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HomeMy WebLinkAbout20170955 Ver 1_PCN Form Submission_20170804Action History (UTC-05:00) Eastern Time (US & Canada) �brrrit by Anonymous User 8/4/2017 10:22:42 AM (Start Event) Accept by Carpenter,Kristi 8/4/2017 10:51:08 AM (DOT Initial Review) • The task was assigned to Carpenter,Kristi . The due date is: August 9, 2017 5:00 PM 8/4/2017 10:23 AM �� � 6fvlslaa of Water Resources Pre-Construction Notification (PCN) Form For Nationwide Permits and Regional General Permits (along with corresponding Water Quality Certifications) June 28, 2017 Ver 1.8 * Please note: fields marked with a red asterisk below are required. You will not be ab/e to submit the form until all mandatory questions are ans�red. Below is a link to the DRAFT online help file. http://edocs.deq.nc.gov/WaterResources/0/doc/549884/Page1.aspx A. Processing Information County (or Counties) where the project is located:* Cherokee Is this a NCDOT Project?* C� Yes �' No (NCDOT only) T.I.P. or state project number: B-4462 WBS # 38376.1.2 (for f�1CDOT use only) � 1a. Type(s) of approval sought from the Corps:* rJ Section 404 Permit (wetlands, streams and waters, Clean Water Act) r Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act) 1b. What type(s) of permit(s) do you wish to seek authorization?* fJ Nationwide Permit (NWP) r Regional General Permit (RGP) Nationwide Permit (NWP) Number: NWP Number Other: List all MN nurrbers you are applying for not on the drop dow n list. 13 - Bank Stabilization 1c. Type(s) of approval sought from the DWR:* check all that apply � 401 Water Quality Certification - Regular � Non-404 Jurisdictional General Permit r 401 Water Quality Certification - Express r Riparian Buffer Authorization 1d. Is this notification solelyfor the record because written approval is not required? For the record only for DWR 401 Certification: I For the record only for Corps Permit: 1e. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts? * C•' Yes !" No C' Yes C•' No If so, attach the acceptance letter from rritigation bank or in-lieu fee program C' Yes C•' No 1f. Is the project located in any of NC's twenty coastal counties?* C' Yes �' No B. Applicant Information 1a. Who is the Primary Contact?* Jeff Hemphill 1b. Primary Contact Email:* jhemphill@ncdot.gov 1c. PrimaryContact Phone:* (xxx)xxx-xxxx (919)707-6126 1d. Who is applying for the permit? r% Owner r Applicant (other than owner) r AgenUConsultant (Check all that apply) 2. Owner I nformation 2a. Name(s) on recorded deed: NCDOT 2b. Deed book and page no.: 2c. Responsible party: (for Corporations) 2d.Address Street Address Address Line 2 �' R�stal / Zip Code 2e. Telephone Number: (xxx)xxx-xxxx 2f. Fax Number: (xxx)xxx-xxxx 2g. Email Address:* jhemphill@ncdot.gov State / Rovince / F�gion Country C. Project Information and Prior Project History 1. Project Information 1a. Name of project:* Replacement of Bridge 148 over Persimmon Creek on SR 1127 (Bell Hill i Road) 1b. Subdivision name: I(iF appropriate) 1c. Nearest municipality/town:* I Murphy 1d. Driving directions* If it is a new project and can not easily be found in a C� rrapping system Rease provide directions. See Vicinity Map inset on title page of Permit Drawings (attached) 2. Project Identification 2a. Property Identification Number: (tax RN or parcel ID) 2b. Propertysize: (in acres) 2c. Project Address Street Address Address Line 2 �� Fbstal / Zip Code State / Rovince / F�gion Country 2d. Site coordinates in decimal degrees I Please collect site coordinates in decimal degrees. Use between 4-6 digits (unless you are using a survey-grade GPS device) after the decimal place as appropriate, based on howthe location was determined. (For example, most mobile phones with GPS provide locational precision in decimal degrees to map coordinates to 5 or 6 digits after the decimal place.) Latitude:* 35.05323 ex:34.208504 3. Surface Waters Longitude:* -84.18059 -77.796371 3a. Name of the nearest body of water to proposed project:* Lake Hiwassee 3b. Water Resources Classification of nearest receiving water:* C Surface Water Lookup 3c. What river basin(s) is your project located in?* Hiwassee RiverBasin Lookup 4. Project Description 4a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this application:* Agricultural, rural residential. 