19980136 Ver 1_Complete File_19980324

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Wayne McDevitt, Secretary
A. Preston Howard, Jr., P.E., Director
1 • •
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
March 27, 1998
Alleghany County
DWQ Project 980136
APPROVAL of 401 Water Quality Certification
Mr. W. O. Atkins
NC DOT
PO Box 558
Elkin NC 28621
Dear Mr. W. O. Atkins:
You have our approval, in accordance with the attached conditions and those listed below, for the
purpose of grading, draining, basing and paving SR 1154 at from SR 1149 to SR 1161, as you described in
your application dated March 24, 1998. After reviewing your application, we have decided that this impact
is covered by General Water Quality Certification Number 3099. This Certification allows you to use
General Permit Number 30 when it is issued by the Corps of Engineers. In addition, you should get any
other federal, state or local permits before you go ahead with your project including (but not limited to)
Sediment and Erosion Control, Coastal Stormwater, Non-Discharge and Water Supply Watershed
regulations. This approval will expire when the accompanying 404 or CAMA permit expires unless
otherwise specified in the General Certification.
This approval is only valid for the purpose and design that you described in your application except as
modified below. If you change your project, you must notify us and you may be required to send us a new
application for a new certification. If the property is sold, the new owner must be given a copy of this
Certification and approval letter and is thereby responsible for complying with all conditions. If total
wetland fillF. for this project (now or in the future) exceed one acre, compensatory mitigation may be reclsired
as described in 15A NCAC 2H .0506 (h) (6) and (7). For this approval to be valid, you must follow the
conditions listed in the attached certification.
If you do not accept any of the conditions of this certification, you may ask for an adjudicatory hearing.
You must act within 60 days of the date that you receive this letter. To ask for a hearing, send a written
petition conforming to Chapter 150B of the North Carolina General Statutes to the Office of Administrative
Hearings, P.O. Box 27447, Raleigh, N.C. 27611-7447. This certification and its conditions are final and
binding unless you ask for a hearing.
This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water
Act. If you have any questions, please telephone John Domey at 919-733-1786.
Since el ,
r
r ton Howard, Jr. P. .
Attachment
cc: Wilmington District Corps of Engineers v
Corps of Engineers Raleigh Field Office
Winston-Salem DWQ Regional Office
Mr. John Domey
Central Files
980136.1tr
Division of Water Quality • Non-Discharge Branch
4401 Reedy Creek Rd., Raleigh, NC 27607 Telephone [phone] FAX A 733-9959
An Equal Opportunity Affirmative Action Employer • 50% recycled/10%a post consumer paper
- ---10
COPY
?r
North Carolina Wildlife Resources Commission O
312 N. Salisbury Street, Raleigh, North Carolina 27604-1188, 919-733-3391
Charles R. Fullwood, Executive Director
MEMORANDUM ;
S
TO: John Thomas, Permit Coordinator
P_ale?gh. OfFIce, T_T.S Army Corps of Engineer- G..
FROM: Joe H. Mickey, Jr. Western Piedmont Region Coordinator
Habitat Conservation Program original signed by
Joe Mickey
DATE: March 20, 1998 9 ?0
SUBJECT: Review of an application by NCDO'Y to replace an existing drainage pipe in an
unnamed tributary to Prather Creek on SR 1154, A] leghany County.
The North Carolina Department of Transportation (NCDOT) is requesting a letter of
concurrence from the North Carolina Wildlife Resources Commission (NCWRC) to obtain a 404
permit from the U.S. Army Corps of Engineers. The NCWRC has reviewed information
provided by the applicant, and field biologists on our staff are familiar with habitat values of the
project area. These comments are provided in accordance with provisions of the Clean Water
Act of 1977 (33 U.S.C. 466 et. seq.) and the Fish and Wildlife Coordination Act (48 Stat. 401, as
amended, 16 U.S.C. 661-667d).
The project will impact an unnamed tributary to Prathers Creek which is NCWRC
Designated Public Mountain Trout Water managed as Hatchc;ry Suppotied. Baszd on review of
the submitted plans, we do not believe this project will cause significant effects to waters
supporting trout. Therefore, we do not object to the project as proposed provided that instream
work and land disturbance within the 25-foot wide buffer zone are prohibited during the trout
spawning season of October 15 through April 1 to protect the egg and fry stages of trout from
off-site sedimentation.
"Thank you for the opportunity to review and comment on this project. if you have any
questions regarding these comments, please contact me at 336/366-2982.
cc: Wayne Atkins, NCDOT, Elkin
Eric Galamb, DWQ

