20010802 Ver 1_Complete File_20010530

A
OF TFR Michael F. Easley
?O? pG Governor
C 7 William G. Ross, Jr., Secretary
> y Department of Environment and Natural Resources
Gregory J. Thorpe, Ph.D.
Acting Director
Division of a4er?Quality.
DWQ Project No.: d 1 - OaOZ
Applicant:
Project Name: -
Date of Issuance
Certificate of Completion
AW 2 4 wep
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, 1650 Mail Service Center, Raleigh, NC,
27699-1650. 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, T P, =Nc--)2LAM , 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 complii ce and intent of the 401 Water Quality Certification and Buffer Rules, the
approved" ications, and other supporting materials.
Siunnhire_ Oe2M.-_ >nate!
Agent's Cbrtification "
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:
If this project was designed by a Certified Professional
I, , as a duly registered Professional (i.e., Engineer,
Landscape Architect, Surveyor, etc.) in the State of North Carolina, having been authorized to observe
(periodically, weekly, full time) the construction of the project, for the Permitee 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 Registration No. Date
AOTZA
N CJ DENMR
Division of Water Quality 1650 Mail Service Center Raleigh, NC 27699-1650
Wetlands/401 Unit: [phone]
Fax [phone]
O?O? W A T ?RQG
O `C
Michael F. Easley
Governor
William G. Ross, Jr., Secretary
Department of Environment and Natural Resources
Kerr T. Stevens
Division of Water Quality
June 4, 2001
Guilford County
DWQ Project No. 01-0802
Replacement of 24-inch RCP, SR 3027 (Old McConnell Loop)
APPROVAL of 401 Water Quality Certification
Mr. Lenwood Smith, H, Division Environmental Officer
NCDOT Division 7
1584 Yanceyville Street
Greensboro, NC 27415
Dear Mr. Smith:
You have our approval, in accordance with the attached conditions and those listed below, to permanently impact 32
linear feet and temporarily impact 10 linear feet of an unnamed tributary to South Buffalo Creek for the purpose of
replacing a 24-inch reinforced concrete pipe under SR 3027 (Old McConnell Loop) in Guilford County. The project
should be constructed in accordance with your application dated 15 May 2001. After reviewing your application, we have
decided that this project is covered by General Water Quality Certification Number 3289. This certification corresponds
to Nationwide Permit 14 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. For this approval to be valid, you must follow the conditions
listed in the attached 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 the proposed fill is in excess of 150 linear feet of stream length or 1 acre of wetlands, compensatory mitigation will
required as described in 15A NCAC 2H.0506 (h) (6) and (7). For this approval to be valid, you must follow the
conditions listed in the attached certification and any additional conditions listed above.
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, 6714 Mail Service Center,
Raleigh, N.C. 27699-6714. This certification and its conditions are final and binding unless you ask for a hearing.
North Carolina Division of Water Quality, 401 Wetlands Certification Unit,
1650 Mail Service Center, Raleigh, NC 27699-1650 (Mailing Address)
2321 Crabtree Blvd., Raleigh, NC 27604-2260 (Location)
919-733-1786 (phone), 919-733-6893 (fax), http://h2o.enr.state.nc.us/newetlands/
Page 2 of 2
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 Ms. Cynthia Van Der Wiele at 919-733-9646 or Ms. Jennifer Frye of the Winston-Salem
Regional Office at 336.771-4600.
Attachment
Pc: Wilmington District Corps of Engineers
Corps of Engineers Raleigh Field Office
NCDWQ Winston-Salem Regional Office
.Central Files
File Copy

