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Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.4 January 2009
Pre-Construction Notification (PCN) Form
A. Applicant Information
1. Processing
1 a. Type(s) of approval sought from the Corps: � Section 404 Permit ❑ Section 10 Permit
1 b. Specify Nationwide Permit (NWP) number: 14 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps? ❑ Yes � No
1d. 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
1e. Is this notification solely for the record For the record only for DWQ For the record only for Corps Permit:
because written approval is not required? 401 Certification:
❑ Yes � No ❑ Yes � No
1f. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation � Yes ❑ No
of impacts? If so, attach the acceptance letter from mitigation bank or in-lieu
fee program.
1 g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h ❑ Yes � No
below.
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ❑ Yes � No
2. Project Information
2a. Name of project: B-5758, Bridge #13 Replacement on SR 1102 over Aberdeen Creek
2b. County: Moore
2c. Nearest municipality / town: Aberdeen
2d. Subdivision name:
2e. NCDOT only, T.I.P. or state WgS Element No: 45714.1.1 / TIP: B-5758
project no:
3. Owner Information
3a. Name(s) on Recorded Deed: North Carolina Department of Transportation
3b. Deed Book and Page No. N/A
3c. Responsible Party (for LLC if Art King
applicable):
3d. Street address: 902 N. Sandhills Blvd.
3e. City, state, zip: Aberdeen, NC 28315
3f. Telephone no.: 910-944-2344
3g. Fax no.: 910-944-5623
3h. Email address: acking@ncdot.gov
Page 1 of 10
PCN Form — Version 1.4 January 2009
4. Applicant Information (if different from owner)
4a. Applicant is: ❑ Agent ❑ Other, specify:
4b. Name:
4c. Business name
(if applicable):
4d. Street address:
4e. City, state, zip:
4f. Telephone no.:
4g. Fax no.:
4h. Email address:
5. Agent/Consultant Information (if applicable)
5a. Name:
5b. Business name
(if applicable):
5c. Street address:
5d. City, state, zip:
5e. Telephone no.:
5f. Fax no.:
5g. Email address:
Page 2 of 10
B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): N/A
1 b. Site coordinates (in decimal degrees): Latitude: 35.0817 Longitude: -79.4624
1c. Property size: 2.9 acres (within project area)
2. Surface Waters
2a. Name of nearest body of water to proposed project: Aberdeen Creek
2b. Water Quality Classification of nearest receiving water: C
2c. River basin: Lumber (HUC: 03040203)
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:
The site consists of a structurally deficient bridge along a two lane section of state road. Land use in the vicinity of the
project is primarily forested, agriculture, and rural residential.
3b. List the total estimated acreage of all existing wetlands on the property: +/- .75 acres
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property: +/- 169 LF
3d. Explain the purpose of the proposed project:
The purpose of the project is to replace the current bridge structure with a new culvert structure 3@14'x9' RCBC, cast-in-
place with top edge bevel and wingwalls 1' — 6" sill in low flow (left) barrels; 3'-6' sill in floodplain (right) barrel.
3e. Describe the overall project in detail, including the type of equipment to be used:
Traffic will be detoured off-site and erosion and sedimentation control measures will be installed. Water will be diverted
around the construction area and the old bridge will be removed and replaced with a 3@14'x9' re-enforced concrete
boxed culvert. The channel will then be excavated and realigned for low flow shaping, and a floodplain bench with
stabilization will be established on each bank. Water will be pumped around the work area during construction by
installed impervious dikes upstream and downstream of the existing bridge. Pumped water between dikes will be
directed into a stilling basin. Equipment to be used include a track, hoe, dump, truck, paving equipment, pumps, and
various hand tools.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the � Yes ❑ No ❑ Unknown
Corps or State been requested or obtained for this property / Comments:
project (including all prior phases) in the past?
4b. If the Corps made the jurisdictional determination, what type
of determination was made? ❑ Preliminary ❑ Final
4c. If yes, who delineated the jurisdictional areas? Agency/Consultant Company: SEPI
Name (if known): K. Hamlin, E. Webster Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
March 1, 2016
5. Project History
5a. Have permits or certifications been requested or obtained for � Yes � No ❑ Unknown
this project (including all prior phases) in the past?
5b. If yes, explain in detail according to "help file" instructions.
6. Future Project Plans
6a. Is this a phased project? ❑ Yes � No
6b. If yes, explain.
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PCN Form — Version 1.4 January 2009
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) or Area of impact
Permanent (P) or (if known) DWQ (401, other) (acres)
Tem ora T
Bottomland
Site 2- P Fill Hardwood No Corps <0.01
Forest
Bottomland
Site 2- T Land Clearing Hardwood No Corps 0.02
Forest
2g. Total wetland impacts 0.03
2h. Comments: 0.03 acres of wetland impacts for construction of toe protection on the upstream side of the culvert -<0.01
acres of permanent wetland fill and 0.02 acres of temporary hand clearing of wetlands for a work area.
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 stream Impact
number (PER) or width length
Permanent (P) or intermitte (feet) (linear
Temporary (T) nt (INT)? feet)
Site 1-P Culvert Aberdeen Creek PER Corps/DWR 30 42
Site 3- T Dewatering Aberdeen Creek PER Corps/DWR 30 95
Site 4-P Bank Aberdeen Creek PER Corps/DWR 30 84
stabilization
3h. Total stream and tributary impacts 221
3i. Comments: 42 LF of permanent stream impacts for culvert installation and 84 LF of impacts for bank stabilization with rip
rap. 95 LF of temporary stream impact from dewatering to install the culvert.
4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individuall list all o en water im acts below.
4a. 4b. 4c. 4d. 4e.
