20191174 Ver 1_PCN Form Submission_20191002

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
20191174
Is a payment required for this project?*
r No payment required
r Fee received
r Fee needed - send electronic notification
Select Project Reviewer*
Joanne Steenhuis:eads\jhsteenhuis
Information for Initial Review
1a. Name of project:
Bridge 61 Repair
1a. Who is the Primary Contact?*
NCDOT
1b. Primary Contact Email:*
[e-mail]
Date Submitted
10/2/2019
Nearest Body of Water
Cross Creek
Basin
Cape Fear
Water Classification
C
Site Coordinates
Latitude:
35.0550
FA. Processina Information
County (or Counties) where the project is located:
Cumberland
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#M
15406.1026112
1a. Type(s) of approval sought from the Corps:
Longitude:
-78.8630
Version# *
1
Reviewing Office*
Wilmington Regional Office - [phone]
1c. Primary Contact Phone:*
[phone]

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:
r 401 Water Quality Certification - Express
r 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?
[J Owner r 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.:
2c. Responsible party:
2d. Address
Street Address
558 Gillespie Street
Address Line 2
City
State / Frwinee / R�gion
Fayetteville
North Carolina
Fbstal / Zip Code
Country
28302
USA
2e. Telephone Number:
2f. Fax Number:
[phone]
[phone]
2g. Email Address:*
*
r Yes r No
r Yes r No

[e-mail]
C. Project Information and Prior Project History U
1. Project Information
1b. Subdivision name:
(d appropriate)
1c. Nearest municipality/ town:
Fayetteville
2. Project Identification
2a. Property Identification Number:
2c. Project Address
Street Address
Address tine 2
City
Fbstal / Zip 03de
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Cross Creek
3b. Water Resources Classification of nearest receiving water:*
C
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.
030300040706
4. Project Description and History
2b. Property size:
State / ftovince / Fbgion
Oxuntry
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:*
Install a temporary Rock Causeway across Cross Creek in order to access the southern side of Bridge 61. The Bent Pedestals have suffered severe erosion as the result of Hurricanes
Matthew and Florence and Rip -rap stone placement is needed to protect the structural integrity of the bridge. The Rock Causeway will be underlaid with Type 2 Fabric with Class II rip -
rap, topped off with crane mats. It is expected that the Rock Causeway will be in place for two weeks or less. Upon completed all disturbed area will be stabilized and the stream bed
returned to it's original condition.
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)
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)
4f. List the total estimated acreage of all existing wetlands on the property:
0 ac
4g. List the total estimated linear feet of all existing streams on the property:
100 If
4h. Explain the purpose of the proposed project:*
Access the southern side of Cross Creek to place rip -rap protection of Bridge 61 Bent Pedestals.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
Project involves accessing down the northern slope at Bridge 61, installing a temporary Rock Causeway, then placing Class II rip -rap at the Bent Pedestals. A Track -hoe Excavator will
place the rip -rap.
4j. Please upload project drawings for the proposed project.
D00090419-09042019094103.pdf 781.55KB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
F Yes r No C Unknown
Comments:
There are no wetlands on the project and Cross Creek is Perennial

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:
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?
DProposed Impacts Inventory
1. Impacts Summary
la. Where are the impacts associated with your project? (check all that apply):
F Wetlands 7 Streams -tributaries
r- Open Waters r- Pond Construction
3. Stream Impacts
F Buffers
3a. Reason for impact (?) 3b.lmpact type * 3c. Type of impact* 3d. S. name* 3e. Stream Type * �[3f. Type of 3gSwidth* 3h. Impact
urisdiction* length*
1 Temp. Rock Causevay Temporary Workpad/Causeway Cross Creek Perennial Both ]�;;;;]
E(0_f:_E
31. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
0
3i. Total stream and ditch impacts:
20
3j. Comments:
The temporary impact area is 720 sf
E. Impact Justification and Mitigation
1. Avoidance and Minimization
31. Total temporary stream impacts:
20
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
There are no alternative designs that would satisfy the projects purpose and need.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Minimized the width of the Rock Causeway
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:
Temporary impacts also below thresholds.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)

1. Diffuse Flow Plan
1a. Does the project include or is it adjacent toprotected riparian buffers identified within one of the NC Riparian Buffer Protection Rules?
r' Yes r No
If no, explain why:
The project is a repair not within an identified Buffer Protection Area.
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
U
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:*
This project is a Maintenance activity that does not require an environmental document.
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 (15ANCAC 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.
The project is a repair
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
r Yes r No r N/A
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?*
r Yes r No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
r Yes r No
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?
NCDOT's Biological Survey Group had completed a survey of the stream to determine if Atlantic Pigtoe was occupying the stream. The determination
was that there were no mussels observed, so, May Affect Not Likely to Adversely Affect.
Consultation Documentation Upload
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?*
NMFS County Index
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?*
B-4949, which was the project that replaced Bridge 61 a few years ago, determined that there were no impacts to cultural resources.
7c. Historic or Prehistoric Information Upload
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:
B-4949 required a MOA coordination with NCDOT Hydraulics Unit and FEMA.
8c. What source(s) did you use to make the floodplain determination?*
FEMA mapping
Miscellaneous
Comments
Miscellaneous attachments not previously requested.
Signature v
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:
James J. RErko, PWS
Signature
�omtO7� S
Date
10/2/2019