20180080 Ver 1_PCN Form Submission_20180118

Action History (UTC-05:00) Eastern Time (US & Canada)
�brrrit by Anonymous User 1/16/2018 7:34:51 PM (Start Event)
Accept by Carpenter,Kristi 1/18/2018 11:11:43 AM (DOT Initial Review)
• The task was assigned to Carpenter,Kristi . The due date is: January 19, 2018 5:00 PM
1/16/2018 7:35 PM

E-PCN Submittal
���
�lulslaa af Water Resources
Pre-Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
December 15, 2017 Ver 2.2
*
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.
Also, if at any point you wish to print a copy of the E-PCN, all you need to do is right-click on the document and you can print a copy of the form.
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:*
Wake
Franklin
Is this project a public transportation project? *(')
C�' Yes C' No
Is this a NCDOT Project?*
r Yes C' No
(NCDOT only) T.I.P. or state project number:
B-4662
WBS #
38457.1.2
(for NCDOT use only)
1a. Type(s) of approval sought from the Corps:*
rJ 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?*
fJ Nationwide Permit (NWP)
r Regional General Permit (RGP)
Nationwide Permit (NWP) Number: 14 - Linear transportation
NWP Number Other:
List all MNnurrbers you are applying for not on the drop down list.
1c. Type(s) of approval sought from the DWR:*

check all that apply
ri 401 Water Quality Certification - Regular r 401 Water Quality Certification - E�ress
r Non-404 Jurisdictional General Permit rJ Riparian Buffer Authorization
*
1d. Is this notification solelyfor the record because written approval is not required?
For the record only for DWR 401 Certification: �' Yes C•' No
For the record only for Corps Permit: �' Yes C�' 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 l" No
Acceptance Letter Attachment
Gick the upload button or drag and drop files here to attach docurrent
I B-4662 EEP signed mitigation form.pdf 62.16KB
FlLE TYFE MJST BE FiJF
1f. Is the project located in anyof NC's twentycoastal counties?*
C' Yes �' No
1h. Is the project located in a designated trout watershed?*
C' Yes C' No
Link to trout information: http://www.saw.usace.army.mil/Missions/Regulatory-Permit-PrograrrUAgency-Coordination/Trout.aspx
B. Applicant Information
1a. Who is the Primary Contact?*
Chris Murray
1b. Primary Contact Email:*
[e-mail]
1c. PrimaryContact Phone:*
(xxx)xxx-xxxx
[phone]
1d. Who is applying for the permit?
rJ Owner r Applicant (other than owner) r Agent/Consultant
(Check all that apply)
2. Owner I nformation
2a. Name(s) on recorded deed:
NCDOT
2b. Deed book and page no.:
Not available
2c. Responsible party:
(for Corporations)
2d.Address

Street Address
2612 N. Duke Street
Address Line 2
Qty
Durham
Fbstal / Zip Code
27704
2e. Telephone Number:
(xxx)xxx-xxxx
[phone]
2f. Fax Number:
(xxx)xxx-xxxx
2g. Email Address:*
[e-mail]
State / R-ovince / I�gion
NC
Country
USA
C. Project Information and Prior Project History
1. Project Information
1a. Name of project:*
Replacement of Bridge 196 over Moccasin Creek on SR 2308 (Fowier
Road) and SR 1726 (Henry Baker Road) on the Wake County/Franklin
County line
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality/town:*
Zebulon. NC
1d. Driving directions*
IF it is a new project and can not easily be found in a C� rrnpping system Rease provide directions.
From Zebulon, travel north on NC 96, turn right and travel north on SR 2310 (Hopkins Chapel Road), turn right on SR 2308 (Fowler Road)
to project site.
2. Project Identification
2a. Property Identification Number:
(tax RN or parcel ID)
Wake County: 1798638850 and 1798810264; Franklin County: 000173,
000174 and 043746
2b. Propertysize:
(in acres)
3.2
2c. Project Address
Street Address
near 9971 Fowler Road
Address Line 2
��
Zebulon
Fbstal / Zip Code
27597
State / Rovince / F�gion
NC
Country
USA

2d. Site coordinates in decimal degrees
I 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.)
i Latitude:* Longitude:*
35.89947 -78.33235
ex:34208504 -77.796371
3. SurFace Waters
3a. Name of the nearest body of water to proposed project:*
Moccasin Creek
3b. Water Resources Classification of nearest receiving water:*
27-86-2; Class C 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:*
E�sting conditions are comprised of wooded land and portions of a house/maintained yard.
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)
C7ick the upload button or drag and drop files here to attach docurrent
USGS map.pdf 2.18MB
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)
aick the upload button or drag and drop files here to attach docurrent
B-4662 Wake County Soil Survey.pdf 911.71 KB
I B-4662 Franklin County Soil Survey.pdf 1.44M6
Fle type rrust be pdf
4d. List the total estimated acreage of all existing wetlands on the property:
0.3
4e. List the total estimated linear feet of all existing streams on the property:
(interrrittent and perennial)
130 linear feet
4f. Explain the purpose of the proposed project:*
I Replacement of Bridge 196 over Moccasin Creek
4g. Describe the overall project in detail, including indirect imapacts and the type of equipment to be used:*
� Replacement of Bridge 196 over Moccasin Creek. Existing structure is a 2-span bridge (1 @207 ft; 1@19.4 ft) with
a new single span bridge (1 @70 ft). Some minor improvements to the roadway are being conducted as part of this
project.
4h. Please upload project drawings for the proposed project.

