20210951 Ver 1_ePCN Application_20210513

I I DWR
Division of Water Resources
Pre-Construction Notification (PCN) Form
April 4,2021 Ver 4
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?*
0 Yes r No
Change only if needed.
BIMS#Assigned* Version#*
20210951 1
Is a payment required for this project?*
✓ No payment required
G Fee received Reviewing Office*
✓ Fee needed-send electronic notification Central Office-[phone]
Select Project Reviewer*
Rob Ridings:eads\rgridings
Information for Initial Review
1a.Name of project:
BRIDGE NO.970158 ON SR 1632(PELT RD.)OVER TURNER SWAMP
1a.Who is the Primary Contact?*
Chad Goggins
lb.Primary Contact Email:* 1c.Primary Contact Phone:*
[e-mail] [phone]
Date Submitted
5/13/2021
Nearest Body of Water
Turner Swamp
Basin
Neuse
Water Classification
C;Sw,NSW
Site Coordinates
Latitude: Longitude:
35.599243 -77.871772
A. Processing Information
County(or Counties)where the project is located:
Wilson
Is this a NCDMS Project
✓ Yes G 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:
BP4.R003

WBS#(?)
BP4.R003.1
Pre-Filing Meeting Information
Is this a courtesy copy notification?*
✓ Yes G No
ID# Version
Pre-fling Meeting or Request Date
4/4/2019
Attach documentation of Pre-Filing Meeting Request here:
Click the upload button or drag and drop files here to attach document
ApriI2019-Div4-BridgeScopings.pdf 236.95KB
Re type nest be FCF
1a.Type(s)of approval sought from the Corps:
I7 Section 404 Permit(wetlands,streams and waters,Clean Water Act)
n Section 10 Permit(navigable waters,tidal waters,Rivers and Harbors Act)
Has this PCN previously been submitted?*
✓ Yes
✓ No
lb.What type(s)of permit(s)do you wish to seek authorization?
fJ Nationwide Permit(NWP)
n Regional General Permit(RGP)
n Standard(IP)
1c.Has the NWP or GP number been verified by the Corps?
✓ Yes 6 No
Nationwide Permit(NWP)Number: 03-Maintenance
NWP Numbers(for multiple NWPS):
Id.Type(s)of approval sought from the DWR:
17 401 Water Quality Certification-Regular n 401 Water Quality Certification-Express
n Non-404 Jurisdictional General Permit n Riparian Buffer Authorization
n Individual 401 Water Quality Certification
le.Is this notification solely for the record because written approval is not required? *
For the record only for DWR 401 Certification: r Yes 6' No
For the record only for Corps Permit: r Yes 6 No
If.Is this an after-the-fact permit application?*
✓ Yes f No
1g.Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
✓ Yes 6' No
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 6' No
1j.Is the project located in a designated trout watershed?
✓ Yes f No
B. Applicant Information
Id.Who is applying for the permit?
n Owner 17 Applicant(other than owner)
le.Is there an Agent/Consultant for this project?*
✓ Yes f No

2.Owner Information
2a.Name(s)on recorded deed:
NC DOT
2b.Deed book and page no.:
2c.Contact Person:
2d.Address
Street Address
P.O.Box 3165
Address Line 2
Oty State/Bovine/FiDgion
Wilson NC
Fbstal/Zip Code Country
27895-3165 USA
2e.Telephone Number: 2f.Fax Number:
[phone]
2g.Email Address:*
[e-mail]
3.Applicant Information(if different from owner)
3a.Name:
Chad Coggins
3b.Business Name:
NCDOT Div 4
3c.Address
Street Address
P.O.Box 3165
Address Line 2
Oty State/Province/Region
Wilson NC
Fbstal/Zip aide Country
27895 USA
3d.Telephone Number: 3e.Fax Number:
[phone]
3f.Email Address:*
[e-mail]
C. Project Information and Prior Project History L)
1. Project Information
lb.Subdivision name:
(if appropriate)
1c.Nearest municipality/town:
Stantonsburg
2. Project Identification
2a.Property Identification Number: 2b.Property size:
2c.Project Address
Street Address
Address Line 2
Cray State/Aovince/Region
Postal/Zip aide Country
3.Surface Waters
3a.Name of the nearest body of water to proposed project:*
Turner Swamp

