20010841 Ver 1_Complete File_20010605

1 f Alan W 'Klimek, P.E. Director
--I DMsior, of Water Ouality
;
DWQ Project No.: 0/091/1 County:
Applicant: AlcboT-
Project Name: L'oyNG/(?- Ill1,4P_p F311
Date of Issuance of 401 Water Quality Certification:
.(,4117-14 aG/?
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, 1650 Mail Service Center, Raleigh, NC,
27699-1650. This form may be returned to DWQ by the applicant, the applicant's authorized agent, or
the project engineer. It is not necessary to send certificates from all of these.
Applicant's Certification
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:
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
A4-- as a duly registered Professional
Engineer, Landscape Architect, Surveyor, etc.) in the State of North Carolina, having been authorized
to observe (periodically, weekly, full time) the construction of the project, for the Perrnitee hereby state
that, to the best of my abilities, due care and diligence was used in the observation of the construction
such that the construction was observed to be built within substantial compliance and intent of the 401
Water Quality Certification and Buffer Rules, the approved plans and specifications, and other
supporting materials.
Signature Registration No. Date
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/
As
Na
0? w A r?Rp?
(LAL r,
Michael F. Easley _
Governor
William G. Ross, Jr., Secretary
Department of Environment and Natural Resources
Kerr T. Stevens
Division of Water Quality
June 8, 2001
Watauga County
DWQ Project No. 010841
SR 1206 (Council Ward Road)
APPROVAL of 401 Water Quality Certification with Additional Conditions
Mr. Heath Slaughter, Division Environmental Officer
NCDOT Division 11
P.O. Box 250
North Wilkesboro, NC 28659
Dear Mr. Slaughter:
You have our approval, in accordance with the attached conditions and those listed below, to impact 120
linear feet of unnamed tributaries and relocated another tributary [from Sta. 0+15 to Sta. 1+001 to Stone
Mountain Branch in order to improve SR 1206 (Council Ward Road) in Watauga County. The project
should be constructed in accordance with your application dated 1 June 2001 (received 5 June 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 be valid, you must follow the conditions listed in the attached certification and any additional
conditions listed below.
1
2
3.
4.
5.
6.
The relocated stream section shall match the existing hydrology and sediment transport.
Any trout conditions as determined by the North Carolina Wildlife Resources Commission, to protect
the egg and fry stages of trout from sedimentation during construction.
Culverts required for this project shall be installed in such a manner that the original stream profile is
not altered (i.e. the depth of the channel should not be reduced by a widening of the streambed).
Existing stream dimensions are to be maintained above and below locations of culvert extensions.
All work shall be performed during low flow conditions.
The presence of equipment in the channels must be minimized. Under no circumstances should 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.
Mowing of existing vegetated buffers is strongly discouraged, so that they may be utilized for storm
water sheet flow.
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/
Page 2 of 2
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 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 919.733.5715 or Ms.
Jennifer Frye of the Winston-Salem Regional Office at 336.771.4600.
Sincerely,
Attachment
cc: Wilmington District Corps of Engineers
Corps of Engineers Asheville Field Office
NCDWQ Winston-Salem Regional Office
Central Files
File Copy

