20100100 Ver 1_Application_20100208

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STATE OF NORTH CAROLINA
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DEPARTMENT OF TRANSPORTATION
BEVERLY EAVES PERDUE P.O. BOX 1587, Greenville, N.C. 27835-1587 EUGENE A. CONTI,Jr.
GOVERNOR SECRETARY
January 13, 2010
Mr. Stephen Lane,
Representative, Division of Coastal Management
North Carolina Department of Environment
And Natural Resources
Division of Coastal Management
Morehead City District
400 Commerce Avenue
Morehead City, North Carolina 28557
Attention: Mr. Stephen Lane
x.001 co
Subject: CAMA Permit Application for B4025, Beaufort 39,SR 1925, Idalia Road Over
Broomfield Swamp Creek,Beaufort County
WBS Element 33392.1.1
Enclosed please find information regarding a Division 2 project located in Beaufort
County. The project name is B-4025, Beaufort 39,SR 1925, Idalia Road over Broomfield Swamp
Creek in Beaufort County. The WBS Element Number is 33392. 1.1 . The proposed scope of
work is to replace the existing timber bridge at Station 15+00 -L- with a proposed 112.62 Feet
Long by 27'-10" Clear Roadway Bridge. Due to the age and condition of the existing structure,
The North Carolina Department of Transportation deemed it necessary to replace the existing
structure. The existing pavement is 20' wide.The Telephone and Cable TV Lines will be
relocated and installed by Directional Bore as shown on the plans. The lines will be placed at a
depth of a minimum of 6'under the bottom of Broomfield Swamp Creek. The Launching and
Receiving Pits are well away from the Riparian Buffer.
The amount of impervious surface has been reduced as much as possible. There will be
grass shoulders throughout the project that will filter runoff from the pavement and thus
minimize water quality impacts. Slopes of vegetated roadside ditches are typically steeper than
3:1 but are consistent with the existing slopes. Flatter slopes were not used due to the additional
wetland impacts that would be created. There will be 2 pipe replacements at Station 17+00,Left
and Right of -L- that discharge into the creek, but the stormwater is treated by wattles at the inlet
and outlet ends of these pipes. A proposed 24" x 36' CSP Cross-Line will be installed at Station
17+45 to convey stormwater. Wattles located near the inlet and outlet end of the pipe will treat
stormwater.
DIVISION TWO • P.O. BOX 15874 GREENVILLE, N.C. 27835
PHONE [phone] • FAX [phone]
C;Sw;NSW. The main wetland complex through which the roadway is located, is dominated by a
Bottomland Hardwood Forest. Approximately 15 Square Feet of 404 Wetland Impacts will be
filled by the proposed project. No Coastal Wetlands will be impacted.No mitigation is required
by the United States Army Corps of Engineers.The Fill Removal, 404 Wetland Credits proposed
for this project are approximately 1217 Sq. Ft. (0.03 acres). The North Carolina Wildlife'
Resources Commission has requested an in water work moratorium from February 15 to June 15.
The North Carolina Department of Transportation requests that this project be authorized
by the issuance of a Coastal Area Management Act General Permit. Please find attached the
completed DCM-MP-1 ,DCM-MP-2, and DCM-MP-5 Forms along with the Preconstruction
Notification Form and appropriate permit drawings and maps. The PS Form 3811,Certified Mail
Receipts from the adjacent property owner notifications are also included. Should you have any
questions regarding this information, please contact me at 252-830-3490 ext. 248.
Sincerely,
Jay hohnn
Environmental Officer
NCDOT, Division 2
DIVISION TWO • P.O. BOX 1587 • GREENVILLE, N.C. 27835
PHONE [phone] • FAX [phone]
x
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APPLICATION for
Nelor Development Permit
past revised 1212710e)
North Carolina DIVISION OF COASTAL MANAGEMENT
1. Primary Applicant/ Landowner Information
Business Name Project Name (if applicable)
North Carolina Department Of Transportation B-4025 Beaufort 39 SR 1925, Idalia Road Beaufort County
WBS Element 33392. 1.1
Applicant 1: First Name MI Last Name
Jay B. Johnson
Applicant 2: First Name MI Last Name
If additional applicants, please attach an additional page(s) with names li sted.
Mailing Address PO Box City State
1 158T Greenville NC
ZIP Country Phone No. FAX No.
27835 1587 us 252-830- 3490 ext. 248 252-830-3341
Street Address (d different from above) City State ZIP
Email
[e-mail]
2. Agent/Contractor Information
Business Name
Agent/ Contractor 1: First Name MI Last Name
Agent/ Contractor 2: First Name MI Last Name
Mailing Address PO Box City State
ZIP
1
Phone No. 1
-

- ext.
Phone No. 2
- - ext.
FAX No. Contractor #
Street Address (if different horn above) City State ZIP
Email
<Form continues on back>
a
Form DCM MP-1 (Page 2 of 5)
r ,
3. Project Location
County (can be multiple) Street Address State Rd. #
Beaufort SR 1925, Idalia Road
Subdivision Name City State Zip
Phone No. Lot NO.(s) (d many, attach additional page with list)
ext.
a. In which NC river basin is the project located? b. Name of body of water nearest to proposed project
Tar-Pamlico Broomfield swamp Creek
c. Is the water body identified in (b) above, natural or manmade? d. Name the closest major water body to the proposed project site.
®Natural []Manmade []Unknown Pamlico River
e. Is proposed work within city limits or planning jurisdiction? I. If applicable, list the planning jurisdiction or city limit the proposed
[]Yes ONO work falls within.
None
4. Site Description
a. Total length of shoreline on the tract (ft.) b. Size of enti re tract (sq.R)
120'(60' North and 60' South) N/A
c. Size of individual lot(s) d. Approximate elevation of tract above NHW (normal high water) or
NWL (normal water leveq
(If many lot sizes, please attach additional page with a list) 5.0" ?NHW or ®NWL
e. Vegetation on tract
Maintained Roadside Grasses
f. Man-made features and uses now on trail
Bridge
g. Identify and describe the existing land uses adiacent to the proposed project site.
Woods
h. How does local government zone the tract? i. Is the proposed project consistent with the applicable zoning?
N/A (Attach zoning compliance certificate, if applicable)
[]Yes ?NO ®NA
j. Is the proposed activity part of an urban waterfront redevelopment proposal? Yes No
k. Has a professional archaeological assessment been done for the tract? If yes, attach a copy. Yes No NA
If yes, by whom? SHPO Rene Gledhill-Early
1. Is the proposed project located in a National Registered Historic District or does it involve a Yes No NA
National Register listed or eligible property?
<Forrn continues on next page>

