20171063 Ver 1_PCN Form Submission_20170825

Action History (UTC-05:00) Eastern Time (US & Canada)
�brrrit by Anonymous User 8/25/2017 11:23:06 AM (Start Event)
Accept by Carpenter,Kristi 8/25/2017 2:43:07 PM (DOT Initial Review)
• The task was assigned to Carpenter,Kristi . The due date is: August 30, 2017 5:00 PM
8/25/2017 11:23 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:*
� Yancey
Is this a NCDOT Project?*
�' Yes �' No
(NCDOT only) T.I.P. or state project number:
B-4848
WBS #
38618.1.2
(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:
Nationwide Permit (NWP) Number:
NWP Number Other:
List all MNnurrbers you are applying for not on the drop down list.
23 - Categorical Exclusions
33 - Temporary Construction
1c. Type(s) of approval sought from the DWR:*
check all that apply
fJ 401 Water Quality Certification - Regular
r 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:
*
C' Yes C•' No
For the record only for Corps Permit: �' Yes C� No

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 C' No
Acceptance Letter Attachment
Qick the upload button or drag and drop files here to attach docurrent
I B-4848 - STR - FB 08 (Cool).pdf 62.28KB
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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?*
NCDOT
I 1b. Primary Contact Email:*
[e-mail]
1c. PrimaryContact Phone:*
(xxx)xxx-xxxx
[phone]
1d. Who is applying for the permit?
I7 Owner r Applicant (other than owner) r AgenUConsultant
(Check all that apply)
2. Owner I nformation
2a. Name(s) on recorded deed:
2b. Deed book and page no.:
I 2c. Responsible party:
(for Corporations)
2d.Address
Street Address
Address Line 2
��
Fbstal / Zip Code
2e. Telephone Number:
(xxx)xxx-xxxx
2f. Fax Number:
(xxx)xxx-xxxx
2g. Email Address:*
[e-mail]
State / Rovince / F�gion
Country
C. Project Information and Prior Project History
1. Project Information

1a. Name of project:*
Replacement of Bridge 3 over Possomtrot Creek on SR 1128.
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality/town:*
Burnsville
1d. Driving directions*
If it is a new project and can not easily be found in a GPS rrapping system Rease provide directions.
35.912819 -82.401301
2. Project Identification
2a. Property Identification Number:
(tax RN or parcel ID)
2b. Propertysize:
(in acres)
2c. Project Address
Street Address
Address Line 2
�Y
Fbstal / Zip Code
State / Rovince / F�gion
Country
2d. Site coordinates in decimal degrees
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:*
35.912819
ex:34.208504
3. Surface Waters
Longitude:*
-82.401301
-77.796371
3a. Name of the nearest body of water to proposed project:*
Possomtrot Creek
3b. Water Resources Classification of nearest receiving water:*
GTR
Surface Water Lookup
3c. What river basin(s) is your project located in?*
French Broad
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:*

The area in the bridge vicinity is comprised of crops and livestock agricultural operations, woods, several single-
family residences and Summit Building Supply Company.
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)
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 docurrent
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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)
825
4f. Explain the purpose of the proposed project:
To replace a functionally obsolete bridge approaching the end of its useful life.
4g. Describe the overall project in detail, including the type of equipment to be used:
The project involves replacing an existing bridge with a double barrel, reinforced concrete box culvert (2@13' x 5')
on newalignment, to the southeast side of the epsting bridge. The roadway grade will be similar to the epsting
grade. The new roadway will be realigned to straighten out S-curves just east of the e�sting bridge and provide an
access point with better radii for large trucks entering and exiting the nearby Summit Building Supply Company.
During construction, traffic will be maintained on the existing structure and roadway. 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
64848_Permit Drawings_20170421.pdf
B-4848_Rdy_Plan s. pdf
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5. Jurisdictional Determinations
2.18M6
1.21 MB
Sa. Have the wetlands or streams been delineated on the propertyor proposed impact areas?*
C' Yes C•' No C' Unknown
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
C' Preliminary C' Approved C' Unknown
Corps AID Number:
6carrple: SAV�2017-99999
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Othe r:
5d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.

Sd1. Jurisdictional determination upload
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6. Project History
6a. Have permits or certifications been requested or obtained for this project (including all prior phases) in the past?*
C' Yes C•' No [" 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 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 Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
r Wetlands r% 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 Culvert Possomtrot Perennial Corps Average 89
Culve rt F2rrranent (P� or Cree k F2rennial (FH� or � 3 (linear feet)
N�p label (e.g. Terrporary (� interrrittent (IfV� (feet)
F�ad Qossing 1)
Row 2
Row 3
Site 1- P Stabilizatio Possomtrot Perennial Corps
Upstream F�rrranent (P) or n Creek F2rennial (�) or
ChBnnel Terrporary(� interrrittent(IN�
Alignment
N�p label (e.g.
F�ad Qossing 1)
Site 1- T Dewatering Possomtrot Perennial Corps
Upstream F2rrranent (P� or Creek FBrennial (� or
ChBnnel Terrporary(� interrrittent(INT)
Alignment
fv�p label (e.g.
Fd�ad Qossing 1)
Average 39
13 (linear feet)
(feet)
Average 19
13 (linear feet)
(feet)