AdSWt
y ?°
?S
401 ISSUED
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY P. O. Box 25201, Raleigh, NC 27611-5202 YND0pTIPPF, -
GOVLRNOR Piiox: 919-733-2520 ','.,.1'scTd?Y?r
June 1, 2001 l
Mr. Steve Lund
U. S. Army Corps of Engineers
Asheville Regulatory Field Office
151 Patton Avenue, Room 143
Asheville, NC 28801
Subject: Nationwide Permit 914
SR 1206 (Council Ward Road)
Watauga County, North Carolina
Dear Mr. Lund:
The NC Department of Transportation is scheduled to grade, drain, base, and pave primarily
along the existing roadway of SR 1206 (Council Ward Road) in Watauga County. This project
will require the replacement of eight (8) wet cross lines as shown below:
1) Replace existing 30'x 73"x 42" CMP at station 0+15 with 2 lines of 40'x 48" CMP.
2) Replace existing 20'x 18" CMP at station 0+50 with a 30'x 24" CMP.
3) Replace existing 30'x 36" CMP at station 3+00 with a 40'x 48" CMP.
4) Replace existing 30'x 18" CMP at station 11+50 with a 50'x 24" CMP.
5) Replace existing 30'x 30" CMP at station 18+00 with a 40'x 36" CMP.
6) Replace existing 40'x 24" CMP at station 33+55 with a 50'x 24" CMP.
7) Replace existing 100'x 24" CMP at station 34+70 with a 100'x 36" CMP.
8) Replace existing 30'x 18" CMP at station 51+50 with a 40'x 24" CMP.
Miscellaneous rip-rap impacts will total 40 linear feet or less. New stream impacts = 120 In. feet.
In addition to the above noted impacts, we are also proposing to relocate a wet ditch from station
0+15 - 1+00. Unnamed tributary #1 of Stone Mountain Branch enters the roadway ditch line
from the east and travels through the ditch starting at station 1+00 and terminates at station 0+15
(Stone Mountain Branch). We are proposing to move the ditch and the stream that travels
through it approximately 2 feet to the east. The existing stream/ditch dimensions, pattern and
profile will remain the same. There should be no net loss or gain of stream linear footage.
Impacts to this area could not be avoided due to right-of-way restrictions on the other side of the
road.
P. O. Box 250, N. WILKESBORo, NC 28659 nn?/((?? qq?
lE?
PHONE [phone] FAx [phone] ?r1? `?
?ECEI?JED
400, Mr. Steve Lund
SR 1206 (Council Ward Road)
Page 2
June 1, 2001
Please note that the crossing at station 0+15 carries Stone Mountain Branch. All of the remaining
wet crossings carry different unnamed tributaries to Stone Mountain Branch (Class: C). Since
this is an existing roadway, the minor modifications proposed in this application should not
remove or degrade existing water quality uses. By utilizing the erosion control measures outlined
in the attachments to this application, downstream water quality standards will be protected.
No Threatened or Endangered Species (or their critical habitat) will be impacted by this project.
Any widening of the existing roadway will be directed away from any adjacent creek whenever
possible with minimum fill placed in any buffer area. Pipe sizes used will be the minimum
necessary to create a safe roadway. The total project length is approximately 1.2 miles. Due to
the proposed work, we are requesting a 404 Nationwide Permit #14.
Attached is a Preconstruction Notification Form, plan sheets with proposed erosion control
measures, pipe crossing information, a marked county map, a marked topography map and
photographs.
By copy of this letter, it is requested that Mr. Ron Linville, Mountain Region Coordinator, with
the North Carolina Wildlife Resources Commission comment directly to you concerning the 404
Nationwide Permit application with a copy sent to me.
By copy of this letter, I am forwarding seven (7) copies of this application package to Cynthia
Van Der Wiele, NCDENR, Division of Water Quality, 401/Wetland Unit, for her review. A
$200.00 check is enclosed for the 401 certification processing fee. It is requested that any
comments related to the 401 certification be forwarded directly to the Corps with a copy sent to
me.
We would like to begin construction as soon as possible. If further information is required, please
let me know. Your early review and consideration will be greatly appreciated.
Sincerely,
Heath Slaughter
Division Environmental Officer
Enclosures
400, Mr. Steve Lund
SR 1206 (Council Ward Road)
Page 3
June 1, 2001
cc: Ron Linville, Western Piedmont Region Coordinator, NCWRC
Brian Cole, US Fish and Wildlife Service
Renee Gledhill-Earley, Environmental Review Coordinator, NCDCR
Cynthia Van Der Wiele, Division of Water Quality (7 copies)
R. C. McCann, PE, Division Engineer
Martin Bolick, District Engineer
Johnny Brown, County Maintenance Engineer
Heath Slaughter, Division Environmental Officer
Neil Trivette, Area Roadside Environmental Engineer

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oFwaTF?
Pre-Construction Notification (PCN) Application Form
For Section 404 and/or Section 10 Nationwide, Regional and General Permits, Section 401
General Water Quality Certifications, and Riparian Buffer and Watershed Buffer Rules
This form is to be used for projects qualifying for any of the U.S. Army Corps of Engineers' (USACE)
Nationwide, Regional or General Permits as required by Section 404 of the Clean Water Act and/or
Section 10 of the Rivers and Harbors Act, and for the North Carolina Division of Water Quality's
(DWQ) associated General 401 Water Quality Certifications. This form is also to be used for any
project requiring approval under any Riparian Buffer Rules implemented by the N.C. Division of Water
Quality. This form should not be used if you are requesting an Individual 404 Permit or Individual 401
Water Quality Certification. The USACE Individual Permit application form is -available online at
http://www.saw.usace.army.mil/wetlands/Permapp.htn
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:Hwww.saw.usace.army.miI/wetlands/regtour.litm, 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
htth://h2o.enr.state.nc.us/ncwetlands 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).
n_ __ 1 _c I,%
4A
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 h:Hwww.saw.usace.arniy.mii/wetlands/nwpfinalFedReQ.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 $200 is required. If either of these thresholds is exceeded, then a fee of $475 is
required. A check made out to the North Carolina Division of Water Quality, with the specific name of
the project or applicant identified, should be stapled to the front of the application package. For more
information, see the DWQ website at ham://li2o.ehnr.state.nc.us/ncwetlands/fees.litnil. 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.
n^-^ It -r I It

