20190178 Ver 1_PCN Form Submission_20190211

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�irlslan af Water Resources
Initial Review
Pre-Construction Notification (PCN) Form
September 29, 2018 Ver 3
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 *
20190178
Is a payment required for this project?*
f No paymentrequired
� Fee received
f Fee needed - send electronic notification
Select Project Reviewer"
Kevin Barnett:eads\khbarnett
Information for Initial Review
1a. Name of project:
Macon County Bridge 29
1a. Who is the PrimaryContact?*
Patrick J. Breedlove
1b. PrimaryContact Email:*
pj breed love@ncd ot.gov
Date Submitted
2/11 /2019
Nearest Body of Water
White Oak Creek
Basin
Little Tennessee
Water Classification
Class C;Tr.
Site Coordinates
Latitude:
3522122
Longitude:
-83.61530
A. Processing Information
County (or Counties) where the project is located:
Macon
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.14.R.115
1a. Type(s) of approval sought from the Corps:
Ve rsion# *
1
Reviewing Office *
Asheville Regional Office - (S28) 296-4500
1c. PrimaryContact Phone:*
(82S)631-1145
::

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?
C' 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?
r Yes r No
B. Applicant Information
1d. Who is applying for the permit?
fJ Owner r 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:
NCDOT Division 14
2b. Deed book and page no.:
2c. Responsible party:
2d. Address
Street Address
253 Webster Road
Address Line 2
�Y
Sylva
Fbstal / Zip Code
28779
2e. Telephone Number:
[phone]
2g. Email Address:*
r 401 Water Quality Certification - E�ress
r Riparian Buffer Authorization
State / Aovince I F�gion
North Carolina
Country
United States
2f. Fax Number:
[phone]
x
C' Yes R No
C' Yes G No

pj b r e e d I o v e@ n cd ot. g o v
C. Project Information and Prior Project History " I
1. Project Information
1b. Subdivision name:
(rf appropriate)
1c. Nearest municipality/town:
Franklin
2. Project Identification
2a. Property Identification Number:
2c. Project Address
Street Address
Address Line 2
ary
Fbstal I Zip Code
2b. Property size:
State / Aovince / Re3ion
Country
3. SurFace Waters
3a. Name of the nearest body of water to proposed project:*
White Oak Creek
3b. Water Resources Classification of nearest receiving water:*
Class C;Tr.
3c. What river basin(s) is your project located in?*
Little Tennessee
3d. Please provide the 12-digit HUC in which the project is located.
060102020304
4. Project Description and History
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:*
Existing land use is an existing 20' 6" L x 20' W timber floor, timber joist bridge on a two lane secondary road. Project site is located in a rural residential area with agriculture fields, a
trout hatchery and a church adjacent to project impact area.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
C' Yes r No r 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)
Macon County - B29 - USGS Topo Map.pdf
1.34 MB
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)
Macon County - B29 - NRCS Soil Survey.pdf 389.11 KB
4f. List the total estimated acreage of all existing wetlands on the property:
0.0
4g. List the total estimated linear feet of all existing streams on the property:
300
4h. Explain the purpose of the proposed project:"
Project is to replace an obsolete and deteriorating wood floor, wood joist bridge structure with a cored slab bridge and an e�sting corrugated metal culvert with an aluminum arch pipe.
4i. 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 and by-pass pipe. An on-site detour will be utilized by a single 48" pipe
structure and a temporary detour bridge. Contractor will remove ewsting bridge and install cored slab bridge in the same footprint. Contractor will install dewatering structure and
remove epsting corrugated metal pipe and replace with an aluminum arch pipe in the same footprint. Bank stabilization materials will be permanently installed once final grading allows.
By-pass pipe and dewatering structures will be removed and temporary impacts areas will be restored. Bridge and arch pipe structure will be constructed utilizing the follow equipment:
crane, excavator, dump truck, paving equipment, pumps and hand tools.
4j. Please upload project drawings for the proposed project.
Macon County - B29 - Permit Plans.pdf 2.61 MB
5. Jurisdictional Determinations
Sa. Have the wetlands or streams been delineated on the property or proposed impact areas?*
f Yes f No r 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 Sa is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
5d1. Jurisdictional determination upload
Macon County - B29 - JD (Appendix 2) Signed.pdf 231.66KB
6. Future Project Plans
6a. Is this a phased project?*
C' Yes r 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?
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
r Wetlands rJ Streams-tributaries
� Open Waters r Pond Construction
3. Stream Impacts
r Buffers
J
Reason for impact (�j 3b.lmpact type * 3a Type of impact* 3d. S. name * 3e. Stream Type * 3f. Type of 3g. S. width* 3h. Impact
(�) Jurisdiction" length"
Stabilization
ite Oak Creek
to White Oak Creek
to White Oak Creek
to White Oak Creek
to White Oak Creek
to White Oak Creek
to White Oak Creek
Perennial
Perennial
Perennial
Perennial
Perennial
Perennial
Perennial
1� 47
Average (feet) (linear feel)
� 45
Average (feet) (linear feel)
� 20
Average (feet) Qinear feet)
� 30
Average(feet) Qinearfeet)
� 70
Average(feet) Qinearfeet)
� 85
Average(feet) (linearfeet)
� 100
Average (feet) Qinear feet)
Stabilization
Stabilization
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
142
3i. Total stream and ditch impacts:
397
3j. Comments:
E. Impact Justification and Mitigation
3i. Total temporary stream impacts:
255
J
1. Avoidance and Minimization

