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HomeMy WebLinkAbout20010954 Ver 1_Complete File_20010621State 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.DENR NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES July 4, 2001 Cumberland County DWQ Project No. 010954 APPROVAL of 401 Water Quality Certification Mr. Terry Gibson, P.E., Division Engineer NVDOT, Division 6 PO Box 1150 Fayetteville, NC 28302 Dear Mr. Gibson: You have our approval, in accordance with the attached conditions and those listed below, to place fill material in 0.01 acres of jurisdictional waters for the purpose of replacing Bridge Number 12 on Sr 2216 in Cumberland County. The project should be constructed in accordance with your application dated June 7, 2001. After reviewing your application, we have decided that this fill is covered by General Water Quality Certification Number 3289. This certification corresponds to the General Permit 198200031 issued by the Corps of Engineers. 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 with the accompanying 404 permit, unless otherwise specified in the Water Quality 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 21-1.0506 (h) (6) and (7). For this approval to remain valid, you must adhere to the conditions listed in the attached certification. 1.) 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. 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 that 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 919-733-9.646. Sincerely, Wetlands/401 Unit 1650 Mail Service Center Raleigh, North Carolina 27699-1650 Telephone 919-733-1786 FAX 733-9959 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 Attachment cc: Wilmington District Corps of Engineers Corps of Engineers Wilmington Field Office DWQ Fayetteville Regional Office Central Files c:\ncdot\SR 2216\wqc\010954wgc.doc 10,91WA • IT 10 -%1, Nook NCDENR NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES Z1 evens Wetlands/401 Unit 1650 Mail Service Center Raleigh, North Carolina 27699-1650 Telephone 919-733-1786 FAX 733-9959 An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post consumer paper 401 ISSUES STATE of NORTH CAROLINA DEPARTMENT OF TRANSPORTATION MICHAEL, F. EASLEY LYNDO TIPPETT GOVERNOR SECRETARY Bridge Maintenance Unit 1'. O. Box 1150 l-avetteville, N. C. 29302 June 7, 2001 USACOE Mr. Richard Spencer Wilmington Regulatory field Office 1' O. Box 1990 Wilmington- N. C. 29402-1990 RF.F: Cumberland County Bridge Number 12 Replacement ('ITP 13-2949) LOCATION: SR-2216 Crossing Lock's Creck Dear Mr. Spcnccr We arc providing herewith an application package and copies of N.C. Department of Transportation I lydraulics Unit sketches (plan and profile) as a part of a project involving the replacement Oran existing bridge with a new bridge. The project should be let to contract in 2001. To our knowledge, no wetlands are involved and total fill in water is expected to be less than 0.01 acre. This bridge is not located in a high quality water area. Please review this material, and if additional inlorn ation is needed, please contact our office. (hank you for your cooperation and assistance in this matter. Sincerely z'4 ??a' L. 1.. 1_)pole, Jr, P.1 Division Bridge Maintenance Engineer Altachments CC: T. R. Gibson, P.E. Division Engineer. John I Iennessey -DWQ-7 Copies W/Attachments Mrs. Renee Gledhill-Earley Slate Ilistoric Preservation Officer Mike Crocker-US Dish & Wildlif''e Service Jim Rerko-Division Environmental Offi-wr DAv IMIMENT RECEDED P_0. Boll 150-Pawleville. NC 28302-11irnre: (910-929-6345) Pax: (910-829-6348) / Z. - Z_ JM (3 CO-L_14AJ?3 of w a-TER j zT? 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 littp-//www.saw.t,tsace artiiy jiiil_/_wetlands/i'er t a1)p,httzi. 