20120975 Ver 1_Application_20121024

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OCT 242012
STATE OF NORTH CAROLINA
DENR WETLANDS AND STOR AT WATER DEPARTMENT OF TRANSPORTATION
BEVERLY EAVES PERDUE EUGENE A CONTI JR
GOVERNOR SECRETARY
October 17 2012
U S Army Corps of Engineers
Regulatory Field Office
69 Darlington Avenue
Wilmington North Carolina 28403 12 0 9 t,-,,
Attention Mr Ronnie Smith
NCDOT Coordinator
Dear Sir
Subject Application for Section 404 Nationwide Permits (NWP) 23, 33 & 12, and
Section 401 Water Quality Certification for the replacement of Bridges No 116
& 117 over Hog Swamp on SR 2262 (Bethesda Church Road) in Robeson TIP
Project B 4619 Federal Aid Project No BRZ 2262 (1), Debit $240 from WBS
No 33800 1 1
Please find enclosed PCN permit drawings stormwater management plan and roadway plans
for the above referenced project proposed by the North Carolina Department of Transportation
(NCDOT) A Categorical Exclusion (CE) was completed for this project on June 22 2009 and
distributed shortly thereafter Additional copies are available upon request The NCDOT
proposes to replace existing Bridges No 116 and 117 over Hog Swamp on SR 2262 in Robeson
County The project involves replacement of the existing structurally deficient bridges and
approaches with new structures Bridge 116 will be replaced with a new 170 foot long bridge
and Bridge 117 with a new 120-feet long bridge Both bridges will include two 11 foot lanes and
4-foot offsets on each side The approach roadway will be widened to a 22 foot pavement width
to provide two 11 foot lanes with six foot shoulders on each side
Proposed permanent impacts to riparian wetlands from bridge construction are 0 02 acre of fill
and 0 03 acre of excavation A temporary work pad will be needed to construct Bridge No 116
and this will involve 0 03 acre of temporary fill in wetlands Utility relocations will require less
than 0 01 acre of fill in wetlands with 0 36 acre of hand clearing Traffic will be detoured off
site during construction
This project calls for a letting date of July 16 2013 and a review date of May 28 2013 however,
the let date may advance as additional funding becomes available
MAILING ADDRESS LOCATION
NC DEPARTMENT OF TRANSPORTATION TELEPHONE [phone]
PROJECT DEVELOPMENT AND ENVIRONMENTAL ANALYSIS FAX [phone] 1020 BIRCH RIDGE DRIVE
NATURAL ENVIRONMENT SECTION RALEIGH NC 27610 4328
1598 MAIL SERVICE CENTER
RALEIGH NC 27699 1598 WEBSITE WWW NCDOT ORG

• of WAT Office Use Only
` o\-' ' o� Corps action ID no
I
,., > - DWQ project no
Form Version 1 3 Dec 10 2008
Pre-Construction Notification (PCN) Form
A Applicant Information
1 Processing
1 a Type(s) of approval sought from the
Corps ® Section 404 Permit ❑ Section 10 Permit
1 b Specify Nationwide Permit(NWP) number 23 33 & 12 or General Permit(GP) number
1 c Has the NWP or GP number been verified by the Corps? ❑ 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
El 401 Water Quality Certification—Express ❑ Riparian Buffer Authorization
le Is this notification solely for the record For the record only for DWQ 401 For the record only for Corps Permit
because written approval is not required? Certification
❑Yes ® No ❑ Yes ® No
1f Is payment into a mitigation bank or in lieu fee program proposed for mitigation ❑ Yes ® No
of impacts? If so attach the acceptance letter from mitigation bank or in lieu
fee program
1 g Is the project located in any of NC s twenty coastal counties If yes answer 1 h ❑Yes ® No
below
1 h Is the project located within a NC DCM Area of Environmental Concern (AEC)? ❑Yes ® No
2 Project Information
2a Name of project Replacement of Bridge Nos 116& 117 over Hog Swamp on SR 2262 (Bethesda
Church Road)
2b County Robeson
2c Nearest municipality/town Fairmont
2d Subdivision name not applicable
2e NCDOT only T I P or state B 4619
project no
3 Owner Information
3a Name(s)on Recorded Deed North Carolina Department of Transportation
3b Deed Book and Page No not applicable
3c Responsible Party(for LLC i f not applicable
applicable)
3d Street address 1598 Mail Service Center
3e City state zip Raleigh NC 27699 1598
3f Telephone no [phone]
3g Fax no [phone]
3h Email address gcashin @ncdot gov
1

