20120662 Ver 1_Application_20120826

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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:
17BP.2.R.17 Lenoir 163 Bridge To Pipe Replacement S R 1324, Kennedy Home Road
Over Canal
WBS Element Number 17BP.2.R.17
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 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.: 252-429-2800
3g. Fax no.: 252-830-3341
3h. Email address: [e-mail]

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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 ): 17BP.2.R.17 Lenoir 163 Bridge To Pipe Replacement
SR 1324, Kennedy Home Road Over Canal
1b. Site coordinates (in decimal degrees):
Latitude: N 35.251571 Longitude: - W
77.702084
(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: Falling Creek, a Tributary of The Neuse River
2b. Water Quality Classification of nearest receiving w ater: C;Sw, NSW
2c. River basin: Middle Neuse 03020202
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:
SR 1324, Kennedy Home Road is a paved Secondary Stat e 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 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:
Bridge To Pipe Replacement ; the existing bridge ha s deteoriated 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 Pilin gs 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 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):
Agency/Consultant Company:
Other:
4d. If yes, list the dates of the Corps jurisdiction al determinations or State determinations and attac h documentation.

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.