Open water Name of
impact number - waterbody Type of impact Waterbody type Area of impact (acres)
Permanent (P) or (if applicable)
Tem ora T
01 Choose one Choose One Choose 0
4f. Total open water impacts 0
4g. Comments: There are no open waters within the project boundaries.
Page 4 of 10
PCN Form - Version 1.4 January 2009
5. Pond or Lake Construction
If ond or lake construction ro osed, then com lete the chart below.
5a. 5b. 5c. 5d. 5e.
Wetland Impacts (acres) Stream Impacts (feet) Upland
Pond ID Proposed use or (acres)
number purpose of pond
Flooded Filled Excavated Flooded Filled Excavated Flooded
P1 Choose One
P2 Choose One
5f. Total 0 0 0 0 0 0 0
5g. Comments: This project does not propose Pond or Lake construction
5h. Is a dam high hazard permit required?
❑ Yes � No If yes, permit ID no:
5i. Expected pond surFace area (acres): N/A
5j. Size of pond watershed (acres): N/A
5k. Method of construction: N/A
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If an im acts re uire miti ation, then ou MUST fill out Section D of this form.
6a.Project is in which protected basin? ❑ Neuse ❑ Tar-Pamlico ❑ Catawba ❑ Randleman ❑ Other:
6b. 6c. 6d. 6e. 6f. 6g.
Buffer impact
number — Reason Buffer mitigation required? Zone 1 impact Zone 2 impact
Permanent (P) or for Stream name (square feet) (square feet)
Tem ora T im act
- Yes/No
6h. Total buffer impacts
6i. Comments:
Page5of10
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
The proposed project will remove and replace a structurally deficient bridge with a culvert on the same alignment.
Roadway approach work is minimized as much as is practical to reduce the overall project footprint. An off-site detour will
be used to avoid the need for a temporary parallel structure. Bank stabilization will be minimized to those areas where
deemed necessary.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Erosion and sedimentation BMPs will be installed prior to construction. Impacts will be minimized by strict enforcement of
Best Management Practices for the protection of surface waters and restrictions against the staging of equipment in or
adjacent to water of the US, and coordination with the Division Environmental Officer.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for � Yes ❑ No
impacts to Waters of the U.S. or Waters of the State?
2b. If yes, mitigation is required by (check all that apply): � DWQ � Corps
❑ Mitigation bank
2c. If yes, which mitigation option will be used for this
project? � Payment to in-lieu fee program
❑ Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
Type: Choose one Quantity N/A
3b. Credits Purchased (attach receipt and letter) Type: Choose one Quantity N/A
Type: Choose one Quantity N/A
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: 42 linear feet
4c. If using stream mitigation, stream temperature: warm
4d. Buffer mitigation requested (DWQ only): 0 square feet
4e. Riparian wetland mitigation requested: 0 acres
4f. Non-riparian wetland mitigation requested: 0 acres
4g. Coastal (tidal) wetland mitigation requested: 0 acres
4h. Comments:
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.
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6. Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires ❑ Yes � No
buffer mitigation?
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.
6c. 6d. 6e.
Zone Reason for impact Total impact Multiplier Required mitigation
(square feet) (square feet)
Zone 1
Zone 2
6f. Total buffer mitigation required:
6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in-lieu fee fund).
6h. Comments:
Page7of10
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 Mana ement Plan
2a. What is the overall percent imperviousness of this project? 33%
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:
A stormwater management plan is included within the permit package. The project will be completed in accordance with
the NCDOT BMP manual to the maximum extent practicable. Construction stormwater management will comply with NCS
000250.
2e. Who will be responsible for the review of the Stormwater Management Plan? DWR 401 Unit
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this project?
❑ Phase II
3b. Which of the following locally-implemented stormwater management programs ❑ NSW
apply (check all that apply): ❑ USMP
❑ Water Supply Watershed
❑ Other:
3c. Has the approved Stormwater Management Plan with proof of approval been ❑ Yes ❑ No
attached?
4. DWQ Stormwater Pro ram 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:
4b. Has the approved Stormwater Management Plan with proof of approval been
attached? ❑ Yes ❑ No
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
Page8of10
PCN Form — Version 1.3 December 10, 2008 Version
F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1 a. Does the project involve an expenditure of public (federal/state/local) funds or the � Yes ❑ No
use of public (federal/state) land?
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 ❑ Yes � No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1 c. If you answered "yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
letter.) ❑ Yes ❑ No
Comments:
2. Violations (DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards, ❑ Yes � No
or Riparian Buffer Rules (15A NCAC 26 .0200)?
2b. Is this an after-the-fact permit application? ❑ Yes � No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in � Yes � No
additional development, which could impact nearby downstream water quality?
3b. If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
This project is a bridge replacement along the existing alignment and will not increase access to nearby properties.
4. Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility.
It is not anticipated that this project will generate any wastewater as it is a roadway project.
Page 9 of 10
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?
5c. If yes, indicate the USFWS Field Office you have contacted.
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
USF&W Endangered Species website: https://www.fws.qov/endanqered/
NCDOT Staff Field Survey
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat? ❑ Yes � No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
The proposed project takes place in Moore County which is not near any coastal or tidal habitat that would support EFH
(i.e. salt marshes, oyster reefs, etc.).
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?
NCDOT Cultural Resources Staff Survey. NC SHPO Reference 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: Refer to Culvert Survey Report
8c. What source(s) did you use to make the floodplain determination? FEMA FIRM Maps
Art C. Kin - - G°°�'
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ApplicanUAgent's Printed Name Applicant/Agent's�Signature Date
(AgenYs signature is valid only if an authorization letter from the applicant
is rovided.
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