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HomeMy WebLinkAbout20020500 Ver 1_Complete File_20020401.iAAgo? STATE OF NORTH CAROLINA DEPARTMENT OF TRANSPORTATION MICHAEL F. EASLEY GOVERNOR P. O. Box 25201, Raleigh, NC 27611-5202 PHONE: 919-733-2520 March 25, 2002 Mrs. Jean Manuele U. S. Army Corps of Engineers Raleigh Regulatory Field Office 6508 Falls of Neuse Road, Suite 120 Raleigh, NC 27615 Subject: Nationwide Permit #3 & #33 Bridge #213 on SR 1361 Ashe County, North Carolina Project Number: 5.7152 (No DWQ Permit Fee Required) 020500: Dear Mrs. Manuele: The NC Department of Transportation is scheduled to rep e B 213 on SR 1361 in he County. The existing 17' long x 18' wide bridge will be replaced with a ne ' long ' wide bridge with steel beams and a woo floor. No detour is proposed. Miscellaneous rip-rap impacts ' total 40 linear feet or ess. New stream ' acts = 401n. feet. The replacement of Bridge #213 will require temporary dewatering. Two 55' long unpervious sandbag dikes will be constructed near the waters edge running parallel with each abutment (see attached diagram). During construction, the creek will be allowed to flow freely through the existing channel as it does now. Any dirty water located inside the construction area will be pumped into a silt bag. The dewatered area will total approximately 220 square feet or 0.005 acres. Once the new structure is in place, the impervious sandbag dike will be removed and preconstruction streambed elevations will be restored. Construction of this project will necessitate impacts to waters of the United States in the New River Basin. The bridge, in question crosses Ripshin Branch (Class: C, Trout, HQW). The Division 11 Environmental Officer reviewed this project for the presence of threatened and endangered species on March 21, 2002. The subject project has been determined to have no effect on any federally listed endangered plant or animal species. Historic compliance work will be scheduled and concurrence with the State Historic Preservation Office will be obtained if required. P. O. Box 250, N. WILKESBORO, NC 28659 PHONE (336) 667-9111 FAx (336) 667-4549 LYNDO TIPPETT SECRETARY i Mrs. Jean Manuele Bridge #213 on SR 1361, Ashe Page 2 March 25, 2002 The 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. Attached is a Preconstruction Notification Form, plan sheets with proposed erosion control measures, 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. 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 appreciated. Sincerely, ;6/? '44- Heath Slaughter Division Environmental Officer Enclosures cc: Jean Manuele, US Army Corps of Engineers (1 additional copy) Ron Linville, Western Piedmont Region Coordinator, NCWRC Cynthia Van Der Wiele, Division of Water Quality (2 copies) R. C. McCann, PE, Division Engineer Heath Slaughter, Division Environmental Officer Neil Trivette, Roadside Environmental Field Operations Engineer Dennis Bennett, Bridge Maintenance Engineer Office Use Only: C Form Version Apri12001 USACE Action ID No. DWQ No. Q 2 O 5 O 0 If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A" rather than leaving the space blank. I. Processing 1. Check all of the approval(s) requested for this project: ® Section 404 Permit ? Section 10 Permit ? 401 Water Quality Certification ? Riparian or Watershed Buffer Rules 2. Nationwide, Regional or General Permit Number(s) Requested: NW #3 & NW #33 It 3. If this notification is solely a courtesy copy because written approval for the 401 Certification is not required, check here: 4. If payment into the North Carolina Wetlands Restoration Program (NCWRP) is proposed for mitigation of impacts (see section VIII - Mitigation), check here: ? 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: (336) 903-9236 Fax Number: (336) 903-9239 E-mail Address: hslauahter@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: (336) 903-9236 Fax Number: (336) 903-9239 E-mail Address: hslaugbLer@dot-state-nc.us Page 3 of 12 III. Project Information Attach a vicinity map clearly showing the location of the property with respect to local landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property boundaries and development plans in relation to surrounding properties. Both the vicinity map and site plan must include a scale and north arrow. The specific footprints of all buildings, impervious surfaces, or other facilities must be included. If possible, the maps and plans should include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion, so long as the property is clearly defined. For administrative and distribution purposes, the USACE requires information to be submitted on sheets no larger than 11 by 17-inch format; however, DWQ may accept paperwork of any size. DWQ prefers full-size construction drawings rather than a sequential sheet version of the full-size plans. If full-size plans are reduced to a small scale such that the final version is illegible, the applicant will be informed that the project has been placed on hold until decipherable maps are provided. 