20010767 Ver 1_Complete File_20010520

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
William G. Ross, Jr., Secretary
Kerr T. Stevens, Director
1 ? •
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
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 contact John Hennessy at 919-733-5694, or the DWQ Washington
Regional Office at 252-946-6481.
Sincerely,
i
Attachment -
cc: Wilmington District Corps of Engineers
Corps of Engineers Washington Field Office
DWQ Washington Regional Office
File Copy
Central Files
c:\ncdot\SR 1776\wgc\010767wgc.doc
Wetlands/401 Unit 1621 Mail Service Center Raleigh, North Carolina 27699-1621
Telephone [phone] FAX [phone]
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f
State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
William G. Ross, Jr., Secretary
Kerr T. Stevens, Director
NC ENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
June 18, 2001
Beaufort County
DWQ Project No. 010767
APPROVAL for 401Water Quality Certification and ADDITIONAL CONDITIONS and Tar-
Pamlico River Buffer Rules
Mr. C.E. Lassiter, P.E., Division Engineer
NCDOT, Division 2
PO Box 1587
Greenville, NC 27835
Dear Mr. Lassiter:
You have our approval, as described in your application dated May 10, 2001, and in accordance with the
attached conditions and those listed below, to place fill material in 0.01 acres of wetlands for the purpose of
paving and widening SR 1776 from SR 1730 to the end of the road in Beaufort County. The project shall
be constructed in accordance with your application dated May 10, 2001. After reviewing your application,
we have decided that this fill is covered by General Water Quality Certification Number 3106. This
certification corresponds to the Nationwide Permit Number 18 issued by the Corps of Engineers. This
approval is also valid for the Tar-Pamlico River buffer rules (15A NCAC 2B .259). In addition, you should
acquire any other federal, state or local permits before you proceed with your project including (but not
limited to) Sediment and Erosion Control, Non-Discharge and Water Supply Watershed regulations. This
approval will expire when the accompanying 404 permit expires unless otherwise specified in the General
Certification.
This approval is valid solely for the purpose and design described in your application (unless modified
below). Should your project change, you must notify the DWQ and submit 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 the conditions. If total wetland fills for this project (now or in the future)
exceed one acre, or of total impacts to streams (now or in the future) exceed 150 linear feet, compensatory
mitigation may be required as described in 15A NCAC 2H .0506 (h) (6) and (7). ). This approval shall
expire with the corresponding Nationwide Permit expires or as otherwise provided in the General
Certification. For this approval to be valid, you must follow the conditions listed in the attached
certification and any additional conditions listed below.
1.) Stormwater shall be directed to sheetflow at nonerosive velocities through the protected stream buffers.
2.) Upon completion of the project, the NCDOT shall complete and return the enclosed "Certification of
Completion Form" to notify DWQ when all work included in the 401 Certification has been completed.
The responsible party shall complete the attached form and return it to the 401/Wetlands Unit of the
Division of Water Quality upon completion of the project.
3.) The NCDOT shall strictly adhere to sediment and erosion control Best Management Practices as
described for High Quality Waters entitled "Design Standards in Sensitive Watersheds" (15A NCAC
04B .0024) throughout design and construction of the project.
Wetlands/401 Unit 1621 Mail Service Center Raleigh, North Carolina 27699-1621
Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/10% post consumer paper
State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
William G. Ross, Jr., Secretary
Kerr T. Stevens, Director -
•
OM% Nook
NC ENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
GENERAL CERTIFICATION FOR PROJECTS ELIGIBLE
FOR CORPS OF ENGINEERS
NATIONWIDE PERMIT NUMBER 18 (MINOR DISCHARGES)
This General Certification is issued in conformity with the requirements of Section 401, Public Laws 92-
500 and 95-217 of the United States and subject to the North Carolina Division of Water Quality
Regulations in 15A NCAC 2H, Section .0500 and 15A NCAC 2B .0200 for the discharge of fill material to
navigable waters and adjacent wetland areas tributary to interstate waters or navigable waters of the United
States (i.e., isolated wetlands) as described in 33 CFR 330 Appendix A (B) (18). This certification replaces
Water Quality Certification Number 2669 issued on January 21, 1992 and Water Quality Certification
Number 2733 issued on May 1, 1992. This WQC is rescinded when the Corps of Engineers reauthorize
Nationwide Permit 18 or when deemed appropriate by the Director of DWQ.
The State of North Carolina certifies that the specified category of activity will not violate applicable
portions of Sections 301, 302, 303, 306 and 307 of the Public Laws 92-500 and 95-217 if conducted in
accordance with the conditions hereinafter set forth.
Conditions of Certification:
1. Activities authorized by this Nationwide Permit require written concurrence from the Division of
Water Quality;
2. That appropriate sediment and erosion control practices which equal or exceed those outlined in the
most recent edition of the "North Carolina Erosion and Sediment Control Planning and Design
Manual" or the "North Carolina Surface Mining Manual" (available from the Division of Land
Resources in the DEHNR Regional or Central Offices) are utilized to prevent violations of the
appropriate turbidity water quality standard (50 NTUs in streams and rivers not designated trout
waters by DWQ; 25 NTUs in all saltwater classes, and all lakes and reservoirs; and 10 NTUs in trout
waters);
3. All sediment and erosion control measures placed in wetlands or waters shall be removed and the
natural grade restored after the Division of Land Resources has released the project;
4. If an environmental document is required, this Certification is not valid until a FONSI or ROD is
issued by the State Clearinghouse;
5. This Certification shall not be used in conjunction with the Certification for Nationwide Permit 14 to
create high ground for road access;
6. Deed restrictions must be placed on all remaining wetlands on the parcel after appropriate use of this
and other Certifications. DWQ shall be sent copies of all deed restrictions applied to this parcel. If
this condition is not met, written DWQ approval is needed to utilize this General Certification (and
Nationwide Permit);

