20190623 Ver 1_PCN Form Submission_20190510

DWR
MOM— of Water Resources
Pre -Construction Notification (PCN) Form
September 29, 2018 Ver 3
21nitial Review
Has this project met the requirements for acceptance in to the review process?*
r Yes
r No
Is this project a public transportation project?*
G Yes r No
Oange only if needed.
BIMS # Assigned
20190623
Is a payment required for this project?*
r No payment required
r Fee received
r Fee needed - send electronic notification
Select Project Reviewer*
Dave Wanucha:eads\djwanucha
Information for Initial Review
1a. Name of project:
Stokes Bridge 105 17BP.9.R.100
1a. Who is the Primary Contact?*
Amy Euliss
1b. Primary Contact Email:*
[e-mail]
Date Submitted
5/10/2019
Nearest Body of Water
Snow Creek
Basin
Roanoke
Water Classification
C
Site Coordinates
Version# *
1
Reviewing Office*
Winston-Salem Regional Office - (336) 776-
9800
1c. Primary Contact Phone:*
[phone]
Latitude: Longitude:
36.403394-80.141213
FA. Processing Information U
County (or Counties) where the project is located:
Stokes
Is this project a public transportation project?*
r Yes r' No
Is this a NCDOT Project?*
r Yes r No
(NCDOT only) T.I.P. or state project number:
B-4819
WBS # (?)
17BP.9.R.100
1a. Type(s) of approval sought from the Corps:

W Section 404 Permit (wetlands, streams and waters, Clean Water Act)
r Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
1b. What types) of permit(s) do you wish to seek authorization?
W Nationwide Permit (NWP)
r' Regional General Permit (RGP)
r' Standard (IP)
1c. Has the NWP or GP number been verified by the Corps?
t' Yes r No
Nationwide Permit (NWP) Number:
Nationwide Permit (NWP) Number:
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
R 401 Water Quality Certification - Regular
F Non-404 Jurisdictional General Permit
r Individual Permit
13 - Bank Stabilization
33 - Temporary Construction
le. Is this notification solelyfor the record because written approval is not required?
For the record only for DWR 401 Certification:
For the record only for Corps Permit:
r- 401 Water Quality Certification - Express
r- Riparian Buffer Authorization
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?
r Yes r No
Acceptance Letter Attachment
1h. Is the project located in any of NC's twenty coastal counties?
f Yes r No
1j. Is the project located in a designated trout watershed?
G Yes r No
FB. Applicant Information
1d. Who is applying for the permit?
W Owner r- Applicant (other than owner)
le. Is there an Agent/Consultant for this project?
f Yes r- No
2. Owner Information
2a. Name(s) on recorded deed:
Pat Ivey-NCDOT Division Engineer
2b. Deed book and page no.:
2c. Responsible party:
2d. Address
Street Address
375 Silas Creek Pk".
Address Line 2
City
State / Frovinoe / Region
Wintson-Salem
NC
Fbstal / Zip Oide
Country
27127
USA
2e. Telephone Number:
2f. Fax Number:
[phone]
*
r Yes r No
f Yes r No

2g. Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
ff appropriate)
1c. Nearest municipality / town:
Walnut Cove
2. Project Identification
2a. Property Identification Number:
2c. Project Address
Street Address
Address Line 2
DtY
Rstal / Zip Code
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Snow Creek
3b. Water Resources Classification of nearest receiving water:*
C
3c. What river basin(s) is your project located in?*
Roanoke
3d. Please provide the 12-digit HUC in which the project is located.
030101030301
4. Project Description and History
2b. Property size:
State / Rwince / Fbgion
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 site is located in a rural portion of Stokes County, near the confluence of Snow Creek and the Dan River. The predominant surrounding landuses are forested and agricultural. The
topography slopes toward Snow Creek and the Dan River.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
r 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)
Fig1_USGS VicinityMap_Bridge105.pdf 449.03KB
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)
Fig2_SoilsMap_Bridge105.pdf 598.33KB
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:
150
4h. Explain the purpose of the proposed project:*
Replace a functionally obsolete bridge, Stokes 105, with a new bridge consisting of 1 @125' 63" MBT with 4'-0" caps. The alignment on the west side of the bridge will be shifted to the
south to straighten the approach to the bridge.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
The project will remove the ebsting timber deck and 1-beams bridge and the accompanying bents. Impervious dikes will be used during the removal of the bents. A single span bridge,
modified bulb tee type, will be installed. Cranes, dump trucks, bulldozers and typical construction equipment will be used. There will be an off -site detour.
4j. Please upload project drawings for the proposed project.
B4819_PermitDrawings_20190410.pdf 1.58MB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes r No O Unknown
Comments:

No wetlands were found within the study area. The only stream is Snow Creek.
5b. If the Corps made a jurisdictional determination, what type of determination was made?
r Preliminary r Approved r Not Verified r Unknown r NIA
Corps AID Number:
5c. If Sa is yes, who delineated the jurisdictional areas?
Name (if known): Heather Smith
Agency/Consultant Company: VHB
Other:
5d1. Jurisdictional determination upload
6. Future Project Plans
6a. Is this a phased project?*
r 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?
FD. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
r Wetlands W Streams -tributaries
r Open Waters r Pond Construction
3. Stream Impacts
❑ Buffers
❑ 3a. Reason for impact (?) 3b.lmpact type * 3c. Type of impact* ��name * 3e. Stream Type-*—] �31`. Type of 3g. S. width * 3h. Impact
(?) Jurisdiction* length*
h;;J�J
S1
Bent Removal
Tem ora
P rY
Dewaterin9
Snow Creek
Perennial
Both
14
Average (feet)
36
(linear feet)
Bank Stabilization
Permanent
Bank Stabilization
Snow Creek
Perennial
Both
31. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
26
3i. Total stream and ditch impacts:
62
3j. Comments:
E. Impact Justification and Mitigation
1. Avoidance and Minimization
3i. Total temporary stream impacts:
36
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
The replacement bridge will be a single span bridge with no new bents in the stream bed. The existing bents will be removed, creating a temporary
impact. The only permanent impacts are associated with bank stabilization.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Impervious dikes will be used to facilitate the removal of the existing bents, for a temporary impact.
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?
r Yes r No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
Permanent impacts to Snow Creek are for bank stabilization only. Bank stabilization is not a loss of water.

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?
r Yes r No
If no, explain why:
This project is located in the Roanoke River Basin and is not subject to state regulated riparian buffer rules.
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
e Yes r No
Comments:
Stormwater management plan is included in the permit drawings.
G. Supplementary Information
1. Environmental Documentation
la. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) 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 Policy Act (NEPA/SEPA)? *
r Yes r No
Comments:*
An environmental document is not required. A State Minimum Criteria Checklist 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 (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?*
r- Yes r No
3b. If you answered "no," provide a short narrative description.
This is a single bridge replacement in a rural area and no further development is expected due to this project.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
r Yes r Nor N/A
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?*
r Yes r No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
r Yes r- No
5c. If yes, indicate the USFWS Field Office you have contacted.
Asheville
5d. Is another Federal agency involved?*
r Yes r No C Unknown
What Federal Agency is involved?
USFWS
5e. Is this a DOT project located within Division's 1-8?
r Yes r No
5f. Will you cut anytrees in order to conduct the work in waters of the U.S.?
r Yes r No

5g. Does this project involve bridge maintenance or removal?
r Yes r No
5g(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 5g(1), did you discover any signs of bat use?
r Yes r No r Unknown
5h. Does this project involve the construction/installation of a wind turbine(s)?*
r Yes r No
51. 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.?
r Yes r No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
The study area was surveyed by VHB staff (formerly Ecological Engineering, LLP) on 4/30/2018 for small-anthered bittercress (Cardamine
micranthera) and 8/28/2018 for Schweinitts sunflower (Helianthus schweinitai). No specimens were found within the study area. Additionally, NCNHP
data, dated July 2018, revealed no known occurrences within 1.0 mile of the study area. A mussel survey was conducted by RK&K for James
spinymussel (Parvaspina collina) and green floater (Lasmigona subviridis) in October 2017. Currently, the green floater is not federally listed but may
be during the course of this project. No known specimens of either species were located in the survey area. NCNHP data, accessed March 2018,
shows occurrences of both species 0.1 stream miles downstream of the bridge. Due to the proAmity of the known occurrence of James spinymussel
and green floater the biological conclusion for both species is MANLAA. The project is consistent with the final Section 4(d) rule for northern long-
eared bats.
Consultation Documentation Upload
B-4819_Mussel Survey Report.pdf
6.75MB
Stokes 105 Small anthered bittercress Survey 20180503.pdf
74.7KB
Stokes105SchweinitzsSunflowerSurvey_20180828.pdf
226.29KB
NLEB sec 7 4d B-4819.pdf
152.4KB
MANLAA concurrence Bridge 105 Pitzer Stokes.pdf
163.5KB
19-196_Bridge Replacement, Bridge no. 105 Pitzer Rd over Snow Creek_ StokesCo..pdf
1.3MB
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
r- 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?*
r Yes
r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
The projectwas reviewed by NCDOT Cultural Resource staff for the presence of Historic Architectural and Archaeological resources. A survey was
required for Archaeology. The 2017 survey did not find evidence of any archaeological sites that would affect this project. Through coordination with
SHPO, it was determined that there were no surveys required for Historic Architecture.
7c. Historic or Prehistoric Information Upload
17-134819 TIP B-4819 No NRHP archaeological sites present Bridge No 105 on SR 1697 Stokes County.pdf 2.14MB
B-4819 Historic Architecture documentation.pdf 13.02KB
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
r Yes r No
8b. If yes, explain how project meets FEMA requirements:
Project meets the requirements of MOA Type 2a, see attached in miscellaneous documents
8c. What source(s) did you use to make the floodplain determination?*
Floodplain Risk Information System
Miscellaneous
Comments
Miscellaneous attachments not previously requested.
B-4819_Final_Approval.pdf 1.5MB
Stokes 105 Cover Letter.pdf 142.01KB
Signature U

W 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 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:
Amy Euliss
Signature
Date
5/10/2019