20011620 Ver 1_Complete File_20011106

' N. C. DEPARTMENT OF TRANSPORTATION
TRANSMITTAL SLIP DATE
I (' S? a
TO: REF. NO. OR ROOM, BLDG.

FRO REF. NO. OR ROOM, BLDG.
K( ?I r
A ION
? NOTE AND FILE ? PER OUR CONVERSATION
? NOTE AND RETURN TO ME ? PER YOUR REQUEST
? RETURN WITH MORE DETAILS ? FOR YOUR APPROVAL
? NOTE AND SEE ME ABOUT THIS ? FOR YOUR INFORMATION
? PLEASE ANSWER ? FOR YOUR COMMENTS
? PREPARE REPLY FOR MY SIGNATURE ? SIGNATURE
? TAKE APPROPRIATE ACTION ? INVESTIGATE AND REPORT
COMMENTS:
11 2

Mrn
STATE of NORTH CAROLINA ro
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY LYNDO TIPPETT
GOVERNOR SECRETARY
November 5, 2001
U.S. Army Corps of Engineers
Raleigh Regulatory Field Office
6508 Falls of the Neuse Road, Suite 120
Raleigh, NC 27609
Attention: Mr. Eric Alsmeyer
NCDOT Coordinator
Subject: Replacement of existing pipe conveying an unnamed tributary to Fox
Creek on SR 1600 (East River Road) in Franklin County.
The North Carolina Department of Transportation (NCDOT) proposes to replace
an existing pipe conveying an unnamed tributary to Fox Creek on SR 1600 (East River
Road) in Franklin County. The existing structure is a 24 inch concrete pipe that is 60 feet
long. Silt that originates from a lumber yard located upstream of the pipe has filled the
pipe. During heavy rains, water flows over the roadway, resulting in a roadway hazard.
The replacement structure is a 48 inch pipe that is 60 feet long.
Wetland delineations were conducted using the field delineation method outlined
in the 1987 Corps of Engineers Wetland Delineation Manual (Environmental Laboratory,
1987). U. S. Army Corps of Engineers (USACE) Wetland Data Forms and a North
Carolina Division of Water Quality (DWQ) Wetland Rating Form are attached to this
application.
Impacts to Waters of the United States
Construction of the project will necessitate impacts to waters of the United States
(Figures 1 and 2) in the Tar-Pamlico River Basin. The project crosses an unnamed
perennial tributary to Fox Creek (DWQ Index No. 28-25, Best Usage Classification C
NSW) and will impact a palustrine emergent-scrub-shrub wetland. The wetland has a
DWQ wetland rating of 39. Permanent impacts at the site associated with the
replacement of the structure and minimal amounts of rip rap to protect the structure
include <0.01 acre fill in surface water, 20 linear feet existing channel impacted and
<0.01 acre fill in wetland.
Division 5, 2612 N. Duke Street, Durham, NC 27704
Phone: [phone] Fax: [phone]
2
Dewatering
The NCDOT proposes to temporarily dewater the stream during the construction
of the project. This will involve the temporary placement of rip rap underlain with filter
fabric in the stream channel approximately 10 feet upstream of the proposed pipe inlet
and approximately 10 feet downstream of the pipe outlet. To maintain water flow during
construction, water upstream of this impervious structure will be temporarily pumped out
and conveyed downstream of the construction activity where it will be allowed to filter
through vegetation before flowing into the stream. The stream will be dewatered less
than three days. This will result in temporary impacts to the surface water. Temporary
impacts to the streams from this activity will result in the dewatering of <0.01 ac of