m. fill Are there wetlands on
(ii) Are there coastal wetlands on the site?
(iii) If yes to either (i) or (ii) above, has a delineation been conducted?
(Attach documentation, if available)
APPLICATION for
Major Development Permit
[]Yes ONO
®Yes ?No
Form DCM MP-1 (Page 3 of 5) APPLICATION for
Major Development Permit
n. Describe existing wastewater treatment facilities.
N/A
o. Describe existing drinking water supply source.
N/A
p. Describe existing stone water management or treatment systems.
N/A
5. Activities and Impacts
a. Will the project be for commercial, public, or private use?
Commercial PublidGovemment
?PrivatelCommunity
b. Give a brief description of purpose, use, and daily operations of the project when complete.
The Existing Timber Bridge Will Be Replaced By A Proposed Cored Slab Bridge. Proposed Telephone Lines and Cable TV
Lines will be relocated by directional Bore.
c. Describe the proposed construction methodology, types of construction equipment to be used during construction, the number of each type
of equipment and where it is to be stored.
The Existing Bridge Will Be Removed and the Proposed Bridge Will Be Installed. Existing Telephone and Cable TV Lines
will be relocated by directional Bore. Typical Roadway Construction Equipment Will Be Used, Including,But Not Limited To
Tracked Excavators,Crane,Dump Trucks, Flat-Bed Trucks,Back-HoeS,And Boom Trucks.
d. List all development activities you propose.
Bridge Replacement and Utility Relocation
e. Are the proposed activities maintenance of an existing project, new work, or both? Both
I. What is the approximate total disturbed land area resulting from the proposed project? 3625 ®Sq. Ft or ?Acres
g. Will the proposed project encroach on any public easement, public accessway or other area Yes No NA
that the public has established use of?
h. Describe location and type of existing and proposed discharges to waters of the state.
N/A
i. Will wastewater or stormwater be discharged into a wetland? Yes No NA
If yes, will this discharged water be of the same salinity as the receiving water? ?Yes ?No ?NA
j. Is there any mitigation proposed? Yes No NA
If yes, attach a mitigation proposal.
<Form continues on back>
6. Additional Information
In addition to this completed application form, (MP-1) the following items below, if applicable, must he submitted in order for the application
package to be complete. Items (a) - (t) are always applicable to any major development application. Please consult the application
instruction booklet on how to property prepare the required items below.
a. A project narrative
u. nn aczmata, oared wont plat pnuuamg plan view and cross-secaonai drawings) drawn to scale. Please give the present status of the
proposed project. Is any portion already complete? If previously authorized work, clearly indicate on maps, plats, drawings to distinguish
between work completed and proposed. -
c. A site or location map that is sufficiently detailed to guide agency personnel unfamiliar with the area to the site.
Form DCM MP-1 (Page 4 of 5)
APPLICATION for
Major Development Permit
d. A copy of the deed (with state application only) or other instrument under which the applicant claims title to the affected properties.
e. The appropriate application fee. Check or money order made payable to DENR.
I. A list of the names and complete addresses of the adjacent waterfront (riparian) landowners and signed return receipts as proof that such
owners have received a copy of the application and plats by certified mail. Such landowners must be advised that they have 30 days in
which to submit comments on the proposed project to the Division of Coastal Management.
Name PCS Phosphate Company,lnc.
Phone No.
Address P.C. Box 425 Aurora, NC 27806 Parcels 2641, 6125,and 8701
Name Frank Fosskey,Sr.
Phone No.
Address 2201 Stuart Drive Durham, NC 27707 Parcel 7200
Name
Phone No.
Address
g. A list of previous state or federal permits issued for work on the project tract. Include permit numbers, permittee, and issuing dates.
None
h. Signed consultant or agent authorization form, if applicable. -
i. Wetland delineation, if necessary.
j. A signed AEC hazard notice for projects in oceanfront and inlet areas. (Must be signed by property owner)
k. A statement of compliance with the N.C. Environmental Policy Act (N.C.G.S. 113A 1-10), if necessary. If the project involves expenditure
of public funds or use of public lands, attach a statement documenting compliance with the North Carolina Environmental Policy Act.
I understand that any permit issued in response to this application will allow only the development described in the application.
The project will be subject to the conditions and restrictions contained in the permit.
I certify that I am authorized to grant, and do in fact grant permission to representatives of state and federal review agencies to
enter on the aforementioned lands in connection with evaluating information related to this permit application and follow-up
monitoring of the project.
I further certify that the information provided in this application is truthful to the best of my knowledge.
Date January 13, 2010 Print Name _Jay B. Johnson
Signature
Please indicate application attachments pertaining to your proposed p ject.
®DCM MP-2 Excavation and Fill Information ®DCM MP-5 Bridges and Culverts
?DCM MP-3 Upland Development
?DCM MP-4 Structures Information
Form DCM MP-2
EXCAVATION and FILL
(Except for bridges and culverts)
Attach this form to Joint Application for CAMA Major Permit, Form DCM MP-1. Be sure to complete all other sections of the Joint
Application that relate to this proposed project. Please include all supplemental information.
Describe below the purpose of proposed excavation and/or fill activities. All values should be given in feet
Access Other
Channel Canal Boat Basin Boat Ramp Rock Groin Rock (excluding .
(NLW or Breakwater shoreline
NWL stabilization
Length
Width
Avg. Existing
Depth NA NA
Final Project

Depth NA NA
1. EXCAVATION ®This section not applicable
a. Amount of material to be excavated from below NHW or NWL in b. Type of material to be excavated.
cubic yards.
c. (i) Does the area to be excavated include coastal wetlands/marsh
(CW), submerged aquatic vegetation (SAV), shell bottom (SB),
or other wetlands (WL)? If any boxes are checked, provide the
number of square feet affected.
?CW ?SAV ?SB
?WL ?None
(ii) Describe the purpose of the excavation in these areas:
d. High-ground excavation in cubic yards.
2. DISPOSAL OF EXCAVATED MATERIAL ®This section not applicable
a. Location of disposal area. b. Dimensions of disposal area.