4 Applicant Information (if different from owner)
4a Applicant is ❑Agent ❑ Other specify
4b Name not applicable
4c Business name
Of applicable)
4d Street address
4e City state zip
4f Telephone no
4g Fax no
4h Email address
5 Agent/Consultant Information (if applicable)
5a Name not applicable
5b Business name
Of applicable)
5c Street address
5d City state zip
5e Telephone no
5f Fax no
5g Email address
2

B Project Information and Prior Project History
1 Property Identification
la Property identification no (tax PIN or parcel ID) not applicable
Latitude 34 426244
lb Site coordinates (in decimal degrees) Longitude 79 109067
(DD DDDDDD) (DD DDDDDD)
1c Property size 23 1 acres
2 Surface Waters
2a Name of nearest body of water(stream river etc)to Hog Swamp
proposed project
2b Water Quality Classification of nearest receiving water C Sw
2c River basin Lumber River Basin
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
Agriculture with residential along roadways and forested stream corridors
3b List the total estimated acreage of all existing wetlands on the property
13 87
3c List the total estimated linear feet of all existing streams(intermittent and perennial) on the property
Two channels of Hog Swamp 553 feet and 570 feet
3d Explain the purpose of the proposed project
To replace two structurally deficient bridges
3e Describe the overall project in detail including the type of equipment to be used
The project involves replacing two bridges on the existing alignment using an off site detour Standard road building
equipment such as trucks dozers and cranes will be used
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 Richard Spencer visited the site on July 15 ®Yes ❑ No ❑ Unknown
2008 but no JD was issued JD is requested with this
application
4b If the Corps made the jurisdictional determination what type
Li Preliminary ❑ Final
of determination was made?
4c If yes who delineated the jurisdictional areas? Agency/Consultant Company ESI
Name(if known) Matt Smith Nicole Loft 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 ❑ Yes [E No ❑ Unknown
for this project(including all prior phases) in the past?
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
3

C Proposed Impacts Inventory
1 Impacts Summary
la Which sections were completed below for your project(check all that apply)
®Wetlands ❑ Streams tributaries ❑ Buffers
® 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 2c 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)
Site 1 ® P ❑ T fill riparian ® Yes ® Corps 0 02
❑ No ❑ DWQ
Site 1 ® P ❑ T excavation riparian ® Yes ® Corps 0 01
❑ No ❑ DWQ
Site 2 ® P ❑ T fill riparian ® Yes [E] Corps <0 01
❑ No ❑ DWQ
Site 2 ❑ P ® T fill riparian ® Yes ® Corps 0 03
❑ No ❑ DWQ
Site 2 ® P ❑T excavation riparian ® Yes ® Corps 0 01
❑ No ❑ DWQ
Site 6 ❑ P ❑ T ❑Yes ❑ Corps
❑ No ❑ DWQ
2g Total wetland impacts 0 05 Perm
0 03 Temp
2h Comments There will be 0 12 ac of hand clearing due to bridge construction &0 36 ac due to utility relocation Due to
rounding site impacts do not match those on the impact summary sheet however total impacts are the same
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 Average Impact
number (PER) or jurisdiction stream length (linear
Permanent(P) or intermittent (Corps 404 10 width feet)
Temporary (T) (INT)? DWQ—non 404 (feet)
other)
Site 1 ❑ P ❑T ❑ PER ❑ Corps
❑ INT ❑ DWQ
Site 2 ❑ P ❑ T ❑ PER ❑ Corps
❑ INT ❑ DWQ
Site 3 ❑ POT
❑ PER ❑ Corps
❑ INT ❑ DWQ
Site 4 ❑ P ❑ T ❑ PER ❑ Corps
❑ INT ❑ DWQ
Site 5 ❑ P ❑ T ❑ PER ❑ Corps
❑ INT ❑ DWQ
Site 6 ❑ P ❑ T ❑ PER ❑ Corps
❑ INT ❑ DWQ
3h Total stream and tributary impacts 0 0 Perm
0 0 Temp
3i Comments
4