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 htti)://wwku.saw.tisace army.tiiil/wetl?iiids/i-et tour.I)tm, 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 htHh2o enr.state. nc us/newetlands 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 (919) 733-1786. 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). 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 r1_ __ 1 - r 1 ? Management (DCM) at (919) 733-2293. 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 (CAMA) Permit and will coordinate the 404/401 Permits. USAGE 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://w_ww.saw.usace.armyr7liI/wetlands/nwp_finalFedRe?.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.m.us/ncwetlands/fees.litml. 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. n..__ n _r I' Office Use Only: Fonn Version April 2001 USACE Action ID No. DWQ No. 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: ? 4. If payment into the North Carolina Wetlands Restoration Program (NCWRP) is proposed for mitigation of impacts (see section VIII -Mitigation), check here: ? If. Applicant Information Owner/Applicant Information Name: " se_" 0,... r Mailing Address: P. o. Telephone Number: Qua - 4e> b- 4?3-_ Fax Number: 9(o -¢eCo i9 s9 E-mail Address:_ t9 ?so?.' e ??? • sco.r¢ . ?-kc- . %_3 s 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: <P-Mo_ A,, s Ae,ov?r_- Company Affiliation: Mailing Address: Telephone Number: E-mail Address: Fax Number: 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 II 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: C-?. - 2. T.I.P. Project Number (NCDOT Only): ( Pb - Z-9 49) 3. Property Identification Number (Tax PIN):a. 4. Location County: Nearest Town: ec- TE.<?"•? Subdivision name (include phase/lot number): r- /A --I Directions to site (include road numbers, landmarks, etc.): 5 z z 1 b L o A -1-60 O. 3C-` So.?TN Jc z- 5 fL Z L '? A?tos? G o c.k s C-? e K 5. Site coordinates, if available (UTM or Lat/Long): (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: 7. Property size (acres): /,-- SS Taa,,r / E?iCE 8. Nearest body of water (stream/river/sound/ocean/lake): vGks cAe E K 9. River Basin: Car'E (Note - this must be one of North Carolina's seventeen designated major river basins. The River Basin map is available at http //li2o enr,st itc..iic.us/adniin/n.iat)s/.) 10. Describe the purpose of the proposed work: -"725 ---I Aa?j '5-91104d w rrrl A 1316--5676% n...__ A _r 1' 1 1. List the type of equipment to be used to construct the project A.1 (7 C-- Y..4, r-+ V-- TR-L?e-K ?xt?.vdTo? I2. Describe the land use in the vicinity of this project: V--i o ?- 1V. 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. ?--` Ira 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:0 ZA 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 strearn channels associated with the project. The applicant must also provide justification for these impacts in Section VII below. All proposed impacts, permanent and ternporary, 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 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 Area of Located within Distance to Site Number Type of impact* impact I00-year Floodplain** Nearest Stream Type of Wetland*** (indicate on map) (acres) es/no (linear feet) * List each impact separately and identify temporary impacts. Impacts include, but are not limited to: mechanized clearing, grading, till, 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 (FF,MA) Flood Insurance Rate Maps (FIRM), or FEMA-approved local Iloodplain maps. Maps are available through the FF,MA Map Service Center at 1-800-358-9616, or online at http?Rv ,%tc.Ji?m?,gnt?. *** List a Nvetland h-pe that best describes wetland to be