Loading...
HomeMy WebLinkAbout20021125 Ver 1_Complete File_20020715 ?T Michael F. Easley, Governor F9 William G. Ross Jr., Secretary O? Q? North Carolina Department of Environment and Natural Resources \ I VON 71- Aian W. Klimek, P.E. Director lit Q ua y Division of Water O `C DWQ Project No.: 0??/oZ S County: G 1 Applicant: NCDOT Project Name s-Z? /307 Date of Issuance of 401 Water Quality Ce cation:- a 3 y 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, Joel B. Setzer, P.E., 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 401 Wa Quality Certification and Buffer Rules, the approved plans and specifications, and o rtSignature: Date: 1.3ol?F? Agent's Certific ion 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: 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 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: 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/ O?O? W A T ?qQG O July 23, 2002 Clay County DWQ Project No. 021125 SR 1307 (Clear Creek Road) APPROVAL of 401 Water Quality Certification with Additional Conditions Mr. J. Ralph Cannady, P.E., County Maintenance Engineer NCDOT Andrews District Office P.O. Box 1551 Andrews, NC 28901 Dear Mr. Cannady: You have our approval, in accordance with the attached conditions and those listed below, to impact 80 linear feet of an unnamed tributary to Clear Creek, Stephens Branch and Camp Branch in order to improve SR 1307 (Clear Creek Road) in Clay County. The project should be constructed in accordance with your application dated July 11, 2002 (received July 15, 2002). After reviewing your application, we have decided that this fill is covered by General Water Quality Certification No. 3375 corresponding to the U.S. Army Corps of Engineers Nationwide Permit Number 14. In addition, you should acquire any other federal, state or local permits before you proceed with your project including (but not limited to) Sediment and Erosion Control, Non-Discharge and Water Supply Watershed regulations. This approval will expire with the accompanying 404 permit unless otherwise specified in the Water Quality Certification. This approval is 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 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 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. NCDOT shall adhere to Best Management Practices for the Protection of Surface Waters (March 1997). 2. In-stream work and land disturbance within the 25-foot wide buffer zone are prohibited during the trout spawning season of October 15 through April 15, or other conditions as determined by the North Carolina Wildlife Resources Commission, to protect the egg and fry stages of trout from sedimentation during construction. 3. Where practicable, storm water should be directed to buffer areas or retention basins and must not be routed directly into streams. Mowing of existing vegetated buffers is strongly discouraged, so that they may be utilized for storm water sheet flow. 4. Temporary or permanent herbaceous vegetation shall be planted on all bare soil within 15 days of ground-disturbing activities to provide long term erosion control. 5. The pipes required for this project shall be installed in such a manner that the original stream profiles are not altered (i.e. the depth of the channel must not be reduced by a widening of the streambed). Existing stream dimensions are to be maintained above and below locations of each culvert. The culvert shall be installed one foot below the stream to allow for fish and other wildlife movement. All wnrlr chnll hP i erfnrmerl cluing lnui flnw rnnrlitinnc 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 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/ncwetlands/ 7. All mechanized equipment operated near surface waters must be regularly inspected and maintained to prevent contamination of stream waters from fuels, lubricants, hydraulic fluids, or other toxic materials. 8. The presence of equipment in the channels must be minimized. Under no circumstances must rock, sand or other materials be dredged from the wetted stream channel under authorization of this permit, except in the immediate vicinity of the culverts. 9. Use of rip-rap for bank stabilization is to be minimized; rather, native vegetation is to be planted when practical. If it is necessary to the project, rip-rap must be limited to the stream bank below the high water mark, and vegetation must be used for stabilization above high water. 10. Native riparian vegetation must be reestablished within the construction limits of the project by the end of the growing season following completion of construction. 11. 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. Mike Parker of the Asheville Regional Office at 828.251.6208. Attachment inc rel , Klim , P.E. Pc: Wilmington District Corps of Engineers John Hendrix, USACE Asheville Field Office NCDWQ Asheville Regional Office Central Files File Copy Jy .,. 