Wetlands/401 Unit 1621 Mail Service Center Raleigh, North Carolina 27699-1621
Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post consumer paper
State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
William G. Ross, Jr., Secretary
Kerr T. Stevens, Director
1 00
NCD.ENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
7. Measures shall be taken to prevent live or fresh concrete from coming into contact with waters of the
state until the concrete has hardened;
8.- Concurrence from DWQ that this Certification applies to an individual project shall expire three
years from the date of the cover letter from DWQ.
Non-compliance with or violation of the conditions herein set forth by a specific fill project shall result in
revocation of this Certification for the project and may also result in criminal and/or civil penalties.
The Director of the North Carolina Division of Water Quality may require submission of a formal
application for individual certification for any project in this category of activity, if it is determined that the
project is likely to have a significant adverse effect upon water quality or degrade the waters so that existing
uses of the wetland or downstream waters are precluded.
Public hearings may be held for specific applications or group of applications prior to a Certification
decision if deemed in the public's best interest by the Director of the North Carolina Division of Water
Quality.
Effective date: 11 February 1997.
DIVISION OF WATER QUALITY
By
A. Preston Howard, Jr. P.E.
Director
WQC # 3106
Wetlands/401 Unit 1621 Mail Service Center Raleigh, North Carolina 27699-1621
Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/10% post consumer paper
State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
William G. Ross, Jr., Secretary
Kerr T. Stevens, Director
DWQ Project No.:
Applicant:
Project Name: _ -
Date of Issuance of 401 Water Quality Certification:
A94. 00
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
County:
Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification or applicable Buffer
Rules, and any subsequent modifications, the applicant is required to return this certificate to the
401/Wetlands Unit, North Carolina Division of Water Quality, 1621 Mail Service Center, Raleigh, NC,
27699-1621. This form may be returned to DWQ by the applicant, the applicant's authorized agent, or the
project engineer. It is not necessary to send certificates from all of these.
Applicant's Certification
I, , hereby state that, to the best of my abilities, due care and
diligence was used in the observation of the construction such that the construction was observed to be built
within substantial compliance and intent of the 401 Water Quality Certification and Buffer Rules, the
approved plans and specifications, and other supporting materials.
Signature: Date:
Agent's Certification
I, , hereby state that, to the best of my abilities, due care and
diligence was used in the observation of the construction such that the construction was observed to be built
within substantial compliance and intent of the 401 Water Quality Certification and Buffer Rules, the
approved plans and specifications, and other supporting materials.
Signature:
Engineer's Certification
Partial Final
Date:
I, , as a duly registered Professional Engineer in the State
of North Carolina, having been authorized to observe (periodically, weekly, full time) the construction of
the project,for the Permittee hereby state that, to the best of my abilities, due care and diligence was used in
the observation of the construction such that the construction was observed to be built within substantial
compliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved plans and
specifications, and other supporting materials.
Signature
Date
Registration No,

Wetlands/401 Unit 1621 Mail Service Center Raleigh, North Carolina 27699-1621
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010767