impacted (e.g., ireshwater/saltwater marsh, forested wetland, beaver pond, Carolina Day, bog, etc.) List the total acreage (estimated) of existing wetlands on the property: O Total area of wetland impact proposed: D 2. Stream Impacts, including all intermittent and perennial streams Strcanr Impact Site Number (indicate on map) Type of Impact* Length of Impact (linear feet) Stream Namc** Average Width of Stream Before Impact Perennial or Intermittent? lease specify) List each impact separately and identify temporary impacts. hnpacts 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 u'r (unnamed tributary) to the nearest downstream named stream into which it (lows. USGS maps are available through the (JSGS at 1-800-358-9616, or online at }g_cyV tisg; ,gnv. Several interret sites also allow direct download and printing of USGS maps (e.g., www.tppo one cnia1, ?c«?r.nrgt lucst.cn3n, etc.). Cumulative impacts (linear distance in feet) to all streams on site: C) Open Water Impacts, including Lakes, Ponds, Estuaries, Sounds, Atlantic Ocean and any other Water of the U. S. Open Water Impact Area of Name of Waterbody Type of Waterbody Site Number Type of Impact* Iinpact (if applicable) (lake, pond, estuary, sound -(,indicate on rna) (acres) bay, ocean, etc. * List each impact sevarateiv and identitv temporary impacts. Impacts include, but are not limited to: fill, excavation, flooding. drainage. bulkheads. etc. 4. Pond Creation 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): ? uplands ? stream ? wetlands Describe the method of construction (e.g., dam/embankment, excavation, installation of draw-down valve or spillway, etc.): F-'//? 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: VI 1. 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. Sep_"C_=- P.?4?-A.? ?yusT? rat(„ 3???-1 T?KF?£t2- N.N?o p..a--- w%Tr1 l? 2 SJrsrJ Q-C__ ^.'Xo 2-No C> Vlll. 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 USAGE 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 htit>;lii4c?:cnr.statc nc.us/nc?yctlt?rtds/stringicle.l?tml. 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 /-, 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 hup!/h2o.eiv.state 'pc.u_shN,ro indca htnt. If use of the NCWRP is proposed, please check the appropriate box on page three and provide the following information: Amount of stream mitigation requested (linear feet): o rn-- __ o _r r? Amount of buffer mitigation requested (square feet): 0 Amount of Riparian wetland mitigation requested (acres): D Amount of Non-riparian wetland mitigation requested (acres): Amount of Coastal wetland mitigation requested (acres): o IX. Environmental Documentation (DWQ Only) J 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 (919) 733-5083 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] 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 V11 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. Will the project impact protected riparian buffers identified within 15A NCAC 213 .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* lmpact (square feet) Multiplier Required Mitigation 1 3 2 1.5 Total * /,one 1 extends out 30 feel perpendicular from near bank of channel; Zone 2 extends an additional 20 fcet from the edge of lone 1. Il,. .. ,. f? ..f 11 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. X1. 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 Vie property. X11. 