20011250 Ver 1_Complete File_20010820

F WA TF Michael F. Easley, Governor
OHO 9pG William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
`
r - Gregory J. Thorpe, Ph.D.
> y Acting Director
p -q Division of Water Quality
October 15, 2001
Henderson County
DWQ Project No. 011250
SR 1712 (Ledbetter Road)
APPROVAL of 401 Water Quality Certification with Additional Conditions
Mr. E.A. Green, P.E., District Engineer
NCDOT
4142 Haywood Road
Horseshoe, NC 28742
Dear Mr. Green:
You have our approval, in accordance with the attached conditions and those listed below, to impact
100 linear feet of Turnbreeches Creek and two of its unnamed tributaries in order to upgrade SR 1712
(Ledbetter Road) in Henderson County. The project should be constructed in accordance with your
application dated 13 August 2001 (received 20 August 2001). After reviewing your application, we
have decided that this fill is covered by General Water Quality Certification No. 3289 corresponding
to the U.S. Army Corps of Engineers Nationwide Permit Number 14. 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 only valid for the purpose and design that you described in your application except as
modified below. If you change your project, you must notify us in writing, and you may be required
to send us a new application. If the property is sold, the new owner must be given a copy of this
Certification and approval letter and is thereby responsible for complying with all conditions. If total
wetland fills for this project (now or in the future) exceed one acre, compensatory mitigation may be
required as described in 15A NCAC 211.0506 (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 below.
1. Sedimentation and Erosion Control Guidelines for Sensitive Watersheds (15A NCAC 4B .0024)
must be implemented prior to any ground-disturbing activities to minimize impacts to
downstream aquatic resources. Temporary or permanent herbaceous vegetation shall be planted
on all bare soil within 10 days of ground-disturbing activities to provide long term erosion
control.
2. Stormwater must be directed to buffer areas or retention basins and must not be routed directly
into streams.
3. In-stream work and land disturbance within the 25-foot wide buffer zone are prohibited during the
trout spawning season of October 15 through April 15, or other conditions as determined by the
North Carolina Wildlife Resources Commission, to protect the egg and fry stages of trout from
sedimentation during construction. Exceptions to the Trout Water Buffer Zone shall consist
solely of work from Sta. 15+00 to Sta. 20+00 and Sta. 20+00 to Sta. 20+00 to Sta. 24+00.
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:/fh2o.enr.state.nc.us/ncwetlands/
4. All culverts required for this project shall be installed in such a manner that the original stream
profiles are not altered (i.e. the depth of the channel must not be reduced by a widening of the
streambed). Existing stream dimensions are to be maintained above and below locations of
culvert extensions. Culverts shall be installed one foot below the stream to allow for fish and
other wildlife movement.
5. All work shall be performed during low flow conditions.
6. All mechanized equipment operated near surface waters must be regularly inspected and
maintained to prevent contamination of stream waters from fuels, lubricants, hydraulic fluids, or
other toxic materials.
7. The presence of equipment in the channels must be minimized. Under no circumstances shall
rock, sand or other materials be dredged from the wetted stream channel under authorization of
this permit, except in the immediate vicinity of the culverts.
8. Existing vegetated buffers shall not be mowed in order to utilize it for storm water sheet flow.
9. Use of rip-rap for bank stabilization is to be minimized; rather, native vegetation is to be planted
when practical. If necessary, rip-rap must be limited to the stream bank below the high water
mark, and vegetation must be used for stabilization above high water.
10. Rock silt screens at culvert outlets shall be removed at project completion.
Upon completion of the project, the NCDOT shall complete and return the enclosed
"Certificate of Completion" form to notify NCDWQ 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 NC 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, 6714 Mail Service Center, Raleigh, N.C. 27699-6714. 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 Ms. Cynthia Van Der Wiele at 919-733-9646
or Mr. Mike Parker of the Asheville Regional Office at 828.251.6208.
Attachment
Pc: Wilmington District Corps of Engineers
Corps of Engineers Asheville Field Office
NCDWQ Asheville Regional Office
Central Files
File Copy

F WAIF Michael F. Easley, Governor
O?0 19 William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
\
r Gregory J. Thorpe, Ph.D.
