20010269 Ver 1_Complete File_20010223

WAIF
QG
r
Michael F. Easley
Governor
William G. Ross, Jr., Secretary
Department of Environment and Natural Resources
w? Kerr T. Stevens
Division of Water Quality
r
March 30, 2001
Randolph County
DWQ Project No. 01-0269
Bridge No. 358, SR 2871
APPROVAL of 401 Water Quality Certification
Mr. E.B. Nelson, P.E.
NCDOT Division 8
P.O. Box 289
Siler City, NC 27344
Dear Mr. Nelson:
You have our approval, in accordance with the attached conditions and those listed below, to impact the Deep River for
the purpose of replacing Bridge No. 358 on SR 2871 in Randolph County. The project should be constructed in
accordance with your application dated 19 February 2001 (received 23 February 2001). After reviewing your application,
we have decided that this project is covered by General Water Quality Certification Number 3289. This certification
corresponds to Nationwide Permit 14 issued by the Corps of Engineers. In addition, you should acquire any other federal,
state or local permits before you proceed with your project including (but not limited to) Sediment and Erosion Control,
Non-Discharge and Water Supply Watershed regulations. This approval will expire with the accompanying §404 permit,
unless otherwise specified in the Water Quality Certification.
This approval is valid solely for the purpose and design described in your application (unless modified below). Should
your project change, you must notify the DWQ and submit a new application. If the property is sold, the new owner must
be given a copy of this Certification and approval letter, and is thereby responsible for complying with all the conditions.
If the proposed fill is in excess of 150 linear feet of stream length or 1 acre of wetlands, compensatory mitigation will
required as described in 15A NCAC 2H.0506 (h) (6) and (7). For this approval to be valid, you must follow the
conditions listed in the attached certification and any additional conditions listed above.
If you do not accept any of the conditions of this certification, you may ask for an adjudicatory hearing. You must act
within 60 days of the date that you receive this letter. To ask for a hearing, send a written petition that conforms to
Chapter 150B of the North Carolina General Statutes to the Office of Administrative Hearings, 6714 Mail Service Center,
Raleigh, N.C. 27699-6714. This certification and its conditions are final and binding unless you ask for a hearing.
- This letter coinpletes-the review of the Division of Water Quality under Section 401 of tlie-Clean-Water Act.- If you have - -
any questions, please telephone John Dorney at 919-733-9646.
Attachment
Pc:

Wilmington District Corps of Engineers 'J \J
Corps of Engineers Raleigh Field Office
NCDWQ Winston-Salem Regional Office
Central Files
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/
MEMORANDUM
TO: John Dorney
Non-Discharge Branch
Regional Contact:
WO Supervisor:
Date:
SUBJECT: WETLAND STAFF REPORT AND RECOMMENDATIONS
Facility Name NCDOT - Bridge 358 on SR 2871
Project Number 01 0269
Recvd From DOT
Received Date 2123/01 Recvd By Region 3/21/2001
Project Type road crossing / bridge replacement
County Randolph
County2
Region Winston-Salem
Certificates Stream
Permit Wetland 'Wetland Wetland Stream Class Acres Feet
Type ;, Type Impact Score Index Prim. Supp. Basin Req. Req.
14 Stream O Y OO N F_- 17-(10.5) F _cF_30,609. F- 80.00
Stream Impacts (ft.)
E 0
F80.00 I -
iF_
Is Wetland Rating Sheet Attached? Q Y * N Did you request more info? Q Y (0 N
. Have Project Changes/Conditions Been Discussed With Applicant? Q Y O N
Is Mitigation required? Q Y 0 N
Recommendation: (*Issue. O Issue/Cond O Deny
Provided by Region: Latitude (ddmmss) 353233 Longitude (ddmmss) 793846
Comments:
The WSRO recommends that this WO Certification be issued.
cc: Regional Office Page Number 1
Central Office
Mitigation Wetland
Mitigation Type Type Acres Feet
d.o 010 2 6 9
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY DIVISION OF HIGHWAYS LYNDO TIPPETT
GOVERNOR SECRETARY
February 19, 2001 "" --?
USACOE
a? a ?1
Mr. John Thomas
6512 Falls of the Neuse Road
Suite 105
Raleigh, N.C. 27615
Re: Randolph Co. Bridge No. 358 Replacement
Location: Randolph County, SR 2871
Dear Mr. Thomas:
We are providing herewith an application package and copies of N.C. Department of Transportation,
Hydraulics Unit structure recommendation as part of a project involving the replacement of an existing
bridge with 1 line of 142"x91" CM Pipe Arch. Construction shall begin in the Summer of 2001.
To our knowledge, no wetlands are involved and total fill in waters is expected to be less than 0.01 acre.
This bridge is not located in a high quality water area.
Please review this material, and if additional information is needed, or you have comments, please contact
our office.
Thank you for your cooperation and assistance in this matter.
Sincerely,
91 41 E.B. Nelson, P.E.
Div. Bridge Maint. Engineer
Attachments
cc: Bill Rosser, P.E. - Division Engineer
John Hennessey - DWQ - 7 copies w/ attachments
Mrs. Renee Gledhill-Earley - State Historic Preservation Officer
Mike Crocker - US Fish & Wildlife Service
PAYMENT
RECEIVED
DIV. 8 BRIDGE MAINTENANCE
PO BOX 289 - SILER CITY - NC - 27344
PH. 919.742.5649 FAX [phone]

LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: IZA-t?4t7o L Ptf - NEAREST TOWN: Ro P K IV'l s.
C-)
rn ?
M
m z
c= --i
DWQ ID: 010269 CORPS ACTION ID:
NATIONWIDE PERIPAIT REQUESTED (PROVIDE NATIONWIDE PERMIT TO
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PER. IITS THAT REQUIRE: r
1) NOTIFICATION TO THE CORPS OF ENGINEERS
2) APPLICATION FOR SECTION 401 CERTIFCATION
3) COORDh IATION 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
OUALTTY. ATTN: JOHN DORNEY. 4401 REEDY CREEK ROAD.
RALEIGH. NC 27607. PLEASE PRINT OR TYPE.
. OWNER'S iAME: N
2. MAILING ADDRESS: I'Do P_' o K Z 8 9
SUBDIVISION NAME
CITY: S 'u-isle G 1TY STATE: N4- ZIP CODE. Z 7 154 z4
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
2/s•lyt7:)oLPj4 r;ejnatf. !Jo. 358
3. TELEPHONE NUMBER: (HOME)
(WORK) 915 7'4 7- -5- t9 4 !)
4. IF APPLICABLE: AGENT'S NAT OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
Ly?l2 lL /? t? L S O
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ECT.)
lsyZ l%7L-'Is Ido. S45,9 dhj 5f- ZQj-71
6. aMPACTED OR NEAREST STRE:?WRIVER: t7 Fc s r- 2 l V lp-r2
RIVER BASIN: 15 APM F/F-i4 e-
7a. IS PROJECT LOCATED NEAR WATER CLASSED AS TROL i , TID A.L S ALTW A TER. (S A),
HIGH QUALITY WATERS (HQ«?, OUTSTANDING RESOLRSE WATERS (OR`s ), WATER _
SUPPLY (WS-I OR WS-IM YES ( ) NO ( ? IF YES. EXPLAP4:
7b. IS THE PROJECT LOCATED W IrEN A NORTH CAROLLNA DNISION OF COAST.-r
NL-s-NAGEMENT AREA OF E_INVIROMENTAL CONCERN (AEC)? YES ( ) `0 (
7c. IF THE PROJECT IS LOCATED WITHIN A COASTAL. COUNTY (SEE PACE 7 FOR LIST OF
COASTAL COUNTIES), WHAT IS THE LAND USE PLAN (LUP) DESIGNATION?
8a. HAVE ANY SECTION 404 PTR S BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROJECT? YES ( ) NO (?) IF YES, PROVIDE ACTION I.D. NUMBER OF PREVIOUS
PERiVIIT..AND ANY ADDITIONAL R FORMATION (INCLUDE PHOTOCOPY OF 401
CERTIFICATION):
8b. ARE ADDITIONAL PERMIT QUESTS EXPECTED FOR THIS PROPERTY D T -z=-
FUTURE? YES ( ) NO ( -I- IF YES, DESCRIBE ANTICIPATED WORK:
9a. ESTIMATED TOTAL. NUIvIBERS OF ACRES IN TRACT OF LAND:
9b. ESTMATED TOT.-kL. NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT S1iE.
NnN /f-
10a. NUMBER OF ACRES OF WETLA?YDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: _
FLOODING:
DRAINAGE :
EXCAVATION:
OTHER:
TOTAL ACRES TO BE IMPACTED:
10b. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF
RELOCATED, PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION:
LENGTH BEFORE:
AFTER: FT
WIDTH BEFORE (based on normal high water contours): FT
AVERAGE DEPTH BEFORE: FT AFTER: FT
(2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: PLACEMENT OF PIPE IN CHANNEL: V
CHANNEL EXCAVATION: COONSTRUCTION OF A DAMI LOODING:
OTHER:
11. IF CONSTRUCTION OF A POND IS PROPOSED, `,WHAT IS THE SIZE OF THE WATERSHED
DRAINING TO THE POND? WHAT IS THE EXPECTED
POND SURFACE AREA?
12. DISCTIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPMENT TO BE USED? (ATTACH PLANS: 81/2 BY 11 DRAWINGS ONLY)
?2??r?,4-try ??.??SnNC, 17--rt?r>c,tf- ir14 t C? I'fz"X -) I " evv'LP-I
ISXC Ay A-T-o 2 17--) lS?f- uTIL? z-,*,r-)
13. PURPOSE OF PROPOSED WORK: (Zenon-C,W- I7 r?Fi ? r?av r R tz+ n e,?f--
