20170361 Ver 1_Carteret 63 PCN signed_20171127

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Corps action ID no.
DWQ project no.
Form Vereion 1.4 January 2009
Pre-Construction Notification (PCN) Form
A. Applicant Information
1. Processing
1a. Type(s) of approval sought from the Corps: ❑X Sedion 404 Permit
❑ Section 10 Permit
1b. Specify Nationwide Permit (NWP) number: 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 ❑X Riparian Buffer Authorization
te. Is this notification solely for the record For the record only for DWQ For the record only for Corps Permit:
berause written approval is not required? 401 CeRifiration:
❑ Yes ❑X No ❑ Yes � No
1f. Is payment into a mitigation bank or in-lieu fee program proposed for
mitigation of impacts? If so, attach the accep[ance letter from mitigation bank ❑ Yes ❑X No
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)? ❑X Yes ❑ No
2. Project Information
2a. Name of projed: Carteret 63
2b. County: Carteret
2c. Nearest municipality / town: Stella
2d. Subdivision name: N/A
2e. NCDOT only, T.I.P. or state projed no: 17BP.2.R.71
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 'rf N�A
applicable):
3d. Street address: 105 Pactolus Highway NC 33 P.O. Box 1587
3e. City, state, zip: Greenville, NC 27835
3f. Telephone no.: 252-439-2800
3g. Fax no.: 252-830-3341
3h. Email address: [e-mail]
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PCN Form — Version 1.4 January 2009

4. Applicant Information (if different from owner)
4a. Applicant is: ❑ Agent ❑X Other, specify: Division 2 Environmental Officer
4b. Name: Jay B. Johnson
4c. Business name North Carolina Department of Transportation
4d. Street address: P.O. Box 1587
4e. City, state, zip: Greenville, NC 27835
4f. Telephone no.: 252-439-2800
4g. Fax no.: 252-830-3341
4h. Email address: [e-mail]
5. AgenUConsultant Information (if applicable)
5a. Name: N/A
5b. Business name
5c. Street address:
5d. City, state, zip:
5e. Telephone no.:
5f. Fax no.:
5a. 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): Carteret 63 Bridge to Bridge Replacement
1 b. Site coordinates (in decimal degrees): Latftude: 34.772406 Longitude: -��.08161
1c. Propertysize: acres
2. Surface Waters
2a. Name of nearest body of water to proposed project: Hadnot Creek
2b. Water Quality Classification of nearest receiving water: SA; HQW
2c. River basin: White Oak
3. Project Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of the projed at the time of this
application:
SR 1104 Old Church Rd is a paved secondary road. Woodlantls arW residential properties dominale the landscape.
3b. List the total estimated acreage of all existing wetlands on the property: 1
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property: 60
3d. Explain the purpose of the proposed project:
Bridge to britlge replacement; the existing bridge has deterioratetl and needs replacement.
3e. Describe the overall project in detail, including the type of equipment to be used:
The existing 52' long timber britlge will be replacetl with a 1(�55' and 1(0�30' core slab bridge.
4. Jurisdic6onal Determinations
4a. Have jurisdictional wetland or stream determinations by the � yes 0 No ❑ Unknown
Corps or State been requested or obtained for this property / Comments:
ro'ect includin all rior hases in the ast?
4b. If the Corps made the jurisdictional determination, what type
of determination was made? ❑ Preliminary ❑ Final
4c. If yes, who delineated the jurisdidional areas? Agency/Consuitant Company:
Name (if known): Other:
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
5. Project History
5a. Have permits or certifications been requested or obtained for � Yes ❑X 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 ❑X No
6b. If yes, explain.
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PCN Form — Version 1.4 January 2009

