20211513 Ver 1_ePCN Application_20211019

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Pre-Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
June 1,2021 Ver 4.1
Initial Review
Has this project met the requirements for acceptance in to the review process?*
Yes
No
Is this project a public transportation project?*
Yes No
Change only if needed.
BIMS#Assigned* Version#*
20211513 1
Is a payment required for this project?*
No payment required
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:
Replace Bridge No.320078 on SR 1526(Burnette Farm Road)over Ballahack Canal in Edgecombe County
la.Who is the Primary Contact?*
Chad Coggins
1 b.Primary Contact Email:* 1c.Primary Contact Phone:*
[e-mail] [phone]
Date Submitted
10/19/2021
Nearest Body of Water
Ballahack Canal
Basin
Tar-Pamlico
Water Classification
QNSW
Site Coordinates
Latitude: Longitude:
35.864489 -77.443727
A. Processing Information
County(or Counties)where the project is located:
Edgecombe
Is this a NCDMS Project
Yes No
Is this project a public transportation project?*
Yes No
Is this a NCDOT Project?*
Yes No
(NCDOT only)T.I.P.or state project number:
BP4-R005

WBS#(?)
BP4.R005.1
Pre-Filing Meeting Information
Is this a courtesy copy notification?*
Yes 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
April20l9-Div4-BridgeScopings.pdf 229KB
File type must be PDF
1a.Type(s)of approval sought from the Corps:
Section 404 Permit(wetlands,streams and waters,Clean Water Act)
Section 10 Permit(navigable waters,tidal waters,Rivers and Harbors Act)
Has this PCN previously been submitted?*
Yes
No
1 b.What type(s)of permit(s)do you wish to seek authorization?
Nationwide Permit(NWP)
Regional General Permit(RGP)
Standard(IP)
1c.Has the NWP or GP number been verified by the Corps?
Yes No
Nationwide Permit(NWP)Number: 14-Linear transportation
NWP Numbers(for multiple NWPS):
1d.Type(s)of approval sought from the DWR:
401 Water Quality Certification-Regular 401 Water Quality Certification-Express
Non-404 Jurisdictional General Permit Riparian Buffer Authorization
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: Yes No
For the record only for Corps Permit: Yes No
1f.Is this an after-the-fact permit application?*
Yes No
1g.Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
Yes No
1g.Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
Yes No
1 It.Is the project located in any of NC's twenty coastal counties?
Yes No
1j.Is the project located in a designated trout watershed?
Yes No
B. Applicant Information
1d.Who is applying for the permit?
Owner Applicant(other than owner)
le.Is there an Agent/Consultant for this project?
Yes No
2.Owner Information

2a.Name(s)on recorded deed:
INC DOT
2b.Deed book and page no.:
2c.Contact Person:
2d.Address
Street Address
P.O.Box 3165
Address Line 2
City State/Province/Region
Wilson NC
Postal/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:
3c.Address
Street Address
P.O.Box 3165
Address Line 2
City State/Province/Region
Wilson NC
Postal/Zip Code Country
27895-3165 USA
3d.Telephone Number: 3e.Fax Number:
[phone]
3f.Email Address:
[e-mail]
C. Project Information and Prior Project History
1.Project Information
1b.Subdivision name:
(if appropriate)
1c.Nearest municipality/town:
Tarboro
2.Project Identification
2a.Property Identification Number: 2b.Property size:
2c.Project Address
Street Address
Address Line 2
City State/Province/Region
Postal/Zip Code Country
3. Surface Waters
3a.Name of the nearest body of water to proposed project:
Ballahack Canal
3b.Water Resources Classification of nearest receiving water:*
C;NSW

3c. What river basin(s)is your project located in?*
Tar-Pamlico
3d.Please provide the 12-digit HUC in which the project is located.
030201030305
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 predominate land uses with some single-family 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 No Unknown
4f.List the total estimated acreage of all existing wetlands on the property:
4g.List the total estimated linear feet of all existing streams on the property:
4h.Explain the purpose of the proposed project:*
The purpose of the proposed project is to replace a structurally deficient bridge.Bridge No.320078 was built in 1968.The bridge is 40 feet long with an approximately 28.9-foot clear
roadway width.Bridge No.320078 is a two-span structure that consists of a reinforced concrete channel beam superstructure with an asphalt wearing surface.It has vertical timber
abutments with concrete caps and an interior bent with timber piles and a concrete cap.
41.Describe the overall project in detail,including indirect impacts and the type of equipment to be used:
Replace Edgecombe bridge 78 which is structurally deficient for current NCDOT standards with a new bridge that meets these standards.An offsite detour will be utilized.Heavy road and
bridge equipment will be used for this project.
5. Jurisdictional Determinations
5a.Have the wetlands or streams been delineated on the property or proposed impact areas?*
Yes No Unknown
Comments:
5b.If the Corps made a jurisdictional determination,what type of determination was made?*
Preliminary Approved Not Verified Unknown N/A
Corps AID Number:
SAW-2019-00705
5c.If 5a is yes,who delineated the jurisdictional areas?
Name(if known):
Agency/Consultant Company: Three Oaks Engineering
Other:
5d.List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
6.Future Project Plans
6a.Is this a phased project?*
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 U
1. Impacts Summary
1a.Where are the impacts associated with your project?(check all that apply):
Wetlands Streams-tributaries Buffers
Open Waters Pond Construction
2.Wetland Impacts
......... ......... ......... ......... .... .......... .... ........... ......... .................. ......... ...... ..........
2a1 Reason M 2b.Impact type*(?) 2c.Type of W.* 2d.W.name* 2e.Forested* 2f.Type of Jurisdicition*�2g.Impact
M area*
_]
Permanent Fill P NON-NCWAM TYPES WB No Both 0(acm
(acres)

