20120861 Ver 1_Application_20120919

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STATE OF NORTH CAROLINA
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DEPARTMENT OF TRANSPORTATION "T y
BEVERLY EAVES PERDUE
GOVERNOR
September 12 2012
USACE
Raleigh Regulatory Field Office
3331 Heritage Trade Drive
Suite 105
Wake Forest NC 27587
Attention Eric Alsmeyer
NCDOT Coordinator
EUGENE A CONTI JR
SECRETARY
2
Q�.
Subject Replacement of Bridge No 420 over Little Black Creek on SR 2756 in Wake County
Project Number (aka WBS Element No) 17BP 5 R 19
Dear Sir
The North Carolina Department of Transportation ( NCDOT) proposes to replace this bridge This
project is similar in nature to projects processed under the Low Impact Bridge Replacement Program
( LIBRP) Accordingly the LIBRP format has been utilized in the permitting of this project A site visit
was conducted by USACE and NCDENR DWQ on January 20 2012 The following are attached to this
cover letter
Attachment G Low /Minimal Impact Bridge Data Sheet
USGS Topographic Map
Attachment L NCDENR DWQ Nationwide 3 /WQC 43883 Data Sheet
Stormwater Management Plan
Jurisdictional Resources Summary Sheets
Permit Drawings
If you have any questions or need additional information please contact Mr Chris Murray at (919) 220
4633
Sincerely
a �
COr J W Bowman P E
Division Engineer
c Division 5 file NCDOT
Rob Ridings, NCDENR DWQ
Division Five — 2612 North Duke StrLet Durham North Carolina 27704
Telephone [phone] Fax [phone]

Low /Minimal Impact Brldae Protect Data Sheet
(WBS
1County
IBridge
Number
Description
Stream
Basin
Classification
SIN
Type
Size
Existing Structure
Type
Size
Suff Rating
Proposed Structure
Type
Size
Stream
USACE Impacts (LF
Non 404 Impacts (L'.
Wetlands
USACE Impacts (AC
Non 404 Impacts (A
CAMA Impacts (AC)
NC DWQ Buffers
Ilmpacts (SF)
Buffer Application Required ( >40 ft) (Y /N)
NC DWQ StormWaterlPermit
Required (YI
T &E
Habitat (y /n)
Species Present
Bio Conclusion
Moratorium
Dates
Native/Hatchery
Trout Waters Trout Species Present
Trout Conditions YIN
WRC Reviewer
CAMA I AECs
Essential Fish I Habitat /n
Nav 10 ernn
USCG I Permit
Historic IProperties
Archaeological I Resources
Tribal 11-ands
4 (Resources
6 LWCF I Resources
Wild andIScenic River
Forest Service 1 Lands
TVA I Area
FEMA1Bu out
FEMA Flood Study
USTs Haz Mats
I Relocatees
Location LAT
LONG
Project Comments r
Com
Lead EVgineer
17BP 5 R 19
Wake
Bridge 910420
Bride No 420 over Little Black Creek on
SR 2756
Neuse
C NSW
27 45 3
Inland
20 ft
Single Span
305ft x282ft
609
Single Span
70ft x30ft
50 linear feet
0 linear feet
0 acre
0 acre
Not Applicable
80 linear ft 924 sf BZ1 & 618 sf BZ2
Yes
No
d k d dw dp k N
dw rfw dg m IN
M h m Y
d k d dw dp k N
dw I dg m I N
M h m N
d k d dw dp k N Eft t
dw rf w dg m I N Eff t
M h m N Eff t
Not Applicable
Not Applicable
Not Applicable
Not Applicable
Not Applicable
Not Applicable
Not Applicable
No
Not Applicable
Not Applicable
No Survey Required
No Survey Required
Not Applicable
Not Applicable
Not Applicable
Not Applicable
Not Applicable
Not Applicable
No
No
No
No
35 54365 deg
78 73569 dea
Division Environmental Officer
9/12/2012

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Road SR 2756
Stream Little Black Creek _
tryµ 1 Latitude 35 54365 and Longitude 78 73569
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A �
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H Sullins
Governor Director
Attachment L Low Impact Bridge Replacement Process
Low Impact Bridge Project Number (aka WBS number) 17BP 5 R 19
County Wake
Bridge No 420 over Little Black Creek on SR 2756
This project can be characterized as meeting the parameters associated with the Low
Impact Bridge Process as agreed to on October 6 2009 Accordingly this project
meets the documentation requirements and approval procedures under NEPA as
defined by FHWA for Low Impact Bridge Replacements
Date September 12 2012
Applicant Name J W Bowman P E
Applicant Address 2612 N Duke Street
Durham NC 27704
Primary Contact for Project Chris Murray PWS
Phone Number [phone]
Is this an after the fact application _Yes X No
River Basin Neuse
Stream Classification C NSW (DWQ Index Number 27 45 -3)
Regulatory Authorization Options for this Activity
Federal USACE Nationwide General Permit 3
State General Water Quality Certification #3883
Local None
Project Description Replacement of existing one span bridge (30 5 foot long bridge) with a
longer one span bridge (70 0 foot long bridge)
Permanent Impacts See attached permit drawing and summary sheet Note stream and
riparian buffer impacts
Stormwater Information See attached stormwater management plan
Signature
Print Name C�/L) kvn'r /+ . %� ✓���X
Title J r U S r can C/t ✓� /ur•• Ft^ I �.�n -(l v1 S
Transportation Permitting Unit
1650 Mail Service Center Raleigh North Carolina 27699 1650
Location 2321 Crabtree Blvd Raleigh North Carolina 27604
Phone [phone] FAX [phone]
Internet http l/h2o enr state nc us /nmetlandsl
An Equal Opportunity \ Affirmative Action Employer
Dee Freeman
Secretary
NorthCarolina
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