1. Name of project: Bridge #213 on SR 1361 2. T.I.P. Project Number or State Project Number (NCDOT Only): 5.7152 3. Property Identification Number (Tax PIN): N/A 4. Location County: Ashe Nearest Town: Farmers Store Subdivision name (include phase/lot number): N/A Directions to site (include road numbers, landmarks, etc.): From Farmers Store, travel east on SR 1359. Turn right onto SR 1361. 5. Site coordinates, if available (UTM or Lat/Long): UTM: 17 445495E 404754IN (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 0.03 acres. 8. Nearest body of water (stream/river/sound/ocean/lake): Ripshin Branch (Class: C. Trout, HQW) 9. River Basin: New (Note - this must be one of North Carolina's seventeen designated major river basins. The River Basin map is available at http://h2o.enr.state.nc.us/admin/m".) Page 4 of 12 10. Describe the purpose of the proposed work: Upgrade existing stream crossing;. 11. List the type of equipment to be used to construct the project: Trackhoe/backhoe and dump trucks 12. Describe the land use in the vicinity of this project: Residential/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: N/A 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. Page 5 of 12 1. Wetland Impacts Wetland Impact Site Number indicate on ma Type of Impact* Area of Impact acres Located within 100-year Floodplain** es/no Distance to Nearest Stream linear feet Type of Wetland*** N/A I * List each impact separately and identify temporary impacts. Impacts include, but are not limited to: mechanized clearing, grading, ti11, excavation, flooding, ditchinedrainage, 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 htW://www.fem&gov. *** List a wetland type that best describes wetland to be impacted (e.g., freshwater/saltwater marsh, forested wetland, beaver pond, Carolina Bay, bog, etc.) List the total acreage (estimated) of existing wetlands on the property: 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) Bridge #213 Replacing bridge 0 feet Ripshin Branch 7 feet Perennial with new bridge Miscellaneous Bridge #213 rip-rap placement for 40 feet or less Ripshin Branch 7 feet Perennial stabilization Bridge #213 Temporary 55 linear feet or 220 Ripshin Branch 7 feet Perennial Dewatering square feet * List each impact separately and identify temporary impacts. Impacts include, but are not limited to: culverts and associated rip-rap, dams (separately list impacts due to both structure and flooding), relocation (include linear feet before and after, and net loss/gain), stabilization activities (cement wall, rip-rap, crib wall, gabions, etc.), excavation, ditching/straightening, etc. If stream relocation is proposed, plans and profiles showing the linear footprint for both the original and relocated streams must be included. ** Stream names can be found on USGS topographic maps. If a stream has no name, list as UT (unnamed tributary) to the nearest downstream named stream into which it flows. USGS maps are available through the USGS at 1-800-358-9616, or online at www.usgs.ov. Several Internet sites also allow direct download and printing of USGS maps (e.g., www.topozone.com. www.mavauest.com, etc.). Cumulative impacts (linear distance in feet) to all streams on site: 40 1n. ft. of new permanent 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, cean, 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 bridge must be replaced due to its condition. Impacts have been minimized by rehabilitating the existing bridge instead of using pipes. By utilizing the erosion control measures as shown in the attached drawings, adverse impacts to streams in the area will be minimized All approyriate BMPs will be used during construction. Page 7 of 12 VIII. Mitigation DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC Division of Water Quality for projects involving greater than or equal to one acre of impacts to freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial streams. USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide Permits, published in the Federal Register on March 9, 2000, mitigation will be required when necessary to ensure that adverse effects to the aquatic environment are minimal. Factors including size and type of proposed impact and function and relative value of the impacted aquatic resource will be considered in determining acceptability of appropriate and practicable mitigation as proposed. Examples of mitigation that may be appropriate and practicable include, but are not limited to: reducing the size of the project; establishing and maintaining wetland and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of f aquatic resource functions and values by creating, restoring, enhancing, or preserving similar functions and values, preferable in the same watershed. If mitigation is required for this project, a copy of the mitigation plan must be attached in order for USACE or DWQ to consider the application complete for processing. Any application lacking a required mitigation plan or NCWRP concurrence shall be placed on hold as incomplete. An applicant may also choose to review the current guidelines for stream restoration in DWQ's Draft Technical Guide for Stream Work in North Carolina, available at http://h2o.enr.state.nc.us/ncwetlands/strmgide.html. 