20190695 Ver 1_401 Application_20190529

Staff Review
Does this application have all the attachments needed to accept it into the review process?
r Yes r No
ID#* Version* 1
20190695
Is this project a public transportation project?* r Yes
r No
Is this a DOT r Yes r No
project?*
Reviewer List:*
Select Reviewing Office:*
Submittal Type:*
401 Application
Joanne Steenhuis:eads\jhsteenhuis
Wilmington Regional Office - [phone]
Does this project require a request for payment to be sent? *
r
Yes
c:
No

Project Submittal Form
Please note: fields marked with a red asterisk below are required. You will not be able to submit the form until all
mandatory questions are answered.
Project Type: r New Project
r Pre -Application Submittal
r More Information Response
r Other Agency Comments
r For the Record Only (Courtesy Copy)
New Project - Please check the new project type if you are trying to submit a new project that needs an official approval
decision.
Pre -Application Submittal - Please check the pre -application submittal if you just want feedback on your submittal and
do not have the expectation that your submittal will be considered a complete application requiring a formal decision.
More Information Response - Please check this type if you are responding to a request for information from staff and
you have and ID# and version for this response.
Other Agency Comments - Please check this if you are submitting comments on an existing project.
Project Contact Information
Name: Mason Herndon
Who is subrritting the information?
Email Address: [e-mail]
Project Information
Project Name: Replacement of Sampson Bridge 213
Is this a public transportation project?
r• Yes
r' No
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
C Yes (-- No C Unknown
TIP#: WBS#:
N/A 17 BP.3. R.66
(Applies to DOT projects only)
County (ies)
Sampson
Please upload all files that need to be submited.
dick the upload button or drag and drop files here to attach docurrent
Sampson Bridge 213 Courtesy
2.05MB
Notification_signed.pdf
Only pdf or krre files are accepted.
Describe the attachments:
Attachment includes a cover letter, SMP, Permit Drawings, WIS and Utility plans for the replacement of Bridge
No. 213 over Kill Swamp on SR 1710 (Emmet Thornton Rd) in Sampson County

rJ By checking the box and signing box below, I certify that:
• I have given true, accurate, and complete information on this form;
• I agree that submission of this 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');
o I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature; AND
o I intend to electronically sign and submit the online form."
Signature:
Submittal Date: Is filled in autorratically.

STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
Roy COOPER
GOVERNOR
Brad Shaver, NCDOT Coordinator
Wilmington Regulatory Field Office
US Army Corps of Engineers
69 Darlington Avenue
Wilmington, NC 28403
JAMES H. TRomom III
SECRETARY
May 29, 2019
Joanne Steenhuis, NCDOT Coordinator
NC Department of Environmental Quality
Division of Water Resources
127 Cardinal Drive Ext.
Wilmington, NC 28405
Subject: Courtesy Notification for Section 404 Nationwide Permits 3 and Section 401 General
Certifications 4132 for proposed replacement of Bridge No. 213 over Kill Swamp on SR 1710
(Emmet Thornton Road) in Sampson County; WBS No. 17BP.3. R.66.
Dear Mr. Shaver and Ms. Steenhuis:
The North Carolina Department of Transportation (NCDOT) is proposing to replace Bridge No. 213 over
Kill Swamp on SR 1710 (Emmet Thornton Rd.) in Sampson County. The existing 3 span - 53 ft. bridge
will be replaced with two span - 90 ft. bridge.
A preliminary jurisdictional determination (PJD) was acquired on this project on June 28, 2019 and the
project was assigned Action Id No. SAW-2017-01255. Impacts associated with the bridge include 0.005
acres of (beneficial) wetland excavation to tie the approach fill removal to the adjacent natural wetland
floodplain elevation. The only utility relocation associated with this project is a Centurylink fiber optic line,
however there are no impacts associate with this utility relocation. The attached permit drawings and utility
plans provide more details on the proposed impacts. Traffic will use an offsite detour during the
construction of this project.
Regulatory Approvals
Section 404 Permit: NCDOT is proposing to construct this project under the conditions of Nationwide 3.
Based on the current design and impacts, notification requirements are not applicable for this project and
written approval from the USACE is not required. NCDOT will abide by all conditions listed in NW 3, and
will include a copy of the certifications in the permit package and/or contract.
Section 401 Permit: The associated 401 General Certification 4132 will also apply to this project.
Notification thresholds or circumstances for these certifications are not applicable to this project therefore
written concurrence from the Division of Water Resources (DWR) is not required. NCDOT will abide by
all conditions listed in GC 4132, and will include a copy of the certifications in the permit package and/or
contract.
Mailing Address:
NC DEPARTMENT OF TRANSPORTATION
DIVISION OF HIGHWAYS
5501 BARBADOS BOULEVARD
CASTLE HAYNE, NC 28429-5647
Telephone: [phone]
Fax: [phone]
Customer Service: 1-877-368-4968
Website: www.ncdot.gov
Location:
5501 BARBADOS BOULEVARD
CASTLE HAYNE, NC 28429-5647

