20090967 Ver 1_Application_20090908

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Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Pre-Construction Notifi lion C Form
A. Applicant Information
1. Processing
1a. Type(s) of approval sought from the
Corps: ® Section 404 Permit ? Section 10 Permit
1b. Specify Nationwide Permit (NWP) number. 3 or General Permit (GP) number.
1c. Has the NWP or GP number been verified by the Corps? ® Yes ? No
1d. Type(s) of approval sought from the DWQ (check all that apply):
® 401 Water Quality Certification - Regular ? Non-404 Jurisdictional General Permit
? 401 Water Quality Certification - Express ® Riparian Buffer Authorization
Ia. Is this notification solely for the record
because written approval is not required? For the record only for DWQ 401
Certification:
? Yes ® No For the record only for Corps Permit:

® Yes ? No
If. Is payment into a mitigation bank or in4ieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in-lieu
fee program. ? Yes ® No
1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1h
below. ® Yes ? No
1h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ® Yes ? No
2. Project Information
2a. Name of project: SR 1304 River Road Shoulder Stabilization
2b. County: Pamlico
2c. Nearest municipality / town: Minnesott Beachl
2d. Subdivision name: N/A
2e. NCDOT only, T.I.P. or state
project no: 2C.069010
3. Owner Information
3a. Name(s) on Recorded Deed: North Carolina Department of Transportation
3b. Deed Book and Page No. N/A
3c. Responsible Party (for LLC if
applicable): N/A
3d. Street address: 105 Pactolus Highway NC 33 P.O. Box 1587
3e. City, state, zip: Greenville, NC 27835
3f. Telephone no.: 252-830-3490
3g. Fax no.: 252-830-3341
3h. Email address: jbjohnson@ncdotgov
Page 1 of 10
PCN Form -Version 1.3 December 10, 2008 Version
4. Applicant information (if different from owner)
4a. Applicant is:. ? Agent ® Other; speafy: Division 2 Environmental.Officer
4b Name: Jay IiAohnson
4c. Business name
(if applicable): North Carolina Depratment of Transportation '
4d. Street address: P.:O..Box 1587
4e. City;,state, zip: Greenville, NC'27835
4f. Telephone no.: 252-8303490;
4g. Fax no.: 252-8303341
4h. Email address: [e-mail]
6. Agent/Consultant Information (if applicable),
5a. Name: N/A
5b. Business name.
(if applicable):-
5c. Streefaddress:
5d. City. state zip: w
5e. Telephone no.:
5f. Fax no.: .
5g. Email address:
B. Project Information and Prior Project History
-1., Property Identification:- '
1a: Property identification no.;(tax PIN or parcel ID): N/A.
Latitude: N 34`975342 Longitude. - W
1b. Site coordinates (in decimal degrees): 76 781473
- (DD.DDDDDD) .(-DD.DDDDDD)
1c: Property size: N/A acres
2: Surface Waters
2a. Name of nearestbody of water (stream; river, etc.) to Neuse
,proposed; project:.
2b. Water Quality, Classificati on Of,nearestreceivingwateir. SA;HQW;NSW
2c. River basin: , Neuse' -
3. Project Description
3a- Describe the existing conditions on the site'and the general (and use in the vicinity of the project at the time of this
application:,
SR 1304, River Road is a paved secondary state highway. Agricultural and Residential Land Uses dominate the
landscape.
3b. List,the total estimated acreage ofalliexisting wettandson the property:
0.04 Acres. This site is part of a larger adjacent wetland system
36. List the.total estimated linear feet of all existing streams (intermittent and perennial) on the properly.
70' This site is part of a longer adjacent stream system
3d. Explain the-purpose of the proposed 'project:
Shoulder Stabilization; the existing shoulder is failing.
3e. Describe the overall project in detail, including the type of equipment to be used:
The, Existing; Shoulder will be stabilized with Rip Rap. Exbavators;Dump Trucks,and Crane Trucks
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property./
project (including all prior phases) in the past? ? Yes ®No ? Unknownr
Comments:
4b. If the Corps made the jurisdictional determination; what type ® Preliminary ? Final
of determination was made? _
4c. If yes, who delineated the. jurisdictional areas? - Agency/Consultant Company:
Name if known): Brad Connell and Stephen Lane Qther.: NCDC(N -
4d. Ityes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
July)2009
5. Project History
5a: Have permits or certifications been requested or obtained for ;? Yes ® No ?' Unknown
this project,(including all prior phases) ;inthe past?
5b. If yes, explain in detail according to 'help file. instructions.
8. Future Project Plans .
6a. Is this a phased project?' ?,Yas ®No
6b. If yes,;explain. '
Page 3 of 10
PCN.Form -Version 1.3 December 10, 2008 Version