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/A Page 8 of 12 2. Mitigation may also be made by payment into the North Carolina Wetlands Restoration Program (NCWRP) with the NCWRP's written agreement. Check the box indicating that you would like to pay into the NCWRP. Please note that payment into the NCWRP must be reviewed and approved before it can be used to satisfy mitigation requirements. Applicants will be notified early in the review process by the 401/Wetlands Unit if payment into the NCWRP is available as an option. For additional information regarding the application process for the NCWRP, check the NCWRP website at hn://h2o.enr.state.nc.gs/ /index.htm. If use of the NCWRP is proposed, please check the appropriate box on page three and provide the following information: Amount of stream mitigation requested (linear feet): 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 (919) 733-5083 to review current thresholds for environmental documentation. Yes El No If yes, has the document review been finalized by the State Clearinghouse? If so, please attach a copy of the NEPA or SEPA final approval letter. Yes ? No ? X. Proposed Impacts on Riparian and Watershed Buffers (DWQ Only) It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to required state and local buffers associated with the project. The applicant must also provide justification for these impacts in Section VII above. All proposed impacts must be listed herein, and must be clearly identifiable on the accompanying site plan. All buffers must be shown on a map, whether or not impacts are proposed to the buffers. Correspondence from the DWQ Regional Office may be included as appropriate. Photographs may also be included at the applicant's discretion. Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233 (Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and Water Supply Buffer Requirements), or other (please identify V Yes ? No ® If you answered "yes", provide the following information: Page 9 of 12 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 * Zone 1 extends out 30 feet perpendicular from near bank of channel; Zone 2 extends an additional 20 feet from the edge of Zone 1. If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation of Property, Conservation Easement, Riparian Buffer Restoration / Enhancement, Preservation or Payment into the Riparian Buffer Restoration Fund). Please attach all appropriate information as identified within 15A NCAC 2B .0242 or.0260. XI. Stormwater (DWQ Only) Describe impervious acreage (both existing and proposed) versus total acreage on the site. Discuss stormwater controls proposed in order to protect surface waters and wetlands downstream from the property. All appropriate best management Practices for sediment and erosion control will be implemented during construction. 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 XUL 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 Page 10 of 12 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 Signatu Date (Agent's signature is valid only if an authorization letter from the applicant is provided.) US Army Corps Of Engineers Field Offices and County Coverage Asheville Regulatory Field Office Alexander Cherokee Iredell Mitchell US Army Corps of Engineers Avery Clay Jackson Polk 151 Patton Avenue Buncombe Cleveland Lincoln Rowan Room 208 Burke Gaston Macon Rutherford Asheville, NC 28801-5006 Cabarrus Graham Madison Stanley Telephone: (828) 271-4854 Caldwell Haywood McDowell Swain Fax: (828) 271-4858 Catawba Henderson Mecklenburg Transylvania Raleigh Regulatory Field Office Alamance Durham Johnston Rockingham US Army Corps Of Engineers Alleghany Edgecombe Lee Stokes 6508 Falls of the Neuse Road Ashe Franklin Nash Surry Suite 120 Caswell Forsyth Northampton Vance Raleigh, NC 27615 Chatham Granville Orange Wake Telephone: (919) 876-8441 Davidson Guilford Person Warren Fax: (919) 876-5283 Davie Halifax Randolph Wilkes Washington Regulatory Field Office Beaufort Currituck Jones US Army Corps Of Engineers Bertie Dare Lenoir Post Office Box 1000 Camden Gates Martin Washington, NC 27889-1000 Carteret* Green Pamlico Telephone: (252) 975-1616 Chowan Hertford Pasquotank Fax: (252) 975-1399 Craven Hyde Perquimans Wilmington Regulatory Field Office Anson Duplin Onslow US Army Corps Of Engineers Bladen Harnett Pender Post Office Box 1890 Brunswick Hoke Richmond Wilmington, NC 28402-1890 Carteret Montgomery Robeson Telephone: (910) 251-4511 Columbus Moore Sampson ,?C-/C) Z Pitt Tyrrell Washington Wayne Union Watauga Yancey Wilson Yadkin *Croatan National Forest Only Page 11 of 12 >\ G I K. 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Bottom: Downstream view taken from Bridge #213 on SR 1361, Ashe County. 