20021350 Ver 1_Complete File_20020823

Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
DWQ Project No.: Oc)-/3 SQ County:
Applicant: NCDOT
Project Name: --S?d //OLD Oz-l-? c? vz -
Date of Issuance of 401 Water Quality Ce ification: 9 - fa -- 10-
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 e 401 WaterQuality Certification and Buffer Rules, the approved plans and
specifications, and o L rtgt! Si
gnature: Date:
Agent's Certifi 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/
Vq AT ?
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OF W ATF
Michael F. Easley, Governor
Q William G. Ross Jr., Secretary
G North Carolina Department of Environment and Natural Resources
r
> Alan W. Klimek, P.E. Director
y
Y Division of Water Quality
c? Z ? 3sv
i Project No.: Q &-as 9 County: ?Ph?f,?rsa?y
cant: p 7-
ct Name: er
of Issuance of 40 Water Quality Certification: /? - G -
Npon 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
01/Wetlands Unit, North Carolina Division of Water Quality, 1650 Mail Service Center, Raleigh, NC,
7699-1650. This form may be returned to DWQ by the applicant, the applicant's authorized agent, or
he project engineer. It is not necessary to send certificates from all of these.
pplicant's Certification
hereby state that, to the best of my abilities, due care
nd diligence was used in the observation of the construction such that the construction was observed to
be built within substantial co pliance and intent of the 401 Water Quality Certification and Buffer
Rules, the ap d 1 specifications, and other supporting materials.
Signature: Date:_
-L1-I `dam-
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: Date:
If this project was designed by a Certified Professional
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
Ow Bow
North Carolina Division of Water Quality 401 Wetlands Certification Unit, AD,
E1+CR
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.uslncwetlands/
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DEPARTMENT OF THE ARMY
WILMINGTON DISTRICT, CORPS OF ENGINEERS
151 PATTON AVENUE
ROOM 208
ASHEVILLE, NORTH CAROLINA 28801-5006
PLY TO
AATTTENT ON OF: e c e i v e .,
S E P 0 9 2002
Permit Number: 200231265
Pl?rmit Type: NW14
Name of County: Henderson
Name of Permittee: NCDOT/SR1100/Gap Creek Road/6.952593/DIV14
Dilate of Issuance: September 3, 2002
Upon completion of the activity authorized by this permit and any mitigation
required by the permit, sign this certification and return it to the following
address:
U.S. Army Corps of Engineers
Attention: CESAW-RG-A
151 Patton Avenue, Room 208
Asheville, North Carolina 28801-5006
Please note that your permitted activity is subject to a compliance 4nspection
l?y an U.S. Army Corps of Engineers representative. If you fail to comply with
his permit you are subject to permit suspension, modification, or revocation.
I hereby certify that the work authorized by the above referenced permit has
een completed in accordance with the terms and conditions of the said permit,
nd required mitigation was completed in accordance with the permit
conditions.
__ I I yO ? ?? a
Signatu of Permittee Date
L`
\NATF Michael F. Easley, Governor
9 William G. Ross Jr., Secretary
?O? QG North Carolina Department of Environment and Natural Resources
1 r Alan W. Klimek, P.E. Director
Uj
> Division of Water Quality
o ?c
September'b, 2002
Henderson County
DWQ Project No. 021350
SR 1100 (Gap Creek Road)
APPIKOVAL of 401 Water Quality Certification with Additional Conditions
Mr. '.A. Green, P.E., District Engineer
NC OT Division 14, District 1
4142 Haywood Road
Horseshoe, NC 28742
Mr. Green:
You have our approval, in accordance with the attached conditions and those listed below, to impact 20
linear feet of unnamed tributaries to Terry Creek in order to improve SR 1100 (Gap Creek Road) in
Henderson County. Grading is proposed to be moderate to heavy. The project should be constructed in
accordance with your application dated August 20, 2002 (received August 23, 2002). After reviewing
your application, we have decided that this fill is covered by General Water Quality Certification No.
337 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
Wat rshed regulations. This approval will expire with the accompanying §404 permit unless otherwise
spec Efied in the Water Quality Certification.
This approval is only valid for the purpose and design that you described in your application except as
mod ?fied below. If you change your project, you must notify us in writing, and you may be required to
send us a new application. If the property is sold, the new owner must be given a copy of this
Certfication and approval letter and is thereby responsible for complying with all conditions. If total
wetl nd fills for this project (now or in the future) exceed one acre, or if stream impacts exceed 150 linear
feet, compensatory mitigation may be required as described in 15A NCAC 2H.0506 (h) (6) and (7). For
this pproval to be valid, you must follow the conditions listed in the attached certification and any
addi Jonal conditions listed below.
1. NCDOT shall use Best Management Practices for the Protection of Surface Waters (NCDOT March
1997).
2. ')edimentation and Erosion Control Guidelines for Sensitive Watersheds [15A NCAC 4B .01241 shall
)e implemented prior to any ground-disturbing activities to minimize impacts to downstream aquatic
esources.
3. ,tormwater 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. 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 IS, 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.
5. Riparian vegetation must be reestablished within the construction limits of the project by the end of
he growing season following completion of construction.
North Carolina Division of Water Quality, 401 Wetlands Certification Unit,
1650 Mail Service Center, Raleigh, NC 27699-1650 (Mailing Address)
2321 Crabtree Blvd., Raleigh, NC 27604-2260 (Location)
919-733-1786 (phone), 919-733-6893 (fax), http://h2o.enr.state.nc.us/ncwetlands/
?J_ PNR-
6. NCDOT is encouraged to use existing on-site vegetation and materials for stream bank stabilization
and to minimize the use of rip rap.
7. The pipes required for this project shall be installed in such a manner that the original stream profile
is not altered (i.e. the depth of the channel must not be reduced by a widening of the streambed).
Existing stream dimensions (including the pattern and profile) are to be maintained above and below
locations of each culvert. The culvert shall be designed and installed to allow for fish and other
wildlife movement as well as prevent headcutting of the streams. If any of the existing pipes are
perched, they shall be removed and replaced, and installed correctly.
8. NCDOT must submit a plan for written DWQ approval to address any headcutting that will occur as a
result of this project.
9. All work shall be performed during low flow conditions.
10. Heavy equipment must be operated from the banks rather than in the stream channel in order to
minimize sedimentation and reduce the likelihood of introducing other pollutants into the stream.
11. 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.
12. 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
Pc: Wilmington District Corps of Engineers
John Hendrix, USACE Asheville Field Office
Mike Parker, NCDWQ Asheville Regional Office
Central Files
File Copy

