20190584 Ver 1_PCN Form Submission_20190502

DWR
IDIOM n of Water Resources
Pre -Construction Notification (PCN) Form
September 29, 2018 Ver 3
21nitial Review
Has this project met the requirements for acceptance in to the review process?*
r Yes
r No
Is this project a public transportation project?*
G Yes r No
Change only if needed.
BIMS # Assigned
20190584
Is a payment required for this project?*
r No payment required
r Fee received
r Fee needed - send electronic notification
Select Project Reviewer*
Rob Ridings:eads\rgridings
Information for Initial Review
1a. Name of project:
Br 970105 on SR 1418 over White Swamp replacement
1a. Who is the Primary Contact?*
Chad Coggins
1b. Primary Contact Email:*
[e-mail]
Date Submitted
5/2/2019
Nearest Body of Water
White Swamp
Basin
Tar -Pamlico
Water Classification
QNSW
Site Coordinates
Latitude: Longitude:
35.77811-77.78320
FA. Processina Information
County (or Counties) where the project is located:
Wilson
Is this project a public transportation project?*
r Yes r' No
Is this a NCDOT Project?*
r Yes r No
(NCDOT only) T.I.P. or state project number:
SF 970105 / State Funded
WBS#M
17BP.4.R.95
1a. Type(s) of approval sought from the Corps:
Version# *
1
Reviewing Office*
Central Office - [phone]
1c. Primary Contact Phone:*
[phone]

W Section 404 Permit (wetlands, streams and waters, Clean Water Act)
r Section 10 Permit (navigable waters, tidal waters, Rivers and Harbors Act)
1b. What types) of permit(s) do you wish to seek authorization?
W Nationwide Permit (NWP)
r' Regional General Permit (RGP)
r' Standard (IP)
1c. Has the NWP or GP number been verified by the Corps?
r 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
F Non-404 Jurisdictional General Permit
F Individual Permit
le. Is this notification solelyfor the record because written approval is not required?
For the record only for DWR 401 Certification:
For the record only for Corps Permit:
F 401 Water Quality Certification - Express
W Riparian Buffer Authorization
1f. Is this an after -the -fact permit application?*
r Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
r Yes r No
1g. Is payment into a mitigation bank or in -lieu fee program proposed for mitigation of impacts?
r Yes r No
Acceptance Letter Attachment
1h. Is the project located in any of NC's twenty coastal counties?
r Yes r No
1j. Is the project located in a designated trout watershed?
C Yes r No
FB. Applicant Information
1d. Who is applying for the permit?
r- Owner rJ Applicant (other than owner)
le. Is there an Agent/Consultant for this project?
r Yes r No
2. Owner Information
2a. Name(s) on recorded deed:
State of North Carolina (NCDOT)
2b. Deed book and page no.:
2c. Responsible party:
NCDOT Div 4
2d.Address
Street Address
P.O. Box 3165
Address Line 2
city
Wilson
Postal / Zip Code
27828
2e. Telephone Number:
[phone]
2g. Email Address:*
State / Frwinee / R�gion
NC
Q�untry
USA
2f. Fax Number:
*
r Yes r No
r Yes r No

[e-mail]
3. Applicant Information (if different from owner)
3a. Name:
Chad Coggins
3b. Business Name:
NCDOT Div 4
3c.Address
Street Address
P.O. Box 3165
Address Line 2
CKY
Wilson
Postal / Zip Cade
27828
3d. Telephone Number:
[phone]
3f. Email Address:*
[e-mail]
C. Project Information and Prior Project History
1. Project Information
1b. Subdivision name:
(ff appropriate)
1c. Nearest municipality/town:
Pender Crossroads
2. Project Identification
2a. Property Identification Number:
2c. Project Address
Street Address
Address Line 2
cfty
Postal / Zip Cede
3. Surface Waters
3a. Name of the nearest body of water to proposed project:*
White Swamp
3b. Water Resources Classification of nearest receiving water:*
QNSW
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.
030201030101
4. Project Description and History
State / Rovince / P pion
NC
Country
USA
3e. Fax Number:
2b. Property size:
State / Fravince / iPogion
Country
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:*
Forestry and Agriculture are the predominant land uses with some rural single-family residential housing.
4b. Have Corps permits or DWR certifications been obtained for this project (including all prior phases) in the past?
r Yes r No r Unknown
4d. Attach an 8 1l/2 X 11 excerpt from the most recent version of the USGS topographic map indicating the location of the project site. (for DWR)
Br 105 topo map.pdf 2.02MB
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)
Br 105 soils map.pdf 1.3MB

