20180609 Ver 1_PCN Form Submission_20180503

Action History (UTC-05:00) Eastern Time (US & Canada)
�brrrit by Anonymous User 5/3/2018 10:19:16 AM (Start Event)
Accept by Carpenter,Kristi 5/3/2018 1:25:01 PM (DOT Initial Review)
. The task was assigned to Carpenter,Kristi. The due date is: May 8, 2018 5:00 PM 5/3/2018 10:20 AM

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�ivislan af Water Resour�es
Pre-Construction Notification (PCN) Form
For Nationwide Permits and Regional General Permits
(along with corresponding Water Quality Certifications)
January 31, 2018 Ver 2.3
*
Please note: fields marked with a red asterisk beloware required. You will not be able 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.
https://edocs.deq. nc.gov/WaterResources/0/edoc/624704/PCN%20Help%20File%202018-1-30.pdf
A. Processing Information
County (or Counties) where the project is located:*
Edgecombe
Is this project a public transportation project?*
C Yes l' No
lhis is any publicly funded by rrunicipal,state or federal funds road, rail, airport transportation project.
Is this a NCDOT Project?*
f• Yes r No
(NCDOT only) T.I.P. or state project number:
B-4932 (Central)
WBS #
40137.1.1
(for �ICDOT use only)
1a. Type(s) of approval sought from the Corps:*
fJ Section 404 Permit (wetlands, streams and waters, Clean Water Act)
�J 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)
r Standard (IP)
This form may be Corps to initiate the standard/individual permit process. Please contact your Corps representative for submittal of standard permits.
All required items that are not provided in the E-PCN and be added to the miscellaneous upload located at the bottom of this form.
Nationwide Permit (NWP) Number: 23 - Categorical Exclusions
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
r% 401 Water Quality Certification - Regular r 401 Water Quality Certification - Express
r Non-404 Jurisdictional General Permit �rJ Riparian Buffer Authorization
r Individual Permit
*
1d. Is this notification solelyfor the record because written approval is not required?
For the record onlyfor DWR 401 Certification: f Yes C' No
For the record onlyfor Corps Permit: C' Yes f' 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 a- in-lieu fee program
C Yes l" No
Acceptance Letter Attachment
C7ick the upload button or drag and drop files here to attach docurrem
B-4932 DMS Acceptance.pdf 144.45KB
F1LE lYFE MJST BE FDF
1f. Is the project located in any of NC's twenty coastal counties?'�
f Yes �' No
1h. Is the project located in a designated trout watershed?*
f Yes r No
Link to trout information: http://wvwv.saw.usace.army.mil/Missions/Regulatory-Permit-Program/Agency-Coordination/Trout.aspx
B. Applicant Information
1a. Who is the Primary Contact? *
NCDOT
1b. PrimaryContact Email:*
[e-mail]
1c. PrimaryContact Phone:�
(xxx)xxx-xxxx
[phone]
1d. Who is applying for the permit?
r Owner rJ Applicant (other than owner) r Agent/Consultant
(Check all that apply)
2. Owner I nformation
2a. Name(s) on recorded deed:
2b. Deed book and page no.:
2c. Responsible party:
(for Corporations)
2d. Address
Street Address
Address Line 2
��
Fbstal / Zip Code
2e. Telephone Number:
State / Rovince / FZegion
Caurdry

(xxx)xxx-xxxx
2f. Fax Number:
(xxx)xxx-xxxx
2g. Email Address:*
[e-mail]
3. Applicant Information (if different from owner)
3a. Applicant is:
f Agent
f' Other
IF other please specrfy.
3b. Name:
3c. Business Name:
(if applicable)
3d. Address
SYreet Address
Address Line 2
Qty
Rutal / Zip Code
3e. Telephone Number:
(xxx)xxx-xxxx
3f. Fax Number:
(xxx)xxx-xxxx
3g. Email Address:*
[e-mail]
State / Rovince / F�gion
Country
C. Project Information and Prior Project History
1. Project Information
1a. Name of project:*
B-4932, Bridge No. 28 on NC 42
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality/town:'�
Old Sparta
1d. Driving directions*
IF it is a new project and can not easily be found in a GPS rrapping system Rease provide directions.
NC 42 over the Tar River, between Old Sparta and Scotts Crossroads
2. Project Identification
2a. Propertyldentification Number:
(tax RN or parcel ID)
2b. Propertysize:
(in acres)

