20021723 Ver 1_Complete File_20021022

Certificate of Completion 2? Jb,?,,\
s
DWQ Project No.: OZl-lZ. County: --
Applicant: tAC -C16-r
Project Name: sg, k-.)Lkz MO"V."Vo 1Z. -
Date of Issuance of 401 Water Quality Certification: 1-n/4107
Upon completion of all work approved within the 401 Water Quality Certification and 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 maybe
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 Ce ification
I, hereby state that, to the best of my abilities, due care and
diligence was used in the observation of e 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 specifica ' d o r supporting materials.
Signature: Date: 03
Agent's Certification
I, (?ASc? ?ccr?? , hereby state that, to the best of my abilities, due care and
diligence was used in the observation of the construction such that the constriction 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: /p-/U-CJ3
If this project 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 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:
O?O? W A T ?9pG
O ?
DWQ Project No.: O Z1-1Z County: Rruyms Jcc.y
Applicant: LQU-C t?c?s'wr,
Project Name: tV\4\r-u odk.w F.L 52 l3?-tZ?
Date of Issuance of 401 Water Quality Certification: Oc?v?x 2 rK , 7- 00 2
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 a icationQ
I, i g5F.C) tAdp, hereby state that, to the best of my ab
was used in the observation (If the construction such that the construction was observed
compliance and intent of the 401 Water Quality Certification and Buffer Rules, the app
specifications, and other sup tin m, rials.
Signature: Date: o
Agent's Certification
I, MP, 11- ? , hereby state that, to the best of my ab
was used in the observation of the construction such that the construction was observed
compliance and intent of the 401 Water Quality Certification and Buffer Rules, the app
specifications, and other supporting materials.
Signature: Date:
ilities, due care and diligence
to be built within substantial
roved plans and
ilities, due care and diligence
to be built within substantial
roved plans and
Engineer's Certification
Partial Final
1, , 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. ;ind other supporting materials.
Signature Registration No.
Date
WETLANDS 1401 c,yROUP
NoV U 7 2003
WATER QUALITYSEC77O
N
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
o?0F W ATFRpG
r
> y
October 28, 2002
Brunswick County
DWQ Project No. 02172
APPROVAL of 401 Water Quality Certification
Mr. H. Allen Pope, P.E., Division Engineer
NCDOT, Division 3
124 Division Drive
Wilmington, NC 28401
Dear Mr. Pope:
You have our approval, in accordance with the attached conditions and those listed below, to place fill material in
0.03 acres of wetlands and 122 linear feet of streams for the purpose of widening SR 1342in Brunswick County.
The project shall be constructed in accordance with your application dated July 17, 2002 (received October 22,
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. 276 1 1-7447. This certification and its conditions are final and binding unless you ask for a hearing.
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

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 FRpG

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.
Sincerely,
Attachment
cc: Wilmington District Corps of Engineers
Corps of Engineers Wilmington Field Office
DWQ Wilmington 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
1
la lim k E.
c:\ncdot\SR 1342\wqc\021723wgc.doc
Re: Brunswick SR 1342
Subject: Re: Brunswick SR 1342
Date: Mon, 28 Oct 2002 17:11:12 -0500
From: John Hennessy <[e-mail]>
To: Mason Herndon <[e-mail]>
I think I figured out what happened. You coed the Regional Office on
the application, not the Central Office. In case you didn't know, all
401s need to be submitted to the Central Office for processing. I will
process ASAP for you.
Mason Herndon wrote:
> John
> The application for Brunswick SR 1342 (Makatoka Rd) was sent out
> via courier this morning. Please let me know when you receive
> this package. I appreciate your cooperation in expediting this
> application. I do not know what happened on the previous
> application, I sent it certified mail and it was stamped by Mail
> Service Center on July 23rd. if you could give me a idea, once
> you receive this application, of when I can expect the permit it
> would be helpful. Is it possible that you could fax me a copy of
> the approval letter? My fax number is [phone]. Thanks
> and I hope you recover from your ailments.
> Mason
> PS: If you keep me posted on the progress of the permit mod for
> U-92B, I would appreciate it. I get asked about it at least a
> couple of times a week.
101,1 10/28/02 5:11 PM
u ?WNt ?n9s
.??. 0 217 2 3
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY DIVISION OF HIGHWAYS LYNDO TIPPETT
GOVERNOR SECRETARY
July 17, 2002
MEMO TO:
FROM:
SUBJECT
Work Order Number:
TIP Number:
Category:
North Carolina Division of Water Quality
401/Wetlands Unit
Mason Herndon, Division 3 Environmental O
North Carolina Department of Transportation
OU! 2 ,
I'4

