20020860 Ver 1_Complete File_20020530

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DWQ Project No.: O C74 County:
Applicant: G - ye- -
Project Name: C91E 05/,
Date of Issuance of 401 Water Quality Certification:
Certificate of Completion
Gregory J. Thorpe, Ph.D.
Acting Director
Division of Water uality
_ a
ZJ
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, 1651) 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
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:
Aoent's Certification
1, ,hl -,? ? iP ??F,?) , 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
a proved Ian n s ectfic ns n o er su ortin g mater' Is.
PI P P P 6
' 8
Or I
If this project was designed by a Certified Professional
Signature: ? !J ?
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 ______
.SUM
o"n
N(.DEfvR
Michael F. Easley
Governor
William G. Ross, Jr., Secretary
Department of Environment and Natural Resources
Division of Water Quality 1650 Mail Service Center Raleigh, NC 27699-1650
Wetlands/401 Unit: [phone]
Fax: [phone]
\O?0 ROG William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
co Alan W. Klimek, P.E. Director
Division of Water Quality
O ?
June 10, 2002
Iredell County
DWQ Project No. 020860
l3ridge No. 340 on SR 2146
APPROVAL of 401 Water Quality Certification with Additional Conditions
Ms. Trish Simon, Division Environmental Officer
NC:DOT Division 12
P.O. Box 47
Shelby, NC 28 1 5 1-0047
Dear Ms. Simon:
You have our approval, in accordance with the attached conditions and those listed below, to incur 80
linear feet of temporary impacts and 100 linear feet of temporary impacts to Little Creek in order to
replace Bridge No. 340 on SR 2146 in Iredell County. The project should be constructed in accordance
with your application dated May 24, 2(X)2 (received May 30, 2002). After reviewing your application. we
have decided that this fill is covered by General Water Quality Certification No. 3366 and 3 375
corresponding to the U.S. Army Corps of Engineers Nationwide Permit Number 33 and 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 Supple
Watershed regulations. This approval will expire with the accompanying 404 permit unless otherwisc
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 its 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 if stream impacts exceed 150 linear feet, compensatory mitigation may be
required as described in 15A NCAC 21-1 .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. Temporary or permanent herbaceous vegetation must be planted on all bare soil within 15 days of
ground-disturbing activities to provide long term erosion control.
2. The structure and rip-rap 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 nor the stream channel
widened). Existing stream dimensions are to be maintained above and below locations of the culvert.
3. 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 6 the stream bank below the high water
mark, and vegetation must be used for stabilization above high water.
4. All work shall be performed during low flow conditions.
5. 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. Heavy equipment should be operated from the bank rather than the stream channel. I lndcr
no circumstances must rock, sand or other materials be dredged from the wetted stream channel under
nnthnri7ntinn of thie i Prmlt rxrrnt in thr immerfintr virinitU of the rnlvrrtc
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N b[NR
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/
6. 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.
)'oil must act within 60 days of the date that you receive this letter. To ask for a hearing, send a written
petition th'it conforms to Chapter 15013 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 hearino.
"I his letter completes the review of the Division of Water Quality under Scction 401 of the Clean Water
Act. if you have any questions, please telephone Ms. Cynthia Van Der Wiele at 919-733-9646 or Mr.
Samar 13ou-Ghazale of the Mooresville: Regional Office at 704.663.1699.
Sinccrely,
1
P.E
Attachment
Pc: Wilmington District Corps of Engineers
John Hendrix, USAGE Asheville Field Office
Samar 1301-1-Ghazale, NCDWQ Mooresville Regional Office
Central Files
File Copy
40i U ED
0 2 0 8 6 0 STATE of NORTH CAROLINA

