20190455 Ver 1_PCN Form Submission_20190410

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 *
20190455
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:
Beaufort Bridge 159
1a. Who is the PrimaryContact?*
NCDOT (Attn: Michael C. Anan, PE)
1b. PrimaryContact Email:*
[e-mail]
Date Submitted
4/10/2019
Nearest Body of Water
Pungo Creek
Basin
Tar-Pamlico
Water Classification
C;Sw,NSW
Site Coordinates
Latitude:
35.53603
Longitude:
-76.77418
A. Processing Information
County (or Counties) where the project is located:
Beaufort
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 # (�)
17. BP.2. R.86
1a. Type(s) of approval sought from the Corps:
Ve rsion# *
1
Reviewing Office *
Washington Regional 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?
F 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?
� 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?
fJ Owner r Applicant (other than owner)
1e. Is there an Agent/Consultant for this project?
C' Yes r No
2. Owner Information
2a. Name(s) on recorded deed:
NCDOT
2b. Deed book and page no.:
2c. Responsible party:
2d. Address
Street Address
1037 W.H. Smith Boulevard
Address Line 2
P.O. Box 1587
�Y
Greenville
Fbstal / Zip Code
27834
r 401 Water Quality Certification - E�ress
rJ Riparian Buffer Authorization
State / Rovince I f�gion
NC
Country
USA
x
C' Yes R No
C' Yes G No

2e. Telephone Number:
[phone]
2g. Email Address:�`
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(rf appropriate)
1 c. Nearest municipality / town:
Pinetown, NC
2. Project Identification
2a. Propertyldentification Number:
WA
2c. Project Address
&reet Address
Jones Bridge Road (SR 1611)
Address Line 2
ary
Pinetown
Postal / Zip Code
27565
3. SurFace Waters
3a. Name of the nearest body of water to proposed project:*
Pungo Creek
3b. Water Resources Classification of nearest receiving water:*
QSw.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.
030201040602
4. Project Description and History
2f. Fax Number:
2b. Propertysize:
S[ate / Awince / Re3ion
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:*
The project area and vicinity consist of rural residential and agricultural areas, silvicultural areas, and undeveloped forested communities. The proposed project and associated impacts
are �nnthin and immediately adjacent to e�tisting NCDOT right-of-way.
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)
Beaufort159_USGS_Topo. pdf
431.2 KB
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)
Beaufort159_NRCS_Soils.pdf 502.58KB
4f. List the total estimated acreage of all existing wetlands on the property:
0.5 acre
4g. List the total estimated linear feet of all existing streams on the property:
125
4h. Explain the purpose of the proposed project:"
Replace ebsting Bridge 159 on SR 1611 (Jones Bridge Street) over Pungo Swamp. The sufficiency rating of the exsting bridge is 37.36.
4i. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
The proposed project will replace the ebsting bridge on Jones Bridge Road (SR 1611) over Pungo Creek in Beaufort County. The project will replace the ewsting prestressed concrete
channels, concrete caps, and timber piles with a cored slab bridge at the same location. The project �,wrk will consist of grading, widening, drainage improvements, bridge replacement,
and pavement markings. The work will be conducted using standard road construction equipment. Equipment will be stored on-site in upland areas. No in-water construction moratoria
will apply to this project.
_;
�
4j. Please upload project drawings for the proposed project.
17BP.2.R.86_Beaufort 159_Permit Package.pdf 3.75M6

5. Jurisdictional Determinations
Sa. Have the wetlands or streams been delineated on the property or proposed impact areas?"
� Yes r No
Comments:
Sb. If the Corps made a jurisdictional determination, what type of determination was made?"
� Preliminary r Approved � Not Verified � Unknown r WA
Corps AID Number:
Sc. If Sa is yes, who delineated the jurisdictional areas?
Name (if known):
Agency/Consultant Company:
Other:
Robert Tumbull
Environmental Services, Inc.
� Unknown
Sd. List the dates of the Corp jurisdiction determination or State determination if a determination was made by the Corps or DWR
Documentation not available.
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?
D. Proposed Impacts Inventory
1. Impacts Summary
1a. Where are the impacts associated with your project? (check all that apply):
,r! Wetlands IJ Streams-tributaries
r Open Waters I� Pond Construction
2. Wetland Impacts
2g. Total Temporary Wetland Impact
0.000
2g. Total Wetland Impact
0.035
2h. Comments:
Impact area at Site 2 is 15 square feet (0.0003 acre).
3. Stream Impacts
rJ Buffers
2g. Total Permanent Wetland Impact
0.035
Reason for impact (?) 3b.lmpact type" 3c. Type of impact" 3d. S. name * 3e. Stream Type * 3f. Type of 3g. S. width" 3h. Impact
(?) Jurisdiction�` length*
inage Improvements Permanent Rip Rap Fill Pungo Swamp Perennial Both 60 18
Average(feet) pinearfeet)