3b.Water Resources Classification of nearest receiving water:*
C;Sw,NS W
3c. What river basin(s)is your project located in?*
Neuse
3d.Please provide the 12-digit HUC in which the project is located.
030202030405
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:*
Forestry and Agriculture are the predominant land uses with some single-family residential housing in the vicinity of this project
4b.Have Corps permits or DWR certifications been obtained for this project(including all prior phases)in the past?*
✓ Yes G 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)
Wilson 158 Topo map.pdf 2.02MB
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)
Wilson 158 Soils map.pdf 2.01MB
4f.List the total estimated acreage of all existing wetlands on the property:
.17
4g.List the total estimated linear feet of all existing streams on the property:
100
4h.Explain the purpose of the proposed project:*
Replace Wilson bridge 158 which is structurally deficient for current NCDOT standards
4i.Describe the overall project in detail,including indirect impacts and the type of equipment to be used:*
Replace Wilson bridge 158 which is structurally deficient for current NCDOT standards with a new bridge meeting these standards in the existing right-of-way with offsite detours.Heavy
road and bridge equipment will be used for this project.
4j.Please upload project drawings for the proposed project.
BP4.R003_Permit Drawings_158.pdf 1.61MB
5.Jurisdictional Determinations
5a.Have the wetlands or streams been delineated on the property or proposed impact areas?*
c Yes r No G Unknown
Comments:
5b.If the Corps made a jurisdictional determination,what type of determination was made?*
✓ Preliminary r Approved 6 Not Verified r Unknown r N/A
Corps AID Number:
5c.If 5a is yes,who delineated the jurisdictional areas?
Name(if known): Chad Coggins
Agency/Consultant Company: NC DOT
Other:
5d1.Jurisdictional determination upload
6. Future Project Plans
6a.Is this a phased project?*
✓ Yes t: 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 177 Buffers
r 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*
1 Permanent Fill P Riverine Swamp Forest Wa-Wd Yes Both 0.020
(acres)
1 mechanized Clearing P Riverine Swamp Forest Wa-Wd Yes Both 0.070
(acres)
1 Hand Clearing T Riverine Swamp Forest Wa-Wd Yes Both 0.080
(acres)
2g.Total Temporary Wetland Impact 2g.Total Permanent Wetland Impact
0.080 0.090
2g.Total Wetland Impact
0.170
2i.Comments:
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 Streambank Stabilization Permanent Bank Stabilization Turner Swamp Perennial Both 30 75
Average(feet) (linear feet)
S2 Impervious Dikes Temporary Dewatering Turner Swamp Perennial Both 30 90
Average(feet) (linear feet)
3i.Total jurisdictional ditch impact in square feet:
0
3i.Total permanent stream impacts: 3i.Total temporary stream impacts:
75 90
3i.Total stream and ditch impacts:
165
3j.Comments:
6. Buffer Impacts(for DWR)
6a.Project is in which protect basin(s)?
Check all that apply.
FT Neuse r Tar-Pamlico
r Catawba r Randleman
r Goose Creek r Jordan Lake
r Other
6b.Impact Type 6c.Per or Temp 6d.Stream name 6e.Buffer mitigation required? 6f.Zone 1 impact 6g.Zone 2 impact
Allowable P Turner Swamp No 1,804 1,234
6h. Total buffer impacts:
Zone 1 Zone 2
Total Temporary impacts: 0.00 0.00
Zone 1 Zone 2
Total Permanent impacts: 1,804.00 1,234.00
Zone 1 Zone 2
Total combined buffer impacts: 1,804.00 1,234.00

6i.Comments:
Supporting Documentation
BP4.R003_Permit Drawings_158.pdf 1.61MB
Buffer Impact Permits_158.pdf 842.91KB
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:
Prior to initiating the design phase of this project all jurisdictional areas were identified and taken into consideration by the design team.Based upon
this information the design team was able to minimize wetland and buffer impacts to the greatest degree practicable.The new structure will also
eliminate the existing in water bent,providing a net improvement to the hydraulic opening.
1b.Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Throughout construction a copy of the permit will be maintained on site and all permit conditions will be strictly adhered to.All construction equipment
and materials will be staged and operated from upland areas.Silt fencing will be installed and regularly inspected to ensure protection of the streams
and wetlands adjacent to the project.Safety fencing will be used to delineate jurisdictional and environmentally sensitive areas from encroachment.
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 this project DOES NOT require Compensatory Mitigation,explain why:
Proposed impacts fall below the NWP condition threshold of impacts/requirements for compensatory mitigation
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 rNo
What type of SCM are you providing?
1 Level Spreader
1 Vegetated Conveyance(lower SHWT)
n Wetland Swale(higher SHWT)
n Other SCM that removes minimum 30%nitrogen
17 Proposed project will not create concentrated stormwater flow through the buffer
Diffuse Flow Documentation
Bridge 158_SMP.pdf 69.87KB
2.Stormwater Management Plan
2a.Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
( Yes r No
Comments:
G. Supplementary Information
1. Environmental Documentation
1a.Does the project involve an expenditure of public(federal/state/local)funds or the use of public(federal/state)land?*
( Yes rNo
1b.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 rNo
1c.If you answered"yes"to the above,has the document review been finalized by the State Clearing House?*
✓ Yes ( No
Comments:*
CE available upon request
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 6 No
3. Cumulative Impacts(DWR Requirement)
3a.Will this project result in additional development,which could impact nearby downstream water quality?*
✓ Yes f• No
3b.If you answered"no,"provide a short narrative description.
The purpose of this project is to replace a structurally deficient bridge at an existing location
4.Sewage Disposal(DWR Requirement)
4a.Is sewage disposal required by DWR for this project?*
✓ Yes Cr Nor 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 f No
5d.Is another Federal agency involved?*
✓ Yes G No r Unknown
5e.Is this a DOT project located within Division's 1-8?
F Yes r No
5j.What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
Neuse River waterdog,Carolina Madtom,and Atlantic Pigtoe all appear on the IPAC TE list dated May 13,2021.Based upon the results of a biological
assessment performed by SEPI in early 2021 the recommended BC for all species will be MANLTAA due to lack of habitat and distance to records.
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?*
✓ Yes f• No
6b.What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
EFH Mapper
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 6' No
7b.What data sources did you use to determine whether your site would impact historic or archeological resources?*
HEU Clearance
7c.Historic or Prehistoric Information Upload
PA 19-03-0008 No Archaeological Survey Required Form Br No 215 on SR 2159 over Br Little Buffalo Creek
1.6MB
Johnston.pdf
NoHistArchSurveyReq_158.pdf 1.42MB
8. Flood Zone Designation(Corps Requirement)
8a.Will this project occur in a FEMA-designated 100-year floodplain?*
✓ Yes 6 No
8c.What source(s)did you use to make the floodplain determination?*
NC FRIS
Miscellaneous u
Comments
Miscellaneous attachments not previously requested.

Signature
R 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:
Chad Coggins
Signature
aoyige-
Date
5/13/2021