20180875 Ver 1_PCN Form Submission_20180622

Action History (UTC-05:00) Eastern Time (US & Canada)
�brrrit by Anonymous User 6/22/2018 3:37:10 PM (Start Event)
Accept by Carpenter,Kristi 6/22/2018 4:15:08 PM (DOT Initial Review)
. The task was assigned to Carpenter,Kristi. The due date is: June 27, 2018 5:00 PM
6/22/2018 3:38 PM

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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:*
Macon
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.111
(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
Macon County - B220 - Mitigation Acceptance Letter.pdf 722.68KB
F1LE lYFE MJST BE FDF
1f. Is the project located in any of NC's twenty coastal counties?'�
f Yes �' No
1h. Is the project located in a designated trout watershed?*
C' Yes r No
Link to trout information: http://wvwv.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?
fJ Owner r Applicant (other than owner) r Agent/Consultant
(Check all that apply)
2. Owner I nformation
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:*
Macon County - Bridge 220
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.
From Franklin take NC-28. Go 5.8 miles take right onto Cowee Creek Road. Go .2 miles take left onto Snow Hill Road. Go 1.1 miles take
right onto Matlock Creek Road. Go 1.6 miles, site is 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
Qty
Fbstal / Zip Code
State / Rovince / Fdegion
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 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:*

35.296335 -83.39144
ex:34.208504 -77.796371
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Matlock Creek
3b. Water Resources Classification of nearest receiving water:*
Class C
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:*
Ewsting land use is an ebsting 16' 6" L x 18' W timber floor on timber joist, single lane bridge on a two lane paved
secondary road. Site is located in a rural residential housing area with agriculture fields and structures nearby.
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
Macon County - B220 - Topo Map.pdf 1.19MB
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
Macon County - B220 - NRCS Soil Map.pdf 588.16KB
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:*
Project is to replace an obsolete and deteriorating owod floor, wooden joist bridge structure.
4g. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
NCDOT contractor will install erosion and sediment control measures. NCDOT contractor will install diversion dike
and by-pass pipe. An on-site detour will be completed by installing temporary detour pipes for temporary roadway
during construction of the aluminum box culvert. Contractor will remove bridge structure and ends bents and new
aluminum box culvert structure will be installed. Backfill material will be placed onto the culvert and rip-rap will be
placed for bank stabilization. Bank stabilization materials will be permanently installed once final grading allows.
Roadway detour and detour pipes will be removed once traffic is placed onto new aluminum box culvert. Box
culvert structure will be constructed utilizing the follow equipment: crane, excavator, dump truck and hand tools.
4h. Please upload project drawings for the proposed project.
aick the upload button or drag and drop files here to attach docurrent
Macon County - B220 - Permit Design Plans.pdf 16.96MB
Macon County - B220 - Hydro Report.PDF 3.25MB
Fle type rrust be pdF
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*

r Yes r No r Unknown
Comme nts:
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
f' Preliminary �' Approved C•' Unknown f' 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.
5d7. Jurisdictional determination upload
aick the upload button or drag and drop files here to attach docurrent
Macon County - B220 - JD (Final).pdf 164.21 KB
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?*
f Yes r No �' Unknown
7. Future Project Plans
7a. Is this a phased project?*
f 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 �J Streams-tributaries r Buffers
r Open Waters r Pond Construction
3. Stream Impacts
ff 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 * 3e. Stream 3f. Type of 3g. Stream 3h. Impact sqfei
type * Type * Jurisdiction * width * length *
g� Site 1 T Dewatering Matlock Creek Perennial Both 8 110 8
N�p label (e.g. I�ad Qossing F2rrranent (Fj or F2rennial (� or Average (linear feet) $
1) Terrporary (� interrrittent (If� (feet) 0

