20190325 Ver 1_PCN Form Submission_20190307

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 *
20190325
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 89 over Lick Creek on SR 1920 (Kemp Road)
1a. Who is the PrimaryContact?*
Christopher Murray
1b. PrimaryContact Email:*
[e-mail]
Date Submitted
3/7/2019
Nearest Body of Water
Lick Creek and Martin Creek
Basin
Neuse
Water Classification
Lick Creek: WS-IV; NSW; Martin Creek: WS-IV; NSW
Site Coordinates
Latitude:
35.96852
A. Processing Information
County (or Counties) where the project is located:
Durham
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-5512
WBS # (�)
55012.1.FD1
1a. Type(s) of approval sought from the Corps:
Longitude:
-78.76885
Ve rsion# *
1
Reviewing Office *
Central Office - [phone]
1c. PrimaryContact Phone:*
[phone]
::

�J 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:
r 401 Water Quality Certification - E�ress
rJ 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?
F 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
B-5512 -DMS mitigation acceptance division 5- Buffer - NS 01.pdf
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?
rJ 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:
NCDOT and Annie H Perry Family
2b. Deed book and page no.:
Book 2927 and page 266
2c. Responsible party:
2d. Address
Street Address
2612 N. Duke Street
Address Line 2
�Y
Durham
Fbstal / Zip Code
27704
2e. Telephone Number:
[phone]
S[ate / FYovince I Region
NC
Cauntry
USA
2f. Fax Number:
74.98KB
x
C' Yes R No
G Yes C' No
�,

2g. Email Address:*
[e-mail]
C. Project Information and Prior Project History "
1. Project Information
1b. Subdivision name:
(rf appropriate)
1c. Nearest municipality/town:
Durham
2. Project Identification
2a. Propertyldentification Number:
0860-02-86-0728;0860-01-97-1497
2c. Project Address
Street Address
near 4899 Kemp Road
Address Line 2
�Y
Durham
Fbstal I Zip Code
27703
3. SurFace Waters
3a. Name of the nearest body of water to proposed project:*
Lick Creek and Martin Creek
3b. Water Resources Classification of nearest receiving water:*
Lick Creek: WS-N; NSW; Martin Creek: WS-IV; NSW
3c. What river basin(s) is your project located in?*
Neuse
3d. Please provide the 12-digit HUC in which the project is located.
030202010502
4. Project Description and History
2b. Property size:
1.6 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:*
Site is surrounded by wooded land. Martin Creek converges with the larger Lick Creek just upstream of the e�tisting bridge.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
C' Yes �' No G 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-5512 USGS topo map.pdf 1.46MB
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-5512 soil survey.pdf 739.2KB
4f. List the total estimated acreage of all existing wetlands on the property:
0 ac
4g. List the total estimated linear feet of all existing streams on the property:
95 linear feet
4h. Explain the purpose of the proposed project:"
Replacement of structurally deficient twn-span bridge (2 @ 35 feet) with a new bridge (1 @ 100 ft) that completely spans Lick Creek.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
Replacement of structurally deficient two-span bridge (2 @ 35 feet) with a new bridge (1 @ 100 ft) that completely spans Lick Creek. Equipment is typical of this type of work and include
crane, back hoe, bull dozer, 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 propertyor proposed impact areas?*
r Yes r No C' Unknown

Comments:
Delineated by Chris Sheats (The Catena Group) on January 7, 2015.
Sb. If the Corps made a jurisdictional determination, what type of determination was made?*
f' Preliminary (' Approved r Not Verified r Unknown f' WA
Corps AID Number:
Unknown; Site visit conducted by Eric Alsmeyer on July 8, 2015 with NCDOT staff Jason Dilday and
Deanna Riffey
Sc. If Sa is yes, who delineated the jurisdictional areas7
Name (if known):
Agency/Consultant Company:
Other:
Chris Sheats
The Catena Group
Sd1. Jurisdictional determination upload
B-5512 (along with B-4833) JD Package sent to USACE.pdf
B-5512 info on USACE visit.pdf
6. Future Project Plans
2.4MB
50.88KB
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 I17 Streams-tributaries
� Open Waters I� Pond Construction
3. Stream Impacts
fJ Buffers
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts: 3i. Total temporery stream impacts:
87 10
3i. Total stream and ditch impacts:
97
3j. Comments:
Note that Martin Creek comes in from the south and converges with Lick Creek at the upstream limit of the e�tisting bridge.
6. Buffer Impacts (for DWR)
6a. Project is in which protect basin(s)?
Qieck all that apply.
fJ Neuse
� Catawba
r Goose Creek
r Other
Impact Type
� Tar-Pamlico
� Randleman
r Jordan Lake
Per or Temp II6d. Stream name Il6e. Buffer mitigation required? Il6f. Zone 1 impact II6g. Zone 2 impact
Site 1 Roadway Fill allowable P Lick CreeWMartin Creek No 606 1,202
Site 1 Roadway Fill mitigable P Martin Creek Yes 2,546 0

