20181530 Ver 1_PCN Form Submission_20181113

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 *
20181530
Is a payment required for this project?*
f No paymentrequired
� Fee received
f Fee needed - send electronic notification
Select Project Reviewer"
Garcy Ward:eads\gpward
Information for Initial Review
1a. Name of project:
B-5302 Bridge No. 3 over Norfolk Southern RR on US 17 Bus (Central)
1a. Who is the PrimaryContact?*
NCDOT
1b. PrimaryContact Email:*
[e-mail]
Date Submitted
11/13/2018
Nearest Body of Water
Taylor Creek
Basin
Tar-Pamlico
Water Classification
SC; NSW
Site Coordinates
Latitude:
35.530422
A. Processing Information
County (or Counties) where the project is located:
Beaufort
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:
B-5302
WBS # (�)
46016.1.1
1a. Type(s) of approval sought from the Corps:
Longitude:
-77073292
Ve rsion# *
1
Reviewing Office *
Washington Regional Office - [phone]
1c. PrimaryContact Phone:*
[phone]
::

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?
fJ Nationwide Permit (NWP)
r Regional General Permit (RGP)
r Standard (IP)
1c. Has the NWP or GP number been verified bythe Corps?
C' Yes r No
Nationwide Permit (NWP) Number:
Nationwide Permit (NWP) Number:
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
rJ 401 Water Quality Certificalion - Regular
r' Non-404 Jurisdictional General Permit
r Individual Permit
23 - Categorical Exclusions
12 - U[iliry Lines
1e. Is this notification solelyfor the record because written approval is not required?
Forthe record onlyfor DWR401 Certification:
For the record only for Corps Permit:
r 401 Water Quality Certification - 6cpress
r Riparian Buffer Authori�ation
1f. Is this an after-the-fact permit application?*
C' 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?
C' Yes r No
Acceptance LetterAttachment
B-5302 Revised - RW - TP 04.pdf
1h. Is the project located in any of NC's twenty coastal counties?
G Yes r No
1i. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
� Yes r No r Unknown
1j. Is the project located in a designated trout watershed?
C' Yes r No
B. Applicant Information
1d. Who is applying for the permit?
�J Owner r Applicant (other than owner)
1e. Is there an Agent/Consultant for this project?
� Yes r No
2. Owner Information
2a. Name(s) on recorded deed:
Multiple properties
2b. Deed book and page no.:
2c. Responsible party:
2d. Address
65.56KB
x
C' Yes G No
C' Yes G No
�

�reet Address
1000 Birch Ridge Dr.
Address Line 2
�Y
Raleigh
Fbstal / Zip Code
27610
2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
State / Rovince I f�gion
NC
Cauntry
USA
2f. Fax Number:
C. Project Information and Prior Project History �
1. Project Information
1b. Subdivision name:
(rf appropriate)
1 c. Nearest municipality / town:
Washington
2. Project Identification
2a. Propertyldentification Number:
2c. Project Address
Street Address
Address Line 2
�ty
Postal / Zip Code
3. SurFace Waters
3a. Name of the nearest body of water to proposed project:"
Taylor Creek
3b. Water Resources Classification of nearest receiving water:*
SC; 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.
030201040103
4. Project Description and History
2b. Property size:
S[ate / FYovince I F�gion
Country
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 bottomland swamp, rural residences and some small businesses along the roadway.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
� 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)
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)
4f. List the total estimated acreage of all existing wetlands on the property:
1.5
4g. List the total estimated linear feet of all existing streams on the property:
N/A
4h. Explain the purpose of the proposed project:*
Replace the ewsting US 17 bridge over the railroad, which will also require relocating epsting water sew�r and power utilities.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
The ebsting 5-span 173 foot structure will be replaced on the existing alignment. The new 3-span bridge will be 246 feet long, with a deck width of 70 feet Standard roadbuilding
equipment will be used. Water and sev�,�r mains for the City of Washington need to be relocated, as v�ll as a sev�,�r main for the Town of Chocowinity. These will be installed using
directional bore to reduce impacts, but will still require excavation and fill in wetlands. Power, telephone, and CATV lines will be relocated without causing impacts.

