19980204 Ver 1_Complete File_19980306

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
I 16rk!W'J
4
•
7
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
March 16, 1998
Surry County
WQC 401 Project # 980204
APPROVAL of 401 Water Quality Certification
Mr. W.O. Atkins
NC DOT
Elkin District Office
Elkin NC 28621
Dear Mr. Atkins:
You have our approval, in accordance with the attached conditions, to place fill material in 0.004 acres of
wetlands or waters for the purpose of repairing SR 1402, as you described in your application dated March 3, 1998.
After reviewing your application, we have decided that this fill is covered by General Water Quality Certification
Number 3127. This Certification allows you to use Nationwide Permit Number 3 when the Corps of Engineers issues
it. 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. Also 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. 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 the Certification and approval letter and is thereby responsible for
complying with all conditions. If total wetland fills for this project (now or in the future) exceed one acre,
compensatory mitigation may be required as described in 15A NCAC 2H.0506 (h). 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 which conforms
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 Dorney at 919-733-1786.
Attachment
cc: Wilmington District Corps of Engineers
Corps of Engineers Raleigh Field Office
Winston-Salem DWQ Regional Office
Mr. John Dorney
Central Files
in ely,
ton n 4Hoaar ,r. P
980204.1tr
Division of Water Quality • Environmental Sciences Branch
Environmental Sciences Branch, 4401 Reedy Creek Rd., Raleigh, NC 27607 Telephone [phone]
FAX [phone]
An Equal Opportunity Affirmative Action Employer • 50% recycled/10% post consumer paper
A '
STATE OF NORTH CAROLINA
JANNa s B. HUNT, JR.
GOVERNOR
DEPARTMENT OF TRANSPORTATION
ELKIN DISTRICT OFFICE
P. O. Box 558
ELKIN, NORTH CAROLINA 28621
MARCH 03, 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
E. NORRIS TOLSON
SECRETARY
.. MAR 6
Re: Project No. 6.742510 - Grade, Drain, Base and Pave SR 1402
York Road, 1.10 Mile, from SR 1345 to SR 1345, in Surry County, NC.
Dear Mr. Jolly:
The North Carolina Department of Transportation, District I Maintenance plans to
Grade, Drain, Base and Pave SR1402 (York Road) in Surry County, to improve
safety for the traveling public.
(1) Sta 21+25 we plan to remove 32' of existing 24" CMP and replace same
with 40' of 24" CMP Type B.
This is a perpendicular crossings of unnamed streams which is a tributary to
Little Fisher River.
We are requesting a 404 Nationwide Permit (#3 Maintenance) from your agency.
I am sending a sketch with the proposed erosion control plan along with a
marked county map.
P. O. Box 558, ELKIN, NC 28621
PHONE [phone] FAx [phone]
Page 2a
Ken Jolly
March 03, 1998
This work does not invo'Ive designated Trout Water. T 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,
Uj,n.() W. O. Atkins, PE
District Engineer
Enclosures
cc: W. E. Hoke, PE, Division Engineer
R. M. Freeman, 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)
11 fx
' T
DEM ID:
CORPS ACTION ID:
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #): 3
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 : % cP?4?'irYl Cn?/ OF 2/2r?S PD i2 j f 7-i'4:1 I iST 2. MAILING ADDRESS : /0-0. /e // 64,-,9,C
SUBDIVISION NAME:
CITY: "a STATE: N(2. ZIP CODE: Z96 2 /
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
3. TELEPHONE NUMBER (HOME):
(WORK) : 24-835'424)
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL,
ADDRESS, PHONE NUMBER :
_ yo,eTN C??o l rr/} ' % c PAR i m E?% of e,4?s P?,e rg %,?
A D Q ?,}? S S 8 /?? /ve, z 8? z/
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY : NEAREST TOWN OR CITY : 9DUti// ?l R ?/