gy Drainage Improvements Temporary Rip Rap Fill Pungo Swamp Perennial Both 60 38
.4verage (feet) pinear feet)
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
18
3i. Total stream and ditch impacts:
56
3j. Comments:
6. Buffer Impacts (for DWR)
6a. Project is in which protect basin(s)?
Check all that apply.
r Neuse
r Catawba
r Goose Creek
r Other
3i. Total temporary stream impacts:
38
,r! Tar-Pamlico
r Randleman
r Jordan Lake
6b. Impact Type 6c. Per or Temp 6d. Stream name 6e. Buffer mitigation required9 6f. Zone 1 impact I6g. Zone 2 impact
B1-Allowable P Pungo Swamp No 1,779 2,155
B2-Allowable P Pungo Swamp No 1,757 1,915
B3-Allowable P Pungo Swamp No 2,925 2,150
B4-Allowable P Pungo Swamp No 392 217
6h. Total buffer impacts:
Total Temporary impacts:
Total Permanent impacts:
Total combined buffer impacts:
6i. Comments:
Zone 1
0.00
Zone 1
6,853.00
Zone 1
6,853.00
Supporting Documentation
17BP2.R.86_Beaufort 159_Permit Package.pdf
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:
The proposed bridge replacement will occur as much as practicable within the footprint of the existing bridge. Fill has been minimized as much as
practicable within the wetland areas and stream channel. Riparian buffer impacts have been minimized as much as practicable.
1b. Specificallydescribe measures taken to avoid or minimize the proposed impacts through construction techniques:
All necessary sediment and erosion control BMPs will be installed and maintained through construction. Disturbed ground will be restored and
stabilized with permanent vegetative cover. NCDOT Best Management Practices will be implemented throughout construction.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
Zone 2
0.00
Zone 2
6,437.00
Zone 2
6,437.00
3.75MB
�
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:
Sheam and impacts are minimized as much as practicable and are <150 feet. Wetland impacts are minimized as much as practicable and area <0.1 acre in size. Buffer impacts result
from the perpendicular crossing of Pungo Swamp.

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
rJ Vegetated Conveyance (lower SHWT)
� Wetland Swale (higher SM/VT)
CJ Other SCM that removes minimum 30 % nitrogen
� Proposed project will not create concentrated stormwater flow through the buffer
Diffuse Flow Documentation
17BP2.R.86_Beaufort 159_SMP.pdf
2. Stormwater Management Plan
2a. Is this a NCDOT project subject to compliance with NCDOT's Individual NPDES permit NCS000250?*
� Yes r No
Comments:
G. Supplementary Information
1. Environmental Documentation
426.34KB
�
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)? *
f• Yes r No
1c. If you answered "yes" to the above, has the document review been finalized by the State Clearing House?*
f Yes � No
Comments:
x
A Categorical Exdusion is being prepared.
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)? *
C' 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.
The proposed project will result in minimum new impervious surface and will not result in any downstream impacts or growth-stimulating effects. The
existing use of Pungo Swamp (C) should not change as a result of this project.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
f Yes r No � WA
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?*
C' Yes r No
Sb. Have you checked with the USFWS concerning Endangered Species Act impacts?*
C' Yes r No
Sd. Is another Federal agency involved?*
C' Yes r No C' Unknown

Se. Is this a DOT project located within Division's 1-8?
G Yes �' No
Sj. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
North Carolina Natural Heritage Program data and on-site evaluation by ESI staff.
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?*
� Yes r No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
www. h a bitat. noaa. gov/protection/efh/efh mappe r
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?*
Archaeology and historic architecture reviews were conducted by NCDOT. Documentation for those reviews is attached.
7c. Historic or Prehistoric Information Upload
17-05-0039NoSurveyRevised.pdf
Beaufort 159 No NRHP form.pdf
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
G Yes r No
Sb. If yes, explain how project meets FEMA requirements:
A FEMA Preliminary Detailed Study was completed.
Sc. What source(s) did you use to make the floodplain determination?*
www.ncfloodmaps.com
Miscellaneous
Comments
Miscellaneous attachments not previously requested.
Signature
*
�J By checking the box and signing below, I certify that:
2.43M6
1.85MB
. 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 hansaction 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:
Robert Turnbull
Signature
r�O�tC C!.•tR!fClf
Date
4/10/2019
.