20181597 Ver 1_PCN Form Submission_20181121

DWR
IDIOM n of Water Resources
Pre -Construction Notification (PCN) Form
September 29, 2018 Ver 3
21nitial Review
Has this project met the requirements for acceptance in to the review process?*
r Yes
r No
Is this project a public transportation project?*
G Yes r No
Change only if needed.
BIMS # Assigned
20181597
Is a payment required for this project?*
r No payment required
r Fee received
r Fee needed - send electronic notification
Select Project Reviewer*
Joanne Steenhuis:eads\jhsteenhuis
Information for Initial Review
1a. Name of project:
B-4438 Bridge No. 47 over Bear Pen Islands Swamp on NC 211 (Central)
la. Who is the Primary Contact?*
NCDOT
1b. Primary Contact Email:*
[e-mail]
Date Submitted
11 /21 /2018
Nearest Body of Water
Bear Pen Islands Swamp
Basin
Lumber
Water Classification
Q Sw
Site Coordinates
..........................
Latitude: Longitude:
34.140887-78.32502
FA. Processina Information
County (or Counties) where the project is located:
Brunswick
Is this project a public transportation project?*
r Yes r' No
Is this a NCDOT Project?*
r Yes r No
(NCDOT only) T.I.P. or state project number:
B-4438
WBS#( )
38365.1.2
la. Type(s) of approval sought from the Corps:
Version# *
1
Reviewing Office*
Wilmington Regional Office - [phone]
1c. Primary Contact Phone:*
[phone]

W Section 404 Permit (wetlands, streams and waters, Clean Water Act)
r Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
1b. What types) of permit(s) do you wish to seek authorization?
r Nationwide Permit (NWP)
V Regional General Permit (RGP)
r' Standard (IP)
1c. Has the NWP or GP number been verified by the Corps?
r Yes r- No
Regional General Permit (RGP) Number:
RGP Numbers (for multiple RGPS):
1d. Type(s) of approval sought from the DWR:
rJ 401 Water Quality Certification - Regular
F Non-404 Jurisdictional General Permit
F Individual Permit
198200031 - NCDOT Bridges, Widening Projects 2015
le. Is this notification solely for the record because written approval is not required?
For the record only for DWR 401 Certification:
For the record only for Corps Permit:
r 401 Water Quality Certification - Express
r Riparian Buffer Authorization
1f. Is this an after -the -fact permit application?*
r Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
r Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
r Yes r No
Acceptance Letter Attachment
B-4438 DIMS Revised.pdf
1h. Is the project located in any of NC's twenty coastal counties?
r Yes r No
1i. Is the project located within a NC DCM Area of Environmental Concern (AEC)?
r Yes r No O Unknown
1j. Is the project located in a designated trout watershed?
r- Yes r No
B. Applicant Information
1d. Who is applying for the permit?
R Owner r Applicant (other than owner)
le. Is there an Agent/Consultant for this project?
r^ Yes r No
2. Owner Information
2a. Name(s) on recorded deed:
Mutiple properties
2b. Deed book and page no.:
2c. Responsible party:
2d. Address
Street Address
1598 Mail Service Center
Address line 2
atY
Raleigh
Postal / Zip Cade
27699-1598
State / Rwince / Fbgion
NC
Country
USA
72.16KB
*
r Yes r No
r Yes r No
u

2e. Telephone Number:
[phone]
2g. Email Address:*
[e-mail]
C. Project Information and Prior Project History
'I. Project Information
1b. Subdivision name:
If appropriate)
1c. Nearest municipality / town:
Bolivia
F-
2. Project Identification
2a. Property Identification Number:
2c. Project Address
Street Address
Address Line 2
CRY
Postal / Zip Cade
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
Bear Pen Islands Swamp
3b. Water Resources Classification of nearest receiving water:*
C; Sw
3c. What river basin(s) is your project located in?*
Lumber
3d. Please provide the 12-digit HUC in which the project is located.
30402060401
4. Project Description and History
2f. Fax Number:
2b. Property size:
State / Province / 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:*
Land use surrounding the bridge consists of agriculture, Juniper Creek Game Lands, and forestland. Existing conditions are the same as land use.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
r' Yes r No r' 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:
1.8
4g. List the total estimated linear feet of all existing streams on the property:
226
4h. Explain the purpose of the proposed project:*
Replacement of Bridge No. 47 that was built in 1954 and is structurally deficient and functionally obsolete.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
The project involves replacement of existing Bridge No. 47, a 53-foot long bridge, with a 105-foot bridge. The new bridge will have 12-foot travel lanes in each direction and 3-foot
shoulders on each side. The new bridge will be placed east of the existing bridge. Traffic will be maintained on the existing bridge. Standard road building equipment, such as trucks,
dozers, and cranes will be used.
4j. Please upload project drawings for the proposed project.
B4438_Permit_Drawings _20181108.pdf 3.6MB
B-4438 Brunswick Roadway Plans.pdf 1.86MB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*