PECIFIC LOCATION (INCLUDE ROAD
NUMBERS, LANDRARKS, ETC.) .Sk 14D2- LLD IeI? e0 -/4,0
Fie o ir]
SQ 1345 To SR 1345, x /o m
G. IMPACTED OR NEAREST STRE.AM/RIVER : ?( tl NAr EZ) n -'L474)24 /o "c;. At /a &v'el
RIVER BASIN: JZAQ L L4
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 ( ] NO (vl' IF YES, EXPLAIN:
7b. IS THE PROJECT LOCATED WITHIN A NORT'r? CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL, CONCERN (AEC) ? YES ( ] NO (X]
7c. I--- THE PROJECT IS "LOCATED WITHIN A CCASTAL COUNT`! (SEE PAGE 7 FOR
LIST OF COASTAL COUNTIES) , -?[-:AT IS _E Lei. CS-- -DL:U\T
FBI k'
8a. raVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON
THIS PROPERTY? YES ( ]' NO (X] IF YES, PROVIDE ACTION I.D. NUMBER OF
PR-E`VIOUS PERMIT AND ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401
CERTIFICATION):
8b. ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN T'rIE
FUTURE? YES ( ] NO (X] IF YES, DESCRIBE ANTICIPATED WORK:
2
9a. ESTIMATED TOTAL NUMBER OF ACRES IN TRACT OF LAND
©. o n -?- AC-
9b. ESTIMATED TOTAL NUMBER OF ACRE'S OF WETLANDS LOCATED ON PROJECT SITE:
10a. NUMBER OF ACRES OF WETLANDS IMPACTED BY T:EE PROPOSED PROJECT BY:
FILLING: EXCAVATION:

r ,OODING: OT'HER: G C SS 7 -114W e?, 1,o /??e,et

DRA:NAGD: TOTAL ACRES TO BE ACTED: d,DO¢ AC
10b. (1) S=- M CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT' (I.
RELOCATED, PROVIDE DISTANCE BOTY. BEEORc AND AFT RELOCATION) :
LY-';GTH BEFORE: FT Ar? T
ER : G~r
WIDTH BEFORE- (based on normal ILcrh water ccr_tou s) :
WIDTH
AVERAGE DEPTH BEFORE:
CT
CT
771 AF ER.
(2) S'RC?1u C?UkL\TNEL 7Y. P Cry WTr:L aC?i^T,T = r`M: (CHECK ALL THAT Af-PLY)
OPEN C ANNnL RELOCATION:
P LACEM ENT OF PIPE IN (79ANNE L:
CHANNEL EXC.aVATT_ON: CONSTRUCT ON OF A DAM/FLOODING:
OTHER :
11. 17 CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE
WATERSHED DRAINING TO THE POND?
WHAT IS THE EXPECTED POND SURFACE AREA?
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF
I
MECHANICAL EQUIPMENT TO BE USED (ATTACH PLANS: S 1/2" X 11" DRAWINGS
ONLY) :

