20090421 Ver 1_Application_20090416

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Pre-'Construction Notification (PCN) Form
A. Applicant Information
1. Processing
Ia. Type(s) of approval sought from the
Corps: X Section 404 Permit ? Section 10 Permit
--------------------
1 b. Specify Nationwide Permit (NWP) num
ber: 3 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps? XYes
1 d Type(s) of approval sought from the DWQ (check all that apply):
X 401 Water Quality Certification - Regular ? Non-404 Jurisdictional General Permit
? 401 Water Quality Certification - Express X Riparian Buffer Authorization
le. Is this notification solely for the record For the record only for DWQ 401
because written approval is not required? Certification:
? Yes X No
1f. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in-lieu
fee program.
1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below.
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
2. Project Information
2a Name of Y
No
For the record only for Corps Permit:
El Yes X No
El Yes X No
XYes El No
? Yes XNo
prole SR 1950, Tuten Road NCDWQ Processing Fee $100
2b. County: Beaufort
2c: Nearest municipality/town: Edward
2d. Subdivision name: N/A
2e. NCDOT only; T.I.P. or state
project no: WBS Element Number 2C.007093
3. Owner Information
3a. Name(s) on Recorded Deed:
3b, Deed Book and Page No.
3c. Responsible Party (for LLC if
3d. Street address:
3e. City, state, zip:
3f. Telephone no.:
3g. Fax no.:
3h. Email address:
Page 1 of 11 I
PCN Form - Version 1.3 December 10, 2008 Version
4. Applicant Information (if different from owner)
4a. Applicant is: X Agent ? Other, specify:
4b. Name: Jay B. Johnson
4c. Business name
(if applicable): North Carolina Department of Transportation
4d. Street address: P.O. Box 1587
4e. City, state, zip: Greenville, NC 27835
4f. Telephone no.: 252-8303490
4g. Fax no.: 252-830-3341
4h. Email address:
5. Agent/Consultant Information (if applicable)
5a. Name:
5b. Business name
(if applicable):
5c. Street address:
5d. City, state, zip:
5e, Telephone no.:
5f. Fax no.:
5g. Email address:
Page 2 of 11
B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): NIA

1 b. Site coordinates (in decimal degrees): Latitude: N 35.320153 Degrees Longitude:
- W 76.903577 Degrees
(DD.DDDDDD) (-DD.DDDDDD)
1 c. Property size: N/A acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
proposed project: Durham Creek
2b. Water Quality Classification of nearest receiving water: C;NSW
2c. River basin: Tar-Pamlico
3. Project Description
3a. 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 Surrounding Area is Wooded and Agricultural With Single Family Homes
3b. List the total estimated acreage of all existing wetlands on the property:
N/A
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
NIA
3d. Explain the purpose of the proposed project:
Pipe to Pipe Replacement
3e. Describe the overall project in detail, including the type of equipment to be used:
Use Highway Construction Equipment to Replace the Existing 48" x 40' Pipe with Proposed 2 @ 48"x 48' CMP
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past?
Comments:

XYes No ? Unknown
4b. If the Corps made the jurisdictional determination, what type
of determination was made?
? Preliminary ? Final
4c. If yes, who delineated the jurisdictional areas?
Name (if known): Agency/Consultant company:
Other: NCDOT and NCDWQ
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
5. Project History
5a. Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past? ? Yes X No ? Unknown
5b. If yes, explain in detail according to "help file" instructions.
6. Future Project Plans
6a. Is this a phased project? [? Yes X No
6b. If yes, explain.
Page 3 of 11
PCN Form - Version 1'.3 December 10, 2008 Version
C. Proposed Impacts Inventory
1. Impacts Summary
I a. Which sections were completed below for your project (check all that apply):
XWetlands XStreams - tributaries XBuffers
? Open Waters ? Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a. 2b: 26. 2d. 2e. 2f.
Wetland impact Type of jurisdiction
number - Type of impact Type of wetland Forested (Corps - 404, 10 Area of impact
Permanent (P) or (if known) DWQ - non-404, other) (acres)
Temporary (T)
W1 X P ? T Fill Bottonland X Yes X Corps 0.09
Hardwood Forest .? No ? DWQ
W2 ? P ? T ? Yes ? Corps
? No ? DWQ
W3' ? P ? T ? Yes ? Corps
? No ? DWQ
W4 ? PEI T ? Yes ? Corps
? No ? DWQ
W5 ? PEI T ? Yes ? Corps
? No ? DWQ
W6 ? P ? T ? Yes ? Corps
? No ? DWQ
2g. Total wetland impacts 0.09
2h. Comments:
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a. 3b. 3c. 3d. 3e. 3f. 3g.
Stream impact Type of impact Stream name Perennial Type of jurisdiction Average Impact
number- (PER) or (Corps-404,10 stream length
Permanent (P) or intermittent DWQ - non-404, width (linear
Temporary (T) (INT)? other) (feet) feet)
Un-Named

