20191547 Ver 1_PCN Form Submission (2)_20191107

DWR
Dlrlslon of Water Resources
Pre -Construction Notification (PCN) Form
September 29, 2018 Ver 3
Initial 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
20191547
Is a payment required for this project?*
r No payment required
r Fee received
r Fee needed - send electronic notification
Select Project Reviewer*
Rob Ridings:eads\rgridings
Information for Initial Review
1a. Name of project:
Bridge 115 over Rocky Swamp on SR1601 (BR-0113 Central)
1a. Who is the Primary Contact?*
NCDOT
1b. Primary Contact Email:*
[e-mail]
Date Submitted
11/7/2019
Nearest Body of Water
Rocky Swamp
Basin
Tar -Pamlico
Water Classification
C;NSW
Site Coordinates
Latitude: Longitude:
36.293723-77.813893
A. Processing Information
County (or Counties) where the project is located:
Halifax
Is this project a public transportation project?*
IT Yes r No
Is this a NCDOT Project?*
IT Yes r No
(NCDOT only) T.I.P. or state project number:
BR-0113
WBS#M
48822.1.1
1a. Type (a) of approval sought from the Corps:
Version#*
1
Reviewing Office*
Central Office - [phone]
1c. Primary Contact Phone:*
[phone]
L.1

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 type(s) 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?
r Yes r No
Nationwide Permit (NWP) Number: 03 - Maintenance
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
W 401 Water Quality Certification - Regular
r Non-404 Jurisdictional General Permit
r Individual Permit
le. Is this notification solely for the record because written approval is not required?
For the record only for DWR401 Certification:
For the record only for Corps Permit:
r 401 Water Quality Certification - Express
FJ 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?
r Yes r No
B. Applicant Information
1d. Who is applying for the permit?
V 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:
NCDOT
2b. Deed book and page no.:
2c. Responsible party:
2d.Address
Street Address
1000 Birch Ridge Drive
Address Line 2
city
Raleigh
Fbstal / Zip Code
27610
2e. Telephone Number:
[phone]
2g. Email Address:*
State / Rovince / Region
NC
Country
USA
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:
frf appropriate)
1c. Nearest municipality/ town:
Brinkleyville
2. Project ctct Identification
2a. Property Identification Number: 2b. Property size:
2c. Project Address
Street Address
Address Line 2
(Sty State / Province / Region
Postal / Zip Code Country
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Rocky Swamp
3b. Water Resources Classification of nearest receiving water:*
C; NS W
3c. What river basin(s) is your project located in?*
Tar -Pamlico
3d. Please provide the 12-digit HUC in which the project is located.
030201020502
4. Project Description and History
4a. Describe the existing conditions on the site and the general land use in the vicinityof the project at the time of this application:*
Land use in the project vicinity consists primarily of forested communities and agricultural fields interspersed with low -density residential sites.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
r Yes r 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:
3.5
4g. List the total estimated linear feet of all existing streams on the property:
550
4h. Explain the purpose of the proposed project:*
The purpose of this project is to replace a structurally deficient bridge.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
This project involves replacing the ebsting 4 span, 68-foot bridge with a 2 span, 90-foot bridge on the wasting alignment. Traffic will be maintained on an off -site detour. Standard road
building equipment, such as trucks, dozers and cranes will be used.
4j. Please upload project drawings for the proposed project.
BR-0113_Buffer Drawings20191029.pdf 1.03MB
BR-0113_Permit DraMngs_20191029.pdf 2.14MB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes r No C Unknown
Comments:
A preliminary JD package was sent to the agencies on 5/6/19. Written verification not received as of
yet.

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): James Mason
Agency/Consultant Company: Three Oaks Engineering
Other:
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 W 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.Typeof 2g. Impact
Jurisdicition*(?) area*
1
Mechanized Clearing
P
mland Hardwood Forest
ff
WB
Yes
Corps
0.020
(acres)
1
Fill
P
land Hardwood Forest
ffom
WB
_
Yes
Corps
]
0.009
(acres)
2g. Total Temporary Wetland Impact
0.000
2g. Total Wetland Impact
0.029
2h. Comments:
Handclearing in wetlands on the northwest side of bridge (WA/WB) will account for 0.02 acre.
3. Stream Impacts
2g. Total Permanent Wetland Impact
0.029
❑ 3a. Reason for impact (?) 3b.lmpact type * 3c. Type of impact* 3d. S. name * 3e. Stream Type* 3f. Type of 3g. S. width * 3h. Impact
(?) Jurisdiction* length*
S1 Impervious dike Temporary Dewatering Rocky Swamp Perennial Both 45 45
Average (feet) (lir�rfeet)
31. Total jurisdictional ditch impact in square feet:
0
31. Total permanent stream impacts: 31. Total temporary stream impacts:
0 45
3i. Total stream and ditch impacts:
45
3j. Comments:
An impervious dike will be used to encapsulate the area for the construction of the interior bent.
6. Buffer Impacts (for DWR)
6a. Project is in which protect basin(s)?

Check all that apply.
F Neuse
r Catawba
r Goose Creek
r Other
V Tar -Pamlico
F Randleman
F Jordan Lake
6b. Impact Type 6c. Per or Temp 6d. Stream name 6e. Buffer mitigation required? 6f. Zone 1 impact 6g. Zone 2 impact
1-Bridge-Allowable
P
Rocky Swamp
No
963
31
2-Road Crossing -Allowable
P
Rocky Swamp
No
1,003
1,259
6h. Total buffer impacts:
Zone 1 Zone 2
Total Temporary impacts: 0.00 0.00
Zone 1
Zone 2
Total Permanent impacts: 1,966.00
1,290.00
Zone 1
Zone 2
Total combined buffer impacts: 1,966.00
1,290.00
61. Comments:
Supporting Documentation
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:
The bridge will be replaced on the wasting alignment. There will be no direct discharge into Rocky Swamp. See stormwater management plan for
additional minimization measures.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
An offsite detour will be used during construction. NCDOT's Design Standards in Sensitive Watersheds will be employed.
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 f• No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
Impacts to streams and wetlands are deemed to be minimal and compensatory mitigation is not proposed.
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
U

Comments:
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 (NEPAUSEPA)?*
r Yes r No
1c. If you answered "yes" to the above, has the document review been finalized bythe State Clearing House?*
r Yes r No
NEPAor SEPA Final Approval Letter
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.
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 (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
r Yes r Nor 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
5c. If yes, indicate the USFWS Field Office you have contacted.
Raleigh
5d. Is another Federal agency involved?*
r Yes r No r Unknown
5e. Is this a DOT project located within Division's 1-8?
r Yes r No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
N.C. Natural Heritage Program database; USFWS-Raleigh Field Office website; biological surveys for protected species listed for Halifax County, which
include Tar River spinymussel, yellow lance, Dwarf wedgemussel, red -cockaded woodpecker. The red -cockaded woodpecker and yellow lance
received biological conclusions of "No Effect". The Tar River spinymussel and dwarfwedgemussel received a biological conclusions of "May Affect, Not
Likely to Adversely Affect" due to suitable habitat and known populations nearby. Concurrence from USFWS was received on 10/24/2019 for these
species (see attached).
Consultation Documentation Upload
20191024_Itr_USFWS _NCDOT_BR-0113.pdf 43.43KB
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?*
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 status?*
r Yes r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
NEPA documentation
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:
NCDOT Hydraulics Unit coordination with FEMA
8c. What source(s) did you use to make the floodplain determination?*
FEMA maps
Miscellaneous U
Comments
Miscellaneous attachments not previously requested.
Signature u
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
Date
11 /7/2019