20000612 Ver 1_Complete File_20000511

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Bill Holman, Secretary
Kerr T. Stevens, Director
© f `
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
May 22, 2000
Washington County
DWQ Project # 000612
APPROVAL of 401 Water Quality Certification
NC Department of Transportation
c/o Don R. Conner
PO Box 850
Edenton, NC 27932
Dear Sirs:
You have our approval, in accordance with the attached conditions and those listed below, to fill 0.06 acres of
wetlands in Washington County for the purpose of SR 1150 improvements as you described in your application
received by the Division of Water Quality on May 11, 2000. After reviewing your application, we have decided that
this fill is covered by General Water Quality Certification Number 3106. This certification allows you to use
Nationwide Permit Number 18 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-Dischar-e and Water Supply Water shed 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. If you change
your project, you must notify us and you may be required to send us a new application. 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 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) (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, 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 919-733-9646.
j.
Frr F.N?
Attachment
cc: Corps of Engineers Washington Field Office
Washington DWQ Regional Office
File Copy
Central Files 000612
Division of Water Quality • Non-Discharge Branch
1621 Mail Service Center, Raleigh, NC 27699-1621 Telephone [phone] FAX # [phone]
An Equal Opportunity Affirmative Action Employer • 50% recycled/10% post consumer paper
http://h2o.enr.state.nc.us/wetlandc.htmI
PAYMENT
RECEIVED
a.^S. r..
i"iTF;
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
JAMES B. HUNT JR.
GOVENOR
U.S. Army Corps of Engineers
Regulatory Field Office
P. O. Box 1000
Washington, NC 27889-1000
ATTENTION: Mr. Michael F. Bell, PWS
NCDOT Coordinator
DAVID McCOY
SECRETARY
May 9, 2000
.1(;" (nn11
0000'2
Dear Sir:
The North Carolina Department of Transportation (NCDOT) is proposing to improve SR 1150 in Washington
County. The existing soil road will be upgraded to a paved surface to improve safety. Minor widening of the
roadway will also be performed to improve safety.
Please find attached a vicinity map along with a plan view of the proposed work and a completed pre-construction
notification form. Wetland impacts will occur as a result of this work. Wetland impacts will be from fill associated
with slight shoulder widening and total 0.055 acres. Additionally, a 48.0" x 40.0' crossline will be replaced and
extended by approximately 20.0'. This pipe crosses an agricultural ditch and the NCDCM has determined that it
does not fall within their jurisdiction.
The NCDOT requests that this work be authorized under the provisions of Nationwide Permit No. 18. By copy of
this letter, the NCDOT also requests that the North Carolina Division of Water Quality issue the appropriate water
quality certification. A check for $200.00 is attached to cover the permit fees. Work will begin as soon as the
permits are issued. Thank you for your attention to this important matter.
Sincerely,
CC: Mr. R. E. Capehart, PE, NCDOT
Mr. David Cox, NCWRC
Ms. Sarah Winslow, NCDMF
Mr. Ron Sechler, NMFS
Mr. Tom McCartney, USFWS
Mr. John Hennessy, NCDWQ
Mr. Steve Trowell, NCDCM
Mr. Sterling Baker, NCDOT
D. R. Conner, PE
Division Engineer
7 -_ '/_? - '?'
T. Lindse ddick, Jr.
Division Environmental Officer
P. O. Box 850 Edenton, NC 27932 [phone] FAY: [phone]
3/25/96
16; < CORPS ACTION ID:
DEbi ID : 0t
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #): NW 18
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: NCDOT,
2. MAILING ADDRESS: P O Box 850
SUBDIVISION NAME:
CITY: Edenton STATE: NC ZIP CODE: 27932
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE): SR 1150 in Washington County. NC
3. TELEPHONE NLti1BER (HOME) :
(WORK): 252-482-7977
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL,
ADDRESS, PHONE NUMBER: Don R Conner. P E
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS
TOPOGRAPHIC MAP OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: Washington NEAREST TOWN OR CITY: Creswell
1
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ETC.):
6. IMPACTED OR NEAREST STREAM/RIVER: Unnamed canal
RIVER BASIN: Pasauot'ank
7a. IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER
(SA), HIGH QUALITY WATERS (HQW), OUTSTANDING RESCURCE WATERS (ORW),
WATER SUPPLY (WS-I OR WS-II)? YES [ ] NO [X] IF YES, EXPLAIN:
7b. IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES[x] NO[ ]
7c. 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?