stream bed and 20 linear feet stream channel. The rip rap underlain with filter fabric will
be removed after construction.
Waters of the U.S. Mitigation
Avoidance: All wetlands and surface waters not affected by the project will be
protected from unnecessary encroachment. No staging of construction equipment or
storage of construction supplies will be allowed in wetlands or near surface waters.
Minimization: The side slopes have been steepened to the extent possible at
jurisdictional sites. Strict enforcement of sedimentation and erosion control Best
Management Practices for the protection of wetlands and surface waters will be enforced
during project construction. Continued coordination will occur with maintenance forces
and the Environmental Officer during construction to minimize impacts to these sites.
Compensatory Mitigation: Construction of the project will result in only minimal
impacts to waters of the United States. Impacts have been avoided and minimized to the
maximum extent possible during the design process. Due to minimal impacts,
compensatory mitigation for stream and wetland impacts will not be provided for this
project.
Riparian Buffer Impacts
The unnamed perennial tributary to Fox Creek is not depicted on the most recent
version of the Louisburg, North Carolina topographic quadrangle (USGS 1978,
photoinspected 1984) (Figure 1). Personnel from the Natural Resource Conservation
Service in Franklin County stated that the Soil Survey of Franklin County has not yet
been published. Therefore, the construction of the project involves a road crossing of a
stream that is not subject to the Tar-Pamlico River Riparian Buffer Rule.
Protected Species
Plants and animals with federal classifications of Endangered, Threatened,
Proposed Endangered and Proposed Threatened are protected under provisions of Section
7 and Section 9 of the ESA. As of February 27, 2001, there are three federally-protected
species listed for Franklin County. They include dwarf wedgemussel (Alasmidonta
. 11
heterodon), Tar spinymussel (Elliptio steinstansana) and Michaux's sumac (Rhus
michauxii). Biological Conclusions of No Effect have been rendered for each species.
Summary
NCDOT proposes to replace an existing pipe conveying an unnamed perennial
tributary to Fox Creek on SR 1600 (East River Road) in Franklin County. Permanent
impacts at the project include <0.01 acre fill in surface water, 20 linear feet existing
channel impacted and <0.01 acre fill in wetland: Temporary impacts to the streams from
dewatering activity will involve <0.01 ac of stream bed and 20 linear feet stream channel.
Application is hereby made for a Department of the Army Section 404
Nationwide Permit (NWP) 3 and NWP 33. Additionally, this application provides
notification to the NCDWQ as Section 401 Water Quality Certification (WQC) No. 3290
and No. 3114 will be utilized for construction of this project. The NCDOT will comply
with all applicable NWP and WQC conditions. A pre-construction notification is
attached with this request. If you have any questions or need additional information,
please contact me at [phone].
Sincerely,
Christopher A. Murray, P.W.S.
Environmental Officer
cc: Mr. John Dorney, NCDWQ, Raleigh
Mr. Scott Capps, P.E., NCDOT District Engineer, Henderson
Mr. Jonathan Tyndall, NCDOT, Bunn