MAY P 0 20
a
WETLANDS GROUP
-WA I!tR-DT?' SECTION
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY P.O. BOX 25201, RALEIGH, N.C. 27611-5201
GOVERNOR
P.O. BOX 47, 1710 East Marion Street
Shelby, N. C. 28151-0047
May 24, 2002
Mr. John W. Hendrix - NCDOT Projects
US Army Corp of Engineers
Asheville Regulatory Field Office
151 Patton Avenue, Room 208
Asheville, N. C. 28801-5006
Dear Mr. Hendrix:
LYNDO TIPPETT
SECRETARY
The North Carolina Department of Transportation, Division of Highways, proposes the following
project for your issuance of a Section 404 Permit. We believe this project can be accomplished
under NWP #14, Linear Transportation Crossing and NWP #33, Temporary Construction, Access
and Dewatering.
COUNTY: Iredell
LOCATION: Bridge #340 replacement on SR 2146, east of Statesville
STREAM: Little Creek (from source to Third Creek), Class C Waters, Yadkin River
Basin
PROJECT DESCRIPTION: The project consists of replacing a deteriorating 20-foot long
bridge with a double line of 50-foot long I I T'x79" CMPA with inlet concrete headwall on 0.10
acres of NCDOT right of way. It is proposed that 10 feet of riprap will be placed on the stream
bank at the inlet and outlet headwalls and five-foot riprap aprons will be placed in the stream
channel extending from the pipe to provide structure stabilization and protection. The base flow
pipe (west pipe) is to be buried a foot below existing streambed elevation based upon thalweg
elevations taken upstream and downstream of the existing pipe. The east pipe will be offset one
foot above the west pipe. The existing stream width is approximately ten feet wide. Floodplain
benches will be constructed to divert base flow through only one pipe and to maintain channel
dimensions at the pipe inlet and outlet. Streambed material excavated during construction will be
stockpiled and placed inside the main flow pipe after installation. Temporary cofferdams will be
used to restrict stream flow and a temporary pipe will divert the stream around the work site during
construction. Upon project completion, the area impacted by the temporary cofferdams will be
restored to pre-construction conditions. I have enclosed a PCN application, a sketch of planned
activities, and location maps relative to the proposed project.
PAYIMI F IN 7
RECEIVED
Mr. John W. Hendrix
Bridge #340 Replacement, SR 2146
May 24, 2002 - Page 2
Based upon the "Guidelines for the Location and Design of Hazardous Spill Basins", which are
referenced in DOT's Best Management Practices for the Protection of Surface Waters, the
applicable locations for the placement of hazardous spill basins are at stream crossings on highways
functionally classified as rural or urban arterials and where the stream crossing is within 'h mile of
the critical area. The proposed project is located in Class C waters; therefore, hazardous spill
basins are not required. Enclosed is the NCDOT hazardous spill basin checklist for this project.
A review of the Natural Heritage information for the threatened species listed for Iredell County,
the bog turtle (Clemmys muhlenbergii), did not reveal any known sites in the immediate vicinity. I
have conducted a survey for this species in the project area on May 21, 2002. None were
observed. It was determined that neither this species nor suitable habitat was located in the
proposed project area. No significant effect on this species is anticipated. A review of the available
information from the National Register of Historic Places was also conducted. It is anticipated that
no historic sites will be affected by the proposed project.
By copy of this letter, we are asking Neil Trivette, NCDOT Roadside Environmental Field
Engineer to comment on the above project. By copy of this letter, we are also requesting
concurrence from the Wildlife Resources Commission and U. S. Fish & Wildlife Service.
By copy of this letter, I am forwarding seven (7) copies of the application package to John Dorney,
NCDENR, Division of Water Quality, 401/Wetland Unit for review.
Your earliest consideration for this request would be greatly appreciated. Should you have any
questions, please call me at 704480-9020.
Respectfully yours,
M.L. Holder, P.E.
Division Engineer
Twelfth Division
BY:
Trish Simon
Division 12 Environmental Officer
Mr. John W. Hendrix
Bridge #340 Replacement, SR 2146
May 24, 2002 - Page 2
Enclosures
cc: Mr. Michael L. Holder, P.E., Division Engineer
Mr. Dan Holderman, P.E. , Division Bridge Engineer
Mr. Neil Trivette, Roadside Environmental Field Engineer
Mr. Ron Linville, WRC
Mr. Brian Cole, USF & WS
Mr. John Dorney, DENR,DWQ,401/Wetlands Unit (7 copies)
File
Office Use Only: 0208 6 Form Version October 2001
USACE Action ID No. 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.
L 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:_ Nationwide #14, #33
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: Mike Holder. NCDOT
Mailing Address: P.O. Box 47
Shelby, NC 28151

Telephone Number: 704-480-9020 Fax Number: 704-480-5401
E-mail Address:
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: Trish Simon
Company Affiliation:
Mailing Address: NCDOT
P.O. Box 47
Shelby. NC 28151

