20120841 Ver 1_Application_20120907

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BEVERLY EAVES PERDUE
GOVERNOR
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
September 07 2012
Wilmington Regulatory Field Office
US Army Corps of Engineers 01B 69 Darlington Avenue
Wilmington North Carolina 28403
Attention Mr Ronnie Smith Project Manager
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EUGENE A CONTI JR
SECRETARY
Subject Project 17BP 8 R 26 — Bridge No 26 culvert installation on Osborne Rd
(Baggetts Creek)
Application for Section 404 Nationwide Permit 14 and 401 Water Quality
Certification #3886
Dear Mr Smith
The North Carolina Department of Transportation ( NCDOT) is scheduled to replace
Bridge No 26 over Baggetts Creek on Osborne Road in Richmond County NC The
bridge is structurally deficient and will be replaced with an aluminum arch culvert at the
same location An off site detour is proposed The associated culvert installation
activities will cause permanent impacts to Baggett s Creek Baggetts Creek is listed by
the North Carolina Division of Water Quality (DWQ) as Class C waters The project was
evaluated by NCDOT for the presence of listed Threatened and Endangered Species for
Richmond County NC as well as State Listed Historic Properties Upon completion of
the assessment NCDOT concluded that there will be no effect to listed species and no
historic properties are located within the project study area
Average stream width at the project location is +/ 13 ft Normal flow width depth and
velocity will be maintained throughout the culvert Sediment transport will also be
maintained during bankfull discharge to provide a stable stream Bank stabilization will
be required on the downstream side of the proposed culvert resulting in permanent fill
impacts Stream banks on the upstream side were determined to be stable during the
site evaluation therefore no bank stabilization with temporary impacts is proposed at
P O BOX 1067 ABERDEEN NORTH CAROLINA 28315
PHONE [phone] FAX [phone]

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this time There is an existing ditch at the northeast project quadrant which will not
require Permanent Soil Reinforcement Matting (PSRM) but will be augmented with
class B riprap near the culvert headwall Standard matting for erosion control and
temporary mulching and seeding will be utilized to stabilize the entire construction
area
The culvert installation will occur in a dry work area An impervious dike will be utilized
to isolate the work area and a pump will discharge water to a stilling basin for sediment
control The construction sequence is depicted on the attached drawings
Mitigation for the unavoidable stream impacts due to the culvert installation footprint
and bank stabilization activities are proposed at a ratio of 1 1 for a total of 84 LF A
preliminary acceptance letter from the North Carolina Ecosystem Enhancement
Program (NCEEP) is attached
By copy of this letter I am forwarding five (5) copies of this application package to Ms
Sonia Carrillo NCDWQ Wetlands Unit Office in Raleigh It is requested that any
comments related to the 401 certification be forwarded directly to me with a copy sent
to the US Army Corps of Engineers
Sincerely
-7
t
Art King
Division Environmental Officer
cc Ms Sonia Carrillo — NCDWQ Wetlands Unit (5 copies)
cc Mr Mason Herndon NCDWQ Fayetteville Regional Office
cc Barry Harrington

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SEP Off, Use Only
Co action ID no
KFT(ga�SNR �`A>F U j DWQ protect no
4MpST RO�,4(� Form Version 1 3 Dec 10 2008
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Page 1 of 11
PCN Form — Version 1 3 December 10 2008 Version
Pre - Construction Notification Form
A Applicant Information
1
Processing
1a
Type(s) of approval sought from the
Corps
® Section 404 Permit El 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
le
Is this notification solely for the record
because written approval is not required?
For the record only for DWQ 401
Certification
❑ Yes N 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 1h
below
❑ Yes
® No
1h
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes
® No
2
Project Information
2a
Name of project
Bridge # 26 Replace with Culvert over Baggetts Creek
2b
County
Richmond
2c
Nearest municipality / town
Cordova
2d
Subdivision name
N/A
2e
NCDOT only T I P or state
project no
17BP 8 R 26
3
Owner Information
3a
Name(s) on Recorded Deed
N/A
3b
Deed Book and Page No
N/A
3c
Responsible Party (for LLC if
applicable)
N/A
3d
Street address
N/A
3e
City state zip
N/A
3f
Telephone no
N/A
3g
Fax no
N/A
3h
Email address
N/A
Page 1 of 11
PCN Form — Version 1 3 December 10 2008 Version