NSU1Ey
021350
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
tel F. Easley Lyndo Tippett
GovEmox Secretary
M ' ,L
Mr. John Hendricks
U. S. Army Corps of Engineers
151 Patton Avenue
Room 143
Asheville, NC 28801
August 20, 2002
FILE COPY
SUBJECT: Proposed Secondary. Road Construction -
SR 1100, Gap Creek Road
Henderson County
State Project No. 6.952593 (DWQ Minor Permit Fee $200)
Dear Mr. Hendricks,

t
Attached are erosion control plans, an application form for a Nationwide Permit, and a county
map section locating SR 1100, Gap Creek Road, in Henderson County. SR 1100 is a gravel road
that we propose to clear, grub, grade, replace/extend pipes, and pave for a distance of 0:26 miles.
Grading will be moderate to heavy.

We are requesting permission to replace and extend pipes in live streams as noted on plans and
the attached pipe schedule. Pipes will be replaced using our standard method of pipe installation
described in the erosion control plans. NCDOT " Best Management Practices for Protection of
Surface Waters" and proper phasing of erosion control items will be used to minimize and
control sedimentation and erosion.
Also by copy of this letter, authorization to proceed under section 401 of the Clean Water Act is
being requested from Mr. John Dorney, Division of Water Quality.
By copy of this letter, we are asking Mr. Owen Anderson, N. C. Wildlife Resources Commission,
to comment to the Corps of Engineers concerning the Nationwide Permit request. Upon review
of the Corps of Engineers we are requesting that Mr. Anderson forward a copy to us (NCDOT)
as well.

