20190142 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 *
20190142
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. 164 over North Prong Stinking Quarter Creek on SR 1113 (Kimesville 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
North Prong Stinking Quarter Creek
Basin
Cape Fear
Water Classification
16-19-8-1; WS-V;NSW; HUC 03030002
Site Coordinates
Latitude: Longitude:
36.004183 -79.492387
A. Processing Information
County (or Counties) where the project is located:
Alamance
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:
WBS # (�)
17BP.7.R.106
1a. Type(s) of approval sought from the Corps:
Ve rsion# *
1
Reviewing Office *
Central Office - [phone]
1c. PrimaryContact Phone:*
[phone]
::

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 Department of Transportation
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:
NCDOT Division 7 Division Engineer, Mr. Mike Mills, PE
3b. Business Name:
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:
Burlington
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:"
North Prong Stinking Quarter Creek
3b. Water Resources Classification of nearest receiving water:*
16-19-8-1; WS-V;NSW; HUC 03030002
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.
030300020308
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)
Bridge164_AlamanceUSGS.pdf 2.73MB
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)
Bridge164_AlamanceSoils.pdf 2.1 MB

4f. List the total estimated acreage of all existing wetlands on the property:
0
4g. List the total estimated linear feet of all existing streams on the property:
— 600 LF in 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 98
linear feet of permanent stream impaci associated with bank stabilization and 20 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 north-west and south-west of the bridge respectively. The
systems outlet prior to the buffer at non-erosive velocities and sheet flow into existing outfalls. The exsting ditches are stable and functioning. PSRM toe protection will be utilized in the
north-west and south-east ditches to protect the fill slopes. 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 drewings for the proposed project.
SF_000164_hyd_wet_04162018. pdf 1.91 MB
SF_000164_hyd_buffer_04162018.pdf 1.62MB
5. Jurisdictional Determinations
Sa. Have the wetlands or streams been delineated on the property or proposed impact areas?*
F Yes �' No �' Unknown
Comments:
Sb. If the Corps made a jurisdictional determination, what type of determination was made?*
f' Preliminary (' Approved r Not Verified r Unknown f' WA
Corps AID Number:
Sc. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Mr. Bob Lepsic
Agency/Consultant Company: Formerlywith EPR
Other:
Sd1. Jurisdictional determination upload
Bridge 164 Div 7 Packet.pdf
6. Future Project Plans
6a. Is this a phased project?*
C' Yes r No
10.58MB
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?
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
r Wetlands 17 Streams-tributaries rJ Buffers
� Open Waters � Pond Construction
3. Stream Impacts
3i. Total jurisdictional ditch impact in square feet:
0

3i. Total permanent stream impacts:
98
3i. Total stream and ditch impacts:
11S
3i. Total temporary stream impacts:
20
3j. Comments:
Of the 118 linear feet of stream impact proposed, only 98 linear feet is permanent impact which will only occur on the banks of the channel and will not
eMend into the thalweg.
6. Buffer Impacts (for DWR)
6a. Project is in which protect basin�s)?
Check all that apply.
r Neuse
� Catawba
� Goose Creek
r Other
6h. Total buffer impacts:
r Tar-Pamlico
r Randleman
fJ Jordan Lake
Zone 1 Zone 2
Total Temporary impacts: 0.00 0.00
Zone 1 Zone 2
Total Permanent impacts: 5,986.00 3,060.00
Zone 1 Zone 2
Total combined buffer impacts: 5,986.00 3,060.00
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
SF_000164_hyd_buffer_04162018.pdf
SF_000164_hyd_wet_04162018.pdf
E. Impact Justification and Mitigation
1. Avoidance and Minimization
1.62 MB
1.91 MB
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 2 span, box beam bridge on the same alignment.
Roadway approach v�nrk was minimized as much as possible to reduce the overall project footprint. Impacts to associated riparian buffers have also
been reduced by promoting sheet flowwhere possible and outletting into 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 existing ditch-lines. An off-site detour will be employed to
avoid the need for a temporery, 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
the 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?
� Yes r No
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 reshicted to the banks only and will not encroach into the thalweg of the channel.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
�
�

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 r No
What type of SCM are you providing?
r Level Spreader
r Vegetated Conveyance (lowar SHWf)
� Wetland Swale (higher SFNVf)
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?*
F 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 (federallstate) land?*
� 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 (NEPAISEPA)? *
C' Yes r No
Comme nts: *
While this project involves an e�enditure 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 26 .0200)? *
� Yes r No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality?*
C' 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'9ow 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. ewsting residences in the
vicinity), this is not a road on a new location (i.e. there is an ebsting road and bridge structure and thus the area already contains impervious
surfaces) and the project drains to North Prong Stinking Quarter 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?*
f Yes r No � 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 habitat? *
C' Yes r No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
r Yes r No
Sc. If yes, indicate the USFWS Field Office you have contacted.
Raleigh
Sd. Is another Federal agency involved?*
C' Yes r No
C' Unknown

Se. Is this a DOT project located within Division's 1-8?
r Yes r No
Sj. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
IPaC and NCNHP record reviews reveal no species for this project location.
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? *
f 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 Alamance 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?*
C' Yes r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
NCDOT Archaeologists reviewed the project study area in February 2017 and NCDOT Architectural Historians reviewed the project study area in
December 2016 and determined there were no eligible resources within the area. Letters are attached.
7c. Historic or Prehistoric Information Upload
17BP7.R.106_No Survey Required Form[HA] 000164.pdf 2.04MB
No National Register Eligible or Listed Archaeological Sites Present PA16-12-006.pdf 3.21 MB
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 Roodplain Mapping Program, FRIS maps
Miscellaneous
Comments
Miscellaneous attachments not previouslyrequested.
Bridge Replacments 2018-02-6 D-7.pdf
Signature
*
�7 By checking the box and signing below, I certify that:
205.47KB
• 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 Iransaction 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
�1�w�w l+ laE�IK� �
��
�
Date
1 /30/2019