C7ick the upload button or drag and drop files here to attach docurrent
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5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the propertyor proposed impact areas?*
�' Yes �' No �' Unknown
Comments:
Delineated by NCDOT personnel in April 2013
5b. If the Corps made a jurisdictional determination, what type of determination was made? *
C' Preliminary C•' Approved f Unknown f' N/A
Corps AID Number:
6carrple: SAV�2017-99999
SAW-2013-01572
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other
AmyJames, Jason Dilday, Deanna Riffey
�[y�Z�SI
5d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
JD signed on August 26, 2013 with expiration date of August 26, 2018.
Sd1. Jurisdictional determination upload
aick the upload button or drag and drop files here to attach docurrent
B-4662-SAW-2013-01572-NCDOT_SR2308_Fowier-Henry Baker Rd_BR196.pdf 5.42MB
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 f 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.
No
D. Proposed I m pacts I nventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
�J Wetlands �J Streams-tributaries rJ Buffers
r 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* 2b. Impact type * 2c. Type of wetland *
Site 1
N�p label (e.g. Road Qassing 1- Qalvert,
dewatering, etc)
Site 1
fv�p label (e.g. R�ad Qossing 1- CLlvert,
dewatering, etc)
Site 2
N�p label (e.g. f�ad Qossing 1- Qalvert,
dewatering, etc)
Site 2
N�p label (e.g. Fd�ad Qassing 1- Qalvert,
dewatering, etc)
Site 2
fv�p label (e.g. I�ad Qossing 1- CLlvert,
dewatering, etc)
P
F2rrranerd (P'j or
Terrporary (�
P
F�rrrenent (P� or
Terrporary (�
P
F�rrrenerd (P� or
Terrporary (�
P
F2rrranerd (P� or
Terrporary (�
P
F2rrrenent (P� or
Terrporary (�
2g. Total Temporary Wetland Impact
0.000
Bottomland Hardwood
Forest
Bottomland Hardwood
Forest
Riverine Swamp
Forest
Riverine Swamp
Forest
Riverine Swamp
Forest
2d. Wetland name *2e. 2f. Type of 2g. Impact
Forested* Jurisdicition* area*
Fill Yes Both 0.020
(404, 10) or d�NR(401, (acres)
other)
Mech. Clear Yes Both 0.100
(404, 10) or C7�ft(401, (acres)
other)
Fill Yes Both 0.010
(404, 10) or L7�NR(401, (acres)
other)
Excavation Yes Both 0.010
(404,10) or GNF2(401, (acres)
other)
Mech. Clear Yes Both 0.130
(404, 10) or C7�R(401, (acres)
other)
2g. Total Permanent Wetland Impact
0.270
2g. Total Wetland Impact
0.270
2h. Comments:
Wetland impacts at both Site 1 and Site 2. Compensatory mitigation proposed for wetland impacts.
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 for 3b.lmpact
impact * type *
Site 2 P
N�p label (e.g. I�ad Q'ossing 1) F2rrrenent (P'j or
Terrporary (�
Site 2 T
N�p label (e.g. 13�ad Qossing 1) F2rrranent (Fj or
Terrporary (�
3c. Type of impact* 3d. Stream name *
Bank Stabilization Moccasin Creek
Dewatering Moccasin Creek
3e. Stream
Type *
Perennial
F�rennial (FH�) or
interrrittent (If�
Perennial
F�rennial (� or
interrrittent (INn
** All Perennial or Intermittent streams must be verified by DWR or delegated local government.
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
90
3i. Total temporarystream impacts:
105
3i. Total stream and tributary impacts:
195
3f. Type of
Jurisdiction *
Both
Both
3g. Stream 3h. Impact
width* length*
25 90
Average(feet) (linearfeet)
25 105
Average(feet) (linearfeet)

