20171047 Ver 1_PCN Form Submission_20170818

Action History (UTC-05:00) Eastern Time (US & Canada)
�brrrit by Anonymous User 8/18/2017 11:53:01 AM (Start Event)
Accept by Carpenter,Kristi 8/18/2017 2:42:29 PM (DOT Initial Review)
• The task was assigned to Carpenter,Kristi . The due date is: August 23, 2017 5:00 PM
8/18/2017 11:53 AM

�� �
6fvlslaa of Water Resources
Pre-Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
June 28, 2017 Ver 1.8
*
Please note: fields marked with a red asterisk below are required. You will not be ab/e to submit the form until all mandatory questions are ans�red.
Below is a link to the DRAFT online help file. http://edocs.deq.nc.gov/WaterResources/0/doc/549884/Page1.aspx
A. Processing Information
County (or Counties) where the project is located:*
Beaufort
Is this a NCDOT Project?*
C� Yes �' No
(NCDOT only) T.I.P. or state project number:
B-5618
WBS #
45573.1.1
(for NCDOT use only)
� 1a. Type(s) of approval sought from the Corps:*
rJ Section 404 Permit (wetlands, streams and waters, Clean Water Act)
r Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
1b. What type(s) of permit(s) do you wish to seek authorization?*
fJ Nationwide Permit (NWP)
r Regional General Permit (RGP)
Nationwide Permit (NWP) Number:
NWP Number Other:
List all MN nurrbers you are applying for not on the drop dow n list.
03 - Maintenance
1c. Type(s) of approval sought from the DWR:*
check all that apply
� 401 Water Quality Certification - Regular
� Non-404 Jurisdictional General Permit
r 401 Water Quality Certification - Express
�7 Riparian Buffer Authorization
1d. Is this notification solelyfor the record because written approval is not required?
For the record only for DWR 401 Certification:
I For the record only for Corps Permit:
1e. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
*
l" Yes C•' No
C' Yes C•' No

If so, attach the acceptance letter from rritigation bank or in-lieu fee program
C' Yes C' No
1f. Is the project located in any of NC's twenty coastal counties?*
C� Yes l" No
1g. Is the project located within a NC DCM Area of Environmental Concern (AEC)?*
C� Yes �' No C' Unknown
B. Applicant Information
1a. Who is the Primary Contact?*
NCDOT (Attn: Hon Yeung)
1b. Primary Contact Email:*
[e-mail]
1c. PrimaryContact Phone:*
(xxx)xxx-xxxx
[phone]
1d. Who is applying for the permit?
fJ Owner r Applicant (other than owner) �J Agent/Consultant
(Check all that apply)
� 2. Owner I nformation
2a. Name(s) on recorded deed:
NCDOT (Attn: Hon Yeung)
2b. Deed book and page no.:
2c. Responsible party:
(for Corporations)
2d.Address
Street Address
105 Pactolus Highway (NC 33)
Address Line 2
�Y
Greenville
Fbstal / Zip Code
27835
2e. Telephone Number:
(xxx)xxx-xxxx
[phone]
2f. Fax Number:
(xxx)xxx-xxxx
2g. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
Robert Turnbull
State / Rovince / f�gion
NC
Country
USA

4b. Business Name:
(if applicable)
Environmental Services, Inc.
4c. Address
Street Address
4901 Trademark Drive
Address Line 2
��
Raleigh
Fbstal / Zip Code
27615
4d. Telephone Number:
[phone]
(xxx)xxx-xxxx
4e. Fax Number:
[phone]
(xxx)xxx-xxxx
4f. Email Address:*
[e-mail]
State / R-ovince / F�gion
NC
Country
USA
AgentAuthorization Letter
Rease provide the Agent Authorization Letter if you are subrritting this docurrent.
B-5618_Agent Authorization.pdf 240.87KB
FlLE 7YFE MJST BE FDF
C. Project Information and Prior Project History
1. Project Information
1a. Name of project:*
� Beaufort Bridge 315 (B-5618)
1b. Subdivision name:
(if appropriate)
i 1c. Nearest municipality/town:*
Edward
1d. Driving directions*
IF it is a new project and can not easily be found in a C� rr�pping system Rease provide directions.
SR 1973 (Main Street) over Durham Creek in Edward, NC
2. Project Identification
2a. Property Identification Number:
(tax RN or parcel ID)
wa
2b. Propertysize:
(in acres)
0.4
2c. Project Address