STATE OF Noiz-m CAROLINA
DEPARTMENT OF TRANSPORTATION
JAMES B. HUNT, JR. E. NORms Tot SON
GOVF,RNOR SECRETARY
MARCH 17, 1998
Mr. Ken Jolly, Office Manager
U. S. Army Corps of Engineers Regulatory Branch
6512 Falls of the Neuse Road
Suite 105
Raleigh, North Carolina 27615

Re: Project No. 6.702267 - Grade, Drain, Base and Pave SR 1154
Andrews Road, 0.59 Mile, from SR 1149 to SR 1161 in Alleghany County,
North Carolina.
Dear Mr. Jolly:
The North Carolina Department of Transportation, District I Maintenance plans to
Grade, Drain, Base and Pave SR1154 (Andrews Road) in Alleghany County, to
improve safety for the traveling public.
(1) Sta 27+40 we plan to remove 50' of existing 48" CMP and replace
same with 60' of 60" CMP Type B.
This is a perpendicular crossings of unnamed stream which is a tributary to
Prathers Creek.
We are requesting a 404 Nationwide Permit (#3 Maintenance) from your agency.
P. O. BOX 558, ELKIN, NC 28621
PHONE [phone] FAx [phone]
Page 2
Ken Jolly
March 17, 1998
I am sending a sketch with the proposed erosion control plan along with
a marked county map.
This work does involve designated Trout Water. I am asking Mr. Joe Mickey,
Mountain Region Coordinator of the North Carolina Wildlife Resources
Commission to comment directly to you concerning the 404 Nationwide Permit
Request. Also by copy of this letter, I am requesting authorization to proceed
under Section 401 of the Clean Water Act from the Division of Environmental
Management.
If further information is required, please let me know.
Your early review and consideration will be greatly appreciated.
Sincerely,

W. O. Atkins, PE
District Engineer
Enclosures
cc: W. E. Hoke, PE, Division Engineer
M. A. Pettyjohn, PE, County Maintenance Engineer
Joe Mickey, Mtn.Regional Coordinator
Matt Gant, PE, Regional Engineer DEHNR
Neil Trivette, Area Roadside Environmental Engineer
Eric Galamb, Water Quality Certification Unit DEM (7)
DEM ID:
CORPS ACTION ID:
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT 11)
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE;
1) NOTIFICATION TO THE CORPS OF ENGINEERS
2) APPLICATION FOR SECTION 401 CERTIFICATION
3) COORDINATION WITH THE NC DIVISION OF COASTAL MANAGEMENT
SEND THE ORIGINAL AND (1) COPY OF THIS COMPLETED FORM TO THE APPROPRIATE
FIELD OFFTCE OF THE CORPS OF ENGINEERS (SEE AGENCY ADDRESSES SHEET). SEVEN
(7) COPIES SHOULD BE SENT TO T14E N.C. DIVISION OF ENVIRONMENTAL MANAGEMENT
(SEE AGENCY ADDRESSES SHEET). P A E PRINT.
1. OWNERS NAME : e E&cM 7ine H7 of /?,4Ns /?o2i,4 i r'oi? Di ?J /l - S/, 1 ?i
2. MAILING ADDRESS: 10,6), P04 5s e i?//4'I/?/o4 T11 6/9-le0 ,- ,'W/4:.?_
CITY: 1?j STATE
SUBDIVISION NAME:
N,C • Z I P CODE: Z
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
3. TELEPHONE NUMBER (HOME):
4.
(WORK) : _3 3?_ z? s -4z4/
IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE' OFFICIALi,
ADDRESS, PHONE NUMBER: 5

LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS 'I'OPCXGRAPI-IIC
MAP OR AERIAL PHOTOGRAPHY WITH SCALY-,):
COUNTY: A//E6 H1q rl V __ NEAREST TOWN OR CITY:
SPECIFIC LOCATION (INCLUDE ROAD
NUNSERS, LANDMARKS, ETC.) : s? //,5-54 14Hd?fc?5 0,9„0
/42o m SP// -;7 9 Tp -!reel/ G /
G. IMPACTED OR NEAPLEST STREAM/RIVER:
RIVER BAS IZT : _SV417i? Fob /r /YEu? .??'yE2
7a. IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER
(SA), HIGH QUALITY WATERS (HQW), OUTSTANDING RESOURCE WATERS (ORW), WATER
SUPPLY (WS-I OR WS-II) ? YES (X) NO ( I IF YES, EXPLAIN; %2ocri Gt/,QTt??
7b. IS TIE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AR°a OF ENVIRONMENTAL CONCEERN (aEC) ? YES ( ) NO
7C. I: THE PROJECT IS LOCATED WITciIN A COASTAL COUNT`! (SEE PAGE 7 FOR
LIST OF COASTAL COG1711ES) WHAT TS L;u\v ;;SE "J=,,,N !LU?) DESISN T_CLNl?
Ba. raVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON
THIS PROPERTY? YES ( J' NO (X IF YES, PROVIDE ACTION I.D. NUMBER OF
PRZVIOUS PERMIT AND ANY ADDITIONAL INFOR!!aTION (INCLUDE PHOTOCOPY OF 401
CERTIFICATION);
Bb. ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN Trr.
FU'T'URE'? YES ( j NO (X) IF YES, DESCR13E ANTICIPATED WORK:
2
9a, ESTIMATED TOTAL NL"MBER OF ACRES I`I TRACT OF D : D, 0/6) ,qc.
9b . ESTIMATED TOTAL NUMBER OF ACRES OF W-ETLAMS LOCATED ON PROJECT SITE:
10a. NUMBER OF ACRES OF STET"\FDS IMPACTED BY 7,E PROPOSED PROJECT BY:
FILLING: -"O_ EXCAVATION: -0-

DPa;NAGE. -?"-
0 ?L00DiNG : - D
T'rEER : G cSS % f,%/./ O, ID /? c,.-- &
TOTAL .kCR".S TO BE ZHPAC= : D.
Ob . (:) S TREAtt GV.ANNEL TO 8E IMPACTED B`! THE PROPOSED PROJECT (I.
A LOCAT::D, PROVIDE DZZSTA.NCE BOT BEFORE AND AF7--'Z RELOCATION) :
LM?GT? BEFORE:
C-r A-FT E R .
WIDTH 3E: 0RE- (based on normal hLgti water cc ntou s) r T
WIDTH A; T^ 1.
CT
AVERAGE DEPTH BEFORE:
Ac
(2) S"'°FaM c7'44 I"? ruvACTS ?g7tr ?? ?-1r?? ?, (CHECK ALL 7-AT Apgr,Y)
OPEN CHANITEL RELOCATION: PLr\C=iiE?iT OF PIPE Ill C:{ANNEI :
C:AINNEL EXCAVATION: CONSTRUCTION OF A DAM/?LOODING:
OTHER.
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS Tc? SIZE OF T
WATERSHED DRAINING TO THE POND? ---. Zd
W -AT IS T'rE EXPECTED POND SURFACE AIZA?
12. DESCRIP'T'ION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF
3
MEC4{ANICAL EQUIPMENT TO BE USED (ATTACH{ PLANS: 8 L/2" ;( LL" DRAWINGS
ONLY) : c of oe 11r,yUE T o E1?G?9??Tc i?
t'i2rR/r7 L3. PURPOSE OF PROPOSED WORK:

14. STATE REASONS WF-:Y IT IS BELIEVED Ti-AT T=:IS ACTIVITY MUST BE CARRIED
0 UT I N W-E TLAND S. (INCLUDE ANY M E-?-S UR.E S T; :,=-N; TO MINIMIZE W E TTLAN'D
IMPACTS) : 0_? fcovE FeT d

15. YOU ARE REQUIRED TO CONTACT T=- U.S. FISH AND WILDLIFE SERVICE'
(USE-4S) AND/OR NATIONAL MARINE FISHERIES SERVICE, (NMFS) (SEE AGENCY
ADDRESSES SHEET) REGARDING T---E PRESENCE OF ANY FEDE:? kLLY LISTED OR
PROPOSED FOR LISTING ENDANGERED OR Tra-EaTENED SPECIES OR CRITIC. PL FABITAT
IN THE PERMIT AREA THAT MAY BE AFFECT::) BY T'r.E PROPOSED PROv'vCT. DATE
CONTACTED: ?Cor.rTAc7' /yfW}9c (ATTACH RESPONSES
FROM TeiESE AGENCIES. )
L6. YOU AREZ REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER
(SHPO) (SEE AG'aNCY ADDRESSES ST ET) REGARDING THE PRESENCE OF HISTORIC
PROPERTIES IN THE PERMIT AREA WHIC: MAY BE_A-I'FECTED BY THE PROPOSED
PROTECT. DATE CONTACTED: Coi-/TAG/ lgioc ___...,,....
17. DOES THE PROJECT INVOLVE AN E:CPLYDITUrZE OF PUBLIC FUNDS OR THE USE OF
PUBLIC (STATE) LAND'
1-1
4