C. Proposed Impacts Inventory
7. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
�X Wetlands ❑X Streams—tributaries ❑ Buffers ❑ Open Waters ❑ Pond Construction
2. Wetland Impacts
If there are we[land impacts proposed on the site, then complete this question for each wedand area impacted.
2a. 2b. 2c. 2d. 2e. 2f.
Wetland impact Type of impact Type of wetland Forested Type of jurisdiction Area of
number Corps (404,10) or impact
Permanent (P) or DWQ (401, other) (acres)
Tem ora
W1 P Fill and Excavation Bottomland Hardwood Foresl Yes Corps 0.04
y� T Hand Clearing Bottomland Hardwood Forest Yes Corps 0.02
1�/3 P Fill Bottomland Hardwood Forest Yes Corps 0.01
y1/q i Hand Clearing Bottomland Hardwood Forest Yes Corps 0.01
W5 P Fill and Excavation Bottomlantl Hartlwood Forest Yes Corps 0.02
� - Choose one Choose one YeslNo -
2g. Total Wetland Impacts: 0.1
2h. Comments:
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 (PER) or Type of Average Impad
number intercnittent (INT)? jurisdiction stream length
Permanent (P) or width (linear
Temporary ("� (feet) feet)
$� T BridgeReplacement HadnotCreek PER DWQ 20 22
S2 - Choose one - -
S3 - Choose one - -
$4 - Choose one - -
S5 - Choose one - -
S6 - Choose one - -
3h. ToWI stream and tributary impacts
3i. Comments:
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PCN Form — Version 1.4 January 2009

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 n water im acts below.
4a. 4b. 4c. 4d. 4e.
Open water Name of waterbody
impad number (if applicable) Type of impact Waterbody Area of impact (aaes)
Pertnanent(P) or type
Tem ora
01 - Choose one Choose
QZ - Choose one Choose
03 - Choose one Choose
Q4 - Choose one Choose
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If ond or lake construction ro sed, then com lete the chart below.
5a. 5b. 5c. 5d. 5e.
Pond ID number Proposed use or Wetland Impacts (acres) Stream Impacts (feet) Upland
purpose of pond (acres)
Flooded Filled Excavated Flooded Filled Excavated
P1 C�oose one
p2 Choose one
5f. Total:
5g. Comments:
5h. Is a dam high hazard permit required? ❑ Yes ❑ No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impactg (for DWQ)
If project will impad a proteded riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If an im cts re uire miti ation, then ou MUST fill out Section D of this form.
6a. Project is in which protected basin? ❑ Neuse ❑ TarvPamlico ❑ Catawba ❑ Randleman ❑ Other:
6b. 6c. 6d. 6e. 6f. 6g.
Buffer Impact Reason for impad Stream name Buffer Zone 1 Zone 2
number— mitigation impad impact
Permanent (P) or required? (square (square
Tem ora feet feet
61 - YeslNo
BZ - Yes/No
g3 - ves/No
g4 - YeslNo
g5 - YeslNo
gg - Yes/No
6h. Total Buffer Impacts:
6i. Comments:
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D. Impact Justification and Mitigation
7. Avoidance and Minimization
ta. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
There are 22 linear feet of stream impads and .1 acres of wetland impacts due to the installation of an 85' x 30' core slab bridge.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Use of existing roadway to operate construction equipment.
2. Com ensato Miti ation for Im acts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for ❑ Yes ❑X 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 ❑ Corys
❑ Mitigation bank
2c. If yes, which mitigation option will be used for this ❑ payment to in-lieu fee program
projed?
❑ Permittee Responsible Mitigation
3. Com lete if Usin a Miti ation Bank
3a. Name of Mitigation Bank:
Type: Choose one Quantity:
3b. Credits Purchased (attach receipt and letter) Type: Choose one Quantity:
Type: Choose one Quantity:
3c. Comments:
4. Com lete if Makin a Pa ment to In-lieu Fee Pro ram
4a. Approval letter from in-lieu fee program is attached. ❑ Yes
4b. Stream mitigation requested: linear feet
4c. If using stream mitigation, stream temperature: Choose one
4d. Buffer mitigation requested (DWQ only): square feet
4e. Riparian wetland mitigaiion requested: acres
4f. Non-riparian wetland mitigation requested: acres
4g. Coastal (tidal) wetland mitigation requested: acres
4h. Camments:
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mi6gation plan.
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PCN Form — Version 1.4 January 2009