4b. Attach an 8 1/2 X 11 excerpt from the most recent version of the USGS topographic map indicating the location of the project site. (for DWR) Qick the upload button or drag and drop files here to attach docurrent Fle type rrust be pdF 4c. Attach an 8 1/2 X 11 excerpt from the most recent version of the published County NRCS Soil Survey map depicting the project site. (for DWR) Gick the upload button or drag and drop files here to attach docurrent Fle type rrust be pdF 4d. List the total estimated acreage of all existing wetlands on the property: 0 4e. List the total estimated linear feet of all existing streams on the property: (interrrittent and perennial) 125' 4f. Explain the purpose of the proposed project: To replace a structurally deficient and functionally obsolete bridge. 4g. Describe the overall project in detail, including the type of equipment to be used: The project involves replacing a single span 36-foot timber deck & steel I beam bridge with a single span, 70-foot cored slab bridge on a new alignment to the north.The e�asting bridge will be utilized as an onsite detour for this project. Standard road building equipment, such as trucks, dozers, and cranes will be used. 4h. Please upload project drawins for the proposed project. C7ick the upload button or drag and drop files here to attach docurrent B-4462 Permit Drawings.pdf 2.02M6 B-4462 Roadway Plans.pdf 1.61 MB B-4462 Permit Application Cover Letter.pdf 40.31 KB Fle type rrust be pdf 5. Jurisdictional Determinations 5a. Have the wetlands or streams been delineated on the property or proposed impact areas?* C' Yes �' No �' Unknown Comments: 5b. If the Corps made a jurisdictional determination, what type of determination was made? * f Preliminary C' Approved �' Unknown Corps AID Number: 6carrple: SAV�2017-99999 Sc. If 5a is yes, who delineated the jurisdictional areas? Name (if known): Agency/Consultant Company: Othe r: i Sd. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation. 5d1. Jurisdictional determination upload C7ick the upload button or drag and drop files here to attach docurrent Fle type rrust be FDF 6. Project History 6a. Have permits or certifications been requested or obtained for this project (including all prior phases) in the past?* C' Yes r No �' Unknown 7. Future Project Plans 7a. Is this a phased project?* C' Yes C•' No Are any other NWP(s), regional general permit(s), or individual permits(s) used, or intended to be used, to authorize any part of the proposed project or related activity? This includes other separate and distant crossing for linear projects that require Department of the Army authorization but don't require pre-construction notification. D. Proposed I m pacts I nventory 1. Impacts Summary 1a. Where are the impacts associated with your project? (check all that apply): r Wetlands rJ Streams-tributaries r Buffers r Open Waters r Pond Construction 2. Wetland Impacts If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted. 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. Site #- 3b.lmpact 3c. Type of 3d. Stream 3e. Stream 3f. 3g. Stream 3h. Impact Reason for type impact name Type Jurisdiction width length impact type Row 1 Site 1 P Bank Persimmon Perennial Corps average 20 N�p label (e.g. F�rrranent (P) or Stabilizatio Cree k F�rennial (� or � � (linear feet) 13�ad C7ossing 1) Terrporary (� n interrrittent (IfV� (feet) Row2 Site 1 T Bank Persimmon Perennial Corps N�p label (e.g. F2rrranent (P� or Stabilizatio Creek F2rennial (� or 13�ad Q'ossing 1) Terrporary (� n interrrittent (INT) "" All Perennial or Intermittent streams must be verified by DWR or delegated local government. 3i. Total jurisdictional ditch impact in square feet: 0 3i. Total permanent stream impacts: 20 3i. Total temporary stream impacts: 50 3i. Total stream and tributary impacts: 70 3j. Comments: Average 50 � � (linear feet) (feet) 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. 5. Pond or Lake Construction If pond or lake construction is proposed, then complete the chart below. 