HomeMy WebLinkAbout20120662 Ver 1_Application_20120801Office Use Only
Corps action ID no
DWQ project no
Form Version 1 3 Dec 10 2008
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PCN Form — Version 1 3 December 10 2008 Version
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Pre - Construction Notification PCN) Form
A Applicant Information
1
Processing
la
Type(s) of approval sought from the
Corps
FE Section 404 Permit ❑ Section 10 Permit
1b Specify Nationwide Permit (NWP) number 14 or General Permit (GP) number
1c
Has the NWP or GP number been verified by the Corps?
❑ Yes
® No
1 d
Type(s) of approval sought from the DWQ (check all that apply)
® 401 Water Quality Certification — Regular ❑ Non 404 Jurisdictional General Permit
❑ 401 Water Quality Certification — Express ® Riparian Buffer Authorization
1e
Is this notification solely for the record
because written approval is not required?
For the record only for DWQ 401
Certification
❑ Yes ® No
For the record only for Corps Permit
® Yes ❑ 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
❑ Yes
® No
1g
Is the project located in any of NC s twenty coastal counties If yes answer 1 h
below
❑ Yes
® No
1h
Is the project located within a NC DCM Area of Environmental Concern (AEC)
TO Yes
® No
2
Project Information
2a
Name of project
17BP 2 R 17 Lenoir 163 Bridge To Pipe Replacement SR 1324
Over Canal
WBS Element Number 17BP 2 R 17
Kennedy Home Road
2b
County
Lenoir
2c
Nearest municipality / town
Kinston
2d
Subdivision name
N/A
2e
NCDOT only T I P or state
project no
17BP 2 R 17
3
Owner Information
3a
Name(s) on Recorded Deed
North Carolina Department of Transportation
3b
Deed Book and Page No
N/A
3c
Responsible Party (for LLC if
applicable)
N/A
3d
Street address
105 Pactolus Highway NC 33 P O Box 1587
3e
City state zip
Greenville NC 27835
3f
Telephone no
252 429 2800
3g
Fax no
252 830 3341
3h
Email address
jbjohnson @ncdot gov
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PCN Form — Version 1 3 December 10 2008 Version
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B Project Information and Prior Project History
1 Property Identification
17BP 2 R 17 Lenoir 163 Bridge To Pipe Replacement
1a Property identification no (tax PIN or parcel ID)
SR 1324 Kennedy Home Road Over Canal
Latitude N 35 251571 Longitude W
1b Site coordinates (in decimal degrees)
77 702084
(DD DDDDDD) ( DD DDDDDD)
1c Property size
N/A acres
2 Surface Waters
2a Name of nearest body of water (stream river etc ) to
Falling Creek a Tributary of The Neuse River
proposed project
2b Water Quality Classification of nearest receiving water
C Sw NSW
2c River basin
Middle Neuse 03020202
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
SR 1324 Kennedy Home Road is a paved Secondary State Highway Woodlands and Agriculture dominate the
landscape
3b List the total estimated acreage of all existing wetlands on the property
0 Square Feet (0 0 Acres) of 404 Wetland Impacts For The Bridge To Pipe Replacement
3c List the total estimated linear feet of all existing streams (intermittent and perennial) on the property
60 This site is part of a longer adjacent stream system
3d Explain the purpose of the proposed project
Bridge To Pipe Replacement the existing bridge has deteonated and needs replacing
3e Describe the overall project in detail including the type of equipment to be used
The Existing 76 Long Timber Bridge on Timber Pilings will be replaced with a Proposed 2 @ 112 x 75 x 48 5 CMPA
with Headwalls
4 Jurisdictional Determinations
4a Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
El Yes ®No El Unknown
project (including all prior phases) in the pasty
Comments
4b If the Corps made the jurisdictional determination what type
Preliminary ❑ Final
of determination was made?
4c If yes who delineated the jurisdictional areas?
Agency /Consultant Company
Name (if known)
Other
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
❑ Yes ® No ❑ Unknown
this project (including all prior phases) in the past?
5b If yes explain in detail according to help file instructions
Page 3 of 11
PCN Form — Version 1 3 December 10 2008 Version
5 Endangered Species and Designated Critical Habitat (Corps Requirement)
5a Will this protect occur in or near an area with federally protected species or ❑Yes
habitat?
5b Have you checked with the USFWS concerning Endangered Species Act
impacts? ❑ Yes
(
5c if yes ind icate the USFWS Field Office you have contacted ❑ Raleigh
❑ Asheville
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® No
5d What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
Mr Travis Wilson NCWRC Mr Mike Sanderson NCDOT NEU
6 Essential Fish Habitat (Corps Requirement)
6a Will this protect occur in or near an area designated as essential fish habitat? I ❑ Yes ® No
6b What data sources did you use to determine whether your site would impact Essential Fish Habitat?