If you have any questions or need additional information, please feel free to contact me.
Sincerely,
Digitally signed by Mason Herndon
DN: cn=Mason Herndon, o=NC Department of
�L Transportation, o@Division
rn email=[e-mail], c=US
Date: 2019.05.29 15:02:00-04'00'
Mason Herndon
NCDOT Division 3
Environmental Program Supervisor
ec: Kristi Lynn Carpenter, Division of Water Resources
Enclosures

North Carolina Department of Transportation .° °°,
Highway Stormwater Program =�
STORMWATER MANAGEMENT PLAN
(Version 2.08; Released April 2018) :A FOR NCDOT PROJECTS In
WBS Element: 17BP.3.R.66 TIP No.: County(ies): Sampson Page 1 of 3
General Project Information
WBS Element:
17BP.3.R.66 TIP Number: Project Type: Bridge Replacement Date: 5/15/2019
NCDOT Contact:
Robert T. Turnbull, Environmental Services, Inc.
Contractor / Desi ner:
HNTB North Carolina, P.C. / James A. Byrd PE
Address:
4901 Trademark Dr.
Raleigh, NC 27610
Address:
343 E. Six Forks Road
Suite 200
Raleigh, NC 27609
Phone:
919 212-1760
Phone:
919 208-9359
Email:
Turnbull esinc.cc
Email:
jab rd hntb.com
City/Town:
Newton Grove
Count (ies):
Sampson
River Basin(s):
Cape Fear F
ICAMA County?
I No
Wetlands within Project Limits?
Yes
IF Project Description
Project Length (lin. miles or feet):
0.12 Surrounding Land Use: JRural Residential and Agriculture
Proposed Project
Existin Site
Project Built -Upon Area ac.
0.6 ac.
0.3 ac.
Typical Cross Section Description:
2 - 10' asphalt paved lanes with 2' paved shoulders, 4' grass shoulders, and roadside
dicth. Roadway progresses from super to normal crown as you progress down the
alignment.
2 - 10' paved lanes with grass shoulders with roadside ditches.
Annual Avg Daily Traffic (veh/hr/day):
Design/Future: 420 Year: 2036
Existing: 210 Year: 2012
General Project Narrative:
(Description of Minimization of Water
Quality Impacts)
State project 17BP.3.R.66 involves the replacement of Sampson County Bridge # 810213 on SR 1710 (Emmet Thornton Rd.) over Kill Swamp. The existing bridge consists of 1
@ 18' - 8", 1 @ 17' - 5", and 1 @ 17' - 4" Reinforced Concrete Deck on Timber Joists and Timber Piles and is to be replaced with a 1 @ 35' - 0" 21" Cored Slab, 1 @ 55'-0" 24"
Cored Slab, Bridge (90' total length, 33' total width) at the same location.
The proposed bridge does not contain deck drains. Storm water from the bridge and approaches will be collected by a storm drain inlets on the left and right side of the road and
discharge into Class "I" Rip -Rap pads located in the northwest quadrant at -L- 17+94 LT and the northeast quadrant at -L- 18+17 RT.
The existing roadside ditch in the southeast quadrant will be impacted by the proposed slope stakes. The proposed ditch will continue to flow from south to north and outlet into
wetlands, matching existing drainage patterns. The proposed ditch in the southeast quadrant will be a Special Lateral base ditch with a 4' base and 3:1 front and back slopes.
The ditch will transition into a'0' depth base ditch to reduce velocity and minimize impacts on wetlands.
Waterbody Information
Surface Water Body (1): Kill Swamp
NCDWR Stream Index No.:
18-68-1-2
NCDWR Surface Water Classification for Water Body
Primary Classification:
Class C
Supplemental Classification:
Swamp Waters Sw
Other Stream Classification:
Impairments:
Aquatic T&E Species?
Comments:
NRTR Stream ID:
Buffer Rules in Effect: N/A
Project Includes Bridge Spanning Water Body?
iYes
I Deck Drains Discharge Over Buffer? N/A
Dissipator Pads Provided in Buffer? N/A
Deck Drains Discharge Over Water Body?
IN2
(If yes, provide justification in the General Project Narrative)
(If yes, describe in the General Project Narrative; if no, justify in the
General Project Narrative)
(If yes, provide justification in the General Project Narrative)

