20191366 Ver 1_PCN Form Submission_20191007

DWR
IDIOM n of Water Resources
Pre -Construction Notification (PCN) Form
September 29, 2018 Ver 3
21nitial Review
Has this project met the requirements for acceptance in to the review process?*
r Yes
r No
Is this project a public transportation project?*
G Yes r No
Change only if needed.
BIMS # Assigned
20191366
Is a payment required for this project?*
r No payment required
r Fee received
r Fee needed - send electronic notification
Select Project Reviewer*
Garcy Ward:eads\gpward
Information for Initial Review
1a. Name of project:
Replace Bridge No. 5 on SR 1777 over Chicod Creek (B-4605 Central)
1a. Who is the Primary Contact?*
Chris Rivenbark
1b. Primary Contact Email:*
[e-mail]
Date Submitted
10/7/2019
Nearest Body of Water
Chicod Creek
Basin
Tar -Pamlico
Water Classification
QNSW
Version# *
1
Reviewing Office*
Washington Regional Office - [phone]
1c. Primary Contact Phone:*
[phone]
Site Coordinates
Latitude: Longitude:
35.546312-77.210139
FA. Processing Information U
County (or Counties) where the project is located:
Pitt
Is this project a public transportation project?*
r Yes r' No
Is this a NCDOT Project?*
r Yes r No
(NCDOT only) T.I.P. or state project number:
B-4605
WBS # (?)
38430.1.3
1a. Type(s) of approval sought from the Corps:

W Section 404 Permit (wetlands, streams and waters, Clean Water Act)
r Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
1b. What types) of permit(s) do you wish to seek authorization?
W Nationwide Permit (NWP)
r' Regional General Permit (RGP)
r' Standard (IP)
1c. Has the NWP or GP number been verified by the Corps?
f Yes r No
Nationwide Permit (NWP) Number: 03 - Maintenance
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
fJ 401 Water Quality Certification - Regular
F Non-404 Jurisdictional General Permit
F Individual Permit
le. Is this notification solelyfor the record because written approval is not required?
For the record only for DWR 401 Certification:
For the record only for Corps Permit:
F 401 Water Quality Certification - Express
W Riparian Buffer Authorization
1f. Is this an after -the -fact permit application?*
r Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
r Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
r Yes r No
Acceptance Letter Attachment
1h. Is the project located in any of NC's twenty coastal counties?
r Yes r No
1j. Is the project located in a designated trout watershed?
C Yes r No
FB. Applicant Information
1d. Who is applying for the permit?
[J Owner r Applicant (other than owner)
le. Is there an Agent/Consultant for this project?
r Yes r No
2. Owner Information
2a. Name(s) on recorded deed:
N/A
2b. Deed book and page no.:
2c. Responsible party:
2d.Address
Street Address
1000 Birch Ridge Dr.
Address Line 2
city
Raleigh
Fbstal / Zip Oide
27610
2e. Telephone Number:
[phone]
2g. Email Address:*
State / Frovinre / R�gion
NC
Country
United States of America
2f. Fax Number:
*
r Yes r No
r Yes r No

[e-mail]
C. Project Information and Prior Project History U
1. Project Information
1b. Subdivision name:
(i appropriate)
1c. Nearest municipality/ town:
Grimesland
2. Project Identification
2a. Property Identification Number: 2b. Property size:
2c. Project Address
Street Address
Address line 2
City State / ftovince / Fbgion
Postal / Zip Oxie O�untry
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Chicod Creek
3b. Water Resources Classification of nearest receiving water:*
C;NSW
3c. What river basin(s) is your project located irl
Tar -Pamlico
3d. Please provide the 12-digit HUC in which the project is located.
030201030603
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:*
The project is an existing two-lane road and bridge. The vicinity is a rural landscape with forested and agricultural areas interspersed with residential homes.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
r Yes 6 No r Unknown
4d. Attach an 8 1/2 X 11 excerpt from the most recent version of the USGS topographic map indicating the location of the project site. (for DWR)
4e. Attach an 8 1/2 X 11 excerpt from the most recent version of the published County NRCS Soil Survey map depicting the project site. (for DWR)
4f. List the total estimated acreage of all existing wetlands on the property:
2.0
4g. List the total estimated linear feet of all existing streams on the property:
150
4h. Explain the purpose of the proposed project:*
The purpose of the project is to replace a bridge with a deteriorating timber substructure and low posted weight limit.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
The project proposes to replace Bridge No. 730005 on SR 1777 (Blackjack-Grimesland Rd.) over Chicod Creek in Pitt County, INC. The proposed project would replace the existing 91'
long by 33' vide tyro -span bridge with a 135' long by 33' wide three -span bridge. The proposed grade will be about 0.5' above the existing ground within the vicinity of the bridge and
roughly matching existing ground outside of the bridge.
Equipment to be used includes cranes, excavators, dump trucks, and paving equipment
4j. Please upload project drawings for the proposed project.
B-4605_UTILITY Permit Drawings_2019-09-10.pdf
2.04MB
B-4605_Permit Drawings_2019-09-10 final.pdf
1.45MB
B-4605_Buffer Drawings_2019-09-10 final.pdf
1.12MB
B-4605 Roadway.pdf
1.65MB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*

