20010091 Ver 1_Complete File_20010124

0tO?, W AT ?RQG
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o?.
Michael F. Easley
Governor
William G. Rass,•Jr., Secretary
Department of Environment and Natural Resources
C Gregory J. Thorpe, Ph.D.
Acting Director
Division of Water Quality
DWQ Project No.:County:
Applicant: ,uc, aT - Buis/vim /Z
Project Name: fF-0'` 61L'
Date of Issuance of 401 Water Quality Certification:
/ NGO 4-D
Z3 I ;Q. /33 8
Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification or applicable Buffer
Rules, and any subsequent modifications, the applicant is required to return this certificate to the
401/Wetlands Unit, North Carolina Division of Water Quality, 1621 Mail Service Center, Raleigh, NC,
27699-1621.This form may be returned to DWQ by the applicant, the applicant's authorized agent, or the
project engineer.It is not necessary to send certificates from all of these.
Applicant's Certification
1 fl1 lc qAcc L. 14atet rt , hereby state that, to the best of my abilities, due care and
diligence was used in the observation of the construction such that the construction was observed to be built
within substantial compli ce d intent of the 401 Water Quality Certification and Buffer Rules, the
approved pla tions, and other supporting mate;ials?
Signature: Date: u
Agent's Certification
1, , hereby state that, to the best of my abilities, due care and
diligence was used in the observation of the construction such that the construction was observed to be built
within substantial compliance and intent of the 401 Water Quality Certification and Buffer Rules, the
approved plans and specifications, and other supporting materials.
Signature: Date:
if this project was designed by a Certified Professional
I, , as a duly registered Professional (i.e., Engineer,
Landscape Architect, Surveyor, ect.) in the State of North Carolina, having been authorized to observe
(periodically, weekly, full time) the construction of the project, for the Permittee hereby state that, to the
best of my abilities, due care and diligence was used in the observation of the construction such that the
construction was observed to be built within substantial compliance and intent of the 401 Water Quality
Certification and Buffer Rules, the approved pl: ns and specifications, and other supporting materials.
Signature Registration No. Date
W111ANDS/401 GROUP
APR '5 2003
WATER QUALITY SECTIC1? ,
Division of Water Quality 1650 Mail Service Center Raleigh, NC 27699-1650
Wetlands/401 Unit [phone]
-NME
0 State of North Carolina
Department of Environment Z" 4
and Natural Resources
Division of Water Quality, ?-
Michael F. Easley, Governor ACDr=3AIR
William G. Ross, Jr., Secretary Kerr T. Stevens, Director
January 25, 2001
Lincoln County
DWQ Project # 010091
APPROVAL of 401 Water Quality Certification
Ms. Trish Simon, Environmental Officer
NCDOT Division 12
P.O. Box 47
Shelby, NC 28151-0047
Dear Nis. Simon:
You have our approval, in accordance with the attached conditions and those listed below, to replace
Bridge No. 231 on SR 1338 over Carpenter Creek in Lincoln County. The project should be
constructed in accordance with your application dated 19 January 2001 (received 24 January 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 valid solely for the purpose and design described in your application (unless
modified below). Should your project change, you must notify the DWQ and submit a new
application. If the property is sold, the new owner must be given a copy of this Certification and
approval letter, and is thereby responsible for complying with all the conditions. If total wetland fills
for this project (now or in the future) exceed one acre, or of total impacts to streams (now or in the
future) exceed 150 linear feet, compensatory mitigation may be required as described in 15A NCAC
2H .0506 (h) (6) and (7). For this approval to remain valid, you must adhere to the conditions listed
in the attached certification.
If you do not accept any of the conditions of this certification, you may ask for an
adjudicatory hearing. You must act within 60 days of the date that you receive this letter.
To ask for a hearing, send a written petition which conforms to Chapter 150B of the North
Carolina General Statutes to the Office of Administrative Ilearings, 6714 Mail Service
Center, Raleigh, N.C. 27699-6711. This certification and its conditions are final and
binding unless you ask for a hearing.
1621 Mail Service Center, Raleigh, North Carolina 27699-1621 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50°' recycled/ 100% post-consumer paper

This letter completes the review of the Division of Water Quality under Section 401 of the Clean
Water Act. If you have any questions, please telephone John Dorney at 919-733-1786.