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i

Pre-Construction Notification (PCN) Application Form
For Section 404 and/or Section 10 Nationwide, Regional and General Permits, Section 401
General Water Quality Certifications, and Riparian Buffer and Watershed Buffer Rules
This form is to be used for projects qualifying for any of the U.S. Army Corps of Engineers' (USACE)
Nationwide, Regional or General Permits as required by Section 404 of the Clean Water Act and/or
Section 10 of the Rivers and Harbors Act, and for the North Carolina Division of Water Quality's
(DWQ) associated General 401 Water Quality Certifications. This form is also to be used for any
project requiring approval under any Riparian Buffer Rules implemented by the N.C. Division of Water
Quality. This form should not be used if you are requesting an Individual 404 Permit or Individual 401
Water Quality Certification. The USACE Individual Permit application form is available online at
http://www.saw.usace.army.mil/wetlands/Perm app.htm.
The USACE is the lead regulatory agency. To review the requirements for the use of Nationwide,
Regional or General permits, and to determine which permit applies to your project, please go to the
USACE website at http://www.saw.usace.anny.mil/wetlands/regtour.htm, or contact one of the field
offices listed at the end of this application. The website also lists the responsible project manager for
each county in North Carolina and provides additional information regarding the identification and
regulation of wetlands and waters of the U.S.
The DWQ issues a corresponding Certification (General or Individual), and cannot tell the applicant
which 401 Certification will apply until the 404 Permit type has been determined by the USACE.
Applicants are encouraged to visit DWQ's 401/Wetlands Unit website at
http://h2o.enr.state.nc.us/ncwetlands to read about current requirements for the 401 Water Quality
Certification Program and to determine whether or not Riparian Buffer Rules are applicable. The
applicant is also advised to read the full text of the General Certification (GC) matching the specific 404
Permit requested. In some cases, written approval for some General Certifications is not required,
provided that the applicant adheres to all conditions of the GC. Applicants lacking access to the internet
should contact DWQ's Central Office in Raleigh at [phone].
Trout Waters Coordination - Special coordination with the North Carolina Wildlife Resources
Commission (NCWRC) is also required for projects occurring in any of North Carolina's twenty-five
counties that contain trout waters. In such cases, the applicant should contact the appropriate NCWRC
regional coordinator (listed by county on the last page of this application).
PAYMENT
Page 1 of 12 RECEIVEC'
E
s
CAMA Coordination - If the project occurs in any of North Carolina's twenty coastal counties (listed on
the last page of this application) the applicant should also contact the North Carolina Division of Coastal
Management (DCM) at [phone]. DCM will determine whether or not the project involves a
designated Area of Environmental Concern, in which case DCM will act as the lead permitting agency.
In such cases, DCM will require a Coastal Area Management Act (LAMA) Permit and will coordinate
the 404/401 Permits.
USACE Permits - Submit one copy of this form, along with supporting narratives, maps, data forms,
photos, etc. to the applicable USACE Regulatory Field Office (addresses are listed at the end of this
application). Upon receipt of an application, the USACE will determine if the application is complete as
soon as possible, not to exceed 30 days. This PCN form is designed for the convenience of the applicant
to address information needs for all USACE Nationwide, Regional or General permits, as well as
information required for State authorizations, certifications, and coordination. Fully providing the
information requested on this form will result in a complete application for any of the USACE
Nationwide, Regional or General permits. To review the minimum amount of information that must be
provided for a complete PCN for each USACE Nationwide permit, see Condition 13, 65 Fed.Reg. 12893
(March 9, 2000), available at http://www.saw.usace.army.mil/wetlands/nwpfinalFedReg.pdf.
Processing times vary by permit and begin once the application has been determined to be complete.
Please contact the appropriate regulatory field office for specific answers to permit processing periods.
401 Water Quality Certification or Buffer Rules - All information is required unless otherwise stated
as optional. Incomplete applications will be returned. Submit seven collated copies of all USACE
Permit materials to the Division of Water Quality, 401/Wetlands Unit, 1650 Mail Service Center,
Raleigh, NC, 27699-1650. If written approval is required or specifically requested for a 401
Certification, then a non-refundable application fee is required. In brief, if project impacts include less
than one acre of cumulative wetland/water impacts and less than 150 feet cumulative impacts to
streams, then a fee of $200 is required. If either of these thresholds is exceeded, then a fee of $475 is
required. A check made out to the North Carolina Division of Water Quality, with the specific name of
the project or applicant identified, should be stapled to the front of the application package. For more
information, see the DWQ website at http://h2o.ehnr.state.nc.us/ncwetlands/fees.html. The fee must be
attached with the application unless the applicant is a federal agency in which case the check may be
issued from a separate office. In such cases, the project must be identifiable on the U.S. Treasury check
so that it can be credited to the appropriate project. If written approval is sought solely for Buffer Rules,
the application fee does not apply, and the applicant should clearly state (in a cover letter) that only
Buffer Rule approval is sought in writing. Wetlands or waters of the U.S. may not be impacted prior to