401 ISSUED
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY 1584 YANCEYVMLE STREET, GREENSBORO, NC 27415
GOVERNOR
May 15, 2001
NC DENR Division of Water Quality
1650 Mail Service Center
Raleigh, NC 27699
ATTN: Ms. Cynthia Van der Wiele
Wetlands/401 Unit
Dear Ms. Van Der Wiele:
010802
LYNDo TIPPETT
SECRETARY
- 7, n
?., 02001
(t?
___crtUA(GROUP
. SECT7Qy
,.,,_ N,
SUBJECT: Guilford County, Replacement of one line of 28-feet long 24-inch Reinforced
Concrete Pipe (RCP) under Old McConnell Loop (SR 3027).
Please find seven (7) copies a Pre-Construction Notification Application package attached for you
review. If you have any questions or need any additional information, please contact Len Smith
[phone] or Paul Ingram at [phone]. Thank you for your time and assistance.
Sincerely,
'?/ ? -4&A/'44-
S. L. Hall
District Engineer, District 2, Division 7
cc: Mr. Eric Alsmeyer, USACE
Mr. Lenwood Smith, II, PWS, NCDOT
RLECEITED
PHONE [phone] FAX [phone]
+? p+w ud°?
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY
GOVERNOR
May 15, 2001
U.S. Army Corps of Engineers
Regulatory Field Office
6508 Falls of the Neuse Road, Suite 105
Raleigh, North Carolina 27615
ATTN: Mr. Eric Alsmeyer.
NCDOT Coordinator
Dear Mr. Alsmeyer:
LYNDO TIPPETT
SECRETARY
SUBJECT: Guilford County, Replacement of one line of 28-feet long 24-inch Reinforced
Concrete Pipe (RCP) under Old McConnell Loop (SR 3027).
The North Carolina Department of Transportation (NCDOT) proposes to replace one (1) line of 28-
feet long 24-inch RCP with one (1) line of 60-feet long 36-inch Corrugated Metal Pipe as part of
secondary road improvement. The existing travel lane and shoulders must be widened to increase
safety and flow. The pipe will be buried at least one foot below streambed to facilitate aquatic life
movement. No Wetlands, High Quality Waters, or Outstanding Resource Waters occur in the
project area. Records from the NCDOT Historic Architect indicate compliance with the National
Historic Preservation Act.
The NCDOT anticipates that the pipe replacement activity will be authorized under Nationwide
Permit 14 and the dewatering operation will be authorized under NWP 33. This application is
intended as a request for formal written authorization from the USACE to dewater the stream under
NWP 33. This application is also intended as request for written authorization from the NC
Division of Water Quality to replace the pipe under General Water Quality Certificate # 3289 (NWP
14). Enclosed please find the project site map and the pre-construction notification form for the
above referenced project. Construction is anticipated to begin in June and take five weeks to
complete.
P. O. Box 14996 Greensboro, NC 27415-4996 Telephone No. [phone] Fax No. [phone]
If you have any questions or need any additional information, please contact Len Smith (336) 375-
5589 or Paul Ingram at [phone]. Thank you for your time and assistance.
Sincerely,
S. L. Hall
District Engineer, District 2, Division 7
cc: Ms. Cynthia Van der Wiele, NCDWQ
Mr. Lenwood Smith, II, PWS, NCDOT
P. O. Box 14996 Greensboro, NC 27415-4996 Telephone No. [phone] Fax No. [phone]