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. X111. Violations (DWQ Only) Is this site in violation of DWQ Wetland Rules (15A NCAC 2H.0500) or any Buffer Rules? Yes ? No 0 Is this an after-the-fact permit application? Yes ? No X 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). Al 0LE n....,, In ..r I'1 A,/0 Applicant/Agent's Signature Pate' (Agent's signature is valid only if an authorization letter from the applicant is provided.) CIS Army Corps Of Engineers Field Offices and County Coverage Asheville Regulatory Field Office Alexander Cherokee Iredell Mitchell Union US Army Corps of Engineers Avery Clay Jackson Polk Watauga 151 Patton Avenue Buncombe Cleveland Lincoln Rowan Yancey Room 208 Burke Gaston Macon Rutherford Asheville, NC 28801-50061 Cabarrus Graham Madison Stanley Telephone: (828) 271-4854 Caldwell Haywood McDowell Swain Fax: (828) 271-4858 Catawba Henderson Mecklenburg Transylvania Raleigh Regulatory Meld Office Alamance Durham Johnston Rockingham Wilson US Army Corps Of Engineers Allegliany Edgecombe Lee Stokes Yadkin 6508 Falls of the Neuse Road Ashe Franklin Nash Surry Suite 120 Caswell Forsyth Northampton Vance Raleigh. NC 27615 Chatham Granville Orange Wake Telephone: (919) 876-8441 Davidson Guilford Person Warren Fax: (919) 876-5283 Davie . Halifax Randolph Wilkes Washington Regulatory Field Office Beaufort Currituck Jones Pitt US Army Corps Of Engineers Bertic Dare Lenoir Tyrrell Post Office Box 1000 Camden Gates Martin Washington Washington, NC 27889-1WO Carteret* Green Pamlico Wayne Telephone: (252) 975-1616 Chowan Hertford Pasquotank Fax: (252) 975-1399 Craven Hyde Perquimans *Croatan Nati onal Forest Only Wilmington Regulatory Field Office Anson Duplin Onslow US Army Corps Of Engineers Bladcn Harnett Pender Post Office Box 1890 Brunswick Hoke Richmond Wilmington, NC 28402-1890 Carteret Montgomery Robeson Telephone: (910) 251-4511 Columbus Moore Sampson Fax: (910) 251-4025 Cumberland New Hanover Scotland US Fis US Fish and Wildlife Service Raleigh Field Office Post Office Box 33726 Raleigh, NC 27636-3726 Telephone: (919) 856-4520 h and Wildlife Service / National N US Fish and Wildlife Service Asheville Field Office 160 Zillicoa Street Asheville, NC 28801 Telephone: (828) 665-1195 farine Fisheries Service National Marine Fisheries Service Habitat Conservation Division Pivers Island Beaufort, NC 28516 Telephone: (252) 728-5090 North Carolina State Agencies Division of Water Quality 401 Wetlands Unit 1650 Mail Service Center Raleigh, NC 27699-1650 Telephone: (919) 733-1786 Fax: (919) 733-9959 Division of Water Quality Wetlands Restoration Program 1619 Mail Service Center Raleigh. NC 27699-1619 Telephone: (9t9) 733-5208 Fax: (919) 733-5321 State Historic Preservation Office Department Of Cultural Resources 4617 Mail Service Center Raleigh, NC 276994617 Telephone: (919) 733-4763 Fax: (919) 715-2671 n..,.- 1 / -r l'1 CAMA and NC Coastal Counties 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: (919) 733-2293 Camden Dare Onslow Tyrrell Fax: (919) 733-1495 Carteret Gates Pamlico Washington NCWRC and NC Trout Counties Western Piedmont Region Coordinator 3855 Idlewild Road Kernersville. NC 27284-9180 Telephone: (336) 769-9453 Mountain Region Coordinator 20830 Great Smoky Mtn. Expressway Waynesville. NC 28786 Telephone: (828) 452-2546 Fax: (828) 506-1754 Alleghany Caldwell Ashe Mitchell Avm Stokes Burke Surry Buncombe Henderson Cherokee Jackson Clay Macon Graham Madison Haywood McDowell Watauga Wilkes Polk Rutherford Swain Transylvania Yancey ?sry, a I J .'.>' q[f s? \ :fit ? ??' at ?, ?? y ? ; © `?: I ? n _ •j ?1 ??/Q ^?p f , • \!i L L ©r r, iI n' v E' C. I ?I ? \,.`{v4 ? a , % '' ? ? e :® T ' , r i` ? y r?I •e •?,nfit? TIt r s` : ?° Y ? ? . •? ti \ tF ,,•?• N g ? r?i 'i! i ? •o ? , ? `?? t I? ? o ? ? - I a ?' ®\ ? ? r ,?y t?,r, \\ ? ??i 1 ps ? •. ,d /? ?Z 1 ?. ? w?•"'r?,j, ? •? ' ee ? (1 Iy _J Tn fiJ \OD? ??1 / ? t s?t,'^ f ` t gtkF i \ ly C. G?.?t? - IL i ? •/ 1= _ _ ISr.? •.i••? ? n_.° f ? IJ ?Q i?l ice. ,, ? ` ? u ?+ rj /, •l? f7 $ A ? -ir a Kri! 1 ? • Iv <ti / 28 y:? ?