20171428 Ver 1_PCN Form Submission_20171107

Action History (UTC-05:00) Eastern Time (US & Canada)
�brrrit by Anonymous User 11/7/2017 11:15:15 AM (Start Event)
Accept by Carpenter,Kristi 11/7/2017 2:56:18 PM (DOT Initial Review)
• The task was assigned to Carpenter,Kristi . The due date is: November 10, 2017 5:00 PM
11 /7/2017 11:15 AM

�� �
6fvlslaa of Water Resources
Pre-Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
November 25, 2017 Ver 2.1
*
Please note: fields marked with a red asterisk below are required. You will not be able to submit the form until all mandatory questions are ans�red.
Below is a link to the online help file.
http://edocs.deq.nc.gov/WaterResources/0/doc/603610/Page1.aspx
A. Processing Information
County(or Counties) where the project is located:*
Onslow
Is this project a public transportation project? (?)
r Yes C' No
Is this a NCDOT Project?
C� Yes C' No
(NCDOT only) T.I.P. or state project number:
WBS #
17BP.3.R.48
(for NCDOT use only)
1a. Type(s) of approval sought from the Corps:
ri 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?
rJ 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.
14 - Linear transportation
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
r Riparian Buffer Authorization

1d. Is this notification solelyfor the record because
written approval is not required?
For the record only for DWR 401 Certification
For the record only for Corps Permit:
*
C' Yes C•' No
C' Yes r No
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 C•' No
1f. Is the project located in anyof NC's twentycoastal counties?*
�' Yes [" No
1g. Is the project located within a NC DCM Area of Environmental Concern (AEC)?*
C' Yes C•' No C' Unknown
1h. Is the project located in a designated trout watershed?*
r No
C' Yes
Link to trout information: http://v�uwv.saw.usace.army.mil/Missions/Regulatory-Permit-Program/Agency-Coordination/Trout.aspx
B. Applicant Information
1a. Who is the Primary Contact?*
NCDOT (attn: Mason Herndon)
1b. Primary Contact Email:*
[e-mail]
1c. PrimaryContact Phone:*
(xxx)xxx-xxxx
[phone]
1d. Who is applying for the permit?
�J Owner r Applicant (other than owner) r Agent/Consultant
(Check all that apply)
2. Owner I nformation
2a. Name(s) on recorded deed:
NCDOT (attn: Mason Herndon)
2b. Deed book and page no.:
2c. Responsible party:
(for Corporations)
2d.Address
Street Address
5501 Barbados Blvd
Address Line 2
��
Castle Hane
Fbstal / Zip Code
28429
2e. Telephone Number:
State / Rovince / I�gion
NC
Country
USA

(xxx)x�c-xxxx
[phone]
2f. Fax Number:
(xxx)x�c-�ocx
2g. Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1a. Name of project:*
OnslowCounty Bridge 134
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality/town:*
Maysville
1d. Driving directions*
If it is a new project and can not easily be found in a G� rrapping system Rease provide directions.
White Oak River Road (SR 1331) over Gibson Branch, west of Maysville.
2. Project Identification
2a. Property Identification Number:
(tax RNor parcel ID)
2b. Propertysize:
(in acres)
approx. 1.5 acres
2c. Project Address
Street Address
White Oak River Road (SR 1331)
Address Line 2
aty
I Maysville
Fbstal / Zip Code
28555
State / FYovince / F�gion
NC
Country
USA
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 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:*
34.91317
ex:34.208504
3. Surface Waters
Longitude:*
-77.27409
-77.796371
3a. Name of the nearest body of water to proposed project:*

