20190177 Ver 1_PCN Form Submission_20190209

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 *
20190177
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 Bridge 56 over Sandy Creek on SR 1526 (Weldons Mill Road)
1a. Who is the PrimaryContact?*
Chris Murray
1b. PrimaryContact Email:*
[e-mail]
Date Submitted
2/9/2019
Nearest Body of Water
Sandy Creek
Basin
Tar-Pamlico
Water Classification
C-NSW+; 28-78-1-(1)
Site Coordinates
Latitude: Longitude:
3628995 -78.32064
A. Processing Information
County (or Counties) where the project is located:
Vance
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-4828
WBS # (�)
38598.1.2
1a. Type(s) of approval sought from the Corps:
Ve rsion# *
1
Reviewing Office *
Central 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:
03 - Maintenance
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
1e. Is this notification solelyfor the record because written approval is not required?
Forthe record onlyfor DWR401 Certification:
For the record onlyfor Corps Permit:
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?
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)
1e. Is there an Agent/Consultant for this project?
f Yes r No
2. Owner Information
2a. Name(s) on recorded deed:
NCDOT
2b. Deed book and page no.:
Various
2c. Responsible party:
2d. Address
Street Address
2612 N. Duke Street
Address Line 2
�Y
Durham
Fbstal / Zip Code
27704
2e. Telephone Number:
[phone]
2g. Email Address:*
r 401 Water Quality Certification - E�ress
rJ Riparian Buffer Authorization
State / Aovince I F�gion
NC
Country
USA
2f. Fax Number:
x
C' Yes R No
C' Yes G No

[e-mail]
C. Project Information and Prior Project History "
1. Project Information
1b. Subdivision name:
(rf appropriate)
1c. Nearest municipality/town:
Henderson
2. Project Identification
2a. Propertyldentification Number:
0543 01008,0543 01007
2c. Project Address
Street Address
near 2368 Weldons Mill Road
Address Line 2
�Y
Henderson
Fbstal I Zip Code
27537
3. SurFace Waters
3a. Name of the nearest body of water to proposed project:*
Sandy Creek
3b. Water Resources Classification of nearest receiving water:*
C-NSW+; 28-78-1-(1)
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.
030201010701
4. Project Description and History
2b. Property size:
6 ac
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:*
Exsting conditions at site include maintained state road, maintained shoulder, wooded land and grassed land.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
C' Yes r No C' 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)
B-4828 USGS topo map.pdf
125MB
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)
B-4828 soil survey.pdf 304.06KB
4f. List the total estimated acreage of all existing wetlands on the property:
<0.01
4g. List the total estimated linear feet of all existing streams on the property:
280
4h. Explain the purpose of the proposed project:*
Replacement of ewsting bridge with a new similar bridge on new location to the east of SR 1526.
Epsting structure: 2@ 40.3 ft timer floor on steel girders with timber caps and piles. Note that in-stream interior pile is located on a concrete sill. A temporary causeway will be installed
to provide access to remove the sill.
Proposed shucture: 1@ 80 ft, 1@ 45 ft 33 inch box beam with 4 ft caps on new alignment to the east of SR 1526 (Weldons Mill Road). A temporary causeway will be installed to
provide access to install the in-stream interior drilled shaft piles.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
Grading, drainage, pavement and structure at the project site. Equipment may include backhoe, crane, bull dozer, excavator, mini excavator, etc. Typical roadway and bridge
construction equipment.
4j. Please upload project drawings for the proposed project.
5. Jurisdictional Determinations

Sa. Have the wetlands or streams been delineated on the propertyor proposed impact areas?*
r Yes r No
Comments:
PJD request sent via email to USACE on 2/S/19.
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
C' Preliminary r Approved C' Not Verified � Unknown C' WA
Corps AID Number:
Sc. If Sa is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
Heather Smith
VHB
early delineation by RK&K personnel Hal Bain in 2013
C' Unknown
Sd1. Jurisdictional determination upload
B-482S FW_ Division 5 Projects (UNCLASSIFIED) from Deannia.pdf 277.98KB
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�I?
No
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
fJ Wetlands IJ Streams-tributaries
� Open Waters � Pond Construction
2. Wetland Impacts
�J Buffers
2a. Site #* (�) 2a7 Reason (?) 2b. Impact type *(�) 2a Type of W. * 2d. W. name * 2e. Forested * Zf. Type of 2g. Impact
Jurisdicition*(') area*
12 I Mech. Clearing P Bottomland Hardwood Forest Wetland Z Yes Both 0.010
I(acres)
2g. Total Temporary Wetland Impact
0.000
2g. Total Wetland Impact
0.010
2h. Comments:
Small amount of minor mechanized dearing in wetland impacts.
3. Stream Impacts
2g. Total Permanent Wetland Impact
0.010
❑ 3a. Reason for impact (�') 3b.lmpact type * 3c. Type of impact" 3d. S. name * 3e. Stream Type * 3f. Type of 3g. S. width" 3h. Impact
(7) Jurisdiction* length*
Bank stabilization Permanent Bank Stabiliration Sand Creek Perennial Both 30 137
S1 Y
Average (feet) pinear feet)
gy Temporary dewatering and Temporary Workpad/Causev✓ay Sandy Creek Perennial Both 30 143
temp. CaUseway Average(feet) Qinearfeet)
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
137
3i. Total stream and ditch impacts:
280
3i. Total temporary stream impacts:
143