C. (i) Do you claim title to disposal area?
?Yes ?NO ?NA
(ii) If no, attach a letter granting permission from the owner.
e. (i) Does the disposal area include any coastal wetlands/marsh
(CW), submerged aquatic vegetation (SAV), shell bottom (SB),
or other wetlands (WL)? If any boxes are checked, provide the
number of square feet affected.
?CW ?SAV ?SB
?WL ?None
(ii) Describe the purpose of disposal in these areas:
d. (i) Will a disposal area be available for future maintenance?
?Yes ?No ?NA
(ii) If yes, where?
f. (i) Does the disposal include any area in the water?
?Yes ?No ?NA
(ii) If yes, how much water area is affected?
Form DCM MP-2 (Excavation and Fill, Page 2 of 3)
r 3. SHORELINE STABILIZATION ?This section not applicable
(If development is a wood groin, use MP-4 - Structures)
a. Type of shoreline stabilization: b. Length: 120'(60' North And 60' South)
LJBulkhead DgRiprap ?Breakwater/Sill DOther. _ Width: 5'
c. Average distance waterward of NHW or NWL: 15' d. Maximum distance waterward of NHW or NWL: 15'
e. Type of stabilization material:
Class 8 Mad
f. (i) Has there been shoreline erosion during preceding 12
months?
?Yes ONo ?NA
(ii) If yes, state amount of erosion and source of erosion amount
information.
g. Number of square feet of fill to be placed below water level.
Bulkhead badkfill _ Riprap 0
Breakwater/Sill Other _
I. Source of fill material.
h. Type of fill material.
Grandel
4. OTHER FILL ACTIVITIES ®This section not applicable
(Excluding Shoreline Stabilization)
a. (i) Will fill material be brought to the site? ?Yes DNo ?NA b. (i) Will fill material be placed in coastal wetlandstmarsh (CW),
If yes submerged aquatic vegetation (SAV), shell bottom (SB), or
other wetlands (WL)? If any boxes are checked, provide the
(ii) Amount of material to be placed in the water _ number of square feet affected.
(iii) Dimensions of fill area ?CW ?SAV
?SB
(iv) Purpose of fill
?WL ?NOne
(ii) Describe the purpose of the fill in these areas:
5. GENERAL
a. How will excavated or fill material be kept on
controlled?
Sift Fences,Rip Rap, and turbidity Curtains
c. (i) Will navigational aids be required as a result of the project? d.
?Yes ONo ?NA
(ii) If yes, explain what type and how they will be implemented.
What type of construction equipment will be used (e.g., dragline,
backhce, or hydraulic dredge)?
Typical Road and Bridge Construction Equipment Boring
Equipment for the Telephone Lines and Cable TV Lines
(i) Will wetlands be crossed in transporting equipment to project
site? ?Yes MNo ?NA
(ii) If yes, explain steps that will be taken to avoid or minimize
environmental impacts.
January 13, 2010
Date Jay B. Johnson
B-4025 Beaufort 39 SR 1925,ldalia Road,Bridge Replacement r Applicant Na
WEIS Element Number 33392.1.1,

Project Name .. .. '! a. % ApphcaM Sg ure / \ r I .. `tee.i>':

hnD DO MP-5
BRIDGES and CULVERTS
Attach this form to Joint Application for CAMA Major Permit, Form DCM MP-1. Be sure to complete all other sections of the Joint
Application that relate to this proposed project. Please include all supplemental information.
1. BRIDGES ?This section not applicable
a. Is the proposed bridge:
?Commercial ®PublictGovemment ?Private/Community
c. Type of bridge (construction material):
Concrete Cored Slab
e. (i) Will proposed bridge replace an existing bridge? ®Yes ?No
If yes,
(ii) Length of existing bridge: 106'
(iii) Width of existing bridge: 27-6"
(iv) Navigation clearance underneath existing bridge: 3'
(v) Will all, or a part of, the existing bridge be removed?
(Explain) All of the Existing Bridge will be Removed
9 Length of proposed bridge: 110'
b. Water body to be crossed by bridge:
Broomfield Swamp Creek
d. Water depth at the proposed crossing at NLW or NWL:
7'
f. (i) Will proposed bridge replace an existing culvert? ?Yes ®No
If yes,
(ii) Length of existing culvert:
(iii) Width of existing culvert:
(iv) Height of the top of the existing culvert above the NHW or
NWL: _
(v) Will all, or a part of, the existing culvert be removed?
(Explain)
h. Width of proposed bridge: 27'27'10"
I. Will the proposed bridge affect existing water flow? ?Yes ENo j. Will the proposed bridge affect navigation by reducing or
If yes, explain: - increasing the existing navigable opening? ?Yes ®No
If yes, explain:
k. Navigation clearance underneath proposed bridge: 3'
1. Have you contacted the U.S. Coast Guard concerning their
approval? ?Yes ®No
If yes, explain:
m. Will the proposed bridge cross wetlands containing no navigable n. Height of proposed bridge above wetlands: 3'
waters? ?Yes ®No
If yes, explain:
2._ CULVERTS This section not applicable
a. Number of culverts proposed: b. Water body in which the culvert is to be placed: .
i
l
Form DCM MP-5 (Bridges and Culverts, Page 2 of 4)
C. Type of culvert (construction material):
d. (i) Will proposed culvert replace an existing bridge?
?Yes ?No
If yes,
(ii) Length of existing bridge:
(iii) Width of existing bridge:
(iv) Navigation clearance underneath existing bridge: _
(v) Will all, or a part of, the existing bridge be removed?
(Blain)
f. Length of proposed culvert:
h. Height of the top of the proposed culvert above the NHW or NWL.
j. Will the proposed culvert affect navigation by reducing or
increasing the existing navigable opening? ?Yes ?No
If yes, explain:
e. (i) Will proposed culvert replace an existing culvert?
?Yes ?No
If yes,
(ii) Length of existing culvert(s):
(iii) Width of existing culvert(s):
(iv) Height of the top of the existing culvert above the NHW or
NWL:
(v) Will all, or a part of, the existing culvert be removed?
(Blain)
9 Width of proposed culvert: _
I. Depth of culvert to be buried below existing bottom contour.
k. Will the proposed culvert affect existing water flow?
?Yes ?No
If yes, explain:
3. EXCAVATION and FILL ?This section not applicable
a.
C.
(i) Will the placement of the proposed bridge of culvert require any
excavation below the NHW or NWL? ®Yes ?No
If yes,
(ii) Avg. length of area to be excavated: 3' West End of
Bridge'
(iii) Avg. width of area to be excavated: 30' West End of
Bridge'
(iv) Avg. depth of area to be excavated: 1_0'
(v) Amount of material to be excavated in cubic yards: 0.3
Cubic Yards
(i) Will the placement of the proposed bridge or culvert require any
high-ground excavation? ®Yes ?No
If yes,
(ii) Avg. length of area to be excavated: 40' North 40' South
(ii) Avg. width of area to be excavated: 15'
(iv) Avg. depth of area to be excavated: 4_5'
(v) Amount of material to be excavated in cubic yards: 200
Cubic Yards
b. (i) Will the placement of the proposed bridge or culvert require any
excavation within coastal wetlands/marsh (CW), submerged
aquatic vegetation (SAV), shell bottom (SB), or other wetlands
(WL)? If any boxes are checked, provide the number of square
feet affected.
?CW ?sAV ?SB
?WL ENone
(ii) Describe the purpose of the excavation in these areas:
Form DCM MP-5 (Bridges and Culverts, Page 3 of 4)
d. If the placement of the bridge or culvert involves any excavation, please complete the following:
(i) Location of the spoil disposal area: Temporary Spoil Area is in 'the Existing Road
(ii) Dimensions of the spoil disposal area: 100'x200'
(iii) Do you claim title to the disposal area? ®Yes ?No (ff no, attach a lettergrantihg permission from the owner.)
(iv) Will the disposal area be available for future maintenance? ®Yes ?No
(v) Does the disposal area include any coastal wetfandstmamh (CW), submerged aquatic vegetation (SAVs), other wetlands (WL), or shell
bottom (SB)?
?CW ?SAV ?WL ?SB ®None
If any boxes are checked, give dimensions if different from (ii) above.
(vi) Does the disposal area include any area below the NRW or NWL7 7 ?Yes ®No
If yes, give dimensions if different from (ii) above.
e. (i) Will the placement of the proposed bridge or culvert result in any
fill (other than excavated material described in Item d above) to
be placed below NHW or NWL? ®Yes ?No
If yes,
(if) Avg. length of area to be filled: 5' Eastern End of Bridge
(iii) Avg. width of area to be filled: 30' Eastern End of Bridge
(iv) Purpose of fill: Slight Westward Shift of the Proposed
Bridge
f. (i) Will the placement of the proposed bridge or culvert result in any
fill (other than excavated material described in Item d above) to
be placed within coastal wetlandshnarsh (C%W submerged
aquatic vegetation (SAV), shell bottom (SB), or other wetlands
(WL)? If any boxes are checked, provide the number of square
feet affected. ?--(
?CW LISAV ?SB
OWL 15 Sc ft. ?None
(ii) Describe the purpose of the excavation in these areas:
Fill for Wingwalls and Eastern End Bent
g. (1) Will the placement of the proposed bridge or culvert result in any
fill (other than excavated material described in Item d above) to
be placed on high-ground? ?Yes ®No
If yes,
(ii) Avg. length of area to be filled:
(iii) Avg. width of area to be filled: _
(iv) Purpose of fill:
a. Will the proposed project require the relocation of any existing b. Will the proposed project require the construction of any temporary
utility lines? ®Yes ?No detour structures? ?Yes ®No
If yes, explain: The Existing Telephone Lines and Cable If yes, explain:
TV Lines will be Relocated and Installed By Directional
Boring.
If this portion of the proposed project has already received
approval from local authorities, please attach a copy of the
approval or certification.

