20171018 Ver 1_PCN Form Submission_20170815

Action History (UTC-05:00) Eastern Time (US & Canada)
�brrrit by Anonymous User 8/15/2017 4:31:16 PM (Start Event)
Accept by Carpenter,Kristi 8/15/2017 4:42:14 PM (DOT Initial Review)
• The task was assigned to Carpenter,Kristi . The due date is: August 18, 2017 5:00 PM
8/15/2017 4:32 PM

�� �
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:*
Alamance
Is this a NCDOT Project?*
C� Yes �' No
(NCDOT only) T.I.P. or state project number:
B-5239
WBS #
42841.1.1
(for NCDOT 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:
Nationwide Permit (NWP) Number:
Nationwide Permit (NWP) Number
NWP Number Other:
List all MNnurrbers you are applying for not on the drop down list.
13 - Bank Stabilization
33 - Temporary Construction
23 - Categorical Exclusions
1c. Type(s) of approval sought from the DWR:*
check all that apply
�7 401 Water Quality Certification - Regular
r Non-404 Jurisdictional General Permit
r 401 Water Quality Certification - Express
�J Riparian Buffer Authorization
*
1d. Is this notification solelyfor the record because written approval is not required?
For the record only for DWR 401 Certification: �' Yes C� No

1d. Is this notification solelyfor the record because written approval is not required?
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?
IF so, attach the acceptance letter from rritigation bank or in-lieu fee program
C' Yes �' No
1f. Is the project located in anyof NC's twentycoastal counties?*
C' Yes C•' No
i B. Applicant Information
1a. Who is the Primary Contact?*
William Barrett
1b. PrimaryContact Email:*
[e-mail]
i 1c. PrimaryContact Phone:*
(xxx)xxx-xxxx
[phone]
1d. Who is applying for the permit?
r Owner r Applicant (other than owner) r Agent/Consultant
(Check all that apply)
2. Owner I nformation
2a. Name(s) on recorded deed:
2b. Deed book and page no.:
2c. Responsible party:
(for Corporations)
2d.Address
Street Address
Address Line 2
�Y
Fbstal / Zip Code
2e. Telephone Number:
(xxx)xxx-x�cx
i 2f. Fax Number:
(xxx)xxx-xxxx
2g. Email Address:*
[e-mail]
State / FYovince / F�gion
Country
C. Project Information and Prior Project History
1. Project Information
1a. Name of project:*
*
C' Yes C•' No

Replacement of Bridge 126 over Mill Race and Bridge 119 over Haw River
on NC 87
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality/town:*
Altamahaw
1d. Driving directions*
If it is a new project and can not easily be found in a GPS rrapping system Rease provide directions.
GPS Mapping
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 e�mple, most mobile phones with GPS provide locational precision in decimal degrees to
map coordinates to 5 or 6 digits after the decimal place.)
� Latitude:*
36.182594
ex:34.208504
3. Surface Waters
Longitude:*
-79.5009942
-77.796371
3a. Name of the nearest body of water to proposed project:*
Haw River
3b. Water Resources Classification of nearest receiving water:*
WS-V, NSW
Surface Water Lookup
3c. What river basin(s) is your project located in?*
Cape Fear
River Basin 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:*
The area of the project consists mostly of some residential areas, some undeveloped areas with a paddle access
(Altamahaw Paddle Access) and commercial property (former mill).