Row 4
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- P Stabilizatio Possomtrot Perennial Corps Average 101
Downstrea F2rrrenent (F'� or n C1'ee k F2rennial (� or � g (linear feet)
rTlChanrlel Terrporary(� interrrittent(IN� (feet)
Alignment
N�p label (e.g.
F�ad Qossing 1)
Row 5 Site 1- T
Downstrea �rrrenent (�j or
mChannel Tenporary(�
Alignment
N�p label (e.g.
Fd�ad Qossing 1)
Dewatering Possomtrot Perennial Corps average 11
Creek F2rennial(�)or �g (linearfeet)
interrrittent (IN�
(feet)
"" 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:
229
3i. Total temporarystream impacts:
30
3i. Total stream and tributary impacts:
259
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.
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 reinforced box culvert (RCBC) has been designed to have as little environmental and surface water impacts
as possible. Channel improvements were made for the proposed RCBC design.
A low flow barrel on the west side of the culvert is 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
bankfull discharge. The barrel invert will be a minimum of one-foot below the streambed to allowfor fish passage,
A high flow barrel on the east side of the culvert will provide flood conveyance during high flow storm events. This
will reduce shear stress on the stream bottom. A floodplain bench will be cut in the ewsting ground at the inlet and
outlet of the right (east) barrel to allowfor additional water conveyance during high flow events. Excavation will be
kept to a minimum to produce as little impacts as possible. Where excavation is necessary, geotextile and riprap
will be utilized to
reduce stream bank erosion.
I The high flow barrel will have a 1.5-foot sill inset at the entrance and e�t of the culvert. The low flow barrel will
have 1.0- foot sills/baffles at 16.9 centers to retain sediment within the culvert. All sills will be constructed
perpendicular to the culvert wall.
A grassed swale is being utilized for treatment before sheet flowing through a wooded area in to Bald Creek.
1b. Specificallydescribe measures taken to avoid or minimize the proposed impacts through construction techniques:*
Best Management Practices for Surface Waters will be used during all phases of construction.
i The project will also adhere to Design Standards for Sensitive Waters, and a trout moratorium will be in place from
October 15 to April 15 of any year.
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 C' No
2c. If yes, mitigation is required by (check all that apply):
r DWR N,7 Corps
2d. If yes, which mitigation option(s) will be used for this project?
r Mitigation bank �J Payment to in-lieu fee program r Permittee Responsible Mitigation
4. Complete if Making a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached.
r Yes
4b. Stream mitigation requested:
(linear feet)
229
4c. If using stream mitigation, stream temperature:
cold
4d. Buffer mitigation requested (DWR only):
(squarefeet)
4e. Riparian wetland mitigation requested:
(acres)
4f. Non-riparian wetland mitigation requested:
(acres)
4g. Coastal (tidal) wetland mitigation requested:
(acres)
4h. Comments

F. Stormwater Management and Diffuse Flow Plan (required by DWR)
1a. Does this project require a Stormwater Management Plan?
C� Yes �' 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 r DEMLR Stormwater Review
r DWR 401 & Buffer Permitting Branch �7 DWR Transportation Permitting Branch
2. Diffuse Flow Plan
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
If no, explain why:
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
qick 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?*
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)?*
�' Yes C' 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.)*
�' Yes l" No
NEPAor SEPAFinal 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)? *

r Yes r 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)
Sa. 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 any signs of bat use?*
C' Yes C•' No f Unknown
If yes, please show the location of the bridge on the permit drawings/project plans.
C7ick the upload button or drag and drop files here to attach docurrent
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5g. Does this project involve the construction/installation of a wind turbine(s)?**

C' Yes r No
If yes, please show the location of the wind turbine(s) on the permit drawings/project plans.
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Sh. 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.?*
C' 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.
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Si. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?*
USFWS Website:
-The project will have no effect, due to lack of habitat, for spreading avens, gray bat, Carolina northern flying
squirrel, Rock gnome lichen, Roan Mountain bluet, and Spruce-fir moss spider.
-The project will have no effect, but habitat is present, for Virginia spiraea, which was surveyed in June 2013, and
May 2015.
-A memo regarding the NELB was sent to the USFWS on 5/30/2017 and this species is in compliance with the 4(d)
rule.
-The project may affect, but not likely to adversely affect the Appalachian elktoe, which was concurred upon by the
Service on April 19, 2017.
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? *
�llSEPA 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:
NCDOT Hydraulics Unit coordination with FEMA.

8c. What source(s) did you use to make the floodplain determination?*
FEMA Maps.
Miscellaneous attachments not previously requested.
Gick the upload button or drag and drop files here to attach docurrent
B-4848 Permit App CL82417.pdf 265.67KB
B-4848 USFWS Concurrence.pdf 179.89KB
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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� �i�llar
Date
8/25/2017
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*
20171063
Version#*
1
Reviewing Office*
Asheville Regional Office - [phone]
Select Project Reviewer*
Kevin Barnett:eads\khbarnett