20160052 Ver 3_US 70 Shoulder Reconstruction - US 70 Sites PCN G-L 4 and 5_20171030

Action History (UTC-05:00) Eastern Time (US & Canada)
�brrrit by Anonymous User 10/30/2017 1:23:00 PM (Supplemental Submital)
Accept by Carpenter,Kristi 10/30/2017 2:37:55 PM (DOT - E�asting Project)
• The task was assigned to Carpenter,Kristi 10/30/2017 1:23 PM

Water Resources
ENVIRONMENTAL OUALITY
Staff Review:
Submittal Type: l" New Project
C' Pre-Application Submittal
C�' More Information Response
New Project - Please check the new project type if you are trying to submit a new project that needs an official approval
decision.
Pre-Application Submittal - Please check the pre-application submittal if you just want feedback on your submittal and do
not have the expectation that your submittal will be considered a complete application requiring a formal decision.
More Information Response - Please check this type if you are responding to a request for information from staff and
you have and ID# and version for this response.
ID#*
20160052
Version*
3
Is this project in a CAMAAEC area?* �' Yes
�' No
Reviewer List:*
Select Reviewing Office:*
Garcy Ward:eads\gpward
Washington Regional Office - [phone]
Project Submittal Interim Form
subrritted: 10/30/2017
Project Contact Information:
Name: Bill Brame Jr
Who is subrritting the inforrration?
Email Address: [e-mail]
Project Information:
Existing ID #:* Existing Version:*
20160052 3
Project Name: US 70 Shoulder Reconstruction
Is this a public transportation project?
l•' Yes
C' No
TI P#:
WBS#: 2.101611
(Applies to
DOT projects
only)

County (ies) *
Carteret
Describe the attachments:
Revised sheets 4 and 5 of PCN. Shows wetland impacts and open water impacts
Please upload all files that need to be submited.
US 70 Sites PCN G-L 4 and 5.pdf
Only pdF files are accepted.
rJ By checking the box and signing box below, I certify that:
570.89KB
o I have given true, accurate, and complete information on this form;
o I agree that submission of this form is a"transaction" subject to Chapter 66, Article 40 of the NC General Statutes (the
"Uniform Electronic Transactions AcY')
o 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');
o I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature; AND
o I intend to electronically sign and submit the form.
Signature:
��� c ,� �

C. Proposed Impacts Inventory
� . Impacts Snmmary
� a. Which sections were completed below for your project (check all that apply):
❑X Wetl�nds ❑�tre�ms — tributaries ❑ Buffers ❑X Open Waters ❑ Pond Construction
2. Wetland Impacts
If there �re wetl�nd impacts proposed on tt�e site, then complete this question for e�ch wetl�nd �re� impacted.
2a. 2b. 2c. 2d. 2e. 2f.
Wetl�nd imp�ct Type of imp�ct Type of wetl�nd Eorested Type of jurisdiction Are� of
number Corps (404, f 0) or imp�ct
Permanent (P) or DW(� (40�, other) (acres)
Tem or� T
W j P �houlder Maintenance Choose one No DW(� 0.03
qj2 - Choose one Choose one Yes/No -
�j� - Choose one Choose one Yes/No -
W4 - Choose one Choose one Yes/No -
W5 - Choose one Choose one Yes/No -
qjg - Choose one Choose one Yes/No -
2B. Total Wetland Impacts: 0.03
2h. Comments:
3. Stream Impact$
Tf there �re perenni�l or intermittent stre�m imp�cts (includin@ tempor�ry imp�cts) proposed on the site, then complete this
question for �Il stream sites imp�cted.
3a. 3b. 3c. 3d. 3e. 3f. 3g.
�tream impact Type of impact �tream name Perennial (PEIt) or Type of Average Impact
number intermittent (INT)? jurisdiction stre�m length
Permanent (P) or width (linear
Tempor�ry (T) ��etj feet)
�j - Choose one - -
�2 - Choose one - -
�3 - Choose one - -
�4 - Choose one - -
�g - Choose one - -
�g - Choose one - -
3h. Total stream and tributary impacts
3i. Comments:
Page 4 of � 0
PCN Eorm — Version i.4 Danuary 200�

4. Open Water Impacts
If tl�ere �re proposed imp�cts to I�kes, ponds, estu�ries, tribut�ries, sounds, the Atl�ntic Ocean, or �ny other open w�ter of
the U.�. then individuall list all o en water im acts below.
4a. 4b. 4c. 4d. 4e.
Open w�ter N�me of w�terbody
impact number (if applicable ) Type of impact Waterbody Area of impact (acres)
Permanent (P) or type
Tem ora T
Qj P Fi� Sound 0.0682
O2 - Choose one Choose
03 - Choose one Choose
04 - Choose one Choose
4f. Total open water impacts
4g. Comments:
5. Pond or Lake Construction
If ond or l�ke construction ro osed, then com lete the ch�rt below.
5a. Sb. 5c. 5d. 5e.
Pond ID number Proposed use or Wetl�nd Imp�cts (�cres) �tre�m Imp�cts (feet) Upl�nd
purpose of pond (acres)
Flooded Fi�ed Excavated Flooded Filled Excavated
p� Choose 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. �ize of pond w�tershed (acres):
5k. Method of construction:
6. Bnffer Impacts (for DWf�1)
Tf project will imp�ct � protected rip�ri�n buffer, then complete the ch�rt below. Tf yes, then individu�lly list �ll buffer imp�cts
below. If an im acts re uire miti ation, then ou MUST fill out �ection D of this form.
6a. Project is in which protected b�sin? ❑ Neuse � Tar-Pamlico � C�t�wb� � Randleman ❑ Other:
6b. 6c. 6d. 6e. 6f. 6@.
Buffer Impact Reason for impact �tream name Buffer Zone i Zone 2
number — mitig�tion imp�ct imp�ct
Permanent (P) or required? (square (square
Tem or� T feet feet
B � - Yes/No
$2 - YesMo
B3 - Yes/No
B4 - Yes/No
B5 - Yes/No
B6 - Yes/No
6h. Total Bnffer Impacts:
6i. Comments:
Page 5 of i 0