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STATE OF NORTH CAROLINA
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DEPARTMENT OF TRANSPORTATION
Patrick McCrory Tony Tata
GOVERNOR SECRETARY
March 17, 2014
U.S. Army Corps of Engineers
Regulatory Field Office
2407 West Fifth Street 2 0 1 4 0 2 8 0
Washington, NC 27889
Attention: Tracey Wheeler
Subject: Request for a NW 3 Permit and DWQ 401 for the replacement of a culvert structure in Mill
Swamp on SR 1300 in Gates County. WBS # 17BP.1.R.55
The North Carolina Department of Transportation is requesting the issuance of a NW 3 permit
and corresponding 401 certification for the replacement of a culvert structure on SR 1300 in Gates County.
The culvert is located on SR 1300/ Paige Riddick Rd. approximately 0.25 mile south of the intersection
with US 13. The culvert is located in Mill Swamp, which is classified by DWR as class "C; NSW" waters.
The existing culvert structure is 3 @ 60" diameter X 37' long. These culverts will be removed using
NCDOT's guidelines for culvert removal. The proposed aluminum arch culvert will be placed on its
existing alignment as shown in the permit drawings. The new culvert structure is 22'9" X 5'4" X 36'0"
with aluminum headwalls located at the outlet and inlet sections of the culvert. The new culvert invert will
be placed more than i foot below the surveyed stream bed. Jurisdictional wetland and surface water
impacts have been minimized on this project. There may be some minor disturbance to vegetation during
sheet piling installation, but there will be no grubbing or permanent impacts. This project will require the
closure of SR 1300 for a 4 -5 day time period. This temporary closure will be coordinated with the local
county officials and conducted during a time period, which minimizes the impact to the traveling public.
Included with this letter are the location map, PCN, and permit drawings. If you have questions
please call me at (252) 482 -1876.
Sincerely,
Jerry Jennings
Division One Engineer
Clay Willis
Division One Environmental Officer
Cc: Garcy Ward, DWQ
Sonia Carrillo, DWQ

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Office 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
Pre - Construction Notification PCN Form
A. Applicant Information
1.
Processing
1 a.
Type(s) of approval sought from the
Corps:
FN Section 404 Permit ❑Section 10 Permit
1 b.
Specify Nationwide Permit (NWP) number: NW 3 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
1 e.
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
1 g.
Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below.
® Yes
❑ No
1 h.
Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes
® No
2.
Project Information
2a.
Name of project:
Replace Pipe Culvert P -109 on SR 1300 /Paige Riddick Rd.
2b.
County:
Gates County
2c.
Nearest municipality / town:
Gates
2d.
Subdivision name:
n/a
2e.
NCDOT only, T.I.P. or state
project no:
17BP.1.R.55
3.
Owner Information
3a.
Name(s) on Recorded Deed:
NCDOT R -O -W SR 1300 -Gates County
3b.
Deed Book and Page No.
3c.
Responsible Party (for LLC if
applicable):
3d.
Street address:
3e.
City, state, zip:
3f.
Telephone no.:
3g.
Fax no.:
3h.
Email address:
Page 1 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):
n/a
Latitude: 36.544475
1b. Site coordinates (in decimal degrees):
Longitude: - 76.754716
(DD.DDDDDD) (- DD.DDDDDD)
1 c. Property size:
0.10 acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to
Mill Swamp
proposed project:
2b. Water Quality Classification of nearest receiving water:
C; NSW
2c. River basin:
Chowan
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:
Project area consist of NCDOT Gates County SR 1300 with the waterway of Mill Swamp passing under the road through
3@ 60 "X37' metal culverts. The adjacent property use is a mix of agricultural, rural residential, and forested area.
3b. List the total estimated acreage of all existing wetlands on the property:
<0.01 acres
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
60 feet of open water in Mill Swamp
3d. Explain the purpose of the proposed project:
Replace deteriorating metal culverts and maintain a stabile road way along SR 1300 for the safety of the traveling public.
3e. Describe the overall project in detail, including the type of equipment to be used:
The existing 3 - 37' long x 60 "dia. metal pipes will be entirely removed using NCDOT guidelines for pipe removal. A new arch
culvert pipe measuring 22'9" X 5'4" X 36' with headwalls will be placed as shown in the provided permit drawings. The new
arch pipe will be buried 1 foot below the surveyed stream bed. The existing waterline will not need to be relocated. Once the
pipe is in place and back filled a new roadway surface and grassed shoulder will be established. The headwall tie in points will
likely need some rip -rap stabilization as shown on the permit drawings. Some temporary disturbance to the vegetated banks
will likely occur from the dewatering process and headwall installation. These banks will be stabilized following NCDOT
erosion control bmp's. There are no permanent impacts resulting from this maintenance project. This work will be
accomplished using a track excavator, backhoe, and dump trucks.
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: Paul Williams, Div. 1 Environmental Specialist
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.
Page 3 of 11
PCN Form — Version 1.3 December 10, 2008 Version