issuance or waiver of a Section 401 Water Quality Certification. Upon receipt of a complete application
for a 401 Certification, the Division of Water Quality has 60 days to prepare a written response to the
applicant. This may include a 401 Certification, an on-hold letter pending receipt of additional
requested information, or denial.
Page 2 of 12
Office Use Only: Form Version April 2001
USACE Action ID No. DWQ No. 01 ®7 6 7
If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A" rather than
leaving the space blank.
1. Processing
Check all of the approval(s) requested for this project:
® Section 404 Permit
Section 10 Permit
® 401 Water Quality Certification
Riparian or Watershed Buffer Rules
2. Nationwide, Regional or General Permit Number(s) Requested:
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: F]
4. If payment into the North Carolina Wetlands Restoration Program (NCWRP) is proposed for
mitigation of impacts (see section VIII - Mitigation), check here: F] -
II. Applicant Information
1. Owner/Applicant Information
Name: North Carolina Department of Transportation
Mailing Address: P.O. Box 1587
Greenville. N.C. 27835
Telephone Number: 252 830 3490
E-mail Address:
NWP 18
2. Agent Information (A signed and dated copy of the Agent Authorization letter must be
attached if the Agent has signatory authority for the owner/applicant.)
Name: Jay Johnson
Company Affiliation: Division 2 Environmental Officer
Mailing Address: Same as above
Telephone Number: Same Fax Number: Same
E-mail Address: jbjohnsongdot.state.nc.us
Fax Number: 252 830 3341
Page 3 of 12
III. Project Information
Attach a vicinity map clearly showing the location of the property with respect to local
landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property
boundaries and development plans in relation to surrounding properties. Both the vicinity map
and site plan must include a scale and north arrow. The specific footprints of all buildings,
impervious surfaces, or other facilities must be included. If possible, the maps and plans should
include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property
boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion,
so long as the property is clearly defined. For administrative and distribution purposes, the
USACE requires information to be submitted on sheets no larger than 11 by 17-inch format;
however, DWQ may accept paperwork of any size. DWQ prefers full-size construction
drawings rather than a sequential sheet version of the full-size plans. If full-size plans are
reduced to a small scale such that the final version is illegible, the applicant will be informed that
the project has been placed on hold until decipherable maps are provided.
1. Name of project: Snake Island Road
2. T.I.P. Project Number (NCDOT Only): N/A
3. Property Identification Number (Tax PIN): N/A
4. Location
County: Beaufort Nearest Town: Pamlico Beach
Subdivision name (include phase/lot number): N/A
Directions to site (include road numbers, landmarks, etc.):
Pamlico Beach SR 1776
US 264 E. from Washington to
5. Site coordinates, if available (UTM or Lat/Long): Lat- 35-24' 30" Long- 76-35' 07"
(Note - If project is linear, such as a road or utility line, attach a sheet that separately lists the
coordinates for each crossing of a distinct waterbody.)
6. Describe the existing land use or condition of the site at the time of this application:Existin
1.75 mi. gravel secondary road mostly undeveloped/forested with residences on Wright
Creek and the Pungo River.
7. Property size (acres): N/A
8. Nearest body of water (stream/river/sound/ocean/lake): South prong of Wright Creek
and Pungo River
9. River Basin: Tar- Pamlico
Page 4 of 12
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http://h2o.enr.state.nc.us/admin/maps/.)
10. Describe the purpose of the proposed work: Widen and pave SR 1776 from SR 1730 to
end.
11. List the type of equipment to be used to construct the project: Typical road construction
equipment.
12. Describe the land use in the vicinity of this project: Residential
IV. Prior Project History
If jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Include
the USACE Action ID Number, DWQ Project Number, application date, and date permits and
certifications were issued or withdrawn. Provide photocopies of previously issued permits,
certifications or other useful information. Describe previously approved wetland, stream -and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits issued for prior segments of the same T.I.P. project, along with
construction schedules.
No previous permits have been issued.
V. Future Project Plans
Are any additional permit requests anticipated for this project in the future? If so, describe the
anticipated work, and provide justification for the exclusion of this, work from the current
application: No additional permit requests are anticipated in the near future.
VI. Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. The applicant must also
provide justification for these impacts in Section VII below. All proposed impacts, permanent
and temporary, must be listed herein, and must be clearly identifiable on an accompanying site
plan. All wetlands and waters, and all streams (intermittent and perennial) must be shown on a
Page 5 of 12
delineation map, whether or not impacts are proposed to these systems. Wetland and stream
evaluation and delineation forms should be included as appropriate. Photographs may be
included at the applicant's discretion. If this proposed impact is strictly for wetland or stream
mitigation, list and describe the impact in Section VIII below. If additional space is needed for
listing or description, please attach a separate sheet.
1. Wetland Impacts
Wetland Impact
Site Number
(indicate on map)
Type of Impact* Area of
Impact
(acres) Located within
100-year Floodplain**
(yes/no) Distance to
Nearest Stream
(linear feet)
Type of Wetland***
Area A,B,C Fill .1 Yes 550, Forested freshwater

