20171493 Ver 1_PCN Form Submission_20171120

Action History (UTC-05:00) Eastern Time (US & Canada)
�brrrit by Anonymous User 11 /20/2017 4:04:45 PM (Start Event)
Accept by Carpenter,Kristi 11/20/2017 5:02:31 PM (DOT Initial Review)
• The task was assigned to Carpenter,Kristi . The due date is: November 23, 2017 5:00 PM
11 /20/2017 4:05 PM

�� �
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:*
Carte ret
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:
B-4863
WBS #
40212.1.2
(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.
6 - Survey Activities
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?*
Robin L. Maycock
1b. Primary Contact Email:*
[e-mail]
1c. PrimaryContact Phone:*
(xxx)xxx-xxxx
[phone]
1d. Who is applying for the permit?
r Owner r Applicant (other than owner) �J Agent/Consultant
(Check all that apply)
2. Owner I nformation
2a. Name(s) on recorded deed:
State of North Carolina
2b. Deed book and page no.:
f�UA
2c. Responsible party:
(for Corporations)
wa
2d.Address
IStreet Address
1321 Mail Service Center
Address Line 2
Qty
Raleigh
Fbstal / Zip Code
27699-1321
State / Rovince / F�gion
North Carolina
Country
USA

2e. Telephone Number:
(xxx)xxx-xxxx
2f. Fax Number:
(xxx)xxx-x�cx
2g. Email Address:*
tim.walton@doa. nc.gov
2a. Name(s) on recorded deed:
NCDOT
2b. Deed book and page no.:
NA
2c. Responsible party:
(for Corporations)
Maria A Rogerson, PE
2d.Address
Street Address
1037 W.H. Smith Blvd
Address Line 2
��
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:
� Robin L. Maycock
4b. Business Name:
(if applicable)
Louis Berger
4c. Address
Street Address
1001 Wade Avenue
Address Line 2
Suite 400
��
Raleigh
Fbstal / Zip Code
27605
4d. Telephone Number:
[phone]
(xxx)xxx-xxxx
State / Rovince / Region
NC
Country
USA
State / FYovince / F�gion
NC
Country

4e. Fax Number:
(xxx)xxx-xxxx
4f. Email Address:*
[e-mail]
AgentAuthorization Letter*
Rease provide the Agent Authorization Letter if you are subrritting this docurrent.
Agent Authorization1.pdf 83.8KB
FlLE IYFE M 1ST BE FflF
C. Project Information and Prior Project History
1. Project Information
1a. Name of project:*
Bridge No. 73 & Bridge No. 96 Replacement
1b. Subdivision name:
(if appropriate)
wa
1c. Nearest municipality/town:*
Harker's Island
1d. Driving directions*
If it is a new project and can not easily be found in a C�5 rrapping system Rease provide directions.
US 70 East to Ottoway, southeast on Harker's Island Road to Bridge over the Straits to Harker's Island, Beaufort, NC
2. Project Identification
2a. Property Identification Number:
(tac RN or parcel ID)
7326-04-8256 and 7325-08-7965
2b. Propertysize:
(in acres)
2
2c. Project Address
Street Address
Bridges No. 73 & 96 Harkers Island Road
Address Line 2
aty
Beaufort
Fbstal / Zip Code
28516
2d. Site coordinates in decimal degrees
State / Fl-ovince / F�gion
North Carolina
Country
USA
� 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:* Longitude:*
i 34.718332 -76.575451
ex:34208504 -77.796371
3. SurFace Waters
3a. Name of the nearest body of water to proposed project:*
The Straits, NCDWQ Index No. 21-35-1-12
3b. Water Resources Classification of nearest receiving water:*
SA, HQW
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:*
Bridges 73 & 96 are to be replaced by a single bridge to the east of the e�sting bridges. The new bridge starts
and ends at the e�sting bridge locations. There is currently only undeveloped roadside, NCWRC boat ramp,
vacant land and water (The Straits) wiiere the proposed bridge will be constructed. The amounts for 3b & 3c are
for the entire study area.
4b. Attach an 8 7/2 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
Harkers Topo.pdf
Fle type rrust be pdF
405.04KB
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)
Qick the upload button or drag and drop files here to attach docurrent
Harkers Soil.pdf
Fle type rrust be pdf
4d. List the total estimated acreage of all existing wetlands on the property:
0.1
4e. List the total estimated linear feet of all existing streams on the property:
(interrrittent and perennial)
3,800 linear foot bridge crossing of the Straits
382.54KB
4f. Explain the purpose of the proposed project:
The Geotechnical Engineering Unit is planning a limited subsurface investigation to gather information for the
foundation design of the new bridge.
4g. Describe the overall project in detail, including the type of equipment to be used:
Up to 41 Standard Penetration Test (SPT) borings. The borings in the sound will be advanced from a jack-up or
conventional barge, and will consist of turning or driving 3-inch to 8-inch diameter steel casing into the sound
bottom creating minimal disturbance. Additional drilling tools will be used to sample the sediments and advance the
hole within the steel casing. All tools will be removed upon completion of the boring. Any borings drilled on land or
in shallow water in the sound/straits will be performed with a rubber tired drill rig, low ground pressure tracked drill
rig, or marsh buggy. These borings will also be 3-inch to 8-inch in diameter. Any disturbance for the borings
should be limited to within a 2-foot radius of the borings location. All borings will be drilled between the dates of
November 1, 2017 and April 1, 2018.
4h. Please upload project drawings for the proposed project.