2c. Project Address
Street Address
Address Line 2
a�y
Rzstal / Zip Code
2d. Site coordinates in decimal degrees
State / FYovince / F�gion
Country
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 e�mple, 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:*
35.790557 -77.550289
ex: 34208504 -77.796371
3. Surface Waters
3a. Name of the nearest body of water to proposed project:'�
Tar River
3b. Water Resources Classification of nearest receiving water:*
C, NSW
Surface Water Lookup
3c. What river basin(s) is your project located in?*
Tar-Pamlico
River Basin 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:*
Land use in the vicinity consists of forest, agriculture, rural residential and commercial development. A NC Wildlife
Resources Commission public boat ramp is adjacent to the project site.
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
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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)
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4d. List the total estimated acreage of all existing wetlands on the property:
1.48
4e. List the total estimated linear feet of all existing streams on the property:
(interrrittent and perennial)
1, 303
4f. Explain the purpose of the proposed project:*
Replace the e�asting bridge built in 1952.
4g. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*

The existing 13-span, 606 foot structure will be replaced on a new location alignment northwest of the existing
bridge. The new 6-span bridge will be 610 feet long, with a deck width of 34 feet. The new roadway grade will be
approwmately 6 feet above the ewsting structure. The ebsting bridge structure will serve as an onsite detour for
traffic during construction. A temporary bridge will be used instead of a causeway for construction access.
Standard roadbuilding equipment will be used.
4h. Please upload project drawings for the proposed project.
C7ick the upload button or drag and drop files here to attach docurrent
B4932_Permit Drawing_Wetland _20171011.pdf 2.67MB
B4932_Permit Drawing_Buffer_20180503.pdf 1.17MB
B4932 Roadway Plans.pdf 2.62MB
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5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
C•' Yes f' No C' Unknown
Comme nts:
A Preliminary JS was requested 5/27/2010, and a revised Preliminary JD
request was sent February 1, 2016. A site visit was made with Tom Steffens
and Garcy Ward.
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
f•' Preliminary �' Approved �' Unknown f' f�llA
Corps AID Number:
6carrple: SAV�2017-99999
5c. If Sa is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Othe r:
Tyler Stanton and AmyJames, NCDOT
5d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
5d1. Jurisdictional determination upload
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6. Project History
6a. Have permits or certifications been requested or obtained for this project (including all prior phases) in the past? *
f Yes C No �' 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):
� Wetlands r% Streams-tributaries �7 Buffers
�J 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 P
Nbp label (e.g. I�ad Qossing 1- CLlvert, F2rrranent (� or
dewatering, etc) Terrporary (�
Site 2 P
N�p label (e.g. Fd�ad Qossing 1- Qalvert, F2rrranent (� or
dewatering, etc) Terrporary (�
Site 2A P
N�p label (e.g. F3�ad Qossing 1- Qalvert, �rrranent (F�) or
dewatering, etc) Terrporary (�
Site 4 P
N�p label (e.g. Finad Qossing 1- Qalvert, F2rrrenent (P� or
dewatering, etc) Terrporary (�
Site 5 P
N�p label (e.g. Fd�ad Qossing 1- Qalvert, F�rrrenent (F) or