` rpn? IpP CTY 'o \ } gyp, ? gip'/,• / C IN y,e v , \ a I6 N n ? a -n z O 0? o 57- mN o c 00 mm _ Z m 3 Z am er 3: 0. o' D CA C) a T Z ( D Z 0 y~ /? N z CA t c C H -00 m Q C ' ?? °° ? 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'?? ?.?? a hf ?.?''+7'.f. ?•Q?•:?sn- ?..:._ ? ?? , d ? t ' r r?.i-= i ? _ ? l 4 \ r I : r - J I? \ ? .r-?h M; Wi"? • '`. ? f^-, - _ dr1t''+iq? _ ?'Jff?1_7 3C? f I r l ! t rj1 ty '? -II••II t 1? - ?r {{!1_?Iitt ) r r. ,t ?i « }y ?' .. ? ?! I "+' a - tTr ???1C. I--??1?_?};y--{{?? ? ,,` ?(}. j? { I J ?'? Nftt ? +j I l • { 7 ?T1,? il,'??[ +?\ ?' `/ f ? D?r ??i•?... t1, lL 11 ?1: 1 If 1,11 i 7 :1 ` I r fI `// 't1 1) l I r 1774 ¢ II ?? 1•, , , ' 1 ` ? r t ?ri'._l ? t_..- t 11, l 1 (tL "r p? °?' . ?? j 7Y? ?{ ` I /( 1'? I r 11' j > "} \t t f ?1 Fl, ' J rr iC ?! ? ? ?-7r-,_ ~? .,?• t? }-tt. -? ? r I l I' J E t 1 f Y,, _ r (", ,r..3A4.t'+ .s?-Y y,. 11 ?:,. •?t ? r/f f ? :1.?,f ? ?,r la\ 1."Ir ? } ?1,) .I,I, (... \ ; ./ :-. , ;({ ?(?' o iv w??1` ?J 7111. r? .' }.ll 11 1 j" - \\ Y"1.?1 H ?lY? \ ? •I`• _ c'.li pS i?,? .'ir , , ,... , 11 r J Yr . }; ...her t I f j r ?' i Y _a .0 ,n o? a ti a Y b .R 3 O? .n .D a U H a w u 'ob v x -r ? x N CO a a j? a m -r 0 <t fff . ' 9 41 c7 ?°`p?' ' J, f1 x w E 000 r _ ?i= ?:' , x 3 A Y! rJ O V 1 I T ' Y i 1 ( I 1 1 I to 1 4v , I ??. •z 1 1 I` LL (L a 41 P.P.UGC t4 - a 1 I U , 1 L9 LJLJ l 1 ?? 1 I Q. ti.I a' 1 1 12, 1 1 1t - ? ? I I 1 1 9 v i ti rp. i , , , 1 T T fl f I i ( L. ...? , R ._ _ _. _. ?._.. ... ._ ,.. .?°. _, .. 3 1 ?I ?J{ aa i t 1 iI t? i : y *04, 401 ISSUED STATE Or NORTH CAROLINA DEPARTMENT OF TRANSPORTATION MICHAEL F. EASLEY LYNDO TIPPETT GOVERNOR SECRETARY 13ridge Maintenance Unit 1'. O. Box 1150 Favetleville, N. C. 28302 June 7, 2001 USAC01, Mr. Richard Spencer Wilmington Regulatory Field Office P 0. Box 1890 Wilmington, N. C. 28402-1890 RFT: Cumberland County Bridge Number 12 Replacement (TIP 13-2949) LOCATION: SR-2216 Crossing Lock's Creek Dear Mr. Spencer We are providing herewith an application package and copies of N_C. Department of Transportation 11 ydraulics Unit sketches (plan and profile) as a part of a project involving the replacement of an existing bridge with a new bridge. The project should be let to contract in 2001. To our knowledge, no wetlands are involved and total fill in water is expected to be less than 0.01 acre. 11is bridge is not located in a high quality water area. Please review this material, and if additional infimnation is needed, please contact our office. Thank you for your cooperation and assistance in this matter. Sincerely eP V1 - i?Z L,. L. Upole, Jr, P.R. Division Bridge Maintenance Engineer Attachments CC: T. R. Gibson, P.E. Division Fnginecr .John I Iemiessey -DWQ-7 Copies W/Attachments Mrs. Renee Gledhill-Earley Stale Ilistoric Preservation Of tcer Mike Crocker-US Fish & WildlilC Service Jim Rerko-Division Environmental Ofrcer PA A4 F!T CER-11-fl P.O. BoxI 150-FayetteviIle. NC 28302-lime: (910-829-0345) Fax: (910-829-6348) '0 12. - G. c ) NJ Od IG. A?- L-Al AJ,a OF \NA T??? 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 Butler 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 ili.tp //wivw_Sa\ Ligace._arniv «iil/wetIatids/1'et-m appjIn! 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._army,?nillwetllnd4/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 11-ttp://12o:enr.?tate.??c uS/nc?yetlaittls 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 (919) 733-1786. 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). 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 n_.._ 1 _rI? Management (DCM) at (919) 733-2293. 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 (CAMA) 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 littp;//www,saw. Lrsace.army_ MI/w-etland_s/nwpfi_rialf gdRp&pot" 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 Iitip://Ii2o.cliiir.state.tic.us/iicwetlands/fees.litmi. 