C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
® Wetlands ? Streams - tributaries ® Buffers
? Open Waters ? Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a. 2b. 2c. 2d. 2e. 2f.
Wetland impact Type of jurisdiction
number- Type of impact Type of wetland Forested (Corps - 404, 10 Area of impact
Permanent (P) or (if known) DWQ - non-404, other) (acres)
Temporary
W1 ? P ? T ? Yes ? Corps
? No ? DWQ
W2 ? P ? T ? Yes ? Corps
? No ? DWQ
W3 ? P ? T ? Yes ? Corps
? No ? DWQ
W4 ? P ? T ? Yes ? Corps
? No ? DWQ
W5 ? P ? T ? Yes ? Corps
? No ? DWQ
W6 ? P ? T ? Yes ? Corps
? No ? DWQ
2g. Total wetland impacts 0
2h. Comments:
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a. 3b. 3c. 3d. 3e. 3f. 3g.
Stream impact Type of impact Stream name Perennial Type of jurisdiction Average Impact
number - (PER) or (Corps - 404, 10 stream length
Permanent (P) or intermittent DWQ - non-404, width (linear
Temporary (T) (INT)? other) (feet) feet)
S1 ®P ? T ? PER ? Corps
? INT ? DWQ
S2 ®P ? T ? PER ? Corps
? INT ? DWQ
S3 ? P ? T ? PER ? Corps
? INT ? DWQ
S4 ? P ? T ? PER ? Corps
? INT ? DWQ
S5 ? P ? T ? PER ? Corps
? INT ? DWQ
S6 ? P ? T ? PER ? Corps
? INT ? DWQ
3h: Total stream and tributary impacts 0
31. Comments:
Page 4 of 10
PCN Form -Version 1.3 December 10, 2008 Version
4. Open Water Impacts
If there are pro posed impacts to lakes, ponds, estuaries, tributaries; sounds, the Atlantic Ocean;,or any other open.water of
the U.S then;individually lista6 open water,impacts below.
.4a_ ..

O n,water
impact number
- Permanent
(P) or
Tem ora . 4b.

Name of w
(if appt i , aterbody .'
cable) `4c.;

Type of impact 4d.

Watebody type 4e.,

Area of impact (acres)
01. ?P?T 0.00
02 p,PpT
03 El P
04 ElP?T
4f. Total open water impacts 0.00
4g. Comments:
5. Pond or Lake Construction
If and or lake construction proposed, then com fete the chart below.
5a.

.Pond IDi 5b.

Proposed use,or,purposeof•
•.,. 56. _
Wetland,knpacts (acres), 5d.
Stream Impacts (feet), 5e.
Upland
(acres).
,number pond Flooded Filled; Excavated 'Flooded Filled Excavated Flooded
P1
P2
5E Total None
5g: Comments:
5h. Is a dam high hazard permit required?,
,,l] Yes E]'No If yes, permit IDno:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for DWQ) '
If project'wiltimpact a protected riparian buffer, then complete the chart below. If yes, then'individually list all. buffer impacts
below. If an im acts, uire "miti ail then: u MUST fill out Section 'D of this form.
6a.
® Neuse. ?'Tar-Pamlico ? Ostler: None
Project is in which protected basin? ? Catawba ? Randleman
6b. 6c. 6d: 6e. 6f. 6g.
. Buffer'impact
number - Reason for Buffer Zone 1 impact Zone 2 ,impact
Permanent (P) impact Stream name mitigation (square feet) (square feet)
or Temporary required?