Gibson Branch
3b. Water Resources Classification of nearest receiving water:*
C
Surface Water Lookup
3c. What river basin(s) is your project located in?*
White Oak
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 e�asting 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
Onslow 134_USGS topo.pdf
Fle type rrust be pdF
C:�'i:�:�']:L:3
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 docurrerrt
Onslow 134_NRCS Soil Survey.pdf
Fle type rrust be pdf
4d. List the total estimated acreage of all existing wetlands on the property:
0.5
4e. List the total estimated linear feet of all existing streams on the property:
(interrrittent and perennial)
200
178.2K6
4f. Explain the purpose of the proposed project:
Replace ewsting Bridge 134 on SR 1331 (White Oak River Road) over Gibson Branch. Sufficiency rating of
ebsting 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 White Oak River Road (SR 1331) over Gibson Branch in Onslow
County. The project will also include appro�amately 0.112 mile of roadway improvements on each end of the
bridge. The project will include the following:
- Replacement of e�asting reinforced concrete deck bridge with a cored slab bridge
- Improvements to 0.112 mile of approach roadway
- Construction of temporary on-site detour on the upstream side of White Oak River Road. On-site detour will be
removed after construction
The project work will consist of grading, widening, drainage improvements, bridge replacement, on-site detour
construction, on-site detour removal, and pavement markings. This work will be conducted using standard road
construction equipment.
4h. Please upload project drawings for the proposed project.
C7ick the upload button or drag and drop files here to attach docurrent
176P.3.R.48_hyd_permit_drawings.pdf 1.72M6
Fle type rrust be pdF
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the propertyor proposed impact areas?*

r Yes r No r Unknown
Comments:
PJD request attached.
5b. If the Corps made a jurisdictional determination, what type of determination was made? *
C' Preliminary C' Approved C' Unknown �' f�llA
Corps AID Number:
Exarrple: SAVw2017-99999
Sc. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Othe r:
Robert Turnbull
Environmental Services, Inc.
Sd. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
5d1. Jurisdictional determination upload
Gick the upload button or drag and drop files here to attach docurrent
Onslow 134 PJD Package_signed.pdf 4.86M6
Fle type rrust be FDF
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 C' 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 r 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.

2a. Site #- Reason for 2b. Impact type * 2c. Type of wetland *
impact *
W1 - Fill P Bottomland Hardwood
N�p label (e.g. Fd�ad Q-ossing 1) F2rrranent (Pj or Terrporary Forest
��
W1 - Fill (Temporary T Bottomland Hardwood
De to u r) F2rrrenent (Pj or rerrporary Fore st
N�p label (e.g. I�ad CXossing 1) �T%
W3 - Fill P Bottomland Hardwood
N�p label (e.g. Id�ad Q-ossing 1) F2rrrsnent (P� or Terrporary FoPest
��
2g. Total Temporary Wetland Impact
0.110
2g. Total Permanent Wetland Impact
0.008
2g. Total Wetland Impact
0.118
2d. Wetland name * 2e•
Forested *
W1
W1
W3
2h. Comments:
1,554 square feet (0.036 acre) of hand clearing within wetlands is also proposed.
Yes
Yes
Yes
2f. 2g. Impact
Jurisdiction area*
type *
Corps 0.004
(404, 10) or d�NR (acres)
(401, other)
Corps 0.110
(404, 10) or CTJVR (acres)
(401, other)
Corps 0.004
(404, 10) or C7JVR (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.
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.
E. Impact Justification and Mitigation
1. Avoidance and Minimization
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 and
roadway. The proposed on-site detour will be constructed as close to White Oak River Road as practicable.
Permanent impacts will result only from the new bridge causeway; all impacts from the on-site detour are
temporary. The on-site detour was the preferred option because the off-site detour available is >10 miles in length
and includes a section of road (on Gibson Bridge Road) that is gravel. To use this as a detour, NCDOT would
have to improve that section of road and pave it, which would raise the profile of the road on the FEMA-regulated
New River. This increase in the roadway profile would require a CLOMR for these improvements, wtiich makes the
off-site detour cost and time prohibitive.

