0141-0154 ADDENDUM NO. 3

NOVEMBER 2, 2020

REHABILITATION OF BRIDGE NO. 06793 & BRIDGE NO. 06794 I-395 OVER

LITTLE MOUNTAIN BROOK & UNNAMED BROOK

FEDERAL AID PROJECT NO. 0395(013)

STATE PROJECT NO. 0141-0154

TOWNS OF THOMPSON

ADDENDUM NO. 3

This Addendum addresses the following questions and answers contained on the “CT DOT

QUESTIONS AND ANSWERS WEBSITE FOR ADVERTISED CONSTRUCTION

PROJECTS”:

Question and Answer No. 6.

PLAN

REVISED PLANS

The following Plan Sheets are hereby deleted and replaced with the like-numbered Plan Sheets:

• 02.01.A3

• 02.02.03.A3

• 03.02.02.A3

PERMITS

The following Permit Approval and Registration is hereby added to the Contract:

• Inland Wetland General Permit (Bridge No. 06794)

The Bid Proposal Form and Detailed Estimate Sheet are not affected by these changes.

There will be no change in the number of calendar days due to this Addendum.

The foregoing is hereby made a part of the contract.

1

JASON M. COITESTATE OF CONNECTICUT DEPARTMENT OF TRANSPORTATION2800 BERLIN TPKEPO BOX 317546NEWINGTON, CT 06111-4113

As of today, the following materials have been received:

ITEM REQUIRED FEE FEE RECEIVED RECEIVED ON

Application Package 10/27/2020

Application Fee 0.00

Your application has been assigned the following number: 202073396Please include this number on all correspondence regarding this application.

State Project No. 141-154 Rehabilitation No. 06794 (Town of Thompson, CT)

Water Resources Construction Activities-GP, Emergency AuthorizationPermit Type:

Dear Applicant:

This letter is to confirm the receipt of the following application package:

10/30/2020

The fee for this application has been discounted 100%.

If there are any questions regarding this notice, please feel free to contact the Central Permit Processing Unit at (860) 424-4004 or DEEP.CentralPermits@ct.gov

If you have specific technical questions regarding your application, please contact the Land and Water Resources Division at 860-424-3019

Please remember to check your security settings to be sure you can receive e-mails from (ct.gov) addresses. Also, please notify the department if your e-mail address changes.

STATE OF CONNECTICUT DEPARTMENT OF TRANSPORTATIONApplicant/Registrant:

To complete application submission:

a. Send an empty/blank email to DEEP.LWRDRegulatorySubmittals@ct.gov

b. An automated email response will contain instructions for uploading a PDF of the Transmittal Form and applicable Program Forms, management plans, or additional supporting documents of your application to the LWRD File Transfer Protocol (FTP) website.

c. Follow directions contained in the email for uploading the Transmittal and Application Forms.

Thank you.

Sincerely,

Central Permit Processing Unit

SalterMJ

Rectangle

DEEP-LWRD-APP-001 Page 1 of 6 Rev. 10/01/19

LWRD License Application

Transmittal Form The Land & Water Resources Division (LWRD) License Application* consists of this Transmittal Form and the program-specific form. All application forms can be found on the Department of Energy & Environmental Protection (DEEP) website at www.ct.gov/deep/lwrdpermitapps. Submit application forms per instructions provided in Part VII of this transmittal form.

Part I: License Type and Fee Information The table below lists various License types issued by DEEP LWRD. If more than one license is necessary for a project, complete only one Transmittal Form. Complete as many Program Forms as applicable for the project. Check the boxes below that correspond with the LWRD license(s) being requested.

Type of License Program

Form Fee

DEEP

USE

ONLY

Licenses for Activities in Aquifer Protection Areas

Aquifer Protection Area Registration

Check one: New Modification1 of # (no fee) Renewal of #

Aquifer Protection Area Permit

Check one: New Modification1 of # (no fee) Renewal of # 1 Note that if you are seeking a modification, you should consult the Aquifer Protection Program at 860-

424-3019 prior to application submittal to determine whether a registration form is necessary.

