20190652 Ver 1_PCN Form Submission_20190516

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
20190652
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 950045 on SR 1353 over Great Swamp replacement
1a. Who is the Primary Contact?*
Chad Coggins
1b. Primary Contact Email:*
[e-mail]
Date Submitted
5/16/2019
Nearest Body of Water
Great Swamp
Basin
Neuse
Water Classification
C;Sw,NSW
Site Coordinates
Latitude:
35.57503
FA. Processina Information
County (or Counties) where the project is located:
Wayne
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 B-4842 Br 950045 (State Funded Project)
WBS # (?)
17BP.4.R.104
1a. Type(s) of approval sought from the Corps:
Longitude:
-77.99967
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:
Fremont
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:*
Great Swamp
3b. Water Resources Classification of nearest receiving water:*
C;Sw,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.
030202030201
4. Project Description and History
State / Rovince / P pion
NC
Country
USA
3e. Fax Number:
2b. Property size:
State / Fraviree / 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 1/2 X 11 excerpt from the most recent version of the USGS topographic map indicating the location of the project site. (for DWR)
Wayne 45 topo.pdf 2.14MB
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)
Wayne 45 soils.pdf 1.91 MB

4f. List the total estimated acreage of all existing wetlands on the property:
0.10
4g. List the total estimated linear feet of all existing streams on the property:
200
4h. Explain the purpose of the proposed project,*
Replace wasting Bridge 45 (950045) 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 45 (950045) which is structurally deficient for current NCDOT standards with a new bridge meeting these standards in the ebsting right-of-way with offsite
detours. Heavy road and bridge building equipment will be used.
4j. Please upload project drawings for the proposed project.
17BP4R104_Permit_Drawings.pdf 4.07MB
17BP4R104_Permit_Drawings _BUFFER.pdf 810.91 KB
5. Jurisdictional Determinations
5a. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes r No C 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 r 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 * M area*
site 1 end bent fill P Riverine Swamp Forest Great Swamp Yes �_]
oth
0.020
(acres)
F771
chanized clearing
f
P
Riverine Swamp Forest
Great Swamp
Yes
Both
0.050
(acres)
2g. Total Temporary Wetland Impact
0.000
2g. Total Wetland Impact
0.070
2h. Comments:
2g. Total Permanent Wetland Impact
0.070

Mechanized clearing not included in threshold of impacts requiring compensatory mitigation (i.e. 0.05 acre of mechanized clearing). 0.04 acre of hand
clearing included in this project. Project includes 0.02 acre of wetland fill. We are not proposing mitigation for jurisdictional impacts (i.e. <0.03
threshold confirmed by Eric Alsmeyer).
6. Buffer Impacts (for DWR)
6a. Project is in which protect basin(s)?
Clh ck all that apply.
R Neuse r Tar -Pamlico
F 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 & approach construction
P
Great Swamp
No
5,440
2,968
6h. Total buffer impacts:
Total Temporary impacts:
Total Permanent impacts:
Total combined buffer impacts:
61. Comments:
Zone 1 Zone 2
0.00 0.00
Zone 1 Zone 2
5,440.00 2,968.00
Zone 1 Zone 2
5,440.00 2,968.00
Supporting Documentation
17BP4R104_Permit_Drawings. pdf
17BP4R104_Permit_Drawings_BUFFER. pdf
E. Impact Justification and Mitigation
1. Avoidance and Minimization
4.07MB
810.91 KB
v
1a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing the project:
Replace in place with offsite detours.
1 b. 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 fill falls below NWP condition threshold of wetland 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

17BP4R104_Permit_Drawings.pdf 4.07MB
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?*
f- Yes r No
v
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 wasting 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?*
r 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 foraging or nesting habitat is not found adjacent to the project area. 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.pdf 196.48KB
NCNHP element occurrence letter.pdf 664.32KB
Wayne Co. TE List.pdf 180.45KB
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 06/03/2016
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?*
f Yes r No
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?*
HEU Clearance
7c. Historic or Prehistoric Information Upload
15-03-0057NoSurvey [HA].pdf 1.93MB
PA 15-03-0057 B-4842 BrNo45 on SR 1353 Hooks Rd over Great Swamp Wayne.pdf 1.37MB
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
F-
Miscellaneous
Comments
Miscellaneous attachments not previously requested.
Signature
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
5/16/2019