List each impact separately and identity temporary impacts. Impacts include, but are not limited to: mechanized clearing, grading, fill,
excavation, flooding, ditching/drainage, etc. For dams, separately list impacts due to both structure and flooding.
** 100-Year floodplains are identified through the Federal Emergency Management Agency's (FEMA) Flood Insurance Rate Maps
(FIRM), or FEMA-approved local floodplain maps. Maps are available through the FEMA Map Service Center at 1-800-358-96L6, or
online at http://www.fema.gov.
*** List a wetland type that best describes wetland to be impacted (e.g., freshwater/saltwater marsh, forested wetland, beaver pond,
Carolina Bay, bog, etc.)
List the total acreage (estimated) of existing wetlands on the property: N/A
Total area of wetland impact proposed: .1 Acre
2. Stream Impacts, including all intermittent and perennial streams N/A
Stream Impact
Site Number
(indicate on map)
Type of Impact* Length of
Impact
(linear feet)
Stream Name** Average Width
of Stream
Before Impact Perennial or
Intermittent?
(please specify)

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: culverts and associated rip-rap,
dams (separately list impacts due to both structure and flooding), relocation (include linear feet before and after, and net loss/gain),
stabilization activities (cement wall, rip-rap, crib wall, gabions, etc.), excavation, ditching/straightening, etc. If stream relocation is
proposed, plans and profiles showing the linear footprint for both the original and relocated streams must be included.
** Stream names can be found on USGS topographic maps. If a stream has no name, list as UT (unnamed tributary) to the nearest
downstream named stream into which it flows. USGS maps are available through the USGS at 1-800-358-9616, or online at
Page 6 of 12
www.usgs.gov. Several intemet sites also allow direct download and printing of USGS maps (e.g., www.topozone.com,
www.mapquest.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: 0
3. Open Water Impacts, including Lakes, Ponds, Estuaries, Sounds, Atlantic Ocean and any
other Water of the U.S. N/A
Open Water Impact
Site Number
(indicate on map)
Type of Impact* Area of
Impact
(acres) Name of Waterbody
(if applicable) Type of Waterbody
(lake, pond estuary, sound,
bay, ocean, etc.)