> Acting Director
p Division of Water Quality
August 23, 2001
Henderson County
DWQ Project No. 011250
SR 1712 (Ledbetter Road)
APPROVAL of 401 Water Quality Certification with Additional Conditions
Mr. E.A. Green, P.E., District Engineer
NCDOT
4142 Haywood Road
Horseshoe, NC 28742
Dear Mr. Green:
You have our approval, in accordance with the attached conditions and those listed below, to impact
100 linear feet of Turnbreeches Creek and two of its unnamed tributaries in order to upgrade SR 1712
(Ledbetter Road) in Henderson County. The project should be constructed in accordance with your
application dated 13 August 2001 (received 20 August 2001). After reviewing your application, we
have decided that this fill is covered by General Water Quality Certification No. 3289 corresponding
to the U.S. Army Corps of Engineers Nationwide Permit Number 14. 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 only valid for the purpose and design that you described in your application except as
modified below. If you change your project, you must notify us in writing, and you may be required
to send us a new application. If the property is sold, the new owner must be given a copy of this
Certification and approval letter and is thereby responsible for complying with all conditions. If total
wetland fills for this project (now or in the future) exceed one acre, compensatory mitigation may be
required as described in 15A NCAC 2H .0506 (h) (6) and (7). For this approval to be valid, you must
follow the conditions listed in the attached certification and any additional conditions listed below.
1. Deed notifications or similar mechanisms shall be placed on all remaining jurisdictional wetlands
and waters to notify the State in order to assure compliance for future wetland and/or water
impact. These mechanisms shall be put in place within 30 days of the date of this letter or the
issuance of the §404 Permit, whichever is later.
2. A final, written stormwater management plan shall be approved by this Office before the impacts
specified in this Certification occur. The stormwater management plan must include plans and
specifications for stormwater management facilities designed to remove 85% TSS according to
the most recent version of the NCDENR Stormwater Best Management Practices Manual.
3. Sedimentation and Erosion Control Guidelines for Sensitive Watersheds (15A NCAC 413 .0024)
must be implemented prior to any ground-disturbing activities to minimize impacts to
downstream aquatic resources. Temporary or permanent herbaceous vegetation shall be planted
on all bare soil within 10 days of ground-disturbing activities to provide long term erosion
control.
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/ncwetlands/
4. In-stream work and land disturbance within the 25-foot wide buffer zone are prohibited during the
trout spawning season of October 15 through April 15, or other conditions as determined by the
North Carolina Wildlife Resources Commission, to protect the egg and fry stages of trout from
sedimentation during construction. Exceptions to the Trout Water Buffer Zone shall consist
solely of work from Sta. 15+00 to Sta. 20+00 and Sta. 20+00 to Sta. 20+00 to Sta. 24+00.
5. All culverts required for this project shall be installed in such a manner that the original stream
profiles are not altered (i.e. the depth of the channel must not be reduced by a widening of the
streambed). Existing stream dimensions are to be maintained above and below locations of
culvert extensions. Culverts shall be installed one foot below the stream to allow for fish and
other wildlife movement.
6. All work shall be performed during low flow conditions.
7. All mechanized equipment operated near surface waters must be regularly inspected and
maintained to prevent contamination of stream waters from fuels, lubricants, hydraulic fluids, or
other toxic materials.
8. The presence of equipment in the channels must be minimized. Under no circumstances shall
rock, sand or other materials be dredged from the wetted stream channel under authorization of
this permit, except in the immediate vicinity of the culverts.
9. Existing vegetated buffers shall not be mowed in order to utilize it for storm water sheet flow.
10. Use of rip-rap for bank stabilization is to be minimized; rather, native vegetation is to be planted
when practical. If necessary, rip-rap must be limited to the stream bank below the high water
mark, and vegetation must be used for stabilization above high water.
