20170941 Ver 1_401 Application_20170731

Office Use Only:
Corps action ID no.
DWQ projed no.
Form Version 1.4 January 2009
Pre-Construction Notification (PCN) Form
A. Applicant Information
1. Processing
1a. Type(s) of approval sought from the Corps: �X Section 404 Permit ❑ Section 10 Permit
1 b. Specify Nationwide Permit (NWP) number: 3 or General Permit (GP) number:
1 c. Has the NWP or GP number been verifed by the Corps? ❑ Yes ❑ No
1d. Type(s) of approval sought from the DWQ (check all that apply):
❑X 401 Water Quality Certification — Regular ❑ Non-404 Jurisdictional General Permit
❑ 401 Water Quality Certifcation — Express ❑X 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 ❑X No ❑ Yes ❑X 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 ❑ Yes ❑X No
or in-lieu fee program.
1 g. Is the project located in any of NC's hventy coastal counties. If yes, answer 1 h � yes ❑X No
below.
1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ❑ Yes ❑X No
2. Project Information
2a. Name of project: Lenoir 23
2b. County: Lenoir
2c. Nearest municipality / town: Kinston
2d. Subdivision name: N!A
2e. NCDOT only, T.I.P. or state project no: 17BP.2.R.74
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 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]
Page 1 of 10
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.: 252-5303341
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.:
5g. Email address:
Page 2 of 10

B. Project Information and Prior Project History
1. PropeRy Identification
1a. Property identification no. (tax PIN or parcel ID): Lenoir 23 Bridge to Bridge Replacement
1b. Site coordinates (in decimal degrees): Latitude: 35.215697 Longitude: -��.5521
1c. Propertysize: acres
2. Surface Waters
2a. Name of nearest body of water to proposed project: Strawberry Branch
2b. Water Quality Classification of nearest receiving water: C; Sw, NSW
2c. River basin: Neuse
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:
SR 1905 Strawberry Branch Rd is a paved secondary road. Woodlands dominate ihe lantlscape.
3b. List the total estimated acreage of all existing wetlands on the property: 0.2
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:
3e. Describe the overall project in detail, including the type of equipment to be used:
The existing 46' long timber bridge will be replaced with a 1@ 45' and 1@ 55' cored slab bridge.
4. Jurisdictional Determinations
4a. Have jurisdictional wetla�d or stream determinations by the � Yes ❑x No ❑ Unknown
Corps or State been requested or obtained for this property /
ro'ect includin all rior hases in the ast? Comments:
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 documen[ation.
5. Project History
5a. Have permits or certifcations 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 fle" instructions.
6. Future Project Plans
6a. Is this a phased project? ❑ Yes X❑ No
6b. If yes, explain.
Page 3 of 10
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):
❑X Wetlands X❑ Streams—tributaries ❑X 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 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 Land Clearing Bottomland Hardwood Forest Yes Corps 0.026
yyZ - Choose one Chooseone Yes/No -
�/�13 P Land Clearing Bottomland Hartlwootl Forest Yes Corps 0.048
�A/q P Land Clearing Botlomland Hardwood Forest Yes Corps 0.01
�/�/5 P Land Clearing Bottomland Hardwood Forest Yes Corps 0.053
1/�Ig - Choose one Choose one Yes/No -
2g. Total Wetland Impacts: 0.137
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 Impact
number intermittent (INT)? jurisdiction stream length
Permanent (P) or width (linear
Temporary (T) (feet) feet)
S1 P Bridge Replacement Strawberry Branch PER DWQ 30 36
S2 T Bridge Replacement Strawberry Branch PER DWQ 30 65
S3 - Choose one - -
$4 - Choose one - -
S5 - Choose one - -
S6 - Choose ane - -
3h. Total stream and tributary impacts 709
3i. Comments:
Page 4 of 10
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 en water im acts below.
4a. 4b. 4c. 4d. 4e.
Open water Name of waterbody
impact number (if applicable) Type of impact Waterbody Area of impact (acres)
Permanent (P) or type
Tem ora
Q� - Choose one Choose
QZ - Choose one Choose
03 - Choose one Choose
pq - Choose one Choose
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If ond or lake construction ro osed, 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 ofpond (acres)
Flooded Filled Excavated Flooded Filled Excavated
P1 Chooseone
p2 Chooseone
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):
5. Size of pond watershed (acres):
5k. Method of construction:
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? ❑X Neuse ❑ Tar-Pamlico ❑ Catawba ❑ Randleman ❑ Other:
6b. 6c. 6d. 6e. 6f. 6g.
Buffer Impact Reason for impact Stream name Buffer Zone 1 Zone 2
number— mitigation impact impact
Permanent(P)or required? (square (square
Tem ora feet feet
B1 P Bridge Replacement Strawberry Branch No 523 292
g2 - Yes/No
B3 P Bridge Replacement Strawberry Branch No 648 403
gq P Britlge Replacement Strawberry Branch No 267 144
B5 P Bridge Replacement Strawberry Branch No 2,778 0
B6 YesMo
6h. Total Buffer Impacts: 4,2�6 83s
6i. Comments:
F'age 5 ot 10