4b. Attach an 8 7/2 X 11 excerpt from the most recent version of the USGS topographic map indicating the location of the project site. (for
DWR)
C7ick the upload button or drag and drop files here to attach docurrent
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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)
aick the upload button or drag and drop files here to attach docurrerrt
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4d. List the total estimated acreage of all existing wetlands on the property:
0.13
4e. List the total estimated linear feet of all existing streams on the property:
(interrrittent and perennial)
700
4f. Explain the purpose of the proposed project:
To replace structurally deficient bridges (Bridge No. 119 has a sufficiency rating of 39.86 out of 100; and Bridge
i No. 126 has a sufficiency rating of 15.37 out of 100 and a substructure appraisal of 4 out of 9) that are also
functionally obsolete (Bridge No. 119 has a structural appraisal of 3 out of 9 and a geometry appraisal of 3 out of
9; and Bridge No. 126 has a structural appraisal of 3 out of 9 and a deck geometry appraisal of 2 out of 9).
4g. Describe the overall project in detail, including the type of equipment to be used:
The project involves replacing Bridge No. 119 (a 275-foot bridge with a 285-foot, 5-span bridge) and Bridge No.
126 (a 51-foot bridge with a 70-foot bridge, single span bridge) on their existing alignments with an on-site detour
to maintain traffic along NC 87.
The on-site detour will be located approximately 20 feet east of the e�sting roadway within a temporary easement.
The total length of the on-site detour alignment is approximately 1, 485 feet. The detour alignment will utilize two
26-foot wide temporary bridges: one 265 feet long over the Haw River and one 86 feet long over the mill race.
Both temporary structures will consist of tv�ro 11-foot lanes with 2-foot offsets on either side. Temporary
connections will be made betv�en the detour and SR 1558 (Old NC 87), SR 1002 (Altamahaw Union Bridge Road)
and the parking area for the Altamahaw Paddle Access canoe point. The picnic area at the Altmahaw Paddle
Access will remain open during construction, although a temporary closure of the driveway may be required in
order to complete the tie of the driveway to the detour.
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
B5239_Hyd ro_Permit_Drawings. pdf
B-5239 Roadway Drawings.pdf
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5. Jurisdictional Determinations
11.47MB
3.8MB
5a. Have the wetlands or streams been delineated on the propertyor proposed impact areas?*
C� Yes �' No !' Unknown
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made? *
C' Preliminary �' Approved C' Unknown
Corps AID Number:
Exarrple: SAV�2017-99999
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Greg Price

Sc. If 5a is yes, who delineated the jurisdictional areas?
Agency/Consultant Company:
Other
NCDOT
5d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
5d1. Jurisdictional determination upload
aick the upload button or drag and drop files here to attach docurrent
i B-5239 Prel JD signature.pdf
B-5239 Wetland forms.pdf
Revised B-5239 Figure 2 topo.pdf
Revised B-5239 Figure 3 Aerial.pdf
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6. Project History
88.54KB
1.04MB
45.44 KB
129.48KB
6a. Have permits or certifications been requested or obtained for this project (including all prior phases) in the past?*
C' Yes C•' No C' Unknown
7. Future Project Plans
7a. Is this a phased project?*
C' Yes �' 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 activit�/? 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):
rJ Wetlands rJ Streams-tributaries rJ 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.
I 2a. Site #- Reason for 2b. Impact type * 2c. Type of wetland
impact
Site 1 CSP - detour
N�p label (e.g. Fd�ad Qossing 1)
Site 2 Fill - rip rap
N�p label (e.g. Finad Qossing 1)
Site 2 - Excavation
fv�p label (e.g. I�ad Qossing 1)
T Bottomland Hardwood
F�rrranent (P) or Terrporary Forest
��
T Bottomland Hardwood
F2rrrsnent (P� or Terrporary FOP2St
��
P Bottomland Hardwood
F�rrrenent (P� or Terrporary Forest
��
2d. Wetland name 2e. Forested 2f. 2g. Impact
Jurisdiction area
type
Yes Corps 0.020
(404, 10) or d�NR (acres)
(401, other)
Yes Corps 0.010
(404, 10) or DJVR (acres)
(401, other)
Yes Corps 0.010
(404, 10) or C7JVR (acres)
(401, other)