13. PURPOSE OF PROPOSED WORK:
Tn ;; ? .c3
/, /,9 n9 f.
14. STATE REASONS WHY IT IS 3ELIEVED =T ACTIVITY MUST BE CARR7=
OUT IN WETLANDS • (INCLUDE ANY MEaSut°S TA=-N TO MINIMIZE WETLAND
IMPACTS) :
T., % Pao v c S Fz i !Z
4 014c N /.
15. YOU ARE REQUIRED TO CONTACT T? U.S. FISH AND WILDLIFE SERVICE
(USF-4S) AND/OR NATIONAL MARINE FISHERIES SERVICE (NMFS) (SEE AGENCY
ADDRESSES SHEET) REGARDING THE PRESENCE' OF ANY FEDERALLY LISTED OR
PROPOSED FOR LISTING ENDANGERED OR T??ATENED SPECIES OR CRITICAL HA31TAT
IN THE PERMIT AREA THAT MAY BE AFFECTED BY THE PROPOSED PROS CT. DATE
CONTACTED : ?`?b CoIl?l4 C:r MADE- (ATTACH RESPONSES
FROM THESE AGENCIES.)
16. YOU ARE REQUIRED TO CONTAC'T' THE STATE HISTORIC PRESERVATION OFFICER
(SHPO) (SEE AGENCY ADDRESSES SHEET)
MAY BE AFFECTED BY THE PROPOSEDRIC
PROPERTIES IN THE PERMIT AREA WHICH
PROJECT. DATE CONTACTED : Nb or 7-ACT m/, A
17. DOES THE PROJECT INVOLVE AN EXPENDIIURE OF PUBLIC FUNDS OR THE USE OF
PUBLIC (STATE) LAND'
4
YES NO (IF NO, GO TO 18)
a. IF YES, DOES THE PROJECT REQUIRE PREPARATION OF AN ENVIR= ENTAL,
DOCUMENT PURSUANT TO THE REQUIREMENTS OF T'rHE NORTH CAROLINA ENVIRONMENTAL,
POLICY ACT?
YES ( ] NO ( ]
b. IF YES, HAS THE DOCUMENT SEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE?
YES H NO
IF ANSWER TO 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE
STATE CLEARINGHOUSE TO DIVISION OF ENVIRONMENTAL MANAGEMENT REGARDING
COMPLIANCE WITH THE NORT'r"_"_ CAROLINA ENVIRONMENTAL POLICY ACT. Nll?
QUESTICNS REGARDING T??E STATE CT..F' RINGFCUSE 25V7:-:r4 PROCESS SHOULD BE
DIRECT= TO MS . C?-`RYS SAGGETT, D=?ECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION, 116 WEST JONES STREET, RAL2IGH,
NORTH CAROLINA 27603-8003, TELEPHONE [phone].
18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF
PROPOSED ACTIVITY INVOLVES THE DISC:-LARGE OF EXCAVATED OR FILL MATERIAL
INTO WETLANDS:
a. WETLAND DELINEATION MA-D SHOWING ALL WETT-ANDS, STREAMS, ,,AL--S
AND PONDS ON T','-:E PROPERTY (FOR NATIONWIDE PEIQ_M-7T NUMBERS 14, 18, 21, 26,
29, AND 38) ALL STREAMS (INTERMITTENT AND PE'RMAZTENT) ON T?--E PROPERTY
MUST BE SHOWN ON THE MAP. MA_p SCALES SHOULD BE 1 INCG'EQUALS SO FEET OR 1
INCH- EQUALS 100 FEET OR THEIR EQUIVALENT.
b. IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO SE
IMPACTED BY PROJECT.
C. IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA
SHEETS RELEVANT TO THE PLACEMENT OF THE DELINEATION LINE.
d. ATTACH A COPY OF.T'riE STORMWATER MANAGEMENT PLAN IF REQ IRED.
e. WHAT IS LAND USE OF SURROUNDING PROPERTY? kUkgl Fj
f. IF APPLIC.AALE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL? &Zil-
5
r,
g. SIGNED AND DATED AGEIT A=ORIZATION LETTER, IF APPLICABLE.
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) EI=R THE ISSUANCE OR WAIVER OF A 401 DIVISION OF
ENVIRONMENTAL MANAGEMENT (WATER QUALITY) CERTIFICATION, AND
3) (IN TEI: TWENTY COASTAL COUNTIES ONLY) , A LETTER FROM THE
NORTH. CAROLINA DIVISION OF COASTAL MANAGEMENT STATING THE, PROPOSED
ACTIVITY IS CONSISTM4T WITH TME NORTH CAROLINA COASTAL MANAGr^MEN'_r
PROGRAM.
LL). n-. J
OWNER'S/AGENT'S SIGNATURE
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED (18(g.))
1 3 B
DATE
6
i
DEM ID:
CORPS ACTION ID:
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #): 3
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?
2. MAILING ADDRESS: ?•? BDEG SS 8 , /I`? /? /`/DIeT// c_4x2y-
SUBDIVISION NAME:
CITY: ?/J STATE: W. C • ZIP CODE: Z 8 60 2 /
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
3. TELEPHONE NUMBER (HOME):
,j - 4241
(WORK) : . ?
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL,
ADDRESS, PHONE
M99TN CAkD NUMBER:
I ?` t41q , , A
0 Aq)el m TKl'NS
EH% P. ,e ,
of _22,4,,L5 E 7-

S. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AERIAL, PHOTOGRAPHY WITH SCALE):
COUNTY : . ?U /e 2 ?/ NEAREST TOWN OR CITY: l 4(wl ,i , ?/