Telephone Number: 704-480-9044 Fax Number: 704-480-5401
E-mail Address: tsimon(a dot.state.nc.us
Page 5 of 12
III. Project Information
Attach a vicinity map clearly showing the location of the property with respect to local
landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property
boundaries and development plans in relation to surrounding properties. Both the vicinity map
and site plan must include a scale and north arrow. The specific footprints of all buildings,
impervious surfaces, or other facilities must be included. If possible, the maps and plans should
include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property
boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion,
so long as the property is clearly defined. For administrative and distribution purposes, the
USACE requires information to be submitted on sheets no larger than 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: Replacement of Bridge #340. SR 2146. Iredell County
2. T.I.P. Project Number or State Project Number (NCDOT Only): 5.7852
3. Property Identification Number (Tax PIN): NCDOT Right of way
4. Location
County: Iredell Nearest Town: Statesville
Subdivision name (include phase/lot number): NA
Directions to site (include road numbers, landmarks, etc.): From Hwy 64 at the
Iredell/Davie County line. turn onto SR 1159 (in Davie County), continue into Iredell
Coun , turn right onto SR 2147, right onto SR 2146; Bridge #340 is on the Iredell/Davie
county line.
5. Site coordinates, if available (UTM or Lat/L.ong): 35°53'24N/80°42'20W
(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:
Bridge on unpaved secondary road
7. Property size (acres): 0.10 acres NCDOT right of way
8. Nearest body of water (stream/river/sound/ocean/lake): Little Creek (From source to Third
Creek) , Class C waters
9. River Basin: Yadkin
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http://h2o.enr.state.nc.us/admin/map-/.)
Page 6 of 12
10. Describe the purpose of the proposed work: The project consists of replacing a deteriorating
and structurally deficient 20' long timber and steel bridge with a double line of 50 foot long,
117"09" CMPA with inlet concrete headwall. At the inlet and outlet five foot riprap aprons
will be placed in the stream channel and ten feet of riprap will be placed on the streambank
pipe for structure stabilization. Temporary impervious cofferdams will be used to restrict
stream flow and the stream will be piped around the site during construction
11. List the type of equipment to be used to construct the project: A trackhoe will be used
for excavation and placement of ripmp.
12. Describe the land use in the vicinity of this project: The surrounding area is wooded and
pastureland.
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:
No. there are no other jurisdictional areas on the unpaved SR 2146, no-. futur permit requests are
anticipated.
VL Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. The applicant must also
provide justification for these impacts in Section VII below. All proposed impacts, permanent
and temporary, must be listed herein, and must be clearly identifiable on an accompanying site
plan. All wetlands and waters, and all streams (intermittent and perennial) must be shown on a
delineation map, whether or not impacts are proposed to these systems. Wetland and stream
evaluation and delineation forms should be included as appropriate. Photographs may be
included at the applicant's discretion. If this proposed impact is strictly for wetland or stream
mitigation, list and describe the impact in Section VIII below. If additional space is needed for
listing or description, please attach a separate sheet.
Page 7 of 12
1. Wetland Impacts
Wetland Impact
Site Number
indicate on ma
Type of Impact* Area of
Impact
acres Located within
100-year Floodplain**
es/no Distance to
Nearest Stream
linear feet
Type of Wetland***

List each impact separately and identity 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 htty://www.fema.gov.
List a wetland type that best describes wetland to be impacted (e.g., freshwater/saltwater marsh, forested wetland, beaver pond,
Carolina Bay, bog, etc.)
List the total acreage (estimated) of existing wetlands on the property: 0
2. Stream Impacts, including all intermittent and perennial streams
Stream
Impact Site
Length of Impact Average Width Perennial or
Number Type of Impact* (linear feet) Stream Name** of Stream Intermittent?
(indicate on Before Impact (please specify)
ma

