20190924 Ver 1_PCN Form Submission_20190712

DWR
IDIOM n 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 * Version#*
20190924 1
Is a payment required for this project?*
r No payment required
r Fee received Reviewing Office*
r Fee needed - send electronic notification Mooresville Regional Office - [phone]
Select Project Reviewer*
Donna Fbod:eads\drhood
Information for Initial Review
1a. Name of project:
Replace Culvert No. 121 over Brown Creek on SR 1230 (Meltonville Church Road)
1a. Who is the Primary Contact?*
Larry Thompson, Environmental Supervisor II, NCDOT Division 10
1b. Primary Contact Email:*
[e-mail]
Date Submitted
7/12/2019
Nearest Body of Water
Brown creek
Basin
Yadkin-PeeDee
Water Classification
C
Site Coordinates
Latitude:
34.881346
Longitude:
-80.301771
1c. Primary Contact Phone:*
[phone]
FA.Processing Information U
County (or Counties) where the project is located:
Anson
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:
17BP.10.C.9
WBS # (?)
17BP.10.C.9
1a. Type(s) of approval sought from the Corps:

W Section 404 Permit (wetlands, streams and waters, Clean Water Act)
F 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)
F' Regional General Permit (RGP)
F' Standard (IP)
1c. Has the NWP or GP number been verified by the 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:
rJ 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:
F 401 Water Quality Certification - Express
F Riparian Buffer Authorization
1f. Is this an after -the -fact permit application?*
r Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
r 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
SR 1230 - Culvert - Division 10 - STIR - YID 104.pdf
1h. Is the project located in any of NC's twenty coastal counties?
r 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?
W Owner F Applicant (other than owner)
le. Is there an Agent/Consultant for this project?
r Yes r No
2. Owner Information
2a. Name(s) on recorded deed:
North Carolina Department of Transportation
2b. Deed book and page no.:
N/A
2c. Responsible party:
N/A
2d.Address
Street Address
716 W Main St.
Address Line 2
qry
Sate / Province / Region
Albemarle
NC
Rstal / Zip Code
(ountry
28001
Stanly
2e. Telephone Number:
2f. Fax Number:
[phone]
[phone]
65.88KB
*
r Yes r No
r Yes r No

2g. Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(d appropriate)
N/A
1c. Nearest municipality/town:
Marshville / Peachland
2. Project Identification
2a. Property Identification Number:
2b. Property size:
N/A
0.6
2c. Project Address
Street Address
SR 1230 (Meltonville Church Road)
Address Line 2
CRY
State / Province / Region
Marshville
NC
Postal / Zip Code
Obuntry
28103
Stanly
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Brown creek
3b. Water Resources Classification of nearest receiving water:*
C
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.
030401040102
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:*
Land use in the project vicinity consists primarily of agriculture, forests and single family residential homes.
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)
Fig_2_17BP_10_C_9_USGS_topo_map.pdf 256.75KB
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)
17BP.10.C.9_Soil Map.pdf 175.78KB
4f. List the total estimated acreage of all existing wetlands on the property:
0.10
4g. List the total estimated linear feet of all existing streams on the property:
1,088
4h. Explain the purpose of the proposed project:*
To replace Anson County Culvert #121 on SR 1230 (Meltonville Church Road) over Brown Creek.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
The existing structure is a triple barrel 96" CMP culvert with wooden headwalls. The proposed structure is a double barrel 12'XS' RCBC buried 1 foot. This structure has been designed
to minimize environmental impacts using 2:1 slopes with guardrail. There are scour holes upstream and downstream of the proposed 12'XS' RCBC which will be filled with rip -rap to
minimize future scour. As part of the project an existing 72" RCP will be replaced with a 66" RCP buried 1' to meet minimum cover requirements. Also, the upstream and downstream
banks of the proposed structure will be reinforced with rip -rap to minimize future scour. Standard construction equipment will be used including trucks, bulldozers, and cranes.
4j. Please upload project drawings for the proposed project.
030121 _HYD_PRM_WET_SET_20190626.pdf
2.67MB
5. Jurisdictional Determinations