-]
Excavation T NON-NCWAM TYPES WB No Both 0.010
(acres)
Mechanized Clearing P NON-NCWAM TYPES 1WB No [Both 0.010
(acres)
Hand Clearing T NON-NCWAM TYPES WB No Both 0.070
(acres)
Mechanized Clearing P NON-NCWAM TYPES WA No Both 0.010
(acres)
E_7
Hand Clearing T NON-NCWAM TYPES WA No Both 0.020
(acres)
2g.Total Temporary Wetland Impact 2g.Total Permanent Wetland Impact
0.100 0.060
2g.Total Wetland Impact
0.160
21.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 S2 Permanent Culvert Ballahack Canal ff77
Both 30 46
Average(feet) (linear feet)
S2 S2 Permanent Bank Stabilization Ballahack Canal Perennial Both 30 80
Average(feet) (linear feet)
S3 S2 Temporary Dewatering Ballahack Canal Perennial Both 30 10
Average(feet) (linear feet)
31.Total jurisdictional ditch impact in square feet:
0
31.Total permanent stream impacts: 3i.Total temporary stream impacts:
126 10
31.Total stream and ditch impacts:
136
3j.Comments:
6. Buffer Impacts (for DWR)
6a.Project is in which protect basin(s)?
Check all that apply.
Neuse Tar-Pamlico
Catawba Randleman
Goose Creek Jordan Lake
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 Ballahack Canal No 6,009 3,742
6h. Total buffer impacts:
Zone 1 Zone 2
Total Temporary impacts: 0.00 0.00
Zone 1 Zone 2
Total Permanent impacts: 6,009.00 3,742.00
Zone 1 Zone 2
Total combined buffer impacts: 6,009.00 3,742.00

61.Comments:
E. Impact Justification and Mitigation u
1.Avoidance and Minimization
la.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 extent practicable.
1 b.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:
Thresholds are not met
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
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?
Yes No
What type of SCM are you providing?
Level Spreader
Vegetated Conveyance(lower SHWT)
Wetland Swale(higher SHWT)
Other SCM that removes minimum 30%nitrogen
Proposed project will not create concentrated stormwater flow through the buffer
2. Stormwater Management Plan
2a.Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?
Yes No
Comments:
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?"
Yes No
1 b.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(NEPA/SEPA)?*
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 No
3. Cumulative Impacts (DWR Requirement)
3a.Will this project result in additional development,which could impact nearby downstream water quality?"
Yes No

3b.If you answered"no,"provide a short narrative description.
The purpose of this project is to replace a structurally deficient bridge at the already existing location.
4. Sewage Disposal (DWR Requirement)
4a.Is sewage disposal required by DWR for this project?*
Yes No 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 No
5b.Have you checked with the USFWS concerning Endangered Species Act impacts?*
Yes No
5d.Is another Federal agency involved?*
Yes No Unknown
5e.Is this a DOT project located within Division's 1-8?
Yes No
5j.What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
Neuse River Waterdog,Tar River Spinymussel,and Atlantic Pigtoe,all appear on the IPAC TE list dated October 17,2021.An aquatic species survey
was conducted in August of 2021 has concluded that for the Tar River Spinymussel and the Atlantic Pigtoe,there is no effect to the species or habitat;
for the Neuse River Waterdog there biological conclusion is May Affect Not Likely to Adversely Affect(MA-NLAA).
6. Essential Fish Habitat(Corps Requirement)
6a.Will this project occur in or near an area designated as an Essential Fish Habitat?
Yes 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 No
7b.What data sources did you use to determine whether your site would impact historic or archeological resources?*
HEU Clearance
8. Flood Zone Designation (Corps Requirement)
8a.Will this project occur in a FEMA-designated 100-year floodplain?*
Yes No
8c.What source(s)did you use to make the floodplain determination?*
NC FRIS
Miscellaneous
Please use the space below to attach all required documentation or any additional information you feel is helpful for application review.Documents should be combined into one file when
possible,with a Cover Letter,Table of Contents,and a Cover Sheet for each Section preferred.
Click the upload button or drag and drop files here to attach document
19-03-0009_NoHistoricProperties.pdf 4.15MB
BP4.R005 Ballahack Canal Aquatic Species Survey Report_Draft 8_09_21.pdf 7.75MB
BP4.R005.1—Buffer_Impacts_Permit_Drawings(002).pdf 1.59MB
BP4.R005.1_Wetland_and_Surface_Water_Permit_Drawings(002).pdf 1.94MB
Edge 78 Soils map.pdf 1.87MB
Edge 78 Topo map.pdf 1.37MB
Edgecombe 78 No Survey form.pdf 1.01 MB
Species List_Raleigh Ecological Services Field Office.pdf 202.37KB
SWMRpdf 69KB
File must be PDF or KMZ
Comments
Signature
*
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
[�ifrr�G��9urd
Date
10/19/2021