impacts?
; 5c. If yss, indicate the USFWS Field OfFice you have contacted.
❑ Yes � No
� Yes ❑ No
❑ Raleigh
� Ashe�ille
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
NC Natural Fieritage Program database and on-site surveys.
� 6. Essential Fish Hab�tat (Corps Requirement)
i 6a. Will this project occur in or near an area designated as essential fish habitat? ❑ Yes
' 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 ar near an area that khe state, federal or tribal
go�ernments have designated as having historic or cultural preservation
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
❑ Yes
�� .
1� .
7b. Whai data sources did you use to determine whether your s9te would impact historic or archeological resources?
Cultural Resources review. Tracking number (14-05-0016).
8. Flood Zone Designatian (Corps Requirementj
8a. Will this project occur in a FEMA-designatad 100-year floodplain? �� Yes ❑ No
8b. If yes, explain how project meets FEMA requirements: NCDOT Hycfraulics caordination with FEMA
8c. What source(s) did you use to make the floodplain determination? NC Floodpfain Mapping Program
http:llfris.nc.govlfr�sllndex.aspx?FIP5=097&ST=NC&user=General%20Public
���� �.��r�
ApplicantlAgent's Printed Name
�� j/� �'J
, � T�' / � /
ApplicantlAg t's E ature Date
(P�qent's signature is �a1id only if an authonzation letter from the applicant
is provided.]
Page 11 of 11
PCN Form — Version 1.3 December 10, 2008 Version
,.,, � i6orth Carolu� �epart►nernt of Tvar►sporCaticn �.`
I��� ._ , �1
— ���.ii�tr.x•�zz��' - �{._.
. >. Hlghway Stoemwatei P:ogeam �
6TORPAlRlATEii MAN,dGEAIIENd7 PLAp9
Narsoo� r.a2; Ke�eased ��i zois� Fqlt kCU67 PRb.lECT5
WBS Element: 17BP.12.R.6Q TIP No.: 77BP.12.Rfid Coun les : Gastan P e 7 of 1
Gencral Pro t Infom�alwn
WBS E�ement: 77BP.12.R.fi0 TIP Num6er: 17BP.12.R.fiD Pro'ect T e: Brod e Re laoement Date: 3IBP2017
NCDOT Contact: Paul Fisher, PE , Contraetor! Desf nar. MA En in�rin Consultants, Inc.: ScoH Brookhart, PE
+�d�� 1024 Birch Ridge Dr +�d�� 598 E Chatham St, Sulte 137 �
Raleigh, NC 276'ID Cary, NC 275'11
Phone: 919-7D7-6720 Phone: 979-297-0224
Email: fishe ncdot. ov �� Email: sbrookhaA maec.com
Ci fl'ovm: Dallas Cou ies : Gaston
Rrver Basln s: Catawda CAMA Cou Na
etlands within Pro'ect Limi�? No
Pro ect Descn wn
Pro'eck Len th Iin. milas or feet : 265' Surroundin Land llse: resider�iall+nroodeti and open farmland
P ed Pro ect Exfstln 3ite
Pro'ect Bullt-U on Area ac. 02 ac. D.1 ac.
Typicaf Cross Section Rascrlption: 2 11' lanes with 7'shoulders (4' paved) tying {o existing alignment. Shoulder with in 22' wicith of pavement (10.5' lanes} with varying width grass shoulclers.
amas with guardrail will pp 7'.
Annual Avg DailyTraftic (vehlhrlday�: Das' nlFuture: 930 Year. 2010 Existin ; � 930 Year. 201U
Genaral ProJect Narretive: The purposo of this projecf is ta replace exisqng hridge No. 176 on SR 1836 aver Hoyle Creek in Gaston CouMy. The existing bridge is a 3-span struclure with a mtal fength of
(Description of Minimization of Water 90'. Tha propased hridgc� is a 3-span sfructure with a Total length of 100'. The proposed bridge will be 6uilt in the same location as the e�cisting l7ridge and maintain ihe exlsting
f�uality Impacts) grade. The road will be closed during cansUuction and a!i �a11'ic will be maved to an ofi�site detaur. All storm drelnage is dischargpd as far away from the stream es pracilical
while maintaining existing flow paftems. Rip Rap is usad ta diifuse flaw where applicable.
Methods utili�ed tn minimFre impacls:
-Prvposed alignmenf placed on ezisting alignment to minimi7e addiiional upstream and dawnsiream impacts to jurisdictlonal feature
-IVew design plaoes henls oul of water, eliminates one bent currenUy at stream'a edge
-Fill slppes set ai 2:7 to minim¢e impad ta exis6ng drainage pattems and fill slopes stabilized wiUi vegetation
-Pramotion of shaat flow (grade iv drain noTe4) and irrrfiltration with grassed shoufders and swalas as praciical.