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVTTY MUST BE CARRIED OUT IN
WETLANDS (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS) -
15. YOU ARE REQUIRED TO CONTACT THE US FISH AND WILDLIFE SERVICE AND/OR
NATIONAL MARINE FISHERIES SERIVE REGARDING THE PRESENCE OF ANY FEDERALY
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: L«7-rS2
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER
(SHPO) REGARDING THE PRESENCE OF HISTORIC PROPERTIES IN THE PERMIT AREA
WHICH MAY BE AFFECTED BY THE PROPOSED PROJECT. DATE CONTACTED
KY L,9:7-r arf-
17. DOES THE PROJECT iNVOLVE AN E ENDITURE OF PUBLIC FUNDS OT THE USE OF
PUBLIC (STATE) LAND? YES ( NO ( ) (IF NO, GO TO 16) _
a. IF YES, DOES THE PROJECT REQUIRE PREPERA77ON OF AN ENVIRONMENTAL
DOCUMENT PURUANT TO THE REQUIREMENTS OF THEEIORTH CAROLINA
ENVIRONMENTAL POLICY ACT? YES ( ) NO
b. IF YES, HAS THE DOCUMENT BEEN REFIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMI IISTRATION STATE CLEARINGHOUSE YES ( ) NO ( %--?
IF ANSWER 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATIONFROM 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 OF FILL MATERIAL INTO
WETLANDS:
a. WETLAND DELINEATION MAP SHOWING ALL WETLANDS, STREAMS, LAKES, AND
PONDS ON THE PROPERTY (FOR NATIONWIDE PEP-MIT NU-MBERS 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 STORMWATER MANAGEMENT PLAN IF REQUIRED.
e. WHAT IS LAND USE OF SURROUNDING PROPOERTY?
£ IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
g. SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE: WTLAiN1DS 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. _
I RAGE vfE.NT PROGRAlvf,
/ Zfo/
OWNER'S/AGENT'S SIGNATURE DATE
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZ.?TION LETTER FROM
THE OWNER IS PROVIDED).
a
nuurvmi uv. rdX•t$1y-(00-0= Jul 1'J 2WU 101.5$ P.04
M 14MUM CRITERIA DETERN NATION CEMCKLIST
The following questions provide direction in determining whether a proposed project bw only a
minimum potential for environmental effects. Answer the following questions by checking
either yea or no. Refer to the attached guidaace for assistance.
TIP Project No.
State Project No. s. ; -7 SZ
Project Location: 2/4Nn oLpW 1?,12'n G,1E No
Project Description: Ow-pi-AZor- i5rz'r G7X - w/ p, p'E-
Anticipated Permit or C'onsultatiou Requirements: M w,->
Special Project Information:
1
LL-v. rax •!wi-roo-v"tn Jul 20 2000 10:58 P.05
Nf[NIMU CR T' RIA YES NO
PAKT A;
I, Is the proposed, project listed as a type which would qualify ?
as a Non Major Action undcr the Minimum Criteria?
PART I3: Mmm uM CRITERIA EXCEpnONS
2. Is the proposed project likely to precipitate sigificwt, foreseeable 0
alterations in land use, ptanaed growth, or development patterns?
3- Does the proposed action divide or disrupt as established con=unity? Q ED,
4. Does the proposed action bypass an existing eommunity7
5. Does the proposed action provide new access to area donWInjug
significant amounts of exploitable natural resources?
6. Is the proposed action likely to have a significant detrimental impact
on air quality?
7. Is the proposed action likely to have a signifcut detrimental impact
