20200058 Ver 1_PCN Form Submission (3)_20200114

DWR
Olrlslon 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
20200058
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:
Bridge No 123 over Meadow Branch on SR 1552 (BR-0120; Central)
1a. Who is the Primary Contact?*
NCDOT
1b. Primary Contact Email:*
[e-mail]
Date Submitted
1/14/2020
Nearest Body of Water
Meadow Branch
Basin
Tar -Pamlico
Water Classification
C; Sw, NSW
Site Coordinates
Latitude: Longitude:
35.703090-77.205065
A. Processing Information
County (or Counties) where the project is located:
Pitt
Is this project a public transportation project?*
IT Yes r No
Is this a NCDOT Project?*
r Yes r No
(NCDOT only) T.I.P. or state project number:
BR-0120
WBS#M
48829.1.1
1a. Type (a) of approval sought from the Corps:
Version#*
1
Reviewing Office*
Washington Regional Office - [phone]
1c. Primary Contact Phone:*
[phone]
V

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
1598 Mail Service Center
Address Line 2
city
Raleigh
Fbstal / Zip Code
27699-1598
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:
ff appropriate)
1c. Nearest municipality/ town:
Stokes
Project 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:*
Meadow Branch
3b. Water Resources Classification of nearest receiving water:*
C; Sw, NSW
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.
030201030503
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:*
General land use in the project vicinity is forestry, agriculture and rural residential.
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:
2.79
4g. List the total estimated linear feet of all existing streams on the property:
424
4h. Explain the purpose of the proposed project:*
Bridge replacement. Built in 1958, the bridge requires replacement due to deterioration of structural elements.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
This project is comprised of the replacement of Bridge No. 730123 over Meadow Branch on SR 1552 (Tucker -Bullock Road) in Pitt County, North Carolina. The bridge will be replaced
on the epsting alignment while detouring traffic offsite. The proposed typical section on either side of the bridge will be normal crown with cross slope of 0.025, and consist of two 10'
lanes with 3' paved shoulder and 3:1 side slopes to wasting ground. The proposed bridge will be apprommately 72 feet long with a clear roadway width of 24.8 feet. Typical road building
equipment such as bulldozers, graders, and cranes will be used.
4j. Please upload project drawings for the proposed project.
BR-0120_Permit_Drawings_20191220.pdf 3.14MB
BR-0120_Permit_DraWngs_BUFFER _20191204.pdf 1.86MB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes r No O Unknown
Comments:
JD package previously submitted

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): Nathan Howell & Lillian Lovingood
Agency/Consultant Company: Three Oaks Engineering
Other:
5d1. Jurisdictional determination upload
BR0120_Updated PJD_Package_07102019.pdf
6. Future Project Plans
7.28MB
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
r Open Waters r Pond Construction
2. Wetland Impacts
W Buffers
U
2a1 Reason (?)
2b. Impact type * M
2c. Type of W.*
2d. W. name *
2e. Forested *
2f. Type of
Jurisdicition*(?)
2g. Impact
area*
1
bridge
P
Riverine Swamp Forest
WB
Yes
Both
0.012
(acres)
bridge
P
Riverine Swamp Forest
WB
Yes
Both
0.023
(acres)
roadway/rip rap
P
Riverine Swamp Forest
WB
f=foth
19=1
2g. Total Temporary Wetland Impact
0.000
2g. Total Wetland Impact
0.037
2h. Comments:
3. Stream Impacts
2g. Total Permanent Wetland Impact
0.037
3a. Reason for impact (?) 3b.lmpact type * 3c. Type of impact* �3�name* ��3e. Stream Type* 3f. Type of ff��
3h. Impact
(?) Jurisdiction* length*
S1
Bridge construction
g
Tem orar
p y
Bank Stabilization
Meadow Branch
Perennial
Both
30
Average (feet)
85
(lir�rfeet)
S2
Bridge construction
Tem ora
p ryAvenge(feet)
Bank StabilizationJMe.d.Branch
Perennial
Both9
(linearfeet)
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
0
3i. Total stream and ditch impacts:
158
3j. Comments:
3i. Total temporary stream impacts:
158

Shown as combined 0.02 ac on the impact summary sheet
6. Buffer Impacts (for DWR)
6a. Project is in which protect basin(s)?
Check 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
Roadway Construction
P
Meadow Branch
No
559
137
Proposed bridge
P
Meadow Branch
No
67
1,038
6h. Total buffer impacts:
Zone 1 Zone 2
Total Temporary impacts: 0.00 0.00
Zone 1 Zone 2
Total Permanent impacts: 626.00 1,175.00
Zone 1 Zone 2
Total combined buffer impacts: 626.00 1,175.00
6i. 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 project utilizes the epsting alignment. Slopes will be 3:1 in jurisdictional wetlands.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Traffic will be maintained during construction by use of an offsite detour route. Design Standards in Sensitive Watersheds Will be implemented. See
the attached Stormwater Management Plan for additional measures.
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 impacts are minimal.
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 SMNT)
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:
G. Supplementary Information
1. Environmental Documentation
la. 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
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 (15ANCAC 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.
The project involves replacing an wasting bridge on the exsting alignment, and should not result in additional development.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
rYes 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?
USFWS County list, NC Natural Heritage Program database.
Consultation Documentation Upload
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 map data.

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 Document
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 mapping.
Miscellaneous U
Comments
Miscellaneous attachments not previously requested.
Signature U
P 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 AGC);
• 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
flack C. Aurt.G ma - /V
Date
1 /14/2020