5(AIT 021125 STATE OF NORTH CAROLINA DEPARTMENT OF TRANSPORTATION MICHAEL. F. EASLEY GOVERNOR July 11, 2002 U.S. Army Corps of Engineers 151 Patton Avenue, Room 208 Asheville, NC 28801-2714 Attention: Mr. John Hendrix NCDOT Coordinator FILE COPY 401 LSSUED LYNDO TIPPETT SECRETARY Subject: Proposed Secondary Road Improvement SR 1307 Clear Creek Road, near Hayesville, NC, Clay County. State Project No. 5.9223 (DWQ Minor Permit Fee 5200) Dear Mr. Hendrix: The North Carolina Department of Transportation (NCDOT) is proposing to improve SR 1307, Clear Creek Road, in Clay County. This proposal entails placing gravel on the road surface and installing three pipes in the road where streams are currently forded. In order to accomplish this work, NC T is requesting permission to install three CMP culverts. The proposed improvements of SR 1307 have been identified as necessary maintenance and safety improvements. These improvements also answer vital environmental concerns. Currently, vehicles must ford three streams allowing silt, motor oil, gasoline, and other substances to enter the streams and severely damage the water quality. The installation of the pipes would correct this problem. Funds have been allocated for this project, and NCDOT would like to perform these activities sometime during 2002. Andrews District Office Phone: (828)321-4105 P. 0. Box 1551, Andrews, N. C. 28901 Fax: (828)321-3228 I am attaching details of the sites which will propose to be in conflict with the stream. I am also attaching photographs, a vicinity map, as well as a USGS map with these sites shown with their coordinates listed. We propose to install the new culverts slightly below the existing streambed elevations where bedrock is not encountered to minimize impacts to wildlife habitats and allow the existing stream gradients to remain as unchanged as is physically possible. No threatened or endangered species are known to be present in or near the project area; therefore, no significant impacts are anticipated from project construction. :1 ly Best management practices will be used to minimize ind control sedimentation and erosion on this project. The construction foreman will review all erosion control measures daily to ensure sedimentation and erosion s being effectively controlled. If the planned devices are not functionintas intended;"Thrill be immediately replaced with better devices. The rock siltscreens and other erosion control devices will be in place prior to pipe culvert construction and will rernmr0iace until the project is stabilized. Impacts to Waters of the United *tates In order to complete the above-mentioned improvements along SR 1307 in Clay County, it will be necessary to impact waters of the United States in the Little Tennessee River Basin. Specifically, NCDOT is requesting to extend/replace one metal culvert each in Stephens Branch (Class C), UT to Clear Creek (Class C Trout), and Camp Branch (Class Q. Listed below is a summary of the proposed impacts. Station Existing Condition Proposed Condition Net Impacts Site #1 NO PIPE 25' x (36" x 22") CMP Arch 25' extension Site #2 NO PIPE 25' x (36" x 22") CMP Arch 25' extension Site #3 NO PIPE 30' x (50" x 31") CMP Arch 30' extension 80 ft. total Permits Requested NCDOT is hereby requesting authorization under NWP 14 and Section 404 of the Clean Water Act to proceed with the construction project outlined above. By copy of this letter, I am asking Mr. Owen Anderson, North Carolina Wildlife Resources Commission (NC WRC) Western Mountain Region Coordinator, to comment directly to you concerning the 404 Nationwide Permit Request. Also, by copy of this letter, I am requesting authorization to proceed under Section 401 of the Clean Water Act from the Division of Environmental Management Again, we would like to proceed with this project during 2002. If you require additional information, please contact me at 828.321.4105. Your early review and consideration will be greatly appreciated. Sincerely, Z 'P J. Ralph Cannady, County Maintenance Engineer Copy: Mr. Richard Phillips, PE, Regional Engineer DEHNR Mr. R.G. Watson, PE, Division Engineer, NCDOT Mr. John Dorney, DWQ, DEHNR Mr. Owen Anderson, Western Mountain Coordinator, NCWRC Mr. B.C. Burch, PE, District Engineer, NCDOT Mr. Terry Woody, Transportation Supervisor III, NCDOT Mr. Mark Davis, Division Environmental Officer, NCDOT Mr. Reid Whitehead, Roadside Environmental Officer, NCDOT Topton Quadrangle Clear Creek Road, SR 1307 Clay County STREAM IMPACTS Station Existing Proposed Condition Net Impacts Latitude/ Longitude Condition Site #1 NO PIPE 25' x (36" x 22") 25' extension 35-08-56/83-40-13 CMP Arch Site #2 NO PIPE 25' x (36" x 22") 25' extension 35-08-35/83-40-07 CMP Arch Site #3 NO PIPE ,x (50" x 31 30' extension 35-08-04/83-40-24 CMP Arch 80 feet total Site #1 f site i?