D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
There are 101 linear feet of stream impacts and .i acres of wetlantl impacts tlue to the installation of an 100' x 33 cored slab bridge.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Use of existing madway 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 ❑ 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. 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 4uantity:
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 mitigation requested: acres
4f. Non-riparian wetland mitigation requested: acres
4g. Coastal (tidal) wetland mitigation requested: acres
4h. Comments:
5. Complete if Using a Permittee Responsible Mitigation Plan
Sa. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
Page 6 of 10
PCN Form — Version 1.4 January 2009

6. Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWQ
6a. Will the project result in an impad 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 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 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 buffer restoration, payment into an approved in-lieu fee fund).
6h. Comments:
Page 7 of 10

E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1a. Does the project include or is it adjacent to protected riparian buffers identified � Yes ❑ 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.
❑X Yes ❑ No
2. Stormwater Mana ement Plan
2a. What is the overall percent imperviousness of this project7 o�p
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, narrative description of the plan:
This bridge replacement projed is located lo the southeast of Kinston, NC antl is in the Neuse River Basin. The total project length is 600 feet along
the existing SR1905 roadway alignment. The projed is locatetl within a 4.7 square mile Shawberry 8ranch drainage area which has a classifcation of
QSw,NSW. The projecYs tlrainage system consists of hvo (2) proposed catch basins ihat direct runoff to ihe wetlantls through a pipe neN✓ork to an
outfall. A rip rap patl is proposetl at the pipe outlet to provide diffuse flow be(ore mnoff enters Buffer Zone 2. The outfall and rip rap patl are located on
ihe down slope side of the britlge antl outside of the wetlands limits.
2e. Who will be responsible for the review of the Stormwater Management Plan? owR aoi unit
3. Certified Local Government Stormwater Review
3a. In which local overnmenYs �urisdiction is this ro'ect? NrA
❑ 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
�Coastalcounties
❑HQW
4a. Which of the following state-implemented stormwater management programs apply �ORW
(check all that apply): ❑Session Law 2006-246
❑X OihBf: NPDES Permit
4b. Has the approved Stormwater Management Plan with proof of approval been � 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 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 (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 Ad (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 0 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 ❑X 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.
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. WII this project occur in or near an area with federally proteded species or � yes ❑X 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 impact Endangered Species or Designated Critical
Habitat?
Onsite fieltl investigation by Jay Johnson "No Effed"
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat? ❑ Yes OX No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
Mr, Travis Wlson, 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
governments have designated as having historic or cultural preservation � Yes ❑X 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 HEU HistoricArchitecture antl Archaeology
8. Flood Zone Designation (Corps Requirement)
8a. WII this project occur in a FEMA-designated 100-year floodplain? ❑X Yes ❑ No
8b. If yes, explain how project meets FEMA requirements:
Designetl to no-rise stantlards
8c. What source(s) did you use to make the floodplain determination?
FEMA FIRM Maps
Jay B.Johnson � a 07-31-2017
ApplicanUAgenPs Printed Name Appliyl�,nUA Ys Signature Date
(Ageqt's sign# f�ue is itl only if an authorization
Jetter from [he licant is rovitletl.
Page 10 of 10