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Home My WebLink About20120662 Ver 1_Application_20120801Office Use Only Corps action ID no DWQ project no Form Version 1 3 Dec 10 2008 Page 1 of 11 PCN Form — Version 1 3 December 10 2008 Version c i r 6 , a i 3 Pre - Construction Notification PCN) Form A Applicant Information 1 Processing la Type(s) of approval sought from the Corps FE Section 404 Permit ❑ Section 10 Permit 1b Specify Nationwide Permit (NWP) number 14 or General Permit (GP) number 1c Has the NWP or GP number been verified by the Corps? ❑ Yes ® No 1 d Type(s) of approval sought from the DWQ (check all that apply) ® 401 Water Quality Certification — Regular ❑ Non 404 Jurisdictional General Permit ❑ 401 Water Quality Certification — Express ® Riparian Buffer Authorization 1e Is this notification solely for the record because written approval is not required? For the record only for DWQ 401 Certification ❑ Yes ® No For the record only for Corps Permit ® Yes ❑ No 1f Is payment into a mitigation bank or in lieu fee program proposed for mitigation of impacts? If so attach the acceptance letter from mitigation bank or in lieu fee program ❑ Yes ® No 1g Is the project located in any of NC s twenty coastal counties If yes answer 1 h below ❑ Yes ® No 1h Is the project located within a NC DCM Area of Environmental Concern (AEC) TO Yes ® No 2 Project Information 2a Name of project 17BP 2 R 17 Lenoir 163 Bridge To Pipe Replacement SR 1324 Over Canal WBS Element Number 17BP 2 R 17 Kennedy Home Road 2b County Lenoir 2c Nearest municipality / town Kinston 2d Subdivision name N/A 2e NCDOT only T I P or state project no 17BP 2 R 17 3 Owner Information 3a Name(s) on Recorded Deed North Carolina Department of Transportation 3b Deed Book and Page No N/A 3c Responsible Party (for LLC if applicable) N/A 3d Street address 105 Pactolus Highway NC 33 P O Box 1587 3e City state zip Greenville NC 27835 3f Telephone no 252 429 2800 3g Fax no 252 830 3341 3h Email address jbjohnson @ncdot gov Page 1 of 11 PCN Form — Version 1 3 December 10 2008 Version c i r 6 , a i 3 B Project Information and Prior Project History 1 Property Identification 17BP 2 R 17 Lenoir 163 Bridge To Pipe Replacement 1a Property identification no (tax PIN or parcel ID) SR 1324 Kennedy Home Road Over Canal Latitude N 35 251571 Longitude W 1b Site coordinates (in decimal degrees) 77 702084 (DD DDDDDD) ( DD DDDDDD) 1c Property size N/A acres 2 Surface Waters 2a Name of nearest body of water (stream river etc ) to Falling Creek a Tributary of The Neuse River proposed project 2b Water Quality Classification of nearest receiving water C Sw NSW 2c River basin Middle Neuse 03020202 3 Project Description 3a Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this application SR 1324 Kennedy Home Road is a paved Secondary State Highway Woodlands and Agriculture dominate the landscape 3b List the total estimated acreage of all existing wetlands on the property 0 Square Feet (0 0 Acres) of 404 Wetland Impacts For The Bridge To Pipe Replacement 3c List the total estimated linear feet of all existing streams (intermittent and perennial) on the property 60 This site is part of a longer adjacent stream system 3d Explain the purpose of the proposed project Bridge To Pipe Replacement the existing bridge has deteonated and needs replacing 3e Describe the overall project in detail including the type of equipment to be used The Existing 76 Long Timber Bridge on Timber Pilings will be replaced with a Proposed 2 @ 112 x 75 x 48 5 CMPA with Headwalls 4 Jurisdictional Determinations 4a Have jurisdictional wetland or stream determinations by the Corps or State been requested or obtained for this property / El Yes ®No El Unknown project (including all prior phases) in the pasty Comments 4b If the Corps made the jurisdictional determination what type Preliminary ❑ Final of determination was made? 4c If yes who delineated the jurisdictional areas? Agency /Consultant Company Name (if known) Other 4d If yes list the dates of the Corps jurisdictional determinations or State determinations and attach documentation 5 Project History 5a Have permits or certifications been requested or obtained for ❑ Yes ® No ❑ Unknown this project (including all prior phases) in the past? 5b If yes explain in detail according to help file instructions Page 3 of 11 PCN Form — Version 1 3 December 10 2008 Version 5 Endangered Species and Designated Critical Habitat (Corps Requirement) 5a Will this protect occur in or near an area with federally protected species or ❑Yes habitat? 5b Have you checked with the USFWS concerning Endangered Species Act impacts? ❑ Yes ( 5c if yes ind icate the USFWS Field Office you have contacted ❑ Raleigh ❑ Asheville �i 1 i� 3 ® No 5d What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat? Mr Travis Wilson NCWRC Mr Mike Sanderson NCDOT NEU 6 Essential Fish Habitat (Corps Requirement) 6a Will this protect occur in or near an area designated as essential fish habitat? I ❑ Yes ® No 6b What data sources did you use to determine whether your site would impact Essential Fish Habitat? Mr Travis Wilson NCWRC 7 Historic or Prehistoric Cultural Resources (Corps Requirement) 7a Will this protect occur in or near an area that the state federal or tribal governments have designated as having historic or cultural preservation ❑ Yes ® No status (e g National Historic Trust designation or properties significant in North Carolina history and archaeology)? 