r Yes r No r Unknown
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
r Preliminary r Approved r Not Verified r Unknown r N/A
Corps AID Number:
SAW-2015-000954
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Adam Efrid
Agency/Consultant Company: Atkins Environmental
Other:
5d. List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
May 4, 2018
5d1. Jurisdictional determination upload
B-4438JD.pdf 120.85KB
6. Future Project Plans
6a. Is this a phased project?*
r 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?
D. Proposed Impacts Inventory
1. Impacts Summary
la. Where are the impacts associated with your project? (check all that apply):
W Wetlands 9 Streams -tributaries
W Open Waters r Pond Construction
2. Wetland Impacts
r Buffers
2a1 Reason (?)
2b. Impact type * (?)
2c. Type of W. *
2d. W. name *
2e. Forested*
2f. Type of
Jurisdicition*(?)
�2g. Impact
area*
1
Fill
P
Riverine Swamp Forest
WB
Yes
Both _]
0.050
(acres)
1
Cut ditch -excavation
P
Riverine Swamp Forest
WB
Yes
Both
0.050
(acres)
Mechanized Clearing
P
Riverine Swamp Forest
WB
Yes
Both
0.003
(acres)
Fill
P
Riverine Swamp Forest
WB
Yes
Both
0.140
(acres)
Mechanized Clearing
P
Riverine Swamp Forest
WB
Yes
Both
0.020
(acres)
3
Bridge - fill
P
Riverine Swamp Forest
WB/WA
Yes
Both
0.040
(acres)
Bridge - excavation
P
Riverine Swamp Forest
WB/WA
Yes
Both
0.005
(acres)
Bridge -
P
Riverine Swamp Forest
WB/WA
Yes
Both
0(acres)
Clearing
CI
Outlet - Mechanized
P
Riverine Swamp Forest
WC
Yes
Both
0.002
Clearing
(acres)
6
Outlet - Mechanized
P
Riverine Swamp Forest
WC
Yes
Both
0.003
Clearing
(acres)
Fill
P
Riverine Swamp Forest
�WA
Yes
Both
0.360
(acres)
17
Mechanized Clearing
P
Riverine Swamp Forest �t_
Yes
Both
0.080
(acres)

2g. Total Temporary Wetland Impact 2g. Total Permanent Wetland Impact
0.000 0.783
2g. Total Wetland Impact
0.783
2h. Comments:
There will be 0.05 acre of hand clearing and 0.03 acre of temporary fill for erosion and sediment control measures in the hand clearing areas.
3. Stream Impacts
F
3a. Reason for impact (?) 3b.lmpact type * 3c. Type of impact * ff�. name * 3e. Stream Type * 3f. Type of 3g. S. width * 3h. Impact
(?) Jurisdiction* length*
g1 Roadway/Bridge Temporary Bank Stabilisation :Ifft
Islands Swamp Perennial Both I�J�;]
31. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
0
3i. Total stream and ditch impacts:
131
3j. Comments:
4. Open Water Impacts
3i. Total temporary stream impacts:
129
4a. Site # 4a1. Impact Reason 4b. Impact type 4c. Name of waterbody 4d. Activity type :114e. Wate rbody type 4f. Impact area
Fill P Bear Pen Islands Swamp Bridge Ditch 0.17
4g. Total temporary open water Impacts: 4g. Total permanent open water impacts:
0.00 0.17
4g. Total open water impacts:
0.17
4h. Comments:
E. Impact Justification and Mitigation
1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
The proposed bridge will not use deck drains. Runoff from the bridge and paved shoulders at the bridge drain into inlets. Runoff is then diffused to a
riprap pad outlet prior to discharging. During planning an offsite detour was evaluated and determined to be to long. Other than no build, impacts to
the wetlands and stream on this project is unavoidable.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
NCDOT Best Management Practices for Construction and Maintenance Activities Will be employed and 3:1 slopes in wetlands..
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):
F DWR V Corps
2d. If yes, which mitigation options) will be used for this project?
i- Mitigation bank W Payment to in -lieu fee F 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.
R Yes r- No
4b. Stream mitigation requested: 4c. If using stream mitigation, what is the stream temperature:
(linear feet) warm

4d. Buffer mitigation requested (DWR only):
(square feet)
4f. Non -riparian wetland mitigation requested:
(acres)
4h. Comments
4e. Riparian wetland mitigation requested:
(acres)
0.78
4g. Coastal (tidal) wetland mitigation requested:
(acres)
F. Stormwater Management and Diffuse Flow Plan (required by DWR) v
1. Diffuse Flow Plan
la. Does the project include or is it adjacent to protected riparian buffers identified within one of the NC Riparian Buffer Protection Rules?
r Yes r No
If no, explain why:
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
r Yes r- No
Comments:
G. Supplementary Information
1. Environmental Documentation
la. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?*
r 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)
Environmental Policy Act (NEPA/SEPA)? *
r Yes r No
1c. If you answered "yes" to the above, has the document review been finalized by the State Clearing House?*
r Yes r 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?*
r- Yes r No
3b. If you answered "no," provide a short narrative description.
Due to the minimal transportation impact resulting from this bridge replacement, this project will neither influence nearby land uses nor stimulate
growth. Therefore, a detailed indirect or cumulative effects study will not be necessary.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
r- Yes r- Nor N/A
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
r No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
r Yes r No

5c. If yes, indicate the USFWS Field Office you have contacted.
Raleigh
5d. Is another Federal agency involved?*
f Yes r No r Unknown
5e. Is this a DOT project located within Division's 1-8?
(7 Yes r No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
USFWS county list and NCNHP database along with field surveys. See attached concurrence letter.
Consultation Documentation Upload
20181004 USFWS Letter B-4438.pdf 31.88KB
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
r Yes r No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
NMFS County Index
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?*
NEPA Documentation
7c. Historic or Prehistoric Information Upload
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
r Yes r- No
8b. If yes, explain how project meets FEMA requirements:
NCDOT Hydraulics Unit coordination with FEMA
8c. What source(s) did you use to make the floodplain determination?*
FEMA Maps
Miscellaneous
Comments
Miscellaneous attachments not previously requested.
Signature
*
W 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 Act");
• 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:
Mack Christopher Rivenbark, III
Signature
Sign
Date
11/21/2018