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 individually list all open water impacts below
4a 4b 4c 4d 4e
Open water Name of
impact number— waterbody Type of impact Waterbody type Area of impact(acres)
Permanent(P) Of applicable)
or Temporary (T)
01 ® P El T Gum Swamp Permanent <0 01
02 ❑ P Z T Gum Swamp Temporary 0 02
03 ❑ P ❑ T
04 ❑ P ❑T
4f Total open water impacts
<0 01 Permanent
0 02 Temporary
4g Comments
5 Pond or Lake Construction
If pond or lake construction proposed then complete the chart below
5a 5b 5c 5d 5e
Wetland Impacts (acres) Stream Impacts (feet) Upland
Pond ID Proposed use or (acres)
number purpose of pond
Flooded Filled Excavated Flooded Filled Excavated Flooded
P1
P2
5f Total
5g Comments
5h Is a dam high hazard permit required?
❑Yes ❑ No If yes permit ID no
51 Expected pond surface area(acres)
5j Size of pond watershed (acres)
5k Method of construction
5

6 Buffer Impacts (for DWQ)
If project will impact a protected ripanan 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 ❑ Tar Pamlico ❑ Other
Project is in which protected basin? ❑ Catawba ❑ Randleman
6b 6c 6d 6e 6f 6g
Buffer impact
number— Reason for impact Buffer Zone 1 impact Zone 2 impact
Permanent(P) or Stream name mitigation (square feet) (square feet)
Temporary (T) required? _
B1 ❑ P ❑T ❑Yes
❑ No _
B2 ❑ P ❑T El
❑ No
B3 ❑ P ❑T ❑ Yes
❑ No
6h Total buffer impacts
6i Comments
6

D Impact Justification and Mitigation
1 Avoidance and Minimization
la Specifically describe measures taken to avoid or minimize the proposed impacts in designing project
The proposed bridges are longer than the existing bridge the proposed bridges will be at approximately the same grade
as the existing structures an off site detour will be used Slopes of 2 4 1 or 3 1 will be constructed in wetlands
lb Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques
Sub regional tier design guidelines for bridge projects were used to develop this project Best management practices
include replacement of bridges along existing alignment minimization of fill slopes and use of hand clearing as opposed
to mechanized clearing
2 Compensatory Mitigation for Impacts to Waters of the U S or Waters of the State
2a Does the project require Compensatory Mitigation for ❑Yes No
impacts to Waters of the U S or Waters of the State? If no explain Due to the minimal amount of impacts
compensatory mitigation is not proposed
2b If yes mitigation is required by (check all that apply) ❑ DWQ ❑ Corps
❑ Mitigation bank
2c If yes which mi tigation option will be used for this ❑ Payment to in lieu fee program
project?
❑ Permittee Responsible Mitigation
3 Complete if Using a Mitigation Bank
3a Name of Mitigation Bank not applicable
3b Credits Purchased (attach receipt and letter) Type Quantity
3c Comments
4 Complete if Making a Payment to In lieu Fee Program
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
5a If using a permittee responsible mitigation plan provide a description of the proposed mitigation plan
7

6 Buffer Mitigation (State Regulated Riparian Buffer Rules)—required by DWQ
6a Will the project result in an impact within a protected riparian buffer that requires ❑Yes ® No
buffer mitigation?
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
6c 6d 6e
Zone Reason for impact Total impact Multiplier Required mitigation
(square feet) (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
8

