20201438 Ver 1_ePCN Application_20201130

I I DWR
Division of Water Resources
Pre-Construction Notification (PCN) Form
October 26,2020 Ver 3.3
Initial Review
Has this project met the requirements for acceptance in to the review process?*
6 Yes
✓ No
Is this project a public transportation project?*
G Yes r No
Change only if needed.
BIMS#Assigned* Version#*
20201438 1
Is a payment required for this project?*
6 No payment required
✓ Fee received Reviewing Office*
✓ Fee needed-send electronic notification Washington Regional Office-[phone]
Select Project Reviewer*
Garcy Ward:eads\gpward
Information for Initial Review
1a.Name of project:
B-6053 Replacement of Bridge No.34 On Providence Road
1a.Who is the Primary Contact?*
Jinger Hickman(City of Elizabeth City)
lb.Primary Contact Email:* 1c.Primary Contact Phone:*
[e-mail] [phone]
Date Submitted
11/30/2020
Nearest Body of Water
Knobbs Creek
Basin
Pasquotank
Water Classification
C;Sw
Site Coordinates
Latitude: Longitude:
36.294312 -76.250410
Pre-Filing Meeting Information
ID# Version
20201438 1
Pre-fling Meeting or Request Date*
10/9/2020
Attach documentation of Pre-Filing Meeting Request here:*
DWR Pre-Filing Meeting Request Form.pdf 52.16KB
A. Processing Information C^U
County(or Counties)where the project is located:
Pasquotank

Is this a NCDMS Project
C- Yes f No
Is this project a public transportation project?*
6 Yes r No
Is this a NCDOT Project?*
6 Yes r No
(NCDOT only)T.I.P.or state project number:
B-6053
WBS#(2)
48754.1.1
1a.Type(s)of approval sought from the Corps:
fJ Section 404 Permit(wetlands,streams and waters,Clean Water Act)
r Section 10 Permit(navigable waters,tidal waters,Rivers and Harbors Act)
Has this PCN previously been submitted?*
C- Yes
6' No
lb.What type(s)of permit(s)do you wish to seek authorization?
17 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 CNo
Nationwide Permit(NWP)Number: 03-Maintenance
Nationwide Permit(NWP)Number: 12-Utility Lines
NWP Numbers(for multiple NWPS):
03 and 12
Id.Type(s)of approval sought from the DWR:
I7 401 Water Quality Certification-Regular I—'401 Water Quality Certification-Express
r Non-404 Jurisdictional General Permit r Riparian Buffer Authorization
r Individual Permit
le.Is this notification solely for the record because written approval is not required? *
For the record only for DWR 401 Certification: F' Yes C' No
For the record only for Corps Permit: l' Yes C' No
If.Is this an after-the-fact permit application?*
C- Yes f No
1g.Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
C Yes ( No
1g.Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
C- Yes r No
Acceptance Letter Attachment
1h.Is the project located in any of NC's twenty coastal counties?
6 Yes C No
1i.Is the project located within a NC DCM Area of Environmental Concern(AEC)?
C- Yes f No C- Unknown
1j.Is the project located in a designated trout watershed?
C Yes 6' No
B. Applicant Information
Id.Who is applying for the permit?
I7 Owner r Applicant(other than owner)
le.Is there an Agent/Consultant for this project?*
C: Yes C' No

2.Owner Information
2a.Name(s)on recorded deed:
City of Elizabeth City
2b.Deed book and page no.:
N/A
2c.Responsible party:
Jinger Hickman(City of Elizabeth City)
2d.Address
Street Address
PO Box 347
Address Line 2
Criy State/Province/Region
Elizabeth City NC
Postal/Zip Corte Country
27907 USA
2e.Telephone Number: 2f.Fax Number:
[phone]
2g.Email Address:*
[e-mail]
4.Agent/Consultant(if applicable)
4a.Name:
Matthew Martin
4b.Business Name:
RK&K
4c.Address
Street Address
8601 Six Forks Road
Address Line 2
Forum 1,Suite 700
Criy State/Province/Region
Raleigh NC
Postal/ZZp Code Country
27615 USA
4d.Telephone Number: 4e.Fax Number:
[phone]
4f.Email Address:*
[e-mail]
Agent Authorization Letter*
Final_Signed_Contract 1.pdf 42.56KB
C. Project Information and Prior Project History
1. Project Information
lb.Subdivision name:
(if appropriate)
NA
1c.Nearest municipality/town:
Elizabeth City
2. Project Identification
2a.Property Identification Number: 2b.Property size:
N/A-City Owned 2.1
2c.Project Address
Street Address
Address Line 2
l7ty State/Rovince/Region
Postal/Zip Code Country