Mr Travis Wilson NCWRC
7 Historic or Prehistoric Cultural Resources (Corps Requirement)
7a Will this protect 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?
NCDOT HEU Historic Architecture and Archaeology
8 Flood Zone Designation (Corps Requirement)
8a Will this protect occur in a FEMA designated 100 year floodplain? (� Yes ❑ No
8b If yes explain how protect meets FEMA requirements Designed to no rise standards
8c What source(s) did you use to make the floodplain determination? FEMA FIRM Maps
Jay B Tohnson
August 2012
Applicant/Agent s Printed Name I ir n /giant s Signature Date
(Agents signatu �fp v i nl I an authorization letter from the applicant
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PCN Form — Version 1 3 December 10 2008 Version
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Page 1 of 10
PCN Form – Version 1.3 December 10, 2008 Version
Office Use Only:
Corps action ID no. _____________
DWQ project no. _______________
Form Version 1.3 Dec 10 2008
Pre-Construction Notification (PCN) Form
A. Applicant Information
1. Processing
1a. Type(s) of approval sought from the
Corps: Section 404 Permit Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: 14 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Co rps? Yes No
1d. Type(s) of approval sought from the DWQ (check all that apply):
401 Water Quality Certification – Regular Non-404 Jurisdictional General Permit
401 Water Quality Certification – Express Riparian Buffer Authorization
1e. Is this notification solely for the record
because written approval is not required?
For the record only for DWQ 401
Certification:
Yes No
For the record only for Corps Permit:
Yes 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 mi tigation bank or in-lieu
fee program.
Yes No
1g. Is the project located in any of NC’s twenty coast al counties. If yes, answer 1h
below.
Yes No
1h. Is the project located within a NC DCM Area of En vironmental Concern (AEC)? Yes No
2. Project Information
2a. Name of project: Widen Shoulders US 258/13
WBS Element Number 45191
2b. County: Greene
2c. Nearest municipality / town: Farmville
2d. Subdivision name: N/A
2e. NCDOT only, T.I.P. or state
project no: 45191
3. Owner Information
3a. Name(s) on Recorded Deed: North Carolina Departm ent of Transportation
3b. Deed Book and Page No. N/A
3c. Responsible Party (for LLC if
applicable): N/A
3d. Street address: 105 Pactolus Highway NC 33 P .O. Box 1587
3e. City, state, zip: Greenville, NC 27835
3f. Telephone no.: 252-439-2800
3g. Fax no.: 252-830-3341
3h. Email address: jbjohnson@ncdot.gov
Page 3 of 10
PCN Form – Version 1.3 December 10, 2008 Version
B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID ): US 258/13, 0.4 Miles South of US 13 & US 258
1b. Site coordinates (in decimal degrees):
Latitude: N 35.528942 Longitude: - W
77.609274
(DD.DDDDDD) (-DD.DDDDDD)
1c. Property size: N/A acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, e tc.) to
proposed project:
Sandy Run, Middle Swamp, a Tributary of Contentnea
Creek
2b. Water Quality Classification of nearest receiving w ater: C;Sw, NSW
2c. River basin: Neuse Contentnea 03020203
3. Project Description
3a. Describe the existing conditions on the site and th e general land use in the vicinity of the project at t he time of this
application:
US 258/13 is a paved Federal Highway. Woodlands and Agriculture dominate the landscape.
3b. List the total estimated acreage of all existing wetlands on the property:
2790 Square Feet (0.064 Acres) of 404 Wetland Impacts For The Shoulder Widening
3c. List the total estimated linear feet of all exis ting streams (intermittent and perennial) on the pr operty:
60' This site is part of a longer adjacent stream sys tem
3d. Explain the purpose of the proposed project:
Shoulder Widening ; the existing roadway shoulders ha ve deteoriated and need to be rebuilt and widened.
3e. Describe the overall project in detail, including the type of equipment to be used:
The existing roadway shoulders have deteriorated and need to be rebuilt and widened. Excavators,Dump Trucks ,and
Crane Trucks will be used for the shoulder widening.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinat ions by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past?
Comments:
Yes No Unknown
4b. If the Corps made the jurisdictional determinat ion, what type
of determination was made? Preliminary Final
4c. If yes, who delineated the jurisdictional areas?
Name (if known): Jay Johnson,NCDOT
Agency/Consultant Company:
Other: NCDOT
4d. If yes, list the dates of the Corps jurisdiction al determinations or State determinations and attac h documentation.
June, 2010
5. Project History
5a. Have permits or certifications been requested or obtained for
this project (including all prior phases) in the pas t? Yes No Unknown
5b. If yes, explain in detail according to “help file ” instructions.
6. Future Project Plans
6a. Is this a phased project? Yes No
6b. If yes, explain.