< Form continues on back>

Form DCM MP-5 (Bridges and Culverts, Page 4 of 4)
c. Will the proposed project require any work channels?
?Yes ®No
If yes, complete Form DCM-MP-2.
e. What type of construction equipment will be used (for example,
dragline, backhoe, or hydraulic dredge)?
Typical Bridge Construction Equipment and Directional
Boring Equipment
d. How will excavated or fill material be kept on site and erosion
controlled?
Turbidity Curtains,Wattles,Rip Rap, and Sift Fences will be
used to retain sediment on-site
f. Will wetlands be crossed in transporting equipment to project site?
?Yes ®No
If yes, explain steps that will be taken to avoid or minimize
environmental impacts.
g. Will the placement of the proposed bridge or culvert require any
shoreline stabilization? ®Yes ?No
If yes, complete form MP-2, Section 3 for Shoreline
Stabilization only.
January 13,2010 WBS Element 33392.1.1 Debit $400
Date
B-4025 Beaufort 39 SR 1925, Idalia Road, Bridge to Bridge
Replacement, Pamlico County WBS Element Number 33392.1.1
Project Name
Jay B. Johnson
Appli tName -,___JI
V
Applica ig u

0&O? W A7' 9O9
O
Office Use Only:
Corps action ID no.
DWQ project no.
Form Version 1.3 Dec 10 2008
Pre-Construction Notification C Form
A. Applicant Information
1. Processing
1a. Type(s) of approval sought from the
Corps:
®Section 404 Permit ? Section 10 Permit
1 b. Specify Nationwide Permit (NWP) number: 3 or General Permit (GP) number:
1c. Has the NWP or GP number been verified by the Corps? ? Yes ® No
1d. Type(s) of approval sought from the DWQ (check all that apply):
® 401 Water Quality Certification - Regular ? Non-404 Jurisdictional General Permit
? 401 Water Quality Certification - Express ® Riparian Buffer Authorization
le. Is this notification solely for the record
because written approval is not required? For the record only for DWQ 401
Certification:
? Yes ® No For the record only for Corps Permit:

® Yes ? No
1f. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation
of impacts? If so, attach the acceptance letter from mitigation bank or in-lieu
fee program. ? Yes ® No
1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h
below. ® Yes ? No
1 h. Is the project located within a NC DCM Area of Environmental Concem (AEC)? ® Yes ? No
2. Project Information

2a.
Name of project: B-4025 Beaufort 39 Bridge Replacement and Telephone Line Relocation SR 1925,
Idalia Road Over Broomfield Swamp Creek
WBS Element Number 33392.1.1
2b. County: Pitt
2c. Nearest municipality / town: Aurora
2d. Subdivision name: N/A
2e. NCDOT only, T.I.P. or state
project no: 33392.1.1
3. Owner Information
3a. Name(s) on Recorded Deed: North Carolina Department of Transportation
3b. Deed Book and Page No. N/A
3c. Responsible Party (for LLC if
applicable): N/A
3d. Street address: 105 Pactolus Highway NC 33 P.O. Box 1587
3e. City, state, zip: Greenville, NC 27835
3f. Telephone no.: 252-830-3490
3g. Fax no.: 252-830-3341
3h. Email address: [e-mail]
Page 1 of 11
PCN Form -Version 1.3 December 10, 2008 Version.