A

B

$625

$1,250

[#996]

[#995]

Licenses for Activities in Tidal Waters

Structures, Dredging & Fill2

Structures, Dredging & Fill2 and Tidal Wetlands (TW)

Structures, Dredging & Fill2 and Section 401 Water Quality Certificate (WQC)3

Structures, Dredging & Fill2; TW; and Section 401 WQC3

Certificate of Permission (if applicable, WQC will be included) 2 For projects larger than 825 square feet, provide Attachment A with an additional fee.

Refer to the instructions (page 4) for fee calculations. 3 For activities requiring a Sec.404 Permit from United States Army Corps of Engineers (USACE).

C

C

C

C

D

$660

$660

$660

$660

$375

[#1085]

[#438]

[#1632]

[#417]

[#410]

General Permit Registration for Coastal Maintenance

Marina and Mooring Field Reconfiguration

Remedial Activities Required by Order

Residential Modification to FEMA Standards

Reconstruction of Permitted Structures

E

F

G

H

$700

$700

$100

$300

[#992]

[#427]

[#423]

[#1741]

General Permit Registration for Minor Coastal Structures

4/40 Docks/Access Stairs

Non-Harbor Moorings

I

J

$700

$250

[#426]

[#422]

General Permit Registration for Dolphin Cove

Structures, Fill, Obstructions, or Encroachments in Dolphin Cove Lagoon, Stamford

K

$100

[#420]

CPPU USE ONLY

App #s: ________________________________

_________________________________

____________________________ -DIV

____________________________ -FM/E

Doc #: _________________________________

Check #: _______________________________

DEEP-LWRD-APP-001 Page 2 of 6 Rev. 10/01/19

Part I: License Type and Fee Information (continued)

Type of License Program

Form Fee

DEEP

USE

ONLY

For Federal Agency Activities Only:

Section 401 Water Quality Certificate (Tidal)

C

None

[#1186]

Licenses for Activities in Non-Tidal Waters

Section 401 Water Quality Certificate (Individual)3

Pre-Construction Notification, USACE General Permits for CT3

Inland Wetlands and Watercourses4

Inland Wetlands and Watercourses4 and WQC3

3 For activities requiring a Sec.404 Permit from USACE.

4 For State Agency Activities OR Activities Conducted on State Owned/Controlled Lands.

L

L

L

L

None

None

None

None

[#1195]

[#1188]

[#365]

[#2225]

For State Agency Activity Conducted on State Owned/Controlled Lands Only:

General Permit Registration for Water Resources Construction Activities

Activities 1-4: Maintenance Plans M $2,500 [#2243]

Activities 5-7: Infrastructure and Public Works Projects N $2,500 [#2244]

Activity 8: Activities Authorized Under a Corps General Permit (Must be submitted after receiving PCN approvals and Flood Management, if applicable.)

O $1,250 [#2245]

Activity 9: Conservation Activities O $1,250 [#2246]

Additional Licenses for Activities

These licenses may be combined with Tidal or Non-Tidal Waters licenses.

Water Diversion – Non-consumptive

Watershed < 0.5 sq. mi.

Watershed ≥ 0.5 sq. mi and < 2.0 sq. mi.

Watershed ≥ 2.0 sq. mi.

L

L

L

$2,050

$4,000

$6,250

[#457]

[#456]

[#455]

For State Agency Activity/Activities Receiving Funding Through a State Agency:

Flood Management Certification

Flood Management Certification with Exemption Request

P

P

None

None

[#1185]

[#1185]

Fee from Attachment A,

if applicable

$0

Total $0 (State Waiver)

*For processing purposes, the terms Application and Applicant are synonymous with the terms Registration and Registrant.

In addition to applicable boxes above, check here if your application is:

eligible for a municipal 50% discount;

for work in tidal waters and being submitted pursuant to CGS section 22a-361(a)(2)(d) to address a

violation; or

receiving state funding including federal funding administered by the state (to help determine need

for Flood Management Certification).

DEEP-LWRD-APP-001 Page 3 of 6 Rev. 10/01/19

Part II: Project and Site Information

1a. Project: Provide a brief description of project/activity/work: Project No.141-154 - I-395, Bridge No.06794 over

unnamed brook (drains to Sunset Hill Brook) in Thompson. Rehabilitation of bridge by slip lining culvert and

installation of headwalls and wingwalls.