3j. Comments:
Permanent stream impacts from bank stabili�ation and temporary stream impacts from dewatering and temporary causeway.
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
Sites 1-4 Bridge Allowable P Sandy Creek No 6,935 4,601
6h. Total buffer impacts:
Total Temporary impacts:
Total Permanent impacts:
Total combined buffer impacts:
6i. Comments:
Supporting Documentation
B4828_Permit_Drawi ngs_20190131. pdf
B4828_Permit_Drawings_Buffer_20190131.pdf
Zone 1
0.00
Zone 1
6,935.00
Zone 1
6,935.00
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:
Temporary construction easement near Station 17+gq Rt was reduced to minimize wetland impacts. A temporary detention basin will constructed in
this area. Only the most minimal amount of rip rap on sUeambanks was designed for the project to provide long-term sUeambank stabilization.
1b. Specificallydescribe measures taken to avoid or minimize the proposed impacts through construction techniques:
Construction will be reviewed by Division 5 environmental personnel and contract inspectors to identify areas to further minimize impacts during
construction.
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:
Project will use Nationwide Permit No. 3. Impacts at site are minimal and do not meet mitigation required thresholds.
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?
G Yes �' 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
Zone 2
0.00
Zone 2
4,601.00
Zone 2
4,601.00
2.63MB
1.41 MB
�

B-4828 SWMP.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:
Project is in compliance.
105.73KB
I G. Supplementary Information ^ I
1. Environmental Documentation
1a. Does the project involve an expenditure of public (federal/state/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)? *
r 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 does not require review by SCH.
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)?*
� 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 narrative description.
Project involves replacement of an e�tisting deficient bridge structure with a new strucure to Ihe east of SR 1526. The design provides improvement to
roadway design and a new bridge meeting current standards. The project does not provide for additional future development.
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
Se. Is this a DOT project located within Division's 1-8?
G Yes �' No
r Unknown
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
Use of the Programmatic Biological Opinion for Bridge and Culvert Replacements/Repairs/Rehabilitations in Eastern North Carolina, NCDOT Divisions
1-8 (June 13, 2018) and a mussel survey on July 31, 2017. Informal consultation request for Atlantic pigtoe sent to USFWS on February 9, 2019.
However, not that species is only listed as Proposed at this time and is not afforded protection under Section 7 of the ESA.
Consultation Documentation Upload
B-4828 FIf�lAL USFWS concurrence request.pdf
101.89K6
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?*
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?*
� Yes r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
Consultation with State Historic Preservation Office and NCDOT HEU personnel. Recent alignment change at project that results in the alignment shift
of the roadway avoids impacts to the adjacent Weldons Mill and results in a No Effect for Historic Structures on 12/11/18. See attached files.
7c. Historic or Prehistoric Information Upload
B4828 13-08-0047RevisedSig ned EffectsForm. pdf
B-4828 hist str NeedSurvey.pdf
B-4828 Vance Archaeological Survey Required Form.pdf
B-4828 Vance No NRHP Archaeological Sites Present Form.pdf
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
G Yes �' No
Sb. If yes, explain how project meets FEMA requirements:
Approved BSR design.
8c. What source(s) did you use to make the floodplain determination?*
Available mapping and SWMP.
Miscellaneous
Comments
See attached Environmental summary for USACE for Franklin 56.
Miscellaneous attachments not previouslyrequested.
Environmental summary for USACE for Franklin 56.pdf
Signature
*
fJ By checking the box and signing below, I certify that:
7.63MB
1.82 MB
1.24M6
3.34MB
131.86KB
. 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:
Chris Murray
Signature
Grf�+s ytuj2�,4Y
�I
Date
2/9/2019