20090534 Ver 1_Application_20090511

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BEVERLY EAVES PERDUE
GOVERNOR
May 5, 2009
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
DIVISION OF HIGHWAYS
North Carolina Division of Water Quality
Attn: Mr. Brian Wrenn
401 Wetlands Certification Unit
2321 Crabtree Boulevard
Raleigh, NC 27604-2260
Subject: Bridge No. 94 over Black Run Creek
Klutz Road, Cabarrus County, NC
(DWQ Minor Permit Fee $240.00),
Dear Mr. Wrenn:
EUGENE A. CONTI, JR.
SECRETARY
FINWRWR
MAY 1 1 2009
WITLANDSNAND ST ECRMWATE BRANCH
090534
The North Carolina Department of Transportation (NCDOT) proposes to replace Bridge
Number 94 on Klutz Road in Cabatrus County by removing the existing 30-foot long by
20-foot wide structure and replacing it with two 142-inch x 91-inch x 60-foot long
corrugated metal pipe (arched).
Protected Species
The North Carolina Natural Heritage Program GIS data layer for both state and federally
protected plant and animal species has been reviewed for this project and no known
occurrences have been previously recorded in this area or for Black Run Creek. A fresh
water mussel survey has not been conducted for this project.
Impacts to Waters of the United States
This project cannot be completed without impacts to waters of the United States. This
project is located within the Yadkin River Basin (Hydrologic Unit # 03040105) and
stream impacts to Black Run Creek will be incurred as a result of this project being
constructed. There will be 40-linear feet of permanent impacts to Black Run Creek.
Avoidance/Minimization
The proposed impacts to the jurisdictional areas on this project have been minimized as
much as practical. NCDOT's best management practices for bridge demolition activities
and the protection of wetlands and surface waters will be adhered to during all phases of
project construction in an effort to eliminate any additional impacts.
716 West Main Street, Albemarle, NC 28001 9 [phone] 9 Fax [phone]
Summary
The purpose of this letter is to request authorization to construct the proposed project
under a Section 401 Water Quality Certificate (WQC) No. GC3704.
If you have any questions or need any additional information concerning this project,
please feel free to contact Mr. Lary Thompson, Division Environmental Supervisor, at
[phone].
Sincerely,

Barry S. Moose, PE
Division Engineer
BSMILBT
cc: Polly Lespinasse, NDWQ
Garland Haywood, BME
Area Field Operations Unit
File
O/20, V4ATE?9OG
1 L/WLn
o-c
Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.0 November 2008
Pre-Construction Notification (PCN) Form
A. Applicant Information
1. Processing
Ia. Type(s) of approval sought from the
Corps: N Section 404 Permit ? Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: 14 or General Permit (GP) number.
1c. Has the NWP or GP number been verified by the Corps? N Yes ? No
Id. Type(s) of approval sought from the DWQ (check all that apply):
N 401 Water Quality Certification - Regular N Non-404 Jurisdictional General Permit
? 401 Water Quality Certification - Express ? Riparian Buffer Authorization
le. Is this notification solely for the record
because written approval is not required? For the record only for DWQ 401
Certification:
? Yes N No For the record only for Corps Permit:

? Yes N No
If. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in-lieu
fee program. ? Yes N No
11g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below. ? Yes S No