Office Use Only: Fonn Version April 2001
USACE Action ID No. DWQ No. 0 .1
If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A" rather than
leaving the space blank.
1. Processing
1. Check all of the approval(s) requested for this project:
® Section 404 Permit
? Section 10 Permit
® 401 Water Quality Certification
? Riparian or Watershed Buffer Rules
2. Nationwide, Regional or General Permit Number(s) Requested:
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: ?
H. Applicant Information
1. Owner/Applicant Information
Name: North Carolina Department of Transportation
Mailing Address: P O Box 250, North Wilkesboro NC 28659
Telephone Number: [phone] Fax Number: [phone]
E-mail Address: hslaughter a dot. state.nc.us
2. Agent Information (A signed and dated copy of the Agent Authorization letter must be
attached if the Agent has signatory authority for the owner/applicant.)
Name: Heath Slaughter Division Environmental Officer
Company Affiliation: North Carolina Department of Transportation
Mailing Address: P. O. Box 250, North Wilkesboro, NC 28659
Telephone Number: [phone] Fax Number: [phone]
E-mail Address: hslaughter a dot. state.nc.us

9
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: ' SR 1206, Council Road
2. T.I.P. Project Number (NCDOT Only): N/A
3. Property Identification Number (Tax PIN): N
4. Location
County: Watauga Nearest Town: Boone
Subdivision name (include phase/lot number): N/A
Directions to site (include road numbers, landmarks, etc.): From Boone, travel northwest on
US 321 until you are several miles from the TN state line. Turn right onto SR 1200. Turn
left onto SR 1201and then left again onto SR 1206
5. Site coordinates, if available (UTM or Lat/Long):
(Note - If project is linear, such as a road or utility line, attach a sheet that separately lists the
coordinates for each crossing of a distinct waterbody.)
6. Describe the existing land use or condition of the site at the time of this application:
Residential/Farm
7. Property size (acres): Approximately 2.9 acres
8. Nearest body of water (stream/river/sound/ocean/lake): Stone Mountain Branch and UTs
of Stone Mountain Branch (Class: C)
9. River Basin: Watauga
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http://li2o.enr.state.nc.us/admin/maps/.)
T%--- A -e l ll