2a. Site #- Reason for 2b. Impact type * 2c. Type of wetland
impact
Site 2- Fill - roadway T Bottomland Hardwood
N�p label (e.g. I�ad Q�ossing 1) F2rrranent (� or Terrporary Fo1'est
��
2g. Temporary Wetland Impact
0.070
2g. Permanent Wetland Impact
0.010
2g. Total Wetland Impact
0.080
2h. Comments:
There will be <0.01 acre of hand clearing in wetland at site 1.
The Permanent impact at site 2 is <0.01 acres.
2d. Wetland name 2e. Forested 2f. 2g. Impact
Jurisdiction area
type
Yes Corps 0.040
(404, 10) or C7JVR (acres)
(401, other)
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.
Row 1
Row 2
Row 3
Row 4
Row 5
Row 6
Row 7
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
Site 1 T Other Haw River Perennial Corps Average 82
N�p label (e.g. F2rrrenent (P� or F2rennial (FH�) or �f�t� (linear feet)
Finad Q-ossing 1) Terrporary (� interrrittent (IN�
Site 1 P Bank Haw River Perennial Corps Average 10
N�p label (e.g. F�rrranent (P� or Stabiliz8tio F�rennial (� or �q�t� (linear feet)
I�ad CYossing 1) Terrporary (� n interrrittent (IfVn
Site 1 T Bank
N�p label (e.g. F2rrrenent (P� or Stabilizatio
Finad Qossing 1) Terrporary (� n
Site 1 T Other
N�p label (e.g. F�rrranent (P� or
I�ad Qossing 1) Terrporary (�
Site 2 T Other
N�p label (e.g. F2rrranent (Pj or
I�ad Qossing 1) Terrporary (�
Site 2 P Bank
fv�p label (e.g. F2rrrenent (P� or Stabilizatio
Fd�ad Qossing 1) Terrporary (� n
Site 2 T Bank
N�p label (e.g. F�rrranent (F'� or Stabilizatio
Fk�ad Qossing 1) Terrporary (� n
Haw River Perennial Corps
F2rennial (FB� or
interrrittent (IN�
Haw River Perennial Corps
F�rennial (� or
interrrittent (IfVn
Mill Race Perennial Corps
F2rennial (FB� or
interrrittent (IIV�
Mill Race Perennial Corps
F2rennial (FH�) or
interrrittent (IN�
Mill Race Perennial Corps
F�rennial (Fff� or
interrrittent (IfV�
�` 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:
28
3i. Total temporary stream impacts:
247
Average 10
(feet) (linear feet)
Average 53
(feet) (linear feet)
Average 97
(feet) (linear feet)
Average 18
(feet) (linear feet)
Average 5
(feet) (linear feet)

3i. Total stream and tributary impacts:
275
3j. Comments:
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.
6a. Project is in which protect basin(s)?*
Check all that apply.
I r Neuse
r Catawba
r Goose Creek
r Other
6b. Impact Type
r Tar-Pamlico
r Randleman
�J Jordan Lake
6c. Per or 6d. Stream name
Te mp
site 1 Road Allowable P Haw River
Location and Exerrpt, Allowable, allowable w/ rritigation F�rrrenent (F) or
Terrporary (�
Site 1 Bridge Allowable P Haw River
I Location and 6cerrpt, Allowable, allowable w/ rritigation F�rrranent (F'� or
Terrporary (�
Site 1 Road Allowable T Haw River
Location and C errpt, Allowable, allowable w/ rritigation F2rrranent (F) or
Terrporary (�
Site 1 Bridge Allowable T Haw River
Location and 6cerrpt, Allowable, allowable w/ rritigation F�rrranent (F) or
Terrporary (�
Site 1 Road Allowable T Haw River
ILocation and 6cerrpt, Allowable, allowable w/ rritigation F�rrranent (P� or
Terrporary (�
Site 2 Road Allowable P Mill Race
Location and C errpt, Allowable, allowable w/ rritigation F2rrranent (� or
Terrporary (�
Site 2 Bridge Allowable P Mill Race
Location and Exerrpt, Allowable, allowable w/ rritigation F2rrranent (F) or
Terrporary (�
Site 2 Road Allowable P Mill Race
ILocation and 6cerrpt, Allowable, allowable w/ rritigation F�rrranent (F'� or
Terrporary (�
Site 2 Bridge Allowable T Mill Race
Location and C errpt, Allowable, allowable w/ rritigation F2rrranent (F) or
Terrporary (�
Site 2 Road Allowable T Mill Race
Location and 6cerrpt, Allowable, allowable w/ rritigation F2rrranent (F) or
Terrporary (�
6e. Buffer 6f. Zone 1 6g. Zone 2
mitigation impact impact
required?
No (squarefeet) 1$2
(square feet)
No
No
No
No
No
No
No
No
No
4,997 2,631
(squarefeet) (squarefeet)
(square feet) 464
(square feet)
3,224 1,722
(squarefeet) (squarefeet)
446 1,149
(squarefeet) (squarefeet)
545 1,372
(squarefeet) (squarefeet)
1,573 (square feet)
(square feet)
959 956
(squarefeet) (squarefeet)
1,731 53
(squarefeet) (squarefeet)
1,082 908
(squarefeet) (squarefeet)