Ili;hway North Carolina Department of Transportation
Sltormwatcr m o
Highway Stormwater Program
STORMWATER MANAGEMENT PLAN
(Version 2.08; Released April 2018) FOR NCDOT PROJECTS
WBS Element: 17BP.3.R.66 TIP No.: County(ies): Sampson Page 2 of 3
Swales
Sheet
No.
Station & Coordinates
(Road and Non Road
Projects)
Surface
Water
Body
Base
Width
(ft)
Front
Slope
(H:1)
Back
Slope
(H:1)
Drainage
Area
(ac)
Recommended
Treatm't Length
(ft)
Actual
Length
(ft)
Longitudinal
Slope
N
Q2
(cfs)
V2
(fps)
Q10
(cfs)
V10
(fps)
Rock
Checks
Used
BMP
Associated w/
Buffer Rules?
4
-L- Sta. 14+50 RT
(1)Kill Swamp
4.0
3.0
3.0
0.6
60
99
3.02 %
1.6
1.8
2.3
2.1
No
No
35.236517,-78.305633
Additional Comments

I lip hWa North Carolina Department of Transportation
gSiaYmta Highway Stormwater Program
STORMWATER MANAGEMENT PLAN
(Version 2.08; Released April 2018) FOR NCDOT PROJECTS
WBS Element: TIP No.: County(ies): Sampson Page 3 of 3
Preformed Scour Holes and Energy Dissipators
Sheet
No.
Station & Coordinates
(Road and Non Road
Projects)
Surface
Energy Dissipator
Type
Riprap Type
Drainage
Area
ac
Conveyance
Structure
Pipe/Structure
Dimensions
(in)
Q10
(cfs)
V10
(fps)
BMP
Associated w/
Buffer Rules?
4
-L- 17+94 LT
(1)Kill Swamp
Riprap Energy
Dissipator Basin
Class 1
0.1
Pipe
15
0.3
0.1
N/A
35.23748,-78.30564
4
-L- 18+17 RT
(1)Kill Swamp
Riprap Energy
Dissipator Basin
Class 1
0.1
Pipe
15
0.4
0.1
N/A
35.237513,-78.305429
Additional Comments
- Keter to the NUUU I best Management Practices I oolboX (2U14), NGUU I Standards, the Federal Highway ACIMmistration (FHWA) Hydraulic Engineering circular No. 14 (HEc-14), I hircl Edition, Hydraulic Uesign of Energy
Dissipators for Culverts and Channels (July 2006), as applicable, for design guidance and criteria.

d��i ��IT���( (/1%� T�I('�� T I( � T I� }�
T�(�i�� T�(�i� NORTH
STATE
S 1L q T 11..d O 1.1 NOR ll J.l 11 'V A 1L � O Ld I N �
STA'F8 8II88T TOTAL
TATE PROJECT REFERENCE NO. E SXRBM
N.0 17BP.3.R.66
�p
DIVISION OF HIGHWAYS
STATE PR0.N0 P APRO.NO. OP9CR PT UN
17BP.3.R.66 PE
1
17BP.3.R.66 RW/UTIL
°'
SAMPSON COUNTY
A, ,,
r
Ab\•
PROJECT
5
LOCATION: REPLACE BRIDGE NO. OVER KILL SWAMP
PERMIT DRAWING
N G
'o
ON SR 1710 (EMMET THORNTON ROAD)
SHEET 1 OF 4
6
11
40
L'
TYPE OF WORK: GRADING, DRAINAGE, PAVING AND STRUCTURE
WETLAND AND SURFACE WATER TS
URMIT
W
VICINITY MAP
OFFSITE DETOUR
NN
4
g3
BEGIN PRO ECT 17BP.3.R.66
NA 2011
-L- POC STA 13+50.00
END BRIDGE
-L- POT STA 17+66+/-
-- SR 1710 (EMMET THORNTON ROAD)
VA IF
VA
TO SR 1711 TO NC 50
END PRO ECT 17BP.3.R.66
BEGIN BRIDGE I -L- POT STA 20+00.00
-L- POT STA 16+76+/-
I
N
O
O
V
NOTES:
A1.
CLEARING ON THIS PROJECT SHALL BE PERFORMED TO THE LIMITS ESTABLISHED BY MODIFIED METHOD III.
2. THIS PROJECT IS NOT WITHIN ANY MUNICIPAL BOUNDARIES.
DOCUMENT NOT CONSIDERED FINAL
UNLESS ALL SIGNATURES COMPLETED
V
GRAPHIC SCALES
DESIGN DATA
PROJECT LENGTH
Prepared In the Offlce of:
HYDRAULICS
ENGINEER
50 25 0 50 100
ADT
ADT
2016 = 210
2036 = 420
B NT H
NT E. Six Forks Roatl, Suite 200
CiNTB NORTH CAROLINA, P.C.
Raleigh, North Carolina 27609
NC License No. C-1554
2078 STANDARD SPECIFICATIONS
K = 10 %
PLANS
D = 60 %
LENGTH OF ROADWAY PROJECT 17BP.3.R.66 = 0.106 MILES
DOUGLAS M. WHEATLEY, PE
SIGNATURE.
50 25 0 50 100
0 *
T = b /o
LENGTH
OF STRUCTURE PROJECT 17BP.3.R.66 = 0.017 MILES
RIGHT OF WAY DATE:
m
y
PROJECT ENGINEER
ROADWAY DESIGN
V = 60 MPH
MARCH 21, 2019
ROY H. TELLIER, PE
ENGINEER
PROFILE HORIZONTAL
(HORIZONTAL)
PROJECT DESIGN ENGINEER
TTST =2% DUAL 4%
TOTAL LENGTH OF PROJECT 17BP.3.R.66 = 0.123 MILES
�p op Q
O
10 5 0 10 20
FUNC CLASS =
LETTING DATE:
T���
V
LOCAL
MARCH 5, 2020
DEREK PIELECH, PE
PROFILE (VERTICAL)
NCDOT CONTACT
SUB —REGIONAL TIER
SIGNATURE.
P.E.