on ambient noise levels for adjoining areas?
8. Is the proposed action likely to have a significant impact as travel
patterns or traffic volumes?
9. Is the proposed action likely to significantly affect water quality? Q
10. Does the proposed action require the relocation of sigaifiicant numbers [?
of people?
11. Is the project likely to be controversial?
12. Will the proposed action require the use of land owned by the
U. S. Forest Service or the National Park Service?
PART C: COMPLL4,NCE WITH STATE AIND FEDERAL REGULATIONS
Ecological impacts
13. Is a federally protected threatened or endangered species, or its habitat,
likely to be kn. paeted by tho proposed action?
14- Does `.he action requira the p:acernent of fill in waters of the United States?
2
.1-4"Ja NUUM-01 Lev. r dx yl?- ???-352f5 Jul 20 2000 10 : 58 P.06
.r
15. Does the project require the placement of a signi$oant amount of 1111 in ?
high quality or relatively rare wetland ecosyatetns, such as mountain bogs
or pine savannahs?
16. Does the project require stream rolocation or cclwmicl changes? C3 17. Is the proposed action located in an Area of Environmental Concern,
as defined in the Coastal Area Management Act?
Cultural Reso es
18. Will the project have an "effect" on a property or size listed on the
NatioW Register of Historic Places?
19. Wilt the proposed action require acgtusition of additional right of way
from publicly owned parkland or recreatianai areas?
Roviewed by; Date:
Project Planning Engineer
Project Planning Unit Head
11 CE--,
? zzl"'
If any questions 2 through 12 are answered "yes". the proposed project does not qualify as a
Non-Major Action. A state environmental assessment (EA) will be required. For assistance,
contact:
William D. Gilmore, P. E.
Manager, Project Development and Envirownental Analysts Branch
P. 0. Box 25201
Raleigh, NC 27611
[phone]
Fax: [phone]
Questions in Part C are designed to assist the Engineer in-determining whether a permit or
consultation with a state or federal resource agency may be required. If any question in Part C is
answered "yes", refer to the Environmental Guidance section of this document and contact the
appropriate individual for assistance.
a.a AA7F
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
JAMES B. HUNT JR.
GOVERNOR
September 19, 2000
COUNTY: Randolph
MEMORANDUM TO: Mr. E.B. Nelson, PE
Bridge Maintenance Superintendent
FROM: Roger E. D'Jernes (?-
Regional Hydraulics Engineer
SUBJECT: Bridge Number 358 Replacement Recommendation
On SR-2871
DAVID MCCOY
SECRETARY
Pursuant to the request on June 29, 2000, for a structure recommendation at the above
subject site, the following is offered.
Drainage Area: 1.3 Square Miles
Existing structure: 41' Single Span Bridge
Recommended pipe size:2 90"
Alternate Structure: 1 (a), 142" X 91" CSPA
This recommendation is made from an office review only. Specific site conditions or
limitations may dictate the use of an alternate structure. If such conditions are noted, please
contact this office for further analysis.
RED
cc: Mr. W.F. Rosser, P.E.
Mr. J.L. Picklesimer, PE, PLS

