20021577 Ver 1_Complete File_20020911

W Ar Michael F. Easley, Governor
(?F
?9
O? p? William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
\
r Alan W. Klimek, P.E. Director
li
ty
Division of Water Qua

O `C
DWQ Project No.: 402 /S7? County:
Applicant: NCDOT
Project Name ?5X 11-5'0 Gz-
Date of Issuance of 401 Water Quality Certific tion:
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 o erd 1 Wa Quality Certification and Buffer Rules, the approved plans and
specifications, and a Is.
Signature: Date:
Agent's Certifi tion
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
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), http://h2o.enr.state.nc.us/ncwetiands/
o?o? w A r
co 7
October 1, 2002
Cherokee County
DWQ Project No. 021577
SR 1150 (Candy Mountain Road)
APPROVAL of 401 Water Quality Certification with Additional Conditions
Mr. Wesley T. Grindstaff, County Maintenance Engineer
NCDOT
P.O. Box 1551
Andrews, NC 28901
Dear Mr. Grindstaff:
You have our approval, in accordance with the attached conditions and those listed below, to impact 43
linear feet of Allen Branch and Bearpaw Creek in order to improve SR 1150 (Candy Mountain Road) in
Cherokee County. The project should be constructed in accordance with your application dated
September 5, 2002 (received September 11, 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 implement Best Management Practices for the Protection of Surface Waters (NCDOT
March 1997).
2. NCDOT shall abide by any conditions or moratoriums as determined by the NC Wildlife Resources
Commission.
3. All work shall be performed during low flow conditions.
4. 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. The presence of equipment in the channels must be minimized.
5. The pipes required for this project shall be designed and installed in a manner that does not initiate a
headcut along the streams. NCDOT must submit a plan for written DWQ approval to address any
headcutting that will occur as a result of this project.
6. Storm water shall be directed to grassed swales, buffer areas or retention basins and not routed
directly to streams.
7. Existing streamside vegetation shall not be mowed in order to utilize it for storm water sheet flow.
8. Riparian vegetation (native trees and shrubs) 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), hftp://h2o.enr.state.nc.us/ncwetiands/
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

9. Use of rip-rap for bank stabilization is to be minimized; rather, native vegetation is to be planted
when practical. If rip-rap is necessary, it must be limited to the stream bank above the high water
mark. Rip rap shall not be placed in the stream bottom.
10. Upon completion of the project, the NCDOT or its authorized agent 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.
Sincerely,
Attachment
P.K I
me E.
Pc: Wilmington District Corps of Engineers
John Hendrix, USACE Asheville Field Office
Mike Parker, NCDWQ Asheville Regional Office
Central Files
File Copy
ITAII
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? pNM 02157
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY
GOVERNOR
September 5, 2002
U.S. Army Corps of Engineers
151 Patton Avenue, Room 208
Asheville, NC 28801-2714
LYNDO TIPPETT
SECRETARY
rt,
BILE COPY ?- ----,?,
? SEP O,
Attention: Mr. John Hendrix
NCDOT Coordinator

Subject: Proposed Secondary Road Construction
SR 1150, Candy Mountain Road, near Murphy, NC, Cherokee County.
State Project No. 6.912007T (DWQ Minor Permit Fee $200)
Dear Mr. Hendrix:
The North Carolina Department of Transportation (NCDOT) is proposing to widen and
resurface SR 1150, Candy Mountain Road, in Cherokee County. This proposal entails a
portion of widening the existing 16' paved roadway to a standard 18' roadway. In order
to accomplish this work, and replace some deteriorated pipe, NCDOT is requesting
permission to extend/replace three CMP culverts.
The proposed improvements of SR 1150 have been identified as necessary maintenance
and safety improvements. Funds have been allocated for this project, and NCDOT would
like to perform these activities sometime during the 2002 paving season calendar year.
I am attaching details of the site where will propose to be in conflict with the stream. I
am also attaching a vicinity map as well as a USGS map with this site shown with its
coordinates listed. We propose to install the new culvert 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.
Best management practices will be used to minimize and control sedimentation and
erosion on this project. The construction foreman will review all erosion control
measures daily to ensure sedimentation and erosion is being effectively controlled. If the
planned devices are not functioning as intended, they will be immediately replaced with
Andrews District Office
P. O. Box 1551, Andrews, N. C. 28901
Phone: [phone] Fax: [phone]
better devices. The rock siltscreens and other erosion control devices will be in place
prior to pipe culvert construction and will remain in place until the project is stabilized.
Impacts to Waters of the United States
In order to complete the above-mentioned improvements along SR 1150 in Cherokee
County, it will be necessary to impact waters of the United States in the Hiwassee River
Basin. Specifically, NCDOT is requesting to extend/replace three metal culverts in Allen
Branch and Bear Paw Creek (Class Q. Listed below is a summary of the proposed
impacts.
Station Existing
Condition Proposed
Condition Net Impacts
Site #1 35' x 48" CMP 50' x 48" CMP 15' extension
Site #2 38' x 36" CMP 55' x 36" CMP 17' extension
Site #3 54' x 24" CMP 65' x 36" CN1P ` ' 11' extension
43 feet 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
(NCWRC) 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 the 2002 calendar year. If you
require additional information, please contact me at 828.321.4105. Your early review
and consideration will be greatly appreciated.
Sincerely,
Wesley T. Grindstaff
County Maintenance Engineer
copy: Mr. Richard Phillips, PE, Regional Engineer DENR
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. Wendell Chastain, Transportation Supervisor, NCDOT
Mr. Mark Davis, Division Environmental Officer, NCDOT
Mr. Reid Whitehead, Roadside Env. Field Op. Technician, NCDOT (w/o attach)