6h. Total buffer impacts:
Temporary impacts
Permanent impacts:
Total buffer impacts
6i. Comments:
Zone 1
6,483.00
Zone 1
8,074.00
Zone 1
14,557.00
Supporting Documentation - i.e. Impact Maps, Plan Sheet, etc.
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Zone 2
4,296.00
Zone 2
5,141.00
Zone 2
9,437.00
, 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:*
The proposed bridge no. 119 is 10 feet longer than the ewsting bridge and proposed bridge no. 126 is 19 feet
longer than the existing bridge; the proposed bridges will be at approximately the same grade as the existing
structure; and 2:1 fill slopes will be used adjacent to wetlands and elsewhere as practicable.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*
This project requires a detour structure. The detour bridge will not discharge any water from the deck and will
have minimal impacts to the stream. The detour structure will be removed and all disturbances will be stabilized.
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?
f Yes
C•' No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
Permanent impacts to Wetlands = <0.01
Permanent impacts to Streams = 28 linear feet of Bank Stabilization (not loss of waters)
All Buffer Impacts are allowable
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
I 1a. Does this project require a Stormwater Management Plan?
�' Yes c" No
1b. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
See attached permit drawings
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
�J 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 C' No
5. DWR 401 Stormwater Review
5a. Is the Stormwater Management Plan (including BMP Supplemental Forms and Operation and Maintenance Agreements) attached?
C' Yes
C' No
Stormwater Management Plan Upload
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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?*
r Yes c' 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)?*
C� 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.)*
C� Yes l" No
NEPA or SEPA Final Approval Letter
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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 �' 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.

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? *
f Yes C•' No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
C' Yes �' No
5c. If yes, indicate the USFWS Field Office you have contacted.
5d. Is this a DOT project located within Division's 1-8?*
C� Yes
C' No
5i. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?*
There are no listed federally listed species in Alamance County.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
C' Yes C•' No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
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
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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 C' No

8b. If yes, explain how project meets FEMA requirements:
Upon completion of the project, the Division shall submit sealed as-built construction plans to the hydraulics Unit
certifying that the drainage structures and roadway embankment that are located within the 100-year floodplain
were built as shown in the construction plans, both horizontally and vertically.
8c. What source(s) did you use to make the floodplain determination?*
i NC Floodplain Mapping Program (FMP)
Miscellaneous attachments not previously requested.
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I B-5239 Cover Letter.pdf 322.37KB
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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� ��Ilc�r
Date
8/15/2017
Initial Review
Is this project a public transportation project?
�' 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?*
r Yes
C' No
BIMS # Assigned*
20171018
Version#*
1
Reviewing Office *
Central Office - [phone]
Select Project Reviewer*
April Norton:eads\arnorton