Q? V4 A T?
UJ,: It Pre-Construction Notification (PCN) Application Doran

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' (USAGE)
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.xisa.ce.armv.mil/wetlands/Perrn__app.htm.
The USACE is the lead regulatory agency. To review the requirements for the use of Nationwide,
Regional or General permits, and to determine which permit applies to your project, please go to the
USACE website at http://www.saw.usace.army. mil/-uyetlands/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/ncwetiands to read about current requirements for the 401 Water Quality
Certification Program and to determine whether or not Riparian Buffer Rules are applicable. The
applicant is also advised to read the full text of the General Certification (GC) matching the specific 404
Permit requested. In some cases, written approval for some General Certifications is not required,
provided that the applicant adheres to all conditions of the GC. Applicants lacking access to the internet
should contact DWQ's Central Office in Raleigh at [phone].
Trout Waters Coordination - Special coordination with the North Carolina Wildlife Resources
Commission (NCWRC) is also required for projects occurring in any of North Carolina's twenty-five
counties that contain trout waters. In such cases, the applicant should contact the appropriate NCWRC
regional coordinator (listed by county on the last page of this application).
Page 1 of 11
r?
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 ht_/hv-vvw.saw.us ce.army.mil/wetlands/nyv t111a1F. ?X,?eg?df.
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:i'/h2o.chnr.stite.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 11

