20191124 Ver 1_PCN Form Submission (2)_20190822

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 * Version#*
20191124 1
Is a payment required for this project?*
r No payment required
r Fee received Reviewing Office*
r Fee needed - send electronic notification Central Office - [phone]
Select Project Reviewer*
Rob Ridings:eads\rgridings
Information for Initial Review
1a. Name of project:
Bridge 500068 SR 1153 (Webb Mill Rd)
1a. Who is the Primary Contact?*
Chad Coggins
1b. Primary Contact Email:* 1c. Primary Contact Phone:*
[e-mail] [phone]
Date Submitted
8/22/2019
Nearest Body of Water
Juniper Swamp
Basin
Neuse
Water Classification
QNSW
Site Coordinates
Latitude:
35.40510
FA. Processing Information
County (or Counties) where the project is located:
Johnston
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-500068(Stated Funded)
WBS # (?)
17BP.4.R.99
Longitude:
-78.38454
1a. Type(s) of approval sought from the Corps:

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:
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 / Frovinee / 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:
Four Oaks
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:*
Juniper Swamp
3b. Water Resources Classification of nearest receiving water:*
QNSW
3c. What river basin(s) is your project located in?*
Neuse
3d. Please provide the 12-digit HUC in which the project is located.
030202011302
4. Project Description and History
State / Rovince / Pagion
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 single-family residential housing in the vicinity of this project.
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)
Johnston 68 Topo Map.pdf 2.43MB
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)
Johnston 68 Soils Map.pdf 1.77MB

4f. List the total estimated acreage of all existing wetlands on the property:
0.04
4g. List the total estimated linear feet of all existing streams on the property:
200
4h. Explain the purpose of the proposed project,*
Replace Bridge 500068 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 Bridge 500068 which is structurally deficient for current NCDOT standards with a new bridge meeting these standards in the eAsting right-of-vay With offsite detours. Heavy
road and bridge building equipment will be used.
4j. Please upload project drawings for the proposed project.
Johnston68_permit plans.pdf 2.37MB
5. Jurisdictional Determinations
Sa. Have the wetlands or streams been delineated on the property or proposed impact areas?*
r Yes r No
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 Unknown
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
Jurisdicition * M
2g. Impact
area*
Site 1
Roadway Fill
P
Riverine Swamp Forest
Juniper Swamp
Yes
Both
0.010
(acres)
Site 1
Roadway Excavation
P
Riverine Swamp Forest
Juniper Swamp
Yes
Both
0.020
(acres)
Site 1
Mechanized Clearing
P
p Forest
fft
Juniper Swamp
��
Both
0.010
(acres)
2g. Total Temporary Wetland Impact
0.000
29. Total Wetland Impact
0.040
2h. Comments:
2g. Total Permanent Wetland Impact
0.040

There is no hand clearing associated with this project.
3. Stream Impacts
3a. Reason for impact (?)
3b.lmpact type *
3c. Type of impact *
3d. S. name *
3e. Stream Type *
Type of
3gSwidth *
3h. Impact
❑
�[3f.
(?)
urisdiction*
length*
S1
Bridge Fill
9
Permanent
Bank Stabilization
Juni er Swam
P P
Perennial
Both
60
34
Average (feet)
(linear fed)
82
Bridge Fill
Temporary
Dewatering
Juniper Swamp
Perennial
Both
60
43
Average (feet)
(linear fed)
S3
Ditch Fill
Permanent
Relocation
Juniper Swam
P P
Perennial
Both
5
85
Average (feet)
(linearfed)
Sq
Ditch Fill
Temporary
Dewatering
Juniper Swamp
Perennial
Both
5
83
Aver�e(fed)
(linear fed)
3i. Total jurisdictional ditch impact in square feet:
0
3i. Total permanent stream impacts:
119
3i. Total stream and ditch impacts:
245
3j. Comments:
6. Buffer Impacts (for DWR)
6a. Project is in which protect basin(s)?
Qheck all that apply.
V Neuse
r Catawba
r Goose Creek
r Other
3i. Total temporary stream impacts:
126
r Tar -Pamlico
r Randleman
r Jordan Lake
6b. Impact Type 6c. Per or Temp 6d. Stream name 6e. Buffer mitigation required? 6f. Zone 1 impact 6g. Zone 2 impact
Roadway & bridge construction P Juniper Swamp No 1,812 1,015 11
6h. Total buffer impacts:
Zone 1 Zone 2
Total Temporary impacts: 0.00 0.00
Zone 1 Zone 2
Total Permanent impacts: 1,812.00 1,015.00
Zone 1 Zone 2
Total combined buffer impacts: 1,812.00 1,015.00
6i. Comments:
Supporting Documentation
Johnston68_permit plans.pdf 2.37MB
Johnston 68 SMP.pdf 130.83KB
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 bridge 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. DOT 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:
Roadway fill and excavation impacts (0.03 acre) fall below NWP condition threshold of impacts/requirements for compensatory mitigation. Also, permanent stream channel impacts (119
linear feet) fall below Regional condition threshold of 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 SMNT)
r Other SCM that removes minimum 30 % nitrogen
r Proposed project will not create concentrated Stormwater flow through the buffer
Diffuse Flow Documentation
Johnston 68 SMP.pdf
Johnston68_permit plans.pdf
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
130.83KB
2.37MB
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
�u
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 C- 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 O 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 (RCW) is included in the IPaC TE list dated August 12, 2019. RCW foraging, or nesting habitat was not found adjacent to
the project area. NCNHP database records no element occurrence within a mile of the project area. (No Affect) / Neuse River Waterdog is included in
the IPaC TE list dated August 12, 2019. The "Proposed Threatened" listing for this species was announced May 2019. This species is active during
cold water events of Winter and early Spring. Therefore, there has not been an appropriate widow of conditions to conduct survey for this species.
Surveys will be conducted when required by T&E protocols. NCNHP database records no element occurrence within a mile of the project area.
(unresolved) // Carolina Madtom is included in the IPaC TE list dated August 12, 2019. The "Proposed Endangered" listing for this species was
announced May 2019. There has not been an appropriate widow of conditions to conduct survey for this species. Surveys will be conducted when
required by T&E protocols. NCNHP database records no element occurrence within a mile of the project area. (unresolved) /// Yellow Lance is included
in the IPaC TE list dated August 12, 2019. Review of the 12-digit HUC GIS element occurrence layer shows this species is not included for the project
identified 12-digit HUC. NCNHP database element occurrence shows Yellow Lance is in a 12-digit HUC one 12-digit HUC unit downstream of the project
site (Lower Mill Creek Sub basin / last observe 06/03/1994); approximately 11 stream miles from the project site. This project meets the current
Section 7 Mussel Programmatic protocols for bridge replacement of a Programmatic BO of "No Affect". (No Affect) //// Michau)(s Sumac (MS) is
included in the IPaC TE list dated August 12, 2019. No MS was found Within the project area. NCNHP database records no element occurrence Within
a mile of the project area. (No Affect) ///// Programmatic BO of MALAA for NLEB.
Consultation Documentation Upload
FWS IPaC TE list.pdf 231.42KB
NCNHP Element Occurrence Lefler.pdf 3.21 MB
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?*
r 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
17-08-0022_%SurveyReq.pdf 3.07MB
AR17-08-0022NoSurvey.pdf 1.33MB
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 is in compliance with FEMA MOA requirements for no impact 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
P 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 Witten signature; AND
• I intend to electronically sign and submit the PCN form.
Full Name:
Chad Coggins
Signature
Date
8/22/2019