Division 14, District 1
Phone: [phone] Haywood Road, Horse Shoe, NC 28742 Fax: [phone]
By copy of this letter, we are also asking Mr. Ed Ingle, Area Roadside Environmental Engineer
(NCDOT), to comment directly to us on the above project.
Your earliest consideration for this request would be appreciated. If any further information is
needed, please contact me or Mr. S. L. Cannon, Assistant District Engineer, at [phone].
Sincerel o
T. A. een, P. E.
District Engineer
EAG/slc
attachment
cc: Mr. Richard Phillips, P. E., NCDENR
Mr. John Dorney, DWQ
Mr. Owen Anderson, Western Mountain Region Coordinator, NCWRC
Mr. E. L. Ingle, Area Roadside Environmental Engineer, NCDOT
Mr. Mark Davis, Division Environmental Officer, NCDOT
Mr. M T. Gibbs, P. E., County Maintenance Engineer, NCDOT
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Offic Use Only: Form Version October 2001
021350
USA 'E Action ID No. DWQ No.
If any particular item is not applicable to this project, please enter "Not Applicable" or "N/A" rather than
leavi g the space blank.
I. 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: NW 14
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here:
' 4._'If payment into the North Carolina Wetlands Restoration Program (NCWRP) is proposed for
mitigation of impacts (see section VIII - Mitigation), check here: ?
H. Applicant Information
1. Owner/Applicant Information
Name: North Carolina Department of Transportation
Mailing. Address: 4142 Haywood Rd
Horse Shoe NC 28742
Telephone Number: [phone] Fax Number: [phone]
E-mail Address: NA
i
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: Edward A. Green, P.E.
Company Affiliation: District Engineer
Mailing Address: 4142 Haywood Rd
Horse Shoe NC 28742
Telephone Number: [phone] Fax Number: [phone]
E-mail Address: egreen(a dot state nc us
Page 5 of 13
i
I
III.
Project Information
Attach a vicinity map clearly showing the location of the property with respect to local
landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property
boundaries and development plans in relation to surrounding properties. -Both the vicinity map
and site plan must include a scale and north arrow. The specific footprints of all buildings,
impervious surfaces, or other facilities must be included. If possible, the maps and plans should
include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property
boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion,
so long as the property is clearly defined. For administrative and distribution purposes, the
USACE requires information to be submitted on sheets no larger than 11 by 17-inch format;
however, DWQ may accept paperwork of any size. DWQ prefers full-size construction
drawings rather than a sequential sheet version of the full-size plans. If full-size plans are
reduced to a small scale such that the final version is illegible, the applicant will be informed that
the project has.been placed on hold until. decipherable maps are provided,
1. Name of proj ect: Gap Creek Rd (SR 1100)
2. T.I.P. Project Number or State:Project_Number (NCDOT Only): N/A
3., Property Identification Number (Tax PIN): see attachments
4. Location
County: Henderson Nearest Town: Tuxedo
Subdivision name (include phase/lot number): N/A
Directions to site (include road numbers, landmarks, etc.): Begin at the intersection of SR
1100 and SR 1265 and continue in a westerly direction for a total distance of 1,400 feet to the
end of project.
5. Site coordinates, if available (UTM or Lat/Long): 35N 11' 00" / 82W 25'41"
(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
Road
7. Property size (acres): 1,400 * 50' = 1.61 acres
8. Nearest body of water (stream/river/sound/ocean/lake): Terry Creek
9. River Basin: Broad
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http://h2o.enr.state.nc.us/admin/maps/.)
Page 6 of 13
10. Describe the purpose of the proposed work: Upgrade SR 1100 to minimum standards for
a NCDOT maintained road.
11. List the type of equipment to be used to construct the project: Widen and pave SR 1100
using hydraulic excavators back hoes bulldozers dump trucks, motor graders, and various
hand tools.
12. Describe the land use in the vicinity of this project: Rural residential
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.
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 work from the. current application:
N/A
VI. j 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.
W,tland Impacts
Page 7 of 13
Wet
Sit
(indi land Impact
: Number
cate on ma
Type of Impact* Area of
Impact
acres Located within
100-year Floodplain**
es/no Distance to
Nearest Stream
linear feet
Type of Wetland***
N/A

* Lit each impact separately and identity temporary impacts. impacts metuae, out are not nit ttea to: mecnanizeu clearing, grauuig, lily
ex avation, 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. Raw Maps
(FIRM), or FEMA-approved local floodplain maps. Maps are available through the FEMA Map Service Center at 1-800-358-9616, or
o line at httn://www.fema.gov.
*** Li-t a wetland type that best describes wetland to be impacted (e.g., freshwater/saltwater marsh, forested wetland, beaver pond,
C? olina Bay, bog, etc.)
,, List the total acreage (estimated) of existing wetlands on the property: N/A
Total area of wetland impact. proposed: N/A
1. Stream Impacts, including all intermittent and perennial streams
S -
Si
(in earn Impact
te Number
icate on map)
Type of Impact* Length of
Impact
(linear feet)
Stream Name** Average
Stream Width Before
Impact Perennial or
Intermittent?
(please specify)
1 Sta. (10+70) CMP extension 10' UT to Terry Creek Perennial
2 ta. (13+30) CMP extension 10' UT to Terry Creek 2' Perennial

