20180377 Ver 1_PCN Form Submission_20180315

Action History (UTC-05:00) Eastern Time (US & Canada)
�brrrit by Anonymous User 3/15/2018 11:03:59 AM (Start Event)
Accept by Carpenter,Kristi 3/15/2018 12:52:14 PM (DOT Initial Review)
• The task was assigned to Carpenter,Kristi . The due date is: March 20, 2018 5:00 PM
3/15/2018 11:04 AM

�� �
�ivislan af Water Resour�es
Pre-Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
January 31, 2018 Ver 2.3
*
Please note: fields marked with a red asterisk beloware required. You will not be able to submit the form until all mandatory questions are ans�red.
Also, if at any point you wish to print a copy of the E-PCN, all you need to do is right-click on the document and you can print a copy of the form.
Below is a link to the online help file.
https://edocs.deq. nc.gov/WaterResources/0/edoc/624704/PCN%20Help%20File%202018-1-30.pdf
A. Processing Information
County (or Counties) where the project is located:*
Buncombe
Is this project a public transportation project?* (')
C Yes l' No
Is this a NCDOT Project?*
f• Yes r No
(NCDOT only) T.I.P. or state project number:
17BP.13.R.22
WBS #
17BP.13.R.22
(for f�D�T use only)
1a. Type(s) of approval sought from the Corps:*
I7 Section 404 Permit (wetlands, streams and waters, Clean Water Act)
I-' 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 down list.
14 - Linear transportation
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 onlyfor DWR 401 Certification:
For the record onlyfor Corps Permit:
*
C' Yes r No
C' Yes f' 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 l" No
Acceptance Letter Attachment
Qick the upload button or drag and drop files here to attach docurrent
Bridge 143 mitigation acceptance.pdf
RLE TYFE MJST BE FDF
1f. Is the project located in anyof NC's twentycoastal counties?'�
f Yes r No
1h. Is the project located in a designated trout watershed?*
C•' Yes C' No
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Link to trout information: http://wrwv.saw.usace.army.mil/Missions/Regulatory-Permit-Program/Agency-Coordination/Trout.aspx
B. Applicant Information
1a. Who is the Primary Contact? *
Yates Allen
1b. PrimaryContact Email:*
[e-mail]
1c. PrimaryContact Phone:�`
(xxx)xxx-xxxx
[phone]
1d. Who is applying for the permit?
rJ Owner r Applicant (other than owner) r Agent/Consultant
(Check all that apply)
2. Owner I nformation
2a. Name(s) on recorded deed:
NC Department of Transportation
2b. Deed book and page no.:
2c. Responsible party:
(for Corporations)
2d. Address
Street Address
55 Orange Street
Address Line 2
PO Box 3279
a�y
Asheville
Rzstal / Zip Code
28802
2e. Telephone Number:
(xxx)xxx-xxxx
[phone]
State / FYovince / F�gion
NC
Country
USA