Office Use Only:
Form Version April 2001
0 11620
USAGE 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:
® Section 404 Permit
? Section 10 Permit
® 401 Water Quality Certification
? Riparian or Watershed Buffer Rules
NOTE: Proiect is located in Tar-Pamlico River Basin: however, strewn crossing is not subiect to
Rule.
2. Nationwide, Regional or General Permit Number(s) Requested: NWP 3 and NWP 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: NCDOT/Christopher A. Murray
Mailing Address: 2612 N. Duke Street Durham NC 27704
Telephone Number: [phone] Fax Number: _ [phone]
E-mail Address: cmurravna.dot.state.nc.us
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:
Company Affiliation:
Mailing Address:
Telephone Number: Fax Number:
E-mail Address:
Page 3 of 11
M. 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: SR 1600 (East River Road) in Franklin County.
2. T.I.P. Project Number (NCDOT Only): NCDOT Division Project non-TIP)
3. Property Identification Number (Tax PIN): N/A
4. Location
County: Franklin Nearest Town: Louisburg
Subdivision name (include phase/lot number): N/A
Directions to site (include road numbers, landmarks, etc.):_ From Louisburg travel east on
NC 56. Turn right and travel south east on SR 1600 to project study area
5. Site coordinates, if available (UTM or Lat/Long): UTM 17 744383E 3997833N
(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: Site is
surrounded by commercial buildings residential houses and wooded land
7. Property size (acres): Project footprint is 0.07 acres
8. Nearest body of water (stream/river/sound/ocean/lake): Unnamed Tributary to Fox Creek
9. River Basin: Tar-Pamlico River
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http:,r,h2o.enr.state.ne_us/admin/Wraps/.)
10. Describe the purpose of the proposed work: Proposed pipe replacement at SR 1600 (East
River Road). The existing 60 foot concrete pipe will be replaced with a 60 foot pipe The
stream will be temporarily dewatered for three davs during construction
Page 4 of 11

,1 1. List the type of equipment to be used to construct the project: Excavator and Backhoe.
12. Describe the land use in the vicinity of this project: Scattered commercial buildings
residential houses and wooded land.
IV. Prior Project History
If jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Include
the USACE Action ID Number, DWQ Project Number, application date, and date permits and
certifications were issued or withdrawn. Provide photocopies of previously issued permits,
certifications or other useful information. Describe previously approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits issued for prior segments of the same T.I.P. project, along with
construction schedules.
No previous project jurisdictional determination or permit history associated with site
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: None anticipated.
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 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***
Site 1 Fill <0.01 No Adjacent Emergent-scrub-shrub

* List each impact separately and identify 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 htq)://eN,vw.1'e na. goy.
Page 5 of 11
I
*** 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: <0.01 acre on site.
Total area of wetland impact proposed: <0.01 acre on site.
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 Im ct Perennial or
Intermittent?
( lease specify)
Site 1 Rip Rap 20 UT Fox Ck. 2 feet Perennial
Site 1 Dewater (Temporary) 20 UT Fox Ck. 2 feet Perennial

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: culverts and associated rip-rap,
dams (separately list impacts due to both structure and flooding), relocation (include linear feet before and after, and net loss/gain),
stabilization activities (cement wall, rip-rap, crib wall, gabions, etc.), excavation, ditching/straightening, etc. If stream relocation is
proposed, plans and profiles showing the linear footprint for both the original and relocated streams must be included
* * Stream names can be found on USGS topographic maps. If a stream has no name, list as UT (unnamed tributary) to the nearest
downstream named stream into which it flows. USGS maps are available through the USGS at 1-800-358-9616, or online at
Lv v,v- t gs c?. Several internet sites also allow direct download and printing of USGS maps (e.g., NNA- lin,
,
t lv?t.nt,uuest.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: 20 feet permanent fill and
20 feet temporary dewatering.
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 Waterbod
(if applicable) y Type of Waterbody
(lake, pond, estuary, sound,
bay, ocean, etc.