-
1 h. Is the project located within a NC DCM Area of Environmental. Concern (AEC)? ?
Yes Z No
2. Project Information
2a. Name of project: SR 2435 (Kluttz Road)
2b. County: Cabarrus
2c. Nearest municipality / town: Mount Pleasant
2d. Subdivision name: N/A
2e. NCDOT only, T.I.P. or state
project no: 108.201311
3. Owner Information
3a. Name on Recorded Deed:
3b. Deed Book and Page No.
3c. Responsible Party (for LLC if
applicable):
3d. Street address:
3e. City, state, zip:
3f. Telephone no.:
3g. Fax no.:
3h. Email address:
Page 1 of 12
PCN Forth - Version 1.0 November 2008 Version
Section A. Applicant Information, continued
4. Applicant Information (if different from owner)
4a. Applicant is: ® Agent ? Other, specify:
4b. Name: Barry S. Moose, PE
.4c. Business name
(if applicable): NC Department of Transportation
4d. Street address: 716 W. Main Street
4e. City, state, zip: Albemarle, NC 28001
4f. Telephone no.: 704982-0101
4g. Fax no.: 704982-3146
4h. Email address: [e-mail]
5. Agent/Consultant Information (if applicable)
5a. Name:
5b. Business name
(if applicable):
5c. Street address:
5d. City, state, zip:
5e. Telephone no.:
5f. Fax no.:
5g. Email address:
Page 2 of 12
PCN Form - November 2008 Version
B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID):
1b. Site coordinates (in decimal degrees): 35.488064'N - 80.431006'W
1c. Property size: .04 (right-of-way width x project length) acres
2. Surface Waters
2a. Name of nearest body of water (stream, Over, etc.) to Black Run Creek
proposed project:
2b. Water Quality Classification of nearest receiving water. WS 11, HOW
2c. River basin: Yadkin
3. Project Description
3a. 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 existing bridge on SR 2435 Kluttz Road, Cabarrus County is 30 feet long and 20 feet wide. The land surrounding
the project site is used as a pasture. There is a former single family residence located in the SE quardrant.
3b. List the total estimated acreage of all existing wetlands on the property:
0
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
60-feet of perennial stream is located in the existing right-of-way.

3d. Explain the purpose of the proposed project:
The purpose of this project is to improve the safety and service level of SR 2435 (Kluttz Road) by removing the existing
bridge and replacing it with 2 lines of 142" x 91" x 60' CMPA with headwalls.
3e. Describe the overall project in detail, including the type of equipment to be used:
Erosion and sediment control devices will be installed prior to the start of any work. The existing bridge will be removed
using NCDOT's Best Management Practices for Bridge Demolition and the site will be dewatered prior to excavation and
pipe placement. The footprint of the project will be prepared for the installation of the new pipes and headwalls. Once
the pipes and headwalls have been placed, flood plain benches will be created in order to maintain the existing stream
motor grader,
dump trucks
ill be used: trackhoe
i
t
i
,
,
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on equ
width through the project area. Typical bridge construct
and paving equipment.

4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
® Yes ? No ? Unknown
project (including all prior phases) in the past?
4b. If the Corps made the jurisdictional determination, what type ? Preliminary ? Final
of determination was made?
4c. If yes, who delineated the jurisdictional areas? Agency/Consultant Company: NCDWQ
Name (if known): Polly Lespinasse Other.
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
4/15/2009
b. Project History
5a. Have permits or certifications been requested or obtained for ? Yes ® No ? Unknown
this project (including all prior phases) in the past?

