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PRE-CONSTRUCT40N NOTIZXCATION (POI
NA?IONWZDE 33
TOi NATIONAL MARINE FISHERIES/BEAUFORT, NC
FISH & WILDLIFE SERVICE/RALEIGH, NC
NC DIVISION OF WATER QUALITY/RALEIGH, NC
EPA/ATLANTA, GA
STATE HISTORIC PRESERVATION OFFICE/RALEIGH, NC
1. ACTION 10.200000860
2. APPLICANT: NCDOT/B-2625
3. DATE OF TRANSMITTAL: MAR. 2, 2000
4. RESPONSE DEADLINE : MAR. 10. 2000
5. COMMENT DEADLINE (10 days from response deadline)
MAR 20 2000
6. SEND COMMENTS TO WILMINGTON DISTRICT CORPS OF ENGINEERS.
b1 NSaTQN RFGULATTQRY EJELLD OFFICE
ATTN: DAVE TzMQX (910) 253.-4634
FAX NO. [phone]
NUMBER OF PAGES, INCLUDING THIS SHEET:

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THIS PACKET OF INFORMATION IS
PROVIDED TO ASSIST YOU IN
COMPLETING THE PRE-
CONSTRUCTION NOTIFICATION (PCN)
FORM THAT IS REQUIRED BY THE
U. S. ARMY CORPS OF ENGINEERS
AND THE NORTH CAROLINA
DIVISION OF ENVIRONMENTAL
MANAGEMENT WHEN APPLYING
FOR CERTAIN NATIONWIDE
PERMITS AUTHORIZED BY THE U.S.
ARMY CORPS OF ENGINEERS
3/25/96
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DEM ID: CORPS ACTION ID: TIP No. B-2625
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT 0): , 33
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
1) NOTIFICATION TO THE CORPS OF ENGINEERS
2) APPLICATION FOR SECTION 401 CERTIFICATION
3) COORDINATION WITH THE NC DIVISION OF COASTAL MANAGZNENT
SEND THE ORIGINAL AND (1) COPY OF THIS COMPLETED FORM TO THU APPROPRIATE
FIELD OFFICE OF THE CORPS OF ENGINEERS (SEE AGENCY ADDRESSES SHEET").
SEVEN (7) COPIES SHOULD BE SENT TO THE N.C. DIVISION OF ENVIRONMENTAL
MANAGEMENT (SEE AGENCY ADDRESSES SHEET). PLEASE PRINT.
1. OWNERS NAME: NC Dopt. of Transportation; Proijoct Dovolopmunt G
Environmontal Analynia Branch
2. MAILING ADDRESS: Poat Offico_Box 25201
SUBDIVISION NAME:
CITY: Ralcigh STATE: NC ZIP CODE: 25201
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (II± DIFFERENT
FROM MAILING ADDRESS ABOVE):
3. TELEPHONE NUMBER (HOME): (WORK): 919-733-3141
4. IF APPLICABLE; AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL,
ADDRESS, PHONE NUMBER;
William D. Gilmoro , P.E., Managor _
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS
TOPOGRAPHIC MAP OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: Sampson NEAREST TOWN OR CITY: Iiarrolla
1
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SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ETC.):
From NC 41 in Harrolls, take SR 1007 to cronning of Black Rivor
6. IMPACTED OR NEAREST STREAM/RIVER: Black River
RIVER BASIN: Cape Fear
7a, IS PROJECT LOCATED NEAR WATP CLASSIFIED AS TROUT, TIDAL SALTWATER
(SA), HIGH QUALITY WATERS (HQW),`OUTSTANDING RESOURCE WATERS (ORW),
WATER SUPPLY (WS-I OR WS-II)? YfS (X] NO [] IF YES, EXPLAIN: _
claaaifiad as ORW, will uno_Doaign Standards in S©naitivu Watornhoda
7b. IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)?YES[ ] NO[X]
7c. IF THE PROJECT IS LOCATED WITHIN A COASTAL COUNTY (SEE PAGE 7 FOR
LIST OF COASTAL COUNTIES), WHAT IS THE LAND USE PLAN (LUP) DESIGNATION?
