20190141 Ver 1_PCN Form Submission_20190130

D1�VR
�irlslan af Water Resources
Pre-Construction Notification (PCN) Form
September 29, 2018 Ver 3
Initial Review
Has this project met the requirements for acceptance in to the review process?*
F Yes
C' No
Is this project a public transportation project?"
� Yes r No
Change only rf needed.
BIMS # Assigned *
20190141
Is a payment required for this project?*
f No paymentrequired
� Fee received
f Fee needed - send electronic notification
Select Project Reviewer"
April Norton:eads\arnorton
Information for Initial Review
1a. Name of project:
Bridge No. 235 over Big Alamance Creek on SR 1005 (Alamance Church Rd)
1a. Who is the PrimaryContact?*
NCDOT Division 7, Division Engineer, Mr. Mike Mills, PE
1b. PrimaryContact Email:*
[e-mail]
Date Submitted
1 /30/2019
Nearest Body of Water
Big Alamance Creek
Basin
Cape Fear
Water Classification
16-19-(1); WS-IV;NSW; 03030002 HUC
Site Coordinates
Latitude: Longitude:
35.983947 -79.657096
A. Processing Information
County (or Counties) where the project is located:
Guilford
Is this project a public transportation project?*
r Yes r No
Is this a NCDOT Project?*
G Yes r No
(NCDOT only) T.I.P. or state project number:
Ve rsion# *
1
Reviewing Office *
Central Office - [phone]
1c. PrimaryContact Phone:*
[phone]
::
WBS # (�)
17BP.7.R.107
1a. Type(s) of approval sought from the Corps:

rJ 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)
1c. Has the NWP or GP number been verified bythe Corps?
F Yes r No
Nationwide Permit (NWP) Number:
03 - Maintenance
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
fJ 401 Water Quality Certification - Regular
r' Non-404 Jurisdictional General Permit
r Individual Permit
1e. Is this notification solelyfor the record because written approval is not required?
Forthe record onlyfor DWR401 Certification:
For the record onlyfor Corps Permit:
1f. Is this an after-the-fact permit application?*
� Yes r No
1g. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
C' Yes r No
1g. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
� Yes r No
Acceptance LetterAttachment
1h. Is the project located in any of NC's twenty coastal counties?
C' Yes r No
1j. Is the project located in a designated trout watershed?
� Yes r No
B. Applicant Information
1d. Who is applying for the permit?
r Owner fJ Applicant (other than owner)
1e. Is there an Agent/Consultant for this project?
f Yes r No
2. Owner Information
2a. Name(s) on recorded deed:
NC DOT
2b. Deed book and page no.:
n/a
2c. Responsible party:
2d. Address
Street Address
PO Box 14996
Address Line 2
�Y
Greensboro
Fbstal / Zip Code
27415
2e. Telephone Number:
[phone]
2g. Email Address:*
r 401 Water Quality Certification - E�ress
rJ Riparian Buffer Authorization
State / Aovince I F�gion
NC
Country
USA
2f. Fax Number:
[phone]
x
C' Yes R No
G Yes C' No

[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
NC DOT Highway Division 7
3b. Business Name:
NCDOT
3c.Address
Street Address
PO Box14996
Address Line 2
�ty
Greensboro
Postal / Zip Code
27415
3d. Telephone Number:
[phone]
3f. Email Address:"
mmil [e-mail]
S[ate / Awince I Region
NC
Country
USA
3e. Fax Number:
[phone]
C. Project Information and Prior Project History �
1. Project Information �
1b. Subdivision name:
(rf appropriate)
1 c. Nearest municipality l town:
Pleasant Garden
2. Project Identification
2a. Propertyldentification Number:
WA
2c. Project Address
Street Address
Address Line 2
ary
Postal / Zip Code
3. SurFace Waters
3a. Name of the nearest body of water to proposed project:"
Big Alamance Creek
3b. Water Resources Classification of nearest receiving water:*
16-19-(1); WS-IV;NSW; 03030002 HUC
3c. What river basin(s) is your project located in?*
Cape Fear
3d. Please provide the 12-digit HUC in which the project is located.
030300020301
4. Project Description and History
2b. Property size:
fWA
S[ate I Rovince I Region
Country
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 project area is a mix of undisturbed, forested areas, and some sparse, maintained lawns and residences.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
C' Yes r No C' Unknown
4d. 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)
Bridge_235_Guilford_USGS.pdf 2.3SMB
4e. 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)
Bridge_235_Guilford_soil.pdf 2.11 MB