I Double line of CMPA
inlet headwall

50 feet

Little Creek

10 feet

Perennial
Riprap apron in stream 5 ft inlet; 5 ft
1 bed at inlet and outlet outlet
for structure protection Total = 10 feet
Placement of riprap on 10 feet (inlet)
1 bank for structure 10 feet (outlet)
protection Total = 20 feet
l Temporary coffer 100 feet "
dam/diversion pipe
" List each impact separately and identify temporaryimpacts. 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 losstgain),
stabilization activities (cement wall, rip-rap, crib wall, gabions, etc.), excavation, ditching/straightening, etc. If stream relocation is
proposed, plans and profiles showing the linear footprint for both the original and relocated streams must be included
Stream names can be found on USGS topographic maps. If a stream has no name, list as UT (unnamed tributary) to the nearest
downstream named stream into which it flows. USGS maps are available through the USGS at 1-800-358-9616, or online at
www.uses.gov. Several intemet sites also allow direct download and printing of USGS maps (e.g., www.tooozone.com,
www.mapquest.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: Double pipe and & dpr
aprons = 60 feet of impacts; Riprap on bank for structure protection = 20 feet; Total
temporary cofferdam and stream diversion impacts = 100 feet
Open Water Impacts, including Lakes, Ponds, Estuaries, Sounds, Atlantic Ocean and any
other Water of the U. S. NO OPEN WATER RvIPACTS
Page 8 of 12
Open Water Impact
Site Number
indicate on ma
Type of Impact* Area of
Impact
acres Name of Wate
(if applicable) ) y Type of Waterbody
(lake, pond, estuary, sound,
bay, ocean, etc.

List each impact separately and identity temporary impacts. Impacts include, but are not limited to: fill, excavation, dredging,
flooding, drainage, bulkheads, etc.
4. Pond Creation NO 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.
NCDOT has chosen to replace the existing bridge with double pipes due to the lower costs
associated with this option Estimated cost of pipe is $40,000; estimated cost for spanning
structure = $100,000. Riprap use is minimized to only what is needed for structure stabilization
around the pipes and headwall. Ten orary cofferdams and a pipe diversion will be utilized to
allow for construction to be done "in the dry" and to reduce sediment impact
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
Page 9 of 12
and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of
aquatic resource functions and values by creating, restoring, enhancing, or preserving similar
functions and values, preferable in the same watershed.
If mitigation is required for this project, a copy of the mitigation plan must be attached in order
for USACE or DWQ to consider the application complete for processing. Any application
lacking a required mitigation plan or NCWRP concurrence shall be placed on hold as
incomplete. An applicant may also choose to review the current guidelines for stream restoration
in DWQ's Draft Technical Guide for Stream Work in North Carolina, available at
http://h2o.enr.state.nc.us/ncwetlands/strmgide.html.
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 (acreageAinear 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.
IMPACTS < 150 FEET; MITIGATION NOT ANTICIPATED
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/wrD/index.httn. 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 we mitigation requested (acres):
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)?
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
Page 10 of 12
If yes, has the document review been finalized by the State Clearinghouse? If so, please attach a
copy of the NEPA or SEPA final approval letter.
Yes ? No ?
X. Proposed Impacts on Riparian and Watershed Butlers (DWQ Only)
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
required state and local buffers associated with the project. The applicant must also provide
justification for these impacts in Section VII above. All proposed impacts must be listed herein,
and must be clearly identifiable on the accompanying site plan. All buffers must be shown on a
map, whether or not impacts are proposed to the buffers. Correspondence from the DWQ
Regional Office may be included as appropriate. Photographs may also be included at the
applicant's discretion.
Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify )?
Yes ? No ® If you answered "yes", provide the following information:
Identify the square feet and acreage of impact to each zone of the riparian buffers. If buffer
mitigation is required calculate the required amount of mitigation by applying the buffer
multipliers.
Zone* Impact Multiplier Required
2
Total
1.5
• Zone 1 extends out 30 feet perpendicular from near bank of channel; Zone 2 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.
NA
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.
No additional impervious surface is proposed in this project.
Page 11 of 12
XU. 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.
NA
XM. 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).
,.. E-7
oC
Applicant/Agent's Signature Date
(Agent's signature is valid only if an authorization letter from the applicant is provided.)
Page 12 of 12
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NCDNVO Stream Classification Form
Project Name: I
-1'1 ?? River Basin: %4 o tf County. f t I 1
livoluaror. M `n'om
h
DWQ Pmjat Number: Neatest Nam Stream: L I'?`? i Latitude: `% /V
SigM1UR:
Due: > ; I? D USGS QU?p?aha? N Longitude: j
8d ° u j O ,1,/ Loution/Diteetions:
C:a T V,/ V
*PLEASE NOTE: !/e.Nraor •nf bn6wner agrra UYU tbe%•run is • at w•fe dkcA, then we ojthis fem is nor
n•eesrarn
,118A trim the best pro/tu/on. j.d8en,.nt o/rh..w/a w, th•%.tam l, • ..sera.!, ditch and.N • mol!/Irf a twrf atr.•w.--rA4 COt.?YT7 / l l'
r dot syste.r sh•a/d nalbe asd• /
Primary Field Indicators: rat/ro•.Nanb..rNU.y
I. Crmmcirnholn" Absent Weak Modrrate Strom,
1) Is Them A Riffle-Pool Sequence? 00 01 0 2 t?f
ls The USDA Textum In Stresmbed
2) Ditferrnt Fmm Sunounding Terrain? 00 O 1 02 3
3) Are Natural Levees Present? (Ze- 0, 02 03
-
4) Is The Channel Sinuous? 00 01 02 erl -
S) Is There An Active (Or Relic) Floodplain Present? 00 01 02 3
6) Is The Channel Braided? 04/ 01 O 2 03
7) Arc Recent Alluvial Deposits Present? 00 01 02 01--
8) Is There A Bsnkfall Bench Present? O o 01 02
3
Is A Continuous Bed & Bank Present?
9) rOOTE: 11&d a A.* Card Sy DtwM.j A.f wrmour swwtry Th,. I? 0
Sae tro O 1 O 2 O?
11 A 2nd Order Or Greater Channel (As Indlealed On Topo
10) M•P And/Or In Field) Present?
0-10413 O No-0
PRIAIARYGEOMORPI(OLOGYINDICATORPOINTS.
11. Hydrology '
Absent #VALUEI
Weak
Moderate
Strong
1) Is Them A Groundwater
Flow/Discharge Present?
00
01
02 ,,,/
0 3
PRIMAR Y HYDROLOG Y INDICA TOR POINTS.
III. Biology 3
lC
lssc
nl #VALUE!
Weak
Moderate
Strong
1) Are Fibrous Roots Present In Streambed? ,
/
lri 02 01 O o
2) Are Rooted Plants Present In Streambed? 03 0 1 O o
3) Is Periphyton Present? 00 O l. OZ G
4) Arc Bivalves Present? 01 02 03
PRIAIARYBIOLOGY INDICATOR POINTS:
Secondarv Field Tndicators:xwko..Arw..Pku„/
1. Geomorphology
F
Absent #VALUEI