5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes r No
Comments:
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:
N/A
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Sara Easterly
Agency/Consultant Company: HDR
Other:
5d1. Jurisdictional determination upload
17BP.10.C.9 SA Stream Form.pdf
113.15KB
17BP.10.C.9 SB Stream Form.pdf
121.69KB
17BP.10.C.9 SC Stream Form.pdf
116.28KB
17BP.10.C.9 WA_WB-Up.pdf
90.76KB
17BP.10.C.9 WA-Wet.pdf
89.91KB
17BP.10.C.9 WB-Wet.pdf
91.43KB
6. Future Project Plans
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?
No
D. Proposed Impacts Inventory
1. Impacts Summary
la. Where are the impacts associated with your project? (check all that apply):
r Wetlands 7 Streams -tributaries r Buffers
r Open Waters r Pond Construction
3. Stream Impacts
u
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
❑
M
Jurisdiction*
length*
S1
' "
66RCP, Buried 1
Permanent
Other
SC, UT to Brown Creek
Intermittent
Corps
P
3
13
Average (feet)
(linear feet)
S2
66" RCP, Buried 1'
Tem ora
p rY
Other
SC, UT to Brown Creek
Intermittent
Cor p s
3
63
Average (feet)
(linear feet)
S3
Bank Stabilization
Permanent
Bank Stabilization
SC, UT to Brown Creek
Intermittent
Corps3
75
Average (feet)
(linear feet)
S4
2 12'XB' RCBC/Scour Hole
@
Permanent
Other
Brown Creek
Perennial
Corps
P s
15
68
Average (feet)
(linear feet)
S5
2@12'XB'RCBC/Scour Hole
Temporary
Other
Brown Creek
Perennial
Corps
15
48
Average (feet)
(linear feet)
S6
Bank Stabilization
Permanent
Bank Stabilization J
Brown Creek
Perennial
Corps
P
15
33
Average (feet)
(linear feet)
S7
Bank Stabilization
Permanent
Bank Stabilization J
SA, UT to Brown Creek
Intermittent
Corps
P
10
41
Average (feet)
(linear feet)
S8
Bank Stabilization
Tem ora
P ry
Bank Stabilization
SA, UT to Brown Creek
Intermittent
Corps
P
10
13
Avenge(feet)
(linear fed)
H
Ditch Relocation
Permanent
Other
SB, UT to Brown Creek
Intermittent
Cor s
P
6
28
Ave age (feet)
(linearfee )
31. Total jurisdictional ditch impact in square feet:
0

31. Total permanent stream impacts:
258
31. Total temporary stream impacts:
124
31. Total stream and ditch impacts:
382
3j. Comments:
Permanent existing channel impacts at Site 1 (SC, UT to Brown Creek) are expected to be 88 feet, 75 feet of which are from bank stabilization.
Temporary impacts at Site 1 are 63 feet. Total permanent impacts at Site 2 (Brown Creek) are 101 feet with 33 feet of those permanent impacts
coming from bank stabilization. There Will be 48 feet of temporary impacts at Site 2. Site 3 (SA, UT to Brown Creek) will have 41 feet of permanent
impacts from bank stabilization and 13 feet of temporary impacts from bank stabilization. Site 4 (SB, UT to Brown Creek) will have 28 feet of permanent
impacts from ditch relocation.
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:
This structure has been designed to minimize environmental impacts using 2:1 slopes with guardrail. There are scour holes upstream and downstream
of the proposed 12'X8' RCBC which will be filled with rip -rap to minimize future scour. As part of the project an existing 72" RCP will be replaced with a
66" RCP buried 1' to meet minimum cover requirements. Also, the upstream and downstream banks of the proposed structure will be reinforced with
rip -rap to minimize future scour.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
NCDOT Best Management Practices for bridge and culvert replacement will be followed as well as Sediment and Erosion Control measures.
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
2c. If yes, mitigation is required by (check all that apply):
r DWR W Corps
2d. If yes, which mitigation option(s) will be used for this project?
r" Mitigation bank W 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:
(linear feet)
109
4d. Buffer mitigation requested (DWR only):
(square feet)
N/A
4f. Non -riparian wetland mitigation requested:
(acres)
N/A
4c. If using stream mitigation, what is the stream temperature:
warm
4e. Riparian wetland mitigation requested:
(acres)
N/A
4g. Coastal (tidal) wetland mitigation requested:
(acres)
WA
4h. Comments
109 linear feet of stream mitigation Will be provided using an in -lieu fee program.
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 in the Yadkin -Pee Dee River basin. No buffer rules exist for this river basin.
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:
See attached

G. Supplementary Information
1. Environmental Documentation
1a. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) 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)
Environmental Policy Act (NEPA/SEPA)? *
r Yes r No
Comments:*
A MCDC was prepared for the project.
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 pipe and culvert replacement project. No additional development will result from 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
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
5i. 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
If yes, please provide details to include type of percussive activity, purpose, duration, and specific location of this activity on the property.
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
USFWS IPAC
Consultation Documentation Upload

17BP.10.C.9_SelfCertification_Letter_20190620.pdf 1.44MB
NHP Project_Report_ TIP_ 17bp10c9_19150_19150.pdf 709.94KB
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?*
National Marine Fisheries Service (NMFS) 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 State Historic Preservation Office (SHPO)
7c. Historic or Prehistoric Information Upload
18-12-0027NoSurveypdf.pdf 3.64MB
AR18-12-0027NoSitesPresent.pdf 2.89MB
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:
The project meets FEMA requirements by matching the existing 100-YR Base Flood Elevation.
8c. What source(s) did you use to make the floodplain determination?*
NC Flood Mapping
Miscellaneous
Comments
Please note NLEB is not listed for Anson County per the USFWS county list updated June 27,2018. Also, the field visit for 17BP.10.C.9 was conducted on November 1, 2018, just one
day outside the optimal survey window of October 31 for SchweiniL, s sunflower (Helianthus schweinitai). There were no stems of Helianthus noted during the site visit. Surveys for
Carolina Heelsplitter (Lasmigona decorata) have been requested; however may be deemed unnecessary.
Miscellaneous attachments not previously requested.
Fig_3_17BP_10_C_9_JS_features _map.pdf 583.42KB
Signature
*
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:
Larry Thompson
Signature
-e-ram0-1-w
Date
7/12/2019