20140938 Ver 2_PCN Form Submission_20180611

Action History (UTC-05:00) Eastern Time (US & Canada)
�brrrit by Anonymous User 6/11/2018 8:18:57 AM (Start Event)
Accept by Carpenter,Kristi 6/11/2018 4:39:05 PM (DOT Initial Review)
. The task was assigned to Carpenter,Kristi. The due date is: June 14, 2018 5:00 PM
6/11/2018 8:20 AM

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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:*
Transylvania
Is this project a public transportation project?*
C Yes l' No
lhis is any publicly funded by rrunicipal,state or federal funds road, rail, airport transportation project.
Is this a NCDOT Project?*
f• Yes r No
(NCDOT only) T.I.P. or state project number:
WBS #
17BP.14.R.126
(for �ICDOT use only)
1a. Type(s) of approval sought from the Corps:*
fJ 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)
r Standard (IP)
This form may be Corps to initiate the standard/individual permit process. Please contact your Corps representative for submittal of standard permits.
All required items that are not provided in the E-PCN and be added to the miscellaneous upload located at the bottom of this form.
Nationwide Permit (NWP) Number: 14 - Linear transportation
NWP Number Other:
List all MNnurrbers you are applying for not on the drop down list.
1c. Type(s) of approval sought from the DWR:*

check all that apply
r% 401 Water Quality Certification - Regular r 401 Water Quality Certification - Express
r Non-404 Jurisdictional General Permit r Riparian Buffer Authorization
r Individual Permit
*
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:
f Yes C' 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 a- in-lieu fee program
C Yes l" No
Acceptance Letter Attachment
C7ick the upload button or drag and drop files here to attach docurrent
Transylvania County - B162 - Mitigation Acceptance Letter.pdf 393.87KB
Transylvania County - B162 - Mitigation Transfer Form.pdf 634.35KB
RLE lYFE 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 f' No
Link to trout information: http://�wvw.saw.usace.army.mil/Missions/Regulatory-Permit-Program/Agency-Coordination/Trout.aspx
B. Applicant Information
1a. Who is the Primary Contact?*
Patrick J. Breedlove
1b. PrimaryContact Email:*
pjbreed [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
(C�eckall that apply)
2. Owner Information
2a. Name(s) on recorded deed:
NCDOT - Division 14
2b. Deed book and page no.:
2c. Responsible party:
(for Corporations)
2d. Address

Street Address
253 Webster Road
Address Line 2
C7ty
Sylva
Fbstal / Zip Code
28779
2e. Telephone Number:
(xxx)xxx-�axx
[phone]
2f. Fax Number:
[phone]
(xxx)xxx-xxxx
2g. Email Address:*
pjbreed [e-mail]
State / Rovince / Region
North Carolina
Country
United States
C. Project Information and Prior Project History
1. Project Information
1a. Name of project:*
Transylvania County - Bridge 162
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality/town:*
Pisgah Forest
1d. Driving directions*
IF it is a new project and can not easily be found in a GPS rrapping system Rease provide directions.
From Pisgah Forest turn right onto Old Hendersonville Highway. Go approxmately 0.8 miles turn left onto Glade Creek Road. Go
approwmately 0.7 miles turn left onto US-64 west. Go appro�amately 1.1 miles and turn right onto NC-280 east. Bridge replacement project is
approximately 0.8 miles in roadway.
2. Project Identification
2a. Propertyldentification Number:
(tax RN or parcel ID)
2b. Propertysize:
(in acres)
2c. Project Address
Street Address
Address Line 2
a�y
Fbstal / Zip Code
2d. Site coordinates in decimal degrees
State / Rovince / FZegion
Caurdry
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:*

35.291420 -82.687511
ex:34.208504 -77.796371
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Sllver Creek
3b. Water Resources Classification of nearest receiving water:*
WS-V; B; Tr.
Surface Water Lookup
3c. What river basin(s) is your project located in?*
French Broad
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 general landscape cover is forested with residential structures in the immediate vicinity of the bridge. The land
use is primarily rural residential and forested.
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)
Qick the upload button or drag and drop files here to attach docurrent
Transylvania County - 6162 - Topo Map.pdf 1.04MB
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)
dick the upload button or drag and drop files here to attach docurrem
Transylvania County - B162 - NRCS Soil Map.pdf 450.76KB
Fle type rrust be pdF
4d. List the total estimated acreage of all existing wetlands on the property:
0.0
4e. List the total estimated linear feet of all existing streams on the property:
(interrrittent and perennial)
120
4f. Explain the purpose of the proposed project:*
To replace a structurally deficient and functionally obsolete timber bridge with a new 16'-4"W x 5'11 "H x 37'L
aluminum box culvert with headwalls on existing location.
4g. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
Traffic will be detoured off-site. Erosion and sedimentation control measures will be installed. Water will be diverted
around the construction area in order to install the culvert in the "dry". The old bridge will be removed. The new
culvert will be installed on the same location as the previous bridge. Excavator, dump truck, cranes, paving
equipment, water pumps, sand bags, diversion pipe and various hand tools will be utilized to accomplish project.
4h. Please upload project drawings for the proposed project.
Gick the upload button or drag and drop files here to attach docurr�nt
Transylvania County - 6162 - Design Impacts (2).pdf 5.34MB
Transylvania County - B162 - Design Impacts.pdf 389.31 KB
Fle type rrust be pdF
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
f Yes f•' No �' Unknown

