20181390 Ver 1_PCN Form Submission_10/11/2018 3:00 PM

Action History (UTC-05:00) Eastern Time (US & Canada)
�brrrit by Anonymous User 10/11/2018 2:59:50 PM (Start Event)
Accept by Carpenter,Kristi 10/11/2018 4:34:01 PM (DOT Initial Review)
. The task was assigned to Carpenter,Kristi. The due date is: October 16, 2018 5:00 PM
10/11/2018 3:00 PM

D1�VR
�irlslan af Water Resources
Pre-Construction Notification (PCN) Form
September 29, 2018 Ver 3
Initial Review
Has this project met the requirements for acceptance in to the review process?*
F Yes
C' No
Is this project a public transportation project?"
� Yes r No
Change only rf needed.
BIMS # Assigned *
20181390
Is a payment required for this project?*
f No paymentrequired
� Fee received
f Fee needed - send electronic notification
Select Project Reviewer"
Rob Ridings:eads\rgridings
Information for Initial Review
1a. Name of project:
Replacement of pipe structures on SR 1600 (East River Road) conveying Jumping Run
1a. Who is the PrimaryContact?*
Heather Montague
1b. PrimaryContact Email:*
[e-mail]
Date Submitted
10/11/2018
Nearest Body of Water
Jumping Run
Basin
Tar-Pamlico
Water Classification
28-28; Class C; NSW
Site Coordinates
Latitude: Longitude:
36.047596 -78248835
A. Processing Information
County (or Counties) where the project is located:
Franklin
Is this project a public transportation project?*
r Yes r No
Is this a NCDOT Project?*
G Yes r No
(NCDOT only) T.I.P. or state project number:
WBS # (�)
5B.203514.4
1a. Type(s) of approval sought from the Corps:
Ve rsion# *
1
Reviewing Office *
Central Office - [phone]
1c. PrimaryContact Phone:*
[phone]

�J 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?
fJ Nationwide Permit (NWP)
r Regional General Permit (RGP)
r Standard (IP)
1c. Has the NWP or GP number been verified bythe Corps?
F Yes r No
Nationwide Permit (NWP) Number:
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
fJ 401 Water Quality Certification - Regular
r' Non-404 Jurisdictional General Permit
r Individual Permit
03 - Maintenance
1e. Is this notification solelyfor the record because written approval is not required?
Forthe record onlyfor DWR401 Certification:
For the record onlyfor Corps Permit:
r 401 Water Quality Certification - E�ress
rJ Riparian Buffer Authorization
1f. Is this an after-the-fact permit application?*
� Yes r No
1g. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
F Yes r No
1g. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts?
� Yes r No
Acceptance LetterAttachment
SR 1600 - Pipe Replacement - Division 5- STR - TP 01.pdf
1h. Is the project located in any of NC's twenty coastal counties?
C' Yes r No
1j. Is the project located in a designated trout watershed?
� Yes r No
B. Applicant Information
1d. Who is applying for the permit?
fJ Owner r Applicant (other than owner)
Is there an AgentlConsultant for this project?
� Yes r No
2. Owner Information
2a. Name(s) on recorded deed:
NCDOT
2b. Deed book and page no.:
fWA
2c. Responsible party:
2d. Address
Street Address
2612 N Duke Sheet
Address Line 2
�Y
Durham
Fbstal / Zip Code
27704
2e. Telephone Number:
[phone]
S[ate / FYovince I Region
NC
Cauntry
USA
2f. Fax Number:
63.74KB
x
C' Yes R No
G Yes C' No
�,