4f. List the total estimated acreage of all existing wetlands on the property:
< 0.10
4g. List the total estimated linear feet of all existing streams on the property:
approximately 1,425 LF within the study area
4h. Explain the purpose of the proposed project:"
The proposed project is to replace a functionally obsolete bridge.
4i. 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. The proposed structure will be replaced o its ebsting alignment. The project proposes 93
linear feet of permanent stream impact associated with bank stabilization and 10 linear feet of temporary impact associated with construction activities. Impervious dikes will be utilized to
install the bank stabilization in the dry. There are no deck drains on the bridge; stormwater will be collected via grated inlets and will outlet at 14+75 LT to a rip rap dissipator where it will
sheet flow into a�nrooded area before entering the riparian buffer. In the southwest quadrant PSRM toe protection is utilized on an ebsting roadside ditch that flows off the project area at
13+00 RT. Also, in the southwest quadrant there is a stable ditch line that will outfall at 16+50 RT onto the proposed bank stabilization and become non-erosive sheet flow before
entering the stream. In the northeast quadrant an existing roadside ditch will be lined with PSRM to provide toe protection. The ditch will outlet into a grated inlet at 17+g5 LT and outlet
at 17+55 LT onto Class B Rip Rap outlet protection and wt�ere flow becomes non-erosive sheet flow and will run 5'+/- before entering buffer wne 2. In the southeast quadrant a lateral
V ditch will outlet at 18+55 RT onto Class B Rip Rap and become non-erosive sheet flowthat will run 5'+/_ before entering buffer mne 2. 2:1 fill slopes are utilized to minimize overall
impacts. Equipment to be used includes a track hoe, dump truck, paving equipment and various hand tools, possibly a crane to move construction material such as reinforced bars of
steel and concrete buckets to place concrete.
4j. Please upload project drawings for the proposed project.
5. Jurisdictional Determinations
Sa. Have the wetlands or streams been delineated on the property or proposed impact areas?"
F Yes r No
Comments:
DWR visited the site in May 2018 and issued an onsite determination letter in July 2018
Sb. If the Corps made a jurisdictional determination, what type of determination was made?*
f' Preliminary f Approved r Not Verified r Unknown 6' WA
Corps AID Number:
Sc. If Sa is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
5d1. Jurisdictional determination upload
NCDOT Guilford 235 Plat.pdf
Bridge 235 Division 7 packet.pdf
DWR Determination Letter.pdf
6. Future Project Plans
6a. Is this a phased project?*
C' Yes
Mr. Bob Lepsic
(formerly of) Ecosystem Planning & Restoration (EPR)
r No
1.44 MB
14.78MB
983.78KB
�' Unknown
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?
No
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
r Wetlands IrJ Streams-tributaries
r Open Waters I� Pond Construction
3. Stream Impacts
fJ Buffers
Reason for impact ('�) 3b.lmpact type * 3c. Type of impact* 3d. S. name * 3e. Stream Type * 3f. Type of 3g. S. width* 3h. Impact
(?) Jurisdiction* length*
16+55 to 16+70 fill Permanent Bank Stabilization Bi Alamance Creek Perennial Both 20 93
� ) 9
Average (feet) (linear feet)
16+55 to 16+70 Temporary Other Big Alamance Creek Perennial Both 20 10
nstl'UCtion aCtiVities) Average(feet) (linearfeet)

3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
93
3i. Total stream and ditch impacts:
103
3i. Total temporery stream impacts:
10
3j. Comments:
Of the 103 linear feet of stream impact proposed, only 93 linear feet is permanent impact which will only occur on the banks of the channel and will not
e�Rend into the thalweg.
6. Buffer Impacts (for DWR)
6a. Project is in which protect basin(s)?
Check all Ihat apply.
� Neuse
r Catawba
r Goose Creek
r Other
Impact Type
STA 14+g0 to 18+70 Allowable
6h. Total buffer impacts:
Total Temporary impacts:
Total Permanent impacts:
Total combined buffer impacts:
Zone 1
0.00
Zone 1
8,699.00
Zone 1
$699.00
� Tar-Pamlico
r Randleman
rJ Jordan Lake
Zone 2
0.00
Zone 2
3,694.00
Zone 2
3,694.00
Buffer mitigation required? I�6f. Zone 1 impact ��6g. Zone 2 impact
6i. Comments:
The impacts associated with the roadway crossing and bridge fall under the "potentially allowable" category per the Jordan Water Supply Buffer Rules
Table of Uses {15A NCAC 02B .0267 (9)}.
Supporting Documentation
400235_Permit Drawings_20181127.pdf
E. Impact Justification and Mitigation
1. Avoidance and Minimization
3.95MB
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
The proposed project is to remove and replace a structurally deficient, 4 span bridge with a 3 span, box beam bridge on the same alignment.
Roadway approach work was minimized as much as possible to reduce the overall project footprint and slopes were reduced to 2:1 to minimize
impacts. Impacts to associated riparian buffers have also been reduced by promoting sheet flow where possible and stabilizing ewsting ditch lines. New
drop inlets will carry stormwater off the bridge and discharge at non-erosive velocities outside the riparian buffer area. There are no changes to
e�tisting ditch-lines. An off-site detour will be employed to avoid the need for a temporary, parallel structure.
1b. Specificallydescribe measures taken to avoid or minimize the proposed impacts through construction techniques:
Erosion and sedimentation BMPs will be installed prior to construction. The outside wetland, stream and riparian areas will be noted with highly visible
fencing. Water will be diverted around the work area to prevent sedimentation of downstream aquatic resources. Impacts will be minimized by strict
enforcement of Best Management Practices for the protection of surface waters, restrictions against staging of equipment in or adjacent to waters of
Ihe US and coordination (including a pre-construction meeting) with the Division Environmental Office Supervisor.
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 r No
Per or Temp I�6d. Stream name
Alamance Creek
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
The impacts associated with the roadway crossing and bridge fall under the "potentially allowable" category per the Jordan Water Supply Buffer Rules Table of Uses {15A NCAC 02B
.0267 (9)}. Further, the stream impacts are restricted to the banks only and will not encroach into the thalweg of the channel.
F. Stormwater Management and Diffuse Flow Plan (required by DWR) J

