20021250 Ver 1_Complete File_20020808

Mr. J.M. Mills, PE
July 27, 2004
DWQ#IMNM v Z.I Z -r 0
Page 4
DWQ Project No.: O Z-t Z--S' ()
County:
Applicant: /V CQ err D /V! S / O,t--, i?"
Project Name: VP- /LAJ yAV Gi4-N L f iL - ! / ! P i ??6 /Z le ?L /if C-
z
Date of Issuance of 401 Water Quality Certification: Ay 5 7-00
Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification or applicable Buffer
Rules, and any subsequent modifications, the applicant is required to return this certificate to the
401/Wetlands Unit, North Carolina Division of Water Quality, 1621 Mail Service Center, Raleigh, NC,
27699-1621. This form may be returned to DWQ by the applicant, the applicant's authorized agent, or
the project engineer. It is not necessary to send certificates from all of these.
Applicant's Certification
I, Yn^ ; A r , 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: 0, YY1 ?- Date: ) d ' Xf -or
Agent's Certification''
I, ?122r/L y Q[.?.2 , hereby state that, to the best of my abilities, due care
and diligence was used in the observation of the construction such that Lhe construction was observed to
be built within substantial compliance dtid h t6ni of the 401 Water Quality Certification and Buffer Rules,
the approved s ands tions, and o1ier 9ti6orting materials.
Signature: 5? Date: ?' 6 J 0 5 -_-
Engineer's Certification
Partial Final
I, , as a duly registered Professional Engineer in the State
of North Carolina, having been authorized to observe (periodically, weekly, full time) the construction of
the project,for the Permittee hereby state that, to the best of my abilities, due care and diligence was used
in the observation of the construction such that the construction was observed to be built within
substantial compliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved
plans and specifications, and other supporting materials.
Signature Registration No.
Date
gO?O? WAT ?9pG
>_ 6 LJ_W`^ -I
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
August 9, 2002
Alamance County
DWQ Project No. 021250
APPROVAL of 401 Water Quality Certification
Mr. J.M. Mills, P.E., Division Engineer
NCDOT, Division,?
PO Box 14996
Greensboro, NC 27415
Dear Mr. Mills:
You have our approval, in accordance with the attached conditions and those listed below, to place permanent fill
material in 30 linear feet, 20 linear feet of temporary fill, and 20 linear feet of rip rap for the purpose of widening
and paving of SR 1112 in Alamance County. The project shall be constructed in accordance with your application
dated July 29, 2002. After reviewing your application, we have decided that this fill is covered.by General Water
Quality Certification Number 3375. This certification corresponds to the 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 total wetland fills for this project (now or in the future) exceed one acre, or of total
impacts to streams (now or in the future) exceed 150 linear feet, compensatory mitigation may be required as
described in 15A NCAC 2H.0506 (h) (6) and (7). For this approval to remain valid, you must adhere to the
conditions listed in the attached certification.
1.) Upon completion of the project, the NCDOT shall complete and return the enclosed "Certification of
Completion Form" to notify DWQ when all work included in the 401 Certification has been completed. The
responsible party shall complete the attached form and return it to the 401/Wetlands Unit of the Division of
Water Quality upon completion of the project.
If you do not accept any of the conditions of this certification, you may ask for an adjudicatory hearing. You must
act within 60 days of the date that you receive this letter. To ask for a hearing, send a written petition that conforms
to Chapter 150B of the North Carolina General Statutes to the Office of Administrative Hearings, P.O. Box 27447,
Raleigh, N.C. 27611-7447. This certification and its conditions are final and binding unless you ask for a hearing.
e M*
N. C. Division of Water Quality 1650 Mail Service Center Raleigh, NC 27699-1650 [phone]
Customer Service: 1 800 623-7748
O?O? W A T FRG
r
GD
NOR
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 contact John Hennessy at 919-733-5694 or Steve Mitchell at 919-571-4700.
