20181573 Ver 1_PCN Form Submission_20181115

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 *
20181573
Is a payment required for this project?*
f• No payment required
f Fee received
f Fee needed - send electronic notification
Select Project Reviewer"
Garcy Ward:eads\gpward
Information for Initial Review
1a. Name of project:
W-5702E SR1141 (Hibbs Rd)
1a. Who is the PrimaryContact?*
Jay B Johnson
1b. PrimaryContact Email:*
[e-mail]
Date Submitted
11/15/2018
Nearest Body of Water
Smiths Swamp
Basin
White Oak
Water Classification
C
Site Coordinates
Latitude:
34.768875
A. Processing Information
County (or Counties) where the project is located:
Carteret
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:
W-5702E
WBS # (�)
44848.1.5
1a. Type(s) of approval sought from the Corps:
Longitude:
-76.865411
Ve rsion# *
1
Reviewing Office *
Wilmington 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:
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
18 - Minor Discharges
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
r 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?
C' 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
1h. Is the project located in any of NC's twenty coastal counties?
� 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?
r Owner rJ Applicant (other than owner)
1e. Is there an Agent/Consultant for this project?
C' Yes r No
2. Owner Information
2a. Name(s) on recorded deed:
North Carolina Department of Transportation
2b. Deed book and page no.:
fWA
2c. Responsible party:
fWA
2d. Address
Street Address
1037 W.H. Smith Blvd
Address Line 2
�ty
Greenville
Postal / Zip Code
27834
S[ate / Awince I Region
NC
Country
USA
x
C•' Yes C' No
C' Yes G No

2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
Jay B Johnson
3b. Business Name:
3c.Address
Street Address
1037 W.H. Smith Blvd
Address Line 2
�Y
Greenville
Fbstal / Zip Code
27534
3d. Telephone Number:
[phone]
3f. Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(rf appropriate)
1c. Nearest municipality/town:
Newport
2. Project Identification
2a. Propertyldentification Number:
W-5702E
2c. Project Address
Street Address
Address Line 2
ary
Fbstal I Zip Code
3. SurFace Waters
3a. Name of the nearest body of water to proposed project:*
Smiths Swamp
3b. Water Resources Classification of nearest receiving water:*
C
3c. What river basin(s) is your project located in?*
White Oak
3d. Please provide the 12-digit HUC in which the project is located.
03020106030
4. Project Description and History
2f. Fax Number:
State / Rovince I F�gion
NC
Country
USA
3e. Fax Number:
2b. Property size:
N/A
State / Aovince I Region
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:*
SR 1141 (Hibbs Rd) is a paved secondary road. woodlands dominate the landscape.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
f Yes �' No r Unknown
4d. Attach an 8 1/2 X 11 excerpt from the most recent version of the USGS topogrephic map indicating the location of the project site. (for DWR)
Quad.pdf 2.91 MB
n

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 1141 Hibbs Road Web Soil Map.pdf 1.1MB
4f. List the total estimated acreage of all existing wetlands on the property:
033
4g. List the total estimated linear feet of all existing streams on the property:
N/A
4h. Explain the purpose of the proposed project:*
Widen northbound SR 1141 (Hibbs Rd) to provide 300' of left turn storage and 150' of right tum storage.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
Northbound SR 1141 will be widened using conventional road building equipment.
4j. Please upload project drawings for the proposed project.
hibbs_psh_permit.pdf 90.63KB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes r No C' Unknown
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
C' Preliminary r Approved C' Not Verified C' Unknown C•' WA
Corps AID Number:
Sc. If Sa is yes, who delineated the jurisdictional areas?
Name (if known): Jay B Johnson
Agency/Consultant Company: NCDOT
Other:
Sd1. Jurisdictional determination upload
6. Future Project Plans
6a. Is this a phased project?*
� 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�/?
No
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
CJ Wetlands I� Streams-tributaries r Buffers
r Open Waters Ir Pond Construction
2. Wetland Impacts
2g. Total Temporary Wetland Impact 2g. Total Permanent Wetland Impact
0.000 0.027
2g. Total Wetland Impact
0.027
2h. Comments:
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:
Only filling area required to accommodate the proposed turn lane onto US 70.
1b. Specificallydescribe measures taken to avoid or minimize the proposed impacts through construction techniques:
Use of existing roadway to operate construction equipment.
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 r No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
Less than .1 acre of impacts.
I 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?
C' Yes r No
If no, explain why:
No jurisdictional streams located within project area.
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
1a. Does the project involve an expenditure of public (federallstate/local) funds or the use of public (federal/state) land?*
f• 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)? *
C' Yes r No
Comme nts: *
WA
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 quality?*
C' Yes r No
3b. If you answered "no," provide a short narrative description.
No additional work is anticipated in the future.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
f 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? *

C' Yes r No
Sb. Have you checked with the USFWS concerning Endangered Species Act impacts?*
C' Yes r No
Sd. Is another Federal agency involved?*
C' Yes �' No
Se. Is this a DOT project located within Division's 1-8?
� Yes r No
C' Unknown
S. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
Onsite field investigation by Jay Johnson "No EffecP'
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?*
No jurisdictional stream in project area.
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?*
f Yes r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
NCDOT HEU Historic Architecture and Archaeology
7c. Historic or Prehistoric Information Upload
Archaeology PA 17-07-0020 Carteret (NSR).pdf 20.97MB
Historic Architecture PA 17-07-0020_NoSurvey.pdf 6.69MB
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?*
fema.gov website
Miscellaneous
Comments
Miscellaneous attachments not previouslyrequested.
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 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:
Jay B Johnson
Signature
Sign
Date
11/15/2018