Attachment
Sincerely,

cc: Wilmington District Corps of Engineers
Corps of Engineers Asheville Field Office
Mooresville DWQ Regional Office
Central Files
i '
4401 ?SS?EDy
Aw SI/TF a?
y r?+.
fta
L
STATE OF NORM CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY P.O. BOX 25201, RALEIGH, N.C 27611-5201 DAVID McCOY
GOVERNOR SECRETARY
P.O. BOX 47, 1710 East Marion Street
Shelby, N. C. 28151-0047
January 19, 2001
Mr. Steve Lund, Project Manager - NCDOT Projects
US Army Corp of Engineers
Asheville Regulatory Field Office
151 Patton Avenue, Room 143
Asheville, N. C. 28891-5006
Dear Mr. Lund:
The North Carolina Department of Transportation, Division of Highways, proposes the following
project for your issuance of a Section 404 Permit. We believe this project can be accomplished
under NWP #14, Linear Transportation Crossings.
COUNTY: Lincoln
LOCATION: Bridge #231, SR 1338
STREAM: Carpenter Creek
PROJECT DESCRIPTION: Replace existing 20' long x 20' wide timber bridge with a double
line of 50' long CMPA, 112" x 75". A total of 50 linear feet of stream will be impacted. Class
"IV" waters involved. No wetlands or HQW involved. Less than 1/4 acre will be affected.
By copy of this letter, we are asking Edward L. Ingle, Area Roadside Environmental Engineer to
comment on the above project. By copy of this letter, we are also requesting a concurrence letter
from the Wildlife Resources Commission, US Fish & Wildlife Service, and the State Historic
Preservation Office.
By copy of this letter, I am forwarding seven (7) copies of the application package to John Dorney,
NCDENR, Division of Water Quality, 401/Wetland Unit for review. A $200.00 check is enclosed
for application processing.
I have conducted a survey for the threatened/endangered species, dwarf-flowered heartleaf
(Hexastylis naniflora) and Michaux's sumac (Rhus michauxii) in the project areas on January 19,
PAYMENT
RECEIVED
200 1. It was determined that no heartleaf species or suitable habitat was located in the proposed
project area. Michaux's sumac is best identified during the months of May through September;
however, it did not appear that this species was located in the project area. No significant effect on
either of these federally listed species is anticipated.
A site location map and a sketch of planned activities are attached. An erosion and sedimentation
control program will be implemented during the project construction, and every effort will be made
to complete the work in a timely manner.
Your earliest consideration for this request would be greatly appreciated. Our personnel are
available to assist with your evaluation of this project, if necessary. Should you have any questions,
please call me at 704-480-5400.
Sincerely,
Trish Simon
Division 12 Environmental Officer
Enclosures
cc: Mr. Michael L. Holder, P.E., Division Engineer
Mr. Dan Holderman, P.E. , Division Bridge Engineer
Mr. Richard Silverman, Historic Architecture
Mr. Ed Ingle, Area Roadside Environmental Engineer
Mr. Ron Linville, NCWRC
Mr. Brian Cole, USF & WS
Ms. Renee Gledhill-Earley, SHPO
Mr. John Domey, NCDENR, DWQ
File
i 'A j
j ,
DWQ ID: CORPS ACTION ID:
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #) 14
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
1. NOTIFICATION TO THE CORPS OF ENGINEERS
2. APPLICATION FOR SECTION 401 CERTIFICATION
3. COORDINATION WITH THE NC DIVISION OF COASTAL MANAGEMENT
SEND THE ORIGINAL AND (1) COPY OF THIS COMPLETED FORM TO THE APPROPRIATE FIELD
OFFICE OF THE CORPS OF ENGINEERS (SEE AGENCY ADDRESSES SHEET). SEVEN (7)
COPIES MUST BE SENT TO THE NC DIVISION OF WATER QUALITY,
ATTN: JOHN DORNEY, 4401 REEDY CREEK ROAD, RALEIGH, NC
27607. PLEASE PRINT OR TYPE.
1. OWNER'S NAME: N.C. DeMmment of Transportation
2. MAILING ADDRESS: P.O. Box 47
SUBDIVISION NAME
CITY: Shelbv STATE: NC ZIP CODE: 28151
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
SR 1338. Bridgc 4231
3. TELEPHONE NUMBER: (HOME) (WORK) [phone]
4. IF APPLICABLE: AGENTS NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
Trish Simon. P.O. Box 47 Shelby NC 28151: 704480-5400
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC MAP
OR AERIAL PHOTOGRAPHY WITH SCALE): N35 30 54. W81 14 04
COUNTY: Lincoln - NEAREST TOWN: Lincolnton
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ETC.) Take 321 North
Business from Lincolnton. Turn right onto SR 1338 and proceed approximately 0.2 miles to Bridges #231.