List each impact separately and identity temporary impacts. impacts include, but are not limited to: fill, excavation, dredging,
flooding, drainage, bulkheads, etc.
4. Pond Creation N/A
If construction of a pond is proposed, associated wetland and stream impacts should be
included above in the wetland and stream impact sections. Also, the proposed pond should
be described here and illustrated on any maps included with this application.
Pond to be created in (check all that apply): E] uplands F? stream E] wetlands
Describe the method of construction (e.g., dam/embankment, excavation, installation of
draw-down valve or spillway, etc.):
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.):
Size of watershed draining to pond: Expected pond surface area:
VII. Impact Justification (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It may be useful to provide
information related to site constraints such as topography, building ordinances, accessibility, and
financial viability of the project. The applicant may attach drawings of alternative, lower-impact
site layouts, and explain why these design options were not feasible. Also discuss how impacts
were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce impacts.
Existing R/W was shifted to take in existing gravel road for the widening and having of this
section. Fill in wetlands was reduced from > 6500 sq ft to 4350 sq ft.
Page 7 of 12
VIII. Mitigation
DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC
Division of Water Quality for projects involving greater than or equal to one acre of impacts to
freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial
streams.
USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on March 9, 2000, mitigation will be required when
necessary to ensure that adverse effects to the aquatic environment are minimal. Factors
including size and type of proposed impact and function and relative value of the impacted
aquatic resource will be considered in determining acceptability of appropriate and practicable
mitigation as proposed. Examples of mitigation that may be appropriate and practicable include,
but are not limited to: reducing the size of the project; establishing and maintaining wetland
and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of
aquatic resource functions and values by creating, restoring, enhancing, or preserving similar
functions and values, preferable in the same watershed.
If mitigation is required for this project, a copy of the mitigation plan must be attached in order
for USACE or DWQ to consider the application complete for processing. Any application
lacking a required mitigation plan or NCWRP concurrence shall be placed on hold as
incomplete. An applicant may also choose to review the current guidelines for stream restoration
in DWQ's Draft Technical Guide for Stream Work in North Carolina, available at
http://h2o.enr.state.nc.us/ncwetlands/strmgide.html.
1. Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
N/A
Page 8 of 12
2. Mitigation may also be made by payment into the North Carolina Wetlands Restoration
Program (NCWRP) with the NCWRP's written agreement. Check the box indicating that
you would like to pay into the.NCWRP. Please note that payment into the NCWRP must be
reviewed and approved before it can be used to satisfy mitigation requirements. Applicants
will be notified early in the review process by the 401/Wetlands Unit if payment into the
NCWRP is available as an option. For additional information regarding the application
process for the NCWRP, check the NCWRP website at http://h2o.enr.state.nc.us/wrp/index.htrn. If
use of the NCWRP is proposed, please check the appropriate box on page three and provide
the following information: N/A
Amount of stream mitigation requested (linear feet):
Amount of buffer mitigation requested (square feet):
Amount of Riparian wetland mitigation requested (acres):
Amount of Non-riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres):
IX. Environmental Documentation (DWQ Only)
Does the project involve an expenditure of public funds or the use of public (federal/state/local)
land?
Yes ® No ?
If yes, does the project require preparation of an environmental document pursuant to the
requirements of the National or North Carolina Environmental Policy Act (NEPA/SEPA)?
Note: If you are not sure whether a NEPA/SEPA document is required, call the SEPA
coordinator at [phone] to review current thresholds for environmental documentation.
Yes ? No
If yes, has the document review been finalized by the State Clearinghouse? If so, please attach a
copy of the NEPA or SEPA final approval letter.
Yes ? No ?
X. Proposed Impacts on Riparian and Watershed Buffers (DWQ Only)
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
required state and local buffers associated with the project. The applicant must also provide
justification for these impacts in Section VII above. All proposed impacts must be listed herein,
and must be clearly identifiable on the accompanying site plan. All buffers must be shown on a
map, whether or not impacts are proposed to the buffers. Correspondence from the DWQ
Regional Office may be included as appropriate. Photographs may also be included at the
applicant's discretion.
Page 9 of 12
Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify )?
Yes ? No ® If you answered "yes", provide the following information:
Identify the square feet and acreage of impact to each zone of the riparian buffers. If buffer
mitigation is required calculate the required amount of mitigation by applying the buffer
multipliers.
Zone* Impact
(square feet) Multiplier Required
Mitigation
1 3.
2 1.5
Total
Zone 1 extends out 30 feet perpendicular from near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.
If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation
of Property, Conservation Easement, Riparian Buffer Restoration / Enhancement, Preservation or
Payment into the Riparian Buffer Restoration Fund). Please attach all appropriate information as
identified within 15A NCAC 2B .0242 or .0260.
XI. Stormwater (DWQ Only)
Describe impervious acreage (both existing and proposed) versus total acreage on the site.
Discuss stormwater controls proposed in order to protect surface waters and wetlands
downstream from the property.
When adequate upland is present in the existing R/W new side ditches from the widening
of SR 1776 will contain and transport stormwater toward wetlands or streams however the
stormwater will flow through a silt basin and over vegetated uplands prior to entering
wetlands or the stream bufffer area. A detail map is enclosed. When no upland exists to
construct side ditches stormwater will sheet flow over the vegetated road shoulder and into
wetlands.
XII. Sewage Disposal (DWQ Only)
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 12
XIII. Violations (DWQ Only)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H.0500) or any Buffer Rules?
Yes ? No
Is this an after-the-fact permit application?
Yes ? No
XIV. Other Circumstances (Optional):
It is the applicant's responsibility to submit the application sufficiently in advance of desired
construction dates to allow processing time for these permits. However, an applicant may
choose to list constraints associated with construction or sequencing that may impose limits on
work schedules (e.g., draw-down schedules for lakes, dates associated with Endangered and
Threatened Species, accessibility problems, or other issues outside of the applicant's control).
? S o v
Applican ge t s Sig a Date
(Agent's Vgalinatffre is id only if an authorization letter from the applicant is provided.)
US Army Corps Of Engineers Field Offices and County Coverage
Asheville Regulatory Field Office Alexander Cherokee Iredell Mitchell
US Army Corps of Engineers Avery Clay Jackson Polk
151 Patton Avenue Buncombe Cleveland Lincoln Rowan
Room 208 Burke Gaston Macon Rutherford
Asheville, NC 28801-5006 Cabarrus Graham Madison Stanley
Telephone: [phone] Caldwell Haywood McDowell Swain
Fax: [phone] Catawba Henderson Mecklenburg Transylvania
Raleigh Regulatory Field Office Alamance Durham Johnston Rockingham
US Army Corps Of Engineers Alleghany Edgecombe Lee Stokes
6508 Falls of the Neuse Road Ashe Franklin Nash Surry
Suite 120 Caswell Forsyth Northampton Vance
Raleigh, NC 27615 Chatham Granville Orange Wake
Telephone: [phone] Davidson Guilford Person Warren
Fax: [phone] Davie Halifax Randolph Wilkes
Washington Regulatory Field Office Beaufort Currituck Jones Pitt
US Army Corps Of Engineers Bertie Dare Lenoir Tyrrell
Union
Watauga
Yancey
Wilson
Yadkin
Page I 1 of 12
Post Office Box 1000 Camden Gates Martin Washington
Washington, NC 27889-1000 Carteret* Green Pamlico Wayne
Telephone: [phone] Chowan Hertford Pasquotank
Fax: [phone] Craven Hyde Perquimans *Croatan National Forest Only
Wilmington Regulatory Field Office Anson Duplin Onslow
US Army Corps Of Engineers Bladen Harnett Pender
Post Office Box 1890 Brunswick Hoke Richmond
Wilmington, NC 28402-1890 Carteret Montgomery Robeson
Telephone: [phone] Columbus Moore Sampson
Fax: [phone] Cumberland New Hanover Scotland
US Fis
US Fish and Wildlife Service
Raleigh Field Office
Post Office Box 33726
Raleigh, NC 27636-3726
Telephone: [phone]
h and Wildlife Service / National 1V
US Fish and Wildlife Service
Asheville Field Office
160 Zillicoa Street
Asheville, NC 28801
Telephone: [phone]
[arine Fisheries Service
National Marine Fisheries Service
Habitat Conservation Division
Pivers Island
Beaufort, NC 28516
Telephone: [phone]
North Carolina State Agencies
Division of Water Quality
401 Wetlands Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
Telephone: [phone]
Fax: [phone]
Division of Water Quality
Wetlands Restoration Program
1619 Mail Service Center
Raleigh, NC 27699-1619
Telephone: [phone]
Fax: [phone]
CAMA and NC Coastal Counties
State Historic Preservation Office
Department Of Cultural Resources
4617 Mail Service Center
Raleigh, NC 27699-4617
Telephone: [phone]
Fax: [phone]
Division of Coastal Management Beaufort Chowan Hertford Pasquotank
1638 Mail Service Center Bertie Craven Hyde Pender
Raleigh, NC 27699-1638 Brunswick Currituck New Hanover Perquimans
Telephone: [phone] Camden Dare Onslow Tyrrell
Fax: [phone] Carteret Gates Pamlico Washington
NCWRC and NC Trout Counties
Western Piedmont Region Coordinator Alleghany Caldwell Watauga
3855 Idlewild Road Ashe Mitchell Wilkes
Kernersville, NC 27284-9180 Avery Stokes
Telephone: [phone] Burke Surry
Mountain Region Coordinator Buncombe Henderson Polk
20830 Great Smoky Mtn. Expressway Cherokee Jackson Rutherford
Waynesville, NC 28786 Clay Macon Swain
Telephone: [phone] Graham Madison Transylvania
Fax: [phone] Haywood McDowell Yancey
Page 12 of 12