10. Describe the purpose of the proposed work: Improvement of SR 1206.
11. List the type of equipment to be used to construct the project: Trackhoe, backhoe, and motor
12. Describe the land use in the vicinity of this project: Residentia]/Farm
IV. Prior Project History
If jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Include
the USACE Action ID Number, DWQ Project Number, application date, and date permits and
certifications were issued or withdrawn. Provide photocopies of previously issued permits,
certifications or other useful information. Describe previously approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits issued for prior segments of the same T.I.P. project, along with
construction schedules.
N/A
V. Future Project Plans
Are any additional permit requests anticipated for this project in the future? If so, describe the
anticipated work, and provide justification for the exclusion of this work from the current
application: No
VI. Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. The applicant must also
provide justification for these impacts in Section VII below. All proposed impacts, permanent
and temporary, must be listed herein, and must be clearly identifiable on an accompanying site
plan. All wetlands and waters, and all streams (intermittent and perennial) must be shown on a
delineation map, whether or not impacts are proposed to these systems. Wetland and stream
evaluation and delineation forms should be included as appropriate. Photographs may be
included at the applicant's discretion. If this proposed impact is strictly for wetland or stream
mitigation, list and describe the impact in Section VIII below. If additional space is needed for
listing or description, please attach a separate sheet.
11?-- C -4r III
4pA
1. Wetland Impacts
Wetland Impact Area of Located within Distance to
Site Number Type of Impact* Impact 100-year Floodplain** Nearest Stream Type of Wetland***
indicate on ma acres ( es/110) feet
N/A
* 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 httn'//????w.tema.gov.
*** List a wetland type that best describes wetland to be impacted (e.g., freshwater/salhvater marsh, forested wetland, beaver pond,
Carolina Bay, bog, etc.)
List the total acreage (estimated) of existing wetlands on the property: 0 acres
Total area of wetland impact proposed: 0 acres
2. Stream Impacts, including all intermittent and perennial streams
Stream Impact Length of Average
Width of Perennial or
Site Number Type of Impact* Impact Stream Name**
Stream Before intermittent?
(indicate on map) (linear feet)
Impact (please specify)
Station No. 0+15 Pipe replacement 10 feet Stone Mountain Branch 3 feet Perennial
Station No. 0+50 Pipe replacement 10 feet UT # 1 of Stone
Mountain Branch 1 foot Perennial
Stations 0+15 - Stream No net loss UT #I of Stone 1 foot Perennial
1+00 Relocation Mountain Branch
Station No. 3+00 Pipe replacement 10 feet UT 112 of Stone
Mountain Branch 3 feet Perennial
Station No. 11+50 Pipe replacement 20 feet UT #3 of Stone
Mountain Branch 1 foot Perennial
Station No. 18+00 Pipe replacement 10 feet UT 84 of Stone
Mountain Branch 1 foot Seep
Station No. 33+55 Pipe replacement 10 feet UT #5 of Stone
Mountain Branch 1 foot Perennial
Station No. 34+70 Pipe replacement 0 feet UT #6 of Stone
Mountain Branch 2 feet Perennial
Station No. 51+50 Pipe replacement 10 feet UT 47 of Stone
Mountain Branch 1 foot Perennial
Miscellaneous Approx. 40
All of the above rip-rap feet Stone Mountain Branch 1-3 feet Perennial Stream or
placement for or less and UTs Seep
stabilization (5 ft./pipe)
* 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 afler, 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
n...-.. c „c 1 .1
40A
NtiA"-\V.usPs.nov. Several Internet sites also allow direct download and printing of USGS maps (e.g., Nruw.topozone.com,
www.nripquest.Coln, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: 1201n. ft. of new impacts.
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, ocean, etc.)
N/A

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: fill, excavation, dredging,
flooding, drainage, bulkheads, etc.
4. Pond Creation
If construction of a pond is proposed, associated wetland and stream impacts should be
included above in the wetland and stream impact sections. Also, the proposed pond should
be described here and illustrated on any maps included with this application.
Pond to be created in (check all that apply): ? uplands ? stream ? wetlands
Describe the method of construction (e.g., dam/embankment, excavation, installation. of
draw-down valve or spillway, etc.): N/A
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.):
Size of watershed draining to pond: Expected pond surface area:
VII. Impact Justification (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It may be useful to provide
information related to site constraints such as topography, building ordinances, accessibility, and
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.
The existing roadway must be widened to achieve an acceptable section width, thus increasing
public safety. The existing pipes must be replaced for the same reason. By utilizing the erosion
control measures as shown in the attached drawings adverse impacts to streams in the area will
be minimized Since this is an existing roadway, the stream impacts cannot be avoided. The
stream relocation from 1+00 to 0+15 could not be avoided due to right-of-way restrictions.
Pipe replacement lengths will be the minimum needed to construct the widened roadway.
n---17 -C In

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
littp://li2o.etir.state.nc.tis/ncwetlands/strm.ide.litmi.
Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
n.. -- 0 -c In