3.Surface Waters
3a.Name of the nearest body of water to proposed project:*
Knobbs Creek
3b.Water Resources Classification of nearest receiving water:*
C;Sw
3c. What river basin(s)is your project located in?*
Pasquotank
3d.Please provide the 12-digit HUC in which the project is located.
03010205
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 area is located around bridge B-6053 on Providence Road approximately 0.10 of a mile west of the intersection with US 17 Business in the town of Elizabeth City in
Pasquotank County,North Carolina.The general land use in the vicinity of the project is a residential neighborhood.
4b.Have Corps permits or DWR certifications been obtained for this project(including all prior phases)in the past?*
r Yes !' 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)
USGS_8.5x11.pdf 877.77KB
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:
0.4
4g.List the total estimated linear feet of all existing streams on the property:
120
4h.Explain the purpose of the proposed project:*
Bridge No.34 has a sufficiency rating of 17.6 out of 100 and is rated as structurally deficient.The 63-year-old year-old timber structure is approaching the end of its useful life.Bridge
No.34 will be replaced on the existing location.
4i.Describe the overall project in detail,including indirect impacts and the type of equipment to be used:*
Bridge No.34 will be replaced on the existing location with a new47'-4"-long bridge.The roadway will include two 10'wide lanes and 3'wide shoulders(7'shoulders where guardrail is
required).All equipment will be staged in the dry.
4j.Please upload project drawings for the proposed project.
B6053 Permit Drawings20201120.pdf 1.97MB
B6053 Prelim UC.pdf 1.32MB
5.Jurisdictional Determinations
5a.Have the wetlands or streams been delineated on the property or proposed impact areas?*
6. Yes C- No O Unknown
Comments:
5b.If the Corps made a jurisdictional determination,what type of determination was made?*
B Preliminary C- Approved C- Not Verified C- Unknown C- N/A
Corps AID Number:
SAW-2020-00839
5c.If 5a is yes,who delineated the jurisdictional areas?
Name(if known): Matthew Martin
Agency/Consultant Company: RK&K
Other:
5d.List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
USACE jurisdiction determination was completed on June 11,2020.
5d1.Jurisdictional determination upload
SAW-2020-00839 Elizabeth City_B6053.pdf 258.99KB
6. Future Project Plans
6a.Is this a phased project?*

C Yes 6. 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?
This is not a phased project.
LD. Proposed Impacts Inventory
1. Impacts Summary
1a.Where are the impacts associated with your project?(check all that apply):
7 Wetlands 17 Streams-tributaries r Buffers
17 Open Waters r Pond Construction
2.Wetland Impacts
2a.Site#*(?) 2a1 Reason(?) 2b.Impact type*(?) 2c.Type of W.* 2d.W.name* 2e.Forested* 2f.Type of 2g.Impact
Jurisdicition*(?) area*
2 Temporary Fill T Riverine Swamp Forest WA Yes Both 0.006
(acres)
3 Temporary Fill T Riverine Swamp Forest WA Yes Both 0.001
(acres)
7 Fill Slope P Riverine Swamp Forest WA Yes Both 0.001
(acres)
2g.Total Temporary Wetland Impact 2g.Total Permanent Wetland Impact
0.007 0.001
2g.Total Wetland Impact
0.008
2h.Comments:
Sites 2 and 3 are temporary impacts associated with fill a temporary fill slope.Site 7 is a permanent impact associated with a permanent fill slope.
Removal of any trees is not anticipated however if needed this will be completed by non-mechanized methods.
3.Stream Impacts
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 Removal and Sheet pile Temporary Workpad/Causeway UT to Knobbs Creek Perennial Both 25 58
installation Average(feet) (linear feet)
3i.Total jurisdictional ditch impact in square feet:
0
3i.Total permanent stream impacts: 3i.Total temporary stream impacts:
0 58
3i.Total stream and ditch impacts:
58
3).Comments:
Temporary impacts shown reflect bent removal and sheet pile installation.
4.Open Water Impacts
4a. Site# 4a1.Impact Reason 4b.Impact type 4c.Name of waterbody 4d.Activity type 4e.Waterbodytype 4f.Impact area
2 Temporary Utility Bore T TA Fill Tributary 0.03
Work pad
3 Temporary Utility Bore T TA Fill Tributary 0.04
Work pad
4 Fill Slope P TA Fill Tributary 0.01
5 Fill Slope P TA Fill Tributary 0.02
6 Fill Slope P TB Fill Tributary 0.01
7 Fill Slope P TB Fill Tributary 0.01
4g.Total temporary open water Impacts: 4g.Total permanent open water impacts:
0.07 0.05

