20020553 Ver 1_Complete File_20020411

I
State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
&111
••
Michael F. Easley, Governor NC ENR
William G. Ross, Jr., Secretary NORTH CAROLINA DEPARTMENT OF
Gregory J. Thorpe, Ph.D., Acting Director ENVIRONMENT AND NATURAL RESOURCES
DWQ Project No.: 6&05!;S County:
Applicant: -*,.e
Project Name: T t?YCacw.? ? o? SR C. k? 8
Date of Issuance of 401 Water Quality Certification: 014 1,30 120(32
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/Wedands Unit, North Carolina Division of Water Quality., 1621 Mail Service Center, Raleigh, NC,
27699-1621. This form may be returned to DWQ by the applicant, the applicant's authorized agent, or the
project engineer. It is not necessary to send certificates from all of these.
Applicant's Certification
L _ Z d-V=4 4 EL- cam. ; ;.hereby state .that, ,to he best of m 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 40.1, -.-Water, Quality Certification and Buffer. Rules„the
approved .plans'and specificationother supporting materials. .
t . •
Signature: r Date:
QS
Agent's Certification
I, , hereby state that, to the best of my abilities, due care and
diligence was used in the observation of the construction such that the construction was observed to be built
within substantial compliance and intent of the 401 Water Quality Certification and Buffer Rules, the
approved plans and specifications, and other supporting materials.
Signature:
Engineer's Certification
Partial Final
Date:
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, and other supporting materials.
Signature
Date
Registration No.
Wetlands/401 Unit 1650 Mail Service Center Raleigh, North Carolina 27699-1621
Telephone [phone] FAX [phone]
An Equal Opportunity Affumative Action Employer 50% recycled/10% post consumer paper
State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
William G. Ross, Jr., Secretary
Gregory J. Thorpe, Ph.D., Acting Director
s11kT11W,J0•
A., 2
NC ENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
April 30, 2002
Halifax County
DWQ Project No. 020553
APPROVAL of 401 Water Quality Certification
Mr. James H. Trogdon III, P.E., Division Engineer
NCDOT, Division 4
PO Box 3165
Wilson, NC 27895-3165
Dear Mr. Trogdon:
You have our approval, in accordance with the attached conditions and those listed below, to place fill
material in 0.4 acres of jurisdictional wetlands and 149 linear feet of streams for the purpose of
improvements and paving of SR 1128 (Sand Pit Road) from 2020 feet west of NC 481 to NC 561 in Halifax
County. The project shall be constructed in accordance with your application dated April 15, 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 Number 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.
pli n offhe-Mjeet,-tire NCB sh2l-l-comp-lete-and-retmm-tlie-enelosed "Certifieatien-ef- - - -
Completion Form" to notify DWQ when all work included in the 401 Certification has been completed.
The responsible party shall complete the attached form and return it to the 401/Wetlands Unit of the
Division of Water Quality upon completion of the project.
If you do not accept any of the conditions of this certification, you may ask for an adjudicatory hearing.
You must act within 60 days of the date that you receive this letter. To ask for a hearing, send a written
petition that conforms to Chapter 150B of the North Carolina General Statutes to the Office of
Administrative Hearings, P.O. Box 27447, Raleigh, N.C. 27611-7447. This certification and its conditions
are final and binding unless you ask for a hearing.
Wetlands/401 Unit 1650 Mail Service Center Raleigh, North Carolina 27699-1621
Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post consumer paper
State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Govemor
William G. Ross, Jr., Secretary
Gregory J. Thorpe, Ph.D., Acting Director
/ • 0
AWWW% 00OW44NOW0 ?Ik - A-
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
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.
Attachment
cc: Wilmington District Corps of Engineers
Corps of Engineers Raleigh Field Office
DWQ Raleigh Regional Office
File Copy
Central Files
c:\ncdot\SR 1128\wqc\020553wgc.doc
Smc ely,
1
e J. Tho h.D.
n Director
Wetlands/401 Unit 1650 Mail Service Center Raleigh, North Carolina 27699-1 62 1
Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/10% post consumer paper

STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY
GOvERNOR
April 15, 2002
U.S. Army Corps of Engineers
Raleigh Regulatory Field Office
6508 Falls of the Neuse Road, Suite 120
Raleigh, NC 27609
LYNDO TIPPETT
SECRETARY
(x?
I'
a
020553
Attention: Ms. Jean B. Manuele
- NCDOT Coordinator
Subject: Secondary road improvements to SR 1128 (Sand Pit Road) from 2,020
feet West of NC 481 to NC 561 in Halifax County.
State Project No. 6.302071T DWQ Minor Permit Fee $475
The North Carolina Department of Transportation (NCDOT) proposes to upgrade
to SR 1128 (Sand Pit Road) from 2,020 feet West of NC 481 to NC 561 in Halifax
County. SR 1128 is an unpaved roadway that will be upgraded to a paved roadway.
Total project length is 3.48 miles.
Transportation and highway laws of North Carolina (G.S. 136-44.6, 136-44.7,
136-44.7A, 136-44.8, and 136-44.9) require the NCDOT to develop annual work
programs for construction and maintenance of secondary roads. These general statutes
specifically set forth requirements for annual construction and paving of existing unpaved
roads. Paving of these roads is performed in priority order as established by the NCDOT
for each unpaved road within a given county. This number is based on characteristics of
each road, including number of homes, schools, churches, businesses, industries,
recreational facilities, traffic counts, presence of school bus routes, and value as a
thoroughfare. Sand Pit Road is scheduled to be paved in the 2001-2002 Secondary Roads
Construction Program. The existing road will be realigned to improve vehicular safety.
Impacts to Waters of the United States
Construction of the project will necessitate impacts to waters of the United States
in the Roanoke River Basin. The project crosses five unnamed perennial tributaries to
Conconnara Swamp. Impacts to the stream from construction include temporary impacts
and minimal impacts due to road realignment. The subject road will be closed during
\ Post Office Box 3165, Wilson, North Carolina 27895-3165 PT 11 `? R ! T
Phone [phone] Fax [phone]
construction and a temporary detour using existing roads will be provided. The five pipe
replacements listed below will impact a total of 650 additional square feet of streambed
and 114 feet of stream channel, due to minimal increases in the length and width of the
proposed pipes.
LOCATION EXISTING EXISTING PROPOSED PROPOSED
Station Diameter (in.) Length (ft.) Diameter (in.) Length (ft.)
20+20 24 32 24 52
32+80 66 34 66 60
89+30 24 32 24 52
178+75 24 36 24 64
184+75 48 48 54 68
In addition to what is listed above, 35 feet of steam channel at Station 20+20 will
be temporally impacted for sediment removal.
The proposed road realignment impacts approximately 0.40 acres, the minimal
amount necessary to accomplish proposed safety improvements to the road. Wetlands
were observed adjacent to the existing roadside ditches, on the right side of the existing
road, from Stations 179+00 to 184+75. Wetland data forms are attached for
documentation.
Waters of the U.S. Mitigation
Avoidance: Minimal ditch work will be performed within the wetland area
identified between Stations 179+00 to 184+75. The proposed realignment is the
minimum necessary to upgrade safety conditions on the subject road by reducing the
curvature and increasing the tangents between reverse curves to meet current
specifications. The proposed realignment has been redesigned to avoid a stream between
Stations 179+00 to 184+75. All wetlands or surface waters not affected by the project
will be protected from unnecessary encroachment. No staging of construction equipment
or storage of construction supplies will be allowed in or near wetlands or surface waters.
Right of Way was unavailable to avoid wetlands.
Minimization: The proposed realignment has been redesigned to minimize
wetland impacts. The side slopes have been steepened to the extent possible at
jurisdictional sites. Strict enforcement of sedimentation and erosion control Best
Management Practices for the protection of wetlands and surface waters will be enforced
during project construction. Continued coordination will occur with maintenance forces
and the Environmental Officer during construction to minimize impacts to waters of the
U.S. at these sites.
Compensatory Mitigation: Construction of the project will result in 0.40 acres of
impacts to waters of the U.S. Impacts have been minimized to the maximum extent
possible during the design process. In-lieu fee mitigation will be offered through the
NC WRP.
Riparian Buffer Impacts
The construction of the project involves five road crossings of streams that are
located within the Roanoke River Basin and therefore is not subject to any Riparian
Buffer Rules. Efforts will be made to minimize the impacts of any additional storm water
by the installation of appropriate best management practices for sediment and erosion
control.
Dewatering
The NCDOT proposes to temporarily dewater the stream during the construction
of the project. This will involve the temporary placement of sandbags or Class B or
Class 2 rip rap covered with filter fabric in the stream channel approximately 10 feet
upstream of the proposed pipe inlet. To maintain water flow during construction, water
upstream of this impervious structure will be temporarily pumped out and conveyed
downstream of the construction activity where it will be allowed to filter through
vegetation before flowing into the stream. The stream will be dewatered for less than
five consecutive calendar days. This will result in temporary impacts to these surface
waters. Temporary impacts to the stream from this activity will result in the dewatering a
total of 400 linear feet stream channel. The sandbags, steel sheeting, or rip rap covered
with filter fabric will be entirely removed after construction.
Regulatory Review
The subject project has been reviewed and concurrence obtained from the State
Historic Preservation Office that there is no effect to any National Register or Study-
listed properties within the subject projects Area of Potential Effects. (See attached
Concurrence Form.)
The subject project has been reviewed by the Environmental Officer and by the
U.S. Fish and Wildlife Service (USFWS) representative for the presence of listed
threatened and endangered species. The subject project has been determined to have no
effect on any listed threatened or endangered plant or animal species.
Permit Issues
The construction of the project is authorized under a Section 404 Nationwide
Permit (NWP) 14, Linear Transportation Crossings. Notification for the use of this NWP
to the USACE is required for this project, as the discharge associated with the project is
greater than 0.10 acre and there are impacts to special aquatic sites (including wetlands).
Accordingly, notification to the North Carolina Division of Water Quality (NCDWQ) for
Section 401 Water Quality Certification (WQC) No. 3375 is required for this project.
NCDOT will comply with all conditions associated with this NWP and WQC.
The purpose of this letter is to also request authorization under a Section 404