020500 STATE OF NORTH CAROLINA DEPARTMENT OF TRANSPORTATION MICHAEL F. EASLEY P. O. Box 25201, Raleigh, NC 27611-5202 LYNDO TIPPETT GOVERNOR PHoNE:919-733-2520 SECRETARY March 25, 2002 Mrs. Jean Manuele U. S. Army Corps of Engineers Raleigh Regulatory Field Office 6508 Falls of Neuse Road, Suite 120 Raleigh, NC 27615 F Subject: Nationwide Permit #3 & #33 Bridge 9213 on SR 1361 Ashe County, North Carolina Project Number: 5.7152 (No DWQ Permit Fee Required) Dear Mrs. Manuele: APR 10 The NC Department of Transportation is scheduled to replace Bridge #213 on SR 1361 in Ashe County. The existing 17' long x 18' wide bridge will be replaced with a new 20' long x 20' wide bridge with steel beams and a wood plank floor. No detour is proposed. Miscellaneous rip-rap impacts will total 40 linear feet or less. New stream impacts = 401n. feet. The replacement of Bridge #213 will require temporary dewatering. Two 55' long impervious sandbag dikes will be constructed near the waters edge running parallel with each abutment (see attached diagram). During construction, the creek will be allowed to flow freely through the existing channel as it does now. Any dirty water located inside the construction area will be pumped into a silt bag. The dewatered area will total approximately 220 square feet or 0.005 acres. Once the new structure is in place, the impervious sandbag dike will be removed and preconstruction streambed elevations will be restored. Construction of this project will necessitate impacts to waters of the United States in the New River Basin. The bridge, in question crosses Ripshin Branch (Class: C, Trout, HQW). The Division 11 Environmental Officer reviewed this project for the presence of threatened and endangered species on March 21, 2002. The subject project has been determined to have no effect on any federally listed endangered plant or animal species. Historic compliance work will be scheduled and concurrence with the State Historic Preservation Office will be obtained if required. t P. O. Box 250, N. WILZESBORO, NC 28659 PHONE (336)667-9111 FAx (336)6674549 Mrs. Jean Manuele Bridge #213 on SR 1361, Ashe Page 2 March 25, 2002 The 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. Attached is a Preconstruction Notification Form, plan sheets with proposed erosion control measures, 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. We would lice to begin construction as soon as possible. If further information is required, please let me know. Your early review and consideration will be appreciated. I Sincerely, -;6&e '4 Heath Slaughter Division Environmental Officer Enclosures cc: Jean Manuele, US Army Corps of Engineers (1 additional copy) Ron Linville, Western Piedmont Region Coordinator, NCWRC Cynthia Van Der Wiele, Division of Water Quality (2 copies) R. C. McCann, PE, Division Engineer Heath Slaughter, Division Environmental Officer Neil Trivette, Roadside Environmental Field Operations Engineer Dennis Bennett, Bridge Maintenance Engineer Office Use Only: Form Version April 2001 USACE Action ID No. DWQ No. 0 n.q n n 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 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: NW #3 & NW #33 It 3. If this notification is solely a courtesy copy because written approval for the 401 Certification is not required, check here: 4. If payment into the North Carolina Wetlands Restoration Program (NCWRP) is proposed for mitigation of impacts (see section VIII - Mitigation), check here: ? 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: (336) 903-9236 Fax Number: (336) 903-9239 E-mail Address: hlaaughter 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: (330 903-9236 Fax Number: (336) 903-9239 E-mail Address: hslaughterna dot state.nc.us Page 3 of 12 M. Project Information Attach a vicinity map clearly showing the location of the property with respect to local landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property boundaries and development plans in relation to surrounding properties. Both the vicinity map and site plan must include a scale and north arrow. The specific footprints of all buildings, impervious surfaces, or other facilities must be included. If possible, the maps and plans should include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion, so long as the property is clearly defined. For administrative and distribution purposes, the USACE requires information to be submitted on sheets no larger than 11 by 17-inch format; however, DWQ may accept paperwork of any size. DWQ prefers full-size construction drawings rather than a sequential sheet version of the full-size plans. If full-size plans are reduced to a small scale such that the final version is illegible, the applicant will be informed that the project has been placed on hold until decipherable maps are provided. 1. Name of project: Bridge #213 on SR 1361 2. T.I.P. Project Number or State Project Number (NCDOT Only): 5.7152 3. Property Identification Number (Tax PIN): N/A 4. Location County: Ashe Nearest Town: Farmers Store Subdivision name (include phase/lot number): N/A Directions to site (include road numbers, landmarks, etc.): From Farmers Store, travel east on SR 1359. Turn rijzht onto SR 1361. 