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?
� Yes r No
What type of SCM are you providing?
r Level Spreader
r Vegetated Conveyance (lower SMNT)
� Wetland Swale (higher SMNT)
r Other SCM that removes minimum 30 % nitrogen
fJ Proposed project will not create concentrated stormwater flow through the buffer
Diffuse Flow Documentation
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
r Yes r No
Comments
G. Supplementary Information
1. Environmental Documentation
1a. Does the project involve an expenditure of public (federallstate/local) funds or the use of public (federal/state) land?*
r Yes r 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)
Environme ntal Policy Act (NEPA/SEPA)? *
f Yes r No
Comme nts: *
While this project involves an expenditure of public funds, it does not exceed the thresholds that require NEPA/SEPA documentation preparation.
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 r No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality? *
f Yes r No
3b. If you answered "no," provide a short narrative description.
Per the NC DWQ April 2004 Version 2.1 Cumulative Impacts policy, small scale public transportation projects — such as widening projects, bridge
replacements and intersection improvements — have a"low potential for cumulative impact since little (if any) new impervious surface is added and the
projects are usually already in developed locales." This proposed project is within a somewhat developed landscape (i.e. epsting residences in the
vicinity), this is not a road on a new location (i.e. there is an existing road and bridge structure and thus the area already contains impervious
surfaces) and the project drains to Big Alamance Creek, which is Class WS-IV; Nutrient Sensitive Waters (NSW), (i.e. not HQW or ORW). We
anticipate the NCDWR will advise us if a qualitative or quantitative analysis is needed.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
r Yes r No r WA
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
Sa. Will this project occur in or near an area with federally protected species or habitat7 *
G Yes �' No
Sb. Have you checked with the USFWS concerning Endangered Species Act impacts?*
F Yes r No
5c. If yes, indicate the USFWS Field Office you have contacted.
Raleigh
Sd. Is another Federal agency involved?*
f Yes r No
�' Unknown

Se. Is this a DOT project located within Division's 1-8?
F Yes r No
Sj. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
IPaC, NCNHP record review and onsite reconnaissance. Mr. Lepsic conducted a survey for vegetation - including Echinacea laevigata (Smooth
coneflower) and Helianthus schweinitai (Sch�init�s sunflower) at the subject site in July 2017. Roadside habitat e�tists on the hillslopes above the
stream floodpain at the bridge, but no specimens of either species were found. The biological conclusion for both plants is No Effect; Habitat Present.
Consultation Documentation Upload
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?*
This project takes place in Guilford County which not near any coastal habitat that would support EFH (i.e. salt marshes, oyster reefs, etc.)
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 status?�`
f Yes r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?"
See attached letters from NCDOT Architectural Historian and NCDOT Archaeologist dated 2017 and 2016, respectively.
7c. Historic or Prehistoric Information Upload
17BP.7.R.107_Historic Archictecture_NothingEligOrAffected 400235.pdf 5.3MB
17BP.7.R.107_No Archaeological Survey Required Form 400235 Guilford.pdf 8.09MB
8. Flood Zone Designation (Corps Requirement)
Sa. Will this project occur in a FEMA-designated 100-year floodplain?"
� Yes r No
8b. If yes, explain how project meets FEMA requirements:
NCDOT MOA
Sc. What source(s) did you use to make the floodplain determination?"
NC Floodplain Mapping Program (Flood Risk Information System)
Miscellaneous
Comments
Miscellaneous attachments not previouslyrequested.
Bridge Replacments 2018-02-6 D-7.pdf
205.47KB
.
�
Signature
*
rJ 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, Artide 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 AcP');
. 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:
James Michael Mills
Signature
�. ���
Date
1 /30/2019