-Rip rap placed in ditches as neoessary to diftuse Now and provide energy dissipetion
Stsum drainage outlets to rip r�p pad h� reduce velocHy and difluse Now
-8ank �taqili�ation providad undor new structu�e ta reduce bank erosion
�.
SurFace Water Bod 1: Ho o Creak NCaWR Straam fndex No.: ___ 1 i-12f1-15��
NCDWR 5urFace Waler Classl8cation for Water Body P�a Classlflcation: Water 5u I IV 5-IV __�
5u lsmental Class'dication:
Other Stream Classification:
Im irments- None � �
A uatic T&E S cies? No Commems: �
NRTR Stream I�: Bu(far Rules in EffecS: N1A
Pro ect Includes Brid e S nni Water Bod . Yes back Urains DiScha e Ovar Buffer? No �Issi tor Pads Provided in Buffar? NIA
Deck Orains Dlscha e ONer Water So No (If yes, pravide justification in the General Projed Narrati�e) {If yres, descri6e in the General PmJect Narrative; if no, jusU(y in the
If s, prowide justifica6ian in She General Projecl Namative Generel Project Narrative)
Bridge #176 Replacement
SR 1836 (�Id Willis School Road}
Gaston County
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Nlap prujettion:lNeb Pleacamr Camer 000rdrt�ates: WC,58�} Edge ti�s: UTM Zme 17N 4V�
USq4 Natural Resources Web Soil Survey 3/7/2017
� Conservatlon Servlce National Cooperative Soil Survey Page 1 of 3
Soil Map--Gastan CouMy, North Carolina
Map Unit Legend
Bridge #176, SR 1936
Gaatan Couaiy No►M Carolma {NC077j
Map Unrt Symbol Map Unn Name Acras m AOI Percent of AOI
CoA Congarea loqm, 0 to 2 percent 3.8 80.346
slopea, xtasionally flaaded
Ma02 Madison ssndy clay loam, B to 0.9 f9.795
15 peroeM slopes,
moderetely eroded
Totali for Area of Inle►eat 4.8 /00.0%
�Naturel Reaoureas Wep Soll Survey 3f772017
Conservatlon Servlea Nativnal Coope�ativa Soll Suney Page 3 of 3
NCDOT
HAZARDOUS SPILL BASIN CHECKLIST
Division:-1� County:- TrP,,�ell project ID:17BP.12.R.b0
River Basin: Catawba Bridge No: 176
Route: SR 1836, Old Willis School Road
Hoyles Creek
Water Quality Criteria:
Stream:
Stream Crossing B1ue Line On USGS
4RW
WSI
W� II,III OR TV, Crossing Within O.Smi of W.S. Critical Area
Roadway Criteria:
Route Designation-
Arterial Urban
Arterial Rural
Additional Site Information:
Is a Hazardous Spill Basin Required?
Yes No
� r
r �
Yes No
r r
Criteria Based Upon NCDOT "Best Management Practices for the
Protection of Surface Waters" (March, 1997).
Yes No
�
r
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r
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r
r
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Observers:
Date/7ime
�, �`� Bat Habitat Assessment Form
county:
Waterf�ody
:��
�l..,w L
�- 2. 3- l5 4' .oc� k M
—�s� ,n .�_
�� J C�`4s %S .._
NCDOT B��dges
TIP or DOT �roject number: %7 %j ./� 1�. 6�
Road Name/SR Number: � '�(�S 5 0� �j S1f ��r�
Bridge Number: ,. J7�
ws-lv���
9� Surrounding habitat w/i� 1 mi. Urban/commercial
of project footprint (approx)
IVatural/rural�•—
Any trees >3" DBH within project foot�rint? yes `
Any shaggy tr�es or snags >5" DBH? yQ$
If yes to shag/snag, how much sunlight do they recei�e during the �ay?
If yes ta shag/snag, list species of f�abitat trees >5" dbh.
If snags >5"p81i are present in sunlit areas, pro�ide photos and location.
lf large hollow trees are present, provide photos and location.
Presence of: In project #ootprint
Ca�es yes no
Abandaned mine5 yes �
If'yes' to any of the aho�e, pro�ide photos, description, anc� location.
Suburban/residential �s
Agricultural ,3�
na
'�J
1-3 hours
4-6 hours 7+ hours
I� �icinty (Q.5 mi)
yes �
yes �
Major water saurce in project footprint: river stream/creek pond
5uitable drinking habitat i� the form of non-stagnant, smooth or slack water? �jr�'�'�
��
Guard rails none concrete iimber meta
Deck type oncret metaf timber open grid
Beam type none concrete steel timber
End/back wall type concrete imber masonry
Creosote evidence yes
5hallow �ertical top sealed cre�ices (% -13�" wide, 4-12" deep) es
deep uertical unsealed cre�ices (% -1Y" wide, 12+" deepJ yes
.- /
Max �eight of bridge deck abovs groundJwater (ft): �z- /S ,
Night roost habitat protected yes no
Bridge alignment: N/S E/W W/S
Hours of sun exposure to bridge 0-1 2-3
Human disturbance under bridge high low none
Emergence count performed? (If yes, complete form next page) yes
E�idence af bats using bird nests, if present? yes
E�ider�ce of bats using bridge? (photos neededj yes
Bat species prese
Additional Comments:
NE/SW
lake sw�mp
no
no
na
no
I�CDaT Bat $ridge Habitat Assessment Forn
Updated 3/18/1!