Sincerely,
Attachment
cc: Wilmington District Corps of Engineers
Corps of Engineers Raleigh Field Office
DWQ Raleigh Regional Office
File Copy
Central Files
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
c:\ncdot\SR 1112\wqc\021250wgc.doc
1
:.. t? AUG 2W2
STATE OF NORTH CAROLINA
DEPARTMENT OF TIRLANSPORTATION"
MICHAEL F. EASLEY 1584 YANCEYVILLE STREET, GREENSBORO, NC 27415 LYNDO TIPPETT
GOVERNOR SECRETARY
July 29, 2002
02 1 2,50
MEMORANDUM TO: Mr. John Hennessy
Wetlands/401 Unit
FROM: C.N. Edwards C uC
District Engineer, District 1, Division 7
SUBJECT: Payment Information - Water Quality Certificate forAlamance County,
Vernon Lane (SR 1112)
In accordance with General Statute 143-215.3D(e) the following information if being provided to
facilitate payment of fees associated with the appropriate Water Quality Certificate:
• Certificates being requested: #3375 (NWP 14) and #3366 (NWP 33)
• Work Order Number : 6.472425
• Amount of fee: $200
PAYMENT
RECEIVED
PHONE [phone] FAX [phone]
I S
s'` 4MF
r+
'l uw,vs'
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY
GOVERNOR
Mrs. Jean Manuele
U.S. Army Corps of Engineers
Regulatory Field Office
6508 Falls of the Neuse Road, Suite 105
Raleigh, North Carolina 2761
(Two Copies)
Mr. John Hennessy
Wetlands/401 Unit
NC DENR Division of Water Quality
1650 Mail Service Center
Raleigh, NC 27699
(Seven Copies)
July 29, 2002
021250
5 LYNDo TIPPETT
SECRETARY
AUG 2002'
SUBJECT: Alamance County, Upgrade of Vernon Lane (SR 1112) from an unpaved secondary
road to a paved secondary road. State Project Number: 6.472425
To Whom It May Concern:
The North Carolina Department of Transportation (NCDOT) proposes to upgrade Vernon Lane (SR
1112) from an unpaved to a paved secondary road to reduce future maintenance needs and increase
traffic safety. This activity will result in impacts to a stream due to the replacement and extension of
a crossline pipe to facilitate travel lane and shoulder widening. The NCDOT anticipates that the pipe
replacement activity will be authorized under Nationwide Permit (NWP) 14 and the dewatering
operation will be authorized under NWP 33. This application is intended as a request for formal
written authorization from the USACE for dewatering activities occurring under NWP 33. This
application is also intended as request for written authorization from the NC Division of Water
Quality to replace the pipes under General Water Quality Certificate # 3375 (NWP 14). The
following information is being provided to satisfy Nationwide Permit Condition 13 (Federal Register
January 15, 2002) and Condition 1 of General Water Quality Certificate # 3375.
I- Ll
1584 YANCEYVILLE STREET, GREENSBORO, NC 2741
PFIONE 336-334-3192 FAX [phone]
PROJECT INFORMATION
Road Name SR Number Project Length
miles Classification
Vernon Lane 1112 0.20 Rural
River Basin: DWQ
ID Water Quality
Designation % New Impervious
Surface
Cape Fear 16-19-8-2-4 C NSW 2
Buffer Rules' Buffer Rule Conditions (where applicable)
No Not Applicable
Protected Species
Presentb Mapped Historic
Pro ertiesc CAMA
AEC Essential Fishery
Habitat
No No No No
'Separate documentation attached as needed: b See the attached Endangered Species Review Sheet for further
information: 'When Applicable - See the attached Historic Status Report.
PIPE REPLACEMENT INFORMATION
Site 1 (10+73) Stream Type Perennial
Station
Existing Pipe 2 @ 30' long 36" CMP Proposed 2 @ 60' long 81" X 59"
Pie CMPA
Construction Diversion channel Dewatering ABC aggregate
Method Device*
Burial Depth 1-foot Erosion 07/29/02
Control Plan
Construction As soon as practicable Duration 4 weeks
Date
Impacts ft. 30-enclosure; 20-rip-rap dissipaters;20-temporary
Special A sill will be placed in one line of pipe to maintain low flow.
Conditions
Restoration Within 15 working days of the of the pipe replacement all temporary
Plan structures will be entirely removed and natural stream contours will be
restored and seeded.
RCP = reinforced concrete pipe; CMP = Corrugated metal pipe; CMPA = Corrugated metal pipe arch; E/C =
Erosion control. *A less intrusive dewatering device may be used in lieu of the one proposed.
MINIMIZATION INFORMATION
Impacts will be minimized by strict enforcement of Best Management Practices for the protection of
surface waters and wetlands, restrictions against the staging of equipment in or adjacent to waters of
the US, and coordination (including a pre-construction meeting) with the Division Environmental
Officer.