NWP 33 to dewater the stream during project construction. The 401 WQC No. 3366
4
(which corresponds to NWP 33) does not requir6 written concurrence from the NCDWQ
as NCDOT intends to comply with conditions for the WQC.
Summary
NCDOT proposes to upgrade and pave SR 1128 in Halifax County. Temporary
impacts to the stream from dewatering activity will involve 400 linear feet stream
channel. An additional 35 feet of steam channel will be temporally impacted due to
sediment removal. The five proposed pipe replacements will impact a total of 114 linear
feet and 650 square feet of existing channel impacted. Total wetland impacts will be 0.40
acres. The project is located in the Roanoke River Basin, which currently has no riparian
buffer regulations in effect. The NCDOT asks for authorization under a NWP 14, Linear
Transportation Crossings. The NCDOT asks that the dewatering of the stream be
authorized under a Section 404 NWP 33. The NCDOT will adhere to all applicable
Section 404 NWPs and Section 401 WQCs conditions. If you have any questions or need
additional information, please contact Franz Enders at [phone].
s H. Trogdon,
i ision Engineer
cc: Mr. David Franklin, USAgE, Wilmington
Mr. John Dorney, NCDW , Ral igh
Mr. David Cox, NCWRC, &M dmoor
Mr. Garland Pardue, USFWS, Raleigh
Mr. Bryant Bunn, P.E., NCDOT Division Maintenance Engineer
Mr. B. A. Mills, District Engineer
NCDOT Division Environmental Officer
Office Use Only: Form Version October 2001
USACE Action ID No. DWQ No. 020553
If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A" rather than
leaving the space blank.
I. Processing
Check all of the approval(s) requested for this project:
® Section 404 Permit
Section 10 Permit
® 401 Water Quality Certification
Riparian or Watershed Buffer Rules
2. Nationwide, Regional or General Permit Number(s) Requested: NWP 14, 33
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: n
4. If payment into the North Carolina Wetlands Restoration Program (NCWRP) is proposed for
mitigation of impacts (see section VIII - Mitigation), check here:
II. Applicant Information
1. Owner/Applicant Information
Name: Mr. James H. Trogdon, III, P.E., Division Engineer
Mailing Address: North Carolina Department of Transportation/Division 4
P.O. Box 3165
Wilson NC 27895-3165
Telephone Number: [phone] Fax Number: [phone]
E-mail Address: jtrogdongdot.statemc.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: Mr. Franz Enders
Company Affiliation: District Environmental Coordinator
Mailing Address: North Carolina Department of Transportation/Division 4
P.O. Box 98
Halifax NC 27839
Telephone Number: [phone] Fax Number: [phone]
E-mail Address: fenderska dot.state.nc.us
Page 5 of 12
III. Project Information
3
Attach a vicinity map clearly showing the location of the property with respect to local
landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property
boundaries and development plans in relation to surrounding properties. Both the vicinity map
and site plan must include a scale and north arrow. The specific footprints of all buildings,
impervious surfaces, or other facilities must be included. If possible, the maps and plans should
include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property
boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion,
so long as the property is clearly defined. For administrative and distribution purposes, the
USACE requires information to be submitted on sheets no larger than 11 by 17-inch format;
however, DWQ may accept paperwork of any size. DWQ prefers full-size construction
drawings rather than a sequential sheet version of the full-size plans. If full-size plans are
reduced to a small scale such that the final version is illegible, the applicant will be informed that
the project has been placed on hold until decipherable maps are provided.
1. Name of project: SR 1128, Sand Pit Road, State Project No. 6.302071T
2. T.I.P. Project Number or State Project Number (NCDOT Only):
Property Identification Number (Tax PIN): NA
4. Location
County: Halifax Nearest Town: Tillery
Subdivision name (include phase/lot number):
Directions to site (include road numbers, landmarks, etc.): Approx. 0.9 miles North of
Tillery on NC 561, turn left onto SR 1128.
5. Site coordinates, if available (UTM or Lat/Long):Dawson Crossroads, Halifax, & Boones
Crossroads Quad M4ps: UTM 18 272334E 4012824N; 18 272639E 4013017N; 18 273939E
4014089N• 18 276128E 4015643N• 18 276255E 4015715N
(Note - If project is linear, such as a road or utility line, attach a sheet that separately lists the
coordinates for each crossing of a distinct waterbody.)
6. Describe the existing land use or condition of the site at the time of this application: Rural,
agricultural
7. Property size (acres): NA
8. Nearest body of water (stream/river/sound/ocean/lake): UT to Conoconnara Swamp (DWQ
ID # 23-33 C)
9. River Basin: Roanoke River
(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.ne.us/admin/mgps/.)
Page 6 of 12
10. Describe the purpose of the proposed work: Road realignment, grading, drainage, base,
paving and erosion control to bring existing gravel road in compliance with standard safety
design specifications.
11. List the type of equipment to be used to construct the project: Heavy construction
equipment (backhoe, excavator, dump truck, bulldozer, grader)
12. Describe the land use in the vicinity of this project: Rural agricultural
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:
NA
VI. Proposed Impacts to Waters of the United States/Waters of the State
It i§-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. Wetland Impacts
Wetland Impact Area of Located within Distance to
Site Number Type of Impact* Impact 100-year Floodplain** Nearest Stream Type of Wetland***
(indicate on map) (acres) (yes/no) (linear feet)
St 179+00-184+75 MC, G, F, D/D 0.40 Yes 0-130 feet Clearcut Forested
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.pov.
*** 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: NA
Total area of wetland impact proposed: 0.40 acres
2. Stream Impacts, including all intermittent and perennial streams
Stream Impact Length of Average Width Perennial or
Site Number Type of Impact* Impact Stream Name** of Stream Intermittent?
(indicate on map) (linear feet) Before Impact (please specify)
20+20 24" RCP 20 onnara
UT to C?on
oc 16 feet Intermittent
no
p
20+20 Sediment 35 UT to C
on
oconnara 16 feet Intermittent
Removal `
no
32+80 2-42"Hx66"W 26 UT to Conoconnara 23 feet Perennial
CMPA Swam
89+30 24" RCP 20 on
oconnara
UT to C 12 feet Intermittent
no
`
178+75 24" RCP 28 UT to Coon
oconnara 10 feet Intermittent
no
184+75 2-54" CMP 20 oconnara
UT to C
on 25 feet Perennial
`
no
* 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, ditch ing/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.mapquest.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: 149
3. Open Water Impacts, including Lakes, Ponds, Estuaries, Sounds, Atlantic Ocean and any
other Water of the U.S.
Open Water Impact Area of Name of Waterbody Type of Waterbody
Site Number Type of Impact* Impact (if applicable) (lake, pond, estuary, sound,
(indicate on map) (acres) bay, ocean, etc.)