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. Office Use Only: Fonn Version April 2001 USACE Action ID No. DWQ No. 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 1. Check all of the approval(s) requested for this project: ?]C 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 ? 3. If this notification is solely a courtesy copy because written approval for the 401 Certification is not required, check here: ? 4. If payment into the North Carolina Wetlands Restoration Program (NCWRP) is proposed for mitigation of impacts (see section VIII - Mitigation), check here: ? IL Applicant Information Owner/Applicant Information Name: T"=tea-" C-•?es4?,P. Mailing Address:_P. o. P,oX kk -5?o fVC-v %k-.`E_f t A _Z S3 -2- Telephone Number: qua - 46b- i 4 ct 3 Fax Number: 9io - 48(. - 19 s9 E-mail Address: tgo5so.a @ =T• STATE . t•-ke 0 s 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: _ SF-M&_ o, s A. I& o,-, Ira Company Affiliation:- Mailing Address: Telephone Number:_ Fax Number: E-mail Address: n...... 7 -r I' 11111. 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 USAGE 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: C.. . - ?E?`o ?e?aE.,r o?- F?.oc_,et? i-L- 2. T.I.P. Project Number (NCDOT Only): ( ?-:, - z 9 4 9 3. Property Identification Number (Tax PIN): ?_A,Zn. 4. Location County: Nearest Town: Subdivision name (include phase/lot number): r-4 /A Directions to site (include road numbers, landmarks, etc.): S 2 z i Z - -A'T&p O . ?. Mt S4? i }1 J<-? S (Z Z Z t "? A c-zo.sQ 40 C k 5 C,26E K Site coordinates, if available (UTM or Lat/Long): (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: 1-11614 wg4 41 G ?.aTio,? xisTinlG-? 7. Property size (acres): 8. Nearest body of water (stream/river/sound/ocean/lake): / vc.ks CAFE K 9. River Basin: Ca,,'E_ FEAr_ _ (Note - this must be one of North Carolina's seventeen designated major river basins. The River Basin map is available at lit.1p //h2 eni-_suite.nc.us/acimin/itiaps/.) 10. Describe the purpose of the proposed work: sre????? A?F??? ,ter ?3r_"04E w, r..4 it /344.0 67 E. I 1. List the type of equipment to be used to construct the project /a. c> C. y.,O- 'A f-, TQ In?-? ? x t_s?v,a?TOtL 12. Describe the land use in the vicinity of this project: V-,j 1V. 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 USAGE 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. , -- I n. 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: 0A - 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 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 Innpact Area of Located within Distance to Site Number Type of lmpact* Impact 100-Sear Floodplain** Nearest Stream . Type of Wetland*** (indicate on map) acres) _ _(yes/no _ (linear feet) Last each impact separately and identify temporary impacts. Impacts include, but are not limited to: mechanized clearing, grading, till, 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 (FI?MA) Flood Insurance Rate Maps (FIRM), or FEMA-approved local floodplain maps. Maps are available through the FE.MA Map Service Center at 1-500-358-9616, or online at 11t1l) wtc.Icula i,op. *** 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: o Total area of wetland impact proposed: D 2. Stream Impacts, including all intermittent and perennial streams Stream Impact Site Number (indicate on ma) Type of Impact* Length of Impact (linear feet) Stream Name** _ Average Width of Stream Before Impact Perennial or Intermittent? leasespecify) List each impact separately and identity 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, gabious, etc.), excavation, ditching/straightening, etc. If stream relocation is proposed, plans and profiles showing the linear footprint for both the original and relocated streams trust be included. Stream names can be found on IJSGS topographic maps. If a stream has no name, list as UT (unnamed tributary) to the nearest downstream named stream into which it flows. 