20180725 Ver 1_PCN Form Submission_20180524

Action History (UTC-05:00) Eastern Time (US & Canada)
�brrrit by Anonymous User 5/24/2018 1:31:22 PM (Start Event)
Accept by Carpenter,Kristi 5/24/2018 5:10:42 PM (DOT Initial Review)
. The task was assigned to Carpenter,Kristi. The due date is: May 29, 2018 5:00 PM 5/24/2018 1:32 PM

�� �
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:*
Columbus
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:
B-4479
WBS #
17. BP.6. R.92
(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: 23 - Categorical Exclusions
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:
For the record only for Corps Permit:
�' Yes C•' No
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
�' Yes �' No
Acceptance Letter Attachment
C7ick the upload button or drag and drop files here to attach docurrent
RLE NF� MJST BE FDF
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?*
Jim Rerko
1b. PrimaryContact Email:*
[e-mail]
1c. PrimaryContact Phone:*
(xxx)xxx-xxxx
[phone]
1d. Who is applying for the permit?
fJ Owner r Applicant (other than owner) r Agent/Consultant
(Check all that apply)
2. Owner I nformation
2a. Name(s) on recorded deed:
NCDOT Project
2b. Deed book and page no.:
2c. Responsible party:
(for Corporations)
2d.Address

Street Address
1000 Transporation Dr.
Address Line 2
C7ty
Fayetteville
Fbstal / Zip Code
28302
2e. Telephone Number:
(xxx)xxx-xxxx
[phone]
2f. Fax Number:
[phone]
(xxx)xxx-xxxx
2g. Email Address:*
[e-mail]
State / R-ovince / I�gion
NC
Country
C. Project Information and Prior Project History
1. Project Information
1a. Name of project:*
17.BP.6.R.92/B-4479
1b. Subdivision name:
(if appropriate)
1c. Nearest municipality/town:*
Clarkton
1d. Driving directions*
If it is a new project and can not easily be found in a GPS rrapping system Rease provide directions.
From Raleigh, I-40 E to I-95 S, take exit 46 toward Elizabethtown and continue on NC-87 S 33 miles and turn right onto US-701 S and
continue for 9.8 miles. Turn left onto US-701 Bus. and take first right onto Red Hill Rd. The project is located on the four bridges over Red
I Hill Swamp.
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 / Rovince / 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.)

Latitude:* Longitude:*
34.449775 -78.661674
ex:34208504 -77.796371
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Red Hill Swamp
3b. Water Resources Classification of nearest receiving water:*
15-4-1
Surface Water Lookup
3c. What river basin(s) is your project located in?*
Lumbe r
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:*
The project site is an existing road, SR 1700 (Red Hill Rd.), with four bridges. The majority of the road corridor
immediately outside of the existing fill slope is a forested wetland.
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)
Qick the upload button or drag and drop files here to attach docurrent
Fig2_ProjectStudyArea_B4479_Columbus.pdf 337.19KB
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)
I C1ick the upload button or drag and drop files here to attach docurrent
Fig2_SoilsMap_B4479_Columbus.pdf 296.76KB
Fle type rrust be pdF
4d. List the total estimated acreage of all existing wetlands on the property:
30 acres
4e. List the total estimated linear feet of all existing streams on the property:
(interrrittent and perennial)
wa
4f. Explain the purpose of the proposed project:*
The project will replace four bridges, 230222, 230226, 230228, and 230230, on SR 1700 over Red Hill Swamp.
4g. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*

State project 176P.6.R.92 involves the replacement of the existing NCDOT Bridges #230222, #230226, #230228,
#230230 on SR 1700 over Red Hill Swamp. Bridge #230222 consists of 1@18.2', 1@17.3', 1@17.1', 1@16.7'
concrete deck on I-Beams with concrete caps and timber piles. Bridge #230226 consists of 1@18.3', 1@18.1',
1@18.2', 1@18.8' concrete deck on I-Beams with concrete caps and timber piles. Bridge #230228 consists of
1@18.4', 2@18.2', 1@18.3' concrete deck on I-Beams with concrete caps and timber piles. Bridge #230230
consists of 1@18.5', 1@18.2', 1@18.4' concrete deck on I-Beams with concrete caps and timber piles. The
proposed bridge for #230222 consists of 1@40', 1@50' 21" cored slab with 2'-6" caps. The proposed bridge for
#230226 consists of 1@45', 1@50' 21" cored slab with 2'-6" caps. The proposed bridge for #230228 consists of
1@40', 1@50' 21" cored slab with 2'-6" caps. The proposed bridge for #230230 consists of 1@35', 1@40' 21"
cored slab with 2'-6" caps.The proposed crossing is located in Zone AE of FIRM Map number 3720120400K and
was studied by Limited Detail Study methods. At bridges #230222 and #230226, one stormwater outfall is
proposed. At bridge #230228, twro stormwater outfalls are proposed. At bridge #230230, four stormwater outfalls
are proposed. All stormwater outfalls will utilize a rip rap pad to dissipate the energy. No deck drains are required
for the proposed bridges.
4h. Please upload project drawings for the proposed project.
Qick the upload button or drag and drop files here to attach docurr�nt
� B4479 Permit Package.pdf
Fle type rrust be pdf
5. Jurisdictional Determinations
5.15M6
5a. Have the wetlands or streams been delineated on the propertyor proposed impact areas?*
C' Yes C' No f" Unknown
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made? *
C' Preliminary C' Approved C' Unknown C' fWA
Corps AID Number:
6carrple: SAV�2017-99999
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Othe r:
Heather Smith
Ecological Engineering
5d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
5d1. Jurisdictional determination upload
C1ick 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
7. Future Project Plans
7a. Is this a phased project?*
C' Yes �' No
C� No
!' Unknown
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 activit�/? This includes other separate and distant crossing for linear projects that require Department of the
Army authorization but don't require pre-construction notification.