Rural
8a. HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON
THIS PROPERTY? YES ( ] 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 THE
FUTURE? YES ( ] NO (X] IF YES, DESCRIBE ANTICIPATED WORK:
9a. ESTIMATED TOTAL NUMBER OF ACRES IN TRACT OF LAND: N/A
9b. ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT
SITE:
N/A
2
10a. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: 0.055 ac EXCAVATION: N/A
FLOODING: N/A OTHER: N/A
DRAINAGE: N/A TOTAL ACRES TO BE IMPACTED: 0.055
10b. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF
RELOCATED, PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION):
LENGTH BEFORE: N/A FT AFTER: N/A FT
WIDTH BEFORE (based on normal high water contours): N/A FT
WIDTH AFTER: N/A
AVERAGE DEPTH BEFORE: N/A FT AFTER: N/A FT
(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: 8 1/2" X 11" DRAWINGS
ONLY) :
expandincr typical section and paving SR 1150 road
construction equipment
13. PURPOSE OF PROPOSED WORK: u grade the facility and improve
3
14. STATE REASONS
OUT IN WETLANDS.
IMPACTS):
project is improvement on existing location, wetlands are
located immediately a& acent to the existing road therefore
impacts to wetlands are unavoidable
T?U.S. FT-i TIM T7T? T?7 TL'L' SERVIGE
15. 7Y?+GU T REQUIRED TG GIFA :3 THE
j,-'UGF;lO1 MARINE *c?Z T Se'ITSS?'T?E --'Tr02-TJRIES SER-V 222 RTPPIFS ?QEE Y?OEw
mz ?rn-
? i? vzc
rr'T'n S SHEET--) REGARDING THE PRESENE=-GF A? l" FElD3F== --'aT v LISTED nn
"RPGSED FOR LISTING ENDP11GERED OR THR=_r T-21T DGPEGI G GRITIGAL
TEGT-
HABITAT IN THE PE? TFE PRGPGS^n PRGanos
rii-?-r¢?-?33??^ THAT ??r BE ?F?G?"? BY - rc,? rzcv r-v o ?a rrco
DATE GGNTAGTED: (ATTACH RESPGNSES FROM THESE AGENG126. )
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OR THE USE
OF PUBLIC (STATE) LAND?
YES [XI NO [] (IF NO, GO TO 18)
a. IF YES, DOES THE PROJECT REQUIRE PREPARATION OF AN
ENVIRONMENTAL DOCUMENT PURSUANT TO THE REQUIREMENTS OF THE NORTH
CAROLINA ENVIRONMENTAL POLICY ACT?
YES [ ] NO [X]
b. IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE?
YES [ ] NO [ ]
IF ANSWER TO 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE
STATE CLEARINGHOUSE TO DIVISION OF ENVIRONMENTAL MANAGEMENT REGARDING
COMPLIANCE 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].
WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED
(INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND
4
18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF
PROPOSED ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OR FILL MATERIAL
INTO WETLANDS:
a. WETLAND DELINEATION MAP SHOWING ALL WETLANDS, STREAMS, LAKES
AND PONDS ON THE 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 SHOULD BE 1 INCH EQUALS
50 FEET OR 1 INCH EQUALS 100 FEET OR THEIR EQUIVALENT.
b. IF AVAILABLE, REPRESENTATIVE 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 THE DELINEATION LINE.
d. ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
e. WHAT IS LAND USE OF SURROUNDING PROPERTY? Rural
f. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
g. SIGNED AND DATED AGENT AUTHORIZATION 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) EITHER THE ISSUANCE OR WAIVER OF A 401 DIVISION OF
ENVIRONMENTAL MANAGEMENT (WATER QUALITY) CERTIFICATION, AND
3) (IN THE TWENTY COASTAL COUNTIES ONLY), A LETTER FROM THE
NORTH CAROLINA DIVISION OF COASTAL MANAGEMENT STATING THE PROPOSED
ACTIVITY IS CONSISTENT WITH THE NORTH CAROLINA COASTAL MANAGEMENT
PROGRAM.
D.R. G57?, (?L L 2

OWNER'S/AGENT'S SIGNATURE
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED (18g.))
DATE
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0 400D C17:S 1 EFKERDISTRICT ENGINEER 4 170048-8722 N0.220 D01
Paat-It' Fax Noto 7671 1;i"4-z _oo p?°gos?
To),
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Co./oapc Co.
Fmood 41 Phar,o
Fax # 43,Z`B7? Fax 4
Here i_ Ac t, ro?,,s?,o„ ?u re acs?ed
otx??- i?? itiia; ^arct 8. -1 1 ? ?n
TL 1?....DG^^u5 }-Ic.;?S
?'eSwC l l
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
JAMES B. HUNT JR. DAVID McCOY
GOVENOR SECRETARY
Sr rr -
May 9, 2000 rv. I; ._.
U.S. Army Corps of Engineers
Regulatory Field Office p
P. O. Box 1000 PAYMENT
Washington, NC 27889-1000 DC'nCI??D 6
ATTENTION: Mr. Michael F. Bell, PWS I?Clrl.?
NCDOT Coordinator
Dear Sir:
The North Carolina Department of Transportation (NCDOT) is proposing to improve SR 1150 in Washington
County. The existing soil road will be upgraded to a paved surface to improve safety. Minor widening of the
roadway will also be performed to improve safety.
Please find attached a vicinity map along with a plan view of the proposed work and a completed pre-construction
notification form. Wetland impacts will occur as a result of this work. Wetland impacts will be from fill associated
with slight shoulder widening and total 0.055 acres. Additionally, a 48.0" x 40.0' crossline will be replaced and
extended by approximately 20.0'. This pipe crosses an agricultural ditch and the NCDCM has determined that it
does not fall within their jurisdiction.
The NCDOT requests that this work be authorized under the provisions of Nationwide Permit No. 18. By copy of
this letter, the NCDOT also requests that the North Carolina Division of Water Quality issue the appropriate water
quality certification. A check for $200.00 is attached to cover the permit fees. Work will begin as soon as the
permits are issued. Thank you for your attention to this important matter.
Sincerely,
D. R. Conner, PE
Division Engineer /J
T. Lindse ddick, Jr.
Division Environmental Officer
CC: Mr. R. E. Capehart, PE, NCDOT
Mr. David Cox, NCWRC
Ms. Sarah Winslow, NCDMF
Mr. Ron Sechler, NMFS
Mr. Tom McCartney, USFWS
Mr. John Hennessy, NCDWQ
Mr. Steve Trowell, NCDCM
Mr. Sterling Baker, NCDOT
P. O. Box 850 Edenton, NC 27932 [phone] FAY: [phone]

DEM ID: CORPS ACTION ID:
3/25/96
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #): NW 18
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: NCDOT
2. MAILING ADDRESS: P 0 Box 850
SUBDIVISION NAME:
CITY: Edenton STATE: NC ZIP CODE: 27932
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE): SR 1150 in Washington County, NC
3. TELEPHONE NUMBER (HOME):
(WORK): 252-482-7977
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL,
ADDRESS, PHONE NUMBER: Don R. Conner. P. E.
