20021656 Ver 1_Complete File_20021014

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
DWQ Project No.: Z l
Applicant: •• C . ,,•
Project Name: n+2 1
Date of Issuance of 401 Water
A `Jo
Certification: O c E-e b4,r- 0.,;2 00-L
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
I, , 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
I, "r r 1 , hereby state that, to the best of my abilities, due care
and diligence as 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 appr and specifications, and other supportizcc??a materials.
Signature: Date: t'" 7. 3 ?`4
If this pf6ject was designed by a Certified Professional
I, , as a duly registered Professional (i.e.,
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 Permitee 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
WENjVDS 1401 OROUp
JUN 1 8 2004
WATER UAL1TYSEC1101V
AipoAr _NR
NTDE
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), hftp://h2o.enr.state.nc.us/ncwetiands/
F \NA Michael F. Easley, Governor
Q 9
QCl QG William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
`
Vj r Alan W. Klimek, P.E. Director
y Division of Water Quality

October 17, 2002
Anson County
DWQ Project No. 021656
SR 1627 (Pinkston-River Road)
APPROVAL of 401 Water Quality Certification with Additional Conditions
Mr. Benton G. Payne, P.E., Division Engineer
NCDOT Division 10
716 West Main Street
Albemarle, North Carolina 28001
Dear Mr. Payne:
You have our approval, in accordance with the attached conditions and those listed below, to incur 30
linear feet of permanent and 20 linear feet of temporary impacts to an unnamed tributary to Pee Dee River
in order to replace a cross pipe on SR 1627 (Pinkston-River Road) in Anson County. The project should
be constructed in accordance with your application dated October 10, 2002 (received October 14, 2002).
After reviewing your application, we have decided that this fill is covered by General Water Quality
Certification Nos. 3366 and 3375 corresponding to the U.S. Army Corps of Engineers Nationwide Permit
Number 33 and General (Regional) Permit No. 198200031. 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 only valid for the purpose and design that you described in your application except as
modified below. If you change your project, you must notify us in writing, and you may be required to
send us 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 conditions. If total
wetland fills for this project (now or in the future) exceed one acre, or if stream impacts 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. Storm water shall be directed to grass-lined ditches, vegetated buffer areas or a storm water collection
device and not routed directly to streams where practicable.
2. Existing vegetated buffers shall not be mowed in order to utilize it for storm water sheet flow.
3. The pipe required for this project shall be installed in such a manner that the original stream profile
are not altered (i.e. the depth of the channel must not be reduced by a widening of the streambed).
Existing stream dimensions (including the pattern and profile) are to be maintained above and below
locations of the pipe. The culvert shall be designed and installed to allow for fish and other wildlife
movement as well as prevent headcutting of the streams. NCDOT must submit a plan for written
DWQ approval to address any headcutting that will occur as a result of this project (e.g., use of cross
vanes downstream of the culvert).
4. Riparian vegetation must be reestablished within the construction limits of the project by the end of
the growing season following completion of construction.
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/ncwetiands/
5. Upon completion of the project, the NCDOT shall complete and return the enclosed
"Certificate of Completion" form to notify NCDWQ 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 NC 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, 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 Mr. Ken
Averitte of the Fayetteville Regional Office at 910.486.1541.
Sincerely,
Attachment
Klimek, P.E.
Pc: Wilmington District Corps of Engineers
Steve Lund, USACE Asheville Field Office
NCDWQ Fayetteville Regional Office
Central Files
File Copy
? lIT?3ECTtOH
STATE OF NORTH CAROLINA - r..M
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY DIVISION OF HIGHWAYS W. LYNDo TIPPETT
GOVERNOR SECRETARY
""dctober 10, 2002
U. S. Army Corps of Engineers 021656
Asheville Regulatory Office
Attn: Mr. Steve Lund, MS, PWS FILE COPY
151 Patton Avenue, Room 208
Asheville, NC 28801-5006
Subject: Anson County, Proposed Replacement of Cross Pipe on SR 1627 (Pinkston-River
Road). State Work Order No. 5.6552 (DWQ Minor Permit Fee $200.00)
Dear Mr. Lund:
The North Carolina Department of Transportation (NCDOT) proposes to replace an existing
cross pipe on SR 1627 (Pinkston-River Road) in Anson County. The purpose of this letter is to
request authorization from the U. S. Army Corps of Engineers to construct the project under a
Section 404 General Permit No. 198200031.
The existing (2) 60" x 40' pipe will be replaced by a single line of 103" x 71" x 60' corrugated
metal pipe. Traffic will be maintained using an off-site detour.
The project area has been reviewed for the presence of listed threatened and endangered species
and described in a Minimum Criteria Checklist. It has been determined that the construction of
this project will have no effect on any listed plant or animal species. There are no wetlands
present, although impacts to surface waters will occur. There will be 30 linear feet of permanent
stream channel loss and approximately 20 linear feet of temporary impacts associated with this
pipe replacement. This is an intermittent stream channel that flows into the Pee Dee River,
Yadkin River Basin, Hydrologic Unit 03040104. A permit drawing and pre-construction
notification form are attached to this letter.
The NCDOT anticipates that the permit application will be authorized under a Section 404
General Permit No. 198200031. We are also hereby requesting a 401 Water Quality
Certification, GC 3375, from the Division of Water Quality. We are providing seven copies of
this application to the North Carolina Department of Environment and Natural Resources,
Division of Water Quality, for their review.
716 West Main Street, Albemarle, NC 28001 • [phone] • Fax [phone]
7
:.L 3 Y