* List each impact separately and identify 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.):
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.):
Size of watershed draining to pond: Expected pond surface area:
VII. Impact Justification (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It may be useful to provide
information related to site constraints such as topography, building ordinances, accessibility, and
Page 6 of I I

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.
All wetlands and surface waters not affected by project construction will be protected from
unnecessary encroachment. The side slopes at the jurisdictional site has been steepened to the
maximum extent possible. Strict enforcement of Best Management Practices for the protection
of wetlands and surface waters will be enforced during construction Only the smallest amount
of fill necessary to complete the project will be placed in waters of the United States
VIII. Mitigation
DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC
Division of Water Quality for projects involving greater than or equal to one acre of impacts to
freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial
streams.
USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on March 9, 2000, mitigation will be required when
necessary to ensure that adverse effects to the aquatic environment are minimal. Factors
including size and type of proposed impact and function and relative value of the impacted
aquatic resource will be considered in determining acceptability of appropriate and practicable
mitigation as proposed. Examples of mitigation that may be appropriate and practicable include,
but are not limited to: reducing the size of the project; establishing and maintaining wetland
and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of
aquatic resource functions and values by creating, restoring, enhancing, or preserving similar
functions and values, preferable in the same watershed.
If mitigation is required for this project, a copy of the mitigation plan must be attached in order
for USACE or DWQ to consider the application complete for processing. Any application
lacking a required mitigation plan or NCWRP concurrence shall be placed on hold as
incomplete. An applicant may also choose to review the current guidelines for stream restoration
in DWQ's Draft Technical Guide for Stream Work in North Carolina, available at
btAV.Hh2o.enr.state.nc.us/ne-,vetlands/strmgide.htm].
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.
Not Applicable.
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
Page 7 of 11
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 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
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 ? No ® If you answered "yes", provide the following information:
NOTE: Proiect is located within the Tar-Pamlico River Basin; however, stream crossinL is not
subiect to the Rule.
Page 8 of 11
.l
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.
I I * Impact Required
Zone f-_- f v+, Multiplier
1 0 3
2 0 1.5
Total 0 I L
* Zone 1 extends out 30 feet perpendicular from near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.
If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation
of Property, Conservation Easement, Riparian Buffer Restoration / Enhancement, Preservation or
Payment into the Riparian Buffer Restoration Fund). Please attach all appropriate information as
identified within 15A NCAC 213 .0242 or.0260.
XI. Stormwater (DWQ Only)
Describe impervious acreage (both existing and proposed) versus total acreage on the site.
Discuss stormwater controls proposed in order to protect surface waters and wetlands
downstream from the property.
Existing: 0.02 acre impervious surface of 0.07 acre total project size Proposed: 0.02 acre
impervious surface of 0.07 acre total project size Erosion and sediment control devices along
the project may be comprised of silt fence temporary rock sediment dam, temporary silt basin
temporary rock silt check dam and rock pipe inlet sediment trap All temporarily disturbed areas
will be revegetated after construction.
XII. Sewage Disposal (DWQ Only)
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from the proposed project, or available capacity of the subject facility.
The project will not generate wastewater.
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
Page 9 of 11
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).
H, .?\ o
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
Telephone: [phone] Chowan Hertford Pasquotank
Fax: [phone] 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 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 Fishenes 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]
Page 10 of 11
. j
Division of Water Quality
401 Wetlands Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
Telephone: [phone]
Fax: [phone]
North Carolina State Agencies
Division of Water Quality
Wetlands Restoration Program
1619 Mail Service Center
Raleigh, NC 27699-1619
Telephone: [phone]
Fax: [phone]
CAMA and NC Coastal Counties
State Historic Preservation Office
Department Of Cultural Resources
4617 Mail Service Center
Raleigh, NC 27699-4617
Telephone: [phone]
Fax: [phone]
Division of Coastal Management Beaufort Chowan Hertford Pasquotank
1638 Mail Service Center Bertie Craven Hyde Pender
Raleigh, NC 27699-1638 Brunswick Currituck New Hanover Perquimans
Telephone: [phone] Camden Dare Onslow Tyrrell
Fax: [phone] Carteret Gates Pamlico Washington
NCWRC and NC Trout Counties
Western Piedmont Region Coordinator Alleghany Caldwell Watauga
3855 Idlewild Road Ashe Mitchell Wilkes
Kernersville, NC 27284-9180 Avery Stokes
Telephone: [phone] Burke Surry
Mountain Region Coordinator Buncombe Henderson Polk
20830 Great Smoky Mtn. Expressway Cherokee Jackson Rutherford
Waynesville, NC 28786 Clay Macon Swain
Telephone: [phone] Graham Madison Transylvania
Fax: [phone] Haywood McDowell Yancey
Page 11 of 11
\?.. f r r ! ?? r' i / F \ f I lTOW r' G '?\
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286
A& 41p.
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c Fairgrounds -= / sfa ? ,1 \ / i? J no ! / `\\.. r "\? I o1,11 ® ' ? ? ,. \ •\ \`?.-_Ir.. • ? :4:19 i / ' ir/ __ ./ , \
/ l/- _ \ ?/ /. / 1? •? \ ? ? l G I. (p/ ?, 'tom /,'
210 '' '? ? w ? ? u
II
BM i n \SCO _/
\ J;'
\J I/' I /!-_`` \ 1 \y'I O ??' i(4 \_ ?? `j ••• j J'.t° • I 6 \ i ^\?Y,e,1{, ??. PROJECT SITE ^\ '`\11`; \
/ -? /- I / I; I?,r??? lil > . ,.. \ • :• / , , e? ,' lT' `\ '\. v%j o Sewa e i
\' I,.' 112x) /? / ?C ?? ?\ ??` \ \?? )_\~
56
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Ft:
0
401
?;J ? / ` \ r--? ? - ? • ? ^ , ,? J I (• , ?/ -- X11 .-?
?? ?\? ??/`?1 ?` • ?? \ i \1439\) ' - -?\ \J ) ? - j? ? 1 1 , ,;
( \`BM \\? \ 1? \\ J ' - 1 YS83 J j/ // '' / J \ O
00
I l .,\
11 ?b
\\ OLD V ?A ??
250
Project Study Area
r i u ?? \ `-\u•-- ?'
SR 1600 East River Road
Franklin County
Louisburg USGS Topo Map (1978, 1984)
Figure 1 1:24,000

