20180713 Ver 1_PCN Form Submission_20180522

Action History (UTC-05:00) Eastern Time (US & Canada)
�brrrit by Anonymous User 5/22/2018 10:26:50 AM (Start Event)
Accept by Carpenter,Kristi 5/24/2018 11:07:00 AM (DOT Initial Review)
. The task was assigned to Carpenter,Kristi. The due date is: May 25, 2018 5:00 PM
5/22/2018 10:28 AM

�� �
6fvlslaa of Water Resources
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 below are 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:*
Dare
Is this project a public transportation project?*
�' Yes C' No
This is any publicly funded by rrunicipal,state or federal funds road, rail, airport transportation project.
Is this a NCDOT Project?*
�' Yes C' No
(NCDOT only) T.I.P. or state project number:
WBS #
1 SP.10281.5
(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?*
�J Nationwide Permit (NWP)
r Regional General Permit (RGP)
� 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: 03 - Maintenance
NWP Number Other:
List all MN nurrbers you are applying for not on the drop dow n 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 r Riparian Buffer Authorization
r Individual Permit
�
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: f 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 �' No
1f. Is the project located in any of NC's twenty coastal counties?*
C� Yes C' 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?*
C' Yes C•' No
I Link to trout information: http://wvwvsaw.usace.army.mil/Missions/Regulatory-Permit-Program/Agency-Coordination/Trout.aspx
B. Applicant Information
1a. Who is the Primary Contact?*
Paul Williams
I 1b. Primary Contact Email:*
[e-mail]
1c. PrimaryContact Phone:*
(xxx)xxx-xxxx
i [phone]
1d. Who is applying for the permit?
r Owner �J Applicant (other than owner) r Agent/Consultant
(Check all that apply)
2. Owner I nformation
2a. Name(s) on recorded deed:
i National Park Service
2b. Deed book and page no.:
2c. Responsible party:
(for Corporations)
2d.Address
Street Address
Address Line 2
�Y
Wstal / Zip Code
2e. Telephone Number:
State / FYovince / F�gion
Country

(xxx)xxx-xxxx
2f. Fax Number:
(xxx)xxx-xxxx
2g. Email Address:*
[e-mail]
3. Applicant Information (if different from owner)
3a. Applicant is:
C' Agent
C�' Other .CDOT Division 1 Environmental Specialist
If other please specify.
3b. Name:
Paul Williams
3c. Business Name:
(if applicable)
NC Department of Transportation
3d.Address
Street Address
113 Airport Dr.
Address Line 2
Qty
Edenton
Fbstal / Zip Code
27932
3e. Telephone Number:
I [phone]
(xxx)xxx-xxxx
3f. Fax Number:
[phone]
(xxx)xxx-xxxx
3g. Email Address:*
[e-mail]
State / Rovince / I�gion
NC
Country
27932
C. Project Information and Prior Project History
1. Project Information
1a. Name of project:*
Park Service Ocean Outfall # 7 Maintenance Project
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality/town:*
Nags Head
1d. Driving directions*
If it is a new project and can not easily be found in a GPS rrapping system Rease provide directions.
MP 21.4 on SR 1243 S. Old Oregon Inlet Road at Park Service Beach Access.

2. Project Identification
2a. Property Identification Number:
(tax RN or parcel ID)
2b. Propertysize:
(in acres)
1
2c. Project Address
Street Address
Address Line 2
��
Nags Head
Fbstal / Zip Code
27959
2d. Site coordinates in decimal degrees
State / R-ovince / 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:*
35.8469
ex: 34.208504
3. Surface Waters
Longitude:*
-75.5632
-77.796371
3a. Name of the nearest body of water to proposed project:*
Atlantic Ocean
3b. Water Resources Classification of nearest receiving water:*
SB
Surface Water Lookup
3c. What river basin(s) is your project located in?*
Pasquotank
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:*
Project area consists of Ocean Outfall # 7 and the Park Service Beach Access. The adjacent property use
consists
of vacation homes and the Cape Hatteras National Seashore.
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
Topo Park Service Outfall_4-26-18.pdf 1.02MB
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)