YES () NO ( (IF NO, GO TO 18)
a, IF YES, DOES THE PROJECT REQUIRE PREP ARATION OF AN ENVIR=J E.ITAL
DOCUMENT PURSUANT TO THE REQUIREMENTS OF THE NORTH CAROLINA ENVIROME?TTAL
POLICY ACT? /Y/r/
YES (] NO (
b. IF YES, HAS THE DOCUMENT BEEN REVIE,,,ED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE?
YES () NO (] Nllr
IF ANSWER TO 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM 7HZ-
STATE CLEARINGFOUSE TO DIVISION OF ENVIRONMENTAL MANAGEMENT REGARDING
CCMPLIANCE WITH THE NORT:i CAROLINA ENVIRONMENTAL POLICY ACT. /'//?
QUESTICNS REGARDING THE STATE CLE-AIZING?:CUSE REVIEW PROC7SS S'IOULD BE
DIR CT:, TO MS. C?,--RYS BAGGE77, DI?cCTOR STATE CT_ZA-R-TNGHOUSE, NORTH
CAROLINA DEPAR7-"MF- iT OF ADMI4\TIS=-,7- ION, l,S 'W'EST JONES STREET, RALEiC':,
NORTH LAROLINA 27603-8003, TELEPHONE [phone].
18 . T .-:'E FOLLOWING ITEMS SnOVZD aE INCLUDED WIT': THIS APPLICATION I:
PROPOSED ACTIVITY INVOLVES Thy DISCHARGE OF EXCAVATED OR FILL MATERT__u
INTO WETLANDS:
a. WETLAND DELIN-ATION MA? SHOWING A.L.-
Li r- - W 7L:ANDS , STRErMS , r - S
AND PONDS ON TKE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14, 18, 21, 26,
2 9, AND 3 8) ALL STREAiMS ( INTERMITTENT AND PER.M.A.L NT) ON THE PROPS c^_'
C
UST BE SHOWN ON THE MAP . MAP SCALES SEOULD BE 1 INC1 EQUALS SO FEET OR 1
INC_: EQUALS 100 FEET OR THEIR EQUIVALENT.
b. IE AVAILABLE, REPRESENTATIVE PHOTOGR.T?-PH OF WETLANDS TO BE
IMPACTED BY PROJECT.
C. IF DELINEATION WAS PERFORIMED 3Y A CONSULTANT, INCLUDE ALL DATA
SHEETS RELEVANT TO T'ciE PLACEMENT OF T"rE DELINF-'-%TION LING..
d. ATTACH: A COPY OF T"r.E STORMWATER KANAGEMENT PLAN IF RE UIRED.
e . WHAT IS LAND USE OF SURROUNDING PROPERTY!? G/ Fi9,,el7f
E. IF APPLICk.BLE, W`-AT IS PROPOSED METHOD OF SEWAGE DISPOSAL? 4
5

g, SIGNED AND DATED AGENT A=CRIZATION LETTER, I: APPLIC;.BLE.
NOTE; WETLANDS OR WATERS OF THE U. S. MAY NOT BE IMPACTED PRIOR TO;
1) ISSUANCE OF A SECTION 404 CORPS OF ENGINEERS PERMIT,
2) EITHER THE ISSUANCE OR WAIVER OF A 401 DIVISION OF
E.WTRONKMINTAL MANAGEX? (WATER QUALITY) CERTIFICATION, AND
3) (IN = T M= COASTAL COQNTI?S ONLY) , A LETTER FROM T'-r-,-:-
NORTH, CAROLINA DIVISION OF COASTAL M_ANAG STATING TEE PROPOSED
ACTIVITv! IS CONSISTEN'T' WITH T=- NORTH CAROLINA COASTAL MANAGr^N*r
PROGRAM.
R?') 0 C a
0 WNE R ' S / AG= ' S SIGNA'T'URE
(AGE'S SIGNATURE VALID ONLY
IF A-UTT-ORI ZATION LETTER FROM
TTr OWNER IS PROVIDED (18c .) )
- 17 19
DATE
6
EROSION CONTROt.
DETAILS AND
SPECIFICATIONS
Std. _# _ Descr Mion S bol
1630.03 Temporary Silt Fence - - ---- -- --- ---- - - ---fl- -++t--
1630.05 Temporary Silt Ditch 7SD
1605.01 Temporary Diversion --- - ------ - -- - - ---- 40 ---
1622.01 Temporary Slope Drain -..__.. --- -- - - .. -- ------ T «-- .--
1630.01 Silt Basin Type-A

