20150751 Ver 2_PCN Form Submission_20190323

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 *
20151716
Is a payment required for this project?*
f No paymentrequired
� Fee received
f Fee needed - send electronic notification
Select Project Reviewer"
Garcy Ward:eads\gpward
Information for Initial Review
1a. Name of project:
Bridge 36 Replacement in Hyde County
1a. Who is the PrimaryContact?*
Paul Williams
1b. PrimaryContact Email:*
pcwill iams2@ncd ot. gov
Date Submitted
3/23/2019
Nearest Body of Water
Smith Creek (Stream Index29-34-26)
Basin
Tar-Pamlico
Water Classification
SQNSW
Site Coordinates
Latitude:
35.486646
Longitude:
-76.481729
A. Processing Information
County (or Counties) where the project is located:
Hyde
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:
WBS # (�)
17BP.1.R.63
1a. Type(s) of approval sought from the Corps:
Ve rsion# *
2
Reviewing Office *
Washington Regional Office - [phone]
1c. PrimaryContact Phone:*
[phone]
::

rJ Section 404 Permit (wetlands, streams and waters, Clean Water Act)
rJ 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?
F Yes r No
Nationwide Permit (NWP) Number:
Nationwide Permit (NWP) Number:
03 - Maintenance
12 - U[iliry Lines
NWP Numbers (for multiple NWPS):
1d. Type(s) of approval sought from the DWR:
rJ 401 Water Quality Certificalion - 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 only for Corps Permit:
r 401 Water Quality Certification - 6cpress
rJ Riparian Buffer Authori�ation
1f. Is this an after-the-fact permit application?*
C' 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?
C' Yes r No
Acceptance LetterAttachment
EEP_mitigation_acceptance. pdf
1h. Is the project located in any of NC's twenty coastal counties?
G 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 �J 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 Right-of-Way SR 1143 Sladesville-Credle Road in Hyde County
2b. Deed book and page no.:
2c. Responsible party:
Paul Williams
2d. Address
60.65KB
x
C' Yes G No
C' Yes G No
�

�reet Address
113 Airport Dr.
Address Line 2
�Y
Edenton
Fbstal / Zip Code
27932
2e. Telephone Number:
[phone]
2g. Email Address:*
pcwill [e-mail]
3. Applicant Information (if different from owner)
3a. Name:
Paul Williams
3b. Business Name:
NC Department of Transportation
3c.Address
Street Address
113 Airport Dr.
Address Line 2
�Y
Edenton
Fbstal / Zip Code
27932
3d. Telephone Number:
[phone]
3f. Email Address:*
pcwill iams2@ncd ot. gov
State / Rovince I f�gion
NC
Cauntry
USA
2f. Fax Number:
[phone]
S[ate / FYovince I Region
NC
Cauntry
USA
3e. Fax Number:
[phone]
C. Project Information and Prior Project History " I
1. Project Information
1b. Subdivision name:
(rf appropriate)
1 c. Nearest municipality l town:
Scranton
2. Project Identification
2a. Propertyldentification Number:
2c. Project Address
Street Address
SR 1143 Sladesville-Credle Road, approximately 0.1 south of SR 1152 Puddin Hill Road
Address Line 2
�Y
Scranton
Fbstal I Zip Code
27575
2b. Property size:
1
St2te / Wovince l F�gion
NC
Country
USA
3. SurFace Waters
3a. Name of the nearest body of water to proposed project:*
Smith Creek (Stream Index29-34-26)
3b. Water Resources Classification of nearest receiving water:*
SC;NSW
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.
030201040505

4. Project Description and History
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:*
Project area consists of NCDOT Hyde County SR 1143 and Bridge #36. The general land use in the vicinity is wooded, rural residential, and agricultural.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?*
� Yes r No � Unknown
4c. If yes, please give the DWR Certification number or the Corps Action ID (exp. SAW-0000-00000).
NCDWR Project No. 20150751
SAW-2015-01879
Project History Upload
CAMA permit.pdf
USACOE_PermitBridge 36 NCSR 1143 NWP 3.pdf
NCDWR Written Approval.pdf
COE_DW R_Permit_Appl ication. pdf
195.61 KB
217.84KB
354.94K6
5.12MB
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)
location_map_36.pdf
5.01 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)
Soil_Map.pdf 602.03KB
4f. List the total estimated acreage of all existing wetlands on the property:
0.5
4g. List the total estimated linear feet of all existing streams on the property:
200
4h. Explain the purpose of the proposed project:*
Replace deteriorating Bridge #36 and maintain a stabile road way along SR 1143 for the safety of the traveling public.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
The ebsting 52' L X 20' W timber bridge will be removed and replaced with the proposed 90' L X 27' W concrete cored slab bridge. The project will result in 0.034 acres of fill in
wetlands, 0.037 acres of temp. hand clearing in wetlands, and 56 linear feet of stream impacts. There will be no permanent utility relocations on this project. A temporary relocation of a
power line and support pole will be required during project construction, and will not impact any jurisdictional wetlands or surface waters. This wnrk will be accomplished using cranes,
track excavators, backhoes, and dump trucks.
4j. Please upload project drawings for the proposed project.
COE_DWR_Permit_Application_Drawings.pdf 4.94MB
Updated_planview streamimpact.pdf 2.12MB
5. Jurisdictional Determinations
Sa. Have the wetlands or streams been delineated on the property or proposed impact areas?"
� Yes r No � Unknown
Comments:
Updated delineations by SEPI
Sb. If the Corps made a jurisdictional determination, what type of determination was made?*
� Preliminary r Approved � Not Verified � Unknown � WA
Corps AID Number:
Sc. If Sa is yes, who delineated the jurisdictional areas?
Name (if known): Bob Lepsic
Agency/Consultant Company: SEPI Engineering and Construction
Other:
Sd1. Jurisdictional determination upload
Hyde 36 data forms.pdf
6. Future Project Plans
6a. Is this a phased project?*
C' Yes r No
127.12KB
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?
I D. Proposed Impacts Inventory " I