4 Aa
Thank you for your assistance with this project. If you have any questions or need any additional
information concerning this project, please contact Mr. Larry Thompson, Division Environmental
Officer, at [phone].
Sincerely,
ir-
Benton G. Payne, P. E.
Division Engineer
LBTBGP
Enclosures
cc: Mr. John Dorney, NCDWQ
Ms. Marella Buncick, USFWS
Ms. Marla Chambers, NCWRC
Mr. Garland Haywood, Bridge Maintenance Engineer
Mr. Larry Thompson, DEO
Area Field Operations Unit
SR 1627 (PINKSTON - RIVER RD.), ANSON COUNTY
Office Use Only' Form Version April 2001
USACE Action ID No. DWQ No. 0 216 5 6
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: General Permit 31
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: ?
II. Applicant Information
Owner/Applicant Information
Name: N. C. Department of Transportation
Mailing Address: 716 West Main Street
Albemarle. NC 28001
Telephone Number: [phone] Fax Number: [phone]
E-mail Address:
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: Benton G. Payne, P. E.
Company Affiliation: Division Engineer
Mailing Address: 716 W. Main Street
Albemarle, NC 28001
Telephone Number: [phone] Fax Number: [phone]
E-mail Address: bpaynegdot state nc us
SR 1627 (PINKSTON - RIVER RD.), ANSON COUNTY
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 1627 (PINKSTON - RIVER RD.)
2. T.I.P. Project Number (NCDOT Only): N/A
3. Property Identification Number (Tax PIN):
4. Location
County: Anson County Nearest Town: Ansonville
Subdivision name (include phase/lot number): N/A
Directions to site (include road numbers, landmarks, etc.): From Hwy. 74 (Wadesboro),
North onto Hwv. 52 into Ansonville, Right onto 1634, Left onto SR-1627 0.9 Miles North of
SR - 1634.
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:
Rural/Agricultural
7. Property size (acres): N/A
8. Nearest body of water (stream/river/sound/ocean/lake): a ee er Y/P`ss/e y 4!?ie,k
9. River Basin: Yadkin Basin
(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/.)
SR 1627 (PINKSTON - RIVER RD.), ANSON COUNTY
10. Describe the purpose of the proposed work: Installation of 1 Line of 103" x 71" CMPA
This will replace an existing 2 lines @a 60" that has Rusted through and shoulder is eroding.
11. List the type of equipment to be used to construct the project: Boom Truck, Back
Hoe Vibratory Roller & Dump Truck to remove existing pipes and install one line of
103"X71" CNIPA.
12. Describe the land use in the vicinity of this project: Wooded on both sides of stream,
cultivated fields beyond wooded buffer.
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.
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
SR 1627 (PINKSTON - RIVER RD.), ANSON COUNTY
mitigation, list and describe the impact in Section VIII below. If additional space is needed for
listing or description, please attach a separate sheet.
1. Wetland Impacts
Wetland Impact
Site Number
indicate on ma
Type of Impact* Area of
Impact
acres Located within
100-year Floodplain**
(es/n0) Distance to
Nearest Stream
(linear feet
Type of Wetland***
N/A N/A N/A N/A N/A N/A