630.02
Silt Basin Type-B f....
1633.01 Temporary Rock Silt Check Type-A -- - ---
1633.02 Temporary Rock Silt Check 'l ype. H ?.
1634.01 Temporary Rock Sediment Dam Type-A
1634.02 Temporary Rock Sediment Dam Type-13 -
1635.0
1
Rock Pipe Inlet Sediment Trap Type-A
1635.02 Rock Pipe Inlet Sediment Trap Type-E3 E3,
1636.01 Rock Silt Screen --- ____ _.
1630.04 Stilling Basin - WI
V- -li
Rock Inlet Sediment Tram:
1632.01 TYPE'-AC)f i A
1632.02 Type-B Of-? f
1632.03 Type-C OR C.;
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EROS..TLN C IT QL...PLAN_._.S1-ILLT
Silt Basin Type B's will be constructed to the dimension of
six feet by three feet by three feed: unless otherwise noted
on the plans.
Generally, the order of installation of the erosion control
measures will be as follows:
Temporary silt basins shall be installed before
clearing and grubbing begins,
Silt fences and temporary silt ditches shall be
installed after clearingl and before grading.
Temporary stone ditch check:; shall be installed ,is
soon as ditchline is established.
Pipe outlet and inlet: protection will be done rice,
soon as the pipe is installed,
Seeding and other permanent erosion control
measures are to be imhlemc!ri t. ('(1 -k , 11 acs praCt i c?:cl ,
RS \
Always SUPER toward ditch line as a
temporary measure in this situation!
*DITCH LINER REQUIREMENTS*
ROAD NAME : SR 1154 ANDREWS ROAD
STATION STATION RT. / LT. 'fYPI?, LINER REQUIRED
10+50 27+25 LT. RII'/RAP
26+75 27+40 RT, RIP/RAP
27+40 33+60 RT. RIP/RAP
30+00 33+60 LT, RIP/RAP
39+90 E.O.P. RT./LT. RINIZAP
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STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
JAMES B. HUNT, JR. E. NORms TOLSON
GOVF,RNOR SECRETARY
MARCH 17, 1998

