20190771 Ver 1_PCN Form Submission_20190610

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
Change only if needed.
BIMS # Assigned
20190771
Is a payment required for this project?*
r No payment required
r Fee received
r Fee needed - send electronic notification
Select Project Reviewer*
Donna Fbod:eads\drhood
Information for Initial Review
1a. Name of project:
Replacement of Bridge #890129 over Lanes Creek
1a. Who is the Primary Contact?*
Larry Thompson - NCDOT Division 10
1b. Primary Contact Email:*
[e-mail]
Date Submitted
6/10/2019
Nearest Body of Water
Lanes Creek
Basin
Yadkin-PeeDee
Water Classification
Ws-V
Site Coordinates
Version# *
1
Reviewing Office*
Mooresville Regional Office - [phone]
1c. Primary Contact Phone:*
[phone]
Latitude:
Longitude:
34.849356
-80.449833
AProcessing Information
U
County (or Counties) where the project is located:
Union
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-5806
WBS # (?)
17BP.10.R.152
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: 03 - Maintenance
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
fJ 401 Water Quality Certification - Regular
F Non-404 Jurisdictional General Permit
F Individual Permit
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?*
C 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?
C Yes t No
Acceptance Letter Attachment
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?
C Yes r No
F. Applicant Information
1d. Who is applying for the permit?
[J Owner r Applicant (other than owner)
le. Is there an Agent/Consultant for this project?
r Yes C No
2. Owner Information
2a. Name(s) on recorded deed:
NCDOT Division 10
2b. Deed book and page no.:
N/A
2c. Responsible party:
2d. Address
Street Address
716 Main Street
Address Line 2
City
State / Frwinee / R�gion
Albemarle
NC
Fbstal / Zip Code
Q�untry
28001
USA
2e. Telephone Number:
2f. Fax Number:
[phone]
[phone]
2g. Email Address:*
*
r Yes C No
r Yes C No

[e-mail]
C. Project Information and Prior Project History U
1. Project Information
1b. Subdivision name:
(i appropriate)
1c. Nearest municipality/ town:
Monroe
2. Project Identification
2a. Property Identification Number:
2b. Property size:
WA
2.5
2c. Project Address
Street Address
SR 2111 (Belk Mill Road) at Lanes Creek
Address Une 2
aty
State / Province / fbgion
Monroe
NC
Fbstal / Zip Code
(Duntry
USA
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Lanes Creek
3b. Water Resources Classification of nearest receiving water:*
WS-V
3c. What river basin(s) is your project located in?*
Yadkin-PeeDee
3d. Please provide the 12-digit HUC in which the project is located.
030401050601
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:*
Ebsting conditions include SR 2111 (Belk Mill Road), agricultural land, residential property, undeveloped forest, and the disturbed/maintained right-of-way.
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)
USGS Figure from B5806 NRTR.pdf
1.88 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)
B5806_Union_Bridge129_Figure2_SoilsMap.pdf 1.71 MB
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:
151
4h. Explain the purpose of the proposed project:*
To remove Bridge #890129 and replace with a new, modern bridge structure.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
Erosion and sedimentation control measures will be installed. Bridge demolition will include the removal of the bridge deck and the removal of the top portion of the bridge piers and
abutments, leaving the footer and approbmately one foot of the masonry abutment to match the excavation elevation and temporary impacts to 123 linear feet to Lanes Creek may
result. Bridge replacement construction using heavy equipment from the upland roadway approaches. No deck drains are proposed on the bridge and runoff from the bridge will be
routed to two catch basins on the west side of the bridge and discharged to the stream floodplain. The proposed bridge will be built on the same alignment with a temporary off -site
detour.
4j. Please upload project drawings for the proposed project.
B-5806_Permit _Plans _2019-05-29.pdf
B-5806_HYD_SMP.pdf
1.63MB
178.83KB
5. Jurisdictional Determinations

