20190210 Ver 1_PCN Form Submission_20190214

D1�VR
�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 *
20190210
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:
A-11 Widening of NC 69
1a. Who is the PrimaryContact?*
Dave McHenry
1b. PrimaryContact Email:*
[e-mail]
Date Submitted
2/14/2019
Nearest Body of Water
Hyatt Mill Creek
Basin
Hiwassee
Water Classification
C
Site Coordinates
Latitude:
35.009696
A. Processing Information
County (or Counties) where the project is located:
Clay
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:
A-11
WBS # (�)
32574.1. F D7
1a. Type(s) of approval sought from the Corps:
Ve rsion# *
1
Reviewing Office *
Asheville Regional Office - (S28) 296-4500
1c. PrimaryContact Phone:*
(82S)586-2141
Longitude:
-83.825602
::

�J 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?
r Nationwide Permit (NWP)
rJ Regional General Permit (RGP)
� Standard (IP)
1c. Has the NWP or GP number been verified bythe Corps?
F Yes r No
Regional General Permit (RGP) Number:
198200031 - NCDOT Bridges, Widening Projects 2015
RGP Numbers (for multiple RGPS):
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:
r 401 Water Quality Certification - E�ress
r Riparian Buffer Authorization
x
C' Yes R No
C' Yes G No
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?
F 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
A-0011 Revised - Division 14 - STR - RW (cool cold) - HI 02.pdf
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 rJ Applicant (other than owner)
1e. Is there an Agent/Consultant for this project?
� 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:
(82S)586-2141
S[ate / FYovince I Region
NC
Cauntry
USA
2f. Fax Number:
68.2KB
�,

2g. Email Address:*
[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
NCDOT Division 14
3b. Business Name:
3c. Address
Street Address
253 Webster Road
Address Line 2
�ty
Sylva
Postal / Zip Code
28779
3d. Telephone Number:
[phone]
3f. Email Address:"
[e-mail]
S[ate / Awince I Region
NC
Country
USA
3e. Fax Number:
C. Project Information and Prior Project History �
1. Project Information �
1b. Subdivision name:
(rf appropriate)
1 c. Nearest municipality l town:
Hayesvil le
2. Project Identification
2a. Propertyldentification Number:
2c. Project Address
Street Address
Address Line 2
6ty
Postal / Zip Code
3. SurFace Waters
3a. Name of the nearest body of water to proposed project:*
Hyatt Mill Creek
3b. Water Resources Classification of nearest receiving water:*
C
3c. What river basin(s) is your project located in?*
Hiwassee
3d. Please provide the 12-digit HUC in which the project is located.
060200020600
4. Project Description and History
2b. Property size:
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 involves widening the existing combination 2-lane and 2-lane with center tum lane road into a combination 5-lane and 4-lane �nnth median divided road in a rural area of Clay
County from Hayesville south to the Georgia line.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
� Yes r No � Unknown
4d. Attach an 8 7/2 X 11 excerpt from the most recent version of the USGS topographic map indicating the location of the project site. (for DWR)
A-0011 Topo.pdf 793.92KB
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)

20190214_11315411603_63_Soil_Map.pdf 758.27KB
4f. List the total estimated acreage of all existing wetlands on the property:
0.65
4g. List the total estimated linear feet of all existing streams on the property:
13753
4h. Explain the purpose of the proposed project:*
The project purpose is to improve mobility and safety on this road consistent with the intent of the Appalachian Regional Commission.
4i. Describe the overell project in detail, including indirect impacts and the type of equipment to be used:*
The project involves widening the e�sting combination 2-lane and 2-lane with center turn lane road into a combination 5-lane and 4-lane with median divided road in a rural area of Clay
County from Hayesville south to the Georgia line. Typical heavy equipment will be used for earth moving and heavy construction.
4j. Please upload project drawings for the proposed project.
A0011 C_Permit Drawings_20181221_Application.pdf 25.01 MB
A0011C_Permit Drawings_pages 44-45 table.pdf 32.67KB
Site 5 design_A-0011C Fullsize_OSM_Plans_2.1.19.pdf 67MB
Site 12 plans_A0011 C_Hyd_PSH2D-1 and PSH2D-2.pdf 1.14MB
5. Jurisdictional Determinations
Sa. Have the wetlands or streams been delineated on the propertyor proposed impact areas?*
� Yes r No r Unknown
Comments:
Sb. If the Corps made a jurisdictional determination, what type of determination was made?*
C' Preliminary r Approved C•' Not Verified � Unknown r WA
Corps AID Number:
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Mary Frazier
Agency/Consultant Company: Three Oaks Engineering
Other:
Sd1. Jurisdictional determination upload
6. Future Project Plans
6a. Is this a phased project?"
� 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 activit�/?
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
fJ Wetlands 117 Streams-tributaries r Buffers
� Open Waters I� Pond Construction
2. Wetland Impacts
✓ I
2a. Site #* (') 2a7 Reason (?) 2b. Impact type *(') 2c. Type of W. * 2d. W. name * 2e. Forested * Zf. Type of 2g. Impact
Jurisdicition*(') area*
5A/WAA fill P Seep WAA No Both 0.060
(acres)
56/WBB fill P Headwater Forest WBB Yes Both 0.010
(acres)
7/WDD fill P Seep WDD No Both 0.060
(acres)
10A/WC fill P Seep WC No Both 0.040
(acres)

