20201520 Ver 1_ePCN Application_20220908

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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:
9/28/2020
BIMS#Assigned" Version#"
20201520 1
Is a payment required for this project?*
No payment required
Fee received Reviewing Office"
Fee needed-send electronic notification Washington Regional Office-[phone]
Select Project Reviewer"
Garcy Ward:eads\gpward
Information for Initial Review
1a.Name of project:
Replacement of Bridge#9 on SR1112(Mouth of The Creek Rd)over Blounts Creek(B-5614 Central)
1a.Who is the Primary Contact?"
Deanna Riffey
1 b.Primary Contact Email:" 1c.Primary Contact Phone:*
[e-mail] [phone]
Date Submitted
9/8/2022
Nearest Body of Water
Blounts Bay
Basin
Tar-Pamlico
Water Classification
SB;NSW
Site Coordinates
Latitude: Longitude:
35.433294 -76.971078
A. Processing Information
County(or Counties)where the project is located:
Beaufort
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:
B-5614
WBS#r)
45569.3.1
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
11.Is the project located within a NC DCM Area of Environmental Concern(AEC)?
Yes No Unknown
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:
Chocowinity
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:
Blounts Bay
3b.Water Resources Classification of nearest receiving water:*
SB;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.
030201040107
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:*
Bridge 9 was built in 1990.Bridge 9 is approximately 600 feet long,24 feet wide and consists of 15 spans.
Land use in the project study area is a combination of maintained roadsides,residential,and undeveloped natural areas.The project study area is rural and predominantly undeveloped
with maintained/mowed road right-of-way,open stream channel flanked by floodplain,several wetlands,and residential homes.
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:
3.16
4g.List the total estimated linear feet of all existing streams on the property:
620
4h.Explain the purpose of the proposed project:"
Bridge 9 is considered structurally deficient due to the superstructure and substructure conditions.
4i.Describe the overall project in detail,including indirect impacts and the type of equipment to be used:
The proposed replacement of Bridge No.9 over the Blounts Creek will be on new alignment to the south of the existing bridge while traffic is maintained on the existing bridge and boater
access will be maintained under the bridge during construction,except for the possibility of short duration closures when construction or demolition has to take place in the channel.
Proposed replacement Bridge 9 will have two 10-foot lanes and 5-foot paved shoulders on both sides of the bridge with 8 spans.
The replacement Bridge 9 will be approximately 962 feet long.A temporary causeway will be installed to provide access for the contractor to remove the timber piles and concrete footings.
The removal of existing timber piles will be conducted using approved NCDOT Best Management Practice methods.
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:
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): Deanna Riffey
Agency/Consultant Company: NCDOT
Other:
5d.List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
Site visit made August 23,2018.
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
2at Reason(?) 2b.Impact type*(?) 2c.Type of W.* 2d.W.name 2e.Forested* 2f.Type of Jurisdicition*2g.Impact
area
0.370
Fill-Road/Bridge P Headwater Forest WA Yes Both
Approach (acres)

r7TIll-Work Bridge ��T Salt/Brackish Marsh WB E::][B.th LI-0-01 -1 -1
2g.Total Temporary Wetland Impact 2g.Total Permanent Wetland Impact
0.008 0.370
2g.Total Wetland Impact
0.378
2i.Comments:
There will be hand clearing of 0.08 acres for WA(Site 1)and 0.002 acres for WB(Site 2)for bridge bents.There will be hand clearing of 0.001 acres for
WC(Site 1-Utilities)and 0.14 acres for WB(Site 2-Utilities)for power lines and telephone cable.
4. Open Water Impacts
4a. Site# 4a1.Impact Reason 4b.Impact type 4c.Name of waterbody 4d.Activity type �114e.Waterbody type 4f.Impact area
Fill P Blounts Creek Bridge Tributary 0.02
Fill T Blounts Creek Bridge Tributary 0.08
Work bridge T Blounts Creek Other Tributary 1.11
4g.Total temporary open water Impacts: 4g.Total permanent open water impacts:
1.19 0.02
4g.Total open water impacts:
1.21
4h.Comments:
0.02 ac of permanent SW impacts equates to 33 ft of existing channel impacts
0.08 ac of temporary SW impacts equates to 65 It of existing channel impacts
6. Buffer Impacts (for DWR)
6a.Project is in which protect basin(s)7
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
Bridge-Allowable P Blounts Creek No 2,700 11 1,883
Proposed Driveway-Mitigable P Blounts Creek Yes 1,341 856
Existing Driveway-Allowable P Blounts Creek No 551 0
Bridge-Allowable P Blounts Creek No 5,504 3,540
Underground power and telephone-Allowable P 11 Blounts Creek No 834 197
Overhead power and telephone-Allowable P Blounts Creek No 203 105
6h. Total buffer impacts:
Zone 1 Zone 2
Total Temporary impacts: 0.00 0.00
Zone 1 Zone 2
Total Permanent impacts: 11,133.00 6,581.00
Zone 1 Zone 2
Total combined buffer impacts: 11,133.00 6,581.00
61.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:
Design Standards in Sensitive Watersheds will be implemented.
1 b.Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
Traffic will be maintained on the existing bridge during construction.Stormwater outfalls will be placed outside of the buffer zones and will have rip-rap
pads to help dissipate energy and reduce velocity.3:1 side slopes will be used.An in-water work moratorium from 2/15-6/30 will be adhered due to
anadromous fish.
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: 4c.If using stream mitigation,what is the stream temperature:
(hne feet)
4e.Riparian wetland mitigation requested:
4d.Buffer mitigation requested(DWR only): (acres)
(square feet) 0.37
4f.Non-riparian wetland mitigation requested: 4g.Coastal(tidal)wetland mitigation requested:
(acres) (acres)
4h.Comments
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 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
1a.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
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.
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
What Federal Agency is involved?
NOAA-National Marine Fisheries Service(NMFS)
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?
NC Natural Heritage Program database,USFWS Raleigh Field Office and IPaC(Information for Planning and Consultation)website,and NOAA National
Marine Fisheries correspondence.
6. Essential Fish Habitat(Corps Requirement)
6a.Will this project occur in or near an area designated as an Essential Fish Habitat?
Yes No
Are there submerged aquatic vegetation(SAV)around the project vicinity?*
Yes No Unknown
Will this project affect submerged aquatic vegetation?*
Yes
No
Unknown
Explain
6b.What data sources did you use to determine whether your site would impact an Essential Fish Habitat?
NOAA EFH Fish Mapper.A survey was done in June 2022.SAV's have been mapped on the northeast side of the project area outside of the footprint of
the bridge.
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?*
Appendix B of CE document-Archaeological:No National Register of Historic Places Eligible or Listed Archaeological Sites Present Form(7/8121)R
Architectural:No Historic Properties Present or Affected Form(12/30/15)
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:
The bridge area is located in Zone AE in a Coastal County.As such,the low chord of the proposed bridge was designed to be at or higher than the low
chord of the existing bridge per CAMA county
requirements.
8c.What source(s)did you use to make the floociplain determination?*
Flood Insurance Rate Map(FIRM)
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
B5614 Permit Drawings.pdf 14.76MB
File must be PDF or KMZ
Comments
Atlantic sturgeon was given a May Affect,Not Likely to Adversely Affect biological conclusion with no moratorium requested by NMFS.The Programmatic Biological Opinion(PBO)will be
used for Northern long-eared bat due to project location in Divisions 1-8.
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
cio�(J�Wglq
Date
9/8/2022