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DIFFUSE FLOW DETAIL
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by U.S. Department of Agriculture.
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5000 4000 3000 2000 1030 0
Scale - 1:2

DATA FORM
ROUTINE WETLAND DETERMINATION.
(1987 COE Wetlands Delineation Manual)
Project/Site: SR 177' Date: S ?o of _
Applicant/Owner: ?t1 ???-
? County: ,8 Mau 4-
_
Investigator: ?s
o,?. State: X ,C. _
Do Normal Circumstances exist on the site? tE:) No "Community ID:
Is the site significantly disturbed (Atypical Situation)? Yes ® Transect ID: _
Is the area a potential Problem Area? Yes Quo Plot ID: -
If needed, explain on reverse.
VEGETATION
Dominant Plant S eci Stratum Indicator Dominant Plant Species Stratum Indicator
1. n d5 - V / Dh J?3.o
i''v
?V
LVIA4.4_--4_tlP?fL 12 ??
2.( Sire,y J 9.- --- -
10.-- - - --
,
__
--

i cad r?IO?Qteo,93 ' -,
5.Aea- 13.-
_
61" 1444-6._ ,ft ?A - --- -
14.- -

7.
-- ---- - - --
15.
--
8.,- ------ ---- --- -- --- ---
16. - -- --
Percent of Dominant Species that are OBL, FACW or FAC
(excluding FAC-). !;70
Remarks:wtk-" V-asz'"4.. L s ?0 ...
HYDROLOGY
- Recorded Data (Describe in Remarks):
Stream, Lake, or ride Gauge
- Aerial Photographs
Other
Recorded Data Available Wetland Hydrology Indicators:
Primary Indicators:
- Inundated
- Saturated in Upper 12 Inches
_ Water Marks
_ Drift Lines
_ Sediment Deposits
Field Observations: _ Drainage Patterns in Wetlands
_
J Secondary Indicators (2 or more required):
(in.)
Depth of Surface Water: - Oxidized Root Channels in Upper 12 Inches

> _ Water-Stained Leaves
(in.)
Depth to Free Water in Pit: _ Local Soil Survey Data
_ FAC-Neutral Test
Depth to Saturated Soil: > id, (in.) - Other (Explain in Remarks)
Remarks: AlQ.+ Aaai ? -
B2 Appendix B Blank and Example Data Forms
SOILS
Map Unit Name
(Series and Phase): ???;e -4s?? Drainage Class:

Taxonomy (Subgroup): c Field Observations
???--- Confirm Mapped Type? Yes No
Profile Description:
Depth Matrix Color
(inches) Horizon (Munsell Moist) Mottle Colors Mottle Abundance/ Texture, Concretions,
(Munsell Moist) Si
/C
ze
ontrast Structure. etc.

