20171370 Ver 1_PCN Form Submission_20171027

Action History (UTC-05:00) Eastern Time (US & Canada)
�brrrit by Anonymous User 10/27/2017 10:24:28 AM (Start Event)
Accept by Carpenter,Kristi 10/27/2017 3:06:01 PM (DOT Initial Review)
• The task was assigned to Carpenter,Kristi . The due date is: November 1, 2017 5:00 PM
10/27/2017 10:25 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:*
Wake
Is this a NCDOT Project?*
C� Yes �' No
(NCDOT only) T.I.P. or state project number:
B-5130 Replace Bridge 318 over Lake Johnson on SR1321 (Avent Ferry
Rd)
WBS #
42289.1.1
(for NCDOT use only)
1a. Type(s) of approval sought from the Corps:*
�J 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?*
r% Nationwide Permit (NWP)
� Regional General Permit (RGP)
Nationwide Permit (NWP) Number:
Nationwide Permit (NWP) Number:
NWP Number Other:
List all MNnurrbers you are applying for not on the drop down list.
03 - Maintenance
13 - Bank Stabilization
1c. Type(s) of approval sought from the DWR:*
check all that apply
r% 401 Water Quality Certification - Regular
r Non-404 Jurisdictional General Permit
r 401 Water Quality Certification - Express
�J Riparian Buffer Authorization
�
1d. Is this notification solelyfor the record because written approval is not required?
For the record only for DWR 401 Certification: C' Yes C� No

1d. Is this notification solelyfor the record because written approval is not required?
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?
IF so, attach the acceptance letter from rritigation bank or in-lieu fee program
C' Yes �' No
1f. Is the project located in anyof NC's twentycoastal counties?*
C' Yes C•' No
i B. Applicant Information
1a. Who is the Primary Contact?*
Jason Dilday
1b. Primary Contact Email:*
[e-mail]
i 1c. PrimaryContact Phone:*
(xxx)xxx-xxxx
[phone]
1d. Who is applying for the permit?
fJ Owner r Applicant (other than owner) r Agent/Consultant
(Check all that apply)
2. Owner I nformation
2a. Name(s) on recorded deed:
2b. Deed book and page no.:
2c. Responsible party:
(for Corporations)
2d.Address
Street Address
Address Line 2
�Y
Fbstal / Zip Code
2e. Telephone Number:
(xxx)xxx-x�cx
i 2f. Fax Number:
(xxx)xxx-xxxx
2g. Email Address:*
[e-mail]
State / FYovince / F�gion
Country
C. Project Information and Prior Project History
1. Project Information
1a. Name of project:*
*
C�' Yes C' No

B-5130 Replace Bridge No.318 over Lake Johnson on SR 1321
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality/town:*
Raleigh
1d. Driving directions*
If it is a new project and can not easily be found in a C�5 rrapping system Rease provide directions.
35.761426, -78.716893
2. Project Identification
i 2a. Property Identification Number:
(tax RN or parcel ID)
2b. Propertysize:
(in acres)
2c. Project Address
Street Address
Address Line 2
a�y
Fbstal / Zip Code
State / FYovince / F�gion
Country
2d. Site coordinates in decimal degrees
Please collect site coordinates in decimal degrees. Use between 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 e>cample, most mobile phones with GPS provide locational precision in decimal degrees to
map coordinates to 5 or 6 digits after the decimal place.)
I Latitude:*
35.761426
ex:34208G04
3. Surface Waters
Longitude:*
-78.716893
-77.796371
3a. Name of the nearest body of water to proposed project:*
I LakeJohnson
3b. Water Resources Classification of nearest receiving water:*
Class B, NSW
i Surface Water Lookup
3c. What river basin(s) is your project located in?*
Neuse
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:*
City of Raleigh Park, predominately forested with minor development adjacent to residential development.

4b. Attach an 8 1/2 X 17 excerpt from the most recent version of the USGS topographic map indicating the location of the project site. (for
DWR)
Gick the upload button or drag and drop files here to attach docurrent
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)
Gick the upload button or drag and drop files here to attach docurrent
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4d. List the total estimated acreage of all existing wetlands on the property:
1.9 ac.
4e. List the total estimated linear feet of all existing streams on the property:
(interrrittent and perennial)
0-all open water
4f. Explain the purpose of the proposed project:
To replace a functionally obsolete bridge.
4g. Describe the overall project in detail, including the type of equipment to be used:
The project involves replacing a 43-foot, single span bridge with a 100-foot, two span bridge on ewsting alignment
using an off-site detour. Standard road building equipment, such as trucks, dozers, and cranes will be used.
4h. Please upload project drawins for the proposed project.
Qick the upload button or drag and drop files here to attach docurrent
65130_Permit Package_20170831.pdf 3.7MB
65130_utilities combined.pdf 1.9M6
B5130_roadway plans.pdf 3.69M6
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5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the propertyor proposed impact areas?*
C� Yes C' No C' Unknown
Comme nts:
5b. If the Corps made a jurisdictional determination, what type of determination was made? *
C•' Preliminary C' Approved C' Unknown
Corps AID Number:
6carrple: SAV�2017-99999
SAW-2009-01782
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Othe r:
James Pflaum
NCDOT
5d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
Field determination 12/29/2009, signed PJD 3/2/10.
5d1. Jurisdictional determination upload

