20221112 Ver 1_ePCN Application_20220818

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Pre-Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
April 13,2022 Ver 4.3
Initial Review
Has this project met the requirements for acceptance in to the review process?*
Yes
No
Is this project a public transportation project?"
Yes No
Change only if needed.
Pre-Filing Meeting Date Request was submitted on:
1/5/2022
BIMS#Assigned" Version#"
20221112 1
Is a payment required for this project?*
No payment required
Fee received Reviewing Office"
Fee needed-send electronic notification Washington Regional Office-[phone]
Select Project Reviewer"
Garcy Ward:eads\gpward
Information for Initial Review
1a.Name of project:
Pasquotank Bridge 5 Replacement Project
1a.Who is the Primary Contact?"
Paul Williams
1 b.Primary Contact Email:" 1c.Primary Contact Phone:*
[e-mail] [phone]
Date Submitted
8/18/2022
Nearest Body of Water
Chapel Creek
Basin
Pasquotank
Water Classification
sC
Site Coordinates
Latitude: Longitude:
36.160961 -76.165993
A. Processing Information
County(or Counties)where the project is located:
Pasquotank
Is this a NCDMS Project
Yes No
Is this project a public transportation project?*
Yes No
Is this a NCDOT Project?"
Yes No

(NCDOT only)T.I.P.or state project number:
WBS#M
17BP.1.R.88
1a.Type(s)of approval sought from the Corps:
Section 404 Permit(wetlands,streams and waters,Clean Water Act)
Section 10 Permit(navigable waters,tidal waters,Rivers and Harbors Act)
Has this PCN previously been submitted?"
Yes
No
1 b.What type(s)of permit(s)do you wish to seek authorization?
Nationwide Permit(N W P)
Regional General Permit(RGP)
Standard(IP)
1c.Has the NWP or GP number been verified by the Corps?
Yes No
Regional General Permit(RGP)Number: 201902350-Work associated with bridge construction,widening,replacement,and
interchanges
RGP Numbers(for multiple RGPS):
1d.Type(s)of approval sought from the DWR:
401 Water Quality Certification-Regular 401 Water Quality Certification-Express
Non-404 Jurisdictional General Permit Riparian Buffer Authorization
Individual 401 Water Quality Certification
le.Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification: Yes No
For the record only for Corps Permit: Yes No
1f.Is this an after-the-fact permit application?*
Yes No
1g.Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
Yes No
1g.Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
Yes No
1 h.Is the project located in any of NC's twenty coastal counties?
Yes No
11.Is the project located within a NC DCM Area of Environmental Concern(AEC)?
Yes No Unknown
1j.Is the project located in a designated trout watershed?
Yes No
B. Applicant Information
1d.Who is applying for the permit?
Owner Applicant(other than owner)
le.Is there an Agent/Consultant for this project?
Yes No
2.Owner Information
2a.Name(s)on recorded deed:
NCDOT Right-of-Way SR 1103 Esclip Road in Pasquotank County
2b.Deed book and page no.:
2c.Contact Person:
Paul Williams

2d.Address
Street Address
113 Airport Dr.
Address Line 2
City State/Province/Region
Edenton NO
Postal/Zip Code Country
27932 USA
2e.Telephone Number: 2f.Fax Number:
[phone] [phone]
2g.Email Address:*
[e-mail]
C. Project Information and Prior Project History
1.Project Information
1 b.Subdivision name:
(if appropriate)
1c.Nearest municipality I town:
Elizabeth City
2.Project Identification
2a.Property Identification Number: 2b.Property size:
1.4
2c.Project Address
Street Address
Esclip Road,approx.400 ft.from SR 1116
Address Line 2
City State/Province/Region
Elizabeth City NO
Postal/Zip Code Country
27909 USA
3. Surface Waters
3a.Name of the nearest body of water to proposed project:
Chapel Creek
3b.Water Resources Classification of nearest receiving water:
SC
3c. What river basin(s)is your project located in?*
Pasquotank
3d.Please provide the 12-digit HUC in which the project is located.
