20210481 Ver 1_ePCN Application_20210304

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#*
20210481 1
Is a payment required for this project?*
✓ No payment required
6 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:
Perquimans Bridge 29 Replacement Project
1a.Who is the Primary Contact?*
Paul Williams
lb.Primary Contact Email:* 1c.Primary Contact Phone:*
pcv.illiams2©ncdot.gov [phone]
Date Submitted
3/4/2021
Nearest Body of Water
UT to Perquimans River
Basin
Pasquotank
Water Classification
C;Sw
Site Coordinates
Latitude: Longitude:
36.312746° -76.509278°
Pre-Filing Meeting Information
ID# Version
Pre-fling Meeting or Request Date*
11/30/2020
Attach documentation of Pre-Filing Meeting Request here:*
Agency Onsite Meeting.pdf 100.28KB
A. Processing Information C^U
County(or Counties)where the project is located:
Perquimans

Is this a NCDMS Project
✓ Yes r No
Is this project a public transportation project?*
✓ Yes r No
Is this a NCDOT Project?*
✓ Yes r No
(NCDOT only)T.I.P.or state project number:
WBS#(�)
17BP.1.R.93
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?*
✓ Yes
r No
lb.What type(s)of permit(s)do you wish to seek authorization?
fJ Nationwide Permit(NWP)
r Regional General Permit(RGP)
r Standard(IP)
1c.Has the NWP or GP number been verified by the Corps?
C Yes rNo
Nationwide Permit(NWP)Number: 03-Maintenance
NWP Numbers(for multiple NWPS):
Id.Type(s)of approval sought from the DWR:
(7 401 Water Quality Certification-Regular r 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: r Yes r No
For the record only for Corps Permit: r Yes r No
If.Is this an after-the-fact permit application?*
✓ Yes r No
1g.Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
CYes rNo
1g.Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
✓ Yes rNo
Acceptance Letter Attachment
lh.Is the project located in any of NC's twenty coastal counties?
✓ Yes C No
1i.Is the project located within a NC DCM Area of Environmental Concern(AEC)?
✓ Yes r No r Unknown
1j.Is the project located in a designated trout watershed?
✓ Yes r No
B. Applicant Information
Id.Who is applying for the permit?
7 Owner r Applicant(other than owner)
le.Is there an Agent/Consultant for this project?*
✓ Yes r No
2.Owner Information

2a.Name(s)on recorded deed:
NCDOT Right-of-Way SR 1200 Bethany Church Road in Perquimans County
2b.Deed book and page no.:
2c.Responsible party:
Paul Williams
2d.Address
Street Address
113 Airport Dr.
Address Line 2
Criy State/Rovince/Region
Edenton NC
Postal/Zip Code Country
27932 USA
2e.Telephone Number: 2f.Fax Number:
[phone] [phone]
2g.Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
lb.Subdivision name:
(f apprcpriate)
1c.Nearest municipality/town:
Belvidere
2. Project Identification
2a.Property Identification Number: 2b.Property size:
1.5
2c.Project Address
Street Address
Bethany Church Road,approx.400 ft.from SR 1001 Sandy Cross Road
Address Line 2
aty State/Bovine/Region
Belvidere NC
Postal/Zip Code Country
27919 USA
3.Surface Waters
3a.Name of the nearest body of water to proposed project:*
UT to Perquimans River
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.
030102050303
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:*
Project area consists of NCDOT Perquimans County SR 1200 and Bridge#29.The general land use in the vicinity is rural residential,farmland,and forested swamp.
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)
B-5416_QuadMap.pdf 2.25MB
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)
Soil Map.pdf 484.76KB

4f.List the total estimated acreage of all existing wetlands on the property:
0.464
4g.List the total estimated linear feet of all existing streams on the property:
206
4h.Explain the purpose of the proposed project:*
The purpose of this project is to replace the aging Bridge#29 that has received deficiency ratings,qualifying it for replacement.NCDOT wants to maintain SR 1200 as a safe and
reliable travel route for the public.
4i.Describe the overall project in detail,including indirect impacts and the type of equipment to be used:*
Replace an eAsting 3-span 52 ft.X25 ft.bridge with a new2-span bridge structure measuring 90 ft.X33 ft.Upon completion of the structure,NCDOT will have to rebuild the roadway
approaches on either end of the bridge.This will involve some minor widening of the roadway bridge approaches.The new bridge will be constructed using a top down methodology,
utilizing an off-site detour.Access to the maintenance paths along the stream will be relocated due to the lengthening of the bridge structure.The project will be built using cranes,
excavators,backhoes,dump trucks and small equipment associated with bridge construction.The project will result in approx 0.10 acres of permanent fill in wetlands,approx 0.04
acres of temporary hand clearing in wetlands,approx 222 sq.ft.of surface water impacts and 106 linear feet of stream impacts from bank stabilization.
4j.Please upload project drawings for the proposed project.
Perquimans_29_Permit_Drawings_2021-02-03.pdf 1.68MB
5.Jurisdictional Determinations
5a.Have the wetlands or streams been delineated on the property or proposed impact areas?*
6' Yes C No C Unknown
Comments:
5b.If the Corps made a jurisdictional determination,what type of determination was made?*
C Preliminary C Approved (7, Not Verified C Unknown C N/A
Corps AID Number:
5c.If 5a is yes,who delineated the jurisdictional areas?
Name(if known): S.Stokes
Agency/Consultant Company: KCI
Other:
5d1.Jurisdictional determination upload
PJD_fillable-form2016-11.pdf 212.79KB
Wetland Data Sheets-Perquimans 29.pdf 3.7MB
B-5416_JurisdictionalFeatures_Map.pdf 1.86MB
6. Future Project Plans
6a.Is this a phased project?*
C Yes (' 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
1a.Where are the impacts associated with your project?(check all that apply):
17 Wetlands 17 Streams-tributaries r Buffers
r Open Waters r Pond Construction
2.Wetland Impacts
2a.Site#*(?) 2a1 Reason(?) 2b.Impact type*(?) 12c.Type of W.* 2d.W.name* 2e.Forested* 2f.Type of 2g.Impact
Jurisdicition*(?) area*
2 Roadway Fill P Bottomland Hardwood Forest W2 Yes Corps 0.088
(acres)
3 Roadway Fill P Bottomland Hardwood Forest W1 Yes Corps 0.008
(acres)
2 Temp.Hand Clearing T Bottomland Hardwood Forest W2 Yes Corps 0.032
(acres)