Street Address
SR 1973 (Main Street)
Address Line 2
Qty
Edward
Fbstal / Zip Code
2d. Site coordinates in decimal degrees
State / R-ovince / I�gion
NC
Country
Please collect site coordinates in decimal degrees. Use betv�en 4-6 digits (unless you are using a survey-grade GPS device) after the decimal place as
appropriate, based on howthe location was determined. (For example, most mobile phones with GPS provide locational precision in decimal degrees to
map coordinates to 5 or 6 digits after the decimal place.)
Latitude:* Longitude:*
35.32372 -76.87383
ex:34.208504 -77.796371
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Durham Creek
3b. Water Resources Classification of nearest receiving water:*
C; NSW
Surface Water Lookup
3c. What river basin(s) is your project located in?*
Tar-Pamlico
RiverBasin Lookup
4. Project Description
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:*
The project study area and vicinity consist of rural residential and agricultural areas, silvicultural areas, and
undeveloped forested communities. The proposed project and associated impacts are within and immediately
adjacent to ebsting NCDOT right-of-way.
4b. Attach an 8 1/2 X 11 excerpt from the most recent version of the USGS topographic map indicating the location of the project site. (for
DWR)
C7ick the upload button or drag and drop files here to attach docurrent
B-5618 topo.pdf 593.36KB
Fle type rrust be pdF
4c. Attach an 8 1/2 X 11 excerpt from the most recent version of the published County NRCS Soil Survey map depicting the project site.
(for DWR)
aick the upload button or drag and drop files here to attach docurrent
B-5618 soils.pdf 5.83MB
Fle type rrust be pdf
4d. List the total estimated acreage of all existing wetlands on the property:
0.25
4e. List the total estimated linear feet of all existing streams on the property:
(interrrittent and perennial)
200
4f. Explain the purpose of the proposed project:

Replace existing bridge 315 on SR 1973 (Main Street) over Durham Creek. The sufficiency rating of the ewsting
bridge is 30.02.
4g. Describe the overall project in detail, including the type of equipment to be used:
The proposed project will replace the bridge on Main Street (SR 1973) over Durham Creek in Beaufort County.
The project will replace the e�asting timber floor bridge with a cored slab bridge. The project work will consist of
grading, widening, drainage improvements, bridge replacement, and pavement markings. This work will be
conducted using standard road construction equipment.
4h. Please upload project drawins for the proposed project.
Gick the upload button or drag and drop files here to attach docurrent
B5618_permit drawings.pdf 2.29M6
Fle type rrust be pdf
5. Jurisdictional Determinations
Sa. Have the wetlands or streams been delineated on the propertyor proposed impact areas?*
C� Yes C' No !' Unknown
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made? *
C� Preliminary C' Approved C' Unknown
Corps AID Number:
Exarrple: SAV�2017-99999
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Othe r:
NCDOT
5d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
Documentation not available as of the date of this application.
5d1. Jurisdictional determination upload
C7ick the upload button or drag and drop files here to attach docurrent
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6. Project History
6a. Have permits or certifications been requested or obtained for this project (including all prior phases) in the past?*
C' Yes C' No f Unknown
7. Future Project Plans
7a. Is this a phased project?*
C' Yes C•' 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? This includes other separate and distant crossing for linear projects that require Department of the
Army authorization but don't require pre-construction notification.
D. Proposed Impacts Inventory