6. IMPACTED OR NEAREST STREAM/RIVER: Carpenter Creek RIVER BASIN: Catawba
7. (a) IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER, (SA),
HIGH QUALITY WATERS (HQW), OUTSTANDING RESOURCE WATERS (ORW), WATER
SUPPLY (WS-I OR WS-11)? YES NO ® IF YES, EXPLAIN:
(b) IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES ? NO X
(c) IF THE PROJECT IS LOCATED WITHIN A COASTAL COUNTY (SEE PAGE 7 FOR LIST OF
COASTAL COUNTIES), WHAT IS THE LAND USE PLAN (LUP) DESIGNATION?
8. (a) HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROJECT? YES ? NO X IF YES, PROVIDE ACTION I.D. NUMBER OF PREVIOUS PERMIT AND
ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401 CERTIFICATION):
(b) ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE FUTURE?
YES ? NO X IF YES, DESCRIBE ANTICIPATED WORK:
9. (a) ESTIMATED TOTAL NUMBERS OF ACRES IN TRACT OF LAND: 1/4 acre- NCDOT Riat of
Way
(b) ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
0.0
10. (a) NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: EXCAVATION:
FLOODING: OTHER :
DRAINAGE : TOTAL ACRES TO BE IMPACTED: 0.0
(b) (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED,
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION:
PIPE EXTENSIONS/ADDITIONS 50 FT
STREAM RELOCATION - LENGTH BEFORE: FT AFTER: _ FT
WIDTH BEFORE (based on normal high water contours): 5-7 FT
AVERAGE DEPTH BEFORE: 0.3 FT AFTER: 0.3 FT
(b) (2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: PLACEMENT OF PIPE IN CHANNEL: X
CHANNEL EXCAVATION: CONSTRUCTION OF A DAM/FLOODING:
OTHER:
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WATERSHED
DRAINING TO THE POND? N/A WHAT IS THE EXPECTED POND SURFACE AREA?
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPMENT TO BE USED? (ATTACH PLANS; 81/2 BY 11 DRAWINGS ONLY)
Replace a 20' long x 20' wide timber bridge with a double line 50' long CMPA, 112" x 75" using a
trackhoe for excavating and riprap work.
13. PURPOSE OF PROPOSED WORK: To replace a deteriorated and structurally deficient bridge and to
provide safe passage for the travelling public
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS)
N/A
15. YOU ARE REQUIRED TO CONTACT THE US FISH AND WILDLIFE SERVICE AND/OR
NATIONAL MARINE FISHERIES SERVICE REGARDING THE PRESENCE OF ANY FEDERALLY
LISTED OR PROPOSED FOR LISTING ENDANGERED OR THREATENED SPECIES OR CRITICAL
HABITAT IN THE PERMIT AREA THAT MAY BE AFFECTED BY THE PROPOSED PROJECT.
DATE CONTACTED: Copy sent 1/19/01.
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICE (SHPO)
REGARDING THE PRESENCE OF HISTORIC PROPERTIES IN THE PERMIT AREA WHICH MAY
BE AFFECTED BY THE PROPOSED PROJECT. DATE CONTACTED: Copy sent 1/19/01.
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OR THE USE OF PUBLIC
(STATE) LAND? YES X NO ? (IF NO, GO TO 16)
(a) IF YES, DOES THE PROJECT REQUIRE PREPARATION OF AN ENVIRONMENTAL
DOCUMENT PURSUANT TO THE REQUIREMENTS OF THE NORTH CAROLINA
ENVIRONMENTAL POLICY ACT? YES ? NO X
(b) IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE YES ? NO ?
IF ANSWER 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE STATE
CLEARINGHOUSE WITH THE NORTH CAROLINA ENVIRONMENTAL POLICY ACT.