2f. Fax Number:
[phone]
(xxx)xxx-xxxx
2g. Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1a. Name of project:*
Bridge 100143, SR 2027 Martin Creek Road
1b. Subdivision name:
(rf appropriate)
1c. Nearest municipality/town:*
Barnardsville
1d. Driving directions*
IF it is a new project and can not easily be found in a GPS rrapping system Rease provide directions.
From Future I-26, US 19/23 turn on to NC 197 towards Barnardsville. Drive approxmately 7.75-8 miles to SR 2027 Martin Creek Rd. Turn
left on to SR 2027. Proceed approximately 0.8 mile to bridge 143 over Martin Creek.
2. Project Identification
2a. Propertyldentification Number:
(tax RN or parcel ID)
2b. Propertysize:
(in acres)
0.2
2c. Project Address
Street Address
Address Line 2
a�y
Fbstal / Zip Code
State / Rovince / F�gion
Caurdry
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 how the 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:* Longitude:*
35.79587 -82.41828
ex:34.208504 -77.796371
3. SurFace Waters
3a. Name of the nearest body of water to proposed project:*
Martin Creek
3b. Water Resources Classification of nearest receiving water:*
HQW WS-II Tr
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:*
Existing bridge on paved SR 2027 surrounded by low density housing, pastures, forestland
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)
C7ickthe upload button or drag and drop files here to attach docurrent
Bridge 143 topo.pdf
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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)
Qick the upload button a- drag and drop files here to attach document
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)
Martin Creek (PER)-150'; UT 1(INT)-78'; UT 2(INT)-20'
4f. Explain the purpose of the proposed project:*
Replace ebsting timber bridge with 3-sided, bottomless, reinforced concrete box culvert
4g. Describe the overall project in detail, including indirect imapacts and the type of equipment to be used:*
We propose to replace the e�asting single span 19' 2" timber bridge with a single barrel 3-sided, bottomless,
reinforced concrete boxculvert (17' wide x2' high x48' long) on 4' caps. Culvert installation will result in
permanent impact to 48 linear feet (LF) of Martin Creek. Temporary impacts to 111 LF of the stream are
necessary for dewatering/diversion during construction. Two unnamed tributaries (UT) to Martin Creek are
present. UT 1 is intermittent and flows in the e�asting roadside ditch. Sixteen linear feet of UT 1 will be permanently
impacted by the extension of an e�sting driveway pipe and another approbmate 10 LF will be impacted by the
placement of bank stabilization. Appro�mately 60 LF of UT 1 will be temporarily impacted as it is relocated to the
realigned ditch. UT 2 flows from a pipe adjacent to a gravel driveway. It will not be impacted. Equipment includes
trackhoe, dump trucks, and possibly a crane.
4h. Please upload project drawings for the proposed project.
C7ick the upload button or drag and drop files here to attach docurrent
Bridge 143 plan sheets.pdf
Bridge 143 SWMP.pdf
Bridge 143 Wetland Impact Summary Sheet Revised May 2008.pdf
Bridge 143 SWMP page 2.pdf
Fle type rrust be pdf
5. Jurisdictional Determinations
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5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
C•' Yes f' No l" Unknown
Comme nts:
Site visits by DOT personnel; PJD form and NC DWQ Methodology for ID of
INT and PER Streams forms attached
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
f Preliminary
Corps AID Number:
l" Approved
C' Unknown
f•' f�llA

6carrple:SAW-2017-99999
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Othe r:
Yates Allen
NC DOT
5d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
March 5 and 13, 2018
5d7. Jurisdictional determination upload
Qick the upload button or drag and drop files here to attach docurrent
Bridge 143 PJD.pdf 102.39KB
INT or PER stream ID UTs 1 and 2.pdf 85.86KB
Fle type rrust be FCF
6. Project History
6a. Have permits or certifications been requested or obtained for this project (including all prior phases) in the past? *
f Yes C No �' Unknown
7. Future Project Plans
7a. Is this a phased project? *
C' Yes r 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 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
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. Reason for impact*3b.lmpact 3c. Type of impact*3d. Stream name *
tYpe *
S1 Martin Creek P Culvert Martin Creek
N�p label (e.g. Finad Qossing 1) F�rrranent (Pj or
Terrporary (�
g2 Martin Creek T Dewatering Martin Creek
fV�p label (e.g. fd�ad Qossing 1) F�rrranent (F) or
Terrporary (�
3e. Stream 3f. Type of
Type* Jurisdiction*
Perennial Both
F�rennial (�) or
interrrittem (IfV�
Perennial Both
F�rennial (FH2) or
interrrittent (IfVn
3g. Stream 3h. Impact sqfe�
width * length *
8 48 3
Average (feet) (linear feet) 8
8 111
Average (feet) (linear feet)
S3 UT 1 P Other UT 1 Intermittent Both 1 16
Nfip label (e.g. f�ad Qossing 1) F2rrranent (P� or F�rennial (F9�) or Average (feet) (linear feet)
Terrporary (� interrritterit (IfV�
4
8
8
8
1
6