1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
,r! Wetlands I17 Streams-tributaries
r Open Waters I� Pond Construction
2. Wetland Impacts
2g. Total Temporary Wetland Impact
0.037
2g. Total Wetland Impact
0.071
2h. Comments:
200 sq. ft. of hand clearing will be permanent.
3. Stream Impacts
� 3a. Reason for impact ("') 3b.lmpact
S1 Riprap stabilization at end Permanent
bent
type " I�3c. Type of impact
nk Stabilization
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
56
3i. Total stream and ditch impacts:
56
3j. Comments:
Stream impact shown on Updated_planview_streamimpact.pdf
E. Impact Justification and Mitigation
1. Avoidance and Minimization
r Buffers
2g. Total Permanent Wetland Impact
0.034
S. name "' 3e. Stream Type
(?)
to Smith Creek Perennial
3i. Total temporary stream impacts:
0
f. Type of 3g. S. width" 3h. Impact
urisdiction" length"
ar s 4 56
P
Average (feet) Qinear feet)
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
NCDOT minimized the roadway width by narrowing the shoulders and bridge width to the minimal amount allowable with the design speed and roadway
geometry. There are no deck drains located on the bridge. The existing bridge demolition will follow NCDOT BMP's for bridge demolition vVnrk. Erosion
and Sediment control plans have been designed and will be followed to retain any runoff from construction activities. An off-site detour is being utilized
to eliminate an additional watland and surface water impacts.
1b. Specificallydescribe measures taken to avoid or minimize the proposed impacts through construction techniques:
Utilizing BMPs for bridge demolition will capture all components of the old structure. Erosion and Control measures will be placed along the entire
project area to reduce soil runoff. A turbidity curtain can be utilized along the banks to capture any siltation that may occur during project construction.
The utilization of precast concrete materials, reduces the potential for uncured concrete entering the adjacent waters.
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?
r Yes �' No
2c. If yes, mitigation is required by (check all that apply):
� DWR I� Corps
2d. If yes, which mitigation option(s) will be used for this project?
r Mitigation bank I17 Payment to in-lieu fee I� 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:
(linear feet)
4d. Buffer mitigation requested (DWR only):
(square feet)
4f. Non-riparian wetland mitigation requested:
(acres)
4h. Comments
Acceptance letter dated July 23, 2015 is attached.
4c. If using stream mitigation, what is the stream temperature:
4e. Riparian wetland mitigation requested:
(acres)
4g. Coastal (tidal) wetland mitigation requested:
(acres)
0.038
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 r No
What type of SCM are you providing?
r Level Spreader
fJ Vegetated Conveyance (lowar SHWT)
r Wetland Swale (higher SM/Vf)
r Other SCM that removes minimum 30 % nitrogen
r Proposed project will not create concentrated stormwater flow through the buffer
Diffuse Flow Documentation
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
� Yes r No
Comments:
NCDOT will follow best management practices for soil and erosion control in compliance w�th N.C. Sediment and Pollution Control Act and NCDOT NPDES permit. Erosion control
devices will be installed and maintained during the project. A grated drop inlet on the SW side will route stormwater to vegetated buffer conveyance prior to entering surface waters. No
deck drains will be located over surface waters.
G. Supplementary Information
1. Environmental Documentation
1a. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federallstate) land?*
� Yes r No
n
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)?*
f Yes r No
Comments:
x
Activity and impacts covered by Minimum Criteria Checklist.
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 quality? *
f Yes r No
3b. If you answered "no," provide a short narrative description.
Project replaces an existing bridge with a bridge.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*

r ves � No r• wn
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? *
f Yes r No
Sb. Have you checked with the USFWS concerning Endangered Species Act impacts?"
� Yes r No
Sd. Is another Federal agency involved?"
� Yes r No
Se. Is this a DOT project located within Division's 1-8?
G Yes r No
� Unknown
Sj. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
NC Natural Heritage Data 6cplorer Website
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?*
National Marine Fisheries Database
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?*
NCDOT Cultural Resources Unit
7c. Historic or Prehistoric Information Upload
13-09-0042NoSurvey.pdf
archaeology_clearance_letter.pdf
8. Flood Zone Designation (Corps Requirement)
Sa. Will this project occur in a FEMA-designated 100-year floodplain?*
G Yes r No
Sb. If yes, explain how project meets FEMA requirements:
FEMA Approved
8c. What source(s) did you use to make the floodplain determination?*
NC DOT Hydraulics Unit
Miscellaneous
Comments
Miscellaneous attachments not previously requested.
Moratorium_correspondence.pdf
Signature
*
jJ By checking the box and signing below, I certify that:
798.96K6
237.23KB
264.91 KB
• 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:
Paul Collins Williams, Jr.
�
�
Signature

. �fi..r� �i>.�• Jr�ii;�...:. , f.
Date
3/23/2019