4f. List the total estimated acreage of all existing wetlands on the property:
0.02
4g. List the total estimated linear feet of all existing streams on the property:
120
4h. Explain the purpose of the proposed project,*
Replace existing Bridge 105 (970105) which is structurally deficient for current NCDOT standards.
41. Describe the overall project in detail, including indirect impacts and the type of equipment to be used:*
Replace existing Bridge 105 (970105) which is structurally deficient for current NCDOT standards with a new bridge meeting these standards in the existing right-of-way with offsite
detours. Heavy road and bridge building equipment will be used.
4j. Please upload project drawings for the proposed project.
17BP.4.R.95_HYD_Permit _Package _10-12-2018.pdf 2.31 MB
5. Jurisdictional Determinations
Sa. Have the wetlands or streams been delineated on the propertyor proposed impact areas?*
r Yes r No r Unknown
Comments:
5b. If the Corps made a jurisdictional determination, what type of determination was made?*
r Preliminary r Approved r Not Verified r Unknown r N/A
Corps AID Number:
5c. If 5a is yes, who delineated the jurisdictional areas?
Name (if known): Chad Coggins
Agency/Consultant Company: NCDOT Div 4 DEO
Other:
5d1. Jurisdictional determination upload
6. Future Project Plans
6a. Is this a phased project?*
r 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?
No, single and complete linear transportation project with independent utility.
D. Proposed Impacts Inventory
1. Impacts Summary
la. Where are the impacts associated with your project? (check all that apply):
W Wetlands W Streams -tributaries W Buffers
r Open Waters r Pond Construction
2. Wetland Impacts
2a1 Reason (?) 2b. Impact type * (?) 2c. Type of W. * 2d. W. name * 2e. Forested* 2f. Type of 2g. Impact
Jurisdicition*(?) area*
Site 1 end bent excavation P Bott
omland Hardwood Forest
White Swamp
Yes
Both
0.010
(acres)
Site 1
mechanized clearing JP
Bottomland Hardwood Forest
White Swamp
Yes
Both
0.010
(acres)
2g. Total Temporary Wetland Impact 2g. Total Permanent Wetland Impact
0.000 0.020
2g. Total Wetland Impact
0.020
2h. Comments:
Mechanized clearing not included in threshold of impacts requiring compensatory mitigation (i.e. 0.01 acre of mechanized clearing). No hand clearing
included in this project. Project includes 0.01 acre of wetland excavation. We are not proposing any mitigation for jurisdictional impacts (i.e. < 0.03
threshold confirmed by Eric Alsmeyer).

3. Stream Impacts
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
F
(?)
Jurisdiction*
length*
S1
stream relocation
Permanent
Relocation :1
ffeSwamp
Intermittent
Both
2
59
Avenge (fee[)
(linear feet)
S2
dewatering for stream
Temporary
Dewatering
White Swamp
Intermittent
Both
2
10
relocation
Average (feet)
(linearfeet)
S3
[de:trer'n,ig forend bent
Temporary
Dewatering
White Swamp
Perennial
Bothuon
Average (feet)
(linear feet)
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
3i. Total temporary stream impacts:
59
45
3i. Total stream and ditch impacts:
104
3j. Comments:
Intermittent stream being relocated in lateral v-ditch associated with road shoulder construction.
6. Buffer Impacts (for DWR)
6a. Project is in which protect basin(s)?
Check all that apply.
r Neuse
P Tar -Pamlico
r Catawba
r Randleman
r Goose Creek
r Jordan Lake
r Other
6b. Impact Type 6c. Per or Temp 6d. Stream name 6e. Buffer mitigation required? 6f. Zone 1 impact 6g. Zone 2 impact
Allowable bridge bridge & approach constructin P White Swamp No 1,858 1,706
6h. Total buffer impacts:
Zone 1 Zone 2
Total Temporary impacts: 0.00 0.00
Zone 1 Zone 2
Total Permanent impacts: 1,858.00 1,706.00
Zone 1 Zone 2
Total combined buffer impacts: 1,858.00 1,706.00
6i. Comments:
Supporting Documentation
17BPA.R.95_HYD_Permit _Package _10-12-2018.pdf 2.31 MB
E. Impact Justification and Mitigation
1. Avoidance and Minimization
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
Replace in place with offsite detours.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques:
All construction equipment will be staged and operated from upland areas. NCDOT will also install silt fencing to protect the streams and wetlands
adjacent to the project. Safety fencing will be used to delineate jurisdictional and environmentally sensitive areas from encroachment.
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 r No
2b. If this project DOES NOT require Compensatory Mitigation, explain why:
Bridge end bent excavation and v-ditch construction falls below NWP condition threshold of wetland impacts / requirement for compensatory mitigation and falls below Regional condition
threshold of stream impacts / requirement for compensatory 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?
r Yes r No
What type of SCM are you providing?
r Level Spreader
W Vegetated Conveyance (lower SHWT)
r Wetland Swale (higher SHWT)
r Other SCM that removes minimum 30 % nitrogen
r Proposed project will not create concentrated stormwater flow through the buffer
Diffuse Flow Documentation
17BP.4.R.95_HYD_Permit_Package_10-12-2018.pdf 2.31 MB
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:
G. Supplementary Information
1. Environmental Documentation
la. Does the project involve an expenditure of public (federal/state/local) funds or the use of public (federal/state) land?*
r 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)
Environmental Policy Act (NEPA/SEPA)?*
r Yes r No
Comments:*
MCDC available on request.
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)?*
r Yes r No
3. Cumulative Impacts (DWR Requirement)
3a. Will this project result in additional development, which could impact nearby downstream water quality?*
r Yes r No
3b. If you answered "no," provide a short narrative description.
Replacing existing two lane bridge with a new two lane bridge.
4. Sewage Disposal (DWR Requirement)
4a. Is sewage disposal required by DWR for this project?*
r Yes r Nor N/A
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?
r Yes r No
5b. Have you checked with the USFWS concerning Endangered Species Act impacts?*
r Yes r No
5c. If yes, indicate the USFWS Field Office you have contacted.