11. Rock silt screens at culvert outlets shall be removed at project completion.
Upon completion of the project, the NCDOT shall complete and return the enclosed
"Certificate of Completion" form to notify NCDWQ 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 NC 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, 6714 Mail Service Center, Raleigh, N.C. 27699-6714. This
certification and its conditions are final and binding unless you ask fora 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 Ms. Cynthia Van Der Wiele at 919-733-9646
or Mr. Mike Parker of the Asheville Regional Office at 828.251.6208.
Attachment
Pc: Wilmington District Corps of Engineers
Corps of Engineers Asheville Field Office
NCDWQ Asheville Regional Office
Central Files
File Copy
d M ST r,
FILE COPY
G
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY LYNDO TIPPETT
Gon EKNOR
Secretary
August 14, 2001
Mr. John Dorney
Division of Water Quality/ Wetlands Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
Subject: Warrant No. 11574 (31-12,50
SR 1712, Ledbetter Road
Work Order 6.952601
I-Ienderson County
Dear Mr. Dorney,
Attached is a check number 11574 in the amount of $200.00 for the subject road. This
check is for the Division of Water Quality's section 401 general certification. If you need
further information in this matter please contact me.
Since
Edward A. Green, PE
District Engineer
EAG/njg
PAY TNT
RECEIVED
Division Id, District I
Phone. (S38)S91-7911 4113 Hayscood Road, Horse Shoe, NC 387.3 Fax: [phone]
1
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY
GovER\oR
•; qj jCt..i J LED
August 13, 2001
Mr. Steve Lund
LYNDO TIPPETT
SECRETARY
U. S. Army Corps of Engineers r-
151 Patton Avenue
Room 143
Asheville, NC 28801
SUBJECT: Proposed Secondary Road Construction
SR 1712, Ledbetter Road
Henderson County
Dear Mr. Lund,
Attached are erosion control plans, an application form for a Nationwide Permit, and a county
map section locating SR 1712, Ledbetter Road, in Henderson County. SR 1712 is a gravel road
that we propose to clear, grub, grade, replace/extend pipes, and pave for a distance of 0.88 miles.
Grading will be moderate to heavy.
We are requesting permission to replace and extend pipes in live streams as noted on plans and
the attached pipe schedule. Pipes will be replaced using our standard method of pipe installation
described in the erosion control plans. NCDOT " Best Management Practices for Protection of
Surface Waters" and proper phasing of erosion control items will be used to minimize and
control sedimentation and erosion.
By copy of this letter to Mr. Richard Phillips, P. E., (DENR) we are requesting a variance to
work in the Trout Water Buffer Zone at locations, described as follows:
Stream Station Range Location
Turnbreeches Creek 15+00- 20+00 Rt.
Turnbreeches Creek 20+00 - 24+00 Lt.

Steve Lund
Page 2
August 13, 2001
Please note that we do not proposed to disturb fill slopes in these locations with the exception of
pipe placement/replacement as indicated on the attached erosion control plans. We are
requesting Mr. Phillips approve our request for said variance when he receives the required
comments from Mr. E. L. Ingle, Area Roadside Environmental Engineer, and Mr. Owen
Anderson, N. C. Wildlife Resources Commission.
Also by copy of this letter, authorization to proceed under section 401 of the Clean Water Act is
being requested from Mr. John Domey, Division of Water Quality.
By copy of this letter, we are asking Mr. Owen Anderson, N. C. Wildlife Resources Commission,
to comment to the Corps of Engineers concerning the Nationwide Permit request and Mr.
Phillips, DENR, concerning the trout water buffer zone variance. Upon review or the Corps of
Engineers we are requesting that Mr. Anderson forward a copy to us (NCDOT) as well.
By copy of this letter, we are also asking Mr. Ed Ingle, Area Roadside Environmental Engineer
(NCDOT), to comment directly to us on the above project.
Your earliest consideration for this request would be appreciated. If any further information is
needed, please contact me at [phone].
#Sincerel , our
Green, P. E.