C7ick the upload button or drag and drop files here to attach docurrent
20171102 64863_GEO_BRDG_BP_plan_sheets.pdf 6.24MB
Fle type rrust be pdF
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the propertyor proposed impact areas?*
C� Yes C' No C' Unknown
Comments:
Map attached
5b. If the Corps made a jurisdictional determination, what type of determination was made? *
C' Preliminary �' Approved C' Unknown C•' N/A
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 NES/EAU staff
5d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
Sd1. Jurisdictional determination upload
qick the upload button or drag and drop files here to attach docurrent
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.
Individual permit anticipated for bridge impacts
D. Proposed I m pacts I nventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
fJ Wetlands r Streams-tributaries r Buffers
fJ 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 *
i impact*
i WB, Geotech Boring T Salt/Brackish Marsh
N�p label (e.g. F�ad Qassing 1) F2rrranent (P� or Terrporary
��
WD, Geotech Boring T Salt/Brackish Marsh
N�p label (e.g. Fd�ad Qossing 1) F2rrranent (F) or Terrporary
��
2g. Total Temporary Wetland Impact
0.100
2g. Total Permanent Wetland Impact
0.000
2g. Total Wetland Impact
0.100
2h. Comments:
Temporary geotechnical investigation with no discharge to waters or wetlands.
2d. Wetland name * Ze. 2f. 2g. Impact
Forested* Jurisdiction area*
type *
CAMA No Both 0.050
(404, 10) or CMR (acres)
(401, other)
CAMA No Both 0.050
(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.
4a. Site #- Reason for 4b. Impact 4c. Name of waterbody* 4d. Activity 4e. Waterbody4f. Impact
impact * type * type * type * area *
The Straits, Geotech T The Straits Other Estuary 0.02
BOring F�rrranent (P� or (if applicable) (acres)
N�p label (e.g. Road C7assing 1) Terrporary (�
4g. Total temporary open water Impacts:
0.02
4g. Total permanent open water impacts:
0.00
4g. Total open water impacts:
0.02
4h. Comments:
Temporary impacts of 16 square feet for 45 borings is approximately 720 square feet or 0.0165 acres.
5. Pond or Lake Construction
If pond or lake construction is proposed, then complete the chart below.
I 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:*
Any disturbance for the borings should be limited to within a 2-foot radius of the borings locations. Borings will be
drilled between the dates of November 1, 2017 and April 1, 2018 to limit impacts to protected aquatic species.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*
There is no permanent construction, but BMPs will be used to minimize turbidity and surface disturbance of
temporary geotechnical investigations.
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:
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
1a. Does this project require a Stormwater Management Plan?
C' Yes �' No
1e. If this project DOES NOT require a Stormwater Management Plan, explain why:
In water v�rork.
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
If no, explain why:
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 C' 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
NEPA or SEPA final approval lette r.) *
C' Yes C•' No
Comments:*
The Type III Categorical Exclusion is currently under review and has been signed by regulatory agencies and in
process of review by the State Clearinghouse.

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 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
I nearby downstream water quality?*
C' Yes C•' No
3b. If you answered "no," provide a short narrative description.
Temporary impacts due to geotechnical investigation borings.
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 generated.
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? *
�' Yes l" No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
C� Yes �' No
5c. If yes, indicate the USFWS Field Office you have contacted.
Raleigh
5d. Is another Federal agency involved?*
C� Yes C' No
What Federal Agency is involved?
NMFS, NOAA, USCG
5e. Is this a DOT project located within Division's 1-8?*
�' Yes C' No
�' Unknown
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?*
i USFWS, NMFS
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
C� Yes �' No
Are there submerged aquatic vegetation (SA� around the project vicinity?*
C•' Yes C' No C' Unknown
Will this project affect submerged aquatic vegetation?*

C' Yes
C' No
C' Unknown
C� E�lain
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
National Marine Fisheries Services
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? *
NC State Historic Preservation Office
7c. Historic or Prehistoric Information Upload
Gick the upload button or drag and drop files here to attach docurrent
Archaeological Survey Response from HPO.pdf 320.92KB
Archaeological Survey Transmittal.pdf 70.75K6
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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 C' No
8b. If yes, explain how project meets FEMA requirements:
Temporary geotechnical investigations, no permanent structures or construction.
8c. What source(s) did you use to make the floodplain determination?*
FEMA Flood Maps
Miscellaneous attachments not previously requested.
Gick the upload button or drag and drop files here to attach docurrent
Harkers Wetlands & SAVs.pdf 1.54M6
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Signature
*
fJ 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.
i Full Name:*
Robin Leslie Maycock

Signature
�l�ir r� �rr�ro��
Date :
I current_date
Initial Review
Is this project a public transportation project? *(')
G Yes C' No
Change only if needed.
Has this project met the requirements for acceptance in to the review process?*
G Yes
C' No
BIMS # Assigned*
20171493
Version#*
Reviewing Office*
Washington Regional Office - [phone]
Select Project Reviewer*
Garcy Ward:eads\gpward