4j. Please upload project drawings for the proposed project.
B-5302_Permit Drawings_20181020.pdf 4.36MB
B5302 Utilities combined.pdf 5.74MB
B-5302_Roadway.pdf 2.86MB
5. Jurisdictional Determinations
Sa. Have the wetlands or streams been delineated on the propertyor proposed impact areas?*
r Yes r No C' Unknown
Comments:
A PJD request was sent November 1, 2016. Wetland lines have since been extended due to utility
easements.
Sb. If the Corps made a jurisdictional determination, what type of determination was made?"
� Preliminary r Approved � Not Verified � Unknown r WA
Corps AID Number:
5c. If Sa is yes, who delineated the jurisdictional areas?
Name (if known): Brian Dustin and Mark Mickley
Agency/Consultant Company: Mulkey, Inc.
Other. Gordon Cashin & Hal Bain made a follow-up visit in 2015.
Sd1. Jurisdictional determination upload
6. Future Project Plans
6a. Is this a phased project?*
f 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 activit�/?
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 � Buffers
I7 Open Waters I� Pond Construction
2. Wetland Impacts
. Site #* (') 2a1 Reason (�) 2b. Impact type *(') 2c. Type of W. * 2d. W. name * 2e. Forested * 2f. Type of 2g. Impact
Jurisdicition*(') area*
Roadway fill P Bottomland Hardwood Forest WA Yes Both 0.560
�adway/Bridg (acres)
Utilities Water/sewer fill P Bottomland Hardwood Forest WA Yes Both 0.060
(acres)
Utilities Water/sewer excavation P Bottomland Hardwood Forest WA Yes Both 0.010
(acres)
Utilities Water/sewer fill P Bottomland Hard�nrood Forest WA Yes Both 0.220
(acres)
Utilities Water/sew�r excavation P Bottomland Hardwood Forest WA Yes Both 0.020
(acres)
�Utilities Water/sewer fill P Bottomland Hard�nrood Forest WA Yes Both 0.120
(acres)
Utilities Water/sewer excavation P Bottomland Hardwood Forest WA Yes Both 0.010
(acres)
Utilities Water/sewer fill P Bottomland Hardv�rood Forest WA Yes Both 0.050
(acres)
Utilities Water/sewer excavation P Bottomland Hard�nrood Forest WA Yes Both 0.010
(acres)

5- Utilities Watedsewer fill P Bottomland Hardwood Forest WA Yes Both 0.010
(acres)
Roadwa /Brid Handclearin T Bottomland Hardwood Forest WA Yes Both 0.391
e y g g (acres)
2g. Total Temporary Wetland Impact
0.391
2g. Total Wetland Impact
1.461
2g. Total Permanent Wetland Impact
1.070
2h. Comments:
There will be 0.09 acre of temporary fill in wetlands in the hand clearing areas for the instalation of erosion control meaures, induding Temporary Silt
Fences and/or Special Sediment Control Fence.
4. Open Water Impacts
4g. Total temporary open water Impacts: 4g. Total permanent open water impacts:
0.01 0.01
4g. Total open water impacts:
0.02
4h. Comments:
Surface Water impacts are to an excavated pond; permanent impacts are 0.002 acre, temporary impacts are 0.007 acre.
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:
Bridge No. 3 will be replaced on the existing alignment, use of directional bore methods all helped to minimize impacts, and traffic will be detoured
offsite.
1b. Specificallydescribe measures taken to avoid or minimize the proposed impacts through construction techniques:
Slopes in wetlands will be 3:1 and use of directional bore methods all helped to minimize impacts. BMP's for Construction and Maintenance Activities
will be implemented.
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 r No
2c. If yes, mitigation is required by (check all that apply):
rJ DWR �J Corps
2d. If yes, which mitigation option(s) will be used for this project?
� 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.
� Yes r No
4b. Stream mitigation requested:
Qlnear feet)
4d. Buffer mitigation requested (DWR only):
(square feet)
4f. Non-riparian wetland mitigation requested:
(aores)
4h. Comments
4c. If using stream mitigation, what is the stream temperature:
4e. Riparian wetland mitigation requested:
(acres)
1.04
4g. Coastal (tidal) wetland mitigation requested:
(aores)
n

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
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?
f Yes r No
If no, explain why:
No stream present.
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?"
� Yes r No
Comments:
G. Supplementary Information
1. Environmental Documentation
1a. Does the project involve an expenditure of public (federallstate/local) funds or the use of public (federal/state) land?*
� Yes r No
�' I
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)? *
r Yes �' No
1c. If you answered "yes" to the above, has the document review been finalized by the State Clearing House?*
r Yes �' No
NEPAor SEPAFinal Approval Letter
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)? *
r Yes r No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality?"
� Yes r No
3b. If you answered "no," provide a short narrative description.
The bridge replaces an e�sting bridge over a railroad. Locat conditions will remain the same as before.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
C' Yes r No C' 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? *
� Yes r No
Sb. Have you checked with the USFWS concerning Endangered Species Act impacts?"
� Yes r No
Sc. If yes, indicate the USFWS Field Office you have contacted.
Raleigh
Sd. Is another Federal agency involved?*
� Yes r No
r Unknown

Se. Is this a DOT project located within Division's 1-8?
r Yes r No
S. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
USFWS County lists, field surveys, NCNHP data, coordination with USFWS Raleigh office.
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?*
C' Yes r No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
NMFS Essential Fish Habitat v�bsite, no streams are present.
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?"
� Yes r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?"
Programmatic CE documentation
7c. Historic or Prehistoric Information Upload
8. Flood Zone Designation (Corps Requirement)
Sa. Will this project occur in a FEMA-designated 100-year floodplain?*
� Yes r No
Sc. What source(s) did you use to make the floodplain determination?"
Hydraulics Unit. Railroad crossing does not involve a FEMA stream, so no coordination required.
Miscellaneous
Comments
Miscellaneous attachments not previouslyrequested.
B-5302 UO NEU narrative_180920.pdf
Signature
*
rJ By checking the box and signing below, I certify that:
208.06KB
• 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 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 AcP');
. 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:
Mack Christopher Rivenbark, III
Signature
Sign
Date
11/13/2018
