20191197 Ver 1_PCN Form Submission (2)_20190910

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 * Version#*
20191197 1
Is a payment required for this project?*
r No payment required
r Fee received Reviewing Office*
r Fee needed - send electronic notification Central Office - [phone]
Select Project Reviewer*
April Norton:eads\arnorton
Information for Initial Review
1a. Name of project:
Bridge No. 224 over South Buffalo Creek on SR 3000 (McConnell Rd)
la. Who is the Primary Contact?*
NCDOT Division 7, Division Engineer, Mr. Mike Mills, PE
1b. Primary Contact Email:* 1c. Primary Contact Phone:*
[e-mail] [phone]
Date Submitted
9/10/2019
Nearest Body of Water
South Buffalo Creek
Basin
Cape Fear
Water Classification
16-11-14-2; WS-V; NSW
Site Coordinates
Latitude: Longitude:
36.059831-79.725445
FA. Processing Information U
County (or Counties) where the project is located:
Guilford
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:
WBS # (?)
17BP.7.R.116
la. 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?
r 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:
F 401 Water Quality Certification - Express
W 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
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?
C Yes r No
FB. Applicant Information
1d. Who is applying for the permit?
r- Owner rJ 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:
NCDOT
2b. Deed book and page no.:
N/A
2c. Responsible party:
2d.Address
Street Address
PO Box14996
Address Line 2
City
State / Frovinre / R�gion
Greensboro
NC
Fbstal / Zip Code
Q�untry
27415
USA
2e. Telephone Number:
2f. Fax Number:
[phone]
[phone]
2g. Email Address:*
*
r Yes r No
r Yes r No

[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
NC DOT Highway Division 7
3b. Business Name:
3c.Address
Street Address
PO Box14996
Address Line 2
CKY
Greensboro
Postal / Zip Code
27415
3d. Telephone Number:
[phone]
3f. Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality/town:
Greensboro
2. Project Identification
2a. Property Identification Number:
N/A
2c. Project Address
Street Address
Address Line 2
City
Postal / Zip Cade
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
South Buffalo Creek
3b. Water Resources Classification of nearest receiving water:*
16-11-14-2; WS-V; NSW
3c. What river basin(s) is your project located in?*
Cape Fear
State / Frovince / Pagion
NC
Country
USA
3e. Fax Number:
[phone]
2b. Property size:
N/A
State / Frovince / R�gion
Country
3d. Please provide the 12-digit HUC in which the project is located.
030300020104
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:*
The project area is a mix of undisturbed, forested areas, some agricultural operations and some sparse, maintained lawns and residences. There is also a large electric transmission
line to the north and west of the project study area.
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)
Bridge _224_Guilford_USGS.pdf 1.81 MB
4e. Attach an 81/2 X 11 excerpt from the most recent version of the published County NRCS Soil Survey map depicting the project site. (for DWR)
Bridge _224_Guilford _soil.pdf 2.24MB