Mr, Ken Jolly, Office Manager
U. S. Army Corps of Engineers Regulatory Branch
6512 Falls of the Neuse Road
Suite 105
Raleigh, North Carolina 27615
Re: Project No. 6.702267 - Grade, Drain, Base and Pave SR 1154
Andrews Road, 0.59 Mile, from SR 1149 to SR 1161 in Alleghany County,
North Carolina.
Dear Mr. Jolly:
The North Carolina Department of Transportation, District I Maintenance plans to
Grade, Drain, Base and Pave SR1154 (Andrews Road) in Alleghany County, to
improve safety for the traveling public.
(1) Sta 27+40 we plan to remove 50' of existing 48" CMP and replace
same with 60' of 60" CMP Type B.
This is a perpendicular crossings of unnamed stream which is a tributary to
Prathers Creek.
We are requesting a 404 Nationwide Permit (#3 Maintenance) from your agency.
P. O. Box 558, ELKIN, NC 28621
PHONE [phone] FAx [phone]
Page 2
Ken Jolly
March 17, 1998
I am sending a sketch with the proposed erosion control plan along with
a marked county map.
This work does involve designated Trout Water. I am asking Mr. Joe Mickey,
Mountain Region Coordinator of the North Carolina Wildlife Resources
Commission to comment directly to you concerning the 404 Nationwide Permit
Request. Also by copy of this letter, I am requesting authorization to proceed
under Section 401 of the Clean Water Act from the Division of Environmental
Management.
If further information is required, please let me know.
Your early review and consideration will be greatly appreciated.
Sincerely,
21/-) e11e 0- 6.
W. O. Atkins, PE
District Engineer
Enclosures
cc: W. E. Hoke, PE, Division Engineer
M. A. Pettyjohn, PE, County Maintenance Engineer
Joe Mickey, Mtn.Regional Coordinator
Matt Gant, PE, Regional Engineer DEHNR
Neil Trivette, Area Roadside Environmental Engineer
Eric Galamb, Water Quality Certification Unit DEM (7)
DEM ID:
CORPS ACTION ID:
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT 11):
.?
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
1) NOTIFICATION TO THE CORPS OF ENGINEERS
2) APPLICATION FOR SECTION 401 CERTIFICATION
3) COORDINATION WITH THE NC DIVISION OF COASTAL MANAGEMENT
SEND THE ORIGINAL AND (1) COPY OF THIS COMPLETED FORM TO THE APPROPRIATE
FIELD OFFICE OF THE CORPS OF ENGINEERS (SEE AGENCY ADDRESSES SHEET), SEVEN
(7) COPIES SHOULD BE SENT TO THE' N.C. DIVISION OF ENVIRONMENTAL MANAGEMENT
(SEE AGENCY ADDRESSES SHEET). PLEASE PRINT,
1 , OWNERS NAME : /V C DEP/?,eilnCN% _oF /:?4t?S/?02%A
2 . MAILING ADDRESS: 10,0, '604 SS 8,_,Ala 4 ??a?
SUBDIVISION NAME:
CITY: ?/*
1STATE: ZIP CODE:
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
3. TELEPHONE NUMBER (HOME):
(WORK) : .336,-9,35-42,41
4 , IF APPLICABLE: AGENT'S NAME' OR RESPONSIBLE CORPORATE' OFFICIAL,
ADDRESS, PHONE NUMBER:
i's /.
N°?eTH CA2ol'NA A??/??i ,y?c?y? o _%,e?4NS 4i/?7
?D Ba,l? ` sp 2/
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY : /911E6 HA /,IV NEAREST TOWN OR CITY: -5;19 ?e
SPECIFIC LOCATION (INCLUDE ROAD
NUMBERS, LANDMARKS, ETC. ) : S.e //S ¢ ?Nc??c S .e0,9,0
1--ko rrl SP/ 49 To /
G. IMPACTED OR NEAREST STREAM/RIVER: __/ie4 NE,E's dek
RIVER BASF ; .Sm417W ?oe? /YEw .e?'vC2
7a. IS PROJECT LOCATED NFEAR WATER CLASSI_ 770 AS TROUT, TIDAL SALTWATEF,
(SA), HIGH QUALITY WATERS (HQW) OUTSTANDING RESOURCE WATERS (ORW), WATER
SUPPLY (WS-1 OR WS-II) ? YES (Xj NO ( j IF YES, EXPLAIN: 2o?ri G'l?fJTck?
PG,e PEI G! I,C4oSS" NG
7b. IS T':=- PROTECT LOCATED WT-THIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC) ? YES ( J No (ate
7C. IF THE PROJECT IS "LOCATED WITHIN A COASTAL COUNTY (SEE PAGE 7 FOR THE' LIST' OF COASTAL COUNTIES) , WF:AT 13 .,w\IL' USE ?7 :,?:?) DES"
-
FftP_ m / )'- uA,4
8a. HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON
THIS PROPERTY? YES ( J ' NO (Xj IF YES, PROVIDE ACTION I . D . NUMBER OF
PREVIOUS PERMIT AND KLTf ADDITIONAL, INFORMATION (INCLUDE PHOTOCOPY OF 40L
CERTIFICATION):
8b. A.RE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN Tlr:_-
FLTTURE? YES ( j NO II IF YE-S, DESCRIBE AN'T'ICIPATED WORK:
2
9a
9b
10a
ESTI:`,tATED TOTAL n-i'2BER OF ACRES IN TRACT OF LAND: O, D/D ?? j yi.../, •?
ESTI,'- D TOTAL NUMBER OF ACRE'S OF WEiLiU- DS LOCAT= ON PROJECT SITE:
9U'M3ER OF ACRES OF WETLkL\rDS IMPACTED BY T-7- PROPOSED PROJ-EC BY:
FILLING: -'p_
FLOODING: - D r
DP a;NAGE . -0-.
-0 -