4. Applicant Information (if different from owner)
4a. Applicant is: ? Agent ® Other, specify: Division 2 Environmental Officer
4b. Name: Jay B. Johnson
4c. Business name
(if applicable): North Carolina Depratment of Transportation
4d. Street address: P.O. Box 1587
4e. City, state, zip: Greenville, NC 27835
4f. Telephone no.: 252-830-3490
4g. Fax no.: 252-830-3341
4h. Email address: [e-mail]
5. Agent/Consultant Information (if applicable)
5a. Name: N/A
5b. Business name
(if applicable):
5c. Street address:
5d. City, state, zip:
5e. Telephone no.:
5f. Fax no.:
5g. Email address:
B. Project Information and Prior Project History
1. Property Identification
1a. Property identification no. (tax PIN or parcel ID): 8-4025 Beaufort 39 SR 1925,ldalia Road Over
Broomfield Swamp Creek
Latitude: N 35.285018 Longitude: - W
1b. Site coordinates (in decimal degrees): 76.788870
(DD.DDDDDD) (-DD.DDDDDD)
1c. Property size: N/A acres
2. Surface Waters
2a. Name of nearest body of water (stream, river, etc.) to Broomfield Swamp Creek
proposed project:
2b. Water Quality Classification of nearest receiving water: C;Sw;NSW
2c. River basin: Tar-Pamlico
3. Project Description
3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application:
SR 1925, Idalia Road is a paved secondary state highway. Woodlands and Agriculture dominate the landscape.
3b. List the total estimated acreage of all existing wetlands on the property:
15 Square Feet of 404 Wetland Impacts For The Bridge Replacement, Cable TV, and Telephone Line Relocation.
3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property:
60' This site is part of a longer adjacent stream system
3d. Explain the purpose of the proposed project:
Bridge To Bridge Replacement, cable TV, and Telephone Line Relocation; the existing bridge has deteoriated and needs
replacing. The Proposed Cable TV and Telephone Lines will be installed by Directional Bore.
3e. Describe the overall project in detail, including the type of equipment to be used:
The Existing 106' Timber Bridge will be replaced with a Proposed 110'x 27-10" Concrete Bridge. A Section of The
Existing Telephone Lines Will Be Relocated By Difrectional Bore From station 14+00,25' Lt. -L- To Station 18+85,25'Lt.-L-
Excavators,Dump Trucks,and Crane Trucks will be used for the Bridge Replacement. boring Equipment will be used for
Cable TV And Telephone Line Installation.
4. Jurisdictional Determinations
4a. Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
? Yes ® No ? Unknown
project (including all prior phases) in the past?
Comments:
4b. If the Corps made the jurisdictional determination, what type
El Preliminary El
Final
of determination was made?
4c. If yes, who delineated the jurisdictional areas? Agency/Consultant Company:
Name (if known): Jay B. Johnson Other: NCDOT
4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation.
September, 2009
5. Project History
5a. Have permits or certifications been requested or obtained for ? Yes ®No ? Unknown
this project (including all prior phases) in the past?
5b. If yes, explain in detail according to `help file' instructions.
Page 3 of 11
PCN Form - Version 1.3 December 10, 2008 Version
6. Future Project Plans
6a. Is this a phased project? ? Yes ® No
6b. If yes, explain.
C. Proposed Impacts Inventory
1. Impacts Summary
1 a. Which sections were completed below for your project (check all that apply):
N Wetlands ? Streams - tributaries ® Buffers
? Open Waters ? Pond Construction
2. Wetland Impacts
If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted.
2a. 2b. 2c. 2d. 2e. 2f.
Wetland impact Type of jurisdiction
number - Type of impact Type of wetland Forested (Corps - 404, 10 Area of impact
Permanent (P) or (if known) DWQ - non-404, other) (acres)
Temporary T
W1 N P ? T Fill Bottomland N Yes N Corps 4 Sq
Ft

Hardwood Forest
? No
? DWQ .
.
W2 N P ? T Fill Bottomland N Yes N Corps g Sq
Ft
Hardwood Forest ? No ? DWQ .
W3 N P ? T Fill Bottomland N Yes N Corps 2 Sq
Ft

Hardwood Forest
? No
? DWQ .
.
W4 ? P ? T ? Yes ? Corps
? No ? DWQ
W5 ? P ? T ? Yes ? Corps
? No ? DWQ
W6 ? P ? T ? Yes ? Corps
? No ? DWQ
2g. Total wetland impacts 15 Sq. Ft.
2h. Comments: 15 Square feet of 404 Wetland Impacts
3. Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this
question for all stream sites impacted.
3a. 3b. 3c. 3d. 3e. 3f. 3g.
Stream impact Type of impact Stream name Perennial Type of jurisdiction Average Impact
number - (PER) or (Corps - 404, 10 stream length
Permanent (P) or intermittent DWQ - non-404, width (linear
Temporary (T) (INT)? other) (feet) feet)
S1 ? P ? T ? PER ? Corps
? INT ? DWQ
S2 ? P ? T ? PER ? Corps
? INT ? DWQ
S3 ? P ? T ? PER ? Corps
? INT ? DWQ
S4 ? P ? T ? PER ? Corps
? INT ? DWQ
S5 ? P ? T ? PER ? Corps
? INT ? DWQ
S6 ? P ? T ? PER ? Corps
? INT ? DWQ
3h. Total stream and tributary impacts None
3i. Comments: No Stream Impacts
Page 5 of 11
PCN Form - Version 1.3 December 10, 2008 Version

4. Open Water Impacts
If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of
the U.S. then individually list all open water impacts below.
4a. 4b. 4c. 4d. 4e.
Open water Name ofwaterbody
impact number - (if applicable) Type of impact Waterbody type Area of impact (acres)
Permanent (P) or
Temporary
01 ?P?T
02 ?P?T
03 ?P?T
04 ?P?T
411 Total open water impacts None
4g. Comments: None
5. Pond or Lake Construction
If and or lake construction proposed, then complete the chart below.
5a. 5b. 5c. 5d. 5e.
Wetland Impacts (acres) Stream Impacts (feet) Upland
Pond ID Proposed use or purpose (acres)
number of pond
Flooded Filled Excavated Flooded Filled Excavated Flooded
P1
P2
5f. Total None
5g. Comments: None
5h. Is a dam high hazard permit required?
? Yes ? No If yes, permit ID no:
5i. Expected pond surface area (acres):
5j. Size of pond watershed (acres):
5k. Method of construction:
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If an impacts require mitigation, then you MUST fill out Section D of this form.
6a.
? Neuse NTar-Pamlico ? Other: None
Project is in which protected basin? ? Catawba ? Randleman
6b. 6c. 6d. 6e. 6f. 6g.
Buffer impact
number- Reason Buffer Zone 1 impact Zone 2 impact
Permanent (P) or for Stream name mitigation (square feet) (square feet)
Temporary (T) impact required?
Bt N P ? T Fill Broomfield Swamp Creek ® Nos 561 Sq. Ft. 417 Sq. Ft.
B2 N P ? T Fill Broomfield Swamp Creek ® Nos 3253 Sq. Ft. 2199 Sq. Ft.
63 N P ? T Fill Broomfield Swamp Creek ® Nos 2241 Sq. Ft. 1508 Sq. Ft.
6h. Total buffer impacts
6i. Comments: See Page 6-A For Total Buffer Impacts
Page 6 of 11 -
PCN Form - Version 1.3 December 10, 2008 Version
6. Buffer Impacts (for DWQ)
If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts
below. If an impacts require mitigation, then you MUST fill out Section D of this form.
6a.
? Neuse ®Tar-Pamlico ? Other: None
Project is in which protected basin? ? Catawba ? Randleman
6b. 6c. 6d. 6e. 6f. 6g.
Buffer impact
number - Reason Buffer Zone 1 impact Zone 2 impact
Permanent (P) or for Stream name mitigation (square feet) (square feet)
Temporary T impact required?
B1 ®P ? T B4 Fill B4 Broomfield Swamp Creek ® Nos 556 Sq. Ft. 418 Sq. Ft.
E32 ?P?T ?Yes
? No
B3 ?P?T ?Yes
? No
6h. Total buffer impacts 6611 Sq Ft 0.15 4542 Sq. Ft. 0.10 Acres
Acres
6i. Comments:
D. Impact Justification and Mitigation
1. Avoidance and Minimization
1 a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
1b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State
2a. Does the project require Compensatory Mitigation for ? Yes ? No
impacts to Waters of the U.S. or Waters of the State?
2b. If yes, mitigation is required by (check all that apply): ? DWQ ? Corps
? Mitigation bank
2c. If yes, which mitigation option will be used for this ? Payment to in-lieu fee program
project.
? Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter) Type Quantity
G-A
Page Hof 11
PCN Form - Version 1.3 December 10, 2008 Version
1
D. Impact Justification and Mitigation
la. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project.
Wetland Impacts have been minimized to the extent feasible, with impacts occurring only where necessary to accommodate
the Proposed Bridge, Telephone Line and Cable TV Lines.
1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques.
Use of existing roadway to operate construction equipment; no equipment will enter wetlands.
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? ? Yes ® No
2b. If yes, mitigation is required by (check all that apply): ? DWQ ? Corps