030102050504
4. Project Description and History
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:
Project area consists of NCDOT Pasquotank County SR 1103 and Bridge#5.The general land use in the vicinity is forested swamp,agriculture,and rural residential with 2 churches in the
vicinity.
4b.Have Corps permits or DWR certifications been obtained for this project(including all prior phases)in the past?*
Yes No Unknown
4f.List the total estimated acreage of all existing wetlands on the property:
2.07
4g.List the total estimated linear feet of all existing streams on the property:
181
4h.Explain the purpose of the proposed project:
The purpose of this project is to replace the aging Bridge#5 that has received deficiency ratings,qualifying it for replacement.NCDOT wants to maintain SR 1103 as a safe and reliable
travel route for the public.

4i.Describe the overall project in detail,including indirect impacts and the type of equipment to be used:*
Replace an existing 3-span 52 ft.long X 25 ft.wide bridge with a new single span bridge structure measuring 70 ft.X 30 ft.Upon completion of the structure,NCDOT will have to rebuild
the roadway approaches on either end of the bridge.This will involve some minor widening of the roadway bridge approaches and the roadway shoulders.The new bridge will be
constructed using a top down methodology,utilizing an off-site detour.Cofferdams around each end bent will be installed for dewatering during end bent construction.The project will be
built using cranes,excavators,backhoes,dump trucks,and small equipment associated with bridge construction.Project will also require the relocation of the power line(overhead)and
the water line(directional bore).The project will result in 0.03 acre of permanent fill in wetlands and 0.38 acre of temporary hand clearing in wetlands.The project will result in 17 linear feet
of permanent stream impacts,51 linear feet of temp.stream impacts,less than 0.01 acre of permanent surface water impacts,and 0.13 acre of temp.surface water impacts.
5. Jurisdictional Determinations
5a.Have the wetlands or streams been delineated on the property or proposed impact areas?*
Yes No Unknown
Comments:
5b.If the Corps made a jurisdictional determination,what type of determination was made?*
Preliminary Approved Not Verified Unknown N/A
Corps AID Number:
SAW-2022-00170
5c.If 5a is yes,who delineated the jurisdictional areas?
Name(if known):
Agency/Consultant Company:
Other:
5d.List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
Field Determination 1/5/2022
6.Future Project Plans
6a.Is this a phased project?*
Yes 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?
D. Proposed Impacts Inventory
1. Impacts Summary
1a.Where are the impacts associated with your project?(check all that apply):
Wetlands Streams-tributaries Buffers
Open Waters Pond Construction
2.Wetland Impacts
2a1 Reason M 2b.Impact type*('l 2c.Type of W.* 2d.W.name 2e.Forested* 2f.Type of Jurisdicition*�2g.Impact
M area
Roadway Fill P Riverine Swamp Forest WD Yes Cores 0.009
(acres)
Roadway Fill T Riverine Swamp Forest WD Yes Corps 0.012
(acres)
Utility Relocation- T Riverine Swamp Forest WD Yes Corps 0.042
Temp.Hand Clearing (acres)
Roadway Fill P Riverine Swamp Forest WC Yes Corps 0.003
(acres)
Roadway Fill T Riverine Swamp Forest WC Yes Corps 0.014
(acres)
Utility Relocation- T Riverine Swamp Forest WC Yes Corps 0.034
Temp.Hand Clearing (acres)
Roadway Fill P Riverine Swamp Forest WB Yes Corps 0.010
(acres)
Roadway Fill T Riverine Swamp Forest WB Yes Corps 0.074
(acres)
Utility Relocation- T Riverine Swamp Forest WB Yes Corps 0.032
Temp.Hand Clearing (acres)

5 Roadway Fill P Riverine Swamp Forest WA Yes Corps 0.011
(acres)
Roadway Fill T Riverine Swamp Forest WA Yes Corps 0.064
(acres)
Utility Relocation- L
Riverine Swamp Forest WA Yes Corps 0.108
Temp.Hand Clearing acres)
2g.Total Temporary Wetland Impact 2g.Total Permanent Wetland Impact
0.380 0.033
2g.Total Wetland Impact
0.413
21.Comments:
All listed on Impact Summary included with Permit Drawings.