3a. Reason for impact*3b.lmpact
type *
S4 UT 1 P
fV�p label (e.g. fd�ad Qossing 1) F�rrranent (Pj or
Terrporary (�
S5 UT 1 T
N�p label (e.g. F3�ad Qossing 1) F�rrranent (F) or
Terrporary (�
3c. Type of impact*3d. Stream name * 3e. Stream
Type *
Stabilization UT 1 Intermittent
F�rennial (Fff2) or
interrrittent (If�
Relocation UT 1 Intermittent
F�rennial (�) or
interrrittent (IfVT)
"' 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:
74
3i. Total temporary stream impacts:
171
3i. Total stream and tributary impacts:
245
3f. Type of 3g. Stream 3h. Impact sqfe�
Jurisdiction* width* length*
Both 1 10 1
Average(feet) (linearfeet) 0
Both 1 60 6
Average (feet) (linear feet) 0
3j. Comments:
Permanent impacts to Martin Creek fall within footprint of temporary dewatering. UT 1 currently flows in an e�sting
roadside ditch. 16 LF of UT 1 will be impacted by extension of exsting driveway pipe and 10 LF will be impacted by
placement of bank stabilization on Martin Creek where UT 1 joins it. 60 LF will be impacted temporarily when the
roadside ditch is relocated.
E. Impact Justification and Mitigation
`�Gnl.n• .. �F1'T.�TiT•�►� � �fl'11"i1F�i.Ti1
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:*
Culvert length has been minimized to meet design and safety standards. Total project length along the roadway is
only 150 feet; distance is needed to tie in to epsting roadway.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*
Erosion control measures will be installed. Site will be dewatered. Excavation will be kept to minimum to install
culvertfooters.
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 �' 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 r% 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.
fJ Yes
4b. Stream mitigation requested:
(linear feet)
48
4c. If using stream mitigation, what is the stream temperature:
cold
r Permittee Responsible Mitigation

4d. Buffer mitigation requested (DWR only):
(square feet)
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)
��* Recent changes to the stormwater rules have required updates to this section ."�
1. Diffuse Flow Plan
1a. 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
For a list of options to meet the diffuse flow requirements, click here.
If no, explain why:
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250? �
C Yes C' No
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?*
l•' 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 (NEPAISEPA)?*
f Yes r No
Comme nts: *
Falls within State Minimum Criteria Checklist (MCCL)
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification Rules (15A NCAC 2H .0500), Isolated Wetland Rules (75A 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?*
f Yes r No
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?*
f Yes l•' No
3b. If you answered "no," provide a short narrative description.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
C' Yes l' No f' N/A
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?*
f Yes �' No
5d. Is another Federal agency involved?*
C' Yes G' No
5e. Is this a DOT project located within Division's 1-8?*
f Yes C No
5f. Will you cut anytrees in order to conduct the work in waters of the U.S.?*
f• Yes C' No
5g. Does this project involve bridge maintenance or removal?*
C•' Yes f No
C' 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.
f• Yes r 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 Sg(1), did you discover anysigns of bat use?*
f Yes C No C' Unknown
"'F' 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.?*
f Yes r No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat? *
https://v�n�wv.fws.gov/raleigh/species/cntylist/buncombe.html
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
f Yes r No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat? *
Current maps/data bases

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 history and archaeology)?*
f Yes �' No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources? *
http://gis. ncdcr.gov/h poweb/
Consultation with NCDOT Archaeology & Historic Architecture Group
7c. Historic or Prehistoric Information Upload
C7ick the upload button or drag and drop files here to attach docurrent
12-10-0036NoSurvey. pdf
AR 12-10-0036effects. pdf
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?*
f Yes r No
8c. What source(s) did you use to make the floodplain determination?*
http://fris.nc.gov/fris/Index.asp�C?FIPS=021&ST=NC&user=General Public
Miscellaneous
Miscellaneous attachments not previously requested.
Qick the upload button or drag and drop files here to attach docurrent
Bridge 143 signed cover letter.pdf
Bridge 143 Buncombe Corps Cover Sheet.pdf
NC NHP report.pdf
Bridge 143 photos.pdf
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Signature
fJ By checking the box and signing below, I certify that:
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■ 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:*
Yates Allen
Signature
yzfes AI/e�
Initial Review

Is this project a public transportation project?* (?)
f• Yes r No
Change only if needed.
Has this project met the requirements for acceptance in to the review process? *
f• Yes
f No
BIMS # Assigned *
20180377
Version#*
Reviewing Office *
Asheville Regional Office - [phone]
Select Project Reviewer*
Kevin Barnett:eads\khbarnett
Is a payment required for this project?*
f No payment required
C•' Fee received
C' Fee needed - send electronic notification