20180724 Ver 1_PCN Form Submission_20180524

Action History (UTC-05:00) Eastern Time (US & Canada)
�brrrit by Anonymous User 5/24/2018 10:15:48 AM (Start Event)
Accept by Carpenter,Kristi 5/24/2018 3:19:01 PM (DOT Initial Review)
. The task was assigned to Carpenter,Kristi. The due date is: May 29, 2018 5:00 PM
5/24/2018 10:17 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:*
Bladen
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 #
15006.1009234
(for NCDOT use only)
1a. Type(s) of approval sought from the Corps:*
rJ Section 404 Permit (wetlands, streams and waters, Clean Water Act)
fJ 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 �' No
1h. Is the project located in a designated trout watershed?*
C' Yes G No
Link to trout information: http://ww�.saw.usace.army.mil/Missions/Regulatory-Permit-Program/Agency-Coordination/Trout.aspx
B. Applicant Information
1a. Who is the Primary Contact?*
James J. Rerko, PWS
1b. Primary Contact Email:*
[e-mail]
1c. PrimaryContact Phone:*
(xxx)xxx-xxxx
[phone]
1d. Who is applying for the permit?
� Owner r Applicant (other than owner) r AgenUConsultant
(Check all that apply)
2. Owner I nformation
2a. Name(s) on recorded deed:
NCDOT
2b. Deed book and page no.:
2c. Responsible party:
(for Corporations)
2d.Address
Street Address
558 Gillespie Street
Address Line 2
��
Fayetteville
Fbstal / Zip Code
28302
2e. Telephone Number:
State / FYovince / F�gion
North Carolina
Country
United States

(xxx)xxx-xxxx
[phone]
2f. Fax Number:
[phone]
(xxx)xxx-xxxx
2g. Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1a. Name of project:*
Bladen Bridges 16-17 Debris Deflectors
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality/town:*
Elizabethtown
1d. Driving directions*
If it is a new project and can not easily be found in a GPS rrepping system Rease provide directions.
Under US 701 bridges 16 & 17 over Cape Fear River just north of Elizabethtown, Bladen County
2. Project Identification
2a. Property Identification Number:
(tax RN or parcel ID)
2b. Propertysize:
(in acres)
2c. Project Address
Street Address
Address Line 2
��
Fbstal / Zip Code
State / R-ovince / F�gion
Country
2d. Site coordinates in decimal degrees
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:*
i 34.632744
ex:34208504
3. Surface Waters
Longitude:*
-78.602876
-77.796371
3a. Name of the nearest body of water to proposed project:*
Cape Fear River
3b. Water Resources Classification of nearest receiving water:*

C
i Surface Water Lookup
3c. What river basin(s) is your project located in?*
Cape Fear
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:*
The e�asting fender system consists of deteriorated v�rood piles that are failing and continually develop drift which
must be removed by State Bridge Maintenance forces. Ewsting conditions are open river with floodplain. There is a
boat ramp at the bridges but the ramp does not provide enough depth to launch the necessary barges. NCDOT
did contact the Corps of Engineers who are currently working at Dam #2 about launching the barges from the Lock
and Dam #2, but, was denied access due to conflicts. While NCDOT is removing the drift, all attempts will be made
to ensure that drift does not get discharged into the current Corps of Engineers project. NCDOT will communicate
with the Lockmaster at Lock and Dam #2.
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)
C1ick the upload button or drag and drop files here to attach docurrent
Bladen Bridge 16 & 17_Vicinity Map.pdf
Fle type rrust be pdf
1.63M6
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
Bladen Bridge 16 & 17_Soils Map.pdf
Fle type rrust be pdf
4d. List the total estimated acreage of all existing wetlands on the property:
0 acre
4e. List the total estimated linear feet of all existing streams on the property:
(interrrittent and perennial)
150 LF perennial Cape Fear River
1.23MB
4f. Explain the purpose of the proposed project:*
Bridge 17 is a fracture critical bridge that has required a fender system for protection. The fender system is failing
due to the aging v�rooden piles and a dolphin system has been designed to provide the necessary protection.
4g. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
The e�asting wooden fender system will be removed by pulling the piles from the river bottom. Drift will be cleared
from the work area. Prior to the removal of the drift, NCDOT will contact the Lockmaster at Lock and Dam #2. The
sheet piles will be driven into the river bottom via a crane with both vibratory hammer and a pile hammer. The nose
of the debris deflector, wt�ich is a closed unit, will be backfilled with #57 stone. Then, sheeting will be driven along
the length of the footing. The sheeting extends 28 feet below the approximate invert of the river and 30 feet above
the appro�mate invert. Steel grating will be installed on the top of the sheeting to eliminate drift wedging between
the ewsting columns and the sheeting. Direct impacts are the two nose sections for Bridge 17, Bents 9 and 10
(716 sq.. ft. ) and Bridge 16 (Bents 6 and 7(365 sq. ft.). Four sections of sheet pile 46 foot in length will
encapsulate the concrete footer for Bridge 17, and four section of sheet pile will encapsulate Bridge 16 concrete
footer 37 foot. Turbidity Curtains will be utilized on the downstream side of the project. The Debris Deflectors
proposed are typical of the Debris Deflectors installed at both B-4712 (Tar Heel Bridge) and B-4028 (NC 11
Bridge).
4h. Please upload project drawings for the proposed project.