C7ick the upload button or drag and drop files here to attach docurrent
Soil_Map.pdf 495.52KB
Fle type rrust be pdf
4d. List the total estimated acreage of all existing wetlands on the property:
0
4e. List the total estimated linear feet of all existing streams on the property:
I (interrrittent and perennial)
0
4f. Explain the purpose of the proposed project:*
i Repair damaged section of ocean outfall to maintain drainage from SR 1243.
4g. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
A section of Ocean Outfall # 7 behind the concrete collar was damaged during recent storms and beach erosion
and needs to be replaced. NCDOT proposes to replace 60 feet of existing 30" CMP with 60 feet of 30" CAP and
construct new support structure with H-piles and timber cradle system.
4h. Please upload project drawings for the proposed project.
C7ick the upload button or drag and drop files here to attach docurrent
Park Service_Outfall_RepairMaint.pdf 181.85KB
Fle type rrust be pdf
5. Jurisdictional Determinations
Sa. Have the wetlands or streams been delineated on the propertyor proposed impact areas?*
C' Yes C•' No C' Unknown
Comme nts:
Sb. If the Corps made a jurisdictional determination, what type of determination was made? *
C' Preliminary C' Approved C' Unknown C� f�UA
Corps AID Number:
5carrple: SAV�2017-99999
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Othe r:
Sd. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
5d1. Jurisdictional determination upload
C7ick 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
6b. If yes, please give the DWR Certification number or the Corps Action ID (exp. SAW-0000-00000).
Action ID 200310765
Project History Upload

Qick the upload button or drag and drop files here to attach docurrent
USCOE NW3 Permit.pdf
Fle type rrust be FDF
, 7. Future Project Plans
7a. Is this a phased project?*
C� Yes �' No
121.42KB
7b. If yes, explain.
This phase of the project will replace an existing 60' section of pipe and qualifies for a maintenance and repair
exemption under CAMA rules. This phase will repair new damage from recent storms and erosion, and the outfall
drainage will be restored to the normal existing flow.
The next phase of the project will replace 160' of pipe oceanward of the concrete collar and will require a CAMA
Major Permit. The next phase will take place later this year and will restore the structure to its original dimensions.
i Permits will be applied for later this summer.
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 I m pacts I nventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
� Wetlands r Streams-tributaries r Buffers
r Open Waters r Pond Construction
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:*
Outfall repairs and pipe replacement will stay on the e�asting alignment and maintain epsting dimensions.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*
Work will be performed during daylight hours and during lowtides. Work area will be limited to 100 feet on either
side of the ocean outfall. All equipment will be removed from the beach at night to the beach access. Due to the
project occurring during the sea turtle nesting season, turtle crawi surveys will be conducted prior to work every
morning. Project will take appro�mately one week. NCDOT is coordinating with USFWS on the project, and will
forward the Concurrence Letter as Supplemental Information when received. NCDOT is also coordinating with NPS
and NCDCM, and will forward any correspondence as Supplemental Information when received.
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?
f Yes C•' No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
No impacts.
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
For a list of options to meet the diffuse flow requirements, click here.
If no, explain why:
Pasquotank River basin.
2. Stormwater Management Plan
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?*
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 �' No
Comments:*
Activity and impacts covered by Minimum Criteria Checklist.
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
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.
Project replaces existing pipe with pipe of the same dimensions.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project? *
C' Yes C' No �' f�UA
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?*

r Yes r No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
�' Yes �' No
5c. If yes, indicate the USFWS Field Office you have contacted.
I Raleigh
5d. Is another Federal agency involved?*
r Yes C' No
What Federal Agency is involved?
NPS
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?
USFWS Raleigh Office
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
�' Yes C' No
Are there submerged aquatic vegetation (SA� around the project vicinity?*
C' Yes f• No �' Unknown
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
National Marine Fisheries Database
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 �' No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources? *
State Historic Preservation Office Historic Properties Map Website
7c. Historic or Prehistoric Information Upload
C1ick the upload button or drag and drop files here to attach docurrem
Fle rrust be FDF
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?*
�' Yes �' No
8b. If yes, explain how project meets FEMA requirements:
f�llA
8c. What source(s) did you use to make the floodplain determination?*
NCFloodmaps.com, Zone VE

Miscellaneous
Miscellaneous attachments not previously requested.
C7ick the upload button or drag and drop files here to attach docurrEnt
Aerial Park Service Outfall_4-26-18.pdf 1.04M6
Fle rrust be FDF or IWQ
Signature
rJ 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:*
Paul Collins Williams, Jr.
Signature
C�)rif/t� �/:r' %{�Y/:am.:. T'%t .
Date Submitted:
5/22/2018
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*
20180713
Version#*
1
Reviewing Office *
Washington Regional Office - [phone]
Select Project Reviewer*
Garcy Ward:eads\gpward
Is a payment required for this project?*
C�' No payment required
C' Fee received
C' Fee needed - send electronic notification