Weak

Moderate

Strong
1) Is There A Head Cut Present in Channel? 0 O 0.S 01 01.5
2) Is Them A Grade Control Point In Channel? 00 00.s O 1
Does Topography Indicate A
?) Natural Drainage Way!
QO
00S
01 t.5
SECONDARY GEOMORPHOL OGY INDICA TOR POINTS.
It. Hydrolop `3
went #VALUEI
Weak
Moderate
Strong
1) Is This Years (Or Last's) Lcalhtter
Present In Stresmbed?

(

01

00.5

O o
2) Is Sediment On Plants (Or Debris) Present? O o 0 U 01
IS
3) Am Wrack Lines Present? 00 0 oS 01
Is Water in Channel And >48 Hra, Since
) Lau Known Rain? r om irmwA/.fw•wf t. as Abo Islip Thu Swp Ad n BN y 00.5
- 01
'S
S) Is There Water In Channel During Dry

Conditions Or In Growin Season)? O o O 0.S

- 01
5
6) Are Hydric Soils Present In Sides Of Channel (Or ts HrW w)? 3 1 m•1S 0 No-0
SECONDARYHYDROLOGY INDICATORPOINTS.

III. Diola¢y
I I
A_b_sen
#VALUEI
Weak

Moderate

Strong
1) Are Fish Present? 0 O OS 01 01.5
2) Are Amphibians Present? o Otis 01 01.5
3) Am AquaticTurtles Present? G4, 00's 01 O 1S
4) Am Crayfish Present? 0 O o s 01 01.5
S) Am Mactobenthos Present? 0
0 O 0.S ,
lYl 01.5
6) Am Iron Oxidizing Bacteria/Fungus Present? ,
,
N9 O 0.S O 1 01.5
7) Is Filamentous Algae Present? O o O 0.S 01 S
8) Are Weiland Plants In Stmambed? SAV
. Mostly OBL Mostly FACW Mostly FAC Mostly FACU Mostly UPL
1
1VOrE:Ift"IAb,ow.0/ANPU.wA,AW 02 01 Oa?s Oos 00 Oo
Abet Skip M. Swp UNLESS SAPP-,.r-).
SECONDARYBIOLOGY INDICATOR POINTS: #VALUEI
TOTAL POINTS rprltrrnrr+Srrotrdnnl- #VALUEI (IjGrrorerThen Or Equal To LE Points The Stream Is At Least Intarwillitimr)
d1o