C7ick the upload button or drag and drop files here to attach docurrent
65130_PrelimJD_signed.pdf
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6. Project History
6.8MB
6a. Have permits or certifications been requested or obtained for this project (including all prior phases) in the past?*
C' Yes C� No C' Unknown
7. Future Project Plans
7a. Is this a phased project?*
C' 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 activit�/? 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 I m pacts I nventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
rJ Wetlands r Streams-tributaries rJ Buffers
r7 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.
2a. Site # - Reason for
impact
#3-fill
N�p label (e.g. Fd�ad Qossing 1)
#3-excavation
N�p label (e.g. Finad Qossing 1)
#3-mechanized clearing
N�p label (e.g. 13�ad CYossing 1)
2b. Impact type * 2c. Type of wetland
P Bottomland Hardwood
F�rrranent (P� or Terrporary Forest
��
P Bottomland Hardwood
F2rrranent (F) or Terrporary FOP2St
��
P Bottomland Hardwood
F�rrranent (� or Terrporary Forest
��
2g. Temporary Wetland Impact
0.000
2g. Permanent Wetland Impact
0.030
2g. Total Wetland Impact
0.030
2h. Comments:
#3- each impact is actually <0.01, however <0.01 cannot be entered.
2d. Wetland name 2e. Forested 2f. 2g. Impact
Jurisdiction area
type
WA No Corps 0.010
(404, 10) or d�NR (acres)
(401, other)
WA No Corps 0.010
(404, 10) or DJVR (acres)
(401, other)
WA No Corps 0.010
(404, 10) or C7J�ft (acres)
(401, other)
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.
4a. Site # - Reason for
� impact
#1-riprap pad for
24"RCP
N�p label (e.g. F3�ad Qossing 1)
#1-riprap pad for
24"RCP
N�p label (e.g. I�ad Qassing 1)
#2-causeway widening
fv�p label (e.g. I�ad CYossing 1)
#2-causeway widening
N�p label (e.g. F�ad Qossing 1)
4b. Impact 4c. Name of waterbody
type
P Lake Johnson
F�rrranerd (P� or (if applicable)
Terrporary (�
T Lake Johnson
F�rrrenent (�j or (if applicable)
Terrporary (�
P LakeJohnson
F2rrrenent (F) or (if applicable)
Terrporary (�
T Lake Johnson
F�rrranent (P� or (if applicable)
Terrporary (�
4d. Activity 4e. Waterbody4f. Impact area
type type
Stabilization Lake 0.01
(acres)
Stabilization Lake 0.01
(acres)
Fill Lake 0.29
(acres)
Fill Lake 0.18
(acres)
4g. Total temporary open water Impacts:
0.19
4g. Total permanent open water impacts:
0.30
4g. Total open water impacts:
0.49
4h. Comments:
#1 riprap pad permanent and temporary impacts are less than 0.01 ac., however <0.01 cannot be entered
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.
fJ Neuse
� Catawba
� Goose Creek
r Other
6b. Impact Type
r Tar-Pamlico
r Randleman
r Jordan Lake
6c. Per or 6d. Stream name
Te mp
#1-Road Crossing, Allowable P Lake Johnson
Location and C errpt, Allowable, allowable w/ rritigation F2rrranent (F) or
Terrporary (�
#2-Road Crossing, Allowable P Lake Johnson
Location and Exerrpt, Allowable, allowable w/ rritigation F2rrranent (P) or
Terrporary (�
6e. Buffer 6f. Zone 1 6g. Zone 2
mitigation impact impact
required?
No 1,617 925
(squarefeet) (squarefeet)
No 2,197 1,337
(square feet) (square feet)