2g. Email Address:*
[e-mail]
C. Project Information and Prior Project History "
1. Project Information
1b. Subdivision name:
(rf appropriate)
1c. Nearest municipality/town:
Louisburg
2. Project Identification
2a. Propertyldentification Number:
inlet: 2823-67-2590, outlet 2823-04-2947
2c. Project Address
Street Address
2136 East River Road
Address Line 2
�Y
Louisburg
Fbstal / Zip Code
27549
3. SurFace Waters
3a. Name of the nearest body of water to proposed project:*
Jumping Run
3b. Water Resources Classification of nearest receiving water:*
28-28; Class C; NSW
3c. What river basin(s) is your project located in?*
Tar-Pamlico
3d. Please provide the 12-digit HUC in which the project is located.
03020101
4. Project Description and History
2b. Property size:
0.34
State / Rovince I f�gion
NC
Country
USA
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:*
Adjacent area is comprised of road shoulder, agriculture and wooded land
4b. Have permits or certifications been requested or obtained for this project (including all prior phases) in the past?*
C' Yes r No � Unknown
4d. 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)
SR 1600 East River Road usgs topo.pdf 393.51 KB
4e. 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)
SR 1600 Franklin County NRCS sheet 11.pdf 249.2KB
4f. List the total estimated acreage of all existing wetlands on the property:
0.02
4g. List the total estimated linear feet of all existing streams on the property:
73
4h. Explain the purpose of the proposed project:*
Pipes have deteriorated and area non-functional.
4i. Describe the overell project in detail, including indirect impacts and the type of equipment to be used:*
Replacement of ewsting pipe structures (2 @ 96" CMP that is 59' long) with a new pipe structure (2 @ 10S" corrugated aluminum pipes with headwalls that are 51.5' long). Project
construction will require dewatering of the site and installation of rip rap bank stabilization. Equipment will indude excavator, backhoe, bull dozer, crane, grader, skid steer, etc.
4j. Please upload project drawings for the proposed project.
5. Jurisdictional Determinations
Sa. Have the wetlands or streams been delineated on the property or proposed impact areas?"
� Yes r No r Unknown

Comments
Sb. If the Corps made a jurisdictional determination, what type of determination was made?*
f' Preliminary (' Approved r Not Verified r Unknown f' WA
Corps AID Number:
Sc. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): G. Price and J. Mathis
Agency/Consultant Company: Carolina Ecosystems, Inc.
Other:
Sd. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
PDJ sent to the USACE 09/04/18
Sd1. Jurisdictional determination upload
6. Future Project Plans
6a. Is this a phased project?*
C' Yes r 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?
fWA
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
,r! Wetlands I17 Streams-tributaries rJ Buffers
r Open Waters I� Pond Construction
2. Wetland Impacts
2g. Total Temporary Wetland Impact 2g. Total Permanent Wetland Impact
0.000 0.020
2g. Total Wetland Impact
0.020
2h. Comments:
3. Stream Impacts
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts: 3i. Total temporary stream impacts:
33 40
3i. Total stream and ditch impacts:

73
3j. Comments:
rip rap in the flow line at the outlet is necessary to heal a scour hole and provide long term stability
6. Buffer Impacts (for DWR)
6a. Project is in which protect basin(s)?
Check all that apply.
� Neuse
r Catawba
r Goose Creek
r Other
CJ Tar-Pamlico
r Randleman
r Jordan Lake
6b. Impact Type 6c. Per or Temp 6d. Stream name 6e. Buffer mitigation required? 6f. Zone 1 impact 6g. Zone 2 impact
Site 1- allowable P Jumping Run No 2,816 0
6h. Total buffer impacts:
Total Temporary impacts:
Total Permanent impacts:
Total combined buffer impacts:
6i. Comments:
Zone 1
0.00
Zone 1
2,816.00
Zone 1
2,816.00
Supporting Documentation
SR 1600 FULL PERMIT PACKAGE INCL SWMP.pdf
E. Impact Justification and Mitigation
1. Avoidance and Minimization
Zone 2
0.00
Zone 2
0.00
Zone 2
0.00
995.09KB
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
Failing pipes are being replaced with the minimal length pipes to fit current roadway standards which will also provide for an appropriately sized
shoulder.
1b. Specificallydescribe measures taken to avoid or minimize the proposed impacts through construction techniques:
Construction will be overseen by NCDOT Division 5 Environmental Staff and Inspection personnel who will be onsite to identify ways to reduce the
proposed stream impacts. if feasible.
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?
� Yes r No
2c. If yes, mitigation is required by (check all that apply):
r DWR � Corps
2d. If yes, which mitigation option(s) will be used for this project?
r Mitigation bank 117 Payment to in-lieu fee I� Permittee Responsible
program Mitigation
4. Complete if Making a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached.
fJ Yes
4b. Stream mitigation requested:
(linear feet)
106
4d. Buffer mitigation requested (DWR only):
(square feet)
4c. If using stream mitigation, what is the stream temperature:
warm
4e. Riparian wetland mitigation requested:
(acres)
�

4f. Non-riparian wetland mitigation requested:
(acres�
4g. Coastal (tidal) wetland mitigation requested:
(acres)
4h. Comments
Following the 10/09/18 NC Interagency Review Team Meeting, the IRT and the Division agreed that appropriate compensation for the planned v�rork in
the mitigation site would be for the permanent stream impacts of 33LF at a 2:1 ratio and temporary stream impacts of 40LF at a 1:1 ratio associated
with the pipe replacement project impacts to the Harris Farm Tract (conservation easement managed under the NCDOT Stewardship Program). Note
the Harris Farm Trect is not under the NCDEQ Stewardship Program.
F. Stormwater Management and Diffuse Flow Plan (required by DWR)
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?
� Yes r No
What type of SCM are you providing?
r Level Spreader
fJ Vegetated Conveyance (lower SHWT)
r Wetland Swale (higher SMNT)
r Other SCM that removes minimum 30 % nitrogen
r Proposed project will not create concentrated stormwater flow through the buffer
Diffuse Flow Documentation
REVISED Franklin SR 1600_HYD_SMPv2.08_20180515 (Apr 2018).pdf
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
F Yes r No
Comments:
G. Supplementary Information
1. Environmental Documentation
46.51 KB
�
1a. Does the project involve an expenditure of public (federallstate/local) funds or the use of public (federallstate) land?*
� Yes r 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)
Environme ntal Policy Act (NEPAISEPA)? *
G Yes r No
1c. If you answered "yes" to the above, has the document review been finalized by the State Clearing House?*
C' Yes r No
Comments:
*
Document has not be finalized by the State Clearing House
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 26 .0200)?*
� Yes r No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water qualit� *
C' Yes r No
3b. If you answered "no," provide a short narretive description.
Replacing exsting structure on exsting facility.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?"
� Yes r No � fWA
5. Endangered Species and Designated Critical Habitat (Corps Requirement)

Sa. Will this project occur in or near an area with federally protected species or habitat?*
r Yes r No
Sb. Have you checked with the USFWS concerning Endangered Species Act impacts?*
G Yes r No
Sc. If yes, indicate the USFWS Field Office you have contacted.
Raleigh
Sd. Is another Federal agency involved?*
C' Yes r No
Se. Is this a DOT project located within Division's 1-8?
� Yes r No
Sf. Will you cut anytrees in order to conduct the work in waters of the U.S.?
C' Yes �' No
Sg. Does this project involve bridge maintenance or removal?
� Yes r No
Sh. Does this project involve the construction/installation of a wind turbine(s)?*
C' Yes �' No
C' Unknown
Si. Does this project involve (1) blasting, and/or (2) other percussive activities that will be conducted by machines, such as jackhammers, mechanized pile drivers, etc.?
� Yes r No
Sj. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
Site investigations and field surveys 02/28/18 and 08/01/18 by Carolina Ecosystems, Inc. staff rendered biological conclusions of No Effect for bald
eagle and Michaux's sumac. Aquatic/mussel surveys were conducted by Three Oaks Engineering on 02/5-9/18 and 02/15/18 with habitat observed,
but no protected species nor any at risk species present. Additionally Section 7 compliance for the Tar River spinymussel, dwarf w�dgemussel, and
yellowlance have been met through the programmatic biological opinion (PBO) issued by the U.S. Fish & Wildlife Service (USFWS). The findings of
the surveys and use of the PBO indicate the following biological conclusion for each of these three species: My Affect, Not Likely to Adversely Affect.
Consultation Documentation Upload
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat? *
f Yes r No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?'�
Available mapping
7. 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 status?"
C' Yes r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
NCDOT HEU SHPO review: No surveys required from either group Historic Structures no Archaeology.
7c. Historic or Prehistoric Information Upload
18-01-0029NoSu rveyReq. pdf 2.15M6
PA 18-01-0029 No Archaeological Survey Required Pipe Replacement on SR 1600 East River Road Rd. Franklin.pdf 37327KB
8. Flood Zone Designation (Corps Requirement)
Sa. Will this project occur in a FEMA-designated 100-year floodplain?*
r Yes r No
Sb. If yes, explain how project meets FEMA requirements:
Grade of roadway and pipe crossing is not changing
8c. What source(s) did you use to make the floodplain determination?*
Available mapping
Miscellaneous
Comments
Miscellaneous attachments not previouslyrequested.
Signature

�J 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, Artide 40 of the NC General Siatutes (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 Act");
• 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:
Heather W. Montague
Signature
Sign
Date
10/11/2018