PCN Application fee for Secondary Road construction on SR 1342
(Makatoka Rd), Brunswick County
6.232079T
N/A
$200.00 fee
PAYMFNT
RFCFI VFW)
124 Division Drive, Wilmington, NC 28401
PHONE: [phone] FAX: [phone]
. r
021723

STATE OF NORTH CAROLINA
of 7 2 l! ;'J
DEPARTMENT OF TRANSPORTATION---
MICHAEL F. EASLEY DIVISION OF HIGHWAYS LYNDO TIPPETT
GOVERNOR SECRETARY
July 17, 2002
David L. Timpy, Regulatory Project Manager
U.S. Army Corps of Engineers
Wilmington Regulatory Field Office
Post Office Box 1890
Wilmington, North Carolina 28402-1890
SUBJECT: Grade, drain, base and pave at SR 1342 (Makatoka Rd), Brunswick County
Dear Mr. Timpy:
Please find enclosed a PCN application from the North Carolina Department of Transportation
for a Nationwide/General Permit from the Army Corp of Engineers for the secondary road
improvement project on SR 1342 (Makatoka Rd.) in Brunswick County, which is 7.1 miles in
length. The scope of the project will be to grade, drain, base and pave the site to current
secondary road standards of 20 ft of pavement and 6 ft of earthen shoulders to improve roadway
safety. Residents and Brunswick County School buses travel this road. No widening beyond the
existing lateral ditches is required on this project, however several pipes will need to be replaced
because of poor condition and lengthened to provide adequate shoulder width. The existing road
has six jurisdictional culvert crossings that occur at intermittent streams. A site visit was
conducted on July 17 with Joanne Steinhuis (DWQ) and Dave Timpy (ACOE) to verify these
determinations. The following table details the location, existing pipe size and the proposed pipe
size:
Site Location Existing Pie Proposed Pipe
1 0.1 miles W of SR 1343 54" x 49 R CMP 2 81" x 59" x 67 ft CSPA
2 1.5 miles W of SR 1343 None 36" x 60 ft CMP
3 3.4 miles W of SR 1343 60" x 36"x 50 ft CMP 2 36" x 60 ft CMP
4 4.9 miles W of SR 1343 2 60"x 48 ft CMP 2 73" x 55" x 60 ft CSPA
5 6.0 miles W of SR 1343 2 60"x 46" x 48 ft CMPA 2 66" x 51" x 60 ft CSPA
6 6.7 miles W of SR 1343 2 24" x 50 R RCP 2 36" x 60 ft CMP
Pipes at sites 1,4 & 5 will have headwalls on both the inlet and outlet ends. A pipe could not be
located in the immediate location of Site 2, therefore it was decided to install a new pipe at this
location to improve alignment and flow at this location rather than utilizing the existing lateral
ditches to maintain flow. Total impacts for this proposed project will consist of 0.03 acres of