Page 8 of 12
* 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.
encroachment. No staging of construction equipment will be allowed in or near wetlands or
waters of the U.S. Strict enforcement of sedimentation and erosion control Best Management
Practices for the protection of wetlands and surface waters will be enforced during project
construction. The preferred alignment was changed to avoid the stream and minimize impacts to
wetlands, and yet still meet minimum design standards. Further avoidance was not practical due
to lack of Right of Way.
VIII. Mitigation
DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC
Division of Water Quality for projects involving greater than or equal to one acre of impacts to
freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial
streams.
USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on March 9, 2000, mitigation will be required when
necessary to ensure that adverse effects to the aquatic environment are minimal. Factors
including size and type of proposed impact and function and relative value of the impacted
aquatic resource will be considered in determining acceptability of appropriate and practicable
mitigation as proposed. Examples of mitigation that may be appropriate and practicable include,
but are not limited to: reducing the size of the project; establishing and maintaining wetland
and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of
Page 9 of 12
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/strmaide.html.
1. Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
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/wrp/index.htm. If
use of the NCWRP is proposed, please check the appropriate box on page three and provide
the following information:
Amount of stream mitigation requested (linear feet):
Amount of buffer mitigation requested (square feet):
Amount of Riparian wetland mitigation requested (acres):
Amount of Non-riparian wetland mitigation requested (acres): 0.80
Amount of Coastal wetland mitigation requested (acres):
IX. Environmental Documentation (DWQ Only)
Does the project involve an expenditure of public funds or the use of public (federal/state/local)
land?
Yes ® No
If yes, does the project require preparation of an environmental document pursuant to the
requirements of the National or North Carolina Environmental Policy Act (NEPA/SEPA)?
Page 10 of 12
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 F-1 . 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 F-1 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 213 .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 1 extends out JU teet perpendicular trom near bank of cnannel; Gone z extends an
additional 20 feet from the edge of Zone 1.
If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation
of Property, Conservation Easement, Riparian Buffer Restoration / Enhancement, Preservation or
Payment into the Riparian Buffer Restoration Fund). Please attach all appropriate information as
identified within 15A NCAC 2B .0242 or .0260.
Page 11 of 12
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.
Temporary dewatering and all appropriate best management practices for sediment and erosion
control will be implemented during pipe replacement.
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.
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).

