20190506 Ver 1_PCN Form Submission_20190418

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 *
20190506
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. 173 Over Back Creek on SR 1149 (Huffman Mill Road)
1a. Who is the PrimaryContact?*
NCDOT Division 7 Division Engineer, Mr. Mike Mills, PE
1b. PrimaryContact Email:*
[e-mail]
Date Submitted
4/18/2019
Nearest Body of Water
Back Creek
Basin
Cape Fear
Water Classification
16-19-5; WS-V; NSW; HUC 030300020305
Site Coordinates
Latitude:
36.047897
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:
Old B-5349
WBS # (�)
17BP.7.R.121
1a. Type(s) of approval sought from the Corps:
Longitude:
-79.512973
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:
14 - Linear transportation
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?
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
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
C' Yes G 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)
wn
1 c. Nearest municipality / town:
Burlington
2. Project Identification
2a. Propertyldentification Number:
WA
2c. Project Address
Street Address
Address Line 2
�Y
Postal / Zip Code
3. SurFace Waters
3a. Name of the nearest body of water to proposed project:"
Back Creek
3b. Water Resources Classification of nearest receiving water:*
16-19-5; WS-V; NSW; HUC 030300020305
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.
030300020305
4. Project Description and History
2b. Property size:
WA
S[ate / FYovince 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, maintained lawns and residences, agricultural land, and commercial land (i.e. adjacent quarry).
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
C' Yes r No � 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 173 USGS.pdf 705.71 KB
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)
Br 173 Soil Survey.pdf 681.32KB

4f. List the total estimated acreage of all existing wetlands on the property:
0.00
4g. List the total estimated linear feet of all existing streams on the property:
—160 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 on-site utilizing a temporary bridge structure. Erosion and sedimentation control measures will be installed. The proposed structure will be replaced on its existing
alignment. The project proposes 144 linear feet of permanent stream impact associated with bank stabilization, 20 linear feet of temporary stream impact associated with construction
access/dev✓atering, and 40 linear feet of temporary stream impact associated with the temporary causeway. 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-east of the bridge. The system outlets prior to the buffer at non-erosive velocities and sheet
flows into a rip-rap lined base ditch 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:
Sb. If the Corps made a jurisdictional determination, what type of determination was made?*
� Preliminary r Approved � Not Verified � Unknown r WA
Corps AID Number:
Sc. If Sa is yes, who delineated the jurisdictional areas?
�' Unknown
Name (if known):
Agency/Consultant Company: Kimley-Fbrn and Associates
Other:
Sd1. Jurisdictional determination upload
B-5349 DWR Stream Call letter.pdf 634.73KB
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):
� Wetlands I17 Streams-tributaries
� Open Waters I� Pond Construction
3. Stream Impacts
�, I
fJ Buffers
❑ 3a. 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"
15+40 to 16+00
15+40 to 16+00
15+60 to 16+00
Stabilization ��Back Creek
Creek
Creek
Perennial
Perennial
Perennial
5 144
Average (feet) Qinear feet)
Average(feet) I� Qinearfeet)
Average (feet) I� Qinear feet)
3i. Total jurisdictional ditch impact in square feet:
0

3i. Total permanent stream impacts:
144
3i. Total stream and ditch impacts:
204
3i. Total temporary stream impacts:
60
3j. Comments:
Of the 204 linear feet of stream impact proposed, only 144 linear feet is permanent impact which will only occur on the banks of the channel and will
not eu[end 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
r Tar-Pamlico
r Randleman
fJ Jordan Lake
6b. Impact Type 6c. Per or Temp 6d. Stream name 6e. Buffer mitigation required9 6f. Zone 1 impact I6g. Zone 2 impact
14+g0 to 16+30 -L- (Bridge) P Back Creek No 2,504 679
16+30 to 16+7p -L- (Bridge) P Back Creek No 120 515
14+g0 to 16+40 -LDET- (Detour Bridge) T Back Creek No 4,647 1,867
12+p5 to 15+10 -LDET- (Detour Fill) T Back Creek Yes 6,418 5,018
6h. Total buffer impacts:
Zone 1 Zone 2
Total Temporary impacts: 11,065.00 6,885.00
Zone 1 Zone 2
Total Permanent impacts: 2,624.00 1,194.00
Zone 1 Zone 2
Total combined buffer impacts: 13,689.00 8,079.00
6i. Comments:
The impacts associated with the roadway crossing and bridge fall under the "allowable" category while the impacts associated with the temporary
onsite detour (i.e. parallel impacts) fall under the "allowable with mitigation" category per the Jordan Water Supply Buffer Rules Table of Uses {15A
NCAC 02B .0267 (9)}.
Supporting Documentation
B5349_PermitDrawings Package_20190417.pdf
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:
The proposed project is to remove and replace a structurally deficient, 6 span bridge with a 2 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 1.5:1 or flatter to
minimize impacts. Impacts to associated riparian buffers have also been reduced by promoting sheet flow where possible and stabilizing existing 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 ebsting ditch-lines. An on-site detour, consisting of a temporary parallel structure, will be utilized. Huffman Mill Road is one of the only
connections over Mackintosh Lake connecting eastern Guilford County with Burlington. Alamance Regional Medical Center is located approbmately
1.3-miles north of the bridge and utilizes this roadway for primary access to the hospital, especially from eastern Guilford County. The nearest off-site
detour v�rould consist of an approximately 11.2-mile detour, having an effect on Alamance Regional Medical Center, as well as access to the Martin
Marietta Quarry and Thompson Arthur Paving and Construction located immediately adjacent the bridge. Further, the Alamance-Burlington School
System utilizes the bridge daily and is concerned an off-site detour will create difficulties for buses as well as studenYs access to bus stops.
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 stream and riparian areas will be noted with highly visible fencing.
Water will be diverted around the v�ork 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
6.85MB
n
2a. Does the project require Compensatory Mitigation for impacts to Waters of the U.S. or Waters of the State?