No
@a. HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON
THIS PROPERTY? YES [ J NO [X] IF YES, PROVIDE ACTION I.D. NUMBER OF
PREVIOUS PERMIT AND ANY ADDITIONAL. INFORMATION (INCLUDE PHOTOCOPY OF 401
CERTIFICATION):
Bb. ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE
FUTURE? YES [X] NO [ ] IF YES, DESCR15L ANTICIPATED WORK: _
9a. ESTIMATED TOTAL NUMBER OF ACRES IN TRACT OF LAND:
9b. ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT
SITE.
temporary impact of 0.05 from mechanized clearing and potential of
55 cubic vards of surface water impact from bridge demolition
2
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10a. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: EXCAVATION:
FLOODING:
DRAINAGE:
OTHER: 0.05 acre mech clearing
TOTAL ACRES TO BE IMPACTED: 0.05
10b. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (ZF
RELOCATED, PROVIDE DYSTANCE BOTH BEFORE AND AFTER RELOCATION :
LENGTH BEFORE: N/A FT AFTER:
FT
WIDTH BEFORE (based on normal high water contours): FT
WIDTH AFTER: FT
AVERAGE DEPTH BEFORE:
FT AFTER:
FT
(2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: PLACEMENT OF PIPE IN CHANNEL:
CHANNEL EXCAVATION: CONSTRUCTION OF A DAM/FLOODING:
OTHER: .
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE
WATERSHED DRAINING TO THE POND?
WHAT IS THE EXPECTED POND SURFACE AREA?
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF
MECHANICAL EQUIPMENT TO BE USED (ATTACH PLANS: 8 1/2" X 11" DRAWINGS
ONLY): Roplacemant of Bridgo No. 58 on SR 1007
13. PURPOSE OF PROPOSED WORK: Construction of public roadway
3
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14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED
OUT IN WETLANDS. (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND
rMphrT-q I -
impacts to wetlands are unavoidable. Wetlands exist adjacent to
the existing roadway.
15. YOU ARE REQUIRED TO CONTACT THE U.S. FISH AND WILDLIFE SERVICE
(USFWS) AND/OR NATIONAL MARINE FISHERIES SERVICE (NMFS) (SEE AGENCY
ADDRESSES SHEET) REGARDING THE PRESENCE OF ANY FEDERALLY LISTED OR
PROPOSED FOR LISTING ENDANGERED QR THREATENED SPECIES OR CRITICAL
HABITAT IN THE PERMIT AREA THAT MAY BE AFFECTED BY THE PROPOSED PROJECT.
DATE CONTACTED: (ATTACH RESPONSES FROM THESE AGENCIES.)
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER
(SHPO) (SEE AGENCY ADDRESSES SHEET) REGARDING THE PRESENCE OF HISTORIC
PROPERTIES IN THE PERMIT AREA WHICH MAY BE AFFECTED BY THE PROPOSED
PROJECT. DATE CONTACTED:
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OR THE USE
OF PUBLIC (STATE) LAND?
YES [Xj NO [3 (IF NO, GO TO 18)
a. IF YES, DOES THE PROJECT REQUIRE PREPARATION OF AN
ENVIRONMENTAL DOCUMENT PURSUANT TO THE REQUIREMENTS OF THE NORTH
CAROLINA ENVIRONMENTAL POLICY ACT?
YES (X3 NO ( 3
b. IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE?
YES [X3 NO [I
IF ANSWER TO 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE
STATE CLEARINGHOUSE TO DIVISION OF ENVIRONMENTAL MANAGEMENT REGARDING
COMPLIANCE WITH THE NORTH CAROLINA ENVIRONMENTAL POLICY ACT.
QUESTIONS REGARDING THE STATE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED TO MS. CHRYS BAGGETT, DIRECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION, 116 WEST JONES STREET, RALEIGH,
NORTH CAROLINA 27603-8003, TELEPHONE [phone].
4
n_ trr..nc.n nt+ ?rnre nLWVMT.aMna TMOhf T n RV TPP PROPOSEn PROJECT BY:
ld STATP PKASnNS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED
18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF
PROPOSED ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OR FILL MATERIAL
INTO WETLANDS:
a. WETLAND DELINEATION MAP SHOWING ALL WETLANDS, STREAMS, LAKES
AND PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14, 18, 21,
26, 29, AND 38). ALL STREAMS (INTERMYTTENT AND PERMANENT) ON THE
PROPERTY MUST BE SHOWN ON THE MAP. MAP SCALES SHOULD BE 1 INCH EQUATES
50 FEET OR 1 INCH EQUALS 100 FEET OR THEIR EQUIVALENT.
b. IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE
IMPACTED BY PROJECT.
C. IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA
SHEETS RELEVANT TO THE PLACEMENT OF THE DELINEATION LINE,
d. ATTACH A COPY OF THE STORK-WATER MANAGEMENT PLAN IF REQUIRED.
e. WHAT IS LAND USE OF SURROUNDING PROPERTY? Rural,
f. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
g. SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE: TETLANDS OR TIATZRS OF TILE V. S. MAY NOT BE IMPACTED PRIOR TO:
1) ISSUANCE OF A SECTION 404 CORPS OF ENGINEERS PERMIT,
2) EITHER T$$ ISSUANCE OR TMIVER OF A 401 DIVISION OF
ENVIRONMENTAL MANAGEMENT (17ATER QUALITY) CERTIFICATION, AND
3) (IN THE TWENTY COASTAI, COUNTIES ONLY), A LETTER FROM THE
NORTH CAROLINA DIVISION OF COASTAL MANAGEMENT STATING THE PROPOSED
ACTIVITY IS CONSISTENT WITH THE NORTH CAROLITUI COASTAL 13A=GEMENT
PROGRAM.
OWNER'S/AGENT'S SIGNATURE
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED (18g.))
5
DATE
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AGENCY ADDRESSES
SNDANCERID BPECZES:
U.S. FISH AND WILDLIFE SERVICE
RALEIGH FIELD OFFICE
P.O. BOX 33726
RALEIGH, NC 27636-3726
TELEPHONE [phone]
1113TORIC M3OUAC>r0:
NATIONAL MARINE FISHERIES 32RVICC
HABITAT CONSERVATION DIVISION
PIV$RS ISLAND
BEAUFORT, NC 28516
TELEPHONE [phone]
STATE HISTORIC PRESERVATION OFFICE
N.C. DIVISION OF ARCHIVES AND HISTORY
109 EAST JONES STREET
RALEIGH, NC 27601
TELEPHONE [phone]
STATE REGULATORY AGENCIES:
MR. JOHN DORNEY
DIVISION OF ENVIRCNMENTAL MANAGEMENT
NORTH CAROLINA DEPARTMENT OF
BNVIAONP,2NT, HEALTH, AND NATURAL
RESOURCES
4401 M20Y CREEK ROAD
RALEIGH, NORT11 CAROLINA 27607
TELEPHONE [phone]
CORPS OP ENanmz 3 n'%= OrrIC8:0:
RALEIGH REGULATORY FIELD OFFICE
US ARMY CORPS OF ENGINEER3
6508 FALLS OF THE NEUSE ROAD,
SUITE 120
RALEIGH, NC 27615
TELEPHONE [phone]
WASHINGTON REGULATORY FIELD OFFICE
US ARMY CORPS OP CNGINEERS
POST OFFICE BOX 1000
WASHINGTON, NC 27889-1000
TELEPHONE [phone]
U.S. CIS11 AND WILDLIFE SERVICE
ASHEVILLE FIELD OFFICE
160 2ILLICOA STREET
ASHEVILLE, NC 28801
TELEPHONE[phone]
MR, STEVE BENTON
DIVISION OF COASTAL MAVAGEMCNT
NORTH CAROLINA DEPARTMENT OF
E11VIRONMENT, HEALTH, AND NATURAL
RESOURCES
POST Orr%CE BOX 27687
RALEIGH, NORTH CAROLINA 27611-7657
TELEPHONE [phone]
EXX [phone]
ASHEVILLE REGULATORY FIELD OFFICE
US AMY CORPS OF ENGINEERS
151 PATTCN AVENUE, ROOM 143
ASHEVILLE, NC 28801-5006
TELEPHONE [phone]
WILMINGTON REGULATORY FIELD OFFICE
US ARMY CORPS OF ENGINEERS
POST OFFICE BOX 1890
WILMINGTON, NO 28402-1890
TELEPHONE [phone]
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