-i - t, T II T rise 1 f .. of W A 7'FR QG r Pre-Construction Notification (PCN) Application Form For Section 404 and/or Section 10 Nationwide, Regional and General Permits, Section 401 General Water Quality Certifications, and Riparian Buffer and Watershed Buffer Rules SR 1307, Clear Creek Road, Clay County HOlTM C.4 M? * X S2 r yA4r of RA NCDOT Division 14, District III Prepared by: Ralph Cannady, PE County Maintenance Engineer Macon & Clay County Office Use Only: Form Version October 2001 USACE Action ID No. DWQ No P 2 1 1 2 5 If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A" rather than leaving the space blank. 1. Processing 1. Check all of the approval(s) requested for this project: ® Section 404 Permit ? Section 10 Permit ® 401 Water Quality Certification ? Riparian or Watershed Buffer Rules 2. Nationwide, Regional or General Permit Number(s) Requested: 14 3. If this notification is solely a courtesy copy because written approval for the 401 Certification is not required, check here: ? N/A 4. If payment into the North Carolina Wetlands Restoration Program (NCWRP) is proposed for mitigation of impacts (see section VIII - Mitigation), check here: ? N/A II. Applicant Information Owner/Applicant Information Name: North Carolina Department of Transportation (NCDOT) Mailing Address: PO Box 1551 Andrews NC 28901 Telephone Number: 828.321.4105 Fax Number: 828.321.3228 E-mail Address: rcannady a (dot. state. nc.us 2. Agent Information (A signed and dated copy of the Agent Authorization letter must be attached if the Agent has signatory authority for the owner/applicant.) Name: J. Ralph Cannady, PE Company Affiliation: County Maintenance Engineer Mailing Address: (same as above) Telephone Number: Fax Number: E-mail Address: 111. 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: Clear Creek Road SR 1307 2. T.I.P. Project Number or State Project Number (NCDOT Only): 5.9223 3. Property Identification Number (Tax PIN) N/A 4. Location County: Clay Nearest Town: Hayesville Subdivision name (include phase/lot number): N/A Directions to site (include road numbers, landmarks, etc.): Take SR 1307, Tusquitee Road, north from Main St in Hayesville Left on Tuni Gap Rd at 10 miles. Right on to Clear Creek Rd at Tuni Gap (Macon Co line). Site 91 is 2.197 mi off Tuni Gap Rd. 5. Site coordinates, if available (UTM or Lat/Long): see attached "Stream Impacts" (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: forest pasture light residential 7. Property size (acres): N/A 8. Nearest body of water (stream/river/sound/ocean/lake): Clear Creek (class C Tr) 9. River Basin: Little Tennessee (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/map-/.) Describe the purpose of the proposed work: Improve existing paved road. 10. List the type of equipment to be used to construct the project: trackhoe, backhoe, dozer loader, grader, dump trucks 11. Describe the land use in the vicinity of this project: forest, pasture, residential 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 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: 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. 1. Wetland Impacts No wetland impacts 4 Wetland Impact Site Number (indicate on map) Type of Impact* Area of Impact acres Located within 100-year Floodplain** es/no Distance to Nearest Stream linear feet Type of Wetland*** * List each impact separately and identify temporary impacts. impacts include, out are nor umtted to: mechwuccu uiuwmE, ?tauu?g .??,, 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:/hvww.fema.aov. *** 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: Total area of wetland impact proposed: 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) Site #1 Culvert 25 ft. Stephens Branch 2 ft. P Site #2 Culvert 25 ft. UT to Clear Creek 2 ft. P Site #3 Culvert 30 ft. Camp Branch 3 ft. P * List each impact separately and identify temporary impacts. Impacts include, but are not limited to: culverts and associated np-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.usas.Qov. 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: 80 linear feet 3. Open Water Impacts, including Lakes, Ponds, Estuaries, Sounds, Atlantic Ocean and any other Water of the U. S. No open water impacts 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. * List each impact separately and identify temporary impacts. Impacts include, but are not limited to: fill, excavation, dredging, flooding, drainage, bulkheads, etc. 4. Pond Creation If construction of a pond is proposed, associated wetland and stream impacts should be included above in the wetland and stream impact sections. Also, the proposed pond should be described here and illustrated on any maps included with this application. Pond to be created in (check all that apply): ? uplands ? stream ? wetlands Describe the method of construction (e.g., dam/embankment, excavation, installation of draw-down valve or spillway, etc.): 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. Erosion and siltation control measures and BMP's will be used during construction to avoid environmental impacts VIII. Mitigation N/A DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC Division of Water Quality for projects involving greater than