20190195 Ver 1_PCN Form Submission_20190212

D1�VR
�irlslan af Water Resources
Initial Review
Pre-Construction Notification (PCN) Form
September 29, 2018 Ver 3
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 *
20190195
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 52 over Sandy Creek on SR 1433 (Person Road)
1a. Who is the PrimaryContact?*
Chris Murray
1b. PrimaryContact Email:*
[e-mail]
Date Submitted
2/12/2019
Nearest Body of Water
Sandy Creek
Basin
Tar-Pamlico
Water Classification
B; NSW+ ID No.: 28-78-1-(8)
Site Coordinates
Latitude:
36.18878
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:
B-4516
WBS # (�)
38400.1. F D2
1a. Type(s) of approval sought from the Corps:
Longitude:
-7820334
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:
13 - Bank Stabilization
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 and others
2b. Deed book and page no.:
Parcel ID numbers for others: 012155, 012228, 036296, 031744
2c. Responsible party:
2d. Address
Street Address
2612 N. Duke Street
Address Line 2
�Y
Durham
Fbstal / Zip Code
27712
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:
Louisburg
2. Project Identification
2a. Propertyldentification Number:
Parcel ID numbers for others: 012155,
01222$ 036296,031744
2c. Project Address
Street Address
near 1620 Person Road
Address Line 2
�Y
Louisburg
Postal / Zip Code
27549
3. SurFace Waters
3a. Name of the nearest body of water to proposed project:"
Sandy Creek
3b. Water Resources Classification of nearest receiving water:*
B; NSW+ ID No.: 28J8-1-(8)
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.
030201010705
4. Project Description and History
2b. Property size:
2.18
S[ate / Awince / Region
NC
Cauntry
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:*
Site is surrounded by wooded land and deared land (i.e. timbered land).
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)
B-4516 usgs topo map.pdf 2.41 MB
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-4516 soil survey.pdf 1.07MB
4f. List the total estimated acreage of all existing wetlands on the property:
0.0
4g. List the total estimated linear feet of all existing streams on the property:
100 linear feet
4h. Explain the purpose of the proposed project:*
Replacement of structurally deficient bridge.
E�sting structure: Seven-span (1 @18.1', 1@16.8', 1@34.6', 1@17.2', 1@167', 1@17.3', 1@17.6') bridge.
Proposed structure: T�nro-span (1 @ 100', 1@50') boxbeam bridge with 4'-0" caps.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
Grading, drainage, paving and sUucture. Equipment is typical of road building and bridge building to include crane, bull dozer, grader, excavator, mini excavator, 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 f Approved �' Not Verified f Unknown f' WA
Corps AID Number:
Sc. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Chris Sheats
Agency/Consultant Company: The Catena Group on December 10, 2014
Other:
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?
None
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
r Wetlands fJ Streams-tributaries fJ Buffers
r Open Waters I� Pond Construction
3. Stream Impacts
�� 3a. Reason for impact ("') 3b.lmpact
cl � I Bank stabilization Perl manent
type " I�3c. Type of impact
nk Stabilization
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
40
3i. Total stream and ditch impacts:
40
3j. Comments:
Impacts to stream from installation of Class II rip rap bank s[abilization.
6. Buffer Impacts (for DWR)
6a. Project is in which protect basin(s)?
Qieck all that apply.
r Neuse
� Catawba
r Goose Creek
r Other
S. name" 3e. Stream Type" 3f. Type of
(J Jurisdiction"
dy Creek Perennial Both
3i. Total temporery stream impacts:
0
r/ Tar-Pamlico
� Randleman
r Jordan Lake
S. width" I 3h. Impact
, __.._*
Average(feet) I� Qinearfeet)

6h. Total buffer impacts:
Zone 1 Zone 2
Total Temporary impacts: 0.00 0.00
Zone 1 Zone 2
Total Permanent impacts 5,012.00 3,400.00
Zone 1 Zone 2
Total combined buffer impacts: 5,012.00 3,400.00
6i. Comments:
Supporting Documentation
B4516_PermitDrawings_20190211.PDF
B4516_PermitDrawings_Buffer_20190211.pdf
E. Impact Justification and Mitigation
1. Avoidance and Minimization
1.39 MB
774.76KB
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
Amount of Class II rip rap proposed to be installed on streambank has been minimized to the minimal amount necessary to provide long term
stabilization.
1b. Specificallydescribe measures taken to avoid or minimize the proposed impacts through construction techniques:
Project will be inspected by Division environmental personnel and Resident Engineer inspectors to ensure minimization is discussed 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
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
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
B-4516 SWMP.pdf 48.41KB
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:
Project will comply with permit.
G. Supplementary Information
1. Environmental Documentation
�
�
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)? *
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 submittal to state dearing 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 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 narretive description.
The project replaces a structurally deficient bridge in exsting location. Roadway design provides similar footprint of epssting roadway with upgrades to
meet current design standards.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
� 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?
r Yes �' No
r Unknown
Sj. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
Discussion with USFWS on February 12, 2019 regarding proposed biological conclusions.
Consultation Documentation Upload
B-4516 FINAL info to USFWS.pdf
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)
851.29KB
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?*
Historic Architecture:
-Historic Architecture Survey Required Form dated February 2Q 2015 indicates presence of National Register listed property �nnthin APE. This is the
Speed Farm (FK285). Survey was required.
-Historic Architecture and Landscapes Effects Form dated May 29/30, 2018 indicates No Adverse Effed from Ihe project.
Archaeology:
-No Archaeological Survey Required Form dated February 23, 2015
7c. Historic or Prehistoric Information Upload

15-02-0016 Historic Archietcture Effects.pdf
B-4516 Archaeologicalno survey.pdf
B-4516 Historic Architecture Survey Required Form.pdf
8. Flood Zone Designation (Corps Requirement)
Sa. Will this project occur in a FEMA-designated 100-year floodplain?"
� Yes r No
8b. If yes, explain how project meets FEMA requirements:
Project has been approved by NCDOT hydraulics unit. Project was studied by Limited Study Methods.
Sc. What source(s) did you use to make the floodplain determination?"
Stormwater Management Plan
Miscellaneous
Comments
Miscellaneous attachments not previouslyrequested.
Environmental summary for USACEpdf
Signature
*
�J By checking the box and signing below, I certify that:
4.52MB
1.79 MB
209.99K6
134.42KB
• 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 Iransaction 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:
Christopher A. Murray
Signature
crf�,:s ytuj2�,4r
Date
2/12/2019