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: mechanized clearing. grading, nu,
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 http:/hti1v%v.fema._ov.
*** 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: N/A
Total area of wetland impact proposed: N/A
2. Stream Impacts, including all intermittent and perennial streams
Stream Impact
Site Number
(indicate on ma
Type of Impact* Length of
Impact
linear feet)
Stream Name** Average Width
of Stream
Before Impact Perennial or
Intermittent?
leasespecify)
1 Single Culvert 20-FT. UT of Pee Dee River Approx. 8-Ft. Perennial
2 Inlet Stabilization 5-17T. UT of Pee Dee River Approx. 8-Ft. Perennial
3 Outlet Stabilization 5-FT. UT of Pee Dee River Approx. 8-Ft. 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
wtivw.uses.aov. Several intemet sites also allow direct download and printing of USGS maps (e.g., www.topozone.com,
w%v%v.mMuest.com, etc.).
Cumulative impacts (linear distance in feet)-to all streams on site: 30 ft. permanent.-20 ft.
tempoL,M
SR 1627 (PINKSTON - RIVER RD.), ANSON COUNTY
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 N/A N/A N/A N/A

• List each impact separately and identify temporary impacts. Impacts include, but are not limited to: fill, excavation, dreagmg.
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.): N/A
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.
NCDOT has determined that the installation of this culvert would not only be financially viabl
to replace the existing structures - This culvert will be of sufficient length to minimize asphalt
contamination from reaching stream-bed, should the road be resurfaced and/or widened in the
future.
Bank stabilization activities will be limited to not more than 15-ft. on either side of the proposed
culvert.
Temporary silt/sediment control devises will be installed down stream during all phases of
construction These shall be removed at the completion of the project.
Page 7 of 12
SR 1627 (PINKSTON - RIVER RD.), ANSON COUNTY
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?Hh2o.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.
No mitigation is proposed for this project.
SR 1627 (PINKSTON - RIVER RD.), ANSON COUNTY
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 htti)://h2o.enr.state.nc.us/wrn/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):
Amount of buffer mitigation requested (square feet):
Amount of Riparian wetland mitigation requested (acres):
Amount of Non-riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres):
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
(Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify N/A )?
Yes ? No 0 If you answered "yes", provide the following information:
Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Neese), 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* Impact
(square feet) Multiplier Required
Mid don
1 3
2 1.5
Total
... ...
Vi w+uau+u, -11-
' Lone 1 e.JenaS OUI .St) lee[ perpc.amcul<u u VU1 uc:u LA LUA _.
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.
Y. 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 pipe replacement activities. There will be no net increase in storm water
runoff as a result of this project being constructed.
XI. 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
XH. 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
=. 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/Agenfs Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)

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2 km E of Ansonville, North Carolina, United States o1 ]ul 1956
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North Carolina Department of Transportation
Typical Plan and Elevation of Pipe Installation Permits
Asphalt Crown
Crown of Roadway
to Creek Bed

ass I or Class II Rip Rap
Slope tection
w
a
0
0
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o
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ti
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'22 o a'd
? VI N V

Typical End Elevation
Elevation 1 Line of Corragated Metal Pipe Arch, 142 X 91
With Class I,or H Rip Rap Slope Protection on Inlet and Outlet end

--
Roadway
18 ft.
Overall Length of Pipe
Class H Rip Rap
Amount of Fill over Pie
1.- R
I or Class II Rip Rap
Shoulder = 6 ft.
Typical Plan View
With Class I or II Rip Rap
nn Tnl,-t and OiitlPt P.m]