C' Yes r No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
Permanent impacts to the surface water for streambank stabilization typically does 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?
G Yes �' No
What type of SCM are you providing?
r Level Spreader
r Vegetated Conveyance (lower SHWT)
r 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 (federallstate) land?*
r Yes �' No
,,
1b. If you answered "yes" to the above, does the project require preparetion of an environmental document pursuant to the requirements of the National or State (North Carolina)
Environmental PolicyAct (NEPAISEPA)?*
C' Yes r No
Comments:
*
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 (15ANCAC 2H .1300), or DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15A NCAC 2B .0200)? *
f 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 Uansportation 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. epsting residences in the
vicinity), this is not a road on a new location (i.e. there is an epsting road and bridge structure and thus the area already contains impervious
surfaces) and the project drains to Back Creek, which is Class WS-V; 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?*
C' Yes �' No F 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.
Raleigh
Sd. Is another Federal agency involved?*
C' Yes r No
5e. Is this a DOT project located within Division's 1-8?
� Yes r No
�' Unknown
S. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
Species review revealed that there are no species listed for this project area. Bald Eagle and Golden Eagle Protection Act - Habitat for the bald eagle
primarily consists of mature forest in probmity to large bodies of open v✓ater for foraging. Large dominant trees are utilized for nesting sites, typically
within 1.0 mile of open water. A desktop-GIS assessment of the project study area, as well as the area within a 1.13-mile radius (1.0 mile plus 660 feet)
of the project limits, was performed on May 23, 2013 using 2010 color aerials. Lake Mackintosh is located appropmately 0.4 miles south of the project
study area. Surveys w�re conducted by KHA biologists throughout areas of suitable nesting habitat on March 21, 2013. No bald eagles or nesting
sites were observed. Suitable nesting trees were observed to be sparse within the study area and within 660 feet of the study area. A review of the
NCNHP database, updated April 2013, revealed no known occurrences of this species within 1.0 mile of the project study area. Due to the results of
the survey, lack of known occurrences, and minimal impact
anticipated for this project, it has been determined that this project will not affect this species.
Consultation Documentation Upload
USFWS Letter.pdf
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?"
� Yes r No
828.98KB
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 is 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 June 2016 and NCDOT Architectural Historian reviewed the project study area in December
2015 and determined there were no eligible resources within the area. Letters are attached.
7c. Historic or Prehistoric Information Upload
OSA Letter.pdf
SHPO letter. pdf
8. Flood Zone Designation (Corps Requirement)
Sa. Will this project occur in a FEMA-designated 100-year floodplain?*
� Yes r No
Sb. If yes, explain how project meets FEMA requirements:
NCDOT MOA
8c. What source(s) did you use to make the floodplain determination?*
FEMA Flood Maps
Miscellaneous
Comments
Miscellaneous attachments not previouslyrequested.
MOA_B-5349_F in al_Approval. pdf
WRC_multibridge 04102013.pdf
2016-10-03_B-5349 CE Final - FFNVA Approved.pdf
Signature
*
�J By checking the box and signing below, I certify that:
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• 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:
J.M. Mills
Signature
c/ f�%'' �i�P//a��,�,
Date
4/18/2019