PECIFIC LOCATION (INCLUDE ROAD
NUMBERS, LANDMARKS, ETC.) SA2 1402 VDP.k 'eo Ab Fk0/y)
,? i, 1345 To SR 13 45 , x /D m .
G. IMPACTED OR NEAREST STREAM/ RIVER: _/!t-IAIAMEJ) 22-'L7R?e4 /o ,c,sht2 &va
RIVER BASIN: 1/A0 k ,' r(
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 ( ] NO (?]' IF YES, EXPLAIN:
7b. IS THE PROjnCT LOCATED WITHIN A NORTIH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC) ? YES ( ] NO (X]
7c. I? THE PROJECT IS`LOCATED WITHIN A COASTAL COUNTY (SEE PAGE 7 FOR
LIST OF COASTAL COUNTIES) , WHAT IS -E LALKO USE ?L,?u\1 (LUP) DES:;7jlNT,^_'=GN?
Figs m za
8a. raVE ANY SECTION 404 PERMITS SEEN PREVIOUSLY REQUESTED FOR USE ON
THIS PROPERTY? YES ( II NO (X] IF YES, PROVIDE ACTION I.D. NUMBER OF
PREVIOUS PERMIT AND ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401
CERTIFICATION):
8b. ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN Ty
FUTURE? YES ( ] NO (X] IF YES, DESCRIBE ANTICIPATED WORK:
2
9a. ESTIMATED TOTAL NUMBER OF ACRES IN TRACT OF L.A,\M : O. D D
9b. ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROTECT SITE:
10a. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: 0 -
FLOODING:
DRAT-NAG-: ^fl?
EXCAVATION: -'D
0T THE _2E,SS T1111) W c12, /..0 19c,e4F
TOTAL ACRES TO BE LNLnACTED : d. 0 0 ¢ Ac .
10b. (_) STREAM CHANNEL TO BE IMPACTED SY T'r-- PROPOSED PROTECT (I:
R:ILOCATED, PROVT.DE DISTANC. BOTY. BEFORE AND AFT R=rOCATIOM :
L2-NGTH BEFORE: A_- E R : •^
WIDTH BEFORE (based on no=al high water coneous) :
CT
WIDTH Ate= I'EZ
AVERAGE DEPTH BEFORE:
CT
Ar E-R .
(2) STREAM CHkL\TNEL 7MPACTS WILL R?r G'S ;,T FEC M: (CHECK ALL TNaT Ao
_ PLY)
OPEN CANNEL RELOCATION:
P LAC '14 ENT OF PIPE IN CHANNEL:
CHANNEL EXCAVATION: ? CONSTRUCTION OF A DAM/FLOODING:
OTHER:
11. IF CONSTRUCTION OF A POND IS PROPOSED, w"FAT IS THE SIZE OF Thy
WATEPSHED DRAINING TO THE POND? VIA
WHAT IS =-- EXPECTED POND SURFACE AREA?
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF
3
MECHANICAL EQUIPMENT TO BE USED (ATTACH PLANS: 8 1/2" X 11" DRAWINGS
ONLY) :

s- 1/ TG ?,l 0 M ?/? I/I G c ?? sr ivG 1,i ?4C
??,
13. PURPOSE OF PROPOSED WORK: ?d G??dE Q"
se 13
/, /o n? .
14. STATE REASONS WFz'Y IT IS 3ELIEVED T:LaT T "-77S AC?'IVITY MUST BE CARRIED
OUT IN WETLANDS. (INCLUDE ANY ME;.S JRES T Aj? TO MINIMIZE 'rIETZRND
IMPACTS) :