WETLAND AND SURFACE WATER IMPACTS SUMMARY
WETLAND IMPACTS SURFACE WATER IMPACTS
Site
No.
Station
(From/To)
Structure
Size / Type
Permanent
Fill In
Wetlands
(ac)
Temp.
Fill In
Wetlands
(ac)
Excavation
in
Wetlands
(ac)
Mechanized
Clearing
in Wetlands
(ac)
Hand
Clearing
in
Wetlands
(ac)
Permanent
SW
impacts
(ac)
Temp.
SW
impacts
(ac)
Existing
Channel
Impacts
Permanent
(ft)
Existing
Channel
Impacts
Temp.
(ft)
Natural
Stream
Design
(ft)
1
-L- Sta. 14+61 to 17+74 RT
21" Cored Slab Bridge
0.005
TOTALS*:
0.005
*Rounded totals are sum of actual impacts
NOTES: Excavation in Wetlands: 210 SF
Revised 2016 09 09

L
O
a
E
U
1n
VICINITY MAP OFFSITE DETOUR
GRAPHIC SCALES
5, 25..5 0 5 100
PLANS
50 25 0 50 100
PROFILE (HORIZONTAL)
10 5 0 10 20
PROFILE (VERTICAL)
STATE OF NORTH CAROLINA
DIVISION OF HIGHWAYS
UTILITIES BY OTHERS PLANS
SAMPSON COUNTY
LOCATION. REPLACE BRIDGE NO.213 OVER KILL SWAMP
ON SR 1770 (EMMET THORNTON ROAD)
TYPE OF WORK: RELOCATE TELEPHONE
INDEX OF SHEETS
SHEET NO.: DESCRIPTION:
UO-1 TITLE SHEET
UO-2 UBO PLAN SHEET
UTILITY OWNERS WITH CONFLICTS
(A) PHONE - CENTURYLINK
UO-2
PREPARED IN THE DPPICE OF,,
T1P, NO, SHFFT NO,
17BP.3.R.66 UO-1
NOTE:
ALL UTILITY WORK SHOWN ON THIS
SHEET WILL BE DONE BY OTHERS,
NO PAYMENT WILL BE MADE TO
THE CONTRACTOR FOR UTILITY WORK
SHOWN ON THIS SHEET.
M A Engineering 598 East Chatham Sheet - Suite 137
Cary, NC 27511
-- Phone: [phone] Fax: [phone]
Consultants" Inc. NC License: F-0160
WEBB WHITE UTILITY PROJECT MANAGER
LONNY SLEEPER DIVISION UTILITY ENGINEER
STEVE DA VIS PROJECT UTILITY COORDINATOR
NAD2011
DIVISION OF HIGHWAYS
DIVISION 03
*OFTR."'
DIV ADDRESS
5501 BARBADOS BLVD
CASTLE HAYNE NC 28429
DEREK PIELECH, P.E.
BRIDGE PROGRAM MANAGER
DIVISION 3
NCDOT

Q.
PROJECT REFERENCE N0. SHEET
17131'.3.13.66
NO.
JO-2
UTILITIES BY OTHERS
NOTE:
ALL PROPOSED
UTILITY WORK SHOWN ON
THIS
SHEET WILL BE
DONE BY OTHERS. NO
PAYMENT WILL
BE MADE TO THE CONTRACTOR
FOR PROPOSED
UTILITY WORK SHOWN ON
THIS
SHEET.
CENTURYLINK CONTACT:
KEVIN GODWIN
n
910.366.2142
[e-mail]
M
N
CENTURYLINK TO REMOVE EXISTING
o
POLES AND BORE AT A MINIMUM
,D
15' BELOW CREEK BOTTOM
GEORGE E WARREN
c�
LINDA P WARREN
DB 863 PG 234
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end