STREAM IMPACTS
Station Existing
Condition Proposed
Condition Net Impacts Latitude/ Longitude
Site # 1 35' x 48" CMP 50' x 48" CMP 15' extension 35-05-30 / 84-12-44
Site # 2 38' x 36" CMP 55' x 36" CMP 17' extension 35-05-38 / 84-13-06
Site # 3 54' x 24" CMP 65' x 36" CMP 11' extension 35-05-33 / 84-13-34
43 feet total
Persimmon Creek Quadrangle
Candy Mountain Road, SR 1150
Cherokee County
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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 1150, Candy Mountain Rd, Cherokee County
f N(1R /;(: ?\
? \x
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io
1. n
Of 10. .-II z
NCDOT Division 14, District III
Prepared by: Wesley T. Grindstaff
County Maintenance Engineer
Cherokee & Graham Counties
Paw,e I
Office Use Only:
USACU Action ID No.
Form Version October 2001
DWQ No.
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) rCyucsted For this project:
® Section 404 Permit
R Section 10 Permit
® 401 Water Quality Certification
Riparian or Watershed Buf'fcr 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 - Miti(-,,ation), check here: F] N/A
II. Applicant Information
1. Owner/Applicant Information
Name: North Carolina Department of Transportation (NCDOT)
Mailing Address: PO 1 fox 1 551
Andrev?s. NC 28901
Telephone Number: 828.321.410 Fax Number: 828.321.3228
E-mail Address: w0xindstall'ci clot. state. tic. us
2. Agent Information (A signal and dated copy of the Agent Authorization letter must be
attached if the A`,erit has signatory authority For the owner/applicant.)
Name: Wcslcy T. Grindstalf'
Company Affiliation: County Maintenance Engineer
Mailing Address: (sank as above)
Telephone Number: Fax Number:
E-mail Address:
Pauc 2
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 scab 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 "top(graphic Quad Map and NRCS Soil Survey with the property
boundaries outlined. Plan drawin?-,s. 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: Candy Mountain Road, SR 1 150
2. T.I.P. Project Number or Statc Project Number (NCDOT Only): 6.912007T
3. Property Identification Nunih,:r t tax PIN)
N; A
4. Location
County: Cherokee Nearest Town: Murphy
Subdivision name (include phase/lot number): N/A
Directions to site (include road numbers. landmarks, etc.): take US 64 \ from Murphy.
Riuht onto NC 294. 6.4 miles then left onto SR 1150.
5. Site coordinates. i f available t l IA/I 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 crossinu, ol'a distinct watcrbody.)
6. Describe the existing land use or condition of the site at the time of this application:
forest, pasture. liuht residential
7. Property size (acres): N/A
8. Nearest body of water (stream'ri ver/sound/ocean/lake): Bear Paw Cr, Allen Br Class C
9. River Basin: IlMllssee
(Note - this must be one of' North Carolina's seventeen designated major river basins. The
River Basin map is available at Iittp://li2o.enr.state.nc.us/admin/maps/.)
10. Describe the purpose of the proposed work: Construct road to current NCDOT secondary
Pa_e 3
road standards
11. List the type ol'cquipment to he used to construct the project: trackhoe, backhoe, dozer
loader, grader. dump trucks
12. Describe the I,111d 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 USACI Action 11) Number- I AW) Project Number, application date, and date permits and
certifications were issued or N\ithdrawn. Provide photocopies of previously issued permits,
certifications or other useful 1111'M nation. Describe previously approved wetland. stream and
buffer impacts. alone with associ,itcd mitigation (where applicable). If this is a NCDOT project,
list and describe permits issued 1-01- prior scuments of the same T.I.P. project, along with
construction schedules.
N/A
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 Nvork 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 neap all impacts to
wetlands. open water. and stream channels associated with the project. The applicant must also
provide justification liar 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. ,uid 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
11a,-,e 4
Wetland Impact Arca of
Site Number Type of Impact* Impact
(indicate on map) - (acres)
++