2c.
If yes, which mitigation option will be used for this
project? ? Mitigation bank

? Payment to in-lieu fee program
? Permittee Responsible Mitigation
3. Complete if Using a Mitigation Bank
3a. Name of Mitigation Bank:
3b. Credits Purchased (attach receipt and letter) Type Quantity
3c. Comments:
4. Complete if Making a Payment to In-lieu Fee Program
4a. Approval letter from in-lieu fee program is attached. ? Yes
4b. Stream mitigation requested: linear feet
4c. If using stream mitigation, stream temperature: ? warm ? cool ?cold
4d. Buffer mitigation requested (DWQ only): square feet
4e. Riparian wetland mitigation requested: acres
4f. Non-riparian wetland mitigation requested: acres
4g. Coastal (tidal) wetland mitigation requested: acres
4h. Comments:
5. Complete if Using a Permittee Responsible Mitigation Plan
5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan.
Page 7 of 11
PCN Form - Version 1.3 December 10, 2008 Version
6. Buffer Mitigation (State Regulated Riparian Buffer Rules) - required by DWQ
6a. Will the project result in an impact within a protected riparian buffer that requires ? Yes ® No
buffer mitigation?
6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the
amount of mitigation required.
6c. 6d. 6e.
Zone Reason for impact Total impact Multiplier Required mitigation
(square feet) (square feet)
Zone 1 3 (2 for Catawba)
Zone 2 1.5
6f. Total buffer mitigation required: None
6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank,
permittee responsible riparian buffer restoration, payment into an approved in-lieu fee fund).
N/A
6h. Comments:
E. Stormwater Management and Diffuse Flow Plan (required by DWQ)
1. Diffuse Flow Plan
1a . Does the project include or is it adjacent to protected riparian buffers identified ® Yes ? No
within one of the NC Riparian Buffer Protection Rules?
1b . If yes, then is a diffuse flow plan included? If no, explain why.
Comments: Sheet Flow through the Vegetated Shoulders and Special Sediment
Control Fence will be used to treat Stormwater Run-Off From the Road. New Pipes
Will Be Installed At Staion 17+00,Lt. And Rt.-L- to Replace Existing Pipes.
Stormwater Will Flow Through Wattles For Treatment. Roadside Ditches Will Not
Enter Into the buffers From Station 14+00 To Station 15+52. Roadside Ditches Will
Not Enter The Buffers From Station 18+00 To Station 20+00-The Roadside Ditches ® Yes ? No
Will Sheet Flow Through Vegetated Uplands Before Entering Into The Buffers. The
Proposed Cross-Line At Station 17+40 Will Take Stormwater From The Left Side
Of -L- To The Right Side Of -L- During Storm Events. This 24" x 36' CSP is located
outside of Buffer Zone 2.The Proposed Driveway Pipes At Station 17+00 Lt. And
RL-L- Will Be Have Wattles To Treat Stormwater Before Entering Into Broomfield
Swamp Creek. These Driveway Pipes are replacing existing 18" pipes as shown on
the plans.
2. Stormwater Management Plan
2a. What is the overall percent imperviousness of this project? N/A Roadway/Bridge Project %
2b. Does this project require a Stonmwater Management Plan? ® Yes ? No
2c. If this project DOES NOT require a Stormwater Management Plan, explain why:
2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan:
Diffuse Flow Through Vegetation and Special Sediment Control Fences at Sta. 14+03.22' Rt.; Sta. 14+85, 29' Lt.;and
Sta.18+70, 261t. An Outlet Energy Dissipator will be used at Station 15+15,29' Lt. Silt Fence will be used to contain
sediment on the project as shown on the plan sheet. A turbidity curtain will be used across the creek on each side of the
bridge during pile removal, as shown on the plan.
? Certified Local Government
2e. Who will be responsible for the review of the Stonmwater Management Plan? ? DWQ Stonnwater Program
® DWQ 401 Unit
3. Certified Local Government Stormwater Review
3a. In which local government's jurisdiction is this project? N/A
? Phase II
3b. Which of the following locally-implemented stormwater management programs ? NSW
El USMP
apply (check all that apply): ? Water Supply Watershed
? Other: N/A
3c. Has the approved Stormwater Management Plan with proof of approval been ? Yes ® No
attached?
4. DWQ Stormwater Program Review
® Coastal counties
4a. Which of the following state-implemented stormwater management programs apply ? HQW
(check all that apply): ? ORW
? Session Law 2006-246
Page 9 of 11
PCN Form -Version 1.3 December 10, 2008 Version
attached?
5. DWQ 401 Unit Stormwater Review
5a . Does the Stormwater Management Plan meet the appropriate requirements? ? Yes ? No
5b . Have all of the 401 Unit submittal requirements been met? ? Yes ? No
F. Supplementary Information
1. Environmental Documentation (DWQ Requirement)
1 a . Does the project involve an expenditure of public (federal/state/local) funds or the ®Yes
? No
use of public (federal/state) land?
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 ? Yes ® No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1c. If you answered yes" to the above, has the document review been finalized by the
State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval
letter.) ? Yes ? No
Comments:
2. Violations (DWQ Requirement)
2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated
Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards, ? Yes ®No
or Riparian Buffer Rules (15A NCAC 2B .0200)?
2b. Is this an after-the-fact permit application? ? Yes ® No
2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s):
3. Cumulative Impacts (DWQ Requirement)
3a. Will this project (based on past and reasonably anticipated future impacts) result in ? Yes ® No
additional development, which could impact nearby downstream water quality?
3b. If you answered 'yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy. If you answered "no," provide a short narrative description.
4. Sewage Disposal (DWQ Requirement)
4a. Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of wastewater generated from
the proposed project, or available capacity of the subject facility.
N/A
Page 10 of 11
PCN Form - Version 1.3 December 10, 2008 Version
5. Endangered Species and Designated Critical Habitat (Corps Requirement)
5a. Will this project occur in or near an area with federally protected species or ? Yes No
habitat?
5b. Have you checked with the USFWS concerning Endangered Species Act ? Yes No
impacts?
El Raleigh
5c. If yes, indicate the USFWS Field Office you have contacted.
? Asheville
5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
On-Site Habitat Investigation of Tar River SpinyMussels by Logan Williams,NCDOT Biologist
6. Essential Fish Habitat (Corps Requirement)
6a. Will this project occur in or near an area designated as essential fish habitat? ® Yes ? No
6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat?
On-Site Investigation,NCDOT Biologist Reports, and Moratorium Information From Travis Wilson, NCWRC
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 El Yes ® No
status (e.g., National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b. What data sources did you use to determine whether your site would impact historic or archeological resources?
NCSHPO
8. Flood Zone Designation (Corps Requirement)
8a. Will this project occur in a FEMA-designated 100-year floodplain? ®Yes ? No
8b. If yes, explain how project meets FEMA requirements: Bridge designed to no-rise standards
8c. What source(s) did you use to make the floodplain determination? FEMA FIRM Maps

