20171544 Ver 1_PCN Form Submission_20171201

Action History (UTC-05:00) Eastern Time (US & Canada)
�brrrit by Anonymous User 11 /30/2017 4:07:56 PM (Start Event)
Accept by Carpenter,Kristi 12/1/2017 12:56:04 PM (DOT Initial Review)
• The task was assigned to Carpenter,Kristi . The due date is: December 5, 2017 5:00 PM
11 /30/2017 4:08 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:*
Lenoir
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:
SF-530049
WBS #
17BP.2.R.84
(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.
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
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
i 1f. Is the project located in anyof NCs twentycoastal counties?*
C' Yes �' No
1h. Is the project located in a designated trout watershed?*
C� 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?*
William Sullivan
1b. PrimaryContact Email:*
[e-mail]
1c. PrimaryContact Phone:*
(xxx)xxx-xxxx
[phone]
1d. Who is applying for the permit?
� Owner r Applicant (other than owner) rJ AgenUConsultant
(Check all that apply)
2. Owner I nformation
2a. Name(s) on recorded deed:
i NCDOT
2b. Deed book and page no.:
i N/A
2c. Responsible party:
(for Corporations)
Heather Lane, PE
2d.Address
SYreet Address
NC Department of Transportation, Division 2
Address Line 2
PO Box1587
��
Greenville
Fbstal / Zip Code
27835
2e. Telephone Number:
SYate / R-ovince / F�gion
NC
Country
USA

(xxx)xxx-x�cx
[phone]
2f. Fax Number:
(xxx)x�c-�ocx
2g. Email Address:*
[e-mail]
4. Agent/Consultant (if applicable)
4a. Name:
William Sullivan
4b. Business Name:
(if applicable)
Kimley-Horn
4c. Address
Street Address
421 Fayettevile Street
Address Line 2
Suite 600
aty
Raleigh
Fbstal / Zip Code
27609
4d. Telephone Number:
[phone]
(xxx)xxx-xxxx
4e. Fax Number:
(xxx)x�c-�ocx
4f. Email Address:*
[e-mail]
AgentAuthorization Letter*
Rease provide the Agent Authorization Letter if you are subrritting this docurrent.
01 b_AGENT AUTHROIZATION.pdf
FlLE 7YFE MJST BE FDF
State / R-ovince / F�gion
NC
Country
USA
346.62KB
C. Project Information and Prior Project History
1. Project Information
1a. Name of project:*
Bridge No. 49 over Bear Creek on SR 1311 (Bear Creek Road)
1b. Subdivision name:
(if appropriate)
n/a
1c. Nearest municipality/town:*
La Grange
1d. Driving directions*