A 7` .
Q'
r
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/Permapp 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.army.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 dread 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).
Page 1 of 12
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 (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 http://www.saw.usace.qM.mil/wetlands/nwpfinalFedReg.-p .
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: Farm Version April 2001
USACE Action ID No. DWQ No. 010 802
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: 14 & 33
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: ?
II. Applicant Information
1. Owner/Applicant Information
Name: Mr. J. M. Mills, PE., Division Engineer - Division 7
Mailing Address: 1584 Yancevville Street
Greensboro, NC 27415
Telephone Number: [phone] Fax Number:[phone]
E-mail Address: [e-mail]
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: Mr. S. L. Hall, District 2 Engineer
Company Affiliation: NCDOT - Division 7
Mailing Address: 1584 Yanceyville Street
Greensboro, NC 27415
Telephone Number: [phone] Fax Number: [phone]
E-mail Address: [e-mail]
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: Old McConnell Loop (SR 3027)
2. T.I.P. Project Number (NCDOT Only): 6.492113T
3. Property Identification Number (Tax PIN):
4. Location
County: Guilford Nearest Town: Greensboro
Subdivision name (include phase/lot number): N/A
Directions to site (include road numbers, landmarks, etc.): Approximately 615 feet from end
of existing pavement.
5. Site coordinates, if available (UTM or Lat/Long): 360 03'41.61"N 79043' 56.10"
(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:
Residential
7. Property size (acres): N/A
8. Nearest body of water (stream/river/sound/ocean/lake): South Buffalo Creek
9. River Basin: Cape Fear
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 httn://h2o.enr.state.nc.us/admin/maps/.)
10. Describe the purpose of the proposed work: Upgrade of an unpaved secondary road to a
paved secondary road.
11. List the type of equipment to be used to construct the project: Road construction
equipment
12. Describe the land use in the vicinity of this project: Forested
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.
N/A
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: N/A
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 ma)
Type of Impact* Area of
Impact
(acres) Located within
100-year Floodplain**
(es/no) Distance to
Nearest Stream
(linear feet)
Type of Wetland***
N/A

List each impact separately anti 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 1-800-358-9616, or
online at htty://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: N/A
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?
(please secif )
A Placement of
pipe in channel 32(pm)
10(tmp) UT to South Buffalo
Creek 2 Feet Perennial

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, 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.
Page 6 of 12
** 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
www.usss.gov. Several internet sites also allow direct download and printing of USGS maps (e.g., www.topozone.com,
www.mapguest.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site:- 32-permanent( pm),
10-temporary (tmp)
3. Open Water Impacts, including Lakes, Ponds, Estuaries, Sounds, Atlantic Ocean and any
other Water of the U.S.
Open Water Impact
Site Number
(indicate on ma)
Type of Impact* Area of
Impact
(acres) Name of Waterbody
(if applicable) Type of Waterbody
(lake, pond, estuary, sound,
bay, cean, etc.)
N/A

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
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.): N/A
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.): N/A
Size of watershed draining to pond: N/A Expected pond surface area: N/A
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.
Expanding shoulder width in order to increase stability. _ Pipe will be buried one foot below
streambed elevation to facilitate aquatic life movement.
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.
USAGE - 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
htt-p://h2o.enr.state.nc.us/ncwetlands/stnngide.htnil.
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.
Pipe will be buried one foot below streambed elevation to facilitate aquatic life movement.
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 h=://h2o.enr.state.nc.us/WM/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): N/A
Amount of buffer mitigation requested (square feet): N/A
Amount of Riparian wetland mitigation requested (acres): N/A
Amount of Non-riparian wetland mitigation requested (acres): N/A
Amount of Coastal wetland mitigation requested (acres): N/A
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
Page 9 of 12
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
(Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify )?
Yes E] 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.
XI.
XII.
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.
N/A
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.
In accordance with February 25,1991 delegation agreement one copv of the sediment and erosion
control plan will be submitted to DENR-Division of Land Ouaility and NCDOT Roadside
Environmental prior to construction.
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.
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).
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 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 Wilson
US Army Corps Of Engineers Alleghany 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: [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
Post Office Box 1000 Camden Gates Martin Washington
Washington, NC 27889-1000 Carteret* Green Pamlico Wayne
Page 11 of 12
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 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 28801 Beaufort, NC 28516
Telephone: [phone] Telephone: [phone] 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]
State Historic Preservation Office
Department Of Cultural Resources
4617 Mail Service Center
Raleigh, NC 27699-4617
Telephone: [phone]
Fax: [phone]
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: [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