5b. If yes, explain in detail according to "help file' instructions.
Page 3 of 12
PCN Form -Version 1.0 November 2008 Version
B. Project Information and Prior Project History
6. Future Project Plans
6a. Is this a. phased project? ® Yes ? No
6b. If yes, explain.
The project will be phased to assure that the site is properly dewatered and constructed to prevent the potential for
sediment loss.
Page 4 of 12
PCN Form -November 2008 Version
C. Proposed Impacts Inventory
1. Impacts Summary
la, Which sections were completed below for your project (check all that apply):
? Wetlands ® Streams - tributaries ? 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.
2a. 2b. 2c. 2d. 2e. 2f.
Wetland impact
number -
Type of
Type of wetland
Forested Type of jurisdiction
(Corps - 404,
Area of impact (acres)
Permanent (P) or impact (if known) DWQ - non-404, other)
Temporary
El Corps
W1 ? P ? T ? Yes E] No ? DWQ
VV2 ? P ? T ? Yes ? No ? Corps
? DWQ
W3 El P El T E] Yes ? No El Corps
? DWQ
W4 ? P ? T El Yes El No [I Corps
? DWQ
W5 ? P ? T ? Yes ? No ? Corps
? DWQ
W6 ? P ? T ? Yes ? No ? Corps
? DWQ
2g. Total wetland Impacts
2h. Comments: N/A
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. 31b . 3c. 3d. 3e. 3f.
Stream impact Type of Stream name Perennial (PER) or Average stream width (feet) Impact
length
number- impact intermittent(INT)?
(linear feet)
Permanent (P) or
Temporary M
Replace
existing
bridge
S1 ®P ? T with (2) Black Run Creek ® PER ? INT 8-Feet 40-Feet
142" x
91"x60'
of CMPA
S2 ? PEI T ? PER ? INT
S3 ? P ? T ? PER ? INT
S4 ?P?T ?PER ?INT
S5 ?P?T ?PER ?INT
S6 ?P?T ?PER ?INT
3g. Total stream and tributary impacts 40
3h. Comments:
Page 5 of 12
PCN Form - Version 1.0 November 2008 Version
C. Proposed Impacts Inventory, continued
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 individual) list all open water impacts below.
4a. 4b. 4c. 4d. 4e.
Open water
Impact number Name of
waterbody
Type of impact
Waterbody type
Area of impact (acres)
- Permanent (if
(P) or applicable)
Temporary
01 ?P?T
02 ?P?T
03 ?P?T
04 ?P?T
4f. Total open water Impacts
4g. Comments: N/A
Page 6 of 12, PCN Form -November 2008 Version
C. Proposed Impacts Inventory, continued
5. Pond or Lake Construction
If nd or lake construction ro osed then complete the chart below.

5a.
Pond ID
5b.
Proposed use or
5c. Wetland Impacts (acres)
5d. Stream Impacts (feet) Se.
Upland
(acres)
number purpose of pond Flooded Filled Excavated Flooded Filled Excavated Flooded
P1
P2
6f. Total
5g. Comments: N/A
5h. Is a dam high hazard permit required?
? Yes ? No if yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for DWQ)
if project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If an impacts require miti ation, then ou MUST fill out Section D of this form.
6a.
Project is in which protected basin? ? Neuse ? Tar-Pamlico ? Other:
? Catawba ? Randleman
6b.
Buffer impact
number -
Permanent (P)
or Temporary 6e.

Reason
for impact 6d.

Stream name 6e.

Buffer
mitigation
required? 6f.

Zone 1 impact (square
feet) 6g

Zone 2 impact
(square feet)
B1 ?P?T ?Yes ?No
B2 ?P?T ?Yes ?No
83 ?P?T ?Yes ?No
6h. Total buffer Impacts
6i. Comments: N/A
Page 7 of 12
PCN Form - November 2008 Version
D. impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
The proposed impacts for this project have been limited to those necessary for the removal of the existing bridge and a
pipe installation that will provide appropriate road shoulder for vehicle recovery and slopes that can be easily stabilized.
Measures will be taken to prevent any additional impacts to the stream by adhereing to NCDOTs Best Management
Practices for the Protection of Surface Waters.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
NCDOT personnel will utilize non-shattering bridge demolition techniques while removing the existing bridge. Any debris
that may fall into Black Run Creek will be promptly removed. The new pipe will be placed on skew with flood plain
benches built on the inlet and outlet of the overflow pipe to help maintain the existing width of Black Run Creek. The .
erosion control plan will be designed for high quality waters, installed at the beginning of the job, and maintained
throughout the life of the project.
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? ? Yes ? No
2b. If yes, mitigation is required by (check all that apply): ? DWQ ? Corps

2c.
If yes, which mitigation option will be used for this
project? ? Mitigation bank
? Payment to in-lieu fee program