3 Temp.Hand Clearing T Bottomland Hardwood Forest W1 Yes Corps 0.008
(acres)
2g.Total Temporary Wetland Impact 2g.Total Permanent Wetland Impact
0.040 0.096
2g.Total Wetland Impact
0.136
2h.Comments:
Site 2:3821 sq.ft.Permanent Fill in Wetlands;1394 sq.ft.Clearing in Wetlands
Site 3:392 sq.ft.Permanent Fill in Wetlands;353 sq.ft.Clearing in Wetlands
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 Bank Stabilization Permanent Bank Stabilization UT to the Perquimans River Perennial Corps 35 106
Average(feet) (linear feet)
3i.Total jurisdictional ditch impact in square feet:
0
3i.Total permanent stream impacts: 3i.Total temporary stream impacts:
106 0
3i.Total stream and ditch impacts:
106
3j.Comments:
Site 1(Bank Stabilization):222 sq.ft.Permanent SW Impacts
E. Impact Justification and Mitigation u
1.Avoidance and Minimization
1a.Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
NCDOT minimized the roadway width by narrowing the shoulders and bridge width to the minimal amount allowable with the design speed and roadway
geometry.There are no deck drains located on the bridge.The existing bridge demolition will follow NCDOT BMP's for bridge demolition work.Erosion
and Sediment control plans have been designed and will be followed to retain any runoff from construction activities.An offsite detour is being utilized
to eliminate any additional wetland and surface water impacts.
1b.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?
r Yes 6. No
2b.If this project DOES NOT require Compensatory Mitigation,explain why:
Impacts are below the threshold requiring mitigation.
F. Stormwater Management and Diffuse Flow Plan (required by DWR) L)
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 t: No
If no,explain why:
NC Riparian Buffer Rules do not apply to the Pasquotank River Basin.
2.Stormwater Management Plan
2a.Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
6 Yes r No
Comments:
NCDOT will follow best management practices for soil and erosion control in compliance with N.C.Sediment and Pollution Control Act and NCDOT NPDES permit.Erosion control
devices will be installed and maintained during the project.A grated drop inlet on the NW side will route storm water to vegetated buffers prior to entering surface waters.No deck drains
will be located over surface waters.

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?*
(7 Yes r No
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 (eNo
Comments:*
Activity and impacts covered by Minimum Criteria Checklist or PCE.
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)?*
✓ Yes f• No
3. Cumulative Impacts(DWR Requirement)
3a.Will this project result in additional development,which could impact nearby downstream water quality?*
✓ Yes (eNo
3b.If you answered"no,"provide a short narrative description.
Project replaces an existing bridge with a bridge.
4.Sewage Disposal(DWR Requirement)
4a.Is sewage disposal required by DWR for this project?*
✓ Yes r No G 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 (eNo
5d.Is another Federal agency involved?*
✓ Yes r No r Unknown
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?
NC Natural Heritage Data Explorer Website
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?*
C Yes (e No
6b.What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
National Marine Fisheries Database
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?*
6 Yes r No
7b.What data sources did you use to determine whether your site would impact historic or archeological resources?*
NCDOT Cultural Resources Unit
7c.Historic or Prehistoric Information Upload

15-03-0019EffectsUPDATE.pdf 1.1MB
15-03-0019SurveyReq.pdf 2.9MB
15-03-0019 Perquimans(NHP).pdf 17.34MB
15-03-0019 Perquimans(SR).pdf 7MB
8. Flood Zone Designation(Corps Requirement)
8a.Will this project occur in a FEMA-designated 100-year floodplain?*
( Yes r No
8b.If yes,explain how project meets FEMArequirements:
FEMA Approved
8c.What source(s)did you use to make the floodplain determination?*
NC DOT Hydraulics Unit,Zone AE
Miscellaneous v
Comments
NCWRC did not request an in-water work moratorium for this project.
CAMA General Permit will be required for this project.
Miscellaneous attachments not previously requested.
multibridge 01302015_WRC.pdf 128.83KB
Signature
*
17 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:
Paul Collins Williams,Jr.
Signature
Date
3/4/2021