-2-
MITIGATION INFORMATION
Stream mitigation is not anticipated, as the impacts to any individual stream do not exceed 150 feet
Wetland mitigation is not anticipated, as wetland impacts do not exceed 0.10 acres and do not occur
in a unique natural wetland.
APPLICATION INFORMATION
Enclosed please find the Pre-construction Notification Form and supporting documentation for the
above referenced project. If you have any questions or need any additional information, please
contact Chuck Edwards at [phone] or Len Smith at [phone]. Your time and effort
are appreciated.
Sincerely,
Mr. M. Mills, P.E.
Division Engineer, Division 7
cc: Mr. Lenwood E. Smith, II, PWS, Division Environmental Officer( a ?? 2q? 6 L
Mr. C.N. Edwards, P.E., District 1 Engineer CMG
Mr. Mike Venable, County Maintenance Engineer, Alamance
Mr. J.L. Cornell, III, Bridge Maintenance Supervisor, District I
Mr. Bryan Spell, Area Roadside Field Operations Engineer
Mr. Dennis Johnson, Grade Crew Foreman
-3-
Office Use Only: Form Version May 2002
021250
USACE Action ID No. DWQ No.
(If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A".)
I. Processing
1. Check all of the approval(s) requested for this project:
N Section 404 Permit ? Riparian or Watershed Buffer Rules
? Section 10 Permit ? Isolated Wetland Permit from DWQ
N 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested: NWP 14 & 33
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 (verify availability with NCWRP prior to submittal of PCN), complete
section VIII and check here: ?
5. If your project is located in any of North Carolina's twenty coastal counties (listed on page
4), and the project is within a North Carolina Division of Coastal Management Area of
Environmental Concern (see the top of page 2 for further details), check here: ?
II. Applicant Information
1. Owner/Applicant Information
Name: Mr. J.M. Mills, P.E, Division Engineer - Division 7
Mailing Address: P.O. Box 14996
Greensboro NC
Telephone Number: [phone] Fax Number: [phone]
E-mail Address: [e-mail]
2. Agent/Consultant 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: Not Applicable
Company Affiliation:
Mailing Address:
Telephone Number: Fax Number:
E-mail Address:
Pagel of 8
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: Vernon Lane (SR 1112)
2. T.I.P. Project Number or State Project Number (NCDOT Only): 6.472425 (non-TIP)
3. Property Identification Number (Tax PIN): Not Applicable
4. Location
County: Alamance Nearest Town: Burlington
Subdivision name (include phase/lot number): Not Applicable
Directions to site (include road numbers, landmarks, etc.): The project is south of
Burlington. From I:85 / IAA go south on N.C. Hwy 49 for 10.3 miles, turn right on to Garner
Road (SR 1108) and go 1.1 miles, turn right on to Mt. Zion Road (SRI 110), go .8 miles and
Vernon Lane (SRI 112) will be on your right.
5. Site coordinates, if available (UTM or Lat/Long): See the attached USGS M.
(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. Property size (acres): Not Applicable
7. Nearest body of water (stream/river/sound/ocean/lake): Little Creek (16-19-8-2-4)
8. River Basin: Cape Fear
(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/maps/.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: A floodplain forest is in the immediate vicinity. PrimarX
land uses are agricultural and residential.
Page 2 of 8
10. Describe the overall project in detail, including the type of equipment to be used:
The project will involve paving an unpaved secondary road and bringing the travel lane
shoulders ditchlines and drainage structures up to current standards. Travel lane widening
will be required to bring the road gp to current standards. Standard shoulder widths will be
6'-8' with deviations shown on the attached site plan. Ditch widths will vary based onsite
conditions Proposed right-of-yLa width is illustrated on the attached site plan. Equipment
used will be standard road construction equipment (trackhoe, grader, backhoe, and
bulldozer)
11. Explain the purpose of the proposed work: To upgrade an unpaved secondary road to a
paved secondary road Paving and widening are being conducted to reduce future
maintenance costs bring the road up to current construction standards, and increase traffic
safety.
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.
Not Applicable
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application.
Not Applicable
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 3 of 8
1. Provide a written description of the proposed impacts: Permanent stream impacts will
result from channel enclosure and placement of rip-rap energy dissipaters. Temporary stream
impacts will result from placement of cofferdams (perennial streams) and siltscreens
2. Individually list wetland impacts below:
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 floodplam maps. Maps are available through the FEMA Map Service Center at 1-800-358-9616, or
online at http://wwtiv.femgZgy.