i
Site 1 Bridge allowable P Lick Creek/Martin Creek No 1,525 26
6h. Total buffer impacts:
Zone 1 Zone 2
Total Temporary impacts: 0.00 0.00
Zone 1 Zone 2
Total Permanent impacts: 4,677.00 1,225.00
Zone 1 Zone 2
Total combined buffer impacts: 4,677.00 1,228.00
6i. Comments:
Buffer mitigation provided for Site 1 Roadway Fill mitigable impacts along Martin Creek. See buffer permit drawings.
Supporting Documentation
20190212_B5512 Permit Drawings.pdf 2.96MB
B5512_Permit Drawings_BUFFER_20190212 (1).pdf 2.3MB
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:
New right of way has been minimized to reduce impacts at project. The existing bridge is a two-span bridge and replacement bridge is a single span
bridge that completely spans Lick Creek.
1b. Specificallydescribe measures taken to avoid or minimize the proposed impacts through construction techniques:
Construction inspection by NCDOT/contract inspectors and NCDOT Division 5 Environmental Staff will occur during the life of the project to identify
methods to reduce impacts to the stream.
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?
� Yes r No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
Project impacts to stream (bank stabilization with rip rap) does not require mitigation.
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?
� Yes � No
What type of SCM are you providing?
r Level Spreader
CJ Vegetated Conveyance (lower SMNT)
� 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
B5512 SWMP.pdf 181.21KB
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
� Yes r No
Comments:
Project is in compliance with NPDES permits.
G. Supplementary Information
�
h
1. Environmental Documentation

1a. Does the project involve an expenditure of public (federallstate/local) funds or the use of public (federallstate) land?*
r Yes �' 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 PolicyAct (NEPA/SEPA)?*
� 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
Comme nts: *
Categorical Exclusion document does not need to be finalized by the SCH.
2. Violations (DWR Requirement)
2a. Is the site in violation of DWR Water Quality Certification Rules (15A NCAC 2H .0500), Isolated Wetland Rules (15ANCAC 2H .1300), or DWR Surface Water or Wetland Standards or
Riparian Buffer Rules (15A NCAC 2B .0200)? *
f 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 deficient bridge. The new bridge is replaced on exsting alignment and does not increase the carrying capacity of the
roadway.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
r Yes r No r �UA
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?*
F Yes r No
Sc. If yes, indicate the USFWS Field Office you have contacted.
Raleigh
Sd. Is another Federal agency involved?*
f Yes r No
Se. Is this a DOT project located within Division's 1-8?
r Yes r No
r Unknown
S. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
See attached Environmental Summary for USACE for info on P/E/T species.
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? *
f 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?"
C' Yes r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
Consultation with State HPO office and NCDOT HEU unit. See attached Environmental Summary for cultural resource findings and appropriate
approvalforms.
7c. Historic or Prehistoric Information Upload
Historical Structure and Archaeology findings.pdf 122.99KB

8. Flood Zone Designation (Corps Requirement)
Sa. Will this project occur in a FEMA-designated 100-year floodplain?"
r Yes r No
Sb. If yes, explain how project meets FEMA requirements:
Project has been designed by PEF to meet FEMA requirements.
Sc. What source(s) did you use to make the floodplain determination?*
Mapping.
Miscellaneous
Comments
Miscellaneous attachments not previouslyrequested.
Environmental summary for USACE.pdf
123.5KB
Signature
*
�J 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 thls 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 Act");
• I understand that an elechonic 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
�
Date
3/7/2019