1b. Site Name and Location

Name of Site: Project No. 141-154

Address of Site: I-395 City/Town: Thompson State: CT Zip Code: 06277

Parcel Location/Tax Assessor's Reference: Map N/A Block Lot

GPS Coordinates/Latitude and Longitude: Provide the exact location of proposed activity, in degrees/minutes/seconds or in decimal degrees: Latitude: 41°58'35.78"N Longitude: 71°51'41.16"W

Parcel/Easement size: If the project is located on a parcel, indicate parcel acreage: N/A acres

If the project is located on a utility/transportation right-of-way or easement, indicate dimensions or acres: See permit plans

Part III: Applicant Information

If an applicant is a corporation, limited liability company, limited partnership, limited liability partnership, or a statutory trust, they must be registered with the Secretary of State. If applicable, the applicant’s name shall be stated exactly as it is registered with the Secretary of State. Please note, for those entities registered with the Secretary of State, the registered name will be the name used by DEEP. This information can be accessed at the Secretary of State's database (CONCORD) at portal.ct.gov/SOTS.

If an applicant is an individual, provide the legal name (include suffix) in the following format: First Name; Middle Initial; Last Name; Suffix (Jr, Sr., II, III, etc.).

Once an authorization has been received, if there are any changes or corrections to your company/facility or individual mailing or billing address or contact information, please complete and submit the Request to Change Company/Individual Information to the address indicated on the form.

1. Applicant/Registrant* Information

Name: Connecticut Department of Transportation

Mailing Address: 2800 Berlin Turnpike

City/Town: Newington State: CT Zip Code: 06131

Business Phone: 860-594-2931 Ext.:

Contact Person: Kimberly C. Lesay Phone: 860-594-2931 Ext:

E-mail Address†: Kimberly.Lesay@ct.gov

†Email is Required. By providing this e-mail address you are agreeing to receive official correspondence from DEEP, at this

electronic address, concerning the subject application. Please remember to check your security settings to be sure you can receive e-mails from “ct.gov” addresses. Also, please notify DEEP if your e-mail address changes.

If co-applicant(s), check this box and attach co-applicant information as Attachment B following this form.

a) Applicant Type (check one):

individual federal agency state agency municipality tribal

business entity (if a business entity, complete i through iii below):

i) business type: corporation limited liability company limited partnership

limited liability partnership statutory trust Other:

ii) provide Secretary of the State business ID #: This information can be accessed at database (CONCORD): portal.ct.gov/SOTS

iii) check here if your business is NOT registered with the Secretary of State’s Office.

*For processing purposes, the terms Application and Applicant are synonymous with the terms Registration and Registrant.

3448

Jason Coite

Jason.Coite@ct.gov

3448

DEEP-LWRD-APP-001 Page 4 of 6 Rev. 10/01/19

Part III: Applicant Information (continued)

b) Applicant’s interest in property at which the proposed activity is located:

site owner option holder lessee facility owner

easement holder operator other (specify):

2. List billing contact, if different than the applicant:

Name:

Mailing Address:

City/Town: State: Zip Code:

Business Phone: Ext.:

Contact Person: Title:

E-mail:

3. Primary contact for departmental correspondence and inquiries if different than applicant:

Name:

Mailing Address:

City/Town: State: Zip Code:

Business Phone: Ext.:

Contact Person: Title:

E-mail:

4. Site/Property Owner*, if different than applicant:

Name:

Mailing Address:

City/Town: State: Zip Code:

Business Phone: Ext.:

Contact Person: Title:

E-mail:

*If the applicant is not the owner, submit written permission from the owner as Attachment C

5. Facility Owner, if different than applicant:

Name:

Mailing Address:

City/Town: State: Zip Code:

Business Phone: Ext.:

Contact Person: Title:

E-mail:

6. Facility Operator, if different than applicant:

Name:

Mailing Address:

City/Town: State: Zip Code:

Business Phone: Ext.:

Contact Person: Title:

E-mail:

DEEP-LWRD-APP-001 Page 5 of 6 Rev. 10/01/19

Part III: Applicant Information (continued)

7. Attorney or other representative, if applicable.

Firm Name:

Mailing Address:

City/Town: State: Zip Code:

Business Phone: Ext.:

Attorney: Title:

E-mail:

8. Engineer(s), surveyor(s) and/or other consultant(s) employed or retained to assist in preparing the

application and designing or constructing the activity.