Ile
y. wises
r
--
? ?.* ?r. ? 'fix,,. ? ?•a, ??. ? V
?. c
r/
r
3 \ , _
V.5 I
3-D TopoQuads Copyright 0 1999 DeLorme Yarmouth, HE 04096 Source Data: OSGS i-----500 ft Scale: 1 : 12,800 Detail: 14-0 Datum: YGS84
C- 4 6 0
Cd.
0201
2MI
22 2M
•; ;" ---'' ,moo <! i
' L1 --1 Ji• A t• /; ` ; .a , ,\ awl,
•1. I
rS .--- ! 7.0
26,6 0458 2&e
1 Wo. o"ZI,. /
V'\ ?j? 1, ',- _I i ,' ` ?. - ..??: I ?A O , • 2"2
{ a 354 ? ?..e "\, 26-M e '?
d\ • . 2957
C134 .7 s i
25M ; i
J
1 `•\ f s 187 r P165 P45
318 ??t2t
L IW! ?gH a,eo \ - P186
som >? • •t4 gem p ? C-130
257'-,
6 i m °m - a 7 3 4 ?Z . ,"-a-
J i• a 7 228 1847 r J i\ 6 7a 2W
962
`Q26 / 257
04 A,? I J r
P44 _i 44,
t /ZOOLOGrAL 5 %/ -• 1 e Imp i' ' i
' r PAM _ ' 218 i '' N P485 ?3 163
2971
P338, 2M 7. t.)
i r l 359
r225 _ r213 \ 28? FA- 1- 304
% i r < 1`` ? 2so9 - 214 0189 199 r \ i
s :> 160
272
2r r 215 ) { i
y ?6 /-- R4S 2819 220\ 27py 9 OYeI'\ lr. 1 '_+ .\Q, J 3 ••C .S ?•r-
P227? r / N 4219 1? + \\ _' \'?.? 7 i
X190
ant
.3 / ° / / •. 29M .1 Z t 3 \ _ J to ' a +
2.11
LJ ° 1
• a 223 - \ 2, • )
372 ?, `^? ,., 1 •°'\ ••y a \\ '-'198 •\ 1.4 i C
7111 1t3a o P504. _=7 y
f i 1365 N` 221 \ - ?` ;: ,°a3 \ zM
1127 ;y 384 TEc ; F? m93 ! ; i2
r ?5 mob.
.9 lb
P
79f"' •\ 10°2-
rl ,1 I !• r .??o? \tgoj .<?? 211 / 349 \ , awww
1121 8 .2
y{'Y\. i 3 N i
' 306/
1 206 l
21 ft MW
aW2
a 111' =~® L? ?P350 + 192
1119 051 X93 208 4
lies 4
X64 1.8 W74 aw. i
270
11t !339aw °209 ?? ?. 29T .6y 6-i ......
mw.s 41 V ,t)0 lOD3 '
Q ?O ? fi ®p k a
?I is 7
R
U N T Y/ M O O R E C O U N:: T Y
?? ?? 111