g2 Site 1A T Culvert
N�p label (e.g. I�ad C7ossing F2rrranent (Fj or
1) Terrporary (lj
S3 Site 76 P Bank
fvbp label (e.g. Finad CYossing F2rrranerit (Fj or Stabilization
1) Terrporary (�
S4 Site 7C P Bank
Nl�p label (e.g. Finad Qossing F2rrranem (�j or Stabilization
1) Terrporary (�
Matlock Creek
Matlock Creek
Matlock Creek
Perennial Both
F2rennial (� or
intermittent (If�
Perennial Both
F�rennial (Fff2) or
imerrrittent (IfVn
Perennial Both
F�rennial (FH� or
interrrittent (IfVn
S5 Site 1D P Culvert Matlock Creek Perennial Both
fv�p label (e.g. Fd�ad Qossing F2rrranent (Fj or F2rennial (� or
1) Terrporary (lj interrri[tent (If�
*' 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:
103
3i. Total temporary stream impacts:
142
3i. Total stream and tributary impacts:
245
3j. Comments:
E. Impact Justification and Mitigation
1. Avoidance and Minimization
8
Average
(feet)
8
Average
(feet)
8
Average
(feet)
8
Average
(feet)
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:*
The e�sting bridge is being replaced with a structure that is adequate for traffic need in the same disturbed
location as the existing bridge structure. The aluminum box culvert was designed for the minimum size to ensure
conveyance of traffic on the current secondary road.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*
The on-site stream (Matlock Creek) will be diverted wtiile the on-site detour is constructed and while the existing
bridge is removed and replaced with the aluminum box culvert. Erosion and sedimentation control measures will be
installed prior to ground disturbance. Both of these measures will aid in the prevention of sediment into
downstream habitats.
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 fJ Corps
2d. If yes, which mitigation option(s) will be used for this project?
r Mitigation bank fJ 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.
�J Yes
4b. Stream mitigation requested:
r Permittee Responsible Mitigation
32 2
(linearfeet) 5
6
22 7
Qinearfeet) 7
6
35 2
(linearfeet) 8
0
46 3
(linearfeet) 6
8

(linear feet)
46
4c. If using stream mitigation, what is the stream temperature:
cold
4d. Buffer mitigation requested (DWR only):
(square feet)
0
4e. Riparian wetland mitigation requested:
(acres)
0
4f. Non-riparian wetland mitigation requested:
(acres)
0
4g. Coastal (tidal) wetland mitigation requested:
(acres)
0
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?
f Yes C•' No
For a list of options to meet the diffuse flow requirements, click here.
If no, explain why:
Project is not located within a 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? *
l•' Yes f 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 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 �' No
Comme nts: *
Minimum Criteria Determination Checklist Completed.
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?*
l" Yes l•' 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?*
C' Yes b' No
3b. If you answered "no," provide a short narrative description.
Project is only to replace e�asting bridge due to deterioration and does not increase the capacity of roads in the
area. Project is not a road widening or improvement project.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
f Yes r No �' f�UA
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? *
f• Yes �' No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
l•' Yes f" No
5c. If yes, indicate the USFWS Field Office you have contacted.
Asheville
5d. Is another Federal agency involved?*
C' Yes C No
5e. Is this a DOT project located within Division's 1-8?*
f Yes f•' No
5f. Will you cut anytrees in order to conduct the work in waters of the U.S.?
f• Yes r No
5g. Does this project involve bridge maintenance or removal?
C Yes C' 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 C' No
Link to the NLEB SLOPES document: http://saw-reg.usace.army.mil/NLEB/1-3a17-signed_NLEB-SLOPES&apps.pdf
If you answered "Yes" to 5g(7), did you discover anysigns of bat use?*
f Yes f•' 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 f" No

If yes, please provide details to include type of percussive activity, purpose, duration, and specific location of this activity on the
property.
Click the upload button or drag and drop files here to attach docurrent
Macon County - B220 - NWP 14 Cover Letter (Final).pdf
Fle rrust be FDF
38.13KB
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?*
C' Yes
r No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat? *
NOAA- Essential Fish Habitat 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 Culture Resource Specialist
7c. Historic or Prehistoric Information Upload
Qick the upload button or drag and drop files here to attach docurrent
Macon County - B220 - Archaeological Clearance.pdf
Macon County - B220 - 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?*
f Yes
r• No
8c. What source(s) did you use to make the floodplain determination?*
NC Flood Maps - Flood Risk Information System
Miscellaneous
Miscellaneous attachments not previously requested.
C7ick the upload button or drag and drop files here to attach docurrent
Macon County - B220 - MCDC (Signed).pdf
Macon County - B220 - NC Hertiage Program.pdf
Macon County - B220 - SWP.pdf
Macon County - B220 - GIS Map.pdf
Macon County - B220 - Vicinity Map.pdf
Macon County - B220 - Site Photos.pdf
Fle rrust be FDF or VWQ
Signature
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�7 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:*
Patrick J. Breedlove
Signature
��rY tr'ra� [�� r�?P�s°�tlr�d
Date Submitted:
6/22/2018
Initial Review
Is this project a public transportation project?* (')
G Yes l' No
C�ange only 'rf needed.
Has this project met the requirements for acceptance in to the review process? *
C Yes
C' No
BIMS # Assigned *
20180875
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
f• Fee received
C' Fee needed - send electronic notification