Comme nts:
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
C Preliminary f Approved f Unknown f' f�UA
Corps AID Number:
Exarrple: 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.
5d1. Jurisdictional determination upload
C7ick the upload button or drag and drop files here to attach docurrent
Transylvania County - B162 - JD (Final).pdf 164.03KB
Fle type rrust be FDF
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
6b. If yes, please give the DWR Certification number or the Corps Action ID (exp. SAW-0000-00000).
USACE Action ID: 2014-01666 (Need Re-certification)
Project History Upload
Click the upload button or drag and drop files here to attach docurrent
Transylvania County - 6162 - Approved NWP 14 (10.7.14).pdf 394.22KB
Transylvania County - B162 - Approved 401 (9.8.14).pdf 1010.26KB
Transylvania County - 6162 - NCWRC Letter (9.18.14).pdf 221.76KB
Fle type rrust be FDF
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 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 � 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 *
g1 Site 1 P Culvert Silver Creek
N�p label (e.g. Finad Qossing F2rrranent (Fj or
1) Terrporary (�
g2 Site 7A T Dewatering Silver Creek
N�p label (e.g. Finad Qossing F2rrranem (Fj or
1) Terrporary (�
3e. Stream 3f. Type of
Type* Jurisdiction*
Perennial Both
F2rennial (Fff�) or
interrrittent (If�
Perennial Both
F�rennial (FH�) or
imerrrittent (IfVn
S3 Site 1B P Bank Silver Creek Perennial Both
Nbp label (e.g. R�ad Qossing F2rrranem (Fj or Stabilization F�rennial (�) or
1) Terrporary (� imerrrittent (IfVn
" 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:
87
3i. Total temporarystream impacts:
100
3i. Total stream and tributary impacts:
187
3j. Comments:
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 to meet secondary road standards was designed for this site. The culvert will be
buried 1 foot belowthe e�asting streambed elevation and sills and baffles will be installed. Floodplain benches will
be installed at the inlet and outlet ends of the culvert to help maintain channel dimensions and aquatic life
passage.
3g. Stream 3h. Impact sqfe�
width * length *
10 37 3
Average (linearfeet) 7
(feet) 0
70 700 7
Average (linearfeet)
(feet) 0
0
0
10 50 5
Average Qinearfeet) 0
(feet) 0
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*
Erosion and sedimentation BMP's will be installed prior to construction. Water will be diverted around the work
area during culvert installation in order to prevent sedimentation into downstream aquatic resources.
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 l" No
2c. If yes, mitigation is required by (check all that apply):
r DWR fJ Corps
2d. If yes, which mitigation option(s) will be used for this project?
r Mitigation bank r% 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.
�J Yes

4b. Stream mitigation requested:
(linear feet)
37
4c. If using stream mitigation, what is the stream temperature:
cold
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 ."**
`A�]�ii�a�C�1nl,F1i
1a. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection
Rules?
f Yes �' No
For a list of options to meet the diffuse flow requirements, click here.
If no, explain why:
Project not located within NC Riparian Buffer Protection Area.
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250? *
G' 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? *
G Yes �' 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: *
Minimum Criteria Determination Checklist (Completed) 8.5.2014
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 (75A NCAC 2B .0200)?*

r Yes r No
2b. Is this an after-the-fact permit application?*
C' Yes C•' 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 qualit�/?*
f Yes r No
3b. If you answered "no," provide a short narrative description.
The project is limited in scope and involves the replacement of an obsolete timber bridge with a new aluminum box
culvert on existing location. The project will neither influence nearby land uses nor stimulate growth.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
C' Yes C No C' 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?*
G Yes �' No
5c. If yes, indicate the USFWS Field Office you have contacted.
Asheville
5d. Is another Federal agency involved?*
f Yes C No
5e. Is this a DOT project located within Division's 1-8?*
l' Yes C No
5f. Will you cut any trees in order to conduct the work in waters of the U.S.?
G Yes C' No
5g. Does this project involve bridge maintenance or removal?
G Yes f 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.
C•' Yes f 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 anysigns of bat use?*
l' 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)?*
l" 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 r No
If yes, please provide details to include type of percussive activity, purpose, duration, and specific location of this activity on the
prope rty.

aick the upload button or drag and drop files here to attach docurrent
Transylvania County - 6162 - NWP 14 Recertification Letter (Final).pdf 68.96KB
Fle rrust be FDF
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
U.S. Fish & Wildlife - ECOS - Online Mapper
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
f Yes
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat? *
NOAA - Essential Fish Habitat Mapper v3.0
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
r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources? *
NCDOT Cultural Resource Specialist
7c. Historic or Prehistoric Information Upload
Qick the upload button or drag and drop files here to attach docurrerrt
Transylvania County - B162 - Archaeological Clearance.pdf
Transylvania County - B162 - Architecture Clearance.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?*
C' Yes
F No
8c. What source(s) did you use to make the floodplain determination?*
NC Floodplain Mapping Program
Miscellaneous
Miscellaneous attachments not previously requested.
aick the upload button or drag and drop files here to attach docurrent
Transylvania County - 6162 - MCDC (Signed).pdf
Transylvania County - B162 - GIS Map.pdf
Transylvania County - B162 - Vicinity Map.pdf
Transylvania County - 6162 - Site Photos.pdf
Transylvania County - B162 - Hydro Report.pdf
Transylvania County - B162 - MCDC (Signed).pdf
Fle rrust be FDF or fWQ
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 Act°);
■ 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:*
Patrick J. Breedlove
Signature
Sign
Date Submitted:
6/11 /2018
Initial Review
Is this project a public transportation project?* (')
f• Yes r No
Change only 'rf needed.
Has this project met the requirements for acceptance in to the review process? *
f• Yes
f No
BIMS # Assigned *
20140938
Version#*
2
Reviewing Office *
Asheville Regional Office - [phone]
Select Project Reviewer'�
Kevin Barnett:eads\khbarnett
Is a payment required for this project?*
C' No payment required
f•' Fee received
f Fee needed - send electronic notification