6. Buffer Impacts (for DWR) If project will impact a protected riparian buffer, then complete the chart below. Individually list all buffer impacts below. E. Impact Justification and Mitigation 1. Avoidance and Minimization 1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:* See Stormwater Management Plan. The proposed bridge will have no direct discharge into the water. The minimum number of deck drains necessary to maintain safe passage by the traveling public will be installed over the overbank floodplain areas. Drains will be installed as far from the stream as possible to mawmize opportunity to diffuse flow. No deck drains will be installed over water. The majority of stormwater runoff from the proposed bridge is to flow to two proposed drop inlets, located at the east approach of the bridge. Stormwater runoff will be discharged at minimum practicable slopes, yielding minimum velocities and diffused with riprap pads at pipe outlets, which the e�sting drainage does not benefit from. All proposed stormwater runoff is discharged as far away from the stream and at lowest velocities as practicable. Design maintains ebsting flow patterns to minimize impacts. The new bridge spans the creek. 1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:* I Best Management Practices for Surface Waters will be used during all phases of construction. 2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State 2a. Does the project require Compensatory Mitigation for impacts to Waters of the U.S. or Waters of the State? C' Yes �' No F. Stormwater Management and Diffuse Flow Plan (required by DWR) 1a. Does this project require a Stormwater Management Plan? C� Yes C' No 1b. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan: See Permit Drawings (attached) 1c. What is the overall percent imperviousness of this project? % 1d. Who will be responsible for the review of the Stormwater Management Plan?* r Certified Local Government r7 DWR 401 & Buffer Permitting Branch 2. Diffuse Flow Plan r DEMLR Stormwater Review r DWR Transportation Permitting Branch 2a. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection Rules? C' Yes If no, explain why: C•' No 5. DWR 401 Stormwater Review 5a. Is the Stormwater Management Plan (including BMP Supplemental Forms and Operation and Maintenance Agreements) attached? G Yes C' No Stormwater Management Plan Upload Gick the upload button or drag and drop files here to attach docurrent file type rrust be pdf G. Supplementary Information 1. Environmental Documentation 1a. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?* �' Yes l" No 1b. 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 (North Carolina) Environmental PolicyAct (NEPA/SEPA)?* �' Yes l" No 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 NEPAor SEPAfinal approval letter.)* r Yes l" No NEPAor SEPAFinal Approval Letter C7ick the upload button or drag and drop files here to attach docurrent FlLE TYFE MJST BE FDF 2. Violations (DWR Requirement) 2a. Is the site in violation of DWR Water Quality Certification Rules (15A NCAC 2H .0500), Isolated Wetland Rules (15A NCAC 2H .1300), or DWR Surface Water or Wetland Standards or Riparian Buffer Rules (15A NCAC 2B .0200)? * C' Yes C•' No 2b. Is this an after-the-fact permit application?* C' Yes C•' No 2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s): 3. Cumulative Impacts (DWR Requirement) 3a. Will this project (based on past and reasonably anticipated future impacts) result in additional development, which could impact nearby downstream water quality?* C' Yes C•' No 3b. If you answered "no," provide a short narrative description. i Due to the minimal transportation impact resulting from this bridge replacement, this project will neither influence nearby land uses nor stimulate growth. Therefore, a detailed indirect or cumulative effects study will not be necessary. 4. Sewage Disposal (DWR Requirement) 4a. Describe, in detail, the treatment methods and dispositions (non-discharge or discharge) of wastewater generated from the proposed project. If the wastewater will be treated at a treatment plant, list the capacity available at that plant. 5. Endangered Species and Designated Critical Habitat (Corps Requirement) 5a. Will this project occur in or near an area with federally protected species or habitat? * C' Yes C' No 5b. Have you checked with the USFWS concerning Endangered Species Act impacts?* �' Yes C' No 5c. If yes, indicate the USFWS Field Office you have contacted. Asheville 5d. Is this a DOT project located within Division's 1-8?* C' Yes C� No 5e. Will you cut anytrees in order to conduct the work in waters of the U.S.?* C' Yes C' No 5f. Does this project involve bridge maintenance or removal?