*** List a wetland type that best describes wetland to be impacted (e.g., freshwater/saltwater marsh, forested wetland, beaver pond,
Carolina Bay, bog, etc.) Indicate if wetland is isolated (determination of isolation to be made by USACE only).
List the total acreage (estimated) of all existing wetlands on the property: Not Applicable
Total area of wetland impact proposed: Not Applicable
3. Individually list all intermittent and perennial stream impacts below:
Stream Impact
Site Number
(indicate on map)
Type of Impact* Length of
Impact
(linear feet)
Stream Name** Average Width
of Stream
Before Impact Perennial or
Intermittent?
(pleasespecify)

1
Pipe replacement 30 (en)
20 (trop)
20
UT to Little Creek
8.5'
Perennial

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: culverts and associated rip-rap,
dams (separately list impacts due to both structure and flooding), relocation (include linear feet before and after, and net loss/gain),
stabilization activities (cement wall, rip-rap, crib wall, gabions, etc.), excavation, ditching/straightening, etc. If stream relocation is
proposed, plans and profiles showing the linear footprint for both the original and relocated streams must be included
** Stream names can be found on USGS topographic maps. If a stream has no name, list as UT (unnamed tributary) to the nearest
downstream named stream into which it flows. USGS maps are available through the USGS at 1-800-358-9616, or online at
www.usszs.sov. Several intemet sites also allow diiect download and printing of USGS maps (e.g., ww-Vv.topozone.com,
x4-%vw.mapgi1est.com1 etc.).
Cumulative impacts (linear distance in feet) to all streams on site: 30- enclosure (en
20- temporaa (trop), 20- rip rap (rp)
Page 4 of 8
4. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.) below:
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, ean, 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.
5. 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.): Not Applicable
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.): Not Applicable
Size of watershed draining to pond: N/A Expected pond surface area: N/A
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.
Pine replacement activities are necessarv to increase travel lane and shoulder width to current
construction standards. Impacts will be minimized by strict enforcement of Best Management
Practices for the protection of wetland and surface waters, restrictions against the staging of
equipment in or adjacent to waters of the US, and coordination (including a pre-construction
meeting) with the Division Environmental Officer.
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.
Page 5 of 8
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/strm2ide.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.
A finding of insignificant impact is anticipated, therefore, a mitigation plan is not provided.
Cumulative impacts are less than 150 feet. The maximum amount of impact to a single
stream is 50 linear feet. No Outstanding Resource Waters, federally protected species or
their habitats, or essential fishery habitats occur in the project area. The project is not located
in a High Quality Water.
2. Mitigation may also be made by payment into the North Carolina Wetlands Restoration
Program (NCWRP). Please note it is the applicant's responsibility to contact the NCWRP at
[phone] to determine availability and to request written approval of mitigation prior
to submittal of a PCN. For additional information regarding the application process for the
NCWRP, check the NCWRP website at http://h2o.enr.state.nc.us/wrp/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): Not Applicable
Amount of buffer mitigation requested (square feet): Not Applicable
Amount of Riparian wetland mitigation requested (acres): Not Applicable
Amount of Non-riparian wetland mitigation requested (acres): Not Applicable
Amount of Coastal wetland mitigation requested (acres): Not Applicable
Page 6 of 8
IX. Environmental Documentation (required by DWQ)
Does the project involve an expenditure of public (federal/state) funds or the use of public
(federal/state) 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 (required by DWQ)
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 )?
Yes ? No ® If you answered "yes", provide the following information:
Identify the square feet and acreage of impact to each zone of the riparian buffers. If buffer
mitigation is required calculate the required amount of mitigation by applying the buffer
multipliers.
Zone* s mare feet Multiplier Required
1 N/A 3
2 N/A 1.5
Total N/A
' "Lone 1 extends out A feet perpendicular from near bank of channel; Gone 1 extends an
additional 20 feet from the edge of Zone 1.
Page 7 of 8
IX. Environmental Documentation (required by DWQ)
Does the project involve an expenditure of public (federal/state) funds or the use of public
(federal/state) 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 (required by DWQ)
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 )?