4f. List the total estimated acreage of all existing wetlands on the property:
-2.75 ac
4g. List the total estimated linear feet of all existing streams on the property:
-120 LF
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 off -site. Erosion and sedimentation control measures will be installed. The proposed structure will be replaced on its existing alignment. The existing structure is a
four span bridge (1 @40'-9", 2@40'-5.5", 1@40' 6.5") reinforced concrete deck on 1-beams. Interior and end bents are reinforced concrete caps on precast, prestressed concrete piles.
The proposed structure is a three span (1 @55, 1 @80, 1 @55), 45" PS Concrete Girder with 4' deep caps. This structure has been designed to have as little environmental, wetland,
and surface water impacts as possible. 2:1 roadway fill slopes will be used near the wetland areas to avoid permanent wetland impacts. The permanent drainage easement (PDE) has
been set to have as little wetland impacts as possible.
To avoid direct discharge of bridge storm water into the receiving water, deck drains are not required for the proposed bridge. Storm water impacts to the stream have been minimized
by utilizing grated inlets and pipes to collect bridge storm water and use rip rap outlet protection at 14+25 RT to dissipate energy to provide a diffuse flow (non -erosive sheet flow) in a
wooded area. This diffuse flowwll run for a distance of 17'+/- before entering the buffer. At the northwest and southwest quadrants there are no existing roadside ditches. At the
northeast quadrant an existing roadside ditch will transition into a V ditch with Class B rip rap at 18+50 LT. The ditch outlets into existing 15" driveway pipe at 17+20 LT where the flow
outlets outside the project easement with a non -erosive velocity and runs approximately 5'+/- before entering the buffer. At the southeast quadrant an existing roadside ditch and an 18"
RCP cross pipe outlets into an existing outlet area onto rip rap outlet protection at 10+60 RT (-Y-) to dissipate energy to provide a diffuse flow (non -erosive sheet flow) in a wooded
area. The diffused flow runs approximately 96'+/- before entering the buffer. Bank stabilization will be installed on both banks to provide protection for the proposed bents. Due to the
nature of low impact bridge replacement, the increases in stormwater discharges (post vs pre condition) are insignificant and the wasting ditches do not need to be modified. Therefore,
additional stormwater measures are not required.
4j. Please upload project drawings for the proposed project.
400224_Permit_Drawings _20190711.pdf 4.22MB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
F Yes
Comments
r No
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
r Preliminary r Approved r Not Verified r Unknown f WA
Corps AID Number:
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Bob Lepsic
Agency/Consultant Company: (formerly with) EPR
Other:
5d1. Jurisdictional determination upload
Bridge 224 Division 7 packet.pdf
GUILFORD-224.pdf
6. Future Project Plans
6a. Is this a phased project?*
r Yes 6 No
15.76MB
165.15KB
f Unknown
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 projector related activity?
No.
[Proposed Impacts Inventory
1. Impacts Summary
la. Where are the impacts associated with your project? (check all that apply):
W Wetlands W Streams -tributaries W Buffers
r Open Waters r Pond Construction
2. Wetland Impacts
2a1 Reason(?) 2b. Impact type * (') 2c. Type of W. * 2d. W. name* 2e. Forested* 2f. Type of �F2g.l.pacl
Jurisdicition * M area*

L- 13+10 to Utility (hand clearing) JT ffornland Hardwood Forest �WA Yes Both 0.010
13+42 (acres)
2g. Total Temporary Wetland Impact
0.010
2g. Total Wetland Impact
0.010
2h. Comments:
The actual acreage of hand clearing is less than 0.01 acres.
3. Stream Impacts
2g. Total Permanent Wetland Impact
0.000
3a. Reason for impact (?)
3b.lmpact type *
3c. Type of impact*
3d. S. name *
3e. Stream Type*
Typeof3g.
S. width *
3h. Impact(?)
F
[3uf.
risdiction*
length*
15+42 to 16+24
Permanent
Bank Stabilization
South Buffalo Creek
Perennial
BothFIL-Average
(feet)
(linear feet)
FIL-
15+42 to 16+24
Tem ora
p ry
Other
South Buffalo Creek
Perennial
Both
40
10
Average (feet)
(linear feet)
FIL-
15+80 to 16+32
Temporary
Workpad/Causeway
South Buffalo Creek
Perennial
Both
40
30
_____]
Average (feet)
(linearfeet)
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts: 3i. Total temporary stream impacts:
70 40
3i. Total stream and ditch impacts:
110
3j. Comments:
Of the 110 linear feet of proposed stream impact, only 70 linear feet is permanent which will only occur on the banks of the channel and will not extend
into the thalweg. There are 10 linear feet of temporary stream impact proposed for actual construction access. A temporary causeway is necessary to
reach the epsting interior bents which will be removed for this project. The temporary causeway is within the proposed permanent limits of rip rap bank
stabilization (and therefore is not additional stream impact).
6. Buffer Impacts (for DWR)
6a. Project is in which protect basin(s)?
Check all that apply.
r Neuse r Tar -Pamlico
r Catawba r Randleman
r Goose Creek P Jordan Lake
r Other
6b. Impact Type
6c. Per or Temp
6d. Stream name 6e. Buffer mitigation required?
6f. Zone 1 impact
6g. Zone 2 impact
Road Crossing/Bridge
P
South Buffalo Creek
No
6,034
1,924
6h. Total buffer impacts:
Zone 1 Zone 2
Total Temporary impacts: 0.00 0.00
Zone 1
Zone 2
Total Permanent impacts: 6,034.00
1,924.00
Zone 1
Zone 2
Total combined buffer impacts: 6,034.00
1,924.00
61. Comments:
The impacts associated with the roadway crossing and bridge fall under the "potentially allowable" category per the Jordan Water Supply Buffer Rules
Table of Uses (15A NCAC 026 .0267 (9))
Supporting Documentation
400224_Permit_Drawings_20190711.pdf 4.22MB
E. Impact Justification and Mitigation