5. Site coordinates, if available (UTM or Lat/Long): UTM: 17 445495E 404754IN (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 0.03 acres. 8. Nearest body of water (stream/river/sound/ocean/lake): Ripshin Branch (Class: C. Trout, HQW) 9. River Basin: New (Note - this must be one of North Carolina's seventeen designated major river basins. The River Basin map is available at http://h2o.enr.state.nc.us/admin/m".) Page 4 of 12 10. Describe the purpose of the proposed work: Upgrade existing stream crossing. dump 11. List the type of equipment to be used to construct the project: Trackhoe/backhoe and trucks 12. Describe the land use in the vicinity of this project: Residential/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: N/A 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. Page 5 of 12 1. Wetland Impacts Wetland Impact Site Number indicate on ma Type of Impact* Area of Impact acres Located within 100-year Floodplain** es/no Distance to Nearest Stream linear feet Type of Wetland*** 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://www.femagov. *** List a wetland type that best describes wetland to be impacted (e.g., freshwater/saltwater marsh, forested wetland, beaver pond, Carolina Bay, bog, etc.) List the total acreage (estimated) of existing wetlands on the property: 0 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) Bridge #213 Replacing bridge 0 feet Ripshin Branch 7 feet Perennial with new bridge Miscellaneous Bridge #213 rip-rap placement for 40 feet or less Ripshin Branch 7 feet Perennial stabilization Temporary 55 linear Bridge #213 Dewatering feet or 220 Ripshin Branch 7 feet Perennial square feet * List each impact separately and identify temporary impacts. Impacts include, but are not limited to: culverts and associated rip-rap, dams (separately list impacts due to both structure and flooding), relocation (include linear feet before and after, and net loss/gain), stabilization activities (cement wall, rip-rap, crib wall, gabions, etc.), excavation, ditching/straightening, etc. If stream relocation is proposed, plans and profiles showing the linear footprint for both the original and relocated streams must be included. ** Stream names can be found on USGS topographic maps. If a stream has no name, list as UT (unnamed tributary) to the nearest downstream named stream into which it flows. USGS maps are available through the USGS at 1-800-358-9616, or online at www.usgs.gov. Several Internet sites also allow direct download and printing of USGS maps (e.g, wwwlWzone.com www.mapguest.com etc.). Cumulative impacts (linear distance in feet) to all streams on site: 401n. ft. of new permanent impacts. Page 6 of 12 3. Open Water Impacts, including Lakes, Ponds, Estuaries, Sounds, Atlantic Ocean and any other Water of the U.S. Open Water Impact Site Number indicate on ma Type of Impact* Area of Impact acres Name of Waterbody (if applicable) Type of Waterbody (lake, pond, estuary, sound, bay, cean, etc. 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 bridge must be replaced due to its condition. Impacts have been minimized by rehabilitating the existing bridge instead of using pipes. By utilizing the erosion control measures as shown in the attached drawings, adverse impacts to streams in the area will be minimised All appropriate BMPs will be used during construction. Page 7 of 12 VIII. Mitigation DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC Division of Water Quality for projects involving greater than or equal to one acre of impacts to freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial streams. USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide Permits, published in the Federal Register on March 9, 2000, mitigation will be required when necessary to ensure that adverse effects to the aquatic environment are minimal. Factors including size and type of proposed impact and function and relative value of the impacted aquatic resource will be considered in determining acceptability of appropriate and practicable mitigation as proposed. Examples of mitigation that may be appropriate and practicable include, but are not limited to: reducing the size of the project; establishing and maintaining wetland and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of, aquatic resource functions and values by creating, restoring, enhancing, or preserving similar functions and values, preferable in the same watershed. If mitigation is required for this project, a copy of the mitigation plan must be attached in order for USACE or DWQ to consider the application complete for processing. Any application lacking a required mitigation plan or NCWRP concurrence shall be placed on hold as incomplete. An applicant may also choose to review the current guidelines for stream restoration in DWQ's Draft Technical Guide for Stream Work in North Carolina, available at http://h2o.enr.state.nc.us/ncwetlands/strrngide.html. 