81 ®P ®T Shoulder
Stabilization,
Neuse ?'Yes
® No
20
40 Sq. Ft.
B2 ?P[IT ?Yes
? No

B3 E] P.? T Yes
El ? No
6h. Total buffer impacts 2o Sq. Ft. 40 Sq. h.
6i. Comments
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1a. Specifically describe measures taken to avoid or minimize the proposed impacts.indesigning project.
Wetland Impacts have been?minimiied to_the,extent feasible, with impacts occurring only where necessary to accommodate
the proposed shoulder stabilization.
1b.. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
,,Use of existing roadway to operate construction equipment; no equipment willenter wetlands.
2 Compensatory Mitigation for Impacts4o' Waters of the U S: or Waters,of the State .
2a. Does the project require Compensatory Mingation,for ?'Yes ® No
impacts to Waters of the U.S. or Waters'of the State?
2b. If yes, .mitigationisrequired by (check all that apply): 'El 'DWQ [],Corps
-
. ....
? Mitigation bank
2c. If yes, which mitigation optionwill be used'for.this project? ? Payment to inAeu fee program
? 'Permittee Responsible Mitigation
3. Complete If Using a Mitigation Banks
3a. Name of Mitigation' Bank:
3b. Credits'Purchased (attach receipt and letter) Type Quantity

Page 6 of 10
PCN Form-Version 1;3.December10, 2008 Version
3c. Comments;
4. Complete ff Making a Payn erit to lh4leu Fee Program,
46. Approval letter from mAeOee program is attached. ? Yes
4b. Stream mifigation requested;' linear feet
4c. If using stream mitigation; stream temperature: ? warm ? cool ?cold
4d. Buffer mitigation:requested (DWQ only square feet '
4e. Riparian wetland mitigation requested: acres
4f. Non-riparian wetland mitigation requested: acres
4g. Coastal (tidal) wetland mitigation requested:. `
, acres
_ ..
4h. Comments:'
5. Complete if Using a Permittee Responsible Mitigation Plan.
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
6. Buffer Mitigation(State'Regulated':RlparianBufferRules) -required by DWQ
6a. Will the project result in an impact within a protected riparian bufferthat requires
buffevmitigstion? . . ? Yes ® No
6b. If yes, then identify the square feet of impact to each zone of.theriparian buffer that requires mitigation. Calculate the
amount of mitigation required