or equal to one acre of impacts to freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial streams. USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide Permits, published in the Federal Register on March 9, 2000, mitigation will be required when necessary to ensure that adverse effects to the aquatic environment are minimal. Factors including size and type of proposed impact and function and relative value of the impacted aquatic resource will be considered in determining acceptability of appropriate and practicable mitigation as proposed. Examples of mitigation that may be appropriate and practicable include, but are not limited to: reducing the size of the project; establishing and maintaining wetland and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of aquatic resource functions and values by creating, restoring, enhancing, or preserving similar functions and values, preferable in the same watershed. If mitigation is required for this project, a copy of the mitigation plan must be attached in order for USACE or DWQ to consider the application complete for processing. Any application lacking a required mitigation plan or NCWRP concurrence shall be placed on hold as incomplete. An applicant may also choose to review the current guidelines for stream restoration in DWQ's Draft Technical Guide for Stream Work in North Carolina, available at http://h2o.enr.state.nc.us/ncwetlands/strm.izide.htmi. 1. Provide a brief description of the proposed mitigation plan. The description should provide as much information as possible, including, but not limited to: site location (attach directions and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet) of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view, preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a description of the current site conditions and proposed method of construction. Please attach a separate sheet if more space is needed. N/A 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 http://h2o.enr.state.nc.us/NvTp/index.litm. If use of the NCWRP is proposed, please check the appropriate box on page three and provide the following information: N/A 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): - 7 IX. Environmental Documentation (DWQ Only) Does the project involve an expenditure of public funds or the use of public (federal/state/local) land? Yes ® No ? If yes, does the project require preparation of an environmental document pursuant to the requirements of the National or North Carolina Environmental Policy Act (NEPA/SEPA)? Note: If you are not sure whether a NEPA/SEPA document is required, call the SEPA coordinator at (919) 733-5083 to review current thresholds for environmental documentation. Yes ? No If yes, has the document review been finalized by the State Clearinghouse? If so, please attach a copy of the NEPA or SEPA final approval letter. Yes ? No X. Proposed Impacts on Riparian and Watershed Buffers (DWQ Only) It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to required state and local buffers associated with the project. The applicant must also provide justification for these impacts in Section VII above. All proposed impacts must be listed herein, and must be clearly identifiable on the accompanying site plan. All buffers must be shown on a map, whether or not impacts are proposed to the buffers. Correspondence from the DWQ Regional Office may be included as appropriate. Photographs may also be included at the applicant's discretion. Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233 (Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and Water Supply Buffer Requirements), or other (please identify )? 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 Miti ation I 3 2 1.5 Total L.VIIC I C[LCnUJ VUL.3V IM perpenolcular trom near bank of channel; "Lone 2 extends an additional 20 feet from the edge of Zone 1. 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. XI. Stormwater (DWQ Only) Describe impervious acreage (both existing and proposed) versus total acreage on the site. Discuss stormwater controls proposed in order to protect surface waters and wetlands downstream from the property. The existing unpaved roadway acts as a pervious surface Applying gravel to the roadway will not impact the pervious nature of the surface. Stormwater will be treated as it has been previously. (See erosion control plan). XH. Sewage Disposal (DWQ Only) Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of wastewater generated from the proposed project, or available capacity of the subject facility. XIII. Violations (DWQ Only) Is this site in violation of DWQ Wetland Rules (15A NCAC 2H.0500) or any Buffer Rules? Yes ? No ? Is this an after-the-fact permit application? Yes ? No ? 