20171446 Ver 1_PCN Form Submission_20171109

Action History (UTC-05:00) Eastern Time (US & Canada)
�brrrit by Anonymous User 11/9/2017 12:51:40 PM (Start Event)
Accept by Carpenter,Kristi 11/9/2017 1:12:33 PM (DOT Initial Review)
• The task was assigned to Carpenter,Kristi . The due date is: November 14, 2017 5:00 PM
11 /9/2017 12:52 PM

�� �
6fvlslaa of Water Resources
Pre-Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
November 25, 2017 Ver 2.1
*
Please note: fields marked with a red asterisk below are required. You will not be able to submit the form until all mandatory questions are ans�red.
Below is a link to the online help file.
http://edocs.deq.nc.gov/WaterResources/0/doc/603610/Page1.aspx
A. Processing Information
County(or Counties) where the project is located:*
Macon
Is this project a public transportation project? (?)
r Yes C' No
Is this a NCDOT Project?
C� Yes C' No
(NCDOT only) T.I.P. or state project number:
17BP.14.R.48
WBS #
(for NCDOT use only)
1a. Type(s) of approval sought from the Corps:
I7 Section 404 Permit (wetlands, streams and waters, Clean Water Act)
� Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
1b. What type(s) of permit(s) do you wish to seek authorization?
�J 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.
14 - Linear transportation
1c. Type(s) of approval sought from the DWR:*
check all that apply
rJ 401 Water Quality Certification - Regular
r Non-404 Jurisdictional General Permit
r 401 Water Quality Certification - E�ress
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
For the record only for Corps Permit:
*
C' Yes C•' No
C' Yes r 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
DMS acceptance Macon 308.pdf
FlLE TYFE MJST BE FDF
1f. Is the project located in any of NC's twenty coastal counties?*
C' Yes C•' No
1h. Is the project located in a designated trout watershed?*
C' No
C� Yes
235.88KB
Link to trout information: http://w�nn�v.saw.usace.army.mil/Missions/Regulatory-Permit-PrograrrUAgency-Coordination/Trout.aspx
6. Applicant Information
1a. Who is the Primary Contact?*
Dave McHenry
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:
i NCDOT, Division 14
2b. Deed book and page no.:
2c. Responsible party:
(for Corporations)
2d.Address
Street Address
253 Webster Road
Address Line 2
a�y
Sylva
Fbstal / Zip Code
28779
State / R'ovince / F�gion
NC
Country
US

2e. Telephone Number:
(xxx)xxx-xxxx
[phone]
2f. Fax Number:
(xxx)xxx-xxxx
2g. Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1a. Name of project:*
Macon Bridge 308 Replacement
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality/town:*
Franklin
1d. Driving directions*
If it is a new project and can not easily be found in a GPS rrapping system Rease provide directions.
Take US 441 west from Jackson County and turn left onto SR 1500 once you reach bottom of Cowee Mountain grade. Travel about 2 miles
up SR 1500 to Bridge 308.
2. Project Identification
2a. Propertyldentification Number:
(tax RNor parcel ID)
2b. Propertysize:
(in acres)
0.1
2c. Project Address
Street Address
Address Line 2
Qty
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 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:*
35.242615
ex:34.208504
3. Surface Waters
Longitude:*
-83.315788
-77.796371
3a. Name of the nearest body of water to proposed project:*

Watauga Creek
3b. Water Resources Classification of nearest receiving water:*
C Tr
Surface Water Lookup
3c. What river basin(s) is your project located in?*
Little Tennessee
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 e�asting conditions are a small timber bridge on a paved secondary road in a mixed rural/residential area.
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)
aick the upload button or drag and drop files here to attach docurrent
Macon 308 Topo.pdf 765.12KB
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)
C7ick the upload button or drag and drop files here to attach docurrent
Macon 308 soils.pdf 357.73KB
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)
150
4f. Explain the purpose of the proposed project:
The purpose of this project is to replace a structural deficient and/or obsolete timber bridge with a modern
crossing structure.
4g. Describe the overall project in detail, including the type of equipment to be used:
I Erosion Controls will be installed and a temporary culvert roadway installed immediately downstream of the old
bridge. The old bridge will be removed with track-hoe and the new aluminum box culvert assembled and installed
in the old bridge I;ocation.
4h. Please upload project drawings for the proposed project.
Gick the upload button or drag and drop files here to attach docurrent
Macon 308 Partial Plans.pdf 9.3MB
Fle type rrust be pdf
5. Jurisdictional Determinations
Sa. Have the wetlands or streams been delineated on the propertyor proposed impact areas?*
C' Yes C•' No C' Unknown
Comme nts:
Sb. If the Corps made a jurisdictional determination, what type of determination was made? *
C� Preliminary C' Approved C' Unknown C' f�UA
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
qick the upload button or drag and drop files here to attach docurrent
Macon 308 PJD.pdf
Fle type rrust be FDF
6. Project History
PLy�'3:/:
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 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 �J 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 #- Reason 3b.lmpact 3c. Type of 3d. Stream name *
for impact* type* impact*
1 P Culvert Watauga Creek
N�p label (e.g. Id�ad F�rrrnnent (�
Qossing1) orTerrporary
��
3e. Stream Type * 3f. 3g. Stream 3h. Impact
Jurisdictior�idth* length*
type *
Perennial Both 8 43
F2rennial (FS2) or interrrittent Average (feet) (linear feet)
(If�

3a. Site #- Reason 3b.lmpact 3c. Type of 3d. Stream name *
for impact* type* impact*
2 P Dewaterin Watauga Creek
N�p label (e.g. Fd�ad F2rrranent (P� g
Qossing 1) or Terrporary
rn
3 P Rip Rap Watauga Creek
N�p label (e.g. Fd�ad F2rrranent (P� Fill
Q ossing 1) or Terrporary
i�i
4 P Rip Rap Watauga Creek
N�p label (e.g. Fd�ad F�rrranent (F) Fill
CYossing 1) or Terrporary
��
3e. Stream Type * 3f. 3g. Stream 3h. Impact
Jurisdictior�idth* length*
type *
Perennial Both 8 80
F2rennial (F8� or interrrittent Average (feet) (linear feet)
(If�
Perennial Both
F2rennial (F9� or interrrittent
QfV�
Perennial Both
F2rennial (F8� 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:
148
3i. Total temporary stream impacts:
0
3i. Total stream and tributary impacts:
148
3j. Comments:
8 15
Average (feet) (linear feet)
8 10
Average (feet) (linear 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:*
The minimum length culvert necessary was designed. And the new culvert will be on the same locations as the old
bridge.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*
Excavation areas will be isolated from flowing water to reduce downstream sedimentation. Particular attention to
sediment and erosion controls will be used on the project due to the sensitive resources that are known to occur
far downstream of the site.
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 r% Corps
2d. If yes, which mitigation option(s) will be used for this project?
r Mitigation bank N7 Payment to in-lieu fee program
4. Complete if Making a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached.
� Yes
4b. Stream mitigation requested:
(linear feet)
46
4c. If using stream mitigation, what is the 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
r Permittee Responsible Mitigation
6. Buffer mitigation (State Regulated Riparian Buffer Rules) - required by DWR
6a. Will the project result in an impact within a protected riparian buffer that requires buffer mitigation? If yes, you must fill out this entire
form - please contact DWR for more information.
C' Yes �' No
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation
calculate the amount of mitigation required in the table below.
6c. Reason for impact
Zone 1
Zone 2
6f. Total buffer mitigation required
0
6d. Total impact Multiplier
(square feet)
0
0
6e. Required
mitigation (square
feet)
0
0
6g. If buffer mitigation is required, is payment to a mitigation bank or NC Division of Mitigation Services proposed?
C' Yes C' No

6h. Attach the acceptance letter from the mitigation bank or NC Division of Mitigation Services.
(FDF only)
6i. If no, then discuss what type of mitigation is proposed.
6j. Comments:
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:
NCGS 000250
1c. What is the overall percent imperviousness of this project?
50
%
1d. Who will be responsible for the review of the Stormwater Management Plan?*
� Certified Local Government r DEMLR Stormwater Review
r DWR 401 & Buffer Permitting Branch �J DWR Transportation Permitting Branch
I 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:
I Not in a protected riparian buffer area.
5. DWR 401 Stormwater Review
5a. Is the Stormwater Management Plan (including BMP Supplemental Forms and Operation and Maintenance Agreements) attached?
r Yes l" No
Stormwater Management Plan Upload
C7ick the upload button or drag and drop files here to attach docurrent
Macon 308 SMP.pdf 55.17KB
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?*
C� 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 C•' No
Comments:*
Minimum Criteria

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
I nearby downstream water quality?*
C' Yes C•' No
3b. If you answered "no," provide a short narrative description.
The project will maintain existing infrastructure and not increase capacity that could facilitate local development.
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.
no wastewater generated with this project
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 �' 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.
Asheville
5d. Is another Federal agency involved?*
C' Yes C•' No
Se. Is this a DOT project located within Division's 1-8?*
C' Yes C•' No
5f. Will you cut any trees in order to conduct the work in waters of the U.S.? *
�' Yes C' No
5g. Does this project involve bridge maintenance or removal?*
r Yes C' No
�' Unknown
5g(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.
G Yes C' No
Link to the NLEB SLOPES document: http://saw-reg.usace.army.mil/NLEB/1-30-17-signed_NLEB-SLOPES&apps.pdF
If you answered "Yes" to 5g(1), did you discover any signs of bat use?*
C' Yes C•' No C' Unknown
*"* If yes, please show the location of the bridge on the permit drawings/project plans.

5h. Does this project involve the construction/installation of a wind turbine(s)?"`*
C' Yes C•' No
5i. 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 G No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?*
USFWS data, NHP data, and qualified biologist inspections
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
C' Yes �' No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
NMFS
� 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 �' No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources? *
NCDOT Human Environment Unit Review
7c. Historic or Prehistoric Information Upload
Gick the upload button or drag and drop files here to attach docurrent
Macon 308 archaeology report.pdf 1.03M6
Macon 308 hist architecture.pdf 6.55MB
Fle rrust be F�F
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:
8c. What source(s) did you use to make the floodplain determination?*
NCDOT Hydraulic Unit
Miscellaneous attachments not previously requested.
C7ick the upload button or drag and drop files here to attach docurrent
Macon 308 Cover Letter.pdf 257.3K6
Macon 308 pictures.pdf 4.57M6
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Signature
*

r% 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:*
I Dave McHenry
Signature
�� �
Date :
I current date
i Initial Review
Is this project a public transportation project? *(')
C•' Yes C' No
Change only if needed.
Has this project met the requirements for acceptance in to the review process?*
G Yes
C' No
BIMS # Assigned*
20171446
Version#*
Reviewing Office*
Asheville Regional Office - [phone]
Select Project Reviewer*
Kevin Barnett:eads\khbarnett