District Engineer
EAG/SMS
attachment
cc: Mr. Richard Phillips, P. E., NCDENR
Mr. John Dorney, DWQ
Mr. Owen Anderson, Western Mountain Region Coordinator, NCWRC
Mr. E. L. Ingle, Area Roadside Environmental Engineer, NCDOT
Mr. Mark Davis, Division Environmental Officer, NCDOT
Mr. M. T. Gibbs, P. E., County Maintenance Engineer, NCDOT

?0 wArF9Q
?O G
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:/hvww.saw. usace.army.mil/wetlands/Penn 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 littp://Nvww.saw.usace.anny.mil/wetlands/re-gtour.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/ncwctlaiids 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 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://w,,vNv.saw.tisace.anny.mil/wetlands/nvpfinalFedReQ.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 5200 is required. If either of these thresholds is exceeded, then a fee of 5475 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://li2o.elinr.state.nc.us/ncwetlands/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.
Page 2 of 12
Office Use Only: Form 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.
I. 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
2. Nationwide, Regional or General Permit Number(s) Requested: 14
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: North Carolina Department of Transportation
Mailing Address: 4142 Havwood Road
Horseshoe, N.C. 28742

Telephone Number: [phone] Fax Number: [phone]
E-mail Address: NA
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: Edward A. Green, P.E.
Company Affiliation: District Engineer
Mailing Address: 4142 Havwood Road
Horseshoe, N.C. 28742

Telephone Number: [phone] Fax Number: [phone]
E-mail Address: egreen a.dot.state.nc.us
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: Ledbetter Road (SR 1712)
2. T.I.P. Project Number (NCDOT Only): NA
3. Property Identification Number (Tax PIN): see attachments
4. Location
County: Henderson Nearest Town:_ Edneyville
Subdivision name (include phase/lot number): NA
Directions to site (include road numbers, landmarks, etc.): Beflin at the intersection of SR
1602 and SR 1712 and proceed in a northerly direction for a total length of 4,650 feet to
the end of the project.
5. Site coordinates, if available (UTM or Lat/Long): see attachments
(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: Rural
Road
7. Property size (acres): 4,650' x 50'=5.34 acres
8. Nearest body of water (stream/river/sound/ocean/lake): Reedvpatcli Creek
9. River Basin: 47r-R,
pEL Broad
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http://h2o.enr.state.nc.us/adniin/neaps/.)
Page 4 of 12
10. Describe the purpose of the proposed work:_ Upgrade SR 1712 to minimum standards
for a NCDOT maintained road.
11. List the type of equipment to be used to construct the project: Widen and nave SR 1712
using hvdraulic excavators, back hoes, bulldozers, dump trucks, motor graders and
various hand tools.
12. Describe the land use in the vicinity of this project: Rural residential.
IV. Prior Project History
If jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Include
the USACE Action ID Number, DWQ Project Number, application date, and date permits and
certifications were issued or withdrawn. Provide photocopies of previously issued permits,
certifications or other useful information. Describe previously approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits issued for prior segments of the same T.I.P. project, along with
construction schedules.
NA
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: NA
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
Page 5 of 12
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***
NA

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 http://www.fema.gov.
*** List a wetland type that best describes wetland to be impacted (e.g., freshwater/saltwater marsh, forested wetland, beaver pond,
Carolina Bay, bog, etc.)
List the total acreage (estimated) of existing wetlands on the property: NA
Total area of wetland impact proposed: NA
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)
1 CHIP Extension 30' t Turnbreecles Creek 2' Perennial
2 CMP Extension 30' Turnbreeches Creek 2' Perennial
3 CMP Extension 20' UT/ Turnbreeches Ck. 1' Perennial
4 CMP Extension 20' UT/ Turnbreeches Ck. 1' 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
www.us¢s.eov. Several intemet sites also allow direct download and printing of USGS maps (e.g., w%,.w.topozonc.com,
www.mapquest.com, etc.).
Page 6 of 12
Cumulative impacts (linear distance in feet) to all streams on site: 100'
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.
NA

"IZIL ca611 1111Naci bcpa1aie1y ana iaenmy 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.): NA
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aestlietic, trout pond,
local stormwater requirement, etc.): NA
Size of watershed draining to pond: NA Expected pond surface area: NA
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.
