19991430 Ver 1_Complete File_19991229

12/29/1999 16:11 NCDOT DIV 2 4 89197339959 11U. «' v??
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
DIVISION 'OF HIGHWAYS
DIVISION Two
991430
Division Two Office
P. O. Box 1587
Greenville, NC 27835
Telephone Number [phone]
Fax Number (2552) 830-3352
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12/29/1999 16:11 NCDOT DIV 2 4 89197339959
DWQ ID: CORPS ACTION ID:

NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #) Etpnrgency Permit
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
COPIES MUST BE SENT TO TKE NC DIVISION OF WATER QUALI'
ATTN: JOHN DORNEY, 4401 REEDY CREEK ROAD, RALEIGH, NC
27607. PLEASE PRINT OR TYPE.
I, OWNER'S NAME: NCDOT
2. MAILING ADDRESS: P.O. Box 1597
j
99,430
SUBDIVISION NAME N/A `
CITY: Greenville STATE: N.C. ZIP CODE: 27835
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
Greene County, S.R. 1.247, .1 miles from S,R 1248
3. TELEPHONE NUMBER: (HOME) N/A (WORK) 252-930-3490
4. IF APPLICABLE: AGENTS NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
Jay Johnson (Division 2 Environmental Offim) 252.830.3490
NO. 729 D02
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC MAP
OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: Greene - NEAREST TOWN: Contentnea
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARK`; "ACT':) Bridge 5 on S.R. 1247,
.1 miles from S.R 1248
6. IMPACTED OR NEAREST STREAMMMR: Contentuea Cred1 Y1 $ASIN: Neusa
7. (a) IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT; SAL SALTWATER, (SA),
HIGH QUALITY WATERS (HQW), OUTSTANDING RESOURCE WAS (ORW), WATER
SUPPLY (WS-1 OR WS-II)? NO 0 IF YES, EXPLAIN:
(b) IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? NO
(c) IF THE PROJECT IS LOCATED WITHIN A COASTAL. COUNTY (SEE PAGE 7 FOR LIST OF
COASTAL COUNTIES), WHAT IS THE LAND USE PLAN (LUP) DESIGNATION? N/A
i
12/2y/lyyy 1b: 11 M VU1 DIV -' y 071J(33"D7 11U.1GJ
8. (a) HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROJECT? NO IF YES, PROVIDE ACTION I.D. NUMBER OF PREVIOUS PERMIT AND ANY
ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401 CERTIFICATION): N/A
(b) ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE FUTURE?
NO . IF YES, DESCRIBE ANTICIPATED WORK: N/A
9. (a) ESTIMATED TOTAL NUMBERS OF ACRES IN TRACT OF LAND: N/A
(b) ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
Iv/A
10. (a) NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING; EXCAVATION:
FLOODING: OTHER ;
DRAINAGE : TOTAL ACRES TO BE IMPACTED;
(b) (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (17 RELOCATED,
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION:
LENGTH BEFORE: FT AFTER FT
WIDTH BEFORE (based on normal high water contours): FT
AVERAGE DEPTH BEFORE: FT AFTER: FT
(b) (2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: PLACEMENT OF PIPE IN CHANNEL: X_
CHANNEL EXCAVATION: CONSTRUCTION OF A DAM/FLOODING:
OTHER:
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WATERSHED
DRAINING TO THE POND? N/A WHAT IS THE EXPECTED POND SURFACE AREA? N/A
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPMENT TO BE USED? (ATTACH PLANS; 81/2 BY I 1 DRAWINGS ONLY)
Bridge 0 5 Washed out due to Hurricane Floyd. To be replaced with 161 " x 10'x 4" arch oiue
w/headw is.
Work will be aceomploW from each Side of the washout. A beckhoe and loader will be used.
13. PURPOSE OF PROPOSED WORK. To replace Bridge # 3 that was damaged beyond repair from
Hurricane Floyd.
14. STATE REASQ]NS Y IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETL,4ND5 (ZAIC,;' ;rte ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS)
er en situat o ee a washed out bridge from Hurricane Floyd. Work will be aclcomulishec
1S. YOU ARE TO CONTACT THE US FISH AND WILDLIFE SERVICE AND/OR
NATIONAL FISHEMS SERVICE REGARDING THE PRESENCE OF ANY FEDERALLY
LISTED OR FOR LISTING ENDANGERED OR THREATENED SPECIES OR CRITICAL
HABITAT IN THE 4P- T AREA THAT MAY BE AFFECTED BY THE PROPOSED PROJECT.
DATE CONTACTEp: Faxed 1=9/1999
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER
(SM) REGARDING THE PRESENCE OF HISTORIC PROPERTIES IN THE PERMIT AREA
WHICH MAY BE AFFECTED BY THE PROPOSED PROJECT. DATE CONTACTED Faxed
12/29/1999.
ti
12/29/1999 16:11 NCDOT DIV 2 4 99197339959
NO. 729
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OR THE USE OF PUBLIC
(STATE) LAND? YES (1F NO, 00 TO 16)
(a) IF YES, DOES THE PROJECT REQUIRE PREPARATION OF AN ENVIRONMENTAL.
DOCUMENT PURSUANT TO THE REQUIREMENTS OF THE NORTH CAROLINA
ENVIRONMENTAL POLICY ACT? NO
(b) IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMMSTRAT ON STATE CLEARINGHOUSE 7 NO
IF ANSWER 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE STATE
CLEARINGHOUSE WITH THE NORTH CAROLINA ENVIRONMENTAL POLICY ACT.
QUESTIONS REGARDING THE STATE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED TO MS. CHRYS BAGGETT, DIRECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION, 116 WEST JONES STREET, RALEIGH,
NORTH CAROLINA 27603-8003, TELEPHONE [phone].
le. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF PROPOSED
ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OF FILL MATERIAL INTO
WETLANDS:
(a) WETLAND DELINEATION MAP SHOWING ALL WETLANDS, STREAMS, LAKES, AND
PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14, 16, 21, 26, 29, AND 38).
ALL STREAM (INTERMITTENT AND PERMANENT) ON THE PROPERTY MUST BE SHOWN ON
THE MAP. MAP SCALES SHOULD BE 1 INCH EQUALS 50 FEET OF I INCH EQUALS 100 FEET
OF THEIR EQUIVALENT.
(b) IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE IMPACTED BY
PRODUCT.
(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 THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
(e) WHAT IS LAND USE OF SURROUNDING PROPERTY? N/A
(fl IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL? N/A
SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE; WETLANDS OR WATERS OF THE US MAY NOT BE IMPACTED PRIOR TO:
1. ISSUANCE OF A SECTION 404 CORPS OF ENGINESKS P
2 EITHER THE ISSUANCE OR WAIVER OF A 401 DTi71SJ WATER QUALITY
CERTIFICATION, AND 3. (IN THE TWENTY COASTAL COUNTIES ONLY), A; FROM THE NORTH
CAROLINA DIVISION OF COASTAL MANAGE 0 THE PROPOSED
ACTIVITY IS CONSISTENT WITH THE NORTH C STAL MANAGEMETT
PROGRAM, to _ t"1 w" . x
OWNER'S/AGENTS SIGNATURE DATE
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED).
i
D04
12/29/1999 16:11 NCDOT DIV 2 4 89197339959
NO.729 D05
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