3.Stream Impacts
3a.Reason for impact(?) 3b.lmpact type' 3c.Type of impact* 3d.S.name* ��3e.Stream Type* 3f.Type of11 3g.S.width 3h.Impact
(?) Jurisdiction* length*
S1 Bridge-end bent protection Permanent Bank Stabilization Chapel Creek Perennial Corps 50 17
Average(feet) Qinear feet)
IF]
2 Bridge-cofferdam Temporary A
Dewatering F"I
reek Perennial Corps 50 51
Average(feet) (linear feet)
31.Total jurisdictional ditch impact in square feet:
0
31.Total permanent stream impacts: 3i.Total temporary stream impacts:
17 51
31.Total stream and ditch impacts:
68
3j.Comments:
All listed on Impact Summary included with Permit Drawings.
4. Open Water Impacts
4a. Site# 4a1.Impact Reason 4b.Impact type 4c.Name of waterbody 4d.Activity type :114e.Waterbody type 4f.Impact area
Bridge-end bent P Chapel Creek Stabilization Other 0.01
protection
Bridge-cofferdam JT Chapel Creek Dewatering Other 0.13
4g.Total temporary open water Impacts: 4g.Total permanent open water impacts:
0.13 0.01
4g.Total open water impacts:
0.14
4h.Comments:
All listed on Impact Summary included with Permit Drawings.
E. Impact Justification and Mitigation
1.Avoidance and Minimization
1a.Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
NCDOT minimized the roadway width by narrowing the shoulders and bridge width to the minimal amount allowable with the design speed and roadway
geometry.There are no deck drains located on the bridge.The existing bridge demolition will follow NCDOT BMP's for bridge demolition work.Erosion
and Sediment control plans have been designed and will be followed to retain any runoff from construction activities.An off-site detour is being utilized to
eliminate any additional wetland and surface water impacts with an on-site detour.
1 b.Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Utilizing BMPs for bridge demolition will capture all components of the old structure.Erosion and Control measures will be placed along the entire project
area to reduce soil runoff.A turbidity curtain can be utilized along the banks to capture any siltation that may occur during project construction.Sheeting
will be used to construct cofferdams to dewatering during construction of the end bents.The utilization of precast concrete materials,reduces the
potential for uncured concrete entering the adjacent waters.
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 No
2b.If this project DOES NOT require Compensatory Mitigation,explain why:
Impacts are below the threshold requiring mitigation.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
1. Diffuse Flow Plan
1a.Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection Rules?
Yes No
If no,explain why:
NC Riparian Buffer Rules do not apply to the Pasquotank River Basin.
2. Stormwater Management Plan
2a.Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?
Yes No
Comments:
NCDOT will follow best management practices for soil and erosion control in compliance with N.C.Sediment and Pollution Control Act and NCDOT NPDES permit.Erosion control devices
will be installed and maintained during the project.Grated Drop Inlets at the NE and NW quadrants will route stormwater to vegetated buffers prior to entering surface waters.No deck
drains will be located over surface waters.
G. Supplementary Information
1. Environmental Documentation
la.Does the project involve an expenditure of public(federallstatellocal)funds or the use of public(federallstate)land?*
Yes No
1 b.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)?*
Yes • No
Comments:*
Activity and impacts covered by Minimum Criteria Checklist or Categorical Exclusion.
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(15A NCAC 2B.0200)?*
Yes No
3. Cumulative Impacts (DWR Requirement)
3a.Will this project result in additional development,which could impact nearby downstream water quality?