dewatering, etc) Terrporary (�
Site 6 P
N�p label (e.g. R�ad Qossing 1- Qalvert, F2rrranent (Fj or
dewatering, etc) Terrporary (�
Site 7 P
Nbp label (e.g. Fd�ad Qossing 1- CLlvert, F2rrranent (F�j or
dewatering, etc) Terrporary (�
Site 8 P
N�p label (e.g. Fd�ad Qossing 1- CLlvert, F2rrranent (P) or
dewatering, etc) Terrporary (�
2g. Total Temporary Wetland Impact
0.000
2g. Total Permanent Wetland Impact
0.250
2g. Total Wetland Impact
0.250
2h. Comments:
There will be <0.01 ac of hand clearing.
Headwater Forest
Bottomland Hardwood
Forest
Bottomland Hardwood
Forest
Bottomland Hardwood
Forest
Bottomland Hardwood
Forest
Bottomland Hardwood
Forest
Bottomland Hardwood
Forest
Bottomland Hardwood
Forest
2d. Wetland name *Ze. 2f. Type of
Forested* Jurisdicition*
WH & WI Yes Both
(404, 10) or Cr✓VR (401
other)
WJ Yes Both
(404, 10) or D✓VR(401
other)
WK Yes Both
(404, 10) or C!✓VR (401
other)
WA Yes Both
(404, 10) or D✓�ft(401
other)
WB Yes Both
(404, 10) or D✓�R(401
other)
WC Yes Both
(404, 10) or CMR(401
other)
WF Yes Both
(404, 10) or DJVR(401
other)
WD Yes Both
(404, 10) or C�R (401
other)
2g.lmpact
area *
0.020
(acres)
0.100
(acres)
0.010
(acres)
0.050
(acres)
0.030
(acres)
0.020
(acres)
0.010
(acres)
0.010
(acres)
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. Reason for impact*3b.lmpact 3c. Type of impact*3d. Stream name *
type *
S1 Site 1 P Fill
fv�p label (e.g. I�ad Qossing F�rrranent (Fj or
1) Terrporary (�
SA
3e. Stream 3f. Type of
Type* Jurisdiction*
Perennial Both
F2rennial (Fffl) or
interrrittent (IfVn
gz Site 7 T Fill SA Perennial Both
N�p label (e.g. Fd�ad Qossing F2rrranent (Fj or F�rennial (FH� or
1) Terrporary (� interrrittent (INfj
3g. Stream 3h. Impact sqfe�
width * length *
3 48 1
Average Qinearfeet) 4
(feet) 4
3 77 5
Average (linearfeet) 1
(feet)

S3 Site 2- relocation P Relocation
N�p label (e.g. Fd�ad Qossing F2rrranent (Fj or
1) Terrporary (lj
S4 Site 2- relocation T Relocation
fvbp label (e.g. Finad Qossing F2rrranem (Fj or
1) Terrporary (�
S5 Site 5 P Fill
N�p label (e.g. Finad Qossing F2rrranem (�j or
1) Terrporary (�
S6 Site 5 T Fill
N�p label (e.g. Fd�ad Q-ossing F�rrranerrt (Fj or
1) Terrporary (�
SA
SA
SB
SB
Perennial Both
F2rennial (� or
intermittent (If�
Perennial Both
F�rennial (Fff2) or
imerrrittent (IfVn
Perennial Both
F�rennial (FH� or
interrrittent (IfVn
Perennial Both
F�rennial (F� or
interrrittent (IfVn
*� 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:
355
3i. Total temporary stream impacts:
60
3i. Total stream and tributary impacts:
415
3j. Comments:
BRIDGE PERMANENT SURFACE WATER IMPACTS BASED ON 76 SF PER BENT (<.01 AC)
TEMPORARY WORK BRIDGE: TEMPORARY SURFACE WATER IMPACTS BASED ON 390 SF DUE TO BENTS
TEMPORARY DEMOLITION WORK BRIDGE: TEMPORARY SURFACE WATER IMPACTS BASED ON 240 SF DUE
TO BENTS
3
Average
(feet)
3
Average
(feet)
2
Average
(feet)
2
Average
(feet)
271 8
(linearfeet) 1
3
36 7
Qinearfeet) 0
8
36 7
(linearfeet) 2
7 7
(linearfeet) 4
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
impact*
Site 3 construction and
demolition
N�p label (e.g. Fd�ad Qossing 1)
Site 3
N�p label (e.g. FUad Qossing 1)
4b. Impact type * 4c. Name of waterbody*
T
F�rrranent (Pj or
Terrporary (�
P
F2rrranent (P� or
Terrporary (lj
4g. Total temporaryopen water Impacts:
0.01
4g. Total permanent open water impacts:
0.01
4g. Total open water impacts:
0.02
4h. Comments:
Tar River
(if applicable)
Tar River
(rf applicable)
4d.Activitytype* 4e.Waterbodytype*4f.lmpact
area *
Bridge Other 0.01
(acres)
Bridge Other 0.01
(acres)
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)?*