IN
1
4RVEY G. & ELLEN H, JOBE
DB 1396-523
PB 111-129

O
DB 2420-714
PB 111-129
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0
COLLEEN H. SUDDERTH
DB 2420-714
PB 111-129
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NATURAL RESOURCE EVALUATION SHEET
State Project # SR Number Road Name County Investigator(s)
3027 Old McConnell Loop Guilford Len Smith, PWs
Date: River Basin: Water Quality Designation Buffer Rules (Y/N)
12/16/00 Cape Fear C NSW No
Primary and Use Percent Residential Percent Agricultural: Percent Undeveloped:
Agriculture 20 60 20
Waters of the US
Streams
M.M. Stream Name Perennial or
Intermittent Ave. Wdth
OHW Ave. Dpth
OHW Ave. Wdth
TOB Ave. Dpth
OB Notes
0.35 UT to South Buffalo
Creek Perennial 2.0' <0.6' 3.0' 4.0'
0.40 UT to South Buffalo
Creek Perennial 5.0' 0.75' 8.0' 3.0'

M.M. = Mile Marker, OHWM = Measurments made from Ordinary High Water Marker, TOB =
Measurments made from the Top of the Bank
Wetlands

M.M. Within 100-year
Floodplain Distance to
Nearest Stream
linear feet
Cowardin Classification
Dominant Plants
N/A

Onen Water
M.M. Name of Waterbody
if applicable) Type of
Waterbod M.M. Name of Waterbody
if applicable) Type of Waterbody
N/A

General Notes/Comments: No wetlands or ponds are present.
Site Coordinate MM. (From East to West) 0.35: 36'03'41.61"N 79043'56.10,'W
Site Coordinate MM 0.40 36'03'40.74"N 79'43'58.85"W
Division Environmental fficer Date
ENDANGERED SPECIES REVIEW FOR DIVISION 7
DISTRICT 2
State Pro'ect # SR Number Road Name County
3027 Old McConell Loo Guilford
Guilford County
Bald Eagle (Haliaeetus leucocephalus). Lake Higgins Area.
Is the activity within the primary or secondary zone Yes ? No
James inymussel (Pleurobema coffin) - Roanoke Basin
Habitat Survey Date Investigator(s) Man-hours Comments/Findings
N/A
Potential Species (Listed in Nearby Counties)
Schweinitz's sunflower (Hellanthus schweinitzit)
Habitat Survey Date Investigator(s) Man-hours Comments/Findings
No 12/16/00 Len Smith 1.0 No habitat
General Notes/Comments:
Division Environmental Officer Date
NCDOT
HAZARDOUS SPILL BASIN CHECKLIST
Division: Seven County: Quilfnrrl Project ID: 6.492113T
River Basin: Cape Fear Bridge No: N/A
Route: 3027 Stream: UT to South Buffalo Creek
Water Quality Criteria:
Yes No
Stream Crossing Blue Line On USGS r.- r
ORW C- F
WSI r r
WS II,III OR IV, Crossing Within 0.5mi of W.S. Critical Area F. F
Roadway Criteria:
Route Designation- Yes No
Arterial Urban r r
Arterial Rural C P
Additional Site Information:
Yes No
Is a Hazardous Spill Basin Required? r r
Criteria Based Upon NCDOT "Best Management Practices for the
Protection of Surface Waters" (March, 1997).
STATION 6+10
EROSION CONTROL PLAN
GUILFORD COUNTY SR3027 (Old McConnell Loop)
Project # 6.492113T Pipe Replacement
Replacement of existing 28' of 24 RCP with 60' of 36" CMP.
Rip Rap sediment dam is required.
Stilling basin is not required.
Silt Fence will be installed as needed.
Seeding with be performed by Roadside Environmental as scheduled.
Comments:
We will close the entire roadway with a detour and replace the existing pipe with 60' of
36" RCP. Once the pipe is installed, we will install rip-rap outside the streambed
stabilize the ends of the pipe. The new pipe will be buried 20% below the existing
streambed. Once work is complete, the temporary dams will be completely removed.
Prepared by: J. P. Ingram 5/2/01

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