5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes r No
Comments:
See attached NRTR prepared by RK&K for delineation information and waters mapping.
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
r Preliminary r Approved r Not Verified r Unknown r N/A
Corps AID Number:
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
Sd1. Jurisdictional determination upload
B5806 NRTR.pdf
JD Figure from B5806 NRTR.pdf
6. Future Project Plans
David Ward
Rummel Klepper and Kahl, LLP
6.87MB
3.01 MB
r Unknown
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?
D. Proposed Impacts Inventory
1. Impacts Summary
la. 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
r Buffers
U
3a. Reason for impact (?) 3b.lmpact type * 3c. Type of impact* 3d. S. name * 3e. Stream Type * [3frrypef. of 3g. S. width * 3h. Impact
(?) isdiction* length*
i1 Bridge replacement Temporary Other Lanes Creek Perennial Both 30 F12ear feet)
31. Total jurisdictional ditch impact in square feet
0
31. Total permanent stream impacts: 31. Total temporary stream impacts:
0 123
3i. Total stream and ditch impacts:
123
3j. Comments:
Temporary impacts which may result are associated with the demolition of the eAsting bridge and the construction of the proposed bridge that may
impact a portion of Lanes Creek.
F. Impact Justification and Mitigation
1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
Replace bridge in -place was incorporated to minimize impacts. The bridge span length was eMended to avoid impacts. Riprap protection of the bridge
abutments is being placed outside of the jurisdictional stream boundary of the perennial stream (aka, Lanes Creek) where possible to avoid impacts.
Work will be conducted from the upland roadway approaches.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
NCDOT Best Management Practices for Construction and Maintenance Activities will be employed. Demolition and construction methods from the
upland roadway approaches will be used to minimize potential temporary demolition related impacts and avoid construction related impacts.
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:
Minimal potential temporary impacts of 123 linear feet to Lanes Creek may occur and no part of the stream bed will be impacted.
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:
Project is located in the Yadkin -Pee Dee River Basin and is not subject to NC Riparian Buffer Protection Rules.
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:
Stormwater runoff from the proposed bridge will be routed to catch basins located on the southwest and northwest sides of the bridge. No deck drains are proposed. Please see
attached Stormwater Management Plan for details on the minimization of water quality impacts.
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
1c. If you answered "yes" to the above, has the document review been finalized by the State Clearing House?*
r Yes r No
Comments:
The Categorical Exclusion document has been finalized and approved by the NCDOT. See Miscellaneous for NCDOT signed Categorical Exclusion
Approval.
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.
Project involves the replacement of an existing bridge and is not anticipated to affect future development.
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
Se. 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
r 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.?
r^ Yes r No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
NCDOT Biological Surveys Group Mussel Survey and NCNHP site specific information is attached. Brandon Phillips of STV Engineers, Inc. conducted
surveys on 10-3-18 for Schweinitts sunflower and 5-24-19 for Michauxs sumac and no protected species were observed.
Consultation Documentation Upload
17BP.10.R.152 Mussel Survey Report.pdf 8.04MB
NCNHP_17bp10r152_bridge_129_union_04302019.pdf 755.97KB
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 EFH 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?*
See attached "No Archaeological Survey Required Form" and "Historic Architecture and Landscapes No Historic Properties Present or Affected Form."
7c. Historic or Prehistoric Information Upload
16-02-0052 PA_B-5806 No Archaeological Survey Required Form Br 129 on SR 2111 Lanes Creek Union.pdf 688.83KB
16-02-0052NHPA.pdf 3.8MB
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:
NCDOT Hydraulics Unit coordination with FEMA.
8c. What source(s) did you use to make the floodplain determination?*
FEMA FIRM maps
Miscellaneous
Comments
Please see attached site photographs. Project previously identified as 17BP.10.R.152 and has been changed to B-5806.
Miscellaneous attachments not previously requested.
B-5806 Photopages.pdf
Pages from Signed_B-5806_Final_CE_05202019.pdf
Signature
*
W By checking the box and signing below, I certify that:
14.27MB
143.6KB

• 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:
Larry Thompson
Signature
Date
6/10/2019