Jay B. Johnson
Q
January 13,
2010
Applicant/Agent's Printed Name nUAgent's Signature Date
(Agent's signs a is v li my if an authorization letter from the applicant
is provided.)
Page l 1 of 11
PCN Form - Version 1.3 December 10, 2008 Version'
Bridge to Bridge Replacement, B-4025, Beaufort 39, SR
1925, Idalia Road Over Broomfield Swamp Creek,
Beaufort County WBS Element Number 33392.1.1
Erosion Control Schedule
• Install erosion/sediment control measures according to plans.
• Grading of slopes; 1.5: 1= stabilize with Class B riprap
• Seed all disturbed areas as soon as final grading is completed.
• Clean out and/or rework all temporary sediment control measures after
significant rainfall event (or as otherwise needed). These measures should be
maintained until a permanent vegetative cover is established and project is
complete
Pipe Installation Schedule
• Install erosion/sediment control devices per plans.
• Remove material while limiting, as much as possible, material and sediment
from entering the stream and/or escaping from the project.
• Prepare pipe foundation while taking care to limit material and sediment from
entering the stream and/or escaping from the project. Where possible new
grade should be below the existing streambed. Bedding material will be washed
stone.
• Place new pipe and compact fill.
• Install slope protection on outlet and inlet ends of pipe (Class B Granite riprap)
• Establish permanent vegetation as soon as possible
• Remove sediment control devices after project has stabilized and permanent
vegetative cover is established.

SUMMARY OF AFFECTED PROPERTY OWNERS

TRACT
NUMBER PROPERTY
OWNER
ADDRESS

2641 PCS PHOSPHATE
COMPANY,Inc P.O. BOX 425
AURORA, NC 27806

6125 PCS PHOSPHATE
COMPANY,Inc. P.O. BOX 425
AURORA, NC 27806

8701 PCS PHOSPHATE
COMPANY,Inc, P.O. BOX 425
AURORA, NC 27806

7200
FRANK FOSKEY,Sr. 2201 STUART
DRIVE
DURHAM, NC 27707

From: Lane, Stephen
Sent: Friday, December 04, 2009 9:06 AM
To: Sutton, Michael W
Subject: RE: Beaufort 39 B-4025
RE Beaufort 39 B-4025.[x[
Hi Mike,
I have visited the following sites and made the following jurisdictional determinations
Beaufort County Bridge 18 (B-5202) on NC99 over Intercepting Canal - Jurisdictional Beaufort County Bridge 39 (B-4025) on
SRI 925 over Broomfield Swamp Canal - Jurisdictional Beaufort County Bridge 60 (B-5200) on NC33 over Blounts Creek -
Jurisdictional Craven County Bridge 10 (B-4086) on SRI l 11 over Brice Creek - Jurisdictional
I also plan to visit the remaining sites you sent me for determ nations next week if we have some normal weather patterns then
and will send you an email on what I find out.
Thanks,
Stephen
-----Original Message-----
From: Sutton, Michael W
Sent: Thursday, December 03, 2009 11:20 AM
To Lane, Stephen
Cc: Caldwell, Betty A; Johnson, Jay B; Jones, Larry L
Subject: Beaufort 39 B-4025
Good Morning Lady and Gentlemen... Beaufort 39,13-4025, SR 1925,ldalia Road Over Broomfield Swamp Canal is up for
replacement. We request a CAMA Jurisdictional Call as soon as possible. Attached are maps for your use.Many Thanks ...mike
Email correspondence to and from this sender is subject to the N.C. Public Records Law and may be disclosed to third parties.
Page 1
From: Wilson, Travis W.
Sent: Friday, October 30, 2009 12:02 PM
To: Sutton, Michael W
Cc: Caldwell, Betty A, Johnson, Jay B
Subject: RE: Bridges
Attachments: multibrige070303.doc, 2002NRTRS.doc
RE Bridges.tst
The 2002NRTRS document contains comments for B-4086: this stream is designated AFSA and these comments are valid. The
multibridge 070303document contains comments for B-4233 and these comments are still valid (no moratorium). However
B-4025 comments are also in the multibridge070303 document but are not accurate. Broomfield Swamp at this location is
designated AFSA and will have a moratorium of Feb 15 to June 15, also I cannot determine why we requested any RCW review
(this may be a cut and paste error). Let me know if you have any questions.
-----Original Message-----
From: Sutton, Michael W
Sent: Thursday, October 29, 2009 10:25 AM
To: Wilson, Travis W.
Cc: Caldwell, Betty A, Johnson, Jay B
Subject: Bridges
Good Morning Mr. Travis.... Hope you are well on this Thursday Morning..... Division 2 is planning to replace Craven 10,
Beaufort 39, and Pitt 65. We would like to know if these bridges are anadromous fish locations and if a moratorium exists ...please
see attachment for maps .... many thanks.... mike
Email correspondence to and from this sender is subject to the N.C. Public Records Law and may be disclosed to third parties.
Page 1
SECTION.1600 - GENERAL PERMIT FOR THE INSTALLATION OF AERIAL AND SUBAQUEOUS
UTILITY LINES WITH ATTENDANT STRUCTURES IN COASTAL WETLANDS: ESTUARINE WATERS:
PUBLIC TRUST WATERS AND ESTUARINE SHORELINES
15A NCAC 07H .1601 PURPOSE
A permit under this Section shall allow for the installation of utility lines both aerially and subaqueously in the coastal
wetland, estuarine water, public trust areas and estuarine and public trust shoreline AECs according to the authority provided
in Subchapter 7J.1100 and according rules in this Section. This general permit shall not apply to the ocean hazard AECs.
History Note: AuthorityG.S. 113-229(cl); 113A-107(a)(b); 113A-113(b); 113A-118.1;
EJr March 1, 1985;
Amended Eff. August 1, 2000; August 1, 1998.
15A NCAC 07H.1602 APPROVAL PROCEDURES
(a) The applicant must contact the Division of Coastal Management and complete an application form requesting approval for
development. The applicant shall provide information on site location, dimensions of the project area, and his name and
address.
(b) The applicant must provide:
(1) confirmation that a written statement has been obtained signed by the adjacent riparian property owners
indicating that they have no objections to the proposed work; or
(2) confirmation that the adjacent riparian property owners have been notified by certified mail of the proposed
work. Such notice should instruct adjacent property owners to provide any comments on the proposed
development in writing for consideration by permitting officials to the Division of Coastal Management
within ten days of receipt of the notice, and, indicate that no response will be interpreted as no objection.
DCM staff will review all comments and determine, based on their relevance to the potential impacts of the
proposed project, if the proposed project can be approved by a General Permit. If DCM staff finds that the
comments are worthy of more in-depth review, the applicant will be notified that he must submit an
application for a major development permit.
(c) No work shall begin until an on-site meeting is held with the applicant and appropriate Division of Coastal Management
representative so that the utility line alignment can be appropriately marked. Written authorization to proceed with the
proposed development will be issued during this visit. Construction on the utility line must begin within twelve months of
this visit or the general authorization expires.
History Note: AuthorityG.S. 113A-107(a)(b); 113A-113(b); 113A-118.1; 113A-229(cl);
EJf. March 1, 1985;
Amended Ef. . January 1, 1990.
15A NCAC 07H .1603 PERMIT FEE
The applicant shall pay a permit fee of four hundred dollars ($400.00) by check or money order payable to the Department.
History Note: Authority G.S. 113-229(cl); 113A-107; 113A-113(b); 113A-118.1; 113A-119; 113A-119.1;
E,ff. March 1, 1985;
Amended Eff.' September 1, 2006; August 1, 2000; March 1, 1991.
15A NCAC 07H .1604 GENERAL CONDITIONS
(a) Utility lines for the purpose of this general permit or any pipes or pipelines for the transportation of potable water,
domestic sanitary sewage, natural gas, and any cable, line, or wire for the transmission, for any purpose, of electrical energy,
telephone and telegraph messages, and radio and television communication.
(b) There must be no resultant change in preconstruction bottom contours. Authorized fill includes only that necessary to
backfill or bed the utility line. Any excess material must be removed to an upland disposal area.
(c) The utility line crossing will not adversely affect a public water supply intake.