* C� Yes C' No 5f(1). If yes, have you inspected the bridge for signs of bat use such as staining, guano, bats, etc.? Representative photos of signs of bat use can be found in the NLEB SLOPES, Appendix F, pages 3-7. C' Yes C' No Link to the NLEB SLOPES document: http://sav�reg.usace.army.mil/NLEB/1-30-17-signed_NLEB-SLOPES&apps.pdF If you answered "Yes" to 5f(1), did you discover anysigns of bat use?* C' Yes �' No C' Unknown If yes, please show the location of the bridge on the permit drawings/project plans. aick the upload button or drag and drop files here to attach docurrent Fle rrust be FDF 5g. Does this project involve the construction/installation of a wind turbine(s)?** C' Yes �' No If yes, please show the location of the wind turbine(s) on the permit drawings/project plans. Gick the upload button or drag and drop files here to attach docurrent Fle rrust be FDF 5h. Does this project involve (1) blasting, and/or (2) other percussive activities that will be conducted by machines, such as jackhammers, mechanized pile drivers, etc.?* �' Yes C' No If yes to either, please provide details to include type of percussive activity, purpose, duration, and specific location of this activity on the property. Gick the upload button or drag and drop files here to attach docurrent Fle rrust be FDF 5i. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?* N.C. Natural Heritage Program database; USFWS-website; biological surveys for protected species listed for Cherokee County. A bat survey report dated June 19, 2017 found summer roosting habitat for Indiana bat (MANLAA). Consultation with NCDOT's Biological Surveys Group on August 2, 2017 confirmed that the potential roost tree identified in the 6/19/17 bat report will not be impacted by this project; therefore, the biological conclusion for Indiana bat is changed to No Effect. No roosting habitat nor nearby occurrences for Gray bat (No Effect), and NLEB is 4(d) compliant (part of Concurrence Letter sent to USFWS). Aquatic screenings/surveys were conducted in 2006 & 2013 and found no mussels — No Effect for Cumberland bean, Tan riffleshell and Little-wing pearlymussel. A Small whorled pogonia survey was conducted on February 25, 2013 - No Habitat/No Effect. An eagle survey was conducted in February 2013 & May 2017 with no nests or specimens observed. 6. Essential Fish Habitat (Corps Requirement) 6a. Will this project occur in or near an area designated as an Essential Fish Habitat?* r Yes r No 6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?* i NMFS County Index 7. Historic or Prehistoric Cultural Resources (Corps Requirement) Link to the State Historic Preservation Office Historic Properties Map (does not include archaeological data: http://gis.ncdcr.gov/hpoweb/ 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 status (e.g., National Historic Trust designation or properties significant in North Carolina historyand archaeology)?* C' Yes C•' No 7b. What data sources did you use to determine whether your site would impact historic or archeological resources? * NEPA Documentation 7c. Historic or Prehistoric Information Upload C7ick the upload button or drag and drop files here to attach docurrent Fle rrust be FDF 8. Flood Zone Designation (Corps Requirement) Link to the FEMA Floodplain Maps: https://msc.fema.gov/portal/search 8a. Will this project occur in a FEMA-designated 100-year floodplain?* C' Yes �' No 8b. If yes, explain how project meets FEMA requirements: 8c. What source(s) did you use to make the floodplain determination?* FEMA Flood Maps Miscellaneous attachments not previously requested. aick the upload button or drag and drop files here to attach docurrent Fle rrust be FDF Signature * rJ By checking the box and signing below, I certify that: ■ I have given true, accurate, and complete information on this form; ■ I agree that submission of this PCN form is a"transaction" subject to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions AcY'); ■ I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions AcY'); ■ I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature; AND ■ I intend to electronically sign and submit the PCN form. Full Name:* Colin Mellor Signature Col� �i�llor Date 8/4/2017 Initial Review Is this project a public transportation project? C' Yes C' No Only change this if the project has been reassigned. Has this project met the requirements for acceptance in to the review process?* G Yes C' No BIMS # Assigned* 20170955 Version#* Reviewing Office* Asheville Regional Office - (828) 296-4500 Select Project Reviewer* Kevin Barnett:eads\khbarnett