See Attachments
Page 7 of 12
VIII. Mitigation
DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC
Division of Water Quality for projects involving greater than or equal to one acre of impacts to
freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial
streams.
USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on March 9, 2000, mitigation will be required when
necessary to ensure that adverse effects to the aquatic environment are minimal. Factors
including size and type of proposed impact and function and relative value of the impacted
aquatic resource will be considered in determining acceptability of appropriate and practicable
mitigation as proposed. Examples of mitigation that may be appropriate and practicable include,
but are not limited to: reducing the size of the project; establishing and maintaining wetland
and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of
aquatic resource functions and values by creating, restoring, enhancing, or preserving similar
functions and values, preferable in the same watershed.
If mitigation is required for this project, a copy of the mitigation plan must be attached in order
for USACE or DWQ to consider the application complete for processing. Any application
lacking a required mitigation plan or NCWRP concurrence shall be placed on hold as
incomplete. An applicant may also choose to review the current guidelines for stream restoration
in DWQ's Draft Technical Guide for Stream Work in North Carolina, available at
http://h2o.cnr.state.nc.us/ncwetlands/strm,i;ide.litml.
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 snap, 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.
NA
Page 8 of 12
2. Mitigation may also be made by payment into the North Carolina Wetlands Restoration
Program (NCWRP) with the NCWRP's written agreement. Check the box indicating that
you would like to pay into the NCWRP. Please note that payment into the NCWRP must be
reviewed and approved before it can be used to satisfy mitigation requirements. Applicants
will be notified early in the review process by the 401/Wetlands Unit if payment into the
NCWRP is available as an option. For additional information regarding the application
process for the NCWRP, check the NCWRP website at http://h2o.enr.state.nc.tis/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): NA
Amount of buffer mitigation requested (square feet): NA
Amount of Riparian wetland mitigation requested (acres): NA
Amount of Non-riparian wetland mitigation requested (acres): NA
Amount of Coastal wetland mitigation requested (acres): NA
IX. Environmental Documentation (DWQ Only)
Does the project involve an expenditure of public funds or the use of public (federal/state/local)
land?
Yes ? No
If yes, does the project require preparation of an environmental document pursuant to the
requirements of the National or North Carolina Environmental Policy Act (NEPA/SEPA)?
Note: If you are not sure whether a NEPA/SEPA document is required, call the SEPA
coordinator at [phone] to review current thresholds for environmental documentation.
Yes ? No ?
If yes, has the document review been finalized by the State Clearinghouse? If so, please attach a
copy of the NEPA or SEPA final approval letter.
Yes ? No ?
X. Proposed Impacts on Riparian and Watershed Buffers (DWQ Only)
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
required state and local buffers associated with the project. The applicant must also provide
justification for these impacts in Section VII above. All proposed impacts must be listed herein,
and must be clearly identifiable on the accompanying site plan. All buffers must be shown on a
map, whether or not impacts are proposed to the buffers. Correspondence from the DWQ
Regional Office may be included as appropriate. Photographs may also be included at the
applicant's discretion.
Page 9 of 12
Will the project impact protected riparian buffers identified within 15A NCAC 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 Impact
(square feet
Multiplier Required
Mitigation
1 3
2 1.5
Total
p-p aiuicuiar irom near oanK of enannel; Lone 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.
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.
XIII. Violations (DWQ Only)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes ? No ?
Page 10 of 12
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).