Yes No
3b.If you answered"no,"provide a short narrative description.
Project replaces an existing bridge with a bridge.
4. Sewage Disposal (DWR Requirement)
4a.Is sewage disposal required by DWR for this project?*
Yes No N/A
5. Endangered Species and Designated Critical Habitat(Corps Requirement)
5a.Will this project occur in or near an area with federally protected species or habitat?*
Yes No
5b.Have you checked with the USFWS concerning Endangered Species Act impacts?*
Yes No
5d.Is another Federal agency involved?*
Yes No Unknown
5e.Is this a DOT project located within Division's 1-8?
Yes No

5j.What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
NC Natural Heritage Data Explorer Website,USFWS IPaC
6. Essential Fish Habitat(Corps Requirement)
6a.Will this project occur in or near an area designated as an Essential Fish Habitat?
Yes No
Are there submerged aquatic vegetation(SAV)around the project vicinity?*
Yes No Unknown
6b.What data sources did you use to determine whether your site would impact an Essential Fish Habitat?
National Marine Fisheries Database
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?*
Yes No
7b.What data sources did you use to determine whether your site would impact historic or archeological resources?*
NCDOT Cultural Resources Unit
8. Flood Zone Designation (Corps Requirement)
Be.Will this project occur in a FEMA-designated 100-year floodplairl
Yes No
8b.If yes,explain how project meets FEMA requirements:
FEMA Approved
8c.What source(s)did you use to make the floodplain determination?*
NCDOT Hydraulics Unit
Miscellaneous
Please use the space below to attach all required documentation or any additional information you feel is helpful for application review.Documents should be combined into one file when
possible,with a Cover Letter,Table of Contents,and a Cover Sheet for each Section preferred.
Click the upload button or drag and drop files here to attach document
SAW-2022-00170 NCDOT Pasquotank Bridge 5_Pasquotank.pdf 458.18KB
Pasquotank_5_Permit-Drawings_2022-07-27.pdf 3.26MB
Bridge 5 Location Map.pdf 1.23MB
NCWRC Moratorium Email.pdf 30.38KB
CAMA JD Email.pdf 43.32KB
19-08-0004_EffectsReq.pdf 517.39KB
19-08-0004_EffectsSigned.pdf 2.39MB
17BP.1.PE.88 Cemetery GPR Concurrence Letter from HPO.pdf 141.71 KB
PA 19-08-0004 Pasquotank(NSR).pdf 7.2MB
2021-193-120.pdf 323.37KB
Pasquotank Bridge 5-Tribal Coordination Letter-Nansemond.pdf 22.26KB
Tribal_Coordination_Letter_-_Catawba.pdf 124.42KB
Soil_Map.pdf 961.67KB
File must be PDF or KMZ
Comments
Chapel Creek is an AFSA,therefore NCWRC is requesting an in water work moratorium from February 15 to June 30.
NCDCM has determined the project is within the Public Trust Access/Public Trust Shoreline AEC.A CAMA General Permit will be required.
NC SHPO determined there will be no adverse effect to the resource with the condition of a two-bar metal rail for the
new bridge.Also,the grave sites will be marked by orange safety fencing;the staging area will remain within
existing ROW and will be noted on final plans.
West Indian Manatee habitat was identified within the project area.Since this species may be present at the time of the project,NCDOT will adhere to the Guidelines for Avoiding Impacts
to the West Indian Manatee:Precautionary Measure for Construction Activities in North Carolina Waters during the construction of this project.
Signature
*
By checking the box and signing below,I certify that:
• The project proponent hereby certifies that all information contained herein is true,accurate,and complete to the best of my knowledge and belief';and
• The project proponent hereby requests that the certifying authority review and take action on this CWA 401 certification request within the applicable reasonable period of time.
• 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:
Paul Collins Williams,Jr.
Signature
Date
8/18/2022