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). C Applicant/Agent's Signature / v Date (Agent's signature is valid only if an authorization letter from the applicant is provided.) MINIMUM CRITERIA DETERMINATION CHECKLIST The following questions provide direction in determining when the Department is required to prepare environmental documents for state-funded construction and maintenance activities. Answer questions for Parts A through C by checking either yes or no. Complete Part D of the checklist when Minimum Criteria Rule categories #8 or # 15 are used. TIP Project No.: N/A State Project No.: 5.9223 Project Location: SR 1307, Clear Creek Road, Clay County Project Description: Unpaved secondary road improvement Anticipated Permit or Consultation Requirements: 401 and 404 Special Project Information: Project consists of placing gravel on existing roadway surface and installing new pipes where streams are currently forded. 07/11/02 1 of4 PART A: MINIMUM CRITERIA YES NO 1. Is the proposed project listed as a type and class of activity allowed under X El the Minimum Criteria Rule in which environmental documentation is not required? If the answer to number 1 is "no", then the project does not qualify as a minimum criteria project. A state environmental assessment is required. If yes, under which category? Nine (9) If either category #8 or #15 is used complete Part D of this checklist. PART B: MINIMUM CRITERIA EXCEPTIONS ?7te; 2:;9alo?ecorriplefed>:b h ' ?t t' a "'. L 2. Could the proposed activity cause significant changes in land use concentrations that would be expected to create adverse air quality impacts? 3. Will the proposed activity have secondary impacts or cumulative impacts that may result in a significant adverse impact to human health or the environment? 4. Is the proposed activity of such an unusual nature or does the proposed activity have such widespread implications, that an uncommon concern for its environmental effects has been expressed to the Department? 5. Does the proposed activity have a significant adverse effect on wetlands; surface waters such as rivers, streams, and estuaries; parklands; prime or unique agricultural lands; or areas of recognized scenic, recreational, archaeological, or historical value? 6. Will the proposed activity endanger the existence of a species on the ? F] Department of Interior's threatened and endangered species list? 7. Could the proposed activity cause significant changes in land use concentrations that would be expected to create adverse water quality or ground water impacts? 07/11/02 2 of 4 YES NO 8. Is the proposed activity expected to have a significant adverse effect on long-term recreational benefits or shellfish, finfish, wildlife, or their natural habitats If any questions 2 through 8 are answered "yes", the proposed project may not qualify as a Minimum Criteria project. A state environmental assessment (EA) may be required. For assistance, contact: Manager, Project Development and Environmental Analysis Branch P. O. Box 25201 Raleigh, NC 27611 (919) 733 -3141 Fax: (919) 733-9794 PART C: COMPLIANCE WITH STATE AND FEDERAL REGULATIONS teriisJ ?I2• o''bo etsviroy menta YES NO ,.+. ?. ??,... ?s.a..,v??.., fl?„ .,•y '?:1 .. 9. Is a federally protected threatened or endangered species, or its El habitat, likely to be impacted by the proposed action? 10. Does the action require the placement of temporary or permanent fill in waters of the United States? 11. Does the project require the placement of a significant amount of 1:1 El fill in high quality or relatively rare wetland ecosystems, such as mountain bogs or pine savannahs? 12. Is the proposed action located in an Area of Environmental Concern, as defined in the coastal Area Management Act? 4', enis:13 L ,;4 D e'co lefer7 bV tke Erie veer ''`'-' tii 9 N1 ! 1 4 Y ..aaYi4N ... Y :...Sh,: ?!..'iY?S .t?•1 .s; 13. Does the project require stream relocation or channel changes? Cultural Resources 13. Will the project have an "effect" on a property or site listed on the National Register of Historic Places? 14. Will the proposed action require acquisition of additional right of . way from publicly owned parkland or recreational areas? Questions in Part "C" are designed to assist the Engineer and the Division Environmental Officer in determining whether a permit or consultation with a state or federal resource agency may be required. If any questions in Part "C" are answered "yes", follow the appropriate permitting procedures prior to beginning project construction. 07/11/02 3 of4 PART D:(To be completed when either category #8 or #15 of the rules are used ' ems I5- 20 0 die complei ?iti 74ivisron ' nvironmenfal Wei 15. Project length: 16. Right of Way width: 17. Project completion date: 18. Total acres of disturbed ground surface: 19. Total acres of wetland impacts: 20. Total linear feet of stream impacts: 21. Project purpose: If Part D of the checklist is completed, send a copy of the entire checklist document to: Don G. Lee State Roadside Environmental Engineer Mail Service Center 1557 Raleigh, NC 27699-1557 (919) 733-2920 Fax (919) 733-9810 Email: dlee@dot.state.nc.us Reviewed by: Date: 7/11/02 Division Environmental Engineer cc: Don Lee Date: 07/11/02 4 of4