20181716 Ver 2_PCN Form Submission_20190325

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 *
20181716
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:
Haywood County Brldge 174 (Revision)
1a. Who is the PrimaryContact?*
Patrick J. Breedlove
1b. PrimaryContact Email:*
pj breed love@ncd ot.gov
Date Submitted
3/25/2019
Nearest Body of Water
Big Creek
Basin
French Broad
Water Classification
Clas C; Tr.; HQW
Site Coordinates
Latitude:
35.77444
A. Processing Information
County (or Counties) where the project is located:
Haywood
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# *
2
Reviewing Office *
Asheville Regional Office - (S28) 296-4500
1c. PrimaryContact Phone:*
(82S)631-1145
Longitude:
-83.10007
::
WBS # (�)
14SP.20441.2
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?
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:
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:
Clyde
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:*
Big Creek
3b. Water Resources Classification of nearest receiving water:*
Clas C: Tr.: HQW
3c. What river basin(s) is your project located in?*
French Broad
3d. Please provide the 12-digit HUC in which the project is located.
060101060305
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:*
Project location is described as a secondary tv�ro lane road with a functionally and structurally obsolete. Bridge 174 is a two span (1 @ 59'; 1@ 56.5') timber floor on a steel girder beam
system. Landscape is rural mountainous terrain located adjacent to a commercial power plant along a NCDOT maintained secondary road with paved parking lots and mowed areas.
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)
Haywood County - B174 & B175 - USGS Topo Map.pdf
1.49 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)
Haywood County - B174 - NRCS Soil Survey.pdf 55979KB
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:
500
4h. Explain the purpose of the proposed project:*
The North Carolina Department of Transportation (NCDOTO is proposing to replace the subject bridge which are functionally and structurally obsolete. Bridge 174 will be replaced with a
135' single span steel plate girder with sloping abutments. The replacement will ensure safe conveyance of traffic and pedestrians within the area.
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 devices prior to grading and during construction activities. The causeway will be installed to remove interior bents on ebsting
bridge and then will be removed. The new bridge structure will be constructed. Traffic will be detoured onsite using staged traffic management while the construction occurs at the
bridge location. The project will also include some minor approach work on the existing roadway. The bridge project will be constructed utiliang the following equipment: crane,
excavators, dump trucks, paving equipment and various hand tools.
4j. Please upload project drawings for the proposed project.
Haywood County - B174 - Permit Plans (Revision).pdf 3.07MB
Haywood County - B174 - Permit Page Revision.pdf 154.81 KB
5. Jurisdictional Determinations
Sa. Have the wetlands or streams been delineated on the property or proposed impact areas?*
� Yes r 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
Haywnod County - B174 - JD (Final).pdf 258.77KB
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?
No.
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"
174 - Site 1 A
174 - Site 1 B
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
30
3i. Total stream and ditch impacts:
130
3j. Comments:
E. Impact Justification and Mitigation
Perennial
3i. Total temporary stream impacts:
100
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
The epsting bridge is being replaced with a clear span structure that is adequate for traffic needs within the same disturbed existing bridge location.
The proposed bridge structure was designed for the minimum size to convey traffic on the secondary road. one interior bent is being remove and
bridge span distance was increased to reduce aquatic impacts.
1b. Specificallydescribe measures taken to avoid or minimize the proposed impacts through construction techniques:
The on-site stream (Big Creek) will be diverted on bridge site temporary by a causeway to remove interior bent. Causeway will not impede more than
50 % of stream flow. Erosion and sedimentation control measures will be installed prior to any ground disturbing activities. All measures listed above
will aid in the prevention of sediment into downstream habitats of Big Creek and the Pigeon River.
Creek
Perennial
Stabilization ��Binp Creek
5 100
Average (feet) (linear feel)
Average (feet) I� Qinear feel)
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:
Project impacts do not exceed mitigation threshold limits.
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?
� Yes r No
If no, explain why:
Project area is not located within a NC Riparian Buffer Area.
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 (federal/state/local) funds or the use of public (federallstate) 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)
Environmental PolicyAct (NEPAISEPA)?"
� 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
MCDC 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)? *
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.
Project is only to replace existing bridge due to deterioration and does not increase the capacity of roads in the area.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
C' Yes r No C' fWA
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? *
� Yes r No
Sb. 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?*
� Yes r No r Unknown

Se. Is this a DOT project located within Division's 1-8?
C' Yes r No
Sf. Will you cut anytrees in order to conduct the work in waters of the U.S.?
F 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.?
F Yes r No
If you answered "Yes" to 5g(1), did you discover any signs of bat use?
C' Yes r No � Unknown
Sh. Does this project involve the construction/installation of a wind turbine(s)?*
f Yes r No
5i. 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.?
r 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.
Haywood County - B174 & B175 - Cover Letter (Revised).pdf 40.62KB
Sj. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
U.S. Fish & Wildlife Service Endangered Species By County Maps, USACE NLEB Slopes, 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?*
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 Mapper
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? *
� Yes r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
NCDOT Cultural Resource Specialist
7c. Historic or Prehistoric Information Upload
Haywood County - B174 & B175 - SHPO Architecture Letter.pdf 98.17KB
Haywood Counry - B174 & B175 - SHPO MOU Architecture Letter.pdf 4.01 MB
Haywood County - B174 - Cultural Screening.pdf 4.68MB
8. Flood Zone Designation (Corps Requirement)
Sa. Will this project occur in a FEMA-designated 100-year floodplain?*
r Yes r No
8b. If yes, explain how project meets FEMA requirements:
NCDOT Programmatic Agreement with N.C. Roodplain Mapping Program.
8c. What source(s) did you use to make the floodplain determination?*
N.C. Rood Maps - Flood Risk Information System
Miscellaneous
Comments
Miscellaneous attachments not previouslyrequested.
Haywood County - B174 - MCDC (Signed).pdf
Haywood County - B174 - SMP.pdf
Flay�wod County - B174 - Site Photos.pdf
Haywnod County - B174 - NC Hertiage Program.pdf
Hay�rood County - B174 - GIS Map.pdf
Haywood County - B174 - Bat Habitat Assessment.pdf
1.62 MB
51.33KB
129MB
2.56M6
2MB
44.23KB
.
Signature �

�J 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 Siatutes (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 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
�'���rrr:!- r,1 �r..p f.���..r'�.r:
Date
3/25/2019