TOTAL ACRES TO BE 2-PACTZD : e!9-
lob.
(1) S?RS.?t cy-ANNGL TO BE IMPACTED 9'! oROPOSED PROJ.. CT (I:
R.:LOCATED, PROV_DE DISTANCE SOT: SEA ORS" ANo A.FT R R LOC.ATIOM :
LZ`TGTH 3EFORE :
C'T A_TER:
WIDT:? 3EFORE (based on normal high water ccntous) :
WIDTH AFTER:
AVERAGE DEPTH BEF OR_F :
C' -r
AF': 7- R. cr
(2) 977E M ClGt, EL r.yya rS r?T 1-1 rT ??nM
? (cvEc< ALL TILaT APqr.,Y)
OPEN C::ANNc'.L R=OGATION: PLACEiMENT OF olor IN C.LIM L:
C'Ht \MEL EXCAVATION: .? CONST?UCT_0N OF .A DM/-E,OODING:
0THER:
11. IF CONSTRUCTION OF A POND IS PROPOSED, WrLAT IS T-r:E SIZE OF T:?E
WATERSHED DRAINING TO TILE POND? ,g///?1
WHAT IS T'rEr' EXPECTED POND SURFACE AREA? NI
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF
3
MEC{ANICAL EQUIPMENT TO BE USED (ATTACH PLANS: 8 1/2" X LL" DRAWINGS
%C yid
ONLY) ..... 13 . PURPOSE OF PROPOSED WORK: 14 12

1/ 5-- S-k- // S,e// ¢ To 5-,e //?/-
14 . STATE REASONS
OUT IN IWETIL r S.
IZdPACTS) % 0 W'Hy IT IS BELIEVED T ::-',%T T::iS
(INCLUDE A_rME1`?S'v? 5 TAY =N TO
1-/Y' i°?o uE S/?Fc T / kC7 V7-,r MUST BE GZ-RIED
MINIMIZE 'rJETT_AIiD
/- A rt i fig E l?? s T , rr G

15. YOU ARE REQUIRED TO CONTACT T?? U.S. FISH AND WILDLIFE SERVICE
(GSrWS) AND/OR NATIONAL MARINE FISHERIES SERVICE (NMFS) (SEE AGENCY
ADDRESSES SHEET) REGARDING T:E PRESENCE OF ANY FEDE?kLLY LISTED OR
PROPOSED FOR LISTING ENDANGERED OR Tr[R.S-kTENGD SPECIES OR CRITICAL F;?13ITAT
IN THE PERMIT AREA THAT MAY BE AFFECTED BY THE PROPOSED PROv--CT. DATE
CONTACT= D : ( ATTACH RES 2ONS ES
FROM THESE AGENCIES.)
L6. YOU ARE REQUIRED TO CONTACT THE STATE F:ISTORIC PRESERVATION OFFT_CER
(SHPO) (SEE AGaNCY ADDRESSES Sr?ET) REGARDING T?E PRESENCE OF HISTORIC
PROPERTIES IN THE PERMIT AREA??WHIC,: MAY BE AFFECTED BY THE PROPOSED
PROJECT. DATE CONTACTED : ) Co,,/T'46/ l'J yoe __?......
17. DOES THE PROJECT INVOLVE AN EXPT.NDITCR.E OF PUBLIC FUNDS OR THE USE OF
PUBLIC (STATE) LAND?
i
4

YES () NO X (IF NO, GO TO 13)
a. IF YES, DOES THE PROJECT REQUIRE PREPARATION OF AN ENVIRC!E.IT'kL
DOCUIt ENT PURSUANT TO THE REQUIREMENTS OF THE NORTH CAROLINA ENVIRONMENTAL
POLICY ACT? Nl
YES () NO ()
b. IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA.
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE?
YES () NO () /v//9
IF ANSWER TO L7b IS YES, THEN SUUMIT APPROPRIATE DOCUMENTATION FROM TH-r'
STATE CLEARINGHOUSE TO DIVISION OF ENVIRONMENTAL MANAGEMENT REGARDING
COMPLIANCE WITH THE NORTH CAROLINA ENVIRONMENTAL POLICY ACT. N/I
QUESTICNS REGARDING THE STATE Cr,E. RINGFCUSE. =ViEW PROCESS SHOULD BE
DIRECT= TO MS. C?---,ZYS BAGGETT, DI?cCTOR ST.`LTE C='RINGEOUSE, NORTH
CAROLINA DEPARTtitE1NT OF ADMTNIST?`.TICN, 116 `NtST JONES STET, 2tiLEIG
NORTH CAROLINA 27603-8003, TELEP OtFE [phone].
18. THE FOLLOWING ITEMS SFiOLZD 87 INCLUDED WITH. THIS APPLICATION Ir
PROPOSED ACTIVITY INVOLVES =E DISCHARGE OF EXCAVATED OR FILL MATERT_AL
INTO WETLANDS:
a. WETLAND DELINEATION MA? SHOWING ALL WETLANDS, STREAIMS, LA:ti:-.S
AND PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14, LS, 2i, 26,
29, kND 38) . ALL STEAMS (INTERMITTENT A1vD PE ?MADIiNT) ON THE PROPERTY
MUST BE SHOWN ON THE MAP. MAP SOLES SHOUIVD BE 1 INCH EQUALS SO FEE i' OR 1
INC_; EQUALS 100 FEET OR THEIR EQUIVALEN'T' .
b . IF AV11ILA3LE , REPRESENTATIVE PHOTOGR-A-PH OF WETLANDS TO BE
IMPACTED BY PROJECT.
C. IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA
SHEETS RELEVANT TO TIRE PLACEMENTOF THE DELINEATION LINE.
d. ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF RE UIRED.
e. WHAT IS LAu\1D USE OF SURROUNDING PROPERTY?
E. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE. DISPOSAL?
5