1. Provide a brief description of the proposed mitigation plan. The description should provide as much information as possible, including, but not limited to: site location (attach directions and/or 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/A Page 8 of 12 2. Mitigation may also be made by payment into the North Carolina Wetlands Restoration Program (NCWRP) with the NCWRP's written agreement. Check the box indicating that you would like to pay into the NCWRP. Please note that payment into the NCWRP must be reviewed and approved before it can be used to satisfy mitigation requirements. Applicants will be notified early in the review process by the 401/Wetlands Unit if payment into the NCWRP is available as an option. For additional information regarding the application process for the NCWRP, check the NCWRP website at hm://h2o enr state.nc.g;g /index.htm If use of the NCWRP is proposed, please check the appropriate box on page three and provide the following information: Amount of stream mitigation requested (linear feet): 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 (919) 733-5083 to review current thresholds for environmental documentation. Yes ? No If yes, has the document review been finalized by the State Clearinghouse? If so, please attach a copy of the NEPA or SEPA final approval letter. Yes ? No ? X. Proposed Impacts on Riparian and Watershed Buffers (DWQ Only) It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to required state and local buffers associated with the project. The applicant must also provide justification for these impacts in Section VII above. All proposed impacts must be listed herein, and must be clearly identifiable on the accompanying site plan. All buffers must be shown on a map, whether or not impacts are proposed to the buffers. Correspondence from the DWQ Regional Office may be included as appropriate. Photographs may also be included at the applicant's discretion. Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233 (Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and Water Supply Buffer Requirements), or other (please identify V Yes ? No ® If you answered "yes", provide the following information: Page 9 of 12 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 s uare feet Multiplier Required Mitigation 1 3 2 1.5 Total * Zone 1 extends out 30 feet perpendicular from near bank of channel; Zone 2 extends an additional 20 feet from the edge of Zone 1. If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation of Property, Conservation Easement, Riparian Buffer Restoration / Enhancement, Preservation or Payment into the Riparian Buffer Restoration Fund). Please attach all appropriate information as identified within 15A NCAC 2B .0242 or .0260. XI. Stormwater (DWQ Only) Describe impervious acreage (both existing and proposed) versus total acreage on the site. Discuss stormwater controls proposed in order to protect surface waters and wetlands downstream from the property. All appropriate best manaizement practices for sediment and erosion control will be implemented during construction. 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 X11L 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 Page 10 of 12 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). 3/2c-/c? 2- Applicant/Agent's Signatu Date (Agent's signature is valid only if an authorization letter from the applicant is provided.) US Army Corps Of Engineers Field Offices and County Coverage Asheville Regulatory Field Office Alexander Cherokee Iredell Mitchell US Army Corps of Engineers Avery Clay Jackson Polk 151 Patton Avenue Buncombe Cleveland Lincoln Rowan Room 208 Burke Gaston Macon Rutherford Asheville, NC 28801-5006 Cabarrus Graham Madison Stanley Telephone: (828) 271-4854 Caldwell Haywood McDowell Swain Fax: (828) 271-4858 Catawba Henderson Mecklenburg Transylvania Raleigh Regulatory Field Office Alamance Durham Johnston Rockingham US Army Corps Of Engineers Alleghany Edgecombe Lee Stokes 6508 Falls of the Neuse Road Ashe Franklin Nash Surry Suite 120 Caswell Forsyth Northampton Vance Raleigh, NC 27615 Chatham Granville Orange Wake Telephone: (919) 876-8441 Davidson Guilford Person Warren Fax: (919) 876-5283 Davie Halifax Randolph Wilkes Washington Regulatory Field Office Beaufort Currituck Jones US Army Corps Of Engineers Bertie Dare Lenoir Post Office Box 1000 Camden Gates Martin Washington, NC 27889-1000 Carteret* Green Pamlico Telephone: (252) 975-1616 Chowan Hertford Pasquotank Fax: (252) 975-1399 Craven Hyde Perquimans Wilmington Regulatory Field Office Anson Duplin Onslow US Army Corps Of Engineers Bladen Harnett Pender Post Office Box 1890 Brunswick Hoke Richmond Wilmington, NC 28402-1890 Carteret Montgomery Robeson Telephone: (910) 251-4511 Columbus Moore Sampson Pitt Tyrrell Washington Wayne Union Watauga Yancey Wilson Yadkin *Croatan National Forest Only Page 11 of 12 111, r- I It. lop 36'35' •---•-..- 333 506 69 ?D P5/ 318 :• 36"35• ,96 1 505 '?,O ' --?? 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