1. Avoidance and Minimization
la. 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, 4 span bridge with a 3 span 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 2:1 to minimize impacts. Impacts to
associated riparian buffers have also been reduced by promoting sheet flowwhere possible and stabilizing existing ditch lines. Newdrop inlets will
carry stormwater off the bridge and discharge at non -erosive velocities outside the riparian buffer area. There are no changes to existing ditch -lines.
An off -site detour will be employed to avoid the need for a temporary, parallel structure.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Erosion and sedimentation BMPs will be installed prior to construction. The outside wetland, stream and riparian areas Will be noted with highly visible
fencing. Water will be diverted around the work 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
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:
The impacts associated with the roadway crossing and bridge fall under the "potentially allowable" category per the Jordan Water Supply Buffer Rules Table of Uses (15A NCAC 02B
.0267 (g)).
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
1. Diffuse Flow Plan
la. 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
What type of SCM are you providing?
r Level Spreader
r Vegetated Conveyance (lower SHWT)
r Wetland Swale (higher SHWT)
r Other SCM that removes minimum 30 % nitrogen
,* 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
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)? *
(' 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 (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?*

O 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 transportation projects — such as widening projects, bridge
replacements and intersection improvements — have a "low 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. wasting residences in the
vicinity), this is not a road on a new location (i.e. there is an eAsting road and bridge structure and thus the area already contains impervious
surfaces) and the project drains to South Buffalo 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?*
r- Yes r Nor WA
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.
Raleigh
5d. Is another Federal agency involved?*
r' Yes r No
5e. Is this a DOT project located within Division's 1-8?
r Yes r No
r Unknown
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
IPaC, NCNHP record review and onsite reconnaissance. Mr. Lepsic conducted a survey for vegetation - including Isotria medeoloides (small whorled
pogonia) and Helianthus schweinitai (Schweinitts sunflower) at the subject site in August 2017. No specimens of either species were found. The
biological conclusion for both plants is No Effect.
Consultation Documentation Upload
Guilford_Pogonia_TE_Lttr.pdf 92.24KB
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?*
This project takes place in Guilford 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?*
r 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 December 2016 and NCDOT Architectural Historians reviewed the project study area in
December 2016 and determined there were no eligible resources within the area. Letters are attached.
7c. Historic or Prehistoric Information Upload
17BP.7.R.116_No Archaeological Survey Required Form 400224 Guilford .pdf 6.5MB
17BP.7.R.116_No Survey Form Required Historic Archictecture 400224.pdf 3.96MB
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 MOA
8c. What source(s) did you use to make the floodplain determination?*
FEMA Flood Map Service Center
Miscellaneous
Comments

Miscellaneous attachments not previously requested.
Signature
m 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:
James Michael Mills
Signature A� �'+
� r Q /,2d,
Date
9/10/2019