S1 X P ? T Excavation for Tributary of X PER X Corps
10
8
Pipes Durham El INT X DWQ
Creek
S2 ? P ? T ? PER ? Corps
? INT ?.DWQ
S3 ? P ? T ? PER ? Corps
? INT ? DWQ
S4 ? P ? T ? PER ? Corps
? INT ? DWQ
S5 ? P ? T ? PER ? Corps
? INT ? DWQ
S6 ? P ? T ? PER . ? Corps
? INT ? DWQ
3h. Total stream and tributary impacts 8'
3i. Comments: Proposed Pipes Are Under the 40' Threshhold
Page 4 of 11
PCN Form - Version 1.3 December 10, 2008 Version
4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individual) list all open water impacts below.
4a.
Open water
impact number -
Permanent (P) or
Tem ora T 4b.
Name of waterbody
(if applicable) 4c.

Type of impact 4d.

Waterbody type 4e.

Area of impact (acres)
01 ?P?T
02 ?P?T
03 ?P?T
04 ?. P ? T
4f. Total open water impacts 0.0
4g. Comments:
5. Pond or Lake Construction
If pond or lake construction proposed, then complete the chart below.
5a.

Pond ID 5b.

Proposed use or purpose 5c.
Wetland Impacts (acres) 5d.
Stream Impacts (feet) 5e.
Upland
(acres)
number of pond
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
P2
5f. Total 0.0 0.0 0.0
5g. Comments:
5h. Is a dam high hazard permit required?
? Yes X No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
Page 5 of 11
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If any impacts require mitigation, then you MUST fill out Section D of this form.
6a.
Neuse XTar-Pamlico ? Other:
Project is in which protected basin? ? Catawba ? Randleman
6b. 6c. 6d. 6e. 6f. 6g.
Buffer impact
number- Reason Buffer Zone 1 impact Zone 2 impact.
Permanent (P) or for Stream name mitigation (square feet) (square feet)
Temporary impact re hired?

B1 XP ? T Pipe
Replac Un-Named Tributary of ? Yes
2,265 Sq. Ft.
1,475 Sq. Ft.
ement Durham Creek X No
B2 ?P?T ?Yes
? No
B3 ?P?T ?Yes
? No
6h. Total buffer impacts 2,265 Sq. Ft. 1,475 Sq. Ft.
6i. Comments:
Page 6 of 11
D. Impact Justification and Mitigation
1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
All Construction Equipment Will Be Operated Within The Footprint of the Existing Roadway So As To Prevent
The Disturbance Of Any Vegetated Areas Or Jurisdictional Waters At The Site
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? ? Yes XNo
2b. If yes, mitigation is required by (check all that apply): ? DWQ ? Corps

2c. If yes, which mitigation option will be used for this

project? ? Mitigation bank

El Payment to in-lieu fee program

? Permittee Responsible Mitigation
3.. Complete if Using a Mitigation Bank N/A
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter) Type Quantity
3c. Comments:
4. Complete if Making a Paymentto In-lieu Fee Program N/A
4a. Approval letter from in-lieu fee program is attached. ? Yes
4b. Stream mitigation requested: linear feet
4c. If using stream mitigation,. stream temperature: ? warm ? cool ?cold
4d. Buffer mitigation requested (DWQ only): square feet
4e. Riparian wetland mitigation requested: acres
4f. Non-riparian wetland mitigation requested: acres
4g. Coastal (tidal) wetland mitigation requested: acres
4h. Comments:
5. Complete if Using a Permittee Responsible Mitigation Plan N/A
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
Page 7 of 11
PCN Form - Version 1.3 December 10, 2008 Version
6. Buffer Mitigation (State Regulated Riparian Buffer Rules) - required by DWQ N/A
6a. Will the project result in an impact within a protected riparian buffer that requires
buffer mitigation? ? Yes X No
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.