a
TEMPORARY PLACEMENT
OF RIP RAP TO FACILITATE
DEWATERING OF STREAM
SR 1600

TEMPORARY PLACEMENT
OF RIP RAP TO FACILITATE
DEWATERING OF STREAM

Note:
Wetland 4-
Rip Rap 00000
0
II
II
II
II
II
II
------------------------
II
II
II
II
---I?----------------------
I
II
Site 1-Construction Impact
SR 1600 East River Road
Franklin County
Figure 2 I"=20'
DATA FORM
ROUTINE WETLAND DETERMINATION
(1937 COO Wetlands Delineation Manual)

FrojectlSite: 5(21600 Date: ?o(14?a
Applicant?Owner: A) r Zsz: County:
Investigator: c_ ... r State: A; t
Do Normal Circumstances exist on the site? No Community ID:. Wet-Can
Is the site significantly disturbed (Atypical Situation)? Yes ? Transact ID: 5,1c I
Is the area a potential Problem Area? Yes t?q Plot ID:
(If needed, explain on reverse.)
VEGETATION
Dominant Plant Soecies Stratum Indicator Dominant Plant Soecies_ Stratum Indicator
1. IC n'$1 C d24 s15 9.
2. S'Q* 11- 104
3. 1 r+(?)aE= cng fq¢eAS ? ? 11Cw 11.
4. CwrcK (-{- 12.
5. on r. Swey: bate,M _ ©6L-- 13.
6. P4 w a U+ r? t n % C r !
14 kD CL_ 14.
7. 15.
8. 16.
Percent of Dominant Species that are.OBL, FACW or FAC
U C -
0
(excluding FAC-). G
Remarks:
?l2va.,.enCC osr
?`-U+At,?j??t.?'?G
$Q?Ct?°Oj a'l: 5+ 1"?
HYDROLOGY
Recorded Data (Describe in Remarks): Watland Hydrology Indicators:
_
-Stream, Lake, or ride Gauge Primary Indicators:
_ Aerial Photographs _ Inundated
Other -Saturated in Upper 12 Inches
_
,,-'No Recorded Data Available Water Marks
T
Drift Lines

_ Sediment Deposits
Field Observations: Drainage Patterns in Wetlands
Secondary Indicators (2 or more required):
Depth of Surface Water: (in.) _ Oxidized Root Channels in Upper.12 Inches
_ W3ter-Stained Leaves
Depth to Free Water in Pit: l Z ` (in.) _ Local Soil Survey Data
FAC-Neutral Test
Depth to Saturated Soil: ',in.) _
r Other (Explain in Remarks)
Remarks:
+

SOILS
MV qp Unit Nsm?
(Series and Phase):
Drainage Class:

Taxonomy (Subgroup): Field Observations
Confirm Mapped Type? Yes No
Profile Descriction:
Depth Matrix Color
(inches Horizon (Munseil Moist) Mottle Colors Mottle Texture, Concretions,
(Munsell Moist) Abundanca/Contrast Stru
ture, etc,
75-,-1 'Z3?- c
Hydric Soil Indicators:
_ Histosol Concretions
Histic Epipedon
^ - High Organic Content in Surface Layer in Sandy Soils
_
Sulfidic Odor Organic Streaking in Sandy Soils
-___ Aquic Moisture Regime Listed on Local Hydric Soils List
Reducing Conditions Listed on National Hydric Soils List
dyed or Low-Chrorna Colors Other (Explain in Remarks)
Remarks:

WETLAND DETERMINATION
Hydrophytic Vegetation Present? a No (Circle) (Circle)
Wetland Hydrology Present? No
Hydric Soils Present? s No Is this Sampling Point Within a Wetland? J
No
Remarks:
W 20- \A I'> ci l ?-4 CniQ 2, ?4/a n e ??rs err .f ?Q?QAf-- 01
DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 CDr Wetlands Delineation Manual)
project/Sits: 59- 160c> Da-te: t0l(Cil of
Applicant/Owner: c?L> Ai County: } rAnk {,?
Investigator: c ?rc Stata: NC
Do Normal Circumstances exist on the site? a No Community ID:. U ,%S
Is the site significantly disturbed (Atypical Situation)? Yes to Transact ID: 5,r-c
Is the area a potential Problem Area? Yes a Plot ID:
(if needed, explain on reverse.)
VEGETATION
Dominant Plant Species Stratum Indicator Dominant Plant Species Stratum Indicator
1.{rOA,1S sfe-n+L^2= - - C? s. M,cr? s?e???.. ViMtilduw.?? ?
C
2. cr r, j,fyM 10.
T
3.7r?t?0. x pJnw- ?1 JX ? fiAc- 11.
4eA4--J 12.
5 ' 9 0 o. f ,,- 5(--1 roc; Pt,?, k fFG f-- 13.
F 6 G 14.