Northern Lon -Eared B�t 4 d Rule Streamli�ned Consultation Form
Federal agencies should use this form for the optional streamlined consultation framework for the nork�ern 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 finaJ. 4(d) rule for the
NLEB for section 7(a)(2) compliance by: (1) notifying the USFWS that an action agency will use the streamlined
frarnework; (2) describing the project with sufficient cletail to support the required determination; and (3} enabling
the USFWS to track effects and determine if reinitiation of cansultation 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 cancurred in writing witli an agency's deternunation that a proposed action �nay affect, but is not
Zikely to adversely affect the NLEB (i.e., the standard informal consultation process). Actions that may cause
pmhibited incidental take require separate formal consnitation. Providing this information does not address
saction 7(a)(2) compliance for any other listed species.
Inforanation to Determine 4(d} Rule
1. Does the project occur wholly outside of the WNS Zone'?
2. Have you contacted the appropriate agency2 to determine if your proj act is near
known hibernacula or maternit roost trees?
3. Could the project distur3� hibernating NLEBs in a known hibernaculum?
4. Could the project alter the entrance or interior environment of a known
hibernaculum?
5. Does the project remiove 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
other trees within a I50-foot radius from the materni�y roost tree frorn June 1
throu�h July 31.
�
0 r''
►_� �
0 ►�
■0 ►=�
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 USFWS to track o�zr assumptions in the
BO.
Agency and Applicant3 (Name, Email, Phone No.): NCDOT, Division 12, Trish Beam,
pdbeam(c�,ncdot.�o_v, 704-480-9044
Praject Name: Bridge #� 76 replacement, SR 183b over Hoyles Creek (Old Willis School Road},
Gaston County
Project Location (inClude coordinates if known): 35.335�91 -81.133844
Basic Project Description (provide narrative below or attach additional in£ormation): Replacement of
timber and steel bridge with a concrete bridge on same location.
1 hltp://www.fws.gov/znidwest/endangeredlmammals/nleb/pdf/WNSZone.pdf
Z See http://www.fws.gov/midwesdendangered/mammals/nleb/nhisites.htanl
3 If applicable - only needed for federal actions with applicants {e.g., for a permit, etc.) who are party to tJze consultation.
GeneraI Pro'ect Information
Does the projeci occur wit�iin 0.25 miles of a laiown hibemaculum?
Does the project occur within 150 feet of a known maternity roost tree?
Does the project include forest conversion4? (if yes, report acreage below)
Estimated total acres of forest conversion
If lmown, estimated acress of forest conversion from A ril 1 to October 31
If known, estimated acres of forest conversion from June 1 to Jul 316
Does the project include tiznber harvest? (if yes, report acreage below)
Estimated total acres of timber harvest
If known, estimated acres of ti.mber �arvest from A ril 1 to October 31
If lrnown, estimated acres of timber harvest from June 1 to Jul 31
Does the project include prescribed fire? {if yes, report acreage below)
Estimated total acres of escribed fire
If known, estimated acras of rescribed fire franrt A ril 1 to October 31
lt 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 canaci#v IMWI
A�ency Deternunation.
❑ �
❑ �
By signing this form, the action agency deternunes that this project may affect the NLEB, but that any
resulting incidental take of the NLEB is not prohibited by the fina14(d) rule.
If the USFWS does not respond within 30 days fram submittal of this form, the action agency may
presume that its determinatio� is informed by the best available information and that iis project
responsibilities under 7{a)(2) with respect to the NLEB -are fixlfilled through the USFWS January 5,
2016, Programmatic BO. The act�on agency will update this determinatzon annually for rt�ulii-year
activities.
The action agency und�rstands that the USFWS presumes that all activi#ies are implemented as
described herein. The action agency will promptly report any departuxes from the described ac�vities to
the appropriate USFWS k'ield Oifice. The actian agency will provide the appropriate USFWS Fie1d
�ffice with fhe results af any swveys conducted for the NLEB. Involved parties will prompdy notify the
appropriate USFW� Field Office upon finding a dead, injured, or sick NLEB,
Signature: -���'•�—� Date Submitted: --' �
° Any activity that temporarily or permanently removes suitable forested habitat, including, but not limited to, tree removal
from development, energy production and transmission, mining, a�iculture, etc. (see page 4$ of the BO).
5 If the project removes iess than 10 trees and tkae acreage is unimown, repart the acreage as less than Q.1 acre.
6 Yf the activity includes tree clearing in J�ne and Ju�q, also include those aereage in April to �ctober.