Zone 6c.
Reason for impact 6d.
Total impact
(square feet)
Multiplier 6e.
Required mitigation
(square feet)
Zone 1 3 (2 for Catawba)
Zone 2 1.5
6f. Total, buffer mitigation required:
6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in-lieu fee fund).
6h. Comments: Proposed Pipes are under the 40' Threshhold
Page 8 of 11
E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
la . Does the project include or is it adjacent to protected riparian buffers identified X Yes ? No
within one of the NC Riparian Buffer Protection Rules?
1 b . If yes, then is a diffuse flow plan included? If no, explain why.
X Yes ? No
Comments:
2. Stormwater Management Plan
2a . What is the overall percent imperviousness of this project? 0%
2b . Does this project require a Stormwater Management Plan? ? Yes X No
2c . If this project DOES NOT require a Stormwater Management Plan, explain why: This Project Will Result In No Net
Increase Of Impervious Surface. During Construction, All Appropriate Stormwater and Erosion Control BMP's
Will Be Strictly Utilized. NCDOT has a NPDES Permit that applies to Roads and Bridges.
2d . If this project DOES require a Stormwater Management Plan, then provide a brief, na rrative description of the plan:
? Certified Local Government
2e . Who will be responsible for the review of the Stormwater Management Plan? ? DWQ Stormwater Program
? DWQ 401 Unit
3. Certified Local Government Stormwater Review NIA
3a. In which local government's jurisdiction is this project?
? Phase II
3b. Which of the following locally-implemented stormwater management programs [I NSW
? USMP
apply (check all that apply): ? Water Supply Watershed
? Other:
3c. Has the approved Stormwater Management Plan with proof of approval been ? Yes ? No
attached?
4. DWQ Stormwater Program Review
Coastal counties
? HQW
4a. Which of the following state-implemented stormwater management programs apply ? ORW
(check all that apply): ? Session Law 2006-246
X Other: NODES Permit
4b: Has the approved Stormwater Management Plan with proof of approval been
attached? ? Yes XNo
5. DWQ 401 Unit Stormwater Review N/A
5a. Does the Stormwater Management Plan meet the appropriate requirements? XYes ? No
5b. Have all of the 401 Unit submittal requirements been met? X Yes ? No
Page 9 of 11
PCN Form - Version 1.3 December 10, 2008 Version
F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
la . Does the project involve an expenditure of public (federal/state/local) funds or the ® Yes ? No
use of public (federal/state) land?
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 ? Yes ® No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1c. If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
? Yes ? No
letter.)
Comments:
2. Violations (DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards, ? Yes ® No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. Is this an after-the-fact permit application? ? Yes ® No
2c. If you answered "yes" to one or both of the above questions, provide an explanation o f the violation(s):
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in ? Yes ® No
additional development, which could impact nearby downstream water quality?
3b. If you answered "yes" to the above, submit a qualitative or quantitative cumulative imp act analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
4. Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility.
Page 10 of 11
PCN Form - Version 1.3 December 10, 2008 Version
S. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or ? Yes No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act ? Yes ® No
impacts?

Raleigh
?
5c. If yes, indicate the USFWS Field Office you have contacted. ? A
h
ill
s
ev
e
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
NHP GIS Data Layer and Onsite Observation
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat? ? Yes ® No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
North Carolina Wildlife Resources Commission
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 ? Yes ® No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
North Carolina State Historic Preservation Office
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain? ® Yes ? No
8b. If yes, explain how project meets FEMA requirements: The Pipe Replacements Will Not Raise the Elevation Within The
Floodplain
8c. What source(s) did you use to make the floodplain determination? NC Flood Map
Jay B. Johnson Feb20a 9 13,
Applicant/Agent's Printed Name Ap an gen Signature Date
(Agent's signature is v i only r n a orization letter from the applicant
s ovi ed.
Page 11 of 11

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BEGIN PROJECT
Y= 583306:4025
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Erosion Control Schedule
• Install erosion/sediment control measures according to plans.
• Grading of slopes; 1.5: 1= stabilize with Class B riprap
• Seed all disturbed areas as soon as final grading is completed.
• Clean out and/or rework all temporary sediment control measures after
significant rainfall event (or as otherwise needed). These measures should be
maintained until a permanent vegetative cover is established and project is
complete
0
Pipe Installation Schedule
• Install erosion/sediment control devices per plans.
• Remove material while limiting, as much as possible, material and sediment
from entering the stream and/or escaping from the project.
• Prepare pipe foundation while taking care to limit material and sediment from
entering the stream and/or escaping from the project. Where possible new
grade should be below the existing streambed. Bedding material will be washed
stone.
• Place new pipe and compact fill.
• Install slope protection on outlet and inlet ends of pipe (Class B Granite riprap)
• Establish permanent vegetation as soon as possible
• Remove sediment control devices after project.has stabilized and permanent
vegetative cover is established.
PROJECT N0. 20.007093
CROSS SECTION OF
CULVERT CROSSING
REPLACE EXISTING 48"x40' CUP WITH
PROPOSED 2 v 48" x 48' CMP
ROAD
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- EXISTING 48' x 40' CMP
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