If it is a new project and can not easily be found in a GPS rrapping system Rease provide directions.
See Figure 1: Vicinity Map
2. Project Identification
2a. Propertyldentification Number:
(tax RNor parcel ID)
wa
2b. Propertysize:
(in acres)
4.7
2c. Project Address
Street Address
4635 Bear Creek Road
Address Line 2
Qty
La Grange
Fbstal / Zip Code
28551
2d. Site coordinates in decimal degrees
State / Rovince / f�gion
NC
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:*
35.248820
ex:34208504
3. Surface Waters
Longitude:*
-77.784303
-77.796371
3a. Name of the nearest body of water to proposed project:*
BearCreek
3b. Water Resources Classification of nearest receiving water:*
WS-IV; Sw, NSW
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:*
The site is composed of an existing bridge over Bear Creek, a 3-way junction, a culvert crossing, a residential
yard, and a small agricultural field. The land in the project vicinity is composed primarily of agricultural fields
intersected by forested riparian buffers.
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
I 03c_Fig2_USGS.pdf
Fle type rrust be pdF
570.74KB
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
03e_Fig4_NRCS.pdf
Fle type rrust be pdf
4d. List the total estimated acreage of all existing wetlands on the property:
0.2 acres
4e. List the total estimated linear feet of all existing streams on the property:
(interrrittent and perennial)
465 linear feet
711.67KB
4f. Explain the purpose of the proposed project:
The purpose of the project is to replace the bridge over Bear Creek on Bear Creek Road (SR 1311).
4g. Describe the overall project in detail, including the type of equipment to be used:
The bridge replacement on SR 1311 (Bear Creek Road) conveys Bear Creek from North to South and ultimately
drains into the Neuse River. The e�asting bridge, overall length (OAL) = 102' and width 21' will be replaced with a
bridge having an OAL = 148' and width = 33'. The new bridge is wider than the e�sting bridge to provide the
required shoulders and lane width necessary for roadway and drainage. The proposed bridge and roadway
improvements will minimize the ebsting overtopping condition and maintain a minimal transition between ewsting
and new roadway. As part of the new design, the 5 existing wooden bents will be replaced by 2 reinforced concrete
bents across Bear Creek. Additionally, the culvert crossing under Bulltown Road with a diameter of 48" and
concrete head walls will be replaced by a 72" aluminum culvert with aluminum head walls. Equipment typical of
bridge projects, including e�cavators, pavers, and skid-steers will be used during construction.
4h. Please upload project drawings for the proposed project.
aick the upload button or drag and drop files here to attach docurrent
B-49_011036378_ERO. pdf
Fle type rrust be pdf
5. Jurisdictional Determinations
3.85M6
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
C� Yes C' No c' Unknown
Comments:
I Kimley-Horn staff conducted a wetland and stream delineation on the site on
March 6, 2017.
Sb. If the Corps made a jurisdictional determination, what type of determination was made? *
C' Preliminary C' Approved C' Unknown C•' fWA
Corps AID Number:
Exarrple: SAV�2017-99999
n/a
Sc. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Othe r:
Beth Reed and William Sullivan
Kimley-Horn
n/a
Sd. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.

A Preliminary Jurisdictional Determination was requested for the proposed project on March 20, 2017 and documentation is pending. A field
reviewwith Tom Steffens of the USACE and Garcy Ward of NCDWR was conducted on August 22, 2017. A Preliminary Jurisdictional
Determination request based on the field review has been included as part of this permit submittal.
5d1. Jurisdictional determination upload
Gick the upload button or drag and drop files here to attach docurrent
05b_Bridge49_Preliminary_JD_Request_20170313.pdf
Fle type rrust be FDF
6. Project History
3.73M6
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 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.
n/a
D. Proposed I m pacts I nventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
r Wetlands rJ 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.
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.
3a. Site #- Reason 3b.lmpact 3c. Type of 3d. Stream name *
for impact* type* impact*
Site 1 T
fv�p label (e.g. Fd�ad F2rrranent (P�
Q ossing 1) or Terrporary
i�i
Site 2 P
N�p label (e.g. Road F�rrranent (P�
CYossing 1) or Terrporary
��
Site 3 T
N�p label (e.g. Fd�ad F�rrranent (P�
Qossing 1) or Terrporary
��
Other BearCreek
Culvert SB (UT to Bear Creek)
Culvert SB (UTto Bear Creek)
3e. Stream Type * 3f. 3g. Stream 3h. Impact
Jurisdictior�idth* length*
type *
Perennial Both
F2rennial (Fff� or interrrittent
QfV�
Perennial Both
F2rennial (� or interrrittent
Qf�
Perennial Both
F2rennial (F8� or interrrittent
QfVn
" All Perennial or Intermittent streams must be verified by DWR or delegated local government.
3i. Total jurisdictional ditch impact in square feet:
40 103
Average (feet) (linear feet)
5 6
Average (feet) (linear feet)
5 23
Average (feet) (linear feet)