Yes ? No ® If you answered "yes", provide the following information:
Identify the square feet and acreage of impact to each zone of the riparian buffers. If buffer
mitigation is required calculate the required amount of mitigation by applying the buffer
multipliers.
Zone* (square feet Multiplier Mi Required
1 N/A 3
2 N/A 1.5
Total N/A
* 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.
Page 7 of 8
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.
Not A_ Wlicable
M. Stormwater (required by DWQ)
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.
The existing` travel lane is 16-feet. The proposed travel lane is 18-feet. The proposed right-of-
Way is 50-feet. The percent new impervious surface (relative to the right-of-way) is 2%.
Because the percent new impervious surface is less than 30% stormwater controls are not being
provided
XU. Sewage Disposal (required by DWQ)
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.
Not Applicable
XM. Violations (required by DWQ)
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 ?
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).
m S? Z-o2-
A licant/Agent's Signature Date
(Agent's nature is valid only if an authorization letter from the applicant is provided.)
Page 8 of 8
NATURAL RESOURCE EVALUATION SHEET
State Project # SR Number Road Name Coup Investigator(s)
. t( 2-Y Z 5 1112 Vernon Lane Alamance Len Smith
Date: River Basin: Water Quality Designation Buffer Rules (Type)
04/04/02 Cape Fear C NWS No
Primary Land Use Percent Residential Percent Agricultural Percent Unmaintained
Residential 50 0 50
Anticipated Permits or Consultations High Quality or Rare Wetlands Federally Threatened or Endangered
Species
NWP 14 & 33 No No
Types of Unmaintained Upland Properties
Community Type Dominant Trees Dominant Shrub(s) Dominant Herb(s)
Flood lain forest Sweet gum Allegheny blackberry Absent

Waters of the US
Streams
ST Stream Name Perennial or
Intermittent Ave. Wdth
(OHWM) Ave. Dpth
(OHWM) Ave. Wdth
OB Ave. Dpth
OB DWQ ID.
10+73 UT to Little Creek Perennial 8.5' <0.5' 11.5' 1' 16-19-8-2-4

ST = Station, OHWM = Measurements made from Ordinary high Water Marker, TOB = Measurements
made from the Top of the Bank
Wetlands

ST Within 100-year
Floodplain Distance to
Nearest Stream
(linear feet
Cowardin Classification
Dominant Plants
N/A

O en Water
ST Name of Waterbody
if applicable) Type of
Waterbod M.M. Name of Waterbody
if applicable) Type of Waterbody
N/A

General Notes/Comments:
Division Environmen a1 Officer '44--'?-+r
July 3, 2002
Date
ENDANGERED SPECIES REVIEW FOR DIVISION 7
DISTRICT 1
State Project # SR Number Road Name Conn
6 , q? Ly L s 1112 Vernon Lane Alamance
Alamance County
No Endangered or Threatened Species are listed.
Orange County
River Basin: Cape Fear
Bald Eagle (Haliaeetus leucocephalus). Cane Creek (Cape Fear Basin) Area.
Is the activity within the primary or secondary zone Yes ? No ?
Smooth Coneflower (Echinacea laevi ata May be surveyed for from June to September
Habitat Survey Date Investigator(s) Man-hours Comments/Findings
N/A
Michaux's Sumac Rhus michauxii May be surveyed for from May to October
Habitat Survey Date Investigator(s) Man-hours Comments/Findings
N/A
Small Whorled P onia Isotria medeoloides May surv ed for from Ma to June
Habitat Survey Date Investigator(s) Man-hours Comments/Findings
N/A
Red Cockaded Woodpecker (Picoides borealis)
Habitat Survey Date Investigator(s) Man-hours Comments/Findings
N/A
Dwarf Wedge Mussel Alasmodonta heterodon) - Neuse Basin
Habitat Survey Date Investigator(s) Man-hours Comments/Findings
N/A
James inymussel (Pleurobema collina - Roanoke Basin
Habitat Survey Date Investigator(s) Man-hours CommenWFindings
N/A
General Notes/Comments: No known protected species habitat present.
Division Environmenta Officer
July 3, 2002
Date
NCDOT
HAZARDOUS SPILL BASIN CHECKLIST
Division Seven County Alamance Project ID: 6.472425
River Basin Cape Fear Bridge No: N/A
Route 1112 Stream UT to Little Creek
Water Ouality Criteria
Yes No
Stream Crossing Blueline on USGS ® ?
ORW ?