QUESTIONS REGARDING THE STATE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED TO MS. CHRYS BAGGETT, DIRECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION, 116 WEST JONES STREET, RALEIGH,
NORTH CAROLINA 27603-8003, TELEPHONE [phone].
18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF PROPOSED
ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OR FILL MATERIAL INTO
WETLANDS: N/A
(a) WETLAND DELINEATION MAP SHOWING ALL WETLANDS, STREAMS, LAKES, AND
PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14, 18, 21, 26, 29, AND 38).
ALL STREAM (INTERMITTENT AND PERMANENT) ON THE PROPERTY MUST BE SHOWN ON
THE MAP. MAP SCALES SHOULD BE 1 INCH EQUALS 50 FEET OF 1 INCH EQUALS 100 FEET
OF THEIR EQUIVALENT.
(b) IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE RVIPACTED BY
PRODUCT.
(c) IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA SHEETS
RELEVANT TO THE PLACEMENT OF THE DELINEATION LINE.
(d) ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
(c) WHAT IS LAND USE OF SURROUNDING PROPERTY?
(f) IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE: WETLANDS OR WATERS OF THE US MAY NOT BE IMPACTED PRIOR TO:
1. ISSUANCE OF A SECTION 404 CORPS OF ENGINEERS PERMIT,
2. EITHER THE ISSUANCE OR WAIVER OF A 401 DIVISION OF WATER QUALITY
CERTIFICATION, AND
3. (IN THE TWENTY COASTAL COUNTIES ONLY), A LETTER FROM THE NORTH
CAROLINA DIVISION OF COASTAL MANAGEMENT STATING THE PROPOSED
ACTIVITY IS CONSISTENT WITH THE NORTH CAROLINA COASTAL MANAGEMENT
_ PROGRAM,
OWNER'S/AGENT'S SIGNATURE DATE
(AGENTS SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED).
14
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STATE of NORTH CAROLINA J
DEPARTMENT OF TRANSPORTATIOTS-
MICHAEL F. EASLEY' DAVID McCOY .._?
GOVERNOR SECRET,?RY
MEMO TO: John Dorney, NCDENR/DWQ/Wetlands/401 Unit
FROM: Trish Simon, Division 12 Environmental Officer Tj
DATE: January 19, 2001
SUBJECT: Pre-construction Notification

Enclosed are seven copies of the pre-construction notification nationwide permit
application for a DOT bridge project in Lincoln County for your review and comments.
is
PAYMENT
RECEIVED
Post Office Box 47 Shelby, North Carolina 28151-0047

,1/ uJ 2 4
r
45,1SS\0

STATE of NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY P.O. Box 25201, RALEIGH, N.C. 27611-5201 DAVIDMcCOY
GOVERNOR SECRETARY
P.O. BOX 47, 1710 East Marion Street
Shelby, N. C. 28151-0047
January 19, 2001
Mr. Steve Lund, Project Manager - NCDOT Projects
US Army Corp of Engineers
Asheville Regulatory Field Office
151 Patton Avenue, Room 143
Asheville, N. C. 28891-5006
Dear Mr. Lund:
The North Carolina Department of Transportation, Division of Highways, proposes the followuig
project for your issuance of a Section 404 Permit. We believe this project can be accomplished
under NWP #14, Linear Transportation Crossings.
COUNTY: Lincoln
LOCATION: Bridge #231, SR 1338
STREAM: Carpenter Creek
PROJECT DESCRIPTION: Replace existing 20' long x 20' wide timber bridge with a double
line of 50' long CMPA, 112" x 75". A total of 50 linear feet of stream will be impacted. Class
"IV" waters involved. No wetlands or HQW involved. Less than 1/4 acre will be affected.
By copy of this letter, we are asking Edward L. Ingle, Area Roadside Environmental Engineer to
comment on the above project. By copy of this letter, we are also requesting a concurrence letter
from the Wildlife Resources Commission, US Fish & Wildlife Service, and the State Historic
Preservation Office.
By copy of this letter, I am forwarding seven (7) copies of the application package to John Dorney,
NCDENR, Division of Water Quality, 401/Wetland Unit for review. A $200.00 check is enclosed
for application processing.