Name: CME Associates, Inc.

Mailing Address: : 101 East River Drive, 1st Floor

City/Town: East Hartford State: CT Zip Code: 06108

Business Phone: 860-290-4100 Ext.: 1148

Contact Person: Naomi Hodges Title: Environmental Scientist

E-mail: nhodges@cmeengineering.com

Service Provided: Liaison Engineering Services, Environmental Services

Part IV: Pre-Application Coordination

If pre-application coordination occurred, provide DEEP LWRD staff contact information:

Staff Name: Interagency Coordination Meeting Date: 10/18/2018

Part V: Supporting Documents

As applicable, check the box by the attachments listed to indicate that they have been submitted. When submitting any supporting documents, please label the documents as indicated in this part (e.g., Attachment A, etc.) and be sure to include the applicant's name as indicated on this application form. Attach the materials below following this transmittal form.

Attachment A Structures, Dredging and Fill fee calculation worksheet (if applicable)

Attachment B Co-applicant information sheet (if applicable)

Attachment C Written permission from land owner (if applicant is not the owner)

Attachment D Additional signature sheet (if applicable)

CHA Companies

Ciara J. Hayes

chayes@chacompanies.com

1147

DEEP-LWRD-APP-001O Page 1 of 1 Rev. 10/01/19

LWRD License Application Form O

General Permit Request for Authorization,

Water Resources Construction Activities (Activities 8 & 9) Activities Authorized Under a USACE General Permit

Conservation Activities

All sections of the LWRD License Application, when applicable, must be posted to the DEEP LWRD FTP site as instructed on Part VII of the LWRD Transmittal Form.

Application Number (as assigned in CPPU e-mail):

Applicant Name (same name used on Part III of the LWRD Transmittal Form):

Supporting Documents

Check the box by the attachments listed to indicate that they have been submitted. When submitting any supporting documents, please label the documents as indicated in this part (e.g., Attachment 31, etc.) and be sure to include the same applicant name used above. NOTE: Attachment numbering is NOT consecutive as the attachments relate to multiple LWRD program applications.

Attachment 29 Attach a copy of USACE PCN authorization, if applicable. USACE PCN #

Attachment 31 Attach a copy of either the DEEP Section 401 Pre-Construction Notification (PCN)

License or the USACE Self-Verification (SV) submittal, including form and plans.

DEEP PCN # 201914657-PCN

Attachment 32 Flood Management Certification (FMC) must be issued prior to submittal of this form, if

required. Attach a copy of the FMC License. FMC #

Connecticut Department of Transportation

202073396

General Permit Request for Authorization, Water Resource Construction Activities (Activities 8 & 9)

Applicant: State of Connecticut, Department of Transportation Project No. 0141-0154 Rehabilitation of Bridge No. 06794, I-395 over Unnamed Brook Town of Thompson