E Stormwater Management and Diffuse Flow Plan (required by DWQ)
1 Diffuse Flow Plan
1a Does the project include or is it adjacent to protected riparian buffers identified ❑Yes ® No
within one of the NC Riparian Buffer Protection Rules?
lb If yes then is a diffuse flow plan included? If no explain why
❑ Yes ❑ No
Comments
2 Stormwater Management Plan
2a What is the overall percent imperviousness of this project? N/A
2b Does this project require a Stormwater Management Plan? ® Yes ❑ No
2c If this project DOES NOT require a Stormwater Management Plan explain why
2d If this project DOES require a Stormwater Management Plan then provide a brief narrative description of the plan
See attached permit drawings
❑ 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
3a In which local government s jurisdiction is this project? not applicable
❑ Phase II
3b Which of the following locally implemented stormwater management programs ❑ NSW
USMP
apply(check all that apply) ❑
❑Water Supply Watershed
El Other
3c Has the approved Stormwater Management Plan with proof of approval been El Yes ❑ No
attached?
4 DWQ Stormwater Program Review
❑ Coastal counties
4a Which of the following state implemented stormwater management programs apply ❑ HQW
(check all that apply) ❑ ORW
❑ Session Law 2006 246
❑ Other
4b Has the approved Stormwater Management Plan with proof of approval been
attached? ❑Yes ❑ No
5 DWQ 401 Unit Stormwater Review
5a Does the Stormwater Management Plan meet the appropriate requirements? ❑Yes ❑ No N/A
5b Have all of the 401 Unit submittal requirements been met? ❑ Yes ❑ No N/A
9

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?
r
lb 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)?
1 c 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
letter) ® Yes ❑ No
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 El Yes ® No
or Riparian Buffer Rules (15A NCAC 2B 0200)7
2b Is this an after the fact permit application? El Yes ® No
2c If you answered yes to one or both of the above questions provide an explanation of the violation(s)
3 Cumulative Impacts (DWQ Requirement)
3a Will this project(based on past and reasonably anticipated future impacts) result in El Yes
additional development which could impact nearby downstream water quality? ® No
3b If you answered yes to the above submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy If you answered no provide a short narrative description
Due to the minimal transportation impact resulting from this bridge replacement this project will neither influence nearby
land uses nor stimulate growth Therefore a detailed indirect or cumulative effects study will not be necessary
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
not applicable
10

5 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?
El Raleigh
5c If yes Ind icate the USFWS Field Office you have contacted
El Asheville
5d What data sources did you use to determine whether your site would impact Endangered Species or Designated Cntical
Habitat?
USFWS County Site NC Natural Heritage site
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?
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 ❑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?
NEPA Documentation
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 NCDOT Hydraulics Unit coordination with FEMA
8c What source(s)did you use to make the floodplain determination? FEMA Maps
Dr Gregory J Thorpe, Ph D
pllca LO !6, l Z
Applicant/Agent s Printed Name A n Agent s Signature Date
(Agents signature is valid only if an authorization letter from the applicant
is provided)
11

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PROPERTY OWNERS
NAMES AND ADDRESSES
PARCEL NO NAMES ADDRESSES
1 HOWARD W FAULK JR RT 4 BOX 163 FAIRMONT NC 28340
2 WILLIAM H MITCHELL 407 CHURCH STREET FAIRMONT NC 28340
3 DONNA PREVATTE 2595 BETHESDA CHURCH RD ORRUM NC 28369
4 LIONEL CHAMBERLAIN PO BOX 595 FAIRMONT NC 28340
Permit Drawing
Sheet 12 of13._
NCDOT
DIVISION OF HIGHWAYS
ROBESON COUNTY
PROJECT 3380011 (B-4619)
BRG #116 & /4117 ON SR 2262
(BETHESDA CHURCH ROAD)
OVER HOG SWAMP
SHEET OF 8/3/12

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A
PROP KRTY OWNERS
NERS
NAMES AND ADDRESSES
PARCEL NO NAMES ADDRESSES SITE NO
1 HOWARD W FAULK JR DB 7G PG 424 1
1 HOWARD W FAULK JR DB 7G PG 424 2
2 WILLIAM H MITCHELL DB 19B PG 319 3
NO 1., TI-1 CAI'; OLINA
DIVISION OF HIGHWAYS
ROBESON COUNTY
TIP PROJECT (B-4619)
BRIDGES NO 116 AND 117 ON
Utility Permit Drawing SR 2262
Sheet 3 of y- (BETHESDA CHURCH RD)
OVER HOG SWAMP
8/1/11

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