I have conducted a survey for the threatened/endangered species, dwarf-flowered heartleaf
(Hexastylis naniflora) and Michaux's sumac (Rhus michauxii) in the project areas on January 19,
PAYMENT
RECEIVED
2001. It was determined that no heartleaf species or suitable habitat was located in the proposed
project area. Michaux's sumac is best identified during the months of May through September;
however, it did not appear that this species was located in the project area. No significant effect on
either of these federally listed species is anticipated.
A site location map and a sketch of planned activities are attached. An erosion and sedimentation
control program will be implemented during the project construction, and every effort will be made
to complete the work in a timely manner.
Your earliest consideration for this request would be greatly appreciated. Our personnel are
available to assist with your evaluation of this project, if necessary. Should you have any questions,
please call me at 704-480-5400.
Sincerely,

Trish Simon
Division 12 Environmental Officer
Enclosures
cc: Mr. Michael L. Holder, P.E., Division Engineer
Mr. Dan Holderman, P.E. , Division Bridge Engineer
Mr. Richard Silverman, Historic Architecture
Mr. Ed Ingle, Area Roadside Environmental Engineer
Mr. Ron Linville, NCWRC
Mr. Brian Cole, USF & WS
Ms. Renee Gledhill-Earley, SHPO
Mr. John Dorney, NCDENR, DWQ
File
0:j 13 t
DWQ ID: CORPS ACTION ID:
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT ##) 14
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
1. NOTIFICATION TO THE CORPS OF ENGINEERS
2. APPLICATION FOR SECTION 401 CERTIFICATION
3. COORDINATION WITH THE NC DIVISION OF COASTAL MANAGEMENT
SEND THE ORIGINAL AND (1) COPY OF THIS COMPLETED FORM TO THE APPROPRIATE FIELD
OFFICE OF THE CORPS OF ENGINEERS (SEE AGENCY ADDRESSES SHEET). SEVEN (7)
COPIES MUST BE SENT TO THE NC DIVISION OF WATER QUALITY,
ATTN: JOHN DORNEY, 4401 REEDY CREEK ROAD, RALEIGH, NC
27607. PLEASE PRINT OR TYPE.
1. OWNER'S NAME: N.C. Department of Transportation
2. MAILING ADDRESS: P.O. Box 47
SUBDIVISION NAME
CITY: Shelbv STATE: NC ZIP CODE: 28151
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
SR 1338, Bridge 4231
3. TELEPHONE NUMBER (HOME) (WORK) [phone]
4. IF APPLICABLE: AGENTS NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
Trish Simon P.O. Box 47. Shelby. NC 28151: 704-480-5400
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC MAP
OR AERIAL PHOTOGRAPHY WITH SCALE): N35 30 54. W81 14 04
COUNTY: Lincoln - NEAREST TOWN: Lincolnton
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ETC.) Take 321 North
Business from Lincolnton. Turn right onto SR 1338 and proceed approximately 0.2 miles to Bridges 4231.
6. IMPACTED OR NEAREST STREAM/RIVER: Carpcnter Creek RIVER BASIN: Catawba
7. (a) IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER, (SA),
HIGH QUALITY WATERS (HQW), OUTSTANDING RESOURCE WATERS (ORW), WATER
SUPPLY (WS-I OR WS-H)? YES NO ® IF YES, EXPLAIN:
(b) IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES ? NO X
(c) IF THE PROJECT IS LOCATED WITHIN A COASTAL COUNTY (SEE PAGE 7 FOR LIST OF
COASTAL COUNTIES), WHAT IS THE LAND USE PLAN (LUP) DESIGNATION?
8. (a) HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROJECT? YES ? NO X IF YES, PROVIDE ACTION I.D. NUMBER OF PREVIOUS PERMIT AND
ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401 CERTIFICATION):
(b) ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE FUTURE?
YES ? NO X IF YES, DESCRIBE ANTICIPATED WORK:
9. (a) ESTIMATED TOTAL NUMBERS OF ACRES IN TRACT OF LAND: 1/4 acre- NCDOT Right of
Way
(b) ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE:
0.0
10. (a) NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: EXCAVATION:
FLOODING: OTHER :
DRAINAGE : TOTAL ACRES TO BE IMPACTED: 0.0
(b) (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED,
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION:
PIPE EXTENSIONS/ADDITIONS 50 FT
STREAM RELOCATION - LENGTH BEFORE: FT AFTER: _ FT
WIDTH BEFORE (based on normal high water contours): 5-7 FT
AVERAGE DEPTH BEFORE: 0.3 FT AFTER: 0.3 FT
(b) (2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: PLACEMENT OF PIPE IN CHANNEL: X
CHANNEL EXCAVATION: CONSTRUCTION OF A DAM/FLOODING:
OTHER:
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WATERSHED
DRAINING TO THE POND? N/A WHAT IS THE EXPECTED POND SURFACE AREA?