7
8
is ?e
44
Creek
tie
Lit
"al
\ eel
Cie
Bruncji
---------------- --

DWQ ID:
010269
CORPS ACTION ID:
NATIONWIDE PER?IMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #0
PRE-CONSTRUCTION NOTIFICATION APPLICATION,
FOR NATIONWIDE PERMITS THAT REQUIRE:
1) NOTIFICATION TO THE CORPS OF ENGINEERS
2) APPLICATION FOR SECTION 401 CERTIFCATION
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 e- g, o i
K Z 8 9
2. MAILING ADDRESS: Igo P SO
SUBDIVISION NAME
CITY: S ILif l2 617"1 STATE: Ne_ ZIP CODE: _Z7 3 4 z4
PROTECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
2l.iyt-?oLP/4 1;4inc,f_ ", 3S8
3. TELEPHONE NUMBER: (HOME)
(WORK) 919 74 Z-5 L, 4 9
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
o-a_ lL /?l fti. -SOh I
LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC
MAP OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: IZ/? N?7o L. rlif - NEAREST TOWN: Ro R g I v j S
c?G
rn?
rn
C z
0

SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ECT.)
fSyZ l%->&llS nl.o . 3 5 E7hJ S f- -405-7/
6. IMPACTED OR NEAREST STREAllvVRIVER: 17 Fc'c T- 2 l ylT--r'L
RIVER BASIN: 45 Apt
i a. IS PROTECT LOCATED NEAR WATER CLASS=D AS TROUT, TIDAL SALTWATER. (SA),
HIGH QUALITY WATERS (HQW), OU°TST_?NDING RESOURSE WATERS (ORW), WATER _
SUPPLY (WS-I OR WS-II)? YES ( ) NO ( V-) IF YES, E.YPL.-EI:
7b. IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
?YUMNAGEMENT AREA OF ENVIROMENTAL CONCERN (AEC)? YES ( 1 NO
7c. IF THE PROJECT IS LOCATED WITHIN A COASTAL. COUNTY (SEE PACE 7 FOR LIST OF
COASTAL COUNTIES), WHAT IS THE LAND USE PLAN (LUP) DESIGNATION?
8a. HAVE ANY SECTION 4044 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROJECT? YES ( ) NO ( ?) IF YES, PROVIDE ACTION I.D. NUMBER OF PREVIOUS
PERMIT.AND ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401
CERTIFICATION):
8b. ARE ADDITIONAL PERM?T? QUESTS EXPECTED FOR THIS PROPERTY LN i rr.
FU I URE? YES( ) NO ( `T IF YES, DESCRIBE ANTICIPATED WORK:
9a. ESTIMATED TOTAL NUMBERS OF ACRES IN TRACT OF LAND: 0,4-
9b. ESMIATED TOTAL NUMBER OF AIRES OF WETLANDS LOCATED ON PROJECT Si E:
N nr, if-
10a. NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: _
FLOODING:
DRAINAGE :
EXCAVATION:
OTHER:
TOTAL ACRES TO BE IMPACTED:
10b. (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF
RELOCATED, PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION:
LENGTH BEFORE: FT AFTER: FT
WIDTH BEFORE (based on normal high water contours): FT
AVERAGE DEPTH BEFORE: FT AFTER: FT
(2) STREAiV1 CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: PLACEMENT OF PIPE IN CHANNEL: V
CHANNEL EXCAVATION: COONSTRUCTION OF A DAM/FLOODING:
OTHER:
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WATERSHED
DRAINING TO THE POND?
POND SURFACE AREA?
WHAT IS THE EXPECTED
12. DISC=ON OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPMENT TO BE USED? (ATTACH PLANS; 81/2 BY 11 DRAWINGS ONLY)
17>Xcf>6-1lS- itil-ril ! C0 /4z"x 1) i" cnn,pA
TLXG //4-Yl4-MrZ- 7y IS SIfc- UT1LI Z- 1e-4
13. PURPOSE OF PROPOSED WORK: IZePL_Aer-K- Prr-FI L.1IC-NT" RIZ)n AIS-
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS) -
15. YOU ARE REQUIRED TO CONTACT THE US FISH AND WILDLIFE SERVICE AND/OR
NATIONAL MARINE FISHERIES SERIVE REGARDING THE PRESENCE OF ANY FEDERALY
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: ?" It L?s rr?srL-
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER
(SHPO) REGARDING THE PRESENCE OF HISTORIC PROPERTIES IN THE PERMIT AREA
WHICH MAY BE AFFECTED BY THE PROPOSED PROJECT. DATE CONTACTED
gY LI?TT1cyL
17. DOES THE PROJECT i dVOLVE AN ENDITURE OF PUBLIC FUNDS OT THE USE OF
PUBLIC (STATE) LAND? YES ( NO ( ) (IF NO, GO TO 16) _
a. IF YES, DOES THE PROJECT REQUIRE PREPERATION OF AN ENVIRONMENTAL
DOCUMENT PURUANT TO THE REQUIREMENTS OF ORTH CAROLINA
ENVIRONMEN'T'AL POLICY ACT? YES( ) NO ( THE
b. IF YES, HAS THE DOCUMENT BEEN REFIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE YES ( ) NO ( %--?
IF ANSWER 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATIONFROM 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 OF FILL MATERIAL INTO
WETLANDS:
a. WETLAND DELINEATION MAP SHOWING ALL WETLANDS, STREAMS, LAKES, AND
PONDS ON THE PROPERTY (FOR NATIONWIDE PEP-MIT NUMBERS 14, 18, 21, 26, 29,
AND 38). ALL STREAKS (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 STORMWATER MANAGEMENT PLAN IF REQUIRED.
e. WHAT IS LAND USE OF SURROUNDING PROPOERTY?
f. IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL?
g. SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE: WTLANDS 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,
2 o/
OWNER'S/AGENT'S SIGNATURE DATE
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED).
.' 1441yui + nuur nri Mv. r dx • 71 y- f JJ-J?25? Jul 1J 2WU 10:b8 P. 04
MINIMUM CRITERIA DETERbONATION CHECKLIST
The following questions provide direction In determining whether a pmpoaed project haw only a
minimum potential for environmental effects. Answer the following questions by checking
either yea or no. Refer to the attached guidance for assistance.
TIP Project No.
State Project No. s -'7 S--Z
Project Location: (2)',NnOL-T`(4 I?iZin c,?E Nv
Ptoject Dweriptlon-. Ow-i'-A-r-le
Anticipated Permit or Consultation Requirements: M w ?-'
Special Project Information:

1
. --+ . i LL-v. rax . yJ `J r oo -o?id? Jul 20 2000 10:58 P.05
PAKf A; MM MUM CRITERIA YES NO
1, Is the prMposCd project listed es a type which would qualify
as a Non Major Action under the Minimum Criteria?
PART B: MM M UM CRITERIA EXCEPTIONS
2. Is the proposed project likely to precipitate siWcant, foreseeable l y
Alterations in land use, planned growth, or development patterns?
3- Does the proposed action divide or disrupt an established community?
4. Does the proposed action bypass an existing cornmunity7
5. Does the proposed action provide new access to area containing
significant amounts of exploitable nauzal resources?
6. Ia the proposed action likely to have a significant detrimental impact ?
on air quality?
7. Is the proposed action likely to have a significant detrimental impact
on ambient noise levels for adjoining areas?
8. Is the proposed action likely to have a significant impact on travel
patterns or traffic volumes?
9, Is the proposed action likely to significantly affect water quality?
10. Does the proposed action require the relocation of significant numbers
of people?
U. Is the project likely to be controversial? Q ff,
12. Will the proposed action require the use of land owned by the Q
U. S. Forest Service or the National Paris seryice?
PART C: COMPLL4,NCE WITH 5-rATE A.N1) FEDERAL REGULATIONS
Ecological lmpacts
13. Is a federally protected threatened or endangered species, or its habitat,
likely to be impacted by tho proposed action?
14. Does the action require the p:acement of fill in waters of the United States?
2
•?? nuunnrJ Lrv. rdxoyt?-(00-JJ2S5 Jul 20 2000 10:58 P.06
15. Does the project require the plac=cnt of a significant amount of 911 in ?
high quality or relatively rare wetland ecosystems, such as mountain bogs
or One savannahs?
16. Does the project require steam ralmdon or chmicl chauges? ?
17. Is the proposed action located in an Area of Environmental Concern,
as defied in the Coastal Area Management Act?
Cultural Reno es
18. Will the prajoct have an "cffcct" on & property or site listed on the
National Register of Historic Places?
19. Wilt the proposed action require acquisition of additional right of way
firm publicly owned parkland or recreational areas?
Reviewed by; Date:
Project Flanning Engineer
Project Planning Unit Head
? a`
? a?
If any questions 2 through 12 are answered "yes". the proposed project does not qualify as a
Non-Major Action. A state environmental assessment (EA) will be required. For assistance,
contact:
William D. Gilmore, P. E.
Manager, Project Development and Environmental Analysis Branch
P. 0. Box 25201
Raleigh, NC 27611
[phone]
Fax: [phone]
Questions in Pare C are designed to assist the Engineer in-determining whether a permit or
consultarion with a state or federal resource agency may be required. If any question in Part C is
answered "Yes", refer to the Environmental Guidance section of this document and contact the
appropriate individual for assistance.