4
Applicant Information (if different from owner)
4a
Applicant is
❑ Agent ® Other specify Division Engineer
4b
Name
Richard W Hancock PE
4c
Business name
(if applicable)
NCDOT Division 8
4d
Street address
902 N Sandhdls Blvd PO Box 1067
4e
City state zip
Aberdeen NC 28315
4f
Telephone no
[phone]
4g
Fax no
[phone]
4h
Email address
rwhancock @ncdot gov
5
Agent/Consultant Information (if applicable)
5a
Name
Tim Welch
5b
Business name
(if applicable)
NCDOT
5c
Street address
902 North Sandhills Blvd PO Box 1067
5d
City state zip
Aberdeen NC 28315
5e
Telephone no
910 944 2344
5f
Fax no
910 944 5623
5g
Email address
twelch @ncdot gov
Page 2 of 11
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)
Not applicable
Latitude 34 8627 Longitude 798361
lb Site coordinates (in decimal degrees)
(DD DDDDDD) (DD DDDDDD)
1c Property size
0 5 acres
2 Surface Waters
2a Name of nearest body of water (stream river etc ) to
Baggetts Creek
proposed project
2b Water Quality Classification of nearest receiving water
Class C
2c River basin
Yadkin Pee Dee
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
The project site consists of a secondary roadway that extends over a substandard bridge located in a rural and relatively
undeveloped area
3b List the total estimated acreage of all existing wetlands on the property
0 00 acres
3c List the total estimated linear feet of all existing streams (intermittent and perennial) on the property
There is 85 linear feet of stream channel within the 60 foot road right of way
3d Explain the purpose of the proposed project
The project will replace an aged structurally deficient bridge with a culvert
3e Describe the overall project in detail including the type of equipment to be used
The project involves replacing a small bridge with (1) 13 1 x 8 2 aluminum arch culvert 51 in length The culvert will be
buried 1 ft Culvert placement will be completed in a dry work area using pumps and impervious dikes Traffic will be
maintained using an offsite detour Road budding equipment such as trucks dozers and cranes will be used during
construction
4 Jurisdictional Determinations
4a Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
❑ Yes ® No ❑ Unknown
project (including all prior phases) in the past?
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

6 Future Project Plans
6a Is this a phased project? ❑Yes ® No
6b If yes explain
Page 4 of 11
PCN Form — Version 1 3 December 10 2008 Version

C Proposed Impacts Inventory
1 Impacts Summary
la Which sections were completed below for your project (check all that apply)
❑ Wetlands ® Streams tributaries ❑ Buffers
❑ Open Waters ❑ Pond Construction
2 Wetland Impacts
If there are wetland impacts proposed on the site then complete this question for each wetland area impacted
2a
2b
2c
2d
2e
2f
Wetland impact
number —
Type of impact
Type of wetland
Forested
Type of jurisdiction
(Corps 404 10
Area of impact
Permanent (P) or
(if known)
DWQ — non 404 other)
(acres)
Temporary T
❑ Yes
❑ Corps
W1 P ❑ T
❑
NA
❑ No
❑ DWQ
❑ Yes
El Corps
W2 ❑ P F] T
❑ No
❑ DWQ
El Yes
El Corps
W3 F] P E] T
❑ No
❑ DWQ
El Yes
El Corps
W4 E:] P ❑ T
❑ No
❑ DWQ
El Yes
El Corps
W5 ❑ P ❑ T
❑ No
❑ DWQ
❑ Yes
El Corps
W6 P ❑ T
❑
❑ No
❑ DWQ
2g Total wetland impacts
2h Comments N/A
3 Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site then complete this
question for all stream sites impacted
3a
3b
3c
3d
3e
3f
39
Stream impact
Type of impact
Stream name
Perennial
Type of jurisdiction
Average
Impact
length
number
Permanent (P) or
(PER) or
intermittent
(Corps 404 10
DWQ — non 404
stream
width
(linear
Temporary (T)
(INT)?
other)
(feet)
feet)
S1 ®P ❑ T
Aluminum arch
culvert
Baggetts Creek
® PER
❑ INT
® Corps
® DWQ
13
53
S2 ®P ❑ T
ization
Bank stabilization
Baggetts Creek
®
❑ INT
❑ Corps
® DWQ
13
20
S3 ®P ❑ T
Bank stabilization
Baggetts Creek
® PER
❑ INT
❑ Corps
® DWQ
13
11
S4 ❑ P ® T
Culvert
construction
Baggetts Creek
® PER
❑ INT
❑ Corps
® DWQ
13
26
❑ PER
El Corps
S5 P ❑ T
❑
❑ INT
❑ DWQ
❑ PER
❑ Corps
S6 ❑ P F1
❑ INT
❑ DWQ
3h Total stream and tributary impacts
110
31 Comments 84 mitigable impact
Page 5 of 11
PCN Form — Version 1 3 December 10 2008 Version