g, SIGNED AND DATED AGENT A=.ORIZATION LETTER, IF A.PPLICA3LE•
NOTE: WETLANDS OR WATERS OF THE U.S. MAY NOT BE IrLPACT= PRIOR TO:
1) ISSUANCE OF A SECTION 404 CORPS OF ENGINEERS PERMIT,
2) EITHER = ISSUANCE OR WAIVER OF A 401 DT77ISION OF
ZNVIROMHEWTAL MANA:GMl T (WATER QUALITY) CERTIFICATION, AND
3) (IN = TWEN77 COASTAL CODNTI?S ONLY) , A LETTER FROM TE
NORTH. CAROL.LNA DIVISION OF COA.STA.L MANAGE STATING THE PROPOSED
ACTIVITY IS CONSISTENT WITH = NORTH CAROL.LNA COASTAL KANAGZMENT
PROGRAM,
OWNER ' S / AG cE IT ' S S I GNA7UR.E
(AGE'S SIGNATURE VALID ONLY
IF AuTfiORIZATION LETTER FROM
T'r OWNER IS PROVIDED (18g.))
- i 7- 9g
DATE
6
EROSION CONTROL
DETAILS AND
SPECIFICATIONS
Std. # scri??t:ic?la

1630.03 Temporary Silt Fence -+++---
1630.05 Temporary Silt Ditch
1605.01 Temporary Diversion
1622.01 Temporary Slope Drain
1630.01 Silt Basin Type-A
1630.02 Silt Basin Type-13 _.... 1f?
1633.01 Temporary Rock Silt Check "T-ype-A -
1633.02 Temporary Rock Silt Check Type--13
1634.01 Temporary Rock Sediment Dam Type-A - ---
1634.02 Temporary Rock Sediment Dam Type-B - ---
1635.01 Rock Pipe Inlet Sediment Trap Type-A - - - - -- A
1635.02 Rock Pipe Inlet Sediment Trap Type-B --- E3
1636.01 Rock Silt Screen_
--- - _
ee "
1630.04 Stilling Basin - v
Rock Inlet Sediment: -T r -(r):

1632.01 Type..
A
[--? (M . •
A
1632.02 Type-B E3 [_] Of=? E3 ,
1632.03 Type..C E " UFO
ut j
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y to , G
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,a
EROSION
Silt Basin Type B's will be constructed to the dimension of
six feet by three feet by three feet: unless otherwise noted
on the plans.
Generally, the order of installation of the erosion control
measures will be as follows:
Temporary silt basins shall be installed before
clearing and grubbing begins.
Silt fences and temporary silt ditches shall be
installed after clearing and before gt-ading.
Temporary stone ditch checks shall be installed as
soon as ditchline is established.
Pipe outlet and inlet protection will be done as
soon as the pipe is installed.
Seeding arid other permanent: cie>:,ic,n cc>>,tro]
measures are to be implement.ed as ;c,on as practic;tl
? RS
Always SUPE1: toward clitch line as a
temporary measure in this situation!
DITCH LINER REQUIREMENTS*
ROAD NAME : SR 1154 ANDREWS ROAD
STATION STATION RT. / LT. TYPE LINER REQUIRED
10+50 27+25 RI I'/RAP
26•+-75 27+40 RIP/1ZAP
274.40 33+60 RIP/IZA P
30+00 33+60 It 1 P/RA I'
39+90 ]ti.O.P. RT./l,T. RIP/RAP
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