NA

9-/O-.o
Applicant/Agent'A 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
US Army Corps of Engineers Avery Clay Jackson Polk
151 Patton Avenue Buncombe Cleveland Lincoln Rowan
Room 208 Burke Gaston Macon Rutherford
Asheville, NC 28801-5006 Cabarrus Graham Madison Stanley
Telephone: [phone] Caldwell Haywood McDowell Swain
Fax: [phone] Catawba Henderson Mecklenburg Transylvania
Raleigh Regulatory Field Office Alamance Durham Johnston Rockingham
US Army Corps Of Engineers Alleghany Edgecombe Lee Stokes
6508 Falls of the Neuse Road Ashe Franklin Nash Surry
Suite 120 Caswell Forsyth Northampton Vance
Raleigh, NC 27615 Chatham Granville Orange Wake
Telephone: [phone] Davidson Guilford Person Warren
Fax: [phone] Davie Halifax Randolph Wilkes
Washington Regulatory Field Office Beaufort Currituck Jones
US Army Corps Of Engineers Bertie Dare Lenoir
Post Office Box 1000 Camden Gates Martin
Washington, NC 27889-1000 Carteret* Green Pamlico
Telephone: [phone] Chowan Hertford Pasquotank
Fax: [phone] Craven Hyde Perquimans
Wilmington Regulatory Field Office Anson Duplin Onslow
US Army Corps Of Engineers Bladen Harnett Pender
Pitt
Tyrrell
Washington
Wayne
Union
Watauga
Yancey
Wilson
Yadkin
*Croatan National Forest Only
Page 11 of 12
Post Office Box 1890 Brunswick Hoke Richmond
Wilmington, NC 28402-1890 Carteret Montgomery Robeson
Telephone: [phone] Columbus Moore Sampson
Fax: [phone] Cumberland New Hanover Scotland
US Fis
US Fish and Wildlife Service
Raleigh Field Office
Post Office Box 33726
Raleigh, NC 27636-3726
Telephone: [phone]
h and Wildlife Service / National iV
US Fish and Wildlife Service
Asheville Field Office
160 Zillicoa Street
Asheville, NC 28801
Telephone: [phone]
larine Fisheries Service
National Marine Fisheries Service
Habitat Conservation Division
Pivers Island
Beaufort, NC 28516
Telephone: [phone]
North Carolina State Agencies
Division of Water Quality
401 Wetlands Unit
1650 Mail Service Center
Raleigh, NC 27699-1650
Telephone: [phone]
Fax: [phone]
Division of Water Quality
Wetlands Restoration Program
1619 Mail Service Center
Raleigh, NC 27699-1619
Telephone: [phone]
Fax: [phone]
CAMA and NC Coastal Counties
State Historic Preservation Office
Department Of Cultural Resources
4617 Mail Service Center
Raleigh, NC 27699-4617
Telephone: [phone]
Fax: [phone]
Division of Coastal Management Beaufort Chowan Hertford Pasquotank
1638 Mail Service Center Bertie Craven Hyde Pender
Raleigh, NC 27699-1638 Brunswick Currituck New Hanover Perquimans
Telephone: [phone] Camden Dare Onslow Tyrrell
Fax: [phone] Carteret Gates Pamlico Washington
NCWRC and NC Trout Counties
Western Piedmont Region Coordinator Alleghany Caldwell Watauga
3855 Idlewild Road Ashe Mitchell Wilkes
Kernersville, NC 27284-9180 Avery Stokes
Telephone: [phone] Burke Surry
Mountain Region Coordinator Buncombe Henderson Polk
20830 Great Smoky Mtn. Expressway Cherokee Jackson Rutherford
Waynesville, NC 28786 Clay Macon Swain
Telephone: [phone] Graham Madison Transylvania
Fax: [phone] Haywood McDowell Yancey
Page 12 of 12
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STATE OF 1.911 ENGLISH STANDARD DRAWING FOR c
NORTH CAROLINA GUIDE FOR RIP RAP AT PIPE OUTLETS
DEPT. OF TRANSPORTATION!
DIVISION OF HIGHWAYS ? a
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TEntroaARY SIm' Dircit:
-TS D
A temporary silt ditch shall be used in place of silt fence in many situadons.
Temporary silt ditches shall be used at the toe of fill slopes to divert runoff into
sediment basins, temporary rock sediment dams, temporary rock silt checks and/or
other sedimentation control measures. T_emporary silt ditches are approximately 1
ft. deep, 2:1 side slopes with ap optional earth berm.
AREAS OF USE:
• Toe of fill slopes where fill exceeds 3 ft in vertical height.
• Alonog streams to intercept flow and/or divert to a controlled outlet.