4 Open Water Impacts
If there are proposed impacts to lakes ponds estuaries tributaries sounds the Atlantic Ocean or any other open water of
the U S then individually list all open water impacts below
4a 4b 4c 4d 4e
Open water Name of waterbody
impact number — (if applicable) Type of impact Waterbody type Area of impact (acres)
Permanent (P) or
Temporary T
01 ❑P ❑T
02 ❑P ❑T
03 ❑P ❑T
04 ❑P ❑T
4f Total open water impacts
4g Comments N/A
5 Pond or Lake Construction
If pon d or lake construction proposed then complete the chart below
5a 5b 5c 5d �5e We tland Impacts (acres) Stream Impacts (feet) and
Pond ID I Proposed use or purpose I I I (acres)
number of pond
Flooded I Filled I Excavated I Flooded I Filled I Excavated I Flooded
P1
P2
517 Total
5g Comments N/A
5h Is a dam high hazard permit required
❑ Yes ❑ No If yes permit ID no
51 Expected pond surface area (acres)
5j Size of pond watershed (acres)
5k Method of construction
6 Buffer Impacts (for DWQ)
If protect will impact a protected riparian buffer then complete the chart below If yes then individually list all buffer impacts
below If any impacts require mitigation then you MUST fill out Section D of this form
6a
Project is in which protected basin?
6b 6c 6d
Buffer impact
number — Reason
Permanent (P) or for
Temporary T impact
131 ❑P FIT
B2 ❑P ❑T
■ • ■
61 Comments
❑ Neuse ❑ Tar Pamlico ❑ Other
❑ Catawba ❑ Randleman
6e 1 61' 1 6g
Buffer Zone 1 impact Zone 2 impact
Stream name mitigation (square feet) (square feet)
required?
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
6h Total buffer impacts
Page 6 of 11
PCN Form — Version 1 3 December 10 2008 Version

D Impact Justification and Mitigation
1 Avoidance and Minimization
1a Specifically describe measures taken to avoid or minimize the proposed impacts in designing project
Use of 2 1 slopes angled wing walls and short culvert design will be utilized to minimize impacts The culvert is being placed
in the same location as the existing bridged crossing to reduce the impacts to the stream and upstream and downstream
banks
1 b Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques
Sedimentation and erosion control best management practices will be in effect throughout the project construction An
impervious dike will be used to isolate the work area and discharge water will be pumped to a stilling basin
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 ❑ No
2b If yes mitigation is required by (check all that apply)
❑ DWQ ® Corps
2c If yes which mitigation option will be used for this
project?
❑ Mitigation bank
® Payment to in lieu fee program
❑ Permittee Responsible Mitigation
3 Complete if Using a Mitigation Bank
3a Name of Mitigation Bank
3b Credits Purchased (attach receipt and letter)
Type
Quantity
3c Comments
4 Complete if Making a Payment to In lieu Fee Program
4a Approval letter from in lieu fee program is attached
❑ Yes
4b Stream mitigation requested
84 linear feet
4c If using stream mitigation stream temperature
® warm ❑ cool []cold
4d Buffer mitigation requested (DWQ only)
square feet
4e Riparian wetland mitigation requested
acres
4f Non riparian wetland mitigation requested
acres
4g Coastal (tidal) wetland mitigation requested
acres
4h Comments Permanent mitigable stream impacts will total 84 linear feet
5 Complete if Using a Permittee Responsible Mitigation Plan
5a If using a permittee responsible mitigation plan provide a description of the proposed mitigation plan
Page 7 of 11
PCN Form —Version 1 3 December 10 2008 Version