1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
rJ Wetlands r Streams-tributaries rJ Buffers
� Open Waters r Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
I 2a. Site #- Reason for 2b. Impact type * 2c. Type of wetland 2d. Wetland name 2e. Forested 2f. 2g. Impact
impact Jurisdiction area
type
W1 P Riverine Swamp Forest W1 Yes Corps 0.010
N�p label (e.g. I�ad Qassing 1) F�rrranent (P� or Terrporary (404, 10) or CANR (acres)
(� (401, other)
2g. Temporary Wetland Impact
0.000
2g. Permanent Wetland Impact
0.010
2g. Total Wetland Impact
0.010
2h. Comments:
Proposed fill impact is 50 square feet (<0.01 acre). 0.19 acre of hand clearing in wetland is also proposed.
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.
"" All Perennial or Intermittent streams must be verified by DWR or delegated local government.
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 individually list
all open water impacts below.
5. Pond or Lake Construction
If pond or lake construction is proposed, then complete the chart below.
6. Buffer Impacts (for DWR)
If project will impact a protected riparian buffer, then complete the chart below. Individually list all buffer impacts below.
6a. Project is in which protect basin(s)?*
Check all that apply.
r Neuse �J Tar-Pamlico
� Catawba r Randleman
� Goose Creek r Jordan Lake
r Other

6b. Impact Type
6c. Per or 6d. Stream name
Te mp
B1 - Allowable P Durham Creek
Location and 6cerrpt, Allowable, allowable w/ rritigation F�rrranent (F) or
Terrporary (�
B2 - Allowable P Durham Creek
I Location and 6cerrpt, Allowable, allowable w/ rritigation F�rrranent (F) or
Terrporary (�
B3 - Allowable P Durham Creek
Location and C errpt, Allowable, allowable w/ rritigation F2rrranent (� or
Terrporary (�
64 - Allowable P Durham Creek
Location and Exerrpt, Allowable, allowable w/ rritigffiion F2rrranent (F) or
I Terrporary (�
6h. Total buffer impacts:
Temporary impacts
Permanent impacts:
Total buffer impacts:
6i. Comments:
Zone 1
0.00
Zone 1
3,719.00
Zone 1
3,719.00
Zone 2
0.00
Zone 2
3,485.00
Zone 2
3,485.00
Supporting Documentation - i.e. Impact Maps, Plan Sheet, etc.
C7ick the upload button or drag and drop files here to attach docurrent
65618_permit drawings.pdf
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E. Impact Justification and Mitigation
1. Avoidance and Minimization
6e. Buffer 6f. Zone 1 6g. Zone 2
mitigation impact impact
required?
No 1,044 876
(squarefeet) (squarefeet)
No
No
No
2.29M6
1,573 771
(squarefeet) (squarefeet)
522 398
(squarefeet) (squarefeet)
580 1,440
(squarefeet) (squarefeet)
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:*
The proposed bridge replacement will occur as much as practicable within the footprint of the existing bridge. Hand
clearing is proposed in the wetland to minimize clearing impacts. Fill has been minimized as much as practicable
� within the wetland areas.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*
A turbidity curtain will be used during the removal of ebsting bridge pilings and installation of new pilings. All
necessary sediment and erosion control BMPs will be installed and maintained through construction. Disturbed
ground will be restored and stabilized with permanent vegetative cover. NCDOT Best Management Practices will
be implemented throughout construction.
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?
C' Yes �' No

2b. If this project DOES NOT require Compensatory Mitigation, explain why:
Wetland impacts are minimized as much as practicable and are >0.01 acre in size. Buffer impacts result from perpendicular crossing of
Durham Creek.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
1a. Does this project require a Stormwater Management Plan?
C� Yes
C' No
1b. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
The proposed bridge does not contain deck drains. All stormwater from the bridge and approaches will be
collected by a storm drainage system and discharged into the wetlands. The drainage system will outlet outside of
buffer limits in the northeast quadrant at -L- station 15+84 LT with the outlet pipe set at 0.3°/o to reduce velocity
into the wetlands.
1c. What is the overall percent imperviousness of this project?
43
%
1d. Who will be responsible for the review of the Stormwater Management Plan?*
r Certified Local Government
r DWR 401 & Buffer Permitting Branch
2. Diffuse Flow Plan
r DEMLR Stormwater Review
�J DWR Transportation Permitting Branch
2a. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection
Rules?
C•' Yes
C' No
2b. All buffer impacts and high ground impacts require diffuse flow or other form of stormwater treatment. Include a plan that fully
documents howdiffuse flowwill be maintained.
If, due to site constraints, a BMP other than a level spreader is proposed, please provide a plan for stormwater treatment as outlined
i in Chapter 8 of the NC Stormwater BMP Manual and attach a BMP Supplement Form
What documentation are you providing?
r Level Spreader
I7 Other BMP
(check all that apply)
Diffused Flow Documentation
C7ick the upload button or drag and drop files here to attach docurrent
65618_Stormwater Mgmt Plan.pdf
Fle type rrust be FDF
5. DWR 401 Stormwater Review
192.04KB
5a. Is the Stormwater Management Plan (including BMP Supplemental Forms and Operation and Maintenance Agreements) attached?
C' Yes
C' No
Stormwater Management Plan Upload
Qick the upload button or drag and drop files here to attach docurrent
65618_Stormwater Mgmt Plan.pdf
file type rrust be pdf
G. Supplementary Information
1. Environmental Documentation
192.04KB
1a. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?*