List each impact separately and identify tempos r% 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 I cdaal Emergcnc\ `lanagement Agency's (FEMA) Flood Insurance Rate Maps
(FIRM), or FLMA-approved local Iloodplain llmjl, Maps are availahlc through the FEMA Map Service Centcr at 1-800-358-9616. or
online at http:/%www.fclna.go%.
List a wetland type that best describes wetland to he impacted (r e . freshwater/saltwater marsh, forested wetland. beaver pond,
Carolina Bi,,. bog. etc.)
List the total acreage (estimatcch ofexisting, \\etlands on the property:
Total area of'wctland impact proposed:
2. Stream Impacts, including all intermittent and perennial streams
Stream Impact
Site Number
(indicate on map)
Type of Impact* Len_(li of
lmi).tct Stream Name**
(line; r Icct )
I, Average Width
of Stream
Before Impact Perennial or
Intermittent?
(please specify)
Site #I culvert -
1; ert UT to Bear Paw Creek 4 feet _
P
Site #2 Culvert 17 fort UT to Bear Paw Creek 3 feet P
Site #3 Culvert I I I'cet UT to Allen Branch 3 feet P

i ?

* List each impact separately ;ind identify temporni impacts. Impact, mcludc. but are not limited to: culverts and associated rip-rap,
dams (separately list impacts due to both structure Mid IloodinL). relocation (include linear feet before and alter, and net loss/gain),
stabilization activities (cement wall. rip-rap, crib \\all. gabions. etc.). excavation, ditching/straightening, etc. If stream relocation is
proposed, plans and profiles showing the linear luotprint 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 \\hich it Ilo\?, t ')GS maps arc ,mailable through the USGS at 1-800-358-9616. or online at
www.usgs.gov. Several internet sites also ilhm direct download and printing of USGS maps (c.(-,.. w\\\\.topozone.com,
www.mapquest.com, etc.). ---
Cumulative impacts (linear cli?t.mce in beet) to all streams on site: 43 linear feet
Located \\ ithin
100-year Floodplain**
(yes/no) Distance to
Nearest Stream
(linear feet)
Type of Wetland***

I
I

Pa-c j
3. Open Water Impacts, inch dIII-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 map) iArea of

Type of, Impact* Impact
?
(acres) -
Name of Waterbody
(ifapplicable) Type of%aterbody