6 Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a Will the project result in an impact within a protected riparian buffer that requires
❑ Yes ® No
buffer mitigation?
6b If yes then identify the square feet of impact to each zone of the riparian buffer that requires mitigation Calculate the
amount of mitigation required
6c
6d
6e
Zone
Reason for impact
Total impact
Multiplier
Required mitigation
(square feet)
(square feet)
Zone 1
3 (2 for Catawba)
Zone 2
1 5
6f Total buffer mitigation required
6g If buffer mitigation is required discuss what type of mitigation is proposed (e g payment to private mitigation bank
permittee responsible riparian buffer restoration payment into an approved in lieu fee fund)
6h Comments N/A
Page 8 of 11
PCN Form — Version 1 3 December 10 2008 Version

E Stormwater Management and Diffuse Flow Plan (required by DWQ)
1 Diffuse Flow Plan
la Does the project include or is it adjacent to protected riparian buffers identified
❑ Yes ® No
within one of the NC Riparian Buffer Protection Rules?
1 b If yes then is a diffuse flow plan included? If no explain why
❑ Yes ❑ No
Comments
2 Stormwater Management Plan
2a What is the overall percent imperviousness of this project?
33%
2b Does this project require a Stormwater Management Plan?
® Yes ❑ No
2c If this project DOES NOT require a Stormwater Management Plan explain why The project will be completed in
accordance with the NCDOT BMP manual to the maximum extent practicable Construction stormwater management will
comply with NCS 000250
2d If this project DOES require a Stormwater Management Plan then provide a brief narrative description of the plan
The proposed project is open shoulder section without shoulder berm gutters or storm drainage systems This will
promote sheet flow through grass shoulder area to provide stormwater treat for pavement runoff Existing ditch at NE
quadrant will be retained There are no proposed ditches and no concetrated flows at all other quadrants The proposed
culvert width is consistent with existing stream width in order to maintain normal flow width depth and velocity and to
maintain sediment transport during bankful discharge The proposed culvert inverts will be buried 1 blow the stream bed
to promote fishpassage Bank stabilization at outlet end and inlet end at bend (west side) will be installed to provide long
term bank stability
❑ Certified Local Government
2e Who will be responsible for the review of the Stormwater Management Plan?
❑ DWQ Stormwater Program
❑ DWQ 401 Unit
3 Certified Local Government Stormwater Review
3a In which local government s jurisdiction is this project?
❑ Phase II
❑ NSW
3b Which of the following locally implemented stormwater management programs
❑ USMP
apply (check all that apply)
❑ Water Supply Watershed
❑ Other
3c Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ❑ No
attached?
4 DWQ Stormwater Program Review
❑ Coastal counties
❑ HQW
4a Which of the following state implemented stormwater management programs apply
❑ ORW
(check all that apply)
❑ Session Law 2006 246
❑ Other
4b Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ❑ No
attached?
5 DWQ 401 Unit Stormwater Review
Page 9 of 11
PCN Form — Version 1 3 December 10 2008 Version

5
Endangered Species and Designated Critical Habitat (Corps Requirement)
5a
Will this project occur in or near an area with federally protected species or
❑ Yes ® No
habitat'?
5b
Have you checked with the USFWS concerning Endangered Species Act
® Yes ❑ No
impacts?
® Raleigh
5c
If yes indicate the USFWS Field Office you have contacted
❑ Asheville
5d
What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
NCDOT PDEA T &E and SHPO screening No impacts anticipated
6
Essential Fish Habitat (Corps Requirement)
6a Will this project occur in or near an area designated as essential fish habitaY,'
❑ Yes ® No
6b
What data sources did you use to determine whether your site would impact Essential Fish Habitat?
http / /sharpfin nmfs noaa gov /website /EFH_Mapper /map aspx
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
❑ 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 standard screening protocol Concurrence forms sent to SHPO
8
Flood Zone Designation (Corps Requirement)
8a Will this project occur in a FEMA designated 100 year floodplain?
❑ Yes ® No
8b
If yes explain how project meets FEMA requirements N/A
8c
What source(s) did you use to make the floodplain determination? Richmond Calinty GIS
Richard W Hancock PE
Applicant/Agent s Printed Name
Date
Applicant/Agent s Signature
(Agents signature is valid only if an authorization letter from the applicant
is provided
Page 11 of 11
PCN Form — Version 1 3 December 10 2008 Version

N
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TO THE PUBLIC AT A NOMINAL COST Disclaimer ThB GIS Unrts go
ADDRESS
V I I I I I I NC DEPARTMENT OF TRANSPORTATION
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w m 3401 CARL SANDBURG CT
O O O O RALEIGH N C 27610

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