* ist each impact separately ana taenttry temporary impacts. mlpacts 111Wuuo, uuL atc 11UL 1111ULUU w. %,u1vc1w 411U 4JOV-Q- .=y-=..y,
ams (separately list impacts due to both structure and flooding), relocation (include linear feet before and after, and net loss/gain),
tabilization activities (cement wall, rip-rap, crib wall, gabions, etc.), excavation, ditching/straightening, etc. If stream relocation is
proposed, plans and profiles showing the linear footprint for both the original and relocated streams must be included.
** Stream names can be found on USGS topographic maps. If a stream has no name, list as UT (unnamed tributary) to the nearest
downstream named stream into which it flows. USGS maps are available through the USGS at 1-800-358-9616, or online at
www.usgs.gov. Several intemet sites also allow direct download and printing of USGS maps (e.g., www.topozone.com,
www.mayouest.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: 20'
Page 8 of 13
2. Open Water Impacts, including Lakes, Ponds, Estuaries, Sounds, Atlantic Ocean and any
other Water of the U.S.
[Onpe Water Impact
to Number
cate on ma
Type of Impact* Area of
Impact
acres Name of Waterbody
(if applicable) Type of Waterbody
(lake, pond, estuary, sound,
bay, ocean, etc.
N/A

* List each impact separately and identity temporary impacts. Impacts include, nut are not umitea to: tut, excavation, areaging,
flooding, drainage, bulkheads, etc.
3. Pond Creation
If construction of a pond is proposed, associated wetland and stream impacts should be
included above in the wetland and stream impact sections. Also, the proposed pond should
be described here and illustrated on any maps included with this application.
Pond to be created in (check all that apply): ? uplands ? stream ?.wetlands
_...Describe the method of construction (e.g., dam/embankment, excavation, installation of
draw-down valve or spillway, etc.): N/A
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.): N/A
Size of watershed draining to pond: N/A Expected pond surface area: N/A
VIII Impact Justification (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It may be useful to provide
information related to site constraints such as topography, building ordinances, accessibility, and
financial viability of the project. The applicant may attach drawings of alternative, lower-impact
site layouts, and explain why these design options were not feasible. Also discuss how impacts
were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce impacts.
NCDOT is proposing to install the minimum amount of metal culverts required to obtain a
standard secondary road typical. Pipes will be installed below the stream bed to prevent
perching and allow for aquatic passage.
Prover erosion control measures will be installed and maintained throughout the life of the
Project.
VII[. Mitigation
DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC
Division of Water quality for projects involving greater than or equal to one acre of impacts to
freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial
streams.
Page 9 of 13
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 prgtect 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
hqn://h2o.enr.sta.te..nc.us/ncwetlands/stnnzide.html.
Provide-a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions.
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
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 httv://h2o.enr.state.nc.us/yn/index.htin. If
use of the NCWRP is proposed, please check the appropriate box on page three and provide
the following information:
Amount of stream mitigation requested (linear feet): N/A
Amount of buffer mitigation requested (square feet): N/A
Amount of Riparian wetland mitigation requested (acres): N/A
Amount of Non-riparian wetland mitigation requested (acres): N/A
Page 10 of 13
Amount of Coastal wetland mitigation requested (acres): N/A
IX. Environmental Documentation (DWQ Only)
Does the project involve an expenditure of public funds or the use of public (federal/state/local)
land?
Yes ® No ?
If yes, does the project require preparation of an environmental document pursuant to the
requirements of the National or North Carolina Environmental Policy Act (NEPA/SEPA)?
Note: If you are not sure whether a NEPA/SEPA document is required, call the SEPA
coordinator at [phone] to review current thresholds for environmental documentation.
Yes ? No Z
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. j 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 .0231.
(Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250. (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify. )?
Yes E] 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* s nTact Multiplier Required
t n
1 3
2 1.5
Total
* Zone 1 extends out 30 feet perpendicular trom near bank of cttannei; zone L extenas an
additional 20 feet from the edge of Zone 1.
Page 11 of 13

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.
N/A
X1. I 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 gavel roadway acts as an impervious surface. Paving of the roadway
should eliminate sedimentation from :.fines associated with gavel surface treatment. The
roadway surface will be approximately 40% of the right-of-way area. Stormwater will be
diverted through settling basins or Bass lined buffers prior to entering streams. (See erosion
).
control plan
Sewage Disposal (DWQ Only)
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from the proposed project, or available capacity of the subject facility.
N/A
Violations (DWQ Only)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H .0500) or any Buffer Rules?
Yes E] No
Is this an after-the-fact permit application?
Yes ? No
Other Circumstances (Optional):
It is the applicant's responsibility to submit the application sufficiently in advance of desired
construction dates to allow processing time for these permits. However, an applicant may
choose to list constraints associated with construction or sequencing that may impose limits on
work schedules (e.g., draw-down schedules for lakes, dates associated with Endangered and
Threatened Species, accessibility problems, or other issues outside of the applicant's control).
Page 12 of 13
G1i
Appl?icant/Agent's' Signature Date
I - , is signature is valid only if an authorization letter from the applicant is provided.)
Page 13 of 13
NORTH CAROLINA DEPARTMENT OF TRANSPORTATION
• DIVISION OF HIGHWAYS
SECONDARY ROAD SURVEY.
SUBJECT

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