0
3i. Total permanent stream impacts:
6
3i. Total temporary stream impacts:
126
3i. Total stream and tributary impacts:
132
3j. Comments:
ermanent and temporary impacts to SB will result from upsizing the e�asting culvert that crosses under Bulltown
I Road and ties into Bear Creek, from 48" to 72". The stream banks downstream of the culvert outlet will be lined
with rip rap for stabilization. Temporary impacts to Bear Creek will result from the replacement of bridge and
roadway structures. All temporary impacts will be returned to pre-existing conditions upon completion of the
proposed project.
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
i 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.
� Neuse
r Catawba
� Goose Creek
r Other
6b. Impact Type *
r Tar-Pamlico
r Randleman
r Jordan Lake
6c. Per or 6d. Stream name *
Te mp *
Site 1; Bridge Road Crossing; P Bear Creek
Allowable F�rrranent (P� or
Location and C errpt, Allowable, allowable w/ rritigation Terrporary (�
Site 1; Bridge Road Crossing; T Bear Creek
Allowable F�rrrenent (Fj or
Location and 6cerrpt, Allowable, allowable w/ rritigation Terrporary (�
6e. Buffer 6f. Zone 1 6g. Zone 2
mitigation impact* impact'�
required?*
No 2,459 1,932
(squarefeet) (squarefeet)
No
Site 2; Culvert Road Crossing; P SB (UTto Bear Creek) No
Allowable F�rrranent (�j or
Location and 6cerrpt, Allowable, allowable w/ rritigation Terrporary (�
Site 2; Culvert Road Crossing; T SB (UTto Bear Creek) No
Allowable F2rrranent (Pj or
Location and 6cerrpt, Allowable, allowable w/ rritigation Terrporary (�
6h. Total buffer impacts:
Zone 1 Zone 2
Temporary impacts: 6,389.00 1,307.00
4,431 1,000
(squarefeet) (squarefeet)
1,194 356
(squarefeet) (squarefeet)
1,958 307
(square feet) (square feet)

i Permanent impacts:
Total buffer impacts:
6i. Comments:
Zone 1
3,653.00
Zone 1
10,042.00
Zone 2
2,288.00
Zone 2
3,595.00
Permanent and temporary buffer impacts will result from two perpendicular road crossings, which are less than
150 linear feet, and are considered Allowable under the Neuse River Basin Buffer Table of Uses. All temporary
impacts will be restored to pre-existing conditions upon completion of the project.
Supporting Documentation - i.e. Impact Maps, Plan Sheet, etc.
aick the upload button or drag and drop files here to attach docurrent
07c_SF-530049_Permit Drawings_Stream.pdf
07b_SF-530049_Permit Drawings_Buffer.pdf
I Fle rrust be FDF
E. Impact Justification and Mitigation
1. Avoidance and Minimization
2.23M6
1.82M6
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:*
Impacts to streams, wetlands, and regulated buffers were avoided and minimized to the extent practical during the
designing of the proposed project. A deliberate effort was made to align the new bridge within the footprint of the
e�asting structure being replaced, to the extent feasible. This will allow the new structure to share roadway facilities
and reduce unnecessary impacts. All roadway widening activities were planned such that there would be no impact
on the small wetland feature on the eastern boundary of the project corridor. Additionally, limits of disturbance and
grading within buffers have been minimized wherever possible, and Design Standards for Nutrient Sensitive
Wetlands will be followed throughout the construction process
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*
Impacts to streams, wetlands, and buffers within the project area will be minimized and avoided throughout the
construction process. To minimize impacts during construction, wherever feasible, staging will occur on e�sting
roadway or upland areas to avoid impacts to the buffer and streams. Silt fencing will be installed around the limits
of disturbance to reduce downstream sedimentation and to confine construction activities to the permitted
boundary. In addition, standard Best Management Practices (BMPs) and Design Standards for Nutrient Sensitive
Watersheds will be followed throughout the construction process.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
i 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:
I Due to the minimal impacts to jurisdictional waters and the pre-e�asting condition of the streams within the site, no compensatory mitigation
has been proposed. Additionally, per the Neuse River Basin Buffer Table of Uses, mitigation is not required for perpendicular roadway
crossings impacting less than 1/3 acre of riparian buffer.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
1a. Does this project require a Stormwater Management Plan?
�' Yes
�' No
1b. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:

The bridge replacement on Bear Creek Road conveys bear creek from north to south and ultimately drains into
the Neuse River. The new bridge is wider than the existing bridge to provide required sholders and lane width
necessary for roadway and drainage. The proposed bridge and roadway improvements minimized the existing
overtopping condition and maintain a minimal transition between e�sting and new roadway. The designed gutter
system will outfall outside of Buffer Zones 1 and 2, and the e�asting flat vegetated floodplain will treat the minimal
increase in impervious area from bridge widening. No new roadside ditches were introduced as part of this project.
The proposed bridge replacement project was not shown to cause an increase in the base flood year level along
the study reach of Bear Creek.
1c. What is the overall percent imperviousness of this project?
46
%
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
�7 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?
�' Yes
�' 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
in Chapter 8 of the NC Stormwater BMP Manual and attach a BMP Supplement Form
What documentation are you providing?
� Level Spreader
�7 Other BMP
(check all that apply)
Diffused Flow Documentation
aick the upload button or drag and drop files here to attach docurrent
B-49_011036378_ERO. pdf
Fle type rrust be FDF
5. DWR 401 Stormwater Review
3.85M6
5a. Is the Stormwater Management Plan (including BMP Supplemental Forms and Operation and Maintenance Agreements) attached?
C� Yes
�' No
Stormwater Management Plan Upload
Gick the upload button or drag and drop files here to attach docurrent
02b_(SF530049)_HYD_SMPv2. pdf
file type rrust be pdf
G. Supplementary Information
� 1. Environmental Documentation
32.75KB
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
Comments:*
C•' No

The proposed project is belowthe minimum criteria required for environmental documentation.
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):
n/a
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 �' No
3b. If you answered "no," provide a short narrative description.
The proposed project intends to replace an existing bridge over Bear Creek on Bear Creek Road (SR 1311). No
additional development is expected as a result of this bridge replacement.
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 or sewage will be generated from the proposed project.
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
Sa. 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
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
�' Unknown
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?*
As of December 26, 2012, the USFWS lists red-cockaded woodpecker and sensitive joint-vetch as the two
federally protected species known to occur in Lenoir County. Habitat for red-cockaded woodpecker is not present
within the study area due to the lack of open, mature pine stands. Forests within the study area contain dense
understories composed of hardv�rood species. Habitat for sensitive joint-vetch is not present within the study area.
Streams within the project study area are disconnected from marshy areas, and are typically low-flow systems with
infrequent bars or benches. Additionally, roadside ditches within the study area are frequently maintained through
mowing and herbicide application. The NCNHP database records, updated July 2017, indicate no known
occurrences of either federally protected species within 1.0 mile of the study area (acccessed October 30, 2017).
Due to the lack of known occurrences, lack of suitable habitat, and the minimal impact resulting from this project, it
is anticipated that the proposed project will not affect any federally protected species
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?*
The NOAA EFH Mapper was accessed October 30, 2017, and no EFH was found to occur within the project area.
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? *
See attached NCSHPO coordination letters.
7c. Historic or Prehistoric Information Upload
Gick the upload button or drag and drop files here to attach docurrent
SHPO_16-09-0031 NoSurveyReq.pdf
SHPO_Lenoir 49 No Survey Required.pdf
Fle rrust be F�F
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
2.17M6
531.84KB
8b. If yes, explain how project meets FEMA requirements:
The proposed project has been modeled in HEC-RAS following the standard NCDOT MOA protocol. A comparison
between the Corrected Effective and Revised plans shows no increase or decrease in base flood level at all cross
sections, and a No Rise Certification was achieved. The project qualifies for an MOA Type 1.
8c. What source(s) did you use to make the floodplain determination?*
The Flood Insurance Study (FIS) Number 37107CV000 for Lenoir County dated effective April 16, 2013 was used
to create the hydraulic analysis.
Miscellaneous attachments not previously requested.
Gick the upload button or drag and drop files here to attach docurrent
03b_Fig 1 _Vicin ity. pdf
03d_Fig3_Aerial Imagery. pdf
NCNHP_Report.pdf
Fle rrust be FDF
Signature
*
N7 By checking the box and signing below, I certify that:
322.11 KB
1.69M6
533.11 KB
■ 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:*
William Sullivan
Signature
���tf �f9r. ��r.�tl d'.11�!
Date :
current_date
Initial Review
Is this project a public transportation project? *(?)
C•' Yes C' No
Change only if needed.
Has this project met the requirements for acceptance in to the review process?*
C•' Yes
�' No
BIMS # Assigned*
20171544
Version#*
Reviewing Office *
Washington Regional Office - [phone]
Select Project Reviewer*
Garcy Ward:eads\gpward