20200399 Ver 1_PCN Form Submission_20200325

DWR
mrlslon 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?*
6 Yes
r No
Is this project a public transportation project?*
G Yes r No
Change only if needed.
BIMS # Assigned
20200399
Is a payment required for this project?*
r No payment required
6 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. 93 over Jacks Swamp on SR 1203 (BR-0118 Central)
1a. Who is the Primary Contact?*
NCDOT
1b. Primary Contact Email:*
[e-mail]
Date Submitted
3/25/2020
Nearest Body of Water
Jacks Swamp
Basin
Chowan
Water Classification
25-4-2-3
Site Coordinates
Latitude:
36.515306
A. Processing Information
County (or Counties) where the project is located:
Northampton
Is this project a public transportation project?*
/: Yes r No
Is this a NCDOT Project?*
IT Yes r No
(NCDOT only) T.I.P. or state project number:
BR-0118
WBS#M
48827.1.1
1a. Type (a) of approval sought from the Corps:
Longitude:
-77.542509
Version#*
1
Reviewing Office*
Washington Regional Office - [phone]
1c. Primary Contact Phone:*
[phone]
U

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:
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
23 - Categorical Exclusions
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
r 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
27604
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:
(if appropriate)
1c. Nearest municipality/ town:
Pleasant Hill
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:*
Jacks Swamp
3b. Water Resources Classification of nearest receiving water:*
25-4-2-3
3c. What river basin(s) is your project located in?*
Chowan
3d. Please provide the 12-digit HUC in which the project is located.
030102040705
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 vicinity consists of agricultural, forest land and scattered rural residential uses.
Built in 1959 the bridge requires replacement due to deterioration of structural elements.
The posted weight limits for the bridge are currently 17 Tons and 23 Tons for single
vehicles and truck tractor -semi trailers, respectively. The existing bridge is 35 feet long
with a clear roadway width of 19 feet. Bridge No. 093 has a sufficiency rating of 50.76 and
is categorized as "Not Deficient". However, the steel superstructure and timber substructure
elements show signs of deterioration and have had to be shored after previous inspections
indicated advanced deterioration. This is a bridge replacement and safety improvement
project.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
F Yes G 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:
4.6
4g. List the total estimated linear feet of all existing streams on the property:
533
4h. Explain the purpose of the proposed project:*
This project is comprised of the replacement of Bridge No. 650093 over Jacks Swamp on SR 1203 (Jack Swamp Road) in Northampton County, North Carolina. The bridge will be
replaced on the ebsting alignment while detouring traffic onsite.
The replacement of Bridge No. 093 is part of the Growing Rural Economy and Agriculture through Transportation and Technology Enhancement or Replacement in North Carolina
(GREATER -NC) Project under the United States Department of Transportation's 2018 Better Utilizing Investments to Leverage Development (BUILD) Grant program. The purpose of the
grant and this bridge replacement project is to provide transportation infrastructure to support economic development and improve physical and digital connectivity in rural communities
in North Carolina. The posted weight restriction on Bridge No. 093 prohibits large or heavy vehicles, typically used in transporting agricultural and manufactured products, from using
the bridge. Replacing the ebsting bridge will eliminate posted weight limits by providing a safe crossing for all legal loads and will make accommodations for broadband installation in
order to support economic competitiveness.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*

The proposed bridge will be a single span 70 feet long with a deck width of 30 feet, replacing the existing 35-foot long single span. The approach roadway will extend 320 feet and 470
on the west and east sides, respectively. The proposed design will provide ten foot paved lanes and no paved shoulders except in the vicinity of the proposed bridge. The bridge will be
replaced on the existing alignment while detouring traffic onsite. Standard road building equipment will be used.
4j. Please upload project drawings for the proposed project.
BR-0118_PERMITS_WETLANDS_20200102.pdf 5.52MB
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:
SAW-2019-01058
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Jim Mason
Agency/Consultant Company: Three Oaks Engineering, Inc.
Other:
5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
9/21/2019
5d1. Jurisdictional determination upload
SAW-2019-01058 NCDOT BR 0118 Jacks Swamp Road JD.pdf 259.69KB
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 r Buffers
r Open Waters r Pond Construction
2. Wetland Impacts
2a1 Reason (?)
2b. Impact type * (?)
2c. Type of W.
m 2d. W. nae *
2e. Forested *
2C Type of ��2g.
Jurisdicition*(?)
Impact
area*
1
Roadway fill
P
Riverine Swamp Forest
WAWD
Yes
Both
0.028
(acres)
1
Mechanized clearing
P
Riverine Swamp Forest
WAWD
Yes
Both
0.017
(acres)
Bridge fill
P
fferine Swamp Forest
WAWD
Yes
Both
0.004
(acres)
Bridge excavation
P
fferine Swamp Forest
WAWD
Yes
Both
0.010
(acres)
Mechanized clearing
P
fferine Swamp Forest
WAWD
Yes
Both
0.009
(acres)
Bridge fill
P
Everine Swamp Forest
WAWD
Yes
Both
0.006
(acres)
Bridge excavation
P
fferine Swamp Forest
WA,WD
Yes
Both
0.005
(acres)
Mechanized clearing
P
fferine Swamp Forest
WAWD
Yes
Both
0.003
(acres)