Hydric Soil Indicators:
H istosol Concretions
- Histic Epipedon High Organic Content in Surface Layer in Sandy Soils
_ Sulfidic Odor - Organic Streaking in Sandy Soils
- Aquic Moisture Regime Listed on Local Hydric Soils Litt: '
Reducing Conditions Listed on National Hydrir Soils List
- Gleyed or Low-Chroma Colors - Other (Explain iri Remark)
Remarks: 44 $sl 5 Gi.t"G?a ?-/0?"G .?. '' , -
WETLAND DETERMINATION
Hydrophytic Vegetation Present? (3 No (Circle) (Circle)
Wetland Hydrology Present? Yes
Hydric Soils Present? Yes G'D Is this Sampling Point Within a Wetland? Yes No
Remarks: /v o h 4 4L ? - --'L.. ea-ex' ^
Approved by HQUSACE 3/92
Appendix B Blank and Example Data Forms B3

DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Delineation Manual)
Project/Site:/Me Date:
Applicant/Owner: ??Z?01 _ County: Z. tr
Investigator: a?? ?m(?,?p,?G?bb State: L
Do Normal Circumstances exist on the site? Y V No Community ID:
Is the site significantly disturbed (Atypical Situation)? Yes Transect ID:
Is the area a potential Problem Area? Yes Plot ID:
If needed, explain on reverse.
VEGETATION
Dominant Plant S e ies Stratum Indicator Dominant Plant e i Stratum Indicator
1._ u5 1?AQ--r OJeZSr/i ?..0
2. ov' re
3?iC+??O??iiw?c?Yt9 aka _C? 3'? 9. ?Ox?un anrvs 6i ?cd.?? Nr?lQl. ??•
10.
11. ----

./j14.;?. C??...'S.a.?__-_ unca(LS&?i.c3'•
4
1z.--------
'5 13.
6.?jy?u?CYs V?K ???a -_ ?/ cdy.+

?
7.I1Saer.?r.?: s ?`? i •t is !l
AP'j 14.- - -- ---

15. ------- --
/ '
/

Percent of Dominant Species that are OBL, FACW or FAC ?.y.?
(excluding FAC-). >_J
-------------------
Remarks: II?YC-
HYDROLOGY
- Recorded Data (Describe in Remarks):
- Stream, Lake, or Tide Gauge
_ Aerial Photographs
??ther
vlVo Recorded Data Available Wetland Hydrology- Indicators:
Primary Indicators:
- Inundated
?turated in Upper 12 Inches
t. ater Marks
Drift Lines
Sediment Deposits
Field Observations: =rainage Patterns in Wetlands
Secondary Indicators (2 or more required):
Depth of Surface Water: ?- (in.) -?i -
ized Root Channels in Upper 12 Inches
S .,
Wat r-Stained Leaves
0
Depth to Free Water in Pit: -?>I (in.) 1 Soil Survey Data
•
FAC-Neutral Test
Depth to Saturated Soil: 3 " (in.) _
- Other (Explain in Remarks)
Remarks: uJ 4?-,+1aPv%j 14 yoQ ro i/o 5 y c s yv--W- ?
B2 Appendix B Blank and Example Data Forms
SOILS
Map Unit Name -^4
(Series and Phase): ?i!? a /o .i
Dranage Class:
f,
Taxonomy (Subgroup): G 4 o y.U Field Observations
1 5 -- Confirm Mapped Type? Yes No
Profile Description:
Depth Matrix Color Mottle Colors Mottle Abundance/ Texture; Concretions,
(inches) Horizon (Munsell Moist) (Munsell Moist) Size/Contrast Strticture. etc.
Hydric Soil Indicators:
Histosol - Concretions
- Histic Epipedon _ p--Hgh Organic Content in Surface Layer in Sandy Soils
_ Sutfidic Odor Organ ic Streaking in Sandy Soils..
Aquic Moisture Regime -_,,t`sted on Local Hydric Soils List `
_ Reducing Conditions Listed on -National Hydric Soils List
_&eEWyed or low-Chromaa Colors - Other (Explain in Remarks)
Remarks: We4_1A., j ot.ti'Z--
WETLAND DETERMINATION
Hydrophytic Vegetation Present? ® No (Circle) (Circle)
Wetland Hydrology Present? es No
Hydric Soils Present? es No Is this Sampling Point Within a Wetland? V No
Remarks: 1 t, \ Z4, J j ?r ?l `jOG?.t?O ctrl.-@- `O
Approved by HQUSACE 3/92
Appendix B Blank and Example Data Forms B3