V1-2 Nbrch, 1993
-II Uo-j EJrlIL1VUo (]UVONVLS HSIloN3
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STATE OF Uiyj
NORTH CAROLINA
DEPT. OF TRANSPORTATION
DIVISION OF HIGHWAYS
RALEIGH, N.C.
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McNIPOIZARY SILT' FENCL:
A temporary silt fence is commonly used at the toe of a fill section to prevent off-
site sedimentation. It is made of permeable filter fabric buried at the bottom,
stretched and supported by steel posts. The silt fence reduces the water flow while
retaining the sediment. They may also be used to divert water flow to protected
outlets. Silt fences need to be checked after each significant rainfall to ensure there
effectiveness. They must be maintained on a regular basis. Silt fences shall not be
installed across streams, ditches, or waterways.
AREAS OF USE:
• At toe of fill sections where sediment runoff can be stored and contained
inside the project limits.
DESIGN CRITERIA:
Material With Wire Without Wire
Fabric Type 3 Class A Type 3 Class B
Steel posts lencth 5 ft 5 ft.
Post spacing 10 ft. 6 ft. maximum
VI-6 March, 1993
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-` y ENGLISH STANDARD DRAINING FOR m STATE OF
0, TEMPORARY SILT FENCE NORTH CAROLINA
Cn -- DEPT. OF. TRANSPORTATION!
° DIVISION OF HIGH'` lAYS
RALEIGH, N.C..
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A silt basin type-B is a temporary basin built to collect sediment flo`vina
throu
drainage way. The silt basin is built at the base of the ditch with its IenQ? gh a
least 2 times the width of the basin. The type-B silt basin is generally builtbn?n° at
--onjunction with temporaryrock silt checks and other devices that control or slow
down water flow. This device must be monitored closely and cleaned out on a
regular basis until grass is established along the ditch line and sedimentation is no
longer a problem.
AREAS OF USE:
• In conjunction with tempor •
aryrock*silt checks and other G'vices used in
drainage ditches.
DESIGN C`9JTERL4:
e See Silt Basin Sizes Typical.
23 1/Iarch, 1992
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DEPT. OF'TRANSPORTATION
DIVISION! OF HIGHWAYS
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DEPT. OF TRANSPORTATION
DIVISI011 OF HIGHWAYS
RALEIGH, N.C.
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DEPT. OF TRANSPORT t11'IO ..I T"
NORTH CAROLINA ROCK PIPE INLET SEDIMEi1T TRAP TYPE 'A' ? i1 tl'r
DIVISION OF HIGHNAYS cl)
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Rocs: SILT SCREEN:

A rock silt screen is a low-level dam structure to be used in streams below culvert
sites. Rock silt screens shall be used to trap sediment transported by running water
and shall be placed in the stream below the construction site within the ri-ht-of-
way or easement boundary. The rock silt screen utilizes class B stone lined with n5
or n57 stone to produce a ripple-effect in the stream to settle the larger sediment
particles transported in the stream from the construction site. The trapped sediment
shall be cleaned out before the device is removed from the stream.
AREAS OF USE:
• In live streams below construction sites where construction occurs in or
adjacent to the stream.
• In live streams below a culvert construction site.
• Where it can be cleaned before it is removed from stream.
DESIGN CRITERIA:
• Structural stone - class B stone
• Sediment control stone - # 5 or tt 57 stone
• Dam height - 1.5 ft. minimum and 3 ft. maximum ( shall not be hi eher than
1 ft. above normal flow of stream) `
VI-2-1 M;irch, 1993
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ENGLISH STANDARD DRAWING FOR "`1} STATE OF
W " ROCK SILT SCREE! NORTH CAROLINA
DEPT. OF TRANSPORTATION
. o
o DIVISION OF HIGHWAYS
RALEIGH, H.C.
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NORTH CAROLINA DRAINAGE DITCHES WITH CLASS 'A' RIP RAP " °
DEPT. OF TRANSPORTATION o
DIVISION OF HIGMYAYS ?p
RALEIGH, N.C.