INTERMITTENT CHANNEL
EVALUATION FORM
ACTION ID APPLICANT NAAIE Al(' ,I) O -r-'' DATE S
PROPOSED CHANNEL WORK(i.e., culvert, relocation, etc.) ?`-1l? { 10[/?
WATERBODY/RIVER BASIN Yadk) r/ COUNTY/CITY
RECENT WEATHER CONDITIONS
P SP NP Observation
? Flsh/SheIItISIVGUS[aceans Present
Benthic Macro Invertebrates
A.nphibi.ms Present/Breeding
Alg ae .,\ad/Or Fungus (water quality function)
Wildlife Channel Use (i.e. tracks, feces, shells, others)
Federally Protected Species Present (Discontinue)
Riffle/Pool Structure
Stable Streambanks
Channel Substrate
(i.e. gravel. cobble, rock, coarse sand)
Riparian Canopy Present (SP =/> 50% closure)
Undercut Banks/Itstream Habitat Structure
Flow In Channel
Wetlands Adjacent'roicontig. With Channel
(Discontinue)
Persistent Pools/Saturated Bottom
(June through Sept.)
SeepsiGroundwater Discharge (June through Sept.)
Adjacent Floodplam Present
Wrack Material or Drift Lines
Hydrophytic Vegetation in/adjacent to channel
Important To Domestic Water Supply? Y /O ON
Does Channel Appear On A Quad Or Soils Map? 0 N
Determination:
Perennial Channel
Intermittent Channel
Ephemeral Channel
Ditch Through Upland
Comments or Description
r 5 t,'J'- r\o s /(/AuM r,
Approx. Drainage area: L2 o<c --PS
(stop) 0 lh-6ortantChannel: LF PRQIECTiMGR. Initials
(proceed) Unimportant Channel: LF
(nojd) (attach nap indicating location of important/unimportant channel)
(no jd)
Evaluator's Signature: 1&1- ?_
/7 1
(if other than C.O.E. project manager)
P=Prescnt SP=Stongly Present NP=Not Present 11/4/98
NCDOT
HAZARDOUS SPILL BASIN CHECKLIST
Division: 12- County: 19666u, Project ID: 5-,0Z 5Zo 17
River Basin: till-b4i ,J Bridge No: 34-0
Route: jC Zi4lF
Water Quality Criteria:
Stream:
CLA55 G?/?z=?5
Yes No
Stream Crossing Blue Line On USGS F-1, r
ORW F F'
WSI r r-1%
WS 11,111 OR IV, Crossing Within 0.5mi of W.S. Critical Area r r---
Roadway Criteria:
Route Designation-
Additional Site Information:
Yes No
Arterial Urban r rd
Arterial Rural r r?
Is a Hazardous Spill Basin Required?
Yes No
r- r-,/'
Criteria Based Upon NCDOT "Best Management Practices for the
Protection of Surface Waters" (March, 1997).
t?
f MAY p ~
2002 D
GROUP
wATtnT UN DS ? ?fCrION
STATE of NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY LYNDO TIPPETT
GOVERNOR_ SECRETARY
pp
MEMO TO: John Dorney, DENR/DWQ/401/Wetlands Unit
FROM: Trish Simon, Division 12 Environmental Officer Ij
DATE: May 24, 2002
SUBJECT: Pre-construction Notifications/401 Automated Payment
020860
PAYMENT
RECEIVED
Enclosed are seven copies of a pre-construction notification permit application for a
bridge project in Iredell County for your review and comments.
Project information for the 401 Automated Payment Procedure
• Work order number: 4312B-549-5.8252-558-SR2146-82340
• TIP #: Not Applicable
• Project Category: $200.00 Fee
is
Post Office Box 47 Shelby, North Carolina 28151-0047

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