4g.Total open water impacts:
0.12
4h.Comments:
Sites 2 and 3 are both temporary utility bore work pad locations.Sites 4,5,6 and 7 are a permanent fill slope.The smallest unit of measure for Open
Water impacts provided by the EPCN is one hundredth of a acre.To provide a better understanding of the impacts the are listed to the thousandth on
the attached impact table and below.
Site 2-Temporary Fill-0.024 acres
Site 3-Temporary Fill-0.038 acres
Site 4-Permanent Fill-0.004 acres
Site 5-Permanent Fill-0.011 acres
Site 6-Permanent Fill-0.001 acres
Site 7-Permanent Fill-0.002 acres
Total Temporary Impact-0.062 acres(Attached impact table rounded total to hundredth 0.07 acres)
Total Permanent Impact-0.018 acres(Attached impact table rounded total to hundredth 0.02 acres)
Total Open Water Impact-0.080 acres
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:
Limits of disturbance for the project were limited to the areas necessary for construction/
easements.Impacts to Waters of the U.S.were limited to the smallest footprint practicable.There are no deck drains located on the bridge.The
existing bridge demolition will follow NCDOT BMP's for bridge demolition work.An offsite detour is being utilized to eliminate any additional wetland and
surface water impacts
lb.Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Utilizing BMPs for bridge demolition will capture all components of the old structure.Erosion and Control measures will be placed along the entire
project area to reduce soil runoff.A turbidity curtain can be utilized along the banks to capture any siltation that may occur during project construction.
The utilization of precast concrete materials,reduces the potential for uncured concrete entering the adjacent waters.
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?
✓ Yes allo
2b.If this project DOES NOT require Compensatory Mitigation,explain why:
The impacts for this project are below both 150 linear feet of stream impacts and below the 1/10th acre of wetland impacts,this project is below the required mitigation thresholds found
in regional condition 3.2(pg 28)and general condition 23(pg 9)of Nationwide Permit#3.
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?
✓ Yes ( No
If no,explain why:
This project does not take place within one of the NC Riparian Buffer Protection Rule watersheds.
2.Stormwater Management Plan
2a.Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
✓ Yes 6 No
2b.Does this project meet the requirements for low density projects as defined in 15A NCAC 02H.1003(2)?
6 Yes r No
Comments:
This project meets the requirements for a low density project.
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?*
6 Yes rNo
lb.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)?*
✓ Yes r No
1c.If you answered"yes"to the above,has the document review been finalized by the State Clearing House?*
✓ Yes allo

Comments:*
The activity and impacts are covered by Minimum Criteria Checklist or PCE.
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)?*
✓ Yes f No
3. Cumulative Impacts(DWR Requirement)
3a.Will this project result in additional development,which could impact nearby downstream water quality?*
✓ Yes (cNo
3b.If you answered"no,"provide a short narrative description.
This is a single and complete project.
4.Sewage Disposal(DWR Requirement)
4a.Is sewage disposal required by DWR for this project?*
✓ Yes r No (7 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?*
✓ Yes 6' No
5b.Have you checked with the USFWS concerning Endangered Species Act impacts?*
✓ yes (7 No
5d.Is another Federal agency involved?*
(' Yes r No r Unknown
What Federal Agency is involved?
Federal Highways Administration
5e.Is this a DOT project located within Division's 1-8?
6 Yes r No
5j.What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
https://wwwfws.gov/raleigh/species/cntylist/pasquotank.html
https://www.fisheries.noa a.gov/southea st/co nsu ltations/north-ca roli na
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?*
6 Yes rNo
Are there submerged aquatic vegetation(SAy)around the project vicinity?*
✓ Yes 6 No r Unknown
6b.What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
https://www.habitat.noaa.gov/application/efhmapper/indexhtml
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?*
✓ Yes f. No
7b.What data sources did you use to determine whether your site would impact historic or archeological resources?*
http://gis.ncdcr.gov/hpoweb/and correspondence wth the State Historic Preservation Office.
7c.Historic or Prehistoric Information Upload
B-6053_SHPO.pdf 95.16KB
8. Flood Zone Designation(Corps Requirement)
8a.Will this project occur in a FEMA-designated 100-year floodplain?*
6 Yes rNo
8b.If yes,explain how project meets FEMA requirements:

NCFMP issued a letter dated June 19,2020 to the City of Elizabeth City stating that the Flood Study Report for the Providence Road Bridge
Replacement Project met FEMA's required guidance for No-Rise Certification.
8c.What source(s)did you use to make the floodplain determination?*
https://msc.fema.gov/portal/searchffsearchresultsanchor
Miscellaneous
Comments
The Wildlife Resources Commission has indicated that just downstream from the project area is designated as a spawning area for anadromous fish and that River herring are likely to
utilize the portion of the tributary in the project location.A moratorium from February 15 to June 30 is therefore required.
Attached is Email communication with Kyle Barns(USAGE).The email confirms the NWP numbers and confirms a"for the record"non-notifying PCN.
Miscellaneous attachments not previously requested.
USACE_Emails.pdf 261.71KB
Signature
*
IJ By checking the box and signing below,I certify that:
• The project proponent hereby certifies that all information contained herein is true,accurate,and complete to the best of my knowledge and belief;and
• The project proponent hereby requests that the certifying authority review and take action on this CWA 401 certification request within the applicable reasonable period of time.
• 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:
Matthew Martin
Signature
[Wm Ylexf Ole ttzie
Date
11/30/2020