3j. Comments:
I Permanent stream impacts from rip rap installation and temporary stream impacts from dewaterting are concurent.
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.
�J Neuse r Tar-Pamlico
r Catawba r Randleman
r Goose Creek r Jordan Lake
� Other
6b. Impact Type * 6c. Per or
i Temp*
Site 1 allowable bridge P
Location and 6cerrpt, Allowable, allowable w/ F2rrranent (P� or
rritigation Terrporary (�
Site 1 road allowable roadway P
Location and 5cerrpt, Allowable, allowable w/ F�rrrenerrt (P� or
rritigation Terrporary (�
Site 1 road allowable P
Location and 5cerrpt, Allowable, allowable w/ F2rrrenent (Pj or
rritigation Terrporary (�
6h. Total buffer impacts:
Temporary impacts:
Permanent impacts:
Total buffer impacts
6i. Comments:
Zone 1
0.00
Zone 1
4,399.00
Zone 1
4,399.00
6d. Stream name *
Moccasin Creek
Moccasin Creek
Moccasin Creek
Zone 2
0.00
Zone 2
2,402.00
Zone 2
2,402.00
Supporting Documentation - i.e. Impact Maps, Plan Sheet, etc.
C7ick the upload button or drag and drop files here to attach docurrent
B-4662 Buffer Permit Drawings.pdf
B-4662_Wetland & Surface Water Permit Drawings.pdf
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E. Impact Justification and Mitigation
6e. Buffer mitigation
required? *
No
No
No
2.28MB
3.54M6
6f. Zone 1
impact*
1,821
(square feet)
673
(square feet)
1,905
(square feet)
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:*
6g. Zone 2
impact*
0
(square feet)
1,168
(square feet)
1,234
(square feet)

Fill slopes have been steepened to minimize and/or reduce impacts to wetlands on the project. The new bridge will
span Moccasin Creek. Rock toe protection is used at the fill slope in wetland areas to prevent "creeping" of fill
slope.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*
Installation of EC devices in mechanized clearing in v�tland impact areas will be actively managed to reduce the
amount of wetland impact.
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
2c. If yes, mitigation is required by (check all that apply):
� DWR �J Corps
2d. If yes, which mitigation option(s) will be used for this project?
r Mitigation bank N7 Payment to in-lieu fee program r Permittee Responsible Mitigation
4. Complete if Making a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached.
� Yes
4b. Stream mitigation requested:
(linear feet)
0
4c. If using stream mitigation, what is the stream temperature:
4d. Buffer mitigation requested (DWR only):
(squarefeet)
0
4e. Riparian wetland mitigation requested:
(acres)
0.27
4f. Non-riparian wetland mitigation requested:
(acres)
4g. Coastal (tidal) wetland mitigation requested:
(acres)
4h. Comments
Mitigation will be provided for 0.27 acres of wetland impact.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
``* Recent changes to the stormwater rules have required updates to this section .*�"
1. Diffuse Flow Plan
1a. 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
1 b. All buffer impacts and high ground impacts require diffuse flow or other form of stormwater treatment. If the project is subject to a
state implemented riparian buffer protection program, include a plan that fully documents how diffuse flow will be maintained.

All Stormwater Control Measures (SCM)s must be designed in accordance with the NC Stormwater Design Manual. Associated
supplement forms and other documentation shall be provided.
What type of SCM are you providing?
� Level Spreader
r% Vegetated Conveyance (lower SI-NVf)
� Wetland Swale (higher SM/Vf)
r Other SCM that removes minimum 30% nitrogen
(check all that apply)
For a list of options to meet the diffuse flow requirements, click here.
Diffus Flow Documentation
C7ick the upload button or drag and drop files here to attach docurrent
i B-4662 SWBMP.pdf
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2. Stormwater Management Plan
41.43K6
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
r Yes C' No
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?*
�' Yes l" 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 l" 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 C•' No
Comme nts: *
Categorical Exclusion completed for the project dated August 24, 2017.
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 �' No
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.
Project only involves bridge replacement and minor roadway improvements for safety and do not add capacity.

4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project? *
C' Yes C' No C' �1/A
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?*
r Yes c" No
5c. If yes, indicate the USFWS Field Office you have contacted.
Raleigh
5d. Is another Federal agency involved?*
C' Yes �' No
5e. Is this a DOT project located within Division's 1-8?*
r Yes C' No
�' Unknown
Sj. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?*
Coordination with NCDOT PDEA-ECAP group. Biological conclusion of MANLTAA for northern long eared bat.
Biological Conclusions of No Effect for dwarf wedgemussel, Tar River spiny mussel, yellow lance, Michaux's sumac,
red-cockaded wroodpecker and bald eagle based on recent surveys.
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?*
Available mapping.
' 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 r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources? *
Coordination with State HPO office.
7c. Historic or Prehistoric Information Upload
C7ick the upload button or drag and drop files here to attach docurrent
AR16-02-0140 Archaeology NoSitesPresent.pdf 3.3MB
Historic structure clearance letter.pdf 102.77KB
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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:
I Project has been designed by NCDOT hydro unit to comply with FEMA regulations.
8c. What source(s) did you use to make the floodplain determination?*
Available mapping.
Miscellaneous
Miscellaneous attachments not previously requested.
aick the upload button or drag and drop files here to attach docurrent
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Signature
*
� 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:*
Christopher A. Murray
Signature
cr{�,+:s 1Crt�.4r
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
C' No
BIMS # Assigned*
20180080
Version#*
Reviewing Office*
Central Office - [phone]
Select Project Reviewer*
Rob Ridings:eads\rgridings
Is a payment required for this project?*
C� No payment required
f Fee received
C' Fee needed - send electronic notification