This is a complete project replacing all four bridges over Red Hill Swamp.
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
rJ Wetlands r Streams-tributaries
r Open Waters r Pond Construction
r Buffers
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 *
16+90/47+20 -L- LT
fv�p label (e.g. F3�ad Qossing 1- Qilvert,
dewatering, etc)
16+g0/47+20 -L- LT
fV�p label (e.g. f�ad CYossing 1- Qalvert,
dewatering, etc)
18+25/47+10 -L- RT
N�p label (e.g. F�ad Qossing 1- CLlvert,
dewatering, etc)
18+25/47+10 -L- RT
N�p label (e.g. Finad Qossing 1- CLlvert,
dewatering, etc)
P
F2rrrenent (Fj or
Terrporary (�
T
F�rrranent (F) or
Terrporary (�
P
F2rrranent (� or
Terrporary (�
T
F2rrranent (Fj or
Terrporary (�
2g. Total Temporary Wetland Impact
1.010
2g. Total Permanent Wetland Impact
0.580
2g. Total Wetland Impact
1.590
2h. Comments:
Riverine Swamp
Forest
Riverine Swamp
Forest
Riverine Swamp
Forest
Riverine Swamp
Forest
E. Impact Justification and Mitigation
1. Avoidance and Minimization
2d. Wetland name *2e. 2f. Type of
Forested * Jurisdicition *
Red Hill Swamp Yes Both
(404, 10) or W�R(401
other)
Red Hill Swamp Yes Both
(404, 10) or C!✓UR(401
other)
Red Hill Swamp Yes Both
(404, 10) ar D✓N2 (401
other)
Red Hill Swamp Yes Both
(404, 10) or D�/�R (401
other)
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:*
The project is replacing all four bridges at the same time and is utilizing 3:1 slopes instead of a more gradual
slope.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:*
The project is utilizing hand clearing in areas to minimize permanent impacts to wetlands. Sediment and erosion
control devices will be installed to prevent additional impacts from sedimentation outside of the construction limits.
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
2g. Impact
area*
0.360
(acres)
0.540
(acres)
0.220
(acres)
0.470
(acres)

2c. If yes, mitigation is required by (check all that apply):
r7 DWR �J Corps
2d. If yes, which mitigation option(s) will be used for this project?
r Mitigation bank r7 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.
r7 Yes
4b. Stream mitigation requested:
(linear feet)
4c. If using stream mitigation, what is the stream temperature:
4d. Buffer mitigation requested (DWR only):
(square feet)
4e. Riparian wetland mitigation requested:
(acres)
1.16 acres
4f. Non-riparian wetland mitigation requested:
(acres)
4g. Coastal (tidal) wetland mitigation requested:
(acres)
4h. Comments
i NCDOT will use NCDMS to fulfill riparian wetland mitigation at a 2:1 ratio.
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 �' No
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:
The project is located in the Lumber River Basin where there are no NC Riparian Buffer Protection 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
Comments:*
See attached approved CE documentation
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 �' 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.
This is a complete project that will replace all four bridges along this section of road. There is no anticipated
additional development related to the replacement of these bridges.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project? *
C' Yes C•' No C' rUA
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? *
G Yes l' No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
r Yes l" No
5c. If yes, indicate the USFWS Field Office you have contacted.
Raleigh
5d. Is another Federal agency involved?*
�' Yes C' No
What Federal Agency is involved?
FEMA
5e. Is this a DOT project located within Division's 1-8?*
c' Unknown

r Yes C' No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
On-site investigations were during the appropriate USFWS survey windows in 2015. No specimens of any
protected species were observed during the surveys of suitable on-site habitat. See attached CE documentation
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?*
EFH Mapper
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 C•' No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources? *
See attached historic and prehistoric upload.
7c. Historic or Prehistoric Information Upload
C7ick the upload button or drag and drop files here to attach docurrent
Historic and Prehistoric for Upload.pdf 3.21 MB
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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?*
�' Yes C' No
8b. If yes, explain how project meets FEMA requirements:
A type 1 MOA was submitted to FEMA and is awaiting approval.
8c. What source(s) did you use to make the floodplain determination?*
FIRM Map number 3720120400K
Miscellaneous
Miscellaneous attachments not previously requested.
aick the upload button or drag and drop files here to attach docurrent
64479_CE. pdf 2.02MB
SR 1700 - Bridges 222 224 228 230 (B-4479) - Division 6- RW - LU 06.pdf 62.22KB
Fle rrust be FDF or FMQ
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:*
James J. Rerko, PWS
Signature
� �.,,nr � f �t�', r�"/�'� S
Date Submitted:
5/24/2018
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*
20180725
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
G Fee received
C' Fee needed - send electronic notification