C�eck all that apply.
r Neuse
r Catawba
r Goose Creek
r Other
r% Tar-Pamlico
r Randleman
r Jordan Lake
6b. Impact Type * 6c. Per or 6d. Stream name *
Temp*
Site 1 Allowable P UT
Location and Exerrpt, Allowable, allowable wl F�rrranent (Fj or
rritigation Terrporary (�
Site 2 Allowable w/ Mitigation P Tar River
Location and 6cerrpt, Allowable, allowable w/ F2rrranent (Fj or
rritigation Terrporary (lj
Site 2 Allowable P Tar River
Location and Exerrpt, Allowable, allowable w/ F2rrranent (� or
rritigation Terrporary (�
Site 3 Allowable P Tar River
Location and 6cerrpt, Allowable, allowable w/ F2rrranem (Fj or
rritigation Terrporary (�
Site 4 Allowable P UT
Location and Exerrpt, Allowable, allowable w/ F2rrranent (Fj or
rritigation Terrporary (�
Site 5 Allowable P UT
Location and Exerrpt, Allowable, allowable w/ F2rrranem (Fj or
rritigation Terrporary (�
6h. Total buffer impacts:
Temporary impacts:
Permanent impacts:
Zone 1
0.00
Zone 1
34,795.00
zane s
0.00
Zone 2
18,115.00
6e. Buffer mitigation 6f. Zone 1 6g. Zone 2
required?* impact* impact*
Yes 4,286 2,039
(squarefeet) (squarefeet)
Yes 14,469 6,316
(squarefeet) (squarefeet)
Yes 7,205 2,337
(squarefeet) (squarefeet)
Yes 4,468 2,932
(squarefeet) (squarefeet)
Yes 4,367 3,469
(squarefeet) (squarefeet)
Yes 0 7,022
(squarefeet) (squarefeet)
Zone 1 Zone 2
Total buffer impacts: 34,795.00 18,115.00
6i. Comments:
A portion of the buffer impacts at Site 2 occur in wetlands and were removed from requested buffer mitigation.
Supporting Documentation - i.e. Impact Maps, Plan Sheet, etc.
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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 preferred alternative avoided the impacts from a temporary detour and avoided impacts to the historic Old
Sparta Vessel, and minimized impacts on the nearby WRC boat ramp.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*

