20090117 Ver 1_Application_20090206

BEVERLY EAVES PERDUE
GOVERNOR
January 22, 2009

STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION

EUGENE A Conn, JR
SECRETARY
Mr William Wescott
U S Army Corps of Engineers
Washington Regulatory Field Office
P O Box 1000
Washington, NC 27889-1000
Mr Rob Ridings ®9 1 1 7
Wetlands/401 Unit _
NC DENR Division of Water Quality
2321 Crabtree Blvd
Raleigh, NC 27604-2260
Subject Nationwide Permit 3 Request, for the placement of np rap in a scour hole
adjacent to a culverted stream crossing on NC 561 over Beaverdam Swamp in Halifax
County
Dear Sirs
Please find enclosed the Pre-Construction Notification for the above referenced project
The stream crossing is currently threatened by the existence of a scour hole adjacent to the
culvert Impacts associated with this project will be limited to the placement of np rap in
the scoured area that is currently 5 feet long, 30 feet wide and approximately 3 feet deep
Our observations indicate that the hole is continuing to increase in size The hole will be
filled to normal stream elevation in an effort to stabilize the stream bed and protect the
existing road crossing This activity will not impact wetlands All appropriate sediment
and erosion control measures will be taken throughout the duration of this project
Beaverdam Swamp is in the Tar-Pamlico River Basin and is classified by the Division of
Water Quality as C, SW, NSW
FEDERALLY-PROTECTED SPECIES AND CULTURAL RESOURCES
The Fish and Wildlife Service (FWS) currently list two federally protected species for Halifax
County (Table 1)
Federal Habitat Biological
Common Name Scientific Name Status Present Conclusion
Red-cockaded Picoides borealis E N No Effect
woodpecker
Dwarf wedge mussel Alasmidonta heterodon E N No affect
Tar spmy mussel Elliptio steinstansana E N No Effect
No element occurrences are listed on the NHP database within one mile of the bridge No pme trees
suitable for RCW foraging or nesting are in, or adjacent to, the bridge This project is not likely to
jeopardize the continued existence of any of the federally protected species listed in Halifax
County
No sites eligible for listing on the National Register occur within the area of potential effect This
project will not affect listed or eligible historic properties
Regulatory Approvals
USACE Section 404 Permit The project qualifies for Nationwide Permit 3 (Maintenance of
previously approved structures) All permit conditions will be followed
NCDWO Section 401 Certification The project qualifies for 401 General Certification number
3687 There no permanent unpacts to Waters of the US So this is just a courtesy copy
Respectfully Yours,
R. E Greene, Jr , PE
Division Engineer - Division 4
[phone] x 3532 ccoggms@dot state nc us
Post Office Box 3165, Wilson, North Carolina 27895-3165
o?OF w A rF9oc
o <
Office Use Only
Corps action ID no
DWQ project no
Form Version 13 Dec 10 2008
Pre-Construction Notification (PCN) Form
A. Applicant Information
1. Processing
la Type(s) of approval sought from the
Corps ® Section 404 Permit ? Section 10 Permit
lb Specify Nationwide Permit (NWP) number 3 or General Permit (GP) number
1c Has the NWP or GP number been verified by the Corps? ? Yes ® No
Id Type(s) of approval sought from the DWQ (check all that apply)
® 401 Water Quality Certification - Regular ? Non-404 Jurisdictional General Permit
? 401 Water Quality Certification - Express ? Riparian Buffer Authorization
1 e Is this notification solely for the record
because written approval is not required? For the record only for DWQ 401
Certification
? Yes ® No For the record only for Corps Permit

? Yes ® No
1f Is payment into a mitigation bank or in-lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in-lieu
fee program ? Yes ® No
1 g Is the project located in any of NC's twenty coastal counties If yes, answer 1 h
below ? Yes ® No
1h Is the project located within a NC DCM Area of Environmental Concern (AEC)? ? Yes ® No
2. Project Information
2a Name of project NC 561
2b County Halifax
2c Nearest municipality / town Enfield
2d Subdivision name
2e NCDOT only, T I P or state
project no
3. Owner Information
3a Name(s) on Recorded Deed
3b Deed Book and Page No
3c Responsible Party (for LLC if
applicable)
3d Street address
3e City, state, zip
3f Telephone no
3g Fax no
3h Email address
Page 1 of 10
PCN Form - Version 1 3 December 10, 2008 Version
4. Applicant Information (if different from owner)
4a Applicant is- ® Agent ? Other, specify
4b Name Ricky E Greene Div 4 Engineer
4c Business name
(if applicable) NCDOT Div of Highways
4d Street address PO Box 3165
4e City, state, zip Wilson, NC 27895-3165
4f Telephone no 252-237-6164x3501
4g Fax no 252-234-6174
4h Email address rgreene(&-ncdot qov
5. Agent/Consultant Information (if applicable)
5a Name Chad Coggms
5b Business name
(d applicable) NCDOT Div 4 Environmental Officer
5c Street address same
5d City, state, zip same
5e Telephone no 252-296-3532
5f Fax no 252-234 6174
5g Email address ccoggms0ncdot gov
Page 2 of 10
B. Project Information and Prior Project History
1. Property Identification
1 a Property identification no (tax PIN or parcel ID)
1 b Site coordinates (in decimal degrees) Latitude 36 2787 Longitude - 77 7436
(DD DDDDDD) (-DD DDDDDD)
1 c Property size acres
2. Surface Waters
2a Name of nearest body of water (stream, river, etc ) to
proposed project
Beaverdam Swamp
2b Water Quality Classification of nearest receiving water C SW NSW
2c River basin Tar-Pamlico
3. Project Description
3a 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 surrounding area is predominantly wooded or agricultural land with scattered single family homes
3b List the total estimated acreage of all existing wetlands on the property
3c List the total estimated linear feet of all existing streams (intermittent and perennial) on the property
3d Explain the purpose of the proposed project
The purpose of this project is to correct an existing scour hole at the inlet of the culvert that threatens the structural
integrity of the highway
3e Describe the overall project in detail, including the type of equipment to be used
Use mechanical highway equipment working from the roadway to deposit nprap into a scour hole at the inlet of the
existing culvert, filling the hole to a level consistent with the surrounding streambed elevation
4. Jurisdictional Determinations
4a Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the pasty
Comments shown on topo map and pics included