2
Roadway fill
P
Riverine Swamp Forest
WA,WD
Yes
Both
0.032
(acres)
2
Mechanized clearing
P
Riverine Swamp Forest
WA,WD
Yes
oth
f
0.002
(acres)
3
Detour fill
T
Riverine Swamp Forest
WD
Yes
Both
0.087
(acres)
Mechanized clearing
P
Riverine Swamp Forest
WD
Yes
Both
0.023
(acres)
Detour fill
T
Riverine Swamp Forest
WD
Yes
Both
0.106
(acres)
Mechanized clearing
P
Riverine Swamp Forest
WD
Yes
Both
0.026
(acres)
2g. Total Temporary Wetland Impact
0.193
2g. Total Wetland Impact
0.358
2h. Comments:
3. Stream Impacts
2g. Total Permanent Wetland Impact
0.165
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*
F
Swamp Perennial Both 4Average (fee) 53nea fcet)
S1 Bridge Temporary Other ffs
S2
Bank Stabilization
Permanent
Bank Stabilization JIack.
p
Swam Iff::]
Both
40erage(feet)
Avrfcet)
(linea125
31. Total jurisdictional ditch impact in square feet:
31. Total permanent stream impacts:
125
31. Total stream and ditch impacts:
178
31. Total temporary stream impacts:
53
3j. Comments:
Permanent impacts to surface water total 0.009 acre, temporary impacts to surface water total 0.004 acre.
E. Impact Justification and Mitigation
1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
Offsite Detour — An offsite detour was not evaluated due to SR 1203 being a dead-end road, making an offsite detour not feasible. No -Build — The no
build alternative would result in eventually closing the road, which is unacceptable given the volume traffic served by SR 1203 (Jack Swamp Road).
Rehabilitation — The bridge was constructed in 1959 and the bridge materials are reaching the end of their useful life. Rehabilitation would require
replacing the steel superstructure and timber substructure components, which would constitute effectively replacing the bridge. Staged Construction —
Staged construction was not considered because the temporary structure can be built with minimum project disturbance. New Alignment — Given that
the alignment for SR 1203 is acceptable, a new alignment was not onsidered as an alternative.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Permanent Impacts — The proposed design will steepen roadway slopes to 2:1 or 1.5:1 with rock plating to minimize wetland impacts.
Temporary Impacts — The proposed temporary design will steepen roadway slopes to as much as possible. The design will also utilize geote#ile
matting within wetland fill areas to minimize wetland impacts. The temporary fill will be removed and the area will be regraded to pre -construction
contours and replanted with riparian vegetation.
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
2c. If yes, mitigation is required by (check all that apply):
W DWR
W Corps
2d. If yes, which mitigation option(s) will be used for this project?
r Mitigation bank W Payment to in -lieu fee r Permittee Responsible
program Mitigation

4. Complete if Making a Payment to In -lieu Fee Program
4a. Approval letter from in -lieu fee program is attached.
r Yes r No
4b. Stream mitigation requested:
(linear feet)
4d. Buffer mitigation requested (DWR only):
(square feet)
4f. Non -riparian wetland mitigation requested:
(acres)
4c. If using stream mitigation, what is the stream temperature:
4e. Riparian wetland mitigation requested:
(acres)
0.165
4g. Coastal (tidal) wetland mitigation requested:
(acres)
4h. Comments
Proposed permanent impacts may be reduced. A DMS acceptance letter will be provided once impacts are finalized.
6. Buffer mitigation (State Regulated Riparian Buffer Rules) - required by DWR
6a. Will the project result in an impact within a protected riparian buffer that requires buffer mitigation? If yes, you must fill out this entire form - please contact DWR for more
information.
r Yes r No
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
1. Diffuse Flow Plan
la. 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
If no, explain why:
The Chow -an basin does not have protected riparian buffers.
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 u
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 (NEPAISEPA)? *
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 minimal transportation impact resulting from the bridge replacement the 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 forth is project?*
r Yes r Nor NIA
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
What Federal Agency is involved?
NOAA Fisheries
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?
NC Natural Heritage Program website, USFWS website, NOAA Fisheries 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 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?
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?*
FFMAfloodplain 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
)04 C. RiarWOAa , IN
Date
3/25/2020