20221188 Ver 1_ePCN Application_20220901

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Pre-Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
April 13,2022 Ver 4.3
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.
Pre-Filing Meeting Date Request was submitted on:
8/1/2022
BIMS#Assigned" Version#"
20221188 1
Is a payment required for this project?*
No payment required
Fee received Reviewing Office"
Fee needed-send electronic notification Wilmington Regional Office-[phone]
Select Project Reviewer"
Hannah Sprinkle:eads\hhsprinkle
Information for Initial Review
1a.Name of project:
Bridge 26 over Gum Swamp Run on SR 1928(HB-0011-Central)
1a.Who is the Primary Contact?"
Jason Dilday
1 b.Primary Contact Email:" 1c.Primary Contact Phone:*
[e-mail] [phone]
Date Submitted
9/1/2022
Nearest Body of Water
Gum Swamp Run
Basin
Lumber
Water Classification
C;SW
Site Coordinates
Latitude: Longitude:
34.160774 -78.580887
A. Processing Information
County(or Counties)where the project is located:
Columbus
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:
HB-0011
WBS#(1)
49870.1.1
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(N W P)
Regional General Permit(RGP)
Standard(IP)
1c.Has the NWP or GP number been verified by the Corps?
Yes No
Regional General Permit(RGP)Number: 201902350-Work associated with bridge construction,widening,replacement,and
interchanges
RGP Numbers(for multiple RGPS):
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 h.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:
n/a
2b.Deed book and page no.:
2c.Contact Person:

2d.Address
Street Address
n/a
Address Line 2
City State/Province/Region
n/a n/a
Postal/Zip Code Country
n/a n/a
2e.Telephone Number: 2f.Fax Number:
[phone]
2g.Email Address:*
maturchy@ncdotgov
3.Applicant Information(if different from owner)
3a.Name:
NCDOT
3b.Business Name:
3c.Address
Street Address
1598 Mail Service Center
Address Line 2
City State/Province/Region
Raleigh NC
Postal/Zip Code Country
27699-1598 us
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:
Old Dock
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:
Gum Swamp Run
3b.Water Resources Classification of nearest receiving water:*
C;SW
3c. What river basin(s)is your project located in?*
Lumber
3d.Please provide the 12-digit HUC in which the project is located.
030402060601
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:*
Land use in the project vicinity consists primarily of swamp and minor residential development.
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:
2.0
4g.List the total estimated linear feet of all existing streams on the property:
250
4h.Explain the purpose of the proposed project:"
Bridge inspections have been performed and it has been determined that due to hydraulic issues the bridge needs to be replaced.
41.Describe the overall project in detail,including indirect impacts and the type of equipment to be used:"
This project involves replacing the 87.5-foot,5 span bridge with a 110-foot,two span bridge on the existing alignment using an on-site detour.Standard road building equipment,such as
trucks,bulldozers and cranes will be used.
5. Jurisdictional Determinations
5a.Have the wetlands or streams been delineated on the property or proposed impact areas?*
Yes No Unknown
Comments:
PJD package included with application
5b.If the Corps made a jurisdictional determination,what type of determination was made?*
Preliminary Approved Not Verified Unknown N/A
Corps AID Number:
5c.If 5a is yes,who delineated the jurisdictional areas?
Name(if known): Greg Price and Chris Underwood
Agency/Consultant Company: NCDOT
Other:
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
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
area*
Roadway fill P Riverine Swamp Forest WANVC Yes Both 0.029
(acres)
1 Mech.Clearing P Riverine Swamp Forest WA/WC Yes Both 0.045
(acres)
2-Detour Temp.Fill T Riverine Swamp Forest WB/WD Yes Both 0.062
acres)
2g.Total Temporary Wetland Impact 2g.Total Permanent Wetland Impact
0.062 0.074
2g.Total Wetland Impact
0.136

21.Comments:
An additional 0.049 ac of hand clearing will occur in the area of the on-site detour.There will be 0.01 acre of temporary fill in the hand clearing area for
erosion control measures
3. Stream Impacts
3a.Reason for impact(?) 3b.lmpact type* 3c.Type of impact* �ff.name* 3e.Stream Type" [3f.Type of 3g.S.width 3h.Impact
(?) urisdiction* length*
S1
Bank stabilization Permanent Bank Stabilization Gum Swam 50 81 P Run Perennial Both
Average(feet) (linear feet)
S2 Bank stabilization Temporary Bank Stabilization J
Gum Swamp Run Perennial Both E;;;J�J
31.Total jurisdictional ditch impact in square feet:
0
31.Total permanent stream impacts: 3i.Total temporary stream impacts:
61 86
31.Total stream and ditch impacts:
147
3j.Comments:
E. Impact Justification and Mitigation U
1.Avoidance and Minimization
1a.Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
The bridge will be replaced on the existing alignment.The new bridge will have less bents in the water than the existing structure.There will be no deck
drains on the new structure.See stormwater management plan for additional minimization measures.
1 b.Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
NCDOT's Best Management Practices for Construction and Maintenance Activities will be employed in all facets of construction and demolition.
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
2c.If yes,mitigation is required by(check all that apply):
DWR Corps
2d.If yes,which mitigation option(s)will be used for this project?
Mitigation bank Payment to in-lieu fee program Permittee Responsible Mitigation
4. Complete if Making a Payment to In-lieu Fee Program
4a.Approval letter from in-lieu fee program is attached.
Yes No
4b.Stream mitigation requested:
(linear feet) 4c.If using stream mitigation,what is the stream temperature:
0
4d.Buffer mitigation requested(DWR only): 4e.Riparian wetland mitigation requested:
(square feet) (acres)
0 0.08
4f.Non-riparian wetland mitigation requested: 4g.Coastal(tidal)wetland mitigation requested:
(acres) (acres)
0 0
4h.Comments
F. Stormwater Management and Diffuse Flow Plan (required by DWR) U
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

If no,explain why:
There are no protected riparian buffers in the project area.
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
1c.If you answered"yes"to the above,has the document review been finalized by the State Clearing House?*
Yes No
Comments:*
Type I Categorical Exclusions do not require submittal to the State Clearing House
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.
Due to minimal transportation impact resulting from this bridge replacement,this project will neither influence nearby land uses nor stimulate growth.
Therefore,a detailed indirect or cumulative effects study will not be necessary.
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
5c.If yes,indicate the USFWS Field Office you have contacted.
Raleigh
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?
N.C.Natural Heritage Program database;USFWS-IPaC query;biological surveys for protected species identified for the project area,which include
American alligator,Waccamaw silverside,wood stork,Northern long-eared bat,red-cockaded woodpecker and Cooley's meadowrue.The American
alligator does not require surveys.The Northern long-eared bat is covered under the programmatic biological opinion for the species and received a
biological conclusion of"May Affect,Likely to Adversely Affect".Habitat for Cooley's meadowrue exists,but no specimens were observed in a survey
conducted on June 2,2022.Habitat for red-cockaded woodpecker does not exist in the study area.Informal concurrence for Waccamaw silverside and
wood stork from USFWS is included with this application.
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?*
NMFS county index
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?*
NEPA documentation
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:
NCDOT hydraulics unit coordination with FEMA.
8c.What source(s)did you use to make the floodplain determination?*
FEMA floodplain mapping
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
HB-0011 General Columbus September 1 2022.pdf 7.99MB
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:
Mack Christopher Rivenbark,III
Signature
wtl �LYti4,xq
Date
9/1/2022