6b. Impact Type
6c. Per or 6d. Stream name
Te mp
#3-Road Crossing, Allowable P Lake Johnson
Location and 6cerrpt, Allowable, allowable w/ rritigation F�rrranent (F) or
Terrporary (�
#1-Utilitywaterline, Exempt P Lake Johnson
Location and 6cerrpt, Allowable, allowable w/ rritigation F�rrranent (P� or
Terrporary (�
6h. Total buffer impacts:
Temporary impacts
Permanent impacts:
Zone 1
0.00
Zone 1
4,141.00
Zone 2
0.00
Zone 2
3,153.00
Zone 1 Zone 2
Total buffer impacts: 4,141.00 3,153.00
6i. Comments:
Buffer drawings were uploaded with the full permit drawings set above in 4h.
Supporting Documentation - i.e. Impact Maps, Plan Sheet, etc.
aick the upload button or drag and drop files here to attach docurrent
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E. Impact Justification and Mitigation
1. Avoidance and Minimization
6e. Buffer
mitigation
required?
No
i.n
6f. Zone 1 6g. Zone 2
impact impact
327 335
(squarefeet) (squarefeet)
0 556
(squarefeet) (squarefeet)
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:*
NCDOT Design Standards in Sensitive Watersheds will be employed. The bridge replacement and associated
roadway improvements have been designed to minimize increases in impervious surface area and maintain
e�asting drainage patterns. No deck drains are proposed for the replacement bridge. A retaining wall has been
proposed from station 19+79 to Begin Bridge and from End Bridge to station 29+25 -L- RT to minimize fill impacts
to Lake Johnson. Stormwater runoff from the travel lanes will flow across a 5.5-foot grass strip prior to flowing
across the 10-foot multi-use path. Along the retaining wall, the stormwater runoff will sheet flow over the top of the
wall after flowing through the 5.5-foot grass strip and across the mulit-use path.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*
The new bridge will have no deck drains or direct discharge to Lake Johnson. Retaining walls will be constructed to
minimize fill impacts to Lake Johnson. Temporary sheet piling will be used in areas along causeway to prevent
temporary fill from pushing out into Lake Johnson. The lake will be drawn down approximately nine feet (el. 333
msl) so that work around the end bents and along causeway can be do "in the dry". Draw�down will occur for no
longer than six months.
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 C•' No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
The permanent impacts are considered minimal and therefore compensatory mitigation is not proposed.

F. Stormwater Management and Diffuse Flow Plan (required by DWR)
1a. Does this project require a Stormwater Management Plan?
C� Yes �' No
1b. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
See attached Permit Drawings.
1c. What is the overall percent imperviousness of this project?
%
1d. Who will be responsible for the review of the Stormwater Management Plan?*
r Certified Local Government r DEMLR Stormwater Review
r DWR 401 & Buffer Permitting Branch �7 DWR Transportation Permitting Branch
2. Diffuse Flow Plan
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 how diffuse flow will 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
r Other BMP
(check all that apply)
Diffused Flow Documentation
Qick the upload button or drag and drop files here to attach docurrent
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5. DWR 401 Stormwater Review
5a. Is the Stormwater Management Plan (including BMP Supplemental Forms and Operation and Maintenance Agreements) attached?
r Yes c" No
Stormwater Management Plan Upload
C7ick the upload button or drag and drop files here to attach docurrent
file type rrust be pdf
I 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?*
r Yes C' 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)?*
�' Yes �' No
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
NEPAor SEPAfinal approval letter.)*
C� Yes �' No

NEPA or SEPA Final Approval Letter
C7ick the upload button or drag and drop files here to attach docurrent
FlLE IYFE MJST BE FDF
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 C•' 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 quality?*
C' Yes C•' No
3b. If you answered "no," provide a short narrative description.
I Due to the minimal transportation impact resulting from this bridge replacement, this project will neither influence
nearby land uses nor stimulate growth. Therefore, a detailed indirect or cumulative effects study will not be
necessary.
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.
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?*
G Yes C' No
5c. If yes, indicate the USFWS Field Office you have contacted.
Raleigh
Sd. Is this a DOT project located within Division's 1-8?*
�' Yes
C' No
Si. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?*
N.C. Natural Heritage Program database; USFWS-Raleigh Field Office website;biological surveys for protected
species listed for Wake County, which include red-cockaded woodpecker (RCW), dwarf wedgemussel and
Michau�s sumac. The species received biological conclusions of "No EffecY'. No habitat is present for RCW or
dwarf wedgemussel. Habitat for MichauXs sumac exists, however no specimens were observed during a 9/22/2016
survey. There were no bald eagles or nest observed within 660 feet of the project area on 9/22/2016.
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?*
i NMFS County Index
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? *
NEPA Documentation
7c. Historic or Prehistoric Information Upload
C7ick the upload button or drag and drop files here to attach docurrent
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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 l" No
8b. If yes, explain how project meets FEMA requirements:
NCDOT Hydraulics Unit coordination with FEMA
8c. What source(s) did you use to make the floodplain determination?*
FEMA Maps
Miscellaneous attachments not previously requested.
aick the upload button or drag and drop files here to attach docurrent
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Signature
*
rJ 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:*
Colin Mellor
Signature
Col� �i�llor
Date

10/27/2017
Initial Review
Is this project a public transportation project?
C' 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?*
G Yes
C' No
BIMS # Assigned*
20171370
Version#*
Reviewing Office*
Central Office - [phone]
Select Project Reviewer*
i Rob Ridings:eads\rgridings