Raleigh
5d. Is another Federal agency involved?*
f Yes r No r Unknown
5e. Is this a DOT project located within Division's 1-8?
r Yes r- No
5j. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat?
Red -cockaded woodpecker is listed as Historic for Wilson County. Foraging or nesting habitat was not found adjacent to the area. NCNHP database
records no element occurrence within a mile of the project area. (No Affect) / Tar River spinymussel is included in the IPaC TE list dated April 30,
2019. However reviewof the 12 digit HUC GIS element occurrence layer shows this species is not included for the project identified 12 digit HUC. Also
NCNHP database records no element occurrence within a mile of the project area. Therefore, this project meets the Section 7 Mussel Programmatic
protocols for bridge replacement of a Programmatic BO of No Affect for this species. (No Affect) // Atlantic Pigtoe (also included in the referenced IPaC
letter) is currently listed as proposed for Wilson Co. Atlantic Pigtoe is also listed has as Historic for Wilson Co. This species is also not included in the
project 12 digit HUC. NCNHP database records no element occurrence Within a mile of the project area. Therefore, this species meets the Section 7
Mussel Programmatic protocols for bridge replacement of a Programmatic BO of No Affect for this species if and when the Atlantic Pigtoe is listed and
included in this Section 7 Mussel Programmatic Process. (No Affect) /// Michawes sumac is listed as Historic for Wilson Co. NCNHP database records
no element occurrence within a mile of the project area. (No Affect) //// Programmatic BO of MALTAA for NLEB
Consultation Documentation Upload
FWS IpaC TE List revised 4 30 3019.pdf 218.39KB
NCNHP elements project review.pdf 583.17KB
Wilson Co. TE List.pdf 183.59KB
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as an Essential Fish Habitat?*
r Yes r No
6b. What data sources did you use to determine whether your site would impact an Essential Fish Habitat?*
GIS / NOAA Atlantic Sturgeon proposed rule dated 06/032/2016
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?*
r Yes r- No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
HEU concurrence With MOA for Historic Bridge affects call
7c. Historic or Prehistoric Information Upload
17-09-0041 Signed EffectsConcForm.pdf 4.49MB
PA 17-09-0041 Wilson (NSR).pdf 7.27MB
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain?*
r Yes r' No
8b. If yes, explain how project meets FEMA requirements:
FEMA MOA..... New bridge replacement project in compliance with FEMA MOA requirements for no impacts to 100 year flood plain.
8c. What source(s) did you use to make the floodplain determination?*
FRIS
Miscellaneous
Comments
Miscellaneous attachments not previously requested.
Signature u
W 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 this PCN form is a "transaction" subject to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
• 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 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:
Chad Coggins

Signature
Date
5/2/2019