1S -7;q ki,
A9 v? S/e 140

N/.
15. YOU ARE REQUIRED TO CONTACT TF_- U.S. FISH AND WILDLIFE SERVICE
(IIS c riS) AND/OR NATIONAL MARINE PRESENCE-S?..SENC?SOPcaNYCFEDERFALLY (SEE AGENCY
ADDRESSES SHEET) REGARDING TL=
PROPOSED FOR LISTING ENDANGERED OR THREATENED SPECIES OR CRITICAL FA3ITAT
IN THE PERMIT AREA THAT MAY BE AFFECTED BY THE PROPOSED PROJECT. DATE
CONTACTED : f/v Col-lTi4 C-T CMADG (ATTACH RESPONSES
FROM THESE AGENCIES.)
16. YOU ARE REQUIRED TO CONTACT THE STATE 1:7STORT_C PRESERVATION OFFICER
(5HP0) (SEE AGENCY ADDRESSES SHEET) RAY B IAFFECTED BY THE PROPOSEDRrC
PROPERTIES IN THE PERMIT AREA WHICH ?
PROJECT. DATE CONTACTED : ND Cot47,4 CT /Y119OG
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OR THE USE OF
PUBLIC (STATE) LAND?
4
YES O NO k (IF NO, GO TO 18)
a. IF YES, DOES THE PROJECT REQUIRE PREPARATION OF AN ENVIR=4ENTAL
DOCUMENT PURSUANT TO THE REQUIREMENTS OF THE NORTH CAROLINA ENVIRONME-WAL
POLICY ACT?
YES N NO (I
b. IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLLNA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE?
YES (I NO O
IF ANSWER TO 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM T:77-
STATE CLEARINGHOUSE TO DIVISION OF ENVIRONMENTAL MANAGEMENT REGARDING
COMPLIANCE WITH THE NORT-r. CAROLINA ENVIRONMENTAL POLICY ACT. 1114
QUESTICNS REGARDING THE STATE CT-ZARINGFCUSE Rc'V77 g PROCESS SHOULD BE
DIRECT= TO MS. CH`RYS BAGGETT, DIRECTOR STATE CILEARINGHOUSE, NORT::
CAROLINA DEPARTMENT OF ADMINISTRATION, 115 WEST JONES STREET, RALEIGH,
NORTH CAROLINA 27603-8003, TELEPHONE [phone].
18. THE FOLLOWING ITEMS SHOU= BE INCLUDED WITH THIS APPLICATION IF
PROPOSED ACTIVITY INVOLVES THEE DISCHARGE OF EXCAVATED OR FILL MATERIAL
INTO WETLANDS:
a. WETLAND DELINEATION MAD SHOWING ALL WE'T'LANDS, STREAMS, LA=S
AND PONDS ON TIKE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14, 18, 21, 26,
29, AND 38) ALL STREAMS (INTERMITTENT AND PERMANENT) ON THE PROPERTY
MUST BE SHOWN ON THE- MAP. MAP SCALES SHOU'1.0 BE 1 INCH* EQUALS 50 FEET OR 1
INC:--- EQUALS 100 FEET OR THEIR EQUIVALENT.
b. IF AVAILABLE, REPRESENTATIVc. PHOTOGRAPH OF WETLANDS TO BE
IMPACTED BY PROJECT.
C. IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA
SHEETS RELEVANT TO THE PLACEMENT OF T?iE DELINEATION LINE.
d. ATTACTIZ A COPY OF.T:HE STORMWATER MANAGEMENT PLAN IF REQ IRED.
e. WHAT IS LAND USE OF SURROUNDING PROPERTY? k U?2,q C F/ati° rI 1
F. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL? ?d
5
g. SIGNED AND DATED AGENT AUTHORIZATI09 LETTER, IF APPLICAZ LE.
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
ENVIRONMENTAL MANAGEMENT (WATER QUALITY) CERTIFICATION, AND
3) (IN THE TWEN7Y COASTAL COUNTIES ONLY) , A LETTER FROM THE
NORTH. CAROLINA DIVISION OF COASTAL MANAGEMENT STATING THE PROPOSED
ACTIVITY IS CONSISTENT WITH THE NORTH CAROL= COASTAL F-kNAGEMENT
PROGRAM.
C41 .D.^?
OWNER'S/AGENT'S SIGNATURE
(AGENT'S SIGNATURE VALID ONLY
IF A=ORIZATION LETTER FROM
TKE OWNER IS PROVIDED (18(7.))
3 B
DATE
6

EROSION CON"TROt-.
DFIAILS AND
SPECIFICATIONS
Std. # Descrivtioln
. .Sz??bol
1630.03 Temporary Silt Fence ---Ff+---+tt--
1630.05 Temporary Silt Ditch - -- - - --- --T S D
-J
1605.01 Temporary Diversion----_______ - ---------_ -- - ---_..ri, ______
1622.01 Temporary Slope Drain - `--
1630.01 Silt Basin 7 ype-A - -____-____ _ -- --------_-.__--_ - _-? .
1630.02 Silt Basin Type-B -------------------- -- - - - ----- - - ??
1633.01 Temporary Rock Silt Check Type-A
1633.02 Temporary Rock Silt Check Type-B - ----- ----).
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
0
1635.02 Rock Pipe Inlet Sediment l-rap Type-B - p
-- B
1636.01 Rock Silt Screen ------------------- ------ ___--- .- .-_-.----._.__??_- -
1630.04 Stilling Basin
Rock Inlet Sediment Trap:
1632.01 Type-A - - - - - A ? OR -. A
1632.02 TYPe - B. -- - --- --- ---- --- - -- --- - - B OR - - B
1632.03 Type-C C OR C

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1

EROSION CONTROL ?Ph?N _?HFFT
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 grading.
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 and other permanent erosion control
measures are to be implemented as soon as practical.
RS
Always SUPER toward ditch line as a
temporary measure in this situation!
*DITCH LINER REQUIREMENTS*
ROAD NAME :SR1402 YORK ROAD
PROJECT NO:6.742510
COUNTY : Surry Co.
STATION
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