Design Standards for Sensitive Watersheds will be incorporated throughout construction of the project. NCDOT
has also agreed to special project conditions approved by the National Marine Fisheries Service (see attached
letter). A split in-water work moratorium from February 15 to June 30 and August 15 to October 31 will be adhered
to.
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?
l•' Yes l" No
2c. If yes, mitigation is required by (check all that apply):
r7 DWR r Corps
2d. If yes, which mitigation option(s) will be used for this project?
r Mitigation bank r% Payment to in-lieu fee program
4. Complete if Making a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached.
rJ Yes
4b. Stream mitigation requested:
Qinear feet)
355
4c. If using stream mitigation, what is the stream temperature:
warm
4d. Buffer mitigation requested (DWR only):
(squarefeet)
19,473
4e. Riparian wetland mitigation requested:
(acres)
0.24
4f. Non-riparian wetland mitigation requested:
(acres)
0
4g. Coastal (tidal) wetland mitigation requested:
(acres)
0
4h. Comments
r Permittee Responsible Mitigation
6. Buffer mitigation (State Regulated Riparian Buffer Rules) - required by DWR
6a. Will the project result in an impact within a protected riparian buffer that requires buffer mitigation? If yes, you must fill out this entire
form - please contact DWR for more information.
C Yes r No
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation
calculate the amount of mitigation required in the table below.
6c. Reason for impact
6d. Total impact Multiplier
(square feet)
Zone 1 bridge construction 14,469 3
6e. Required
mitigation (square
feet)
43,407

Zone 2 bridge construction 5,004 1.5 7,506
6f. Total buffer mitigation required
50913
6g. If buffer mitigation is required, is payment to a mitigation bank or NC Division of Mitigation Services proposed?
G Yes f No
6h. Attach the acceptance letter from the mitigation bank or NC Division of Mitigation Services.
B-4932 DMS Acceptance.pdf 144.45KB
(FDF only)
6j. Comments:
A portion of the buffer impacts at Site 2 occur in wetlands and were removed from requested buffer mitigation.
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
1b. 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?
r Level Spreader
r Vegetated Conveyance (lower SMNT)
r Wetland Swale (higher SHWT)
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
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2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250? *
C Yes r 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?�
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)?*
r 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
NEPAor SEPAfinal approval letter.)*
G' Yes C' No
NEPA or SEPA Final Approval Letter
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RLE NFE NL6T BE FOF
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 .7300), or
DWR Surface Water or Wetland Standards or Riparian Buffer Rules (75A NCAC 2B .0200)?*
f Yes �' No
2b. Is this an after-the-fact permit application?*
C' Yes C•' No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project (based on past and reasonablyanticipated future impacts) result in additional development, which could impact
nearby downstream water quality?*
l" Yes �' No
3b. If you answered "no," provide a short narrative description.
Due to the minimal transportation impact resulting from this bridge replacement, this project will neither influence
nearby land use nor stimulate growth. Therefore,a detailed cumulative effects study will not be necessary.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
f Yes f' No f' N/A
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 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 r No
What Federal Agency is involved?
National Marine Fisheries Service
5e. Is this a DOT project located within Division's 1-8?*
G Yes r No
�' Unknown
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
USFWS County lists, coordination with USFWS Raleigh Field Office, field surveys, coordination with National
Marine Fisheries Service, NCNHP data.
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
f Yes l•' No

6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat? *
NMFS Essential Fish Habitat �bsite
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 l" No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources? *
NEPA/SEPA documentation
7c. Historic or Prehistoric Information Upload
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B4932 Historic.pdf 257.47KB
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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?*
f• Yes �' No
8b. If yes, explain how project meets FEMArequirements:
NCDOT Hydraulics Unit coordination with FEMA
8c. What source(s) did you use to make the floodplain determination?*
FEMA maps
Miscellaneous
Miscellaneous attachments not previously requested.
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B4932 NMFS Concurrence Letter.pdf 164.93KB
B4932 USFWS Concurrence Letter.pdf 49.26KB
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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.
Full Name:*
Colin Mellor
Signature
Col� I�7e1fD�

Initial Review
Is this project a public transportation project?* (')
C Yes r No
Change only 'rf needed.
Has this project met the requirements for acceptance in to the review process?*
C Yes
C' No
BIMS # Assigned *
20180609
Version#*
Reviewing Office *
Central Office - [phone]
Select Project Reviewer'�
Rob Ridings:eads\rgridings
Is a payment required for this project?*
C' No payment required
C' Fee received
f' Fee needed - send electronic notification