App cantLA ent's Signature . / hate
(A nt's sign ture is valid only if an authorization letter from the applicant is provided.)
Page 12 of 12
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IYl-LIJ1?1 lXL LI'?I 11 'IVII Iu/.'.Ji-? ?vv -il ?? •^J -- -- -- --
County: Halifax NCDOT Division # 4 District 4 1
CONCURRENCE FORM FOR PROPERTIES NOT ELIGIBLE FOR THE NATIONAL
REGISTER OI! IIIST-TORIC PLACES,
FOR STATE FUNDED SECONDARY ROAD PROJECTS ONLY
Project Description: Pave and Widen' H61i6x=SR 1:128' from NC 481 to NC 561, including part of the Tilletty
On May 17, 2001, representatives of the..
Noah Carolina Department o€TtartSporiativn (NCDOT).
North Carolina State Historic Preservation Office (HPO)
? Other -- - - -
Reviewed the. subject project at
? a scoping meeting
photograph review session/consultation:.
[].. other-----
All parties present agreed
There are no properties'over. fifty:years old'within iha pmj.ect's Federal Permit Site's (or Sites') area'(or
areas) of potential effects (APE).
V/ There are no properties less. than fifty, years old, that:are considered to meet Criterion Consideration G
within the project's Federal Permit Site's:(or sites' area (or areas) of potential effects.
There are properties over fift y years. old (list attached-) vicithin the project's Federal Permit Site's (or Sites')
area (or areas) of potential effegt1,-but based pn the.'historical information available and the photographs of
each property, properties. identified as are, considered not eligible for the National Register and
no further evaluation is necessary.
here are no National ]Register or Study-Listed; proper ties located within the secondary road project's area
of potential effects. Heem.'la?c_.au
Y There are no historic properties affected.b' this:pxoject..:Note: The Tillery Resettlement District, HX 541
(SL) and the Hermitage, HX S (NB) will not?be• affected b) this project.
j
Signed:

Representative, NCDOT

Date

State Historic Preservation Officer
"'^. If a survey report is prepared, a final copy of this form' and the attached list will-be-tneWed. -
DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Delineation Manual)
ProjectlSite: SR 11 2_2 14 A L-1 FA Y? 60s Date: 11/14/61
Applicant/Owner: ? j C ' n T"- County: i F' 64
Investigator: >rv?t 1 ITC1 >;" State: lL)C-
Do Normal Circumstances exist on the site? a No Community ID:
Is the site significantly disturbed (Atypical Situation)? es No- Transect ID:
Is the area a potential Problem Area? es No Plot ID:
If needed, a lain on reverse. I_ I
VFGFTATION
Dominant Plant Species Stratum Indicator Dominant Plant Species Stratum Indicator

EC.
S J
3 11
-- --- - -
_ _
.
4. c1 I -- --?? --- _VfL? L_-- ____
-
12.- ------ - --
jdt1L -t f S r? (?uS 1?
5
-- FALW-C8 13.-- _ --
.
- -
&
W
6. F 14. -- -- --- ---
_
A
? l? iY?rz 1. _ ?1 C?
7.?j 15.---- ----- -- --- -
Q

Percent of Dominant Species that are OBL, FACW or FACj ej G
(excluding FAC- . ---------------- -
Remarks: C A
C? ??? t ?Vt.? ?ti C (? Ut S t? tiL L
Ci 155-" YJ f i
'
)
L
1v t.u
-

uynoni nmy
_ Recorded Data (Describe in Remarks): Wetland Hydrology Indicators:
Stream, Lake, or Tide Gauge
- Primary Indicators:
Aerial Photographs _ Inundated
_ Other _ Saturated in Upper 12 Inches
ZW Recorded Data Available _ Water hbrks
_ Drift Lines
_ Sediment Deposits
Field Observations: Drainage Patterns in Wetlands
Secondary Indicators (2 or more required):
t
f S
f
W
D
h (in
) t/Oxxi¢ed Root Channels in Upper 12 Inches
er:
ept
o
ur
ace
a .
_ Water-Stained Leaves
Depth to Free Water in Pit: (in.) L ?/_ Local Sol Survey Data
FAC-Neutral Test
Depth to Saturated Soil: (in.) _ Other (Explain in Remarks)
Remarks:
G 1 d L?j VA
((?i?'l L 1 4 l G'
132 Appendix B Blank and Example Data Forms
cn'ri c
Map Unit Name
(Series and Phase): CA (a SUAI W I G7 ? ?? Drainage Class:
Field Observations
Taxonomy (Subgroup): -_-__ -?- Confirm Mapped Type? Yes No
Profile Description:
Depth Matrix Color Mottle Colors Mottle Abundance/ Texture, Concretions,
(inches) Horizon (Munsell Moist) (Munseli Moist) Sim/Contrast Structure etc

8-1 2- r- 4z
- -
Hydric Soil Indicators:
_ Histosol
_ Histic Epipedon _ Concretions
- High Organic Content in Surface Layer in Sandy Soils
_ Sulfidic Odor -f 2anic Streaking in Sandy Soils
_ Aquic Moisture Regime
Reducing Conditions ? Listed on Local Hydric Soils List
Listed on National Hydric Soils List
.'Gleyed or Low-Chrome Colors _ Other (Explain in Remarks)
Remarks:
ML,?? 1:7 7
W1=T1 ANI'1 n1:TFRIIAINATIAN
Hydrophytic Vegetation Present? Y No (Circle) (Circle)
Wetland Hydrology Present? a No
Hydric Soils Present? es, No Is this Sampling Point Within a Wetland? C1.4 ? No
Remarks:
f,wvw Y. n.w-- -.-
Appendix B Blank and Example Data Forms B3
North Carolina
Department of Environment and Natural Resources
Michael F. Easley, Governor
William G. Ross Jr., Secretary
RECEIPT
July 26, 2002
Mr. Phil Harris
NC Department of Transportation
1548 Mail Service Center
Raleigh, NC 27699-1548
Re: Project: Sand Pitt Road (SR 1128)
DWQ #: 020553
County: Halifax
The North Carolina Wetlands Restoration Program (NCWRP) has received a check in the
amount of $ 12,000 check number 1324583, as payment for the compensatory mitigation requirements
of the 401 Water Quality Certification and/or Section 404 Permit issued for the subject project. This
receipt serves as notification that the compensatory mitigation requirements for this project have been
satisfied. Please note that you must also comply with all other conditions of this certification and any
other state, federal or local government permits or authorization associated with this activity.
The NCWRP, by acceptance of this payment, acknowledges that the NCWRP is responsible for
the compensatory mitigation requirements associated with the subject permit and agrees to provide the
compensatory mitigation as specified in the permit. The NCWRP will restore .80 acres of non-riparian
wetlands in Cataloging Unit 03010107 of the Roanoke River basin.
If you have any questions or need additional inforr-nation, please contact Crystal Braswell at
I
[phone].
Sincerely,
7-
R d .Ferrell,
Program Manager
cc: Rob Ridings, Wetlands/401 Unit
Jean Manuele, USACOE
file
Wetlands Restoration Program 1619 Mail Service Center Raleigh, NC 27699-1619
[phone] Fax: [phone]