7b What data sources did you use to determine whether your site would impact historic or archeological resources? NCDOT HEU Historic Architecture and Archaeology 8 Flood Zone Designation (Corps Requirement) 8a Will this protect occur in a FEMA designated 100 year floodplain? (� Yes ❑ No 8b If yes explain how protect meets FEMA requirements Designed to no rise standards 8c What source(s) did you use to make the floodplain determination? FEMA FIRM Maps Jay B Tohnson August 2012 Applicant/Agent s Printed Name I ir n /giant s Signature Date (Agents signatu �fp v i nl I an authorization letter from the applicant Page 11 of 11 PCN Form — Version 1 3 December 10 2008 Version � 4 t� r s s 1 s i k � Page 1 of 10 PCN Form – Version 1.3 December 10, 2008 Version Office Use Only: Corps action ID no. _____________ DWQ project no. _______________ Form Version 1.3 Dec 10 2008 Pre-Construction Notification (PCN) Form A. Applicant Information 1. Processing 1a. Type(s) of approval sought from the Corps: Section 404 Permit Section 10 Permit 1b. Specify Nationwide Permit (NWP) number: 14 or General Permit (GP) number: 1c. Has the NWP or GP number been verified by the Co rps? Yes No 1d. Type(s) of approval sought from the DWQ (check all that apply): 401 Water Quality Certification – Regular Non-404 Jurisdictional General Permit 401 Water Quality Certification – Express Riparian Buffer Authorization 1e. Is this notification solely for the record because written approval is not required? For the record only for DWQ 401 Certification: Yes No For the record only for Corps Permit: Yes No 1f. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts? If so, attach the acceptance letter from mi tigation bank or in-lieu fee program. Yes No 1g. Is the project located in any of NC’s twenty coast al counties. If yes, answer 1h below. Yes No 1h. Is the project located within a NC DCM Area of En vironmental Concern (AEC)? Yes No 2. Project Information 2a. Name of project: Widen Shoulders US 258/13 WBS Element Number 45191 2b. County: Greene 2c. Nearest municipality / town: Farmville 2d. Subdivision name: N/A 2e. NCDOT only, T.I.P. or state project no: 45191 3. Owner Information 3a. Name(s) on Recorded Deed: North Carolina Departm ent of Transportation 3b. Deed Book and Page No. N/A 3c. Responsible Party (for LLC if applicable): N/A 3d. Street address: 105 Pactolus Highway NC 33 P .O. Box 1587 3e. City, state, zip: Greenville, NC 27835 3f. Telephone no.: 252-439-2800 3g. Fax no.: 252-830-3341 3h. Email address: jbjohnson@ncdot.gov Page 3 of 10 PCN Form – Version 1.3 December 10, 2008 Version B. Project Information and Prior Project History 1. Property Identification 1a. Property identification no. (tax PIN or parcel ID ): US 258/13, 0.4 Miles South of US 13 & US 258 1b. Site coordinates (in decimal degrees): Latitude: N 35.528942 Longitude: - W 77.609274 (DD.DDDDDD) (-DD.DDDDDD) 1c. Property size: N/A acres 2. Surface Waters 2a. Name of nearest body of water (stream, river, e tc.) to proposed project: Sandy Run, Middle Swamp, a Tributary of Contentnea Creek 2b. Water Quality Classification of nearest receiving w ater: C;Sw, NSW 2c. River basin: Neuse Contentnea 03020203 3. Project Description 3a. Describe the existing conditions on the site and th e general land use in the vicinity of the project at t he time of this application: US 258/13 is a paved Federal Highway. Woodlands and Agriculture dominate the landscape. 3b. List the total estimated acreage of all existing wetlands on the property: 2790 Square Feet (0.064 Acres) of 404 Wetland Impacts For The Shoulder Widening 3c. List the total estimated linear feet of all exis ting streams (intermittent and perennial) on the pr operty: 60' This site is part of a longer adjacent stream sys tem 3d. Explain the purpose of the proposed project: Shoulder Widening ; the existing roadway shoulders ha ve deteoriated and need to be rebuilt and widened. 3e. Describe the overall project in detail, including the type of equipment to be used: The existing roadway shoulders have deteriorated and need to be rebuilt and widened. Excavators,Dump Trucks ,and Crane Trucks will be used for the shoulder widening. 4. Jurisdictional Determinations 4a. Have jurisdictional wetland or stream determinat ions by the Corps or State been requested or obtained for this property / project (including all prior phases) in the past? Comments: Yes No Unknown 4b. If the Corps made the jurisdictional determinat ion, what type of determination was made? Preliminary Final 4c. If yes, who delineated the jurisdictional areas? Name (if known): Jay Johnson,NCDOT Agency/Consultant Company: Other: NCDOT 4d. If yes, list the dates of the Corps jurisdiction al determinations or State determinations and attac h documentation. June, 2010 5. Project History 5a. Have permits or certifications been requested or obtained for this project (including all prior phases) in the pas t? Yes No Unknown 5b. If yes, explain in detail according to “help file ” instructions. 6. Future Project Plans 6a. Is this a phased project? Yes No 6b. If yes, explain.