S. Fe 5-1<? c ct 5 Q, ?- 16.
Percent of Dominant Species that ara.0BL, FACW or FAC 0

(excluding FAC-).
3 7J < J
Remarks:
4<Itjet k-CIA C . a? ?-(? a p?+-e ?`i c
S ?eC S q f- St` ?e
HYDROLOGY
Recorded Data (Describe in Remarks): Wetland Hydrology Indicators:
Stream, Lake, or Tide Gauge Primary Indicators:
Aerial Photographs _ Inundated
_ Other -Saturated in Upper 12 Incites
_ No Recorded Data Available _ Water Marks
Drift Lines
_
Sediment Deposits
Field Observations: Drainage Patterns in Wetlands
Secondary indicators (2 or more required):
Depth of Surface Water: (in.) Oxidized Root Channels in Upper.12 Inches
Water-Stained Leaves
Depth to Free Water in Pit: (in.) Local Soil Survey Data
FAC-Neutral Test
Depth to Saturated Soil: (in.) _ Other (Explain in Remarks'
Remarks:
(if4(a-1d' ??cJ"olo?.1 ?s ? of eV1h"t

SOILS

Man Unit Name
(Series and Phase): Drainage Class:

Taxonomy {Subgroup}: Field Observations
Confirm Mapped Type? Yes No
Profile Descriation
Depth
inches Horizon Matrix Color
(Munssll Moist Mottle Colors
(Muns.311 Moist) Mottle Texture, Concretions,
Abundance/Contrast Structure, etc.
0-00
S n ? d Q
,ti-?

B
Hydric Soil Indicators:
Histosol
Histic Epipedon
_ Suifidic Odor
Aquic !Moisture Regime
_ Reducing Conditions
Gleysd or Low-Chroma Colors
_ Concretions
_ High Organic Content in Surface Layer in Sandy Soils
Organic Streaking in Sandy Soils
Listed on Local Hydric Soils List
Listed on National Hydric Soils List
Other (Explain in Ran-arks)
Remarks:
e
WETLAND DETERMINATION
Hydrophytic Vegetation Present? as No (Circle) (Circle)
Wetland Hydrology Present? s
Hydric Soils Present? Yes o Is this Sampling Point Within a Wetland? Ye 10
a
t Remarks:
P(?<,4 ^ F- q t- 5 4C
?l
WETLAND RATING WORKSHEET (4th VERSION),
Project Name: SX Iboo County: t=rGtik-1t-
Nearest Road: 5 Date:
Wetland Area (ac) : stye Wet land Width (ft): 13 -
Name of Evaluator(s) : c4,,,5 mvrrc-.;b
Wetland Location:
on sound or estuary
pond or lake
"n perennial stream
on intermittent stream
within interstream divide
other
Soiis
Soil Series n!(A-
predominantly organic
(humus, muck or peat)
predominantly mineral (non-sandy)
predominantly sandy
H-..rdr'aulic Factors
freshwater brackish
steep topography
ditched or channelized
total wetland width > 100 feet.
Adjacent Land Use:
(Within 1/2 mi upstream,
upslope, or radius)
/-forested/natural veg. _;
f'" agriculture/urbanized
impervious surface;
Adjacent Special Natural Areas
Dominant Vesetation
(1)
(2)
(3)
loodin; and wetness
semipermanently to
permanently flooded or
inundated
_,:?'seasonal ly flooded or
inundated
intermittently flooded or
.temporary surface water
Wetland Type (select one)* no evidence of flooding or
Bottomland Hardwood Forest, surface water
Swamp Forest Bog/Fen
Carolina Bay Headwater Forest
Pocosin Bog Forest
Pine Savannah Ephemeral Wetland
Freshwater Marsh / Other: -o
*The rating system cannot be applied to salt or brackish marshes or
stream channels.
WATER STORAGE.
ia.:Y:G., Ll`lI'. .)Ii•Ysa?......,....a..
POLLUTANT REMOVAL
WILDLIFE HABITAT
AQUATIC LIFE VALUE
RECREATION/LDUCATION
$ Add I point if in sensitive watershed
.... - . - . I _0 I - - .
DEM RAT I-NG
2 x 4.00 =

(/ * x 5.00
t
2.0 0 =
2' x
=
4.00
--
,__?_? x 1.00 =
WETLAND SCORE =
(TOTAL)
and >10%, nonpoint disturbance