wetlands and 122 ft of stream impacts that are associated with unnamed tributaries to Falls
Swamp and Muddy Creek, which are classified as C Sw by the Division of Water Quality.
By copy of this letter and application, the North Carolina Department of Transportation
(NCDOT) also requests authorization by the North Carolina Division of Water Quality
(NCDWQ) for the corresponding Section 401 Water Quality Certification.
If you have any question or concerns, please feel free to contact me at [phone].
Sincerely,
Mason Herndon, Division Environmental Officer
Division 3
Enclosures
Cc: Joanne Steinhuis, NCDWQ, Wilmington
Office Use Only: Form Version May 2002
USACE Action ID No. DWQ No.
(If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A".)
1. Processing
1. Check all of the approval(s) requested for this project:
® Section 404 Permit ? Riparian or Watershed Buffer Rules
? Section 10 Permit ? Isolated Wetland Permit from DWQ
® 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested: NWP 14
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: ?
H. Applicant Information
Owner/Applicant Information
Name: H Allen Pope P E Division 3 Engineer
Mailing Address: North Carolina Department of Transportation
_ 124 Division Dr.
Wilmington, N.C. 28401
Telephone Number: [phone] Fax Number: (910) 251- 5727
E-mail Address:
2. Agent/Consultant Information (A signed and dated copy of the Agent Authorization letter
mast be attached if the Agent has signatory authority for the owner/applicant.)
Name: Mason Herndon
Company Affiliation: Division 3 Environmental Officer
Mailing Address: North Carolina Department of Transportation
124 Division Dr.
Wilmington, N.C. 28401
Telephone Number: [phone] Fax Number: (9101251-5727
E-mail Address: mherndonga dot.state.ne.us
Page 5 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 I1 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: Makatoka Rd (SR 1342)
2. T.I.P. Project Number or State Project Number (NCDOT Only): 6.232079T
3. Property Identification Number (Tax PIN):
4. Location
County: Brunswick Nearest Town: Supply
Subdivision name (include phase/lot number):
Directions to site (include road numbers, landmarks, etc.): From US 17 take Hwy 211 North
0.5 miles to SR 1342 to the left towards Prospect unimproved section is 3.8 miles from Hwy
211 just north of Prospect
5. Site coordinates, if available (UTM or Lat/Long): See' attached sheet'
(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):
7. Nearest body of water (stream/river/sound/ocean/lake): Fall Swamp & Muddy Creek
8. River Basin: Lumber
(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: Existing unpaved road is bordered by managed pinelands,
and some residences Road is traveled by school buses.
Page 6 of 12
10. Describe the overall project in detail, including the type of equipment to be used:
To grade drain, base and pave existing secondary road with standard road construction
equipment No widening of existing road bed is required on this project Work primarily
consist of replacing degraded pipes pulling of lateral ditches grading, applying base and
paving.
11. Explain the purpose of the proposed work: To bprove existing secondary road by bringing
it up to typical DOT secondary _paved road standards of 20 ft of pavement and 6 ft earth
shoulders
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.
No previous permits been issued
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.
No additional permit request are anticipated in the near future
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 7 of 12
1. Provide a written description of the proposed impacts: Impacts will include the
replacement and lengthening of 5 pipes in jurisdictional areas and the installation of one new
crossline
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***
1 fill .01 no adjacent forested wetland
2 fill .007 no adjacent forested wetland
3 fill .003 no adjacent forested wetland
4 fill .006 no adjacent forested wetland
5 fill .005 no adjacent forested wetland
6 fill 003 no adjacent forsted wetland
* 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 http://www.fema.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.) 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: N/A
Total area of wetland impact proposed: 0.03
3. Individually list all intermittent and perennial stream impacts below:
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 2-81" x59"CSPA 18 UT Fall Swamp 9 ft Intermittent
2 36" CMP 60 Ut Fall Swamp 7.5 ft Intermittent
3 2- 36" CMP 10 UT Muddy Branch 10 ft Intermittent
4 2-60"x51" CSPA 12 UT Muddy Branch 18 ft Intermittent
5 2-66"x51."CSPA 12 UT Muddy Branch l5 ft Intermittent
6 2-36" CMP 10 UT Muddy Branch 12 ft Intermittent
* 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., www.topozone.com,
www.mapguest.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: 122
Page 8 of 12
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 Wat)
(if applicable) Type of Waterbody
(lake, pond, estuary, sound,
bay, ocean, etc.
N/A

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: fill, excavation, dredging,
flooding, drainage, bulkheads, etc.
Pond Creation N/A
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.):
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.
All wetlands or surface waters not affected by this vrroiect will be protected from unnecessary
encroachment No staging of construction equipment will be allowed in or near wetlands or
waters Strict enforcement of sedimentation and erosion control BMP's will be enforced.
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 9 of 12
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/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.
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/wry/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
Page 10 of 12
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* Impact
(square feet Multiplier Required
Mitigation
1 3
2 1.5
Total
* Zone I extends out 30 feet perpendicular from near hank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.
Page 1 I of 12
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 (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.
Strict enforcment of Sedimentation and Erosion Control BMP's will be enforced duriny,
construction to protect wetlands & waters of U.S.
XII. 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.
XIII. 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-fast 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).
None
-16-oZ
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 12 of 12
KEY TO COUNTY ROAD NUMBERS
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