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS
TOPOGRAPHIC MAP OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: Washington NEAREST TOWN OR CITY: Creswell
1
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ETC.):
6. IMPACTED OR NEAREST STREAM/RIVER: Unnamed canal
RIVER BASIN: Pascniot-ank
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 [X] IF YES, EXPLAIN:
7b. IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES(xl NO[ ]
7c. 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?
Rural
8a. HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON
THIS PROPERTY? YES [ ] 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 THE
FUTURE? YES ( ] NO (X] IF YES, DESCRIBE ANTICIPATED WORK:
9a. ESTIMATED TOTAL NUMBER OF ACRES IN TRACT OF LAND: N/A
9b. ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT
SITE:
2
10a. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: 0.055 ac EXCAVATION: N/A
FLOODING: N/A OTHER: N/A
DRAINAGE: N/A TOTAL ACRES TO BE IMPACTED: 0.055-
10b. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF
RELOCATED, PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION):
LENGTH BEFORE: N/A FT AFTER: N/A FT
WIDTH BEFORE (based on normal high water contours): N/A FT
WIDTH AFTER: N/A
AVERAGE DEPTH BEFORE: N/A FT AFTER: N/A FT
(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: 8 1/2" X 11" DRAWINGS
ONLY) :
ex8anding typical section and paving SR 1150 road
13. PURPOSE OF PROPOSED WORK: upgrade the facility and improve
3
14. STATE REASONS
OUT IN WETLANDS.
IMPACTS):
groiect is improvement on existing location. wetlands are
located immediately adjacent to the existing road. therefore
impacts to wetlands are unavoidable
15 ZVU ARE REQUIRED G Ct7NT-AGT--111 T4-9- FTCSS 1TTl ;71 T^T 1FE SER-VIGS

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17. DOES THE PROJECT INVOLVE AN EXPENDITUR3 OF PUBLIC FUNDS OR THE USE
OF PUBLIC (STATE) LAND?
YES [X] NO [] (IF NO, GO TO 13)
a. IF YES, DOES THE PROJECT REQUIRE PREPA-ZATION OF AN
ENVIRONMENTAL DOCUMENT PURSUANT TO THE REQUIREI-^NTS OF THE NORTH
CAROLINA ENVIRONMENTAL POLICY ACT?
YES [ ] NO [X]
b. IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION STATE CLE_?RINGHOUSE?
YES [ ] NO [ ]
IF ANSWER TO 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE
STATE CLEARINGHOUSE TO DIVISION OF ENVIRONb?ENTAT, MANAGEMENT REGARDING
COMPLIANCE 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].
WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED
(INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND
4
18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF
PROPOSED ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OR FILL MATERIAL
INTO WETLANDS:
a. WETLAND DELINEATION MAP SHOWING ALL WETLANDS, STREAMS, LAKES
AND PONDS ON THE 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 SHOULD BE 1 INCH EQUALS
50 FEET OR 1 INCH EQUALS 100 FEET OR THEIR EQUIVALENT.
b. IF AVAILABLE, REPRESENTATIVE 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 THE DELINEATION LINE.
d. ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
e. WHAT IS LAND USE OF SURROUNDING PROPERTY? Rural
f. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
g. SIGNED AND DATED AGENT AUTHORIZATION 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) EITHER THE ISSUANCE OR WAIVER OF A 401 DIVISION OF
ENVIRONMENTAL MANAGEMENT (WATER QUALITY) CERTIFICATION, AND
3) (IN THE TWENTY COASTAL COUNTIES ONLY), A LETTER FROM THE
NORTH CAROLINA DIVISION OF COASTAL MANAGEMENT STATING THE PROPOSED
ACTIVITY IS CONSISTENT WITH THE NORTH CAROLINA COASTAL MANAGEMENT
PROGRAM.

ylZrluz-s
OWNER'S/AGENT'S SIGNATURE
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED (18g.))
DATE
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