r Yes r No
1b. 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 PolicyAct (NEPA/SEPA)?*
C' Yes �' No
Comments:*
State Minimum Criteria Checklist has been prepared.
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)? *
C' Yes �' No
2b. Is this an after-the-fact permit application?*
C' 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 (DWR Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in additional development, which could impact
nearby downstream water qualit�i?*
C' Yes �' No
3b. If you answered "no," provide a short narrative description.
The proposed project will result in minimum new impervious surface and will not result in any downstream impacts
or growth-stimulating effects. The existing use of Durham Creek (C) should not change as a result of this project.
4. Sewage Disposal (DWR Requirement)
4a. Describe, in detail, the treatment methods and dispositions (non-discharge or discharge) of wastewater generated from the
proposed project. If the wastewater will be treated at a treatment plant, list the capacity available at that plant.
i No wastewater will be produced as a result of this project.
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?*
C' Yes C•' No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
C' Yes C•' No
5c. If yes, indicate the USFWS Field Office you have contacted.
5d. Is this a DOT project located within Division's 1-8?*
C•' Yes
C' No
5i. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?*
Biological evaluations by NCDOT Staff.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*

r Yes r No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
http://wvwv. habitat. noaa.gov/protection/efh/efhmapper/
7. Historic or Prehistoric Cultural Resources (Corps Requirement)
Link to the State Historic Preservation Office Historic Properties Map (does not include archaeological data: http://gis.ncdcr.gov/hpoweb/
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 (e.g., National Historic Trust designation or properties significant in North Carolina historyand archaeology)?*
C' Yes C•' No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources? *
A cultural resources reviewwas conducted by NCDOT. Documentation for these reviews is attached.
7c. Historic or Prehistoric Information Upload
Gick the upload button or drag and drop files here to attach docurrent
Archaeology PA 16-07-0031 Beaufort (NSR).pdf 9.62M6
Historic Architecture 16-07-0031 NoSurvey.pdf 1.82M6
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8. Flood Zone Designation (Corps Requirement)
Link to the FEMA Floodplain Maps: https://msc.fema.gov/portal/search
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
C•' Yes �' No
8b. If yes, explain how project meets FEMA requirements:
� Durham Creek is a FEMA Limited Detailed Study stream and meets MOA Type 1 criteria - max decrease of 0.1'.
8c. What source(s) did you use to make the floodplain determination?*
�wwv.ncfloodmaps.com
Miscellaneous attachments not previously requested.
C7ick the upload button or drag and drop files here to attach docurrent
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Signature
*
r% By checking the box and signing below, I certify that:
■ 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 AcY');
■ I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic
Transactions AcY');
■ 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:*
Robert T. Turnbull
Signature

�c�f��� r.r•t6r/Frftl
Date
8/18/2017
Initial Review
Is this project a public transportation project?
G Yes C' No
Only change this if the project has been reassigned.
' Has this project met the requirements for acceptance in to the review process?*
C' Yes
C' No
I BIMS#Assigned*
20171047
Version#*
Reviewing Office*
Washington Regional Office - [phone]
Select Project Reviewer*
i Garcy Ward:eads\gpward