(lake, pond, estuary, sound,

bury, ocean, etc.)
- - -

List eaen impact scparatct\ mio IdenUly tcmhomli Impacts. Inlp?icts include, nut are not limited to: till. r.xca\auon, 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 appleF I uplands F stream wetlands
Describe the method of construction (e.??.. dam/embankment, excavation. installation of
draw-down valve or spillwaN. etc.):
Proposed use or purpose ol' pond (e.g., livestock watering, irrigation, aesthetic. trout pond,
local stor?nwater regUirernellt_ etC.):
Size of ?Latershed 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. l is applicant nwy 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 durinL, Construction to reduce impacts.
Erosion and siltation control measures and 13\III's will be used during construction to avoid
environmental impacts
VIII. Mitigation N/A
DWQ - In accordance with 1 5:A NCAC 21-1 .0500, mitigation may be required by the NC
Division of Water t>uahty 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.
Pa,r 0
USAGE - In accordance with the Final Notlcc of Issuance and Modification of Nationwide
Permits, published in the Fedcrtl Register on \larch 9, 2000, mitigation will be required when
necessary to cnsurc 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 MII he considered in dCcrntinin`(y acceptability of appropriate and practicable
mitigation as proposed. Examples ol'mitigation that may be appropriate and practicable include,
but are not limited to: reduci I L' the size of' the project; establishing and maintaining wetland
and/or upland \e1-1etated buffers to protect open \\atcrs such as streams; and replacing losses of
aquatic resource functions and \alucs by creating, restoring, enhancing, or preserving similar
functions and v alucs, preferable in the same watershed.
If mitigation is required for this project, a cope ol' the mitigation plan must be attached in order
for USACE or MV( to consider the application complete for processing. And application
lacking a required mitigation plan or NCWRI' concurrence shall be placed on hold as
incomplete. An applicant may also choose to rcyiew the current guidelines for stream restoration
in DWQ's Dral't Technical Guide for Stream Work in North Carolina, available at
http://l12o.enr.state.nc.tts/ncwctlands'Strm?-11de.Iltntl.
1. Provide a brief description of the proposed mithuation plan. The description should provide
as much in1'6rnuttiun as possihle. includin2. but not limited to: site location (attach directions
and/or map. il'ofl:site), affected stream and ri\cr basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, cnhancrnlent. creation, or preservation), a plan view,
preservation mcchanisin (?. .. deed restrictions, conservation easement, etc.), and a
description ol'the current site conditions and proposed method of construction. Please attach
a separate sheet i l'more space is needed.
N/;A
2. Mitigation may also be m.tdc by pa%mcnt into the North Carolina Wetlands Restoration
Pro`aranl (N,O RI') with the \('WRI''s m-ittcn agreement. Checl: the box tndicatlng that
you would lilac to pay into the NCWRI'. I'Ic;tse note that payment into the NC'AA'I)P must be
reviewed and approved bctOrc it can be used to satisfy mitigation requirements. Applicants
will be notil-Icd carly in the review process by the 401/Wetlands Unit il' payment into the
NCWRP is available as an option. For additional information regarding the application
process fur the N('WRP. check the NCWRI) website at http://h2o.enr.state.nc.us/wrp'index.htm. If
use of the NI' is proposed. please check the appropriate box on pauc three and provide
the foliowin-! Hil'Ornlation: VA
Amount ol'stivanl mitigation requested (Ilneal' feet):
Amount of huller mitigation requested (syuarc feet):
Amount ol'Riparian wetlancl mitigation requested (acres):
Amount ul'\on-riparian wetland nlitigation requested (acres):
Amount of CO,tstal wetland mitigation rcyucsted (acres):
I' w r
IX. Environmental Documentation (MVQ Onl) )
Does the project Imk)l\?e an e.xpcnditure ol' public funds or the use of public (federal, state/local)
land?
Yes Z No ?
If yes, does the project require preparation ol' an environmental doCtlmcnt pursuant to the
requirements o1' the National M' North Carolina Environmental Policy Act (NEPA/SEPA)?
Note: Iii you arc not sure \Octher a Nl"'I) A Sl`PA document is required, call the SEPA
coordinator at (919) 7>3-5083 to rev icw current thresholds for environmental docununtation.
Yes ? No
If yes, has the document revie?\ hcen finalized h\ the State Clearinghouse? I I'so, please attach a
copy of the Nl-TA or EPA final approval letter.
Ycs ? No
X. Proposed Impacts on Riparian and NVatershed Buffers (DWQ Only)
It is the applicant's for agents) resportsibilit.\ to determine. delineate and map all impacts to
required state and local buffers associated \\itl the project. The applic'aw must also provide
justification fur these impacts in Scction VII ;All proposed impacts must be listed herein,
and must be clcarl.\ identiliablc on the accolul?;tlr, in?? site plan. All buffers must be shown on a
map, whether or not impacts arc proposal to the huffers. Correspondence from the DWQ
Regional 01'1icc ni,t\ be included as appropriate. I'hoto-raphs may also he included at the
applicant's discretion.
Will the project impact protcc!,d riparian huil-crs identified within 15:A y4" AC 213 .0233
(Neese). 15A 2B .0251 Tar-Pantli", ?. ? A NCAC 213 .025U (lZan?!lenuu? Rules and
Water Supple 13ufl'-'l i\)cquircmcntsl. or other identify )?
lees F-j No D Ifyou ;u!s??crcd "yes", provide the l'ollom in, inl'ormation:
Identify the square I'cct and acrca1-1e of impact tO each zone of the riparian hufhcrs. If buffer
mitigation is rcquircd calculate the required ;u»ount of mitigation by applyinp, the buffer
multipliers.
Zone Impact It i pI ier - Required
Alu
(s(Juare feet) Miti,-,atioit
I
1.5
Total * zone I -C- -\I out 30 feet I)erpen(iiculur 1`1 111 n,_ar I)Mlk ul'Cllannel: Zone 2 extends ?ui?
ndditiun.il -'h Icet from the ?Jcr ol,zon?: I

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 213 .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 compacted paved roadway acts as an impervious surface. Widening the roadway by
1' in each travel lane will increase the impervious area from 2.58 to 2.90 acres. Stormwater will
be diverted through settling basins or grass lined buffers prior to entering streams.
XII. 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.
XI11. 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 F-] 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).
Wesley T. Grindstaff 08/30/02
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
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