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NORTH CAROLINA DRAINAGE DITCHES WITH CLASS 'B' ?;Ip p?,p 1?'o rooo
DEPTDI. OF VISIOtJ OF HIGHWAYS TRANSPORTATION RALEIGH, N.C.

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'-V) X11:11 :t!1??!?I l`I 1lCli( Sl(!llr i?I' 1'C?ll'_'11 lirlliewn Cill:IrIv sion:. Ih: ston'y' sh;ll
;'.:1•.... }'_I_I1. ii.n? 1' ?;iClllt to tll, of ail' ait
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>;er, ? n?_r I t .n 1 1:(1 ?, ? ! ; rc„!`••_:?1_:?l is ; ?a!,:c.:t t??.t?.•
.`J USCU iii 1'laC f!i ai:n? l)1'Q\'1C::i1 Ju., 'I'.E? a')1 1'i.
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'11? li::_ ''!d ?!'t?:. :!? ;i:!I?f'Cl_ `?1?!:!? ?(i??i:1Li1i C.L1?41'?l!1? _r_el ??'11! nor L-r l):Iihlri?(l.
>ri ?iv!1': illy; i?l ei tit= al)rr01'aI to the L•Il?'N`hLe no _LeC1t!_ 1'aCl?i1J11 1: i':i7Ull.d, Illy
vailous size, 01, tli: stone 4zllau be e(luallY : istiibutcd tli" r:(lu1rLC1 Size Iail i il: si7..: 0_` ail
ind*, dual stony particle N\ih be d?telrl->;r?'?ci b%- measuh:L-la its Ion' dimension.
?IC)ne or broken con'_rete for Rip Rai) shall rrieLi the re(lulremenis o 1 abie iU ! -1 i01' the Class
TABLE 1642-I
ACCEPTANCE CRiTERI.a FOR FZIP R.?2
--?L,N-n STONE FOR EROSION CONTROL
1 EQ IRE D "ST n` r SIS - I.\CIi ES
I A 2 -I 6 I
IJ y 1 7
17
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?-ncc 0_ t .
_? rT •,_ u.,?l Cl. Of file Mat(i1ati furnis.lz;l can be I::is than tIV- IilIILu i?1 51L- si):CIIic'CI nor no
more than It,.W'o of 111-1 niar.Ilal can exceed the niaxI-num s1Z,- spec fled.
PEPE Iti'STALLATION
All pipe installed on the project will be installed using the standard method of pipe
installation - Method "A", Standard No. 300.01 of the NCDOT - "Roadway Standard
Drawings".
All pipes shall be laid in accordance with Section 300 of the North Carolina Department of
Transportation "Standard Specifications for Roads and Structures", July, 1995. Pipes mill
be installed in'the drywherever possible.
Pipes laid in streams large enough to support trout will be installed si.1 (6) inches below the
stream bed to allow the bottom of the pipe to silt over so that trout movement will be over
a natural stream bed.
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o° METHOD OF STRUCTURAL PLATE NORTH CAROLINA
o PIPE & PIPE ARCH INSTALLATION DEPT` OF TRANSPORTATION
W DIVISION 01 HIGHWAYS
MET110D 'A' RALEIGH, N.C.
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Typical Section
Showin; Proposed Work, & Erosion Control
Proposed
Slope
No grading to
be done on creek Buffer
side of evstvtQ Zone Existing
roadway. ? Slope
A
Stream
I
Grade, Base, and Pave Proposed
Widenin,z
(.Cut Side)
Ben shall be constructed cn shoulder a*td i«U be maintained tlroushout
construction. The roadway is to be sloped to the cut Side where possible. If not
possible, water N iU be released t1hru down slop: pipe or stone Lned ditches.
082° 19'0.00' W 082° 18'30.00" W 082°.18'0.00" W 082° 1T 30.00" W 082°.17' 0.00" W 082° 16' 30.00" 1/V
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C,
Name: BAT CAVE Location: 035° 23'56.7" N 082° 17'55.9" W
Date: 8/10/101 Caption: Ledbetter Road (SR 1712)
Scale: 1 inch equals 2000 feet
1997• h1artech. Inc.