6. Buffer Mitigafion (State Regulated Riparian Buffer Rules) — required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires � Yes ❑X No
buffer mitigation?
6b. If yes, then identify the square feet of impact to each zone of the riparian buifer that requires mitigation. Calculate the
amount of mitigation required.
6c. 6d. 6e.
Zone Reason for impact Total impact Multiplier Required mitigatian
(square feet) (square feet)
Zone 1 3(2 for Catawba)
Zone 2 1.5
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 buifer restoration, payment into an approved in-lieu fee fund).
6h. Comments:
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E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
7. Diffuse Flow Plan
1 a. Does the project include or is it adjacent to protected riparian buffers identified � Yes Ox No
within one of the NC Ri arian Buffer Protection Rules?
1 b. If yes, then is a diffuse flow plan included? If no, explain why.
❑ Yes ❑ No
2. Stortnwater Mana ement Plan
2a. What is the overall percent imperviousness of this projed? o�o
2b. Does this ro'ect re uire a Stormwater Mana ement 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, nartative description of the plan:
The exisNng bridge is 52.0 feet long. The replacement structure will be a 1@ 55' and 1(a� 30' long bridge, providing a 27.83' clear deck width. The
roadway grade of the new strudure will be appro�malely the same as the epsting strudure. There will be no tlirecl tlischarge into the stream (dedc
drains on the bridge). All existing stommvater dreinage pattems were maintainetl on lhe project to the fullest ex[ent. The storm drainage system
picking up the bridge deck tlrainage will be outleted oulsitle of the CAMA Buffer onto a dissipator pad, in a proposed ditch on the southwest quadrant
of the bridge. Trie ezisting ditches on the norihwest, soulhwest, and southeast quadranis were tied into prposed ditches due to widening of the
proposed roadway footprint filling in the existing ditches. All three of these ditches were ditched to the stream, just as ihe euisting ditches were.
2e. Who will be responsible for the review of the Stormwater Management Plan? owrz ao� Unit
3. Certified Local Govemment Stormwater Review
3a. In which local overnmenPs'urisdiction is this ro'ect? N�A
❑ 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 appraved 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
❑X Otller: NPDES Permit
4b. Has the approved Stormwater Management Plan with proof of approval been � yes ❑x No
ariached?
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 8 of 10
PCN Form — Version 1.4 January 2009

F, Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1a. Does the project involve an expenditure of public (federaUstate/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 0 No
(North Carolina) Environmental Policy Ad (NEPA/SEPA)?
1c. 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 X� No
or Riparian Buffer Rules (15A NCAC 26 .0200)?
2b. Is lhis an aftervthe-fact permit application? ❑Yes ❑X 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 impads) result in �Yes ❑ No
additionai development, which could impact nearby downstream water quality?
3b. If you answered "yes" to the above, submit a qualitative ar quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
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.
Page 9 of 10
PCN Form — Version 1.4 January 2009

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 OX No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act � Yes ❑X 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 impad Endangered Species or Designated Critical
Habitat?
Onsite field invesl'gation by Jay Johnson "No Eifecf'
6. Essential Fish Habitat (Corps Requirement)
6a. Will this projed occur in or near an area designated as essential fish habitat? ❑ Yes 0 No
6b. What data sources did you use to detertnine whether your site would impact Essential Fish Habitat?
Mc Travis Wilson, NCWRC
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
7a. Will this project occur in or near an area that the state, federal or tribal
govemments have designated as having historic or cultural preservation � yes � No
status (e.g., National Historic Trust designation or properties sign"dicant in
North Carolina history and arohaeology)?
7b. What data sources did you use to determine whether your site would impad historic or archeological resources?
NCDOT HEU Historic Architecture and Archaeology
8. Flood Zone Designation (Corps Requirement)
Sa. Will this project occur in a FEMA-designated 100-year floodplain? ❑X Yes ❑ No
Sb. If yes, explain how project meets FEMA requirements:
Designed to no-rise slarWards
8c. What source(s) did you use to make the floodplain determination?
FEMA FIRM Maps
Jay B.Johnson 06-27-2017
ApplicanUAgenYs Printed Name Appli� UA enY ignature Date
(AgenCs sign re is lid o Ny if an authorization
letter from the licant is roviUetl.
Page 10 of 10