? Pennittee Responsible Mitigation
3. Complete If Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter) Type Quantity
3c. Comments:
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
4c. If using stream mitigation, stream temperature: wane, cool, cold
4d. Buffer mitigation requested (DWQ 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:
5. Complete If Using a Pennlttee Responsible Mitigation Plan
5a. If using a pennittee responsible mitigation plan, provide a description of the proposed mitigation plan.
Page 8 of 12
PCN Form -Version 1.0 November 2008 Version
D. Impact Justification and Mitigation, continued
6. Buffer Mitigation (State Regulated Riparian Buffer Rules) - required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation? ? Yes N 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.

Zone
Reason for impact Total impact
(square feet) Multiplier Required mitigation
(square feet)
Zone 1 3 (2 for Catawba)
Zone 2 1.5
Total buffer mitigation required:
6c. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in-lieu fee fund).
6d. Comments:
Page 9 of 12
PCN Form -November 2008 Version
E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan

la. Does the project include or is it adjacent to protected riparian buffers identified ? Yes ® No
within one of the NC Riparian Buffer Protection Rules?
1b. If yes, then is a diffuse flow plan included? ? Yes ? No
2. Determination If the Project Requires a Stormwater Management Plan

2a. Does the project require a Non-404 Jurisdictional General Permit? ® Yes ? No
2b. Is the project subject to General Certification 3704 or 3705? ? Yes ® No
3. Determination of Stormwater Review Jurisdiction

3a. Is this project subject to any of the following state-implemented stormwater ? Coastal counties
? HOW
management programs (check all that apply)? ? ORW
If so, attach one copy of the approval letter from the DWQ and one copy of the ? Session Law 2006-246
approved stormwater management plan. ® Other: NCDOT Phase II
3b. In which local government's jurisdiction is this project? N/A
3c. Is this local government certified to implement a state stormwater program? ? Yes ? No
If so, attach one copy of the approval letter from the local government and one copy
of the approved stormwater management plan (or one copy of the approved
Stornwater management plan stamped as approved).
4. Information R uired for DWQ 401 Unit Stormwater Review

There is a 0% increase in

4a.
What is the overall percent imperv iousness according to the most current site plan? impervious area. The
roadway base will remain the
same width.
4b. Does this project contain any areas that meet the criteria for "high density" per ? y? No
General Certifications 3704 and 3705?

4c. If the site is over 24% impervious and/or contains high density areas, then provide a brief narrative description of the
stormwater management plan.
4d. Has a completed BMP Supplement Form with all required items been submitted ? Yes ? No
for each stormwater BMP?
Page 10 of 12
PCN Form -Version 1.0 November 2008 Version
F. Supplementary information, continued
6. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or ? Yes ® No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act ? Yes ® No
impacts?
El Raleigh
5c. If yes, indicate the USFWS Field Office you have contacted. ? Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
Natural Heritage Program GIS database and field review for suitable habitat.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat? ? Yes ® No
8b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
South Atlantic Fishery Management Council
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
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 ? Yes ®No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
NCDOT GIS datebase/NCDOT Historic Architecture Group and National Register of Historic Places
8. Flood Zone Designation (Corps Requirement)
Be. Will this project occur in a FEMA-designated 100-year floodplain? ® Yes ? No
8b. If yes, explain how project meets FEMA requirements: This project is exempt from FEMA requirements.
8c. What source(s) did you use to make the floodplain determination? NCDOT GIS data layer (Cabarus County Flood Zones)
PE
Moose
Barry S ???eaao+?
,
. !s 04/21109
AppiicanttAgent's Printed Name Applicant/Agent'sStgftature
(Agent's signature is valid only it an authorization letter from the applicant
Date
is provided.)
Page 12 of 12
PCN Form - November 2008 Version
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Date: 4/14/2009 Caption: SR 2435 (Kluttz Road)
Scale: 1 inch equals 1000 feet Carbarrus County

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