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPMENT TO BE USED? (ATTACH PLANS; 81/2 BY 11 DRAWINGS ONLY)
Replace a 20' long x 20' wide timber bridge with a double line 50' long CMPA, 112" x 75" using a
tmckhoe for excavating and riprap «vork
13. PURPOSE OF PROPOSED WORK: To replace a deteriorated and structurally deficient bridge and to
provide safe passage for the travelling public
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS)
N/A
15. YOU ARE REQUIRED TO CONTACT THE US FISH AND WILDLIFE SERVICE AND/OR
NATIONAL MARINE FISHERIES SERVICE REGARDING THE PRESENCE OF ANY FEDERALLY
LISTED OR PROPOSED FOR LISTING ENDANGERED OR THREATENED SPECIES OR CRITICAL
HABITAT IN THE PERMIT AREA THAT MAY BE AFFECTED BY THE PROPOSED PROJECT.
DATE CONTACTED: Copy sent 1/19/01.
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICE (SHPO)
REGARDING THE PRESENCE OF HISTORIC PROPERTIES IN THE PERMIT AREA WHICH MAY
BE AFFECTED BY THE PROPOSED PROJECT. DATE CONTACTED: Copy sent 1/19/01.
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OR THE USE OF PUBLIC
(STATE) LAND? YES X NO ? (IF NO, GO TO 16)
(a) IF YES, DOES THE PROJECT REQUIRE PREPARATION OF AN ENVIRONMENTAL
DOCUMENT PURSUANT TO THE REQUIREMENTS OF THE NORTH CAROLINA
ENVIRONMENTAL POLICY ACT? YES ? NO X
(b) IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE YES ? NO ?
IF ANSWER 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE STATE
CLEARINGHOUSE WITH THE NORTH CAROLINA ENVIRONMENTAL POLICY ACT.
QUESTIONS REGARDING THE STATE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED TO MS. CHRYS BAGGETT, DIRECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION, 116 WEST JONES STREET, RALEIGH,
NORTH CAROLINA 27603-8003, TELEPHONE [phone].
18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF PROPOSED
ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OR FILL MATERIAL INTO
WETLANDS: N/A
(a) WETLAND DELINEATION MAP SHOWING ALL WETLANDS, STREAMS, LAKES, AND
PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14, 18, 21, 26, 29, AND 38).
ALL STREAM (INTERMITTENT AND PERMANENT) ON THE PROPERTY MUST BE SHOWN ON
THE MAP. MAP SCALES SHOULD BE 1 INCH EQUALS 50 FEET OF 1 INCH EQUALS 100 FEET
OF THEIR EQUIVALENT.
(b) IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE IMPACTED BY
PRODUCT.
(c) IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA SHEETS
RELEVANT TO THE PLACEMENT OF THE DELINEATION LINE.
(d) ATTACH A COPY OF THE STORM[WATER MANAGEMENT PLAN IF REQUIRED.
(c) WHAT IS LAND USE OF SURROUNDING PROPERTY?
(fl IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE: WETLANDS OR WATERS OF THE US MAY NOT BE IIviPACTED PRIOR TO:
1. ISSUANCE OF A SECTION 404 CORPS OF ENGINEERS PERMIT,
2. EITHER THE ISSUANCE OR WAIVER OF A 401 DIVISION OF WATER QUALITY
CERTIFICATION, AND
3. (IN THE TWENTY COASTAL COUNTIES ONLY), A LETTER FROM THE NORTH
CAROLINA DIVISION OF COASTAL MANAGEMENT STATING THE PROPOSED
ACTIVITY IS CONSISTENT WITH THE NORTH CAROLINA COASTAL MANAGEMENT
-I PROGRAM,
OWNER'S/AGENT'S SIGNATURE DATE
(AGENTS SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED).

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