? Yes ®No ? Unknown
4b If the Corps made the junsdictional determination, what type
of determination was made? ? preliminary ? Final
4c If yes, who delineated the junsdicbonal areas?
Name (if known) Agency/Consultant Company
Other
4d If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation
5. Project History
5a Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past? ? Yes ® No ? Unknown
5b If yes, explain in detail according to "help file" instructions
6. Future Project Plans
6a Is this a phased project? ? Yes ® No
6b If yes, explain
Page 3 of 10
PCN Form - Version 1 3 December 10, 2008 Version
E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
la Does the project include or is it adjacent to protected riparian buffers identified ® Yes ? No
within one of the NC Riparian Buffer Protection Rules?
1b If yes, then is a diffuse flow plan included? If no, explain why

Comments not chap stormwater outfall facility, changing not affecting any buffers
2. Stormwater Management Plan
2a What is the overall percent imperviousness of this project? 0%
2b Does this project require a Stormwater Management Plan? ? Yes ® No
2c If this project DOES NOT require a Stormwater Management Plan, explain why 0% change in impervious surface
2d If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan
? Certified Local Government
2e Who will be responsible for the review of the Stormwater Management Plan? ? DWQ Stormwater Program
? DWQ 401 Unit
3. Certified Local Government Stormwater Review
3a In which local government's jurisdiction is this project?
? Phase II
3b Which of the following locally-implemented stormwater management programs ? NSW
? USMP
apply (check all that apply) ? Water Supply Watershed
? Other
3c Has the approved Stormwater Management Plan with proof of approval been ? Yes ? No
attached?
4. DWQ Stormwater Program Review
? Coastal counties

4a Which of the following state-implemented stormwater management programs apply ? HOW
? ORW
(check all that apply) ? Session Law 2006-246
? Other
4b Has the approved Stormwater Management Plan with proof of approval been
attached? ? Yes ? No
S. DWQ 401 Unit Stormwater Review
5a Does the Stormwater Management Plan meet the appropriate requirements? ? Yes ? No
5b Have all of the 401 Unit submittal requirements been met? ? Yes ? No
Page 8 of 10
PCN Form - Version 1 3 December 10, 2008 Version
F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
la Does the project involve an expenditure of public (federaUstate/local) funds or the ® Yes ? No
use of public (federal/state) land?
lb 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 ? Yes ® No
(North Carolina) Environmental Policy Act (NEPA/SEPA)? ,
1 c 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
letter ) ? Yes ? No
Comments
2. Violations (DWQ Requirement)
2a Is the site to violation of DWQ Wetland Rules (15A NCAC 2H 0500), Isolated
Wetland Rules (15A NCAC 2H 1300), DWQ Surface Water or Wetland Standards, ? Yes ® No
or Riparian Buffer Rules (15A NCAC 2B 0200)?
2b Is this an after-the-fact permit application? ? Yes ® No
2c If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s)
3. Cumulative Impacts (DWQ Requirement)
3a Will this project (based on past and reasonably anticipated future impacts) result in ? Yes ® No
additional development, which could impact nearby downstream water quality?
3b If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy If you answered "no," provide a short narrative description
4. Sewage Disposal (DWQ Requirement)
4a Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility
Page 9 of 10
PCN Form - Version 1 3 December 10, 2008 Version
S. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a Wil
l?t' project occur in or near an area with federally protected species or El Yes ® No
ll
5b Have you checked with the USFWS concerning Endangered Species Act
? ? Yes
No
impacts
5c If yes, indicate the USFWS Field Office you have contacted El Raleigh
? Asheville
5d What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
NHP GIS data layer, onsite observation, and a previously completed mussel survey
6. Essential Fish Habitat (Corps Requirement)
6a Will this project occur in or near an area designated as essential fish habitats ? Yes ® No
6b What data sources did you use to determine whether your site would impact Essential Fish Habitat?
The Anadromous fish spawning area (AFSA) GIS layer was consulted and showed no Essential Fish Habitat on this
stream
T. Historic or Prehistoric Cultural Resources (Corps Requirement)
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
t
t ? Yes ® No
s
a
us (e g , National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b What data sources did you use to determine whether your site would impact historic or archeological resources?
Only working in stream channel within existing ROW
8. Flood Zone Designation (Corps Requirement)
8a Will this project occur in a FEMA-designated 100-year floodplain? FE Yes ? No
8b If yes, explain how project meets FEMA requirements This project will not raise the elevation within the floodplain
8c What source(s) did you use to make the floodplain determination? NC flood Map
Ricky E Greene
Applicant/Agent's Printed Name App i n s ignature Date
(Agent's signature is vah only it an author¢ation letter om the applicant
is provided
Page 10 of 10
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