106/WD fill P Seep WD No Both 0.040
(acres)
2g. Total Temporary Wetland Impact
0.000
2g. Total Wetland Impact
0.210
2h. Comments:
3. Stream Impacts
Reason for impact (�)
stabilization
emporery
nk stabili�ation
emporary
emporary
nk stabili�ation
3nnelchange
vert
water
nk stabilization
vert
water
nk stabilization
vert
nk stabilization
annelchange
vert
annelchange
2g. Total Permanent Wetland Impact
0.210
type 3c. Type of impact" 3d. S. name" 3e. Stream Type" 3f. Type of 3g. S. width" 3h. Impact
(?) Jurisdiction* length*
Culvert 1/SAA Perennial Both 2 106
Average (feet) (linear feet)
Dewatering 1/SAA Perennial Both 2 35
Average (feet) (linear feel)
Stabilization 1/SAA Perennial Both 2 18
Average (feet) (linear feel)
Culvert 2/SCC Perennial Both 3 123
Average (feet) Qinear feet)
Dewatering 2/SCC Perennial Both 3 39
Average(feet) Qinearfeet)
Stabili�ation 2/SCC Perennial Both 3 15
Average(feet) Qinearfeet)
Culvert 3/Hyatt Perennial Both 3 20
Average(feet) (linearfeet)
Dewatering 3/Hyatt Perennial Both 3 12
Average(feet) (linearfeet)
Culvert 4/SEE Perennial Both 2 41
Average(feet) (linearfeet)
Stabilization 4/SEE Perennial Both 2 17
Average(feet) (linearfeet)
Stabilization 4/SEE Perennial Both 2 15
Average(Feet) (linearfeet)
Relocation 5/Hyatt Perennial Both 8 605
Average(feet) Qinearfeet)
Culvert 6/Cole Hyatt Perennial Both 15 76
Average(feet) Qinearfeet)
Dewatering 6/ Cole Hyatt Perennial Both 15 116
Average(feet) (linearfeet)
Stabilization 6/Cole Hyatt Perennial Both 15 44
Average(feet) Qinearfeet)
Culvert 8/SF Perennial Both 2 107
Average (feet) (linear feet)
Dewatering 8/SF Perennial Both 2 5
Average (feet) (linear feet)
Stabilization S/SF Perennial Both 2 18
Average (feet) (linear feet)
Culvert 9/SD Perennial Both 1 62
Average (feet) (linear feet)
Stabilization 9/SD Perennial Both 1 25
Average (feet) (linear feel)
Relocation 10/SB Perennial Both 2 547
Average (feet) Qinear feet)
Culvert 11/SB Perennial Both 3 85
Average(feet) Qinearfeet)
Relocation 11/SB Perennial Both 3 115
Average(feet) Qinearfeet)
Dewatering 11/SB Perennial Both 3 106
Average (feet) Qinear feet)

S25 channel change Permanent Relocation 12/SB Perennial Both � 234
Average (feet) Qinear feet)
S26 culvert Permanent Culvert 13/SB Perennial Both � 11
Average (feet) (linear feet)
gy7 dewater Temporary Dewatering 13/SB Perennial Both � 33
Average (feet) Qinear feet)
S28
bank stabilization Permanent Bank Stabiliration 13/SB Perennial Both 4 10
Average (feet) (linear feet)
S29
culvert Permanent Culvert 14/Blair Perennial Both 15 60
Average (feet) (linear feel)
S30 dewater Temporary Dewatering 14/Blair Perennial Both 15 210
Average (feet) (linear feet)
S31
bank stabilization Permanent Bank Stabilization 14/Blair Perennial Both 15 88
Average (feet) Qinear feel)
S32
culvert Permanent Culvert 15/SA Perennial Both 8 57
Average(feet) Qinearfeet)
S33 dev✓ater Temporary Dewatering 15/SA Perennial Both 8 35
Average(feet) Qinearfeet)
channel chan e Permanent Relocation 15/SA Perennial Both 8 126
S34 9
Average(feet) (linearfeet)
S35
bank stabilization Permanent Stabilization 15/SA Perennial Both 8 39
Average(feet) (linearfeet)
S36
culvert Permanent Culvert 16/SA Perennial Both 4 180
Average(feet) (linearfeet)
S37 dewater Temporary Dewatering 16/SA Perennial Both 4 55
Average(feet) (linearfeet)
channel chan e Permanent Relocation 17/SA Perennial Both 3 127
S38 9 Average(feet) (linearfeet)
S39 dewater Temporary Dewatering 17/SA Perennial Both 3 85
Average(Feet) (linearfeet)
S40
culvert Permanent Culvert 17A/SA Perennial Both 2 80
Average(feet) Qinearfeet)
dewater Tem orar Dewaterin 17A/SA Perennial Both 2 51
S41 p Y 9
Average (feet) Qinear feet)
S42
bank stabilization Permanent Stabilization 17A/SA Perennial Both 2 15
Average (feet) Qinear feet)
3i. Total jurisdictional ditch impact in square feet:
3i. Total permanent stream impacts:
3,049
3i. Total stream and ditch impacts:
3848
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:
Efforts were made to avoid streams and v�tlands and competing resources w�th horizontal alignment changes and slope steepening. Natural design
techniques were applied to stream relocation sites where prectical.
1b. Specificallydescribe measures taken to avoid or minimize the proposed impacts through construction techniques:
Dewatering will be used to avoid culvert extension v�nrk in the wet and bank plugs will be retained to do culvert relocations in the dry. Where rip rap is
used ion streambed, it will be embedded into the channel bottom with heavy equipment to "choke-ouY' voids and e�edite natural bed development
and sediment transport.
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
3i. Total temporary stream impacts:
799
�
2c. If yes, mitigation is required by (check all that apply):
fJ DWR i,�/ Corps