Attachment 29: USACE PCN Authorization

October 19, 2020 Regulatory Division File Number: NAE-2019-03272 CT DEEP File Number: 201912866-PCN & 201914657-PCN Kimberly Lesay Connecticut Department of Transportation 2800 Berlin Turnpike Newington, Connecticut 06131 kimberly.lesay@ct.gov Dear Kimberly Lesay: We have reviewed your application to place fill within Waters of the U.S., including wetlands, in order to rehabilitate Bridge No. 06793 and Bridge No. 06794. Regarding Bridge No. 06793, the project will involve temporary placement of fill in approximately 400 sf of Little Mountain Brook and 1,845 sf of unnamed wetland resulting from the installation of cofferdams upstream and downstream along with a bypass pipe and rip rap splash pad. Permanent placement of fill will occur in approximately 1,751 sf of Little Mountain Brook and approximately 155 sf of unnamed wetland resulting from the installation of permanent access roads to the inlet and outlet; and reconstructing a scour pool and rock weir with rounded boulders. The work associated with Bridge No. 06793 is located at 41.944879 N, -71.880468 W, Thompson, Connecticut and shown on the enclosed plans titled “ENVIRONMENTAL PERMIT PLANS; STATE PROJECT NO. 141-154; REHABILITATION OF BRIDGE NO. 06793; I-394 OVER LITTLE MOUNTAIN BROOK; (SITE NO. 1); IN THE TOWN OF THOMPSON,” on 7 sheets, and dated “July 8, 2019.” Regarding Bridge No. 06794, the project will involve the temporary placement of fill in approximately 5,539 sf of unnamed wetland and 597 sf of unnamed stream resulting from the installation of cofferdams upstream and downstream along with construction of a temporary access road to the outlet. Permanent placement of fill will occur in approximately 1,617 sf of unnamed wetland and 2,978 sf of unnamed stream resulting from regrading with natural streambed material, installing a riprap scour hole at the outlet, and constructing a permanent access road to the inlet. The work associated with Bridge No. 06794 is located at 41.976764 N, -71.861256 W, Thompson, Connecticut and shown on the enclosed plans titled “ENVIRONMENTAL PERMIT PLANS; STATE PROJECT NO. 141-154; REHABILITATION OF BRIDGE NO. 06794; I-395 OVER UNNAMED BROOK; (SITE NO. 2); IN THE TOWN OF THOMPSON,” on 10 sheets, and dated “November 12, 2019.” Based on the information you have provided, we verify that the activity is authorized under General Permit # 19 of the enclosed August 19, 2016 Federal permit known as the Connecticut General Permits (GPs). This verification is subject to the following special conditions:

1. Compensatory mitigation shall consist of purchasing .03 credits from the Connecticut In-

Lieu Fee (ILF) program for impacts associated with Bridge No. 06794. The permittee must send a cashier’s check or bank draft for the amount calculated on the enclosed “Connecticut In-lieu Fee Project Impact Worksheet” to: Executive Director, National Audubon-Society, Inc., Connecticut Chapter, Attn: ILF Program, 185 East Flat Hill Road, Southbury, CT 06488. The check shall payable to “National Audubon Society, Inc.” and include the Corps file number “NAE-2019-03272” and the statement, “For ILF account only.” The enclosed “Connecticut In-lieu Fee Project Impact Worksheet” must accompany the check to ensure proper crediting. Work shall not begin until the Corps receives a copy of the confirmation letter from the Audubon-CT to the permittee stating that Audubon-CT has received and the check and accepts responsibility for mitigation. The in-lieu fee amount is valid for one year from the date of this permit and is subject to change.

2. You must complete and return the enclosed Work Start Notification Form to this office at least two weeks before the anticipated starting date.

Please review the enclosed GPs and general conditions carefully to be sure that you and whoever does the work understand its requirements. A copy of the GPs and this verification letter shall be available at the project site throughout the time the work is underway. Performing work within our jurisdiction that is not specifically authorized by this determination or failing to comply with any special condition provided above and all the terms and conditions of the GPs may subject you to the enforcement provisions of our regulations. This authorization expires on August 19, 2021. You must commence or have under contract to commence the work authorized herein by August 19, 2021, and complete the work by August 19, 2022. If not, you must contact this office to determine the need for further authorization before beginning or continuing the activity. We recommend that you contact us before this authorization expires to discuss reissuance. Please contact us immediately to discuss modification of this authorization if you change the plans or construction methods for work within our jurisdiction. We must approve any changes before you undertake them. This authorization does not obviate the need to obtain other Federal, state, or local authorizations required by law. The Connecticut Department of Energy & Environmental Protection (DEEP) has issued a Water Quality Certification (WQC) for this project, as required under Section 401 of the Clean Water Act, based on their review of the project. We continually strive to improve our customer service. In order for us to better serve you, we would appreciate your completing our Customer Service Survey located at http://corpsmapu.usace.army.mil/cm_apex/f?p=regulatory_survey. Please contact Ms. Charlotte Skolnick, of my staff, at (978) 318-8145 if you have any questions.

General Permit Request for Authorization, Water Resource Construction Activities (Activities 8 & 9)

Applicant: State of Connecticut, Department of Transportation Project No. 0141-0154 Rehabilitation of Bridge No. 06794, I-395 over Unnamed Brook Town of Thompson

Attachment 31: DEEP Section 401 Pre-Construction Notification (PCN) License