C. Proposed Impacts Inventory
1. Impacts Summary
1 a. 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
Type of jurisdiction
number —
Type of impact
Type of wetland
Forested
(Corps - 404, 10
Area of impact
Permanent (P) or
(if known)
DWQ — non -404, other)
(acres)
Temporary
❑ Yes
❑ Corps
W1 ❑ P ❑ T
❑ No
❑ DWQ
❑ Yes
❑ Corps
W2 ❑ P ❑ T
❑ No
❑ DWQ
❑ Yes
❑ Corps
W3 ❑ P ❑ T
❑ No
❑ DWQ
❑ Yes
❑ Corps
W4 ❑ P FIT
❑ No
❑ DWQ
❑ Yes
❑ Corps
W5 ❑ P ❑ T
❑ No
❑ DWQ
❑ Yes
❑ Corps
W6 ❑ P ❑ T
❑ No
❑ DWQ
2g. Total wetland impacts
2h. Comments: None
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.
3g•
Stream impact
Type of impact
Stream name
Perennial
Type of jurisdiction
Average
Impact
number -
(PER) or
(Corps - 404, 10
stream
length
Permanent (P) or
intermittent
DWQ — non -404,
width
(linear
feet)
Temporary (T)
(INT)?
other)
(feet)
❑ PER
❑ Corps
S1 ❑ P ❑ T
❑ INT
❑ DWQ
❑ PER
❑ Corps
S2 [_1 P F1
❑ INT
❑ DWQ
❑ PER
❑ Corps
S3 ❑ P ❑ T
❑ INT
❑ DWQ
❑ PER
❑ Corps
S4 ❑ P FIT
❑ INT
❑ DWQ
❑ PER
❑Corps
S5 ❑ P ❑ T
❑ INT
❑ DWQ
❑ PER
❑ Corps
S6 ❑ P ❑ T
[:11 NT
❑ DWQ
3h. Total stream and tributary impacts
3i. Comments: None
Page 5 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.
Impacts have been avoided by utilizing a arch culvert that reduces the footprint along the tributary bottom.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Turbidity curtains and sheet piling will be used during the pipe replacement to reduce suspended sediments in the water
column. NCDOT will follow our BMP's during pipe removal /installation and install erosion control devices to prevent sediment
loss from the project site.
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: n/a
3b. Credits Purchased (attach receipt and letter)
Type
Quantity
3c. Comments: n/a
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:
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: n/a
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.
n/a c
Page 7of11
PCN Form — Version 1.3 December 10, 2008 Version

E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1.
Diffuse Flow Plan
1 a.
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?
n/a %
2b.
Does this project require a Stormwater Management Plan?
® Yes ❑ No
2c.
If this project DOES NOT require a Stormwater Management Plan, explain why:
2d.
If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
NCDOT will follow best management practices for soil and erosion control in compliance with N.C. Sediment and
Pollution Control Act and NCDOT NPDES permit. During installation of the culvert a turbidity curtain will be placed in the
stream, on the culvert outlet ends, and sheet piling will be used to dewater the site.
❑ 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?
N/A
❑ Phase II
❑ NSW
3b.
Which of the following locally - implemented stormwater management programs
❑ USMP
apply (check all that apply):
❑ Water Supply Watershed
® Other: N/A
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: ncdot
4b. Has the approved Stormwater Management Plan with proof of approval been
El Yes No
attached?
5.
DWQ 401 Unit Stormwater Review
5a.
Does the Stormwater Management Plan meet the appropriate requirements?
❑ Yes ❑ No
5b. Have all of the 401 Unit submittal requirements been met?
❑ Yes ❑ No
Page 9of11
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?
NC Natural Heritage Database
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat?
TO Yes ® No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
National Marine Fisheries Database
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?
NC State Historic Preservation Data
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: Structure design complies with Hydraulic Engineer designs
8c. What source(s) did you use to make the floodplain determination? C Flood Maps
Paul Williams
3/17/14
Applicant/Agent's Printed Name
Date
Applicant/Agent's Signature
(Agent's 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

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Mill Swamp
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