(d) The utility line route or construction method will not disrupt the movement of those species of aquatic life indigenous to
the waterbody.
(e) Individuals shall allow authorized representatives of the Department of Environment, Health, and Natural Resources to
make periodic inspections at any time necessary to ensure that the activity being performed under authority of this general
permit is in accordance with the terms and conditions prescribed herein.
(f) This general permit will not be applicable to proposed construction where the Department has determined, based on an
initial review of the application, that notice and review pursuant to G.S. 113A-119 is necessary because there are unresolved
questions concerning the proposed activity=s impact on adjoining properties or on water quality; air quality; coastal wetlands;
cultural or historic sites; wildlife; fisheries resources; or public trust rights.
(g) This permit does not eliminate the need to obtain any other required state, local, or federal authorization, nor, to abide by
regulations adopted by any federal or other state agency.
(h) Development carried out under this permit must be consistent with all local requirements, AEC guidelines, and local Land
Use Plans current at the time of authorization.
History Note. Authority G.S. 113-229(cl); 113A-107(a)(b); 113A-113(b); 113A-118.1;
Ef. March 1, 1985;
Amended Eff. May 1, 1990;
RRC Objection due to ambiguity Ef. . May 19,1994;
Amended Efj: August 1, 1998; July 1, 1994.
15A NCAC 07H .1605 SPECIFIC CONDITIONS
Proposed utility line installations must meet each of the following specific conditions to be eligible for authorization by this
general permit:
(1) All domestic sanitary sewer line requests must be accompanied by a statement of prior approval from the
NC Division Water Quality.
(2) All spoils which are permanently removed must be placed on a high ground disposal site and stabilized so
as not to return to waters, marsh or other wetlands.
(3) Any additional backfill material required must be clean sand or rock free of organic matter.
(4) Cuts through wetlands must be minimized.
(5) Finished grades or subaqueous or wetland crossing must be returned to preproject contours.
(6) There can be no work within any productive shellfish beds.
(7) No excavation or filling activities will be permitted between April 1 and September 30 of any yearwithin
any designated primary nursery area.
(8) Subaqueous lines must be placed at a depth of six feet below the project depth of federal projects. In other
areas they will be installed at a minimum depth of two feet below the bottom contour.
(9) The minimum clearance for aerial communication lines or any lines not transmitting electricity will be 10'
above the clearance required for bridges in the vicinity.
(10) The minimum clearance for aerial electrical transmission lines shall be consistent with those established by
the US Army Corps of Engineers and US Coast Guard.
(11) The installation of a utility line on pipe bents or otherwise above the elevation of mean high or mean
ordinary water must be of sufficient height to allow for traditional navigation in the water body.
Additionally the utility line must not interfere with the waterflow, of normal or flood waters.
(12) Natural gas lines must not exceed I I inches in diameter.
History Note: Authority G.S. 113-229(cl); 113A-107(a)(b); 113A-113(b); 113A-118.1;
Ef. March 1, 1985;
Amended E$ August 1, 1998.
¦ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
¦ Print your name and address on the reverse
so that we can return the card to you.
¦ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
7 KDNV? f 70S
2201 ?JneTJ?.P.
?uR?IAM y ?lC k-77,9'7
2. Article Number
(l-mnsfer fmm service label)
i
SECTION .
A. Signature
x k. A?
COMPLETE THIS PS Form 3811, February 2004
B..-Received by
d A2(/ Pnn//eC pNSame?) f' I C Dattef D llivery k I - `
D. Is delivery address different from item 17 ? s (((
If YES, enter delivery address below: 0 No
3. ,,S__,e,/rvice Type
y.Certtfled Mall 0 Exprese Mail
0 Registered 0 Return Receipt for Merchandise
0 Insured Mail 0 C.O.D.
4. Restricted Delivery? (Extra Feel 0 Yes
7009 0080 0002 4028 7847
Domestic Return Receipt 10259502#1-1540
¦ Complete items 1, 2, and 3. Also Complete
item 4 if Restricted Delivery is desired.
¦ Print your name and address on the reverse
so that we can return the card to you.
¦ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
?C5 ?-r+o s ?sNC.
P.o-Box `fZS
I 1 ? Agent j
,? Addressee I
¢{tecerved by (P nted Name) / C. Data of Delivery
D. Is delivery address different from item 17 ? Yes
If YES, enter delivery address below: ? No
3. Service Type 4
O
A/c'- ^-7 p b ?CC r"ed Mail 13 Express Mail
(/F Q y o[ o ? Registered 0 Return Receipt for Merchandise
0 Insured Mail ? C.O.D.
4. Restricted Delivery? (Extra Fee) 0 Yes
2. Article Number - - - - - - -
(Transferfromservicelabel) 7009 0080 0002 4028 7854 i
PS Form 3811, February 2004 Domestic Return Receipt 102595-0244'1540 "
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