1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*
All in stream work will be surrounded by a turbidity curtain as shown on the permit drawings. 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. The on-site detour corridor will be hand cleared; geote�ile fabric will be placed to assist
in removal of temporary fill to return the wetland area to pre-existing grade.
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:
Permanent wetland impacts are less than 0.1 acre. No stream impacts are proposed.
Due to the possibility that compaction and/or other site alterations might prevent the temporary wetland impact area from re-attaining
jurisdictional wetland status; DOT will provide an update on the wetland areas temporarily impacted at Site 1(-DET1- 14+51 to 16+96). This
update will be conducted for two growing seasons after the detour has been removed and shall consist of photographs and a brief report on
the progress of the areas in re-attaining wetland jurisdictional status. DOT will schedule a field meeting with the regulatory agencies after the
second growing to determine if the wetland areas temporarily impacted by this project have re-attained jurisdictional wetland status. If the
wetland areas temporarily impacted by this project have not re-attained jurisdictional v�tland status, DOT will coordinate with the regulatory
agencies to determine if additional monitoring is required or if compensatory mitigation is required from the Division of Mitigation Services.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
1a. Does this project require a Stormwater Management Plan?
�' Yes
l" 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 a rip-rap pad on the edge of the wetlands in the
southeastern quadrant at -L- 18-+19 LT.
Only the two southern quadrants contain roadside ditches. Both are impacted by the proposed slope stakes. The
proposed ditch in the western quadrant ties to the exsting ditch prior to entering Gibson Branch and passes
through a 15" drive pipe. The ditch in the southeastern quadrant outlets into wetlands prior to reaching Gibson
Branch. All ewsting drainage patterns are maintained in the proposed design with special later'V' ditches, and
class'B' rip-rap is added at the outlet of the southeastern quadrant ditch to dissipate the concentrated flow.
To facilitate the construction of the proposed bridge, an onsite detour is proposed on the upstream side of White
Oak River Road. The southwestern ditch will be impacted by the proposed detour and will be designed to dissipate
prior to entering Gibson Branch to minimize impacts to the stream.
1c. What is the overall percent imperviousness of this project?
51
%
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
�' No
If no, explain why:
Project is located in the White Oak River Basin.

5. DWR 401 Stormwater Review
5a. Is the Stormwater Management Plan (including BMP Supplemental Forms and Operation and Maintenance Agreements) attached?
G Yes C' No
Stormwater Management Plan Upload
C7ick the upload button or drag and drop files here to attach docurrent
17BP.3.R.48_SMP.pdf 205.45KB
file type rrust be pdf
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?*
C� 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)?*
C' Yes �' No
Comme nts: *
State Minimum Criteria Checklist has been prepared for this project.
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 C•' 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.
The proposed project will result in minimum new impervious surface and will not result in any downstream impacts
or growth-stimulating effects. The e�asting use of Gibson Branch (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.
� 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 r No

5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
C' Yes C•' No
5d. Is another Federal agency involved?*
C' Yes C•' No
5e. Is this a DOT project located within Division's 1-8?*
C� Yes C' No
c' Unknown
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?*
North Carolina Natural Heritage Program Data and onsite evaluation by ESI Staff
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
C' Yes C•' No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
http://Nn�wv. 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 history and 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 in October and November 2016. Documentation for these
reviews is attached.
7c. Historic or Prehistoric Information Upload
aick the upload button or drag and drop files here to attach docurrent
Onslow134NoHASurvey.pdf 2.18M6
Structure 660134 Onslow No Archaeological Survey Required Form.pdf 2.46M6
Fle rrust be FDF
8. Flood Zone Designation (Corps Requirement)
I Link to the FEMAFIoodplain Maps: https://msc.fema.gov/portal/search
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
G Yes C' No
8b. If yes, explain how project meets FEMA requirements:
Gibson Branch is a FEMA Limited Detail Study stream.
8c. What source(s) did you use to make the floodplain determination?*
vw�w.ncfloodmaps.com
Miscellaneous attachments not previously requested.
Gick the upload button or drag and drop files here to attach docurrent
Fle rrust be FDF
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:*
Mason Herndon
Signature
fi�C.�.Icrr.+it �fE'�/�'�dfm!
Date :
current_date
Initial Review
Is this project a public transportation project? *(')
C� Yes C' No
Change only if needed.
I Has this project met the requirements for acceptance in to the review process?*
C� Yes
C' No
BIMS # Assigned*
20171428
Version#*
1
Reviewing Office *
Wilmington Regional Office - [phone]
Select Project Reviewer*
Joanne Steenhuis:eads\jhsteenhuis