1JSGS maps are available through the IJSGS at 1-800-358-9616, or online at t??tu gc v. Several internet sites also allow direct download and printing of 1JSUS snaps (e.g., yv,t t?°.tc x?zouecon, ww:j :AWtpelucst a}m, etc.). Cumulative impacts (linear distance in feet) to all streams on site: t./ 3. Open Water Impacts, including Lakes, Ponds, Estuaries, Sounds, Atlantic Ocean and any other Water of the U. S. Open Water Impact Area of Name Waterbody Type of Waterbody Site Number Type of Imp act* Impact (if applicable) (lake, pond, estuary, sound, (indicate on map) (acres) bay, ocean, etc. n,.__ / _r I' List each impact separately and identily temporary impacts. Impacts include, Nut are not Inwted to: tilt, excavation, dredging, flooding, drainage, bulkhauis, etc. 4. Pond Creation 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): ? uplands ? stream ? 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: V11. 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. A% s-c 4 r.16, 3 ?ss?-t Ti N?P?E 7- & OA O R.? - 4a Q?SZ? E v_.r Trt P. 2 'S ip p, r? e- ?- a .?-?? o e L__ l e> :L.o y,? T+-?1 ,? t-?-c ? ?a ca, 4m_% 0 S3.0 ' C1,3 %A1q-r_ -_V V5 q- %, V111. 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 t1SACE 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://h2 o. en F. state.nc.us/nc wetlands/strnwide.littnl. 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. NI., 2. Mitigation may also be made „b, y 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 httpJA12o.entstate.ne.ushr index.htm. If use of the NCWRP is proposed, please check the appropriate box on page three and provide the following information: Amount of stream mitigation requested (linear feet): 0 Amount of buffer mitigation requested (square feet): 0 Amount of Riparian wetland mitigation requested (acres): 0 Amount of Non-riparian wetland mitigation requested (acres): v Amount of Coastal wetland mitigation requested (acres): o 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 (919) 733-5083 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 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. Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233 (Neuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and Water Supply Buffer Requirements), or other (please identify )? Yes ? No V 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 * /,one I extends out :io teet perpenwcuwr from near M11K o? c11,111M, i.vne L e;ucnlus all additional 20 feet from the edge of lone 1. If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation of Prope?ty, 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 213 .0242 or.0260. X1. 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 fron) the property. X11. 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. X111. Violations (DWQ Only) Is this site in violation of DWQ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules? Yes ? No 0 Is this an after-the-fact permit application? Yes ? No V?d 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). A/ou ? --- x'z. (, W///d! Applicant/Agent's Signature Date' (Agent's signature is valid 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 Union US Army Corps of Engineers Avery Clay Jackson Polk Watauga 151 Patton Avenue Buncombe Cleveland Lincoln Rowan Yancey Room 209 Burke Gaston Macon Rutherford Asheville. NC 29901-5006 Cabarrus Graham Madison Stanley Telephone: (929) 271-4954 Caldwell Haywood McDowell Swain Fax: (929) 2714959 Catawba Henderson Mecklenburg Transylvania Raleigh Regulatory Field Office Alamance Durham Johnston Rockingham Wilson US Army Corps Of Engineers Alleghany Edgecombe Lee Stokes Yadkin 65(19 Falls of the Neuse Road Ashe Franklin Nash Surry Suite 120 Caswell Forsyth Northampton Vance Raleigh, NC 27615 Chatham Granville Orange Wake Telephone: (919) 876-9441 Davidson Guilford Person Warren Fax: (919) 976-5293 Davie Halifax Randolph Wilkes Washington Regulatory Field Office Beaufort Currituck Jones Pitt US Army Corps Of Engineers Bertie Dare Lenoir Tyrrell Post Office Box 1000 Camden Gates Martin Washington Washington, NC 27999-It100 Carterct* Green Pamlico Wayne Telephone: (252) 975-1616 Chowan Hertford Pasquotank Fax: (252) 975-1399 Craven Hyde Perquimans *Croatan Nati onal Forest Only Wilmington Regulatory Field Office Anson Duplin Onslow US Army Corps Of Engineers Bladen Harnett Pender Post Office Box 1990 Brunswick Hoke Richmond Wilmington, NC 29402-1990 Carteret Montgomery Robeson Telephone: (910) 2514511 Columbus Moore Sampson Fax: (910) 2514025 Cumberland New Hanover Scotland US Fish and Wildlife Service / National Marine Fisheries Service US Fish and Wildlife Service US Fish and Wildlife Service National Marine Fisheries Service Raleigh Field Office Asheville Field Office Habitat Conservation Division Post Office Box 33726 160 Zillicoa Street Pivers Island Raleigh, NC 27636-3726 Asheville, NC 28901 Beaufort, NC 29516 Telephone: (919) 8564520 Telephone: (828) 665-1195 Telephone: (252) 728-5090 North Carolina State Agencies Division of Water Quality 401 Wetlands Unit 1650 Mail Service Center Raleigh, NC 27699-1650 Telcphone: (919) 733-1786 Fax: (919) 733-9959 Division of Water Quality Wetlands Restoration Program 1619 Mail Service Center Raleigh, NC 27699-1619 Telephone: (919) 733-5208 Fax: (919) 733-5321 State Historic Preservation Office Department Of Cultural Resources 4617 Mail Service Center Raleigh, NC 27699-4617 Telephone: (919) 733-4763 Fax: (919) 715-2671 CAMA and NC Coastal Counties Division of Coastal Management Beaufort Chowan Hertford Pasquotank 1638 Mail Service Center Bertic Craven Hyde Pender Raleigh, NC 27699-1638 Brunswick Currituck New Hanover Perquimans Telephone: (919) 733-2293 Camden Dare Onslow Tyrrell Fax: (919) 733-1495 Carteret Gates Pamlico Washington NCWRC and NC Trout Counties Western Piedmont Region Coordinator 3855 Idlewild Road Kemersvillc, NC 27284-9180 Telephone: (336) 769-9453 Mountain Region Coordinator 20830 Great Smoky Mtn. Expressway Waynesville. NC_ 28786 Telephone: (928) 452-2546 Fax: (928)506-1.754 Allegliany Caldwell Watauga Ashe Mitchell Wilkes Avery Stokes Burke Surrv Buncombe Henderson Polk Cherokee Jackson Rutherford Clay Macon Swain Graham Madison Transvlvania Haywood McDowell Yancey n....,, ill „r i ll 1 e'er: © 6 / S 7, s ? .r • v .may ss )O 7, ? r< Yb?Sv ! + ? ? z,?W3 1 'PS Ig F ? r.y I? S' I °? ?• r•i;:.rL r t ,, .? It r ? • Y IRZFIZwI ? .. i > ?i!" ?} r l © r. / ?f(.R r? (.,C) .v I GYf ? ?• J t V? ? '\? I ? t o s I .? i it L ?t' r :.•rb a?' t L. I _,iT , ??, :`? ? j • ? •`? ? t J_ h rt ?rlA 4 n P ?zYr? . 3 fi { I? x ztp.; fry1 y ?? z p, ? r ? 18 lu ? ? 16 ? W-?. ?r?i .. i ^? P 10 1 ???`y.-6 ? ??:. V ,n st'{ ? ? ° {y ? ? • J M ,'xy ???y+? \ IC. ?? . t ? 1?D?''[4?5'I,?, a. , Y. N I: •s?np ?i a • _ ?'?. I_ y l n ooo ' M s z Fr 12 Cd I? _ Kati .? 'Ak n-. _ _ _ pS°.r :Ft?„?' ? U r ???"1, a..1"' ? i•?F?m ;?1F ? ? Iff 7 T 61 ??? ,? ,fit 4 {? It.` . ?•• I' _ _?i rl .. 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I ! a d I r I f I t v f I 1 - , _ i ; a 4 IF INCORRECT RETURN TO NC DEPARTMENT OF TRANSPORTATION 9104861493 DATE 05/16/2001 NET AMOUNT $200.00 1 WARRANT NO. 6955