WSI ? Z
WS II, III, or IV Crossing Within 0.5 mi. of W.S. Critical Area ?
Roadway Criteria
Route Designation
Yes No
Arterial Urban ?
Arterial Rural ?
Additional Site Information:
Yes
Is a Hazardous Spill Basin Required? ?
No
Z
Criteria Based Upon NCDOT "Best Management Practices for the
Protection of Surface Waters" (March, 1997).
SITE # 1
SR 1112
VERNON LANE
SCALE I" = 50'
CAPE FEAR RIVER BASIN
TEMPORARY SILT FENCE -H ??-
TEMP. ROCK SEDIMENT DAM
TYPE B
TEMPORARY ROCK SILT CHECK .
TYPE B
SILT BASIN TYPE - B
RIP-RAP WITH LINER
. \\ 1 O X4K Z\
10+50
SPF?GE (D o c
c
?ox3',z \
100
30'
?D
83 C> fD.
-?--
I 114'-15^ PLASTIC NO PIPE \ IG
I I?
MARK STEVEN MCCRAVEY
521-321
f
PE2tMANLNT DRAINAGE
EAsIthim
11+17
-No- 1
12+7o oUlsD
30'
/5.33!?
1 VII
I 30'-M. Cl" r I _ _ f
?,? EIP
1
\ X4XZ ?` x,31..15„ RCL
,
I
t Fez o P85? n
IN
w LLS ?.:• _
TYPICAL CROSS SECTION (M)
4' 6. 9. I 9. 8.
$ ?DL I-rl R. PAV ME2VT - SHE
• v • I •• rEn TT. /•?' A fT. I tI?- YGR R 1- r
?K
X30'-24" RCP
\
\
THIS PROJECT IS IN THE
NEUSE RIVER BASIN
YES.-. it-NO
HIGH QUALITY WATERVAU,
YES NO

July 29, 2002
Site 1
Construction Sequence and Erosion Control Plan for Replacement of
Pipe with Pipe Using a Diversion - Alamance County, SR 1112
Work to begin as soon as practicable following authorization.
Construction is anticipated to take 4 weeks.
1. Prior to beginning pipe removal and installation, drill holes and place supporting bolts
in one end of a single line of 60' long 81" X 59" CM pipe arch
2. nstall a rock silt dam downstream of the proposed diversion channel outlet to prevent
incidental sediment loss from the diversion channel.
3. Dig a diversion channel to dewater the construction area. The diversion channel will
be approximately the same width as the existing channel.
4. Line the diversion channel with poly-fabric to prevent sediment loss.
5. Install ABC aggregate or a less intrusive dewatering device to force flow into the
diversion channel.
6. Breach the inlet and outlet darns of the diversion channel.
7. Remove one existing two lines of 30' long 36" CM pipe.
8. Excavate to sufficient depth to allow burial of the pipes to 1', place base stone, and
two lines of 60' long 81" X 59" CM pipe arch.
9. Backfill the new lines of pipe and place rip rap only as needed.
10. Prior to removing the diversion place cofferdams to divert flow into the pipe without
the sill.
11. Starting from the downstream end, remove the dewatering structure and restore the
natural stream contours.
12. Place ABC aggregate at each end of the diversion channel forcing flow through the
pipe without the sill.
13. Dewater the diversion channel, backfill with suitable material, and compact the
backfilled material.
14. Construct mold and pour concrete sill in-the appropriate line of pipe.
15. Following setting of the concrete sill remove the cofferdams.
16. Notify landscape department for final seeding.
17. Silt fences to be placed as site conditions require.
18. A 10' X 15' dirt bag will be used to remove excess water in the hole where the new
pipe is being replaced.
19. Site conditions and weather may alter these plans.
20. A pump around system or rock silt screen may be utilized in place of a diversion
channel if conditions allow.
I
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J `' 6it1 - ' IN ``..? "f-,•?,; J /r ?r k • ?V709
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Name: KIMESVILLE Location: 17 634639 E 3977770 N
Date: 7/29/2002 Caption: Location of the permitted activity - SR 1112
Scale: 1 inch equals 2000 feet
Copyright (C) 1997, Wptech, Inc.
View of the existing pipe inlets - SRI] 12.
View immediately upstream from the existing pipes - SR 1112.
View immediately downstream from the existing pipes - SR 1112.
View of the existing pipe outlets - SR 1112.
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