r Yes r No r Unknown
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
r Preliminary r Approved r Not Verified r Unknown r N/A
Corps AID Number:
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company: Axiom Environmental
Other: Preliminary JD request submitted June 2015
5d1. Jurisdictional determination upload
6. Future Project Plans
6a. Is this a phased project?*
r Yes r 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
la. Where are the impacts associated with your project? (check all that apply):
W Wetlands r Streams -tributaries W Buffers
r Open Waters r Pond Construction
2. Wetland Impacts
2a1 Reason (?)
2b. Impact type * (?)
2c. Type of W.
2d. W. name *
2e. Forested*
2f. Type of
Jurisdicition*(?)
2g. Impact
area*
1
Bridge - Fill
P
Riverine Swamp Forest
WC
No
Corps
0.005
(acres)
Bridge - Fill
P
Riverine Swamp Forest
WD
Yes
Corps
0.005
(acres)
Bridge -Fill
P
Riverine Swamp Forest
WA
�
Corps
0.006
(acres)
Bridge -Excavation
P
Riverine Swamp Forest
WA
�
Corps
0.002
(acres)
Bridge - Fill
P
Riverine Swamp Forest
WB
Yes
Corps
0.008
(acres)
Utility- Excavation
Riverine Swamp Forest
WA
f=Corips
0.001
IL
(acres)
2g. Total Temporary Wetland Impact
2g. Total Permanent Wetland Impact
0.000
0.027
2g. Total Wetland Impact
0.027
2h. Comments:
Hand clearing in wetlands for sites 1, 2, & 3 is <0.01 acre per site and 0.01 acres for
site 4. Total hand clearing in wetlands = 0.03 acre. There will be
<0.01 acre of temporary fill in the hand clearing areas for erosion control.
6. Buffer Impacts (for DWR)
6a. Project is in which protect basin(s)?
Clh ck all that apply.
r Neuse
,P Tar -Pamlico
r Catawba
r Randleman
r Goose Creek
r Jordan Lake
r Other

6b. Impact Type
6c. Per or Temp
6d. Stream name
6e. Buffer mitigation required?
6f. Zone 1 impact
6g. Zone 2 impact
Bridge
P
Chicod Creek
No
225
475
Bridge
P
Chicod Creek
No
980
55
Bridge
P
Chicod Creek
No
340
280
Bridge
P
Chicod Creek
No
120
505
6h. Total buffer impacts:
Zone 1 Zone 2
Total Temporary impacts: 0.00 0.00
Zone 1
Zone 2
Total Permanent impacts: 1,665.00
1,315.00
Zone 1
Zone 2
Total combined buffer impacts: 1,665.00
1,315.00
61. Comments:
Wetlands in Buffers: Zone 1: 740 sq. ft. total, Zone 2: 705 sq. ft. total (see attached permit drawings)
Supporting Documentation
Impact Justification and Mitigation
1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
Proposed bridge is 44 ft. longer than emsting; grade is roughly the same as emsting ground; bridge runoff will be discharged outside the riparian buffer
zone through grated inlets at either side of the bridge, and flowwill be diffused with a riprap pad at the proposed pipe outlet and at the lowest velocity
practicable. Design Standards in Sensitive Watersheds will be implemented.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Traffic will be maintained offsite during construction, thus minimizing the project footprint; construction activities inside environmentally sensitive areas
have been limited to the ma>amum extent practicable and will be contained inside safety/silt fencing. Slopes will be 3:1 in wetlands.
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?
r Yes r No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
Proposed mechanized clearing in the wetland will not result in the placement of dredge or fill material in the wetland. Permanent wetland impacts are less than 0.1 acre.
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?
r Yes r No
What type of SCM are you providing?
r Level Spreader
r Vegetated Conveyance (lower SHWT)
r Wetland Swale (higher SHWT)
r Other SCM that removes minimum 30 % nitrogen
W Proposed project will not create concentrated stormwater flow through the buffer
Diffuse Flow Documentation
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
r Yes r No
Comments:

Stormwater Management Plan is included in the permit drawings
G. Supplementary Information
1. Environmental Documentation
1a. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?*
r Yes r No
1b. 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)?*
r Yes r No
Comments:*
An environmental document was not required.
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)?*
r Yes r No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality?*
r Yes r No
3b. If you answered "no," provide a short narrative description.
Per the "Cumulative Impacts and the 401 Water Quality Certification and Isolated Wetland Permit Programs (April 10, 2004, Version 2.1)" document,
the proposed bridge replacement does not meet any of the "growth stimulating" or "downstream impacts" criteria.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
r Yes r No r 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?*
r Yes r No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
r Yes r No
5d. Is another Federal agency involved?*
r Yes r No
5e. Is this a DOT project located within Division's 1-8?
r Yes r No
r Unknown
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
1. US Fish & Wildlife Endangered Species, Threatened Species, Federal Species of Concern, and Candidate Species for Pitt County, Updated 10-05-
2018
2. NOAA National Marine Fisheries Service
3. Eastern North Carolina Programmatic Biological Assessment of Potential Effects on Tar River Spinymussel, Dwarf Wedgemussel, and Yellow Lance
in Association vdth Bridge and Culvert Replacements
4.USFWS Informal Concurrence Letter
Consultation Documentation Upload
20191003_Itr_USFWS_NCDOT_B-4605.pdf 41.3KB
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
r Yes r No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
NOAA Essential Fish Habitat Mapper
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?*
r Yes
r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*

NC State Historic Preservation Office data (http://gis.ncdcr.gov/hpoweb); PCE documentation
Scoping comments from NC State Historic Preservation Office and NCDOT Archaeology
7c. Historic or Prehistoric Information Upload
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
r Yes
r No
8b. If yes, explain how project meets FEMA requirements:
Approved as MOA Type 1 by NC Floodplain Mapping Program
8c. What source(s) did you use to make the floodplain determination?*
DFIRM Panel 5624
Miscellaneous
Comments
Miscellaneous attachments not previously requested.
Signature
W By checking the box and signing below, I certify that:
• 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:
Mack Christopher Rivenbark III
Signature
J" e. A6T"Oh1 , Y11
Date
10/7/2019