1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
The existing bridge and corrugated metal pipe are being replaced with structures that are adequate for traffic needs in the same disturbed location.
Both structures were designed for the minimum size criteria to ensure conveyance of traffic on the secondary road.
1b. Specificallydescribe measures taken to avoid or minimize the proposed impacts through construction techniques:
The on-site streams (White Oak Creek) and (UT to White Oak Creek) will be diverted while the on-site detour is constructed, the ewsting bridge
removed and the aluminum arch pipe is constructed. 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?
� Yes r No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
Proposed impacts do not require mitigation.
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?
C' Yes r No
If no, explain why:
Project is not located within a N.C. 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 r No
Comments:
I G. Supplementary Information " I
1. Environmental Documentation
1a. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federallstate) land?*
r 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 (NEPAISEPl�?"
� Yes r No
1c. If you answered "yes" to the above, has the document review been finalized by the State Clearing House?*
� Yes r No
Comments:
x
NCDOT MCDC Attached.
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification Rules (15A NCAC 2H .0500�, Isolated Wetland Rules (15ANCAC 2H .1300), or DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15A NCAC 2B .0200)7 *
r Yes r No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality?*
� Yes r No
3b. If you answered "no," provide a short narrative description.
The project is only to replace the existing subject bridge and culvert due to deterioration and does not increase the capacity of roads in the area. The
proposed project is not a road widening or improvement project.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
C' 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 federelly protected species or habitat?*
� Yes r No
Sb. 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.
Asheville
Sd. Is another Federal agency involved?*
C' Yes r No
Se. Is this a DOT project located within Division's 1-8?
C' Yes r No
5f. Will you cut anytrees in order to conduct the work in waters of the U.S.?
r Yes r No
Sg. Does this project involve bridge maintenance or removal?
F Yes r No
5g(1). If yes, have you inspected the bridge for signs of bat use such as staining, guano, bats, etc.?
� Yes r No
If you answered "Yes" to 5g(1), did you discover any signs of bat use?
f Yes r No r Unknown
5h. Does this project involve the construction/installation of a wind turbine(s)?*
C' Yes r No
r Unknown
Si. Does this project involve (7) blasting, and/or (2) other percussive activities that will be conducted by machines, such as jackhammers, mechanized pile drivers, etc.?
F Yes r No
If yes, please provide details to include type of percussive activity, purpose, duration, and specific location of this activity on the property.
Macon County - B29 - NWP 3 Cover Letter.pdf 39.14KB
Sj. 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
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? *
NOAA - Essential Fish Habitat v 3.0
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 Culture Resources Specialist
7c. Historic or Prehistoric Information Upload
Macon County - B29 - Archaeological Screening.pdf
Macon County - B29 - Architecture Screening.pdf
8. Flood Zone Designation (Corps Requirement)
Sa. Will this project occur in a FEMA-designated 100-year floodplain?*
C' Yes r No
8c. What source(s) did you use to make the floodplain determination?*
N.C. Flood Maps - Flood Risk Information System
Miscellaneous
Comments
701.76KB
1.42 MB
� �
Miscellaneous attachments not previouslyrequested.

Macon County - B29 - MCDC (Signed).pdf
Macon County - B29 - NC Hertiage Program.pdf
Macon County - B29 - SMP.pdf
Macon County - B29 - Project Photos.pdf
Macon County - B29 - Vicinity Map.pdf
Signature
*
�J By checking the box and signing below, I certify that:
503.26KB
323MB
52.24KB
2.03MB
844.17KB
. 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 Act");
. I agree to conduct this hansaction 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 Jeremy Breedlove
Signature
,'7�ri�r��%;.��.r59...✓i r
Date
2/11 /2019