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 1ittp:02o.cnr.state.tic.us/wrp/inde..litm. If
use of the NCWRP is proposed, please check the appropriate box on page three and provide
the following information:
Amount of stream mitigation requested (linear feet): N/A
Amount of buffer mitigation requested (square feet): N/A
Amount of Riparian wetland mitigation requested (acres): N/A
Amount of Non-riparian wetland mitigation requested (acres): N/A
Amount of Coastal wetland mitigation requested (acres): N/A
IX. Environmental Documentation (DWQ Only)
Does the project involve an expenditure of public funds or the use of public (federal/state/local)
land?
Yes ® No ?
If yes, does the project require preparation of an environmental document pursuant to the
requirements of the National or North Carolina Environmental Policy Act (NEPA/SEPA)?
Note: If you are not sure whether a NEPA/SEPA document is required, call the SEPA
coordinator at [phone] to review current thresholds for environmental documentation.
Yes ? No
If yes, has the document review been finalized by the State Clearinghouse? If so, please attach a
copy of the NEPA or SEPA final approval letter.
Yes ? No ?
X. Proposed Impacts on Riparian and Watershed Buffers (DWQ Only)
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
required state and local buffers associated with the project. The applicant must also provide
justification for these impacts in Section VII above. All proposed impacts must be listed herein,
and must be clearly identifiable on the accompanying site plan. All buffers must be shown on a
map, whether or not impacts are proposed to the buffers. Correspondence from the DWQ
Regional Office may be included as appropriate. Photographs may also be included at the
applicant's discretion.
Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Neuse), 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:
"--- n t
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
# "Lone 1 calends out 3U lect perpendicular trom near bank of channel; Gone L 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 2B .0242 or.0260.
N/A
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.
Please refer to the attached erosion control plan.
XH. 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.
N/A
XIII. Violations (DWQ Only)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H.0500) or any Buffer Rules?
Yes ? No
Is this an after-the-fact permit application?
Yes ? No
n....., In ..c 1 11
XIV. Other Circumstances (Optional):
It is the applicant's responsibility to submit the application sufficiently in advance of desired
construction dates to allow processing time for these permits. However, an applicant may
choose to list constraints associated with construction or sequencing that may impose limits on
work schedules (e.g., draw-down schedules for lakes, dates associated with Endangered and
Threatened Species, accessibility problems, or other issues outside of the applicant's control).
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
US Army Corps Of Engineers Field Offices and County Coverage
Asheville Regulatory Field Office Alexander Cherokee Iredell Mitchell
US Anny 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 Alannance Durlia n Johnston Rockingham
US Anny Corps Of Engineers Alleglnany Edgecombe Lee Stokes
6508 Falls of the Neuse Road Ashe Franklin Nash Suer}'
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
Waslington, 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
Post Office Box 1890 Brunswick Hoke Ricluuond
Wilmington, NC 28402-1890 Carteret Montgomery Robeson
Telephone: [phone] Columbus Moore Sampson
Fax: [phone] Cumberland New Hanover Scotland
Pitt
Tyrrell
Washington
Wayne
Union.
Watauga
• Yancey
Wilson
Yadkin
*Croatann National Forest Only

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 N.'
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 Perquinnans
Telephone: [phone] Camden Dare Onslow Tyrrell
Fax: [phone] Carteret Gates Pamlico Washington
NCWRC and NC Trout Countieg
Western Piedmont Region Coordinator Alleglnany Caldwell Watauga
3855 Idlewild Road Ashe Mitchell Wilkes
Kennersville, NC 27284-9180 Avery Stokes
Telephone: [phone] Burke Surry
Mountain Region Coordinator Buncombe Henderson Polk
20830 Great Smoky Mtn. ENpressNN,ay Cherokee Jackson Rutherford
Waynesville, NC 28786 Clay Macon Swain
Telephone: [phone] Gralnann Madison Transylvai-da
Fax: [phone] Haywood McDowell Yancey
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NORTH CAROLINA DEPARTMENT OF TRANSPORTATION
EROSION AND SEDIMENTATION CONTROL PLAN
PROJECT b, 7520'73 -T SR S?'/o? O'6 COUNTY V,7 ?u u e q
PREPARED BY C L /i. J'?c ! e /-7'
APPROVED BY
DATE 3 -;3 '2-0j
Std? z ?n .s .ri tinn vm nl Page
245.03 Temporary Silt Ditch .............................. r;o VI -2
245.05 Temporary Diversion ............................. 'M VI 4
893
01 Temporary Silt Fence
VI-6
. --------
th B
i
h E E-
890.05 erm
ar
t
Temporary Slope Drain w ......... - VI-3
245.01 Silt Basin Type A .................................. : - -------- VI-10
_ 245.02 Silt Basin Type B ___ ________________"_
----------------- 7/7 ___ VI 12
.892.04 Temporary Rock Silt Check Type-A ......... . ----------- VI-14
895.10 Temporary Rock Silt Check Type-B ._..._... . ------------ VI 16
892.01 Temporary Rock Sediment Dam Type-A
892.02 Temporary Rock Sediment Dam Type-B _ _.
1) -----------
VI-20
897.01 Rock Pipe Inlet Protection - 'e eo 110

eie
o
VI - 22
894.01 ______________________
Rock Silt Screen ...................................... __•
... 2. ?
_ 5 VI-24
2^-.5.04 Stilling Basin .......................................... .......... .. v:q ----- VI-26
Rock Inlet Protection:
896.01 Type A ............................... ACC - OR - A 1? ----- VI 30
896.02 Type B ............................... B OR - ..[3 -----
VI -
32
8°6.03 Type C ------------------ .. C? ] --OR - - C) VI-34
Pipe Outlet Energy Dissipator ...... ©©a ....
0000 VI - 35
Inlet/Outlet Protection .......... .. D .... N/A
March, 1993
ROADSIDE ENVIRONMENTAL ENGINEER
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