a`'SWF
r6?
?Qowrd?
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
JAMES B. HUNT JR.
GovERNOR
September 19, 2000
COUNTY: Randolph
MEMORANDUM TO: Mr. E.B. Nelson, PE
Bridge Maintenance Superintendent
FROM: Roger E. D'Jernes
Regional Hydraulics Engineer
SUBJECT: Bridge Number 358 Replacement Recommendation
On SR-2871
DAVID MCCOY
SECRETARY
Pursuant to the request on June 29, 2000, for a structure recommendation at the above
subject site, the following is offered.
Drainage Area: 1.3 Square Miles
Existing structure: 41' Single Span Bridge
Recommended pipe size: 2 90"
Alternate Structure: 1 (a? 142" X 91" CSPA
This recommendation is made from an office review only. Specific site conditions or
limitations may dictate the use of an alternate structure. If such conditions are noted, please
contact this office for further analysis.
RED
cc: Mr. W.F. Rosser, P.E.
Mr. J.L. Picklesimer, PE, PLS
0
I-D SopoQuads Copyright ® 1999 DeLorme Yarmouth, 12 04096 Source Data: DSGS I--- 500 ft Scale: 1 : 12,800 Detail: 14-0 Datum: VGS84
/ X460
v 0 ) ..•
-1 218° • 49
\ ' -- ' t'-_., , •\ I 248, /• X72 1' 02q, p
P397 i _
113
-'; ' • ,= 440. /" / 25,1 • l "'« a - ?- I
Wl.
1 ?
? e\ s 1 ?, ?? 1 i•• 0201 2 /•'ti..
it P459
J ati --` 4 / r' a 1.4 02
2821 .
7.0
F I i/ i )' // zb,a c C458 lib J i
-632
'-C486?
j .O ,- .1, ti ._•? I rr°°, O??A O ; 2saz r 2M
raft
? a ,\ ? ai
i i 81 it 4 `
( a 11 /
3 /' .. / ?.l' • . \ 2557 u 25? g
188 c-'C134
1- -1
2638 \ i
ZW7
187 1 P165 l P45 ;yam,
3
.7 318
u+e w5 ° -. ••\ _ asos ,4 asea P186 2591
a '•a r ?2sa?ev? •t'2l
sovm
..? .2mat' /257 ; N m °"' 3 4 p? 030 ?-
M tr N
i' °? 228 ! "o, ? 73 a, / '1 i
184 _..\ 162 ! /
%04 I zb! o1.wr \ P491 i / ..? sao ase2?.y2 I
\ a r
P44 48?? -21
!!! N 283 /
rNnc ? /•21 P485
O 163 i
P338-1 Z331 29111 2974 l
1., 359 '') i/° 1.3 Ilow
j 0 I (225 1213 - ) .894 Fa- , ?.304 I
J -n
r ? 2 2909 - '4 214 1, t C189 199 1 \ i
03
- - ]60,\
X212
4a 220\ mt 215
29os .9 Oner\ (i-.? i •`?•?b l .s .5 2rri4
•/ ?•j"
P22?iw' i .? N 219 _ ?90
\P449- 7 as43
1 2x45
/ / 42 1 .' f• , 3 / OMOM 2883 I
.3 2873 4 I
,123_, , Ll31 -/ •`\ -,•\ 2901 '1 ••\ - 1:? .5 1 3r:
372 n ` wMYy Pt6 \ 223 `. 2908 1 +• N ` ^ / \ 4 C
ages i
' 198
1 ,136 za4s9 P504\• r
1C7 1887 1.5 l:
f ) % • r -.\ 221 $ ` ;y% 1003
?2 N r y l i s 2929 \ :? y^ p2
„zr i' y ?'
aM3 384 SEG`? ?_- am3 . ??, P-196_\ 4222
?• c c-
1, 211 349 ?•\ , ].? 1
121 s ' 1'' /: ?? tii /J \ l 1 X.. 3?8 \ ./ 2 ^ 1
. _ ?? •? !? N
306,,/
1 1 206
•'? .a ?. 2° t i { .t; !? / ^ ya \ t ! `2ffl n ?` X73. n ' 's
IB 1120 or 2672 2m 192 i
live i 1°02 05 . ') 208
,,,9 *A
x.344 ., zees 493 °' _ .? 2V4 i
. •
/ 2es¢ /. ° 210 ?i ''' -? '/ • ` ` , 2873 i
-ow
{.•r 339 209IOM 415 ........ sSlf .6 °
2"D
2M a
u N T Y, M O O R E C O U N' T Y
i
6
7
8
'^ ` , j, .4:?^' `• ?. s leu
Creek
ri,
Ito
=ark
'Te
_ ?? _ ? --?.. ? ?• 1 1, ???`?. Y? ?L?y
O
N
O O
o

w z

LA.) z
0
N

O O
w n
\
N V
o y
O ?
N

O
A

O C
O

O
O
i

z

H

N p
o
O
O
0
D
Z
Z
O
J
v
N
Ln
D
m
0
N
\
O
O
\
N
O
O
N
Z`
n