C7ick the upload button or drag and drop files here to attach docurrent
i Bladen 16-17 Debris Deflector Plans - Signed.pdf 2.5MB
jim etown.pdf 2.73M6
Bladen Bridge 16&17_Wetland Impact Summary.pdf 330.36KB
I Fle type rrust be pdf
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
C' Yes �' No �' Unknown
Comments:
I Proposed work is within the Cape Fear River.
5b. If the Corps made a jurisdictional determination, what type of determination was made? *
f Preliminary C' Approved C' Unknown C•' N/A
Corps AID Number:
I5carrple:SAV�2017-99999
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Othe r:
5d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
5d1. Jurisdictional determination upload
aick the upload button or drag and drop files here to attach docurrent
Fle type rrust be F�F
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
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):
r Wetlands r Streams-tributaries r Buffers
r% Open Waters r Pond Construction
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 *
Bridges 16 & 17
fv�p label (e.g. Finad Qossing 1)
Work Bridge / Barge
Landing
fV�p label (e.g. Fd�ad Qossing 1)
4b. Impact type * 4c. Name of waterbody* 4d. Activity type * 4e. Waterbody type *4f. Impact
area*
P Cape Fear River Fill Tributary 0.02
F2rrrenent (Fj or (if applicable) (acres)
Terrporary (�
T Cape Fear River Other Tributary 0.09
F�rrranent (�j or (if applicable) (acres)
Terrporary (�
4g. Total temporary open water Impacts:
0.09
4g. Total permanent open water impacts:
0.02
4g. Total open water impacts:
0.11
4h. Comments:
Work Bridge / Barge Landing was designed to maintain at least 6 foot of draft for barge movements.
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:*
I Debris Deflectors are designed with minimal impact to the Cape Fear River. They are consistent with the most
recently installed Debris Deflectors at both the B-4028 and B-4712 projects.
1b. Specificallydescribe measures taken to avoid or minimize the proposed impacts through construction techniques:*
All work will take place from barges.
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
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
The installation of the debris deflectors is a retrofit which is necessary to protect the bridges. Bridge 17 is a fracture critical bridge structure.
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 �' No
For a list of options to meet the diffuse flow requirements, click here.
If no, explain why:
Bladen County does not have NC Riparian Buffer Rules.

2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
�' 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 C' No
1c. If you answered "yes" to the above, has the document review been finalized bythe State Clearing House? (If so, attach a copy of the
NEPAor SEPAfinal approval letter.)*
f Yes C•' No
Comments:*
I Project is federally funded.
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)? *
f Yes C•' 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 qualit�i?*
C' Yes �' No
3b. If you answered "no," provide a short narrative description.
� Project is a retrofit that will not result in additional development.
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 l" No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
C' Yes C•' No
5d. Is another Federal agency involved?*

r Yes r No r Unknown
5e. Is this a DOT project located within Division's 1-8?*
�' Yes �' No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
Natural Heritage site / USFWS Site
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
C' Yes r No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
I EFH website
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 C•' No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
� Project is a retrofit that will protect Bridges 16 & 17
7c. Historic or Prehistoric Information Upload
C7ick the upload button or drag and drop files here to attach docurrent
Fle rrust be FflF
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?*
r Yes C' No
8b. If yes, explain how project meets FEMA requirements:
Project is a retrofit that will not affect the Cape Fear River Floodplain.
8c. What source(s) did you use to make the floodplain determination?*
NCDOT Hydraulic / Bridge Units
Miscellaneous
Miscellaneous attachments not previously requested.
C7ick the upload button or drag and drop files here to attach docurrent
Fle rrust be FDF or IMQ
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
I 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:*
James J. RErko, PWS
Signature
r.�:wrc� r%iYrt�C', r�'J�'� S
Date Submitted:
5/24/2018
Initial Review
Is this project a public transportation project? *(�)
�' Yes �' No
Change only if needed.
Has this project met the requirements for acceptance in to the review process?*
�' Yes
C' No
BIMS # Assigned*
20180724
Version#*
1
Reviewing Office *
Wilmington Regional Office - [phone]
Select Project Reviewer*
Joanne Steenhuis:eads\jhsteenhuis
Is a payment required for this project?*
C' No payment required
C' Fee received
C' Fee needed - send electronic notification