Zone. 6c.
Reason for impact 6d.
Total impact
(square feet)
,
Multiplier 6e
Required mitigation
(square feet)
Zone t (2 for Catawba)
.. .
Zone 2 1.5:
6f: Total buffer mitigation required: None
6g. If buffer mitigation is required, .discuss ,what type of mitigation is proposed (e.g.,:payment to private mitigation bank,
pemtittee responsible riparian buffer restoration; payment;into an approved iri Iieu`fee fund).
N/A
'6h: Comments:
E. Stormwatei Management and Diffuse Flow Plan (!squired by DWQ)
1. Diffuse Flow Plan
la. Does the project include or is it adjacerit to protected riparian buffers'identified
- ® Yes
? No
one of:the NC Riparian:BufferProtection;Rules?
within ,
1b. If yes, then is 'a diffuse flow plan included? If no, explain why.
Comments: Shouolder Stabil zation.project covered by NCDOT Stetewide.NPDES . ?' Yes ® No
Permit .,
2. Stormwater Management Plan
2a. What is the.overall percent imperviousness of this project?. N/A Roadway Project %
2b. Does this project require a Stonnwat_er Management Plan? ? Yes, ®'No
2c. If this pro' , a StormwaterManagement Plan, explain why: Covered by,NCDOT-Statewide.NPDES
tect DOES NOT require
Permit'
2d. If this project DOES require a=Stormwater-Managernent Plan, then provide a brief, narrative description of the plan:
?.Certed Local Government-
2e. Who will be responsible for.the review of;the Stormwater Management Plan? ? DWQ:Stormwater Program . .
? DW(QI401 unit
3. Certified Local GovernmentStormwater Review
3a. In which local govemment's jurisdiction is this project?
? Phased
3b. Which of the following locally-implemented stormwater management programs ? NSW
? USMP
apply (check all that apply): ? Water Supply Watershed
? Other:
3c. Has the approved StorrnwaterManagement'Plan with proof of approval been ?.Yes ® No
attached?
4. DWQ:Stormwater.Program Review
® Coastal counties
? HQW'
4a. Which of the following'state-implememed stomiwater,manageiiientprograms apply ? ORW
(check all that apply)`. ? Session Law 2006-246
? Other:
4b. Has the approved Stormwater Management Plan with proof of approval been
yes
® No
attached. .
5. DWQ'401 Unlf Stormwater Review
5a. Does the Stonnwater Management P16wineet the appropriate requirements? ? Yes ? No
5b. Have all of,the:401'Unifsubmittal , requirements been met? ? Yes ?.No
Page 8:of=10
PCN'Form - Ve slom9:3 December! b, 2008'Version
i
F. SupplementaryInformation
1. Environmental Documentation (DWQ. Requirement)
1a. Does the project involve an expenditure of public.(federal/state0ocal) funds or the
' ®Yes ? No
public (federal/state) lands
use of - _
1b. If you answered "yes" to the above,' doesithe project require preparation of an
environmental document puisuanfto the,requirements of the National or State EJ Yes ® No
(North Carolina)' Environmental Policy Act,(NEPA/SEPA)?
1c. If you answered ".yes" tothe above, has the document review been finalized,by the
State Clearing House? (If so,-;attach a copy of.the,NEPA or SEPA final approval
? Yes
? No
letter:):
Comments:
2. Violations (DWQ Requirement)
2a: Is the site in violation of DWQ Wetland Rules (15A NCAC 21-1.0500), Isolated
Wetland Rules (15A NCAC 2H 1300), DN/Q Surface Water or Welland Standards, ' ? Yes ® No
or Ripar ian Buffer Rules (15A NCAC 2B .0200)?
2b. Is this an after-the-fact permit application? ? Yes ® No.
2c: If you answered;^yes" to one or both of the above questions, provide an explanation:of.the violation(s):
3. Cumulative Impacts (DWQ Requirement)'
3a. Will this project (based on past and reasonably anticipated future impacts) result in !
? Yes
No
additional development, which could impact nearby downstream water.quality?
3b. If you answered 'yes" to the atiove, submit a qualitative or quantitative cumulative impact, analysis, in accordance with the
most recent DWQ policy: If you answered "no? provide a:short narrative description.
4. Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods and disposition ,(non-discharge or.discharge) of wastewater generated from
the proposed project, or available, capacity of the,subject facility.
N/A
Page 9 of 10
PCN'Form - Version 1.3; December 10, 2008 V*sion
S. Endangered Species and Designated Critical;Habitat(Corps Requirement),
5a. Will this project,occur in or near an area with federally protected species or ®No
[I Yes
habitat? _
5b. Have you checked with the USFWS conceming; Endangered,Species Act. ? Yes. ®No
impacts?
? Raleigh
5c. Ifyes, indicate the USFWS Field Office`you have contacted
? Asheville
5d. What data sources did,you.use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
On-Site-Habitat ' Investigation
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur iror near an area designated as essential fish habitat? ?`Yes. ®No
6b. What data sources did you.use to determine whether your site would impact Essential:Fish Habitat?
On-Site Investigation
7. Historic or Prehistoric Cultural Resources (Corps'Requirement)
7a. Will this project occur in ornearan area that the state, federal or tribal
govemritents have designated as having historic orcuttural preservation t] Yes ® No.
status (e g.,,N,ational Historic Trust designation or properties significant in
North Carolina history and archaeology)?' ' ,.
7b. What data sources did you. use to determine whether your site would impact historic or archeological resources?
8. Flood Zone Designation (Corps Requirement).
Be. Will this project occur in a FEMA-designated 100-year floodplain? ® Yes ? No
8b. If yes, explain how project meets FEMA;requirements: Shouolder Stabilization designed to no-rise standards
8c. What source(s) did you use to make the floodplain determination? FEMA FIRM Maps
Septmeber3,
2006
Applicant/Agent'sPrintedName" p nt/ ents Signature
' Date
.. (Agent's signatu v Id nl an authorization letter from thle applicant
is provided.)
Install erosion/sediment control,measures according to,plans: ,
o Gradng,off slopes, 15: a'= stabilize with Class B riprap
o Seed AAistnrbed areas. as soon as'final graiding is co®npleted:
Cleau -out and/or rework,all temporary: seden<ent controUmeasures after
sigriifcant raiiitall eve ot;(or.a&otheawise needed). These meas6ees`should be
maintained untiFa pcrmanenf vegetative cover is established and projeclt is -
complete
o When PjpAap is,being placed,do not exeeed_ 5 foot waterwai•dfrom Nor®al "
Water Level 'of Pimgo Creek

.............. .............
.....................................
... ............ .................
:io
PROJECT NO. 2C.069010, (;ROSS SECTION OF
DATE JUNE 15.2009 CULVERT CROSSING
ROAD SR 1304 SR I304,RIVER ROAD
ROAD NAME RIVER ROAD PAMLICO COUNTY
SHOULDER AND SLOPE STABILIZATION
REVISED AUGUST 5, 2009
SR 1304
EXISTING PAVEMENT
PROPOSED RIP RAP
EXISTING SHOULDER
I@ 6;
NOT TO SCALE
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