2d. If yes, which mitigation option(s) will be used for this project?
r Mitigation bank rJ Payment to in-lieu fee r Permittee Responsible
program Mitigation
4. Complete if Making a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached.
r Yes r No
4b. Stream mitigation requested:
Qinear Feet)
1931
4d. Buffer mitigation requested (DWR only):
(square feet)
4f. Non-riparian wetland mitigation requested:
(acres)
4h. Comments
Note that 229 feet of the 1931 feet is actualty cool water regime.
4c. If using stream mitigation, what is the stream temperature:
cold
4e. Riparian wetland mitigation requested:
(acres)
0.21
4g. Coastal (tidal) wetland mitigation requested:
(acres)
6. Buffer mitigation (State Regulated Riparian Buffer Rules) - required by DWR
6a. Will the project result in an impact within a protected riparian buffer that requires buffer mitigation? If yes, you must fill out this entire form - please contact DWR for more
information.
C' Yes r No
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:
Not in Tar-Pam. Neuse, or Catawba basins
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:
Alsq an individual SMP is included in the plan sheets.
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?*
F 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: *
A type III CE was prepared.
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 (15ANCAC 26.0200)?*
� Yes r No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water qualit�/? *
C' Yes r No
3b. If you answered "no," provide a short narrative description.

This project does add lanes, but it will not provide new road service to areas without road access and the roadway improvements are not anticipated
to generate appreciable traffic increase.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
f Yes r No � fWA
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?*
� Yes r No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
� Yes r No
Sc. If yes, indicate the USFWS Field Office you have contacted.
Asheville
Sd. Is another Federal agency involved?*
r Yes r No
What Federal /�ency is involved?
Federal Highway Administration
Se. Is this a DOT project located within Division's 1-8?
f Yes r No
Sf. 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?
� Yes r No
Sg(1). If yes, have you inspected the bridge for signs of bat use such as staining, guano, bats, etc.?
r Yes r No
If you answered "Yes" to Sg(1), did you discover any signs of bat use?
� Yes r No � Unknown
Sh. Does this project involve the construction/installation of a wind turbine(s)?*
C' Yes r No
C' Unknown
Si. 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.?
� 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.
A-11 GP narrative.pdf 411.38KB
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
Available NHP data and field surveys by qualified staff.
Consultation Documentation Upload
16-307 TIP A-0011A Clay COunty Concurrence.pdf
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?*
NMFS website
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
207.8KB
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?*
� Yes r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
PA screening by NCDOT HEU staff and coordination with SHPO
7c. Historic or Prehistoric Information Upload
16-08-0010Effects.pdf
AR16-OS-0010noeligiblesites. pdf
1179M6
3.06MB
8. Flood Zone Designation (Corps Requirement)

Sa. Will this project occur in a FEMA-designated 100-year floodplain?*
r Yes r No
Sb. If yes, explain how project meets FEMA requirements:
The hydraulic analyses , modeling, and project design were coordinated with NC Roodplain Management under MOU.
8c. What source(s) did you use to make the floodplain determination?*
NC Floodmaps.
Miscellaneous
Comments
Attached are impact site photos and stream relocation design and monitoring plan information.
Miscellaneous attachments not previouslyrequested.
A-11_stream impact location photos_sites 5 thru 17A.pdf 52MB
A-11_sheam monitoring plan for sites 10-12, 15, 17.pdf 22.59KB
NC 69 Plans as built in 1990s_8.3064122_plans not in order or complete.pdf 2.08MB
Site 5 design information_A-0011C_Hyatt_Mill_Ck_Technical_Memo_02.01.19.pdf 17.33MB
Site 5 design information_Existing_ProposedConditions_Writeup_02.01.19.pdf 52.37KB
Site 5_Stream Relocation Monitoring Plan.pdf 1.55MB
Signature
*
,r! 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 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 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:
Dave McHenry
Signature
i� �
n�
�
Date
2/14/2019